Fortæller

DEFF Research Database (Denmark)

Larsen, Gorm

2012-01-01

Siden Gerard Genettes ”Discours du récit” (1972) er distinktionen mellem hvem, der taler, og hvem, der ser, blevet cementeret som et grundparadigme i narratologien og litteraturteorien. Genettes pointe var, at den etablerede narrative teori – som fx Wayne C. Booths The Rhetoric of Fiction (1961...... narratologi blevet forsøgt udfordret, enten fordi det hævdes, at en tekst ikke nødvendigvis er udstyret med en fortæller, eller fordi begrebet om fortæller antages at bero på en misvisende og reduktiv antropomorficering. Eller omvendt fordi der i Genettes begrebsdannelse ligger en forkastelse af...... forestillingen om en implicit forfatter (implied author) og dermed også en afvisning af en upålidelige fortæller. Kapitlet præsenterer begreberne fortæller og synsvinkel i narratologien med afsæt i Genettes bestemmelser og diskutere de problemer, der opstår i kølvandet herpå. Det være sig både de rent...

Find a Health Center

Data.gov (United States)

U.S. Department of Health & Human Services — HRSA Health Centers care for you, even if you have no health insurance – you pay what you can afford based on your income. Health centers provide services that...

42 CFR 124.515 - Compliance alternative for community health centers, migrant health centers and certain National...

Science.gov (United States)

2010-10-01

..., migrant health centers and certain National Health Service Corps sites. 124.515 Section 124.515 Public... Unable To Pay § 124.515 Compliance alternative for community health centers, migrant health centers and... migrant health center under section 329 of the Act is in substantial compliance with the terms and...

The health of loblolly pine stands at Fort Benning, GA

Science.gov (United States)

Soung-Ryoul Ryu; G. Geoff Wang; Joan L. Walker

2013-01-01

Approximately two-thirds of the red-cockaded woodpecker (Picoides borealis) (RCW) groups at Fort Benning, GA, depend on loblolly pine (Pinus taeda) stands for nesting or foraging. However, loblolly pine stands are suspected to decline. Forest managers want to replace loblolly pine with longleaf pine (P. palustris...

Benefits Analysis of Multi-Center Dynamic Weather Routes

Science.gov (United States)

Sheth, Kapil; McNally, David; Morando, Alexander; Clymer, Alexis; Lock, Jennifer; Petersen, Julien

2014-01-01

Dynamic weather routes are flight plan corrections that can provide airborne flights more than user-specified minutes of flying-time savings, compared to their current flight plan. These routes are computed from the aircraft's current location to a flight plan fix downstream (within a predefined limit region), while avoiding forecasted convective weather regions. The Dynamic Weather Routes automation has been continuously running with live air traffic data for a field evaluation at the American Airlines Integrated Operations Center in Fort Worth, TX since July 31, 2012, where flights within the Fort Worth Air Route Traffic Control Center are evaluated for time savings. This paper extends the methodology to all Centers in United States and presents benefits analysis of Dynamic Weather Routes automation, if it was implemented in multiple airspace Centers individually and concurrently. The current computation of dynamic weather routes requires a limit rectangle so that a downstream capture fix can be selected, preventing very large route changes spanning several Centers. In this paper, first, a method of computing a limit polygon (as opposed to a rectangle used for Fort Worth Center) is described for each of the 20 Centers in the National Airspace System. The Future ATM Concepts Evaluation Tool, a nationwide simulation and analysis tool, is used for this purpose. After a comparison of results with the Center-based Dynamic Weather Routes automation in Fort Worth Center, results are presented for 11 Centers in the contiguous United States. These Centers are generally most impacted by convective weather. A breakdown of individual Center and airline savings is presented and the results indicate an overall average savings of about 10 minutes of flying time are obtained per flight.

School-Based Health Centers

Science.gov (United States)

... care group, such as a community health center, hospital, or health department. A few are run by the school district itself. Centers often get money from charities and the government so they can give care ...

Airborne electromagnetic data and processing within Leach Lake Basin, Fort Irwin, California: Chapter G in Geology and geophysics applied to groundwater hydrology at Fort Irwin, California

Science.gov (United States)

Bedrosian, Paul A.; Ball, Lyndsay B.; Bloss, Benjamin R.; Buesch, David C.

2014-01-01

From December 2010 to January 2011, the U.S. Geological Survey conducted airborne electromagnetic and magnetic surveys of Leach Lake Basin within the National Training Center, Fort Irwin, California. These data were collected to characterize the subsurface and provide information needed to understand and manage groundwater resources within Fort Irwin. A resistivity stratigraphy was developed using ground-based time-domain electromagnetic soundings together with laboratory resistivity measurements on hand samples and borehole geophysical logs from nearby basins. This report releases data associated with the airborne surveys, as well as resistivity cross-sections and depth slices derived from inversion of the airborne electromagnetic data. The resulting resistivity models confirm and add to the geologic framework, constrain the hydrostratigraphy and the depth to basement, and reveal the distribution of faults and folds within the basin.

Defense.gov Special Report: Fort Hood Shooting

Science.gov (United States)

identify possible insider threats, Army Secretary John M. McHugh told lawmakers. Story Obama: Soldiers ," Army Secretary John M. McHugh told lawmakers. Story President Praises Swift Response to Fort Hood Remarks on Fort Hood Shooting at White House McHugh, Odierno Address Fort Hood Shooting Before Congress

Field Demonstration of Aviation Turbine Fuel MIL-T-83133C, Grade JP-8 (NATO Code F-34), at Fort Bliss, TX

Science.gov (United States)

1992-09-01

APO NY 09052 CDR US ARMY NATICK RD&E CTR DOD PROJ MGR, MOBILE ELECTRIC POWER ATTN: SATNC-US US ARMY TROOP SUPPORT COMMAND NATICK MA 01760-5020 ATUN ...US ARMY QUARTERMASTER SCHOOL ATUN : LOEA-PL (MR LeVAN) I ATTN: ATSM-CDM 1 NEW CUMBERLAND PA 17070 ATSM-PWD I FORT LEE VA 23801 PETROLEUM FIELD OFFICE...ARTILLERY CENTER US ARMY INFANTRY SCHOOL & FORT BLISS ATTN: ATSH-CD-MIS-M I ATUN : ATZC-ISL-PP 3 ATSH-CD-TSM-T 1 ATZC-ISL-MM 3 FORT BENNING GA 31905-5400

The WIMS-E module W-FORTE

International Nuclear Information System (INIS)

Roth, M.J.

1983-09-01

There are three distinct versions of the WIMS lattice cell program. WIMS-E is the most general, WIMSD4 is restricted to clusters or to one dimensional slab or annular geometry, and LWRWIMS is designed principally for light water reactor geometries. W-FORTE is used to transfer data from WIMSD4 or LWRWIMS to WIMS-E. A description of the W-FORTE module is given, and includes the relevant data for WIMSD4, LWRWIMS and W-FORTE. (UK)

76 FR 68220 - Navistar Truck Development and Technology Center; a Subsidiary of Navistar International...

Science.gov (United States)

2011-11-03

... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-75,151; TA-W-75,151A] Navistar... Renaissance and Alpha Personnel, Inc. Fort Wayne, IN; Navistar Truck Reliability Center, a Subsidiary of... Reliability Center, a Subsidiary of Navistar International Corporation, Truck Division, 3033 Wayne Trace, Fort...

Inpatient Behavioral Health Recapture A Busiess Case Analysis at Evans Army Community Hospital Fort Carson, Colorado

Science.gov (United States)

2009-07-20

and Obstetrics /Gynecology. Inpatient care includes Obstetrics , Intensive Care, and Post Anesthesia Care/Same Day Surgery. EACH Mission: Delivering...charged with murder in Iraq shooting deaths, 2009). EACH Inpt Psych 13 Fort Carson has not been immune to the increase in suicides and violence among...to identify Soldiers with PTSD symptoms. In 2008, however, attention returned to Fort Carson as a number of local homicides and other violence tied

76 FR 17139 - Health Center Program

Science.gov (United States)

2011-03-28

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Health Center Program AGENCY: Health Resources and Services Administration, HHS. ACTION: Notice of Noncompetitive... Improvement Project (CIP) from Saint Vincent's Catholic Medical Centers (SVCMC) of New York, current grantee...

Health Services Cost Analyzing in Tabriz Health Centers 2008

Directory of Open Access Journals (Sweden)

Massumeh gholizadeh

2015-08-01

Full Text Available Background and objectives : Health Services cost analyzing is an important management tool for evidence-based decision making in health system. This study was conducted with the purpose of cost analyzing and identifying the proportion of different factors on total cost of health services that are provided in urban health centers in Tabriz. Material and Methods : This study was a descriptive and analytic study. Activity Based Costing method (ABC was used for cost analyzing. This cross–sectional survey analyzed and identified the proportion of different factors on total cost of health services that are provided in Tabriz urban health centers. The statistical population of this study was comprised of urban community health centers in Tabriz. In this study, a multi-stage sampling method was used to collect data. Excel software was used for data analyzing. The results were described with tables and graphs. Results : The study results showed the portion of different factors in various health services. Human factors by 58%, physical space 8%, medical equipment 1.3% were allocated with high portion of expenditures and costs of health services in Tabriz urban health centers. Conclusion : Based on study results, since the human factors included the highest portion of health services costs and expenditures in Tabriz urban health centers, balancing workload with staff number, institutionalizing performance-based management and using multidisciplinary staffs may lead to reduced costs of services. ​

Assessment of DOD Wounded Warrior Matters -- Fort Drum

Science.gov (United States)

2011-09-30

their relation to military duties. The six factors that are evaluated are: physical capacity or stamina , upper extremities, lower extremities...Health Net Federal Services contractor. The Fort Drum MEDDAC Referral Management Office created a “Reports Cell ” which was responsible for obtaining...Care Division had created a CLR/Reports Cell group that focused specifically on obtaining CLRs, inputting them into patients’ AHLTA records and

Renewable Energy Opportunities at Fort Hood, Texas

Energy Technology Data Exchange (ETDEWEB)

Solana, Amy E.; Warwick, William M.; Orrell, Alice C.; Russo, Bryan J.; Parker, Kyle R.; Weimar, Mark R.; Horner, Jacob A.; Manning, Anathea

2011-11-14

This report presents the results of Pacific Northwest National Laboratory's (PNNL) follow-on renewable energy (RE) assessment of Fort Hood. Fort Hood receives many solicitations from renewable energy vendors who are interested in doing projects on site. Based on specific requests from Fort Hood staff so they can better understand these proposals, and the results of PNNL's 2008 RE assessment of Fort Hood, the following resources were examined in this assessment: (1) Municipal solid waste (MSW) for waste-to-energy (WTE); (2) Wind; (3) Landfill gas; (4) Solar photovoltaics (PV); and (5) Shale gas. This report also examines the regulatory issues, development options, and environmental impacts for the promising RE resources, and includes a review of the RE market in Texas.

Relationship of Work Therapy to Psychiatric Length of Stay and Readmission

Science.gov (United States)

Barbee, Margaret S.; and others

1969-01-01

Results indicated that participants in an in-hospital work-therapy program, randomly selected patients in Fort Logan Mental Health Center, had longer stays in both intensive treatment and total hospitalization and had more readmissions to Fort Logan than nonparticipants. Reprints available from authors at Fort Logan Mental Health Center, Denver,…

77 FR 21448 - Security Zone; 2012 Fleet Week, Port Everglades, Fort Lauderdale, FL

Science.gov (United States)

2012-04-10

... Environmental Health Risks and Safety Risks. This rule is not an economically significant rule and does not create an environmental risk to health or risk to safety that may disproportionately affect children...-AA87 Security Zone; 2012 Fleet Week, Port Everglades, Fort Lauderdale, FL AGENCY: Coast Guard, DHS...

Fort Valley studies: A natural laboratory for research and education

Science.gov (United States)

Brian W. Geils

2008-01-01

Drought, wildfire, extinction, and invasive species are considered serious threats to the health of our forests. Although these issues have global connections, we most readily see their consequences locally and attempt to respond with management based on science. For 100 years, the Fort Valley Experimental Forest (FVEF) has provided educational and experimental support...

The Fort McMurray Demonstration Project in social marketing: health- and safety-related behaviour among oil sands workers.

Science.gov (United States)

Guidotti, T L; Watson, L; Wheeler, M; Jhangri, G S

1996-08-01

This is the first round in a series of surveys conducted in Fort McMurray as part of the Fort McMurray Demonstration Project in social marketing. This component of the survey was intended to focus on the most prominent group of employed workers in the community and to compare their patterns of response with the community as a whole. Respondents to the survey were overwhelmingly male (96%), married (72.9%) and living in households of two to five persons (87.9%). They were predominantly aged 30-44 (55%) and graduates of high school (53.5%). Younger male workers (below age 30) were more likely to have a high school diploma (78.3%) or some additional technical or vocational training (21.7% compared to 12.5% overall) and to be unmarried or separated. Attitudes toward safety-related behaviours were stronger than for respondents from the community as a whole. Approximately 70-100% of all age groups and both sexes showed strong agreement with attitudes involving child car seats and the unacceptability of drinking and driving. These attitudes include strong advocacy of vigorous enforcement of occupational health and safety standards. However, they showed a variability similar to the community as a whole in behaviour at home compared to work, generally reporting more consistent use of personal protection on the job than in their own homes, particularly hearing protection. Even so, they were much less likely to perform stretching and warm-up exercises prior to exertion than community residents in general. The potential may exist to transfer the technology and attitudes from workplace health and safety to community safety. One possible strategy to accomplish this is to involve workers in this industry directly in community initiatives. This strategy may be generalizable to any community in which there are major employers who place a heavy emphasis on risk control and occupational health and safety.

FOUR YEARS OF OPERATIONS AND RESULTS WITH FORTE

International Nuclear Information System (INIS)

D. ROUSSEL-DUPRE; P. KLINGNER; L. CARLSON; ET AL

2001-01-01

The FORTE (Fast Onboard Recording of Transient Events) satellite was launched on 29 August 1997 and has been in continuous operation since that time. FORTE was placed in a nearly circular, 825-km-altitude, 70 degrees inclination orbit by a Pegasus rocket funded by Air Force Space Test Program. The Department of Energy funded the FORTE satellite, which was designed and built at Los Alamos. FORTE's successful launch and engineered robustness were a result of several years of dedicated work by the joint Los Alamos National Laboratory/Sandia National Laboratory project team, led through mission definition, payload and satellite development, and launch by Dr. Stephen Knox. The project is now led by Dr. Abram Jacobson. FORTE carries a suite of instruments, an optical system and a rf system, for the study of lightning and anthropogenic signals. As a result of this effort, new understandings of lightning events have emerged as well as a more complete understanding of the relationship between optical and rf lightning events. This paper will provide an overview of the FORTE satellite and will discuss the on orbit performance of the subsystems

Mental Health Screening Center

Science.gov (United States)

... Releases & Announcements Public Service Announcements Partnering with DBSA Mental Health Screening Center These online screening tools are not ... you have any concerns, see your doctor or mental health professional. Depression Screening for Adult Depression Screening for ...

Utilization of Mental Health Services in School-Based Health Centers

Science.gov (United States)

Bains, Ranbir M.; Cusson, Regina; White-Frese, Jesse; Walsh, Stephen

2017-01-01

Background: We summarize utilization patterns for mental health services in school-based health centers. Methods: Administrative data on school-based health center visits in New Haven, Connecticut were examined for the 2007-2009 school years. Relative frequencies of mental health visits by age were calculated as a percentage of all visits and were…

The Fort McMurray Demonstration Project in Social Marketing: theory, design, and evaluation.

Science.gov (United States)

Guidotti, T L; Ford, L; Wheeler, M

2000-02-01

The Fort McMurray Demonstration Project in Social Marketing is a multifaceted program that applies the techniques of social marketing to health and safety. This paper describes the origins of the project and the principles on which it was based. VENUE: Fort McMurray, in the province of Alberta, Canada, was selected because the community had several community initiatives already underway and the project had the opportunity to demonstrate "value added." The project is distinguished from others by a model that attempts to achieve mutually reinforcing effects from social marketing in the community as a whole and from workplace safety promotion in particular. Specific interventions sponsored by the project include a media campaign on cable television, public activities in local schools, a community safety audit, and media appearance by a mascot that provides visual identity to the project, a dinosaur named "Safetysaurus." The project integrated its activities with other community initiatives. The evaluation component emphasizes outcome measures. A final evaluation based on injury rates and attitudinal surveys is underway. Baseline data from the first round of surveys have been compiled and published. In 1995, Fort McMurray became the first city in North America to be given membership in the World Health Organization's Safe Community Network.

Medical Waste Management in Community Health Centers.

Science.gov (United States)

Tabrizi, Jafar Sadegh; Rezapour, Ramin; Saadati, Mohammad; Seifi, Samira; Amini, Behnam; Varmazyar, Farahnaz

2018-02-01

Non-standard management of medical waste leads to irreparable side effects. This issue is of double importance in health care centers in a city which are the most extensive system for providing Primary Health Care (PHC) across Iran cities. This study investigated the medical waste management standards observation in Tabriz community health care centers, northwestern Iran. In this triangulated cross-sectional study (qualitative-quantitative), data collecting tool was a valid checklist of waste management process developed based on Iranian medical waste management standards. The data were collected in 2015 through process observation and interviews with the health center's staff. The average rate of waste management standards observance in Tabriz community health centers, Tabriz, Iran was 29.8%. This case was 22.8% in dimension of management and training, 27.3% in separating and collecting, 31.2% in transport and temporary storage, and 42.9% in sterilization and disposal. Lack of principal separation of wastes, inappropriate collecting and disposal cycle of waste and disregarding safety tips (fertilizer device performance monitoring, microbial cultures and so on) were among the observed defects in health care centers supported by quantitative data. Medical waste management was not in a desirable situation in Tabriz community health centers. The expansion of community health centers in different regions and non-observance of standards could predispose to incidence the risks resulted from medical wastes. So it is necessary to adopt appropriate policies to promote waste management situation.

Medline Plus

Full Text Available ... Pain (Broward Health Medical Center, Fort Lauderdale, FL, 5/12/2014) Total Ankle Replacement (Doctors Hospital, Coral ... Pain (Broward Health Medical Center, Fort Lauderdale, FL, 5/12/2014) Back Pain SI (Sacroiliac) Fusion Surgery ( ...

Medline Plus

Full Text Available ... Disorders Knee Arthroscopy for Treatment of a Meniscus Tear (Broward Health Medical Center, Fort Lauderdale, FL, 11/ ... Disorders Knee Arthroscopy for Treatment of a Meniscus Tear (Broward Health Medical Center, Fort Lauderdale, FL, 11/ ...

Medline Plus

Full Text Available ... and Disorders Knee Arthroscopy for Treatment of a Meniscus Tear (Broward Health Medical Center, Fort Lauderdale, FL, ... and Disorders Knee Arthroscopy for Treatment of a Meniscus Tear (Broward Health Medical Center, Fort Lauderdale, FL, ...

School Based Health Centers

Science.gov (United States)

Children's Aid Society, 2012

2012-01-01

School Based Health Centers (SBHC) are considered by experts as one of the most effective and efficient ways to provide preventive health care to children. Few programs are as successful in delivering health care to children at no cost to the patient, and where they are: in school. For many underserved children, The Children's Aid Society's…

Indian public health standards in primary health centers and community health centers in Shimla District of Himachal Pradesh: A descriptive evaluation

Directory of Open Access Journals (Sweden)

Raman Chauhan

2016-01-01

Full Text Available Introduction: The health planners in India have visualized primary health centers (PHCs and community health centers (CHCs as the key healthcare delivery institutions in rural areas. These centers are supposed to have health manpower, infrastructure, and service delivery as per the Indian public health standards (IPHS guidelines (2010. Materials and Methods: A cross-sectional study was conducted in seven CHCs and 12 PHCs, randomly selected from eight blocks of Shimla District and evaluated in terms of health manpower, infrastructure, and services from September 2011 to August 2012. Data was collected from the selected units using structured data collection instruments designed by the IPHS. Results: The health centers were assessed according to IPHS guidelines. Outpatient department services and referral services were provided in all the centers studied. No specialist doctor was posted at any of CHCs against a sanctioned strength of at least four (surgeon, physician, obstetrician, and pediatrician per CHC. In 3 (42.8% CHCs and 8 (75% PHCs, no pharmacist was posted. Eight (75% PHCs did not have any staff nurse posted. Three (42.8% CHCs and 10 (83.3% PHCs did not have a laboratory technician. In CHCs, separate labor room was available in 6 (85.7% whereas a separate laboratory was available in all seven. Separate labor room and laboratory were available in four (25% PHCs. Conclusions: IPHS guidelines are not being followed at PHC and CHC levels of the district. Health manpower shortage is the key bottleneck in service delivery. Political advocacy is needed to ensure sufficient health manpower availability to deliver quality healthcare.

Implementing health management information systems: measuring success in Korea's health centers.

Science.gov (United States)

Chae, Y M; Kim, S I; Lee, B H; Choi, S H; Kim, I S

1994-01-01

This article analyses the effects that the introduction and adoption of a health management information system (HMIS) can have on both the productivity of health center staff as well as on user-satisfaction. The focus is upon the service provided by the Kwonsun Health Center located in Suwon City, Korea. Two surveys were conducted to measure the changes in productivity and adoption (knowledge, persuasion, decision, implementation and confirmation) of health center staff over time. In addition, a third survey was conducted to measure the effects of HMIS on the level of satisfaction perceived by the visitors, by comparing the satisfaction level between the study health center and a similar health center identified as a control. The results suggest that HMIS increased the productivity and satisfaction of the staff but did not increase their persuasion and decision levels; and, that is also succeeded in increasing the levels of visitors' satisfaction with the services provided.

Clinical quality performance in U.S. health centers.

Science.gov (United States)

Shi, Leiyu; Lebrun, Lydie A; Zhu, Jinsheng; Hayashi, Arthur S; Sharma, Ravi; Daly, Charles A; Sripipatana, Alek; Ngo-Metzger, Quyen

2012-12-01

To describe current clinical quality among the nation's community health centers and to examine health center characteristics associated with performance excellence. National data from the 2009 Uniform Data System. Health centers reviewed patient records and reported aggregate data to the Uniform Data System. Six measures were examined: first-trimester prenatal care, childhood immunization completion, Pap tests, low birth weight, controlled hypertension, and controlled diabetes. The top 25 percent performing centers were compared with lower performing (bottom 75 percent) centers on these measures. Logistic regressions were utilized to assess the impact of patient, provider, and institutional characteristics on health center performance. Clinical care and outcomes among health centers were generally comparable to national averages. For instance, 67 percent of pregnant patients received timely prenatal care (national = 68 percent), 69 percent of children achieved immunization completion (national = 67 percent), and 63 percent of hypertensive patients had blood pressure under control (national = 48 percent). Depending on the measure, centers with more uninsured patients were less likely to do well, while centers with more physicians and enabling service providers were more likely to do well. Health centers provide quality care at rates comparable to national averages. Performance may be improved by increasing insurance coverage among patients and increasing the ratios of physicians and enabling service providers to patients. © Health Research and Educational Trust.

Warm Dry Weather Conditions Cause of 2016 Fort McMurray Wild Forest Fire and Associated Air Quality

Science.gov (United States)

de Azevedo, S. C.; Singh, R. P.; da Silva, E. A., Sr.

2016-12-01

The climate change is evident from the increasing temperature around the world, day to day life and increasing frequency of natural hazards. The warm and dry conditions are the cause of frequent forest fires around the globe. Forest fires severely affect the air quality and human health. Multi sensor satellites and dense network of ground stations provide information about vegetation health, meteorological, air quality and atmospheric parameters. We have carried out detailed analysis of satellite and ground data of wild forest fire that occurred in May 2016 in Fort McMurray, Alberta, Canada. This wild forest fire destroyed 10 per cent of Fort McMurray's housing and forced more than 90,000 people to evacuate the surrounding areas. Our results show that the warm and dry conditions with low rainfall were the cause of Fort McMurray wild fire. The air quality parameters (particulate matter, CO, ozone, NO2, methane) and greenhouse gases measured from Atmospheric Infrared Sounder (AIRS) satellite show enhanced levels soon after the forest fire. The emissions from the forest fire affected health of population living in surrounding areas up to 300 km radius.

Academic Medical Centers as digital health catalysts.

Science.gov (United States)

DePasse, Jacqueline W; Chen, Connie E; Sawyer, Aenor; Jethwani, Kamal; Sim, Ida

2014-09-01

Emerging digital technologies offer enormous potential to improve quality, reduce cost, and increase patient-centeredness in healthcare. Academic Medical Centers (AMCs) play a key role in advancing medical care through cutting-edge medical research, yet traditional models for invention, validation and commercialization at AMCs have been designed around biomedical initiatives, and are less well suited for new digital health technologies. Recently, two large bi-coastal Academic Medical Centers, the University of California, San Francisco (UCSF) through the Center for Digital Health Innovation (CDHI) and Partners Healthcare through the Center for Connected Health (CCH) have launched centers focused on digital health innovation. These centers show great promise but are also subject to significant financial, organizational, and visionary challenges. We explore these AMC initiatives, which share the following characteristics: a focus on academic research methodology; integration of digital technology in educational programming; evolving models to support "clinician innovators"; strategic academic-industry collaboration and emergence of novel revenue models. Copyright © 2014 Elsevier Inc. All rights reserved.

76 FR 59166 - Navistar Truck Development and Technology Center, a Subsidiary of Navistar International...

Science.gov (United States)

2011-09-23

... Development and Technology Center, a Subsidiary of Navistar International Corporation Truck Division, Fort... International Corporation, Truck Division, Fort Wayne, Indiana (subject firm). The negative determination was... is a headcount reduction across the nation, made possible by the Global Outsourcing. * * * '' The...

Bent's Old Fort: Amphibians and Reptiles

Science.gov (United States)

Muths, E.

2008-01-01

Bent's Old Fort National Historic Site sits along the Arkansas River in the semi-desert prairie of southeastern Colorado. The USGS provided assistance in designing surveys to assess the variety of herpetofauna (amphibians and reptiles) resident at this site. This brochure is the results of those efforts and provides visitors with information on what frogs, toads, snakes and salamanders might be seen and heard at Bent's Old Fort.

Art and community health: lessons from an urban health center.

Science.gov (United States)

Siegel, Wilma Bulkin; Bartley, Mary Anne

2004-01-01

Staff at a nurse-managed urban health center conducted a series of art sessions to benefit the community. The authors believe the program's success clearly communicated the relationship between art and community health. As a result of the success of the sessions, plans are in the works to make art a permanent part of the health center's services.

Marketing and Community Mental Health Centers.

Science.gov (United States)

Ferniany, Isaac W.; Garove, William E.

1983-01-01

Suggests that a marketing approach can be applied to community mental health centers. Marketing is a management orientation of providing services for, not to, patients in a systematic manner, which can help mental health centers improve services, strengthen community image, achieve financial independence and aid in staff recruitment. (Author)

[Effectiveness of support for asbestos health consultation in health centers].

Science.gov (United States)

Nagamatsu, Yasuko

2011-09-01

In this research, we aimed to evaluate the support for asbestos health consultation in health centers. In this exploratory descriptive study, a self-administered original questionnaire was developed and used. Among all 517 health centers, valid responses were returned from 323 (62.5%) consenting centers. Consultations in the previous year ranged from 0-108 cases, with a facility median of 3.0 cases. Among staff members, 86.4% did not receive training and 35.4% had never used the manual. Workplaces that use asbestos within their jurisdiction were recognized by 39.2% of staff members, and 16.7% of these members always supported consultants psychologically. The staff members were not confident about asbestos health consultation: 71.2% for general questions, 76.2% for questions about asbestos-related diseases, and 76.4% for questions about risk of asbestos-related diseases; 51.4% were not confident about the Asbestos-Related Health Damage Relief System. Health center staff members who were significantly more confident were those who had more staff to work with; dealt with many consultations in the previous year; recognized the workplaces using asbestos within their jurisdiction; often used the manual and often psychologically supported consultants. According to the covariance structure analysis model, the 'use of support systems' consisting of 'the use of manual', 'training attendance' and 'recognition of workplaces that use asbestos' positively affected the frequency of psychological support (peffective in building the confidence of health center staff in relation to asbestos health consultation, although the use of these support systems was low.

[Health centers: history and future prospects.].

Science.gov (United States)

Colin, Marie-Pierre; Acker, Dominique

2009-03-29

Health houses and health centers are often hailed as specifically modern forms of medical practice in mobile healthcare provision. Yet the concept of health center emerged in the seventeenth century. The founding principles of these institutions were to promote access to good-quality universal healthcare and to practice a form of healthcare that treated patients in their globality (i.e. within their social and environmental context) based on public healthcare measures. Though they constitute a response to a specific healthcare project, healthcare centers face a number of specific difficulties that pose a challenge to their durability and development. Payment per consultation is ill-adapted to the remuneration of their services, and methods of remuneration that may be applicable to independent medical practitioners do not apply in the context of health centers, which may struggle to survive without the support of territorial collectivities (i.e. regional and local authorities) or associations. Health houses face similar difficulties in terms of their structural expenses. Expectations are high for trying out new methods of remuneration. The perspective and experience of healthcare centers will likely prove to be essential in this context. Their future needs to be envisaged alongside health houses and medical hubs. The growth of precarity and the increasing difficulties affecting access to healthcare provision need to be taken into account. The choice of the specific type of structure will depend on local realities, on the political will of regional authorities and on the specific projects of healthcare professionals. Yet whatever solution is envisaged, it will not be possible without public funding.

NSU Art Museum Fort Lauderdale | Art Museum in Fort Lauderdale

Science.gov (United States)

NSU Art Museum Fort Lauderdale Visit Admissions Hours & Admission Policies & Accessibility Airports Shop & Dine About the Café & Store Store Café Menu Art Exhibitions Currently on View Thursday 2-for-1 specials on wine and craft beer in the Museum Café, and hands-on art projects for all

Nuclear Energy Center: upper St. Lawrence region. Part I. Siting. Part II. Fort Drum surrogate site, description and impact assessment. Part III. Dispersed sites impact assessment and comparison with the NEC

Energy Technology Data Exchange (ETDEWEB)

Merry, P.A.; Luner, C.; Hong, S.W.; Canham, H.O.; Boggs, J.F.; McCool, T.P.

1976-12-01

This report is one of many supporting documents used by the Nuclear Regulatory commission in the preparation of the Nuclear Energy Center Site Survey (NECSS) mandated by Congress. While the overall study focuses on the feasibility and practicability of nuclear energy centers (NECs), this report is directed towards choosing a suitable surrogate site in the upper St. Lawrence region of New York State, assessing the probable impacts associated with construction and operation of the NEC, and comparing these impacts with those associated with small dispersed nuclear power stations. The upper St. Lawrence region is surveyed to identify a specific site that might be suitable for a surrogate NEC. Several assumptions about the basic design of an NEC are delineated, and a general overview of the characteristics of the region is given. The Fort Drum Military Reservation is chosen as a suitable surrogate site. Fort Drum and the surrounding area are described in terms of land use and population patterns, terrestrial and aquatic ecology, water use and quality, meteorology, institutional framework, and socioeconomic structure. The impacts associated with NEC development are assessed. Then the impacts associated with smaller dispersed nuclear power stations located throughout New York State are assessed and compared with the impacts associated with the NEC. Finally, the impacts due to development of the transmission line networks associated with the NEC and with the dispersed power stations are assessed and compared.

FORTE spacecraft vibration mitigation. Final report

International Nuclear Information System (INIS)

Maly, J.R.

1996-02-01

This report documents work that was performed by CSA Engineering, Inc., for Los Alamos National Laboratory (LANL), to reduce vibrations of the FORTE spacecraft by retrofitting damped structural components into the spacecraft structure. The technical objective of the work was reduction of response at the location of payload components when the structure is subjected to the dynamic loading associated with launch and proto-qualification testing. FORTE is a small satellite that will be placed in orbit in 1996. The structure weighs approximately 425 lb, and is roughly 80 inches high and 40 inches in diameter. It was developed and built by LANL in conjunction with Sandia National Laboratories Albuquerque for the United States Department of Energy. The FORTE primary structure was fabricated primarily with graphite epoxy, using aluminum honeycomb core material for equipment decks and solar panel substrates. Equipment decks were bonded and bolted through aluminum mounting blocks to adjoining structure

Fortælling og fortolkning i Jyske Bank

DEFF Research Database (Denmark)

Albrechtsen, Charlotte

Afhandlingen præsenterer en undersøgelse af et konkret eksempel på storytelling brugt som strategisk ledelses- og kommunikationsredskab i en organisations interne kommunikation. Eksemplet er fortællingen "Slaget ved Vejle", som stammer fra Jyske Bank og udgør under afhandlingens case. De overordn......Afhandlingen præsenterer en undersøgelse af et konkret eksempel på storytelling brugt som strategisk ledelses- og kommunikationsredskab i en organisations interne kommunikation. Eksemplet er fortællingen "Slaget ved Vejle", som stammer fra Jyske Bank og udgør under afhandlingens case. De......, at medarbejderne forholder sig reflekteret, nuanceret og kritisk til den strategiske fortælling, og at der er stor diversitet i deres oplevelser, fortolkninger og vurderinger af fortællingen. Desuden ser afhandlingen nærmere på hvad begrebet "storytelling" dækker over, og hvordan der hidtil er forsket i...

Cancer incidence in Fort Chipewyan, Alberta : 1995-2006

Energy Technology Data Exchange (ETDEWEB)

Chen, Y. [Alberta Cancer Board, Edmonton, AB (Canada). Division of Population Health and Information Surveillance

2009-02-15

A high number of cases of cholangiocarcinoma, a rare form of bile duct cancer, as well as high rates of other cancers were reported by a physician working in Fort Chipewyan, Alberta in 2006. Concerns were raised by local residents, attributing cancers in their community to environmental contamination from a range of industrial development including the oil sands development, uranium mining and pulp mills. However, an initial review of the Alberta Cancer Registry did not confirm an increased incidence of cancer in Fort Chipewyan. In the summer/fall of 2007, a working group was formed to support the Alberta Cancer Board in doing a cluster investigation based on the guidelines of the United States Centre for Disease Control and Prevention. This report presented an investigation to determine if there was an elevated rate of cholangiocarcinoma in Fort Chipewyan and whether there was an elevated rate of cancers overall in Fort Chipewyan. The report provided background information on the Athabasca oil sands, uranium mining, and Fort Chipewyan as well as previous investigations of cancer incidence in Fort Chipewyan. Study methods were also presented with particular reference to study and comparison populations; cancer classification and inclusion criteria; active case ascertainment and verification; methods of analysis; and ethical approval. Results were also presented. The specific cancers that were discussed were cholangiocarcinoma, leukemia, colon cancer, and cancer in First Nations in Alberta. It was concluded that the observed number of cases of cholangiocarcinoma was within the expected range. 121 refs., 12 tabs., 3 figs., 5 appendices.

75 FR 2549 - Health Center Program

Science.gov (United States)

2010-01-15

... Program AGENCY: Health Resources and Services Administration, HHS ACTION: Notice of Noncompetitive Replacement Award to Regional Health Care Affiliates. SUMMARY: The Health Resources and Services Administration (HRSA) will be transferring Health Center Program (section 330 of the Public Health Service Act...

78 FR 42788 - School-Based Health Center Program

Science.gov (United States)

2013-07-17

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration School-Based... Gadsden County. SUMMARY: HRSA will be transferring a School-Based Health Center Capital (SBHCC) Program... support the expansion of services at school-based health centers will continue. SUPPLEMENTARY INFORMATION...

Accelerated Adoption of Advanced Health Information Technology in Beacon Community Health Centers.

Science.gov (United States)

Jones, Emily; Wittie, Michael

2015-01-01

To complement national and state-level HITECH Act programs, 17 Beacon communities were funded to fuel community-wide use of health information technology to improve quality. Health centers in Beacon communities received supplemental funding. This article explores the association between participation in the Beacon program and the adoption of electronic health records. Using the 2010-2012 Uniform Data System, trends in health information technology adoption among health centers located within and outside of Beacon communities were explored using differences in mean t tests and multivariate logistic regression. Electronic health record adoption was widespread and rapidly growing in all health centers, especially quality improvement functionalities: structured data capture, order and results management, and clinical decision support. Adoption lagged for functionalities supporting patient engagement, performance measurement, care coordination, and public health. The use of advanced functionalities such as care coordination grew faster in Beacon health centers, and Beacon health centers had 1.7 times higher odds of adopting health records with basic safety and quality functionalities in 2010-2012. Three factors likely underlie these findings: technical assistance, community-wide activation supporting health information exchange, and the layering of financial incentives. Additional technical assistance and community-wide activation is needed to support the use of functionalities that are currently lagging. © Copyright 2015 by the American Board of Family Medicine.

Undervisning mellem fortælling og feedback

DEFF Research Database (Denmark)

Andersen, Kirsten Margrethe

2016-01-01

Feedback gør det muligt for den enkelte at forstå, hvordan jeg kan blive bedre til det, jeg er ved at lære. Fortællinger gør det muligt for den enkelte at udvide horisonten og derved komme til en forståelse af, hvilke mulige perspektiver der er for at forholde sig til den verden, som fortællingen...

76 FR 1441 - Health Center Program

Science.gov (United States)

2011-01-10

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Health Center Program AGENCY: Health Resources and Services Administration, HHS. ACTION: Notice of Noncompetitive... for Services (IDS) and a portion of the Capital Improvement Project (CIP) from Saint Vincent's...

Adolescent mental health: Challenges with maternal noncompliance

OpenAIRE

Nejtek, Vicki A; Hardy, Sarah; Winter, Scott

2010-01-01

Vicki A Nejtek, Sarah Hardy, Scott WinterUniversity of North Texas Health Science Center, Fort Worth, TX, USAAbstract: The leading cause of suicide ideation, attempts, and completion in adolescents is persistent and unresolved parental conflict. National statistics show extremely high rates of childhood neglect and abuse are perpetrated most often by single mothers. Psychiatric disorders arising from maternal–child dysfunction are well-documented. However, resources to prevent offsp...

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.

Structural remains at the early mediaeval fort at Raibania, Orissa

Directory of Open Access Journals (Sweden)

Bratati Sen

2013-11-01

Full Text Available The fortifications of mediaeval India occupy an eminent position in the history of military architecture. The present paper deals with the preliminary study of the structural remains at the early mediaeval fort at Raibania in the district of Balasore in Orissa. The fort was built of stone very loosely kept together. The three-walled fortification interspersed by two consecutive moats, a feature evidenced at Raibania, which is unparallel in the history of ancient and mediaeval forts and fortifications in India. Several other structures like the Jay-Chandi Temple Complex, a huge well, numerous tanks and remains of an ancient bridge add to the uniqueness of the Fort in the entire eastern region.

Le Fort I Maxillary Advancement Using Distraction Osteogenesis

Science.gov (United States)

Combs, Patrick D.; Harshbarger, Raymond J.

