Are Statewide Data Systems Meeting the Local Institution's Needs? AIR Forum Paper 1978.

Science.gov (United States)

Bryson, Charles H.

Statewide data collection systems emerged in the late sixties as the vehicle to achieving greater efficiency and accountability in higher education. The expectations of statewide systems were that they would meet the needs of various levels of management. The example presented in this paper is the Georgia management information system and its…

Data integration for statewide transportation planning : final report

Science.gov (United States)

2009-08-01

The goal of this study was to investigate the data availability, accessibility, and interoperability issues arisen from the statewide : transportation planning activities undertaken at WisDOT and to identify possible approaches for addressing these i...

WisDOT statewide customer satisfaction survey : [project brief].

Science.gov (United States)

2013-03-01

The Wisconsin Department of Transportation (WisDOT) is a major public agency with numerous customers utilizing a variety of services and programs to support the entire statewide multimodal transportation system. The department also houses the Divisio...

A guide for statewide impaired-driving task forces.

Science.gov (United States)

2009-09-01

The purpose of the guide is to assist State officials and other stakeholders who are interested in establishing an : Impaired-Driving Statewide Task Force or who are exploring ways to improve their current Task Force. The guide : addresses issues suc...

Tobacco Smoke Pollution in Hospitality Venues Before and After Passage of Statewide Smoke-Free Legislation.

Science.gov (United States)

Buettner-Schmidt, Kelly; Boursaw, Blake; Lobo, Marie L; Travers, Mark J

2017-03-01

In 2012, North Dakota enacted a comprehensive statewide law prohibiting smoking in enclosed public places. Disparities in tobacco control exist in rural areas. This study's objective was to determine the extent to which the passage of a comprehensive, statewide, smoke-free law in a predominantly rural state influenced tobacco smoke pollution in rural and nonrural venues. A longitudinal cohort design study comparing the levels of tobacco smoke pollution before and after passage of the statewide smoke-free law was conducted in 64 restaurants and bars statewide in North Dakota. Particulate matter with a median aerodynamic diameter of <2.5 μm (a valid atmospheric marker of tobacco smoke pollution) was assessed. A significant 83% reduction in tobacco smoke pollution levels occurred after passage of the law. Significant reductions in tobacco smoke pollution levels occurred in each of the rural categories; however, no difference by rurality was noted in the analysis after passage of the law, in contrast to the study before passage. To our knowledge, this was the largest, single, rural postlaw study globally. A comprehensive statewide smoke-free law implemented in North Dakota dramatically decreased the level of tobacco smoke pollution in bars and restaurants. © 2016 The Authors. Public Health Nursing Published by Wiley Periodicals, Inc.

A case study: planning a statewide information resource for health professionals: an evidence-based approach

Science.gov (United States)

Chew, Katherine; Watson, Linda; Parker, Mary

2009-01-01

Question: What is the best approach for implementing a statewide electronic health library (eHL) to serve all health professionals in Minnesota? Setting: The research took place at the University of Minnesota Health Sciences Libraries. Methods: In January 2008, the authors began planning a statewide eHL for health professionals following the five-step process for evidence-based librarianship: formulating the question, finding the best evidence, appraising the evidence, assessing costs and benefits, and evaluating the effectiveness of resulting actions. Main Results: The authors identified best practices for developing a statewide eHL for health professionals relating to audience or population served, information resources, technology and access, funding model, and implementation and sustainability. They were compared to the mission of the eHL project to drive strategic directions by developing recommendations. Conclusion: EBL can guide the planning process for a statewide eHL, but findings must be tailored to the local environment to address information needs and ensure long-term sustainability. PMID:19851487

Benchmarking statewide trauma mortality using Agency for Healthcare Research and Quality's patient safety indicators.

Science.gov (United States)

Ang, Darwin; McKenney, Mark; Norwood, Scott; Kurek, Stanley; Kimbrell, Brian; Liu, Huazhi; Ziglar, Michele; Hurst, James

2015-09-01

Improving clinical outcomes of trauma patients is a challenging problem at a statewide level, particularly if data from the state's registry are not publicly available. Promotion of optimal care throughout the state is not possible unless clinical benchmarks are available for comparison. Using publicly available administrative data from the State Department of Health and the Agency for Healthcare Research and Quality (AHRQ) patient safety indicators (PSIs), we sought to create a statewide method for benchmarking trauma mortality and at the same time also identifying a pattern of unique complications that have an independent influence on mortality. Data for this study were obtained from State of Florida Agency for Health Care Administration. Adult trauma patients were identified as having International Classification of Disease ninth edition codes defined by the state. Multivariate logistic regression was used to create a predictive inpatient expected mortality model. The expected value of PSIs was created using the multivariate model and their beta coefficients provided by the AHRQ. Case-mix adjusted mortality results were reported as observed to expected (O/E) ratios to examine mortality, PSIs, failure to prevent complications, and failure to rescue from death. There were 50,596 trauma patients evaluated during the study period. The overall fit of the expected mortality model was very strong at a c-statistic of 0.93. Twelve of 25 trauma centers had O/E ratios benchmarking method that screens at risk trauma centers in the state for higher than expected mortality. Stratifying mortality based on failure to prevent PSIs may identify areas of needed improvement at a statewide level. Copyright © 2015 Elsevier Inc. All rights reserved.

Statewide Transportation Engineering Warehouse for Archived Regional Data (STEWARD).

Science.gov (United States)

2009-12-01

This report documents Phase III of the development and operation of a prototype for the Statewide Transportation : Engineering Warehouse for Archived Regional Data (STEWARD). It reflects the progress on the development and : operation of STEWARD sinc...

Characteristics and Effects of a Statewide STEM Program

Directory of Open Access Journals (Sweden)

Jeffrey D. Weld

2015-10-01

Full Text Available A comprehensive statewide STEM (science, technology, engineering, mathematics reform initiative enters its fifth year in the U.S. state of Iowa. A significant proportion of the state’s pre K-12 students and teachers participate in one or more of the twenty programs offered, ranging from classroom curricular innovations to teacher professional development, and from community STEM festivals to career exploration events. An external, inter-university evaluation consortium measures annual progress of the initiative through the Iowa STEM Monitoring Project. Results show citizens to be increasingly aware of and supporting of STEM education; students to be increasingly interested in STEM as well as outperforming nonparticipating peers on state math and science tests; and teachers more confident and knowledgeable in teaching STEM. Iowa’s STEM initiative has garnered national acclaim though challenges remain with regard to expanding the participation of learners of diversity, as well as ensuring the long-term sustainability of the programs and structures that define Iowa’s statewide STEM initiative.

Nebraska Statewide Wind Integration Study: April 2008 - January 2010

Energy Technology Data Exchange (ETDEWEB)

EnerNex Corporation, Knoxville, Tennessee; Ventyx, Atlanta, Georgia; Nebraska Power Association, Lincoln, Nebraska

2010-03-01

Wind generation resources in Nebraska will play an increasingly important role in the environmental and energy security solutions for the state and the nation. In this context, the Nebraska Power Association conducted a state-wide wind integration study.

Staff turnover in statewide implementation of ACT: relationship with ACT fidelity and other team characteristics

OpenAIRE

Rollins, Angela L.; Salyers, Michelle P.; Tsai, Jack; Lydick, Jennifer M.

2010-01-01

Staff turnover on assertive community treatment (ACT) teams is a poorly understood phenomenon. This study examined annual turnover and fidelity data collected in a statewide implementation of ACT over a 5-year period. Mean annual staff turnover across all observations was 30.0%. Turnover was negatively correlated with overall fidelity at Year 1 and 3. The team approach fidelity item was negatively correlated with staff turnover at Year 3. For 13 teams with 3 years of follow-up data, turnover ...

Design of a statewide radiation survey

International Nuclear Information System (INIS)

Nagda, N.L.; Koontz, M.D.; Rector, H.E.; Nifong, G.D.

1989-01-01

The Florida Institute of Phosphate Research (FIPR) recently sponsored a statewide survey to identify all significant land areas in Florida where the state's environmental radiation rule should be applied. Under this rule, newly constructed buildings must be tested for radiation levels unless approved construction techniques are used. Two parallel surveys - a land-based survey and a population-based survey - were designed and conducted to address the objective. Each survey included measurements in more than 3000 residences throughout the state. Other information sources that existed at the outset of the study, such as geologic profiles mapped by previous investigators and terrestrial uranium levels characterized through aerial gamma radiation surveys, were also examined. Initial data analysis efforts focused on determining the extent of evidence of radon potential for each of 67 counties in the state. Within 18 countries that were determined to have definite evidence of elevated radon potential, more detailed spatial analyses were conducted to identify areas of which the rule should apply. A total of 74 quadrangles delineated by the U.S. Geological Survey, representing about 7% of those constituting the state, were identified as having elevated radon potential and being subject to the rule

Statewide and Metropolitan Transportation Planning Processes : a TPCB Peer Exchange

Science.gov (United States)

2016-04-20

This report highlights key recommendations and noteworthy practices identified at Statewide and Metropolitan Transportation Planning Processes Peer Exchange held on September 9-10, 2015 in Shepherdstown, West Virginia. This event was sponsored ...

California Statewide Plug-In Electric Vehicle Infrastructure Assessment

Energy Technology Data Exchange (ETDEWEB)

Melaina, Marc; Helwig, Michael

2014-05-01

The California Statewide Plug-In Electric Vehicle Infrastructure Assessment conveys to interested parties the Energy Commission’s conclusions, recommendations, and intentions with respect to plug-in electric vehicle (PEV) infrastructure development. There are several relatively low-risk and high-priority electric vehicle supply equipment (EVSE) deployment options that will encourage PEV sales and

Louisiana's statewide beach cleanup

Science.gov (United States)

Lindstedt, Dianne M.; Holmes, Joseph C.

1989-01-01

Litter along Lousiana's beaches has become a well-recognized problem. In September 1987, Louisiana's first statewide beach cleanup attracted about 3300 volunteers who filled 16,000 bags with trash collected along 15 beaches. An estimated 800,173 items were gathered. Forty percent of the items were made of plastic and 11% were of polystyrene. Of all the litter collected, 37% was beverage-related. Litter from the oil and gas, commercial fishing, and maritime shipping industries was found, as well as that left by recreational users. Although beach cleanups temporarily rid Louisiana beaches of litter, the real value of the effort is in public participation and education. Civic groups, school children, and individuals have benefited by increasing their awareness of the problems of trash disposal.

The Soft Underbelly of System Change: The Role of Leadership and Organizational Climate in Turnover during Statewide Behavioral Health Reform

OpenAIRE

Aarons, Gregory A.; Sommerfeld, David H.; Willging, Cathleen E.

2011-01-01

This study examined leadership, organizational climate, staff turnover intentions, and voluntary turnover during a large-scale statewide behavioral health system reform. The initial data collection occurred nine months after initiation of the reform with a follow-up round of data collected 18 months later. A self-administered structured assessment was completed by 190 participants (administrators, support staff, providers) employed by 14 agencies. Key variables included leadership, organizati...

Statewide Transportation Improvement Program 2010-2013 : sorted by MPO and RPA.

Science.gov (United States)

2006-01-01

Iowas Statewide Transportation Improvement Program (STIP) has been : developed in conformance with the guidelines prescribed by 23 USC. The : STIP is generated to provide the Federal Highway Administration (FHWA) and : Federal Transit Administrati...

Variations in statewide water quality of New Jersey streams, water years 1998-2009

Science.gov (United States)

Heckathorn, Heather A.; Deetz, Anna C.

2012-01-01

Statistical analyses were conducted for six water-quality constituents measured at 371 surface-water-quality stations during water years 1998-2009 to determine changes in concentrations over time. This study examined year-round concentrations of total dissolved solids, dissolved nitrite plus nitrate, dissolved phosphorus, total phosphorus, and total nitrogen; concentrations of dissolved chloride were measured only from January to March. All the water-quality data analyzed were collected by the New Jersey Department of Environmental Protection and the U.S. Geological Survey as part of the cooperative Ambient Surface-Water-Quality Monitoring Network. Stations were divided into groups according to the 1-year or 2-year period that the stations were part of the Ambient Surface-Water-Quality Monitoring Network. Data were obtained from the eight groups of Statewide Status stations for water years 1998, 1999, 2000, 2001-02, 2003-04, 2005-06, 2007-08, and 2009. The data from each group were compared to the data from each of the other groups and to baseline data obtained from Background stations unaffected by human activity that were sampled during the same time periods. The Kruskal-Wallis test was used to determine whether median concentrations of a selected water-quality constituent measured in a particular 1-year or 2-year group were different from those measured in other 1-year or 2-year groups. If the median concentrations were found to differ among years or groups of years, then Tukey's multiple comparison test on ranks was used to identify those years with different or equal concentrations of water-quality constituents. A significance level of 0.05 was selected to indicate significant changes in median concentrations of water-quality constituents. More variations in the median concentrations of water-quality constituents were observed at Statewide Status stations (randomly chosen stations scattered throughout the State of New Jersey) than at Background stations

Stuck in Neutral: Stalled Progress in Statewide Comprehensive Smoke-Free Laws and Cigarette Excise Taxes, United States, 2000–2014

Science.gov (United States)

King, Brian A.; Babb, Stephen D.

2016-01-01

Introduction Increasing tobacco excise taxes and implementing comprehensive smoke-free laws are two of the most effective population-level strategies to reduce tobacco use, prevent tobacco use initiation, and protect nonsmokers from secondhand smoke. We examined state laws related to smoke-free buildings and to cigarette excise taxes from 2000 through 2014 to see how implementation of these laws from 2000 through 2009 differs from implementation in more recent years (2010–2014). Methods We used legislative data from LexisNexis, an online legal research database, to examine changes in statewide smoke-free laws and cigarette excise taxes in effect from January 1, 2000, through December 31, 2014. A comprehensive smoke-free law was defined as a statewide law prohibiting smoking in all indoor areas of private work sites, restaurants, and bars. Results From 2000 through 2009, 21 states and the District of Columbia implemented comprehensive smoke-free laws prohibiting smoking in work sites, restaurants, and bars. In 2010, 4 states implemented comprehensive smoke-free laws. The last state to implement a comprehensive smoke-free law was North Dakota in 2012, bringing the total number to 26 states and the District of Columbia. From 2000 through 2009, 46 states and the District of Columbia implemented laws increasing their cigarette excise tax, which increased the national average state excise tax rate by $0.92. However, from 2010 through 2014, only 14 states and the District of Columbia increased their excise tax, which increased the national average state excise tax rate by $0.20. Conclusion The recent stall in progress in enacting and implementing statewide comprehensive smoke-free laws and increasing cigarette excise taxes may undermine tobacco prevention and control efforts in the United States, undercutting efforts to reduce tobacco use, exposure to secondhand smoke, health disparities, and tobacco-related illness and death. PMID:27309417

Statewide Transportation Improvement program 2011-2014 : sorted by MPO and RPA.

Science.gov (United States)

2010-01-01

Iowas Statewide Transportation Improvement Program (STIP) has been : developed in conformance with the guidelines prescribed by 23 USC and 49 : USC. The STIP is generated to provide the Federal Highway Administration : (FHWA) and Federal Transit A...

Statewide Transportation Improvement Program 2012-2015 : sorted by MPO and RPA.

Science.gov (United States)

2011-01-01

Iowas Statewide Transportation Improvement Program (STIP) has been : developed in conformance with the guidelines prescribed by 23 USC and 49 : USC. The STIP is generated to provide the Federal Highway Administration : (FHWA) and Federal Transit A...

Development of a statewide motorcycle safety plan for Texas : technical report.

Science.gov (United States)

2013-02-01

The objective of this research project was to develop a statewide plan to reduce motorcycle crashes and : injuries in the state of Texas. The project included a review of published literature on current and proposed : countermeasures for reducing the...

The Critical Role of a Well-Articulated, Coherent Design in Professional Development: An Evaluation of a State-Wide Two-Week Program for Mathematics and Science Teachers

Science.gov (United States)

Saderholm, Jon; Ronau, Robert N.; Rakes, Christopher R.; Bush, Sarah B.; Mohr-Schroeder, Margaret

2017-01-01

This evaluation study examined a state-wide professional development program composed of two institutes, one for mathematics teachers and one for science teachers, each spanning two weeks. The program was designed to help teachers transform their practice to align with Common Core State Standards for Mathematics and Next Generation Science…

Staff turnover in statewide implementation of ACT: relationship with ACT fidelity and other team characteristics.

Science.gov (United States)

Rollins, Angela L; Salyers, Michelle P; Tsai, Jack; Lydick, Jennifer M

2010-09-01

Staff turnover on assertive community treatment (ACT) teams is a poorly understood phenomenon. This study examined annual turnover and fidelity data collected in a statewide implementation of ACT over a 5-year period. Mean annual staff turnover across all observations was 30.0%. Turnover was negatively correlated with overall fidelity at Year 1 and 3. The team approach fidelity item was negatively correlated with staff turnover at Year 3. For 13 teams with 3 years of follow-up data, turnover rates did not change over time. Most ACT staff turnover rates were comparable or better than other turnover rates reported in the mental health and substance abuse literature.

From Theory to Practice: Considerations for Implementing a Statewide Voucher System.

Science.gov (United States)

Doyle, Denis P.

This monograph analyzes trends in American educational philosophy and history in its proposal to implement an all-public statewide school voucher system. Following an introduction, section 1, "Alternative Voucher Systems," discusses three concepts: universal unregulated vouchers, favored by Milton Friedman; regulated compensatory vouchers,…

Using Action Research Projects to Examine Teacher Technology Integration Practices

Science.gov (United States)

Dawson, Kara

2012-01-01

This study examined the technology integration practices of teachers involved in a statewide initiative via one cycle of action research. It differs from other studies of teacher technology integration practices because it simultaneously involved and provided direct benefits to teachers and researchers. The study used thematic analysis to provide…

Technical architecture of ONC-approved plans for statewide health information exchange.

Science.gov (United States)

Barrows, Randolph C; Ezzard, John

2011-01-01

ONC-approved state plans for HIE were reviewed for descriptions and depictions of statewide HIE technical architecture. Review was complicated by non-standard organizational elements and technical terminology across state plans. Findings were mapped to industry standard, referenced, and defined HIE architecture descriptions and characteristics. Results are preliminary due to the initial subset of ONC-approved plans available, the rapid pace of new ONC-plan approvals, and continuing advancements in standards and technology of HIE, etc. Review of 28 state plans shows virtually all include a direct messaging component, but for participating entities at state-specific levels of granularity (RHIO, enterprise, organization/provider). About ½ of reviewed plans describe a federated architecture, and ¼ of plans utilize a single-vendor "hybrid-federated" architecture. About 1/3 of states plan to leverage new federal and open exchange technologies (DIRECT, CONNECT, etc.). Only one plan describes a centralized architecture for statewide HIE, but others combine central and federated architectural approaches.

The Nevada Proficiency Examination Program: Evaluating the Writing Samples.

Science.gov (United States)

Howard, Edward H.

Writing tests are part of the mandated statewide proficiency examination in Nevada. The ninth-grade screening test and the eleventh-grade diploma-certifying test require that a student write a paragraph and a business letter, each on an assigned topic and each at an acceptable level of proficiency. Pilot tests, extended discussion, and statistical…

23 CFR 450.216 - Development and content of the statewide transportation improvement program (STIP).

Science.gov (United States)

2010-04-01

... Programming § 450.216 Development and content of the statewide transportation improvement program (STIP). (a... Equity Bonus funds; (5) Emergency relief projects (except those involving substantial functional...

Making an Impact Statewide to Benefit 21st-Century School Leadership

Science.gov (United States)

Hewitt, Kimberly Kappler; Mullen, Carol A.; Davis, Ann W.; Lashley, Carl

2012-01-01

How can institutions of higher education, local education agencies, and departments of education partner to build capacity for 21st-Century school leadership? The model (IMPACT V) we describe utilizes a systems-wide partnership approach to cultivate shared leadership within influenced middle and high schools statewide to leverage technology as a…

Cost-effectiveness analysis of a statewide media campaign to promote adolescent physical activity.

Science.gov (United States)

Peterson, Michael; Chandlee, Margaret; Abraham, Avron

2008-10-01

A cost-effectiveness analysis of a statewide social marketing campaign was performed using a statewide surveillance survey distributed to 6th through 12th graders, media production and placement costs, and 2000 census data. Exposure to all three advertisements had the highest impact on both intent and behavior with 65.6% of the respondents considering becoming more active and 58.3% reporting becoming more active. Average cost of the entire campaign was $4.01 per person to see an ad, $7.35 per person to consider being more active, and $8.87 per person to actually become more active, with billboards yielding the most positive cost-effectiveness. Findings highlight market research as an essential part of social marketing campaigns and the importance of using multiple marketing modalities to enhance cost-effectiveness and impact.

Criminal Justice Profile--Statewide, 1984. Supplement to "Crime and Delinquency in California."

Science.gov (United States)

California State Dept. of Justice, Sacramento. Bureau of Criminal Statistics and Special Services.

This California annual Criminal Justice Statewide Profile presents data which supplements the Bureau of Criminal Statistics' (BCS) annual Crime and Delinquency publication. This monograph summarizes and combines data pertaining to California's justice system. The profile consists of two sections. The first section consists of 12 tables displaying…

Building Statewide Infrastructure for the Academic Support of Students With Mild Traumatic Brain Injury.

Science.gov (United States)

Gioia, Gerard A; Glang, Ann E; Hooper, Stephen R; Brown, Brenda Eagan

To focus attention on building statewide capacity to support students with mild traumatic brain injury (mTBI)/concussion. Consensus-building process with a multidisciplinary group of clinicians, researchers, policy makers, and state Department of Education personnel. The white paper presents the group's consensus on the essential components of a statewide educational infrastructure to support the management of students with mTBI. The nature and recovery process of mTBI are briefly described specifically with respect to its effects on school learning and performance. State and local policy considerations are then emphasized to promote implementation of a consistent process. Five key components to building a statewide infrastructure for students with mTBI are described including (1) definition and training of the interdisciplinary school team, (2) professional development of the school and medical communities, (3) identification, assessment, and progress monitoring protocols, (4) a flexible set of intervention strategies to accommodate students' recovery needs, and (5) systematized protocols for active communication among medical, school, and family team members. The need for a research to guide effective program implementation is stressed. This guiding framework strives to assist the development of support structures for recovering students with mTBI to optimize academic outcomes. Until more evidence is available on academic accommodations and other school-based supports, educational systems should follow current best practice guidelines.

A Statewide Survey for Container-Breeding Mosquitoes in Mississippi.

Science.gov (United States)

Goddard, Jerome; Moraru, Gail M; Mcinnis, Sarah J; Portugal, J Santos; Yee, Donald A; Deerman, J Hunter; Varnado, Wendy C

2017-09-01

Container-breeding mosquitoes are important in public health due to outbreaks of Zika, chikungunya, and dengue viruses. This paper documents the distribution of container-breeding mosquito species in Mississippi, with special emphasis on the genus Aedes. Five sites in each of the 82 Mississippi counties were sampled monthly between May 1 and August 31, 2016, and 50,109 mosquitoes in 14 species were collected. The most prevalent and widely distributed species found was Ae. albopictus, being found in all 82 counties, especially during July. A recent invasive, Ae. japonicus, seems to be spreading rapidly in Mississippi since first being discovered in the state in 2011. The most abundant Culex species collected were Cx. quinquefasciatus (found statewide), Cx. salinarius (almost exclusively in the southern portion of the state), and Cx. restuans (mostly central and southern Mississippi). Another relatively recent invasive species, Cx. coronator, was found in 20 counties, predominantly in the southern one-third of the state during late summer. Co-occurrence data of mosquito species found in the artificial containers were also documented and analyzed. Lastly, even though we sampled extensively in 410 sites across Mississippi, no larval Ae. aegypti were found. These data represent the first modern statewide survey of container species in Mississippi, and as such, allows for better public health readiness for emerging diseases and design of more effective vector control programs.

2011-2013 Indiana Statewide Imagery and LiDAR Program: Lake Michigan Watershed Counties

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Indiana's Statewide LiDAR data is produced at 1.5-meter average post spacing for all 92 Indiana Counties covering more than 36,420 square miles. New LiDAR data was...

America's Children 1976: A Bicentennial Assessment.

Science.gov (United States)

Fleming, Virginia; And Others

This factbook presents 87 pages of pictures, graphs, diagrams, quotations, statistics, and text aimed at portraying the current status of children in America. The major areas examined include: (1) children in poverty; (2) child health; (3) family changes and day care; and (4) special child care needs for handicapped, abused, or neglected children.…

Statewide improvement approach to clinician burnout: Findings from the baseline year

Directory of Open Access Journals (Sweden)

Heather R. Britt

2017-12-01

We propose a socio-ecological framework for acting on burnout, using a data-driven quality improvement paradigm enabled by a statewide coalition, to ensure that continued efforts do not rest solely at the feet of individuals or systems. Despite high burnout levels, engagement and satisfaction with work are also high, suggesting there is still hope for stemming the tide of burnout.

The smoking ban next door: do hospitality businesses in border areas have reduced sales after a statewide smoke-free policy?

Science.gov (United States)

Klein, Elizabeth G; Hood, Nancy E

2015-01-01

Despite numerous studies demonstrating no significant economic effects on hospitality businesses following a statewide smoke-free (SF) policy, regional concerns suggest that areas near states without SF policies may experience a loss of hospitality sales across the border. The present study evaluated the impact of Ohio's statewide SF policy on taxable restaurant and bar sales in border and non-border areas. Spline regression analysis was used to assess changes in monthly taxable sales at the county level in full-service restaurants and bars in Ohio. Data were analyzed from four years prior to policy implementation to three years post-policy. Change in the differences in the slope of taxable sales for border (n = 21) and non-border (n = 67) counties were evaluated for changes following the statewide SF policy enforcement, adjusted for unemployment rates, general trends in the hospitality sector, and seasonality. After adjusting for covariates, there was no statistically significant change in the difference in slope for taxable sales for either restaurants (β = 0.9, p = 0.09) or bars (β = 0.2, p = 0.07) following the SF policy for border areas compared to non-border areas of Ohio. Border regions in Ohio did not experience a significant change in bar and restaurant sales compared to non-border areas following a statewide SF policy. Results support that Ohio's statewide SF policy did not impact these two areas differently, and provide additional evidence for the continued use of SF policies to provide protection from exposure to secondhand smoke for both workers and the general public. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Pharmacy-based statewide naloxone distribution: A novel "top-down, bottom-up" approach.

Science.gov (United States)

Morton, Kate J; Harrand, Brianna; Floyd, Carly Cloud; Schaefer, Craig; Acosta, Julie; Logan, Bridget Claire; Clark, Karen

To highlight New Mexico's multifaceted approach to widespread pharmacy naloxone distribution and to share the interventions as a tool for improving pharmacy-based naloxone practices in other states. New Mexico had the second highest drug overdose death rate in 2014 of which 53% were related to prescription opioids. Opioid overdose death is preventable through the use of naloxone, a safe and effective medication that reverses the effects of prescription opioids and heroin. Pharmacists can play an important role in providing naloxone to individuals who use prescription opioids. Not applicable. Not applicable. A multifaceted approach was utilized in New Mexico from the top down with legislative passage of provisions for a statewide standing order and New Mexico Department of Health support for pharmacy-based naloxone delivery. A bottom up approach was also initiated with the development and implementation of a training program for pharmacists and pharmacy technicians. Naloxone Medicaid claims were used to illustrate statewide distribution and utilization of the pharmacist statewide standing order for naloxone. Percent of pharmacies dispensing naloxone in each county were calculated. Trained pharmacy staff completed a program evaluation form. Questions about quality of instruction and ability of trainer to meet stated objectives were rated on a Likert scale. There were 808 naloxone Medicaid claims from 100 outpatient pharmacies during the first half of 2016, a 9-fold increase over 2014. The "A Dose of R x eality" training program evaluation indicated that participants felt the training was free from bias and met all stated objectives (4 out of 4 on Likert scale). A multi-pronged approach coupling state and community collaboration was successful in overcoming barriers and challenges associated with pharmacy naloxone distribution and ensured its success as an effective avenue for naloxone acquisition in urban and rural communities. Copyright © 2017 American Pharmacists

Predictors of Suicidal Ideation in a Statewide Sample of Transgender Individuals

OpenAIRE

Rood, Brian A.; Puckett, Julia A.; Pantalone, David W.; Bradford, Judith B.

2015-01-01

Transgender individuals experience violence and discrimination, which, in addition to gender transitioning, are established correlates of psychological distress. In a statewide sample of 350 transgender adults, we investigated whether a history of violence and discrimination increased the odds of reporting lifetime suicidal ideation (SI) and whether differences in SI were predicted by gender transition status. Violence, discrimination, and transition status significantly predicted SI. Compare...

Hawai'i Youth at Risk? Conceptual Challenges in Communicating a Statewide Mentoring Initiative.

Science.gov (United States)

Pollard, Vincent Kelly

This paper discusses several issues considered as part of a statewide mentoring initiative. It is divided into three sections. The first section summarizes the key issues associated with short-term mentoring and mentoring in a longer-term, socially transformative context. Data from Comprehensive School Alienation Program is discussed concerning…

Statewide Dissemination of a Rural, Non-Chain Restaurant Intervention: Adoption, Implementation and Maintenance

Science.gov (United States)

Nothwehr, F.; Haines, H.; Chrisman, M.; Schultz, U.

2014-01-01

The obesity epidemic calls for greater dissemination of nutrition-related programs, yet there remain few studies of the dissemination process. This study, guided by elements of the RE-AIM model, describes the statewide dissemination of a simple, point-of-purchase restaurant intervention. Conducted in rural counties of the Midwest, United States,…

Kwajalein Infrastructure Prioritization Methodology

Science.gov (United States)

2012-07-01

trouble generating their own (Rowa). Another simple example is when a softball game was set up between USAKA staff and the Marshallese people (Bigleow...11 September 2011. Bigelow, Sheila. “USAKA heads to Ebeye for softball game.” http://www.army.mil/article/49706/usaka-heads-to-ebeye-for... softball -game/. 11 September 2011. CIA The World Factbook. www.cia.gov/library/publications/the-world-factbook/geos/rm.html. 11 Sptember 2011

Preliminary concept for statewide intercity bus and rail transit system : priority corridor ranking and analysis.

Science.gov (United States)

2009-03-01

This product summarizes the preliminary concept and priority corridors for development of a potential : statewide intercity bus and rail network. The concept is based upon the results of Tasks 1 through 5 of Texas : Department of Transportation Proje...

Taking Stock of Private-School Choice: Scholars Review the Research on Statewide Programs

Science.gov (United States)

Wolf, Patrick J.; Harris, Douglas N.; Berends, Mark; Waddington, R. Joseph; Austin, Megan

2018-01-01

In the past few years, four states have established programs that provide public financial support to students who choose to attend a private school. These programs--a tax-credit-funded scholarship initiative in Florida and voucher programs in Indiana, Louisiana, and Ohio--offer a glimpse of what expansive statewide choice might look like. What…

A task force model for statewide change in nursing education: building quality and safety.

Science.gov (United States)

Mundt, Mary H; Clark, Margherita Procaccini; Klemczak, Jeanette Wrona

2013-01-01

The purpose of this article was to describe a statewide planning process to transform nursing education in Michigan to improve quality and safety of patient care. A task force model was used to engage diverse partners in issue identification, consensus building, and recommendations. An example of a statewide intervention in nursing education and practice that was executed was the Michigan Quality and Safety in Nursing Education Institute, which was held using an integrated approach to academic-practice partners from all state regions. This paper describes the unique advantage of leadership by the Michigan Chief Nurse Executive, the existence of a nursing strategic plan, and a funding model. An overview of the Task Force on Nursing Education is presented with a focus on the model's 10 process steps and resulting seven recommendations. The Michigan Nurse Education Council was established to implement the recommendations that included quality and safety. Copyright © 2013 Elsevier Inc. All rights reserved.

Examining the Satisfaction of Educational Leaders and Their Intent to Pursue Career Advancement in Public School Administration

Science.gov (United States)

Conrad, Tracey L.; Rosser, Vicki J.

2007-01-01

This statewide study examined selected demographic characteristics, worklife experiences, and personal issues that influence the satisfaction of administrators (assistant principals, principals, assistant superintendents) and their intent to leave their positions and careers or pursue career advancement in public school administration. The results…

Variation in the use of advanced imaging at the time of breast cancer diagnosis in a statewide registry.

Science.gov (United States)

Henry, N Lynn; Braun, Thomas M; Breslin, Tara M; Gorski, David H; Silver, Samuel M; Griggs, Jennifer J

2017-08-01

Although national guidelines do not recommend extent of disease imaging for patients with newly diagnosed early stage breast cancer given that the harm outweighs the benefits, high rates of testing have been documented. The 2012 Choosing Wisely guidelines specifically addressed this issue. We examined the change over time in imaging use across a statewide collaborative, as well as the reasons for performing imaging and the impact on cost of care. Clinicopathologic data and use of advanced imaging tests (positron emission tomography, computed tomography, and bone scan) were abstracted from the medical records of patients treated at 25 participating sites in the Michigan Breast Oncology Quality Initiative (MiBOQI). For patients diagnosed in 2014 and 2015, reasons for testing were abstracted from the medical record. Of the 34,078 patients diagnosed with stage 0-II breast cancer between 2008 and 2015 in MiBOQI, 6853 (20.1%) underwent testing with at least 1 imaging modality in the 90 days after diagnosis. There was considerable variability in rates of testing across the 25 sites for all stages of disease. Between 2008 and 2015, testing decreased over time for patients with stage 0-IIA disease (all P diagnosis decreased over time in a large statewide collaborative. Additional interventions are warranted to further reduce rates of unnecessary imaging to improve quality of care for patients with breast cancer. Cancer 2017;123:2975-83. © 2017 American Cancer Society. © 2017 American Cancer Society.

A California statewide three-dimensional seismic velocity model from both absolute and differential times

Science.gov (United States)

Lin, G.; Thurber, C.H.; Zhang, H.; Hauksson, E.; Shearer, P.M.; Waldhauser, F.; Brocher, T.M.; Hardebeck, J.

2010-01-01

We obtain a seismic velocity model of the California crust and uppermost mantle using a regional-scale double-difference tomography algorithm. We begin by using absolute arrival-time picks to solve for a coarse three-dimensional (3D) P velocity (VP) model with a uniform 30 km horizontal node spacing, which we then use as the starting model for a finer-scale inversion using double-difference tomography applied to absolute and differential pick times. For computational reasons, we split the state into 5 subregions with a grid spacing of 10 to 20 km and assemble our final statewide VP model by stitching together these local models. We also solve for a statewide S-wave model using S picks from both the Southern California Seismic Network and USArray, assuming a starting model based on the VP results and a VP=VS ratio of 1.732. Our new model has improved areal coverage compared with previous models, extending 570 km in the SW-NE directionand 1320 km in the NW-SE direction. It also extends to greater depth due to the inclusion of substantial data at large epicentral distances. Our VP model generally agrees with previous separate regional models for northern and southern California, but we also observe some new features, such as high-velocity anomalies at shallow depths in the Klamath Mountains and Mount Shasta area, somewhat slow velocities in the northern Coast Ranges, and slow anomalies beneath the Sierra Nevada at midcrustal and greater depths. This model can be applied to a variety of regional-scale studies in California, such as developing a unified statewide earthquake location catalog and performing regional waveform modeling.

Analyzing the Measurement Equivalence of a Translated Test in a Statewide Assessment Program

Directory of Open Access Journals (Sweden)

Jorge Carvajal-Espinoza

2016-09-01

Full Text Available When tests are translated into one or more languages, the question of the equivalence of items across language forms arises. This equivalence can be assessed at the scale level by means of a multiple group confirmatory factor analysis (CFA in the context of structural equation modeling. This study examined the measurement equivalence of a Spanish translated version of a statewide Mathematics test originally constructed in English by using a multi-group CFA approach. The study used samples of native speakers of the target language of the translation taking the test in both the source and target language, specifically Hispanics taking the test in English and Spanish. Test items were grouped in twelve facet-representative parcels. The parceling was accomplished by grouping items that corresponded to similar content and computing an average for each parcel. Four models were fitted to examine the equivalence of the test across groups. The multi-group CFA fixed factor loadings across groups and results supported the equivalence of the two language versions (English and Spanish of the test. The statistical techniques implemented in this study can also be used to address the performance on a test based on dichotomous or dichotomized variables such as gender, socioeconomic status, geographic location and other variables of interest.

Statewide Policy Change in Pediatric Dental Care, and the Impact on Pediatric Dental and Physician Visits.

Science.gov (United States)

Zlotnick, Cheryl; Tam, Tammy; Ye, Yu

2017-10-01

Introduction In 2007, the California signed legislation mandating a dental visit for all children entering kindergarten or first grade; no such mandate was made for physician visits. This study examines the impact of this policy change on the risk factors associated with obtaining pediatric dental and physician health care visits. Methods Every 2 years, California Health Interview Survey conducts a statewide survey on a representative community sample. This cross-sectional study took advantage of these data to conduct a "natural experiment" assessing the impact of this policy change on both pediatric physician and dental care visits in the past year. Samples included surveys of adults and children (ages 5-11) on years 2005 (n = 5096), 2007 (n = 4324) and 2009 (n = 4100). Results Although few changes in risk factors were noted in pediatric physician visits, a gradual decrease in risk factors was found in pediatric dental visits from 2005 to 2009. Report of no dental visit was less likely for: younger children (OR -0.81, CI 0.75-0.88), insured children (OR 0.34, CI 0.22-0.53), and children who had a physician's visit last year (OR 0.37, CI 0.25-0.53) in 2005. By 2007, absence of insurance was the only risk factor related to having no dental visit (OR 0.34, CI 0.19-0.61). By 2009, no a priori measured risk factors were associated with not having a dental visit for children aged 5-11 years. Conclusions A statewide policy mandating pediatric dental visits appears to have reduced disparities. A policy for medical care may contribute to similar benefits.

Employment status matters: a statewide survey of quality-of-life, prevention behaviors, and absenteeism and presenteeism.

Science.gov (United States)

Merchant, James A; Kelly, Kevin M; Burmeister, Leon F; Lozier, Matt J; Amendola, Alison; Lind, David P; KcKeen, Arlinda; Slater, Tom; Hall, Jennifer L; Rohlman, Diane S; Buikema, Brenda S

2014-07-01

To estimate quality-of-life (QoL), primary care, health insurance, prevention behaviors, absenteeism, and presenteeism in a statewide sample of the unemployed, self-employed, and organizationally employed. A statewide survey of 1602 Iowans included items from the Centers for Disease Control and Prevention QoL and Behavioral Risk Factor Surveillance System Survey prevention behavior questionnaires used to assess employee well-being; their indicator results are related to World Health Organization's Health and Work Performance Questionnaire-derived absenteeism and presenteeism scores. The unemployed exhibited poorer QoL and prevention behaviors; the self-employed exhibited many better QoL scores due largely to better prevention behaviors than those employed by organizations. Higher QoL measures and more prevention behaviors are associated with lower absenteeism and lower presenteeism. Employment status is related to measures of well-being, which are also associated with absenteeism and presenteeism.

A School-Based Dental Program Evaluation: Comparison to the Massachusetts Statewide Survey.

Science.gov (United States)

Culler, Corinna S; Kotelchuck, Milton; Declercq, Eugene; Kuhlthau, Karen; Jones, Kari; Yoder, Karen M

2017-10-01

School-based dental programs target high-risk communities and reduce barriers to obtaining dental services by delivering care to students in their schools. We describe the evaluation of a school-based dental program operating in Chelsea, a city north of Boston, with a low-income and largely minority population, by comparing participants' oral health to a Massachusetts oral health assessment. Standardized dental screenings were conducted for students in kindergarten, third, and sixth grades. Outcomes were compared in bivariate analysis, stratified by grade and income levels. A greater percentage of Chelsea students had untreated decay and severe treatment need than students statewide. Yet, fewer Chelsea third graders had severe treatment need, and more had dental sealants. There was no significant difference in the percentage of Chelsea students having severe treatment need or dental sealants by income level. Students participating in our program do not have lower decay levels than students statewide. However, they do have lower levels of severe treatment need, likely due to treatment referrals. Our results confirm that school-based prevention programs can lead to increased prevalence of dental sealants among high-risk populations. Results provide support for the establishment of full-service school-based programs in similar communities. © 2017, American School Health Association.

Improving Accuracy and Relevance of Race/Ethnicity Data: Results of a Statewide Collaboration in Hawaii.

Science.gov (United States)

Pellegrin, Karen L; Miyamura, Jill B; Ma, Carolyn; Taniguchi, Ronald

2016-01-01

Current race/ethnicity categories established by the U.S. Office of Management and Budget are neither reliable nor valid for understanding health disparities or for tracking improvements in this area. In Hawaii, statewide hospitals have collaborated to collect race/ethnicity data using a standardized method consistent with recommended practices that overcome the problems with the federal categories. The purpose of this observational study was to determine the impact of this collaboration on key measures of race/ethnicity documentation. After this collaborative effort, the number of standardized categories available across hospitals increased from 6 to 34, and the percent of inpatients with documented race/ethnicity increased from 88 to 96%. This improved standardized methodology is now the foundation for tracking population health indicators statewide and focusing quality improvement efforts. The approach used in Hawaii can serve as a model for other states and regions. Ultimately, the ability to standardize data collection methodology across states and regions will be needed to track improvements nationally.

Contracting for Statewide Student Achievement Tests: A Review. Department of Public Instruction 98-4.

Science.gov (United States)

Wisconsin State Legislative Audit Bureau, Madison.

The Wisconsin legislature has required the Department of Public Instruction to adopt or approve standardized tests for statewide use to measure student attainment of knowledge and concepts in grades 4, 8, and 10. Although school districts generally gave high ratings to the contents of TerraNova (McGraw Hill), the testing instrument most recently…

A Multilevel, Statewide Investigation of School District Anti-Bullying Policy Quality and Student Bullying Involvement.

Science.gov (United States)

Gower, Amy L; Cousin, Molly; Borowsky, Iris W

2017-03-01

Although nearly all states in the United States require school districts to adopt anti-bullying policies, little research examines the effect of these policies on student bullying and health. Using a statewide sample, we investigated associations between the quality of school district anti-bullying policies and student bullying involvement and adjustment. School district anti-bullying policies (N = 208) were coded for their quality based on established criteria. District-level data were combined with student reports of bullying involvement, emotional distress, and school connectedness from a state surveillance survey of 6th, 9th, and 12th grade students (N = 93,437). Results indicated that policy quality was positively related to bullying victimization. Furthermore, students reporting frequent perpetration/victimization who also attended districts with high-quality policies reported more emotional distress and less school connectedness compared with students attending districts with low quality policies. Although statistically significant, the magnitude of these associations was small. Having a high-quality school district anti-bullying policy is not sufficient to reduce bullying and protect bullying-involved young people. Future studies examining policy implementation will inform best practices in bullying prevention. © 2017, American School Health Association.

Implementing Statewide Severe Maternal Morbidity Review: The Illinois Experience.

Science.gov (United States)

Koch, Abigail R; Roesch, Pamela T; Garland, Caitlin E; Geller, Stacie E

2018-03-07

Severe maternal morbidity (SMM) rates in the United States more than doubled between 1998 and 2010. Advanced maternal age and chronic comorbidities do not completely explain the increase in SMM or how to effectively address it. The Centers for Disease Control and Prevention and American College of Obstetricians and Gynecologists have called for facility-level multidisciplinary review of SMM for potential preventability and have issued implementation guidelines. Within Illinois, SMM was identified as any intensive or critical care unit admission and/or 4 or more units of packed red blood cells transfused at any time from conception through 42 days postpartum. All cases meeting this definition were counted during statewide surveillance. Cases were selected for review on the basis of their potential to yield insights into factors contributing to preventable SMM or best practices preventing further morbidity or death. If the SMM review committee deemed a case potentially preventable, it identified specific factors associated with missed opportunities and made actionable recommendations for quality improvement. Approximately 1100 cases of SMM were identified from July 1, 2016, to June 30, 2017, yielding a rate of 76 SMM cases per 10 000 pregnancies. Reviews were conducted on 142 SMM cases. Most SMM cases occurred during delivery hospitalization and more than half were delivered by cesarean section. Hemorrhage was the primary cause of SMM (>50% of the cases). Facility-level SMM review was feasible and acceptable in statewide implementation. States that are planning SMM reviews across obstetric facilities should permit ample time for translation of recommendations to practice. Although continued maternal mortality reviews are valuable, they are not sufficient to address the increasing rates of SMM and maternal death. In-depth multidisciplinary review offers the potential to identify factors associated with SMM and interventions to prevent women from moving along the

New Mexico statewide geothermal energy program. Final technical report

Energy Technology Data Exchange (ETDEWEB)

Icerman, L.; Parker, S.K. (ed.)

1988-04-01

This report summarizes the results of geothermal energy resource assessment work conducted by the New Mexico Statewide Geothermal Energy Program during the period September 7, 1984, through February 29, 1988, under the sponsorship of the US Dept. of Energy and the State of New Mexico Research and Development Institute. The research program was administered by the New Mexico Research and Development Institute and was conducted by professional staff members at New Mexico State University and Lightning Dock Geothermal, Inc. The report is divided into four chapters, which correspond to the principal tasks delineated in the above grant. This work extends the knowledge of the geothermal energy resource base in southern New Mexico with the potential for commercial applications.

A Guide to Effective Statewide Laws/Policies: Preventing Discrimination against LGBT Students in K-12 Schools.

Science.gov (United States)

Lambda Legal Defense and Education Fund, New York, NY.

This document presents guidance for stopping discrimination, harassment, and violence against lesbian, gay, bisexual, and transgender (LGBT) students in schools. Section 1, "Lambda Legal Defense and Education Fund on the Legal Considerations for Creating and Changing Statewide Laws and Policies," discusses the various types of statewide…

Impact of Online Learning Modules on Medical Student Microbiology Examination Scores

OpenAIRE

Johnson, Mary T.

2008-01-01

Medical students have a limited amount of time in which to acquire working knowledge of an enormous amount of information, and this is especially relevant for microbiology. One large midwestern medical school is unique in having medical microbiology taught at nine regional campuses using a single core curriculum. A committee of statewide course directors writes a licensure board-style final examination that is referenced to the core and used at all campuses. To prepare for the final examinati...

Road Map to Statewide Implementation of the Pyramid Model. Roadmap to Effective Intervention Practices #6

Science.gov (United States)

Dunlap, Glen; Smith, Barbara J.; Fox, Lise; Blase, Karen

2014-01-01

This document is a guide--a "Road Map"--for implementing widespread use of the Pyramid Model for Promoting Social Emotional Competence in Infants and Young Children (http://www.challengingbehavior.org/do/pyramid_model. htm). It is a road map of systems change. The Road Map is written for statewide systems change, although it could be…

Development of a central data warehouse for statewide ITS and transportation data in Florida phase III : final report.

Science.gov (United States)

2009-12-15

This report documents Phase III of the development and operation of a prototype for the Statewide Transportation : Engineering Warehouse for Archived Regional Data (STEWARD). It reflects the progress on the development and : operation of STEWARD sinc...

Predictors of Suicidal Ideation in a Statewide Sample of Transgender Individuals.

Science.gov (United States)

Rood, Brian A; Puckett, Julia A; Pantalone, David W; Bradford, Judith B

2015-09-01

Transgender individuals experience violence and discrimination, which, in addition to gender transitioning, are established correlates of psychological distress. In a statewide sample of 350 transgender adults, we investigated whether a history of violence and discrimination increased the odds of reporting lifetime suicidal ideation (SI) and whether differences in SI were predicted by gender transition status. Violence, discrimination, and transition status significantly predicted SI. Compared with individuals with no plans to transition, individuals with plans or who were living as their identified gender reported greater odds of lifetime SI. We discuss implications for SI disparities using Meyer's minority stress model.

Effects of patient health literacy, patient engagement and a system-level health literacy attribute on patient-reported outcomes: a representative statewide survey.

Science.gov (United States)

Kaphingst, Kimberly A; Weaver, Nancy L; Wray, Ricardo J; Brown, Melissa L R; Buskirk, Trent; Kreuter, Matthew W

2014-10-07

The effects of health literacy are thought to be based on interactions between patients' skill levels and health care system demands. Little health literacy research has focused on attributes of health care organizations. We examined whether the attribute of individuals' experiences with front desk staff, patient engagement through bringing questions to a doctor visit, and health literacy skills were related to two patient-reported outcomes. We administered a telephone survey with two sampling frames (i.e., household landline, cell phone numbers) to a randomly selected statewide sample of 3358 English-speaking adult residents of Missouri. We examined two patient-reported outcomes - whether or not respondents reported knowing more about their health and made better choices about their health following their last doctor visit. Multivariable logistic regression models were used to examine the independent contributions of predictor variables (i.e., front desk staff, bringing questions to a doctor visit, health literacy skills). Controlling for self-reported health, having a personal doctor, time since last visit, number of chronic conditions, health insurance, and sociodemographic characteristics, respondents who had a good front desk experience were 2.65 times as likely (95% confidence interval [CI]: 2.13, 3.30) and those who brought questions were 1.73 times as likely (95% CI: 1.32, 2.27) to report knowing more about their health after seeing a doctor. In a second model, respondents who had a good front desk experience were 1.57 times as likely (95% CI: 1.26, 1.95) and those who brought questions were 1.66 times as likely (95% CI: 1.29, 2.14) to report making better choices about their health after seeing a doctor. Patients' health literacy skills were not associated with either outcome. Results from this representative statewide survey may indicate that one attribute of a health care organization (i.e., having a respectful workforce) and patient engagement through

Avoiding a knowledge gap in a multiethnic statewide social marketing campaign: is cultural tailoring sufficient?

Science.gov (United States)

Buchthal, O Vanessa; Doff, Amy L; Hsu, Laura A; Silbanuz, Alice; Heinrich, Katie M; Maddock, Jay E

2011-03-01

In 2007, the State of Hawaii, Healthy Hawaii Initiative conducted a statewide social-marketing campaign promoting increased physical activity and nutrition. The campaign included substantial formative research to develop messages tailored for Hawaii's multiethnic Asian and Pacific Islander populations. The authors conducted a statewide random digital dialing telephone survey to assess the campaign's comparative reach among individuals with different ethnicities and different levels of education and income. This analysis suggests that the intervention was successful in reaching its target ethnic audiences. However, a knowledge gap related to the campaign appeared among individuals with incomes less than 130% of the poverty level and those with less than a high school education. These results varied significantly by message and the communication channel used. Recall of supermarket-based messages was significantly higher among individuals below 130% of the poverty level and those between 18 and 35 years of age, 2 groups that showed consistently lower recall of messages in other channels. Results suggest that cultural tailoring for ethnic audiences, although important, is insufficient for reaching low-income populations, and that broad-based social marketing campaigns should consider addressing socioeconomic status-related channel preferences in formative research and campaign design.

An Annual Report to the Legislature on Oregon Public Schools. Oregon Statewide Report Card. 2014-2015

Science.gov (United States)

Oregon Department of Education, 2015

2015-01-01

The Oregon Statewide Report Card is an annual publication required by law (ORS 329.115), which reports on the state of public schools and their progress towards the goals of the Oregon Educational Act for the 21st Century. The purpose of the Oregon Report Card is to monitor trends among school districts and Oregon's progress toward achieving the…

Filling the Void: The Roles of a Local Applied Research Center and a Statewide Workforce Training Consortium

Science.gov (United States)

Perniciaro, Richard C.; Nespoli, Lawrence A.; Anbarasan, Sivaraman

2015-01-01

This chapter describes the development of an applied research center at Atlantic Cape Community College and a statewide workforce training consortium run by the community college sector in New Jersey. Their contributions to the economic development mission of the colleges as well as their impact on the perception of community colleges by…

State of Hawaii, Department of Health, Clean Water Branch State-wide Water Quality Sampling Dataset 1999-2006 (NODC Accession 0013723)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Monitoring Section of the State of Hawaii, Department of Health, Clean Water Branch collects water quality data at over 300 coastal locations state-wide using...

State of Hawaii, Department of Health, Clean Water Branch State-wide Water Quality Sampling Dataset 1973-1998 (NODC Accession 0013724)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Monitoring Section of the State of Hawaii, Department of Health, Clean Water Branch collects water quality data at over 300 coastal locations state-wide using...

Development of a State-Wide 3-D Seismic Tomography Velocity Model for California

Science.gov (United States)

Thurber, C. H.; Lin, G.; Zhang, H.; Hauksson, E.; Shearer, P.; Waldhauser, F.; Hardebeck, J.; Brocher, T.

2007-12-01

We report on progress towards the development of a state-wide tomographic model of the P-wave velocity for the crust and uppermost mantle of California. The dataset combines first arrival times from earthquakes and quarry blasts recorded on regional network stations and travel times of first arrivals from explosions and airguns recorded on profile receivers and network stations. The principal active-source datasets are Geysers-San Pablo Bay, Imperial Valley, Livermore, W. Mojave, Gilroy-Coyote Lake, Shasta region, Great Valley, Morro Bay, Mono Craters-Long Valley, PACE, S. Sierras, LARSE 1 and 2, Loma Prieta, BASIX, San Francisco Peninsula and Parkfield. Our beta-version model is coarse (uniform 30 km horizontal and variable vertical gridding) but is able to image the principal features in previous separate regional models for northern and southern California, such as the high-velocity subducting Gorda Plate, upper to middle crustal velocity highs beneath the Sierra Nevada and much of the Coast Ranges, the deep low-velocity basins of the Great Valley, Ventura, and Los Angeles, and a high- velocity body in the lower crust underlying the Great Valley. The new state-wide model has improved areal coverage compared to the previous models, and extends to greater depth due to the data at large epicentral distances. We plan a series of steps to improve the model. We are enlarging and calibrating the active-source dataset as we obtain additional picks from investigators and perform quality control analyses on the existing and new picks. We will also be adding data from more quarry blasts, mainly in northern California, following an identification and calibration procedure similar to Lin et al. (2006). Composite event construction (Lin et al., in press) will be carried out for northern California for use in conventional tomography. A major contribution of the state-wide model is the identification of earthquakes yielding arrival times at both the Northern California Seismic

Leveraging a Statewide Clinical Data Warehouse to Expand Boundaries of the Learning Health System.

Science.gov (United States)

Turley, Christine B; Obeid, Jihad; Larsen, Rick; Fryar, Katrina M; Lenert, Leslie; Bjorn, Arik; Lyons, Genevieve; Moskowitz, Jay; Sanderson, Iain

2016-01-01

Learning Health Systems (LHS) require accessible, usable health data and a culture of collaboration-a challenge for any single system, let alone disparate organizations, with macro- and micro-systems. Recently, the National Science Foundation described this important setting as a cyber-social ecosystem. In 2004, in an effort to create a platform for transforming health in South Carolina, Health Sciences South Carolina (HSSC) was established as a research collaboration of the largest health systems, academic medical centers and research intensive universities in South Carolina. With work beginning in 2010, HSSC unveiled an integrated Clinical Data Warehouse (CDW) in 2013 as a crucial anchor to a statewide LHS. This CDW integrates data from independent health systems in near-real time, and harmonizes the data for aggregation and use in research. With records from over 2.7 million unique patients spanning 9 years, this multi-institutional statewide clinical research repository allows integrated individualized patient-level data to be used for multiple population health and biomedical research purposes. In the first 21 months of operation, more than 2,800 de-identified queries occurred through i2b2, with 116 users. HSSC has developed and implemented solutions to complex issues emphasizing anti-competitiveness and participatory governance, and serves as a recognized model to organizations working to improve healthcare quality by extending the traditional borders of learning health systems.

State-wide performance criteria for international safeguards

International Nuclear Information System (INIS)

Budlong-Sylvester, K.W.; Pilat, Joseph F.; Stanbro, W.D.

2001-01-01

Traditionally, the International Atomic Energy Agency (IAEA) has relied upon prescriptive criteria to guide safeguards implementation. The prospect of replacing prescriptive safeguards criteria with more flexible performance criteria would constitute a structural change in safeguards and raises several important questions. Performance criteria imply that while safeguards goals will be fixed, the means of attaining those goals will not be explicitly prescribed. What would the performance objectives be under such a system? How would they be formulated? How would performance be linked to higher level safeguards objectives? How would safeguards performance be measured State-wide? The implementation of safeguards under performance criteria would also signal a dramatic change in the manner the Agency does business. A higher degree of flexibility could, in principle, produce greater effectiveness and efficiency, but would come with a need for increased Agency responsibility in practice. To the extent that reliance on prescriptive criteria decreases, the burden of justifying actions and ensuring their transparency will rise. Would there need to be limits to safeguards implementation? What would be the basis for setting such limits? This paper addresses these and other issues and questions relating to both the formulation and the implementation of performance-based criteria.

Validation of a risk stratification tool for fall-related injury in a state-wide cohort.

Science.gov (United States)

McCoy, Thomas H; Castro, Victor M; Cagan, Andrew; Roberson, Ashlee M; Perlis, Roy H

2017-02-06

A major preventable contributor to healthcare costs among older individuals is fall-related injury. We sought to validate a tool to stratify such risk based on readily available clinical data, including projected medication adverse effects, using state-wide medical claims data. Sociodemographic and clinical features were drawn from health claims paid in the state of Massachusetts for individuals aged 35-65 with a hospital admission for a period spanning January-December 2012. Previously developed logistic regression models of hospital readmission for fall-related injury were refit in a testing set including a randomly selected 70% of individuals, and examined in a training set comprised of the remaining 30%. Medications at admission were summarised based on reported adverse effect frequencies in published medication labelling. The Massachusetts health system. A total of 68 764 hospitalised individuals aged 35-65 years. Hospital readmission for fall-related injury defined by claims code. A total of 2052 individuals (3.0%) were hospitalised for fall-related injury within 90 days of discharge, and 3391 (4.9%) within 180 days. After recalibrating the model in a training data set comprised of 48 136 individuals (70%), model discrimination in the remaining 30% test set yielded an area under the receiver operating characteristic curve (AUC) of 0.74 (95% CI 0.72 to 0.76). AUCs were similar across age decades (0.71 to 0.78) and sex (0.72 male, 0.76 female), and across most common diagnostic categories other than psychiatry. For individuals in the highest risk quartile, 11.4% experienced fall within 180 days versus 1.2% in the lowest risk quartile; 57.6% of falls occurred in the highest risk quartile. This analysis of state-wide claims data demonstrates the feasibility of predicting fall-related injury requiring hospitalisation using readily available sociodemographic and clinical details. This translatable approach to stratification allows for identification of

Elder Abuse Identification in the Prehospital Setting: An Examination of State Emergency Medical Services Protocols.

Science.gov (United States)

Namboodri, Brooke L; Rosen, Tony; Dayaa, Joseph A; Bischof, Jason J; Ramadan, Nadeem; Patel, Mehul D; Grover, Joseph; Brice, Jane H; Platts-Mills, Timothy F

2018-03-22

To describe statewide emergency medical service (EMS) protocols relating to identification, management, and reporting of elder abuse in the prehospital setting. Cross-sectional analysis. Statewide EMS protocols in the United States. Publicly available statewide EMS protocols identified from published literature, http://EMSprotocols.org, and each state's public health website. Protocols were reviewed to determine whether elder abuse was mentioned, elder abuse was defined, potential indicators of elder abuse were listed, management of older adults experiencing abuse was described, and instructions regarding reporting were provided. EMS protocols for child abuse were reviewed in the same manner for the purpose of comparison. Of the 35 publicly available statewide EMS protocols, only 14 (40.0%) mention elder abuse. Of protocols that mention elder abuse, 6 (42.9%) define elder abuse, 10 (71.4%) describe indicators of elder abuse, 8 (57.1%) provide instruction regarding management, and 12 (85.7%) provide instruction regarding reporting. Almost twice as many states met each of these metrics for child abuse. Statewide EMS protocols for elder abuse vary in regard to identification, management, and reporting, with the majority of states having no content on this subject. Expansion and standardization of protocols may increase the identification of elder abuse. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

Socioeconomic and travel demand forecasts for Virginia and potential policy responses : a report for VTrans2035 : Virginia's statewide multimodal transportation plan.

Science.gov (United States)

2009-01-01

VTrans2035, Virginia's statewide multimodal transportation plan, requires 25-year forecasts of socioeconomic and travel activity. Between 2010 and 2035, daily vehicle miles traveled (DVMT) will increase between 35% and 45%, accompanied by increases i...

Results from a Multi-Modal Program Evaluation of a Four Year Statewide Juvenile Sex Offender Treatment and Reentry Program

Science.gov (United States)

Underwood, Lee A.; Dailey, Frances L. L.; Merino, Carrie; Crump, Yolanda

2015-01-01

The results of the Program Evaluation show the OJJ Statewide Sex Offender Treatment program is exceptionally productive in meeting over 90% of its established performance markers. These markers included successful screening and assessment of risk and psychosocial needs, completion of initial and master treatment plans, establishment of sex…

Changes in Obesity Awareness, Obesity Identification, and Self-Assessment of Health: Results from a Statewide Public Education Campaign

Science.gov (United States)

Tsai, Adam G.; Boyle, Tracy F.; Hill, James O.; Lindley, Corina; Weiss, Karl

2014-01-01

Background: Due to the high prevalence of obesity, individuals may be desensitized to weight as a personal health concern. Purpose: To evaluate changes in obesity awareness associated with a statewide public education campaign in Colorado. Methods: Cross-sectional random digit dial telephone surveys (n = 1,107 pre, n = 1101 post) were conducted…

Developing and maintaining state-wide adolescent pregnancy prevention coalitions: a preliminary investigation.

Science.gov (United States)

Nezlek, J B; Galano, J

1993-09-01

This paper presents the results of a study of state-wide adolescent pregnancy prevention coalitions. Key informants in five states throughout the southern United States were given semi-structured interviews regarding the adolescent pregnancy prevention coalitions in their states. From these interviews and other documents, conclusions were drawn regarding the nature and importance of the environments within which these coalitions operate, the universe of activities in which coalitions engage, and the stages of development of these coalitions. Katz and Kahn's model of social organizations served as the basis for understanding coalitions in terms of these three considerations. Future research should consider the utility of organizational models that can explain more fully the organization--committee hybrid structure that tends to characterize these coalitions.

A Statewide Partnership for Implementing Inquiry Science

Science.gov (United States)

Lytle, Charles

The North Carolina Infrastructure for Science Education (NC-ISE) is a statewide partnership for implementing standards-based inquiry science using exemplary curriculum materials in the public schools of North Carolina. North Carolina is the 11th most populous state in the USA with 8,000,000 residents, 117 school districts and a geographic area of 48,718 miles. NC-ISE partners include the state education agency, local school systems, three branches of the University of North Carolina, the state mathematics and science education network, businesses, and business groups. The partnership, based upon the Science for All Children model developed by the National Science Resources Centre, was initiated in 1997 for improvement in teaching and learning of science and mathematics. This research-based model has been successfully implemented in several American states during the past decade. Where effectively implemented, the model has led to significant improvements in student interest and student learning. It has also helped reduce the achievement gap between minority and non-minority students and among students from different economic levels. A key program element of the program is an annual Leadership Institute that helps teams of administrators and teachers develop a five-year strategic plan for their local systems. Currently 33 of the117 local school systems have joined the NC-ISE Program and are in various stages of implementation of inquiry science in grades K-8.

Office-based preventive dental program and statewide trends in dental caries.

Science.gov (United States)

Achembong, Leo N; Kranz, Ashley M; Rozier, R Gary

2014-04-01

To evaluate the impact of a North Carolina Medicaid preventive dentistry program in primary care medical offices (Into the Mouths of Babes Program [IMBP]) on decayed, missing, and filled teeth (dmft) of kindergarten students statewide and in schools with a large proportion of students from low-income families. An ecologic study using panel data of 920,505 kindergarten students with 11,694 school-year observations examined the effect of the IMBP on dmft scores from 1998 to 2009. Ordinary least squares regression with fixed effects determined the association between IMBP visits per child 0 to 4 years of age per county and mean dmft scores per kindergarten student per school, controlling for school-level poverty and ethnicity, county-level Medicaid enrollment, and supply of dentists and physicians. Mean dmft per kindergarten student per school increased from 1.53 in 1998 to 1.84 in 2004, then decreased to 1.59 in 2009. The mean number of IMBP visits per child 0 to 4 years of age per county increased from 0.01 in 2000 to 0.22 in 2009. A 1-unit increase in IMBP visits per county was associated with a 0.248 (95% confidence interval, -0.40 to -0.10) decrease in dmft per kindergarten student per school. For schools with more students at high risk for dental disease, a 1-unit increase in IMBP visits was associated with a 0.320 (95% confidence interval, -0.55 to -0.09) decrease in dmft. IMBP reduced dental caries among targeted vulnerable children, which helped reduce oral health disparities among preschool-aged children in North Carolina.

The World Factbook

Science.gov (United States)

1994-01-01

Lago de Yojoa (the country’s largest source of freshwater) with heavy metals as well as several rivers and streams Ptarturc hazairds: subject to... Madre de Dios , Apurimac), La Rafael REY Rey; Democratic Coordinator, ( 1994 est.) Libertad (from La Libertad), Los Jose BARBA Caballero, Democratic... Madre de Dios . Moquegua. Pasco. Judicial branch: Supreme Court of Justice mining and telecommunications industries. In Piura. Puno. San Martin. Tacna

Total Factbook 2003

International Nuclear Information System (INIS)

2003-01-01

This report presents the activities and results of the Group Total-Fina-Elf for the year 2003. It brings information and economic data on the following topics: the corporate and business; the upstream activities with the reserves, the costs, standardized measure and changes of discounted future net cash flow,oil and gas acreage, drilling, liquefied natural gas, pipelines; downstream activities with refining and marketing maps, refinery, petroleum products, sales, retail gasoline outlets; chemicals with sales and operating income by sector, major applications, base chemicals and polymers, intermediates and performance polymers. (A.L.B.)

Developing a statewide public health initiative to reduce infant mortality in Oklahoma.

Science.gov (United States)

Dooley, Suzanna; Patrick, Paul; Lincoln, Alicia; Cline, Janette

2014-01-01

The Preparing for a Lifetime, It's Everyone's Responsibility initiative was developed to improve the health and well- being of Oklahoma's mothers and infants. The development phase included systematic data collection, extensive data analysis, and multi-disciplinary partnership development. In total, seven issues (preconception/interconception health, tobacco use, postpartum depression, breastfeeding, infant safe sleep, preterm birth, and infant injury prevention) were identified as crucial to addressing infant mortality in Oklahoma. Workgroups were created to focus on each issue. Data and media communications workgroups were added to further partner commitment and support for policy and programmatic changes across multiple agencies and programs. Leadership support, partnership, evaluation, and celebrating small successes were important factors that lead to large scale adoption and support for the state-wide initiative to reduce infant mortality.

Successful long-term maintenance following Nutrition Care Process Terminology implementation across a state-wide health-care system.

Science.gov (United States)

Vivanti, Angela; O'Sullivan, Therese A; Porter, Jane; Hogg, Marion

2017-09-01

Three years following a state-wide Nutrition Care Process Terminology (NCPT) implementation project, the present study aimed to (i) assess changes in NCPT knowledge and attitudes, (ii) identify implementation barriers and enablers and (iii) seek managers' opinions post-implementation. Pre-implementation and three years post-implementation, all Queensland Government hospitals state-wide were invited to repeat a validated NCPT survey. Additionally, a separate survey sought dietetic managers' opinions regarding NCPT's use and acceptance, usefulness for patient care, role in service planning and continued use. A total of 238 dietitians completed the survey in 2011 and 82 dietitians in 2014. Use of diagnostic statement in the previous six months improved (P  0.05). Key elements in sustaining NCPT implementation over three years included ongoing management support, workshops/tutorials, discussion and mentor and peer support. The most valued resources were pocket guides, ongoing workshops/tutorials and mentor support. Dietetic managers held many positive NCPT views, however, opinions differed around the usefulness of service planning, safer practice, improving patient care and facilitating communication. Some managers would not support NCPT unless it was recommended for practice. Immediate improvements following the NCPT implementation project were sustained over three years. Moving forward, a professional focus on continuing to incorporate NCPT into standard practice will provide structure for process and outcomes assessment. © 2017 State of Queensland. Nutrition and Dietetics © 2017 Dietitians Association of Australia.

Under Pressure: Financial Effect of the Hospital-Acquired Conditions Initiative-A Statewide Analysis of Pressure Ulcer Development and Payment.

Science.gov (United States)

Meddings, Jennifer; Reichert, Heidi; Rogers, Mary A M; Hofer, Timothy P; McMahon, Laurence F; Grazier, Kyle L

2015-07-01

To assess the financial effect of the 2008 Hospital-Acquired Conditions Initiative (HACI) pressure ulcer payment changes on Medicare, other payers, and hospitals. Retrospective before-and-after study of all-payer statewide administrative data for more than 2.4 million annual adult discharges in 2007 and 2009 using the Healthcare Cost and Utilization Project State Inpatient Datasets for California. How often and by how much the 2008 payment changes for pressure ulcers affected hospital payment was assessed. Nonfederal acute care California hospitals (N = 311). Adults discharged from acute-care hospitals. Pressure ulcer rates and hospital payment changes. Hospital-acquired pressure ulcer rates were low in 2007 (0.28%) and 2009 (0.27%); present-on-admission pressure ulcer rates increased from 2.3% in 2007 to 3.0% in 2009. According to clinical stage of pressure ulcer (available in 2009), hospital-acquired Stage III and IV ulcers occurred in 603 discharges (0.02%); 60,244 discharges (2.42%) contained other pressure ulcer diagnoses. Payment removal for Stage III and IV hospital-acquired ulcers reduced payment in 75 (0.003%) discharges, for a statewide payment decrease of $310,444 (0.001%) for all payers and $199,238 (0.001%) for Medicare. For all other pressure ulcers, the Hospital-Acquired Conditions Initiative reduced hospital payment in 20,246 (0.81%) cases (including 18,953 cases with present-on-admission ulcers), reducing statewide payment by $62,538,586 (0.21%) for all payers and $47,237,984 (0.32%) for Medicare. The total financial effect of the 2008 payment changes for pressure ulcers was negligible. Most payment decreases occurred by removal of comorbidity payments for present-on-admission pressure ulcers other than Stages III and IV. The removal of payment for hospital-acquired Stage III and IV ulcers by implementation of the HACI policy was 1/200th that of the removal of payment for other types of pressure ulcers that occurred in implementation of the

Illinois statewide gas utility plan, 1993-2002. Volume 1. Executive summary

International Nuclear Information System (INIS)

1992-12-01

The second Illinois Statewide Natural Gas Utility Plan is a continuation of the Least-Cost Planning effort introduced by the Public Utilities Act of 1986. The purpose of the Plan, like its predecessor, is to provide a framework and a set of policies which will allow and encourage local distribution companies to develop least-cost plans consistent with the goals of the Act: to provide efficient, environmentally sound, reliable, and equitable public utility service at the least possible cost. The Plan assesses natural gas demand and supply under five scenarios for the period 1993-2002. Key issues related to the development of least-cost natural gas plans are identified, and policies for addressing the issues are developed. The rationale and potential for natural gas demand side management (DSM) programs and policies are explored, and recommendations made with respect to utility DSM capability-building and DSM cost-recovery

Facts about Hospital Worker Safety

Science.gov (United States)

... statistics show that hospitals are still relatively hazardous workplaces, and they have much room to improve. OSHA has developed this factbook to help hospital safety managers and other stakeholders understand the challenges of worker ...

Analysis of Gastric Lavage Reported to a Statewide Poison Control System.

Science.gov (United States)

Donkor, Jimmy; Armenian, Patil; Hartman, Isaac N; Vohra, Rais

2016-10-01

As decontamination trends have evolved, gastric lavage (GL) has become a rare procedure. The current information regarding use, outcomes, and complications of GL could help refine indications for this invasive procedure. We sought to determine case type, location, and complications of GL cases reported to a statewide poison control system. This is a retrospective review of the California Poison Control System (CPCS) records from 2009 to 2012. Specific substances ingested, results and complications of GL, referring hospital ZIP codes, and outcomes were examined. Nine hundred twenty-three patients who underwent GL were included in the final analysis, ranging in age from 9 months to 88 years. There were 381 single and 540 multiple substance ingestions, with pill fragment return in 27%. Five hundred thirty-six GLs were performed with CPCS recommendation, while 387 were performed without. Complications were reported for 20 cases. There were 5 deaths, all after multiple ingestions. Among survivors, 37% were released from the emergency department, 13% were admitted to hospital wards, and 48% were admitted to intensive care units. The most commonly ingested substances were nontricyclic antidepressant psychotropics (n = 313), benzodiazepines (n = 233), acetaminophen (n = 191), nonsteroidal anti-inflammatory drugs (n = 107), diphenhydramine (n = 70), tricyclic antidepressants (n = 45), aspirin (n = 45), lithium (n = 36), and antifreeze (n = 10). The geographic distribution was clustered near regions of high population density, with a few exceptions. Toxic agents for which GL was performed reflected a broad spectrum of potential hazards, some of which are not life-threatening or have effective treatments. Continuing emergency physician and poison center staff education is required to assist in patient selection. Copyright © 2016 Elsevier Inc. All rights reserved.

Using Logistic Regression for Validating or Invalidating Initial Statewide Cut-Off Scores on Basic Skills Placement Tests at the Community College Level

Science.gov (United States)

Secolsky, Charles; Krishnan, Sathasivam; Judd, Thomas P.

2013-01-01

The community colleges in the state of New Jersey went through a process of establishing statewide cut-off scores for English and mathematics placement tests. The colleges wanted to communicate to secondary schools a consistent preparation that would be necessary for enrolling in Freshman Composition and College Algebra at the community college…

Peer Crowd Identification and Adolescent Health Behaviors: Results From a Statewide Representative Study.

Science.gov (United States)

Jordan, Jeffrey W; Stalgaitis, Carolyn A; Charles, John; Madden, Patrick A; Radhakrishnan, Anjana G; Saggese, Daniel

2018-02-01

Peer crowds are macro-level subcultures that share similarities across geographic areas. Over the past decade, dozens of studies have explored the association between adolescent peer crowds and risk behaviors, and how they can inform public health efforts. However, despite the interest, researchers have not yet reported on crowd size and risk levels from a representative sample, making it difficult for practitioners to apply peer crowd science to interventions. The current study reports findings from the first statewide representative sample of adolescent peer crowd identification and health behaviors. Weighted data were analyzed from the 2015 Virginia Youth Survey of Health Behaviors ( n = 4,367). Peer crowds were measured via the I-Base Survey™, a photo-based peer crowd survey instrument. Frequencies and confidence intervals of select behaviors including tobacco use, substance use, nutrition, physical activity, and violence were examined to identify high- and low-risk crowds. Logistic regression was used to calculate adjusted odds ratios for each crowd and behavior. Risky behaviors clustered in two peer crowds. Hip Hop crowd identification was associated with substance use, violence, and some depression and suicidal behaviors. Alternative crowd identification was associated with increased risk for some substance use behaviors, depression and suicide, bullying, physical inactivity, and obesity. Mainstream and, to a lesser extent, Popular, identities were associated with decreased risk for most behaviors. Findings from the first representative study of peer crowds and adolescent behavior identify two high-risk groups, providing critical insights for practitioners seeking to maximize public health interventions by targeting high-risk crowds.

Measurement of fine particles and smoking activity in a statewide survey of 36 California Indian casinos

Science.gov (United States)

Jiang, Ru O-Ting; Cheng, Ka I-Chung; Acevedo-Bolton, Viviana; Klepeis, Neil E; Repace, James L; Ott, Wayne R; Hildemann, Lynn M

2011-01-01

Despite California's 1994 statewide smoking ban, exposure to secondhand smoke (SHS) continues in California's Indian casinos. Few data are available on exposure to airborne fine particles (PM2.5) in casinos, especially on a statewide basis. We sought to measure PM2.5 concentrations in Indian casinos widely distributed across California, exploring differences due to casino size, separation of smoking and non-smoking areas, and area smoker density. A selection of 36 out of the 58 Indian casinos throughout California were each visited for 1–3 h on weekend or holiday evenings, using two or more concealed monitors to measure PM2.5 concentrations every 10 s. For each casino, the physical dimensions and the number of patrons and smokers were estimated. As a preliminary assessment of representativeness, we also measured eight casinos in Reno, NV. The average PM2.5 concentration for the smoking slot machine areas (63 μg/m3) was nine times as high as outdoors (7 μg/m3), whereas casino non-smoking restaurants (29 μg/m3) were four times as high. Levels in non-smoking slot machine areas varied: complete physical separation reduced concentrations almost to outdoor levels, but two other separation types had mean levels that were 13 and 29 μg/m3, respectively, higher than outdoors. Elevated PM2.5 concentrations in casinos can be attributed primarily to SHS. Average PM2.5 concentrations during 0.5–1 h visits to smoking areas exceeded 35 μg/m3 for 90% of the casino visits. PMID:20160761

Perceptions of electronic health record implementation: a statewide survey of physicians in Rhode Island.

Science.gov (United States)

Wylie, Matthew C; Baier, Rosa R; Gardner, Rebekah L

2014-10-01

Although electronic health record use improves healthcare delivery, adoption into clinical practice is incomplete. We sought to identify the extent of adoption in Rhode Island and the characteristics of physicians and electronic health records associated with positive experience. We performed a cross-sectional study of data collected by the Rhode Island Department of Health for the Health Information Technology Survey 2009 to 2013. Survey questions included provider and practice demographics, health record information, and Likert-type scaled questions regarding how electronic health record use affected clinical practice. The survey response rate ranged from 50% to 65%, with 62% in 2013. Increasing numbers of physicians in Rhode Island use an electronic health record. In 2013, 81% of physicians used one, and adoption varied by clinical subspecialty. Most providers think that electronic health record use improves billing and quality improvement but has not improved job satisfaction. Physicians with longer and more sophisticated electronic health record use report positive effects of introduction on all aspects of practice examined (P electronic health record introduction (P electronic health record vendors most frequently used in Rhode Island, 5 were associated with improved job satisfaction. We report the largest statewide study of electronic health record adoption to date. We found increasing physician use in Rhode Island, and the extent of adoption varies by subspecialty. Although older physicians are less likely to be positive about electronic health record adoption, longer and more sophisticated use are associated with more positive opinions, suggesting acceptance will grow over time. Copyright © 2014 Elsevier Inc. All rights reserved.

HPV vaccine hesitancy: findings from a statewide survey of health care providers.

Science.gov (United States)

McRee, Annie-Laurie; Gilkey, Melissa B; Dempsey, Amanda F

2014-01-01

Health care provider recommendations are critical for human papillomavirus (HPV) vaccine uptake. We sought to describe providers' HPV vaccine recommendation practices and explore their perceptions of parental hesitancy. A statewide sample (n = 575) of Minnesota health care providers (20% pediatricians, 47% family medicine physicians, and 33% nurse practitioners) completed our online survey in April 2013. Only 76% of health care providers reported routinely recommending HPV vaccine for girls ages 11 to 12 years, and far fewer (46%) did so for boys (p parents' concerns (74%), but many lacked time to probe reasons (47%) or believed that they could not change parents' minds (55%). Higher levels of self-efficacy and outcome expectations were associated with routine recommendations (p HPV vaccine. Improving providers' self-efficacy to address hesitancy may be important for improving vaccination rates. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

Use Contexts and Usage Patterns of Interactive Case Simulation Tools by HIV Healthcare Providers in a Statewide Online Clinical Education Program.

Science.gov (United States)

Wang, Dongwen

2017-01-01

We analyzed four interactive case simulation tools (ICSTs) from a statewide online clinical education program. Results have shown that ICSTs are increasingly used by HIV healthcare providers. Smart phone has become the primary usage platform for specific ICSTs. Usage patterns depend on particular ICST modules, usage stages, and use contexts. Future design of ICSTs should consider these usage patterns for more effective dissemination of clinical evidence to healthcare providers.

The Soft Underbelly of System Change: The Role of Leadership and Organizational Climate in Turnover during Statewide Behavioral Health Reform.

Science.gov (United States)

Aarons, Gregory A; Sommerfeld, David H; Willging, Cathleen E

2011-01-01

This study examined leadership, organizational climate, staff turnover intentions, and voluntary turnover during a large-scale statewide behavioral health system reform. The initial data collection occurred nine months after initiation of the reform with a follow-up round of data collected 18 months later. A self-administered structured assessment was completed by 190 participants (administrators, support staff, providers) employed by 14 agencies. Key variables included leadership, organizational climate, turnover intentions, turnover, and reform-related financial stress ("low" versus "high") experienced by the agencies. Analyses revealed that positive leadership was related to a stronger empowering climate in both high and low stress agencies. However, the association between more positive leadership and lower demoralizing climate was evident only in high stress agencies. For both types of agencies empowering climate was negatively associated with turnover intentions, and demoralizing climate was associated with stronger turnover intentions. Turnover intentions were positively associated with voluntary turnover. Results suggest that strong leadership is particularly important in times of system and organizational change and may reduce poor climate associated with turnover intentions and turnover. Leadership and organizational context should be addressed to retain staff during these periods of systemic change.

Correspondence of biological condition models of California streams at statewide and regional scales

Science.gov (United States)

May, Jason T.; Brown, Larry R.; Rehn, Andrew C.; Waite, Ian R.; Ode, Peter R; Mazor, Raphael D; Schiff, Kenneth C

2015-01-01

We used boosted regression trees (BRT) to model stream biological condition as measured by benthic macroinvertebrate taxonomic completeness, the ratio of observed to expected (O/E) taxa. Models were developed with and without exclusion of rare taxa at a site. BRT models are robust, requiring few assumptions compared with traditional modeling techniques such as multiple linear regression. The BRT models were constructed to provide baseline support to stressor delineation by identifying natural physiographic and human land use gradients affecting stream biological condition statewide and for eight ecological regions within the state, as part of the development of numerical biological objectives for California’s wadeable streams. Regions were defined on the basis of ecological, hydrologic, and jurisdictional factors and roughly corresponded with ecoregions. Physiographic and land use variables were derived from geographic information system coverages. The model for the entire state (n = 1,386) identified a composite measure of anthropogenic disturbance (the sum of urban, agricultural, and unmanaged roadside vegetation land cover) within the local watershed as the most important variable, explaining 56 % of the variance in O/E values. Models for individual regions explained between 51 and 84 % of the variance in O/E values. Measures of human disturbance were important in the three coastal regions. In the South Coast and Coastal Chaparral, local watershed measures of urbanization were the most important variables related to biological condition, while in the North Coast the composite measure of human disturbance at the watershed scale was most important. In the two mountain regions, natural gradients were most important, including slope, precipitation, and temperature. The remaining three regions had relatively small sample sizes (n ≤ 75 sites) and had models that gave mixed results. Understanding the spatial scale at which land use and land cover affect

The World Factbook 2002

Science.gov (United States)

2002-01-01

branch: unicameral Congress of the Economy -overview: Thanks to strong foreign Madre de Dios , Moquegua, Pasco, Piura, Puno, San Republic of Peru or...Ancash), Grau (from FIM 1, others 17 presidential election and FUJIMORI’s subsequent Tumbes, Piura), Inca (from Cusco, Madre de Dios , Judicial branch...current issues: air pollution from G R E E C E industrial emissions; rivers polluted from raw sewage, . / heavy metals , detergents; deforestation

The World Factbook 2000

Science.gov (United States)

2000-01-01

Loreto, election results: percent of vote by party - C90/NM coins, all framed by a green wreath Madre de Dios , Moquegua, Pasco, Piura, Puno, San 52.1...was brought under control. In Tumbes, Piura), Inca (from Cusco, Madre de Dios , FUJIMORI]; Civic Works Movement or OBRAS 1998, El Nino’s impact on...pollution from Literacy: industrial emissions; rivers polluted from raw sewage, definition: age 15 and over can read and write SOFIA N Bse c heavy metals

The World Factbook 1999

Science.gov (United States)

1999-01-01

Arequipa, Ayacucho, Cajamarca, Callao*, Cusco, Huancavelica, Huanuco, lea, Junin, La Libertad, Lambayeque, Lima, Loreto, Madre de Dios , Moquegua...Inca (from Cusco, Madre de Dios , Apurimac), La Libertad (from La Libertad), Los Libertadores-Huari (from lea, Ayacucho, Huancavelica), Mariategui...industrial emissions; rivers polluted from raw sewage, heavy metals , detergents; deforestation; forest damage from air pollution and resulting acid rain

Forging successful academic-community partnerships with community health centers: the California statewide Area Health Education Center (AHEC) experience.

Science.gov (United States)

Fowkes, Virginia; Blossom, H John; Mitchell, Brenda; Herrera-Mata, Lydia

2014-01-01

Increased access to insurance under the Affordable Care Act will increase demands for clinical services in community health centers (CHCs). CHCs also have an increasingly important educational role to train clinicians who will remain to practice in community clinics. CHCs and Area Health Education Centers (AHECs) are logical partners to prepare the health workforce for the future. Both are sponsored by the Health Resources and Services Administration, and they share a mission to improve quality of care in medically underserved communities. AHECs emphasize the educational side of the mission, and CHCs the service side. Building stronger partnerships between them can facilitate a balance between education and service needs.From 2004 to 2011, the California Statewide AHEC program and its 12 community AHECs (centers) reorganized to align training with CHC workforce priorities. Eight centers merged into CHC consortia; others established close partnerships with CHCs in their respective regions. The authors discuss issues considered and approaches taken to make these changes. Collaborative innovative processes with program leadership, staff, and center directors revised the program mission, developed common training objectives with an evaluation plan, and defined organizational, functional, and impact characteristics for successful AHECs in California. During this planning, centers gained confidence as educational arms for the safety net and began collaborations with statewide programs as well as among themselves. The AHEC reorganization and the processes used to develop, strengthen, and identify standards for centers forged the development of new partnerships and established academic-community trust in planning and implementing programs with CHCs.

Outcomes of a statewide anti-tobacco industry youth organizing movement.

Science.gov (United States)

Dunn, Caroline L; Pirie, Phyllis L; Oakes, J Michael

2004-01-01

To outline the design and present select findings from an evaluation of a statewide anti-tobacco industry youth organizing movement. A telephone survey was administered to teenagers to assess associations between exposure to anti-industry youth organizing activities and tobacco-related attitudes and behaviors. A group-level comparison between areas high and low in youth organizing activities was planned. Methodological obstacles necessitated a subject-level analytic approach, with comparisons being made between youth at higher and lower levels of exposure. Six rural areas (comprising 13 counties) and two urban regions of Minnesota were selected for survey. The study comprised 852 youth, aged 15 to 17 years old, randomly selected from county-specific sampling frames constructed from a marketing research database. Exposure index scores were developed for two types of activities designed to involve youth in the anti-industry program: branding (creating awareness of the movement in general) and messaging (informing about the movement's main messages). Attitudinal outcomes measured attitudes about the tobacco industry and the effectiveness of youth action. Behavioral outcomes included taking action to get involved in the organization, spreading an anti-industry message, and smoking susceptibility. Branding index scores were significantly correlated with taking action to get involved (p strategy for involving youth in tobacco prevention and generating negative attitudes about the industry.

Statewide Inferior Vena Cava Filter Placement, Complications, and Retrievals: Epidemiology and Recent Trends.

Science.gov (United States)

Charalel, Resmi A; Durack, Jeremy C; Mao, Jialin; Ross, Joseph S; Meltzer, Andrew J; Sedrakyan, Art

2018-03-01

Public awareness of inferior vena cava (IVC) filter-related controversies has been elevated by the Food and Drug Administration (FDA) safety communication in 2010. To examine population level trends in IVC filter utilization, complications, retrieval rates, and subsequent pulmonary embolism (PE) risk. A retrospective cohort study. Patients receiving IVC filters during 2005-2014 in New York State. IVC filter-specific complications, new PE occurrences and IVC filter retrievals were evaluated as time-to-event data using Kaplan-Meier analysis. Estimated cumulative risks were obtained at various timepoints during follow-up. There were 91,873 patients receiving IVC filters between 2005 and 2014 in New York State included in the study. The average patient age was 67 years and 46.6% were male. Age-adjusted rates of IVC filter placement increased from 48 cases/100,000 in 2005 to 52 cases/100,000 in 2009, and decreased afterwards to 36 cases/100,000 in 2014. The estimated risks of having an IVC filter-related complication and filter retrieval within 1 year was 1.5% [95% confidence interval (CI), 1.4%-1.6%] and 3.5% (95% CI, 3.4%-3.6%). One-year retrieval rate was higher post-2010 when compared with pre-2010 years (hazard ratio, 2.70; 95% CI, 2.50-2.91). Among the 58,176 patients who did not have PE events before or at the time of IVC filter placement, the estimated risk of developing subsequent PE at 1 year was 2.0% (95% CI, 1.9%-2.1%). Our findings suggest that FDA communications may be effective in modifying statewide clinical practices. Given the 2% observed PE rate following prophylactic IVC filter placement, large scale pragmatic studies are needed to determine contemporary safety and effectiveness of IVC filters.

Towards automated statewide land cover mapping in Wisconsin using satellite remote sensing and GIS techniques

International Nuclear Information System (INIS)

Cosentino, B.L.; Lillesand, T.M.

1991-01-01

Attention is given to an initial research project being performed by the University of Wisconsin-Madison, Environmental Remote Sensing Center in conjunction with seven local, state, and federal agencies to implement automated statewide land cover mapping using satellite remote sensing and geographical information system (GIS) techniques. The basis, progress, and future research needs for this mapping program are presented. The research efforts are directed toward strategies that integrate satellite remote sensing and GIS techniques in the generation of land cover data for multiple users of land cover information. The project objectives are to investigate methodologies that integrate satellite data with other imagery and spatial data resident in emerging GISs in the state for particular program needs, and to develop techniques that can improve automated land cover mapping efficiency and accuracy. 10 refs

Creating a Statewide Educational Data System for Accountability and Improvement: A Comprehensive Information and Assessment System for Making Evidence-Based Change at School, District, and Policy Levels

Science.gov (United States)

Felner, Robert D.; Bolton, Natalie; Seitsinger, Anne M.; Brand, Stephen; Burns, Amy

2008-01-01

This article reports on one ongoing statewide effort to create a high-quality data reporting and utilization system (i.e., High-Performance Learning Community [HiPlaces] Assessment) to inform educational accountability and improvement efforts system. This effort has undergoing refinement for more than a decade. The article describes the features…

Statewide Groundwater Recharge Modeling in New Mexico

Science.gov (United States)

Xu, F.; Cadol, D.; Newton, B. T.; Phillips, F. M.

2017-12-01

It is crucial to understand the rate and distribution of groundwater recharge in New Mexico because it not only largely defines a limit for water availability in this semi-arid state, but also is the least understood aspect of the state's water budget. With the goal of estimating groundwater recharge statewide, we are developing the Evapotranspiration and Recharge Model (ETRM), which uses existing spatial datasets to model the daily soil water balance over the state at a resolution of 250 m cell. The input datasets includes PRISM precipitation data, MODIS Normalized Difference Vegetation Index (NDVI), NRCS soils data, state geology data and reference ET estimates produced by Gridded Atmospheric Data downscalinG and Evapotranspiration Tools (GADGET). The current estimated recharge presents diffuse recharge only, not focused recharge as in channels or playas. Direct recharge measurements are challenging and rare, therefore we estimate diffuse recharge using a water balance approach. The ETRM simulated runoff amount was compared with USGS gauged discharge in four selected ephemeral channels: Mogollon Creek, Zuni River, the Rio Puerco above Bernardo, and the Rio Puerco above Arroyo Chico. Result showed that focused recharge is important, and basin characteristics can be linked with watershed hydrological response. As the sparse instruments in NM provide limited help in improving estimation of focused recharge by linking basin characteristics, the Walnut Gulch Experimental Watershed, which is one of the most densely gauged and monitored semiarid rangeland watershed for hydrology research purpose, is now being modeled with ETRM. Higher spatial resolution of field data is expected to enable detailed comparison of model recharge results with measured transmission losses in ephemeral channels. The final ETRM product will establish an algorithm to estimate the groundwater recharge as a water budget component of the entire state of New Mexico. Reference ET estimated by GADGET

Effect Of A “No Superuser Opioid Prescription” Policy On ED Visits And Statewide Opioid Prescription

Directory of Open Access Journals (Sweden)

Zachary P. Kahler

2017-07-01

Full Text Available Introduction: The U.S. opioid epidemic has highlighted the need to identify patients at risk of opioid abuse and overdose. We initiated a novel emergency department- (ED based interventional protocol to transition our superuser patients from the ED to an outpatient chronic pain program. The objective was to evaluate the protocol’s effect on superusers’ annual ED visits. Secondary outcomes included a quantitative evaluation of statewide opioid prescriptions for these patients, unique prescribers of controlled substances, and ancillary testing. Methods: Patients were referred to the program with the following inclusion criteria: ≥ 6 visits per year to the ED; at least one visit identified by the attending physician as primarily driven by opioid-seeking behavior; and a review by a committee comprising ED administration and case management. Patients were referred to a pain management clinic and informed that they would no longer receive opioid prescriptions from visits to the ED for chronic pain complaints. Electronic medical record (EMR alerts notified ED providers of the patient’s referral at subsequent visits. We analyzed one year of data pre- and post-referral. Results: A total of 243 patients had one year of data post-referral for analysis. Median annual ED visits decreased from 14 to 4 (58% decrease, 95% CI [50 to 66]. We also found statistically significant decreases for these patients’ state prescription drug monitoring program (PDMP opioid prescriptions (21 to 13, total unique controlled-substance prescribers (11 to 7, computed tomography imaging (2 to 0, radiographs (5 to 1, electrocardiograms (12 to 4, and labs run (47 to 13. Conclusion: This program and the EMR-based alerts were successful at decreasing local ED visits, annual opioid prescriptions, and hospital resource allocation for this population of patients. There is no evidence that these patients diverted their visits to neighboring EDs after being informed that they

Tactical emergency medical support programs: a comprehensive statewide survey.

Science.gov (United States)

Bozeman, William P; Morel, Benjamin M; Black, Timothy D; Winslow, James E

2012-01-01

Specially trained tactical emergency medical support (TEMS) personnel provide support to law enforcement special weapons and tactics (SWAT) teams. These programs benefit law enforcement agencies, officers, suspects, and citizens. TEMS programs are increasingly popular, but there are wide variations in their organization and operation and no recent data on their prevalence. We sought to measure the current prevalence and specific characteristics of TEMS programs in a comprehensive fashion in a single southeastern state. North Carolina emergency medical services (EMS) systems have county-based central EMS oversight; each system was surveyed by phone and e-mail. The presence and selected characteristics of TEMS programs were recorded. U.S. Census data were used to measure the population impact of the programs. All of the 101 EMS systems statewide were successfully contacted. Thirty-three counties (33%) have TEMS programs providing medical support to 56 local law enforcement agencies as well as state and federal agencies. TEMS programs tend to be located in more populated urban and suburban areas, serving a population base of 5.9 million people, or 64% of the state's population. Tactical medics in the majority of these programs (29/33; 88%) are not sworn law enforcement officers. Approximately one-third of county-based EMS systems in North Carolina have TEMS programs. These programs serve almost two-thirds of the state's population base, using primarily nonsworn tactical medics. Comparison with other regions of the country will be useful to demonstrate differences in prevalence and program characteristics. Serial surveillance will help track trends and measure the growth and impact of this growing subspecialty field.

Statewide prevalence of school children at risk of anaphylaxis and rate of adrenaline autoinjector activation in Victorian government schools, Australia.

Science.gov (United States)

Loke, Paxton; Koplin, Jennifer; Beck, Cara; Field, Michael; Dharmage, Shyamali C; Tang, Mimi L K; Allen, Katrina J

2016-08-01

The prevalence of school students at risk of anaphylaxis in Victoria is unknown and has not been previously studied. Similarly, rates of adrenaline autoinjector usage in the school environment have yet to be determined given increasing prescription rates. We sought to determine time trends in prevalence of school children at risk of anaphylaxis across all year levels and the annual usage rate of adrenaline autoinjectors in the school setting relative to the number of students at risk of anaphylaxis. Statewide surveys from more than 1,500 government schools including more than 550,000 students were used and prevalence rates (%) with 95% CIs were calculated. The overall prevalence of students at risk of anaphylaxis has increased 41% from 0.98% (95% CI, 0.95-1.01) in 2009 to 1.38% (95% CI, 1.35-1.41) in 2014. There was a significant drop in reporting of anaphylaxis risk with transition from the final year of primary school to the first year of secondary school, suggesting a change in parental reporting of anaphylaxis risk among secondary school students. The number of adrenaline autoinjectors activated per 1000 students at risk of anaphylaxis ranged from 6 to 8 per year, with consistently higher activation use in secondary school students than in primary school students. Statewide prevalence of anaphylaxis risk has increased in children attending Victorian government schools. However, adrenaline autoinjector activation has remained fairly stable despite known increase in the rates of prescription. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

The Michigan Spine Surgery Improvement Collaborative: a statewide Collaborative Quality Initiative.

Science.gov (United States)

Chang, Victor; Schwalb, Jason M; Nerenz, David R; Pietrantoni, Lisa; Jones, Sharon; Jankowski, Michelle; Oja-Tebbe, Nancy; Bartol, Stephen; Abdulhak, Muwaffak

2015-12-01

OBJECT Given the scrutiny of spine surgery by policy makers, spine surgeons are motivated to demonstrate and improve outcomes, by determining which patients will and will not benefit from surgery, and to reduce costs, often by reducing complications. Insurers are similarly motivated. In 2013, Blue Cross Blue Shield of Michigan (BCBSM) and Blue Care Network (BCN) established the Michigan Spine Surgery Improvement Collaborative (MSSIC) as a Collaborative Quality Initiative (CQI). MSSIC is one of the newest of 21 other CQIs that have significantly improved-and continue to improve-the quality of patient care throughout the state of Michigan. METHODS MSSIC focuses on lumbar and cervical spine surgery, specifically indications such as stenosis, disk herniation, and degenerative disease. Surgery for tumors, traumatic fractures, deformity, scoliosis, and acute spinal cord injury are currently not within the scope of MSSIC. Starting in 2014, MSSIC consisted of 7 hospitals and in 2015 included another 15 hospitals, for a total of 22 hospitals statewide. A standardized data set is obtained by data abstractors, who are funded by BCBSM/BCN. Variables of interest include indications for surgery, baseline patient-reported outcome measures, and medical history. These are obtained within 30 days of surgery. Outcome instruments used include the EQ-5D general health state score (0 being worst and 100 being the best health one can imagine) and EQ-5D-3 L. For patients undergoing lumbar surgery, a 0 to 10 numeric rating scale for leg and back pain and the Oswestry Disability Index for back pain are collected. For patients undergoing cervical surgery, a 0 to 10 numeric rating scale for arm and neck pain, Neck Disability Index, and the modified Japanese Orthopaedic Association score are collected. Surgical details, postoperative hospital course, and patient-reported outcome measures are collected at 90-day, 1-year, and 2-year intervals. RESULTS As of July 1, 2015, a total of 6397 cases

A statewide consortium's adoption of a unified nursing curriculum: evaluation of the first two years.

Science.gov (United States)

Tse, Alice M; Niederhauser, Victoria; Steffen, John J; Magnussen, Lois; Morrisette, Nova; Polokoff, Rachael; Chock, Johnelle

2014-01-01

This article provides an evaluation of the first two years of implementation of a statewide nursing consortium (SNC) curriculum on nursing faculty work life, teaching productivity, and quality of education. In response to the call for nursing education reform, the SNC incorporated new approaches to competency-based, student-centered learning and clinical education. Faculty and two cohorts of students were measured at three points over the first two years of the curriculum implementation. The expected positive impact of the SNC was documented at the start of the first year, but not sustained. Students reported having more confidence in their clinical skills at the start of the first year, yet demonstrated significantly less confidence in their ability after two years. Faculty indicated that the SNC allowed greater opportunity for collaboration, but that the experience did not alter their classroom performance or satisfaction beyond the first year.

The Impact of the State-Wide and District Dropout Prevention Plans on the Dropout Rates, Graduation Rates, GED Completions, and Truancy Rates of High School Teens in Mississippi

Science.gov (United States)

Spencer, Amanda Jean Martin

2011-01-01

In 2006, as part of the compliance with the No Child Left Behind Act of 2001, Mississippi implemented a state-wide dropout prevention plan. The Mississippi Department of Education through the Office of Dropout Prevention supplied a skeletal format to serve as a guideline for all 152 individual school districts within the state. The school…

Department of Defense Software Factbook

Science.gov (United States)

2017-07-07

Domain 107 Figure 72: Project Distribution by Operating Environment 108 Figure 73: Program Distribution by Language Family 109 Figure 74: Reported...across system domains, development organizations, and languages , this data summary is most useful to high- level decision makers. The data can be used...reports are provided at the project level or subsystem level, not at the DoD Acquisition Program level. The data points analyzed in this report are

Total fact-book 2000-2005

Energy Technology Data Exchange (ETDEWEB)

NONE

2005-07-01

TOTAL S.A., a French society incorporated in France on March 28, 1924, together with its subsidiaries and affiliates, is the fourth largest publicly-traded integrated oil and gas company in the world. This document provides statistical data and information on the corporate (highlights, statements), upstream (production, costs,main producing fields, drilling), upstream maps, downstream (refining, distillation, retail gasoline outlets) and chemicals (sales, specialities). (A.L.B.)

Total fact-book 2000-2005

International Nuclear Information System (INIS)

2005-01-01

TOTAL S.A., a French society incorporated in France on March 28, 1924, together with its subsidiaries and affiliates, is the fourth largest publicly-traded integrated oil and gas company in the world. This document provides statistical data and information on the corporate (highlights, statements), upstream (production, costs,main producing fields, drilling), upstream maps, downstream (refining, distillation, retail gasoline outlets) and chemicals (sales, specialities). (A.L.B.)

TotalFinaElf Factbook 2002

International Nuclear Information System (INIS)

2002-01-01

This report presents the activities and results of the Group Total-Fina-Elf for the year 2002. It brings information and economic data on the following topics: the corporate and business; the upstream activities with the reserves, the costs, standardized measure and changes of discounted future net cash flow,oil and gas acreage, drilling, liquefied natural gas, pipelines; downstream activities with refining and marketing maps, refinery, petroleum products, sales, retail gasoline outlets; chemicals with sales and operating income by sector, major applications, base chemicals and polymers, intermediates and performance polymers. (A.L.B.)

Emergency Department Visits Prior to Suicide and Homicide: Linking Statewide Surveillance Systems.

Science.gov (United States)

Cerel, Julie; Singleton, Michael D; Brown, Margaret M; Brown, Sabrina V; Bush, Heather M; Brancado, Candice J

2016-01-01

Emergency departments (EDs) serve a wide range of patients who present at risk of impending suicide and homicide. Two statewide surveillance systems were probabilistically linked to understand who utilizes EDs and then dies violently within 6 weeks. Each identified case was matched with four randomly selected controls on sex, race, date of birth, resident zip code, and date of ED visit vs. date of death. Matched-pair odds ratios were estimated by conditional logistic regression to assess differences between cases and controls on reported diagnoses and expected payment sources. Of 1,599 suicides and 569 homicides in the 3-year study period, 10.7% of decedents who died by suicide (mean = 13.6 days) and 8.3% who died by homicide (mean = 16.3 days) were seen in a state ED within 6 weeks prior to death. ED attendees who died by suicide were more likely to have a diagnosis of injury/ poisoning diagnosis or mental disorder and more likely to have Medicare. Those who died by homicide were more likely to have a diagnosis of injury/poisoning and less likely to have commercial insurance. It is essential for research to further explore risk factors for imminent suicide and homicide in ED patients who present for psychiatric conditions and general injuries.

How Statewide LGB Policies Go From “Under Our Skin” to “Into Our Hearts”: Fatherhood Aspirations and Psychological Well-Being Among Emerging Adult Sexual Minority Men

Science.gov (United States)

2013-01-01

Researchers have noted increasingly the public health importance of addressing discriminatory policies towards lesbian, gay, and bisexual (LGB) populations. At present, however, we know little about the mechanisms through which policies affect LGB populations’ psychological well-being; in other words, how do policies get under our skin? Using data from a study of sexual minority young men (N = 1,487; M = 20.80 (SD = 1.93); 65 % White; 92 % gay), we examined whether statewide bans (e.g., same-sex marriage, adoption) moderated the relationship between fatherhood aspirations and psychological well-being. Fatherhood aspirations were associated with lower depressive symptoms and higher self-esteem scores among participants living in states without discriminatory policies. In states with marriage equality bans, fatherhood aspirations were associated with higher depressive symptoms and lower self-esteem scores, respectively. Fatherhood aspirations were associated negatively with self-esteem in states banning same-sex and second parent adoptions, respectively. Our findings underscore the importance of recognizing how anti-equality LGB policies may influence the psychosocial development of sexual minority men. PMID:24233971

A Statewide Examiniation of Mental Health Courts in Illinois: Program Characteristics and Operations

Directory of Open Access Journals (Sweden)

Arthur J. Lurigio

2015-07-01

Full Text Available This study represents the only broad-based, statewide evaluation of mental health courts (MHCs conducted to date.  Data were collected from 2010 to 2013 at each of the nine active MHC programs operating in Illinois at the start of the study. The purpose of the study was to compare and contrast the adjudicatory and supervisory models of each established Illinois MHC program by utilizing a variety of research methodologies. A four-year recidivism analysis of case-level data from three Illinois MHCs was also conducted. Illinois MHCs were largely characterized by the '10 essential elements of an MHC', such as voluntary participation, informed choice and hybrid team approaches to case manage clients. Results of the recidivism analysis suggest that MHCs compare favorably to other types of probation. Overall, findings revealed that Illinois MHCs are delivering services effectively and efficiently in a well-coordinated, client-centered team approach. Differences found among the MHCs are not evidence of significant variance from the model, and instead represent responsiveness to the unique culture of the court, the niche-filling character of the program, the expectations of the program stakeholders and the nature and extent of the local service environment.

The Republic of the Philippines: Background and U.S. Relations

Science.gov (United States)

2009-01-15

Central Intelligence Agency, World Factbook; United Nations Development Programme. The HDI ranks countries according to human development indicators of...economic assistance in Mindanao. The Philippines faces terrorist threats from several groups, including Jemaah Islamiyah (JI), the main Southeast Asian ...people contacts. Filipino-Americans number approximately three million, making them the second- largest Asian -American group in the United States

A Cyber Ray Hope for Ethiopian Children

Science.gov (United States)

Szente, Judit; Hoot, James

2004-01-01

Major obstacles threaten the future of Ethiopia. Global publicity regarding the drought of 1986 has left the world with images of starving and orphaned Ethiopian children. Such conditions do still exist in parts of this nation, in which 45 percent of the population falls below the national poverty line (The World Factbook, 2003). In a nation of…

Development of statewide geriatric patients trauma triage criteria.

Science.gov (United States)

Werman, Howard A; Erskine, Timothy; Caterino, Jeffrey; Riebe, Jane F; Valasek, Tricia

2011-06-01

The geriatric population is unique in the type of traumatic injuries sustained, physiological responses to those injuries, and an overall higher mortality when compared to younger adults. No published, evidence-based, geriatric-specific field destination criteria exist as part of a statewide trauma system. The Trauma Committee of the Ohio Emergency Medical Services (EMS) Board sought to develop specific criteria for geriatric trauma victims. A literature search was conducted for all relevant literature to determine potential, geriatric-specific, field-destination criteria. Data from the Ohio Trauma Registry were used to compare elderly patients, defined as age >70 years, to all patients between the ages of 16 to 69 years with regards to mortality risk in the following areas: (1) Glasgow Coma Scale (GCS) score; (2) systolic blood pressure (SBP); (3) falls associated with head, chest, abdominal or spinal injury; (4) mechanism of injury; (5) involvement of more than one body system as defined in the Barell matrix; and (6) co-morbidities and motor vehicle collision with one or more long bone fracture. For GCS score and SBP, those cut-off points with equal or greater risk of mortality as compared to current values were chosen as proposed triage criteria. For other measures, any criterion demonstrating a statistically significant increase in mortality risk was included in the proposed criteria. The following criteria were identified as geriatric-specific criteria: (1) GCS score trauma; (2) SBP trauma. In addition, these data suggested that elderly patients with specific co-morbidities be given strong consideration for evaluation in a trauma center. The state of Ohio is the first state to develop evidence-based geriatric-specific field-destination criteria using data from its state-mandated trauma registry. Further analysis of these criteria will help determine their effects on over-triage and under-triage of geriatric victims of traumatic injuries and the impact on the

Impact of Helmet Use on Injury and Financial Burden of Motorcycle and Moped Crashes in Hawai‘i: Analysis of a Linked Statewide Database

Science.gov (United States)

Castel, Nikki A; Wong, Linda L; Steinemann, Susan

2016-01-01

Helmet use reduces injury severity, disability, hospital length of stay, and hospital charges in motorcycle riders. The public absorbs billions of dollars annually in hospital charges for unhelmeted, uninsured motorcycle riders. We sought to quantify, on a statewide level, the healthcare burden of unhelmeted motorcycle and moped riders. We examined 1,965 emergency medical service (EMS) reports from motorcycle and moped crashes in Hawai‘i between 2007–2009. EMS records were linked to hospital medical records to assess associations between vehicle type, helmet use, medical charges, diagnoses, and final disposition. Unhelmeted riders of either type of vehicle suffered more head injuries, especially skull fractures (adjusted odds ratio (OR) of 4.48, P motorcycle and moped riders, with a significant (P = .006) difference between helmeted ($27,176) and unhelmeted ($40,217) motorcycle riders. Unhelmeted riders were twice as likely to self-pay (19.3%, versus 9.8% of helmeted riders), and more likely to have Medicaid or a similar income-qualifying insurance plan (13.5% versus 5.0%, respectively). Protective associations with helmet use are stronger among motorcyclists than moped riders, suggesting the protective effect is augmented in higher speed crashes. The public financial burden is higher from unhelmeted riders who sustain more severe injuries and are less likely to be insured. PMID:27980882

Less Is More: Results of a Statewide Analysis of the Impact of Blood Transfusion on Coronary Artery Bypass Grafting Outcomes.