2014-01-01

Treatment of maxillary hypoplasia has traditionally involved conventional Le Fort I osteotomies and advancement. Advancements of greater than 10 mm risk significant relapse. This risk is greater in the cleft lip and palate population, whose anatomy and soft tissue scarring from prior procedures contributes to instability of conventional maxillary advancement. Le Fort I advancement with distraction osteogenesis has emerged as viable, stable treatment modality correction of severe maxillary hypoplasia in cleft, syndromic, and noncleft patients. In this article, the authors provide a review of current data and recommendations concerning Le Fort I advancement with distraction osteogenesis. In addition, they outline their technique for treating severe maxillary hypoplasia with distraction osteogenesis using internal devices. PMID:25383054

Case Study: Fort Mill High School--A Culture of Continuous Improvement

Science.gov (United States)

Southern Regional Education Board (SREB), 2014

2014-01-01

This is the latest in a series of case studies highlighting best practices High Schools That Work (HSTW) network schools and districts are implementing to prepare students better for further studies and careers. Fort Mill High School is in Fort Mill, South Carolina, an outlying suburb of Charlotte, North Carolina. Fort Mill links high quality…

Hydrologic Analysis of Fort Leonard Wood, Missouri

Science.gov (United States)

2015-08-01

drainage areas are different, hydrological analysis will be conducted on the two basins individually. The results of the two analyses will be combined to...ER D C TR -1 5- 4 Environmental Quality and Installations Hydrologic Analysis of Fort Leonard Wood, Missouri En gi ne er R es ea rc h...Environmental Quality and Installations ERDC TR-15-4 August 2015 Hydrologic Analysis of Fort Leonard Wood, Missouri Michael L. Follum, Darla C. McVan

Fortællerfiktionen

DEFF Research Database (Denmark)

Reitan, Rolf

Bogen er en kritisk nærlæsning af Gérard Genettes Discours du récit og viser, hvorden den franske teoretiker løser og forenkler en række centrale problemer i traditionel fortælleteori, idet han uudtalt forudsætter et fiktionsbegreb, som han eksplicit afviser som narratologisk relevant. Det...

Fort Valley's early scientists: A legacy of distinction

Science.gov (United States)

Andrew J. Sanchez Meador; Susan D. Olberding

2008-01-01

When the Riordan brothers of Flagstaff, Arizona, asked Gifford Pinchot to determine why there was a deficit in ponderosa pine seedlings, neither party understood the historical significance of what they were setting in motion for the field of forest research. The direct result of that professional favor was the establishment of the Fort Valley Experiment Station (Fort...

Reflector dowel strength test, Fort St. Vrain

International Nuclear Information System (INIS)

Doll, D.W.

1975-01-01

The strength of the 44.45 mm (1.75 in.) diameter Fort St. Vrain (FSV) reflector dowel for loads directed radially inward toward the center of the element was measured. For a statically applied load, the strength exceeded 5783 N (1300 lb) in direct shear. This strength remained after load cycling 100 times to 4448 N (1000 lb), 10 times to 4893 N (1100 lb), 10 times to 5338 N (1200 lb), and two times to 5783 N (1300 lb). Typically, the deflection to ultimate failure was approximately 1.0 mm (0.04 in.). At about 3316 N (750 lb) and 0.20 mm (0.008 in.) deflection, one of the webs between the dowel and a coolant hole cracked, apparently redistributing the load. No further failure occurred up to the ultimate load of 5783+ N (1300+ lb)

Academic health centers and society: an ethical reflection.

Science.gov (United States)

Pellegrino, E D

1999-08-01

Academic health centers--which combine university, medical school, and hospital--exist to satisfy universal human needs and thus are by definition instruments of social purpose. Their core mission is threefold: to provide medical knowledge that can help relieve and prevent illness and suffering, to supply practitioners able to apply that knowledge wisely, and to serve as sites where optimal use of medical knowledge can be demonstrated and investigated. Maintaining a balance between core mission and responsiveness to social trends is a delicate exercise. Overly close accommodation to such trends can endanger the core mission, as has occurred in the United States with regard to managed care. Society and academic health centers have mutual obligations. Obligations of society include giving academic health centers financial and other support and allowing them sufficient freedom to pursue their mission; obligations of academic medical centers include accepting greater scrutiny by society and providing social criticism on matters relating to health. A task for the future is to discern how academic health centers can be responsive to social needs without being totally subservient to societal desires.

Neutron flux distribution measurement in the Fort St. Vrain initial core (results of Fort St. Vrain start-up test A-7)

International Nuclear Information System (INIS)

Marshall, A.C.; Brown, J.R.

1975-01-01

A description is given of a test to measure the axial flux distribution at several radial locations in the Fort St. Vrain core representing unrodded, rodded, and partially rodded regions. The measurements were intended to verify the calculational accuracy of the three-dimensional calculational model used to compute axial power distributions for the Fort St. Vrain core. (U.S.)

Oral health knowledge of health care workers in special?children?s center

OpenAIRE

Wyne, Amjad; Hammad, Nouf; Splieth, Christian

2015-01-01

Objective: To determine the oral health knowledge of health care workers in special children?s center. Methods: A self-administered questionnaire was used to collect following information: demographics, oral hygiene practices, importance of fluoride, dental visits, cause of tooth decay, gingival health, and sources of oral health information. The study was conducted at Riyadh Center for Special Children in Riyadh City from December 2013 to May 2014. Results: All 60 health care workers in the ...

Fort Collins Science Center- Policy Analysis and Science Assistance Branch : Integrating social, behavioral, economic and biological sciences

Science.gov (United States)

2010-01-01

The Fort Collins Science Center's Policy Analysis and Science Assistance (PASA) Branch is a team of approximately 22 scientists, technicians, and graduate student researchers. PASA provides unique capabilities in the U.S. Geological Survey by leading projects that integrate social, behavioral, economic, and biological analyses in the context of human-natural resource interactions. Resource planners, managers, and policymakers in the U.S. Departments of the Interior (DOI) and Agriculture (USDA), State and local agencies, as well as international agencies use information from PASA studies to make informed natural resource management and policy decisions. PASA scientists' primary functions are to conduct both theoretical and applied social science research, provide technical assistance, and offer training to advance performance in policy relevant research areas. Management and research issues associated with human-resource interactions typically occur in a unique context, involve difficult to access populations, require knowledge of both natural/biological science in addition to social science, and require the skill to integrate multiple science disciplines. In response to these difficult contexts, PASA researchers apply traditional and state-of-the-art social science methods drawing from the fields of sociology, demography, economics, political science, communications, social-psychology, and applied industrial organization psychology. Social science methods work in concert with our rangeland/agricultural management, wildlife, ecology, and biology capabilities. The goal of PASA's research is to enhance natural resource management, agency functions, policies, and decision-making. Our research is organized into four broad areas of study.

Anatomy of the Le Fort I segment: Are arterial variations a potential risk factor for avascular bone necrosis in Le Fort I osteotomies?

Science.gov (United States)

Bruneder, Simon; Wallner, Jürgen; Weiglein, Andreas; Kmečová, Ĺudmila; Egger, Jan; Pilsl, Ulrike; Zemann, Wolfgang

2018-05-02

Osteotomies of the Le Fort I segment are routine operations with low complication rates. Ischemic complications are rare, but can have severe consequences that may lead to avascular bone necrosis of the Le Fort I segment. Therefore the aim of this study was to investigate the blood supply and special arterial variants of the Le Fort I segment responsible for arterial hypoperfusion or ischemic avascular necrosis after surgery. The arterial anatomy of the Le Fort I segment's blood supply using 30 halved human cadaver head specimens was analyzed after complete dissection until the submicroscopic level. In all specimens the arterial variants of the Le Fort I segment and also the arterial diameters measured at two points were evaluated. The typical known vascularization pattern was apparent in 90% of all specimens, in which the ascending palatine (D1: 1,2 mm ± 0,34 mm; D2: 0,8 mm ± 0,34 mm) and ascending pharyngeal artery (D1: 1,3 mm ± 0,58 mm; D2: avascular segment necrosis after surgery. An individualized operation plan may prevent ischemic complications in at-risk patients. Copyright © 2018 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

78 FR 17087 - Special Local Regulation; New River Raft Race, New River; Fort Lauderdale, FL

Science.gov (United States)

2013-03-20

...-AA08 Special Local Regulation; New River Raft Race, New River; Fort Lauderdale, FL AGENCY: Coast Guard... on the New River in Fort Lauderdale, Florida during the Rotary Club of Fort Lauderdale New River Raft... States during the Rotary Club of Fort Lauderdale New River Raft Race. On March 23, 2013, Fort Lauderdale...

40 CFR 81.63 - Metropolitan Fort Smith Interstate Air Quality Control Region.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Metropolitan Fort Smith Interstate Air... Air Quality Control Regions § 81.63 Metropolitan Fort Smith Interstate Air Quality Control Region. The Metropolitan Fort Smith Interstate Air Quality Control Region (Arkansas-Oklahoma) has been revised to consist...

Tourism, Tolerance, or Hospitality? An Assessment of a Native/Non-Native, Urban/Rural Youth Exchange Program between Fort Good Hope, NWT, and East Vancouver, BC

Science.gov (United States)

Hern, Matt

2009-01-01

This article considers and assesses a youth exchange project between two community-based youth centers: The Purple Thistle Centre in East Vancouver, British Columbia, and the K'asho Got'ine Youth Centre in Fort Good Hope, Northwest Territories. Both centers serve primarily low-income youth, but after that the similarities are very few. The…

Role of the health center in health crisis management, especially in a radiation disaster

International Nuclear Information System (INIS)

Kurahashi, Toshiyuki

2013-01-01

In a disaster, in particular a radiation disaster, health centers should play an active role in taking advantage of its own expertise. There are various causes of a health crisis; the response to a health crisis is defined according to each cause. However, it should be adequately addressed by assuming the worst case for a health crisis of unknown cause. The role of health centers, in addition to the implementation of appropriate and timely treatment of any health crisis, is prevention of a future health crisis, advanced preparation, and damage recovery; activities during normal times are also important to maintain. Regarding the specific activities of the health center, judgment in the preference of measures to be performed is important. That the information is collected properly based on the idea of risk communication, coordination, and public relations transmission is required also for health centers. (author)

Fort St. Vrain circulator operating experience

International Nuclear Information System (INIS)

Brey, H.L.

1988-01-01

Fort St. Vrain, on the system of Public Service Company of Colorado, is the only high-temperature gas-cooled power reactor in the United States. Four helium circulators are utilized in this plant to transfer heat from the reactor to the steam generators. These unique machines have a single stage axial flow helium compressor driven by a single stage steam turbine. A single stage water driven (pelton wheel) turbine is the back-up drive utilizing either feed water, condensate, or fire water as the driving fluid. Developmental testing of the circulators was accomplished prior to installation into Fort St. Vrain. A combined machine operating history of approximately 250,000 hours has shown these machines to be of conservative design and proven mechanical integrity. However, many problems have been encountered in operating the complex auxiliaries which are necessary for successful circulator and plant operation. It has been 15 years since initial installation of the circulators occurred at Fort St. Vrain. During this time, a number of significant issues had to be resolved dealing specifically with machine performance. These events include cavitation damage of the pelton wheels during the initial plant hot functional testing, cracks in the water turbine buckets and cervic coupling, static shutdown seal bellows failure, and, most recently, degradation of components within the steam drive assembly. Unreliable operation particularly with the circulator auxiliaries has been a focus of attention by Public Service Company of Colorado. Actions to replace or significantly modify the existing circulators and their auxiliaries are currently awaiting decisions concerning the long-term future of the Fort St. Vrain plant. (author). 10 refs, 7 figs, 2 tabs

Fort St. Vrain circulator operating experience

Energy Technology Data Exchange (ETDEWEB)

Brey, H. L.

1988-08-15

Fort St. Vrain, on the system of Public Service Company of Colorado, is the only high-temperature gas-cooled power reactor in the United States. Four helium circulators are utilized in this plant to transfer heat from the reactor to the steam generators. These unique machines have a single stage axial flow helium compressor driven by a single stage steam turbine. A single stage water driven (pelton wheel) turbine is the back-up drive utilizing either feed water, condensate, or fire water as the driving fluid. Developmental testing of the circulators was accomplished prior to installation into Fort St. Vrain. A combined machine operating history of approximately 250,000 hours has shown these machines to be of conservative design and proven mechanical integrity. However, many problems have been encountered in operating the complex auxiliaries which are necessary for successful circulator and plant operation. It has been 15 years since initial installation of the circulators occurred at Fort St. Vrain. During this time, a number of significant issues had to be resolved dealing specifically with machine performance. These events include cavitation damage of the pelton wheels during the initial plant hot functional testing, cracks in the water turbine buckets and cervic coupling, static shutdown seal bellows failure, and, most recently, degradation of components within the steam drive assembly. Unreliable operation particularly with the circulator auxiliaries has been a focus of attention by Public Service Company of Colorado. Actions to replace or significantly modify the existing circulators and their auxiliaries are currently awaiting decisions concerning the long-term future of the Fort St. Vrain plant. (author). 10 refs, 7 figs, 2 tabs.

Recruiting community health centers into pragmatic research: Findings from STOP CRC.

Science.gov (United States)

Coronado, Gloria D; Retecki, Sally; Schneider, Jennifer; Taplin, Stephen H; Burdick, Tim; Green, Beverly B

2016-04-01

Challenges of recruiting participants into pragmatic trials, particularly at the level of the health system, remain largely unexplored. As part of Strategies and Opportunities to STOP Colon Cancer in Priority Populations (STOP CRC), we recruited eight separate community health centers (consisting of 26 individual safety net clinics) into a large comparative effectiveness pragmatic study to evaluate methods of raising the rates of colorectal cancer screening. In partnership with STOP CRC's advisory board, we defined criteria to identify eligible health centers and applied these criteria to a list of health centers in Washington, Oregon, and California affiliated with Oregon Community Health Information Network, a 16-state practice-based research network of federally sponsored health centers. Project staff contacted centers that met eligibility criteria and arranged in-person meetings of key study investigators with health center leadership teams. We used the Consolidated Framework for Implementation Research to thematically analyze the content of discussions during these meetings to identify major facilitators of and barriers to health center participation. From an initial list of 41 health centers, 11 met the initial inclusion criteria. Of these, leaders at three centers declined and at eight centers (26 clinic sites) agreed to participate (73%). Participating and nonparticipating health centers were similar with respect to clinic size, percent Hispanic patients, and percent uninsured patients. Participating health centers had higher proportions of Medicaid patients and higher baseline colorectal cancer screening rates. Common facilitators of participation were perception by center leadership that the project was an opportunity to increase colorectal cancer screening rates and to use electronic health record tools for population management. Barriers to participation were concerns of center leaders about ability to provide fecal testing to and assure follow-up of

How Do Le Fort-Type Fractures Present in a Pediatric Cohort?

Science.gov (United States)

Macmillan, Alexandra; Lopez, Joseph; Luck, J D; Faateh, Muhammad; Manson, Paul; Dorafshar, Amir H

2018-05-01

Le Fort-type fractures are very rare in children, and there is a paucity of literature presenting their frequency and characteristics. The purpose of this study was to determine the etiology, frequency, and fracture patterns of children with severe facial trauma associated with pterygoid plate fractures in a pediatric cohort. We performed a retrospective cohort study of all children aged younger than 16 years with pterygoid plate and facial fractures who presented to our institute between 1990 and 2010. Patient charts and radiologic records were reviewed for demographic and fracture characteristics. Patients were categorized into 2 groups as per facial fracture pattern: non-Le Fort-type fractures (group A) and Le Fort-type fractures (group B). Other variables including dentition age, frontal sinus development, mechanism of injury, injury severity, and concomitant injuries were recorded. Univariate methods were used to compare groups. We identified 24 children; 25% were girls, and 20.8% were of nonwhite race. Most presented with Le Fort-type fracture patterns (group B, 66.7%). Age was significantly different between group A and group B (mean, 5.9 years and 9.9 years, respectively; P = .009). No significant differences in Injury Severity Score, rate of operative repair, and length of stay were found between groups. Most children with severe facial fractures and pterygoid plate fractures presented with Le Fort-type fracture patterns in our cohort. The mean age of children with Le Fort-type fractures was greater than in those with non-Le Fort-type patterns. However, Le Fort-type fractures did occur in younger children with deciduous and mixed dentition. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Center for Environmental Health Sciences

Data.gov (United States)

Federal Laboratory Consortium — The primary research objective of the Center for Environmental Health Sciences (CEHS) at the University of Montana is to advance knowledge of environmental impacts...

Center for Devices and Radiological Health Publications Index, August 1988

International Nuclear Information System (INIS)

1988-08-01

This is the first Publications Index to be published by the Center for Devices and Radiological Health. Previous indexes, titled 'Bureau of Radiological Health Publications Index', were published before the Center was formed in 1982 through the merger of the Bureau of Radiological Health and the Bureau of Medical Devices; the last of these indexes was published in October 1980. The 1988 edition contains records of medical device and radiological health documents authored or published by the Center from 1978 through 1986. It should not be considered all-inclusive since those documents for which bibliographic information was not available have been excluded. The Publications Index is being distributed to Center staff, state radiological health programs, and libraries on the Center's publication mailing list. The Center plans to update and publish the Index every other year to provide a convenient record of published Center documents

Le Fort I Maxillary Advancement Using Distraction Osteogenesis

OpenAIRE

Combs, Patrick D.; Harshbarger, Raymond J.

2014-01-01

Treatment of maxillary hypoplasia has traditionally involved conventional Le Fort I osteotomies and advancement. Advancements of greater than 10 mm risk significant relapse. This risk is greater in the cleft lip and palate population, whose anatomy and soft tissue scarring from prior procedures contributes to instability of conventional maxillary advancement. Le Fort I advancement with distraction osteogenesis has emerged as viable, stable treatment modality correction of severe maxillary hyp...

Mental Health Services in School-Based Health Centers: Systematic Review

Science.gov (United States)

Bains, Ranbir Mangat; Diallo, Ana F.

2016-01-01

Mental health issues affect 20-25% of children and adolescents, of which few receive services. School-based health centers (SBHCs) provide access to mental health services to children and adolescents within their schools. A systematic review of literature was undertaken to review evidence on the effectiveness of delivery of mental health services…

Are health centers in Thailand ready for health information technology? : a national survey.

Science.gov (United States)

Kijsanayotin, Boonchai; Speedie, Stuart

2006-01-01

The Thailand universal health care coverage scheme was instituted in 2001 and The Thailand Ministry of Public Health (MOPH) is restructuring its information systems to support this reform. The MOPH anticipates developing computerized health information systems which can provide information for administration tasks and can improve both healthcare delivery and public health services. To achieve these target goals, knowledge about users and organizations is vital. The knowledge of how health center workers currently use information technology (IT), their knowledge of IT, and acceptance of IT are not only beneficial to policy makers but also to system designers and implementers. The primary objective of this study is to learn how health centers in Thailand use IT, the level of basic IT knowledge among their workers, and their acceptance of health IT. We surveyed a random cross sectional sample of 1,607 health centers representing the total of 9,806 in Thailand in 2005. With an 82% response rate, the preliminary results indicate that information technology usage is pervasive in health centers. The respondents showed a moderately high degree of health information technology acceptance with a modest level of basic IT knowledge. There were no differences in degrees of acceptance among the four geographic regions. The mean score of "intention to use IT" was 5.6 on a scale of 7 and the average basic IT knowledge score was 13 out of 20. These results suggests the possibility of project success if the national health center information system projects are developed and implemented.

Fort Carson Wind Resource Assessment

Energy Technology Data Exchange (ETDEWEB)

Robichaud, R.

2012-10-01

This report focuses on the wind resource assessment, the estimated energy production of wind turbines, and economic potential of a wind turbine project on a ridge in the southeastern portion of the Fort Carson Army base.

Renewable Energy Opportunities at Fort Sill, Oklahoma

Energy Technology Data Exchange (ETDEWEB)

Boyd, Brian K.; Hand, James R.; Horner, Jacob A.; Orrell, Alice C.; Russo, Bryan J.; Weimar, Mark R.; Nesse, Ronald J.

2011-03-31

This document provides an overview of renewable resource potential at Fort Sill, based primarily upon analysis of secondary data sources supplemented with limited on-site evaluations. This effort focuses on grid-connected generation of electricity from renewable energy sources and on ground source heat pumps for heating and cooling buildings. The effort was funded by the U.S. Army Installation Management Command (IMCOM) as follow-on to the 2005 Department of Defense (DoD) Renewables Assessment. The site visit to Fort Sill took place on June 10, 2010.

Renewable Energy Opportunities at Fort Polk, Louisiana

Energy Technology Data Exchange (ETDEWEB)

Solana, Amy E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Boyd, Brian K. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Horner, Jacob A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Gorrissen, Willy J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Orrell, Alice C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Weimar, Mark R. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Hand, James R. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Russo, Bryan J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Williamson, Jennifer L. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

2010-11-17

This document provides an overview of renewable resource potential at Fort Polk, based primarily upon analysis of secondary data sources supplemented with limited on-site evaluations. This effort focuses on grid-connected generation of electricity from renewable energy sources and also on ground source heat pumps for heating and cooling buildings. The effort was funded by the U.S. Army Installation Management Command (IMCOM) as follow-on to the 2005 Department of Defense (DoD) Renewables Assessment. The site visit to Fort Polk took place on February 16, 2010.

Adolescent Health Care in School-Based Health Centers. Position Statement

Science.gov (United States)

National Assembly on School-Based Health Care, 2008

2008-01-01

School-based health centers (SBHCs) are considered one of the most effective strategies for delivering preventive care, including reproductive and mental health care services, to adolescents--a population long considered difficult to reach. National Assembly on School-Based Health Care (NASBHC) recommends practices and policies to assure…

Health care employee perceptions of patient-centered care.

Science.gov (United States)

Balbale, Salva Najib; Turcios, Stephanie; LaVela, Sherri L

2015-03-01

Given the importance of health care employees in the delivery of patient-centered care, understanding their unique perspectives is essential for quality improvement. The purpose of this study was to use photovoice to evaluate perceptions and experiences around patient-centered care among U.S. Veterans Affairs (VA) health care employees. We asked participants to take photographs of salient features in their environment related to patient-centered care. We used the photographs to facilitate dialogue during follow-up interviews. Twelve VA health care employees across two VA sites participated in the project. Although most participants felt satisfied with their work environment and experiences at the VA, they identified several areas for improvement. These included a need for more employee health and wellness initiatives and a need for enhanced opportunities for training and professional growth. Application of photovoice enabled us to learn about employees' unique perspectives around patient-centered care while engaging them in an evaluation of care delivery. © The Author(s) 2014.

Fort Independence: An Eighteenth-Century Frontier Homesite and Militia Post in South Carolina.

Science.gov (United States)

1982-12-01

included in this instance as a condiment , but it could also indicate that the Fort Independence garrison was familiar with the strategy employed by the Fort...archeological investigation of Fort Charlotte, McCormick County, South Carolina. Notebook, Institute of Archeology and Anthropology, University of South

Health Extension in New Mexico: An Academic Health Center and the Social Determinants of Disease

Science.gov (United States)

Kaufman, Arthur; Powell, Wayne; Alfero, Charles; Pacheco, Mario; Silverblatt, Helene; Anastasoff, Juliana; Ronquillo, Francisco; Lucero, Ken; Corriveau, Erin; Vanleit, Betsy; Alverson, Dale; Scott, Amy

2010-01-01

The Agricultural Cooperative Extension Service model offers academic health centers methodologies for community engagement that can address the social determinants of disease. The University of New Mexico Health Sciences Center developed Health Extension Rural Offices (HEROs) as a vehicle for its model of health extension. Health extension agents are located in rural communities across the state and are supported by regional coordinators and the Office of the Vice President for Community Health at the Health Sciences Center. The role of agents is to work with different sectors of the community in identifying high-priority health needs and linking those needs with university resources in education, clinical service and research. Community needs, interventions, and outcomes are monitored by county health report cards. The Health Sciences Center is a large and varied resource, the breadth and accessibility of which are mostly unknown to communities. Community health needs vary, and agents are able to tap into an array of existing health center resources to address those needs. Agents serve a broader purpose beyond immediate, strictly medical needs by addressing underlying social determinants of disease, such as school retention, food insecurity, and local economic development. Developing local capacity to address local needs has become an overriding concern. Community-based health extension agents can effectively bridge those needs with academic health center resources and extend those resources to address the underlying social determinants of disease. PMID:20065282

Campus Health Centers' Lack of Information Regarding Providers: A Content Analysis of Division-I Campus Health Centers' Provider Websites.

Science.gov (United States)

Perrault, Evan K

2018-07-01

Campus health centers are a convenient, and usually affordable, location for college students to obtain health care. Staffed by licensed and trained professionals, these providers can generally offer similar levels of care that providers at off-campus clinics can deliver. Yet, previous research finds students may forgo this convenient, on-campus option partially because of a lack of knowledge regarding the quality of providers at these campus clinics. This study sought to examine where this information deficit may come from by analyzing campus health centers' online provider information. All Division-I colleges or universities with an on-campus health center, which had information on their websites about their providers (n = 294), had their providers' online information analyzed (n = 2,127 providers). Results revealed that schools commonly offer professional information (e.g., provider specialties, education), but very little about their providers outside of the medical context (e.g., hobbies) that would allow a prospective student patient to more easily relate. While 181 different kinds of credentials were provided next to providers' names (e.g., MD, PA-C, FNP-BC), only nine schools offered information to help students understand what these different credentials meant. Most schools had information about their providers within one-click of the homepage. Recommendations for improving online information about campus health center providers are offered.

Utilization of maternal health services in rural primary health centers ...

African Journals Online (AJOL)

Utilization of maternal health services in rural primary health centers in Sub- Saharan Africa. ... their pregnancies were normal during antenatal care visits, hostile attitude of health workers, poverty and mode of payment. Majority of the PHCs provided antenatal, normal delivery, and post natal services. Rural mothers lacked ...

Drilling and Testing the DOI041A Coalbed Methane Well, Fort Yukon, Alaska

Science.gov (United States)

Clark, Arthur; Barker, Charles E.; Weeks, Edwin P.

2009-01-01

The need for affordable energy sources is acute in rural communities of Alaska where costly diesel fuel must be delivered by barge or plane for power generation. Additionally, the transport, transfer, and storage of fuel pose great difficulty in these regions. Although small-scale energy development in remote Arctic locations presents unique challenges, identifying and developing economic, local sources of energy remains a high priority for state and local government. Many areas in rural Alaska contain widespread coal resources that may contain significant amounts of coalbed methane (CBM) that, when extracted, could be used for power generation. However, in many of these areas, little is known concerning the properties that control CBM occurrence and production, including coal bed geometry, coalbed gas content and saturation, reservoir permeability and pressure, and water chemistry. Therefore, drilling and testing to collect these data are required to accurately assess the viability of CBM as a potential energy source in most locations. In 2004, the U.S. Geological Survey (USGS) and Bureau of Land Management (BLM), in cooperation with the U.S. Department of Energy (DOE), the Alaska Department of Geological and Geophysical Surveys (DGGS), the University of Alaska Fairbanks (UAF), the Doyon Native Corporation, and the village of Fort Yukon, organized and funded the drilling of a well at Fort Yukon, Alaska to test coal beds for CBM developmental potential. Fort Yukon is a town of about 600 people and is composed mostly of Gwich'in Athabascan Native Americans. It is located near the center of the Yukon Flats Basin, approximately 145 mi northeast of Fairbanks.

Oral health knowledge of health care workers in special children's center.

Science.gov (United States)

Wyne, Amjad; Hammad, Nouf; Splieth, Christian

2015-01-01

To determine the oral health knowledge of health care workers in special children's center. A self-administered questionnaire was used to collect following information: demographics, oral hygiene practices, importance of fluoride, dental visits, cause of tooth decay, gingival health, and sources of oral health information. The study was conducted at Riyadh Center for Special Children in Riyadh City from December 2013 to May 2014. All 60 health care workers in the center completed the questionnaire. A great majority (95%) of the workers brushed their teeth twice or more daily. More than two-third (71.7%) of the workers knew that fluoride helps in caries prevention. One in five (21.7%) workers thought that a dental visit only becomes necessary in case of a dental problem. Similarly, 13.3% of the workers thought to "wait till there is some pain in case of a dental cavity" before seeking dental treatment. The workers ranked soft drinks/soda (98.3%), flavored fizzy drinks (60%) and sweetened/flavored milks (43.3%) as top three cariogenic drinks. A great majority (95%) of the workers correctly responded that blood on toothbrush most probably is a sign of "gum disease". Dentists (50%) and media (45%) were the main source of their oral health information. There was no significant difference (p > 0.05) in workers' response in relation to their specific job. The special health care workers in the disabled children's center generally had satisfactory oral health knowledge and practices.

78 FR 49357 - National Health Center Week, 2013

Science.gov (United States)

2013-08-14

... America A Proclamation Community health centers play a critical role in providing affordable, high-quality... people living in the United States depends on their services. They are an important source of jobs in... extend our thanks to the women and men who operate America's health centers. NOW, THEREFORE, I, BARACK...

National Center for Health Statistics

Science.gov (United States)

... Submit Search the CDC National Center for Health Statistics Note: Javascript is disabled or is not supported ... Survey of Family Growth Vital Records National Vital Statistics System National Death Index Vital Statistics Rapid Release ...

Cost-income analysis of oral health units of health care centers in Yazd city

Directory of Open Access Journals (Sweden)

Hosein Fallahzadeh

2012-01-01

Full Text Available Background and Aims: Increasing demands for health care's services on one hand and limited resources on the other hand brings about pressure over governments to find out a mechanism for fair and appropriate distribution of resources. Economic analysis is one of the appropriate tools for policy making on this priority. The aim of this study was to assess capital and consumption of oral health units of health care centers in Yazd city and comparing it with revenue of these centers and determining of cost effectiveness.Materials and Methods: In this descriptive cross sectional study, all health care centers of Yazd city with active dentistry department were evaluated. The data has been extracted from current documents in health care center of county based issued receipts and daily information registers.Results: Expended cost for providing of oral hygiene services in second half of 2008 in 13 medical health centers of Yazd included active dentistry section was 557.887.500 Rials and revenue to cost ratio was about 34%. The most provided service was related to tooth extraction and the average of tooth restoration in each working day was 0.48.Conclusion: With attention to low tariffs of dentistry services in medical health centers and paying subsidy to target groups, expenses of oral hygiene are always more than its revenue.

75 FR 55587 - Family-to-Family Health Information Center Program

Science.gov (United States)

2010-09-13

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Family-to-Family Health Information Center Program AGENCY: Health Resources and Services Administration, HHS... Vermont Family-to-Family Health Information Center (F2F HIC) grant (H84MC00002) from the Parent to Parent...

En fascinerende fortælling om det 20. århundredes musik

DEFF Research Database (Denmark)

Bonde, Lars Ole

2011-01-01

Anmeldelse af Karl Aage Rasmussen: Musik i det tyvende århundrede: En fortælling. Gyldendal 2011.......Anmeldelse af Karl Aage Rasmussen: Musik i det tyvende århundrede: En fortælling. Gyldendal 2011....

Analysis of Delayed Sea Breeze Onset for Fort Ord Prescribed Burning Operations

Science.gov (United States)

2015-12-01

DELAYED SEA BREEZE ONSET FOR FORT ORD PRESCRIBED BURNING OPERATIONS by Dustin D. Hocking December 2015 Thesis Advisor: Wendell Nuss Second...AND DATES COVERED Master’s thesis 4. TITLE AND SUBTITLE ANALYSIS OF DELAYED SEA BREEZE ONSET FOR FORT ORD PRESCRIBED BURNING OPERATIONS 5...release; distribution is unlimited 12b. DISTRIBUTION CODE 13. ABSTRACT (maximum 200 words) The U.S. Army conducts prescribed burns at Fort Ord

Planning for the Mercy Center for Breast Health.

Science.gov (United States)

Olivares, V Ed

2002-01-01

During the last months of 2000, administrators at the Mercy San Juan Medical Center in Carmichael, Calif., convened a steering committee to plan the Mercy Center for Breast Health. The Steering Committee was composed of the director of ancillary and support services, the oncology clinical nurse specialist, the RN manager of the oncology nursing unit, the RN surgery center manager, and me, the manager of imaging services. The committee was responsible for creating a new business with five specific objectives: to position the Center as a comprehensive diagnostic and resource center for women; to generate physician referrals to the Breast Center through various vehicles; to create awareness of the Breast Center's capabilities among area radiologists; to create awareness of the Breast Center among employees of six sister facilities; to create "brand awareness" for the Mercy Center for Breast Health among referring physicians and patients who could use competing centers in the area. The Steering Committee's charter was to design a center with a feminine touch and ambience and to provide a "one-stop shopping" experience for patients. A major component of the Breast Center is the Dianne Haselwood Resource Center, which provides patients with educational support and information. The Steering Committee brought its diverse experience and interests to bear on arranging for equipment acquisition, information and clerical systems, staffing, clinic office design, patient care and marketing. Planning the Mercy Center for Breast Health has been a positive challenge that brought together many elements of the organization and people from different departments and specialties to create a new business venture. Our charge now is to grow and to live up to our vision of offering complete breast diagnostic, education and support services in one location.

UNDER-UTILIZATION OF COMMUNITY HEALTH CENTERS IN PURWOREJO REGENCY, CENTRAL JAVA

OpenAIRE

Atik Triratnawati

2006-01-01

The basic strategy of the Ministry of Health to achieve Health For All In Indonesia 2010 is through health paradigm, decentralization, professionalism and health service management. Community health centers play an important role to achieve the goal. Unfortunately, underutilization of community health centers is still a problem in Purworejo. The purpose of this study was to know the utilization of community health centers using a sociological health approach. Qualitative research by observati...

Nurse-midwives in federally funded health centers: understanding federal program requirements and benefits.

Science.gov (United States)

Carter, Martha

2012-01-01

Midwives are working in federally funded health centers in increasing numbers. Health centers provide primary and preventive health care to almost 20 million people and are located in every US state and territory. While health centers serve the entire community, they also serve as a safety net for low-income and uninsured individuals. In 2010, 93% of health center patients had incomes below 200% of the Federal Poverty Guidelines, and 38% were uninsured. Health centers, including community health centers, migrant health centers, health care for the homeless programs, and public housing primary care programs, receive grant funding and enjoy other benefits due to status as federal grantees and designation as federally qualified health centers. Clinicians working in health centers are also eligible for financial and professional benefits because of their willingness to serve vulnerable populations and work in underserved areas. Midwives, midwifery students, and faculty working in, or interacting with, health centers need to be aware of the regulations that health centers must comply with in order to qualify for and maintain federal funding. This article provides an overview of health center regulations and policies affecting midwives, including health center program requirements, scope of project policy, provider credentialing and privileging, Federal Tort Claims Act malpractice coverage, the 340B Drug Pricing Program, and National Health Service Corps scholarship and loan repayment programs. © 2012 by the American College of Nurse-Midwives.

Center for Maritime Safety and Health Studies

Data.gov (United States)

Federal Laboratory Consortium — Established in November 2015, the Center for Maritime Safety and Health Studies (CMSHS) promotes safety and health for all maritime workers, including those employed...

Health professionals’ experiences of person-centered collaboration in mental health care

Directory of Open Access Journals (Sweden)

Rita Sommerseth

2008-10-01

Full Text Available Rita Sommerseth, Elin DysvikUniversity of Stavanger, Faculty of Social Sciences, Department of Health Studies, Stavanger, NorwayObjective: The basic aim in this paper is to discuss health care professionals’ experiences of person-centered collaboration and involvement in mental health rehabilitation and suggest ways of improving this perspective. Furthermore, the paper explains the supportive systems that are at work throughout the process of rehabilitation.Method: The study design is a qualitative approach using three focus group interviews with a total of 17 informants with different professional backgrounds such as nurses, social workers, and social pedagogies. In addition, one nurse and one social worker participated in a semistructured in-depth interview to judge validity.Results: Our results may demonstrate deficits concerning mental health care on several levels. This understanding suggests firstly, that a person-centered perspective and involvement still are uncommon. Secondly, multidisciplinary work seems uncommon and only sporadically follows recommendations. Thirdly, family support is seldom involved. Lastly, firm leadership and knowledge about laws and regulations seems not to be systematically integrated in daily care.Conclusion: Taking these matters together, the improvement of a person-centered perspective implies cooperation between different services and levels in mental health care. In order to bring about improvement the health care workers must critically consider their own culture, coordination of competence must be increased, and leadership at an institutional and organizational level must be improved so that scarce rehabilitation resources are used to the optimal benefit of people with a mental illness.Keywords: multidisciplinary teams, person-centered collaboration, supportive systems, rehabilitation

75 FR 39265 - National Center for Health Statistics (NCHS), Classifications and Public Health Data Standards...

Science.gov (United States)

2010-07-08

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics (NCHS), Classifications and Public Health Data Standards Staff, Announces the... Prevention, Classifications and Public Health Data Standards, 3311 Toledo Road, Room 2337, Hyattsville, MD...

78 FR 53148 - National Center for Health Statistics (NCHS), Classifications and Public Health Data Standards...

Science.gov (United States)

2013-08-28

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics (NCHS), Classifications and Public Health Data Standards Staff, Announces the... Administrator, Classifications and Public Health Data Standards Staff, NCHS, 3311 Toledo Road, Room 2337...

78 FR 9055 - National Center for Health Statistics (NCHS), Classifications and Public Health Data Standards...

Science.gov (United States)

2013-02-07

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics (NCHS), Classifications and Public Health Data Standards Staff, Announces the..., Medical Systems Administrator, Classifications and Public Health Data Standards Staff, NCHS, 3311 Toledo...

Fort Peck-Wolf Point transmission line project, Montana

International Nuclear Information System (INIS)

1992-01-01

The primary objective of the project is to replace the existing 36-mile Fort Peck-Wolf Point transmission line which has reached the end of its useful service life. Presently, the overall condition of this existing section of the 47-year-old line is poor. Frequent repairs have been required because of the absence of overhead ground wires. The continued maintenance of the line will become more expensive and customer interruptions will persist because of the damage due to lightning. The expense of replacing shell rotted poles, and the concern for the safety of the maintenance personnel because of hazards caused by severe shell rot are also of primary importance. The operational and maintenance problems coupled with power system simulation studies, demonstrate the need for improvements to the Wolf Point area to serve area loads. Western's Wolf Point Substation is an important point of interconnection for the power output from the Fort Peck Dam to area loads as far away as Williston, North Dakota. The proposed transmission line replacement would assure that there will continue to be reliable transmission capacity available to serve area electrical loads, as well as provide a reliable second high-voltage transmission path from the Fort Peck generation to back-up a loss of the Fort Peck-Wolf Point 115-kV Line No. 1

42 CFR 405.2462 - Payment for rural health clinic and Federally qualified health center services.

Science.gov (United States)

2010-10-01

... integral and subordinate part of a hospital, skilled nursing facility or home health agency participating... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for rural health clinic and Federally qualified health center services. 405.2462 Section 405.2462 Public Health CENTERS FOR MEDICARE & MEDICAID...

75 FR 56549 - National Center for Health Statistics (NCHS), Classifications and Public Health Data Standards...

Science.gov (United States)

2010-09-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics (NCHS), Classifications and Public Health Data Standards Staff, Announces the... Public Health Data Standards Staff, NCHS, 3311 Toledo Road, Room 2337, Hyattsville, Maryland 20782, e...

New York State Health Foundation grant helps health centers win federal expansion funds.