Science.gov (United States)

Crawford, Todd C; Magruder, J Trent; Fraser, Charles; Suarez-Pierre, Alejandro; Alejo, Diane; Bobbitt, Jennifer; Fonner, Clifford E; Canner, Joseph K; Horvath, Keith; Wehberg, Kurt; Taylor, Bradley; Kwon, Christopher; Whitman, Glenn J; Conte, John V; Salenger, Rawn

2018-01-01

Debate persists over the association between blood transfusions, especially those considered discretionary, and outcomes after cardiac operations. Using data from the Maryland Cardiac Surgery Quality Initiative, we sought to determine whether outcomes differed among coronary artery bypass grafting (CABG) patients receiving 1 U of red blood cells (RBCs) vs none. We used a statewide database to review patients who underwent isolated CABG from July 1, 2011, to June 30, 2016, across 10 Maryland cardiac surgery centers. We included patients who received 1 U or fewer of RBCs from the time of the operation through discharge. Propensity scoring, using 20 variables to control for treatment effect, was performed among patients who did and did not receive a transfusion. These two groups were matched 1:1 to assess for differences in our primary outcomes: operative death, prolonged postoperative length of stay (>14 days), and a composite postoperative respiratory complication of pneumonia or reintubation, or both. Of 10,877 patients who underwent CABG, 6,124 (56%) received no RBCs (group 1) during their operative hospitalization, and 981 (9.0%) received 1 U of RBCs (group 2), including 345 of 981 patients (35%) who received a transfusion intraoperatively. Propensity score matching generated 937 well-matched pairs. Compared with group 2, propensity-matched analysis revealed significantly greater 30-day survival in group 1 (99% vs 98%, p = 0.02) and reduced incidence of prolonged length of stay (3.7% vs 4.0%, p < 0.01). Our collaborative statewide analysis demonstrated that even 1 unit of blood was associated with significantly worse survival and longer length of stay after CABG. Multiinstitutional quality initiatives may seek to address discretionary transfusions and possess the potential to improve patient outcomes. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

The United States Army and the Sergeant Problem: The Army’s Systemic Inability to Produce Enough Sergeants and a Proposal to Fix it

Science.gov (United States)

2014-04-23

Intelligence Agency https://www.cia.gov/ library / publications/the-world-factbook/index.html (accessed November 24, 2013); John Pike, "Royal Thai Army" http...accessed November 24, 2013); Barbara LePoer, Thailand: A Country Study, Area Handbook Series (Washington, DC: Library of Congress, 1989), 246, 259...accessed December 22, 2013); "Professional Leadership Programs: Apprenticeship, Internship, and Multicultural Fellowship", http

Genome Structural Diversity among 31 Bordetella pertussis Isolates from Two Recent U.S. Whooping Cough Statewide Epidemics.

Science.gov (United States)

Bowden, Katherine E; Weigand, Michael R; Peng, Yanhui; Cassiday, Pamela K; Sammons, Scott; Knipe, Kristen; Rowe, Lori A; Loparev, Vladimir; Sheth, Mili; Weening, Keeley; Tondella, M Lucia; Williams, Margaret M

2016-01-01

During 2010 and 2012, California and Vermont, respectively, experienced statewide epidemics of pertussis with differences seen in the demographic affected, case clinical presentation, and molecular epidemiology of the circulating strains. To overcome limitations of the current molecular typing methods for pertussis, we utilized whole-genome sequencing to gain a broader understanding of how current circulating strains are causing large epidemics. Through the use of combined next-generation sequencing technologies, this study compared de novo, single-contig genome assemblies from 31 out of 33 Bordetella pertussis isolates collected during two separate pertussis statewide epidemics and 2 resequenced vaccine strains. Final genome architecture assemblies were verified with whole-genome optical mapping. Sixteen distinct genome rearrangement profiles were observed in epidemic isolate genomes, all of which were distinct from the genome structures of the two resequenced vaccine strains. These rearrangements appear to be mediated by repetitive sequence elements, such as high-copy-number mobile genetic elements and rRNA operons. Additionally, novel and previously identified single nucleotide polymorphisms were detected in 10 virulence-related genes in the epidemic isolates. Whole-genome variation analysis identified state-specific variants, and coding regions bearing nonsynonymous mutations were classified into functional annotated orthologous groups. Comprehensive studies on whole genomes are needed to understand the resurgence of pertussis and develop novel tools to better characterize the molecular epidemiology of evolving B. pertussis populations. IMPORTANCE Pertussis, or whooping cough, is the most poorly controlled vaccine-preventable bacterial disease in the United States, which has experienced a resurgence for more than a decade. Once viewed as a monomorphic pathogen, B. pertussis strains circulating during epidemics exhibit diversity visible on a genome structural

A California Statewide App to Simulate Fate of Nitrate in Irrigated Agricultural System

Science.gov (United States)

Diamantopoulos, E.; Walkinshaw, M.; Harter, T.; O'Geen, A. T.

2017-12-01

Groundwater resources are very important for California's economic development and environmental sustainability. Nitrate is by far the most widespread anthropogenic groundwater pollutant in California's mostly alluvial groundwater basins. Major sources are synthetic fertilizer and dairy manure, but also septic systems and urban wastewater effluent. Here, we evaluate agricultural soils in California according to their risk for nitrate leaching. We conducted over 1 million numerical simulations taking into account the effect of climate, crop type, irrigation and fertilization management scenarios across all 4,568 agricultural soil profiles occurring in California. The assessment was done solving 1-D Richards equation and the advection-dispersion equation numerically. This study is focused on the complex water and nitrate dynamics occurring at the shallow vadose zone (rootzone). The results of this study allow the construction of state-wide maps which can be used for the identification of high-risk regions and the design of agricultural nutrient management policy. We investigate how pollution risk can be minimized by adopting simple irrigation and fertilization methods. Furthermore, we show that these methods are more effective for the most permeable soil profiles along with high demanding crops in terms of fertilization amount and irrigation water. We also present how seasonal (winter) climate conditions contribute on nitrate leaching.

Electricity decision-making: New techniques for calculating statewide economic impacts from new power supply and demand-side management programs

Science.gov (United States)

Tegen, Suzanne Isabel Helmholz

This dissertation introduces new techniques for calculating and comparing statewide economic impacts from new coal, natural gas and wind power plants, as well as from demand-side management programs. The impetus for this work was two-fold. First, reviews of current literature and projects revealed that there was no standard way to estimate statewide economic impacts from new supply- and demand-side electricity options. Second, decision-makers who were interviewed stated that they were overwhelmed with data in general, but also lacked enough specific information about economic development impacts to their states from electricity, to make informed choices. This dissertation includes chapters on electricity decision-making and on economic impacts from supply and demand. The supply chapter compares different electricity options in three states which vary in natural resource content: Arizona, Colorado and Michigan. To account for differing capacity factors, resources are compared on a per-megawatt-hour basis. The calculations of economic impacts from new supply include: materials and labor for construction, operations, maintenance, fuel extraction, fuel transport, as well as property tax, financing and landowner revenues. The demand-side chapter compares residential, commercial and industrial programs in Iowa. Impact calculations include: incremental labor and materials for program planning, installation and operations, as well as sales taxes and electricity saved. Results from supply-side calculations in the three states analyzed indicate that adding new wind power can have a greater impact to a state's economy than adding new gas or coal power due to resource location, taxes and infrastructure. Additionally, demand-side management programs have a higher relative percentage of in-state dollar flow than supply-side solutions, though demand-side programs typically involve fewer MWh and dollars than supply-side generation. Methods for this dissertation include researching

Use of a Novel Accounting and Grouping Method for Major Trunk Injury-Analysis of Data from a Statewide Trauma Financial Survey.

Science.gov (United States)

Joubert, Kyla D; Mabry, Charles D; Kalkwarf, Kyle J; Betzold, Richard D; Spencer, Horace J; Spinks, Kara M; Porter, Austin; Karim, Saleema; Robertson, Ronald D; Sutherland, Michael J; Maxson, Robert T

2016-09-01

Major trunk trauma is common and costly, but comparisons of costs between trauma centers (TCs) are rare. Understanding cost is essential to improve quality, manage trauma service lines, and to facilitate institutional commitment for trauma. We have used results of a statewide trauma financial survey of Levels I to IV TC to develop a useful grouping method for costs and clinical characteristics of major trunk trauma. The trauma financial survey collected billing and clinical data on 75 per cent of the state trauma registry patients for fiscal year 2012. Cost was calculated by separately accounting for embedded costs of trauma response and verification, and then adjusting reasonable costs from the Medicare cost report for each TC. The cost-to-charge ratios were then recalculated and used to determine uniform cost estimates for each patient. From the 13,215 patients submitted for the survey, we selected 1,094 patients with major trunk trauma: lengths of stay ≥ 48 hours and a maximum injury of AIS ≥3 for either thorax or abdominal trauma. These patients were then divided into three Injury Severity Score (ISS) groups of 9 to 15, 16 to 24, or 25+ to stratify patients into similar injury groups for analysis of cost and cost drivers. For abdominal injury, average total cost for patients with ISS 9 to 15 was $17,429. Total cost and cost per day increased with severity of injury, with $51,585 being the total cost for those with ISS 25. Similar trends existed for thoracic injury. Use of the Medicare cost report and cost-to-charge ratios to compute uniform costs with an innovative grouping method applied to data collected across a statewide trauma system provides unique information regarding cost and outcomes, which affects quality improvement, trauma service line management, and decisions on TC participation.

How statewide LGB policies go from ‘‘under our skin’’ to ‘‘into our hearts’’: fatherhood aspirations and psychological well-being among emerging adult sexual minority men.

Science.gov (United States)

Bauermeister, José A

2014-08-01

Researchers have noted increasingly the public health importance of addressing discriminatory policies towards lesbian, gay, and bisexual (LGB) populations. At present, however, we know little about the mechanisms through which policies affect LGB populations’ psychological well-being; in other words, how do policies get under our skin? Using data from a study of sexual minority young men (N = 1,487; M = 20.80 (SD = 1.93); 65% White; 92% gay), we examined whether statewide bans (e.g., same-sex marriage, adoption) moderated the relationship between fatherhood aspirations and psychological well-being. Fatherhood aspirations were associated with lower depressive symptoms and higher self-esteem scores among participants living in states without discriminatory policies. In states with marriage equality bans, fatherhood aspirations were associated with higher depressive symptoms and lower self-esteem scores, respectively. Fatherhood aspirations were associated negatively with self-esteem in states banning same-sex and second parent adoptions, respectively. Our findings underscore the importance of recognizing how anti-equality LGB policies may influence the psychosocial development of sexual minority men.

Statewide dissemination of a rural, non-chain restaurant intervention: adoption, implementation and maintenance

Science.gov (United States)

Nothwehr, F.; Haines, H.; Chrisman, M.; Schultz, U.

2014-01-01

The obesity epidemic calls for greater dissemination of nutrition-related programs, yet there remain few studies of the dissemination process. This study, guided by elements of the RE-AIM model, describes the statewide dissemination of a simple, point-of-purchase restaurant intervention. Conducted in rural counties of the Midwest, United States, the study targeted randomly selected, non-chain, family-style restaurants. Owners were recruited through mail, then telephone follow-up. Data were collected through telephone at baseline, and 3, 6, 12 and 18 months post-adoption. Using mixed methods, measures captured the program adoption rate, characteristics of adopters and non-adopters, program implementation and maintenance issues, and owner and customer satisfaction. Analyses involved descriptive statistics and summaries of qualitative data. The program adoption rate was 28%. Adopters were similar to responding non-adopters demographically, but varied in attitudes. The majority of restaurants maintained the program for at least 12 months. Adopters and their customers expressed satisfaction with the program. With some adjustments, the RE-AIM model was helpful in guiding evaluation of this process. Results provide implications for future dissemination of this and other programs with regard to research procedures and potential barriers that may be encountered. Research on alternative strategies for widespread dissemination of such programs is needed in this and other settings. PMID:24650944

Addressing College Drinking as a Statewide Public Health Problem: Key Findings From the Maryland Collaborative.

Science.gov (United States)

Arria, Amelia M; Jernigan, David H

2018-03-01

Excessive drinking among college students is a serious and pervasive public health problem. Although much research attention has focused on developing and evaluating evidence-based practices to address college drinking, adoption has been slow. The Maryland Collaborative to Reduce College Drinking and Related Problems was established in 2012 to bring together a network of institutions of higher education in Maryland to collectively address college drinking by using both individual-level and environmental-level evidence-based approaches. In this article, the authors describe the findings of this multilevel, multicomponent statewide initiative. To date, the Maryland Collaborative has succeeded in providing a forum for colleges to share knowledge and experiences, strengthen existing strategies, and engage in a variety of new activities. Administration of an annual student survey has been useful for guiding interventions as well as evaluating progress toward the Maryland Collaborative's goal to measurably reduce high-risk drinking and its radiating consequences on student health, safety, and academic performance and on the communities surrounding college campuses. The experiences of the Maryland Collaborative exemplify real-world implementation of evidence-based approaches to reduce this serious public health problem.

Applying a statewide geospatial leaching tool for assessing soil vulnerability ratings for agrochemicals across the contiguous United States.

Science.gov (United States)

Ki, Seo Jin; Ray, Chittaranjan; Hantush, Mohamed M

2015-06-15

A large-scale leaching assessment tool not only illustrates soil (or groundwater) vulnerability in unmonitored areas, but also can identify areas of potential concern for agrochemical contamination. This study describes the methodology of how the statewide leaching tool in Hawaii modified recently for use with pesticides and volatile organic compounds can be extended to the national assessment of soil vulnerability ratings. For this study, the tool was updated by extending the soil and recharge maps to cover the lower 48 states in the United States (US). In addition, digital maps of annual pesticide use (at a national scale) as well as detailed soil properties and monthly recharge rates (at high spatial and temporal resolutions) were used to examine variations in the leaching (loads) of pesticides for the upper soil horizons. Results showed that the extended tool successfully delineated areas of high to low vulnerability to selected pesticides. The leaching potential was high for picloram, medium for simazine, and low to negligible for 2,4-D and glyphosate. The mass loadings of picloram moving below 0.5 m depth increased greatly in northwestern and central US that recorded its extensive use in agricultural crops. However, in addition to the amount of pesticide used, annual leaching load of atrazine was also affected by other factors that determined the intrinsic aquifer vulnerability such as soil and recharge properties. Spatial and temporal resolutions of digital maps had a great effect on the leaching potential of pesticides, requiring a trade-off between data availability and accuracy. Potential applications of this tool include the rapid, large-scale vulnerability assessments for emerging contaminants which are hard to quantify directly through vadose zone models due to lack of full environmental data. Copyright © 2015 Elsevier Ltd. All rights reserved.

Strengthening Knowledge Co-Production Capacity: Examining Interest in Community-University Partnerships

Directory of Open Access Journals (Sweden)

Kathleen P. Bell

2013-09-01

Full Text Available Building successful, enduring research partnerships is essential for improving links between knowledge and action to address sustainability challenges. Communication research can play a critical role in fostering more effective research partnerships, especially those concerned with knowledge co-production processes. This article focuses on community-university research partnerships and factors that influence participation in the co-production process. We identify specific pathways for improving partnership development through a prospective analytical approach that examines community officials’ interest in partnering with university researchers. Using survey responses from a statewide sample of Maine municipal officials, we conduct a statistical analysis of community-university partnership potential to test a conceptual model of partnership interest grounded in natural resource management theory and environmental communication. Our findings both support and advance prior research on collaborations. Results reveal that belief in the helpfulness of the collaborator to solve problems, institutional proximity, familiarity, perceived problem severity and problem type and trust influence interest in developing community-university partnerships. These findings underscore the benefits of proactively assessing partnership potential prior to forming partnerships and the important roles for communication research within sustainability science, especially with regard to strengthening partnership formation and knowledge co-production processes.

A Prevalence Study of Intestinal Parasites in Southern Belize

Science.gov (United States)

2000-11-15

1999 -. Belize. , Vol. 2000. http://www.odci.gov/cia/publications/nsolo/factbook/bh .htm. Crompton, D. W. (1999). How much human helminthiasis is...environmental predictors of soil-transmitted helminthiasis in a rural community in Malaysia. Southeast Asian J Trop Med Public Health 28, 811-5. Hilman, R. S...transmitted helminthiasis and schistosomiasis at community level." World Health Organization, Geneva. 153 Muller, R. (1981). "Introduction to helminthology

Predicting Citizen Satisfaction with Government Services in Belize

Science.gov (United States)

2015-03-26

foreign country. These activities are limited to medical assistance in areas where services are not available, construction of surface transportation...also supports the conclusion that reconstruction spending outside of CERP, which accounted for approximately 90% of the funds expensed over the...thousand per citizen (CIA: The World Factbook, 2014). The largest sector of Belize’s economy is tourism , which accounts for 33.2% of the GDP and 30.1

Effectiveness of a Statewide Abusive Head Trauma Prevention Program in North Carolina.

Science.gov (United States)

Zolotor, Adam J; Runyan, Desmond K; Shanahan, Meghan; Durrance, Christine Piette; Nocera, Maryalice; Sullivan, Kelly; Klevens, Joanne; Murphy, Robert; Barr, Marilyn; Barr, Ronald G

2015-12-01

Abusive head trauma (AHT) is a serious condition, with an incidence of approximately 30 cases per 100,000 person-years in the first year of life. To assess the effectiveness of a statewide universal AHT prevention program. In total, 88.29% of parents of newborns (n = 405 060) in North Carolina received the intervention (June 1, 2009, to September 30, 2012). A comparison of preintervention and postintervention was performed using nurse advice line telephone calls regarding infant crying (January 1, 2005, to December 31, 2010). A difference-in-difference analysis compared AHT rates in the prevention program state with those of other states before and after the implementation of the program (January 1, 2000, to December 31, 2011). The Period of PURPLE Crying intervention, developed by the National Center on Shaken Baby Syndrome, was delivered by nurse-provided education, a DVD, and a booklet, with reinforcement by primary care practices and a media campaign. Changes in proportions of telephone calls for crying concerns to a nurse advice line and in AHT rates per 100,000 infants after the intervention (June 1, 2009, to September 30, 2011) in the first year of life using hospital discharge data for January 1, 2000, to December 31, 2011. In the 2 years after implementation of the intervention, parental telephone calls to the nurse advice line for crying declined by 20% for children younger than 3 months (rate ratio, 0.80; 95% CI, 0.73-0.87; P programmatic efforts and evaluation are needed to demonstrate an effect on AHT rates.

Methicillin-resistant Staphylococcus aureus in Saarland, Germany: a statewide admission prevalence screening study.

Directory of Open Access Journals (Sweden)

Mathias Herrmann

Full Text Available BACKGROUND: The screening of hospital admission patients for methicillin resistant Staphylococcus aureus (MRSA is of undisputed value in controlling and reducing the overall MRSA burden; yet, a concerted parallel universal screening intervention throughout all hospitals of an entire German Federal State has not yet been performed. METHODOLOGY/PRINCIPAL FINDINGS: During a four-week period, all 24 acute care hospitals of the State of Saarland participated in admission prevalence screening. Overall, 436/20,027 screened patients revealed MRSA carrier status (prevalence, 2.2/100 patients with geriatrics and intensive care departments associated with highest prevalence (7.6/100 and 6.3/100, respectively. Risk factor analysis among 17,975 admission patients yielded MRSA history (OR, 4.3; CI₉₅ 2.7-6.8, a skin condition (OR, 3.2; CI₉₅ 2.1-5.0, and/or an indwelling catheter (OR, 2.2; CI₉₅ 1.4-3.5 among the leading risks. Hierarchical risk factor ascertainment of the six risk factors associated with highest odd's ratios would require 31% of patients to be laboratory screened to allow for detection of 67% of all MRSA positive admission patients in the State. CONCLUSIONS/SIGNIFICANCE: State-wide admission prevalence screening in conjunction with risk factor ascertainment yields important information on the distribution of the MRSA burden for hospitals, and allows for data-based decisions on local or institutional MRSA screening policies considering risk factor prevalence and expected MRSA identification rates.

Impact of Maine's statewide nutrition policy on high school food environments.

Science.gov (United States)

Whatley Blum, Janet E; Beaudoin, Christina M; O'Brien, Liam M; Polacsek, Michele; Harris, David E; O'Rourke, Karen A

2011-01-01

We assessed the effect on the food environments of public high schools of Maine's statewide nutrition policy (Chapter 51), which banned "foods of minimal nutritional value" (FMNV) in public high schools that participated in federally funded meal programs. We documented allowable exceptions to the policy and describe the school food environments. We mailed surveys to 89 high school food-service directors to assess availability pre-Chapter 51 and post-Chapter 51 of soda, other sugar-sweetened beverages, and junk food. Frequency data were tabulated pre-Chapter 51 and post-Chapter 51, and Fisher exact test was used to assess significance in changes. We conducted food and beverage inventories at 11 high schools. The survey return rate was 61% (N = 54). Availability of soda in student vending significantly decreased pre-Chapter 51 versus post-Chapter 51 (P = .04). No significant changes were found for other sugar-sweetened beverages and junk food. Exceptions to Chapter 51 were permitted to staff (67%), to the public (86%), and in career and technical education programs (31%). Inventories in a subset of schools found no availability of soda for students, whereas other sugar-sweetened beverages and junk food were widely available in à la carte, vending machines, and school stores. Candy, considered a FMNV, was freely available. Soda advertisement on school grounds was common. Student vending choices improved after the implementation of Chapter 51; however, use of FMNV as the policy standard may be limiting, as availability of other sugar-sweetened beverages and junk food was pervasive. School environments were not necessarily supportive of the policy, as advertisement of soda was common and some FMNV were available. Furthermore, local exceptions to Chapter 51 likely reduced the overall effect of the policy.

Spatially quantifying and attributing 17 years of land cover change to examine post-agricultural forest transition in Hawai`i

Science.gov (United States)

Lucas, M.; Trauernicht, C.; Carlson, K. M.; Miura, T.; Giambelluca, T. W.; Chen, Q.

2017-12-01

The past decades in Hawaii have seen large scale land use change and land cover shifts. However, much these dynamics are only described anecdotally or studied at a single locale, with little information on the extent, rate, or direction of change. This lack of data hinders any effort to assess, plan, and prioritize land management. To improve assessments of statewide vegetation and land cover change, this project developed high resolution, sub-pixel, percent cover maps of forest, grassland and bare earth at annual time steps from 1999 to 2016. Vegetation cover was quantified using archived LANDSAT imagery and a custom remote-sensing algorithm developed in the Google Earth Engine platform. A statistical trend analysis of annual maps of the these three proportional land covers were then used to detect land cover transitions across the archipelago. The aim of this work focused on quantifying the total area of change, annual rates of change and final vegetation cover outcomes statewide. Additionally these findings were attributed to past and current land uses and management history by compiling spatial datasets of development, agriculture, forest restoration sites and burned areas statewide. Results indicated that nearly 10% of the state's land surfaces are suspected to have transitioned between the three cover classes during the study period. Total statewide net change resulted in a gain in forest cover with largest areas of change occurring in unmanaged areas, current and past pastoral land, commercial forestry and abandoned cultivated land. The fastest annual rates of change were forest increases that occurred in restoration areas and commercial forestry. These findings indicate that Hawaii is going through a forest transition, primarily driven by agricultural abandonment with likely feedbacks from invasive species, but also influenced by the establishment of forestry production on former agricultural lands that show potential for native forest restoration. These

Adding evidence-based behavioral weight loss strategies to a statewide wellness campaign: a randomized clinical trial.

Science.gov (United States)

Leahey, Tricia M; Thomas, Graham; Fava, Joseph L; Subak, Leslee L; Schembri, Michael; Krupel, Katie; Kumar, Rajiv; Weinberg, Brad; Wing, Rena R

2014-07-01

We determined the efficacy and cost-effectiveness of adding an evidence-based Internet behavioral weight loss intervention alone or combined with optional group sessions to ShapeUp Rhode Island 2011 (SURI), a 3-month statewide wellness campaign. We randomized participants (n = 230; body mass index = 34.3 ±6.8 kg/m(2); 84% female) to the standard SURI program (S) or to 1 of 2 enhanced programs: SURI plus Internet behavioral program (SI) or SI plus optional group sessions (SIG). The primary outcome was weight loss at the end of the 3-month program. Weight losses differed among all 3 conditions (S: 1.1% ±0.9%; SI: 4.2% ±0.6%; SIG: 6.1% ±0.6%; Ps ≤ .04). Both SI and SIG increased the percentage of individuals who achieved a 5% weight loss (SI: 42%; SIG: 54%; S: 7%; Ps < .001). Cost per kilogram of weight loss was similar for S ($39) and SI ($35); both were lower than SIG ($114). Although weight losses were greatest at the end of SURI with optional group sessions, the addition of an Internet behavioral program was the most cost-effective method to enhance weight losses.

EIT Course via Statewide TV

Science.gov (United States)

Marstrander, Jan H.; Talbot, Thomas F.

1975-01-01

Discusses the television broadcasting of a refresher course in mathematics and engineering fundamentals for those preparing to take the Engineer-in-Training (EIT) State Board Examination in Alabama. (MLH)

Family-friendliness in Medical Studies in Baden-Württemberg. Results of a state-wide study.

Science.gov (United States)

Niehues, Johanna; Prospero, Katrin; Fegert, Jörg M; Liebhardt, Hubert

2012-01-01

This paper describes the results of the study on "Family-friendliness of the Medical Studies in Baden-Württemberg" carried out in 2009-2011 by the working group "Family, Time policy and E-Learning" of the University Hospital of Ulm, supported by the Ministry of Science, Research and the Arts of Baden-Württemberg. This state-wide survey of the studying conditions and personal circumstances of medical students with children at the five medical schools in Baden-Württemberg aims to describe existing and necessary factors of family-friendliness. A total of 238 students with children participated in the quantitative online survey conducted during the summer semester 2010 which was based on topics from previous qualitative interviews with student parents.The data shows that even though founding a family while at university is usually planned, student parents are faced with significant compatibility issues, demonstrating the need for additional measures to individualise course organisation and to make the curriculum more flexible. At the same time, the need to significantly increase information and advisory services alongside the establishment of additional support services for student parents is discernable. The study contributes to the debate on the family-friendliness of universities and university hospitals and adds practice-oriented approaches to solutions.

Effects of a Statewide Protocol for the Management of Peritoneal Dialysis-Related Peritonitis on Microbial Profiles and Antimicrobial Susceptibilities: A Retrospective Five-Year Review.

Science.gov (United States)

McGuire, Amanda L; Carson, Christine F; Inglis, Timothy J J; Chakera, Aron

2015-12-01

♦ Peritonitis is a major complication of peritoneal dialysis (PD) and is associated with significant morbidity and mortality. Early empirical antibiotic therapy is recommended, with the choice of agents guided by local resistance patterns. As routine use of specific antimicrobial agents can drive resistance, regular assessment of causative organisms and their susceptibility to empirical therapy is essential. ♦ We conducted a retrospective review of all PD peritonitis cases and positive PD fluid cultures obtained over a 5-year period in Western Australia following the introduction of a statewide protocol for the initial management of PD peritonitis with intraperitoneal vancomycin and gentamicin. ♦ The incidence of PD peritonitis decreased from 1 in 16 patient months (0.75/year at risk) to 1 in 29 patient months (0.41/year at risk) over the 5 years. There were 1,319 culture-positive samples and 1,069 unique isolates identified. Gram-positive bacteria accounted for 69.9% of positive cultures, with vancomycin resistance averaging 2% over the study period. Gram-negative bacteria accounted for 25.4% of positive cultures, with gentamicin resistance identified in an average of 8% of organisms. No increase in antimicrobial resistance to vancomycin or gentamicin occurred over the 5 years and there was no change in the proportion of gram-positive (69.9%), gram-negative (25.4%) or fungal (4.4%) organisms causing PD peritonitis. ♦ Over time, the peritonitis rates have dramatically improved although the profile of causative organisms remains similar. Empirical treatment of PD peritonitis with intraperitoneal vancomycin and gentamicin remains efficacious, with high levels of susceptibility and no evidence that the introduction of this statewide empirical PD peritonitis treatment protocol is driving resistance to these agents. Copyright © 2015 International Society for Peritoneal Dialysis.

U.S. nuclear plant statistics, 8th Edition

International Nuclear Information System (INIS)

Anon.

1993-01-01

Wolf Creek was the lowest cost nuclear plant in 1992 according to the annual plant rankings in UDI's comprehensive annual statistical factbook for US nuclear power plants (operating, under construction, deferred, canceled or retired). The book covers operating and maintenance expenses for the past year (1992), annual and lifetime performance statistics, capitalization expenses and changes in capitalization, construction cost information, joint ownership of plants and canceled plants. First published for CY1984 statistics

Michigan Pharmacists Transforming Care and Quality: Developing a Statewide Collaborative of Physician Organizations and Pharmacists to Improve Quality of Care and Reduce Costs.

Science.gov (United States)

Choe, Hae Mi; Lin, Alexandra Tungol; Kobernik, Kathleen; Cohen, Marc; Wesolowicz, Laurie; Qureshi, Nabeel; Leyden, Tom; Share, David A; Darland, Rozanne; Spahlinger, David A

2018-04-01

Inappropriate drug use, increasing complexity of drug regimens, continued pressure to control costs, and focus on shared accountability for clinical measures drive the need to leverage the medication expertise of pharmacists in direct patient care. A statewide strategy based on the collaboration of pharmacists and physicians regarding patient care was developed to improve disease state management and medication-related outcomes. Blue Cross Blue Shield of Michigan (BCBSM) partnered with Michigan Medicine to develop and implement a statewide provider-payer program called Michigan Pharmacists Transforming Care and Quality (MPTCQ), which integrates pharmacists within physician practices throughout the state of Michigan. As the MPTCQ Coordinating Center, Michigan Medicine established an infrastructure integrating clinical pharmacists into direct patient care within patient-centered medical home (PCMH) practices and provides direction and guidance for quality and process improvement across physician organizations (POs) and their affiliated physician practices. The primary goal of MPTCQ is to improve patient care and outcomes related to Medicare star ratings and HEDIS measures through integration of clinical pharmacists into direct patient care. The short-term goal is to adopt and modify Michigan Medicine's integrated pharmacist practice model at participating POs, with the long-term goal of developing a sustainable model of pharmacist integration at each PO to improve patient care and outcomes. Initially, pharmacists are delivering disease management (diabetes, hypertension, and hyperlipidemia) and comprehensive medication review services with future plans to expand clinical services. In 2015, 10 POs participated in year 1 of the program. In collaboration with the MPTCQ Coordinating Center, each PO identified 1 "pharmacist transformation champion" (PTC). The PTC implemented the integrated pharmacist model at 2 or 3 practice sites with at least 2 practicing physicians per

WiFi RFID demonstration for resource tracking in a statewide disaster drill.

Science.gov (United States)

Cole, Stacey L; Siddiqui, Javeed; Harry, David J; Sandrock, Christian E

2011-01-01

To investigate the capabilities of Radio Frequency Identification (RFID) tracking of patients and medical equipment during a simulated disaster response scenario. RFID infrastructure was deployed at two small rural hospitals, in one large academic medical center and in two vehicles. Several item types from the mutual aid equipment list were selected for tracking during the demonstration. A central database server was installed at the UC Davis Medical Center (UCDMC) that collected RFID information from all constituent sites. The system was tested during a statewide disaster drill. During the drill, volunteers at UCDMC were selected to locate assets using the traditional method of locating resources and then using the RFID system. This study demonstrated the effectiveness of RFID infrastructure in real-time resource identification and tracking. Volunteers at UCDMC were able to locate assets substantially faster using RFID, demonstrating that real-time geolocation can be substantially more efficient and accurate than traditional manual methods. A mobile, Global Positioning System (GPS)-enabled RFID system was installed in a pediatric ambulance and connected to the central RFID database via secure cellular communication. This system is unique in that it provides for seamless region-wide tracking that adaptively uses and seamlessly integrates both outdoor cellular-based mobile tracking and indoor WiFi-based tracking. RFID tracking can provide a real-time picture of the medical situation across medical facilities and other critical locations, leading to a more coordinated deployment of resources. The RFID system deployed during this study demonstrated the potential to improve the ability to locate and track victims, healthcare professionals, and medical equipment during a region-wide disaster.

The significance of recruiting underrepresented minorities in medicine: an examination of the need for effective approaches used in admissions by higher education institutions

Directory of Open Access Journals (Sweden)

Obed Figueroa

2014-09-01

Full Text Available The purpose of this paper is to examine the significance of recruiting underrepresented minorities in medicine (URM. This would include African Americans, Hispanics, and Native Americans. The research findings support the belief that URMs, upon graduating, are more likely to become practitioners in underserved communities, thereby becoming a resource that prompts us to find effective ways to help increase their college enrollments statewide. This paper analyzes the recruitment challenges for institutions, followed by a review of creative and effective approaches used by organizations and universities. The results have shown positive outcomes averaging a 50% increase in minority enrollments and retention. In other areas, such as cognitive development, modest gains were achieved in programs that were shorter in duration. The results nevertheless indicated steps in the right direction inspiring further program developments.

Costs and effects of a state-wide health promotion program in primary schools in Germany - the Baden-Württemberg Study: A cluster-randomized, controlled trial.

Directory of Open Access Journals (Sweden)

Dorothea Kesztyüs

Full Text Available To evaluate the cost-effectiveness of the state-wide implementation of the health promotion program "Join the Healthy Boat" in primary schools in Germany.Cluster-randomized intervention trial with wait-list control group. Anthropometric data of 1733 participating children (7.1 ± 0.6 years were taken by trained staff before and after a one year intervention period in the academic year 2010/11. Parents provided information about the health status, and the health behaviour of their children and themselves, parental anthropometrics, and socio-economic background variables. Incidence of abdominal obesity, defined as waist-to-height ratio (WHtR ≥ 0.5, was determined. Generalized linear models were applied to account for the clustering of data within schools, and to adjust for baseline-values. Losses to follow-up and missing data were analysed. From a societal perspective, the overall costs, costs per pupil, and incremental cost-effectiveness ratio (ICER to identify the costs per case of averted abdominal obesity were calculated.The final regression model for the incidence of abdominal obesity shows lower odds for the intervention group after an adjustment for grade, gender, baseline WHtR, and breakfast habits (odds ratio = 0.48, 95% CI [0.25; 0.94]. The intervention costs per child/year were €25.04. The costs per incidental case of averted abdominal obesity varied between €1515 and €1993, depending on the different dimensions of the target group.This study demonstrates the positive effects of state-wide, school-based health promotion on incidental abdominal obesity, at affordable costs and with proven cost-effectiveness. These results should support allocative decisions of policymakers. An early start to the prevention of abdominal obesity is of particular importance because of its close relationship to non-communicable diseases.German Clinical Trials Register (DRKS, Freiburg University, Germany, DRKS-ID: DRKS00000494.

Barriers, facilitators, and potential strategies for increasing HPV vaccination: A statewide assessment to inform action

Directory of Open Access Journals (Sweden)

Kathleen B. Cartmell

2018-06-01

Full Text Available Objective: The objective was to investigate how state level strategies in South Carolina could maximize HPV vaccine uptake. Design: An environmental scan identified barriers, facilitators, and strategies for improving HPV vaccination in South Carolina. Interviews were conducted with state leaders from relevant organizations such as public health agencies, medical associations, K-12 schools, universities, insurers, and cancer advocacy organizations. A thematic content analysis design was used. Digital interview files were transcribed, a data dictionary was created and data were coded using the data dictionary. Results: Thirty four interviews were conducted with state leaders. Barriers to HPV vaccination included lack of HPV awareness, lack of provider recommendation, HPV vaccine concerns, lack of access and practice-level barriers. Facilitators included momentum for improving HPV vaccination, school-entry Tdap requirement, pharmacy-based HPV vaccination, state immunization registry, HEDIS measures and HPV vaccine funding. Strategies for improving HPV vaccination fell into three categories: 1 addressing lack of awareness about the importance of HPV vaccination among the public and providers; 2 advocating for policy changes around HPV vaccine coverage, vaccine education, and pharmacy-based vaccination; and 3 coordination of efforts. Discussion: A statewide environmental scan generated a blueprint for action to be used to improve HPV vaccination in the state. Keywords: HPV, HPV vaccines, Cervical cancer, Prevention, Health systems, Barriers, Facilitators, Strategies, South Carolina

Seroprevalence of HCV and HIV infection among clients of the nation's longest-standing statewide syringe exchange program: A cross-sectional study of Community Health Outreach Work to Prevent AIDS (CHOW).

Science.gov (United States)

Salek, Thomas P; Katz, Alan R; Lenze, Stacy M; Lusk, Heather M; Li, Dongmei; Des Jarlais, Don C

2017-10-01

The Community Health Outreach Work to Prevent AIDS (CHOW) Project is the first and longest-standing statewide integrated and funded needle and syringe exchange program (SEP) in the US. Initiated on O'ahu in 1990, CHOW expanded statewide in 1993. The purpose of this study is to estimate the prevalences of hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infection, and to characterize risk behaviors associated with infection among clients of a long-standing SEP through the analysis of the 2012 CHOW evaluation data. A cross-sectional sample of 130 CHOW Project clients was selected from January 1, 2012 through December 31, 2012. Questionnaires captured self-reported exposure information. HIV and HCV antibodies were detected via rapid, point-of-care FDA-approved tests. Log-binomial regressions were used to estimate prevalence proportion ratios (PPRs). A piecewise linear log-binomial regression model containing 1 spline knot was used to fit the age-HCV relationship. The estimated seroprevalence of HCV was 67.7% (95% confidence interval [CI]=59.5-75.8%). HIV seroprevalence was 2.3% (95% CI=0-4.9%). Anti-HCV prevalence demonstrated age-specific patterns, ranging from 31.6% through 90.9% in people who inject drugs (PWID) HIV prevalence compared with HCV prevalence reflects differences in transmissibility of these 2 blood-borne pathogens and suggests much greater efficacy of SEP for HIV prevention. Copyright © 2017 Elsevier B.V. All rights reserved.

Outcome of the 'Drip-and-Ship' Paradigm among Patients with Acute Ischemic Stroke: Results of a Statewide Study.

Science.gov (United States)

Qureshi, Adnan I; Chaudhry, Saqib A; Rodriguez, Gustavo J; Suri, M Fareed K; Lakshminarayan, Kamakshi; Ezzeddine, Mustapha A

2012-01-01

BACKGROUND: The 'drip-and-ship' paradigm denotes a treatment regimen in patients in whom intravenous (IV) recombinant tissue plasminogen activator (rt-PA) is initiated at the emergency department (ED) of a community hospital, followed by transfer within 24 h to a comprehensive stroke center. Although the drip-and-ship paradigm has the potential to increase the number of patients who receive IV rt-PA, comparative outcomes have not been assessed at a population-based level. METHODS: Statewide estimates of thrombolysis, associated in-hospital outcomes, and hospitalization charges were obtained from 2008-2009 Minnesota Hospital Association data for all patients hospitalized with a primary diagnosis of ischemic stroke. Patients who were assigned the drip-and-ship code [International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) V45.88] were classified under the drip-and-ship paradigm. Patients who underwent thrombolysis (ICD-9-CM code 99.10) without drip-and-ship code were classified as primary ED arrival. Patient outcomes were analyzed after stratification into patients treated with IV rt-PA through primary ED arrival or drip-and-ship paradigm. RESULTS: Of the 21,024 admissions, 602 (2.86%) received IV rt-PA either through primary ED arrival (n = 473) or the drip-and-ship paradigm (n = 129). IV rt-PA was administered in 30 hospitals, of which 13 hospitals used the drip-and-ship paradigm; the number of patients treated with the drip-and-ship paradigm varied from 1 to 40 between the 13 hospitals. The rates of secondary intracerebral or subarachnoid hemorrhage were higher in patients treated with IV rt-PA through primary ED arrival compared with those treated with the drip-and-ship paradigm (8.5 vs. 3.1%, respectively; p = 0.038). The in-hospital mortality rate was similar among ischemic stroke patients receiving IV rt-PA through primary ED arrival or the drip-and-ship paradigm (5.9 vs. 7.0%, respectively). The mean hospital charges were USD

FINAL TECHNICAL REPORT FOR FORESTRY BIOFUEL STATEWIDE COLLABORATION CENTER (MICHIGAN)

Energy Technology Data Exchange (ETDEWEB)

LaCourt, Donna M.; Miller, Raymond O.; Shonnard, David R.

2012-04-24

A team composed of scientists from Michigan State University (MSU) and Michigan Technological University (MTU) assembled to better understand, document, and improve systems for using forest-based biomass feedstocks in the production of energy products within Michigan. Work was funded by a grant (DE-EE-0000280) from the U.S. Department of Energy (DOE) and was administered by the Michigan Economic Development Corporation (MEDC). The goal of the project was to improve the forest feedstock supply infrastructure to sustainably provide woody biomass for biofuel production in Michigan over the long-term. Work was divided into four broad areas with associated objectives: • TASK A: Develop a Forest-Based Biomass Assessment for Michigan – Define forest-based feedstock inventory, availability, and the potential of forest-based feedstock to support state and federal renewable energy goals while maintaining current uses. • TASK B: Improve Harvesting, Processing and Transportation Systems – Identify and develop cost, energy, and carbon efficient harvesting, processing and transportation systems. • TASK C: Improve Forest Feedstock Productivity and Sustainability – Identify and develop sustainable feedstock production systems through the establishment and monitoring of a statewide network of field trials in forests and energy plantations. • TASK D: Engage Stakeholders – Increase understanding of forest biomass production systems for biofuels by a broad range of stakeholders. The goal and objectives of this research and development project were fulfilled with key model deliverables including: 1) The Forest Biomass Inventory System (Sub-task A1) of feedstock inventory and availability and, 2) The Supply Chain Model (Sub-task B2). Both models are vital to Michigan’s forest biomass industry and support forecasting delivered cost, as well as carbon and energy balance. All of these elements are important to facilitate investor, operational and policy decisions. All

A correction factor for estimating statewide agricultural injuries from ambulance reports.

Science.gov (United States)

Scott, Erika E; Earle-Richardson, Giulia; Krupa, Nicole; Jenkins, Paul

2011-10-01

Agriculture ranks as one of the most hazardous industries in the nation. Agricultural injury surveillance is critical to identifying and reducing major injury hazards. Currently, there is no comprehensive system of identifying and characterizing fatal and serious non-fatal agricultural injuries. Researchers sought to calculate a multiplier for estimating the number of agricultural injury cases based on the number of times the farm box indicator was checked on the ambulance report. Farm injuries from 2007 that used ambulance transport were ascertained for 10 New York counties using two methods: (1) ambulance reports including hand-entered free text; and (2) community surveillance. The resulting multiplier that was developed from contrasting these two methods was then applied to the statewide Emergency Medical Services database to estimate the total number of agricultural injuries for New York state. There were 25,735 unique ambulance runs due to injuries in the 10 counties in 2007. Among these, the farm box was checked a total of 90 times. Of these 90, 63 (70%) were determined to be agricultural. Among injury runs where the farm box was not checked, an additional 59 cases were identified from the free text. Among these 122 cases (63 + 59), four were duplicates. Twenty-four additional unique cases were identified from the community surveillance for a total of 142. This yielded a multiplier of 142/90 = 1.578 for estimating all agricultural injuries from the farm box indicator. Sensitivity and specificity of the ambulance report method were 53.4% and 99.9%, respectively. This method provides a cost-effective way to estimate the total number of agricultural injuries for the state. However, it would not eliminate the more labor intensive methods that are required to identify of the actual individual case records. Incorporating an independent source of case ascertainment (community surveillance) increased the multiplier by 17%. Copyright © 2011 Elsevier Inc. All rights

Costs and effects of a state-wide health promotion program in primary schools in Germany – the Baden-Württemberg Study: A cluster-randomized, controlled trial

Science.gov (United States)

Kesztyüs, Tibor; Kilian, Reinhold; Steinacker, Jürgen M

2017-01-01

Aim To evaluate the cost-effectiveness of the state-wide implementation of the health promotion program “Join the Healthy Boat” in primary schools in Germany. Methods Cluster-randomized intervention trial with wait-list control group. Anthropometric data of 1733 participating children (7.1 ± 0.6 years) were taken by trained staff before and after a one year intervention period in the academic year 2010/11. Parents provided information about the health status, and the health behaviour of their children and themselves, parental anthropometrics, and socio-economic background variables. Incidence of abdominal obesity, defined as waist-to-height ratio (WHtR) ≥ 0.5, was determined. Generalized linear models were applied to account for the clustering of data within schools, and to adjust for baseline-values. Losses to follow-up and missing data were analysed. From a societal perspective, the overall costs, costs per pupil, and incremental cost-effectiveness ratio (ICER) to identify the costs per case of averted abdominal obesity were calculated. Results The final regression model for the incidence of abdominal obesity shows lower odds for the intervention group after an adjustment for grade, gender, baseline WHtR, and breakfast habits (odds ratio = 0.48, 95% CI [0.25; 0.94]). The intervention costs per child/year were €25.04. The costs per incidental case of averted abdominal obesity varied between €1515 and €1993, depending on the different dimensions of the target group. Conclusion This study demonstrates the positive effects of state-wide, school-based health promotion on incidental abdominal obesity, at affordable costs and with proven cost-effectiveness. These results should support allocative decisions of policymakers. An early start to the prevention of abdominal obesity is of particular importance because of its close relationship to non-communicable diseases. Trial registration German Clinical Trials Register (DRKS), Freiburg University, Germany

The Middle East. Domestic sufficiency of fossil fuel resources

Energy Technology Data Exchange (ETDEWEB)

Swegle, John A. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Kessinger, Samuel E. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

2016-08-01

In this paper, we’ve compared energy production and consumption across the broader Middle East, paying special attention to three different countries; Saudi Arabia, one of the world’s largest oil producers (second in the CIA World Factbook ranking of crude oil producing countries), with a growing population in the mid-range (47th in the world, according to the CIA World Factbook, and fifth among the nations in this region), a large GDP and GDP per capita (15th in the world, second in this region in GDP, and 21st in GDP per capita in the world, just behind the US at 19th); Qatar, the world’s fourth largest producer of natural gas, with a small native population (and a relatively large foreign labor contingent) that is very wealthy (with the world’s highest GDP per capita, more than twice that of the US); and Egypt, the most populous nation in the region (with the world’s 16th largest population), but relatively poor (with a GDP per capita of about a fifth that of the US and a twelfth that of Qatar); Egypt is a significant energy producer – 29th in the world in crude oil production and 17th in natural gas production – but production has stalled or declined in recent years, and domestic consumption has overtaken production.

Pediatric Exposures to Topical Benzocaine Preparations Reported to a Statewide Poison Control System.

Science.gov (United States)

Vohra, Rais; Huntington, Serena; Koike, Jennifer; Le, Kevin; Geller, Richard J

2017-08-01

Topical benzocaine is a local anesthetic commonly used to relieve pain caused by teething, periodontal irritation, burns, wounds, and insect bites. Oral preparations may contain benzocaine concentrations ranging from 7.5% to 20%. Pediatric exposure to such large concentrations may result in methemoglobinemia and secondarily cause anemia, cyanosis, and hypoxia. This is a retrospective study of exposures reported to a statewide poison control system. The electronic health records were queried for pediatric exposures to topical benzocaine treated at a healthcare facility from 2004 to 2014. Cases of benzocaine exposure were reviewed for demographic and clinical information, and descriptive statistical analysis was performed. The query resulted in 157 cases; 58 were excluded due to co-ingestants, or miscoding of non-benzocaine exposures. Children four years of age and younger represented the majority of cases (93%) with a median age of 1 year. There were 88 cases of accidental/ exploratory exposure, while 6 cases resulted from therapeutic application or error, 4 cases from adverse reactions, and 1 case from an unknown cause. Asymptomatic children accounted for 75.5% of cases, but major clinical effects were observed in 5 patients. Those with serious effects were exposed to a range of benzocaine concentrations (7.5-20%), with 4 cases reporting methemoglobin levels between 20.2%-55%. Methylene blue was administered in 4 of the cases exhibiting major effects. The majority of exposures were accidental ingestions by young children. Most exposures resulted in minor to no effects. However, some patients required treatment with methylene blue and admission to a critical care unit. Therapeutic application by parents or caregivers may lead to adverse effects from these commonly available products.

Real-time web-based assessment of total population risk of future emergency department utilization: statewide prospective active case finding study.

Science.gov (United States)

Hu, Zhongkai; Jin, Bo; Shin, Andrew Y; Zhu, Chunqing; Zhao, Yifan; Hao, Shiying; Zheng, Le; Fu, Changlin; Wen, Qiaojun; Ji, Jun; Li, Zhen; Wang, Yong; Zheng, Xiaolin; Dai, Dorothy; Culver, Devore S; Alfreds, Shaun T; Rogow, Todd; Stearns, Frank; Sylvester, Karl G; Widen, Eric; Ling, Xuefeng B

2015-01-13

An easily accessible real-time Web-based utility to assess patient risks of future emergency department (ED) visits can help the health care provider guide the allocation of resources to better manage higher-risk patient populations and thereby reduce unnecessary use of EDs. Our main objective was to develop a Health Information Exchange-based, next 6-month ED risk surveillance system in the state of Maine. Data on electronic medical record (EMR) encounters integrated by HealthInfoNet (HIN), Maine's Health Information Exchange, were used to develop the Web-based surveillance system for a population ED future 6-month risk prediction. To model, a retrospective cohort of 829,641 patients with comprehensive clinical histories from January 1 to December 31, 2012 was used for training and then tested with a prospective cohort of 875,979 patients from July 1, 2012, to June 30, 2013. The multivariate statistical analysis identified 101 variables predictive of future defined 6-month risk of ED visit: 4 age groups, history of 8 different encounter types, history of 17 primary and 8 secondary diagnoses, 8 specific chronic diseases, 28 laboratory test results, history of 3 radiographic tests, and history of 25 outpatient prescription medications. The c-statistics for the retrospective and prospective cohorts were 0.739 and 0.732 respectively. Integration of our method into the HIN secure statewide data system in real time prospectively validated its performance. Cluster analysis in both the retrospective and prospective analyses revealed discrete subpopulations of high-risk patients, grouped around multiple "anchoring" demographics and chronic conditions. With the Web-based population risk-monitoring enterprise dashboards, the effectiveness of the active case finding algorithm has been validated by clinicians and caregivers in Maine. The active case finding model and associated real-time Web-based app were designed to track the evolving nature of total population risk, in a

Trucks involved in fatal accidents factbook 2008.

Science.gov (United States)

2011-03-01

This document presents aggregate statistics on trucks involved in traffic accidents in 2008. The : statistics are derived from the Trucks Involved in Fatal Accidents (TIFA) file, compiled by the : University of Michigan Transportation Research Instit...

Buses involved in fatal accidents factbook 2007

Science.gov (United States)

2010-03-01

This document presents aggregate statistics on buses involved in traffic accidents in 2007. The : statistics are derived from the Buses Involved in Fatal Accidents (BIFA) file, compiled by the : University of Michigan Transportation Research Institut...

Trucks involved in fatal accidents factbook 2007.

Science.gov (United States)

2010-01-01

This document presents aggregate statistics on trucks involved in traffic accidents in 2007. The : statistics are derived from the Trucks Involved in Fatal Accidents (TIFA) file, compiled by the : University of Michigan Transportation Research Instit...

Corporate Social Responsibility in the Garment Industry. The Case of the Clean Clothes Campaign and Developing States

OpenAIRE

Wawrzyniak, Tomasz

2017-01-01

The aim of the article is to investigate the Clean Clothes Campaign (CCC) organization and its efforts to alleviate the poor situation of workers in developing states and to promote the idea of Corporate Social Responsibility. It starts with a brief example of two such developing countries, Bangladesh and Cambodia, data for which has been drawn from Eurostat, Trading Economics, and the CIA’s World Factbook. It then moves to its main focus, that is, the description of the structure of the CCC,...

Evaluating RITES, a Statewide Math and Science Partnership Program

Science.gov (United States)

Murray, D. P.; Caulkins, J. L.; Burns, A. L.; de Oliveira, G.; Dooley, H.; Brand, S.; Veeger, A.

2013-12-01

The Rhode Island Technology-Enhanced Science project (RITES) is a NSF-MSP Program that seeks to improve science education by providing professional development to science teachers at the 5th through 12th grade levels. At it's heart, RITES is a complex, multifaceted project that is challenging to evaluate because of the nature of its goal: the development of a large, statewide partnership between higher education and K12 public school districts during a time when science education strategies and leadership are in flux. As a result, these difficulties often require flexibility and creativity regarding evaluation, study design and data collection. In addition, the research agenda of the project often overlaps with the evaluator's agenda, making collaboration and communication a crucial component of the project's success. In it's 5th year, RITES and it's evaluators have developed a large number of instruments, both qualitative and quantitative, to provide direction and feedback on the effectiveness of the project's activities. RITES personnel work closely with evaluators and researchers to obtain a measure of how RITES' 'theory-of-action' affects both student outcomes and teacher practice. Here we discuss measures of teacher and student content gains, student inquiry gains, and teacher implementation surveys. Using content questions based on AAAS and MOSART databases, teachers in the short courses and students in classrooms showed significant normalized learning gains with averages generally above 0.3. Students of RITES-trained teachers also outperformed their non-RITES peers on the inquiry-section of the NECAP test, and The results show, after controlling for race and economic status, a small but statistically significant increase in test scores for RITES students. Technology use in the classroom significantly increased for teachers who were 'expected implementers' where 'expected implementers' are those teachers who implemented RITES as the project was designed. This

California drug courts: outcomes, costs and promising practices: an overview of Phase II in a statewide study.

Science.gov (United States)

Carey, Shannon M; Finigan, Michael; Crumpton, Dave; Waller, Mark

2006-11-01

The rapid expansion of drug courts in California and the state's uncertain fiscal climate highlighted the need for definitive cost information on drug court programs. This study focused on creating a research design that can be utilized for statewide and national cost-assessment of drug courts by conducting in-depth case studies of the costs and benefits in nine adult drug courts in California. A Transactional Institutional Costs Analysis (TICA) approach was used, allowing researchers to calculate costs based on every individual's transactions within the drug court or the traditional criminal justice system. This methodology also allows the calculation of costs and benefits by agency (e.g., Public Defender's office, court, District Attorney). Results in the nine sites showed that the majority of agencies save money in processing an offender though drug court. Overall, for these nine study sites, participation in drug court saved the state over 9 million dollars in criminal justice and treatment costs due to lower recidivism in drug court participants. Based on the lessons learned in Phases I and II, Phase III of this study focuses on the creation of a web-based drug court cost self-evaluation tool (DC-CSET) that drug courts can use to determine their own costs and benefits.

Pediatric Exposures to Topical Benzocaine Preparations Reported to a Statewide Poison Control System

Directory of Open Access Journals (Sweden)

Rais Vohra

2017-07-01

Full Text Available Introduction: Topical benzocaine is a local anesthetic commonly used to relieve pain caused by teething, periodontal irritation, burns, wounds, and insect bites. Oral preparations may contain benzocaine concentrations ranging from 7.5% to 20%. Pediatric exposure to such large concentrations may result in methemoglobinemia and secondarily cause anemia, cyanosis, and hypoxia. Methods: This is a retrospective study of exposures reported to a statewide poison control system. The electronic health records were queried for pediatric exposures to topical benzocaine treated at a healthcare facility from 2004 to 2014. Cases of benzocaine exposure were reviewed for demographic and clinical information, and descriptive statistical analysis was performed. Results: The query resulted in 157 cases; 58 were excluded due to co-ingestants, or miscoding of non-benzocaine exposures. Children four years of age and younger represented the majority of cases (93% with a median age of 1 year. There were 88 cases of accidental/ exploratory exposure, while 6 cases resulted from therapeutic application or error, 4 cases from adverse reactions, and 1 case from an unknown cause. Asymptomatic children accounted for 75.5% of cases, but major clinical effects were observed in 5 patients. Those with serious effects were exposed to a range of benzocaine concentrations (7.5–20%, with 4 cases reporting methemoglobin levels between 20.2%–55%. Methylene blue was administered in 4 of the cases exhibiting major effects. Conclusion: The majority of exposures were accidental ingestions by young children. Most exposures resulted in minor to no effects. However, some patients required treatment with methylene blue and admission to a critical care unit. Therapeutic application by parents or caregivers may lead to adverse effects from these commonly available products.

A statewide teleradiology system reduces radiation exposure and charges in transferred trauma patients.

Science.gov (United States)

Watson, Justin J J; Moren, Alexis; Diggs, Brian; Houser, Ben; Eastes, Lynn; Brand, Dawn; Bilyeu, Pamela; Schreiber, Martin; Kiraly, Laszlo

2016-05-01

Trauma transfer patients routinely undergo repeat imaging because of inefficiencies within the radiology system. In 2009, the virtual private network (VPN) telemedicine system was adopted throughout Oregon allowing virtual image transfer between hospitals. The startup cost was a nominal $3,000 per hospital. A retrospective review from 2007 to 2012 included 400 randomly selected adult trauma transfer patients based on a power analysis (200 pre/200 post). The primary outcome evaluated was reduction in repeat computed tomography (CT) scans. Secondary outcomes included cost savings, emergency department (ED) length of stay (LOS), and spared radiation. All data were analyzed using Mann-Whitney U and chi-square tests. P less than .05 indicated significance. Spared radiation was calculated as a weighted average per body region, and savings was calculated using charges obtained from Oregon Health and Science University radiology current procedural terminology codes. Four-hundred patients were included. Injury Severity Score, age, ED and overall LOS, mortality, trauma type, and gender were not statistically different between groups. The percentage of patients with repeat CT scans decreased after VPN implementation: CT abdomen (13.2% vs 2.8%, P < .01) and cervical spine (34.4% vs 18.2%, P < .01). Post-VPN, the total charges saved in 2012 for trauma transfer patients was $333,500, whereas the average radiation dose spared per person was 1.8 mSV. Length of stay in the ED for patients with Injury Severity Score less than 15 transferring to the ICU was decreased (P < .05). Implementation of a statewide teleradiology network resulted in fewer total repeat CT scans, significant savings, decrease in radiation exposure, and decreased LOS in the ED for patients with less complex injuries. The potential for health care savings by widespread adoption of a VPN is significant. Copyright © 2016 Elsevier Inc. All rights reserved.

Empowering High School Students in Scientific Careers: Developing Statewide Partnerships

Science.gov (United States)

Aguilar, C.; Swartz, D.

2008-05-01

Center for Multiscale Modeling of Atmospheric Processes (CMMAP) is a National Science Foundation Science and Technology Center focused on improving the representation of cloud processes in climate models. The Center is divided into three sections including Knowledge Transfer, Research, and Education and Diversity. The Science Education and Diversity mission is to educate and train people with diverse backgrounds in Climate and Earth System Science by enhancing teaching and learning and disseminating science results through multiple media. CMMAP is partnering with two local school districts to host an annual global climate conferences for high school students. The 2008 Colorado Global Climate Conference seeks "To educate students on global and local climate issues and empower them to se their knowledge." The conference is sponsored by CMMAP, The Governor's Energy Office, Poudre School District, Thompson School District, Clif Bar, and Ben and Jerry's Scoop Shop of Fort Collins. The conference seeks to inspire students to pursue future education and careers in science fields. Following an opening welcome from the Governor's Energy Office, Keynote Piers Sellers will discuss his experiences as an atmospheric scientist and NASA astronaut. Students will then attend 3 out of 16 breakout sessions including such sessions as "Hot poems, Cool Paintings, and the treasures of Antiquity of Climate Change", "Mitigation vs Adaptation", "Bigfoot Walks(What Size is our carbon footprint?)" "The Wedges: Reduc ing Carbon Emissions", and "We the People: Climate and Culture of Climate Change" to name a few. Using The Governor's High School Conference on the Environment sponsored by the Wisconsin Center for Environmental Education as a model we are developing statewide partnerships to bring high school students together to look at global climate issues that will impact their future and of which they can be part of the solution through their education and career paths. In addition to

Mothers of Very Low Birth Weight Children at School Age: Quality of Life Outcomes from the Newborn Lung Project Statewide Cohort Study

Science.gov (United States)

Witt, Whitney P.; Litzelman, Kristin; Spear, Hilary A.; Wisk, Lauren E.; Levin, Nataliya; McManus, Beth M.; Palta, Mari

2012-01-01

Purpose This study aimed to: (1) determine the health-related quality of life (HRQoL) in mothers of five year old very low birth weight (VLBW) and normal birth weight (NBW) children; (2) determine what extent stress mediates the relationship between case status and maternal HRQoL; and (3) examine the pre-pregnancy, pregnancy, birth, and child health-related factors in predicting maternal HRQoL among mothers of five year old VLBW children. Methods A telephone interview was administered to 297 mothers of VLBW children and 290 mothers of NBW children who were enrolled in the Newborn Lung Project Statewide Cohort Study. Results Mothers of VLBW children experienced worse physical and mental HRQoL than mothers of NBW children (52.8 versus 55.3 points, p<0.0001, and 48.9 versus 50.5 points, p=0.02, respectively). Adjusted analyses showed that maternal mental HRQoL was similar between cases and controls while physical HRQoL when children were age five was significantly different between cases and controls (Beta:−2.02, p=0.0006); this relationship was mediated by maternal stress. Among mothers of VLBW children, stress significantly contributed to adverse HRQoL outcomes when children were age five. Child behavior problems at age two were also associated with worse subsequent maternal mental HRQoL (Beta: −1.8 per SD, p=0.004), while each week of neonatal intensive care unit stay was associated with worse physical HRQoL (Beta: −0.26, p=0.02). Conclusions While caring for a VLBW child negatively impacts the HRQoL of mothers, this relationship was partially explained by maternal stress. Addressing maternal stress may be an important way to improve long-term HRQoL. PMID:22161725

Social assessment of siting a low-level radioactive waste storage facility in Michigan

International Nuclear Information System (INIS)

Stoffle, R.W.; Traugott, M.J.; Stone, J.V.; McIntyre, P.D.; Davidson, C.C.; Jensen, F.V.; Coover, G.E.

1990-01-01

This report presents findings from a social assessment of siting a low-level radioactive waste storage facility in Michigan. Social assessments derive from direct interaction between researchers and study participants. The report is organized into five chapters. Chapter One, Summary of Findings, focuses on key findings from the statewide telephone surveys and the in-depth ethnographic study conducted by the SNR/ISR study team. These and additional findings are discussed in greater detail in the three subsequent chapters. Chapter Two, Statewide Telephone Survey Findings, presents the knowledge, attitudes and beliefs statewide residents have regarding the LLRW project. Chapter Three, Statewide Demographic Findings, presents a detailed examination of differences among various demographic groups and includes regional analysis. Chapter Four, Hillsdale-area Ethnographic Study Findings, discusses perceived impacts of the proposed LLRW storage facility on local residents who mistakenly came to believe that their area had been specially selected as the location for the facility. Specifically, the chapter presents the development, spread, shape and persistence of what is termed a risk perception shadow in the greater Hillsdale area. Possible causes of the shadow also are discussed, and comparisons are made between statewide and Hillsdale-area survey populations. Chapter Five, Research Methods, presents a discussion of the social assessment research methods used to derive these findings

Wood products trade and foreign markets. Annual production, consumption, and trade issue. Principal countries impacting US trade in wood products. Foreign agriculture circular

International Nuclear Information System (INIS)

1993-05-01

The Forest Products Division has compiled production, consumption, and trade data on selected wood products for twenty eight significant countries. The data, collected from various sources, is not necessarily compatible with US export and import data normally published in this circular, which comes from the US Census Bureau. To supplement this data, the following perspectives offer a comparative snapshot of conditions in these countries, both in the general economy and the wood products sector. Economic information was extracted from the 1992 World Factbook; Central Intelligence Agency

Maternal symptoms of stress, depression, and anxiety are related to nonresponsive feeding styles in a statewide sample of WIC participants.

Science.gov (United States)

Hurley, Kristen M; Black, Maureen M; Papas, Mia A; Caulfield, Laura E; Caufield, Laura E

2008-04-01

Parenting, including nonresponsive feeding styles, has been related to under- or overweight among young children. The relationship between maternal mental health and feeding styles has not been examined. We hypothesized that mothers who report more symptoms of stress, depression, or anxiety report less responsive (e.g. more controlling, indulgent, and uninvolved) feeding styles than mothers who report fewer symptoms of stress, depression, or anxiety. Our analyses included 702 mother-infant pairs from a statewide sample of Special Supplemental Nutrition Program for Women, Infants, and Children mothers. We assessed maternal mental health and feeding styles by a telephone survey. After adjusting for potential confounding variables, maternal stress symptomatology was significantly associated with forceful (beta = 0.03; 95% CI = 0.02, 0.05) and uninvolved (OR = 1.4; 95% CI = 1.1, 1.7) feeding style scores, maternal depression symptomatology was significantly associated with forceful (beta = 0.03; 95% CI = 0.004, 0.05), indulgent (beta = 0.03; 95% CI = 0.004, 0.06), and uninvolved (OR = 1.5; 95% CI = 1.001, 2.2) feeding styles scores, and maternal anxiety symptomatology was significantly related to restrictive (beta = 0.11; 95% CI = 0.01, 0.21), forceful (beta = 0.04; 95% CI = 0.02, 0.06), and uninvolved (OR = 1.4; 95% CI = 1.01, 1.9) feeding style scores. Among mothers who perceived their infant as temperamentally fussy, there was a significant positive relationship between restrictive feeding styles scores and 3 indices of maternal mental health (stress, beta = 0.18; 95% CI = 0.07, 0.28; depression, beta = 0.21; 95% CI = 0.04, 0.38; and cumulative mental health symptomatology, beta = 0.29; 95% CI = 0.10, 0.48). Mothers who report stress, depression, or anxiety symptoms are at risk for nonresponsive feeding styles. These findings provide support for broadening the focus of existing child nutrition programs to include strategies that recognize how issues of maternal

Development of a model web-based system to support a statewide quality consortium in radiation oncology.

Science.gov (United States)

Moran, Jean M; Feng, Mary; Benedetti, Lisa A; Marsh, Robin; Griffith, Kent A; Matuszak, Martha M; Hess, Michael; McMullen, Matthew; Fisher, Jennifer H; Nurushev, Teamour; Grubb, Margaret; Gardner, Stephen; Nielsen, Daniel; Jagsi, Reshma; Hayman, James A; Pierce, Lori J

A database in which patient data are compiled allows analytic opportunities for continuous improvements in treatment quality and comparative effectiveness research. We describe the development of a novel, web-based system that supports the collection of complex radiation treatment planning information from centers that use diverse techniques, software, and hardware for radiation oncology care in a statewide quality collaborative, the Michigan Radiation Oncology Quality Consortium (MROQC). The MROQC database seeks to enable assessment of physician- and patient-reported outcomes and quality improvement as a function of treatment planning and delivery techniques for breast and lung cancer patients. We created tools to collect anonymized data based on all plans. The MROQC system representing 24 institutions has been successfully deployed in the state of Michigan. Since 2012, dose-volume histogram and Digital Imaging and Communications in Medicine-radiation therapy plan data and information on simulation, planning, and delivery techniques have been collected. Audits indicated >90% accurate data submission and spurred refinements to data collection methodology. This model web-based system captures detailed, high-quality radiation therapy dosimetry data along with patient- and physician-reported outcomes and clinical data for a radiation therapy collaborative quality initiative. The collaborative nature of the project has been integral to its success. Our methodology can be applied to setting up analogous consortiums and databases. Copyright © 2016 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Statewide Quality Improvement Initiative to Reduce Early Elective Deliveries and Improve Birth Registry Accuracy.

Science.gov (United States)

Kaplan, Heather C; King, Eileen; White, Beth E; Ford, Susan E; Fuller, Sandra; Krew, Michael A; Marcotte, Michael P; Iams, Jay D; Bailit, Jennifer L; Bouchard, Jo M; Friar, Kelly; Lannon, Carole M

2018-04-01

To evaluate the success of a quality improvement initiative to reduce early elective deliveries at less than 39 weeks of gestation and improve birth registry data accuracy rapidly and at scale in Ohio. Between February 2013 and March 2014, participating hospitals were involved in a quality improvement initiative to reduce early elective deliveries at less than 39 weeks of gestation and improve birth registry data. This initiative was designed as a learning collaborative model (group webinars and a single face-to-face meeting) and included individual quality improvement coaching. It was implemented using a stepped wedge design with hospitals divided into three balanced groups (waves) participating in the initiative sequentially. Birth registry data were used to assess hospital rates of nonmedically indicated inductions at less than 39 weeks of gestation. Comparisons were made between groups participating and those not participating in the initiative at two time points. To measure birth registry accuracy, hospitals conducted monthly audits comparing birth registry data with the medical record. Associations were assessed using generalized linear repeated measures models accounting for time effects. Seventy of 72 (97%) eligible hospitals participated. Based on birth registry data, nonmedically indicated inductions at less than 39 weeks of gestation declined in all groups with implementation (wave 1: 6.2-3.2%, Pinitiative, they saw significant decreases in rates of early elective deliveries as compared with wave 3 (control; P=.018). All waves had significant improvement in birth registry accuracy (wave 1: 80-90%, P=.017; wave 2: 80-100%, P=.002; wave 3: 75-100%, Pinitiative enabled statewide spread of change strategies to decrease early elective deliveries and improve birth registry accuracy over 14 months and could be used for rapid dissemination of other evidence-based obstetric care practices across states or hospital systems.

90-day Readmission After Lumbar Spinal Fusion Surgery in New York State Between 2005 and 2014: A 10-year Analysis of a Statewide Cohort.

Science.gov (United States)

Baaj, Ali A; Lang, Gernot; Hsu, Wei-Chun; Avila, Mauricio J; Mao, Jialin; Sedrakyan, Art

2017-11-15

MINI: We assessed 90-day readmission and evaluated risk factors associated with readmission after lumbar spinal fusion surgery in New York State. The overall 90-day readmission rate was 24.8%. Age, sex, race, insurance, procedure, number of operated spinal levels, health service area, and comorbidities are major risk factors for 90-day readmission. Retrospective cohort study. The aim of this study was to assess 90-day readmission and evaluate risk factors associated with readmission after lumbar fusion in New York State. Readmission is becoming an important metric for quality and efficiency of health care. Readmission and its predictors following spine surgery are overall poorly understood and limited evidence is available specifically in lumbar fusion. The New York Statewide Planning and Research Cooperative System (SPARCS) was utilized to capture patients undergoing lumbar fusion from 2005 to 2014. Temporal trend of 90-day readmission was assessed using Cochran-Armitage test. Logistic regression was used to examine predictors associated with 90-day readmission. There were 86,869 patients included in this cohort study. The overall 90-day readmission rate was 24.8%. On a multivariable analysis model, age (odds ratio [OR] comparing ≥75 versus New York-Pennsylvania border: 0.67, 95% CI: 0.61-0.73), and comorbidity, i.e., coronary artery disease (OR: 1.26, 95% CI: 1.19-1.33) were significantly associated with 90-day readmission. Directions of the odds ratios for these factors were consistent after stratification by procedure type. Age, sex, race, insurance, procedure, number of operated spinal levels, HSA, and comorbidities are major risk factors for 90-day readmission. Our study allows risk calculation to determine high-risk patients before undergoing spinal fusion surgery to prevent early readmission, improve quality of care, and reduce health care expenditures. 3.

Human bromethalin exposures reported to a U.S. Statewide Poison Control System.

Science.gov (United States)

Huntington, Serena; Fenik, Yelena; Vohra, Rais; Geller, Richard J

2016-03-01

Bromethalin is an increasingly used alternative to long-acting anticoagulant and cholecalciferol rodenticides. There are few reports of human exposures, and no existing professional society guidelines on medical management of bromethalin ingestions. The aim of this retrospective data review is to characterize bromethalin exposures reported to the California Poison Control System (CPCS) between 1997 and 2014. This is an observational retrospective case review of our statewide poison control system's electronic medical records. Following Institutional Board Review and Research Committee approvals, poison center exposures related to bromethalin were extracted using substance code and free text search strategies. Case notes of bromethalin exposures were reviewed for demographic, clinical, laboratory, and outcome information; inclusion criteria for the study was single-substance, human exposure to bromethalin. There were 129 calls related to human bromethalin exposures (three cases met exclusion criteria). The age range of cases was 7 months-90 years old, with the majority of exposures (89 cases; 70.6%), occurring in children younger than 5 years of age (median age of 2 years). Most exposures occurred in the pediatric population as a result of exploratory oral exposure. One hundred and thirteen patients (89.7%) had no effects post exposure, while 10 patients (7.9%) had a minor outcome. Adverse effects were minor, self-limited, and mostly gastrointestinal upset. There were no moderate, major, or fatal effects in our study population. The approximate ingested dose, available in six cases, ranged from 0.067 mg/kg to 0.3 mg/kg (milligrams of bromethalin ingested per kilogram of body weight), and no dose-symptom threshold could be established from this series. Exposures were not confirmed through urine or serum laboratory testing. The prognosis for most accidental ingestions appears to be excellent. However, bromethalin exposures may result in a higher number of

Prevalence of Self-Reported Lifetime History of Traumatic Brain Injury and Associated Disability: A Statewide Population-Based Survey.

Science.gov (United States)

Whiteneck, Gale G; Cuthbert, Jeffrey P; Corrigan, John D; Bogner, Jennifer A

2016-01-01

To investigate the prevalence of all severities of traumatic brain injury (TBI), regardless of treatment setting, and their associated negative outcomes. A total of 2701 adult Coloradoans. A statewide, population-based, random digit-dialed telephone survey. The lifetime history of TBI was assessed by a modification of the Ohio State University TBI Identification Method; activity limitation and life satisfaction were also assessed. The distribution of self-reported lifetime injury was as follows: 19.8%, no injury; 37.7%, injury but no TBI; 36.4%, mild TBI; and 6.0%, moderate-severe TBI. Of those reporting a TBI, 23.1% were hospitalized, 38.5% were treated in an emergency department, 9.8% were treated in a physician's office, and 27.5% did not seek medical care. A clear gradient of activity limitations and low life satisfaction was seen, with the highest proportions of these negative outcomes occurring in people reporting more severe TBI and the lowest proportions in those not reporting a TBI. Approximately twice as many people reported activity limitations and low life satisfaction after nonhospitalized TBI compared with hospitalized TBI. This investigation highlights the seriousness of TBI as a public health problem and the importance of including all severities of TBI, no matter where, or if treated, in estimating the prevalence of disability co-occurring with TBI.

Indoor smoking ordinances in workplaces and public places in Kansas.

Science.gov (United States)

Neuberger, John S; Davis, Ken; Nazir, Niaman; Dunton, Nancy; Winn, Kimberly; Jacquot, Sandy; Moler, Don

2010-08-01

The purpose of this study was to investigate the preferences of elected city officials regarding the need for a statewide clean indoor air law and to analyze the content of local smoking ordinances. A survey of elected officials in 57 larger Kansas cities obtained information on the perceived need for statewide legislation, venues to be covered, and motivating factors. Clean indoor air ordinances from all Kansas cities were analyzed by venue. The survey response rate was 190 out of 377 (50.4%) for elected officials. Over 70% of the respondents favored or strongly favored greater restrictions on indoor smoking. Sixty percent favored statewide legislation. Among these, over 80% favored restrictions in health care facilities, theaters, indoor sports arenas (including bowling alleys), restaurants, shopping malls, lobbies, enclosed spaces in outdoor arenas, and hotel/motel rooms. Officials who had never smoked favored a more restrictive approach. Employee and public health concerns were cited as influential by 76%-79% of respondents. Thirty-eight ordinances, covering over half of the state's population, were examined. They varied considerably in their exemptions. Official's attitudes toward smoking regulations were associated with their smoking status. The examination of existing ordinances revealed a piecemeal approach to smoking regulations.

Mapping one strong 'Ohana: using network analysis and GIS to enhance the effectiveness of a statewide coalition to prevent child abuse and neglect.

Science.gov (United States)

Cardazone, Gina; U Sy, Angela; Chik, Ivan; Corlew, Laura Kate

2014-06-01

Network analysis and GIS enable the presentation of meaningful data about organizational relationships and community characteristics, respectively. Together, these tools can provide a concrete representation of the ecological context in which coalitions operate, and may help coalitions identify opportunities for growth and enhanced effectiveness. This study uses network analysis and GIS mapping as part of an evaluation of the One Strong 'Ohana (OSO) campaign. The OSO campaign was launched in 2012 via a partnership between the Hawai'i Children's Trust Fund (HCTF) and the Joyful Heart Foundation. The OSO campaign uses a collaborative approach aimed at increasing public awareness of child maltreatment and protective factors that can prevent maltreatment, as well as enhancing the effectiveness of the HCTF Coalition. This study focuses on three elements of the OSO campaign evaluation: (1) Network analysis exploring the relationships between 24 active Coalition member organizations, (2) GIS mapping of responses to a randomized statewide phone survey (n = 1,450) assessing awareness of factors contributing to child maltreatment, and (3) Combined GIS maps and network data, illustrating opportunities for geographically-targeted coalition building and public awareness activities.

Stepping up to the challenge: the development, implementation, and assessment of a statewide, regional, leadership program for school nutrition directors.

Science.gov (United States)

Bergman, Jacqueline J; Briggs, Marilyn M; Beall, Deborah L; Curwood, Sandy; Gray, Pilar; Soiseth, Scott; Taylor, Rodney K; Zidenberg-Cherr, Sheri

2015-01-01

A statewide professional development program was developed and implemented throughout California for school nutrition directors with the goal of creating healthy school environments and regional networks for collaboration and healthy school environment sustainability. Needs of school nutrition directors were identified through a needs assessment questionnaire. Results of the needs assessment questionnaire (n = 256) identified (a) planning cost-effective menus; (b) reducing calories, sodium, saturated fat, and trans fat in menus; and (c) using U.S. Department of Agriculture foods cost-effectively as the most useful topics. Highest rated topics informed the content of the professional development program. A post-professional development questionnaire identified key "insights, inspirations, and strategies" as (a) marketing of school foods program, (b) expansion of salad bars, and (c) collaboration with community partners. A 6-month follow-up questionnaire identified that 86% of participants made progress toward implementing at least one of their five insights, inspirations, and strategies in their school districts. Most common areas that were implemented were marketing and branding (32%), revamping salad bars (18%), and motivating staff (16%). School and Community Actions for Nutrition survey analysis showed a significant increase in the use of marketing methods in school nutrition programs from baseline to 6-month post-program implementation (p = .024). © 2014 Society for Public Health Education.

Enhancing Clinical Content and Race/Ethnicity Data in Statewide Hospital Administrative Databases: Obstacles Encountered, Strategies Adopted, and Lessons Learned.

Science.gov (United States)

Pine, Michael; Kowlessar, Niranjana M; Salemi, Jason L; Miyamura, Jill; Zingmond, David S; Katz, Nicole E; Schindler, Joe

2015-08-01

Eight grant teams used Agency for Healthcare Research and Quality infrastructure development research grants to enhance the clinical content of and improve race/ethnicity identifiers in statewide all-payer hospital administrative databases. Grantees faced common challenges, including recruiting data partners and ensuring their continued effective participation, acquiring and validating the accuracy and utility of new data elements, and linking data from multiple sources to create internally consistent enhanced administrative databases. Successful strategies to overcome these challenges included aggressively engaging with providers of critical sources of data, emphasizing potential benefits to participants, revising requirements to lessen burdens associated with participation, maintaining continuous communication with participants, being flexible when responding to participants' difficulties in meeting program requirements, and paying scrupulous attention to preparing data specifications and creating and implementing protocols for data auditing, validation, cleaning, editing, and linking. In addition to common challenges, grantees also had to contend with unique challenges from local environmental factors that shaped the strategies they adopted. The creation of enhanced administrative databases to support comparative effectiveness research is difficult, particularly in the face of numerous challenges with recruiting data partners such as competing demands on information technology resources. Excellent communication, flexibility, and attention to detail are essential ingredients in accomplishing this task. Additional research is needed to develop strategies for maintaining these databases when initial funding is exhausted. © Health Research and Educational Trust.

The relationship between processes and outcomes for injured older adults: a study of a statewide trauma system.

Science.gov (United States)

Saillant, N N; Earl-Royal, E; Pascual, J L; Allen, S R; Kim, P K; Delgado, M K; Carr, B G; Wiebe, D; Holena, D N

2017-02-01

Age is a risk factor for death, adverse outcomes, and health care use following trauma. The American College of Surgeons' Trauma Quality Improvement Program (TQIP) has published "best practices" of geriatric trauma care; adoption of these guidelines is unknown. We sought to determine which evidence-based geriatric protocols, including TQIP guidelines, were correlated with decreased mortality in Pennsylvania's trauma centers. PA's level I and II trauma centers self-reported adoption of geriatric protocols. Survey data were merged with risk-adjusted mortality data for patients ≥65 from a statewide database, the Pennsylvania Trauma Systems Foundation (PTSF), to compare mortality outlier status and processes of care. Exposures of interest were center-specific processes of care; outcome of interest was PTSF mortality outlier status. 26 of 27 eligible trauma centers participated. There was wide variation in care processes. Four trauma centers were low outliers; three centers were high outliers for risk-adjusted mortality rates in adults ≥65. Results remained consistent when accounting for center volume. The only process associated with mortality outlier status was age-specific solid organ injury protocols (p = 0.04). There was no cumulative effect of multiple evidence-based processes on mortality rate (p = 0.50). We did not see a link between adoption of geriatric best-practices trauma guidelines and reduced mortality at PA trauma centers. The increased susceptibility of elderly to adverse consequences of injury, combined with the rapid growth rate of this demographic, emphasizes the importance of identifying interventions tailored to this population. III. Descriptive.

Evaluation of a statewide science inservice and outreach program: Teacher and student outcomes

Science.gov (United States)

Lott, Kimberly Hardiman

Alabama Science in Motion (ASIM) is a statewide in-service and outreach program designed to provide in-service training for teachers in technology and content knowledge. ASIM is also designed to increase student interest in science and future science careers. The goals of ASIM include: to complement, enhance and facilitate implementation of the Alabama Course of Study: Science, to increase student interest in science and scientific careers, and to provide high school science teachers with curriculum development and staff development opportunities that will enhance their subject-content expertise, technology background, and instructional skills. This study was conducted to evaluate the goals and other measurable outcomes of the chemistry component of ASIM. Data were collected from 19 chemistry teachers and 182 students that participated in ASIM and 6 chemistry teachers and 42 students that do not participate in ASIM using both surveys and student records. Pre-treatment Chi-Square tests revealed that the teachers did not differ in years of chemistry teaching experience, major in college, and number of classes other than chemistry taught. Pre-treatment Chi-Square tests revealed that the students did not differ in age, ethnicity, school classification, or school type. The teacher survey used measured attitudes towards inquiry-based teaching, frequency of technology used by teacher self-report and perceived teaching ability of chemistry topics from the Alabama Course of Study-Science. The student surveys used were the Test of Science Related Attitudes (TOSRA) and a modified version of the Test of Integrated Process Skills (TIPS). The students' science scores from the Stanford Achievement Test (SAT-9) were also obtained from student records. Analysis of teacher data using a MANOVA design revealed that participation in ASIM had a significantly positive effect on teacher attitude towards inquiry-based teaching and the frequency of technology used; however, there was no

The implementation and evaluation of an evidence-based statewide prehospital pain management protocol developed using the national prehospital evidence-based guideline model process for emergency medical services.

Science.gov (United States)

Brown, Kathleen M; Hirshon, Jon Mark; Alcorta, Richard; Weik, Tasmeen S; Lawner, Ben; Ho, Shiu; Wright, Joseph L

2014-01-01

In 2008, the National Highway Traffic Safety Administration funded the development of a model process for the development and implementation of evidence-based guidelines (EBGs) for emergency medical services (EMS). We report on the implementation and evaluation of an evidence-based prehospital pain management protocol developed using this model process. An evidence-based protocol for prehospital management of pain resulting from injuries and burns was reviewed by the Protocol Review Committee (PRC) of the Maryland Institute for Emergency Medical Services Systems (MIEMSS). The PRC recommended revisions to the Maryland protocol that reflected recommendations in the EBG: weight-based dosing and repeat dosing of morphine. A training curriculum was developed and implemented using Maryland's online Learning Management System and successfully accessed by 3,941 paramedics and 15,969 BLS providers. Field providers submitted electronic patient care reports to the MIEMSS statewide prehospital database. Inclusion criteria were injured or burned patients transported by Maryland ambulances to Maryland hospitals whose electronic patient care records included data for level of EMS provider training during a 12-month preimplementation period and a 12-month postimplementation period from September 2010 through March 2012. We compared the percentage of patients receiving pain scale assessments and morphine, as well as the dose of morphine administered and the use of naloxone as a rescue medication for opiate use, before and after the protocol change. No differences were seen in the percentage of patients who had a pain score documented or the percent of patients receiving morphine before and after the protocol change, but there was a significant increase in the total dose and dose in mg/kg administered per patient. During the postintervention phase, patients received an 18% higher total morphine dose and a 14.9% greater mg/kg dose. We demonstrated that the implementation of a revised

Racial and Ethnic Disparities in Health and Health Care: an Assessment and Analysis of the Awareness and Perceptions of Public Health Workers Implementing a Statewide Community Transformation Grant in Texas.

Science.gov (United States)

Akinboro, Oladimeji; Ottenbacher, Allison; Martin, Marcus; Harrison, Roderick; James, Thomas; Martin, Eddilisa; Murdoch, James; Linnear, Kim; Cardarelli, Kathryn

2016-03-01

Little is known about the awareness of public health professionals regarding racial and ethnic disparities in health in the United States of America (USA). Our study objective was to assess the awareness and perceptions of a group of public health workers in Texas regarding racial health disparities and their chief contributing causes. We surveyed public health professionals working on a statewide grant in Texas, who were participants at health disparities' training workshops. Multivariable logistic regression was employed in examining the association between the participants' characteristics and their perceptions of the social determinants of health as principal causes of health disparities. There were 106 respondents, of whom 38 and 35 % worked in health departments and non-profit organizations, respectively. The racial/ethnic groups with the highest incidence of HIV/AIDS and hypertension were correctly identified by 63 and 50 % of respondents, respectively, but only 17, and 32 % were knowledgeable regarding diabetes and cancer, respectively. Seventy-one percent of respondents perceived that health disparities are driven by the major axes of the social determinants of health. Exposure to information about racial/ethnic health disparities within the prior year was associated with a higher odds of perceiving that social determinants of health were causes of health disparities (OR 9.62; 95 % CI 2.77, 33.41). Among public health workers, recent exposure to information regarding health disparities may be associated with their perceptions of health disparities. Further research is needed to investigate the impact of such exposure on their long-term perception of disparities, as well as the equity of services and programs they administer.

Does Automated Feedback Improve Writing Quality?

Science.gov (United States)

Wilson, Joshua; Olinghouse, Natalie G.; Andrada, Gilbert N.

2014-01-01

The current study examines data from students in grades 4-8 who participated in a statewide computer-based benchmark writing assessment that featured automated essay scoring and automated feedback. We examined whether the use of automated feedback was associated with gains in writing quality across revisions to an essay, and with transfer effects…

How Instructional Coaches Support Data-Driven Decision Making: Policy Implementation and Effects in Florida Middle Schools

Science.gov (United States)

Marsh, Julie A.; McCombs, Jennifer Sloan; Martorell, Francisco

2010-01-01

This article examines the convergence of two popular school improvement policies: instructional coaching and data-driven decision making (DDDM). Drawing on a mixed methods study of a statewide reading coach program in Florida middle schools, the article examines how coaches support DDDM and how this support relates to student and teacher outcomes.…

Effects of statewide health promotion in primary schools on children's sick days, visits to a physician and parental absence from work: a cluster-randomized trial.

Science.gov (United States)

Kesztyüs, Dorothea; Lauer, Romy; Traub, Meike; Kesztyüs, Tibor; Steinacker, Jürgen Michael

2016-12-12

Based on the World Health Organization's global school health initiative we investigate intervention effects of statewide health promotion in schools on the numbers of children's sick days and visits to a physician, and parental days off work due to child illness. Cluster-randomized trial with 1-year follow-up in primary schools in the state of Baden-Württemberg, Germany. Anthropometric measurements of first and second grade school children were taken by trained staff. Parents filled in questionnaires for information about socio-demographics, health-related variables, numbers of children's sick days, visits to a physician, and days parents had to stay off work to care for a sick child. Longitudinal differences in the outcome variables were calculated between baseline and follow-up. Intraclass correlation coefficients were determined to quantify a possible clustering of data in schools. Accordingly, linear models and linear mixed models were applied to identify relationships and ascertain significances. Data from 1943 children (1 st grade n = 1024, 6.6 ± 0.4 years old; 2 nd grade n = 919, 7.6 ± 0.4 years old) were available at baseline. Unadjusted differences regarding both grades were found between mean longitudinal changes in intervention and control group in children's sick days (-3.2 ± 7.1 vs. -2.3 ± 5.6, p = 0.013), and maternal days off work (-0.9 ± 2.4 vs. -0.5 ± 2.8, p = 0.019). The intervention effect on sick days was adjusted in a linear regression for baseline values, gender and migration background and confirmed for first grade children (B = -0.83, p = 0.003). The intervention effect on maternal days off work lost its significance after adjusting for baseline values. No significant differences were detected in the numbers of children's visits to a physician and paternal days off work. School-based health promotion slightly reduces sick days in first grade children. Subsequently, parents may not

Heterogeneity among hospitals statewide in percentage shares of the annual growth of surgical caseloads of inpatient and outpatient major therapeutic procedures.

Science.gov (United States)

Dexter, Franklin; Jarvie, Craig; Epstein, Richard H

2018-04-18

Suppose that it were a generalizable finding, in both densely populated and rural states, that there is marked heterogeneity among hospitals in the percentage change in surgical caseload and/or in the total change in caseload. Then, individual hospitals should not simply rely on federal and state forecasts to infer their expected growth. Likewise, individual hospitals and their anesthesiology groups would best not rely on national or US regional surgical trends as causal reasons for local trends in caseload. We examined the potential utility of using state data on surgical caseload to predict local growth by using 6 years of data for surgical cases performed at hospitals in the States of Florida and Iowa. Observational cohort study. 303 hospitals in Iowa and Florida. Cases with major therapeutic procedures in 2010 or 2011 were compared pairwise by hospital with such cases in 2015 and 2016. Changes in counts of cases were decreases or increases, while study of growth set decreases equal to zero. Hospitals in Iowa had slightly lesser percentage changes than did hospitals in Florida (Mann-Whitney P = 0.016). Hospitals in Iowa had greater variability among hospitals in the change in counts of cases with a major therapeutic procedure than did hospitals in Florida (P < 0.0001). The 10% of hospitals with the largest growths in counts of cases accounted for approximately half of the total growth in Iowa (70%) and Florida (54%). The large share of total growth attributable to the upper 10th percentile of hospitals was not caused solely by the hospitals having large percentage growths, based on there being weak correlation between growth and percentage growth, among the hospitals that grew (Iowa: Kendall's tau = 0.286 [SE 0.120]; Florida tau = 0.253 [SE 0.064]). Even if the data from states or federal agencies reported growth in surgical cases, there is too much concentration of growth at a few hospitals for statewide growth rates to be useful for

Anthropogenic hydrological cycle disturbance at a regional scale: State-wide evapotranspiration trends (1979-2015) across Nebraska, USA

Science.gov (United States)

Szilagyi, Jozsef

2018-02-01

Trends in monthly evapotranspiration (ET) rates across Nebraska, the most intensely irrigated state within the US, were calculated by the calibration-free version of the nonlinear complementary relationship of evaporation over the 1979-2015 period utilizing North American Regional Reanalysis (NARR) net radiation, 10-m wind velocity, as well as Parameter Regression Independent Slope Model (PRISM) air- and dew-point temperature data. State-averaged modeled ET rates rose by 5.5 mm decade-1 due to the presence of wide-spread large-scale irrigation projects in accordance with a 2.4 mm decade-1 increase in PRISM precipitation (P) and a simultaneous -2.8 mm decade-1 drop in United States Geological Survey's state-averaged annual streamflow rates, raising the state-wide ET to P ratio from 0.89 to 0.91 over the modeled time-period. ET rates over irrigated crops increased by 7 mm decade-1 despite a -4.4 mm decade-1 drop in precipitation rates. A similar increase in ET rates (6 mm decade-1) required 8.1 mm decade-1 increase in precipitation rates across the non-irrigated Sand Hills of Nebraska. Published NARR ET rates are unable to pick up this unusual regional trend. Since an increase in precipitation rates should normally decrease the ET ratio, as predicted by the Budyko curve, this study yields evidence on how dramatically sustained large-scale irrigation can alter the regional hydrologic cycle not only through a) trivially depleting streamflow rates and/or lowering groundwater table levels; b) suppressing precipitation locally (while enhancing it a long distance downwind), but also; c) reversing the trajectory of the regional ET ratio under generally increasing trends of precipitation.

Statewide ban on recreational fires resulted in a significant decrease in campfire-related summer burn center admissions.

Science.gov (United States)

Hoang, David Manh; Reid, Dixie; Lentz, Christopher William

2013-01-01

Every summer, there is an increase in the number of burn injuries caused by accidents around campfires. Because of the prevalence of drought, high winds, and uncontrolled wild fires, a statewide ban on recreational fires was instituted in New Mexico from June to July 2011. We hypothesized that this legislation would have a significant impact on burn admissions caused by campfire-related injuries. A retrospective review of summer admissions to a state burn center was conducted to assess the effect of this ban on recreational fire injuries, and these data were compared with that of the previous summer when no ban was in effect. All burn admissions to a state burn center were reviewed from Memorial Day to Labor Day in 2010 and 2011. Data collected included cause, % TBSA, age, days of hospitalization, intensive care unit days, and total surface area grafted. Nonparametric statistical analysis was performed with Fisher exact test for dichotomous data and Mann-Whitney test for continuous data with significance at P fires during the study period (n = 14 [17%] in 2010 and 4 [5%] in 2011; P = .02). This resulted in a decrease in the number of patient-days from 91 in 2010 to 25 in 2011. Half of the camp fire admissions required skin grafts to definitively close the wounds (6/14 in 2010 and 2/4 in 2011). Recreational fire bans targeted at controlling wildfires during conditions favoring rapid spread were associated with a 3- to 4-fold decrease in campfire-related burn admissions. Compared with a summer when no fire ban was in effect, the number of patient-days decreased from 91 to 25.

Status of and changes in water quality monitored for the Idaho statewide surface-water-quality network, 1989—2002

Science.gov (United States)

Hardy, Mark A.; Parliman, Deborah J.; O'Dell, Ivalou

2005-01-01

The Idaho statewide surface-water-quality monitoring network consists of 56 sites that have been monitored from 1989 through 2002 to provide data to document status and changes in the quality of Idaho streams. Sampling at 33 sites has covered a wide range of flows and seasons that describe water-quality variations representing both natural conditions and human influences. Targeting additional high- or low-flow sampling would better describe conditions at 20 sites during hydrologic extremes. At the three spring site types, sampling covered the range of flow conditions from 1989 through 2002 well. However, high flows at these sites since 1989 were lower than historical high flows as a result of declining ground-water levels in the Snake River Plain. Summertime stream temperatures at 45 sites commonly exceeded 19 and 22 degrees Celsius, the Idaho maximum daily mean and daily maximum criteria, respectively, for the protection of coldwater aquatic life. Criteria exceedances in stream basins with minimal development suggest that such high temperatures may occur naturally in many Idaho streams. Suspended-sediment concentrations were generally higher in southern Idaho than in central and northern Idaho, and network data suggest that the turbidity criteria are most likely to be exceeded at sites in southern Idaho and other sections of the Columbia Plateaus geomorphic province. This is probably because this province has more fine-grained soils that are subject to erosion and disturbance by land uses than the Northern Rocky Mountains province of northern and central

Instructional, Transformational, and Managerial Leadership and Student Achievement: High School Principals Make a Difference

Science.gov (United States)

Valentine, Jerry W.; Prater, Mike

2011-01-01

This statewide study examined the relationships between principal managerial, instructional, and transformational leadership and student achievement in public high schools. Differences in student achievement were found when schools were grouped according to principal leadership factors. Principal leadership behaviors promoting instructional and…

Examining social, physical, and environmental dimensions of tornado vulnerability in Texas.

Science.gov (United States)

Siebeneck, Laura

2016-01-01

To develop a vulnerability model that captures the social, physical, and environmental dimensions of tornado vulnerability of Texas counties. Guided by previous research and methodologies proposed in the hazards and emergency management literature, a principle components analysis is used to create a tornado vulnerability index. Data were gathered from open source information available through the US Census Bureau, American Community Surveys, and the Texas Natural Resources Information System. Texas counties. The results of the model yielded three indices that highlight geographic variability of social vulnerability, built environment vulnerability, and tornado hazard throughout Texas. Further analyses suggest that counties with the highest tornado vulnerability include those with high population densities and high tornado risk. This article demonstrates one method for assessing statewide tornado vulnerability and presents how the results of this type of analysis can be applied by emergency managers towards the reduction of tornado vulnerability in their communities.

A state-wide assessment of the association between epidural analgesia, maternal fever and neonatal antibiotics in Colorado, 2007-2012.

Science.gov (United States)

White, Alice; Olson, Daniel; Messacar, Kevin

2017-03-01

To determine if an association exists between epidural analgesia, maternal fever and neonatal antibiotic exposure in a state-wide birth cohort. We performed a retrospective cohort study of the population-based Colorado Department of Public Health and Environment birth certificate database. Data included all reported births in the state of Colorado between 2007 and 2012. Live, non-preterm, vaginal, singleton, in-hospital births were included in analysis. Maternal epidural analgesia and maternal fever. Neonatal antibiotic treatment for suspected sepsis. A stratified analysis was conducted to evaluate whether epidural use was an effect modifier of the association between maternal fever and neonatal antibiotic treatment. The final cohort included 261 457 births. 2.2% of women who received an epidural had a fever, as compared with 0.4% of women who did not receive an epidural (OR: 5.4; 95% CI 4.9 to 6.0), and neonates born to women who received an epidural had 1.26 times increased odds of antibiotic treatment (95% CI 1.1 to 1.4). Stratification by epidural use did not alter the association between maternal fever and neonatal antibiotic treatment. Colorado providers treat neonates born to mothers with maternal fever without respect to whether the mother had an epidural. Further research into improved criteria for neonatal sepsis evaluation that accounts for the contribution of maternal epidural fever should be developed to decrease unnecessary neonatal antibiotic exposure. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Operability and location of Wisconsin's timber resource.

Science.gov (United States)

Jerold T. Hahn; Mark H. Hansen

1989-01-01

Data collected during the 1983 Wisconsin Statewide forest inventory were used to examine operability of the timber resource based on seven operability components. Operability is the ease or difficulty of managing or harvesting timber because of physical conditions in the stand or on the site.

Operability and location of Michigan's timber resource.

Science.gov (United States)

Mark H. Hansen; Jerold T. Hahn

1987-01-01

Operability is the ease or difficulty of managing or harvesting timber because of physical conditions in the stand or on the site. Data collected during the 1980 Michigan statewide forest inventory were used to examine operability of the timber resource based on seven operability components.

Results of Statewide TerraNova Testing, Fall 1998.

Science.gov (United States)

La Marca, Paul M.

This summary provides key findings about state, district, and school level performance on the TerraNova examinations (CTB/McGraw Hill) in Nevada in 1998-1999. The TerraNova tests are used to assess students in grades 4, 8, and 10 as stipulated by Nevada law. Within this summary, a description of performance as measured by national percentile…

Role of Surgical Services in Profitability of Hospitals in California: An Analysis of Office of Statewide Health Planning and Development Annual Financial Data.

Science.gov (United States)

Moazzez, Ashkan; de Virgilio, Christian

2016-10-01

With constant changes in health-care laws and payment methods, profitability, and financial sustainability of hospitals are of utmost importance. The purpose of this study is to determine the relationship between surgical services and hospital profitability. The Office of Statewide Health Planning and Development annual financial databases for the years 2009 to 2011 were used for this study. The hospitals' characteristics and income statement elements were extracted for statistical analysis using bivariate and multivariate linear regression. A total of 989 financial records of 339 hospitals were included. On bivariate analysis, the number of inpatient and ambulatory operating rooms (ORs), the number of cases done both as inpatient and outpatient in each OR, and the average minutes used in inpatient ORs were significantly related with the net income of the hospital. On multivariate regression analysis, when controlling for hospitals' payer mix and the study year, only the number of inpatient cases done in the inpatient ORs (β = 832, P = 0.037), and the number of ambulatory ORs (β = 1,485, 466, P = 0.001) were significantly related with the net income of the hospital. These findings suggest that hospitals can maximize their profitability by diverting and allocating outpatient surgeries to ambulatory ORs, to allow for more inpatient surgeries.

Effects of statewide health promotion in primary schools on children’s sick days, visits to a physician and parental absence from work: a cluster-randomized trial

Directory of Open Access Journals (Sweden)

Dorothea Kesztyüs

2016-12-01

Full Text Available Abstract Background Based on the World Health Organization’s global school health initiative we investigate intervention effects of statewide health promotion in schools on the numbers of children’s sick days and visits to a physician, and parental days off work due to child illness. Methods Cluster-randomized trial with 1-year follow-up in primary schools in the state of Baden-Württemberg, Germany. Anthropometric measurements of first and second grade school children were taken by trained staff. Parents filled in questionnaires for information about socio-demographics, health-related variables, numbers of children’s sick days, visits to a physician, and days parents had to stay off work to care for a sick child. Longitudinal differences in the outcome variables were calculated between baseline and follow-up. Intraclass correlation coefficients were determined to quantify a possible clustering of data in schools. Accordingly, linear models and linear mixed models were applied to identify relationships and ascertain significances. Results Data from 1943 children (1st grade n = 1024, 6.6 ± 0.4 years old; 2nd grade n = 919, 7.6 ± 0.4 years old were available at baseline. Unadjusted differences regarding both grades were found between mean longitudinal changes in intervention and control group in children’s sick days (−3.2 ± 7.1 vs. -2.3 ± 5.6, p = 0.013, and maternal days off work (−0.9 ± 2.4 vs. -0.5 ± 2.8, p = 0.019. The intervention effect on sick days was adjusted in a linear regression for baseline values, gender and migration background and confirmed for first grade children (B = −0.83, p = 0.003. The intervention effect on maternal days off work lost its significance after adjusting for baseline values. No significant differences were detected in the numbers of children’s visits to a physician and paternal days off work. Conclusions School-based health promotion

A Framework for Statewide Analysis of Site Suitability, Energy Estimation, Life Cycle Costs, Financial Feasibility and Environmental Assessment of Wind Farms: A Case Study of Indiana

Science.gov (United States)

Kumar, Indraneel

In the last decade, Midwestern states including Indiana have experienced an unprecedented growth in utility scale wind energy farms. For example, by end of 2013, Indiana had 1.5 GW of wind turbines installed, which could provide electrical energy for as many as half-a-million homes. However, there is no statewide systematic framework available for the evaluation of wind farm impacts on endangered species, required necessary setbacks and proximity standards to infrastructure, and life cycle costs. This research is guided to fill that gap and it addresses the following questions. How much land is suitable for wind farm siting in Indiana given the constraints of environmental, ecological, cultural, settlement, physical infrastructure and wind resource parameters? How much wind energy can be obtained? What are the life cycle costs and economic and financial feasibility? Is wind energy production and development in a state an emission free undertaking? The framework developed in the study is applied to a case study of Indiana. A fuzzy logic based AHP (Analytic Hierarchy Process) spatial site suitability analysis for wind energy is formulated. The magnitude of wind energy that could be sited and installed comprises input for economic and financial feasibility analysis for 20-25 years life cycle of wind turbines in Indiana. Monte Carlo simulation is used to account for uncertainty and nonlinearity in various costs and price parameters. Impacts of incentives and cost variables such as production tax credits, costs of capital, and economies of scale are assessed. Further, an economic input-output (IO) based environmental assessment model is developed for wind energy, where costs from financial feasibility analysis constitute the final demand vectors. This customized model for Indiana is used to assess emissions for criteria air pollutants, hazardous air pollutants and greenhouse gases (GHG) across life cycle events of wind turbines. The findings of the case study include

Comprehensive Family Services and Customer Satisfaction Outcomes

Science.gov (United States)

Huebner, Ruth A.; Jones, Blake L.; Miller, Viola P.; Custer, Melba; Critchfield, Becky

2006-01-01

Comprehensive Family Services (CFS) is a strengths-based and partnership-oriented approach to casework implemented through multiple initiatives. This study examines the relationship between the practice of CFS and satisfaction of clients, foster parents, and community partners. CFS indicators are paired with statewide customer satisfaction survey…

A narrative account of implementation lessons learnt from the dissemination of an up-scaled state-wide child obesity management program in Australia: PEACH™ (Parenting, Eating and Activity for Child Health) Queensland.

Science.gov (United States)

Croyden, Debbie L; Vidgen, Helen A; Esdaile, Emma; Hernandez, Emely; Magarey, Anthea; Moores, Carly J; Daniels, Lynne

2018-03-13

PEACH™QLD translated the PEACH™ Program, designed to manage overweight/obesity in primary school-aged children, from efficacious RCT and small scale community trial to a larger state-wide program. This paper describes the lessons learnt when upscaling to universal health coverage. The 6-month, family-focussed program was delivered in Queensland, Australia from 2013 to 2016. Its implementation was planned by researchers who developed the program and conducted the RCT, and experienced project managers and practitioners across the health continuum. The intervention targeted parents as the agents of change and was delivered via parent-only group sessions. Concurrently, children attended fun, non-competitive activity sessions. Sessions were delivered by facilitators who received standardised training and were employed by a range of service providers. Participants were referred by health professionals or self-referred in response to extensive promotion and marketing. A pilot phase and a quality improvement framework were planned to respond to emerging challenges. Implementation challenges included engagement of the health system; participant recruitment; and engagement. A total of 1513 children (1216 families) enrolled, with 1122 children (919 families) in the face-to-face program (105 groups in 50 unique venues) and 391 children (297 families) in PEACH™ Online. Self-referral generated 68% of enrolments. Unexpected, concurrent and, far-reaching public health system changes contributed to poor program uptake by the sector (only 56 [53%] groups delivered by publicly-funded health organisations) requiring substantial modification of the original implementation plan. Process evaluation during the pilot phase and an ongoing quality improvement framework informed program adaptations that included changing from fortnightly to weekly sessions aligned with school terms, revision of parent materials, modification of eligibility criteria to include healthy weight children and

The rare and undiagnosed diseases diagnostic service - application of massively parallel sequencing in a state-wide clinical service.

Science.gov (United States)

Baynam, Gareth; Pachter, Nicholas; McKenzie, Fiona; Townshend, Sharon; Slee, Jennie; Kiraly-Borri, Cathy; Vasudevan, Anand; Hawkins, Anne; Broley, Stephanie; Schofield, Lyn; Verhoef, Hedwig; Walker, Caroline E; Molster, Caron; Blackwell, Jenefer M; Jamieson, Sarra; Tang, Dave; Lassmann, Timo; Mina, Kym; Beilby, John; Davis, Mark; Laing, Nigel; Murphy, Lesley; Weeramanthri, Tarun; Dawkins, Hugh; Goldblatt, Jack

2016-06-11

The Rare and Undiagnosed Diseases Diagnostic Service (RUDDS) refers to a genomic diagnostic platform operating within the Western Australian Government clinical services delivered through Genetic Services of Western Australia (GSWA). GSWA has provided a state-wide service for clinical genetic care for 28 years and it serves a population of 2.5 million people across a geographical area of 2.5milion Km(2). Within this context, GSWA has established a clinically integrated genomic diagnostic platform in partnership with other public health system managers and service providers, including but not limited to the Office of Population Health Genomics, Diagnostic Genomics (PathWest Laboratories) and with executive level support from the Department of Health. Herein we describe report presents the components of this service that are most relevant to the heterogeneity of paediatric clinical genetic care. Briefly the platform : i) offers multiple options including non-genetic testing; monogenic and genomic (targeted in silico filtered and whole exome) analysis; and matchmaking; ii) is delivered in a patient-centric manner that is resonant with the patient journey, it has multiple points for entry, exit and re-entry to allow people access to information they can use, when they want to receive it; iii) is synchronous with precision phenotyping methods; iv) captures new knowledge, including multiple expert review; v) is integrated with current translational genomic research activities and best practice; and vi) is designed for flexibility for interactive generation of, and integration with, clinical research for diagnostics, community engagement, policy and models of care. The RUDDS has been established as part of routine clinical genetic services and is thus sustainable, equitably managed and seeks to translate new knowledge into efficient diagnostics and improved health for the whole community.

Social and Economic Determinants of the Level of Support for Environmental Protection and Economic Growth in a Rural Population.

Science.gov (United States)

Murdock, Steve H.; Schriner, Eldon C.

Based on a secondary analysis of data from a statewide survey of North Dakota residents conducted during the spring of 1976, this study examined the differences in levels of support for environmental protection and economic growth via respondent characteristics, respondent characteristics within residence types, and occupational and social class…

Academic Performance, Course Completion Rates, and Student Perception of the Quality and Frequency of Interaction in a Virtual High School

Science.gov (United States)

Hawkins, Abigail; Graham, Charles R.; Sudweeks, Richard R.; Barbour, Michael K.