Science.gov (United States)

Sandman, David; Cozine, Maureen

2012-11-01

With approximately 1.2 million New Yorkers poised to gain health insurance coverage as a result of federal health reform, demand for primary care services is likely to increase greatly. The Affordable Care Act includes $11 billion in funding to enhance primary care access at community health centers. Recognizing a need and an opportunity, in August 2010 the New York State Health Foundation made a grant of nearly $400,000 to the Community Health Care Association of New York State to work with twelve health centers to develop successful proposals for obtaining and using these federal funds. Ultimately, eleven of the twelve sites are expected to receive $25.6 million in federal grants over a five-year period-a sixty-four-fold return on the foundation's investment. This article describes the strategy for investing in community health centers; identifies key project activities, challenges, and lessons; and highlights its next steps for strengthening primary care.

Targeting Net Zero Energy at Fort Carson: Assessment and Recommendations

Energy Technology Data Exchange (ETDEWEB)

Anderson, K.; Markel, T.; Simpson, M.; Leahey, J.; Rockenbaugh, C.; Lisell, L.; Burman, K.; Singer, M.

2011-10-01

The U.S. Army's Fort Carson installation was selected to serve as a prototype for net zero energy assessment and planning. NREL performed the comprehensive assessment to appraise the potential of Fort Carson to achieve net zero energy status through energy efficiency, renewable energy, and electric vehicle integration. This report summarizes the results of the assessment and provides energy recommendations. This study is part of a larger cross-laboratory effort that also includes an assessment of renewable opportunities at seven other DoD Front Range installations, a microgrid design for Fort Carson critical loads and an assessment of regulatory and market-based barriers to a regional secure smart grid.

Morphological anomalies in two Lutzomyia (Psathyromyia) shannoni (Diptera: Psychodidae: Phlebotominae) specimens collected from Fort Rucker, Alabama, and Fort Campbell, Kentucky.

Science.gov (United States)

Florin, David A; Lawyer, Phillip; Rowton, Edgar; Schultz, George; Wilkerson, Richard; Davies, Stephen J; Lipnick, Robert; Keep, Lisa

2010-09-01

This report describes two male specimens of the sand fly species Lutzomyia shannoni (Dyar) (Diptera: Psychodidae: Phlebotominae) collected at Fort Rucker, AL, and Fort Campbell, KY, in dry ice-baited light traps during September 2005. The specimens were observed to have anomalies to the number of spines on the gonostyli. The taxonomic keys of Young and Perkins (Mosq. News 44: 263-285; 1984) use the number of spines on the gonostylus in the first couplet to differentiate two major groupings of North American sand flies. The two anomalous specimens were identified as L. shannoni based on the following criteria: (1) both specimens possess antennal ascoids with long, distinct proximal spurs (a near diagnostic character of L. shannoni in North America), (2) the sequences of the partial cytochrome c oxidase subunit 1 gene from both specimens indicated L. shannoni, and (3) the sequences of the internal transcribed spacer 2 molecular marker from both specimens indicated L. shannoni. The anomalous features are fundamentally different from each other as the Fort Rucker specimen possesses a fifth spine (basally located) on just one gonostylus, whereas the Fort Campbell specimen possesses five spines (extra spines subterminally located) on both gonostyli. Because the gonostyli are part of the external male genitalia, anomalies in the number of spines on the gonostyli may have serious biological consequences, such as reduced reproductive success, for the possessors. These anomalies are of taxonomic interest as the specimens could easily have been misidentified using available morphological keys.

76 FR 68625 - Establishment of the Fort Monroe National Monument

Science.gov (United States)

2011-11-07

... period of slavery in the colonies and, later, this Nation. Two hundred and forty-two years later, Fort... 1863. Thus, Old Point Comfort marks both the beginning and end of slavery in our Nation. The Fort... North Beach area lies the only undeveloped shoreline remaining on Old Point Comfort, providing modern...

Kennedy Space Center environmental health program

International Nuclear Information System (INIS)

Marmaro, G.M.; Cardinale, M.A.; Summerfield, B.R.; Tipton, D.A.

1992-01-01

The Kennedy Space Center's environmental health organization is responsible for programs which assure its employees a healthful workplace under diverse and varied working conditions. These programs encompass the disciplines of industrial hygiene, radiation protection (health physics), and environmental sanitation/pollution control. Activities range from the routine, such as normal office work, to the highly specialized, such as the processing of highly toxic and hazardous materials

Inventory of Forts in Indonesia

Science.gov (United States)

Rinandi, N.; Suryaningsih, F.

2015-08-01

The great archipelago in Indonesia with its wealthy and various nature, the products and commodities of tropic agriculture and the rich soil, was through the centuries a region of interest for other countries all over the world. For several reasons some of these countries came to Indonesia to establish their existence and tried to monopolize the trading. These countries such as the Portuguese, the Spanish, the Dutch and the British built strengthened trade stations which later became forts all over Indonesia to defend their interest. The archipelago of Indonesia possesses a great number of fortification-works as legacies of native rulers and those which were built by European trading companies and later became colonial powers in the 16th to the 19th centuries. These legacies include those specific structures built as a defence system during pre and within the period of World War II. These fortresses are nowadaysvaluable subjects, because they might be considered as shared heritage among these countries and Indonesia. It's important to develop a vision to preserve these particular subjects of heritage, because they are an interesting part of the Indonesian history and its cultural treasures. The Government of the Republic of Indonesia has national program to compile a comprehensive documentation of the existing condition of these various types of forts as cultural heritage. The result of the 3 years project was a comprehensive 442 forts database in Indonesia, which will be very valuable to the implementation of legal protection, preservation matters and adaptive re-use in the future.

Cranial nerve injury after Le Fort I osteotomy.

Science.gov (United States)

Kim, J-W; Chin, B-R; Park, H-S; Lee, S-H; Kwon, T-G

2011-03-01

A Le Fort I osteotomy is widely used to correct dentofacial deformity because it is a safe and reliable surgical method. Although rare, various complications have been reported in relation to pterygomaxillary separation. Cranial nerve damage is one of the serious complications that can occur after Le Fort I osteotomy. In this report, a 19-year-old man with unilateral cleft lip and palate underwent surgery to correct maxillary hypoplasia, asymmetry and mandibular prognathism. After the Le Fort I maxillary osteotomy, the patient showed multiple cranial nerve damage; an impairment of outward movement of the eye (abducens nerve), decreased vision (optic nerve), and paraesthesia of the frontal and upper cheek area (ophthalmic and maxillary nerve). The damage to the cranial nerve was related to an unexpected sphenoid bone fracture and subsequent trauma in the cavernous sinus during the pterygomaxillary osteotomy. Copyright © 2010 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

The Fort McMurray Demonstration Project in Social Marketing: no demonstrable effect on already falling injury rates following intensive community and workplace intervention.

Science.gov (United States)

Guidotti, Tee L; Deb, Pooja; Bertera, Robert; Ford, Lynda

2009-10-01

The Fort McMurray Demonstration Project in Social Marketing attempted to achieve mutually reinforcing effects from thematically coordinated educational and awareness efforts in the community as a whole and in the workplace and the inclusion of occupational safety within the framework of a community health promotion project. The study community was Fort McMurray, a small, industrial city in northern Alberta. The Mistahiai Health Region, several hundred kilometers to the west and also dominated by one city, Grande Prairie, served as the reference community. The intervention was based on media and events staged at public events, with supporting educational activities in schools and the community. It relied heavily on community-based partners and volunteers. Data on healthcare utilization of selected preventable injuries were obtained from Alberta Health for the time period 1990-1996 for the Regional Health Authorities of Northern Lights, where the only large population centre is Fort McMurray, and Mistahia. Age-adjusted aggregate injury rates were analyzed for evidence of an effect of the intervention. Severity was measured by proxy, using the number of diagnostic claims submitted for reimbursement for medical services in a given year. The communities differed in age-specific injury rates, with Fort McMurray showing higher rates for residents aged less than 55. Young adults and older adolescents showed higher levels of severity. Injury rates fell substantially and at similar rates in both communities over the five-year period. However, in both communities injury rates were already falling before the intervention in Fort McMurray began and continued to fall at about the same rate, slowing toward the end of the period. No evidence was found for an effect of the Project or for acceleration of the reduction in injury frequency in the intervention area. Over the period, fewer medical services were delivered in office settings and more in emergency rooms, in both

Patient-centered medical home model: do school-based health centers fit the model?

Science.gov (United States)

Larson, Satu A; Chapman, Susan A

2013-01-01

School-based health centers (SBHCs) are an important component of health care reform. The SBHC model of care offers accessible, continuous, comprehensive, family-centered, coordinated, and compassionate care to infants, children, and adolescents. These same elements comprise the patient-centered medical home (PCMH) model of care being promoted by the Affordable Care Act with the hope of lowering health care costs by rewarding clinicians for primary care services. PCMH survey tools have been developed to help payers determine whether a clinician/site serves as a PCMH. Our concern is that current survey tools will be unable to capture how a SBHC may provide a medical home and therefore be denied needed funding. This article describes how SBHCs might meet the requirements of one PCMH tool. SBHC stakeholders need to advocate for the creation or modification of existing survey tools that allow the unique characteristics of SBHCs to qualify as PCMHs.

Johnson Space Center Health and Medical Technical Authority

Science.gov (United States)

Fogarty, Jennifer A.

2010-01-01

1.HMTA responsibilities: a) Assure program/project compliance with Agency health and medical requirements at identified key decision points. b) Certify that programs/projects comply with Agency health and medical requirements prior to spaceflight missions. c) Assure technical excellence. 2. Designation of applicable NASA Centers for HMTA implementation and Chief Medical Officer (CMO) appointment. 3. Center CMO responsible for HMTA implementation for programs and projects at the center. JSC HMTA captured in "JSC HMTA Implementation Plan". 4. Establishes specifics of dissenting opinion process consistent with NASA procedural requirements.

Utilization of Mental Health Services in School-Based Health Centers.

Science.gov (United States)

Bains, Ranbir M; Cusson, Regina; White-Frese, Jesse; Walsh, Stephen

2017-08-01

We summarize utilization patterns for mental health services in school-based health centers. Administrative data on school-based health center visits in New Haven, Connecticut were examined for the 2007-2009 school years. Relative frequencies of mental health visits by age were calculated as a percentage of all visits and were stratified by sex, ethnicity/race, and insurance status. Mental health visits accounted for the highest proportion of visits (31.8%). The proportion of mental health visits was highest at 8 years (42.8%) and at 13 years (39.0%). The proportion of mental health visits among boys (38.4%) was higher than among girls (26.7%). Hispanic students had a lower proportion of mental health visits than black students (23.5% vs 35.8%) in all but 2 age groups. Students in the white/other ethnicity category had higher proportions of mental health visits than Hispanic and black students between ages 12 and 15. Students with no health insurance (22.5%) had lower proportions of mental health visits than students covered by Medicaid (34.3%) or private insurance (33.9%). The percentage of mental health visits by students with private insurance was highest (37.2%-49%) in the 13-15 age range. Usage patterns for mental health issues show pronounced, nonrandom variation relative to age and other demographic characteristics especially with 8-year-old boys. © 2017, American School Health Association.

UNDER-UTILIZATION OF COMMUNITY HEALTH CENTERS IN PURWOREJO REGENCY, CENTRAL JAVA

Directory of Open Access Journals (Sweden)

Atik Triratnawati

2006-06-01

Full Text Available The basic strategy of the Ministry of Health to achieve Health For All In Indonesia 2010 is through health paradigm, decentralization, professionalism and health service management. Community health centers play an important role to achieve the goal. Unfortunately, underutilization of community health centers is still a problem in Purworejo. The purpose of this study was to know the utilization of community health centers using a sociological health approach. Qualitative research by observation, in-depth interview and focus group discussion were done among different types of group. The study was done in Purworejo District on February and March 2000. The main problems related to underutilization of community health centers are mostly on administration (less quality services, un-efficient, long hours waiting, strong bureaucratic system (physician has a dominant power, overlapping programs, poor coordination and integration with other divisions and cultural behavior of the community (labeling/stigma, self-care dominant, lack of community participation. To overcome under-utilization of community health centers the administration and bureaucracy should be changed into more efficient, not bureaucratic management. In addition social changes of the community culture is needed. As a consequence through these changes the staff of the health centers will be more efficient and effective.

Water-resources and land-surface deformation evaluation studies at Fort Irwin National Training Center, Mojave Desert, California

Science.gov (United States)

Densmore-Judy, Jill; Dishart, Justine E.; Miller, David; Buesch, David C.; Ball, Lyndsay B.; Bedrosian, Paul A.; Woolfenden, Linda R.; Cromwell, Geoffrey; Burgess, Matthew K.; Nawikas, Joseph; O'Leary, David; Kjos, Adam; Sneed, Michelle; Brandt, Justin

2017-01-01

The U.S. Army Fort Irwin National Training Center (NTC), in the Mojave Desert, obtains all of its potable water supply from three groundwater basins (Irwin, Langford, and Bicycle) within the NTC boundaries (fig. 1; California Department of Water Resources, 2003). Because of increasing water demands at the NTC, the U.S. Geological Survey (USGS), in cooperation with the U.S. Army, completed several studies to evaluate water resources in the developed and undeveloped groundwater basins underlying the NTC. In all of the developed basins, groundwater withdrawals exceed natural recharge, resulting in water-level declines. However, artificial recharge of treated wastewater has had some success in offsetting water-level declines in Irwin Basin. Additionally, localized water-quality changes have occurred in some parts of Irwin Basin as a result of human activities (i.e., wastewater disposal practices, landscape irrigation, and/or leaking pipes). As part of the multi-faceted NTC-wide studies, traditional datacollection methods were used and include lithological and geophysical logging at newly drilled boreholes, hydrologic data collection (i.e. water-level, water-quality, aquifer tests, wellbore flow). Because these data cover a small portion of the 1,177 square-mile (mi2 ) NTC, regional mapping, including geologic, gravity, aeromagnetic, and InSAR, also were done. In addition, ground and airborne electromagnetic surveys were completed and analyzed to provide more detailed subsurface information on a regional, base-wide scale. The traditional and regional ground and airborne data are being analyzed and will be used to help develop preliminary hydrogeologic framework and groundwater-flow models in all basins. This report is intended to provide an overview of recent water-resources and land-surface deformation studies at the NTC.

The Oral Health Care Manager in a Patient-Centered Health Facility.

Science.gov (United States)

Theile, Cheryl Westphal; Strauss, Shiela M; Northridge, Mary Evelyn; Birenz, Shirley

2016-06-01

The dental hygienist team member has an opportunity to coordinate care within an interprofessional practice as an oral health care manager. Although dental hygienists are currently practicing within interprofessional teams in settings such as pediatric offices, hospitals, nursing homes, schools, and federally qualified health centers, they often still assume traditional responsibilities rather than practicing to the full extent of their training and licenses. This article explains the opportunity for the dental hygiene professional to embrace patient-centered care as an oral health care manager who can facilitate integration of oral and primary care in a variety of health care settings. Based on an innovative model of collaboration between a college of dentistry and a college of nursing, an idea emerged among several faculty members for a new management method for realizing continuity and coordination of comprehensive patient care. Involved faculty members began working on the development of an approach to interprofessional practice with the dental hygienist serving as an oral health care manager who would address both oral health care and a patient's related primary care issues through appropriate referrals and follow-up. This approach is explained in this article, along with the results of several pilot studies that begin to evaluate the feasibility of a dental hygienist as an oral health care manager. A health care provider with management skills and leadership qualities is required to coordinate the interprofessional provision of comprehensive health care. The dental hygienist has the opportunity to lead closer integration of oral and primary care as an oral health care manager, by coordinating the team of providers needed to implement comprehensive, patient-centered care. Copyright © 2016 Elsevier Inc. All rights reserved.

National Center for Disaster Medicine and Public Health

Data.gov (United States)

Federal Laboratory Consortium — The National Center for Disaster Medicine and Public Health (NCDMPH) is an academic center tasked with leading federal, and coordinating national, efforts to develop...

Fort Valley's early scientists: A legacy of distinction (P-53)

Science.gov (United States)

Andrew J. Sanchez Meador; Susan D. Olberding

2008-01-01

When the Riordan brothers of Flagstaff, Arizona asked Gifford Pinchot to determine why there was a deficit in ponderosa pine seedlings, neither party understood the historical significance of what they were setting in motion for the field of forest research. The direct result of that professional favor was the establishment of the Fort Valley Experiment Station (Fort...

The role of health centers in preventive care provision

Directory of Open Access Journals (Sweden)

Shemetova G.N.

2017-12-01

Full Text Available Aim: to assess the importance of the Centers of Health in the organization and provision of preventive care to the population, in the early detection of risk factors for the development of chronic non-communicable diseases and the development of a healthy lifestyle. Material and Methods. On the basis of the Health Center of Engels Center for Medical Prevention in the Saratov Region, the detection of risk factors for 2011-2015 was analyzed according to statistical reporting (form No. 68 and health cards (form025-CZ/y of 207 patients. To assess the satisfaction of visitors with the work of the Center, a specially developed questionnaire was conducted, which included 22 questions that characterize the patient profile, his attitude to the organization and the results of the survey, and the motivation to modify the way of life. Results. The study confirmed the important role of the Centers of Health in the organization and provision of preventive care to the population, the formation of a healthy lifestyle and the early detection of diseases and risk factors for their development. Conclusion. Only joint efforts of medical institutions, authorities, educational organizations, mass media can lead to the formation of the population's responsibility for their health and readiness to modify the way of life.

Renewable Energy Opportunities at Fort Campbell, Tennessee/Kentucky

Energy Technology Data Exchange (ETDEWEB)

Hand, James R.; Horner, Jacob A.; Kora, Angela R.; Orrell, Alice C.; Russo, Bryan J.; Weimar, Mark R.; Nesse, Ronald J.

2011-03-31

This document provides an overview of renewable resource potential at Fort Campbell, based primarily upon analysis of secondary data sources supplemented with limited on-site evaluations. This effort focuses on grid-connected generation of electricity from renewable energy sources and also on ground source heat pumps for heating and cooling buildings. The effort was funded by the U.S. Army Installation Management Command (IMCOM) as follow-on to the 2005 Department of Defense (DoD) Renewables Assessment. The site visit to Fort Campbell took place on June 10, 2010.

Renewable Energy Opportunities at Fort Drum, New York

Energy Technology Data Exchange (ETDEWEB)

Brown, Scott A.; Orrell, Alice C.; Solana, Amy E.; Williamson, Jennifer L.; Hand, James R.; Russo, Bryan J.; Weimar, Mark R.; Rowley, Steven; Nesse, Ronald J.

2010-10-20

This document provides an overview of renewable resource potential at Fort Drum, based primarily upon analysis of secondary data sources supplemented with limited on-site evaluations. This effort focuses on grid-connected generation of electricity from renewable energy sources and also on ground source heat pumps for heating and cooling buildings. The effort was funded by the U.S. Army Installation Management Command (IMCOM) as follow-on to the 2005 Department of Defense (DoD) Renewables Assessment. The site visit to Fort Drum took place on May 4 and 5, 2010.

Defining the medical imaging requirements for a rural health center

CERN Document Server

2017-01-01

This book establishes the criteria for the type of medical imaging services that should be made available to rural health centers, providing professional rural hospital managers with information that makes their work more effective and efficient. It also offers valuable insights into government, non-governmental and religious organizations involved in the planning, establishment and operation of medical facilities in rural areas. Rural health centers are established to prevent patients from being forced to travel to distant urban medical facilities. To manage patients properly, rural health centers should be part of regional and more complete systems of medical health care installations in the country on the basis of a referral and counter-referral program, and thus, they should have the infrastructure needed to transport patients to urban hospitals when they need more complex health care. The coordination of all the activities is only possible if rural health centers are led by strong and dedicated managers....

Microgrid Enabled Distributed Energy Solutions (MEDES) Fort Bliss Military Reservation

Science.gov (United States)

2014-02-01

FINAL REPORT Microgrid Enabled Distributed Energy Solutions (MEDES) Fort Bliss Military Reservation ESTCP Project EW-201140 FEBRUARY...TITLE AND SUBTITLE Microgrid Enabled Distributed Energy Solutions (MEDES) 5a. CONTRACT NUMBER W912HQ-11-C-0082 Fort Bliss, Texas...Lockheed Martin’s Intelligent Microgrid Solution can provide more energy security while also lowering electric utility costs and greenhouse gas emissions

The Community Mental Health Center as a Matrix Organization.

Science.gov (United States)

White, Stephen L.

1978-01-01

This article briefly reviews the literature on matrix organizational designs and discusses the ways in which the matrix design might be applied to the special features of a community mental health center. The phases of one community mental health center's experience in adopting a matrix organizational structure are described. (Author)

Evaluation of health care services provided for older adults in primary health care centers and its internal environment. A step towards age-friendly health centers.

Science.gov (United States)

Alhamdan, Adel A; Alshammari, Sulaiman A; Al-Amoud, Maysoon M; Hameed, Tariq A; Al-Muammar, May N; Bindawas, Saad M; Al-Orf, Saada M; Mohamed, Ashry G; Al-Ghamdi, Essam A; Calder, Philip C

2015-09-01

To evaluate the health care services provided for older adults by primary health care centers (PHCCs) in Riyadh, Kingdom of Saudi Arabia (KSA), and the ease of use of these centers by older adults. Between October 2013 and January 2014, we conducted a descriptive cross-sectional study of 15 randomly selected PHCCs in Riyadh City, KSA. The evaluation focused on basic indicators of clinical services offered and factors indicative of the ease of use of the centers by older adults. Evaluations were based upon the age-friendly PHCCs toolkit of the World Health Organization. Coverage of basic health assessments (such as blood pressure, diabetes, and blood cholesterol) was generally good. However, fewer than half of the PHCCs offered annual comprehensive screening for the common age-related conditions. There was no screening for cancer. Counseling on improving lifestyle was provided by most centers. However, there was no standard protocol for counseling. Coverage of common vaccinations was poor. The layout of most PHCCs and their signage were good, except for lack of Braille signage. There may be issues of access of older adults to PHCCs through lack of public transport, limited parking opportunities, the presence of steps, ramps, and internal stairs, and the lack of handrails. Clinical services and the internal environment of PHCCs can be improved. The data will be useful for health-policy makers to improve PHCCs to be more age-friendly.

Evaluation of health care services provided for older adults in primary health care centers and its internal environment. A step towards age-friendly health centers

Directory of Open Access Journals (Sweden)

Adel A. Alhamdan

2015-09-01

Full Text Available Objectives: To evaluate the health care services provided for older adults by primary health care centers (PHCCs in Riyadh, Kingdom of Saudi Arabia (KSA, and the ease of use of these centers by older adults. Methods: Between October 2013 and January 2014, we conducted a descriptive cross-sectional study of 15 randomly selected PHCCs in Riyadh City, KSA. The evaluation focused on basic indicators of clinical services offered and factors indicative of the ease of use of the centers by older adults. Evaluations were based upon the age-friendly PHCCs toolkit of the World Health Organization. Results: Coverage of basic health assessments (such as blood pressure, diabetes, and blood cholesterol was generally good. However, fewer than half of the PHCCs offered annual comprehensive screening for the common age-related conditions. There was no screening for cancer. Counseling on improving lifestyle was provided by most centers. However, there was no standard protocol for counseling. Coverage of common vaccinations was poor. The layout of most PHCCs and their signage were good, except for lack of Braille signage. There may be issues of access of older adults to PHCCs through lack of public transport, limited parking opportunities, the presence of steps, ramps, and internal stairs, and the lack of handrails. Conclusions: Clinical services and the internal environment of PHCCs can be improved. The data will be useful for health-policy makers to improve PHCCs to be more age-friendly.

Oral health knowledge of health care workers in special children’s center

Science.gov (United States)

Wyne, Amjad; Hammad, Nouf; Splieth, Christian

2015-01-01

Objective: To determine the oral health knowledge of health care workers in special children’s center. Methods: A self-administered questionnaire was used to collect following information: demographics, oral hygiene practices, importance of fluoride, dental visits, cause of tooth decay, gingival health, and sources of oral health information. The study was conducted at Riyadh Center for Special Children in Riyadh City from December 2013 to May 2014. Results: All 60 health care workers in the center completed the questionnaire. A great majority (95%) of the workers brushed their teeth twice or more daily. More than two-third (71.7%) of the workers knew that fluoride helps in caries prevention. One in five (21.7%) workers thought that a dental visit only becomes necessary in case of a dental problem. Similarly, 13.3% of the workers thought to “wait till there is some pain in case of a dental cavity” before seeking dental treatment. The workers ranked soft drinks/soda (98.3%), flavored fizzy drinks (60%) and sweetened/flavored milks (43.3%) as top three cariogenic drinks. A great majority (95%) of the workers correctly responded that blood on toothbrush most probably is a sign of “gum disease”. Dentists (50%) and media (45%) were the main source of their oral health information. There was no significant difference (p > 0.05) in workers’ response in relation to their specific job. Conclusion: The special health care workers in the disabled children’s center generally had satisfactory oral health knowledge and practices. PMID:25878636

Structural remains at the early mediaeval fort at Raibania, Orissa

OpenAIRE

Sen, Bratati

2013-01-01

The fortifications of mediaeval India occupy an eminent position in the history of military architecture. The present paper deals with the preliminary study of the structural remains at the early mediaeval fort at Raibania in the district of Balasore in Orissa. The fort was built of stone very loosely kept together. The three-walled fortification interspersed by two consecutive moats, a feature evidenced at Raibania, w...

78 FR 45543 - Center for Mental Health Services; Notice of Meeting

Science.gov (United States)

2013-07-29

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Mental Health Services; Notice of Meeting Pursuant to Public Law 92-463, notice is hereby given that the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Mental...

Black Swan Event Assessment for Fort Leonard Wood, Missouri

Science.gov (United States)

2016-03-01

ER D C/ CE RL S R- 16 -1 Net Zero Planning for Fort Leonard Wood Black Swan Event Assessment for Fort Leonard Wood, Missouri Co ns...search for other technical reports published by ERDC, visit the ERDC online library at http://acwc.sdp.sirsi.net/client/default. Net Zero Planning for...1.8 degrees Celsius knots 0.5144444 meters per second miles (US statute) 1,609.347 meters miles per hour 0.44704 meters per second ERDC/CERL SR

75 FR 41922 - Notice of Intent To Rule on Request To Release Airport Property at Fort Smith Regional Airport...

Science.gov (United States)

2010-07-19

... To Release Airport Property at Fort Smith Regional Airport, Fort Smith, AR AGENCY: Federal Aviation... rule and invites public comment on the release of land at Fort Smith Regional Airport under the.... John Parker, Airport Director, Fort Smith Regional Airport, at the following address: Fort Smith...

Liquid radwaste processing history at Fort Calhoun Nuclear Station

International Nuclear Information System (INIS)

Bilau, A.; Rutar, F.

1989-01-01

This report presents a historical perspective of liquid radwaste processing at the Fort Calhoun Unit 1 Nuclear Power Station, located in east central Nebraska. Of particular interest is the textual and graphical comparison of the operational implications of the various waste processing methods employed in the last ten years at the Fort Calhoun Station. Fort Calhoun's waste collection and processing systems are described in detail. These process systems include evaporation and solidification employing an in-plant drum solidification system. This solidification system was later replaced with vendor solidification services which solidified wastes in large liners. Ultimately, the plant converted its processing operation to ion exchange cleanup using ion selective media. The operational and economic impact of each of these process systems is discussed including overall costs, personnel exposure, capital expenditure requirements, burial volumes generated, maintenance and reliability assessments. Operational goals and performance criteria employed in the decision-making process for selection of the optimal technology are discussed, including the impact of various influent and effluent requirements

Trends in Mental Health and Substance Abuse Services at the Nation’s Community Health Centers: 1998–2003

Science.gov (United States)

Druss, Benjamin G.; Bornemann, Thomas; Fry-Johnson, Yvonne W.; McCombs, Harriet G.; Politzer, Robert M.; Rust, George

2006-01-01

Objective. We examined trends in delivery of mental health and substance abuse services at the nation’s community health centers. Methods. Analyses used data from the Health Resources and Services Administration (HRSA), Bureau of Primary Care’s (BPHC) 1998 and 2003 Uniform Data System, merged with county-level data. Results. Between 1998 and 2003, the number of patients diagnosed with a mental health/substance abuse disorder in community health centers increased from 210 000 to 800 000. There was an increase in the number of patients per specialty mental health/substance abuse treatment provider and a decline in the mean number of patient visits, from 7.3 visits per patient to 3.5 by 2003. Although most community health centers had some on-site mental health/substance abuse services, centers without on-site services were more likely to be located in counties with fewer mental health/substance abuse clinicians, psychiatric emergency rooms, and inpatient hospitals. Conclusions. Community health centers are playing an increasingly central role in providing mental health/substance abuse treatment services in the United States. It is critical both to ensure that these centers have adequate resources for providing mental health/substance abuse care and that they develop effective linkages with mental health/substance abuse clinicians in the communities they serve. PMID:17008573

An Archaeological Curation-Needs Assessment for Fort Irwin, Naval Air Station, North Island, Edwards Air Force Base, Marine Corps Air-Ground Combat Center, Twentynine Palms

National Research Council Canada - National Science Library

Trimble, Michael

1997-01-01

.... Louis District, conducted an investigation of all archaeological materials and associated records in the care of NAS North Island, Edwards Air Force Base, Fort Irwin, and MCAGCC Twentynine Palms...

76 FR 40733 - National Institute for Occupational Safety and Health, (NIOSH), World Trade Center Health Program...

Science.gov (United States)

2011-07-11

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Institute for Occupational Safety and Health, (NIOSH), World Trade Center Health Program Science/Technical Advisory Committee (WTCHP-STAC) Correction: This notice was published in the Federal Register on June 23...

Four aspects of the scope and quality of family planning services in US publicly funded health centers: Results from a survey of health center administrators.

Science.gov (United States)

Carter, Marion W; Gavin, Loretta; Zapata, Lauren B; Bornstein, Marta; Mautone-Smith, Nancy; Moskosky, Susan B

2016-10-01

This study aims to describe aspects of the scope and quality of family planning services provided by US publicly funded health centers before the release of relevant federal recommendations. Using nationally representative survey data (N=1615), we describe four aspects of service delivery: family planning services provided, contraceptive methods provided onsite, written contraceptive counseling protocols and youth-friendly services. We created a count index for each issue and used multivariable ordered logistic regression to identify health center characteristics associated with scoring higher on each. Half of the sample received Title X funding and about a third each were a community health center or health department clinic. The vast majority reported frequently providing contraceptive services (89%) and STD services (87%) for women in the past 3 months. Service provision to males was substantially lower except for STD screening. A total of 63% and 48% of health centers provided hormonal IUDs and implants onsite in the past 3 months, respectively. Forty percent of health centers included all five recommended contraceptive counseling practices in written protocols. Of youth-friendly services, active promotion of confidential services was among the most commonly reported (83%); offering weekend/evening hours was among the least (42%). In multivariable analyses, receiving Title X funding, having larger volumes of family planning clients and being a Planned Parenthood clinic were associated with higher scores on most indices. Many services were consistent with the recommendations for providing quality family planning services, but there was room for improvement across domains and health centers types. As assessed in this paper, the scope and quality of these family planning services was relatively high, particularly among Planned Parenthood clinics and Title X-funded centers. However, results point to important areas for improvement. Future studies should assess

Advancing a conceptual model to improve maternal health quality: The Person-Centered Care Framework for Reproductive Health Equity.

Science.gov (United States)

Sudhinaraset, May; Afulani, Patience; Diamond-Smith, Nadia; Bhattacharyya, Sanghita; Donnay, France; Montagu, Dominic

2017-11-06

Background: Globally, substantial health inequities exist with regard to maternal, newborn and reproductive health. Lack of access to good quality care-across its many dimensions-is a key factor driving these inequities. Significant global efforts have been made towards improving the quality of care within facilities for maternal and reproductive health. However, one critically overlooked aspect of quality improvement activities is person-centered care. Main body: The objective of this paper is to review existing literature and theories related to person-centered reproductive health care to develop a framework for improving the quality of reproductive health, particularly in low and middle-income countries. This paper proposes the Person-Centered Care Framework for Reproductive Health Equity, which describes three levels of interdependent contexts for women's reproductive health: societal and community determinants of health equity, women's health-seeking behaviors, and the quality of care within the walls of the facility. It lays out eight domains of person-centered care for maternal and reproductive health. Conclusions: Person-centered care has been shown to improve outcomes; yet, there is no consensus on definitions and measures in the area of women's reproductive health care. The proposed Framework reviews essential aspects of person-centered reproductive health care.

Sundhedsprofessionelles begejstring for fortællinger fra levet erfaring

DEFF Research Database (Denmark)

Liveng, Anne; Larsen, Christine; Lange, Mads

2018-01-01

I 2013 etablerede psykiatrien i Region Hovedstaden, Danmark, et undervisningsprogram om recovery for sundhedsprofessionelle. Evalueringer af programmet viste et udtalt engagement i fortællingen fra underviseren med levet erfaring. Artiklen diskuterer hvordan dette kan forstås. Evalueringsmaterialet...... analyseres ud fra et læringsteoretisk perspektiv og fokuserer på: 1) Betydningen af fortællingens emotionelle indhold, 2) Rolle-bytningen mellem personen med levet erfaring og sundhedsprofessionelle, og 3) Workshoppene som et læringsrum, der aktiverer refleksioner over strukturer og organisering af...

Fort Saint Vrain operational experience

International Nuclear Information System (INIS)

Fuller, C.H.

1989-01-01

Fort St. Vrain (FSV), on the system of the Public Service Company of Colorado, is the only high temperature gas-cooled (HTGR) power reactor in the United States. The plant features a helium-cooled reactor with a uranium-thorium fuel cycle. The paper describes the experience made during its operation. (author). 2 refs, 4 figs, 2 tabs

Den tabte fortælling

DEFF Research Database (Denmark)

Jørgensen, Kenneth Mølbjerg

2008-01-01

Ledelse er et af nøgleordene i fornyelsen af den offentlige sektor. Vi har imidlertid glemt et væsentligt aspekt af ledelse. Dette skyldes ikke mindst, at omgangsformen i dag er reguleret af information, mens den tidligere var reguleret af fortælleevnen. Evnen til dialog, indlevelse og nærvær er...

The Breast Health Center at Women & Infants Hospital: origin, philosophy, and features.

Science.gov (United States)

Falkenberry, S S; Chung, M; Legare, R; Strenger, R; Wallace, D; Phillips, G; Morry, S; Marchant, D J; Cady, B

2000-04-01

The Breast Health Center, a component of the program in Women's Oncology at Women & Infants Hospital, is a multidisciplinary center devoted to the treatment and study of benign and malignant breast diseases. The philosophy, structure, and function of The Breast Health Center are described along with its specific components. The Breast Health Center's three fundamental missions of patient care, education, and research are discussed.

The role of clinical toxicologists and poison control centers in public health.

Science.gov (United States)

Sutter, Mark E; Bronstein, Alvin C; Heard, Stuart E; Barthold, Claudia L; Lando, James; Lewis, Lauren S; Schier, Joshua G

2010-06-01

Poison control centers and clinical toxicologists serve many roles within public health; however, the degree to which these entities collaborate is unknown. The objective of this survey was to identify successful collaborations of public health agencies with clinical toxicologists and poison control centers. Four areas including outbreak identification, syndromic surveillance, terrorism preparedness, and daily public health responsibilities amenable to poison control center resources were assessed. An online survey was sent to the directors of poison control centers, state epidemiologists, and the most senior public health official in each state and selected major metropolitan areas. This survey focused on three areas: service, structure within the local or state public health system, and remuneration. Questions regarding remuneration and poison control center location within the public health structure were asked to assess if these were critical factors of successful collaborations. Senior state and local public health officials were excluded because of a low response rate. The survey was completed in October 2007. A total of 111 respondents, 61 poison control centers and 50 state epidemiologists, were eligible for the survey. Sixty-nine (62%) of the 111 respondents, completed and returned the survey. Thirty-three (54%) of the 61 poison control centers responded, and 36 of the 50 state epidemiologists (72%) responded. The most frequent collaborations were terrorism preparedness and epidemic illness reporting. Additional collaborations also exist. Important collaborations exist outside of remuneration or poison control centers being a formal part of the public health structure. Poison control centers have expanded their efforts to include outbreak identification, syndromic surveillance, terrorism preparedness, and daily public health responsibilities amenable to poison control center resources. Collaboration in these areas and others should be expanded. Published

Job satisfaction survey among health centers staff

OpenAIRE

Shahnazi, Hossein; Daniali, Seyede Shahrbanoo; Sharifirad, Gholamreza

2014-01-01

Background: Due to the importance of health care organizations with significant responsibility for prevention and care, assessment of job satisfaction among health care staff is essential. Quality of health services will be decreased provided they are not satisfied. Materials and Methods: This study was a cross-sectional analysis of health care staff in Khomeinishahr (centers, buildings, and networks) If they had at least 6 months work experience, they could enter the study. Data included a t...

A revisionist view of the integrated academic health center.

Science.gov (United States)

Rodin, Judith

2004-02-01

Like many academic health centers that had expanded aggressively during the 1990s, the nation's first vertically integrated academic health center, the University of Pennsylvania Health System, was profoundly challenged by the dramatic and unanticipated financial impacts of the Balanced Budget Act of 1997. The author explains why-although Penn's Health System had lost $300 million over two years and its debts threatened to cause serious financial and educational damage to the rest of the University-Penn chose to manage its way out of the financial crisis (instead of selling or spinning off its four hospitals, clinical practices, and possibly even its medical school). A strategy of comprehensive integration has not only stabilized Penn's Health System financially, but strengthened its position of leadership in medical education, research, and health care delivery. The author argues that a strategy of greater horizontal integration offers important strategic advantages to academic health centers. In an era when major social and scientific problems demand broadly multidisciplinary and highly-integrated approaches, such horizontally integrated institutions will be better able to educate citizens and train physicians, develop new approaches to health care policy, and answer pressing biomedical research questions. Institutional cultural integration is also crucial to create new, innovative organizational structures that bridge traditional disciplinary, school, and clinical boundaries.

77 FR 50519 - Center for Mental Health Services (CMHS); Amendment of Meeting

Science.gov (United States)

2012-08-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Mental Health Services (CMHS); Amendment of Meeting Pursuant to Public Law 92-463, notice is... Substance Abuse and Mental Health Services Administration's (SAMHSA), Center for Mental Health Services...

Rumlige fortællinger fra mobilt og web-baseret GIS

DEFF Research Database (Denmark)

Møller-Jensen, Lasse

2009-01-01

Denne artikel handler om begrebet rumlige fortællinger med anvendelse af fortællingshenvisninger, og disses potentielle rolle ved implementation af fleksible og tematiske turistinformationssystemer. Artiklen fokuserer på brugen af mobile, positionsbekendte enheder, såsom visse PDA'er og smartphon......, samt på web-gis. Der præsenteres to anvendelseseksempler: et fra det centrale København og et fra et område nær Accra, Ghana....

75 FR 48853 - National Health Center Week, 2010

Science.gov (United States)

2010-08-11

... communities by conducting outreach and education, ensuring patients can communicate with their providers, and... information technology systems, and meet their critical care needs. The reforms in the landmark new health.... Community health centers are at the heart of a modern, reformed health care system in America. We must...

Vegetation studies, National Training Center, Fort Irwin, California

Energy Technology Data Exchange (ETDEWEB)

Brandt, C.A.; Rickard, W.H.; Cadoret, N.A.

1997-09-01

During the spring of 1992, the Pacific Northwest National Laboratory (PNNL) conducted surveys of the Avawatz and Granite mountains springs for the National Training Center (NTC) to evaluate the occurrence of sensitive plant species in these areas. PNNL also conducted a survey of the eastern outwash of the Paradise Range for the occurrence of Lane Mountain milk vetch (Astragalus jaegerianus). In spring of 1993, PNNL conducted an additional study of Lane Mountain milk vetch on the NTC to determine habitat characteristics for this plant and to develop a method for predicting its potential occurrence, based on simple habitat attributes. The results of these studies are itemized.

Cultural keystone species in oil sands mine reclamation, Fort McKay, Alberta, Canada

Energy Technology Data Exchange (ETDEWEB)

Garibaldi, A.; Straker, J. [Stantec Ltd., Sidney, BC (Canada)

2009-07-01

Cultural keystone species (CKS) shape the cultural identify of people through the roles they have in diet, material and spiritual practices. The use of the CKS concept is regarded as a method of addressing linked social and ecological issues. This paper presented the results of using the CKS model in the indigenous community of Fort McKay, Alberta to address, social, ecological and spiritual values in regional mine-land reclamation. Fort McKay is at the epicenter of the existing mine developments. Its residents regard human and environmental health to be be linked and therefore experience the effects of development and subsequent reclamation on both cultural and ecological levels. The community is actively engaged in working with the local mining companies on issues of mine reclamation design. In order to hold meaning to the local people, oil sand operators used the CKS concept in their reclamation efforts to take into account ecological functionality and also address the linked social factors. Five CKS were identified through a literature review and extensive community interviews. The list includes moose, cranberry, blueberry, ratroot and beaver. These 5 CKS were used to focus discussions and make recommendations for relevant land reclamation within Fort McKay traditional territory. The project has influenced the way both the community and oil sands operators engage with reclamation. Lessons learned from this process will help direct reclamation activities on other portions of traditional territory, while offering guidance to other regional developers for addressing cultural values in reclamation on their leases. 15 refs., 1 fig.

National Maternal and Child Oral Health Resource Center

Science.gov (United States)

... State Offices Search the Organizations Database Center for Oral Health Systems Integration and Improvement (COHSII) COHSII is a ... needs of the MCH population. Brush Up on Oral Health This monthly newsletter provides Head Start staff with ...

U.S. academic medical centers under the managed health care environment.

Science.gov (United States)

Guo, K

1999-06-01

This research investigates the impact of managed health care on academic medical centers in the United States. Academic medical centers hold a unique position in the U.S. health care system through their missions of conducting cutting-edge biomedical research, pursuing clinical and technological innovations, providing state-of-the-art medical care and producing highly qualified health professionals. However, policies to control costs through the use of managed care and limiting resources are detrimental to academic medical centers and impede the advancement of medical science. To survive the threats of managed care in the health care environment, academic medical centers must rely on their upper level managers to derive successful strategies. The methods used in this study include qualitative approaches in the form of key informants and case studies. In addition, a survey questionnaire was sent to 108 CEOs in all the academic medical centers in the U.S. The findings revealed that managers who perform the liaison, monitor, entrepreneur and resource allocator roles are crucial to ensure the survival of academic medical centers, so that academic medical centers can continue their missions to serve the general public and promote their well-being.

Audit of a diabetic health education program at a large Primary Health Care Center in Asir region.

Science.gov (United States)

Al-Khaldi, Y M; Khan, M Y

2000-09-01

To evaluate the health education program in a large Primary Health Care Center, to find out the problems faced by the staff and to suggest the practical and relevant solutions. This study was carried out at Wasat Abha Primary Health Care Center, Asir region during 1997. The files of diabetics who attended the center were evaluated for health education topics by using a checklist. The essential structure of diabetic health education program was assessed by using another check list designed by the investigators. Data entry and analysis was carried out through SPSS package. Chi-square test was applied wherever necessary. The total number of diabetics who attended Wasat Abha Primary Health Care Center was 198. The duration of diabetes mellitus was 7.7+5.8 years. Ninety percent of these were married, 50.5% were educated and 79% were employed. Compliance to appointment was good in 60% and poor in 30% of diabetics. About 73% of the diabetics received at least one health education topic while 27% did not receive any health education at all. Only 33% of diabetic patients had adequate health education. Ninety one percent were provided with diabetic identification cards, 80% were explained about diabetes and 77% were educated about the role of diet. Essential structure for diabetes education program was found to be unsatisfactory. Effective diabetic health education program needs the availability of all essential structures, community participation and integration of the government and private sectors. The deficiencies in the structures and the process of health education programs in our practice are almost universal to other Primary Health Care Centers in the Asir region. Providing the Primary Health Care Centers with all essential structures and annual auditing are complimentary to a successful diabetic health education program.

BRAND EQUITY OF LAHORE FORT AS A TOURISM DESTINATION BRAND

OpenAIRE

KASHIF, MUHAMMAD; SAMSI, SITI ZAKIAH MELATU; SARIFUDDIN, SYAMSULANG

2015-01-01

ABSTRACTStudies that measure the brand equity of destination brands by using the Customer-Based Brand Equity (CBBE) model in a developing country context are scarce. The present study investigates the destination brand equity of the Lahore Fort by employing the CBBE model in a developing country context of Pakistan. Following the positivist tradition, we adopted a survey-based approach to collect data from 237 tourists visiting the Lahore Fort. Data were collected through a questionnaire deve...

Health Status and Health Care Experiences among Homeless Patients in Federally Supported Health Centers: Findings from the 2009 Patient Survey

Science.gov (United States)

Lebrun-Harris, Lydie A; Baggett, Travis P; Jenkins, Darlene M; Sripipatana, Alek; Sharma, Ravi; Hayashi, A Seiji; Daly, Charles A; Ngo-Metzger, Quyen

2013-01-01

Objective To examine health status and health care experiences of homeless patients in health centers and to compare them with their nonhomeless counterparts. Data Sources/Study Setting Nationally representative data from the 2009 Health Center Patient Survey. Study Design Cross-sectional analyses were limited to adults (n = 2,683). We compared sociodemographic characteristics, health conditions, access to health care, and utilization of services among homeless and nonhomeless patients. We also examined the independent effect of homelessness on health care access and utilization, as well as factors that influenced homeless patients' health care experiences. Data Collection Computer-assisted personal interviews were conducted with health center patients. Principal Findings Homeless patients had worse health status—lifetime burden of chronic conditions, mental health problems, and substance use problems—compared with housed respondents. In adjusted analyses, homeless patients had twice the odds as housed patients of having unmet medical care needs in the past year (OR = 1.98, 95 percent CI: 1.24–3.16) and twice the odds of having an ED visit in the past year (OR = 2.00, 95 percent CI: 1.37–2.92). Conclusions There is an ongoing need to focus on the health issues that disproportionately affect homeless populations. Among health center patients, homelessness is an independent risk factor for unmet medical needs and ED use. PMID:23134588

Comprehensive Inventory and Determinations of Eligibility for Fort Riley Buildings: 1857-1963

Science.gov (United States)

2009-09-01

become fashionable . Stone residences built at Fort Riley after the 1850s all have rock-faced walls and most have contrasting smooth-faced lintels...507 is significant as a wood-framed Folk Victorian cottage. While Building 507 is one of four Folk Victorian buildings at Fort Riley, it possesses a

Employee health benefit redesign at the academic health center: a case study.

Science.gov (United States)

Marshall, Julie; Weaver, Deirdre C; Splaine, Kevin; Hefner, David S; Kirch, Darrell G; Paz, Harold L

2013-03-01

The rapidly escalating cost of health care, including the cost of providing health care benefits, is a significant concern for many employers. In this article, the authors examine a case study of an academic health center that undertook a complete redesign of its health benefit structure to control rising costs, encourage use of its own provider network, and support employee wellness. With the implementation in 2006 of a high-deductible health plan combined with health reimbursement arrangements and wellness incentives, the Penn State Hershey Medical Center (PSHMC) was able to realize significant cost savings and increase use of its own network while maintaining a high level of employee satisfaction. By contracting with a single third-party administrator for its self-insured plan, PSHMC reduced its administrative costs and simplified benefit choices for employees. In addition, indexing employee costs to salary ensured that this change was equitable for all employees, and the shift to a consumer-driven health plan led to greater employee awareness of health care costs. The new health benefit plan's strong focus on employee wellness and preventive health has led to significant increases in the use of preventive health services, including health risk assessments, cancer screenings, and flu shots. PSHMC's experience demonstrates the importance of clear and ongoing communication with employees throughout--before, during, and even after--the process of health benefit redesign.

Assessment of groundwater, soil-gas, and soil contamination at the Vietnam Armor Training Facility, Fort Gordon, Georgia, 2009-2010

Science.gov (United States)

Guimaraes, Wladmir B.; Falls, W. Fred; Caldwell, Andral W.; Ratliff, W. Hagan; Wellborn, John B.; Landmeyer, James E.

2011-01-01

The U.S. Geological Survey, in cooperation with the U.S. Department of the Army Environmental and Natural Resources Management Office of the U.S. Army Signal Center and Fort Gordon, Georgia, assessed the groundwater, soil gas, and soil for contaminants at the Vietnam Armor Training Facility (VATF) at Fort Gordon, from October 2009 to September 2010. The assessment included the detection of organic compounds in the groundwater and soil gas, and inorganic compounds in the soil. In addition, organic contaminant assessment included organic compounds classified as explosives and chemical agents in selected areas. The assessment was conducted to provide environmental contamination data to the U.S. Army at Fort Gordon pursuant to requirements of the Resource Conservation and Recovery Act Part B Hazardous Waste Permit process. Four passive samplers were deployed in groundwater wells at the VATF in Fort Gordon. Total petroleum hydrocarbons were detected above the method detection level at all four wells. The only other volatile organic compounds detected above their method detection level were undecane and pentadecane, which were detected in two of the four wells sampled. Soil-gas samplers were deployed at 72 locations in a grid pattern across the VATF. Total petroleum hydrocarbons were detected in 71 of the 72 samplers (one sampler was destroyed in the field and not analyzed) at levels above the method detection level, and the combined mass of benzene, toluene, ethylbenzene, and total xylene was detected above the detection level in 31 of the 71 samplers that were analyzed. Other volatile organic compounds detected above their respective method detection levels were naphthalene, 2-methyl-naphthalene, tridecane, 1,2,4-trimethylbenzene, and perchloroethene. Subsequent to the soil-gas survey, four areas determined to have elevated contaminant mass were selected and sampled for explosives and chemical agents. No detections of explosives or chemical agents above their

Assessing the integration of health center and community emergency preparedness and response planning.

Science.gov (United States)

Wineman, Nicole V; Braun, Barbara I; Barbera, Joseph A; Loeb, Jerod M

2007-11-01

To assess the state of health center integration into community preparedness, we undertook a national study of linkages between health centers and the emergency preparedness and response planning initiatives in their communities. The key objectives of this project were to gain a better understanding of existing linkages in a nationally representative sample of health centers, and identify health center demographic and experience factors that were associated with strong linkages. The objectives of the study were to gain a baseline understanding of existing health center linkages to community emergency preparedness and response systems and to identify factors that were associated with strong linkages. A 60-item questionnaire was mailed to the population of health centers supported by the Health Resources and Services Administration's Bureau of Primary Health Care in February 2005. Results were aggregated and a chi square analysis identified factors associated with stronger linkages. Overall performance on study-defined indicators of strong linkages was low: 34% had completed a hazard vulnerability analysis in collaboration with the community emergency management agency, 30% had their role documented in the community plan, and 24% participated in community-wide exercises. Stronger linkages were associated with experience responding to a disaster and a perception of high risk for experiencing a disaster. The potential for health centers to participate in an integrated response is not fully realized, and their absence from community-based planning leaves an already vulnerable population at greater risk. Community planners should be encouraged to include health centers in planning and response and centers should receive more targeted resources for community integration.

Violence against health workers in Family Medicine Centers.

Science.gov (United States)

Al-Turki, Nouf; Afify, Ayman Am; AlAteeq, Mohammed

2016-01-01

Health care violence is a significant worldwide problem with negative consequences on both the safety and well-being of health care workers as well as workplace activities. Reports examining health care violence in Saudi Arabia are limited and the results are conflicting. To estimate the prevalence and determine the demographic and occupational characteristics associated with workplace violence in primary care centers in Riyadh, Saudi Arabia. A cross-sectional study included 270 health care workers in 12 family medicine centers in Riyadh during November and December 2014. A structured self-administered questionnaire was used to estimate the frequency, timing, causes, reactions, and consequences of workplace violence plus participants' demographic and occupational data. A total 123 health care workers (45.6%) experienced some kind of violence over 12 months prior to the study. These included physical (6.5%) and nonphysical violence (99.2%), including verbal violence (94.3%) and intimidation (22.0%). Offenders were patients (71.5%) in the majority of cases, companions (20.3%), or both (3.3%). Almost half (48.0%) of health care workers who experienced violence did nothing, 38.2% actively reported the event, and 13.8% consulted a colleague. A significant association of workplace violence was found with working multiple shifts, evening or night shift, and lack of an encouraging environment to report violence. Workplace violence is still a significant problem in primary care centers. The high frequency of violence together with underreporting may indicate the inefficiency of the current safety program. More safety programs and training activities for health care workers, efficient reporting system, and zero tolerance policies need to be implemented to minimize workplace violence against health workers.

Preliminary assessment of streamflow characteristics for selected streams at Fort Gordon, Georgia, 1999-2000

Science.gov (United States)

Stamey, Timothy C.

2001-01-01

In 1999, the U.S. Geological Survey, in cooperation with the U.S. Army Signal Center and Fort Gordon, began collection of periodic streamflow data at four streams on the military base to assess and estimate streamflow characteristics of those streams for potential water-supply sources. Simple and reliable methods of determining streamflow characteristics of selected streams on the military base are needed for the initial implementation of the Fort Gordon Integrated Natural Resources Management Plan. Long-term streamflow data from the Butler Creek streamflow gaging station were used along with several concurrent discharge measurements made at three selected partial-record streamflow stations on Fort Gordon to determine selected low-flow streamflow characteristics. Streamflow data were collected and analyzed using standard U.S. Geological Survey methods and computer application programs to verify the use of simple drainage area to discharge ratios, which were used to estimate the low-flow characteristics for the selected streams. Low-flow data computed based on daily mean streamflow include: mean discharges for consecutive 1-, 3-, 7-, 14-, and 30-day period and low-flow estimates of 7Q10, 30Q2, 60Q2, and 90Q2 recurrence intervals. Flow-duration data also were determined for the 10-, 30-, 50-, 70-, and 90-percent exceedence flows. Preliminary analyses of the streamflow indicate that the flow duration and selected low-flow statistics for the selected streams averages from about 0.15 to 2.27 cubic feet per square mile. The long-term gaged streamflow data indicate that the streamflow conditions for the period analyzed were in the 50- to 90-percent flow range, or in which streamflow would be exceeded about 50 to 90 percent of the time.

Prevalence of psychological disorders among patients attending community health centers, Perak, Malaysia

Directory of Open Access Journals (Sweden)

Asma Perveen

2017-09-01

Full Text Available Objective: The purpose of this study was to explore the prevalence of psychological disorders among community health centers in Batang Padang district Perak. Material & Methods: To conduct this study survey research method was used, seven community health centers in Batang Padang District, Perak were contacted to collect data from (N=216 respondents, who attended health facilities in Batang Padang District. There is no age limit, no education difference and no other requirement needed. Instrument and Materials: Depression, Anxiety and Stress Scale (DASS-21 PRIME Screen and PRIME MD Patient Health Questionnaire (PHQ. Results: Data collected from seven health community centers revealed that prevalence of Stress 86%, anxiety 124%, depression 67, psychotic symptoms 16%, somatoform symptoms 52%, panic symptoms 28%, and substance abuse 21%. the higher prevalence was stress and depression among people attending health centers. Conclusion: Results findings indicated that there is significant prevalence of psychological disorder among community health centers. Analysis of the results help us to determine that there is strong need to provide psychological services, awareness and education plan, management and prevention for psychological disorders

The geology and mechanics of formation of the Fort Rock Dome, Yavapai County, Arizona

Science.gov (United States)

Fuis, Gary S.

1996-01-01

The Fort Rock Dome, a craterlike structure in northern Arizona, is the erosional product of a circular domal uplift associated with a Precambrian shear zone exposed within the crater and with Tertiary volcanism. A section of Precambrian to Quaternary rocks is described, and two Tertiary units, the Crater Pasture Formation and the Fort Rock Creek Rhyodacite, are named. A mathematical model of the doming process is developed that is consistent with the history of the Fort Rock Dome.

Ecological Baseline, Fort Hood, Texas

Science.gov (United States)

1980-08-01

cedar eTm (Uiimus crassifolia), Texas ash (Fraxinus texansis), and Texas persimmon ( Diospyros texana). Conversely, the two predominant tree species...Ilex decidua), Mex- ican buckeye (Ungnadia spjeciosa), and Texas persimmon ( Diospyros texana). Vines included greenbrier (Smilax bona-nox) and white...Hedgehey Cactus (Echinocereus sp.) has been observed on Fort Hood. Due to the brief period of flowering for this genus , the individual species were not

The relationship between media literacy and health literacy among pregnant women in health centers of Isfahan.

Science.gov (United States)

Akbarinejad, Farideh; Soleymani, Mohammad Reza; Shahrzadi, Leila

2017-01-01

The ability to access, analyze, evaluate, and convey information in various forms of media including print and nonprint requires media literacy, but the capacity to obtain, process, and understand basic information and services needed for appropriate decisions regarding health, considered an important element in a woman's ability to participate in health promotion and prevention activities for herself and her children, is needed to a level of health literacy. The purpose of this study was to determine the relationship between media literacy and health literacy among pregnant women in health centers in Isfahan. This study used a descriptive correlation study. Data collection tools include Shahin media literacy and functional health literacy in adults' questionnaires. The population include pregnant women in health centers of Isfahan (4080 people). Ten out of the 351 health centers in Isfahan were selected as cluster. Data were analyzed using both descriptive and inferential statistics. Media literacy of respondents in the five dimensions was significantly lower than average 61.5% of pregnant women have inadequate health literacy, 18.8% had marginal health literacy, and only 19.7% of them have had adequate health literacy. There was a significant positive relationship between media literacy and health literacy among pregnant women. This study showed that the majority of pregnant women covered by health centers had limited health literacy and media literacy. Since one of the basic requirements for the utilization of health information is needed for adequate media literacy, promotion of media literacy is necessary for the respondents.

Health at the center of health systems reform: how philosophy can inform policy.

Science.gov (United States)

Sturmberg, Joachim P; Martin, Carmel M; Moes, Mark M

2010-01-01

Contemporary views hold that health and disease can be defined as objective states and thus should determine the design and delivery of health services. Yet health concepts are elusive and contestable. Health is neither an individual construction, a reflection of societal expectations, nor only the absence of pathologies. Based on philosophical and sociological theory, empirical evidence, and clinical experience, we argue that health has simultaneously objective and subjective features that converge into a dynamic complex-adaptive health model. Health (or its dysfunction, illness) is a dynamic state representing complex patterns of adaptation to body, mind, social, and environmental challenges, resulting in bodily homeostasis and personal internal coherence. The "balance of health" model-emergent, self-organizing, dynamic, and adaptive-underpins the very essence of medicine. This model should be the foundation for health systems design and also should inform therapeutic approaches, policy decision-making, and the development of emerging health service models. A complex adaptive health system focused on achieving the best possible "personal" health outcomes must provide the broad policy frameworks and resources required to implement people-centered health care. People-centered health systems are emergent in nature, resulting in locally different but mutually compatible solutions across the whole health system.

Achieving excellence in community health centers: implications for health reform.

Science.gov (United States)

Gurewich, Deborah; Capitman, John; Sirkin, Jenna; Traje, Diana

2012-02-01

Existing studies tell us little about care quality variation within the community health center (CHC) delivery system. They also tell us little about the organizational conditions associated with CHCs that deliver especially high quality care. The purpose of this study was to examine the operational practices associated with a sample of high performing CHCs. Qualitative case studies of eight CHCs identified as delivering high-quality care relative to other CHCs were used to examine operational practices, including systems to facilitate care access, manage patient care, and monitor performance. Four common themes emerged that may contribute to high performance. At the same time, important differences across health centers were observed, reflecting differences in local environments and CHC capacity. In the development of effective, community-based models of care, adapting care standards to meet the needs of local conditions may be important.

Comparing Performance of Public and Cooperative Health Centers

Directory of Open Access Journals (Sweden)

Mostafa Farahbakhsh

2012-04-01

Full Text Available Background: Health cooperatives in similar structure of health network in Iran, give primary health cares to defined population with supervisory of public sector. Materials and method: This study compares health system performance between public (PHC and cooperative (CHC health centers. Results: Client's satisfaction was 4.14 in CHC and 3.9 in PHC in 5 point Likert scale. The mean for daily health services of CHC and PHC were 110.8 and 85 respectively. Conclusion: Health cooperatives are appropriate strategy for downsizing of government in health sector

Electricity Generation from Geothermal Resources on the Fort Peck Reservation in Northeast Montana

Energy Technology Data Exchange (ETDEWEB)

Carlson, Garry J. [Gradient Geophysics Inc., Missoula, MT (United States); Birkby, Jeff [Birkby Consulting LLC, Missoula, MT (United States)

2015-05-12

Tribal lands owned by Assiniboine and Sioux Tribes on the Fort Peck Indian Reservation, located in Northeastern Montana, overlie large volumes of deep, hot, saline water. Our study area included all the Fort Peck Reservation occupying roughly 1,456 sq miles. The geothermal water present in the Fort Peck Reservation is located in the western part of the Williston Basin in the Madison Group complex ranging in depths of 5500 to 7500 feet. Although no surface hot springs exist on the Reservation, water temperatures within oil wells that intercept these geothermal resources in the Madison Formation range from 150 to 278 degrees F.

Community health centers and community development financial institutions: joining forces to address determinants of health.

Science.gov (United States)

Kotelchuck, Ronda; Lowenstein, Daniel; Tobin, Jonathan N

2011-11-01

Community health centers and community development financial institutions share similar origins and missions and are increasingly working together to meet community needs. Addressing the social and economic determinants of health is a common focus. The availability of new federal grants and tax credits has led these financial institutions to invest in the creation and expansion of community health centers. This article reviews the most recent trends in these two sectors and explores opportunities for further collaboration to transform the health and well-being of the nation's low-income communities.

Technical evaluation report of the Fort St. Vrain final draft upgraded technical specifications

International Nuclear Information System (INIS)

Kimura, C.Y.

1989-01-01

This report is a technical evaluation of the final draft of the Fort St. Vrain (FSV) Upgraded Technical Specifications (UT/S) as issued by Public Service of Colorado (PSC) on May 27, 1988 with subsequent supplemental updates issued on June 15, 1988 and August 5, 1988. It has been compared for consistency, and safety conservatism with the Fort St. Vrain (FSV) Updated Final Safety Analysis Report (FSAR), the FSV Safety Evaluation Report (SER), the Facility Operating License, DPR-34, and all amendments to the Facility Operating License issued as of June 1, 1988, and Appendix A to the Operating License DPR-34, Technical Specifications. Because of the age of the plant, no supplements to the Fort St. Vrain SER have been issued since the original SER was not issued as a WASH or a NUREG report. This made it necessary to review all amendments to the Facility Operating License since they would contain the safety evaluations done to support changes to the Facility Operating License. The upgraded Fort St. Vrain Technical Specifications were also broadly compared with the latest Westinghouse Standard Technical Specifications (WSTS) to assure that what was proposed for Fort St. Vrain was consistent with the latest NRC staff practices for standard technical specifications

Violence against health workers in Family Medicine Centers

Directory of Open Access Journals (Sweden)

Al-Turki N

2016-05-01

Full Text Available Nouf Al-Turki,1 Ayman AM Afify,1 Mohammed AlAteeq2 1Family Medicine Department, Prince Sultan Military Medical City, 2Department of Family Medicine and PHC, King Abdul-Aziz Medical City, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia Background: Health care violence is a significant worldwide problem with negative consequences on both the safety and well-being of health care workers as well as workplace activities. Reports examining health care violence in Saudi Arabia are limited and the results are conflicting.Objective: To estimate the prevalence and determine the demographic and occupational characteristics associated with workplace violence in primary care centers in Riyadh, Saudi Arabia.Methods: A cross-sectional study included 270 health care workers in 12 family medicine centers in Riyadh during November and December 2014. A structured self-administered questionnaire was used to estimate the frequency, timing, causes, reactions, and consequences of workplace violence plus participants’ demographic and occupational data.Results: A total 123 health care workers (45.6% experienced some kind of violence over 12 months prior to the study. These included physical (6.5% and nonphysical violence (99.2%, including verbal violence (94.3% and intimidation (22.0%. Offenders were patients (71.5% in the majority of cases, companions (20.3%, or both (3.3%. Almost half (48.0% of health care workers who experienced violence did nothing, 38.2% actively reported the event, and 13.8% consulted a colleague. A significant association of workplace violence was found with working multiple shifts, evening or night shift, and lack of an encouraging environment to report violence.Conclusion: Workplace violence is still a significant problem in primary care centers. The high frequency of violence together with underreporting may indicate the inefficiency of the current safety program. More safety programs and training activities for health care

Analysis of health in health centers area in Depok using correspondence analysis and scan statistic

Science.gov (United States)

Basir, C.; Widyaningsih, Y.; Lestari, D.

2017-07-01

Hotspots indicate area that has a higher case intensity than others. For example, in health problems of an area, the number of sickness of a region can be used as parameter and condition of area that determined severity of an area. If this condition is known soon, it can be overcome preventively. Many factors affect the severity level of area. Some health factors to be considered in this study are the number of infant with low birth weight, malnourished children under five years old, under five years old mortality, maternal deaths, births without the help of health personnel, infants without handling the baby's health, and infant without basic immunization. The number of cases is based on every public health center area in Depok. Correspondence analysis provides graphical information about two nominal variables relationship. It create plot based on row and column scores and show categories that have strong relation in a close distance. Scan Statistic method is used to examine hotspot based on some selected variables that occurred in the study area; and Correspondence Analysis is used to picturing association between the regions and variables. Apparently, using SaTScan software, Sukatani health center is obtained as a point hotspot; and Correspondence Analysis method shows health centers and the seven variables have a very significant relationship and the majority of health centers close to all variables, except Cipayung which is distantly related to the number of pregnant mother death. These results can be used as input for the government agencies to upgrade the health level in the area.

Violence against health workers in Family Medicine Centers

Science.gov (United States)

Al-Turki, Nouf; Afify, Ayman AM; AlAteeq, Mohammed

2016-01-01

Background Health care violence is a significant worldwide problem with negative consequences on both the safety and well-being of health care workers as well as workplace activities. Reports examining health care violence in Saudi Arabia are limited and the results are conflicting. Objective To estimate the prevalence and determine the demographic and occupational characteristics associated with workplace violence in primary care centers in Riyadh, Saudi Arabia. Methods A cross-sectional study included 270 health care workers in 12 family medicine centers in Riyadh during November and December 2014. A structured self-administered questionnaire was used to estimate the frequency, timing, causes, reactions, and consequences of workplace violence plus participants’ demographic and occupational data. Results A total 123 health care workers (45.6%) experienced some kind of violence over 12 months prior to the study. These included physical (6.5%) and nonphysical violence (99.2%), including verbal violence (94.3%) and intimidation (22.0%). Offenders were patients (71.5%) in the majority of cases, companions (20.3%), or both (3.3%). Almost half (48.0%) of health care workers who experienced violence did nothing, 38.2% actively reported the event, and 13.8% consulted a colleague. A significant association of workplace violence was found with working multiple shifts, evening or night shift, and lack of an encouraging environment to report violence. Conclusion Workplace violence is still a significant problem in primary care centers. The high frequency of violence together with underreporting may indicate the inefficiency of the current safety program. More safety programs and training activities for health care workers, efficient reporting system, and zero tolerance policies need to be implemented to minimize workplace violence against health workers. PMID:27330300

Fort Collins Science Center: Invasive Species Science

Science.gov (United States)

Stohlgren, Tom

2004-01-01

Invasive, non-native species of plants, animals, and disease organisms adversely affect the ecosystems they enter. Like "biological wildfires," they can quickly spread, and they affect nearly all terrestrial and aquatic ecosystems. Invasive species have become the greatest environmental challenge of the 21st century in terms of economic, environmental, and human health costs, with an estimated impact in the U.S. of over $138 billion per year. Managers of Department of the Interior and other public and private lands and waters rank invasive species as their top resource management problem.

Prevalence of psychological disorders among patients attending community health centers, Perak, Malaysia

Directory of Open Access Journals (Sweden)

Asma Perveen

2017-09-01

Full Text Available Objective: The purpose of this study was to explore the prevalence of psychological disorders among community health centers in Batang Padang district Perak. Material & Methods: To conduct this study survey research method was used, seven community health centers in Batang Padang District, Perak were contacted to collect data from (N=216 respondents, who attended health facilities in Batang Padang District. There is no age limit, no education difference and no other requirement needed. Instrument and Materials: Depression, Anxiety and Stress Scale (DASS-21 PRIME Screen and PRIME MD Patient Health Questionnaire (PHQ. Results: Data collected from seven health community centers revealed that prevalence of Stress 86%, anxiety 124%, depression 67, psychotic symptoms 16%, somatoform symptoms 52%, panic symptoms 28%, and substance abuse 21%. the higher prevalence was stress and depression among people attending health centers. Conclusion: Results findings indicated that there is significant prevalence of psychological disorder among community health centers. Analysis of the results help us to determine that there is strong need to provide psychological services, awareness and education plan, management and prevention for psychological disorders

Building diversity in a complex academic health center.

Science.gov (United States)

South-Paul, Jeannette E; Roth, Loren; Davis, Paula K; Chen, Terence; Roman, Anna; Murrell, Audrey; Pettigrew, Chenits; Castleberry-Singleton, Candi; Schuman, Joel

2013-09-01

For 30 years, the many diversity-related health sciences programs targeting the University of Pittsburgh undergraduate campus, school of medicine, schools of the health sciences, clinical practice plan, and medical center were run independently and remained separate within the academic health center (AHC). This lack of coordination hampered their overall effectiveness in promoting diversity and inclusion. In 2007, a group of faculty and administrators from the university and the medical center recognized the need to improve institutional diversity and to better address local health disparities. In this article, the authors describe the process of linking the efforts of these institutions in a way that would be successful locally and applicable to other academic environments. First, they engaged an independent consultant to conduct a study of the AHC's diversity climate, interviewing current and former faculty and trainees to define the problem and identify areas for improvement. Next, they created the Physician Inclusion Council to address the findings of this study and to coordinate future efforts with institutional leaders. Finally, they formed four working committees to address (1) communications and outreach, (2) cultural competency, (3) recruitment, and (4) mentoring and retention. These committees oversaw the strategic development and implementation of all diversity and inclusion efforts. Together these steps led to structural changes within the AHC and the improved allocation of resources that have positioned the University of Pittsburgh to achieve not only diversity but also inclusion and to continue to address the health disparities in the Pittsburgh community.

Fortælleværksteder

DEFF Research Database (Denmark)

Krøjer, Jo; Hutters, Camilla

2009-01-01

Unges valg af videregående uddannelse er omgærdet af forventninger. Forventninger til hvad man skal vælge. Forventninger til hvor lang tid, man skal være om at tage en uddannelse. Og forventninger til, hvad uddannelsen skal føre til. Artiklen præsenterer fortælleværkstedet, en metode til kollekti...... refleksioner over egne og adres forventninger til og tanker om uddannelsesvalg....

75 FR 12766 - National Center on Minority Health and Health Disparities; Notice of Closed Meetings

Science.gov (United States)

2010-03-17

... Health and Health Disparities; Notice of Closed Meetings Pursuant to section 10(d) of the Federal... and Health Disparities Special Emphasis Panel Loan Repayment Program for Health Disparities Research... Review, National Center on Minority Health and Health Disparities, 6707 Democracy Boulevard, Suite 800...

Sexual Violence Screening Practices of Student Health Centers Located on Universities in Florida

Science.gov (United States)

Halstead, Valerie; Williams, Jessica R.; Gattamorta, Karina; Gonzalez-Guarda, Rosa

2017-01-01

Objective: The purpose of this study is to describe current sexual violence screening practices of student health centers located on universities in Florida. Participants: Institutional level data was collected from 33 student health centers from November 2015 through January 2016. The student health centers were located on public or private…

77 FR 58354 - Bend-Fort Rock Ranger District; Oregon; Withdrawal of Notice for Preparation of an Environmental...

Science.gov (United States)

2012-09-20

...-Fort Rock Ranger District; Oregon; Withdrawal of Notice for Preparation of an Environmental Impact... Administration, USDOT. ACTION: Notice of withdrawal. SUMMARY: The Bend-Fort Rock Ranger District and FHWA are..., Project Leader, Bend- Fort Rock Ranger District, 63095 Deschutes Market Road, Bend, OR 97701, phone 541...

78 FR 78966 - Board of Scientific Counselors, National Center for Health Statistics

Science.gov (United States)

2013-12-27

... Scientific Counselors, National Center for Health Statistics In accordance with section 10(a)(2) of the...), National Center for Health Statistics (NCHS) announces the following meeting of the aforementioned..., NCHS; discussion of vital statistics; future program reviews; National Health Interview Survey 2017...

Promoting Ecological Health Resilience for Minority Youth: Enhancing Health Care Access through the School Health Center.

Science.gov (United States)

Clauss-Ehlers, Caroline C. C.

2003-01-01

Discusses the demographic realities of children of color in the U.S., with a focus on health care needs and access issues that have an enormous influence on health status. An ecologic model is presented that incorporates cultural values and community structures into the school health center. (Contains 50 references.) (GCP)

Cannon Fire Soon to Accompany Bugle Call at Fort Detrick | Poster

Science.gov (United States)

Beginning June 14, the familiar bugle calls at Fort Detrick will be joined by a special percussion instrument: a cannon. A single cannon shot will be fired on the first note of “Reveille,” which signals the start of each day and is accompanied by the raising of the American flag. “Reveille” sounds at 6:30 a.m. At 5 p.m., Fort Detrick plays “Retreat,” which alerts the post that

Site-Based Budgeting in Fort Worth, Texas.

Science.gov (United States)

Peternick, Lauri; Sherman, Joel

1998-01-01

Examines the Fort Worth Independent School District's decentralized decision-making system through three lenses: a review of site-based decision-making procedures at several schools; an examination of who participates; and stakeholders' perceptions. Some schools operated democratically, significantly including teachers, parents, and community…

Outcomes of antiretroviral treatment: a comparison between hospitals and health centers in Ethiopia.

Science.gov (United States)

Balcha, Taye T; Jeppsson, Anders

2010-01-01

the objective of this study was to compare the outcomes of antiretroviral therapy (ART) between hospital and health center levels in Ethiopia. medical records of 1709 ART patients followed for 24 months at 2 hospitals and 3 health centers in the Oromia region of Ethiopia were reviewed. Noted outcomes of ART were currently alive and on treatment; lost to follow-up (LTFU); transferred out (TO); and died (D). of 1709 HIV-positive patients started on ART between September 2006 and February 2007, 1044 (61%) remained alive and were on treatment after 24-month follow-up. In all, 835 (57%) of ART patients at hospitals and 209 (83%) at health centers were retained in the program. Of those who were alive and receiving ART, 79% of patients at health centers and 72% at hospitals were clinically or immunologically improving. In addition, 331 (23%) patients at hospitals were LFTU as compared to 24 (10%) of patients at health centers (relative risk [RR] at 95% confidence interval [CI]: .358 [.231-.555]). While 11% was the mortality rate at hospitals, 5% of patients at health centers also died (RR at 95% CI: .360 [.192-.673]). antiretroviral therapy at health centers was associated with more favorable outcomes than at hospitals.

75 FR 9421 - National Center on Minority Health and Health Disparities; Notice of Closed Meeting

Science.gov (United States)

2010-03-02

... Health and Health Disparities; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Health Disparities Special Emphasis Panel; Loan Repayment Program for Health Disparities Research..., National Center on Minority Health and Health Disparities, 6707 Democracy Boulevard, Suite 800, Bethesda...

Construction experience on PCRV liners at Fort St. Vrain

International Nuclear Information System (INIS)

Cliff, J.O.; Wunderlich, R.G.

1976-01-01

The construction of the steel liners for the Fort St. Vrain prestressed concrete reactor vessel presented many unique problems for which techniques were developed to satisfy the rigid specification requirements. The PCRV cavity liner was fabricated from 1.9cm carbon steel plate. The liners were partially fabricated by Pittsburgh-Des Moines Steel Company at their Pittsburgh manufacturing facility. The liners were then shipped by rail to within approximately five miles of the jobsite and then trucked the remaining distance. The construction techniques, dimensional control, concrete support and testing utilized on the Fort St. Vrain project are presented in detail and demonstrate the flexibility of the PCRV for field construction. (author)

Barriers and facilitators to implementing a patient-centered model of contraceptive provision in community health centers.

Science.gov (United States)

Politi, Mary C; Estlund, Amy; Milne, Anne; Buckel, Christina M; Peipert, Jeffrey F; Madden, Tessa

2016-01-01

The Contraceptive CHOICE Project developed a patient-centered model for contraceptive provision including: (1) structured, evidence-based counseling; (2) staff and health care provider education; and (3) removal of barriers such as cost and multiple appointments to initiate contraception. In preparation for conducting a research study of the CHOICE model in three community health settings, we sought to identify potential barriers and facilitators to implementation. Using a semi-structured interview guide guided by a framework of implementation research, we conducted 31 qualitative interviews with female patients, staff, and health care providers assessing attitudes, beliefs, and barriers to receiving contraception. We also asked about current contraceptive provision and explored organizational practices relevant to implementing the CHOICE model. We used a grounded theory approach to identify major themes. Many participants felt that current contraceptive provision could be improved by the CHOICE model. Potential facilitators included agreement about the necessity for improved contraceptive knowledge among patients and staff; importance of patient-centered contraceptive counseling; and benefits to same-day insertion of long-acting reversible contraception (LARC). Potential barriers included misconceptions about contraception held by staff and providers; resistance to new practices; costs associated with LARC; and scheduling challenges required for same-day insertion of LARC. In addition to staff and provider training, implementing a patient-centered model of contraceptive provision needs to be supplemented by strategies to manage patient and system-level barriers. Community health center staff, providers, and patients support patient-centered contraceptive counseling to improve contraception provision if organizations can address these barriers.

NASA Human Health and Performance Center (NHHPC)

Science.gov (United States)

Davis, Jeffery R.

2010-01-01

This slide presentation reviews the purpose, potential members and participants of the NASA Human Health and Performance Center (NHHPC). Included in the overview is a brief description of the administration and current activities of the NHHPC.