2013-01-01

This study examined the relationship between students' perceptions of teacher-student interaction and academic performance at an asynchronous, self-paced, statewide virtual high school. Academic performance was measured by grade awarded and course completion. There were 2269 students who responded to an 18-item survey designed to measure student…

The Influence of Performance-Based Accountability on the Distribution of Teacher Salary Increases

Science.gov (United States)

Bifulco, Robert

2010-01-01

This study examines how aspects of a district's institutional and policy environment influence the distribution of teacher salary increases. The primary hypothesis tested is that statewide performance-based accountability policies influence the extent to which districts backload teacher salary increases. I use data on teacher salaries from the…

Aftershocks: The Role of State Labor Policies in Shaping Teacher Sensemaking, Satisfaction and Exit Decisions in North Carolina

Science.gov (United States)

Feldman, Rachel Carly

2017-01-01

This dissertation examines how teachers respond to state-wide labor reforms. In 2013 and 2014, the state of North Carolina drastically altered compensation for teachers. Policymakers affected labor by attempting to revoke tenure for all teachers (and succeeded in eliminating it for new teachers), discontinuing supplemental pay for advanced…

Sex, Kids, and Politics. Health Services in Schools.

Science.gov (United States)

Emihovich, Catherine; Herrington, Carolyn D.

This book examines practical, cultural, and political implications of placing health service programs in public schools, detailing three cases of Florida school districts, where a controversial statewide initiative for health services in schools recently went into effect. The plan supports programs to promote the health of medically underserved…

Guest Speakers in School-Based Sexuality Education

Science.gov (United States)

McRee, Annie-Laurie; Madsen, Nikki; Eisenberg, Marla E.

2014-01-01

This study, using data from a statewide survey (n = 332), examined teachers' practices regarding the inclusion of guest speakers to cover sexuality content. More than half of teachers (58%) included guest speakers. In multivariate analyses, teachers who taught high school, had professional preparation in health education, or who received…

Barriers to Providing the Sexuality Education That Teachers Believe Students Need

Science.gov (United States)

Eisenberg, Marla E.; Madsen, Nikki; Oliphant, Jennifer A.; Sieving, Renee E.

2013-01-01

Background: Sexuality education teachers' perspectives are important to gain a full understanding of the issues surrounding teaching this subject. This study uses a statewide sample of public school teachers to examine what sexuality education content is taught, what barriers teachers face, and which barriers are associated with teaching specific…

Economic effects of smoke-free laws on rural and urban counties in Kentucky and Ohio.

Science.gov (United States)

Pyles, Mark K; Hahn, Ellen J

2012-01-01

Numerous empirical studies have examined the influence of smoke-free legislation on economic activity, with most finding a null effect. The influence could possibly differ in rural areas relative to urban areas due to differing rates of smoking prevalence and access to prevention and treatment programs. Furthermore, the discussion of the effectiveness of smoke-free laws has been extended to consider local ordinances relative to statewide laws. This study examines these issues using 21 local laws in Kentucky and the Ohio statewide smoke-free law. The number of employees, total wages paid, and number of reporting establishments in all hospitality and accommodation services in Kentucky and Ohio counties were documented, beginning the first quarter 2001 and ending the last quarter of 2009. A generalized estimating equation time-series design is used to estimate the impact of local and state smoke-free laws in Kentucky and Ohio rural and urban counties. There is no evidence that the economies in Kentucky counties were affected in any way from the implementation of local smoke-free laws. There was also no evidence that total employment or the number of establishments was influenced by the statewide law in Ohio, but wages increased following the implementation of the law. Furthermore, there is no evidence that either rural or urban counties experienced a loss of economic activity following smoke-free legislation. The study finds no evidence that local or state smoke-free legislation negatively influences local economies in either rural or urban communities.

A statewide review of postnatal care in private hospitals in Victoria, Australia

Directory of Open Access Journals (Sweden)

Forster Della A

2010-05-01

Full Text Available Abstract Background Concerns have been raised in Australia and internationally regarding the quality and effectiveness of hospital postnatal care, although Australian women receiving postnatal care in the private maternity sector rate their satisfaction with care more highly than women receiving public maternity care. In Victoria, Australia, two-thirds of women receive their maternity care in the public sector and the remainder in private health care sector. A statewide review of public hospital postnatal care in Victoria from the perspective of care providers found many barriers to care provision including the busyness of postnatal wards, inadequate staffing and priority being given to other episodes of care; however the study did not include private hospitals. The aim of this study was replicate the review in the private sector, to explore the structure and organisation of postnatal care in private hospitals and identify those aspects of care potentially impacting on women's experiences and maternal and infant care. This provides a more complete overview of the organisational structures and processes in postnatal care in all Victorian hospitals from the perspective of care providers. Methods A mixed method design was used. A structured postal survey was sent to all Victorian private hospitals (n = 19 and key informant interviews were undertaken with selected clinical midwives, maternity unit managers and obstetricians (n = 11. Survey data were analysed using descriptive statistics and interview data analysed thematically. Results Private hospital care providers report that postnatal care is provided in very busy environments, and that meeting the aims of postnatal care (breastfeeding support, education of parents and facilitating rest and recovery for women following birth was difficult in the context of increased acuity of postnatal care; prioritising of other areas over postnatal care; high midwife-to-woman ratios; and the number and

Do Adolescents with Specific Language Impairment Understand Driving Terminology?

Science.gov (United States)

Pandolfe, Jessica M.; Wittke, Kacie; Spaulding, Tammie J.

2016-01-01

Purpose: This study examined if adolescents with specific language impairment (SLI) understand driving vocabulary as well as their typically developing (TD) peers. Method: A total of 16 adolescents with SLI and 16 TD comparison adolescents completed a receptive vocabulary task focused on driving terminology derived from statewide driver's manuals.…

Effects of Absence and Cognitive Skills Index on Various Achievement Indicators. A Study of ISTEP Scores, Discrepancies, and School-Based Math and English Tests of 1997-1998 Seventh Grade Students at Sarah Scott Middle School, Terre Haute, Indiana.

Science.gov (United States)

Davis, Holly S.

This study examines the correlation between absence, cognitive skills index (CSI), and various achievement indicators such as the Indiana Statewide Testing for Educational Progress (ISTEP) test scores, discrepancies, and school-based English and mathematics tests for 64 seventh-grade students from one middle school. Scores for each of the subtests…

Implications of a Health Careers Exploration Program for Minority Student Matriculation

Science.gov (United States)

Christie, Angelica Ellman

2017-01-01

Organizations that deliver programs to promote the entry of students from marginalized populations into the U.S. health workforce often struggle to demonstrate the effective achievement of outcomes, and face diminishing fiscal resources. This study was an empirical examination of the extent and manner that a statewide, precollege, health careers…

Associations between Sexually Experienced Adolescents' Sources of Information about Sex and Sexual Risk Outcomes

Science.gov (United States)

Secor-Turner, Molly; Sieving, Renee E.; Eisenberg, Marla E.; Skay, Carol

2011-01-01

The objective of this study was to describe prevalent informal sources of information about sex and examine associations between informal sources of information about sex and sexual risk outcomes among sexually experienced adolescents. Work involved the secondary analysis of data from the Minnesota Student Survey, a statewide survey to monitor…

Do Interim Assessments Reduce the Race and SES Achievement Gaps?

Science.gov (United States)

Konstantopoulos, Spyros; Li, Wei; Miller, Shazia R.; van der Ploeg, Arie

2017-01-01

The authors examined differential effects of interim assessments on minority and low socioeconomic status students' achievement in Grades K-6. They conducted a large-scale cluster randomized experiment in 2009-2010 to evaluate the impact of Indiana's policy initiative introducing interim assessments statewide. The authors used 2-level models to…

Contextualizing Relationship Education and Adolescent Attitude toward Sexual Behavior: Considering Class Climate

Science.gov (United States)

Morrison, Sandra U.; Adler-Baeder, Francesca; Bub, Kristen L.; Duke, Adrienne

2018-01-01

Background: Using data from a statewide relationship education (RE) program targeting a diverse adolescent sample, this study examined RE implementation in classroom environments. Objective: The purpose of this study was to explore (1) whether there is a beneficial RE program effect for change in individual attitudes toward sexual delay, (2)…

The trauma ecosystem: The impact and economics of new trauma centers on a mature statewide trauma system.

Science.gov (United States)

Ciesla, David J; Pracht, Etienne E; Leitz, Pablo T; Spain, David A; Staudenmayer, Kristan L; Tepas, Joseph J

2017-06-01

Florida serves as a model for the study of trauma system performance. Between 2010 and 2104, 5 new trauma centers were opened alongside 20 existing centers. The purpose of this study was to explore the impact of trauma system expansion on system triage performance and trauma center patients' profiles. A statewide data set was queried for all injury-related discharges from adult acute care hospitals using International Classification of Diseases, Ninth Revision (ICD-9) codes for 2010 and 2014. The data set, inclusion criteria, and definitions of high-risk injury were chosen to match those used by the Florida Department of Health in its trauma registry. Hospitals were classified as existing Level I (E1) or Level II (E2) trauma centers and new E2 (N2) centers. Five N2 centers were established 11.6 to 85.3 miles from existing centers. Field and overall trauma system triage of high-risk patients was less accurate with increased overtriage and no change in undertriage. Annual volume at N2 centers increased but did not change at E1 and E2 centers. In 2014, Patients at E1 and E2 centers were slightly older and less severely injured, while those at N2 centers were substantially younger and more severely injured than in 2010. The injured patient-payer mix changed with a decrease in self-pay and commercial patients and an increase in government-sponsored patients at E1 and E2 centers and an increase in self-pay and commercial patients with a decrease in government-sponsored patients at N2 centers. Designation of new trauma centers in a mature system was associated with a change in established trauma center demographics and economics without an improvement in trauma system triage performance. These findings suggest that the health of an entire trauma system network must be considered in the design and implementation of a regional trauma system. Therapeutic/care management study, level IV; epidemiological, level IV.

Salary and Ranking and Teacher Turnover: A Statewide Study

Science.gov (United States)

Garcia, Cynthia Martinez; Slate, John R.; Delgado, Carmen Tejeda

2009-01-01

This study examined three years of data obtained from the Academic Excellence Indicator System of the State of Texas regarding teacher turnover rate and teacher salary. Across all public school districts, teacher salary was consistently negatively related to teacher turnover; that is, where salary was lower, turnover rate was higher When data were…

A Statewide Private Microwave Wide Area Network for Real-time Natural Hazard Monitoring

Science.gov (United States)

Williams, M. C.; Kent, G.; Smith, K. D.; Plank, G.; Slater, D.; Torrisi, J.; Presser, R.; Straley, K.

2013-12-01

The Nevada Seismological Laboratory (NSL) at the University of Nevada, Reno, operates the Nevada Seismic Network, a collection of ground motion instruments installed throughout Nevada and California, for the purposes of detecting, locating, and notifying the public of earthquakes in the state. To perform these tasks effectively, NSL has designed and built a statewide wireless microwave wide-area network (WAN) in order to receive ground motion data in near real-time. This network consists of radio access points, backhauls, and backbone communication sites transmitting time-series, images, and datalogger diagnostics to our data center servers in Reno. This privately managed communication network greatly reduces the dependence on third-party infrastructure (e.g. commercial cellular networks), and is vital for emergency management response and system uptime. Any individual seismograph or data collection device is networked through a wireless point-to-multipoint connection to a remote access point (AP) using a low-cost radio/routerboard combination. Additional point-to-point connections from AP's to radio backhauls and/or mountaintop backbone sites allow the Data Center in Reno to communicate with and receive data directly from each datalogger. Dataloggers, radios, and routers can be configured using tablets on-site, or via desktop computers at the Data Center. Redundant mountaintop links can be added to the network and facilitate the re-routing of data (similar to a meshed network) in the event of a faulty, failing, or noisy communication site. All routers, radios, and servers, including those at the Data Center, have redundant power and can operate independently in the event of a grid power or public Internet outage. A managed server room at the Data Center processes earthquake data for notifications and acts as a data source for remote users. Consisting of about 500 hosts, and spanning hundreds of miles, this WAN provides network operators access to each router and

Establishment of a Web-based System for Collection of Patient-reported Outcomes After Radical Prostatectomy in a Statewide Quality Improvement Collaborative.

Science.gov (United States)

Lucas, Steven M; Kim, Tae-Kyung; Ghani, Khurshid R; Miller, David C; Linsell, Susan; Starr, Jay; Peabody, James O; Hurley, Patrick; Montie, James; Cher, Michael L

2017-09-01

To report on the establishment of a unified, electronic patient-reported outcome (PRO) infrastructure and pilot results from the first 5 practices enrolled in the web-based collection system developed by the Michigan Urological Surgery Improvement Collaborative. Eligible patients were those undergoing radical prostatectomy of 5 academic and community practices. PRO was obtained using a validated 21-item web-based questionnaire, regarding urinary function, erection function, and sexual interest and satisfaction. Data were collected preoperatively, at 3 months, and 6 months postoperatively. Patients were provided a link via email to complete the surveys. Perioperative and PRO data were analyzed as reports for individual patients and summary performance reports for individual surgeons. Among 773 eligible patients, 688 (89%) were enrolled preoperatively. Survey completion rate was 88%, 84%, and 90% preoperatively, at 3 months, and 6 months. Electronic completion rates preoperatively, at 3 months, and 6 months were 70%, 70%, and 68%, respectively. Mean urinary function scores were 18.3, 14.3, and 16.6 (good function ≥ 17), whereas mean erection scores were 18.7, 7.3, and 9.1 (good erection score ≥ 22) before surgery, at 3 months, and 6 months. Variation was noted for erectile function among the practices. Collection of electronic PRO via this unified, web-based format was successful and provided results that reflect expected recovery and identify opportunities for improvement. This will be extended to more practices statewide to improve outcomes after radical prostatectomy. Copyright © 2017 Elsevier Inc. All rights reserved.

Open access tools for quality-assured and efficient data entry in a large, state-wide tobacco survey in India.

Science.gov (United States)

Shewade, Hemant Deepak; Vidhubala, E; Subramani, Divyaraj Prabhakar; Lal, Pranay; Bhatt, Neelam; Sundaramoorthi, C; Singh, Rana J; Kumar, Ajay M V

2017-01-01

A large state-wide tobacco survey was conducted using modified version of pretested, globally validated Global Adult Tobacco Survey (GATS) questionnaire in 2015-22016 in Tamil Nadu, India. Due to resource constrains, data collection was carrid out using paper-based questionnaires (unlike the GATS-India, 2009-2010, which used hand-held computer devices) while data entry was done using open access tools. The objective of this paper is to describe the process of data entry and assess its quality assurance and efficiency. In EpiData language, a variable is referred to as 'field' and a questionnaire (set of fields) as 'record'. EpiData software was used for double data entry with adequate checks followed by validation. Teamviewer was used for remote training and trouble shooting. The EpiData databases (one each for each district and each zone in Chennai city) were housed in shared Dropbox folders, which enabled secure sharing of files and automatic back-up. Each database for a district/zone had separate file for data entry of household level and individual level questionnaire. Of 32,945 households, there were 111,363 individuals aged ≥15 years. The average proportion of records with data entry errors for a district/zone in household level and individual level file was 4% and 24%, respectively. These are the errors that would have gone unnoticed if single entry was used. The median (inter-quartile range) time taken for double data entry for a single household level and individual level questionnaire was 30 (24, 40) s and 86 (64, 126) s, respectively. Efficient and quality-assured near-real-time data entry in a large sub-national tobacco survey was performed using innovative, resource-efficient use of open access tools.

Student Assistance Program Outcomes for Students at Risk for Suicide

Science.gov (United States)

Biddle, Virginia Sue; Kern, John, III; Brent, David A.; Thurkettle, Mary Ann; Puskar, Kathryn R.; Sekula, L. Kathleen

2014-01-01

Pennsylvania's response to adolescent suicide is its Student Assistance Program (SAP). SAP has been funded for 27 years although no statewide outcome studies using case-level data have been conducted. This study used logistic regression to examine drug-/alcohol-related behaviors and suspensions of suicidal students who participated in SAP. Of the…

Level and Intensity of Early Intervention Services for Infants and Toddlers with Disabilities: The Impact of Child, Family, System, and Community-Level Factors on Service Provision

Science.gov (United States)

Hallam, Rena A.; Rous, Beth; Grove, Jaime; LoBianco, Tony

2009-01-01

Data from a statewide billing and information system for early intervention are used to examine the influence of multiple factors on the level and intensity of services provided in a state early intervention system. Results indicate that child and family factors including entry age, gestational age, Medicaid eligibility, access to third party…

The Impacts of Budget Reductions on Indiana's Public Schools: The Impact of Budget Changes on Student Achievement, Personnel, and Class Size for Public School Corporations in the State of Indiana

Science.gov (United States)

Jarman, Del W.; Boyland, Lori G.

2011-01-01

In recent years, economic downturn and changes to Indiana's school funding have resulted in significant financial reductions in General Fund allocations for many of Indiana's public school corporations. The main purpose of this statewide study is to examine the possible impacts of these budget reductions on class size and student achievement. This…

Predictive Validity and Accuracy of Oral Reading Fluency for English Learners

Science.gov (United States)

Vanderwood, Michael L.; Tung, Catherine Y.; Checca, C. Jason

2014-01-01

The predictive validity and accuracy of an oral reading fluency (ORF) measure for a statewide assessment in English language arts was examined for second-grade native English speakers (NESs) and English learners (ELs) with varying levels of English proficiency. In addition to comparing ELs with native English speakers, the impact of English…

Resident Transitions to Assisted Living: A Role for Social Workers

Science.gov (United States)

Fields, Noelle LeCrone; Koenig, Terry; Dabelko-Schoeny, Holly

2012-01-01

This study explored key aspects of resident transitions to assisted living (AL), including the frequency and importance of preadmission resident education and the potential role of social workers in this setting. To examine the factors that may help or hinder resident transitions to AL, a written survey was administered to a statewide,…

Integrating environmental equity, energy and sustainability: A spatial-temporal study of electric power generation

Science.gov (United States)

Touche, George Earl

The theoretical scope of this dissertation encompasses the ecological factors of equity and energy. Literature important to environmental justice and sustainability are reviewed, and a general integration of global concepts is delineated. The conceptual framework includes ecological integrity, quality human development, intra- and inter-generational equity and risk originating from human economic activity and modern energy production. The empirical focus of this study concentrates on environmental equity and electric power generation within the United States. Several designs are employed while using paired t-tests, independent t-tests, zero-order correlation coefficients and regression coefficients to test seven sets of hypotheses. Examinations are conducted at the census tract level within Texas and at the state level across the United States. At the community level within Texas, communities that host coal or natural gas utility power plants and corresponding comparison communities that do not host such power plants are tested for compositional differences. Comparisons are made both before and after the power plants began operating for purposes of assessing outcomes of the siting process and impacts of the power plants. Relationships between the compositions of the hosting communities and the risks and benefits originating from the observed power plants are also examined. At the statewide level across the United States, relationships between statewide composition variables and risks and benefits originating from statewide electric power generation are examined. Findings indicate the existence of some limited environmental inequities, but they do not indicate disparities that confirm the general thesis of environmental racism put forth by environmental justice advocates. Although environmental justice strategies that would utilize Title VI of the 1964 Civil Rights Act and the disparate impact standard do not appear to be applicable, some findings suggest potential

Democracy and Schooling in California: The Legacy of Helen Heffernan and Corinne Seeds. Historical Studies in Education

Science.gov (United States)

Weiler, Kathleen

2011-01-01

Helen Heffernan and Corinne Seeds were nationally recognized as leaders of the progressive education movement and were key figures in what was probably the most concerted attempt to put the ideals of progressive education into practice in a state-wide system of public education in the United States. This book examines the struggle over public…

Alabama Kids Count 2002 Data Book.

Science.gov (United States)

Curtis, Apreill; Bogie, Don

This Kids Count data book examines statewide trends in well-being of Alabamas children. The statistical portrait is based on 18 indicators in the areas of child health, education, safety, and security: (1) infant mortality rate; (2) low weight births; (3) child health index; (4) births to unmarried teens; (5) first grade retention; (6) school…

Aligning Career and Technical Education with High-Wage and High-Demand Occupations in Tennessee. Summary. Issues & Answers. REL 2011-No. 111

Science.gov (United States)

Mokher, Christine

2011-01-01

This study examines the availability of career and technical education program areas in Tennessee high schools, concentrations (a three-or-more credit sequence in a program area) completed by 2007/08 high school graduates, and how these concentrations align with jobs in the labor market. It looks at how these outcomes differ, statewide and by…

Aligning Career and Technical Education with High-Wage and High-Demand Occupations in Tennessee. Issues & Answers. REL 2011-No. 111

Science.gov (United States)

Mokher, Christine

2011-01-01

This study examines the availability of career and technical education program areas in Tennessee high schools, concentrations (a three-or-more credit sequence in a program area) completed by 2007/08 high school graduates, and how these concentrations align with jobs in the labor market. It looks at how these outcomes differ, statewide and by…

Are Expectations Alone Enough? Estimating the Effect of a Mandatory College-Prep Curriculum in Michigan

Science.gov (United States)

Jacob, Brian; Dynarski, Susan; Frank, Kenneth; Schneider, Barbara

2017-01-01

This article examines the impacts of the Michigan Merit Curriculum (MMC), a statewide college-preparatory curriculum that applies to the high school graduating class of 2011 and later. Our analyses suggest that the higher expectations embodied in the MMC had slight impact on student outcomes. Looking at student performance in the ACT, the only…

The State of Washington's Children, Fall 2001. [Ninth Annual Report].

Science.gov (United States)

Washington Univ., Seattle. School of Public Health and Community Medicine.

This Kids Count report is the ninth to examine annually statewide trends in the well-being of Washington's children. The statistical portrait is based on indicators of child well-being in five areas: (1) family and community, including teen birth rate, teen pregnancy rate, divorces involving children, and births to unmarried mothers; (2) economic…

The State of Washington's Children. [Seventh Annual Report].

Science.gov (United States)

Marvinney, Sandy, Ed.

This KIDS COUNT seventh annual report examines statewide trends in the well-being of Washington's children. The statistical portrait is based 24 key indicators of well-being: (1) teen birth rate; (2) teen pregnancy rate; (3) births to unmarried mothers; (4) divorces involving children; (5) family foster caseload; (6) average real wages; (7) per…

Automated Cancer Registry Notifications: Validation of a Medical Text Analytics System for Identifying Patients with Cancer from a State-Wide Pathology Repository.

Science.gov (United States)

Nguyen, Anthony N; Moore, Julie; O'Dwyer, John; Philpot, Shoni

2016-01-01

The paper assesses the utility of Medtex on automating Cancer Registry notifications from narrative histology and cytology reports from the Queensland state-wide pathology information system. A corpus of 45.3 million pathology HL7 messages (including 119,581 histology and cytology reports) from a Queensland pathology repository for the year of 2009 was analysed by Medtex for cancer notification. Reports analysed by Medtex were consolidated at a patient level and compared against patients with notifiable cancers from the Queensland Oncology Repository (QOR). A stratified random sample of 1,000 patients was manually reviewed by a cancer clinical coder to analyse agreements and discrepancies. Sensitivity of 96.5% (95% confidence interval: 94.5-97.8%), specificity of 96.5% (95.3-97.4%) and positive predictive value of 83.7% (79.6-86.8%) were achieved for identifying cancer notifiable patients. Medtex achieved high sensitivity and specificity across the breadth of cancers, report types, pathology laboratories and pathologists throughout the State of Queensland. The high sensitivity also resulted in the identification of cancer patients that were not found in the QOR. High sensitivity was at the expense of positive predictive value; however, these cases may be considered as lower priority to Cancer Registries as they can be quickly reviewed. Error analysis revealed that system errors tended to be tumour stream dependent. Medtex is proving to be a promising medical text analytic system. High value cancer information can be generated through intelligent data classification and extraction on large volumes of unstructured pathology reports.

Autism Spectrum Disorder Reclassified: A Second Look at the 1980s Utah/UCLA Autism Epidemiologic Study

Science.gov (United States)

Miller, Judith S.; Bilder, Deborah; Farley, Megan; Coon, Hilary; Pinborough-Zimmerman, Judith; Jenson, William; Rice, Catherine E.; Fombonne, Eric; Pingree, Carmen B.; Ritvo, Edward; Ritvo, Riva-Ariella; McMahon, William M.

2013-01-01

The purpose of the present study was to re-examine diagnostic data from a state-wide autism prevalence study (n = 489) conducted in the 1980s to investigate the impact of broader diagnostic criteria on autism spectrum disorder (ASD) case status. Sixty-four (59%) of the 108 originally "Diagnosed Not Autistic" met the current ASD case definition.…

Sex Differences in College Student Drug Use

Science.gov (United States)

Strimbu, Jerry L.; And Others

1973-01-01

Determines patterns of drug usage and related behavior of college, university, and junior college students on a state-wide basis. This article focuses on sex as it relates to the total pattern of drug abuse of nine specific substances among a large group of college students and examines results in terms of both practical and statistical…

Alabama Kids Count 2001 Data Book.

Science.gov (United States)

Curtis, Apreill; Bogie, Don

This Kids Count data book examines statewide trends in well-being for Alabama's children. The statistical portrait is based on 17 indicators in the areas of health, education, safety, and security. The indicators are: (1) infant mortality rate; (2) low weight births; (3) child health index; (4) births to unmarried teens; (5) first grade retention;…

Nevada Kids Count Data Book, 1997.

Science.gov (United States)

We Can, Inc., Las Vegas, NV.

This Kids Count data book is the first to examine statewide indicators of the well being of Nevada's children. The statistical portrait is based on 15 indicators of child well being: (1) percent low birth-weight babies; (2) infant mortality rate; (3) percent of children in poverty; (4) percent of children in single-parent families; (5) percent of…

The State of Washington's Children, Summer 2002. [Tenth Annual Report].

Science.gov (United States)

Connell, Frederick A.; Brandon, Richard; Hill, Sheri L.; Carter, S. Louise; Garrison, Michelle M.; DeWys, Shelley; Mandell, Dorothy J.

This Kids Count report is the tenth to examine annually statewide trends in the well-being of Washington's children and focuses on child poverty and the needs of the working poor. The statistical portrait is based on indicators of child well-being in five areas: (1) family and community, including teen birth rate, teen pregnancy rate, births to…

Valuable Work, Minimal Rewards: A Report on the Wisconsin Child Care Work Force.

Science.gov (United States)

Burton, Alice; And Others

A 1994 state-wide survey examined the status of child care profession in Wisconsin. Surveyed were 326 family child care providers, 104 child care center directors, and 254 center teaching staff. Responses indicated that child care teaching staff have experienced a wage increase of just over 1 percent per year since 1988, and continue to earn low…

An Exploration of the Impact of Accountability Testing on Teaching in Urban Elementary Classrooms

Science.gov (United States)

Bisland, Beverly Milner

2015-01-01

This study explores accountability testing in the elementary schools of New York City with particular emphasis on the impact of a statewide social studies test on the value given to social studies instruction in comparison to other subjects. The attitudes of a group of elementary teachers are examined. Some of the teachers taught all subjects in…

Meghan Rene, et al., v. Dr. Suellen Reed, et al. "Due Process." Lesson Plans for Secondary School Teachers on the Constitutional Requirement of "Due Process of Law." Courts in the Classroom: Curriculum Concepts and Other Information on Indiana's Courts for the K-12 Educator.

Science.gov (United States)

Osborn, Elizabeth

In the Rene v. Reed case, Meghan Rene and other disabled students argued that their due process rights were violated in regard to the Indiana Statewide Testing for Educational Progress (ISTEP) graduation examination. This set of four lesson plans uses the case of Rene v. Reed, which was first argued before the Indiana Supreme Court, to study the…

Child Safety: A State of the State Report. An Arkansas Kids Count Special Report.

Science.gov (United States)

Huddleston, Richard A.

This Kids Count report uses data from the Arkansas Department of Health to examine statewide trends in child safety. The findings suggested that in 1996, about one-third of child deaths in Arkansas were due to non-natural causes, with substantial racial and sex differences. Causes such as accidents, homicides, and suicides were more common for…

Prescribed burning cost recovery analysis on nonindustrial private forestland in North Carolina

Science.gov (United States)

Ronald J. Myers; William Powell; Mark Megalos

2012-01-01

A statewide internal analysis of prescribed burning costs was conducted by the North Carolina Division of Forest Resources (NCDFR) in 2008 to examine the regional differences of site preparation and silvicultural burning costs, and to determine which components were most responsible for losses or gains. This study analyzed actual costs for 90 site preparation (2,559...

Predictors of Family Conflict at the End of Life: The Experience of Spouses and Adult Children of Persons with Lung Cancer

Science.gov (United States)

Kramer, Betty J.; Kavanaugh, Melinda; Trentham-Dietz, Amy; Walsh, Matthew; Yonker, James A.

2010-01-01

Purpose: Guided by an explanatory matrix of family conflict at the end of life, the purpose of this article was to examine the correlates and predictors of family conflict reported by 155 spouses and adult children of persons with lung cancer. Design and Methods: A cross-sectional statewide survey of family members of persons who died from lung…

Why Work for Extension? An Examination of Job Satisfaction and Motivation in a Statewide Employee Retention Study

Science.gov (United States)

Harder, Amy; Gouldthorpe, Jessica; Goodwin, Jeff

2014-01-01

Understanding motivation and job satisfaction is important for increasing rates of employee retention within Extension. The purpose of the study reported here was to explore factors positively affecting the motivation of Extension professionals in their careers. An online survey of Extension professionals in Colorado was conducted. Factors such as…

The Wisconsin Assessment of the Social and Built Environment (WASABE): a multi-dimensional objective audit instrument for examining neighborhood effects on health.

Science.gov (United States)

Malecki, Kristen C; Engelman, Corinne D; Peppard, Paul E; Nieto, F Javier; Grabow, Maggie L; Bernardinello, Milena; Bailey, Erin; Bersch, Andrew J; Walsh, Matthew C; Lo, Justin Y; Martinez-Donate, Ana

2014-11-13

Growing evidence suggests that mixed methods approaches to measuring neighborhood effects on health are needed. The Wisconsin Assessment of the Social and Built Environment (WASABE) is an objective audit tool designed as an addition to a statewide household-based health examination survey, the Survey of the Health of Wisconsin (SHOW), to objectively measure participant's neighborhoods. This paper describes the development and implementation of the WASABE and examines the instrument's ability to capture a range of social and built environment features in urban and rural communities. A systematic literature review and formative research were used to create the tool. Inter-rater reliability parameters across items were calculated. Prevalence and density of features were estimated for strata formed according to several sociodemographic and urbanicity factors. The tool is highly reliable with over 81% of 115 derived items having percent agreement above 95%. It captured variance in neighborhood features in for a diverse sample of SHOW participants. Sidewalk density in neighborhoods surrounding households of participants living at less than 100% of the poverty level was 67% (95% confidence interval, 55-80%) compared to 34% (25-44%) for those living at greater than 400% of the poverty level. Walking and biking trails were present in 29% (19-39%) of participant buffer in urban areas compared to only 7% (2-12%) in rural communities. Significant environmental differences were also observed for white versus non-white, high versus low income, and college graduates versus individuals with lower level of education. The WASABE has strong inter-rater reliability and validity properties. It builds on previous work to provide a rigorous and standardized method for systematically gathering objective built and social environmental data in a number of geographic settings. Findings illustrate the complex milieu of built environment features found in participants neighborhoods and have

The relation between media promotions and service volume for a statewide tobacco quitline and a web-based cessation program

Directory of Open Access Journals (Sweden)

Schillo Barbara A

2011-12-01

Full Text Available Abstract Background This observational study assessed the relation between mass media campaigns and service volume for a statewide tobacco cessation quitline and stand-alone web-based cessation program. Methods Multivariate regression analysis was used to identify how weekly calls to a cessation quitline and weekly registrations to a web-based cessation program are related to levels of broadcast media, media campaigns, and media types, controlling for the impact of external and earned media events. Results There was a positive relation between weekly broadcast targeted rating points and the number of weekly calls to a cessation quitline and the number of weekly registrations to a web-based cessation program. Additionally, print secondhand smoke ads and online cessation ads were positively related to weekly quitline calls. Television and radio cessation ads and radio smoke-free law ads were positively related to web program registration levels. There was a positive relation between the number of web registrations and the number of calls to the cessation quitline, with increases in registrations to the web in 1 week corresponding to increases in calls to the quitline in the subsequent week. Web program registration levels were more highly influenced by earned media and other external events than were quitline call volumes. Conclusion Overall, broadcast advertising had a greater impact on registrations for the web program than calls to the quitline. Furthermore, registrations for the web program influenced calls to the quitline. These two findings suggest the evolving roles of web-based cessation programs and Internet-use practices should be considered when creating cessation programs and media campaigns to promote them. Additionally, because different types of media and campaigns were positively associated with calls to the quitline and web registrations, developing mass media campaigns that offer a variety of messages and communicate through

Health information exchange implementation: lessons learned and critical success factors from a case study.

Science.gov (United States)

Feldman, Sue S; Schooley, Benjamin L; Bhavsar, Grishma P

2014-08-15

Much attention has been given to the proposition that the exchange of health information as an act, and health information exchange (HIE), as an entity, are critical components of a framework for health care change, yet little has been studied to understand the value proposition of implementing HIE with a statewide HIE. Such an organization facilitates the exchange of health information across disparate systems, thus following patients as they move across different care settings and encounters, whether or not they share an organizational affiliation. A sociotechnical systems approach and an interorganizational systems framework were used to examine implementation of a health system electronic medical record (EMR) system onto a statewide HIE, under a cooperative agreement with the Office of the National Coordinator for Health Information Technology, and its collaborating organizations. The objective of the study was to focus on the implementation of a health system onto a statewide HIE; provide insight into the technical, organizational, and governance aspects of a large private health system and the Virginia statewide HIE (organizations with the shared goal of exchanging health information); and to understand the organizational motivations and value propositions apparent during HIE implementation. We used a formative evaluation methodology to investigate the first implementation of a health system onto the statewide HIE. Qualitative methods (direct observation, 36 hours), informal information gathering, semistructured interviews (N=12), and document analysis were used to gather data between August 12, 2012 and June 24, 2013. Derived from sociotechnical concepts, a Blended Value Collaboration Enactment Framework guided the data gathering and analysis to understand organizational stakeholders' perspectives across technical, organizational, and governance dimensions. Several challenges, successes, and lessons learned during the implementation of a health system to the

Mixed methods for implementation research: application to evidence-based practice implementation and staff turnover in community-based organizations providing child welfare services.

Science.gov (United States)

Aarons, Gregory A; Fettes, Danielle L; Sommerfeld, David H; Palinkas, Lawrence A

2012-02-01

Many public sector service systems and provider organizations are in some phase of learning about or implementing evidence-based interventions. Child welfare service systems represent a context where implementation spans system, management, and organizational concerns. Research utilizing mixed methods that combine qualitative and quantitative design, data collection, and analytic approaches are particularly well suited to understanding both the process and outcomes of dissemination and implementation efforts in child welfare systems. This article describes the process of using mixed methods in implementation research and provides an applied example of an examination of factors impacting staff retention during an evidence-based intervention implementation in a statewide child welfare system. The authors integrate qualitative data with previously published quantitative analyses of job autonomy and staff turnover during this statewide implementation project in order to illustrate the utility of mixed method approaches in providing a more comprehensive understanding of opportunities and challenges in implementation research.

Demographic and geographic differences in exposure to secondhand smoke in Missouri workplaces, 2007-2008.

Science.gov (United States)

Harris, Jenine K; Geremakis, Caroline; Moreland-Russell, Sarah; Carothers, Bobbi J; Kariuki, Barbara; Shelton, Sarah C; Kuhlenbeck, Matthew

2011-11-01

African Americans, Hispanics, service and blue-collar workers, and residents of rural areas are among those facing higher rates of workplace secondhand smoke exposure in states without smokefree workplace laws. Consequently, these groups also experience more negative health effects resulting from secondhand smoke exposure. The objective of this study was to examine disparities in workplace secondhand smoke exposure in a state without a comprehensive statewide smokefree workplace law and to use this information in considering a statewide law. We developed a logistic multilevel model by using data from a 2007-2008 county-level study to account for individual and county-level differences in workplace secondhand smoke exposure. We included sex, age, race, annual income, education level, smoking status, and rural or urban residence as predictors of workplace secondhand smoke exposure. Factors significantly associated with increased exposure to workplace secondhand smoke were male sex, lower education levels, lower income, living in a small rural or isolated area, and current smoking. For example, although the overall rate of workplace exposure in Missouri is 11.5%, our model predicts that among young white men with low incomes and limited education living in small rural areas, 40% of nonsmokers and 56% of smokers may be exposed to secondhand smoke at work. Significant disparities exist in workplace secondhand smoke exposure across Missouri. A statewide smokefree workplace law would protect all citizens from workplace secondhand smoke exposure.

Examination Management and Examination Malpractice: The Nexus

Science.gov (United States)

Ogunji, James A.

2011-01-01

Examination malpractice or cheating has become a global phenomenon. In different countries of the world today, developed and developing, academic dishonesty especially cheating in examinations has heightened and taken frightening dimension. In many countries of the world this phenomenon has become a serious matter of concern that has left many…

Prevalence of Internet gaming disorder in German adolescents: diagnostic contribution of the nine DSM-5 criteria in a state-wide representative sample.

Science.gov (United States)

Rehbein, Florian; Kliem, Sören; Baier, Dirk; Mößle, Thomas; Petry, Nancy M

2015-05-01

Internet gaming disorder (IGD) is included as a condition for further study in Section 3 of the DSM-5. Nine criteria were proposed with a threshold of five or more criteria recommended for diagnosis. The aims of this study were to assess how the specific criteria contribute to diagnosis and to estimate prevalence rates of IGD based on DSM-5 recommendations. Large-scale, state-representative school survey using a standardized questionnaire. Germany (Lower Saxony). A total of 11 003 ninth-graders aged 13-18 years (mean = 14.88, 51.09% male). IGD was assessed with a DSM-5 adapted version of the Video Game Dependency Scale that covered all nine criteria of IGD. In total, 1.16% [95% confidence interval (CI) = 0.96, 1.36] of respondents were classified with IGD according to DSM-5 recommendations. IGD students played games for longer periods, skipped school more often, had lower grades in school, reported more sleep problems and more often endorsed feeling 'addicted to gaming' than their non-IGD counterparts. The most frequently reported DSM-5 criteria overall were 'escape adverse moods' (5.30%) and 'preoccupation' (3.91%), but endorsement of these criteria rarely related to IGD diagnosis. Conditional inference trees showed that the criteria 'give up other activities', 'tolerance' and 'withdrawal' were of key importance for identifying IGD as defined by DSM-5. Based on a state-wide representative school survey in Germany, endorsement of five or more criteria of DSM-5 internet gaming disorder (IGD) occurred in 1.16% of the students, and these students evidence greater impairment compared with non-IGD students. Symptoms related to 'give up other activities', 'tolerance' and 'withdrawal' are most relevant for IGD diagnosis in this age group. © 2015 Society for the Study of Addiction.

Does Changing Examiner Stations During UK Postgraduate Surgery Objective Structured Clinical Examinations Influence Examination Reliability and Candidates' Scores?

Science.gov (United States)

Brennan, Peter A; Croke, David T; Reed, Malcolm; Smith, Lee; Munro, Euan; Foulkes, John; Arnett, Richard

2016-01-01

Objective structured clinical examinations (OSCE) are widely used for summative assessment in surgery. Despite standardizing these as much as possible, variation, including examiner scoring, can occur which may affect reliability. In study of a high-stakes UK postgraduate surgical OSCE, we investigated whether examiners changing stations once during a long examining day affected marking, reliability, and overall candidates' scores compared with examiners who examined the same scenario all day. An observational study of 18,262 examiner-candidate interactions from the UK Membership of the Royal College of Surgeons examination was carried at 3 Surgical Colleges across the United Kingdom. Scores between examiners were compared using analysis of variance. Examination reliability was assessed with Cronbach's alpha, and the comparative distribution of total candidates' scores for each day was evaluated using t-tests of unit-weighted z scores. A significant difference was found in absolute scores differences awarded in the morning and afternoon sessions between examiners who changed stations at lunchtime and those who did not (p design and examiner experience in surgical OSCEs and beyond. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Challenges and Choices: A Multidistrict Analysis of Statewide Mandated Democratic Engagement

Science.gov (United States)

Marsh, Julie A.; Hall, Michelle

2018-01-01

This article seeks to deepen our understanding of the nature and quality of democratic participation in educational reform by examining the first-year implementation of California's Local Control Funding Formula (LCFF) mandating civic engagement in district decision-making. Drawing on democratic theory, empirical literature, and data from 10…

Health Examination by PET. (1) Cancer Examination

International Nuclear Information System (INIS)

Uno, Koichi

2006-01-01

Cancer examination by positron emission tomography (PET) started in Japan in 1994 and has been rapidly popularized. This paper describes author's experience of the examination in his hospital along the recent Japanese guideline for the PET cancer examination. Fluorodeoxyglucose (FDG) is intravenously injected at 3.7 (or 4.6, for diabetic patients) MBq/kg after 4-5 hr fasting and 40 min later, imaging is conducted with additional delayed scan at 2 hr to reduce the possible false positive. Image is taken by the equipment with PET-specific camera, of which quality assurance (QA) is maintained according to the guideline, and 3D image is constructed by the ordered subset expectation maximization method. Number of examinees during 4.5 years are 18,210 (M/F=9,735/8,475), and 236 (1.3%), together with use of other test measures like ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), biochemical marker and occult blood as well, are found to have cancer of thyroid, large bowel, lung, breast and others. The false negative rate by PET alone is 78/236 (33%) for cancer. PET examination has problems of image reading and specificity of organs, and tasks of informed consent, test cost, increased exchange of information and radiation exposure. However, PET cancer examination will be established as a routine diagnostic tool when the accumulated evidence of early cancer detection is shown useful for improving the survival rate and for reducing the medicare cost. (T.I.)

Profile of Risk Factors for Non-Communicable Diseases in Punjab, Northern India: Results of a State-Wide STEPS Survey.

Directory of Open Access Journals (Sweden)

J S Thakur

Full Text Available Efforts to assess the burden of non-communicable diseases risk factors has improved in low and middle-income countries after political declaration of UN High Level Meeting on NCDs. However, lack of reliable estimates of risk factors distribution are leading to delay in implementation of evidence based interventions in states of India.A STEPS Survey, comprising all the three steps for assessment of risk factors of NCDs, was conducted in Punjab state during 2014-15. A statewide multistage sample of 5,127 residents, aged 18-69 years, was taken. STEPS questionnaire version 3.1 was used to collect information on behavioral risk factors, followed by physical measurements and blood and urine sampling for biochemical profile.Tobacco and alcohol consumption were observed in 11.3% (20% men and 0.9% women and 15% (27% men and 0.3% women of the population, respectively. Low levels of physical activity were recorded among 31% (95% CI: 26.7-35.5 of the participants. The prevalence of overweight and obesity was 28.6% (95% CI: 26.3-30.9 and 12.8% (95% CI: 11.2-14.4 respectively. Central obesity was higher among women (69.3%, 95% CI: 66.5-72.0 than men (49.5%, 95% CI: 45.3-53.7. Prevalence of hypertension in population was 40.1% (95% CI: 37.3-43.0. The mean sodium intake in grams per day for the population was 7.4 gms (95% CI: 7.2-7.7. The prevalence of diabetes (hyperglycemia, hypertriglyceridemia and hypercholesterolemia was 14.3% (95% CI: 11.7-16.8, 21.6% (95% CI: 18.5-25.1 and 16.1% (95% CI: 13.1-19.2, respectively. In addition, 7% of the population aged 40-69 years had a cardiovascular risk of ≥ 30% over a period of next 10 years.We report high prevalence of risk factors of chronic non-communicable diseases among adults in Punjab. There is an urgent need to implement population, individual and programme wide prevention and control interventions to lower the serious consequences of NCDs.

Mixed Methods for Implementation Research: Application to Evidence-Based Practice Implementation and Staff Turnover in Community Based Organizations Providing Child Welfare Services

Science.gov (United States)

Aarons, Gregory A.; Fettes, Danielle L.; Sommerfeld, David H.; Palinkas, Lawrence

2013-01-01

Many public sector services systems and provider organizations are in some phase of learning about or implementing evidence-based interventions. Child welfare service systems represent a context where implementation spans system, management, and organizational concerns. Research utilizing mixed methods that combine qualitative and quantitative design, data collection, and analytic approaches are particularly well-suited to understanding both the process and outcomes of dissemination and implementation efforts in child welfare systems. This paper describes the process of using mixed methods in implementation research and provides an applied example of an examination of factors impacting staff retention during an evidence-based intervention implementation in a statewide child welfare system. We integrate qualitative data with previously published quantitative analyses of job autonomy and staff turnover during this statewide implementation project in order to illustrate the utility of mixed method approaches in providing a more comprehensive understanding of opportunities and challenges in implementation research. PMID:22146861

Examining the utility of satellite-based wind sheltering estimates for lake hydrodynamic modeling

Science.gov (United States)

Van Den Hoek, Jamon; Read, Jordan S.; Winslow, Luke A.; Montesano, Paul; Markfort, Corey D.

2015-01-01

Satellite-based measurements of vegetation canopy structure have been in common use for the last decade but have never been used to estimate canopy's impact on wind sheltering of individual lakes. Wind sheltering is caused by slower winds in the wake of topography and shoreline obstacles (e.g. forest canopy) and influences heat loss and the flux of wind-driven mixing energy into lakes, which control lake temperatures and indirectly structure lake ecosystem processes, including carbon cycling and thermal habitat partitioning. Lakeshore wind sheltering has often been parameterized by lake surface area but such empirical relationships are only based on forested lakeshores and overlook the contributions of local land cover and terrain to wind sheltering. This study is the first to examine the utility of satellite imagery-derived broad-scale estimates of wind sheltering across a diversity of land covers. Using 30 m spatial resolution ASTER GDEM2 elevation data, the mean sheltering height, hs, being the combination of local topographic rise and canopy height above the lake surface, is calculated within 100 m-wide buffers surrounding 76,000 lakes in the U.S. state of Wisconsin. Uncertainty of GDEM2-derived hs was compared to SRTM-, high-resolution G-LiHT lidar-, and ICESat-derived estimates of hs, respective influences of land cover type and buffer width on hsare examined; and the effect of including satellite-based hs on the accuracy of a statewide lake hydrodynamic model was discussed. Though GDEM2 hs uncertainty was comparable to or better than other satellite-based measures of hs, its higher spatial resolution and broader spatial coverage allowed more lakes to be included in modeling efforts. GDEM2 was shown to offer superior utility for estimating hs compared to other satellite-derived data, but was limited by its consistent underestimation of hs, inability to detect within-buffer hs variability, and differing accuracy across land cover types. Nonetheless

Information Management for the Watershed Approach in the Pacific Northwest

Science.gov (United States)

A collection of interviews with leaders and key participants in the statewide watershed approach activities in the State of Washington. Additionally, there are reviews of Washington’s statewide watershed activities in a case study fashion.

Consideration of Agricultural Education as a Career: A Statewide Examination by High School Class Year of Predicting Factors

Science.gov (United States)

Thieman, Erica B.; Rosch, David M.; Suarez, Cecilia E.

2016-01-01

The shortage of teachers in Illinois is reflective of a recent trend where agricultural education graduates of in-state post-secondary institutions have not met the need for the number of available teaching positions. The retirement of the many teachers from the Baby Boomer generation is looming over the profession, making recruitment efforts…

Demographic and Geographic Differences in Exposure to Secondhand Smoke in Missouri Workplaces, 2007-2008

OpenAIRE

Harris, Jenine K.; Geremakis, Caroline; Moreland-Russell, Sarah; Carothers, Bobbi J.; Shelton, Sarah C.; Kariuki, Barbara; Kuhlenbeck, Matthew

2011-01-01

Introduction African Americans, Hispanics, service and blue-collar workers, and residents of rural areas are among those facing higher rates of workplace secondhand smoke exposure in states without smokefree workplace laws. Consequently, these groups also experience more negative health effects resulting from secondhand smoke exposure. The objective of this study was to examine disparities in workplace secondhand smoke exposure in a state without a comprehensive statewide smokefree workplace ...

Archaeological predictive model set.

Science.gov (United States)

2015-03-01

This report is the documentation for Task 7 of the Statewide Archaeological Predictive Model Set. The goal of this project is to : develop a set of statewide predictive models to assist the planning of transportation projects. PennDOT is developing t...

Metallographic examination in irradiated materials examination facility

Energy Technology Data Exchange (ETDEWEB)

Choo, Yong Sun; Lee, Key Soon; Park, Dae Gyu; Ahn, Sang Bok; Yoo, Byoung Ok

1998-01-01

It is very important to have equipment of metallographic examination in hot-cell to observe the micro-structure of nuclear fuels and materials irradiated at nuclear power and/or research reactor. Those equipment should be operated by master-slave manipulators, so they are designed, manufactured and modified to make exercise easy and no trouble. The metallographic examination equipment and techniques as well as its operation procedure are described, so an operator can practice the metallography in hot-cell. (author). 5 refs., 7 tabs., 21 figs.

The state - local regulatory nexus in US growth management: claims of property and participation in the localist resistance

OpenAIRE

T A Clark

1994-01-01

Influenced possibly more by volume than substance, some scholars have concluded that significant progress is being realized in state-level land-use regulation in the United States. In truth, more time must pass before a definitive evaluation of the more comprehensive efforts can be made. In this critical paper I examine the statewide growth-management legislation of the four states having tripartite (local - regional - state) administrative hierarchies: Florida, Vermont, Maine, and Georgia. T...

The Impact of Incarceration on Obesity: Are Prisoners with Chronic Diseases Becoming Overweight and Obese during Their Confinement?

OpenAIRE

Gates, Madison L.; Bradford, Robert K.

2015-01-01

Introduction. The association between incarceration and weight gain, along with the public health impact of former prisoners who are overweight or obese, warrants more investigation to understand the impact of prison life. Studies regarding incarceration’s impact on obesity are too few to support assertions that prisons contribute to obesity and comorbid conditions. This study examined a statewide prison population over several years to determine weight gain. Methods. Objective data for weigh...

DISCUSSANT'S COMMENTS FOR AMERICAN AGRICULTURAL ECONOMICS ASSOCIATION ANNUAL MEETING, SELECTED PAPERS SESSION SP-2BB: "FOOD DEMAND, FOOD POLICY, AND FOOD MARKET ISSUES"

OpenAIRE

Jonk, Yvonne

1998-01-01

These papers investigate issues in food demand, food processing, and food markets. Policy issues are examined, both in the context of the food stamp program in the domestic market and the industrial policy options in the food sector in emerging Central European economies. The Effect of an Electronic Benefit Transfer (EBT) System on Food Expenditure of Food Stamp Recipients: Evidence from the Maryland Statewide Implementation, J. William Levedahl. Incorporating Nutrients in Food Demand Analysi...

Beliefs of Certified Public Accountants toward Distance Education: A Statewide Georgia Survey.

Science.gov (United States)

Perdue, Kathy J.; Valentine, Thomas

1998-01-01

Examines the beliefs of certified public accountants (CPAs) in the state of Georgia concerning the effectiveness of distance education in providing continuing professional education (CPE). Findings indicate that the CPAs believe distance education to be an effective mode of learning, and that necessary technological capabilities are available to…

23 CFR 450.208 - Coordination of planning process activities.

Science.gov (United States)

2010-04-01

... process. (h) The statewide transportation planning process should be consistent with the Strategic Highway... 23 Highways 1 2010-04-01 2010-04-01 false Coordination of planning process activities. 450.208... Coordination of planning process activities. (a) In carrying out the statewide transportation planning process...

Standard examination stage for the fuels and materials examination facility

International Nuclear Information System (INIS)

Hess, J.W.; Frandsen, G.B.

1980-01-01

A Standard Examination Stage (SES) has been designed, fabricated, and tested for use in the Fuel and Materials Examination Facility (FMEF) at the Hanford Reservation near Richland, WA. The SES will perform multiple functions in a variety of nuclear fuel, absorber, and blanket pin handling, positioning, and examination operations in 11 of 22 work stations in the FMEF Nondestructive Examination (NDE) cell. Preprogrammable, automated, closed loop computer control provides precision positioning in the X, Y and Z directions and in pin rotational positioning. Modular construction of both the mechanical hardware and the electrical and control system has been used to facilitate in-cell maintainability

Environmental and economic evaluation of the Massachusetts Smoke-Free Workplace Law.

Science.gov (United States)

Alpert, Hillel R; Carpenter, Carrie M; Travers, Mark J; Connolly, Gregory N

2007-08-01

An environmental and economic evaluation of the smoke-free law in Massachusetts provides a broad appreciation of how a state-wide smoking ban affects the health of patrons and workers as well as the industries that are commonly concerned about the effects of smoking bans on business. The aim of this study is to evaluate environmental and economic effects of the statewide Massachusetts statewide Smoke-Free Workplace Law. Before and after the smoking ban, air quality testing was conducted in a sample (n = 27) of hospitality venues and state-wide economic changes were assessed. Compliance, in terms of patronage was measured by person-counts. Environmental outcomes were respirable suspended particles (RSP) less than 2.5 microns in diameter (PM2.5). Economic outcomes were meals tax collections, employment in the food services and drinking places and accommodations industries. On average, levels of respirable suspended particles (RSPs) less than 2.5 microns in diameter (PM2.5) decreased 93% in these venues after the Massachusetts Smoke-free Workplace Law went into effect. No statistically significant changes were observed among the economic indicators. This evaluation demonstrates that the state-wide Massachusetts law has effectively improved indoor air quality in a sample of Massachusetts venues and has not negatively affected several economic indicators.

Nondestructive examination

International Nuclear Information System (INIS)

Mletzko, U.

1980-01-01

Visual examination is treated as a method for the control of size and shape of components, surface quality and weld performance. Dye penetrant, magnetic particle and eddy current examinations are treated as methods for the evaluation of surface defects and material properties. The limitations to certain materials, defect sizes and types are shown. (orig./RW)

Economic Intervention and Parenting: A Randomized Experiment of Statewide Child Development Accounts

Science.gov (United States)

Nam, Yunju; Wikoff, Nora; Sherraden, Michael

2016-01-01

Objective: We examine the effects of Child Development Accounts (CDAs) on parenting stress and practices. Methods: We use data from the SEED for Oklahoma Kids (SEED OK) experiment. SEED OK selected caregivers of infants from Oklahoma birth certificates using a probability sampling method, randomly assigned caregivers to the treatment (n = 1,132)…

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

Science.gov (United States)

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

2012-07-01

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

Operator licensing examiner standards

International Nuclear Information System (INIS)

1987-05-01

The Operator Licensing Examiner Standards provide policy and guidance to NRC examiners and establish the procedures and practices for examining and licensing of applicants for NRC operator licenses pursuant to Part 55 of Title 10 of the Code of Federal Regulations (10 CFR 55). They are intended to assist NRC examiners and facility licensees to understand the examination process better and to provide for equitable and consistent administration of examinations to all applicants by NRC examiners. These standards are not a substitute for the operator licensing regulations and are subject to revision or other internal operator examination licensing policy changes

Application of a Musical Whistling Certificate Examination System as a Group Examination

Science.gov (United States)

Mori, Mikio; Ogihara, Mitsuhiro; Sugahara, Shin-Ichi; Taniguchi, Shuji; Kato, Shozo; Araki, Chikahiro

Recently, some professional whistlers have set up music schools to teach musical whistling. However, so far, there is no licensed examination for musical whistling. In this paper, we propose an examination system for evaluating musical whistling. The system conducts an examination in musical whistling on a personal computer (PC). It can be used to award four grades, from the second to the fifth. These grades are designed according to the standards adopted by the school for musical whistling established by the Japanese professional whistler Moku-San. It is expected that the group examination of this examination is held in the examination center where other general certification examinations are held. Thus, the influence of the whistle sound on the PC microphone normally used should be considered. For this purpose, we examined the feasibility of using a bone-conductive microphone for a musical whistling certificate examination system. This paper shows that the proposed system in which bone-transmitted sounds are considered gives good performance under a noisy environment, as demonstrated in a group examination of musical whistling using bone-transmitted sounds. The timing of a candidates whistling tends to not match because the applause sound output from the PC was inaudible for a person older than 60 years.