Health Care Employee Perceptions of Patient-Centered Care: A Photovoice Project

Science.gov (United States)

Balbale, Salva Najib; Turcios, Stephanie; LaVela, Sherri L.

2015-01-01

Given the importance of health care employees in the delivery of patient-centered care, understanding their unique perspective is essential for quality improvement. The purpose of this study was to use photovoice to evaluate perceptions and experiences around patient-centered care among Veterans Affairs (VA) health care employees. We asked participants to take photographs of salient features in their environment related to patient-centered care. We used the photographs to facilitate dialogue during follow-up interviews. Twelve VA health care employees across two VA sites participated in the project. Although most participants felt satisfied with their work environment and experiences at the VA, several areas for improvement were identified. These included a need for more employee health and wellness initiatives and a need for enhanced opportunities for training and professional growth. Application of photovoice enabled us to learn about employees' unique perspectives around patient-centered care while engaging them in an evaluation of care delivery. PMID:25274626

Medicaid Expansion And Grant Funding Increases Helped Improve Community Health Center Capacity.

Science.gov (United States)

Han, Xinxin; Luo, Qian; Ku, Leighton

2017-01-01

Through the expansion of Medicaid eligibility and increases in core federal grant funding, the Affordable Care Act (ACA) sought to increase the capacity of community health centers to provide primary care to low-income populations. We examined the effects of the ACA Medicaid expansion and changes in federal grant levels on the centers' numbers of patients, percentages of patients by type of insurance, and numbers of visits from 2012 to 2015. In the period after expansion (2014-15), health centers in expansion states had a 5 percent higher total patient volume, larger shares of Medicaid patients, smaller shares of uninsured patients, and increases in overall visits and mental health visits, compared to centers in nonexpansion states. Increases in federal grant funding levels were associated with increases in numbers of patients and of overall, medical, and preventive service visits. If federal grant levels are not sustained after 2017, there could be marked reductions in health center capacity in both expansion and nonexpansion states. Project HOPE—The People-to-People Health Foundation, Inc.

Holistic Health Care for the Medically Uninsured: The Church Health Center of Memphis

OpenAIRE

Morris, G. Scott

2015-01-01

The Church Health Center (CHC) in Memphis was founded in 1987 to provide quality, affordable health care for working, uninsured people and their families. With numerous, dedicated financial supporters and health care volunteers, CHC has become the largest faith-based health care organization of its type nationally, serving >61,000 patients. CHC embraces a holistic approach to health by promoting wellness in every dimension of life. It offers on-site services including medical care, dentistry,...

Assessing the public health impact of using poison center data for public health surveillance.

Science.gov (United States)

Wang, Alice; Law, Royal; Lyons, Rebecca; Choudhary, Ekta; Wolkin, Amy; Schier, Joshua

2017-12-13

The National Poison Data System (NPDS) is a database and surveillance system for US poison centers (PCs) call data. The Centers for Disease Control and Prevention (CDC) and American Association of Poison Control Centers (AAPCC) use NPDS to identify incidents of potential public health significance. State health departments are notified by CDC of incidents identified by NPDS to be of potential public health significance. Our objective was to describe the public health impact of CDC's notifications and the use of NPDS data for surveillance. We described how NPDS data informed three public health responses: the Deepwater Horizon incident, national exposures to laundry detergent pods, and national exposures to e-cigarettes. Additionally, we extracted survey results of state epidemiologists regarding NPDS incident notification follow-up from 1 January 2015 to 31 December 2016 to assess current public health application of NPDS data using Epi Info 7.2 and analyzed data using SAS 9.3. We assessed whether state health departments were aware of incidents before notification, what actions were taken, and whether CDC notifications contributed to actions. NPDS data provided evidence for industry changes to improve laundry detergent pod containers safety and highlighted the need to regulate e-cigarette sale and manufacturing. NPDS data were used to improve situational awareness during the 2010 Deepwater Horizon oil spill. Of 59 health departments and PCs who responded to CDC notifications about anomalies (response rate = 49.2%), 27 (46%) reported no previous awareness of the incident, and 20 (34%) said that notifications contributed to public health action. Monitoring NPDS data for anomalies can identify emerging public health threats and provide evidence-based science to support public health action and policy changes.

BRAND EQUITY OF LAHORE FORT AS A TOURISM DESTINATION BRAND

Directory of Open Access Journals (Sweden)

Muhammad Kashif

2015-06-01

Full Text Available Studies that measure the brand equity of destination brands by using the Customer-Based Brand Equity (CBBE model in a developing country context are scarce. The present study investigates the destination brand equity of the Lahore Fort by employing the CBBE model in a developing country context of Pakistan. Following the positivist tradition, we adopted a survey-based approach to collect data from 237 tourists visiting the Lahore Fort. Data were collected through a questionnaire developed to explain the relationship of brand awareness, brand image, brand association, and brand loyalty with Lahore Fort’s overall brand equity. We used various robust statistical techniques such as correlation, regression and confirmatory factor analysis (using PLS method to reach meaningful conclusions and found that brand image and brand associations positively contribute to brand loyalty. Furthermore, brand loyalty significantly contributes towards overall brand equity. Pragmatically, this study measures the customer based brand equity of the Lahore Fort, a destination brand. The results are useful as they suggest a few strategies that can help policy makers to enhance Lahore Fort’s brand performance.

Comparison of maxillary stability after Le Fort I osteotomy for occlusal cant correction surgery and maxillary advanced surgery.

Science.gov (United States)

Ueki, Koichiro; Hashiba, Yukari; Marukawa, Kohei; Yoshida, Kan; Shimizu, Chika; Nakagawa, Kiyomasa; Yamamoto, Etsuhide

2007-07-01

To compare postoperative maxillary stability following Le Fort I osteotomy for the correction of occlusal cant as compared with conventional Le Fort I osteotomy for maxillary advancement. The subjects were 40 Japanese adults with jaw deformities. Of these, 20 underwent a Le Fort I osteotomy and intraoral vertical ramus osteotomy (IVRO) to correct asymmetric skeletal morphology and inclined occlusal cant. The other 20 patients underwent a Le Fort I osteotomy and sagittal split ramus osteotomy (SSRO) to advance the maxilla. Lateral and posteroanterior cephalograms were taken postoperatively and assessed statistically. Thereafter, the 2 groups were followed for time-course changes. There was no significant difference between the 2 groups with regard to time-course changes during the immediate postoperative period. This suggests that maxillary stability after Le Fort I osteotomy for cant correction does not differ from that after Le Fort I osteotomy for maxillary advancement.

Intention and Usage of Computer Based Information Systems in Primary Health Centers

Science.gov (United States)

Hosizah; Kuntoro; Basuki N., Hari

2016-01-01

The computer-based information system (CBIS) is adopted by almost all of in health care setting, including the primary health center in East Java Province Indonesia. Some of softwares available were SIMPUS, SIMPUSTRONIK, SIKDA Generik, e-puskesmas. Unfortunately they were most of the primary health center did not successfully implemented. This…

Chronic Childhood Trauma, Mental Health, Academic Achievement, and School-Based Health Center Mental Health Services

OpenAIRE

Larson, S; Chapman, S; Spetz, J; Brindis, CD

2017-01-01

Children and adolescents exposed to chronic trauma have a greater risk for mental health disorders and school failure. Children and adolescents of minority racial/ethnic groups and those living in poverty are at greater risk of exposure to trauma and less likely to have access to mental health services. School-based health centers (SBHCs) may be one strategy to decrease health disparities.Empirical studies between 2003 and 2013 of US pediatric populations and of US SBHCs were included if rese...

Using women's health research to develop women leaders in academic health sciences: the National Centers of Excellence in Women's Health.

Science.gov (United States)

Carnes, M; VandenBosche, G; Agatisa, P K; Hirshfield, A; Dan, A; Shaver, J L; Murasko, D; McLaughlin, M

2001-01-01

While the number of women entering U.S. medical schools has risen substantially in the past 25 years, the number of women in leadership positions in academic medicine is disproportionately small. The traditional pathway to academic leadership is through research. Women's health research is an ideal venue to fill the pipeline with talented women physicians and scientists who may become academic leaders in positions where they can promote positive change in women's health as well as mentor other women. The Office on Women's Health (OWH) in the U.S. Department of Health and Human Services has contracted with 18 academic medical centers to develop National Centers of Excellence in Women's Health. Emphasizing the integral link between women's health and women leaders, each of the Centers of Excellence must develop a leadership plan for women in academic medicine as part of the contract requirements. This paper describes the training programs in women's health research that have developed at five of the academic medical centers: the University of Wisconsin, Magee Women's Hospital, the University of Maryland, Medical College of Pennsylvania Hahnemann University, and the University of Illinois at Chicago. We discuss some of the challenges faced for both initiation and future viability of these programs as well as criteria by which these programs will be evaluated for success.

The occupational safety of health professionals working at community and family health centers.

Science.gov (United States)

Ozturk, Havva; Babacan, Elif

2014-10-01

Healthcare professionals encounter many medical risks while providing healthcare services to individuals and the community. Thus, occupational safety studies are very important in health care organizations. They involve studies performed to establish legal, technical, and medical measures that must be taken to prevent employees from sustaining physical or mental damage because of work hazards. This study was conducted to determine if the occupational safety of health personnel at community and family health centers (CHC and FHC) has been achieved. The population of this cross-sectional study comprised 507 nurses, 199 physicians, and 237 other medical personnel working at a total of 18 family health centers (FHC) and community health centers (CHC) in Trabzon, Turkey. The sample consisted of a total of 418 nurses, 156 physicians, and 123 other medical personnel. Sampling method was not used, and the researchers tried to reach the whole population. Data were gathered with the Occupational Safety Scale (OSS) and a questionnaire regarding demographic characteristics and occupational safety. According to the evaluations of all the medical personnel, the mean ± SD of total score of the OSS was 3.57 ± 0.98; of the OSS's subscales, the mean ± SD of the health screening and registry systems was 2.76 ± 1.44, of occupational diseases and problems was 3.04 ± 1.3 and critical fields control was 3.12 ± 1.62. In addition, occupational safety was found more insufficient by nurses (F = 14.18; P occupational safety to be insufficient as related to protective and supportive activities.

Fort Collins Science Center Ecosystem Dynamics branch--interdisciplinary research for addressing complex natural resource issues across landscapes and time

Science.gov (United States)

Bowen, Zachary H.; Melcher, Cynthia P.; Wilson, Juliette T.

2013-01-01

The Ecosystem Dynamics Branch of the Fort Collins Science Center offers an interdisciplinary team of talented and creative scientists with expertise in biology, botany, ecology, geology, biogeochemistry, physical sciences, geographic information systems, and remote-sensing, for tackling complex questions about natural resources. As demand for natural resources increases, the issues facing natural resource managers, planners, policy makers, industry, and private landowners are increasing in spatial and temporal scope, often involving entire regions, multiple jurisdictions, and long timeframes. Needs for addressing these issues include (1) a better understanding of biotic and abiotic ecosystem components and their complex interactions; (2) the ability to easily monitor, assess, and visualize the spatially complex movements of animals, plants, water, and elements across highly variable landscapes; and (3) the techniques for accurately predicting both immediate and long-term responses of system components to natural and human-caused change. The overall objectives of our research are to provide the knowledge, tools, and techniques needed by the U.S. Department of the Interior, state agencies, and other stakeholders in their endeavors to meet the demand for natural resources while conserving biodiversity and ecosystem services. Ecosystem Dynamics scientists use field and laboratory research, data assimilation, and ecological modeling to understand ecosystem patterns, trends, and mechanistic processes. This information is used to predict the outcomes of changes imposed on species, habitats, landscapes, and climate across spatiotemporal scales. The products we develop include conceptual models to illustrate system structure and processes; regional baseline and integrated assessments; predictive spatial and mathematical models; literature syntheses; and frameworks or protocols for improved ecosystem monitoring, adaptive management, and program evaluation. The descriptions

Sustaining the edge: factors influencing strategy selection in academic health centers.

Science.gov (United States)

Walsh, Anne M; Szabat, Kathryn

2002-01-01

Competition within the acute care sector as well as increased penetration by managed care organizations has influenced the structure and role of academic health centers during the past decade. The market factors confronting academic health centers are not dissimilar from conditions that confront other organizations competing in mature industries characterized by declining profitability and intense rivalry for market share. When confronted with intense competition or adverse external events, organizations in other industries have responded to potential threats by forming alliances, developing joint ventures, or merging with another firm to maintain their competitive advantage. Although mergers and acquisitions dominated the strategic landscape in the healthcare industry during the past decade, recent evidence suggests that other types of strategic ventures may offer similar economic and contracting benefits to member organizations. Academic health centers have traditionally been involved in network relationships with multiple partners via their shared technology, collaborative research, and joint educational endeavors. These quasi-organizational relationships appear to have provided a framework for strategic decisions and allowed executives of academic health centers to select strategies that were competitive yet closely aligned with their organizational mission. The analysis of factors that influenced strategy selection by executives of academic health centers suggests a deliberate and methodical approach to achieving market share objectives, expanding managed care contracts, and developing physician networks.

Comparison of the Performance of Health Volunteers in the Health Centers of Shahid Beheshti University of Medical Sciences

Directory of Open Access Journals (Sweden)

Ahmad-Reza Farsar

2015-02-01

Full Text Available Background and Objective: Health volunteers are the women who do charity work to prevent, protect and promote the health status of the covered neighbors and hereby cooperate with the health centers. The aim of this study was to compare the health volunteer's performance in the covered health centers by Shahid Beheshti University of Medical Sciences.Materials and Methods: This descriptive- analytical study was performed by the participation of 2060 Health volunteers, who were cooperating with 90 covered health centers by Shahid Beheshti University of Medical Sciences. These include Shomal, Shargh, Shemiranat, Pakdasht, Damavand and Firoozkooh. We used census sampling method. Demographic data was gathered through interviews with the health volunteers and their performance evaluated by the supervisor of the volunteers; through the evaluation forms and these data gathered together.Results: The mean (SD of the health volunteers performance was 30.9 (16.4 in all centers. They were 35.1 (22 in Shargh, 34 (14.5 in Shomal, 32 (11.3 in Firoozkooh, 28.3 (14 in Shemiranat, 7.9 (9.2 in Damavand and 23.6 (8.5 in Pakdasht respectively. The mean (SD of the efficacy of health volunteers was 8.6 (9.9 in all centers. They were 11.7 (5.6 in Firoozkooh, 10.7 (15.7 in Shargh, 9.4 (6.8 in Shomal, 7.9 (4.9 in Damavand, 7.9 (6.1 in Shemiranat and 4.6 (4.3 in Pakdasht respectively. Older and married volunteers with more experience performed better. There was no significant relationship between the efficacy of health volunteers with their literacy level, employment status and absorber of them.              Conclusion: The health volunteers of Shomal, Shargh and Firoozkooh had the best performances respectively. The performances of those in Shemiranat, Damavand and Pakdasht were less than the overall health centers’ mean score. The efficacy score of Firoozkooh, Shomal and Shargh health centers were above the overall health centers’ mean score respectively

Feltarbejde i Thule. Sammenfiltringen af steder, folk og fortællinger

Directory of Open Access Journals (Sweden)

Kirsten Hastrup

2016-07-01

Full Text Available På baggrund af lang tids arbejde i Thuleregionen i det nordvestligste Grønland vil jeg diskutere, hvordan steder, folk og fortællinger gensidigt former hinanden. ’Felten’ er således formateret af mange forhold, historiske og nutidige, naturlige og kulturelle, og man må besinde sig på feltens flydende form, selv når den ser mest solid ud. Steder er i sig selv flygtige; de opstår i mødet med mennesker, som tillægger dem betydning. Folk kan se nok så traditionelle ud, men de lever i samme verden som antropologen, der kommer for at lære af dem. Endelig er fortællingerne ikke stivnede vidnesbyrd om tidligere tider; de er tværtimod et vigtigt redskab i håndteringen af højst nutidige udfordringer, som kommer til syne i det endnu ufortalte. Bag fortællingen om Thule ligger en større diskussion af enhver felts plasticitet.

Opportunities for Increasing Human Papillomavirus Vaccine Provision in School Health Centers

Science.gov (United States)

Moss, Jennifer L.; Feld, Ashley L.; O'Malley, Brittany; Entzel, Pamela; Smith, Jennifer S.; Gilkey, Melissa B.; Brewer, Noel T.

2014-01-01

Background: Uptake of human papillomavirus (HPV) vaccine remains low among adolescents in the United States. We sought to assess barriers to HPV vaccine provision in school health centers to inform subsequent interventions. Methods: We conducted structured interviews in the fall of 2010 with staff from all 33 school health centers in North…

Smithsonian Marine Station (SMS) at Fort Pierce

Science.gov (United States)

share current Smithsonian research on the plants and animals of the Indian River Lagoon and marine Smithsonian Marine Station at Fort Pierce Website Search Box Search Field: SMS Website Search Twitter SMS Home › Welcome to the Smithsonian Marine Station Homepage slideshow Who We Are... The

Managing the risks of on-site health centers.

Science.gov (United States)

Gorman, Kathleen M; Miller, Ross M

2011-11-01

This review sought to assess compliance concerns, determine risk management strategies, and identify opportunities for future research to contribute to employers' understanding of the laws and regulations that apply to on-site care. A comprehensive review of databases, professional organizations' websites, and journals resulted in 22 publications reporting on the consequences of noncompliance among on-site health centers accepted for inclusion. None of those studies reported a study design or quantifiable outcome data. Two noncompliance themes were repeated among the publications. First, direct penalties included fines, civil actions, loss of licensure, and, potentially, criminal charges. Second, noncompliance also resulted in indirect costs such as employee mistrust and lowered standards of care, which jeopardize on-site health centers' ability to demonstrate a return on investment. Further research with rigorous methodology is needed to inform employer decisions about on-site health services and associated risk management. Copyright 2011, SLACK Incorporated.

Cultural health capital and the interactional dynamics of patient-centered care.

Science.gov (United States)

Dubbin, Leslie A; Chang, Jamie Suki; Shim, Janet K

2013-09-01

As intuitive and inviting as it may appear, the concept of patient-centered care has been difficult to conceptualize, institutionalize and operationalize. Informed by Bourdieu's concepts of cultural capital and habitus, we employ the framework of cultural health capital to uncover the ways in which both patients' and providers' cultural resources, assets, and interactional styles influence their abilities to mutually achieve patient-centered care. Cultural health capital is defined as a specialized collection of cultural skills, attitudes, behaviors and interactional styles that are valued, leveraged, and exchanged by both patients and providers during clinical interactions. In this paper, we report the findings of a qualitative study conducted from 2010 to 2011 in the Western United States. We investigated the various elements of cultural health capital, how patients and providers used cultural health capital to engage with each other, and how this process shaped the patient-centeredness of interactions. We find that the accomplishment of patient-centered care is highly dependent upon habitus and the cultural health capital that both patients and providers bring to health care interactions. Not only are some cultural resources more highly valued than others, their differential mobilization can facilitate or impede engagement and communication between patients and their providers. The focus of cultural health capital on the ways fundamental social inequalities are manifest in clinical interactions enables providers, patients, and health care organizations to consider how such inequalities can confound patient-centered care. Copyright © 2013 Elsevier Ltd. All rights reserved.

Contingent post-closure plan, hazardous waste management units at selected maintenance facilities, US Army National Training Center, Fort Irwin, California

International Nuclear Information System (INIS)

1992-01-01

The National Training Center (NTC) at Fort Irwin, California, is a US Army training installation that provides tactical experience for battalion/task forces and squadrons in a mid- to high-intensity combat scenario. Through joint exercises with US Air Force and other services, the NTC also provides a data source for improvements of training doctrines, organization, and equipment. To meet the training and operational needs of the NTC, several maintenance facilities provide general and direct support for mechanical devices, equipment, and vehicles. Maintenance products used at these facilities include fuels, petroleum-based oils, lubricating grease, various degreasing solvents, antifreeze (ethylene glycol), transmission fluid, brake fluid, and hydraulic oil. Used or spent petroleum-based products generated at the maintenance facilities are temporarily accumulated in underground storage tanks (USTs), collected by the NTC hazardous waste management contractor (HAZCO), and stored at the Petroleum, Oil, and Lubricant (POL) Storage Facility, Building 630, until shipped off site to be recovered, reused, and/or reclaimed. Spent degreasing solvents and other hazardous wastes are containerized and stored on-base for up to 90 days at the NTC's Hazardous Waste Storage Facility, Building 703. The US Environmental Protection Agency (EPA) performed an inspection and reviewed the hazardous waste management operations of the NTC. Inspections indicated that the NTC had violated one or more requirements of Subtitle C of the Resource Conservation and Recovery Act (RCRA) and as a result of these violations was issued a Notice of Noncompliance, Notice of Necessity for Conference, and Proposed Compliance Schedule (NON) dated October 13, 1989. The following post-closure plan is the compliance-based approach for the NTC to respond to the regulatory violations cited in the NON

Heat-pump-centered integrated community energy systems

Energy Technology Data Exchange (ETDEWEB)

Schaetzle, W.J.; Brett, C.E.; Seppanen, M.S.

1979-12-01

The heat-pump-centered integrated community energy system (HP-ICES) supplies district heating and cooling using heat pumps and a thermal energy storage system which is provided by nature in underground porous formations filled with water, i.e., aquifers. The energy is transported by a two-pipe system, one for warm water and one for cool water, between the aquifers and the controlled environments. Each energy module contains the controlled environments, an aquifer, wells for access to the aquifer, the two pipe water distribution system and water source heat pumps. The heat pumps upgrade the energy in the distribution system for use in the controlled environments. Economically, the system shows improvement on both energy usage and capital costs. The system saves over 60% of the energy required for resistance heating; saves over 30% of the energy required for most air-source heat pumps and saves over 60% of the energy required for gas, coal, or oil heating, when comparing to energy input required at the power plant for heat pump usage. The proposed system has been analyzed as demonstration projects for a downtown portion of Louisville, Kentucky, and a section of Fort Rucker, Alabama. The downtown Louisville demonstration project is tied directly to major buildings while the Fort Rucker demonstration project is tied to a dispersed subdivision of homes. The Louisville project shows a payback of approximately 3 y, while Fort Rucker is approximately 30 y. The primary difference is that at Fort Rucker new heat pumps are charged to the system. In Louisville, either new construction requiring heating and cooling systems or existing chillers are utilized. (LCL)

RadNet Air Data From Fort Smith, AR

Science.gov (United States)

This page presents radiation air monitoring and air filter analysis data for Fort Smith, AR from EPA's RadNet system. RadNet is a nationwide network of monitoring stations that measure radiation in air, drinking water and precipitation.

Health services at the Kennedy Space Center

Science.gov (United States)

Ferguson, E. B.; Humbert, P.; Long, I. D.; Tipton, D. A.

1992-01-01

Comprehensive occupational health services are provided to approximately 17,000 workers at the Kennedy Space Center and an additional 6000 on Cape Canaveral Air Force Station. These areas cover about 120,000 acres encompassing part of the Merritt Island Wild Life Refuge and wetlands which are the habitat of numerous endangered and protected species of wildlife. The services provided at the Kennedy Space Center optimally assure a safe and healthy working environment for the employees engaged in the preparation and launching of this country's Space Shuttle and other important space exploration programs.

Area health education centers and health science library services.

Science.gov (United States)

West, R T; Howard, F H

1977-07-01

A study to determine the impact that the Area Health Education Center type of programs may have on health science libraries was conducted by the Extramural Programs, National Library of Medicine, in conjunction with a contract awarded by the Bureau of Health Manpower, Health Resources Administration, to develop an inventory of the AHEC type of projects in the United States. Specific study tasks included a review of these programs as they relate to library and information activities, on-site surveys on the programs to define their needs for library services and information, and a categorization of library activities. A major finding was that health science libraries and information services are generally not included in AHEC program planning and development, although information and information exchange is a fundamental part of the AHEC type of programs. This study suggests that library inadequacies are basically the result of this planning failure and of a lack of financial resources; however, many other factors may be contributory. The design and value of library activities for these programs needs explication.

Reinventing the academic health center.

Science.gov (United States)

Kirch, Darrell G; Grigsby, R Kevin; Zolko, Wayne W; Moskowitz, Jay; Hefner, David S; Souba, Wiley W; Carubia, Josephine M; Baron, Steven D

2005-11-01

Academic health centers have faced well-documented internal and external challenges over the last decade, putting pressure on organizational leaders to develop new strategies to improve performance while simultaneously addressing employee morale, patient satisfaction, educational outcomes, and research growth. In the aftermath of a failed merger, new leaders of The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center encountered a climate of readiness for a transformational change. In a case study of this process, nine critical success factors are described that contributed to significant performance improvement: performing a campus-wide cultural assessment and acting decisively on the results; making values explicit and active in everyday decisions; aligning corporate structure and governance to unify the academic enterprise and health system; aligning the next tier of administrative structure and function; fostering collaboration and accountability-the creation of unified campus teams; articulating a succinct, highly focused, and compelling vision and strategic plan; using the tools of mission-based management to realign resources; focusing leadership recruitment on organizational fit; and "growing your own" through broad-based leadership development. Outcomes assessment data for academic, research, and clinical performance showed significant gains between 2000 and 2004. Organizational transformation as a result of the nine factors is possible in other institutional settings and can facilitate a focus on crucial quality initiatives.

Tri-Service Center for Oral Health Studies (TSCOHS)

Data.gov (United States)

Federal Laboratory Consortium — The Tri-Service Center for Oral Health Studies (TSCOHS), a service of the Postgraduate Dental College, is chartered by the Department of Defense TRICARE Management...

76 FR 35683 - Medicare Program; Conditions of Participation (CoPs) for Community Mental Health Centers

Science.gov (United States)

2011-06-17

... Community Mental Health Centers; Proposed Rule #0;#0;Federal Register / Vol. 76 , No. 117 / Friday June 17... (CoPs) for Community Mental Health Centers AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS... participation (CoPs) that community mental health centers (CMHCs) would have to meet in order to participate in...

Outpatient prescription practices in rural township health centers in Sichuan Province, China

Directory of Open Access Journals (Sweden)

Jiang Qian

2012-09-01

Full Text Available Abstract Background Sichuan Province is an agricultural and economically developing province in western China. To understand practices of prescribing medications for outpatients in rural township health centers is important for the development of the rural medical and health services in this province and western China. Methods This is an observational study based on data from the 4th National Health Services Survey of China. A total of 3,059 prescriptions from 30 township health centers in Sichuan Province were collected and analyzed. Seven indicators were employed in the analyses to characterize the prescription practices. They are disease distribution, average cost per encounter, number of medications per encounter, percentage of encounters with antibiotics, percentage of encounters with glucocorticoids, percentage of encounters with combined glucocorticoids and antibiotics, and percentage of encounters with injections. Results The average medication cost per encounter was 16.30 Yuan ($2.59. About 60% of the prescriptions contained Chinese patent medicine (CPM, and almost all prescriptions (98.07% contained western medicine. 85.18% of the prescriptions contained antibiotics, of which, 24.98% contained two or more types of antibiotics; the percentage of prescriptions with glucocorticoids was 19.99%; the percentage of prescriptions with both glucocorticoids and antibiotics was 16.67%; 51.40% of the prescriptions included injections, of which, 39.90% included two or more injections. Conclusions The findings from this study demonstrated irrational medication uses of antibiotics, glucocorticoids and injections prescribed for outpatients in the rural township health centers in Sichuan Province. The reasons for irrational medication uses are not only solely due to the pursuit of maximizing benefits in the township health centers, but also more likely attributable to the lack of medical knowledge of rational medication uses among rural doctors and the

Vegetation inventory, mapping, and classification report, Fort Bowie National Historic Site

Science.gov (United States)

Studd, Sarah; Fallon, Elizabeth; Crumbacher, Laura; Drake, Sam; Villarreal, Miguel

2013-01-01

A vegetation mapping and characterization effort was conducted at Fort Bowie National Historic Site in 2008-10 by the Sonoran Desert Network office in collaboration with researchers from the Office of Arid lands studies, Remote Sensing Center at the University of Arizona. This vegetation mapping effort was completed under the National Park Service Vegetation Inventory program which aims to complete baseline mapping inventories at over 270 national park units. The vegetation map data was collected to provide park managers with a digital map product that met national standards of spatial and thematic accuracy, while also placing the vegetation into a regional and even national context. Work comprised of three major field phases 1) concurrent field-based classification data collection and mapping (map unit delineation), 2) development of vegetation community types at the National Vegetation Classification alliance or association level and 3) map accuracy assessment. Phase 1 was completed in late 2008 and early 2009. Community type descriptions were drafted to meet the then-current hierarchy (version 1) of the National Vegetation Classification System (NVCS) and these were applied to each of the mapped areas. This classification was developed from both plot level data and censused polygon data (map units) as this project was conducted as a concurrent mapping and classification effort. The third stage of accuracy assessment completed in the fall of 2010 consisted of a complete census of each map unit and was conducted almost entirely by park staff. Following accuracy assessment the map was amended where needed and final products were developed including this report, a digital map and full vegetation descriptions. Fort Bowie National Historic Site covers only 1000 acres yet has a relatively complex landscape, topography and geology. A total of 16 distinct communities were described and mapped at Fort Bowie NHS. These ranged from lush riparian woodlands lining the

Strategies to improve chronic disease management in seven metro Boston community health centers.

Science.gov (United States)

Ndumele, Chima D; Russell, Beverley E; Ayanian, John Z; Landon, Bruce E; Keegan, Thomas; O'Malley, A James; Hicks, Leroi S

2009-01-01

The Community, Health Center, and Academic Medicine Partnership Project (CHAMPP) is a partnership between medical researchers, community health centers (CHCs), and a community advisory committee focused on reducing cardiovascular morbidity related to hypertension and diabetes for non-Hispanic Black and Hispanic populations in Boston, Massachusetts. We conducted site visits at seven participating CHCs, located in Boston. The visits were to solicit health center staff opinions about site-specific barriers and enabling factors for optimum preventative cardiovascular care for racial/ethnic minority patients receiving hypertension and diabetes care at their centers. Site visits included a tour of each health center and a series of directed interviews with center personnel. Site visit notes were reviewed to identify themes that emerged during the course of each site visit. A summary matrix was developed for each health center, which included information regarding the most salient and persistent themes of the visit. Site visits uncovered several patient-, provider-, CHC-, and community-based factors that either facilitate or hinder optimal care of chronic disease patients. Commonly referenced barriers included the need for improved patient adherence to provider recommendations; insufficient time for providers to address complex health issues presented by patients and the need for a broader range of healthier food options in surrounding communities. Interactive patient groups and community health workers (CHWs) have been well received when implemented. Recommendations included adopting case management as a part of usual care for chronic disease patients; additionally, widespread implementation of CHWs may to provide a platform for more comprehensive care for patients.

Slaget ved Vejle og andre fortællinger fra Jyske Bank

DEFF Research Database (Denmark)

Albrechtsen, Charlotte

Storytelling som ledelsesværktøj er en form for retorik idet formålet med at bruge fortællinger i kommunikationen fra ledelse til medarbejdere er at påvirke modtagerne/medarbejderne. Imidlertid er refleksioner over modtagerinstansen så godt som fraværende både i den populære debat om storytelling...... og i den eksisterende forskning i emnet. Foruden at introducere til forskningen i storytelling præsenterer artiklens forfatter, som er ph.d.-studerende, en modtagerorienteret analyse af en fortælling fra Jyske Bank....

77 FR 2548 - Board of Scientific Counselors, National Center for Health Statistics

Science.gov (United States)

2012-01-18

... Scientific Counselors, National Center for Health Statistics In accordance with section 10(a)(2) of the...), National Center for Health Statistics (NCHS) announces the following meeting of the aforementioned...; review of the ambulatory and hospital care statistics program; a discussion of the NHANES genetics...

Low footwall accelerations and variable surface rupture behavior on the Fort Sage Mountains fault, northeast California

Science.gov (United States)

Briggs, Richard W.; Wesnousky, Steven G.; Brune, James N.; Purvance, Matthew D.; Mahan, Shannon

2013-01-01

The Fort Sage Mountains fault zone is a normal fault in the Walker Lane of the western Basin and Range that produced a small surface rupture (L 5.6 earthquake in 1950. We investigate the paleoseismic history of the Fort Sage fault and find evidence for two paleoearthquakes with surface displacements much larger than those observed in 1950. Rupture of the Fort Sage fault ∼5.6  ka resulted in surface displacements of at least 0.8–1.5 m, implying earthquake moment magnitudes (Mw) of 6.7–7.1. An older rupture at ∼20.5  ka displaced the ground at least 1.5 m, implying an earthquake of Mw 6.8–7.1. A field of precariously balanced rocks (PBRs) is located less than 1 km from the surface‐rupture trace of this Holocene‐active normal fault. Ground‐motion prediction equations (GMPEs) predict peak ground accelerations (PGAs) of 0.2–0.3g for the 1950 rupture and 0.3–0.5g for the ∼5.6  ka paleoearthquake one kilometer from the fault‐surface trace, yet field tests indicate that the Fort Sage PBRs will be toppled by PGAs between 0.1–0.3g. We discuss the paleoseismic history of the Fort Sage fault in the context of the nearby PBRs, GMPEs, and probabilistic seismic hazard maps for extensional regimes. If the Fort Sage PBRs are older than the mid‐Holocene rupture on the Fort Sage fault zone, this implies that current GMPEs may overestimate near‐fault footwall ground motions at this site.

Assessment of groundwater, soil-gas, and soil contamination at the Vietnam Armor Training Facility, Fort Gordon, Georgia, 2009-2011

Science.gov (United States)

Guimaraes, Wladmir B.; Falls, W. Fred; Caldwell, Andral W.; Ratliff, W. Hagan; Wellborn, John B.; Landmeyer, James E.

2012-01-01

The U.S. Geological Survey, in cooperation with the U.S. Department of the Army Environmental and Natural Resources Management Office of the U.S. Army Signal Center and Fort Gordon, Georgia, assessed the groundwater, soil gas, and soil for contaminants at the Vietnam Armor Training Facility (VATF) at Fort Gordon, from October 2009 to September 2011. The assessment included the detection of organic compounds in the groundwater and soil gas, and inorganic compounds in the soil. In addition, organic contaminant assessment included organic compounds classified as explosives and chemical agents in selected areas. The assessment was conducted to provide environmental contamination data to the U.S. Army at Fort Gordon pursuant to requirements of the Resource Conservation and Recovery Act Part B Hazardous Waste Permit process. This report is a revision of "Assessment of soil-gas, surface-water, and soil contamination at the Vietnam Armor Training Facility, Fort Gordon, Georgia, 2009-2010," Open-File Report 2011-1200, and supersedes that report to include results of additional samples collected in July 2011. Four passive samplers were deployed in groundwater wells at the VATF in Fort Gordon. Total petroleum hydrocarbons and benzene and octane were detected above the method detection level at all four wells. The only other volatile organic compounds detected above their method detection level were undecane and pentadecane, which were detected in two of the four wells. Soil-gas samplers were deployed at 72 locations in a grid pattern across the VATF on June 3, 2010, and then later retrieved on June 9, 2010. Total petroleum hydrocarbons were detected in 71 of the 72 samplers (one sampler was destroyed in the field and not analyzed) at levels above the method detection level, and the combined mass of benzene, toluene, ethylbenzene, and total xylene (BTEX) was detected above the detection level in 31 of the 71 samplers that were analyzed. Other volatile organic compounds

FORT NAMUTONI: FROM MILITARY STRONGHOLD TO TOURIST ...

African Journals Online (AJOL)

STRONGHOLD TO TOURIST CAMP. Col Dr Jan Ploeger*. "... this fortress was not just a white elephant, it was actually occupied and played a major role in the settlement of Germans in the far North." (own translation) - D.W. Krynauw Die Verhaal van. Namutoni, p 3. Introduction. Fort Namutoni, the last White outpost east of ...

Role of public health center for nuclear disaster

International Nuclear Information System (INIS)

Okada, Tsuyoshi

2012-01-01

The role of public health center such as surveillance screening, mass decontamination, health consultation and management, and dosage of stable iodine tablets are thought by Nuclear Safety Commission in 2008. The pollution screening and decontamination, internal exposure screening and valuation, dosage of iodine tablets, health consultation of residents and risk communication, comparative evaluation of health risks, health management under the low dose exposure are discussed to handle problems by the government and local government, and to protect the right to know information. In order to prepare the serious health hazard, the children's thyroid gland test and internal exposure test and the follow-up system have to be practiced by the local government. (S.Y.)

CMS Innovation Center Health Care Innovation Awards

Science.gov (United States)

Berry, Sandra H.; Concannon, Thomas W.; Morganti, Kristy Gonzalez; Auerbach, David I.; Beckett, Megan K.; Chen, Peggy G.; Farley, Donna O.; Han, Bing; Harris, Katherine M.; Jones, Spencer S.; Liu, Hangsheng; Lovejoy, Susan L.; Marsh, Terry; Martsolf, Grant R.; Nelson, Christopher; Okeke, Edward N.; Pearson, Marjorie L.; Pillemer, Francesca; Sorbero, Melony E.; Towe, Vivian; Weinick, Robin M.

2013-01-01

Abstract The Center for Medicare and Medicaid Innovation within the Centers for Medicare & Medicaid Services (CMS) has funded 108 Health Care Innovation Awards, funded through the Affordable Care Act, for applicants who proposed compelling new models of service delivery or payment improvements that promise to deliver better health, better health care, and lower costs through improved quality of care for Medicare, Medicaid, and Children's Health Insurance Program enrollees. CMS is also interested in learning how new models would affect subpopulations of beneficiaries (e.g., those eligible for Medicare and Medicaid and complex patients) who have unique characteristics or health care needs that could be related to poor outcomes. In addition, the initiative seeks to identify new models of workforce development and deployment, as well as models that can be rapidly deployed and have the promise of sustainability. This article describes a strategy for evaluating the results. The goal for the evaluation design process is to create standardized approaches for answering key questions that can be customized to similar groups of awardees and that allow for rapid and comparable assessment across awardees. The evaluation plan envisions that data collection and analysis will be carried out on three levels: at the level of the individual awardee, at the level of the awardee grouping, and as a summary evaluation that includes all awardees. Key dimensions for the evaluation framework include implementation effectiveness, program effectiveness, workforce issues, impact on priority populations, and context. The ultimate goal is to identify strategies that can be employed widely to lower cost while improving care. PMID:28083297

77 FR 71636 - Huntington Foam LLC, Fort Smith, AR; Notice of Revised Determination on Reconsideration

Science.gov (United States)

2012-12-03

... Smith, AR; Notice of Revised Determination on Reconsideration On August 8, 2012, the Department of Labor... workers and former workers of Huntington Foam LLC, Fort Smith, Arkansas (subject firm). The workers are... reconsideration investigation, I determine that workers of Huntington Foam LLC, Fort Smith, Arkansas, who were...

Behavioral Health and Health Care Reform Models: Patient-Centered Medical Home, Health Home, and Accountable Care Organization

OpenAIRE

Bao, Yuhua; Casalino, Lawrence P.; Pincus, Harold Alan

2013-01-01

Discussions of health care delivery and payment reforms have largely been silent about how behavioral health could be incorporated into reform initiatives. This paper draws attention to four patient populations defined by the severity of their behavioral health conditions and insurance status. It discusses the potentials and limitations of three prominent models promoted by the Affordable Care Act to serve populations with behavioral health conditions: the Patient Centered Medical Home, the H...