Operator licensing examiner standards

International Nuclear Information System (INIS)

1983-10-01

The Operator Licensing Examiner Standards provide policy and guidance to NRC examiners and establish the procedures and practices for examining and licensing of applicants for NRC operator licenses pursuant to Part 55 of Title 10 of the Code of Federal Regulations (10 CFR 55). They are intended to assist NRC examiners and facility licensees to understand the examination process better and to provide for equitable and consistent administration of examinations to all applicants by NRC examiners. These standards are not a substitute for the operator licensing regulations and are subject to revision or other internal operator examination licensing policy changes. As appropriate, these standards will be revised periodically to accommodate comments and reflect new information or experience

You've got mail! An examination of a statewide direct-mail marketing campaign to promote deceased organ donor registrations.

Science.gov (United States)

Quick, Brian L; LaVoie, Nicole R; Morgan, Susan E; Bosch, Dave

2015-11-01

This study extends previous direct-mail campaigns by evaluating the effectiveness of a marketing campaign promoting organ donation message strategies from the vantage point of organ donors, organ recipients, individuals on the waiting list, or a combination of these three frames. Illinois residents were randomly assigned to one of four organ donation brochures disseminated via U.S. postal mail. Registrations occurred via the Internet and U.S. postal mail. Individuals register at a greater rate following exposure to the combination framed message compared to organ donor, organ recipient, and waiting list narratives. The campaign revealed that individuals are more likely to register via U.S. postal mail than the Internet. Direct-mail marketing efforts were shown to be an effective approach to promote organ and tissue donation registrations. The results demonstrated a preference for the combination framed brochure. The results are discussed with an emphasis on the practical implications of utilizing direct-mail marketing efforts to promote organ donation among young adults. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

77 FR 63669 - Notice of FTA Transit Program Changes, Authorized Funding Levels and Implementation of the Moving...

Science.gov (United States)

2012-10-16

... public transit vehicles, and short headway bi-directional services for a substantial part of weekdays and... selected through an area-wide or statewide competitive selection process by the designated recipient. Under... transportation plan and must also be selected through an area-wide or statewide competitive selection process by...

Social Determinants of HIV-Related Stigma in Faith-Based Organizations.

Science.gov (United States)

Coleman, Jason D; Tate, Allan D; Gaddist, Bambi; White, Jacob

2016-03-01

To examine the association between social factors in faith-based settings (including religiosity and proximity to people living with HIV/AIDS) and HIV stigma. A total of 1747 congregants from primarily African American faith-based organizations of Project FAITH (Fostering AIDS Initiatives That Heal), a South Carolina statewide initiative to address HIV-related stigma, completed a survey. Female gender (P = .001), higher education (P stigma and with lower odds of stigmatizing attitudes (P stigma in African American communities.

Examination stress at unified state examination: student destabilization or success factor?

Directory of Open Access Journals (Sweden)

Svetlana N. Kostromina

2017-01-01

Full Text Available The aim of the research is to clear up the influence of examination stress on the results of completing examination papers by students in the situation of trial General and Unified State Examinations, imitating the real-life environment of unified state certification of schoolchildren. The tasks of the research included determining the dynamics of psychophysiological stress indices at different examination stages, and evaluating additional factors (the subject in which the examination is held, the strategy of solving the variant, success of solving the task etc., influencing the quantity and quality of stress reactions at the examination.The novelty of the research is in the attempt to overcome the problem of confusing the notions of examination stress and examination anxiety, caused by metering the students’ state either before or after the examination. The technology of online monitoring the students’ psychophysiological state is used in the work, which makes it possible to eliminate a number of restrictions occurring during subjective evaluation of the state by the students themselves. Telemetric cardiorhythmography was chosen as the basic method. The method is based on a three-component model of extreme states with consequent domination of one of the three stress-reactive systems. A cardiointervalogramm was being registered in the research process in the online mode and underwent spectral analysis. The following indices of heart rate variability were recorded in order to determine stress reactions: the total power of the spectrum (TP, the spectrum power in low-frequency (LF and high-frequency (HF regions, and a vegetative balance index (relation of the spectrum powers in low-frequency and high-frequency regions (LF/HF. When the total power of the heart rate fell and, at the same time, the vegetative balance index rose, a conclusion was made of there being a stress reaction. Twenty-five students of an illustrious school were examined

Medical marijuana legalization and cigarette and marijuana co-use in adolescents and adults.

Science.gov (United States)

Wang, Julie B; Ramo, Danielle E; Lisha, Nadra E; Cataldo, Janine K

2016-09-01

Medical marijuana legalization is associated with a higher prevalence of marijuana use which may affect cigarette use and nicotine dependence in co-users. In the present study, we examined relationships between statewide legalization of medical marijuana and prevalence of cigarette and marijuana co-use and nicotine dependence in co-using adolescents and adults. Data were analyzed from the 2013 National Survey on Drug Use and Health. We compared cigarette and marijuana co-use in the past 30days across age categories (12-64 years) by statewide medical marijuana legalization. Logistic regression models were used to estimate the odds of having nicotine dependence among current cigarette smokers who also reported past 30-day marijuana use and "ever but not current" marijuana use (vs. "never" use) adjusting for covariates including statewide legalization of medical marijuana. Overall, 5.1% of the sample reported past 30-day cigarette and marijuana co-use and a higher proportion of co-users resided in states where medical marijuana was legal compared to illegal (5.8% vs. 4.8%; p=0.0011). Co-use was associated with greater odds of having nicotine dependence compared to cigarette-only use across age categories. Odds were highest and up to 3-times higher in adolescents aged 12-17 years (OR=3.54; 95%CI: 1.81-6.92) and adults aged 50-64 years (OR=3.08; CI: 1.45-6.55). Marijuana policy could inadvertently affect cigarette and marijuana co-use and pose challenges to tobacco cessation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Electroconvulsive Therapy (ECT) and Race: A Report of ECT Use and Sociodemographic Trends in Texas.

Science.gov (United States)

Williams, Julie; Chiu, Lawrence; Livingston, Robin

2017-06-01

Minimal research on race and other sociodemographic disparities in patients receiving electroconvulsive therapy (ECT) exists. One previously noted national trend reveals whites receiving ECT disproportionately more than other races. The aim of this study is to determine whether a county ECT program demonstrates similar disparities observed at the state and national levels. This study examined 21 years of ECT data, between 1993 and 2014, provided by the Texas Department of State Health Services, focusing on race, sex, age, and payer source and 2.5 years of the same variables from a Harris County hospital ECT program. In addition, population demographic data for Harris County and the state of Texas during the same period were obtained from the Department of State Health Services Web site. Despite an overall decrease in the population of whites countywide and statewide, whites continue to use more ECT than African Americans, Latinos, and Asians in both Harris County and Texas. However, the rates of ECT use in minorities increased overall. Both countywide and statewide, ECT was used more than twice as often in women than men. Statewide, elderly patients (>65 years old) saw decreases in ECT use, and there was an increase in private third-party payer source. Electroconvulsive therapy remains underused among African Americans, Latinos, and Asians. Hypotheses and areas for future study include cultural beliefs, stigma, patient and provider knowledge of ECT, and access to care. Despite this, the general use of ECT in Texas has increased overall, and minority use is slowly on the rise.

Comparison of Government and Non-Government Alcohol and Other Drug (AOD) Treatment Service Delivery for the Lesbian, Gay, Bisexual, and Transgender (LGBT) Community.

Science.gov (United States)

Mullens, Amy B; Fischer, Jane; Stewart, Mary; Kenny, Kathryn; Garvey, Shane; Debattista, Joseph

2017-07-03

Lesbian, gay, bisexual, and transgender (LGBT) populations are more likely to misuse alcohol and other drugs (AOD), compared to the general population. However, LGBT engagement with AOD treatment is often precluded by insensitivity and misunderstanding of LGBT issues. These treatment barriers may be a consequence of either worker attitudes, organizational factors or a combination of both. Few studies have compared service context as an impediment to AOD treatment. This pilot study sought to examine and compare staff attitudes, knowledge and awareness of LGBT issues in two state-wide AOD services within Australia. One organization was a government service, whilst the other was faith based. A cross-sectional study of a convenience sample (N = 130) of workers employed in a state-wide government AOD service (n = 65), and a state-wide non-government service (n = 65) was conducted. Participants self-completed a questionnaire comprising tools previously used to assess staff attitudes, knowledge and awareness of LGBT issues. Few significant differences in attitudes and awareness of LGBT issues between government and non-government respondents were found. Nearly all respondents were supportive of LGBT persons irrespective of organizational context, with a small number of negative views. Although most respondents demonstrated awareness of organizational policies and practices relating to LGBT clients, many were "unsure" or "neutral" of what these might be. It is confirming that the majority of staff report supportive attitudes towards LGBT clients. Findings suggest that organizations need to continue to take leadership to strengthen organizational training and capacity to deliver LGBT friendly AOD treatment practices.

Operator licensing examiner standards

International Nuclear Information System (INIS)

1993-01-01

The Operator Licensing Examiner Standards provide policy and guidance to NRC examiners and establish the procedures and practices for examining licensees and applicants for reactor operator and senior reactor operator licenses at power reactor facilities pursuant to Part 55 of Title 10 of the Code of Federal Regulations (10 CFR 55). The Examiner Standards are intended to assist NRC examiners and facility licensees to better understand the initial and requalification examination processes and to ensure the equitable and consistent administration of examinations to all applicants. These standards are not a substitute for the operator licensing regulations and are subject to revision or other internal operator licensing policy changes

Examinations for radiologists. 1250 examination questions, with comments

International Nuclear Information System (INIS)

Albes, G.

2007-01-01

The first section presents self-tests and learning tips for a realistic assessment and optimisation of students' learning styles. Rhetoric and communicative competences are looked into, and hints are given on how to organize ones's documents. The second section contains more than 1250 examination questions from all fields of radiology, with which examination situations can be simulated for self-studies. The student is shown how to provide structured answers to complex questions, how to solve clinical problems step by step, how to assess facts, to develop key statements, etc. (orig.)

State Systems Change Spotlight: Nevada. Transforming State Systems to Improve Outcomes for Children with Disabilities

Science.gov (United States)

Ruedel, Kristin; Nelson, Gena; Bailey, Tessie; Pierce, Jennifer

2018-01-01

Data show that effective and ongoing communication and evaluation can have a positive impact on local and statewide systems change. Local and statewide systems change requires ongoing communication and evaluation. The Nevada Department of Education (NDE) used a communication protocol to support implementation of the Assess-Plan-Teach (APT) model.…

The sights and insights of examiners in objective structured clinical examinations

Directory of Open Access Journals (Sweden)

Lauren Chong

2017-12-01

Full Text Available Purpose The objective structured clinical examination (OSCE is considered to be one of the most robust methods of clinical assessment. One of its strengths lies in its ability to minimise the effects of examiner bias due to the standardisation of items and tasks for each candidate. However, OSCE examiners’ assessment scores are influenced by several factors that may jeopardise the assumed objectivity of OSCEs. To better understand this phenomenon, the current review aims to determine and describe important sources of examiner bias and the factors affecting examiners’ assessments. Methods We performed a narrative review of the medical literature using Medline. All articles meeting the selection criteria were reviewed, with salient points extracted and synthesised into a clear and comprehensive summary of the knowledge in this area. Results OSCE examiners’ assessment scores are influenced by factors belonging to 4 different domains: examination context, examinee characteristics, examinee-examiner interactions, and examiner characteristics. These domains are composed of several factors including halo, hawk/dove and OSCE contrast effects; the examiner’s gender and ethnicity; training; lifetime experience in assessing; leadership and familiarity with students; station type; and site effects. Conclusion Several factors may influence the presumed objectivity of examiners’ assessments, and these factors need to be addressed to ensure the objectivity of OSCEs. We offer insights into directions for future research to better understand and address the phenomenon of examiner bias.

Examiner Reliability of Fluorosis Scoring: A Comparison of Photographic and Clinical Examination Findings

Science.gov (United States)

Cruz-Orcutt, Noemi; Warren, John J.; Broffitt, Barbara; Levy, Steven M.; Weber-Gasparoni, Karin

2012-01-01

Objective To assess and compare examiner reliability of clinical and photographic fluorosis examinations using the Fluorosis Risk Index (FRI) among children in the Iowa Fluoride Study (IFS). Methods The IFS examined 538 children for fluorosis and dental caries at age 13 and obtained intra-oral photographs from nearly all of them. To assess examiner reliability, duplicate clinical examinations were conducted for 40 of the subjects. In addition, 200 of the photographs were scored independently for fluorosis by two examiners in a standardized manner. Fluorosis data were compared between examiners for the clinical exams and separately for the photographic exams, and a comparison was made between clinical and photographic exams. For all 3 comparisons, examiner reliability was assessed using kappa statistics at the tooth level. Results Inter-examiner reliability for the duplicate clinical exams on the sample of 40 subjects as measured by kappa was 0.59, while the repeat exams of the 200 photographs yielded a kappa of 0.64. For the comparison of photographic and clinical exams, inter-examiner reliability, as measured by weighted kappa, was 0.46. FRI scores obtained using the photographs were higher on average than those obtained from the clinical exams. Fluorosis prevalence was higher for photographs (33%) than found for clinical exam (18%). Conclusion Results suggest inter-examiner reliability is greater and fluorosis scores higher when using photographic compared to clinical examinations. PMID:22316120

Operator licensing examiner standards

International Nuclear Information System (INIS)

1994-06-01

The Operator Licensing Examiner Standards provide policy and guidance to NRC examiners and establish the procedures and practices for examining licensees and applicants for reactor operator and senior reactor operator licenses at power reactor facilities pursuant to Part 55 of Title 10 of the Code of Federal Regulations (10 CFR 55). The Examiner Standards are intended to assist NRC examiners and facility licensees to better understand the initial and requalification examination processes and to ensure the equitable and consistent administration of examinations to all applicants. These standards are not a substitute for the operator licensing regulations and are subject to revision or other internal operator licensing policy changes. Revision 7 was published in January 1993 and became effective in August 1993. Supplement 1 is being issued primarily to implement administrative changes to the requalification examination program resulting from the amendment to 10 CFR 55 that eliminated the requirement for every licensed operator to pass an NRC-conducted requalification examination as a condition for license renewal. The supplement does not substantially alter either the initial or requalification examination processes and will become effective 30 days after its publication is noticed in the Federal Register. The corporate notification letters issued after the effective date will provide facility licensees with at least 90 days notice that the examinations will be administered in accordance with the revised procedures

Explaining MRI examinations DVD

International Nuclear Information System (INIS)

Takatsu, Yasuo; Komeda, Takuya

2010-01-01

When conducting MRI examinations, there are various things to be careful of. There is often stress related to the MRI examinations, so in order to perform an examination safely and smoothly, sufficient explanation must be given. An explanation of what to do and what not to do during an examination should be outlined in a brochure given to patients before the examination. There may be many patients who have misgivings about their MRI examinations, so to reduce their anxiousness and deepen their understanding of MRI examinations and to improve the safety and effiency of MRI examinations,; we created a DVD about MRI examinations. We gathered MRI-related safety information and instructions, and assessed the effect that the information might have on patients. We started a workgroup for a project to plan and record a video according to the Storyboard. When editing, we reviewed the length of each segment, the amount of information on screen, and the overall length of the DVD. We discussed the issue within the workgroup and had hospital approval. It was possible for us to complete it without depending on the supplier and the cost was kept to a minimum. Finally, we decided on a viewing location. We asked a hospital volunteers to see a complete DVD and we evaluated their responses by questionnaires. As the result, their understanding and anxieties related to MRI examinations were alleviated, as expected. Their anxiety seemed to be eased. Patients also seemed to have a deeper understanding of MRI examinations having seen an examination being conducted. (author)

Physical examination of swine.

Science.gov (United States)

Masters, B J; Hamilton, M; Masters, P G

1992-07-01

Swine may be examined to evaluate a disease state or a lowered economic performance or as a herd health consultation. As much of the examination as possible should be performed without handling the animal. A thorough history, evaluation of herd records, environmental examination, and herd examination should be performed prior to the evaluation of an individual animal. All necessary equipment should be available when starting the individual examination. The animals is then restrained and examined, and necessary samples are taken. Post-mortem examinations or slaughter house evaluations are a very frequent part of a health examination on swine. All samples taken should be in accordance with the standards of the laboratory that you use. You should work closely with the laboratory to obtain the best results. Physical examination of swine can be rewarding for the veterinarian as well as the producer. The most important aspect to remember is to have enough information and the proper equipment available to handle the animals for the minimal amount of time to gain the maximum benefits. Vietnamese pot-bellied pigs are similar to domestic swine in terms of their diseases and health but are dissimilar in management; pot-bellied pigs are frequently brought to the veterinarian for individual examinations. History is the most valuable part of the examination, followed by observation. Pot-bellied pigs prefer to be held securely with a hand under the chin and rump. The examination is conducted similarly to the examination of any companion animal. Chemical restraint often is necessary for sampling or minor surgical procedures. Owners should be consulted prior to the use of any restraint. This will help win their approval and confidence when working on their pets. While performing the physical examination, look at the pig's overall health as well as specific breed characteristics. Try to stay abreast of swine vaccination recommendations; you may be consulted in this regard. Most

Vegetation Change in Blue Oak Woodlands in California

Science.gov (United States)

Barbara A. Holzman; Barbara H. Allen-Diaz

1991-01-01

A preliminary report of a statewide project investigating vegetation change in blue oak (Quercus douglasii) woodlands in California is presented. Vegetation plots taken in the 1930s, as part of a statewide vegetation mapping project, were relocated and surveyed. Species composition, cover and tree stand structure data from the earlier study were...

75 FR 48579 - Approval and Promulgation of Implementation Plans; State of Missouri

Science.gov (United States)

2010-08-11

... statewide 10 CSR 10-6.170 rule contains the same level of restrictions. In general, the statewide rule.... What revisions is EPA approving? A. Rescission of 10 CSR 10-5.290, More Restrictive Emission Limitations for Particulate Matter in South St. Louis Area B. Changes to 10 CSR 10-6.400, Restriction of...

The Role of Political Action and Media in Increasing Public Awareness of Water Scarcity: Combined Effects on Water Use Behavior

Science.gov (United States)

Quesnel, K.; Roby, N.; Gonzales, P.; Ajami, N.

2016-12-01

In the midst of California's current drought, authorities have enacted widespread initiatives aimed at coping with water scarcity, for example the first mandatory statewide urban water use reductions in 2015. But to what extent have these measures resulted in decreased water consumption? To answer this question, our research examines the impact of political actions on water use by using media as a proxy. News media outlets have heavily covered the progression of the California drought, and this outreach has played an important role in disseminating information and raising public awareness. To our knowledge, the relationship between political action/media coverage and water use has yet to be examined. In this study, we extract the number of articles related to the term "California Drought" from six widely-read national and statewide newspapers from 2005 to 2015. We study the relationship between media and monthly urban water use at the utility level using multivariate panel regression and principal components analysis to examine how media interacts with other modes of influence such as climate, price, and the state of the economy and how populations of different socio-demographics are affected by media outreach. We also use daily household-level water use readings from recently installed Automated Meter Infrastructure (AMI) in one utility to examine the relationship on a finer spatiotemporal scale. Using a policy timeline, Google search rates, and newspaper article trends confirms the relationship between political actions, public awareness, and media outreach. Preliminary modeling indicates that media plays a significant role in altering water use patterns for residential customers and in utilities with specific local characteristics.

Examine Your Skin

Science.gov (United States)

... Support Donate Share Facebook Twitter Newsletter Examine Your Skin Watch the video below and in only two minutes, you can learn to examine your skin. A special thanks to Dr. Martin Weinstock, MD, ...

Wood's lamp examination

Science.gov (United States)

... this page: //medlineplus.gov/ency/article/003386.htm Wood lamp examination To use the sharing features on this page, please enable JavaScript. A Wood lamp examination is a test that uses ultraviolet ( ...

X-ray examination of the stomach - a highly informative noninvasive examination method

Energy Technology Data Exchange (ETDEWEB)

Grehn, S.

1987-10-01

The X-ray examination of the stomach still holds its own in this age of sophisticated endoscopic examination techniques. Nevertheless, it needs to be based on a meticulous examination technique performed by the physian in person on the patient and resulting in convincing imaging. (orig.)

Health-related quality of life of mothers of very low birth weight children at the age of five: results from the Newborn Lung Project Statewide Cohort Study.

Science.gov (United States)

Witt, Whitney P; Litzelman, Kristin; Spear, Hilary A; Wisk, Lauren E; Levin, Nataliya; McManus, Beth M; Palta, Mari

2012-11-01

This study aimed to determine the health-related quality of life (HRQoL) in mothers of 5-year-old very low birth weight (VLBW) and normal birth weight (NBW) children, with a focus on the role of stress. This cohort study is ancillary to the Newborn Lung Project. A telephone interview collected information on symptoms of stress and HRQoL from 297 mothers of VLBW children and 290 mothers of NBW children who were enrolled in the Newborn Lung Project Statewide Cohort Study. Staged multiple regression analyses were used to evaluate the relationship between caregiver status and maternal HRQoL and the role stress played in this relationship. Additional multiple regression analyses were also used to evaluate the correlates of poor maternal HRQoL among VLBW mothers. Mothers of VLBW children experienced worse physical and mental HRQoL than mothers of NBW children. Adjusted analyses showed that physical HRQoL was significantly different between these mothers (β: -1.87, P = 0.001); this relationship was attenuated by maternal stress. Among the mothers of VLBW children, stress significantly contributed to adverse HRQoL outcomes when children were aged five. Child behavior problems at the age of two were also associated with worse subsequent maternal mental HRQoL (β: -0.18, P = 0.004), while each week of neonatal intensive care unit stay was associated with worse physical HRQoL (β: -0.26, P = 0.02). Caring for a VLBW child is negatively associated with the HRQoL of mothers; this relationship might be, in part, explained by maternal stress. Addressing maternal stress may be an important way to improve long-term HRQoL.

Radionuclide examinations

International Nuclear Information System (INIS)

Lentle, B.C.

1989-01-01

This paper reports on radionuclide examinations of the pancreas. The pancreas, situated retroperitonally high in the epigastrium, was a particularly difficult organ to image noninvasively before ultrasonography and computed tomography (CT) became available. Indeed the organ still remains difficult to examine in some patients, a fact reflected in the variety of methods available to evaluate pancreatic morphology. It is something of a paradox that the pancreas is metabolically active and physiologically important but that its examination by radionuclide methods has virtually ceased to have any role in day-to-day clinical practice. To some extent this is caused by the tendency of the pancreas's commonest gross diseases emdash carcinoma and pancreatitis, for example emdash to result in nonfunction of the entire organ. Disorders of pancreatic endocrine function have generally not required imaging methods for diagnosis, although an understanding of diabetes mellitus and its nosology has been advanced by radioimmunoassay of plasma insulin concentrations

Establishing a Peer Client-Server Internet Architecture for Virginia's Schools.

Science.gov (United States)

Bull, Glen; And Others

1996-01-01

Virginia's Public Education Network (PEN) was one of the first statewide public school Internet systems. PEN began as a regional pilot that led to the establishment of a regional prototype, Teacher-LINK. Teacher-LINK in turn became the basis for the statewide K-12 Internet system. Topics include PEN's educational content, Internet services, and…

Examine Your Skin

Medline Plus

Full Text Available ... Support Donate Share Facebook Twitter Newsletter Examine Your Skin Watch the video below and in only two minutes, you can learn to examine your skin. A special thanks to Dr. Martin Weinstock, MD, ...

Making a difference: Ten case studies of DSM/IRP interactive efforts and related advocacy group activities

Energy Technology Data Exchange (ETDEWEB)

English, M.; Schexnayder, S.; Altman, J. [Tennessee Univ., Knoxville, TN (United States). Energy, Environment and Resources Center; Schweitzer, M. [Oak Ridge National Lab., TN (United States)

1994-03-01

This report discusses the activities of organizations that seek to promote integrated resource planning and aggressive, cost-effective demand-side management by utilities. The activities of such groups -- here called energy efficiency advocacy groups (EEAGs) -- are examined in ten detailed am studies. Nine of the cases involve some form of interactive effort between investor-owned electric utilities and non-utility to develop policies, plans, or programs cooperatively. Many but not all of the interactive efforts examined are formal collaboratives. In addition, all ten cases include discussion of other EEAG activities, such as coalition-building, research, participation in statewide energy planning, and intervention in regulatory proceedings.

Examine Your Skin

Medline Plus

Full Text Available ... Suggestions Examine Your Skin Newly Diagnosed? Understanding Your Pathology Biopsy: The First Step Sentinel Node Biopsy Melanoma ... Suggestions Examine Your Skin Newly Diagnosed? Understanding Your Pathology Biopsy: The First Step Sentinel Node Biopsy Melanoma ...

Radiologic examination

International Nuclear Information System (INIS)

Thoeni, R.F.

1989-01-01

The radiographic examination of the upper and lower gastrointestinal tract has been changed drastically by the introduction of endoscopic procedures that are now widely available. However, the diagnostic approach to the small bowel remains largely unchanged. Ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) are occasionally employed but are not primary imaging modalities for small bowel disease. Even though small bowel endoscopes are available, they are infrequently used, and no scientific paper on their employment has been published. Barium studies are still the mainstay for evaluating patients with suspected small bowel abnormalities. This paper discusses the anatomy and physiology of the small bowel and lists the various types of barium and pharmacologic aids used for examining it. The different radiographic methods for examining the small bowel with barium, including SBFT, dedicated SBFT, enteroclysis, peroral pneumocolon (PPC), and retrograde small bowel examination, are described and put into perspective. To some degree such an undertaking must be a personal opinion, but certain conclusions can be made based on the available literature and practical experience. This analysis is based on the assumption that all the various barium techniques are performed with equal expertise by the individual radiologist, thus excluding bias from unfamiliarity with certain aspects of a procedure, such as intubation or skilled compression during fluoroscopy. Also, the use of water-soluble contrast material, CT, and MRI for evaluating suspected small bowel abnormalities is outlined

Dose from radiological examinations

International Nuclear Information System (INIS)

Imamura, Keiko; Uji, Teruyuki; Sakuyama, Keiko; Fujikawa, Mitsuhiro; Fujii, Masamichi

1976-01-01

Relatively high gonad doses, several hundred to one thousand mR, have been observed in case of pelvis, hip-joint, coccyx, lower abdomen and lumber examination. Dose to the ovary is especially high in barium enema and I.V.P. examinations. About 12 per cent of the 4-ray examination are high-dose. The gonad dose is relatively high in examination of abdomen and lower extremities, in infants. The dose to the eyes is especially high, 1.0 to 2.5R per exposure, in temporal bone and nasal sinuses tomography. X-ray doses have been compared with dose limits recommended by ICRP and with the gonad dose from natural radiations. The gonad dose in lumbar examination, barium enema, I.V.P. etc. is as high as the maximum permissible dose per year recommended by ICRP. Several devices have been made for dose reduction in the daily examinations: (1) separating the radiation field from the gonad by one centimeter decreases the gonad dose about one-half. (2) using sensitive screens and films. In pelvimetry and in infant hip-joint examination, the most sensitive screen and film are used. In the I.V.P. examination of adult, use of MS screen in place of FS screen decreases the dose to one-third, in combination with careful setting of radiation field, (3) use of grid increases the dose about 50 percent and the lead rubber protection (0.1mm lead equivalent) decreases the gonad dose to one-thirtieth in the spinal column examination of infant, (4) A lead protector, 1mm thickness and 2.5cm in diameter, on the eyes decreases the dose to about one-eighth in the face and nead examinations. These simple and effective methods for dose reduction. Should be carried out in as many examinations as possible in addition to observing dose limits recommended by ICRP. (Evans, J.)

Status of the nondestructive examination equipment for the fuels and materials examination facility

International Nuclear Information System (INIS)

Frandsen, G.B.

1980-01-01

The present status of Nondestructive Examination (NDE) Equipment proposed for the Fuels and Materials Examination Facility (FMEF) now under construction at the Hanford Engineering Development Laboratory is discussed. Items discussed include the NDE cell receiving machine, the dismantling machine, the standard examination stage, profilometry, eddy current, wire wrap removal machine, surface examination, gamma scan and general NDE equipment

A GIS-Enabled, Michigan-Specific, Hierarchical Groundwater Modeling and Visualization System

Science.gov (United States)

Liu, Q.; Li, S.; Mandle, R.; Simard, A.; Fisher, B.; Brown, E.; Ross, S.

2005-12-01

, automatically extract data and attributes, and simulate unsteady groundwater flow and contaminant transport in response to water and land management decisions; * Visualize and map model simulations and predictions with data from the statewide groundwater database in a seamless interactive environment. IGW-M has the potential to significantly improve the productivity of Michigan groundwater management investigations. It changes the role of engineers and scientists in modeling and analyzing the statewide groundwater database from heavily physical to cognitive problem-solving and decision-making tasks. The seamless real-time integration, real-time visual interaction, and real-time processing capability allows a user to focus on critical management issues, conflicts, and constraints, to quickly and iteratively examine conceptual approximations, management and planning scenarios, and site characterization assumptions, to identify dominant processes, to evaluate data worth and sensitivity, and to guide further data-collection activities. We illustrate the power and effectiveness of the M-IGW modeling and visualization system with a real case study and a real-time, live demonstration.

Fuel cycle and waste newsletter, Vol. 4, No. 1, April 2008

International Nuclear Information System (INIS)

2008-04-01

This issue of the Fuel Cycle and Waste Newsletter presents the International Decommissioning Network, the cooperation between INPRO (the International Project on Innovative Nuclear Reactors and Fuel Cycles) and NEFW (IAEA's Division of Nuclear Fuel Cycle and Waste Technology), the policies and strategies for spent fuel and radioactive waste management, recent developments of decommissioning waste, integrated approach to decommissioning and environmental remediation, CEG Workshop, repatriation of sealed sources in Latin America, the technical working Group on research reactors (TWGRR), an update on research reactor networks, Atominstitut Vienna, modernization and refurbishment of research reactors, a new CRP on innovative methods in research reactor analysis, management of damaged spent nuclear fuel, influence of high-burnup UOX and MOX water reactor fuel on spent fuel management, a new CRP on improvement in the computer code modelling of high burnup nuclear fuel (FUMEX-3), reuse options for reprocessed uranium (RepU), a basic fact-book on coated particle fuel, recent publications and upcoming meetings

TMI-2 core examination

International Nuclear Information System (INIS)

Hobbins, R.R.; MacDonald, P.E.; Owen, D.E.

1983-01-01

The examination of the damaged core at the Three Mile Island Unit 2 (TMI-2) reactor is structured to address the following safety issues: fission product release, transport, and deposition; core coolability; containment integrity; and recriticality during severe accidents; as well as zircaloy cladding ballooning and oxidation during so-called design basis accidents. The numbers of TMI-2 components or samples to be examined, the priority of each examination, the safety issue addressed by each examination, the principal examination techniques to be employed, and the data to be obtained and the principal uses of the data are discussed in this paper

The Outpatient Physical Examination.

Science.gov (United States)

Artandi, Maja K; Stewart, Rosalyn W

2018-05-01

The physical examination in the outpatient setting is a valuable tool. Even in settings where there is lack of evidence, such as the annual physical examination of an asymptomatic adult, the physical examination is beneficial for the physician-patient relationship. When a patient has specific symptoms, the physical examination-in addition to a thorough history-can help narrow down, or in many cases establish, a diagnosis. In a time where imaging and laboratory tests are easily available, but are expensive and can be invasive, a skilled physical examination remains an important component of patient evaluation. Copyright © 2018 Elsevier Inc. All rights reserved.

Leadership, Innovation Climate, and Attitudes toward Evidence-Based Practice during a Statewide Implementation

Science.gov (United States)

Aarons, Gregory A.; Sommerfeld, David H.

2012-01-01

Objective: Leadership is important in practice change, yet there are few studies addressing this issue in mental health and social services. This study examined the differential roles of transformational (i.e., charismatic) leadership and leader-member exchange (i.e., the relationship between a supervisor and their direct service providers) on…

The Effects of the Louisiana Scholarship Program on Student Achievement after Two Years. Louisiana Scholarship Program Evaluation Report #1. Technical Report

Science.gov (United States)

Mills, Jonathan N.; Wolf, Patrick J.

2016-01-01

The Louisiana Scholarship Program (LSP) is a statewide initiative offering publicly-funded vouchers to enroll in local private schools to students in low-performing schools with family income no greater than 250 percent of the poverty line. Initially established in 2008 as a pilot program in New Orleans, the LSP was expanded statewide in 2012.…

Florida statewide radiation study

International Nuclear Information System (INIS)

Nagda, N.L.; Koontz, M.D.; Fortmann, R.C.; Schoenborn, W.A.; Mehegan, L.L.

1987-01-01

Florida phosphate deposits contain higher levels of uranium than most other soils and rocks, thus exposing the population to higher-than-desirable levels of radon and its short-lived daughters. The Florida Legislature ordered a survey of significant land areas where an environmental radiation standard should be applied. Among other things, the study assessed indoor radon in 6,000 homes, soil radon at 3,000 residences, and all data existing prior to the study. The report explains the purpose of the study, how it was designed and conducted, and its results. It concludes with a discussion of radon/radon decay product equilibrium factor, correlation between indoor and soil radon, and preliminary attempts to develop a safe threshold for soil radon below which few elevated indoor levels would be anticipated

Place and Policy: Secondhand Smoke Exposure in Bars and Restaurants.

Science.gov (United States)

Buettner-Schmidt, Kelly; Boursaw, Blake; Lobo, Marie L

2018-06-04

Rural populations have been identified as having tobacco use disparities, with contributing factors including less demand for policy change than in urban areas, resulting in higher age-adjusted death rates related to tobacco use. In 2012, the rural state of North Dakota enacted a statewide comprehensive law requiring all bars and restaurants to be smoke-free. The purpose of this longitudinal study, performed in three phases, was to assess the continued effects of a statewide comprehensive smoke-free law in a primarily rural state, using a stratified random sample. Particulate matter and compliance indicators were assessed in restaurants and bars 21 months after enactment of the comprehensive law. Results were compared with the findings from the Phase 1 and Phase 2 samples, in which venues were assessed before passage of the law and approximately 3 months after enactment, respectively. The comprehensive, statewide, smoke-free law led to immediate, sustained, and substantial reductions in secondhand smoke and eliminated previous significant disparities in secondhand smoke exposure in rural communities. Although indoor smoke-free compliance with the law was generally high, compliance in required outdoor smoke-free areas was low. Compliance with signage requirements, both indoors and outdoors, was low. The comprehensive statewide smoke-free law created a just distribution of smoke-free laws statewide, resulting in increased protection of rural populations from secondhand smoke. Targeted public health interventions to address compliance may reduce secondhand smoke levels in outlier venues that continue to have high levels of secondhand smoke.

X-ray examination apparatus

International Nuclear Information System (INIS)

Bernstein, S.; Griswa, P.J.; Halter, P. Jr.; Kidd, H.J.

1980-01-01

Apparatus for x-ray cardiovascular examination and which can also be used for general purpose examination is described. An advantage of the system is that there is no mechanical connection between the image intensifier and source to interfere with the medical examiner or emergency procedures. (U.K.)

Factors affecting public support for forest-based biorefineries: A comparison of mill towns and the general public in Maine, USA

International Nuclear Information System (INIS)

Marciano, James A.; Lilieholm, Robert J.; Teisl, Mario F.; Leahy, Jessica E.; Neupane, Binod

2014-01-01

Community views toward the risks and benefits of emerging renewable energy technologies are important factors in facility siting decisions and their eventual success. While the actual socioeconomic and biophysical impacts of proposed industrial developments are fraught with uncertainty, understanding public perceptions is critical in managing costs and benefits to local citizens. Here, we explore the social acceptability of forest-based biorefineries in Maine using random utility modeling to identify how project attributes and citizen characteristics interact to affect level of support. Using a statewide sample (Statewide) and a subsample of mill towns (Mill Towns), we found that: (1) in both samples, individual characteristics had similar coefficients and significance levels except for pro-environment attitudes; (2) the coefficients related to the industry’s negative attributes were notably different between the two samples, while positive attributes were not; (3) in both samples, positive industry attributes such as “producing products from a sustainable resource” and “increased economic development” were the most influential variables in determining the level of support for a new biorefinery in an individual’s community; and (4) in general, Mill Town respondents were more accepting of potential negative attributes such as increased levels of truck traffic, odor, noise, and air and water pollution. - Highlights: • We examined social views of bioproducts processing in mill towns and statewide. • Environmental sustainability was a major concern expressed by both samples. • Views were affected by proximity to processing, and by respondent characteristics. • Public concerns should be considered along the entire supply chain. • Views toward biorefineries may be influenced by views of related industries

Evaluating the role of land cover and climate uncertainties in computing gross primary production in Hawaiian Island ecosystems.

Science.gov (United States)

Kimball, Heather L; Selmants, Paul C; Moreno, Alvaro; Running, Steve W; Giardina, Christian P

2017-01-01

Gross primary production (GPP) is the Earth's largest carbon flux into the terrestrial biosphere and plays a critical role in regulating atmospheric chemistry and global climate. The Moderate Resolution Imaging Spectrometer (MODIS)-MOD17 data product is a widely used remote sensing-based model that provides global estimates of spatiotemporal trends in GPP. When the MOD17 algorithm is applied to regional scale heterogeneous landscapes, input data from coarse resolution land cover and climate products may increase uncertainty in GPP estimates, especially in high productivity tropical ecosystems. We examined the influence of using locally specific land cover and high-resolution local climate input data on MOD17 estimates of GPP for the State of Hawaii, a heterogeneous and discontinuous tropical landscape. Replacing the global land cover data input product (MOD12Q1) with Hawaii-specific land cover data reduced statewide GPP estimates by ~8%, primarily because the Hawaii-specific land cover map had less vegetated land area compared to the global land cover product. Replacing coarse resolution GMAO climate data with Hawaii-specific high-resolution climate data also reduced statewide GPP estimates by ~8% because of the higher spatial variability of photosynthetically active radiation (PAR) in the Hawaii-specific climate data. The combined use of both Hawaii-specific land cover and high-resolution Hawaii climate data inputs reduced statewide GPP by ~16%, suggesting equal and independent influence on MOD17 GPP estimates. Our sensitivity analyses within a heterogeneous tropical landscape suggest that refined global land cover and climate data sets may contribute to an enhanced MOD17 product at a variety of spatial scales.

Examine Your Skin

Medline Plus

Full Text Available ... Facebook Twitter Newsletter Examine Your Skin Watch the video below and in only two minutes, you can learn to examine your skin. A special thanks to Dr. Martin Weinstock, MD, PhD, Professor of Dermatology, Brown University, for permission to use this video. UPDATED: ... Melanoma Facts Melanoma Prevention ...

INTER-EXAMINER VARIABILITY

African Journals Online (AJOL)

Objective: To establish whether inter-examiner variability is still a significant factor for the undergraduate orthopaedic clinical ... D. The scores for each student were tabulated and the range, mean, and pass rate determined for each of the examiners. ... has not the heart to reject the man”, consistently gave higher scores (1).

Preliminary Report on Floodplain Animals of the Upper Mississippi River and the Illinois Waterway Including Some Probable Impacts of Increased Commercial Traffic,

Science.gov (United States)

1975-01-01

case of the canvasback, it is conceivable that a large oil spill in a concentration area during the peak migration period could destroy a substantial...winter crowned Lichtenstein secondary resident kinglet succession 123. Ruby-crowned Regulus calendula Statewide Statewide younger stand, C winter...Regulus calendula . Ruby-crowned Kinglet TV-c Family MOTACLLLIDAS - pipits Anthus spinoletta ’Water Pipit, TV-r Family BOHIYCILLIDAE - waxwings

10 CFR 709.31 - DOE standards for polygraph examiners and polygraph examinations.

Science.gov (United States)

2010-01-01

... minimum qualifications: (1) The examiner must be an experienced CI or criminal investigator with extensive... in psychology, physiology, interviewing, and interrogation. (2) The examiner must have a favorably...

Online video examination

DEFF Research Database (Denmark)

Qvist, Palle

have large influence on their own teaching, learning and curriculum. The programme offers streamed videos in combination with other learning resources. It is a concept which offers video as pure presentation - video lectures - but also as an instructional tool which gives the students the possibility...... to construct their knowledge, collaboration and communication. In its first years the programme has used Skype video communication for collaboration and communication within and between groups, group members and their facilitators. Also exams have been mediated with the help of Skype and have for all students......, examiners and external examiners been a challenge and opportunity and has brought new knowledge and experience. This paper brings results from a questionnaire focusing on how the students experience the video examination....

Comparison of team-focused CPR vs standard CPR in resuscitation from out-of-hospital cardiac arrest: Results from a statewide quality improvement initiative.

Science.gov (United States)

Pearson, David A; Darrell Nelson, R; Monk, Lisa; Tyson, Clark; Jollis, James G; Granger, Christopher B; Corbett, Claire; Garvey, Lee; Runyon, Michael S

2016-08-01

feedback device (OR 0.47), and endotracheal intubation (OR 0.44) were associated with less likelihood for a good neurologic outcome. In our statewide OHCA cohort, TFCPR was associated with improved survival with good neurological outcome. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Integrating address geocoding, land use regression, and spatiotemporal geostatistical estimation for groundwater tetrachloroethylene.

Science.gov (United States)

Messier, Kyle P; Akita, Yasuyuki; Serre, Marc L

2012-03-06

Geographic information systems (GIS) based techniques are cost-effective and efficient methods used by state agencies and epidemiology researchers for estimating concentration and exposure. However, budget limitations have made statewide assessments of contamination difficult, especially in groundwater media. Many studies have implemented address geocoding, land use regression, and geostatistics independently, but this is the first to examine the benefits of integrating these GIS techniques to address the need of statewide exposure assessments. A novel framework for concentration exposure is introduced that integrates address geocoding, land use regression (LUR), below detect data modeling, and Bayesian Maximum Entropy (BME). A LUR model was developed for tetrachloroethylene that accounts for point sources and flow direction. We then integrate the LUR model into the BME method as a mean trend while also modeling below detects data as a truncated Gaussian probability distribution function. We increase available PCE data 4.7 times from previously available databases through multistage geocoding. The LUR model shows significant influence of dry cleaners at short ranges. The integration of the LUR model as mean trend in BME results in a 7.5% decrease in cross validation mean square error compared to BME with a constant mean trend.

Concurrent Use of Cigarettes and Smokeless Tobacco in Minnesota

Directory of Open Access Journals (Sweden)

Raymond G. Boyle

2012-01-01

Full Text Available Cigarette smokers are being encouraged to use smokeless tobacco (SLT in locations where smoking is banned. We examined state-wide data from Minnesota to measure changes over time in the use of SLT and concurrent use of cigarettes and SLT. The Minnesota Adult Tobacco Survey was conducted four times between 1999 and 2010 and has provided state-wide estimates of cigarette smoking, SLT use and concurrent use of SLT by smokers. The prevalence of SLT was essentially unchanged through 2007, then increased significantly between 2007 and 2010 (3.1% versus 4.3%, P<0.05. Similarly, the prevalence of cigarette smokers who reported using SLT was stable then increased between 2007 and 2010 (4.4% versus 9.6%, P<0.05. The finding of higher SLT use by smokers could indicate that smokers in Minnesota are in an experimental phase of testing alternative products as they adjust to recent public policies restricting smoking in public places. The findings are suggestive that some Minnesota smokers are switching to concurrent use of cigarettes and SLT. Future surveillance reports will be necessary to confirm the results.

Motorcycle crash-related emergency department visits and hospitalizations for traumatic brain injury in North Carolina.

Science.gov (United States)

Harmon, Katherine J; Marshall, Stephen W; Proescholdbell, Scott K; Naumann, Rebecca B; Waller, Anna E

2015-01-01

To examine statewide emergency department (ED) visit data for motorcycle crash morbidity and healthcare utilization due to traumatic brain injuries (TBIs) and non-TBIs. North Carolina ED data (2010-2012) and hospital discharge data (2009-2011). Statewide ED visits and hospitalizations due to injuries from traffic-related motorcycle crashes stratified by TBI status. Descriptive study. Descriptive statistics include age, sex, mode of transport, disposition, expected source of payment, hospital length of stay, and hospital charges. Over the study period, there were 18 780 ED visits and 3737 hospitalizations due to motorcycle crashes. Twelve percent of ED visits for motorcycle crashes and 26% of hospitalizations for motorcycle crashes had a diagnosis of TBI. Motorcycle crash-related hospitalizations with a TBI diagnosis had median hospital charges that were nearly $9000 greater than hospitalizations without a TBI diagnosis. Emergency department visits and hospitalizations due to motorcycle crashes with a TBI diagnosis consumed more healthcare resources than motorcycle crash-related ED visits and hospitalizations without a TBI diagnosis. Increased awareness of motorcyclists by other road users and increased use of motorcycle helmets are 2 strategies to mitigate the incidence and severity of motorcycle crash injuries, including TBIs.

Secondary Students' Writing Achievement Goals: Assessing the Mediating Effects of Mastery and Performance Goals on Writing Self-Efficacy, Affect, and Writing Achievement

Science.gov (United States)

Yilmaz Soylu, Meryem; Zeleny, Mary G.; Zhao, Ruomeng; Bruning, Roger H.; Dempsey, Michael S.; Kauffman, Douglas F.

2017-01-01

The two studies reported here explored the factor structure of the newly constructed Writing Achievement Goal Scale (WAGS), and examined relationships among secondary students' writing achievement goals, writing self-efficacy, affect for writing, and writing achievement. In the first study, 697 middle school students completed the WAGS. A confirmatory factor analysis revealed a good fit for this data with a three-factor model that corresponds with mastery, performance approach, and performance avoidance goals. The results of Study 1 were an indication for the researchers to move forward with Study 2, which included 563 high school students. The secondary students completed the WAGS, as well as the Self-efficacy for Writing Scale, and the Liking Writing Scale. Students also self-reported grades for writing and for language arts courses. Approximately 6 weeks later, students completed a statewide writing assessment. We tested a theoretical model representing relationships among Study 2 variables using structural equation modeling including students' responses to the study scales and students' scores on the statewide assessment. Results from Study 2 revealed a good fit between a model depicting proposed relationships among the constructs and the data. Findings are discussed relative to achievement goal theory and writing. PMID:28878707

Nuclear medical examinations

International Nuclear Information System (INIS)

Chiba, Kazuo; Yamada, Hideo

1983-01-01

Nuclear medical examinations for cerebral vascular diseases were outlined. These procedures developed associated with development of scanners, production of radionuclides and development of labelled compounds. Examination of cerebral circulation with 133 Xe and sup(87m)Kr was replaced by CT. Furthermore, emission CT developed. Each of brain scintiscan, measurement of regional cerebral blood flow, positron emission CT and single photon emission CT was reviewed. (Namekawa, K.)

Corporate-sponsored low-cost screening program at the workplace

International Nuclear Information System (INIS)

Kessler, H.B.; Engstrom, P.F.; Devine, P.J.; Rimer, B.; Gatenby, R.A.

1989-01-01

This paper reports the results of a mobile screening mammography program offered to employees of a large corporation. The examination was available to women 35 or older. Women were charged $30 for a standard two-view examination; the remaining costs were underwritten by the employer. In the first year of the program 3,627 examination were performed; 63 biopsies were recommended. To date, 54 biopsies have been completed. Nine cancers were identified; seven state I and two stage II cancers were diagnosed. The distribution and prevalence rates were similar to (slightly higher than) statewide statistics. Mobile screening programs conducted at the worksite provide an inexpensive convenient alternation to more traditional screening programs. The inherent advantages of this program are the low cost, relative ease with which the examination can be obtained, and the positive role that corporate medical personnel assume in encouraging participation

42 CFR 21.53 - Examination.

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Examination. 21.53 Section 21.53 Public Health... Appointment § 21.53 Examination. The examination of candidates for original appointment as officers to any... education and their training and experience. In the discretion of the Surgeon General the examination of any...

Hypothesis-driven physical examination curriculum.

Science.gov (United States)

Allen, Sharon; Olson, Andrew; Menk, Jeremiah; Nixon, James

2017-12-01

Medical students traditionally learn physical examination skills as a rote list of manoeuvres. Alternatives like hypothesis-driven physical examination (HDPE) may promote students' understanding of the contribution of physical examination to diagnostic reasoning. We sought to determine whether first-year medical students can effectively learn to perform a physical examination using an HDPE approach, and then tailor the examination to specific clinical scenarios. Medical students traditionally learn physical examination skills as a rote list of manoeuvres CONTEXT: First-year medical students at the University of Minnesota were taught both traditional and HDPE approaches during a required 17-week clinical skills course in their first semester. The end-of-course evaluation assessed HDPE skills: students were assigned one of two cardiopulmonary cases. Each case included two diagnostic hypotheses. During an interaction with a standardised patient, students were asked to select physical examination manoeuvres in order to make a final diagnosis. Items were weighted and selection order was recorded. First-year students with minimal pathophysiology performed well. All students selected the correct diagnosis. Importantly, students varied the order when selecting examination manoeuvres depending on the diagnoses under consideration, demonstrating early clinical decision-making skills. An early introduction to HDPE may reinforce physical examination skills for hypothesis generation and testing, and can foster early clinical decision-making skills. This has important implications for further research in physical examination instruction. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Assessing ultrasonic examination results

International Nuclear Information System (INIS)

Deutsch, V.; Vogt, M.

1977-01-01

Amongst nondestructive examination methods, the ultrasonic examination plays an important role. The reason why its scope of application is so wide is because the sound conducting capacity is the only property the material of a test specimen has to have. As the fields are so manifold, only main aspects can be described briefly. The list of references, however, is very extensive and gives plenty of information of all the problems concerning the assessment of ultrasonic examination results. (orig./RW) [de

Ultrasonographic examination in juvenile idiopathic arthritis is better than clinical examination for identification of intraarticular disease

DEFF Research Database (Denmark)

Nielsen, Hans Erik; Strandberg, Charlotte; Andersen, Steen

2013-01-01

The diagnosis of juvenile idiopathic arthritis (JIA) is formally based on clinical examination, but ultrasound (US) examination is used increasingly. Our purpose was to compare US and clinical examination in the assessment of synovitis in JIA.......The diagnosis of juvenile idiopathic arthritis (JIA) is formally based on clinical examination, but ultrasound (US) examination is used increasingly. Our purpose was to compare US and clinical examination in the assessment of synovitis in JIA....

TMI-2 core examination plan

International Nuclear Information System (INIS)

Owen, D.E.; MacDonald, P.E.; Hobbins, R.R.; Ploggr, S.A.

1982-01-01

The Three Mile Island (TMI-2) core examination is divided into four stages: (1) before removing the head; (2) before removing the plenum; (3) during defueling; and (4) offsite examinations. Core examinations recommended during the first three stages are primarily devoted to documenting the post-accident condition of the core. The detailed analysis of core damage structures will be performed during offsite examinations at government and commercial hot cell facilities. The primary objectives of these examinations are to enhance the understanding of the degraded core accident sequence, to develop the technical bases for reactor regulations, and to improve LWR design and operation

Views about secondhand smoke and smoke-free policies among North Carolina restaurant owners before passage of a law to prohibit smoking.

Science.gov (United States)

Linnan, Laura A; Weiner, Bryan J; Bowling, J Michael; Bunger, Erin M

2010-01-01

This study examined the knowledge, attitudes, and beliefs about secondhand smoke and smoke-free policies among North Carolina restaurant owners and managers before passage of House Bill 2, which prohibited smoking in most restaurants and bars. A random sample of North Carolina restaurants was selected to participate. A 15-minute telephone survey was completed by 523 restaurant owners and managers (one per participating restaurant) who spoke English and operated a restaurant that had seating for guests and was not a corporate headquarters for a restaurant chain (response rate, 36.7%). Bivariable analyses using chi2 tests of association were conducted. Multivariable modeling with logistic regression was used to examine relationships among several predictor variables and current smoking policies at participating restaurants, support among owners and managers for a statewide ban on smoking in restaurants, and beliefs among owners and managers about the economic impact of smoke-free policies. Restaurant owners and managers were aware that secondhand smoke causes cancer and asthma (79% and 73% or respondents, respectively) but were less aware that it causes heart attacks (56%). Sixty-six percent of restaurants did not permit any smoking indoors. Sixty percent of owners and managers supported a statewide smoke-free law. Owners and managers who were current smokers, those who worked at a restaurant with an employee smoking prevalence of more than 25%, and those who worked in a restaurant without a 700% smoke-free policy were significantly less likely to support a statewide law requiring smoke-free public places. Only owner and manager smoking status and no current smoke-free indoor policy were significant independent predictors of the belief that instituting a smoke-free policy would have negative economic consequences for the restaurant. Although participating establishments were a representative sample of North Carolina restaurants, an overall survey response rate of 36

Risk factors for unplanned readmissions in older adult trauma patients in Washington State: a competing risk analysis.

Science.gov (United States)

Fawcett, Vanessa J; Flynn-O'Brien, Katherine T; Shorter, Zeynep; Davidson, Giana H; Bulger, Eileen; Rivara, Frederick P; Arbabi, Saman

2015-03-01

Hospital readmission is a significant contributor to increasing health care use related to caring for older trauma patients. This study was undertaken with the following aims: determine the proportion of older adult trauma patients who experience unplanned readmission, as well as risk factors for these readmissions and identify the most common readmission diagnoses among these patients. We conducted a retrospective cohort study of trauma patients age 55 years and older who survived their hospitalization at a statewide trauma center between 2009 and 2010. Linking 3 statewide databases, nonelective readmission rates were calculated for 30 days, 6 months, and 1 year after index discharge. Competing risk regression was used to determine risk factors for readmission and account for the competing risk of dying without first being readmitted. Subhazard ratios (SHR) are reported, indicating the relative risk of readmission by 30 days, 6 months, and 1 year. The cumulative readmission rates for the 14,536 participants were 7.9%, 18.9%, and 25.2% at 30 days, 6 months, and 1 year, respectively. In multivariable models, the strongest risk factors for readmission at 1 year (based on magnitude of SHR) were severe head injury (adjusted SHR = 1.47; 95% CI, 1.24-1.73) and disposition to a skilled nursing facility (SHR = 1.54; 95% CI, 1.39-1.71). The diagnoses most commonly associated with readmission were atrial fibrillation, anemia, and congestive heart failure. In this statewide study, unplanned readmissions after older adult trauma occurred frequently up to 1 year after discharge, particularly for patients who sustained severe head trauma and who could not be discharged home independently. Examining common readmission diagnoses might inform the development of interventions to prevent unplanned readmissions. Copyright © 2015 American College of Surgeons. All rights reserved.