Administrative Challenges to the Integration of Oral Health With Primary Care: A SWOT Analysis of Health Care Executives at Federally Qualified Health Centers.

Science.gov (United States)

Norwood, Connor W; Maxey, Hannah L; Randolph, Courtney; Gano, Laura; Kochhar, Komal

Inadequate access to preventive oral health services contributes to oral health disparities and is a major public health concern in the United States. Federally Qualified Health Centers play a critical role in improving access to care for populations affected by oral health disparities but face a number of administrative challenges associated with implementation of oral health integration models. We conducted a SWOT (strengths, weaknesses, opportunities, and threats) analysis with health care executives to identify strengths, weaknesses, opportunities, and threats of successful oral health integration in Federally Qualified Health Centers. Four themes were identified: (1) culture of health care organizations; (2) operations and administration; (3) finance; and (4) workforce.

Maxillary distraction osteogenesis at Le Fort-I level induces bone apposition at infraorbital rim.

Science.gov (United States)

Rattan, Vidya; Jena, Ashok Kumar; Singh, Satinder Pal; Utreja, Ashok Kumar

2014-09-01

The aim of this study is to evaluate whether there is any remodeling of bone at infraorbital rim following maxillary distraction osteogenesis (DO) at Le Fort-I level. Twelve adult subjects in the age range of 17-21 years with complete unilateral cleft lip and palate underwent advancement of the maxilla by DO. The effect of maxillary DO on the infraorbital rim remodeling was evaluated from lateral cephalograms recorded prior to the DO (T0), at the end of DO (T1), and at least 2-years after the DO (T2) by Walker's analysis. The ANOVA and two-tailed t test were used and probability value (P value) 0.05 was considered as statistically significant level. There was anterior movement of maxilla by 9.22 ± 3.27 mm and 7.67 ± 3.99 mm at the end of immediate (T1) and long-term (T2) follow-up of maxillary DO, respectively. The Walker's analysis showed 1.49 ± 1.22 mm and 2.31 ± 1.81 mm anterior movement of the infraorbital margin (Orbitale point) at the end of T1 and T2, respectively (P distraction osteogenesis at Le Fort-I level induced significant bone apposition at infraorbital rim. Patients with mild midface hypoplasia who would otherwise may be candidates for osteotomy at Le Fort-II or Le Fort-III level may benefit from maxillary distraction at Le Fort-I level.

The Examination of The Outdoors of Family Health-Care Center: A Case Study In Çanakkale City Center

OpenAIRE

SAĞLIK, Alper; KELKİT, Abdullah

2017-01-01

The gardens of the health-care centers are areas of fear, anxiety and stress based. In the process of the treatment of patients, these areas have psychological, physical and social significance. For this reason, health-care center gardens should be designed to help treatment of patients. Well designed gardens are important for elimination of adverse effects of clinical environments on patients and helping patients to stay away from the stress by ensuring their socia...

Reconsidering the popularity of primary health centers in India: a case study from rural Maharashtra.

Science.gov (United States)

Kamat, V R

1995-07-01

Most evaluations of India's primary health care (PHC) program have been critical of the ways government primary health centers have been functioning. It has been commonly noted that utilization of health services is poor and community participation in the PHC outreach program low. Additionally, medical officers and health center staff are often accused of being negligent in their duties. In this paper I argue that it is worthwhile examining how a popular primary health center functions in a context marked by a growing demand for Western medicines. Attention is drawn to the ingenious ways in which health personnel respond to client demands and government medicine shortages. The case of a popular primary health center in rural Maharashtra is presented. This health center is both the site of public and private health care. Discussed is the manner in which rural populations in India maximize available health care options given time, cash and transportation constraints. Current thinking about community health financing is considered in light of existing health care utilization patterns, community evaluation of free services, perceptions of entitlement and the likely response of practitioners to such schemes.

Holistic Health Care for the Medically Uninsured: The Church Health Center of Memphis.

Science.gov (United States)

Morris, G Scott

2015-11-05

The Church Health Center (CHC) in Memphis was founded in 1987 to provide quality, affordable health care for working, uninsured people and their families. With numerous, dedicated financial supporters and health care volunteers, CHC has become the largest faith-based health care organization of its type nationally, serving >61,000 patients. CHC embraces a holistic approach to health by promoting wellness in every dimension of life. It offers on-site services including medical care, dentistry, optometry, counseling, social work, and nutrition and fitness education, to promote wellness in every dimension of life. A 2012 economic analysis estimated that a $1 contribution to the CHC provided roughly $8 in health services. The CHC has trained >1200 Congregational Health Promoters to be health leaders and is conducting research on the effectiveness of faith community nurses partnering with congregations to assist in home care for patients recently discharged from Memphis hospitals. The MEMPHIS Plan, CHC's employer-sponsored health care plan for small business and the self-employed, offers uninsured people in lower-wage jobs access to quality, affordable health care. The CHC also conducts replications workshops several times a year to share their model with leaders in other communities. The Institute for Healthcare Improvement (IHI) recently completed a case study that concluded: "The CHC is one of a very few organizations successfully embodying all three components of the IHI Triple Aim by improving population health outcomes, enhancing the individual's health care experience, and controlling costs. All three have been part of the Center's DNA since its inception, and as a transforming force in the community, the model is well worth national attention."

Preparedness and Emergency Response Learning Centers: supporting the workforce for national health security.

Science.gov (United States)

Richmond, Alyson L; Sobelson, Robyn K; Cioffi, Joan P

2014-01-01

The importance of a competent and prepared national public health workforce, ready to respond to threats to the public's health, has been acknowledged in numerous publications since the 1980s. The Preparedness and Emergency Response Learning Centers (PERLCs) were funded by the Centers for Disease Control and Prevention in 2010 to continue to build upon a decade of focused activities in public health workforce preparedness development initiated under the Centers for Public Health Preparedness program (http://www.cdc.gov/phpr/cphp/). All 14 PERLCs were located within Council on Education for Public Health (CEPH) accredited schools of public health. These centers aimed to improve workforce readiness and competence through the development, delivery, and evaluation of targeted learning programs designed to meet specific requirements of state, local, and tribal partners. The PERLCs supported organizational and community readiness locally, regionally, or nationally through the provision of technical consultation and dissemination of specific, practical tools aligned with national preparedness competency frameworks and public health preparedness capabilities. Public health agencies strive to address growing public needs and a continuous stream of current and emerging public health threats. The PERLC network represented a flexible, scalable, and experienced national learning system linking academia with practice. This system improved national health security by enhancing individual, organizational, and community performance through the application of public health science and learning technologies to frontline practice.

[Health Centers: science and ideology in the re-organization of public health in the twentieth century].

Science.gov (United States)

Mello, Guilherme Arantes; Viana, Ana Luiza d'Ávila

2011-12-01

Health Centers appeared in the United States around 1910. They provided social assistance in conjunction with some type of medical care. Their original separation between preventive and curative medicine was superseded by the concept of whole health in the 1940s, when Health Center discourse became part of medical education. In the 1960s, the notion of community medicine arose out of the war on poverty. These ideas spread through Brazil in the 1920s and were strengthened under the Vargas policy of national construction, but it was the Serviço Especial de Saúde Pública (Special Public Health Service) that was primarily responsible for lending them their practical and conceptual shape in this country.

Health Coaching to Optimize Well-Being among Returning Veterans with Suicide Risk

Science.gov (United States)

2017-10-01

REPORT: Annual PREPARED FOR: U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012 DISTRIBUTION STATEMENT...ACRONYM(S) U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012 11. SPONSOR/MONITOR’S REPORT NUMBER(S) 12...the intervention and obtaining quantitative health outcome data. 15. SUBJECT TERMS Veterans, suicide, psychological well-being, health coaching

Wood-Fired Boiler System Evaluation at Fort Stewart, GA

National Research Council Canada - National Science Library

Potts, Noel

2002-01-01

Part of the plan to modernize the central energy plant (CEP) at Fort Stewart, GA is focused on the installations wood-fired boiler, which provides steam for heating, cooling, and domestic hot water. The U.S...

Association between proximity to a health center and early childhood mortality in Madagascar.

Directory of Open Access Journals (Sweden)

Saori Kashima

Full Text Available OBJECTIVE: To evaluate the association between proximity to a health center and early childhood mortality in Madagascar, and to assess the influence of household wealth, maternal educational attainment, and maternal health on the effects of distance. METHODS: From birth records of subjects in the Demographic and Health Survey, we identified 12565 singleton births from January 2004 to August 2009. After excluding 220 births that lacked global positioning system information for exposure assessment, odds ratios (ORs and their 95% confidence intervals (CIs for neonatal mortality and infant mortality were estimated using multilevel logistic regression models, with 12345 subjects (level 1, nested within 584 village locations (level 2, and in turn nested within 22 regions (level 3. We additionally stratified the subjects by the birth order. We estimated predicted probabilities of each outcome by a three-level model including cross-level interactions between proximity to a health center and household wealth, maternal educational attainment, and maternal anemia. RESULTS: Compared with those who lived >1.5-3.0 km from a health center, the risks for neonatal mortality and infant mortality tended to increase among those who lived further than 5.0 km from a health center; the adjusted ORs for neonatal mortality and infant mortality for those who lived >5.0-10.0 km away from a health center were 1.36 (95% CI: 0.92-2.01 and 1.42 (95% CI: 1.06-1.90, respectively. The positive associations were more pronounced among the second or later child. The distance effects were not modified by household wealth status, maternal educational attainment, or maternal health status. CONCLUSIONS: Our study suggests that distance from a health center is a risk factor for early childhood mortality (primarily, infant mortality in Madagascar by using a large-scale nationally representative dataset. The accessibility to health care in remote areas would be a key factor to achieve

Florida Public Health Training Center: Evidence-Based Online Mentor Program

Science.gov (United States)

Frahm, Kathryn A.; Alsac-Seitz, Biray; Mescia, Nadine; Brown, Lisa M.; Hyer, Kathy; Liburd, Desiree; Rogoff, David P.; Troutman, Adewale

2013-01-01

This article describes an Online Mentor Program (OMP) designed to support and facilitate mentorships among and between Florida Department of Health (FDOH) employees and USF College of Public Health students using a Web-based portal. The Florida Public Health Training Center (FPHTC) at the University of South Florida (USF) College of Public Health…

Centering Pregnancy and Traditional Prenatal Care: A Comparison of Health Practices

OpenAIRE

Shakespear, Kaylynn

2008-01-01

Centering Pregnancy is an alternative method of providing prenatal care with increased education and social support with health assessment in a group setting. This study, a cross-sectional, correlational, convenience-sample design, sought to determine the difference between women who receive prenatal care in Centering Pregnancy prenatal care and those in traditional prenatal care in regards to health behaviors. Adult pregnant women (n = 125) were surveyed from at least 28 weeks gestation. The...

Cultural health capital and the interactional dynamics of patient-centered care

OpenAIRE

Dubbin, Leslie A.; Chang, Jamie Suki; Shim, Janet K.

2013-01-01

As intuitive and inviting as it may appear, the concept of patient-centered care has been difficult to conceptualize, institutionalize and operationalize. Informed by Bourdieu's concepts of cultural capital and habitus, we employ the framework of cultural health capital to uncover the ways in which both patients' and providers' cultural resources, assets, and interactional styles influence their abilities to mutually achieve patient-centered care. Cultural health capital is defined as a speci...

Physical environment and job satisfaction in a community mental health center.

Science.gov (United States)

Folkins, C; O'Reilly, C; Roberts, K; Miller, S

1977-01-01

Relocation of professional staff in a community mental health center provided a setting in which to evaluate the effects of physical environment on job satisfaction. Two mental health teams moved from an old, drab central clinic building to new satellite clinics while a third team remained in the old building. Relocated staff reported significant increase in satisfaction with physical surroundings as compared to staff that did not move. Furthermore, satisfaction with physical surroundings had some impact on overall satisfaction ratings. Physical surroundings in a community mental health center may be a mediating variable for staff morale and effectiveness.

[Study of the work and of working in Family Health Care Support Center].

Science.gov (United States)

Lancman, Selma; Gonçalves, Rita Maria de Abreu; Cordone, Nicole Guimarães; Barros, Juliana de Oliveira

2013-10-01

To understand the organization of and the working conditions in family health care support centers, as well as subjective experiences related to work in two of these centers. This was a case study carried out during 2011 and 2012 in two family health care support centers in Sao Paulo, Southeastern Brazil. Data were collected and analyzed using two theoretical-methodological references from ergonomics and work psychodynamics influenced, respectively, by ergonomic work analysis, developed based on open observations of a variety of tasks and on interviews and in practice in work psychodynamics, carried out using think tanks about the work. The work of the Family Health Care Support Centers in question is constituted on the bases of complex, diversified actions to be shared among the various professionals and teams involved. Innovative technological tools, which are not often adopted by primary health care professionals, are used and the parameters and productivity measures do not encompass the specificity and the complexity of the work performed. These situations require constant organizational rearrangement, especially between the Family Health Care Support Centers and the Family Health Care Teams, causing difficulties in carrying out the work as well as in constituting the identity of the professionals studied. The study attempts to lend greater visibility to the work processes at the Family Health Care Support Centers in order to contribute to advances in public policy on primary healthcare. It is important to stress that introducing changes at work, which affect both its organization and work conditions, is above all a commitment, which to be effective, must be permanent and must involve the different levels of hierarchy.

National Resource Center for Health and Safety in Child Care and Early Education

Science.gov (United States)

... National Resource Center for Health and Safety in Child Care and Early Education (NRC) at the University of Colorado College of ... National Resource Center for Health and Safety in Child Care and Early Education Email: info@NRCKids.org Please read our disclaimer ...

Wind resource assessment and wind energy system cost analysis: Fort Huachuca, Arizona

Energy Technology Data Exchange (ETDEWEB)

Olsen, T.L. [Tim Olsen Consulting, Denver, CO (United States); McKenna, E. [National Renewable Energy Lab., Golden, CO (United States)

1997-12-01

The objective of this joint DOE and National Renewable Energy Laboratory (NREL) Strategic Environmental Research and Development Program (SERDP) project is to determine whether wind turbines can reduce costs by providing power to US military facilities in high wind areas. In support of this objective, one year of data on the wind resources at several Fort Huachuca sites was collected. The wind resource data were analyzed and used as input to an economic study for a wind energy installation at Fort Huachuca. The results of this wind energy feasibility study are presented in the report.

Surgical risk factors and maxillary nerve function after le fort I osteotomy

DEFF Research Database (Denmark)

Thygesen, Torben Henrik; Jensen, Allan Bardow; Norholt, SE

2009-01-01

PURPOSE: Data on intraoperative risk factors for long-term postoperative complications after Le Fort I osteotomy (LFO) are limited. The aim of this study was to describe prospectively the overall postoperative changes in maxillary nerve function after LFO, and to correlate these changes with a nu......PURPOSE: Data on intraoperative risk factors for long-term postoperative complications after Le Fort I osteotomy (LFO) are limited. The aim of this study was to describe prospectively the overall postoperative changes in maxillary nerve function after LFO, and to correlate these changes...

Patient-Centered Personal Health Record and Portal Implementation Toolkit for Ambulatory Clinics: A Feasibility Study.

Science.gov (United States)

Nahm, Eun-Shim; Diblasi, Catherine; Gonzales, Eva; Silver, Kristi; Zhu, Shijun; Sagherian, Knar; Kongs, Katherine

2017-04-01

Personal health records and patient portals have been shown to be effective in managing chronic illnesses. Despite recent nationwide implementation efforts, the personal health record and patient portal adoption rates among patients are low, and the lack of support for patients using the programs remains a critical gap in most implementation processes. In this study, we implemented the Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit in a large diabetes/endocrinology center and assessed its preliminary impact on personal health record and patient portal knowledge, self-efficacy, patient-provider communication, and adherence to treatment plans. Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit is composed of Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit-General, clinic-level resources for clinicians, staff, and patients, and Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit Plus, an optional 4-week online resource program for patients ("MyHealthPortal"). First, Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit-General was implemented, and all clinicians and staff were educated about the center's personal health record and patient portal. Then general patient education was initiated, while a randomized controlled trial was conducted to test the preliminary effects of "MyHealthPortal" using a small sample (n = 74) with three observations (baseline and 4 and 12 weeks). The intervention group showed significantly greater improvement than the control group in patient-provider communication at 4 weeks (t56 = 3.00, P = .004). For other variables, the intervention group tended to show greater improvement; however, the differences were not significant. In this preliminary study, Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit showed potential for filling the gap in the current

San Joaquin Valley Aerosol Health Effects Research Center (SAHERC)

Data.gov (United States)

Federal Laboratory Consortium — At the San Joaquin Valley Aerosol Health Effects Center, located at the University of California-Davis, researchers will investigate the properties of particles that...

University of Illinois at Chicago Health Policy Center - Funding

Data.gov (United States)

U.S. Department of Health & Human Services — 1991-2015. Centers for Disease Control and Prevention (CDC). State Tobacco Activities Tracking and Evaluation (STATE) System. Funding Data, Appropriations...

Analysis of potential water-supply management options, 2010-60, and documentation of revisions to the model of the Irwin Basin Aquifer System, Fort Irwin National Training Center, California

Science.gov (United States)

Voronin, Lois M.; Densmore, Jill N.; Martin, Peter

2014-01-01

The Fort Irwin National Training Center is considering several alternatives to manage their limited water-supply sources in the Irwin Basin. An existing three-dimensional, finite-difference groundwater-flow model—the U.S. Geological Survey’s MODFLOW—of the aquifer system in the basin was updated and the initial input dataset was supplemented with groundwater withdrawal data for the period 2000–10. The updated model was then used to simulate four combinations, or scenarios, of groundwater withdrawal and recharge over the next 50 years (January 2011 through December 2060). The scenarios included combinations of continuing withdrawals from currently active production wells, supplementing any increases in demand with withdrawals from an inactive production well, reducing withdrawal amounts and rates, and reducing the discharge of treated wastewater to infiltration ponds that provide a recharge source to the underlying aquifer. Results of the simulations indicated that, depending on the scenario implemented, groundwater levels would rise (over the next 50 years) from 40 feet to as much as 65 feet in the northwestern part of the Irwin Basin, and from 5 feet to 10 feet in the southeastern part.

Evaluation of Student Care Process in Urban and Rural Health Care Centers and Health House in Tabriz Using Tracer Methodology

Directory of Open Access Journals (Sweden)

Neda Kabiri

2015-08-01

Full Text Available Background and Objectives : Tracer methodology is a novel evaluation method which its purpose is to provide an accurate assessment of systems and processes for the delivery of care, treatment, and services at a health care organization. This study aimed to assess student care process in Tabriz using Tracer methodology. Material and Methods : This cross-sectional study was conducted in autumn 1391. Population study consisted of all the students who were covered by Tabriz health care center and study sample included an urban health care center, a rural health care center, a health house, and two schools in urban and rural areas which were selected by simple sampling method. Also, all the complicated and problematic processes were chosen to be assessed. Data were collected by interviewing, observing, and surveying documents and were compared with current standards. Results : The results of this study declared the percentage of points that each target group gained from tracer evaluation in student care process was 77% in health house, 90% in rural health care center and 83% in urban health care center. Findings indicated that documentation was the main weak point. Conclusion : According to the results of this study, student care process is sufficient; despite the fact that there are some deficiencies in caring process, as it may be improved through appropriate strategies. Furthermore, tracer methodology seems to be a proper method to evaluate various levels of health care system. ​

Building research infrastructure in community health centers: a Community Health Applied Research Network (CHARN) report.

Science.gov (United States)

Likumahuwa, Sonja; Song, Hui; Singal, Robbie; Weir, Rosy Chang; Crane, Heidi; Muench, John; Sim, Shao-Chee; DeVoe, Jennifer E

2013-01-01

This article introduces the Community Health Applied Research Network (CHARN), a practice-based research network of community health centers (CHCs). Established by the Health Resources and Services Administration in 2010, CHARN is a network of 4 community research nodes, each with multiple affiliated CHCs and an academic center. The four nodes (18 individual CHCs and 4 academic partners in 9 states) are supported by a data coordinating center. Here we provide case studies detailing how CHARN is building research infrastructure and capacity in CHCs, with a particular focus on how community practice-academic partnerships were facilitated by the CHARN structure. The examples provided by the CHARN nodes include many of the building blocks of research capacity: communication capacity and "matchmaking" between providers and researchers; technology transfer; research methods tailored to community practice settings; and community institutional review board infrastructure to enable community oversight. We draw lessons learned from these case studies that we hope will serve as examples for other networks, with special relevance for community-based networks seeking to build research infrastructure in primary care settings.

Status of the Fort St. Vrain decommissioning

International Nuclear Information System (INIS)

Fisher, M.J.

1990-01-01

Fort St. Vrain is a high temperature gas cooled reactor. It has been shut down as a result of financial and technical difficulties. Fort St. Vrain has been planning for defueling and decommissioning for at least three years. The preliminary decommissioning plan, in accordance with the NRC's final rule, has been submitted and is being reviewed by the NRC. The basis of the preliminary decommissioning plan has been SAFSTOR. Public Service Company, who is the owner and operator of FSV, is scheduled to submit a proposed decommissioning plan to the NRC in the fourth quarter of 1990. PSC has gone out for bid on the decontamination and dismantlement of FSV. This paper includes the defueling schedule, the independent spent fuel storage installation status, the probability of shipping fuel to DOE, the status of the preliminary decommissioning plan submittal, the issuance of a possession only license and what are the results of obtaining this license amendment, preliminary decommissioning activities allowed prior to the approval of a proposed decommissioning plan, the preparation of a proposed decommissioning plan and the status of our decision to proceed with SAFSTOR or DECON as identified in the NRC's final decommissioning rule

Strategic Analysis and Plan for Implementing Telemedicine at Fort Greely

National Research Council Canada - National Science Library

Bolton, Karl

2003-01-01

.... To best accomplish this, a strategic analysis and business case analysis was conducted. Introspective strategic analysis tools revealed an organization that is capable of supporting a telemedicine program at Fort Greely...

77 FR 59931 - Single Source Program Expansion Supplement Award to Area Health Education Centers (AHEC) Program...

Science.gov (United States)

2012-10-01

... Program Expansion Supplement Award to Area Health Education Centers (AHEC) Program Grantee; Exception to... Competition--Single Source Program Expansion Supplement Award to Area Health Education Centers (AHEC) Program... supplement award to the University of Guam School of Nursing, an Area Health Education Center (AHEC) Program...

Behavioral health and health care reform models: patient-centered medical home, health home, and accountable care organization.

Science.gov (United States)

Bao, Yuhua; Casalino, Lawrence P; Pincus, Harold Alan

2013-01-01

Discussions of health care delivery and payment reforms have largely been silent about how behavioral health could be incorporated into reform initiatives. This paper draws attention to four patient populations defined by the severity of their behavioral health conditions and insurance status. It discusses the potentials and limitations of three prominent models promoted by the Affordable Care Act to serve populations with behavioral health conditions: the Patient-Centered Medical Home, the Health Home initiative within Medicaid, and the Accountable Care Organization. To incorporate behavioral health into health reform, policymakers and practitioners may consider embedding in the reform efforts explicit tools-accountability measures and payment designs-to improve access to and quality of care for patients with behavioral health needs.

Analysis of suffering at work in Family Health Support Centers.

Science.gov (United States)

Nascimento, Débora Dupas Gonçalves do; Oliveira, Maria Amélia de Campos

2016-01-01

Analyzing the work process in the Family Health Support Center. An exploratory, descriptive case study using a qualitative approach. Focus groups were conducted with 20 workers of a Family Health Support Center, and the empirical material was subjected to content analysis technique and analyzed in light of Work Psychodynamics. The category of suffering is presented herein as arising from the dialectical contradiction between actual work and prescribed work, from resistance to the Family Health Support Center's proposal and a lack of understanding of their role; due to an immediatist and curative culture of the users and the Family Health Strategy; of the profile, overload and identification with work. The dialectical contradiction between expectations from Family Health Strategy teams and the work in the Family Health Support Center compromises its execution and creates suffering for workers. Analisar o processo de trabalho no Núcleo de Apoio à Saúde da Família. Estudo de caso exploratório, descritivo e de abordagem qualitativa. Grupos focais foram realizados com 20 trabalhadores do Núcleo de Apoio à Saúde da Família, o material empírico foi submetido à técnica de análise de conteúdo e analisado à luz da Psicodinâmica do Trabalho. Apresenta-se aqui a categoria sofrimento que neste estudo decorre da contradição dialética entre o trabalho real e o trabalho prescrito, da resistência à proposta do Núcleo de Apoio à Saúde da Família e da falta de compreensão de seu papel; da cultura imediatista e curativa do usuário e da Estratégia Saúde da Família; do perfil, sobrecarga e identificação com o trabalho. A contradição dialética entre expectativas das equipes da Estratégia Saúde da Família e o trabalho no Núcleo de Apoio à Saúde da Família compromete sua efetivação e gera sofrimento aos trabalhadores.

School Health Connection Goes Electronic: Developing a Health Information Management System for New Orleans' School-Based Health Centers. Program Results Report

Science.gov (United States)

Rastorfer, Darl

2011-01-01

From February 2008 through April 2011, School Health Connection, a program of the Louisiana Public Health Institute, developed an electronic health information management system for newly established school-based health centers in Greater New Orleans. School Health Connection was established as part of a broader effort to restore community health…

The Fort Smith radioactive belt, Northwest Territories

International Nuclear Information System (INIS)

Charbonneau, B.W.

1980-01-01

The Fort Smith Belt is an elongate zone, about 200 km x 50 km, extending from the East Arm of Great Slave Lake southerly into northeastern Alberta. The major feature of the belt is that it is one of the most radioactive regions so far recognized in the Canadian Shield. Potassium, uranium, and thorium are all enriched but the greatest increase is in thorium. The dominant rock type underlying the area is a foliated porphyritic granite. This rock contains an average of about 80 ppm thorium (with areas of tens of square kilometres containing up to 200 ppm) and approximately 11 ppm uranium. In places, dark elongate zones rich in biotite, apatite, and opaque minerals within the porphyritic granite may contain an order of magnitude more uranium and thorium than the porphyry. Radioactive minerals within both the porphyry and the dark zones are principally monazite (containing up to 16% ThO 2 ) and isolated grains of uraninite. This foliated porphyritic granite is interpreted as being pre- or syntectonic with respect to the Hudsonian event because its foliation parallels that of the surrounding rocks. There has been subsequent deformation. The second characteristic feature of the Fort Smith Belt is the development of a peripheral zone where eU is enriched relative to eTh correlating mainly with granitoid rocks which surround the thorium-rich area and wherein ratios of eU/eTh exceed 1:2 (compared to the crustal average of 1:4). Uranium may have moved laterally into this marginal area from the thorium-rich porphyry, possibly in a vapour phase. There is a possibility that concentrations of uranium as well as other metals such as Cu, Mo, Zn, Sn, and W could exist in the porphyry and its margin in appropriate chemical and/or structural traps. The radioactive granite rocks of the Fort Smith Belt are adjacent to uranium-thorium occurrences in the nearby Proterozoic Nonacho sediments but whether or not a genetic relationship exists between the two situations is uncertain. (auth)

A Record Linkage Protocol for a Diabetes Registry at Ethnically Diverse Community Health Centers

OpenAIRE

Maizlish, Neil A.; Herrera, Linda

2005-01-01

Community health centers serve ethnically diverse populations that may pose challenges for record linkage based on name and date of birth. The objective was to identify an optimal deterministic algorithm to link patient encounters and laboratory results for hemoglobin A1c testing and examine its variability by health center site, patient ethnicity, and other variables. Based on data elements of last name, first name, date of birth, gender, and health center site, matches with ≥50% to < 100% o...

Estimate the Health Literacy in Health Centers in the Border of Yazd City: Cross sectional study

Directory of Open Access Journals (Sweden)

Sakineh Gerayllo

2017-06-01

Conclusion: Health literacy of women in general was unacceptable, and recommendations were made to establish continuous training for women to improve their views. Also consideration should be given to centers to plan the transformation of health literacy which has been launched, to increase the Health literacy of the population being studied as recipients of health services.

Spaceflight Radiation Health program at the Lyndon B. Johnson Space Center

Energy Technology Data Exchange (ETDEWEB)

Johnson, A.S.; Badhwar, G.D.; Golightly, M.J.; Hardy, A.C.; Konradi, A.; Yang, T.C.

1993-12-01

The Johnson Space Center leads the research and development activities that address the health effects of space radiation exposure to astronaut crews. Increased knowledge of the composition of the environment and of the biological effects of space radiation is required to assess health risks to astronaut crews. The activities at the Johnson Space Center range from quantification of astronaut exposures to fundamental research into the biological effects resulting from exposure to high energy particle radiation. The Spaceflight Radiation Health Program seeks to balance the requirements for operational flexibility with the requirement to minimize crew radiation exposures. The components of the space radiation environment are characterized. Current and future radiation monitoring instrumentation is described. Radiation health risk activities are described for current Shuttle operations and for research development program activities to shape future analysis of health risk.

Spaceflight Radiation Health program at the Lyndon B. Johnson Space Center

International Nuclear Information System (INIS)

Johnson, A.S.; Badhwar, G.D.; Golightly, M.J.; Hardy, A.C.; Konradi, A.; Yang, T.C.

1993-12-01

The Johnson Space Center leads the research and development activities that address the health effects of space radiation exposure to astronaut crews. Increased knowledge of the composition of the environment and of the biological effects of space radiation is required to assess health risks to astronaut crews. The activities at the Johnson Space Center range from quantification of astronaut exposures to fundamental research into the biological effects resulting from exposure to high energy particle radiation. The Spaceflight Radiation Health Program seeks to balance the requirements for operational flexibility with the requirement to minimize crew radiation exposures. The components of the space radiation environment are characterized. Current and future radiation monitoring instrumentation is described. Radiation health risk activities are described for current Shuttle operations and for research development program activities to shape future analysis of health risk

The Fall of Fort Eben Emael: The Effects of Emerging Technologies on the Successful Completion of Military Objectives

Science.gov (United States)

2004-06-18

of Sickle,” World War II Magazine, November 2003, 59. 11Ibid., 60. 12Abbeville is 100 miles north of Paris near the English Channel. 13T. N. Mout... catacombs of Fort Eben Emael. A further understanding of the dynamics of the fort and her defenders can be gained by the knowledge that that fort was...Green Devils German Paratroopers 1939-45 ( Paris , France: Histories & Collections, 1997), 27. Helmut Wenzl (Left in photo) Born - 10 March

75 FR 39051 - Desoto Mills LLC, Fort Payne, AL; Notice of Negative Determination Regarding Application for...

Science.gov (United States)

2010-07-07

... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-73,416] Desoto Mills LLC, Fort... applicable to workers and former workers at Desoto Mills, LLC, a Subsidiary of Fruit of the Loom, Fort Payne... * * * locations outside the Desoto Mills Plant.'' The petitioner compares the situation at this location with...

FIND: Fort Calhoun Station, Unit 2

International Nuclear Information System (INIS)

Williams, W.H.

1976-07-01

This index is presented for the microfiche material of Docket 50548 which concerns the application of Omaha Public Power District to build and operate Fort Calhoun Station, Unit 2. The information includes both application and review material dated from September 1975 through March 1976. There are five amendments to the PSAR and one supplement to the ER which have been incorporated by reference into the respective reports. Docket RESAR-3 is used as a reference for portions of the PSAR

Tetanus Seroprevalence among Pregnant Women in Ben-U Sen Health Center in Diyarbakir

Directory of Open Access Journals (Sweden)

Ali Ceylan

2011-08-01

Full Text Available Aim: At the aim of this study was to determine the tetanus seroprevalence among pregnant women and childbearing aged woman living in the Ben-u Sen Health Center region that is in lower socio-economical level. Materials and methods: In this descriptive study, a team including the staff of health center and several volunteers visited the houses of pregnant women living in the health center coverage region and questionnaires were completed through face to face interviews. The study group included 214 pregnant women. Among them, serum samples of 197 subjects’ were studied for anti-toxic antibody for tetanus. For control, serum samples from 200 women living in the same health center region were collected. It was evaluated as partially protective, protective and longterm protection when tetanus antibody level was 0,01-<0,1 IU/ml, 0,1-<1.0 IU/ml and 1,0 IU/ml and over, respectively. Results: The mean age of the women was 26,4, mean marriage and first pregnancy ages were 17,9 and 18,9, respectively, and 40% of the subjects had never been examined or received follow up by a health center. It was revealed that 25.8% of the subjects were not protected and 74.2% had a full protection level of antibody. Within the control group, the same levels of antibodies were detected in 40.0% and 60.0% of the women, respectively. Conclusion: The study indicates that the immunity levels against tetanus are not satisfactory and every childbearing aged woman should be included in a vaccination program whenever they receive any examination in a health center. [TAF Prev Med Bull 2011; 10(4.000: 481-486

Medline Plus

Full Text Available ... Forest University Baptist Medical Center, Winston-Salem, NC, 12/16/13) Transesophageal Echocardiogram (TEE) (Shawnee Mission Medical ... Broward Health Medical Center, Fort Lauderdale, FL, 5/12/2014) Total Ankle Replacement (Doctors Hospital, Coral Gables, ...

Medline Plus

Full Text Available ... Medical Center, Fort Lauderdale, FL, 5/12/2014) Total Ankle Replacement (Doctors Hospital, Coral Gables, FL, 11/ ... City, UT, 11/20/2012) Anterior Approach to Total Hip Replacement (St. John's Health Center, Santa Monica, ...

Community health centers' impact on the political and economic environment: the Massachusetts example.

Science.gov (United States)

Hunt, James W

2005-01-01

Since their inception in 1965, community health centers have thrived against tough odds, including patchwork funding, an unpredictable public policy environment, and a volatile healthcare marketplace. Much of this long-term success has been attributed to the centers' ability to affect their economic and political environment. Massachusetts provides an excellent example of this outward orientation. It was here that the centers first took hold, grew rapidly as a result of grassroots activity, and came together as a group for advocacy and mutual assistance. This article examines the Massachusetts experience in light of the health centers' ability to survive and grow.

Coordinated Management of Academic Health Centers.

Science.gov (United States)

Balser, Jeffrey R; Stead, William W

2017-01-01

Academic health centers (AHCs) are the nation's primary resource for healthcare discovery, innovation, and training. US healthcare revenue growth has declined sharply since 2009, and is forecast to remain well below historic levels for the foreseeable future. As the cost of education and research at nearly all AHCs is heavily subsidized through large transfers from clinical care margins, our institutions face a mounting crisis. Choices centering on how to increase the cost-effectiveness of the AHC enterprise require unprecedented levels of alignment to preserve an environment that nurtures creativity. Management processes require governance models that clarify decision rights while harnessing the talents and the intellectual capital of a large, diverse enterprise to nimbly address unfamiliar organizational challenges. This paper describes key leadership tactics aimed at propelling AHCs along this journey - one that requires from all leaders a commitment to resilience, optimism, and willingness to embrace change.

ALARA and decommissioning: The Fort St. Vrain experience

Energy Technology Data Exchange (ETDEWEB)

Borst, T.; Niehoff, M. [Public Service Co. of Colorado, Platteville, CO (United States); Zachary, M. [Scientific Ecology Group, Platteville, CO (United States)

1995-03-01

The Fort St. Vrain Nuclear Generating Station, the first and only commercial High Temperature Gas Cooled Reactor to operate in the United States, completed initial fuel loading in late 1973 and initial startup in early 1974. Due to a series of non-nuclear technical problems, Fort St. Vrain never operated consistently, attaining a lifetime capacity factor of slightly less than 15%. In August of 1989, the decision was made to permanently shut down the plant due to control rod drive and steam generator ring header failures. Public Service Company of Colorado elected to proceed with early dismantlement (DECON) as opposed to SAFSTOR on the bases of perceived societal benefits, rad waste, and exposure considerations, regulatory uncertainties associated with SAFSTOR, and cost. The decommissioning of Fort St. Vrain began in August of 1992, and is scheduled to be completed in early 1996. Decommissioning is being conducted by a team consisting of Westinghouse, MK-Ferguson, and Scientific Ecology Group. Public Service Company of Colorado as the licensee provides contract management and oversight of contractor functions. An aggressive program to maintain project radiation exposures As Low As Reasonably Achievable (ALARA) has been established, with the following program elements: temporary and permanent shielding contamination control; mockup training; engineering controls; worker awareness; integrated work package reviews communication; special instrumentation; video camera usage; robotics application; and project committees. To date, worker exposures have been less than project estimates. from the start of the project through Februrary of 1994, total exposure has been 98.666 person-rem, compared to the project estimate of 433 person-rem and goal of 347 person-rem. The presentation will discuss the site characterization efforts, the radiological performance indicator program, and the final site release survey plans.

77 FR 72868 - The Centers for Disease Control (CDC)/Health Resources and Services Administration (HRSA...

Science.gov (United States)

2012-12-06

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention The Centers for Disease Control (CDC)/Health Resources and Services Administration (HRSA) Advisory Committee on HIV, Viral... announcements of meetings and other committee management activities, for both the Centers for Disease Control...

Opening remarks for the Fort Valley Centennial Celebration

Science.gov (United States)

G. Sam Foster

2008-01-01

The Rocky Mountain Research Station recognizes and values the contributions of our scientists and collaborators for their work over the past century at Fort Valley Experimental Forest. With the help of our partners and collaborators, Rocky Mountain Research Station is working to improve coordination across its research Program Areas and Experimental Forests and Ranges...

A visual progression of the Fort Valley Restoration Project treatments using remotely sensed imagery (P-53)

Science.gov (United States)

Joseph E. Crouse; Peter Z. Fule

2008-01-01

The landscape surrounding the Fort Valley Experimental Forest in northern Arizona has changed dramatically in the past decade due to the Fort Valley Restoration Project, a collaboration between the Greater Flagstaff Forest Partnership, Coconino National Forest, and Rocky Mountain Research Station. Severe wildfires in 1996 sparked community concern to start restoration...

Fortællinger om sorg og tab – når det personlige bliver socialt?

DEFF Research Database (Denmark)

Christensen, Dorthe Refslund; Sandvik, Kjetil

2016-01-01

Vi fortæller om døden, om det at miste og føle sorg. Kulturhistorisk er litteratur, teater og malerkunst scener for netop dette emne. Som socialt fænomen ser vi dog ikke i samme omfang fortællinger om død, tab og sorg, eftersom emnet typisk har været anskuet som et privat anliggende. Bestemte...

77 FR 47671 - TA-W-81,520, T-Mobile USA, Inc., Call Center, Allentown, PA; TA-W-81,520G, T-Mobile USA, Inc...

Science.gov (United States)

2012-08-09

... DEPARTMENT OF LABOR Employment and Training Administration TA-W-81,520, T-Mobile USA, Inc., Call Center, Allentown, PA; TA- W-81,520G, T-Mobile USA, Inc., Headquarters Office, Bellevue, WA; Amended... of T-Mobile USA, Inc., Call Center, Allentown, Pennsylvania (TA-W-81,520), Fort Lauderdale, Florida...

[The Psychosocial Adaptation Process of Psychiatric Nurses Working in Community Mental Health Centers].

Science.gov (United States)

Min, So Young

2015-12-01

The aim of this study was to verify psychosocial issues faced by psychiatric and community mental health nurse practitioners (PCMHNP) working in community mental health centers, and to identify the adaptation processes used to resolve the issues. Data were collected through in-depth interviews between December 2013 and August 2014. Participants were 11 PCMHNP working in community mental health centers. Analysis was done using the grounded theory methodology. The first question was "How did you start working at a community mental health center; what were the difficulties you faced during your employment and how did you resolve them?" The core category was 'regulating within relationships.' The adaptation process was categorized into three sequential stages: 'nesting,' 'hanging around the nest,' and 'settling into the nest.' Various action/interaction strategies were employed in these stages. The adaptation results from using these strategies were 'psychiatric nursing within life' and 'a long way to go.' The results of this study are significant as they aid in understanding the psychosocial adaptation processes of PCMHNP working in community mental health centers, and indicate areas to be addressed in the future in order for PCMHNP to fulfill their professional role in the local community.

Meeting baccalaureate public/community health nursing education competencies in nurse-managed wellness centers.

Science.gov (United States)

Thompson, Cheryl W; Bucher, Julia A

2013-01-01

The purpose of this article is to describe how community health competencies for baccalaureate nursing education have been met by locating clinical experiences in nurse-managed wellness centers. Such centers are an ideal setting for students to integrate theoretical concepts into clinical practice while building on previous learning. Students are able to develop skills in community health nursing practice at individual, family, and population level. In addition, the practice setting provides other advantages. Clients who represent a vulnerable population group receive valuable health services. Students gain learning opportunities that are broader than community health competencies, and faculty are provided clinical practice, research, and scholarship opportunities. The challenges to year-round sustainability of nurse-managed centers are burdensome; however, the benefits outweigh the difficulty of those challenges. Copyright © 2013 Elsevier Inc. All rights reserved.

Plan for radiological security at a university health center

International Nuclear Information System (INIS)

Huiaman Mendoza, G.M.; Sanchez Riojas, M.M.; Felix JImenez, D.

1998-01-01

This work shows a radiological security plan applied to a Basic Radiological Service at a university health center. Factors taken into account were installation designs, equipment operation parameters, work procedures, image system and responsibilities

Incidence and risk factors of urinary incontinence in women visiting Family Health Centers

OpenAIRE

K?l??, Meral

2016-01-01

Background The objective of this study is to determine the incidence and the risk factors of the urinary incontinence in women visiting the Health Family Center. Methods 430 women, who visited three Family Health Centers in the city center of Erzurum for any reason between 25 November and 20 January 2016, were included in this study without any sampling. The data were collected by using the face-to-face interview method. Percentage distribution, Chi square test, and logistic regression analys...

Results of the Community Health Applied Research Network (CHARN) National Research Capacity Survey of Community Health Centers.

Science.gov (United States)

Song, Hui; Li, Vivian; Gillespie, Suzanne; Laws, Reesa; Massimino, Stefan; Nelson, Christine; Singal, Robbie; Wagaw, Fikirte; Jester, Michelle; Weir, Rosy Chang

2015-01-01

The mission of the Community Health Applied Research Network (CHARN) is to build capacity to carry out Patient-Centered Outcomes Research at community health centers (CHCs), with the ultimate goal to improve health care for vulnerable populations. The CHARN Needs Assessment Staff Survey investigates CHCs' involvement in research, as well as their need for research training and resources. Results will be used to guide future training. The survey was developed and implemented in partnership with CHARN CHCs. Data were collected across CHARN CHCs. Data analysis and reports were conducted by the CHARN data coordinating center (DCC). Survey results highlighted gaps in staff research training, and these gaps varied by staff role. There is considerable variation in research involvement, partnerships, and focus both within and across CHCs. Development of training programs to increase research capacity should be tailored to address the specific needs and roles of staff involved in research.

A comparison of health behaviors of women in centering pregnancy and traditional prenatal care.

Science.gov (United States)

Shakespear, Kaylynn; Waite, Phillip J; Gast, Julie

2010-03-01

Researchers sought to determine the difference in health behaviors between women who receive prenatal care via the Centering Pregnancy approach and those involved in traditional prenatal care. Using a cross-sectional design, adult pregnant women (n = 125) were surveyed from at least 28 weeks gestation to delivery. The sample was comprised of primarily white low income women. Using multiple linear regression it was determined that women in Centering Pregnancy had significantly lower index health behavior scores compared with the traditional care group showing that those in Centering Pregnancy reported engaging in fewer health promoting behaviors. Furthermore, no differences were observed for smoking or weight gain behaviors between groups. Additionally, those in Centering Pregnancy reported a lower perceived value of prenatal care. The results of this study suggest that Centering Pregnancy is not adequately aiding its patients in adopting healthy behaviors during pregnancy.

Analysis and evaluation of recent operational experience from the Fort St. Vrain HTGR

International Nuclear Information System (INIS)

Moses, D.L.; Lanning, W.D.

1985-05-01

The Fort St. Vrain operating experience to be discussed here includes notable safety-related events which have occurred since late 1981 when ORNL was first contracted to provide technical assistance to AEOD. Earlier Fort St. Vrain operating experience through the time of successful full-power testing in November 1981 has been summarized by the licensee and the reactor vendor, GA Technologies, Inc. (GA), in papers presented at several different forums during 1982. In addition, extensive and very useful detailed evaluations of preoperational and startup testing and of the rise-to-power operating experience through completion of the first refueling outage in August 1979 have been compiled into a series of reports under the sponsorship of the Electric Power Research Institute (EPRI). Finally, the US Department of Energy's Fort St. Vrain Improvement Plan provides a summary of the major operational limits which have affected the plant since start-up. The events discussed here are categorized based on the major systems affected, namely, (1) primary system and reactor vessel, (2) electrical systems, and (3) the reactor building. In all cases to be discussed, the lessons to be learned are vigilance and prevention. These lessons translate into the need for the recognition and control of unexpected situations and of their potential for branching effects. At Fort St. Vrain, these lessons are found in the effects of moisture ingress, in the challenges experienced to the supply of essential electrical power, and in controlling the environment of the reactor building. 13 refs

Improving Pain Care with Project ECHO in Community Health Centers.

Science.gov (United States)

Anderson, Daren; Zlateva, Ianita; Davis, Bennet; Bifulco, Lauren; Giannotti, Tierney; Coman, Emil; Spegman, Douglas

2017-10-01

Pain is an extremely common complaint in primary care, and patient outcomes are often suboptimal. This project evaluated the impact of Project ECHO Pain videoconference case-based learning sessions on knowledge and quality of pain care in two Federally Qualified Health Centers. Quasi-experimental, pre-post intervention, with comparison group. Two large, multisite federally qualified health centers in Connecticut and Arizona. Intervention (N = 10) and comparison (N = 10) primary care providers. Primary care providers attended 48 weekly Project ECHO Pain sessions between January and December 2013, led by a multidisciplinary pain specialty team. Surveys and focus groups assessed providers' pain-related knowledge and self-efficacy. Electronic health record data were analyzed to evaluate opioid prescribing and specialty referrals. Compared with control, primary care providers in the intervention had a significantly greater increase in pain-related knowledge and self-efficacy. Providers who attended ECHO were more likely to use formal assessment tools and opioid agreements and refer to behavioral health and physical therapy compared with control providers. Opioid prescribing decreased significantly more among providers in the intervention compared with those in the control group. Pain is an extremely common and challenging problem, particularly among vulnerable patients such as those cared for at the more than 1,200 Federally Qualified Health Centers in the United States. In this study, attendance at weekly Project ECHO Pain sessions not only improved knowledge and self-efficacy, but also altered prescribing and referral patterns, suggesting that knowledge acquired during ECHO sessions translated into practice changes. © 2017 American Academy of Pain Medicine.

Mental health status of women in Jordan: a comparative study between attendees of governmental and UN relief and works agency's health care centers.

Science.gov (United States)

Al-Modallal, Hanan; Hamaideh, Shaher; Mudallal, Rula

2014-05-01

This study aimed at investigating differences in mental health problems between attendees of governmental and United Nations Relief and Works Agency for Palestine Refugees health care centers in Jordan. Further, predictors of mental health problems based on women's demographic profile were investigated. A convenience sample of 620 women attending governmental and United Nations Relief and Works Agency for Palestine Refugees health care centers in Jordan was recruited for this purpose. Independent samples t-tests were used to identify differences in mental health, and multiple linear regression was implemented to identify significant predictors of women's mental health problems. Results indicated an absence of significant differences in mental health problems between attendees of the two types of health care centers. Further, among the demographic indicators that were tested, income, spousal violence, and general health were the predictors of at least three different mental health problems in women. This study highlights opportunities for health professionals to decrease women's propensity for mental health problems by addressing these factors when treating women attending primary care centers in different Jordanian towns, villages, and refugee camps.

Customer Quality during Prenatal Care in Health Care Centers in Tabriz City

Directory of Open Access Journals (Sweden)

Jafar Sadegh Tabrizi

2015-07-01

Full Text Available Background and Objectives :  Customer Quality (CQ refers to customer’s characteristics and is concerned with the knowledge, skills and confidence of health services customers who actively participate with health team in proper decision-making, appropriate activities and changing environment and health related behaviors. The purpose of this study was measuring customer quality of pregnant women during prenatal care. Materials and Methods :  This is a cross- sectional study which was conducted with the participation of 185 pregnant women who received prenatal care from urban health centers in Tabriz city. All participants were selected randomly from 40 health centers. Customer quality was measured based on CQMH-CQ questionnaire.  Questionnaire content validity was reviewed and confirmed by 10 experts and its reliability was confirmed based on Cronbach's alpha index (α = 0.714. Spss v.17 was used for data analysis. Results : According to the results, the mean score of customer quality among pregnant women was (11.29± 67.79   and only %14 of the participants reported the highest customer quality score and ability of continuity of care under stressful situations. There was a positive relationship between customer quality score and visiting midwife and a better evaluation of overall quality of care, but there was inverse relationship with early registration at health centers. Conclusion :  The participation of pregnant women in service delivery process and decision-making can promote costumer quality. Furthermore, training health care providers in empowering patients and using their abilities to improve quality of care and paying attention to patient-centered care will be helpful. ​

Oral health in Brazil - Part II: Dental Specialty Centers (CEOs

Directory of Open Access Journals (Sweden)

Vinícius Pedrazzi

2008-08-01

Full Text Available The concepts of health promotion, self-care and community participation emerged during the 1970s and, since then, their application has grown rapidly in the developed world, showing evidence of effectiveness. In spite of this, a major part of the population in the developing countries still has no access to specialized dental care such as endodontic treatment, dental care for patients with special needs, minor oral surgery, periodontal treatment and oral diagnosis. This review focuses on a program of the Brazilian Federal Government named CEOs (Dental Specialty Centers, which is an attempt to solve the dental care deficit of a population that is suffering from oral diseases and whose oral health care needs have not been addressed by the regular programs offered by the SUS (Unified National Health System. Literature published from 2000 to the present day, using electronic searches by Medline, Scielo, Google and hand-searching was considered. The descriptors used were Brazil, Oral health, Health policy, Health programs, and Dental Specialty Centers. There are currently 640 CEOs in Brazil, distributed in 545 municipal districts, carrying out dental procedures with major complexity. Based on this data, it was possible to conclude that public actions on oral health must involve both preventive and curative procedures aiming to minimize the oral health distortions still prevailing in developing countries like Brazil.

An Evaluation of Army Wellness Center Clients' Health-Related Outcomes.

Science.gov (United States)

Rivera, L Omar; Ford, Jessica Danielle; Hartzell, Meredith Marie; Hoover, Todd Allan

2018-01-01

To examine whether Army community members participating in a best-practice based workplace health promotion program (WHPP) experience goal-moderated improvements in health-related outcomes. Pretest/posttest outcome evaluation examining an autonomously participating client cohort over 1 year. Army Wellness Center facilities on 19 Army installations. Army community members sample (N = 5703), mostly Active Duty Soldiers (64%). Assessment of health risks with feedback, health assessments, health education classes, and health coaching sessions conducted by health educators at a recommended frequency of once a month for 3 to 12 months. Initial and follow-up outcome assessments of body mass index (BMI), body fat, cardiorespiratory fitness, blood pressure, and perceived stress. Mixed model linear regression testing for goal-moderated improvements in outcomes. Clients experienced significant improvements in body fat (-2% change), perceived stress (-6% to -12% change), cardiorespiratory fitness (+6% change), and blood pressure (-1% change) regardless of health-related goal. Only clients with a weight loss goal experienced BMI improvement (-1% change). Follow-up outcome assessment rates ranged from 44% (N = 2509) for BMI to 6% (N = 342) for perceived stress. Army Wellness Center clients with at least 1 follow-up outcome assessment experienced improvements in military readiness correlates and chronic disease risk factors. Evaluation design and follow-up-related limitations notwithstanding results suggest that best practices in WHPPs can effectively serve a globally distributed military force.

Assessment of oral health attitudes and behavior among students of Kuwait University Health Sciences Center.

Science.gov (United States)

Ali, Dena A

2016-01-01

The aims of this study were to assess attitudes and behavior of oral health maintenance among students in four faculties (Medicine, Dentistry, Pharmacy, and Allied Health) and to compare oral health attitudes and behavior of all students at Kuwait University Health Sciences Center (KUHSC) based on their academic level. Students enrolled in the Faculties of Dentistry, Medicine, Pharmacy, and Allied Health at KUHSC were evaluated regarding their oral health attitudes and behavior by an e-mail invitation with a link to the Hiroshima University Dental Behavior Inventory survey that was sent to all 1802 students with Kuwait University Health Sciences Center e-mail addresses. The data were analyzed for frequency distributions, and differences among the groups were assessed using the Mann-Whitney U test, Chi-square test, and Kruskal-Wallis test. P values less than 0.05 were considered to be statistically significant ( P < 0.05). The results of this study indicated that dental students achieved better oral health attitudes and behavior than that of their nondental professional fellow students ( P < 0.05). Students in advanced academic levels and female students demonstrated better oral health attitudes and behavior. Dental students and students who were in advanced levels of their training along with female students demonstrated better oral health practices and perceptions than students in lower academic levels and male students, respectively. Additional studies for investigating the effectiveness and identifying areas requiring modification within the dental curriculum at KUHSC may be warranted.

Fort St. Vrain core performance

International Nuclear Information System (INIS)

McEachern, D.W.; Brown, J.R.; Heller, R.A.; Franek, W.J.

1977-07-01

The Fort St. Vrain High Temperature Gas Cooled Reactor core performance has been evaluated during the startup testing phase of the reactor operation. The reactor is graphite moderated, helium cooled, and uses coated particle fuel and on-line flow control to each of the 37 refueling regions. Principal objectives of startup testing were to determine: core and control system reactivity, radial power distribution, flow control capability, and initial fission product release. Information from the core demonstrates that Technical Specifications are being met, performance of the core and fuel is as expected, flow and reactivity control are predictable and simple for the operator to carry out

Third party testing : new pilot facility for mining processes opens in Fort McKay

International Nuclear Information System (INIS)

Jaremko, D.

2007-01-01

Fort McKay lies 65 kilometres north of Fort McMurray, Alberta and is the centre of operational oilsands mining activity. As such, it was chosen for a pilot testing facility created by the Geneva-based SGS Group. The reputable facility provides an opportunity for mining producers to advance their processes, including environmental performance, by allowing them to test different processes on their own oilsands. The Northern Lights partnership, led by Synenco Energy, was the first client at the facility. Due to outsourcing, clients are not obligated to make substantial capital investment into in-house research. The Northern Lights partnership will be using the facility to test extraction processes on bitumen from its leases. Although the Fort McKay facility is SGS's first venture into the oilsands industry, it operates in more than 140 companies globally, including the mineral industry, and specializes in inspection, verification, testing and certification. SGS took the experience from its minerals extraction business to identify what could be done to help the oilsands industry by using best practices developed from global operations. The facility lies on the Fort McKay industrial park owned by the Fort McKay First Nation. An existing testing facility called McMurray Resources Research and Testing was expanded by the SGS Group to include environmental analysis capabilities. The modular units that lie on 6 acres include refrigerated ore storage to maintain ore integrity; modular ore and materials handling systems; extraction equipment; and, zero discharge process water and waste disposal systems. Froth treatment will be added in the near future to cover the entire upstream side of the mining processing business. A micro-upgrader might be added in the future to manufacture synthetic crude. 3 figs

Third party testing : new pilot facility for mining processes opens in Fort McKay

Energy Technology Data Exchange (ETDEWEB)

Jaremko, D.

2007-12-15

Fort McKay lies 65 kilometres north of Fort McMurray, Alberta and is the centre of operational oilsands mining activity. As such, it was chosen for a pilot testing facility created by the Geneva-based SGS Group. The reputable facility provides an opportunity for mining producers to advance their processes, including environmental performance, by allowing them to test different processes on their own oilsands. The Northern Lights partnership, led by Synenco Energy, was the first client at the facility. Due to outsourcing, clients are not obligated to make substantial capital investment into in-house research. The Northern Lights partnership will be using the facility to test extraction processes on bitumen from its leases. Although the Fort McKay facility is SGS's first venture into the oilsands industry, it operates in more than 140 companies globally, including the mineral industry, and specializes in inspection, verification, testing and certification. SGS took the experience from its minerals extraction business to identify what could be done to help the oilsands industry by using best practices developed from global operations. The facility lies on the Fort McKay industrial park owned by the Fort McKay First Nation. An existing testing facility called McMurray Resources Research and Testing was expanded by the SGS Group to include environmental analysis capabilities. The modular units that lie on 6 acres include refrigerated ore storage to maintain ore integrity; modular ore and materials handling systems; extraction equipment; and, zero discharge process water and waste disposal systems. Froth treatment will be added in the near future to cover the entire upstream side of the mining processing business. A micro-upgrader might be added in the future to manufacture synthetic crude. 3 figs.

Use of qualitative methods and user-centered design to develop customized health information technology tools within federally qualified health centers to keep children insured.

Science.gov (United States)

DeVoe, Jennifer; Angier, Heather; Likumahuwa, Sonja; Hall, Jennifer; Nelson, Christine; Dickerson, Kay; Keller, Sara; Burdick, Tim; Cohen, Deborah

2014-01-01

Lack of health insurance negatively impacts children's health. Despite federal initiatives to expand children's coverage and accelerate state outreach efforts, millions of US children remain uninsured or experience frequent gaps in coverage. Most current efforts to enroll and retain eligible children in public insurance programs take place outside of the health care system. This study is a partnership between patients' families, medical informaticists, federally qualified health center (FQHC) staff, and researchers to build and test information technology tools to help FQHCs reach uninsured children and those at risk for losing coverage.

Stennis Space Center observes 2009 Safety and Health Day

Science.gov (United States)

2009-01-01

Sue Smith, a medical clinic employee at NASA's John C. Stennis Space Center, takes the temperature of colleague Karen Badon during 2009 Safety and Health Day activities Oct. 22. Safety Day activities included speakers, informational sessions and a number of displays on safety and health issues. Astronaut Dominic Gorie also visited the south Mississippi rocket engine testing facility during the day to address employees and present several Silver Snoopy awards for outstanding contributions to flight safety and mission success. The activities were part of an ongoing safety and health emphasis at Stennis.

Patient Engagement in Community Health Center Leadership: How Does it Happen?

Science.gov (United States)

Sharma, Anjana E; Huang, Beatrice; Knox, Margae; Willard-Grace, Rachel; Potter, Michael B

2018-05-18

Patient engagement in primary care leadership is an important means to involve community voices at community health centers. Federally qualified health centers (FQHCs) are mandated to have patient representation within their governing boards, while practices seeking patient-centered medical home certification receive credit for implementing patient advisory councils (PACs). Our objective was to compare and contrast how community health centers engage patients in clinic management, decision-making and planning within governing boards versus PACs. Qualitative study conducted from August 2016 to June 2017 at community health centers in California, Arizona and Hawaii. We interviewed practice leaders of patient engagement programs at their site. Eligible clinics had patient representatives within their governing board, PAC, or both. We assessed patient demographics, roles and responsibilities of patients participating, and extent of involvement in quality improvement among governing boards versus PACs. We interviewed 19 sites, of which 17 were FQHCs that had governing boards. Of the 17 FQHCs, 11 had also implemented PACs. Two non-FQHC safety-net sites had PACs but did not have governing boards. Governing board members had formal, structured membership responsibilities such as finances and hiring personnel. PAC roles were more flexible, focusing on day-to-day clinic operations. Clinics tended to recruit governing board patient members for their skill set and professional experience; PAC member recruitment focused more on demographic representation of the clinic's patient population. Both groups worked on quality improvement, but governing boards tended to review clinic performance metrics, while PAC members were involved in specific project planning and implementation to improve clinical outcomes and patient experience. Patient involvement in clinic improvement in CHCs includes higher-level decision-making and governance through mechanisms such as governing boards, as

Rail Outloading Capability Study, Fort Polk, Louisiana,

Science.gov (United States)

1977-06-01

regardless of experience, to avoid wasted man -hours. The main problem at Fort Polk is that no blocking and bracing material stockpile exists and no...ti1 hottul only thtrough the 0111crinost hole; to defect within 20 days after it is determined to -tuit Owt ttrtk in tuse. III thle caste of classes 3...wheels, slipping, or similar trak (meh causes. 1 -------------------- (12) " Shelly spots" means a condition 2 ------------------------ % where a thin

A Study of Children's Geographic Access to Health Services (Health Care Centers and Clinical Laboratories in Kermanshah City, Iran

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Sohyla Reshadat

2018-02-01

Full Text Available Background Given that the protection of children's health is of special importance due to their special age and physical conditions, the present study aimed to investigate the condition of children's Geographic access to health services (Health Centers and Clinical Laboratories in Kermanshah city, Iran. Materials and Methods: In this applied study, the research approach was descriptive-analytic using quantitative models in Geographic information system (GIS environment. The statistical population was the whole population of young girls aged 0-14 years old in Kermanshah, Iran. Moreover, to evaluate the spatial deployment pattern of health services and the correct and true access of this groupto such services, all data and information were collected through the Iranian Statistics Center and evaluated using the Arc-GIS Software. The latest published population statistics on the Population and Housing Census in 2011 were considered the basis for the analyses. Results: The results of the present study demonstrated that more than 40% and 60% of the young girls aged 0-14 years old in Kermanshah were deprived of proper access to health centers and clinical laboratories, respectively. In terms of the status of children’s access in the Second Scenario (access to health services by vehicles and during 5, 10, and 15 minutes, about 5.53%, 93.1% and 15.1% lacked access to health centers, respectively. In addition, in terms of the status of children’s access to clinical laboratories during 5, 10, and 15 minutes, 17.26%, 65.4% and 51% lacked access to clinical laboratories, respectively. Conclusion: The access of young girls aged 0-14 years old to health services in Kermanshah was undesirable in the access to health services through walking. Additionally, the access of this groupto health services in the access to health services by vehicles was far better than the first one.

78 FR 78380 - Notice of Inventory Completion: U.S. Department of the Interior, National Park Service, Fort...

Science.gov (United States)

2013-12-26

... completion of an inventory of human remains under the control of Fort Bowie National Historic Site, Bowie, AZ....R50000] Notice of Inventory Completion: U.S. Department of the Interior, National Park Service, Fort... completed an inventory of human remains, in consultation with the appropriate Indian tribes or Native...

Fra erfaringer til betydninger: Tolkning af fortællinger om eksamensgruppebegivenheder fra folkeskolelærerstuderende ved Aalborg Seminarium

DEFF Research Database (Denmark)

Silleborg, Ellen

2004-01-01

karakter. Denne situation giveruoverensstemmelser i de studerendes følelsesliv, og hovedparten af fortællingerne afspejler en i mange henseender konfliktfyldt eksamensgruppeproces. I fortællingernes betydninger ses en loyal men privatiseret etik, hvor ansvarlighed bliver til selvskyld. Alle implicerede...

La fouille du fort Saint-Georges à Chinon (Indre-et-Loire. Premiers résultats The excavation of fort Saint-Georges at Chinon (Indre-et-Loire. First results

Directory of Open Access Journals (Sweden)

Bruno Dufaÿ

2006-05-01

Full Text Available Cette note présente les premiers résultats des fouilles menées en 2003 et 2004 sur la quasi-totalité du fort Saint-Georges à Chinon (Indre-et-Loire. Celui-ci est l’un des trois éléments de la forteresse médiévale qui domine la ville. La fouille a permis de préciser la fonction du fort, construit dans la deuxième moitié du XIIe s., à l’époque où Chinon est le centre administratif des possessions continentales des Plantagenêt, rois d’Angleterre. Du point de vue militaire, il formait une fortification avancée, protégeant le château principal, selon une structure que Richard Cœur de Lion appliquera au Château Gaillard. À l’intérieur, de vastes bâtiments constituaient des logis, conçus peut-être au départ pour héberger la chancellerie royale.This article presents the first results of the excavations undertaken in 2003 and 2004 over almost all of the Fort Saint-Georges at Chinon (Indre-et-Loire, one of three elements of the medieval fortress which dominates the town. The excavation enabled us to clarify the function of the fort, built in the 2nd half of the 12th century at a time when Chinon was the administrative centre of the continental possesions of the Plantagenet King of England. From a military point of view, it formed an advanced fortification protecting the main castle, within a structure that Richard the Lionheart would apply to the Chayeau Gaillard. Inside, some vast buildings made up the dwellings, designed perhaps initially to house the royal chanceller.

University of Washington Center for Child Environmental Health Risks Research

Data.gov (United States)

Federal Laboratory Consortium — The theme of the University of Washington based Center for Child Environmental Health Risks Research (CHC) is understanding the biochemical, molecular and exposure...

Health professionals' job satisfaction and associated factors at public health centers in West Ethiopia.

Science.gov (United States)

Deriba, Beyazin Kebede; Sinke, Shimele Ololo; Ereso, Berhane Megersa; Badacho, Abebe Sorsa

2017-05-30

Human resources are vital for delivering health services, and health systems cannot function effectively without sufficient numbers of skilled, motivated, and well-supported health workers. Job satisfaction of health workers is important for motivation and efficiency, as higher job satisfaction improves both employee performance and patient satisfaction. Even though several studies have addressed job satisfaction among healthcare professionals in different part of the world, there are relatively few studies on healthcare professionals' job satisfaction in Ethiopia. A facility-based cross-sectional study was conducted among health professionals working in health centers in April 2015 using self-administered structured questionnaires. All 322 health professionals working in 23 randomly selected public health centers were included. Factor scores were computed for the identified items by varimax rotation to represent satisfaction. Multivariate linear regression analysis was performed, and the effect of independent variables on the regression factor score quantified. Three hundred eight respondents participated with a response rate of 95.56%. The overall level of job satisfaction was 41.46%. Compensation (benefits) (beta 0.448 [95% CI 0.341 to 0.554]), recognition by management (beta 0.132 [95% CI 0.035 to 0.228]), and opportunity for development (beta 0.123 [95% CI 0.020 to 0.226]) were associated with job satisfaction. A unit increase in salary and incentives and recognition by management scores resulted in 0.459 (95% CI 0.356 to 0.561) and 0.156 (95% CI 0.065 to 0.247) unit increases in job satisfaction scores, respectively. The overall level of job satisfaction in health professionals was low. Salary and incentives, recognition by management, developmental opportunities, and patient appreciation were strong predictors of job satisfaction.

Investigating Medication Errors in Educational Health Centers of Kermanshah

Directory of Open Access Journals (Sweden)

Mohsen Mohammadi

2015-08-01

Full Text Available Background and objectives : Medication errors can be a threat to the safety of patients. Preventing medication errors requires reporting and investigating such errors. The present study was conducted with the purpose of investigating medication errors in educational health centers of Kermanshah. Material and Methods: The present research is an applied, descriptive-analytical study and is done as a survey. Error Report of Ministry of Health and Medical Education was used for data collection. The population of the study included all the personnel (nurses, doctors, paramedics of educational health centers of Kermanshah. Among them, those who reported the committed errors were selected as the sample of the study. The data analysis was done using descriptive statistics and Chi 2 Test using SPSS version 18. Results: The findings of the study showed that most errors were related to not using medication properly, the least number of errors were related to improper dose, and the majority of errors occurred in the morning. The most frequent reason for errors was staff negligence and the least frequent was the lack of knowledge. Conclusion: The health care system should create an environment for detecting and reporting errors by the personnel, recognizing related factors causing errors, training the personnel and create a good working environment and standard workload.

NIEHS/EPA CEHCs: Children's Environmental Health and Disease Prevention Center - Dartmouth College

Science.gov (United States)

The Columbia Center for Children’s Environmental Health (CCCEH) at Columbia University studies long-term health of urban pollutants on children raised in minority neighborhoods in inner-city communities.

75 FR 42448 - Board of Scientific Counselors (BSC), Coordinating Center for Health Promotion (CCHP): Notice of...

Science.gov (United States)

2010-07-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention (CDC) Board of Scientific Counselors (BSC), Coordinating Center for Health Promotion (CCHP): Notice of Charter Amendment... Disease Prevention and Health Promotion (NCCDPHP). [[Page 42449

Patients' satisfaction evaluation with the health center of elis province.

Science.gov (United States)

Karavida, Angeliki; Stamouli, Maria-Aggeliki; Balis, Charalampos

2014-01-01

Patient satisfaction related to the provided health services is a key indicator of the quality of the health sector. The SERVQUAL model was employed as a way of measuring the level of patient satisfaction with the services of the Health Center of Elis Province. Although certain aspects such as "Assurance" and "Empathy" meet the users' needs, improvements like a detailed medical record and an overhaul of the equipment need to be introduced.

Sex Workers and HIV/AIDS: Analyzing Participatory Culture-Centered Health Communication Strategies

Science.gov (United States)

Basu, Ambar; Dutta, Mohan J.

2009-01-01

An emerging trend in health communication research advocates the need to foreground articulations of health by participants who are at the core of any health campaign. Scholarly work suggests that the culture-centered approach to health communication can provide a theoretical and practical framework to achieve this objective. The culture-centered…

75 FR 78997 - Centers for Disease Control and Prevention/Health Resources and Services Administration (CDC/HRSA...

Science.gov (United States)

2010-12-17

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Centers for Disease Control and Prevention/Health Resources and Services Administration (CDC/HRSA) Advisory Committee... and other committee management activities, for both the Centers for Disease Control and Prevention and...

Piloting CenteringParenting in Two Alberta Public Health Well-Child Clinics.

Science.gov (United States)

Johnston, Jennifer Cyne; McNeil, Deborah; van der Lee, Germaeline; MacLeod, Cheryl; Uyanwune, Yvonne; Hill, Kaitlyn

2017-05-01

To pilot a group health service delivery model, CenteringParenting, for new parents, to assess its feasibility and impact on maternal and infant outcomes. Families attended six, 2-hr group sessions in their child's first year of life with three to seven other families. Health assessments, parent-led discussions, and vaccinations occurred within the group. Demographic, breastfeeding, vaccination, maternal psychosocial health, parenting, and satisfaction data were collected and compared to a representative cohort. Four groups ran in two clinics. Four to eight parent/infant dyads participated in each group, 24 total dyads. Most participating parents were mothers. Dyads in the group model received 12 hr of contact with Public Health over the year compared to 3 hr in the typical one-on-one model. Participants were younger, more likely to have lower levels of education, and lower household income than the comparison group. Parents reported improvements in parenting experiences following the program. At 4 months, all CenteringParenting babies were vaccinated compared to 95% of babies in the comparison group. The pilot was successfully completed. Additional research is required to examine the effectiveness of CenteringParenting. Data collected provide insight into potential primary outcomes of interest and informs larger, rigorously designed longitudinal studies. © 2016 Wiley Periodicals, Inc.

Factors Affecting Sexual History Taking in a Health Center Serving Homeless Persons.

Science.gov (United States)

Sowicz, Timothy Joseph; Bradway, Christine K

2018-03-01

Low rates of documentation of sexual histories have been reported and research on sexual history taking (SHT) has focused on the content of, barriers to collecting, and interventions to improve documentation of sexual histories. Absent from this literature is an understanding of the contextual factors affecting SHT. To address this gap, a focused ethnography of one health center was conducted. Data were collected through observations of health care encounters and interviews with health care providers (HCPs). No SHT was observed and this was likely influenced by patients' characteristics, communication between patients and HCPs, the prioritization of patients' basic needs, and time constraints imposed upon encounters. Given that the health center studied serves patients experiencing homelessness, behavioral health concerns, and opioid use disorder, findings illuminate areas for future inquiry into a patient population affected by social as well as physiologic determinants of health and potentially at high risk for adverse sexual health outcomes.

77 FR 37318 - Eighth Coast Guard District Annual Safety Zones; Sound of Independence; Santa Rosa Sound; Fort...

Science.gov (United States)

2012-06-21

...-AA00 Eighth Coast Guard District Annual Safety Zones; Sound of Independence; Santa Rosa Sound; Fort... Coast Guard will enforce a Safety Zone for the Sound of Independence event in the Santa Rosa Sound, Fort... during the Sound of Independence. During the enforcement period, entry into, transiting or anchoring in...

Forest pathology and entomology at Fort Valley Experimental Forest

Science.gov (United States)

Brian W. Geils

2008-01-01

Forest pathology and entomology have been researched at Fort Valley Experimental Forest throughout its history. The pathogens and insects of particular interest are mistletoes, decay and canker fungi, rusts, bark beetles, and various defoliators. Studies on life history, biotic interactions, impacts, and control have been published and incorporated into silvicultural...

Medline Plus

Full Text Available ... Center, Fort Lauderdale, FL, 5/12/2014) Back Pain SI (Sacroiliac) Fusion Surgery (Broward Health Coral Springs, ... SC, 6/14/2013) Brain and Nerves Back Pain SI (Sacroiliac) Fusion Surgery (Broward Health Coral Springs, ...

Bioequivalence of fixed-dose combination Myrin®-P Forte and reference drugs in loose combination.

Science.gov (United States)

Wang, H F; Wang, R; O'Gorman, M; Crownover, P; Naqvi, A; Jafri, I

2013-12-01

Myrin®-P Forte is a fixed-dose combination (FDC) tablet containing rifampicin (RMP, 150 mg), isoniazid (INH, 75 mg), ethambutol (EMB) hydrochloride (275 mg) and pyrazinamide (PZA, 400 mg) developed for the treatment of tuberculosis (TB). This study was conducted at a single centre--the Pfizer Clinical Research Unit in Singapore. To demonstrate the bioequivalence of each drug component of the Myrin-P Forte FDC and the individual product in loose combination. In a randomized, open-label, single-dose, two-way, crossover study, subjects received single doses of Myrin-P Forte or four individual products under fasting conditions in a crossover fashion with at least 7 days washout between doses. The primary measures for comparison were peak plasma concentration (C(max)) and the area under plasma concentration-time curve (AUC). Of 36 subjects enrolled, 35 completed the study. The adjusted geometric mean ratios and 90% confidence intervals for C(max) and AUC values were completely contained within bioequivalence limits (80%, 125%) for all four drugs in both formulations. Both treatments were generally well tolerated in the study. The Myrin-P Forte FDC tablet formulation is bioequivalent to the four single-drug references for RMP, INH, EMB hydrochloride and PZA at equivalent doses.

Primary coolant chemistry of the Peach Bottom and Fort St. Vrain high-temperature gas-cooled reactors

International Nuclear Information System (INIS)

Burnette, R.D.; Baldwin, N.L.

1980-11-01

The chemical impurities in the primary coolants of the Peach Bottom and Fort St. Vrain reactors are discussed. The impurity mixtures in the two plants were quite different because the sources of the impurities were different. In the Peach Bottom reactor, the impurities were dominated by H 2 and CH 4 , which are decomposition products of oil. In the Fort St. Vrain reactor, there were high levels of CO, CO 2 , and H 2 O. Although oil ingress at Peach Bottom created carbon deposits on virtually all surfaces, its effect on reactor operation was negligible. Slow outgassing of water from the thermal insulation at Fort St. Vrain caused delays in reactor startup. The overall graphite oxidation in both plants was negligible

Primary coolant chemistry of the Peach Bottom and Fort St. Vrain high temperature gas-cooled reactors

International Nuclear Information System (INIS)

Burnette, R.D.; Baldwin, N.L.

1981-01-01

The chemical impurities in the primary coolants of the Peach Bottom and Fort St. Vrain reactors are discussed. The impurity mixtures in the two plants were quite different because the sources of the impurities were different. In the Peach Bottom reactor, the impurities were dominated by H 2 and CH 4 , which are decomposition products of oil. In the Fort St. Vrain reactor, there were high levels of CO, CO 2 , and H 2 O. Although oil ingress at Peach Bottom created carbon deposits on virtually all surfaces, its effect on reactor operation was negligible. Slow outgassing of water from the thermal insulation at Fort St. Vrain caused delays in reactor startup. The overall graphite oxidation in both plants was negligible. (author)

Referral Practices Among U.S. Publicly Funded Health Centers That Offer Family Planning Services.

Science.gov (United States)

Carter, Marion W; Robbins, Cheryl L; Gavin, Loretta; Moskosky, Susan

2018-01-29

Referrals to other medical services are central to healthcare, including family planning service providers; however, little information exists on the nature of referral practices among health centers that offer family planning. We used a nationally representative survey of administrators from 1,615 publicly funded health centers that offered family planning in 2013-14 to describe the use of six referral practices. We focused on associations between various health center characteristics and frequent use of three active referral practices. In the prior 3 months, a majority of health centers (73%) frequently asked clients about referrals at clients' next visit. Under half (43%) reported frequently following up with referral sources to find out if their clients had been seen. A third (32%) of all health centers reported frequently using three active referral practices. In adjusted analysis, Planned Parenthood clinics (adjusted odds ratio 0.55) and hospital-based clinics (AOR 0.39) had lower odds of using the three active referral practices compared with health departments, and Title X funding status was not associated with the outcome. The outcome was positively associated with serving rural areas (AOR 1.39), having a larger client volume (AOR 3.16), being a part of an insurance network (AOR 1.42), and using electronic health records (AOR 1.62). Publicly funded family planning providers were heavily engaged in referrals. Specific referral practices varied widely and by type of care. More assessment of these and other aspects of referral systems and practices is needed to better characterize the quality of care.

Caries risk assessment tool and prevention protocol for public health nurses in mother and child health centers, Israel.

Science.gov (United States)

Natapov, Lena; Dekel-Markovich, Dan; Granit-Palmon, Hadas; Aflalo, Efrat; Zusman, Shlomo Paul

2018-01-01

Dental caries is the most prevalent chronic disease in children. Caries risk assessment tools enable the dentists, physicians, and nondental health care providers to assess the individual's risk. Intervention by nurses in primary care settings can contribute to the establishment of oral health habits and prevention of dental disease. In Israel, Mother and Child Health Centers provide free preventive services for pregnant women and children by public health nurses. A caries prevention program in health centers started in 2015. Nurses underwent special training regarding caries prevention. A customized Caries Risk Assessment tool and Prevention Protocol for nurses, based on the AAPD tool, was introduced. A two-step evaluation was conducted which included a questionnaire and in-depth phone interviews. Twenty-eight (out of 46) health centers returned a completed questionnaire. Most nurses believed that oral health preventive services should be incorporated into their daily work. In the in-depth phone interviews, nurses stated that the integration of the program into their busy daily schedule was realistic and appropriate. The lack of specific dental module for computer program was mentioned as an implementation difficulty. The wide use of our tool by nurses supports its simplicity and feasibility which enables quick calculation and informed decision making. The nurses readily embraced the tool and it became an integral part of their toolkit. We provide public health nurses with a caries risk assessment tool and prevention protocol thus integrating oral health into general health of infants and toddlers. © 2017 Wiley Periodicals, Inc.