Ultrasonographic examination of plantar fasciitis: a comparison of patient positions during examination.

Science.gov (United States)

Ahn, Jae Hoon; Lee, Choong Woo; Park, ChanJoo; Kim, Yoon-Chung

2016-01-01

Musculoskeletal ultrasound is a non-invasive and low-cost modality for real-time visualisation of the plantar fascia. Ultrasound examination for plantar fasciitis is generally performed with the patient in a prone position, although the rational for using a prone position has not been validated. The aim of the study was to investigate if ultrasound examination in a supine position, which is more comfortable than the prone position, is valid. We conducted a prospective study of 30 participants with plantar fasciitis, 8 men (27 %) and 22 women (73 %), with a mean age of 53.9 ± 12.6 (range, 32 to 77) years, and an equal distribution of left and right feet. The plantar heel was divided into three portions for ultrasound examination: medial, central and lateral. Two measurements of plantar fascia thickness were obtained for each portion, with participants in 2 positions (supine and prone) and for 2 ankle postures (neutral and 15° of plantarflexion). Mean measurements of plantar fascia thickness were compared between the two positions (Wilcoxon signed rank tests for non-normally distributed data and paired t-tests for normally distributed data). Participants were asked to report their preferred position for examination, supine or prone. The measured thickness was comparable for both supine and prone positions, for both ankle postures, neutral and 15° of plantarflexion (p > 0.05). A specific self-reported preferred position was not identified. Ultrasound examination of plantar fasciitis can be performed in the supine position without any significant difference in measurement compared to examination in the conventional prone position. The Catholic Medical Center Office of Human Research Protection Program (CMC-OHRP)/Institutional Review Board approved the current study (Approval No. KC12DISI0338), and all participants provided their written informed consent for participation and publication.

Cardiac Limited Ultrasound Examination Techniques to Augment the Bedside Cardiac Physical Examination.

Science.gov (United States)

Kimura, Bruce J; Shaw, David J; Amundson, Stan A; Phan, James N; Blanchard, Daniel G; DeMaria, Anthony N

2015-09-01

The current practice of physical diagnosis is dependent on physician skills and biases, inductive reasoning, and time efficiency. Although the clinical utility of echocardiography is well known, few data exist on how to integrate 2-dimensional screening "quick-look" ultrasound applications into a novel, modernized cardiac physical examination. We discuss the evidence basis behind ultrasound "signs" pertinent to the cardiovascular system and elemental in synthesis of bedside diagnoses and propose the application of a brief cardiac limited ultrasound examination based on these signs. An ultrasound-augmented cardiac physical examination can be taught in traditional medical education and has the potential to improve bedside diagnosis and patient care. © 2015 by the American Institute of Ultrasound in Medicine.

Computer tomographic examinations in epilepsy

International Nuclear Information System (INIS)

De Villiers, J.F.K.

1984-01-01

Epileptic patients that was examined at the Universitas Hospital (Bloemfontein) by means of computerized tomography for the period July 1978 - December 1980, are divided into two groups: a) Patients with general epilepsy of convulsions - 507; b) Patients with vocal or partial epilepsy - 111. The method of examination and the results for both general and vocal epilepsy are discussed. A degenerative state was found in 35% of the positive computer tomographic examinations in general epilepsy and 22% of the positive examinations for vocal epilepsy. The purpose of the article was to explain the circumstances that can be expected when a epileptic patient is examined by means of computerized tomography

The Hypothesis-Driven Physical Examination.

Science.gov (United States)

Garibaldi, Brian T; Olson, Andrew P J

2018-05-01

The physical examination remains a vital part of the clinical encounter. However, physical examination skills have declined in recent years, in part because of decreased time at the bedside. Many clinicians question the relevance of physical examinations in the age of technology. A hypothesis-driven approach to teaching and practicing the physical examination emphasizes the performance of maneuvers that can alter the likelihood of disease. Likelihood ratios are diagnostic weights that allow clinicians to estimate the post-probability of disease. This hypothesis-driven approach to the physical examination increases its value and efficiency, while preserving its cultural role in the patient-physician relationship. Copyright © 2017 Elsevier Inc. All rights reserved.

Carbon dioxide emission trends in cars and light trucks: A comparative analysis of emissions and methodologies for Florida's counties (2000 and 2008)

International Nuclear Information System (INIS)

Garren, S.J.; Pinjari, A.R.; Brinkmann, R.

2011-01-01

This paper investigates methodologies to quantify CO 2 emissions from cars and light trucks in Florida. The most widely used methodology to calculate greenhouse gas emissions in the transportation sector at the local level uses a harmonic average (HA) methodology based on nationally averaged fuel economies that assume 55% city and 45% highway VMTs. This paper presents a local condition (LC) methodology that accounts for county-level variations in city and highway VMTs, as opposed to assumed uniform driving conditions. Both HA and LC methodologies were used to estimate and compare absolute and per capita CO 2 emissions both statewide and counties for 2000 and 2008. From 2000 to 2008, statewide absolute and per capita CO 2 emissions increased similarly using HA and LC methodologies; however, the percent change varied considerably among counties. Statewide CO 2 emissions calculated from HA and LC methodologies differed by only -0.2% (2000) and 1.7% (2008); however, the differences in the county-level emissions ranged from -8.0% to 14.9% (2000) and from -5.6% to 17.0% (2008). While either the HA or the LC methodology yields a similar result statewide, significant variation exists at the county level, warranting the need to consider local driving conditions when estimating county-level emissions. - Highlights: → The paper evaluates GHG emission methods for on-road passenger vehicles in Florida. → The paper compares methods that assume the harmonic average with actual VMTs driven. → The paper analyzes statewide GHG emissions aggregated by county for 2000 and 2008. → The paper improves on methods that balance bottom-up with top-down GHG emissions.

Temporal and spatial trends in sediment contaminants associated with toxicity in California watersheds

International Nuclear Information System (INIS)

Siegler, Katie; Phillips, Bryn M.; Anderson, Brian S.; Voorhees, Jennifer P.; Tjeerdema, Ron S.

2015-01-01

California's Stream Pollution Trends program (SPoT) assesses long-term water quality trends, using 100 base-of-the-watershed sampling sites. Annual statewide sediment surveys from 2008 to 2012 identified consistent levels of statewide toxicity (19%), using the freshwater amphipod Hyalella azteca. Significant contaminant trends included a decrease in PCBs, stable concentrations of metals and PAHs, and a statewide increase in detections and concentrations of pyrethroid pesticides. The pyrethroid pesticide bifenthrin was detected in 69% of samples (n = 410). Detection of toxicity increased in a subset of samples tested at a more environmentally relevant test temperature (15 °C), and the magnitude of toxicity was much greater, indicating pyrethroid pesticides as a probable cause. Pyrethroid toxicity thresholds (LC50) were exceeded in 83% of samples with high toxicity. Principal components analysis related pyrethroids, metals and total organic carbon to urban land use. - Highlights: • Toxicity and contaminant concentrations were higher in urban dominated watersheds. • Average and range of total pyrethroid concentrations increased between 2008 and 2012. • Pyrethroid toxicity thresholds (LC50) were exceeded in 83% of samples with high toxicity. - Detections and concentrations of current use pesticides are increasing in California urban watersheds, while legacy organochlorine contaminants are decreasing statewide.

Exploration of the attitudes of nursing students to peer physical examination and physical examination of patients.

Science.gov (United States)

Wearn, Andy M; Bhoopatkar, Harsh; Mathew, Thomas K; Stewart, Lisa

2013-08-01

The use of peer physical examination (PPE) in early clinical skills has been studied amongst medical students. The majority of students are comfortable with using peer physical examination, when sensitive areas are excluded. Students' attitudes are related to their personal characteristics: gender, age, religious faith, and ethnicity. There is no data on nursing students' attitudes to peer physical examination. Identify and explore: Dual cohort, cross-sectional, anonymous survey. Three-year undergraduate nursing programme, skills centre and service clinical learning. All first and third year nursing students were asked to complete a modified Examining Fellow Students questionnaire at the end of 2008. The questionnaire asked students to indicate which of 12 body areas they would not be willing to examine/have examined by a peer of the same/opposite gender. This study also asked students which of the 12 body areas they felt uncomfortable examining on patients. The response rate was 76% (128/168). The students were predominantly female (93% female; 7% male). Most students were comfortable with examining non-sensitive body regions of peers (78.2%-100% willing) and patients (92.3-100% willing). Male gender was significantly associated with willingness to examine and be examined by peers (p=0.001); Asian students were significantly less willing to engage in peer physical examination with opposite gender (pexamining patients of either gender (pexamination shows similarities and differences to other studies. Student characteristics were not related to patient examination attitudes. Copyright © 2012 Elsevier Ltd. All rights reserved.

13 CFR 108.690 - Examinations.

Science.gov (United States)

2010-01-01

....690 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION NEW MARKETS VENTURE CAPITAL (âNMVCâ) PROGRAM Recordkeeping, Reporting, and Examination Requirements for NMVC Companies Examinations of Nmvc Companies by Sba for Regulatory Compliance § 108.690 Examinations. All NMVC companies must submit to annual...

Analysis of switch and examine combining with post-examining selection in cognitive radio

Science.gov (United States)

Agarwal, Rupali; Srivastava, Neelam; Katiyar, Himanshu

2018-06-01

To perform spectrum sensing in fading environment is one of the most challenging tasks for a CR system. Diversity combining schemes are used to combat the effect of fading and hence detection probability of CR gets improved. Among many diversity combining techniques, switched diversity offers one of the lowest complexity solutions. The receiver embedded with switched diversity looks for an acceptable diversity path (having signal to noise ratio (SNR) above the required threshold) to receive the data. In conventional switch and examine combining (SEC) scheme, when no acceptable path is found after all the paths are examined, the receiver randomly chooses an unacceptable path. Switch and examine combining with post-examining selection (SECp) is a modified version of conventional SEC. In SECp, the conventional SEC scheme is altered in a way that it selects the best path when no acceptable path is found after all paths have been examined. In this paper, formula for probability of detection ( ?) is derived using SECp and SEC diversity combining technique over Rayleigh fading channel. Also the performance of SECp is compared with SEC and no diversity case. Performance comparison is done with the help of SNR vs. ? and complementary receiver operating characteristic curves.

Dosimetry in endoscopic examinations

International Nuclear Information System (INIS)

Aldred, Martha Aurelia; Paes, Walter Siqueira; Fausto, Agnes M.F.; Nucci, Jose Roberto; Yoshimura, Elisabeth Mateus; Okuno, Emico; Maruta, Luis Massuo

1996-01-01

Equivalent and effective doses in occupational exposures are evaluated considering that some specific endoscopic examinations, radiographic and fluoroscopic images of patients are taken with the medical staff near to the radiation field. Examinations are simulated using an anthropomorphic phantom as a member of the medical staff. Thermoluminescent dosemeters are attached in several positions of the phantom in order to determine some organ doses. From the comparison between the doses experimentally determined and the International and the Brazilian recommended occupational dose limits, the maximum number of examination that any member of the staff can perform was calculated

30 CFR 850.14 - Examination.

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Examination. 850.14 Section 850.14 Mineral..., EXAMINATION, AND CERTIFICATION OF BLASTERS PERMANENT REGULATORY PROGRAM REQUIREMENTS-STANDARDS FOR CERTIFICATION OF BLASTERS § 850.14 Examination. (a) The regulatory authority shall ensure that candidates for...

Statewide summary for Mississippi: Chapter H in Emergent wetlands status and trends in the northern Gulf of Mexico: 1950-2010

Science.gov (United States)

Handley, Larry; Spear, Kathryn A.; Leggett, Ali; Thatcher, Cindy A.

2012-01-01

. Recreation and tourism have a significant impact on Mississippi’s economy as well, annually attracting approximately 1.8 million visitors to the coast and generating approximately \\$3.5 billion statewide, about one-third of which comes from coastal tourism. Ninety percent of the coastal tourism expenditures come from recreational boating and related industries. Marine recreational fishing generates more than \\$50 million annually, with approximately 280,000 participants, more than a million recreational fishing expeditions, and over 40,000 resident saltwater sportfishing licenses sold each year. More than one-fourth of the anglers fishing in coastal Mississippi are tourists. Landings of shrimp, crabs, oysters, and finfish equal approximately 99.8 million kg (220 million lbs) of seafood annually. The entire seafood industry in coastal Mississippi, including processing of seafood caught in other Gulf States, generates approximately \\$450 million per year.

50 CFR 228.18 - Cross-examination.

Science.gov (United States)

2010-10-01

... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Cross-examination. 228.18 Section 228.18...-examination. (a) The presiding officer may: (1) Require the cross-examiner to outline the intended scope of the cross-examination; (2) Prohibit parties from cross-examining witnesses unless the presiding...

European windpower: project financing examined

International Nuclear Information System (INIS)

Mitchell, Catherine

1993-01-01

In part two of an examination of funding mechanisms for wind-generated electricity, the financing of wind projects in the major producers - Denmark, the Netherlands, Germany and the UK is examined. Part one examined the tariff and subsidy mechanisms available for wind generation in the same countries. (author)

38 CFR 4.61 - Examination.

Science.gov (United States)

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Examination. 4.61 Section... DISABILITIES Disability Ratings The Musculoskeletal System § 4.61 Examination. With any form of arthritis (except traumatic arthritis) it is essential that the examination for rating purposes cover all major...

Examination to assess the clinical examination and documentation of spine pathology among orthopedic residents.

Science.gov (United States)

Haglin, Jack M; Zeller, John L; Egol, Kenneth A; Phillips, Donna P

2017-12-01

The Accreditation Council for Graduate Medical Education (ACGME) guidelines requires residency programs to teach and evaluate residents in six overarching "core competencies" and document progress through educational milestones. To assess the progress of orthopedic interns' skills in performing a history, physical examination, and documentation of the encounter for a standardized patient with spinal stenosis, an objective structured clinical examination (OSCE) was conducted for 13 orthopedic intern residents, following a 1-month boot camp that included communications skills and curriculum in history and physical examination. Interns were objectively scored based on their performance of the physical examination, communication skills, completeness and accuracy of their electronic medical record (EMR), and their diagnostic conclusions gleaned from the patient encounter. The purpose of this study was to meaningfully assess the clinical skills of orthopedic post-graduate year (PGY)-1 interns. The findings can be used to develop a standardized curriculum for documenting patient encounters and highlight common areas of weakness among orthopedic interns with regard to the spine history and physical examination and conducting complete and accurate clinical documentation. A major orthopedic specialty hospital and academic medical center. Thirteen PGY-1 orthopedic residents participated in the OSCE with the same standardized patient presenting with symptoms and radiographs consistent with spinal stenosis. Videos of the encounters were independently viewed and objectively evaluated by one investigator in the study. This evaluation focused on the completeness of the history and the performance and completion of the physical examination. The standardized patient evaluated the communication skills of each intern with a separate objective evaluation. Interns completed these same scoring guides to evaluate their own performance in history, physical examination, and communications

30 CFR 955.14 - Examination.

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Examination. 955.14 Section 955.14 Mineral... AND ON INDIAN LANDS § 955.14 Examination. (a) Certificate issuance or reissuance. After submitting an... examination, as provided in paragraph (b) of this section. (b) Administration and content. (1) On a regular...

Examination process of a nuclear reactor fuel assembly and examination machine to bring the process into operation

International Nuclear Information System (INIS)

Delaroche, P.; Leseur, A.; Saglio, R.; Vaubert, Y.

1983-01-01

The machine to examine a fuel assembly of a nuclear reactor includes a support on which the assembly to be examined is placed, a source emitting waves, directed to the assembly to be examined, devices to examine the assembly to be examined that receive the emitted wave by the said source and that have been reflected by the assembly. The examination devices have an axis, this axis being directed to a mirror, this mirror being inclined in such a way that it reflects the waves reflected by the assembly to the examination devices, a radiation protection, to avoid the radiation emitted by the assembly, being diposed between the assembly and the examination devices [fr

12 CFR 741.1 - Examination.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Examination. 741.1 Section 741.1 Banks and... Unions and That Are Not Codified Elsewhere in NCUA's Regulations § 741.1 Examination. As provided in... examination may require access to all records, reports, contracts to which the credit union is a party, and...

The utility of mock oral examinations in preparation for the American Board of Surgery certifying examination.

Science.gov (United States)

Higgins, Rana M; Deal, Rebecca A; Rinewalt, Daniel; Hollinger, Edward F; Janssen, Imke; Poirier, Jennifer; Austin, Delores; Rendina, Megan; Francescatti, Amanda; Myers, Jonathan A; Millikan, Keith W; Luu, Minh B

2016-02-01

Determine the utility of mock oral examinations in preparation for the American Board of Surgery certifying examination (ABS CE). Between 2002 and 2012, blinded data were collected on 63 general surgery residents: 4th and 5th-year mock oral examination scores, first-time pass rates on ABS CE, and an online survey. Fifty-seven residents took the 4th-year mock oral examination: 30 (52.6%) passed and 27 (47.4%) failed, with first-time ABS CE pass rates 93.3% and 81.5% (P = .238). Fifty-nine residents took the 5th-year mock oral examination: 28 (47.5%) passed and 31 (52.5%) failed, with first-time ABS CE pass rates 82.1% and 93.5% (P = .240). Thirty-eight responded to the online survey, 77.1% ranked mock oral examinations as very or extremely helpful with ABS CE preparation. Although mock oral examinations and ABS CE passing rates do not directly correlate, residents perceive the mock oral examinations to be helpful. Copyright © 2016 Elsevier Inc. All rights reserved.

Triple jump examination evaluation of faculty examiners by dental student examinees.

Science.gov (United States)

Navazesh, Mahvash; Rich, Sandra K; Keim, Robert G

2014-05-01

The triple jump examination (TJE) is an oral examination that poses challenges for objective assessment. Student satisfaction levels with faculty assessment can provide information on quality of teaching and students' perceptions of the learning environment. The purpose of this study was to determine scale and interrater reliability of an instrument used by approximately 576 first-year dental students at one U.S. dental school for assessment of their faculty evaluators following midterm and final TJEs over a three-year period. One hundred and one faculty members served as administrators of the TJE with a range of one to 187 times (mean=44.10, median=29, mode=11). The grand mean for six items on a six-point Likert scale was 5.39 with a pooled standard deviation of 1.01. Results indicate positive agreement toward performance of examiners with strong interrater reliability (Average Measures ICC=0.936, Single Measures ICC=0.708) (F5,23475 = 51.564, pperform acceptable assessment from the students' perspective. Overall, these students expressed a high level of satisfaction with TJE faculty performance.

A Practical Concussion Physical Examination Toolbox.

Science.gov (United States)

Matuszak, Jason M; McVige, Jennifer; McPherson, Jacob; Willer, Barry; Leddy, John

With heightened awareness of concussion, there is a need to assess and manage the concussed patient in a consistent manner. Unfortunately, concussion physical examination has not been standardized or supported by evidence. Important questions remain about the physical examination. Review of ClinicalKey, Cochrane, MEDLINE, and PubMed prior to July 2015 was performed using search terms, including concussion, mTBI, physical examination, mental status, cranial nerves, reflexes, cervical, vestibular, and oculomotor. The references of the pertinent articles were reviewed for other relevant sources. Clinical review. Level 3. The pertinent physical examination elements for concussion include evaluation of cranial nerves, manual muscle testing, and deep tendon reflexes; inspecting the head and neck for trauma or tenderness and cervical range of motion; Spurling maneuver; a static or dynamic balance assessment; screening ocular examination; and a mental status examination that includes orientation, immediate and delayed recall, concentration, mood, affect, insight, and judgment. Other examination elements to consider, based on signs, symptoms, or clinical suspicion, include testing of upper motor neurons, cervical strength and proprioception, coordination, pupillary reactivity, and visual acuity; examination of the jaw, temporomandibular joint, and thoracic spine; fundoscopic evaluation; orthostatic vital signs; assessment of dynamic visual acuity; and screening for depression, anxiety, substance abuse disorders, and preinjury psychiatric difficulties. Various elements of the physical examination, such as screening ocular examination, cervical musculoskeletal examination, static and/or dynamic balance assessment, and mental status examination, appear to have utility for evaluating concussion; however, data on validity are lacking.

X-ray examinations pose little risk

International Nuclear Information System (INIS)

Servomaa, A.; Komppa, T.

1997-01-01

X-ray examinations account for about 15 per cent of Finns' radiation exposure and for roughly one out of a hundred deaths from cancer. The risk is small when compared to other risks in life and to the health benefits obtained from the examinations. About 4.1 million x-ray examinations were conducted in Finland in 1995, i.e. an average of 0.8 examinations per inhabitant. The mean effective dose was about 0.67 mSv per examination and about 0.54 mSv per inhabitant. Natural background radiation causes an annual radiation dose of approximately 3 mSv per person. Examinations of bones and soft tissues accounted for the highest number of x-ray images, roughly 2.1 million, of which half were examinations of the extremities. Some 1.3 million x-ray images were taken of the pulmonary organs, most of them being examinations of the lungs. Computed tomography and examinations of the gastrointestinal tract accounted for about 130,000 images each. To assess the radiation risk involved in x-ray examinations, we need knowledge or an estimate of the radiation doses of organs sensitive to radiation. Efficient calculation methods are available for this purpose. (orig.)

Financial Leverage Behaviour and Firm Performance: Evidence from Publicly Quoted Companies in Nigeria

Directory of Open Access Journals (Sweden)

Godsday Okoro Edesiri

2014-08-01

Full Text Available This paper scrutinizes financial leverage behaviour and firm performance of publicly quoted companies in Nigeria. Data of Leverage, Profitability and Firm Size were sourced from the Nigerian Stock Exchange Fact-book and Annual Report and Accounts of 120 publicly quoted companies in Nigeria during the period 1990 through 2013. Findings suggest that profitability and firm size had a negative effect on financial leverage behaviour of publicly quoted companies in Nigeria. Thus, it was recommended that firms should carry out projects that would help enhance size and profitability in all aspect of the firm. Size in terms of assets would help increase the internal funding. This in turn will have a positive impact on the financial structure of firm as more of internally generated funds will be used instead of external borrowings. Firms should not assume that making of profit shows good application of leverage as this was not found to be true from the analysis. This implies that the result can be relied upon for policy direction.

Ultrasonic Examination of Double-Shell Tank 241-AY-101. Examination completed October 2007

International Nuclear Information System (INIS)

Pardini, Allan F.; Weier, Dennis R.

2008-01-01

AREVA NC Inc., under contract from CH2M Hill Hanford Group, has performed an ultrasonic examination of selected portions of Double-Shell Tank 241-AY-101. PNNL is responsible for preparing a report(s) that describes the results of the AREVA ultrasonic examinations. This report is Revision 1 - more data has been added to the original report. The purpose of this examination was to provide information that could be used to evaluate the integrity of the wall of the primary tank. The requirements for the ultrasonic examination of Tank 241-AY-101 were to detect, characterize (identify, size, and locate), and record measurements made of any wall thinning, pitting, or cracks that might be present in the wall of the primary tank. Any measurements that exceed the requirements set forth in the Engineering Task Plan, RPP-Plan-27202 (Jensen 2005) and summarized on page 1 of this document, are to be reported to CH2M Hill Hanford Group and the Pacific Northwest National Laboratory for further evaluation. Under the contract with CH2M Hill Hanford Group, all data is to be recorded on electronic media and paper copies of all measurements are provided to Pacific Northwest National Laboratory for third-party evaluation. Pacific Northwest National Laboratory is responsible for preparing a report(s) that describes the results of the AREVA NC Inc. ultrasonic examinations.

34 CFR 101.79 - Cross-examination.

Science.gov (United States)

2010-07-01

... 34 Education 1 2010-07-01 2010-07-01 false Cross-examination. 101.79 Section 101.79 Education...-examination. A witness may be cross-examined on any matter material to the proceeding without regard to the scope of his direct examination. ...

Annual State of Connecticut Obstetrics and Gynecology Resident Research Day.

Science.gov (United States)

Seagle, Brandon-Luke L; Ballard, Jennifer; Kakar, Freshta; Panarelli, Erin; Samuelson, Robert; Shahabi, Shohreh

2015-01-01

To increase opportunities for Obstetrics and Gynecology(Ob/Gyn) residents to present their research, an Annual State of Connecticut Ob/Gyn Resident Research Day (RRD) was created. At the first annual RRD, 33 residents, representing five of six Connecticut Ob/Gyn residency programs, presented 39 poster and eight oral presentations. RRD evaluators rated the overall symposium and the quality of resident oral and poster presentations as either "excellent" or "above average." Residency program directors reported that the symposium was "very helpful" for evidencing resident scholarship as required by the Accreditation Council for Graduate Medical Education (ACGME). Surveyed residents reported that the symposium promoted their research and was a valuable investment of their time. An annual specialty-specific, statewide RRD was created, experienced good participation, and was well evaluated. The annual, statewide Ob/Gyn RRD may serve as a model for development of other specialty-specific, statewide RRD events.

A Practical Concussion Physical Examination Toolbox

Science.gov (United States)

Matuszak, Jason M.; McVige, Jennifer; McPherson, Jacob; Willer, Barry; Leddy, John

2016-01-01

Context: With heightened awareness of concussion, there is a need to assess and manage the concussed patient in a consistent manner. Unfortunately, concussion physical examination has not been standardized or supported by evidence. Important questions remain about the physical examination. Evidence Acquisition: Review of ClinicalKey, Cochrane, MEDLINE, and PubMed prior to July 2015 was performed using search terms, including concussion, mTBI, physical examination, mental status, cranial nerves, reflexes, cervical, vestibular, and oculomotor. The references of the pertinent articles were reviewed for other relevant sources. Study Design: Clinical review. Level of Evidence: Level 3. Results: The pertinent physical examination elements for concussion include evaluation of cranial nerves, manual muscle testing, and deep tendon reflexes; inspecting the head and neck for trauma or tenderness and cervical range of motion; Spurling maneuver; a static or dynamic balance assessment; screening ocular examination; and a mental status examination that includes orientation, immediate and delayed recall, concentration, mood, affect, insight, and judgment. Other examination elements to consider, based on signs, symptoms, or clinical suspicion, include testing of upper motor neurons, cervical strength and proprioception, coordination, pupillary reactivity, and visual acuity; examination of the jaw, temporomandibular joint, and thoracic spine; fundoscopic evaluation; orthostatic vital signs; assessment of dynamic visual acuity; and screening for depression, anxiety, substance abuse disorders, and preinjury psychiatric difficulties. Conclusion: Various elements of the physical examination, such as screening ocular examination, cervical musculoskeletal examination, static and/or dynamic balance assessment, and mental status examination, appear to have utility for evaluating concussion; however, data on validity are lacking. PMID:27022058

Secondhand Smoke Exposure 7 Years After an Indoor Smoke-Free Law.

Science.gov (United States)

St Claire, Ann W; Amato, Michael S; Boyle, Raymond G; Rode, Peter; Kinney, Ann M

2018-01-01

To examine locations of secondhand smoke (SHS) exposure among nonsmokers, 7 years after a statewide smoke-free policy. Data collected via statewide, random digit dial telephone survey. Response rates were 64.7% for landline and 73.5% for cell phone. Minnesota, 2014. Representative sample of 7887 nonsmoking adults. Self-reported locations of SHS exposure and opinions on smoke-free restrictions. Descriptive statistics and logistic regression. A total of 35.5% of nonsmokers reported SHS exposure in the past 7 days. The greatest proportion of exposure occurred in community settings (31.7%) followed by cars (6.9%) and in the home (3.2%). Young adults were more likely to be exposed in a home or car than older adults. Nonsmokers living with a smoker were 39.6 (20.6-75.8) times more likely to be exposed to SHS in their home and 5.3 (4.1-6.8) times more likely to be exposed in a car, compared to those who did not live with a smoker. SHS exposure continues after comprehensive smoke-free policies restricted it from public places. Disparities in exposure rates exist for those who live with a smoker, are young, and have low incomes. Findings suggest the need for additional policies that will have the greatest public health benefit.

Secondary Students' Writing Achievement Goals: Assessing the Mediating Effects of Mastery and Performance Goals on Writing Self-Efficacy, Affect, and Writing Achievement

Directory of Open Access Journals (Sweden)

Meryem Yilmaz Soylu

2017-08-01

Full Text Available The two studies reported here explored the factor structure of the newly constructed Writing Achievement Goal Scale (WAGS, and examined relationships among secondary students' writing achievement goals, writing self-efficacy, affect for writing, and writing achievement. In the first study, 697 middle school students completed the WAGS. A confirmatory factor analysis revealed a good fit for this data with a three-factor model that corresponds with mastery, performance approach, and performance avoidance goals. The results of Study 1 were an indication for the researchers to move forward with Study 2, which included 563 high school students. The secondary students completed the WAGS, as well as the Self-efficacy for Writing Scale, and the Liking Writing Scale. Students also self-reported grades for writing and for language arts courses. Approximately 6 weeks later, students completed a statewide writing assessment. We tested a theoretical model representing relationships among Study 2 variables using structural equation modeling including students' responses to the study scales and students' scores on the statewide assessment. Results from Study 2 revealed a good fit between a model depicting proposed relationships among the constructs and the data. Findings are discussed relative to achievement goal theory and writing.

Individual plant examination: Submittal guidance

International Nuclear Information System (INIS)

1989-08-01

Based on a Policy Statement on Severe Accidents Regarding Future Designs and Existing Plants, the performance of a plant examination is requested from the licensee of each nuclear power plant. The plant examination looks for vulnerabilities to severe accidents and cost-effective safety improvements that reduce or eliminate the important vulnerabilities. This document delineates guidance for reporting the results of that plant examination. 38 refs., 2 tabs

Organization of roentgenofluorographic examination of population

International Nuclear Information System (INIS)

Khomenko, A.G.; Yukelis, L.I.; Ivanova, E.S.

1988-01-01

The organizational-methodical supervision of roentgenofluorography comprises two main subdivisions: supervision of stationary and transportable roentgenofluorographic rooms as well as control and organization of mass preventive examinations of the population. The second subdivision comprises planning, accountancy of examinations, control of examination of different groups of population. Problems of registration and accountancy of the examined patients, groups of increased risk, peculiarities of children and teenage examination as well as application of computers are discussed

7 CFR 4290.692 - Examination fees.

Science.gov (United States)

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Examination fees. 4290.692 Section 4290.692... Recordkeeping, Reporting, and Examination Requirements for RBICs Examinations of Rbics by the Secretary for Regulatory Compliance § 4290.692 Examination fees. (a) General. The Secretary will assess fees for...

13 CFR 108.692 - Examination fees.

Science.gov (United States)

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Examination fees. 108.692 Section...NMVCâ) PROGRAM Recordkeeping, Reporting, and Examination Requirements for NMVC Companies Examinations of Nmvc Companies by Sba for Regulatory Compliance § 108.692 Examination fees. (a) General. SBA will...

47 CFR 13.209 - Examination procedures.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Examination procedures. 13.209 Section 13.209 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL RADIO OPERATORS Examination System § 13.209 Examination procedures. (a) Each examination for a commercial radio operator license must be administered at a...

Louisiana motorcycle fatalities in the wake of governmentally implemented change: a retrospective analysis of the motorcycle morbidity and mortality before, during, and after the repeal of a statewide helmet mandate.

Science.gov (United States)

Strom, Shane F; Ambekar, Sudheer; Madhugiri, Venkatesh S; Nanda, Anil

2013-06-01

On August 15, 2004, Louisiana's universal motorcycle helmet mandate was reinstated. Previous studies have shown that mortality and morbidity of motorcycle riders who crashed had increased during the 5 years the mandate was repealed. The objective of this study was to discern whether the reinstatement of the universal helmet mandate has resulted in a subsequent decrease in motorcycle-related mortality and morbidity in the state of Louisiana. A retrospective analysis was performed observing the regularity of helmet use and the associated morbidity and mortality of motorcycle traffic accidents from the time before, during, and after the universal motorcycle helmet mandate was repealed in the state of Louisiana. Fatality statistics were obtained through the National Highway Safety Traffic Association. Injury, helmet use, and collision data were obtained from the Louisiana Highway Safety Commission. Motorcycle registration data were obtained from the Federal Highway Administration. Motorcycle crash-related fatalities increased significantly when the statewide helmet mandate was repealed, and interestingly, after reinstatement, these fatality rates never returned to their previous lows. Motorcycle fatalities have increased out of proportion to the increase in motorbike registrations, even when yearly fatalities are normalized to fatalities per 10,000 registered bikes. An all-time high in fatalities was seen in 2006, a year subsequent to the mandate's reinstatement. Fatalities per collision were elevated significantly after the mandate's repeal but did not return to prerepeal lows after the mandate's reinstatement. Although helmet use after reinstatement has reached all-time highs, fatality rates have remained elevated since the original mandate repeal in 1999. Other achievable changes in state policy and law enforcement should be explored to quell this heightened risk to motorcycle enthusiasts in Louisiana, and states considering changing their own motorcycle helmet

Detecting Changes in Newspaper Reporting of Suicide after a Statewide Social Marketing Campaign.

Science.gov (United States)

Abbott, Michele; Ramchand, Rajeev; Chamberlin, Margaret; Marcellino, William

2018-06-01

A social marketing campaign was introduced in California in 2012, promoting media adherence to consensus-based guidelines on reporting about suicide. We examine adherence to these guidelines by applying quantitative scores to articles in California and a national control group in two six-month intervals prior to and following campaign implementation. Utilizing a difference-in-difference approach, we found no significant effect of the campaign, though the type of article content was a significant indicator of the overall score. Findings also demonstrated a nation-wide downward trend in the quality of reporting. Qualitative results suggest a need for more flexible guidelines in light of a technologically driven news culture.

5 CFR 339.303 - Examination procedures.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Examination procedures. 339.303 Section... QUALIFICATION DETERMINATIONS Medical Examinations § 339.303 Examination procedures. (a) When an agency orders or offers a medical examination under this subpart, it must inform the applicant or employee in writing of...

50 CFR 18.88 - Cross-examination.

Science.gov (United States)

2010-10-01

... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false Cross-examination. 18.88 Section 18.88... PLANTS (CONTINUED) MARINE MAMMALS Notice and Hearing on Section 103 Regulations § 18.88 Cross-examination... examination; and (2) Exclude cross-examination questions that are immaterial, irrelevant or unduly repetitious...

Using State-Wide Multiple Measures for School Leadership and Management: Costs Incurred vs. Benefits Gained

Science.gov (United States)

Hentschke, Guilbert; Wohlstetter, Priscilla; Hirman, Jennifer; Zeehandelaar, Dara

2011-01-01

In this article, we examine the utility and value of multiple measures of school performance for school leaders and managers. The research was conducted within the context of the state of California through an investigation of how operators, managers and authorisers of autonomous "charter" (publicly financed but privately operated)…

21 CFR 880.6265 - Examination gown.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Examination gown. 880.6265 Section 880.6265 Food... § 880.6265 Examination gown. (a) Identification. An examination gown is a device intended for medical... covering during a medical examination. (b) Classification. Class I (general controls). The device is exempt...

7 CFR 15.118 - Cross-examination.

Science.gov (United States)

2010-01-01

... 7 Agriculture 1 2010-01-01 2010-01-01 false Cross-examination. 15.118 Section 15.118 Agriculture Office of the Secretary of Agriculture NONDISCRIMINATION Rules of Practice and Procedure for Hearings...-examination. Cross-examination will be limited to the scope of direct examination and matters at issue in the...

37 CFR 1.809 - Examination procedures.

Science.gov (United States)

2010-07-01

... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Examination procedures. 1.809... Biological Material § 1.809 Examination procedures. (a) The examiner shall determine pursuant to § 1.104 in... deposited biological material sufficient to specifically identify it and to permit examination; and (4) The...

Examination of optimal radiation quality in the lead equivalent examination of x-ray protective clothing

International Nuclear Information System (INIS)

Inoue, Shinichi; Matsuzawa, Rie; Matsumoto, Mitsuhiro

2004-01-01

The objective of this study was to determine the effective lead thickness of the apron for radiation protective clothing, i.e., the lead equivalent, a method of performing the lead equivalent examination is provided in the Japanese Industrial Standards (JIS). We proposed a method of computation using an attenuation coefficient, and examined the measurement accuracy and optimal radiation quality using both. We were able to compute the lead equivalent with sufficient accuracy when using radiation quality of about 60 keV in the range of radiation quality examined. This technique was also examined in the measurement used for the marketing of radiation protective clothing. (author)

Performance on the adult rheumatology in-training examination and relationship to outcomes on the rheumatology certification examination.

Science.gov (United States)

Lohr, Kristine M; Clauser, Amanda; Hess, Brian J; Gelber, Allan C; Valeriano-Marcet, Joanne; Lipner, Rebecca S; Haist, Steven A; Hawley, Janine L; Zirkle, Sarah; Bolster, Marcy B

2015-11-01

The American College of Rheumatology (ACR) Adult Rheumatology In-Training Examination (ITE) is a feedback tool designed to identify strengths and weaknesses in the content knowledge of individual fellows-in-training and the training program curricula. We determined whether scores on the ACR ITE, as well as scores on other major standardized medical examinations and competency-based ratings, could be used to predict performance on the American Board of Internal Medicine (ABIM) Rheumatology Certification Examination. Between 2008 and 2012, 629 second-year fellows took the ACR ITE. Bivariate correlation analyses of assessment scores and multiple linear regression analyses were used to determine whether ABIM Rheumatology Certification Examination scores could be predicted on the basis of ACR ITE scores, United States Medical Licensing Examination scores, ABIM Internal Medicine Certification Examination scores, fellowship directors' ratings of overall clinical competency, and demographic variables. Logistic regression was used to evaluate whether these assessments were predictive of a passing outcome on the Rheumatology Certification Examination. In the initial linear model, the strongest predictors of the Rheumatology Certification Examination score were the second-year fellows' ACR ITE scores (β = 0.438) and ABIM Internal Medicine Certification Examination scores (β = 0.273). Using a stepwise model, the strongest predictors of higher scores on the Rheumatology Certification Examination were second-year fellows' ACR ITE scores (β = 0.449) and ABIM Internal Medicine Certification Examination scores (β = 0.276). Based on the findings of logistic regression analysis, ACR ITE performance was predictive of a pass/fail outcome on the Rheumatology Certification Examination (odds ratio 1.016 [95% confidence interval 1.011-1.021]). The predictive value of the ACR ITE score with regard to predicting performance on the Rheumatology Certification Examination

Facilitators and Barriers of Implementing a Measurement Feedback System in Public Youth Mental Health.

Science.gov (United States)

Kotte, Amelia; Hill, Kaitlin A; Mah, Albert C; Korathu-Larson, Priya A; Au, Janelle R; Izmirian, Sonia; Keir, Scott S; Nakamura, Brad J; Higa-McMillan, Charmaine K

2016-11-01

This study examines implementation facilitators and barriers of a statewide roll-out of a measurement feedback system (MFS) in a youth public mental health system. 76 % of all state care coordinators (N = 47) completed interviews, which were coded via content analysis until saturation. Facilitators (e.g., recognition of the MFS's clinical utility) and barriers (e.g., MFS's reliability and validity) emerged paralleling the Exploration, Adoption/Preparation, Implementation, and Sustainment framework outlined by Aarons et al. (Adm Policy Mental Health Mental Health Serv Res, 38:4-23, 2011). Sustainment efforts may leverage innovation fit, individual adopter, and system related facilitators.

Substance Use among Youth with Currently and Formerly Incarcerated Parents

Science.gov (United States)

Davis, Laurel; Shlafer, Rebecca J.

2017-01-01

Parental incarceration impacts millions of children in the U.S. and has important consequences for youths’ adjustment. Children of incarcerated parents are at risk for a host of negative psychosocial outcomes, including substance abuse problems. Using data from a statewide survey of youth behavior, the effect of both present and past parental incarceration on youths’ report of their substance use behaviors was examined. Both present and past parental incarceration was significantly associated with use of alcohol, tobacco, marijuana, and prescription drugs, as well as substance abuse and dependence. Implications for practice and research are discussed. PMID:29170570

Pulmonary and Critical Care In-Service Training Examination Score as a Predictor of Board Certification Examination Performance.

Science.gov (United States)

Kempainen, Robert R; Hess, Brian J; Addrizzo-Harris, Doreen J; Schaad, Douglas C; Scott, Craig S; Carlin, Brian W; Shaw, Robert C; Duhigg, Lauren; Lipner, Rebecca S

2016-04-01

Most trainees in combined pulmonary and critical care medicine fellowship programs complete in-service training examinations (ITEs) that test knowledge in both disciplines. Whether ITE scores predict performance on the American Board of Internal Medicine Pulmonary Disease Certification Examination and Critical Care Medicine Certification Examination is unknown. To determine whether pulmonary and critical care medicine ITE scores predict performance on subspecialty board certification examinations independently of trainee demographics, program director competency ratings, fellowship program characteristics, and prior medical knowledge assessments. First- and second-year fellows who were enrolled in the study between 2008 and 2012 completed a questionnaire encompassing demographics and fellowship training characteristics. These data and ITE scores were matched to fellows' subsequent scores on subspecialty certification examinations, program director ratings, and previous scores on their American Board of Internal Medicine Internal Medicine Certification Examination. Multiple linear regression and logistic regression were used to identify independent predictors of subspecialty certification examination scores and likelihood of passing the examinations, respectively. Of eligible fellows, 82.4% enrolled in the study. The ITE score for second-year fellows was matched to their certification examination scores, which yielded 1,484 physicians for pulmonary disease and 1,331 for critical care medicine. Second-year fellows' ITE scores (β = 0.24, P ITE odds ratio, 1.12 [95% confidence interval, 1.07-1.16]; Internal Medicine Certification Examination odds ratio, 1.01 [95% confidence interval, 1.01-1.02]). Similar results were obtained for predicting Critical Care Medicine Certification Examination scores and for passing the examination. The predictive value of ITE scores among first-year fellows on the subspecialty certification examinations was comparable to second

45 CFR 81.79 - Cross-examination.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Cross-examination. 81.79 Section 81.79 Public... UNDER PART 80 OF THIS TITLE Hearing Procedures § 81.79 Cross-examination. A witness may be cross-examined on any matter material to the proceeding without regard to the scope of his direct examination. ...

46 CFR 71.50-3 - Drydock examination, internal structural examination, underwater survey, and alternate hull exam...

Science.gov (United States)

2010-10-01

..., underwater survey, and alternate hull exam intervals. 71.50-3 Section 71.50-3 Shipping COAST GUARD...-3 Drydock examination, internal structural examination, underwater survey, and alternate hull exam... wooden hulls must undergo two drydock and two internal structural examinations within any five year...

Discrepancies between the school examination en central examination grades of non-Dutch students. Extent and explanations

NARCIS (Netherlands)

Rekers-Mombarg, L. T. M.; Harms, G. J.; van der Werf, M. P. C.

2009-01-01

From previous research in Dutch secondary education it is known that the central (national) examination grades are at average lower than school examination grades, and that the discrepancy between both grades is larger for students from non-Dutch origin. This study examined the individual

Ultrasonic Examination of Double-Shell Tank 241-AY-101 Examination Completed August 2003

International Nuclear Information System (INIS)

Pardini, Allan F.; Posakony, Gerald J.

2003-01-01

COGEMA Engineering Corporation (COGEMA), under a contract from CH2M Hill Hanford Group (CH2M Hill), has performed an ultrasonic nondestructive examination of selected portions of Double-Shell Tank 241-AY-101. The purpose of this examination was to provide information that could be used to evaluate the integrity of the wall of the secondary tank. The requirements for the ultrasonic examination of Tank 241-AY-101 were to detect, characterize (identify, size, and locate), and record measurements made of any wall thinning or pitting that might be present in the wall of the secondary tank. Any measurements that exceed the requirements set forth in the Engineering Task Plan (ETP), RPP--11832 (Jensen 2002) and summarized on page 1 of this document, are reported to CH2M Hill and the Pacific Northwest National Laboratory (PNNL) for further evaluation. Under the contract with CH2M Hill, all data is to be recorded on disk and paper copies of all measurements are provided to PNNL for third-party evaluation. PNNL is responsible for preparing a report that describes the results of the COGEMA ultrasonic examinations

Ultrasonic Examination of Double-Shell Tank 241-AP-104. Examination Completed August 2004

International Nuclear Information System (INIS)

Pardini, Allan F.; Posakony, Gerald J.

2004-01-01

COGEMA Engineering Corporation (COGEMA), under a contract from CH2M Hill Hanford Group (CH2M Hill), has performed an ultrasonic nondestructive examination of selected portions of Double-Shell Tank 241-AP-104. The purpose of this examination was to provide information that could be used to evaluate the integrity of the wall of the primary tank. The requirements for the ultrasonic examination of Tank 241-AP-104 were to detect, characterize (identify, size, and locate), and record measurements made of any wall thinning, pitting, or cracks that might be present in the wall of the primary tank. Any measurements that exceed the requirements set forth in the Engineering Task Plan (ETP), RPP-17750 (Jensen 2003) and summarized on page 1 of this document, are reported to CH2M Hill and the Pacific Northwest National Laboratory (PNNL) for further evaluation. Under the contract with CH2M Hill, all data is to be recorded on disk and paper copies of all measurements are provided to PNNL for third-party evaluation. PNNL is responsible for preparing a report that describes the results of the COGEMA ultrasonic examinations

Ultrasonic Examination of Double-Shell Tank 241-SY-103. Examination completed February 2004

International Nuclear Information System (INIS)

Pardini, Allan F.; Posakony, Gerald J.

2004-01-01

COGEMA Engineering Corporation (COGEMA), under a contract from CH2M Hill Hanford Group (CH2M Hill), has performed an ultrasonic nondestructive examination of selected portions of Double-Shell Tank 241-SY-103. The purpose of this examination was to provide information that could be used to evaluate the integrity of the wall of the primary tank. The requirements for the ultrasonic examination of Tank 241-SY-103 were to detect, characterize (identify, size, and locate), and record measurements made of any wall thinning, pitting, or cracks that might be present in the wall of the primary tank. Any measurements that exceed the requirements set forth in the Engineering Task Plan (ETP), RPP-17750 (Jensen 2003) and summarized on page 1 of this document, are reported to CH2M Hill and the Pacific Northwest National Laboratory (PNNL) for further evaluation. Under the contract with CH2M Hill, all data is to be recorded on disk and paper copies of all measurements are provided to PNNL for third-party evaluation. PNNL is responsible for preparing a report that describes the results of the COGEMA ultrasonic examinations

Ultrasonic Examination of Double-Shell Tank 241-AZ-102 Examination Completed August 2003

International Nuclear Information System (INIS)

Pardini, Allan F.; Posakony, Gerald J.

2003-01-01

COGEMA Engineering Corporation (COGEMA), under a contract from CH2M Hill Hanford Group (CH2M Hill), has performed an ultrasonic nondestructive examination of selected portions of Double-Shell Tank 241-AZ-102. The purpose of this examination was to provide information that could be used to evaluate the integrity of the wall of the primary tank. The requirements for the ultrasonic examination of Tank 241-AZ-102 were to detect, characterize (identify, size, and locate), and record measurements made of any wall thinning, pitting, or cracks that might be present in the wall of the primary tank. Any measurements that exceed the requirements set forth in the Engineering Task Plat (ETP), RPP-11832 (Jensen 2002) and summarized on page 1 of this document, are reported to CH2M Hill and the Pacific Northwest National Laboratory (PNNL) for further evaluation. Under the contract with CH2M Hill, all data is to be recorded on disk and paper copies of all measurements are provided to PNNL for third-party evaluation. PNNL is responsible for preparing a report that describes the results of the COGEMA ultrasonic examinations

Quality Assessment of Colonoscopy Reporting: Results from a Statewide Cancer Screening Program

Directory of Open Access Journals (Sweden)

Jun Li

2010-01-01

Full Text Available This paper aimed to assess quality of colonoscopy reports and determine if physicians in practice were already documenting recommended quality indicators, prior to the publication of a standardized Colonoscopy Reporting and Data System (CO-RADS in 2007. We examined 110 colonoscopy reports from 2005-2006 through Maryland Colorectal Cancer Screening Program. We evaluated 25 key data elements recommended by CO-RADS, including procedure indications, risk/comorbidity assessments, procedure technical descriptions, colonoscopy findings, specimen retrieval/pathology. Among 110 reports, 73% documented the bowel preparation quality and 82% documented specific cecal landmarks. For the 177 individual polyps identified, information on size and morphology was documented for 87% and 53%, respectively. Colonoscopy reporting varied considerately in the pre-CO-RADS period. The absence of key data elements may impact the ability to make recommendations for recall intervals. This paper provides baseline data to assess if CO-RADS has an impact on reporting and how best to improve the quality of reporting.

Comparing Physical Examination With Sonographic Versions of the Same Examination Techniques for Splenomegaly.

Science.gov (United States)

Cessford, Tara; Meneilly, Graydon S; Arishenkoff, Shane; Eddy, Christopher; Chen, Luke Y C; Kim, Daniel J; Ma, Irene W Y

2017-12-08

To determine whether sonographic versions of physical examination techniques can accurately identify splenomegaly, Castell's method (Ann Intern Med 1967; 67:1265-1267), the sonographic Castell's method, spleen tip palpation, and the sonographic spleen tip technique were compared with reference measurements. Two clinicians trained in bedside sonography patients recruited from an urban hematology clinic. Each patient was examined for splenomegaly using conventional percussion and palpation techniques (Castell's method and spleen tip palpation, respectively), as well as the sonographic versions of these maneuvers (sonographic Castell's method and sonographic spleen tip technique). Results were compared with a reference standard based on professional sonographer measurements. The sonographic Castell's method had greater sensitivity (91.7% [95% confidence interval, 61.5% to 99.8%]) than the traditional Castell's method (83.3% [95% confidence interval, 51.6% to 97.9%]) but took longer to perform [mean ± SD, 28.8 ± 18.6 versus 18.8 ± 8.1 seconds; P = .01). Palpable and positive sonographic spleen tip results were both 100% specific, but the sonographic spleen tip method was more sensitive (58.3% [95% confidence interval, 27.7% to 84.8%] versus 33.3% [95% confidence interval, 9.9% to 65.1%]). Sonographic versions of traditional physical examination maneuvers have greater diagnostic accuracy than the physical examination maneuvers from which they are derived but may take longer to perform. We recommend a combination of traditional physical examination and sonographic techniques when evaluating for splenomegaly at the bedside. © 2017 by the American Institute of Ultrasound in Medicine.

An examination of the factors affecting people's participation in future health examinations based on community health exam interventions.

Science.gov (United States)

Tu, Shih-Kai; Liao, Hung-En

2014-01-01

Community-based intervention health examinations were implemented at a health care facility to comply with the government's primary health care promotion policy. The theory of planned behavior model was applied to examine the effect that community-based health examinations had on people's health concepts regarding seeking future health examinations. The research participants were individuals who had received a health examination provided at two branches of a hospital in central Taiwan in 2012. The hospital's two branches held a total of 14 free community-based health examination sessions. The hospital provided health examination equipment and staff to perform health examinations during public holidays. We conducted an exploratory questionnaire survey to collect data and implemented cross-sectional research based on anonymous self-ratings to examine the public's intention to receive future community-based or hospital-based health examinations. Including of 807 valid questionnaires, accounting for 89.4% of the total number of questionnaires distributed. The correlation coefficients of the second-order structural model indicate that attitudes positively predict behavioral intentions (γ = .66, p intentions (γ = .66, p intentions (γ = -.71, p > .05). The results of the first-order structural model indicated that the second-order constructs had a high explanatory power for the first-order constructs. People's health concepts regarding health examinations and their desire to continue receiving health examinations must be considered when promoting health examinations in the community. Regarding hospital management and the government's implementation of primary health care, health examination services should address people's medical needs to increase coverage and participation rates and reduce the waste of medical resources.

76 FR 18399 - Changes To Implement the Prioritized Examination Track (Track I) of the Enhanced Examination...

Science.gov (United States)

2011-04-04

... prioritized examination fee, processing fee, and publication fee. Therefore, the fee amount due on filing for...) the $4,000 prioritized examination fee; (3) the $130 processing fee; and (4) the $300 publication fee...) prioritized examination fee; (3) the $130 processing fee; and (4) the $300 publication fee. Under prioritized...

Neurological examination in small animals

Directory of Open Access Journals (Sweden)

Viktor Paluš

2014-03-01

Full Text Available This clinical review about the neurological examination in small animals describes the basics about the first steps of investigation when dealing with neurological patients. The knowledge of how to perform the neurological examination is important however more important is how to correctly interpret these performed tests. A step-by-step approach is mandatory and examiners should master the order and the style of performing these tests. Neurological conditions can be sometimes very distressing for owners and for pets that might not be the most cooperating. The role of a veterinary surgeon, as a professional, is therefore to collect the most relevant history, to examine a patient in a professional manner and to give to owners an educated opinion about the further treatment and prognosis. However neurological examinations might look challenging for many. But it is only the clinical application of neuroanatomy and neurophysiology to an every-day situation for practicing veterinarians and it does not require any specific in-to-depth knowledge. This clinical review is aimed not only to provide the information on how to perform the neurological examination but it is also aimed to appeal on veterinarians to challenge their daily routine and to start practicing on neurologically normal patients. This is the best and only way to differentiate between the normal and abnormal in a real situation.

Correlation of United States Medical Licensing Examination and Internal Medicine In-Training Examination Performance

Science.gov (United States)

Perez, Jose A., Jr.; Greer, Sharon

2009-01-01

The Internal Medicine In-Training Examination (ITE) is administered during residency training in the United States as a self-assessment and program assessment tool. Performance on this exam correlates with outcome on the American Board of Internal Medicine Certifying examination. Internal Medicine Program Directors use the United States Medical…

Estimation of the number of wild pigs found in the United States

Energy Technology Data Exchange (ETDEWEB)

Mayer, J. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

2014-08-01

Based on a compilation of three estimation approaches, the total nationwide population of wild pigs in the United States numbers approximately 6.3 million animals, with that total estimate ranging from 4.4 up to 11.3 million animals. The majority of these numbers (99 percent), which were encompassed by ten states (i.e., Alabama, Arkansas, California, Florida, Georgia, Louisiana, Mississippi, Oklahoma, South Carolina and Texas), were based on defined estimation methodologies (e.g., density estimates correlated to the total potential suitable wild pig habitat statewide, statewide harvest percentages, statewide agency surveys regarding wild pig distribution and numbers). In contrast to the pre-1990 estimates, none of these more recent efforts, collectively encompassing 99 percent of the total, were based solely on anecdotal information or speculation. To that end, one can defensibly state that the wild pigs found in the United States number in the millions of animals, with the nationwide population estimated to arguably vary from about four million up to about eleven million individuals.

Radiographic examination of the equine head

International Nuclear Information System (INIS)

Park, R.D.

1993-01-01

Radiographic examinations of the equine head can be performed with portable x-ray machines. The views comprising the examination depend on the area of the head being examined. With a knowledge of radiographic anatomy and radiographic signs of disease, valuable diagnostic information can be obtained from the radiographic examination. In addition, the radiographic information can also be used to develop a prognosis and determine the most appropriate therapy

Breast Self- Examination Contradiction

OpenAIRE

Ayla Akkas Gursoy

2008-01-01

Breast cancer is very important health problem among women in the World and Turkey. Although treatment chance is very rising and survival is getting longer thanks to early diagnosis in breast cancer. Some discussion is making related to breast self examination which is one of the early detection methods in recent years. This article consider the discussions about breast self examination under the historical development light. [TAF Prev Med Bull 2008; 7(3.000): 257-260

Breast Self- Examination Contradiction

Directory of Open Access Journals (Sweden)

Ayla Akkas Gursoy

2008-06-01

Full Text Available Breast cancer is very important health problem among women in the World and Turkey. Although treatment chance is very rising and survival is getting longer thanks to early diagnosis in breast cancer. Some discussion is making related to breast self examination which is one of the early detection methods in recent years. This article consider the discussions about breast self examination under the historical development light. [TAF Prev Med Bull 2008; 7(3.000: 257-260

Predictive value of the korean academy of family medicine in-training examination for certifying examination.

Science.gov (United States)

Cho, Jung-Jin; Kim, Ji-Yong

2011-09-01

In-training examination (ITE) is a cognitive examination similar to the written test, but it is different from the Clinical Practice Examination of the Korean Academy of Family Medicine (KAFM) Certification Examination (CE). The objective of this is to estimate the positive predictive value of the KAFM-ITE for identifying residents at risk for poor performance on the three types of KAFM-CE. 372 residents who completed the KAFM-CE in 2011 were included. We compared the mean KAFM-CE scores with ITE experience. We evaluated the correlation and the positive predictive value (PPV) of ITE for the multiple choice question (MCQ) scores of 1st written test & 2nd slide examination, the total clinical practice examination scores, and the total sum of 2nd test. 275 out of 372 residents completed ITE. Those who completed ITE had significantly higher MCQ scores of 1st written test than those who did not. The correlation of ITE scores with 1st written MCQ (0.627) was found to be the highest among the other kinds of CE. The PPV of the ITE score for 1st written MCQ scores was 0.672. The PPV of the ITE score ranged from 0.376 to 0.502. The score of the KAFM ITE has acceptable positive predictive value that could be used as a part of comprehensive evaluation system for residents in cognitive field.

From IPE [individual plant examinations] to IPEEE [individual plant examination of external events

International Nuclear Information System (INIS)

Newton, I.M.

1994-01-01

In addition to doing individual plant examinations (IPEs) which assess risk to nuclear plants from internal factors, all US plants are now also required to analyse external events and submit an IPEEE (Individual Plant Examination of External Events). Specifically, the IPEEEs require an assessment of plant-specific risks from the following types of initiating events: seismic events; fire; wind; tornadoes; flooding; accidents involving transportation or nearby facilities, such as oil refineries. (author)

Cost accounting of radiological examinations. Cost analysis of radiological examinations of intermediate referral hospitals and general practice.

Science.gov (United States)

Lääperi, A L

1996-01-01

The purpose of this study was to analyse the cost structure of radiological procedures in the intermediary referral hospitals and general practice and to develop a cost accounting system for radiological examinations that takes into consideration all relevant cost factors and is suitable for management of radiology departments and regional planning of radiological resources. The material comprised 174,560 basic radiological examinations performed in 1991 at 5 intermediate referral hospitals and 13 public health centres in the Pirkanmaa Hospital District in Finland. All radiological departments in the hospitals were managed by a specialist in radiology. The radiology departments at the public health care centres operated on a self-referral basis by general practitioners. The data were extracted from examination lists, inventories and balance sheets; parts of the data were estimated or calculated. The radiological examinations were compiled according to the type of examination and equipment used: conventional, contrast medium, ultrasound, mammography and roentgen examinations with mobile equipment. The majority of the examinations (87%) comprised conventional radiography. For cost analysis the cost items were grouped into 5 cost factors: personnel, equipment, material, real estate and administration costs. The depreciation time used was 10 years for roentgen equipment, 5 years for ultrasound equipment and 5 to 10 years for other capital goods. An annual interest rate of 10% was applied. Standard average values based on a sample at 2 hospitals were used for the examination-specific radiologist time, radiographer time and material costs. Four cost accounting versions with varying allocation of the major cost items were designed. Two-way analysis of variance of the effect of different allocation methods on the costs and cost structure of the examination groups was performed. On the basis of the cost analysis a cost accounting program containing both monetary and

Practice-related examinations are feasible

Directory of Open Access Journals (Sweden)

Schrauth, Markus

2005-04-01

Full Text Available The 9th Revision of the German Federal Medical Training Regulations demands a practice-related assessment of medical students. On the way to these new regulations German faculties face as well problems related to a lack of experience of lecturers, tutors, examiners, and students with the required examination procedures as strains of a financial and logistic kind. How to succeed in introducing suitable examinations at short notice and which positive effects can be achieved is shown by the Faculty of Medicine of the university of Tübingen.

Guidelines examination of victims of sexual assault harmonization of forensic and medico-legal examination of persons.

Science.gov (United States)

Ludes, B; Geraut, A; Väli, M; Cusack, D; Ferrara, D; Keller, E; Mangin, P; Vieira, D N

2018-02-21

Sexual assault is a complex situation with medical, psychological, and legal aspects. Forensic experts play a major role in terms of forensic and gynecological medical examination and evidence collection in order to maintain the chain of custody. Victims should be examined by a specially trained medico-legal examiner in order to avoid multiple examinations in the surroundings that do not meet minimum health standards. The evolution and treatment of sexual assault victims are time-intensive and should optimally be provided by a team that includes a forensic medical doctor. These guidelines will be of interest to forensic medical doctors who will have responsibility for the examination and assessment of victims of sexual violence and can be used as a day-to-day service document and/or a guide to develop health service for victims of sexual violence.

Nervous system examination on YouTube.

Science.gov (United States)

Azer, Samy A; Aleshaiwi, Sarah M; Algrain, Hala A; Alkhelaif, Rana A

2012-12-22

Web 2.0 sites such as YouTube have become a useful resource for knowledge and are used by medical students as a learning resource. This study aimed at assessing videos covering the nervous system examination on YouTube. A research of YouTube was conducted from 2 November to 2 December 2011 using the following key words "nervous system examination", "nervous system clinical examination", "cranial nerves examination", "CNS examination", "examination of cerebellum", "balance and coordination examination". Only relevant videos in the English language were identified and related URL recorded. For each video, the following information was collected: title, author/s, duration, number of viewers, number of posted comments, and total number of days on YouTube. Using criteria comprising content, technical authority and pedagogy parameters, videos were rated independently by three assessors and grouped into educationally useful and non-educationally useful. A total of 2240 videos were screened; 129 were found to have relevant information to nervous system examination. Analysis revealed that 61 (47%) of the videos provided useful information on the nervous system examination. These videos scored (mean ± SD, 14.9 ± 0.2) and mainly covered examination of the whole nervous system (8 videos, 13%), cranial nerves (42 videos, 69%), upper limbs (6 videos, 10%), lower limbs (3 videos, 5%), balance and co-ordination (2 videos, 3%). The other 68 (53%) videos were not useful educationally; scoring (mean ± SD, 11.1 ± 3.0). The total viewers of all videos was 2,189,434. Useful videos were viewed by 1,050,445 viewers (48% of total viewers). The total viewership per day for useful videos was 1,794.5 and for non-useful videos 1,132.0. The differences between the three assessors were insignificant (less than 0.5 for the mean and 0.3 for the SD). Currently, YouTube provides an adequate resource for learning nervous system examination, which can be used by medical students

5 CFR 330.401 - Competitive examination.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Competitive examination. 330.401 Section 330.401 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS RECRUITMENT... examination. In each entrance examination for the positions of custodian, elevator operator, guard, and...

Examine Your Skin

Medline Plus

Full Text Available ... We Are Be On Our PAGE MIF Staff Programs & Services Scientific Advisory Board Advisory Board Patrons & Sponsors ... us for One-on-One Support Donate Share Facebook Twitter Newsletter Examine Your Skin Watch the video ...

Examine Your Skin

Medline Plus

Full Text Available ... Store In Memory Melanoma Info Melanoma Facts Melanoma Prevention Sunscreen Suggestions Examine Your Skin Newly Diagnosed? Understanding ... Biopsy: The First Step Sentinel Node Biopsy Melanoma Treatment: Stages I & II Melanoma Treatment: Stage III Melanoma ...

Nondestructive examination development and demonstration plan

International Nuclear Information System (INIS)

Weber, J.R.

1991-01-01

Nondestructive examination (NDE) of waste matrices using penetrating radiation is by nature very subjective. Two candidate systems of examination have been identified for use in WRAP 1. This test plan describes a method for a comparative evaluation of different x-ray examination systems and techniques

Ultrasonic Examination of Double-Shell Tank 214-AW-102 Knuckle Region. Examination completed February 2003

International Nuclear Information System (INIS)

Pardini, Allan F.; Posakony, Gerald J.

2003-01-01

COGEMA Engineering Corporation (COGEMA), under a contract from CH2M Hill Hanford Group (CH2M Hill), has performed an ultrasonic examination of the knuckle region of Double-Shell Tank 241-AW-102 utilizing the Remotely Operated Nondestructive Examination (RONDE) system. The purpose of this examination was to provide information that could be used to evaluate the integrity of the knuckle region of the primary tank. The requirements for the ultrasonic examination of Tank 241-AW-102 were to detect, characterize (identify, size, and locate), and record measurements made of any circumferentially oriented cracks that might be present in the knuckle area of the primary tank. Any measurements that exceed the requirements set forth in the Engineering Task Plan (ETP), RPP-7869, are reported to CH2M Hill and the Pacific Northwest National Laboratory (PNNL) for further evaluation. Under the contract with CH2M Hill, all data is to be recorded on disk and paper copies of all measurements are provided t o PNNL for third-party evaluation. PNNL is responsible for preparing a report(s) that describes the results of the COGEMA ultrasonic examinations

Examine Your Skin

Medline Plus

Full Text Available ... us for One-on-One Support Donate Share Facebook Twitter Newsletter Examine Your Skin Watch the video ... 29498 © 2013 Melanoma International Foundation. All Rights Reserved. Privacy Policy | Terms of Use Toll-free: 866-463- ...

Examining the reliability and validity of the Hebrew version of the Mini Mental State Examination.

Science.gov (United States)

Werner, P; Heinik, J; Mendel, A; Reicher, B; Bleich, A

1999-10-01

The Mini Mental State Examination is used worldwide for the screening and diagnosis of dementia. The aim of the present study was to examine the reliability and validity of the Hebrew version of the Mini Mental State Examination. The Hebrew version of the Mini Mental State Examination was administered to 36 demented and 19 non-demented elderly persons. Test-retest reliability scores were calculated as exact agreement rates, and ranged from good to excellent for all the items. Strong convergent validity, as measured by the correlation between the MMSE and the CAM-COG (r = 0.94), was found. Good predictive value was observed as over three-quarters of the participants were correctly classified as demented or non-demented. The Hebrew version of the MMSE was found to be a useful and valid instrument for the determination of dementia in the elderly population.

30 CFR 75.361 - Supplemental examination.

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Supplemental examination. 75.361 Section 75.361... MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Ventilation § 75.361 Supplemental examination. (a) Except for certified persons conducting examinations required by this subpart, within 3 hours before anyone...

25 CFR 11.1014 - Medical examination.

Science.gov (United States)

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Medical examination. 11.1014 Section 11.1014 Indians... ORDER CODE Juvenile Offender Procedure § 11.1014 Medical examination. The children's court may order a medical examination for a minor who is alleged to be a juvenile offender. ...

CT examinations in older patients

International Nuclear Information System (INIS)

Sciuk, J.; Peters, P.E.

1989-01-01

A total of 2,878 unselected subsequent CT examinations carried out in 1984 were analyzed retrospectively. All studies were performed in a university hospital with a centralized department of diagnostic radiology. Most of the patients investigated were hospitalized; there were only 12% outpatients. Of the patients studied 12.6% were older than 65 years and 20.5% older than 60; 17.7% were emergency cases and patients between 16 and 25 years of age represented the largest fraction. In all other age groups the relative distribution between emergency cases and regular studies revealed no significant differences. There was no statistically significant difference between the older age group (patients older than 65 years) and the total population of this study in almost all items investigated, i.e., no differences in CT examination time and no differences in preparation time (time between two CT studies). The rate of abdominal CT examinations was 7% higher in the older age group, while the relative distribution of all other CT examinations was again comparable to the total population under study. Thus, the expected increase in patients in the older age group does not measurably prolong the CT examination time. This statement applies to a major referral center with a high percentage of inpatients. (orig.) [de

Non-Power Reactor Operator Licensing Examiner Standards

International Nuclear Information System (INIS)

1994-06-01

The Non-Power Reactor Operator Licensing Examiner Standards provide policy and guidance to NRC examiners and establish the procedures and practices for examining and licensing of applicants for NRC operator licenses pursuant to Part 55 of Title 10 of the Code of Federal Regulations (10 CFR Part 55). They are intended to assist NRC examiners and facility licensees to understand the examination process better and to provide for equitable and consistent administration of examinations to all applicants by NRC examiners. These standards are not a substitute for the operator licensing regulations and are subject to revision or other internal operator examination licensing policy changes. As appropriate, this standard will be revised periodically to accommodate comments and reflect new information or experience

19 CFR 19.10 - Examination packages.

Science.gov (United States)

2010-04-01

... 19 Customs Duties 1 2010-04-01 2010-04-01 false Examination packages. 19.10 Section 19.10 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY... Examination packages. Merchandise sent from a bonded warehouse to the appraiser's stores for examination shall...

30 CFR 75.364 - Weekly examination.

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Weekly examination. 75.364 Section 75.364... MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Ventilation § 75.364 Weekly examination. (a) Worked-out... bleeder system. (b) Hazardous conditions. At least every 7 days, an examination for hazardous conditions...

22 CFR 42.66 - Medical examination.

Science.gov (United States)

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Medical examination. 42.66 Section 42.66... NATIONALITY ACT, AS AMENDED Application for Immigrant Visas § 42.66 Medical examination. (a) Medical examination required of all applicants. Before the issuance of an immigrant visa, the consular officer shall...

13 CFR 107.692 - Examination fees.

Science.gov (United States)

2010-01-01

... Addition—% of base examination fee No prior violations 15 Partnership or limited liability company 5... liability company, you will pay an additional charge equal to 5% of your base fee; (4) If you are a Licensee... COMPANIES Recordkeeping, Reporting, and Examination Requirements for Licensees Examinations of Licensees by...

Technological Change in the Workplace: A Statewide Survey of Community College Library and Learning Resources Personnel.

Science.gov (United States)

Poole, Carolyn E.; Denny, Emmett

2001-01-01

Discussion of the effects of technostress on library personnel focuses on an investigation that examined how employees in Florida community college libraries and learning resources centers are dealing with technological change in their work environment. Considers implications for planning and implementing technological change and includes…

Radiographic examination for successful dental implant

International Nuclear Information System (INIS)

Lee, Sam Sun; Choi, Soon Chul

2005-01-01

Recently implant has become an important field in dental clinic. Radiographic examination of pre- and post-operation is essential for successful treatment. Clinicians should have knowledge about the purpose of the radiographic examination, suitable imaging modality for the cases, anatomic landmarks of tooth and jaw bone, advantage and limitation of panoramic radiographic examination for implant, principle and interpretation of cross-sectional imaging, bone mineral density, post-operative radiographic examination. This paper will be helpful to get above information for dentists who want to do dental implant successfully.

37 CFR 1.167 - Examination.

Science.gov (United States)

2010-07-01

... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Examination. 1.167 Section 1.167 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF... Examination. Applications may be submitted by the Patent and Trademark Office to the Department of Agriculture...

Southeast Asian Languages Proficiency Examinations.

Science.gov (United States)

Brown, James Dean; And Others

The design, administration, revision, and validation of the Southeast Asian Summer Studies Institute proficiency examinations are reported. The examinations were created as parallel language proficiency tests in each of five languages: Indonesian, Khmer, Tagalog, Thai, and Vietnamese. Four tests were developed in each language: multiple-choice…

22 CFR 92.60 - Examination procedures.

Science.gov (United States)

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Examination procedures. 92.60 Section 92.60... and Letters Rogatory § 92.60 Examination procedures. (a) Explaining interrogatory to witness. If the... examination of a witness propound such inquiries as may be necessary to satisfy himself whether the witness is...

22 CFR 41.108 - Medical examination.

Science.gov (United States)

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Medical examination. 41.108 Section 41.108... AND NATIONALITY ACT, AS AMENDED Application for Nonimmigrant Visa § 41.108 Medical examination. (a) Requirements for medical examination. An applicant for a nonimmigrant visa shall be required to take a medical...

10 CFR 55.21 - Medical examination.

Science.gov (United States)

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Medical examination. 55.21 Section 55.21 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) OPERATORS' LICENSES Medical Requirements § 55.21 Medical examination. An applicant for a license shall have a medical examination by a physician. A licensee shall have a medical...

46 CFR 11.707 - Examination requirements.

Science.gov (United States)

2010-10-01

... 46 Shipping 1 2010-10-01 2010-10-01 false Examination requirements. 11.707 Section 11.707 Shipping... OFFICER ENDORSEMENTS Professional Requirements for Pilots § 11.707 Examination requirements. (a) An... required to pass the examination described in subpart I of this part. (b) An applicant for an extension of...

28 CFR 12.40 - Public examination.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Public examination. 12.40 Section 12.40... ESPIONAGE, COUNTERESPIONAGE, OR SABOTAGE MATTERS UNDER THE ACT OF AUGUST 1, 1956 § 12.40 Public examination. Registration statements shall be available for public examination at the offices of the Registration Unit...

19 CFR 134.53 - Examination packages.

Science.gov (United States)

2010-04-01

... 19 Customs Duties 1 2010-04-01 2010-04-01 false Examination packages. 134.53 Section 134.53... TREASURY COUNTRY OF ORIGIN MARKING Articles Found Not Legally Marked § 134.53 Examination packages. (a) Site of marking—(1) Customs custody. Articles (or containers) in examination packages may be marked by...

To License or Not to License: An Examination of State Statutes Regarding Private Investigators and Digital Examiners

Directory of Open Access Journals (Sweden)

Thomas Lonardo

2008-09-01

Full Text Available In this paper the authors examine statutes that regulate, license, and enforce investigative functions in each US state. After identification and review of Private Investigator licensing requirements, the authors find that very few state statutes explicitly differentiate between Private Investigators and Digital Examiners. After contacting all state agencies the authors present a distinct grouping organizing state approaches to professional Digital Examiner licensing. The authors conclude that states must differentiate between Private Investigator and Digital Examiner licensing requirements and oversight.

A disjointed effort: paediatric musculoskeletal examination.

LENUS (Irish Health Repository)

Gill, Irwin

2012-07-01

Musculoskeletal (MSK) symptoms are a frequent cause of emergency department attendance for children, and while most often indicative of benign or self-limiting disease, such symptoms can occasionally be the first presentation of serious illness such as leukaemia or juvenile idiopathic arthritis. MSK examination, however, is often not included as part of the routine paediatric examination. The authors aimed to evaluate how often and how thoroughly MSK examination was performed during admissions to the paediatric ward and to compare it with the examination of other symptoms in relation to the presenting complaint and eventual diagnosis.

Assessing the Special Education Faculty Shortage: The Crisis in California--A Statewide Study of the Professoriate

Science.gov (United States)

Evans, Susan; Eliot, Michael; Hood, Jolene; Driggs, Max; Mori, Ayako; Johnson, Theresa

2005-01-01

This article examines several questions related to the faculty shortage in special education. Using California as a case, the authors address these questions: (1) What were the personal and professional characteristics of current special education faculty preparing special education credential and doctoral candidates?; (2) What were the…

40 CFR 750.40 - Cross-examination.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Cross-examination. 750.40 Section 750... Processing and Distribution in Commerce Exemptions § 750.40 Cross-examination. (a) After the close of the... cross-examination. The request must be received by EPA within one week after a full transcript of the...

Health examination for A-bomb survivors

International Nuclear Information System (INIS)

Ito, Chikako

1996-01-01

The health examination for A-bomb survivors by national, prefectural and city administrations was described and discussed on its general concept, history, time change of examinee number, improvement of examination, prevalence of individual diseases, significance of cancer examinations, examinees' point of view and future problems. Subjects were the survivors living in Hiroshima city: in 1994, their number was 100,188, whose ages were 63 y in average for males consisting of 39.5% and 67 y for females of 60.5%. The examination was begun in 1957 on the law for medical care for the survivors firstly and then systematically in 1961. From 1965, it was performed 4 times a year, and in 1988, one examination in the four was made for cancer. Authors' Center examined previously 90% but recently 70% of the examinees. The remainder underwent the examination in other medical facilities. Tests are blood analysis, electrocardiography and computed radiography of chest with imaging plate, of which data have been accumulated either in photodisc or in host computer. From 1973 to 1993, the cardiovascular diseases increased from 6.1% to 26.9%, metabolic and endocrinic ones like diabetes, 3.6% to 19.7%, and bowel ones, 0.9% to 12.3%. Correlations of these diseases with A-bomb irradiation are not elucidated and possibly poor. Five classes of cancer examinations are performed but the examinee rate in the survivors is as low as 7.6-21.8% (1993). The cancer of the large intestine is increasing. The overall examinee rates in the survivors were 70.6% in 1965-1967, 69.5% in 1976-1977 and 58.2% in 1990. In conclusion, how to examine the survivors, who are getting older, as many as possible is the future problem. (H.O.)

8 CFR 1245.5 - Medical examination.

Science.gov (United States)

2010-01-01

... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Medical examination. 1245.5 Section 1245.5... examination. Pursuant to section 232(b) of the Act, an applicant for adjustment of status shall be required to have a medical examination by a designated civil surgeon, whose report setting forth the findings of...

8 CFR 245.5 - Medical examination.

Science.gov (United States)

2010-01-01

... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Medical examination. 245.5 Section 245.5... THAT OF PERSON ADMITTED FOR PERMANENT RESIDENCE § 245.5 Medical examination. Pursuant to section 232(b) of the Act, an applicant for adjustment of status shall be required to have a medical examination by...

High School Principals and School Reform: Lessons Learned from a Statewide Study of Project Re:Learning.

Science.gov (United States)

Anderson, Lorin W.; Shirley, J. Robert

1995-01-01

Summarizes a study examining the high school principal's role in providing the leadership needed to explore and implement Project Re:Learning. The 4-phase study initially included 15 schools and involved questionnaires, interviews, and shadowing. Identifies six types of administrators: the absent administrator, the pawn, the pragmatic principal,…

40 CFR 750.8 - Cross-examination.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Cross-examination. 750.8 Section 750.8... Section 6 of the Toxic Substances Control Act § 750.8 Cross-examination. (a) After the close of the... cross-examination. The request shall be received by EPA within one week after a full transcript of the...

78 FR 27343 - Medical Examiner's Certification Integration

Science.gov (United States)

2013-05-10

... efficiency; (2) reflect current medical terminology and examination components; and (3) be a self-contained... 391 [Docket No. FMCSA-2012-0178] RIN 2126-AB40 Medical Examiner's Certification Integration AGENCY...: FMCSA proposes to require certified medical examiners (MEs) performing physical examinations on drivers...

Examination of factors associated with use rates after transition from a universal to partial motorcycle helmet use law.

Science.gov (United States)

Russo, Brendan J; Barrette, Timothy P; Morden, Jeffery; Savolainen, Peter T; Gates, Timothy J

2017-01-02

Motorcycle riders account for a disproportionately high number of traffic injuries and fatalities compared to occupants of other vehicle types. Though research has demonstrated the benefits of helmet use in preventing serious and fatal injuries in the event of a crash, helmet use has remained relatively stable in the United States, where the most recent national estimates show a 64% use rate. Use rates have been markedly lower among those states that do not have a universal helmet law for all riders. In 2012, the state of Michigan repealed its longstanding mandatory helmet use law. In order to gain insights as to the effects of this legislative change, a study was conducted to examine short-term changes in helmet use and identify factors associated with use rates. A statewide direct observation survey was conducted 1 year after the transition from a universal helmet law to a partial helmet law. A random parameters logistic regression model was estimated to identify motorcyclist, roadway, and environmental characteristics associated with helmet use. This modeling framework accounts for both intravehicle correlation (between riders and passengers on the same motorcycle) as well as unobserved heterogeneity across riders due to important unobserved factors. Helmet use was shown to vary across demographic segments of the motorcyclist population. Use rates were higher among Caucasian riders, as well as among those age 60 and above. No significant difference was observed between male and female riders. Use was also found to vary geographically, temporally, and with respect to various environmental characteristics. Geographically, helmet use rates tended to be correlated with historical restraint use trends, which may be reflective of riding environment and general differences in the riding population. To this end, rates were also highly variable based upon the type of motorcycle and whether the motorcyclist was wearing high-visibility gear. The study results demonstrate

Radionuclide examination in rheumatology

International Nuclear Information System (INIS)

Streda, A.; Kolar, J.; Valesova, M.

1984-01-01

On the basis of twenty years of experience with the use of radionuclides in bone and articular rheumatic diseases indications for such examinations are summed up. The main advantage of the use of radionuclide methods is that they bring forward early diagnosis of tissue reconstruction which can thus be detected at the stage of microstructural changes. They also provide earlier and more reliable detection of the degree of the pathological process than is provided by X-ray examination. In some cases scintiscan may also be found useful as a method for following up the results of treatment of rheumatic diseases. (author)

Present State Examination

DEFF Research Database (Denmark)

Pedersen, Kamilla; Bertelsen, Aksel

Present State Examination (PSE) 5. udgave er en revideret version af speciallæge i psykiatri Aksel Bertelsens oprindelige materiale. Aksel Bertelsen er ophavsmand til PSE og til den danske udgave af ICD-10. Revisionen omfatter et forbedret layout, en modernisering af sproget, tilføjelse af...

A study of the effects of English language proficiency and scientific reasoning skills on the acquisition of science content knowledge of Hispanic English language learners and native English language-speaking students participating in grade 10 science classes

Science.gov (United States)

Torres, Hector Neftali, Sr.

2000-11-01

The purpose of this study was to examine the effects of English language proficiency and levels of scientific reasoning skills of Hispanic English language learners and native English language speaking students on their acquisition of science content knowledge as measured by a state-wide standardized science test. The researcher studied a group of high school Hispanic English language learners and native English language speaking students participating in Grade 10 science classes. The language proficiency of the students was to be measured through the use of the Test of English as a Foreign Language (TOEFL) instrument. A Classroom Test of Scientific Reasoning developed by Lawson (1978) was administered in either English or Spanish to the group of Hispanic English language learners and in English to the group of native English language-speaking students in order to determine their levels of scientific reasoning skills. The students' acquisition of science content knowledge was measured through the use of statewide-standardized science test developed by the State's Department of Education. This study suggests that the levels of English language proficiency appear to influence the acquisition of science content knowledge of Hispanic English language learners in the study. The results of the study also suggest that with regards to scientific reasoning skills, students that showed high levels or reflective reasoning skills for the most part performed better on the statewide-standardized science test than students with intuitive or transitional reasoning skills. This assertion was supported by the studies conducted by Lawson and his colleagues, which showed that high levels of reasoning or reflective reasoning skills are prerequisite for most high school science courses. The findings in this study imply that high order English language proficiency combined with high levels of reasoning skills enhances students' abilities to learn science content subject matter. This

7 CFR 97.100 - Examination of applications.

Science.gov (United States)

2010-01-01

... 7 Agriculture 3 2010-01-01 2010-01-01 false Examination of applications. 97.100 Section 97.100... PLANT VARIETY AND PROTECTION Examinations, Allowances, and Denials § 97.100 Examination of applications. (a) [Reserved] (b) Examinations of applications shall include a review of all available documents...

46 CFR 176.635 - Preliminary examination requirements.

Science.gov (United States)

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Preliminary examination requirements. 176.635 Section... (UNDER 100 GROSS TONS) INSPECTION AND CERTIFICATION Hull and Tailshaft Examinations § 176.635 Preliminary examination requirements. (a) If you exclusively use divers to examine the underwater hull plating, you must...

Examination of musculoskeletal chest pain

DEFF Research Database (Denmark)

Brunse, Mads Hostrup; Stochkendahl, Mette Jensen; Vach, Werner

2010-01-01

using a standardized examination protocol, (2) to determine inter-observer reliability of single components of the protocol, and (3) to determine the effect of observer experience. Eighty patients were recruited from an emergency cardiology department. Patients were eligible if an obvious cardiac or non......-cardiac diagnosis could not be established at the cardiology department. Four observers (two chiropractors and two chiropractic students) performed general health and manual examination of the spine and chest wall. Percentage agreement, Cohen's Kappa and ICC were calculated for observer pairs (chiropractors.......01 to 0.59. Provided adequate training of observers, the examination protocol can be used in carefully selected patients in clinical settings and should be included in pre- and post-graduate clinical training....

Health care quality measures for children and adolescents in Foster Care: feasibility testing in electronic records.

Science.gov (United States)

Deans, Katherine J; Minneci, Peter C; Nacion, Kristine M; Leonhart, Karen; Cooper, Jennifer N; Scholle, Sarah Hudson; Kelleher, Kelly J

2018-02-22

Preventive quality measures for the foster care population are largely untested. The objective of the study is to identify healthcare quality measures for young children and adolescents in foster care and to test whether the data required to calculate these measures can be feasibly extracted and interpreted within an electronic health records or within the Statewide Automated Child Welfare Information System. The AAP Recommendations for Preventive Pediatric Health Care served as the guideline for determining quality measures. Quality measures related to well child visits, developmental screenings, immunizations, trauma-related care, BMI measurements, sexually transmitted infections and depression were defined. Retrospective chart reviews were performed on a cohort of children in foster care from a single large pediatric institution and related county. Data available in the Ohio Statewide Automated Child Welfare Information System was compared to the same population studied in the electronic health record review. Quality measures were calculated as observed (received) to expected (recommended) ratios (O/E ratios) to describe the actual quantity of recommended health care that was received by individual children. Electronic health records and the Statewide Automated Child Welfare Information System data frequently lacked important information on foster care youth essential for calculating the measures. Although electronic health records were rich in encounter specific clinical data, they often lacked custodial information such as the dates of entry into and exit from foster care. In contrast, Statewide Automated Child Welfare Information System included robust data on custodial arrangements, but lacked detailed medical information. Despite these limitations, several quality measures were devised that attempted to accommodate these limitations. In this feasibility testing, neither the electronic health records at a single institution nor the county level Statewide

"PERLE bedside-examination-course for candidates in state examination" - Developing a training program for the third part of medical state examination (oral examination with practical skills).

Science.gov (United States)

Karthaus, Anne; Schmidt, Anita

2016-01-01

In preparation for the state examination, many students have open questions and a need for advice. Tutors of the Skills Lab PERLE-"Praxis ERfahren und Lernen" (experiencing and learning practical skills) have developed a new course concept to provide support and practical assistance for the examinees. The course aims to familiarize the students with the exam situation in order to gain more confidence. This enables the students to experience a confrontation with the specific situation of the exam in a protected environment. Furthermore, soft skills are utilized and trained. Concept of the course: The course was inspired by the OSCE-model (Objective Structured Clinical Examination), an example for case-based learning and controlling. Acquired knowledge can be revised and extended through the case studies. Experienced tutors provide assistance in discipline-specific competencies, and help in organizational issues such as dress code and behaviour. Evaluation of the course: An evaluation was conducted by the attending participants after every course. Based on this assessment, the course is constantly being developed. In March, April and October 2015 six courses, with a total of 84 participants, took place. Overall 76 completed questionnaires (91%) were analysed. Strengths of the course are a good tutor-participants-ratio with 1:4 (1 Tutor provides guidance for 4 participants), the interactivity of the course, and the high flexibility in responding to the group's needs. Weaknesses are the tight schedule, and the currently not yet performed evaluation before and after the course. In terms of "best practise", this article shows an example of how to offer low-cost and low-threshold preparation for the state examination.

Web-based pathology practice examination usage

Directory of Open Access Journals (Sweden)

Edward C Klatt

2014-01-01

Full Text Available Context: General and subject specific practice examinations for students in health sciences studying pathology were placed onto a free public internet web site entitled web path and were accessed four clicks from the home web site menu. Subjects and Methods: Multiple choice questions were coded into. html files with JavaScript functions for web browser viewing in a timed format. A Perl programming language script with common gateway interface for web page forms scored examinations and placed results into a log file on an internet computer server. The four general review examinations of 30 questions each could be completed in up to 30 min. The 17 subject specific examinations of 10 questions each with accompanying images could be completed in up to 15 min each. The results of scores and user educational field of study from log files were compiled from June 2006 to January 2014. Results: The four general review examinations had 31,639 accesses with completion of all questions, for a completion rate of 54% and average score of 75%. A score of 100% was achieved by 7% of users, ≥90% by 21%, and ≥50% score by 95% of users. In top to bottom web page menu order, review examination usage was 44%, 24%, 17%, and 15% of all accessions. The 17 subject specific examinations had 103,028 completions, with completion rate 73% and average score 74%. Scoring at 100% was 20% overall, ≥90% by 37%, and ≥50% score by 90% of users. The first three menu items on the web page accounted for 12.6%, 10.0%, and 8.2% of all completions, and the bottom three accounted for no more than 2.2% each. Conclusions: Completion rates were higher for shorter 10 questions subject examinations. Users identifying themselves as MD/DO scored higher than other users, averaging 75%. Usage was higher for examinations at the top of the web page menu. Scores achieved suggest that a cohort of serious users fully completing the examinations had sufficient preparation to use them to support

46 CFR 176.655 - Hull examination reports.

Science.gov (United States)

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Hull examination reports. 176.655 Section 176.655... TONS) INSPECTION AND CERTIFICATION Hull and Tailshaft Examinations § 176.655 Hull examination reports. (a) If you use only divers for the underwater survey portion of the Alternative Hull Examination (AHE...

Design and implementation of online examination administration ...

African Journals Online (AJOL)

Online examination system is a web-based examination system where examination is taken online i.e. through the internet or intranet using computer system. It is an effective solution for mass education evaluation. We have developed an online examination system based on a Browser/Server framework using Microsoft ...

38 CFR 18b.58 - Cross-examination.

Science.gov (United States)

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Cross-examination. 18b.58... Procedures § 18b.58 Cross-examination. A witness may be cross-examined on any matter material to the proceeding without regard to the scope of his direct examination. ...

A Matter of Exposition: Examination and Education

Science.gov (United States)

Schröder, Sabrina; Thompson, Christiane

2015-01-01

While current literature on examination and testing mostly engages with the objectivity of exams and their procedural logic, this article is concerned with the 'ethical dimension' of examination: Examinations provoke a particular relation to oneself, possibly self-transformation. The praxis of examination entails self-confrontation in the light of…

Analysis based on the passrate of the 2013 ICO examinations taken by worldwide examiners

Directory of Open Access Journals (Sweden)

Wen Liu

2014-12-01

Full Text Available AIM: To find out the weaknesses of the cultivation of the Chinese ophthalmology physicians and the gap between Chinese and the international ophthalmology physicians, so that provide the advice on the future cultivation of the Chinese ophthalmology physicians. METHODS: The passrate of the 2013 ICO examinations taken by worldwide examiners by common statistical methods was analyzed. RESULTS:The results indicated that the test scores of Chinese candidates' were lower than that of the international average level, there was a obvious gap existed between Chinese and other countries' ophthalmology physicians. It showed that Chinese candidates were not quite adaptable to this examination, basic science and clinical level needed to be improved. CONCLUSION: It may shows that the effects on the mid-anaphase of our country's ophthalmology residency training are not so good, which area we should pay more attentions.

Examinations in radiology with commented answers

International Nuclear Information System (INIS)

Wittmaack, F.M.

1980-01-01

This book is meant to be a help in the preparation for the examination in the subject of radiology. Original questions from the examinations of the past years and questions put by the author cover all subjects of the catalogue. All questions are answered, with additional comments in order to ensure the understanding of the subject, thus creating best preconditions for a successful examination. (orig./HP) [de

46 CFR 115.655 - Hull examination reports.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Hull examination reports. 115.655 Section 115.655... CERTIFICATION Hull and Tailshaft Examinations § 115.655 Hull examination reports. (a) If you use only divers for the underwater survey portion of the Alternative Hull Examination (AHE), you must provide the Officer...

Best practices: the Utah Youth Suicide Study: best practices for suicide prevention through the juvenile court system.

Science.gov (United States)

Gray, Doug; Dawson, Kristin L; Grey, Todd C; McMahon, William M

2011-12-01

Utah is among a group of Western Mountain states in which suicide rates among youths are consistently high. The Utah Youth Suicide Study incorporated data from every government agency in Utah, utilizing a statewide Office of the Medical Examiner. A key finding was that 63% of suicide decedents had contact with the juvenile courts. The group developed a best practices model within the juvenile court system for early mental health intervention. Significant cost savings were demonstrated. The model includes screening at-risk teenagers with the Youth Outcome Questionnaire. Treatment includes both psychiatric care and in-home behavioral intervention. Services were effectively delivered on a large scale.

Preliminary construction of a service provider--informed domestic violence research agenda.

Science.gov (United States)

Murray, Christine E; Welch, Metoka L

2010-12-01

This article presents the results of a statewide survey of domestic violence (DV) service providers that focused on the needs, background characteristics, and opinions of service providers related to research. The survey included an examination of service providers' motivation for working in the field, research background and training, and perceptions of research as well as the topics they believe are important for researchers to study, the resources they consult to learn about DV, and their suggestions to help researchers learn more about the nature of their work. The results are integrated into a preliminary agenda for future DV research that accounts for the needs and insight of service providers.

Effects of contact-based mental illness stigma reduction programs: age, gender, and Asian, Latino, and White American differences.

Science.gov (United States)

Wong, Eunice C; Collins, Rebecca L; Cerully, Jennifer L; Yu, Jennifer W; Seelam, Rachana

2018-03-01

Mental illness stigma disproportionately affects help seeking among youth, men, and ethnic minorities. As part of a comprehensive statewide initiative to reduce mental illness stigma and discrimination in California, a broad set of contact-based educational programs were widely disseminated. This study examined whether the effects of contact-based educational programs varied depending on the age, gender, and race-ethnicity of participants. Participants (N = 4122) attended a contact-based educational program that was delivered as part of the statewide initiative to reduce mental illness stigma and discrimination. Self-administered surveys assessing beliefs, attitudes, and intentions toward mental illnesses and treatment were conducted immediately before and after participation in contact-based educational programs. Participant age, gender, and race-ethnicity significantly moderated pre-post changes in mental illness stigma. Although all groups exhibited significant pre-post changes across most of the stigma domains assessed, young adults, females, and Asian and Latino American participants reported larger improvements compared to older adults, males, and Whites, respectively. Findings suggest that contact-based educational programs can achieve immediate reductions in mental illness stigma across a variety of sociodemographic groups and may particularly benefit young adults and racial-ethnic minorities. Further research is needed to assess whether contact-based educational programs can sustain longer-term changes and aid in the reduction of disparities in mental illness stigma and treatment.

Computer assisted Objective structured clinical examination versus Objective structured clinical examination in assessment of Dermatology undergraduate students.

Science.gov (United States)

Chaudhary, Richa; Grover, Chander; Bhattacharya, S N; Sharma, Arun

2017-01-01

The assessment of dermatology undergraduates is being done through computer assisted objective structured clinical examination at our institution for the last 4 years. We attempted to compare objective structured clinical examination (OSCE) and computer assisted objective structured clinical examination (CA-OSCE) as assessment tools. To assess the relative effectiveness of CA-OSCE and OSCE as assessment tools for undergraduate dermatology trainees. Students underwent CA-OSCE as well as OSCE-based evaluation of equal weightage as an end of posting assessment. The attendance as well as the marks in both the examination formats were meticulously recorded and statistically analyzed using SPSS version 20.0. Intercooled Stata V9.0 was used to assess the reliability and internal consistency of the examinations conducted. Feedback from both students and examiners was also recorded. The mean attendance for the study group was 77% ± 12.0%. The average score on CA- OSCE and OSCE was 47.4% ± 19.8% and 53.5% ± 18%, respectively. These scores showed a mutually positive correlation, with Spearman's coefficient being 0.593. Spearman's rank correlation coefficient between attendance scores and assessment score was 0.485 for OSCE and 0.451 for CA-OSCE. The Cronbach's alpha coefficient for all the tests ranged from 0.76 to 0.87 indicating high reliability. The comparison was based on a single batch of 139 students. Such an evaluation on more students in larger number of batches over successive years could help throw more light on the subject. Computer assisted objective structured clinical examination was found to be a valid, reliable and effective format for dermatology assessment, being rated as the preferred format by examiners.

LABORATORY EXAMINATION IN NERVE AGENT INTOXICATION

Directory of Open Access Journals (Sweden)

Jiří Bajgar

2013-01-01

Full Text Available Diagnosis of nerve agent intoxication is based on anamnestic data, clinical signs and laboratory examination. For acute poisoning, cholinesterase activity in the blood (erythrocyte AChE, plasma/serum BuChE is sensitive, simple and most frequent laboratory examination performed in biochemical laboratories. Specialized examinations to precise treatment (reactivation test or to make retrospective diagnosis (fluoride induced reactivation etc. can be conducted. Other sophisticated methods are available, too.

Conversion between Addenbrooke's Cognitive Examination III and Mini-Mental State Examination.

Science.gov (United States)

Matías-Guiu, Jordi A; Pytel, Vanesa; Cortés-Martínez, Ana; Valles-Salgado, María; Rognoni, Teresa; Moreno-Ramos, Teresa; Matías-Guiu, Jorge

2017-12-10

We aim to provide a conversion between Addenbrooke's Cognitive Examination III (ACE-III) and Mini-Mental State Examination (MMSE) scores, to predict the MMSE result based on ACE-III, thus avoiding the need for both tests, and improving their comparability. Equipercentile equating method was used to elaborate a conversion table using a group of 400 participants comprising healthy controls and Alzheimer's disease (AD) patients. Then, reliability was assessed in a group of 100 healthy controls and patients with AD, 52 with primary progressive aphasia and 22 with behavioral variant frontotemporal dementia. The conversion table between ACE-III and MMSE denoted a high reliability, with intra-class correlation coefficients of 0.940, 0.922, and 0.902 in the groups of healthy controls and AD, behavioral variant frontotemporal dementia, and primary progressive aphasia, respectively. Our conversion table between ACE-III and MMSE suggests that MMSE may be estimated based on the ACE-III score, which could be useful for clinical and research purposes.

Examination report: Remote video examination of air slots under the primary tank at 241-AN-107

International Nuclear Information System (INIS)

Pedersen, L.T.

1998-01-01

This report documents the results of remote video examination of air slots in the insulating concrete slab beneath the primary tank at 241-AN-107. Life Extension Equipment Engineering has selected tank 241-AN-107 for ultrasonic evaluation of tank wall, knuckle, and floor plates. Access to the primary tank floor plates is via the air slots which were formed into the insulating concrete slab during tank construction (reference drawings H-2-71105 and H-2-71160). Prior to deployment of the ultrasonic inspection equipment it is desirable to examine the air slots for obstructions and debris which could impede the ultrasonic equipment. The criteria, equipment description, deliverables, and responsibilities for examination of the air slots are described in HNF-1949, Rev. 0, ''Engineering Task Plan for Remote Video Examination of Air Slots Under the Primary Tank at 241-AN-107''

Jose Cabrera (Zorita) tube examination

International Nuclear Information System (INIS)

Kuchirka, P.J.

1986-01-01

Jose Cabrera (Zorita) tube examination procedures are discussed. This plant continues to use phosphate water chemistry (sodium/phosphate ratio = 2.1). Three hot leg tube segments were pulled from the Jose Cabera (Zorita) plant in 1985. One tube had a field EC indication on the OD at the first tube support plate and the other two had field EC indications on their ID about 3 inches above the bottom of the tube sheet. All three tubes were initially sent to Battelle for preliminary NDE and decontamination. Segments of two tubes were sent to Westinghouse for destructive examination. The results of the laboratory eddy current and radiographic examinations are given. The results of the visual examinations are also given. The tube with OD indications was destructively examined and shallow intergranular pitting and intergranular attack, up to 2 mils deep, were found on the OD in the tube sheet region. Local areas of IGA, up to 5 mils deep, were found on the OD within the tube support plate region. A summary of this information together with supporting micrographs is given. It was hypothesized that a caustic crevice environment was the cause of this mild degradation. Shallow areas of thinning or wastage, up to 3 mils, were found just above the top of the tube sheet in the sludge pile region. Even more shallow wastage was found at the edges of support plate locations. This wastage is believed to be the remnant of early plant chemistry when a higher sodium/phosphate ratio and higher phosphate concentration were allowed

Number of radiological examinations in Finland in 2008

International Nuclear Information System (INIS)

Tenkanen-Rautakoski, P.

2010-06-01

STUK (Radiation and Nuclear Safety Authority in Finlad) collected the number of radiological examinations classified to those made to adult and child patients in Finland in 2008. The work was based on the statute of the Ministry of Social Affairs and Health on the medical use of radiation. In 2008, approximately 3.9 million x-ray examinations were made in Finland. Earlier, the number of x-ray examinations has been investigated in 1984, 1995, 2000 and in 2005. During this time the total number of x-ray examinations has slightly diminished. During 2005 and 2008 the number of x-ray examinations has slightly increased, although the average number of examinations per inhabitant has still slightly decreased. The proportions of conventional x-ray examinations, computed tomography examinations, angiographic and interventional procedures were ca. 90.2%, 8.3%, 0.8% and 0.8%, respectively. In proportion to the Finnish population about 717 x-ray examinations per 1000 inhabitants were performed in 2008. Dental examinations are excluded from this number, but CT examinations (ca. 60 per 1000 inhabitants) and interventional x-ray procedures (ca. 5 per 1000 inhabitants) are included. Slightly more than 0.5 million ultrasound examinations and 190 000 MRI examinations were reported. Of the all x-ray examinations made in 2008, ca 7.5% were made to child patients. 0-16-year-old were thought to be child patients in this study. 8% of conventional x-ray examinations and 2% of computed tomography examinations and angiographic examination were made to child patients. (orig.)

Performance on the Cardiovascular In-Training Examination in Relation to the ABIM Cardiovascular Disease Certification Examination.

Science.gov (United States)

Indik, Julia H; Duhigg, Lauren M; McDonald, Furman S; Lipner, Rebecca S; Rubright, Jonathan D; Haist, Steven A; Botkin, Naomi F; Kuvin, Jeffrey T

2017-06-13

The American College of Cardiology In-Training Exam (ACC-ITE) is incorporated into most U.S. training programs, but its relationship to performance on the American Board of Internal Medicine Cardiovascular Disease (ABIM CVD) Certification Examination is unknown. ACC-ITE scores from third-year fellows from 2011 to 2014 (n = 1,918) were examined. Covariates for regression analyses included sex, age, medical school country, U.S. Medical Licensing Examination Step, and ABIM Internal Medicine Certification Examination scores. A secondary analysis examined fellows (n = 511) who took the ACC-ITE in the first and third years. ACC-ITE scores were the strongest predictor of ABIM CVD scores (p ITE scores from first to third year was a strong predictor of the ABIM CVD score (p ITE is strongly associated with performance on the ABIM CVD Certification Examination. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Ultrasonic Examination of Double-Shell Tank 241-SY-102. Examination Completed June 2004

International Nuclear Information System (INIS)

Pardini, Allan F.; Posakony, Gerald J.

2004-01-01

COGEMA Engineering Corporation (COGEMA), under a contract from CH2M Hill Hanford Group (CH2M Hill), has performed an ultrasonic nondestructive examination of selected portions of Double-Shell Tank 241-SY-102. The purpose of this examination was to provide information that could be used to evaluate the integrity of the wall of the primary tank. The requirements for the ultrasonic examination of Tank 241-SY-102 were to detect, characterize (identify, size, and locate), and record measurements made of any wall thinning, pitting, or cracks that might be present in the wall of the primary tank. Any measurements that exceed the requirements set forth in the Engineering Task Plan (ETP), RPP-17750 (Jensen 2003) and/SUMmarized on page 1 of this document, are reported to CH2M Hill and the Pacific Northwest National Laboratory (PNNL) for further evaluation. Under the contract with CH2M Hill, all data is to be recorded on disk and paper copies of all measurements are provided to PNNL for third-party evaluation. PNNL is responsible for preparing a report that describes the results of the COGEMA

Verification and Examination Management of Complex Systems

Directory of Open Access Journals (Sweden)

Stian Ruud

2014-10-01

Full Text Available As ship systems become more complex, with an increasing number of safety-critical functions, many interconnected subsystems, tight integration to other systems, and a large amount of potential failure modes, several industry parties have identified the need for improved methods for managing the verification and examination efforts of such complex systems. Such needs are even more prominent now that the marine and offshore industries are targeting more activities and operations in the Arctic environment. In this paper, a set of requirements and a method for verification and examination management are proposed for allocating examination efforts to selected subsystems. The method is based on a definition of a verification risk function for a given system topology and given requirements. The marginal verification risks for the subsystems may then be evaluated, so that examination efforts for the subsystem can be allocated. Two cases of requirements and systems are used to demonstrate the proposed method. The method establishes a systematic relationship between the verification loss, the logic system topology, verification method performance, examination stop criterion, the required examination effort, and a proposed sequence of examinations to reach the examination stop criterion.

Examining hydrogen transitions.

Energy Technology Data Exchange (ETDEWEB)

Plotkin, S. E.; Energy Systems

2007-03-01

This report describes the results of an effort to identify key analytic issues associated with modeling a transition to hydrogen as a fuel for light duty vehicles, and using insights gained from this effort to suggest ways to improve ongoing modeling efforts. The study reported on here examined multiple hydrogen scenarios reported in the literature, identified modeling issues associated with those scenario analyses, and examined three DOE-sponsored hydrogen transition models in the context of those modeling issues. The three hydrogen transition models are HyTrans (contractor: Oak Ridge National Laboratory), MARKAL/DOE* (Brookhaven National Laboratory), and NEMS-H2 (OnLocation, Inc). The goals of these models are (1) to help DOE improve its R&D effort by identifying key technology and other roadblocks to a transition and testing its technical program goals to determine whether they are likely to lead to the market success of hydrogen technologies, (2) to evaluate alternative policies to promote a transition, and (3) to estimate the costs and benefits of alternative pathways to hydrogen development.

Pressure piping systems examination. 2. ed

Energy Technology Data Exchange (ETDEWEB)

1993-03-01

This Code is Part 13 of the IP Model Code of Safe Practice in the Petroleum Industry. Its purpose is to provide a guide to safe practices in the in-service examination and test of piping systems used in the petroleum and chemical industries. The Code gives general requirements regarding the provision and maintenance of adequate documentation, in-service examination, the control of modifications and repairs, examination frequency, protective devices and testing of piping systems. (author)

Internal examination of CAGR's

International Nuclear Information System (INIS)

Walton, P.J.; Langley, J.P.; Simons, C.R.; Hart, J.D.

1975-01-01

During selected reactor maintenance periods it will be necessary to conduct examinations of reactor internal components to gain assurance of their continuing integrity throughout the design life. Equipment for remote examination is being developed that will measure the distortions of the graphite moderator bricks and extract samples from them for analysis. Other remotely operated equipment will allow closed circuit TV viewing inside the reactors: the equipment provides both wide field and detailed inspection facilities within a single compact unit. Manipulators are being developed to ring the viewing units to the best vantage points. Reeling and handling gear will be operated from outside the vessels and these provide full containment at all times. (author)

Computer assisted Objective structured clinical examination versus Objective structured clinical examination in assessment of Dermatology undergraduate students

Directory of Open Access Journals (Sweden)

Richa Chaudhary

2017-01-01

Conclusions: Computer assisted objective structured clinical examination was found to be a valid, reliable and effective format for dermatology assessment, being rated as the preferred format by examiners.

Computerized examination system on radioprotection knowledge

International Nuclear Information System (INIS)

Stanescu, Gabriel; Rosca Fartat, Gabriela; Ghilea, Simion

2008-01-01

The aim of this paper is to present the recognition system of the education and training in the field of radioprotection based on the examination system and the software solutions adopted by the regulatory authority in Romania. The Romanian Radiation Protection system is in place since 1950, when the first nuclear research reactor was built and activities involving radioactive sources started to be developed, and several developing phases were passed through. Linked to the Romanian Radiation Protection system an Education, Training and Recognition system was developed. The recognition of the competencies achieved by the personnel in the framework of the education and training system consists in obtaining a work permit. It is mandatory at least for the radiological safety officers to posses a work permit granted by the Romanian Regulatory Body (CNCAN) based on an examination of the radioprotection knowledge. The examination consists in solving a questionnaire on radioprotection and legislation issues. Each participant receives a questionnaire with 60 questions and has to solve it in a time limit of one hour. In 2007 the examination system has been improved by authors who designed a software and a database which contains all the questions and answers with related explanations. For each examination session the software generates randomly for each participant the examination questionnaire. More than 2000 questions and answers from the database are published on the web site of CNCAN for different fields of ionizing radiation applications. Moreover the generated questions and participant's answers are registered in order to perform the further analysis and review. The result is an objective and transparent examination system which encourages the continuous training and retraining. (author)

The risk-adjusted vision beyond casemix (DRG) funding in Australia. International lessons in high complexity and capitation.

Science.gov (United States)

Antioch, Kathryn M; Walsh, Michael K

2004-06-01

Hospitals throughout the world using funding based on diagnosis-related groups (DRG) have incurred substantial budgetary deficits, despite high efficiency. We identify the limitations of DRG funding that lack risk (severity) adjustment for State-wide referral services. Methods to risk adjust DRGs are instructive. The average price in casemix funding in the Australian State of Victoria is policy based, not benchmarked. Average cost weights are too low for high-complexity DRGs relating to State-wide referral services such as heart and lung transplantation and trauma. Risk-adjusted specified grants (RASG) are required for five high-complexity respiratory, cardiology and stroke DRGs incurring annual deficits of $3.6 million due to high casemix complexity and government under-funding despite high efficiency. Five stepwise linear regressions for each DRG excluded non-significant variables and assessed heteroskedasticity and multicollinearlity. Cost per patient was the dependent variable. Significant independent variables were age, length-of-stay outliers, number of disease types, diagnoses, procedures and emergency status. Diagnosis and procedure severity markers were identified. The methodology and the work of the State-wide Risk Adjustment Working Group can facilitate risk adjustment of DRGs State-wide and for Treasury negotiations for expenditure growth. The Alfred Hospital previously negotiated RASG of $14 million over 5 years for three trauma and chronic DRGs. Some chronic diseases require risk-adjusted capitation funding models for Australian Health Maintenance Organizations as an alternative to casemix funding. The use of Diagnostic Cost Groups can facilitate State and Federal government reform via new population-based risk adjusted funding models that measure health need.