Sexual Function in Breastfeeding Women in Family Health Centers of Tabriz, Iran, 2012

Directory of Open Access Journals (Sweden)

Jamileh Malakoti

2013-06-01

Full Text Available Introduction:There are conflicting evidences about the effects of breastfeeding on postpartum maternal sexual functioning. With regard to the methodological weaknesses of previous studies and cultural differences affecting their issue, the present study aims to evaluate sexual functions of lactating women and its components. Methods:This is a descriptive study in which 200 eligible postpartum women were selected from eight health centers of Tabriz (25 from each center. The eligible women were called and invited to attend the health center. The evaluation was performed using the Persian version of normalized questionnaire of the Female Sexual Function Index (FSFI. The participants’ sexual function scores above 28 were considered desirable (regarding the cut-off point mentioned in the Persian version of the questionnaire. Results:Almost all of the lactating women suffered from sexual dysfunctions. Regarding the sexual performance’s components the lowest scores were for libido and sexual arousal. Conclusion:According to the findings of the studies, in order to prevent the effects of sexual dysfunction on lactating women and their family members it is necessary to develop sexual health programs in health centers.

Renewable Energy Opportunities at Fort Hood, Texas

Energy Technology Data Exchange (ETDEWEB)

Chvala, William D.; Warwick, William M.; Dixon, Douglas R.; Solana, Amy E.; Weimar, Mark R.; States, Jennifer C.; Reilly, Raymond W.

2008-06-30

The document provides an overview of renewable resource potential at Fort Hood based primarily upon analysis of secondary data sources supplemented with limited on-site evaluations. The effort was funded by the U.S. Army Installation Management Command (IMCOM) as follow-on to the 2005 DoD Renewables Assessment. This effort focuses on grid-connected generation of electricity from renewable energy sources and also ground source heat pumps for heating and cooling buildings, as directed by IMCOM.

Hvorfor faldt de fra? Fortællinger om frafald på Global Studies

DEFF Research Database (Denmark)

Keiding, Tina Bering; Petersen, Sarah

2015-01-01

Rapporten formidlerresultaterne af en mindre kvalitativ undersøgelse af studerendes overvejelser og begrundelser for studieskift/-ophør på Globale Studier, Aarhus Universitet. Formålet er at få indblik i de faktorer, de studerende oplever, som afgørende for studieskift/-ophør. Rapporten er...... udarbejdet af Center for Undervisningsudvikling og Digitale Medier (CUDiM), Aarhus Universitet. Undersøgelsen er initieret af Globale Studier, som et led i en strategisk indsats for at minimere frafaldet på uddannelserne. Notatet bekræfter forskningens pointer om at frafald er et komplekst fænomen, og at den......, Sommersel, & Søgaard Larsen 2013). Specifikt i forhold til Globale Studier peger undersøgelsen på både interne og eksterne forhold. Centrale temaer i de studerendes fortællinger er: Manglende karrierefortællinger, og udfordringer i spændingsfeltet mellem beskeden sproglig progression, en stor arbejdsindsats...

Hypertension care at primary health care centers: a report from Abha, Saudi Arabia.

Science.gov (United States)

Al-Homrany, Mohammed A; Khan, Mohd Yunus; Al-Khaldi, Yahia Mater; Al-Gelban, Khalid S; Al-Amri, Hasan Saed

2008-11-01

It is well known that effective management of hypertension reduces the incidence of myo-cardial infarction, stroke and vascular complications. The Ministry of Health, Kingdom of Saudi Arabia, introduced the Quality Assurance Guidelines with the hope to improve the management of hypertension in its centers. We conducted an audit of two Primary Health Care Centers namely, Al-Manhal (MPHCC) and Al-Numais (NPHCC), to evaluate how well hypertension was managened at these centers. A check list was derived from the Quality Assurance Manual to audit the process and to assess the health outcome. A retrospective study on a chosen sample of 120 files of hypertensive patients, out of 256 from both the Primary Health Care Centers was performed, during the last three months of the year 2000. Results showed that 61% of the patients were between 45-64 years of age, 56% were females, 85% were married, 54% were illiterate and 7.5% were smokers. A total of 92% of the patients had primary hypertension and 25% had a positive family history of hypertension. Beta-blockers were the most commonly used drugs in both the centers. Although the recording of the information was not perfect, there was no statistical difference in the socio-demongraphic data and also the means of the total score in both the centres. On the other hand, carrying out the important procedures for hypertensive patients was found to be better at MPHCC in comparison to NPHCC (p compliance to appointment in both the centers. Our study reveals that the process of hypertension care at the two Primary Health Care Centres in Aseer region was not in accordance with the recommended national standards. The reasons include lack of updating systems, recall system and provision of laboratory services and all these factors need to be addressed to improve care.

Calculation of Void in the Fort Saint Vrain Material

Energy Technology Data Exchange (ETDEWEB)

Potter, David Charles [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Taylor, Craig Michael [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Coons, James Elmer [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2017-05-11

The percent void of the Fort Saint Vrain (FSV) material is estimated to be 21.1% based on the volume of the gap at the top of the drums, the volume of the coolant channels in the FSV fuel element, and the volume of the fuel handling channel in the FSV fuel element.

Hydrogeochemical cycling and chemical denudation in the Fort River Watershed, central Massachusetts: An appraisal of mass-balance studies

Science.gov (United States)

Yuretich, Richard F.; Batchelder, Gail L.

1988-01-01

The Fort River watershed in central Massachusetts receives precipitation with a composition similar to that in Hubbard Brook (New Hampshire), yet the average stream water chemistry is substantially different, showing higher pH and TDS. This is largely a function of bedrock and surficial geology, and chemical differences among small streams within the Fort River watershed are apparently controlled by the composition and thickness of the prevailing surficial cover. The surficial deposits determine groundwater and surface water flow paths, thereby affecting the resultant contact time with mineral matter and the chemistry of the runoff. Despite the rural setting, over 95% of the annual sodium and chloride in the streams comes from road salt; after correcting for this factor, cation denudation rates are about equal to those at Hubbard Brook. However, silica removal is occurring at a rate more than 30% greater in the Fort River. When climatic conditions in Hubbard Brook and Fort River are normalized, weathering rates appear consistently higher in the Fort River, reflecting differences in weathering processes (i.e., cation exchange and silicate breakdown) and hydrogeology. Because of uncertainties in mechanisms of cation removal from watersheds, the silica denudation rate may be a better index of weathering intensity.

Sustainability Analysis of the Water Resources and Supply of the Vieux Fort Region of Saint Lucia

Science.gov (United States)

Coles, D.; Johnson, B.; Morgan, F.

2005-05-01

In the Vieux Fort region of the Caribbean island of St. Lucia, water needs are becoming acute. The water supply shortfalls during the dry season will continue to grow as population and development increase, unless action is taken. Actions to address the problem should include measures to optimize the present water delivery system and the development of a new supply, through new intakes, groundwater, or reservoir construction. An investigation into the potential for groundwater resources using electrical resistivity soundings indicated a likely pervasive, shallow aquitard of clay materials below the water table; the shallowness of this aquitard virtually precludes the existence of productive perched aquifers. Consequently, a model of Grande Riviere du Vieux Fort (Big Vieux Fort River) seasonal surface-water flow was developed, based on a digital elevation model and rainfall data, allowing us to analyze the possible productivity of any new intakes placed along the river. A specific site downstream of the present intake was recommended for potential development. Recommendations were given for short, medium and long-term development of the resources and supply of the Vieux Fort region of southern St. Lucia.

Energy efficiency campaign for residential housing at the Fort Lewis army installation

Energy Technology Data Exchange (ETDEWEB)

AH McMakin; RE Lundgren; EL Malone

2000-02-23

In FY1999, Pacific Northwest National Laboratory conducted an energy efficiency campaign for residential housing at the Fort Lewis Army Installation near Tacoma, Washington. Preliminary weather-corrected calculations show energy savings of 10{percent} from FY98 for energy use in family housing. This exceeded the project's goal of 3{percent}. The work was funded by the U.S. DOEs Federal Energy Management Program (FEMP), Office of Energy Efficiency and Renewable Energy. The project adapted FEMP's national ``You Have the Power Campaign'' at the local level, tailoring it to the military culture. The applied research project was designed to demonstrate the feasibility of tailored, research-based strategies to promote energy conservation in military family housing. In contrast to many energy efficiency efforts, the campaign focused entirely on actions residents could take in their own homes, as opposed to technology or housing upgrades. Behavioral change was targeted because residents do not pay their own utility bills; thus other motivations must drive personal energy conservation. This campaign augments ongoing energy savings from housing upgrades carried out by Fort Lewis. The campaign ran from September 1998 through August 1999. The campaign strategy was developed based on findings from previous research and on input from residents and officials at Fort Lewis. Energy use, corrected to account for weather differences, was compared with the previous year's use. Survey responses from 377 of Fort Lewis residents of occupied housing showed that the campaign was moderately effective in promoting behavior change. Of those who were aware of the campaign, almost all said they were now doing one or more energy-efficient things that they had not done before. Most people were motivated by the desire to do the right thing and to set a good example for their children. They were less motivated by other factors.

Electricity and risk of public health center had measles vaccine damage in Indonesia

Directory of Open Access Journals (Sweden)

Anggita Bunga Anggraini

2016-03-01

Full Text Available AbstrakLatar belakang: Puskesmas yang memiliki vaksin campak rusak dipengaruhi oleh beberapa faktor risiko.Oleh karena itu perlu diidentifikasi beberapa faktor risiko dominan yang mempengaruhinya.Metode: Analisis menggunakan sebagian data Riset Fasilitas Kesehatan (Rifaskes tahun 2011. Rifaskestersebut dilakukan di seluruh Puskesmas di 33 provinsi di Indonesia. Selanjutnya, pada analisis ini hanyamenggunakan data Puskesmas di provinsi yang memiliki cakupan imunisasi campak di atas angka prevalensinasional (81,6%, dan Puskesmas yang memiliki angka prevalensi campak di atas angka prevalensi nasional(1,18%. Analisis data statistik dilakukan dengan menggunakan analisis regresi logistik untuk menentukanbeberapa faktor risiko dominan yang mempengaruhi Puskesmas yang memiliki vaksin campak rusak.Hasil: Sebanyak 7 (Riau, Jakarta, Nusa Tenggara Barat, Nusa Tenggara Timur, Sulawesi Tengah, SulawesiSelatan, Gorontalo sebanyak 1259 Puskesmas memenuhi kriteria inklusi. Puskesmas yang berlokasi diperdesaan dibandingkan dengan perkotaan berisiko 3,4 kali lipat yang merupakan Puskesmas yang memilikivaksin campak rusak [rasio odds suaian (ORa = 3,37; 95% interval kepercayaan (CI = 1,34-8,26]. Selanjutnya,Puskesmas dengan ketersediaan listrik PLN kurang dari 24 jam dibandingkan dengan tersedia selama 24jam mempunyai risiko 2,1 kali lipat merupakan Puskesmas yang memiliki vaksin campak rusak (ORa =2,10; 95% CI = 1,02-4,33.Kesimpulan: Puskesmas yang mempunyai kerusakan vaksin campak yang rusak lebih banyak terjadi di Puskesmasdi perdesaan dan yang tidak tersedia listrik PLN maupun ketersediaan listrik sehari-hari kurang dari 24 jammerupakan Puskesmas yang memiliki vaksin campak rusak. (Health Science Journal of Indonesia 2015;6:116-20Kata kunci: vaksin campak rusak, Puskesmas AbstractBackground: The Public Health Center (PHC had broken measles vaccine was influenced by a numberof risk factors. Therefore, it was necessary to identify some dominant risk factors that

Preliminary assessment report for Fort William Henry Harrison, Montana Army National Guard, Helena, Montana

International Nuclear Information System (INIS)

DuWaldt, J.; Meyer, T.

1993-07-01

This report presents the results of the preliminary assessment (PA) conducted by Argonne National Laboratory at a Montana Army National Guard (MTARNG) property near Helena, Montana. Preliminary assessments of federal facilities are being conducted to compile the information necessary for completing preremedial activities and to provide a basis for establishing corrective actions in response to releases of hazardous substances. The principal objective of the PA is to characterize the site accurately and determine the need for further action by examining site activities, quantities of hazardous substances present, and potential pathways by which contamination could affect public health and the environment. This PA satisfies, for the Fort William Henry Harrison property, requirements of the Department of Defense Installation Restoration Program

Master Environmental Plan: Fort Wingate Depot Activity, Gallup, New Mexico

Energy Technology Data Exchange (ETDEWEB)

Biang, C.A.; Yuen, C.R.; Biang, R.P.; Antonopoulos, A.A.; Ditmars, J.D.

1990-12-01

The master environmental plan is based on an environmental assessment of the areas requiring environmental evaluation (AREEs) at Fort Wingate Depot Activity near Gallup, New Mexico. The Fort Wingate Depot Activity is slated for closure under the Base Closure and Realignment Act, Public Law 100--526. The MEP assesses the current status, describes additional data requirements, recommends actions for the sites, and establishes a priority order for actions. The plan was developed so that actions comply with hazardous waste and water quality regulations of the State of New Mexico and applicable federal regulations. It contains a brief history of the site, relevant geological and hydrological information, and a description of the current status for each AREE along with a discussion of the available site-specific data that pertain to existing or potential contamination and the impact on the environment. 35 refs., 27 figs., 23 tabs.

Biosecurity and Health Monitoring at the Zebrafish International Resource Center.

Science.gov (United States)

Murray, Katrina N; Varga, Zoltán M; Kent, Michael L

2016-07-01

The Zebrafish International Resource Center (ZIRC) is a repository and distribution center for mutant, transgenic, and wild-type zebrafish. In recent years annual imports of new zebrafish lines to ZIRC have increased tremendously. In addition, after 15 years of research, we have identified some of the most virulent pathogens affecting zebrafish that should be avoided in large production facilities, such as ZIRC. Therefore, while importing a high volume of new lines we prioritize safeguarding the health of our in-house fish colony. Here, we describe the biosecurity and health-monitoring program implemented at ZIRC. This strategy was designed to prevent introduction of new zebrafish pathogens, minimize pathogens already present in the facility, and ensure a healthy zebrafish colony for in-house uses and shipment to customers.

Development and initial validation of a computer-administered health literacy assessment in Spanish and English: FLIGHT/VIDAS

Directory of Open Access Journals (Sweden)

Ownby RL

2013-08-01

Full Text Available Raymond L Ownby,1 Amarilis Acevedo,2 Drenna Waldrop-Valverde,3 Robin J Jacobs,1 Joshua Caballero,4 Rosemary Davenport,1 Ana-Maria Homs,1 Sara J Czaja,5 David Loewenstein51Department of Psychiatry and Behavioral Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA; 2Center for Psychological Studies, Nova Southeastern University, Fort Lauderdale, FL, USA; 3Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA; 4College of Pharmacy, Department of Pharmacy Practice, Nova Southeastern University, Fort Lauderdale, FL, USA; 5University of Miami Miller School of Medicine, Miami, FL, USAAbstract: Current measures of health literacy have been criticized on a number of grounds, including use of a limited range of content, development on small and atypical patient groups, and poor psychometric characteristics. In this paper, we report the development and preliminary validation of a new computer-administered and -scored health literacy measure addressing these limitations. Items in the measure reflect a wide range of content related to health promotion and maintenance as well as care for diseases. The development process has focused on creating a measure that will be useful in both Spanish and English, while not requiring substantial time for clinician training and individual administration and scoring. The items incorporate several formats, including questions based on brief videos, which allow for the assessment of listening comprehension and the skills related to obtaining information on the Internet. In this paper, we report the interim analyses detailing the initial development and pilot testing of the items (phase 1 of the project in groups of Spanish and English speakers. We then describe phase 2, which included a second round of testing of the items, in new groups of Spanish and English speakers, and evaluation of the new measure's reliability and validity in relation to other measures. Data are presented that show

78 FR 48163 - Board of Scientific Counselors, National Center for Health Statistics

Science.gov (United States)

2013-08-07

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Board of... Federal Advisory Committee Act (Pub. L. 92-463), the Centers for Disease Control and Prevention (CDC... listed below. All requests must contain the name, address, telephone number, and organizational...

78 FR 17411 - Board of Scientific Counselors, National Center for Health Statistics

Science.gov (United States)

2013-03-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Board of... Federal Advisory Committee Act (Pub. L. 92-463), the Centers for Disease Control and Prevention (CDC... contain the name, address, telephone number, and organizational affiliation of the presenter. Written...

78 FR 48438 - Board of Scientific Counselors, National Center for Health Statistics

Science.gov (United States)

2013-08-08

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Board of... Federal Advisory Committee Act (Pub. L. 92-463), the Centers for Disease Control and Prevention (CDC... listed below. All requests must contain the name, address, telephone number, and organizational...

Thunderstorm and Lightning Studies using the FORTE Optical Lightning System (FORTE/OLS)

International Nuclear Information System (INIS)

Argo, P.; Franz, R.; Green, J.; Guillen, J.L.; Jacobson, A.R.; Kirkland, M.; Knox, S.; Spalding, R.; Suszcynsky, D.M.

1999-01-01

Preliminary observations of simultaneous RF and optical emissions from lightning as seen by the FORTE spacecraft are presented. RF/optical pairs of waveforms are routinely collected both as individual lightning events and as sequences of events associated with cloud-to-ground (CG) and intra-cloud (IC) flashes. CG pulses can be distinguished from IC pulses based on the properties of the RF and optical waveforms, but mostly based on the associated RF spectrograms. The RF spectrograms are very similar to previous ground-based VHF observations of lightning and show signatures associated with return strokes, stepped and dart leaders, and attachment processes,. RF emissions are observed to precede the arrival of optical emissions at the satellite by a mean value of 280 microseconds. The dual phenomenology nature of these observations are discussed in terms of their ability to contribute to a satellite-based lightning monitoring mission

Thunderstorm and Lightning Studies using the FORTE Optical Lightning System (FORTE/OLS)

Energy Technology Data Exchange (ETDEWEB)

Argo, P.; Franz, R.; Green, J.; Guillen, J.L.; Jacobson, A.R.; Kirkland, M.; Knox, S.; Spalding, R.; Suszcynsky, D.M.

1999-02-01

Preliminary observations of simultaneous RF and optical emissions from lightning as seen by the FORTE spacecraft are presented. RF/optical pairs of waveforms are routinely collected both as individual lightning events and as sequences of events associated with cloud-to-ground (CG) and intra-cloud (IC) flashes. CG pulses can be distinguished from IC pulses based on the properties of the RF and optical waveforms, but mostly based on the associated RF spectrograms. The RF spectrograms are very similar to previous ground-based VHF observations of lightning and show signatures associated with return strokes, stepped and dart leaders, and attachment processes,. RF emissions are observed to precede the arrival of optical emissions at the satellite by a mean value of 280 microseconds. The dual phenomenology nature of these observations are discussed in terms of their ability to contribute to a satellite-based lightning monitoring mission.

Final Sampling and Analysis Plan for Background Sampling, Fort Sheridan, Illinois

National Research Council Canada - National Science Library

1995-01-01

.... This Background Sampling and Analysis Plan (BSAP) is designed to address this issue through the collection of additional background samples at Fort Sheridan to support the statistical analysis and the Baseline Risk Assessment (BRA...

Costs and clinical quality among Medicare beneficiaries: associations with health center penetration of low-income residents.

Science.gov (United States)

Sharma, Ravi; Lebrun-Harris, Lydie A; Ngo-Metzger, Quyen

2014-01-01

Determine the association between access to primary care by the underserved and Medicare spending and clinical quality across hospital referral regions (HRRs). Data on elderly fee-for-service beneficiaries across 306 HRRs came from CMS' Geographic Variation in Medicare Spending and Utilization database (2010). We merged data on number of health center patients (HRSA's Uniform Data System) and number of low-income residents (American Community Survey). We estimated access to primary care in each HRR by "health center penetration" (health center patients as a proportion of low-income residents). We calculated total Medicare spending (adjusted for population size, local input prices, and health risk). We assessed clinical quality by preventable hospital admissions, hospital readmissions, and emergency department visits. We sorted HRRs by health center penetration rate and compared spending and quality measures between the high- and low-penetration deciles. We also employed linear regressions to estimate spending and quality measures as a function of health center penetration. The high-penetration decile had 9.7% lower Medicare spending ($926 per capita, p=0.01) than the low-penetration decile, and no different clinical quality outcomes. Compared with elderly fee-for-service beneficiaries residing in areas with low-penetration of health center patients among low-income residents, those residing in high-penetration areas may accrue Medicare cost savings. Limited evidence suggests that these savings do not compromise clinical quality.

78 FR 74163 - Harrison Medical Center, a Subsidiary of Franciscan Health System Bremerton, Washington; Notice...

Science.gov (United States)

2013-12-10

... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-83,070] Harrison Medical Center, a Subsidiary of Franciscan Health System Bremerton, Washington; Notice of Negative Determination... workers of Harrison Medical Center, a subsidiary of Franciscan Health System, Bremerton, Washington...

The Union Health Center: a working model of clinical care linked to preventive occupational health services.

Science.gov (United States)

Herbert, R; Plattus, B; Kellogg, L; Luo, J; Marcus, M; Mascolo, A; Landrigan, P J

1997-03-01

As health care provision in the United States shifts to primary care settings, it is vital that new models of occupational health services be developed that link clinical care to prevention. The model program described in this paper was developed at the Union Health Center (UHC), a comprehensive health care center supported by the International Ladies Garment Workers Union (now the Union of Needletrades, Industrial and Textile Employees) serving a population of approximately 50,000 primarily minority, female garment workers in New York City. The objective of this paper is to describe a model occupational medicine program in a union-based comprehensive health center linking accessible clinical care with primary and secondary disease prevention efforts. To assess the presence of symptoms suggestive of occupational disease, a health status questionnaire was administered to female workers attending the UHC for routine health maintenance. Based on the results of this survey, an occupational medicine clinic was developed that integrated direct clinical care with worker and employer education and workplace hazard abatement. To assess the success of this new approach, selected cases of sentinel health events were tracked and a chart review was conducted after 3 years of clinic operation. Prior to initiation of the occupational medicine clinic, 64% (648) of the workers surveyed reported symptoms indicative of occupational illnesses. However, only 42 (4%) reported having been told by a physician that they had an occupational illness and only 4 (.4%) reported having field a workers' compensation claim for an occupational disease. In the occupational medicine clinic established at the UHC, a health and safety specialist acts as a case manager, coordinating worker and employer education as well as workplace hazard abatement focused on disease prevention, ensuring that every case of occupational disease is treated as a potential sentinel health event. As examples of the success

Academic health centers in competitive markets.

Science.gov (United States)

Reuter, J; Gaskin, D

1997-01-01

Academic health center (AHC) hospitals and other major teaching hospitals have funded a portion of their academic missions through patient care revenues. Using all-payer state discharge data, this DataWatch presents information on how these institutions are being affected by market changes. Although AHCs are not as successful as other hospitals are in attracting managed care patients, competitive pressures had not eroded AHCs' financial status as of 1994. However, increasing enrollment in managed care and potential changes in both Medicare and Medicaid suggest that pressure on the financing of these institutions' social missions will continue to grow over time.

Strategic Energy Management Plan For Fort Buchanan, Puerto Rico

Energy Technology Data Exchange (ETDEWEB)

Parker, Steven A.; Hunt, W. D.

2001-10-31

This document reports findings and recommendations as a result of a design assistance project with Fort Buchanan with the goals of developing a Strategic Energy Management Plan for the Site. A strategy has been developed with three major elements in mind: 1) development of a strong foundation from which to build, 2) understanding technologies that are available, and 3) exploring financing options to fund the implementation of improvements. The objective of this report is to outline a strategy that can be used by Fort Buchanan to further establish an effective energy management program. Once a strategy is accepted, the next step is to take action. Some of the strategies defined in this Plan may be implemented directly. Other strategies may require the development of a more sophisticated tactical, or operational, plan to detail a roadmap that will lead to successful realization of the goal. Similarly, some strategies are not single events. Rather, some strategies will require continuous efforts to maintain diligence or to change the culture of the Base occupants and their efforts to conserve energy resources.

Site Investigations with the Site Characterization and Analysis Penetrator System at Fort Dix, New Jersey

Science.gov (United States)

1993-07-01

rod system or through a tremie tube ; both procedures were used interchangeably at Fort Dix to demon- strate the efficiency and effectiveness of each...allows delivery through either a l/4-in.-diam grout tube or a 3/8-in.-diam rout tube . The grout used at Fort Dix consisted of a mixture of water and... microfine , blended Portland cement (Lehigh Geocem’, Leeds, Alabama). The grout is a suspension of a uniformly produced cement clinker interground with

Evaluation of Environmental Health Indicators of Halva and Tahini Production Centers in Ardakan, Yazd

Directory of Open Access Journals (Sweden)

Mohammad Taghi Ghaneian

2014-03-01

Results: Generally, 75% production centers had favorable hygienic status and 25% had slightly favorable hygienic status. According to obtained results, hygienic status of production centers had relatively favorable and favorable conditions and only in January and February in 31.3% and 18.8% processing hall and 12.5% product store was in a very favorable hygienic status. The results showed that in terms of environmental health status, 62.5% production centers in raw materials store part, 66.66% in production processing hall, 20.83% in packaging hall, 60.41% in product store and 37.5% in bathrooms had favorable status. Based on the results, hygienic status of bathrooms and processing hall achieved lowest and highest score, respectively. Statistical analysis showed that between hygienic status and production rate (p=0.411 there is no significant relationship. Conclusion: The results of this study indicate that the halva and tahini production centers of Ardakan city in terms of environmental health indicators had slightly favorable status to favorable and none of the production centers had not very favorable conditions. The results of this study can be used to improve health status of halva and tahini production centers.

Quality Improvement Initiative in School-Based Health Centers across New Mexico

Science.gov (United States)

Booker, John M.; Schluter, Janette A.; Carrillo, Kris; McGrath, Jane

2011-01-01

Background: Quality improvement principles have been applied extensively to health care organizations, but implementation of quality improvement methods in school-based health centers (SBHCs) remains in a developmental stage with demonstration projects under way in individual states and nationally. Rural areas, such as New Mexico, benefit from the…

Analgesic Usage in Elderly at Public Health Center: A study in West Java, Indonesias

Directory of Open Access Journals (Sweden)

Gembong Soeyono Putro

2017-03-01

Full Text Available Background: Various analgesics prescriptions for elderly are not appropriate according to the guideline and can cause the increase of side effects such as gastric problems. Puskesmas as a public health center in Indonesia has an important role in anticipating this problem. The objectives of this study was to identify the analgesic usage in elderly patients at the public health center. Methods: This retrospective descriptive study was conducted for 3 months at Tanjungsari public health center, Sumedang, West Java, Indonesia, using total sampling. The data was taken from 417 medical records from 2013. The data taken from medical records were: sex, analgesic drug, diagnosis, and drug for gastric problem. Results: From the collected data, the most analgesics prescribed for the elderly patients was paracetamol, followed by Piroxicam, Mefenamic acid, and Ibuprofen. Not all of the elderly patients who received NSAIDs, were given gastric drug. Conclusions: The most prescribed analgesic drug given to elderly patients at the public health center is paracetamol. [AMJ.2017;4(1:16–9

Bringing Wellness to Schools: Opportunities for and Challenges to Mental Health Integration in School-Based Health Centers.

Science.gov (United States)

Lai, Karen; Guo, Sisi; Ijadi-Maghsoodi, Roya; Puffer, Maryjane; Kataoka, Sheryl H

2016-12-01

School-based health centers (SBHCs) reduce access barriers to mental health care and improve educational outcomes for youths. This qualitative study evaluated the innovations and challenges of a unique network of SBHCs in a large, urban school district as the centers attempted to integrate health, mental health, and educational services. The 43 participants sampled included mental health providers, primary care providers, and care coordinators at 14 SBHCs. Semistructured interviews with each participant were audio recorded and transcribed. Themes were identified and coded by using Atlas.ti 5.1 and collapsed into three domains: operations, partnership, and engagement. Interviews revealed provider models ranging from single agencies offering both primary care and mental health services to colocated services. Sites where the health agency provided at least some mental health services reported more mental health screenings. Many sites used SBHC wellness coordinators and coordination team meetings to facilitate relationships between schools and health agency and community mental health clinic providers. Partnership challenges included confidentiality policies and staff turnover. Participants also highlighted student and parent engagement through culturally sensitive services, peer health advocates, and "drop-in" lunches. Staffing and operational models are critical in the success of integrating primary care, mental health care, and education. Among the provider models observed, the combined primary care and mental health provider model offered the most integrated services. Despite barriers, providers and schools have begun to implement novel solutions to operational problems and family engagement in mental health services.

NHSC Jobs Center for Primary Care Medical, Dental and Mental Health Providers

Data.gov (United States)

U.S. Department of Health & Human Services — The National Health Service Corps (NHSC) Jobs Center helps doctors and nurses who are interested in working at areas where there is the highest need find out more...

A Phenomenological Study: Community Mental Health Centers Leaders Influence on Clinician Effectiveness

Science.gov (United States)

Williams, Beth B.

2011-01-01

Some clinical leaders of community mental health centers are not aware of successful methods for supporting and empowering staff to be more effective, specifically when the staff is experiencing change because of new health information technology. Clinical leaders in community mental health face similar management issues as do other business,…

Fort Lewis natural gas and fuel oil energy baseline and efficiency resource assessment

International Nuclear Information System (INIS)

Brodrick, J.R.; Daellenbach, K.K.; Parker, G.B.; Richman, E.E.; Secrest, T.J.; Shankle, S.A.

1993-02-01

The mission of the US Department of Energy (DOE) Federal Energy Management Program (FEMP) is to lead the improvement of energy efficiency and fuel flexibility within the federal sector. Through the Pacific Northwest Laboratory (PNL), FEMP is developing a fuel-neutral approach for identifying, evaluating, and acquiring all cost-effective energy projects at federal installations; this procedure is entitled the Federal Energy Decision Screening (FEDS) system. Through a cooperative program between FEMP and the Army Forces Command (FORSCOM) for providing technical assistance to FORSCOM installations, PNL has been working with the Fort Lewis Army installation to develop the FEDS procedure. The natural gas and fuel oil assessment contained in this report was preceded with an assessment of electric energy usage that was used to implement a cofunded program between Fort Lewis and Tacoma Public Utilities to improve the efficiency of the Fort's electric-energy-using systems. This report extends the assessment procedure to the systems using natural gas and fuel oil to provide a baseline of consumption and an estimate of the energy-efficiency potential that exists for these two fuel types at Fort Lewis. The baseline is essential to segment the end uses that are targets for broad-based efficiency improvement programs. The estimated fossil-fuel efficiency resources are estimates of the available quantities of conservation for natural gas, fuel oils number-sign 2 and number-sign 6, and fuel-switching opportunities by level of cost-effectiveness. The intent of the baseline and efficiency resource estimates is to identify the major efficiency resource opportunities and not to identify all possible opportunities; however, areas of additional opportunity are noted to encourage further effort

Leaktightness in HTGRs - experience at Fort St. Vrain

International Nuclear Information System (INIS)

Neylan, A.J.; Barker, R.A.; Deardorff, A.F.

1976-01-01

The Fort St. Vrain Prestressed Concrete Reactor Vessel is the first utilized to contain the helium coolant of a High Temperature Gas-Cooled Reactor. Because the helium coolant contains fission products, leakage from the vessel is limited to 15 percent of vessel inventory per year. This paper describes the fabrication methods and development tests used to assure this leaktightness and the leakage test conducted to verify it. (author)

Understanding and Predicting Social Media Use Among Community Health Center Patients: A Cross-Sectional Survey

Science.gov (United States)

2014-01-01

Background The use of social media by health care organizations is growing and provides Web-based tools to connect patients, caregivers, and providers. Objective The aim was to determine the use and factors predicting the use of social media for health care–related purposes among medically underserved primary care patients. Methods A cross-sectional survey was administered to 444 patients of a federally qualified community health center. Results Community health center patients preferred that their providers use email, cell phones for texting, and Facebook and cell phone apps for sharing health information. Significantly more Hispanic than white patients believed their providers should use Facebook (P=.001), YouTube (P=.01), and Twitter (P=.04) for sharing health information. Use and intentions to use social media for health-related purposes were significantly higher for those patients with higher subjective norm scores. Conclusions Understanding use and factors predicting use can increase adoption and utilization of social media for health care–related purposes among underserved patients in community health centers. PMID:25427823

Sustainable Model for Public Health Emergency Operations Centers for Global Settings

OpenAIRE

Balajee, S. Arunmozhi; Pasi, Omer G.; Etoundi, Alain Georges M.; Rzeszotarski, Peter; Do, Trang T.; Hennessee, Ian; Merali, Sharifa; Alroy, Karen A.; Phu, Tran Dac; Mounts, Anthony W.

2017-01-01

Capacity to receive, verify, analyze, assess, and investigate public health events is essential for epidemic intelligence. Public health Emergency Operations Centers (PHEOCs) can be epidemic intelligence hubs by 1) having the capacity to receive, analyze, and visualize multiple data streams, including surveillance and 2) maintaining a trained workforce that can analyze and interpret data from real-time emerging events. Such PHEOCs could be physically located within a ministry of health epidem...

The Carter Center Mental Health Program: addressing the public health crisis in the field of mental health through policy change and stigma reduction.

Science.gov (United States)

Palpant, Rebecca G; Steimnitz, Rachael; Bornemann, Thomas H; Hawkins, Katie

2006-04-01

Some of the most pervasive and debilitating illnesses are mental illnesses, according to World Health Organization's The World Health Report 2001--Mental Health: New Understanding, New Hope. Neuropsychiatric conditions account for four of the top five leading causes of years of life lived with disability in people aged 15 to 44 in the Western world. Many barriers prevent people with mental illnesses from seeking care, such as prohibitive costs, lack of insurance, and the stigma and discrimination associated with mental illnesses. The Carter Center Mental Health Program, established in 1991, focuses on mental health policy issues within the United States and internationally. This article examines the public health crisis in the field of mental health and focuses on The Carter Center Mental Health Program's initiatives, which work to increase public knowledge of and decrease the stigma associated with mental illnesses through their four strategic goals: reducing stigma and discrimination against people with mental illnesses; achieving equity of mental health care comparable with other health services; advancing early promotion, prevention, and early intervention services for children and their families; and increasing public awareness about mental illnesses and mental health issues.

Medline Plus

Full Text Available ... Doctors Hospital, Coral Gables, FL, 11/27/2012) Arthritis Arthroscopic Ankle Fusion on 72 Year-Old with Severe Arthritis Pain (Broward Health Medical Center, Fort Lauderdale, FL, ...

Simulation of groundwater flow to assess future withdrawals associated with Base Realignment and Closure (BRAC) at Fort George G. Meade, Maryland

Science.gov (United States)

Raffensperger, Jeff P.; Fleming, Brandon J.; Banks, William S.L.; Horn, Marilee A.; Nardi, Mark R.; Andreasen, David C.

2010-01-01

Increased groundwater withdrawals from confined aquifers in the Maryland Coastal Plain to supply anticipated growth at Fort George G. Meade (Fort Meade) and surrounding areas resulting from the Department of Defense Base Realignment and Closure Program may have adverse effects in the outcrop or near-outcrop areas. Specifically, increased pumping from the Potomac Group aquifers (principally the Patuxent aquifer) could potentially reduce base flow in small streams below rates necessary for healthy biological functioning. Additionally, water levels may be lowered near, or possibly below, the top of the aquifer within the confined-unconfined transition zone near the outcrop area. A three-dimensional groundwater flow model was created to incorporate and analyze data on water withdrawals, streamflow, and hydraulic head in the region. The model is based on an earlier model developed to assess the effects of future withdrawals from well fields in Anne Arundel County, Maryland and surrounding areas, and includes some of the same features, including model extent, boundary conditions, and vertical discretization (layering). The resolution (horizontal grid discretization) of the earlier model limited its ability to simulate the effects of withdrawals on the outcrop and near-outcrop areas. The model developed for this study included a block-shaped higher-resolution local grid, referred to as the child model, centered on Fort Meade, which was coupled to the coarser-grid parent model using the shared node Local Grid Refinement capability of MODFLOW-LGR. A more detailed stream network was incorporated into the child model. In addition, for part of the transient simulation period, stress periods were reduced in length from 1 year to 3 months, to allow for simulation of the effects of seasonally varying withdrawals and recharge on the groundwater-flow system and simulated streamflow. This required revision of the database on withdrawals and estimation of seasonal variations in

Surface-water quantity and quality, aquatic biology, stream geomorphology, and groundwater-flow simulation for National Guard Training Center at Fort Indiantown Gap, Pennsylvania, 2002-05

Science.gov (United States)

Langland, Michael J.; Cinotto, Peter J.; Chichester, Douglas C.; Bilger, Michael D.; Brightbill, Robin A.

2010-01-01

Base-line and long-term monitoring of water resources of the National Guard Training Center at Fort Indiantown Gap in south-central Pennsylvania began in 2002. Results of continuous monitoring of streamflow and turbidity and monthly and stormflow water-quality samples from two continuous-record long-term stream sites, periodic collection of water-quality samples from five miscellaneous stream sites, and annual collection of biological data from 2002 to 2005 at 27 sites are discussed. In addition, results from a stream-geomorphic analysis and classification and a regional groundwater-flow model are included. Streamflow at the facility was above normal for the 2003 through 2005 water years and extremely high-flow events occurred in 2003 and in 2004. Water-quality samples were analyzed for nutrients, sediments, metals, major ions, pesticides, volatile and semi-volatile organic compounds, and explosives. Results indicated no exceedances for any constituent (except iron) above the primary and secondary drinking-water standards or health-advisory levels set by the U.S. Environmental Protection Agency. Iron concentrations were naturally elevated in the groundwater within the watershed because of bedrock lithology. The majority of the constituents were at or below the method detection limit. Sediment loads were dominated by precipitation due to the remnants of Hurricane Ivan in September 2004. More than 60 percent of the sediment load measured during the entire study was transported past the streamgage in just 2 days during that event. Habitat and aquatic-invertebrate data were collected in the summers of 2002-05, and fish data were collected in 2004. Although 2002 was a drought year, 2003-05 were above-normal flow years. Results indicated a wide diversity in invertebrates, good numbers of taxa (distinct organisms), and on the basis of a combination of metrics, the majority of the 27 sites indicated no or slight impairment. Fish-metric data from 25 sites indicated results

Informal report on measurements of slant TEC by FORTE

International Nuclear Information System (INIS)

Massey, R.S.

1997-01-01

Los Alamos National Laboratory's Space and Atmospheric Sciences group is now operating the FORTE satellite, which has two sets of instruments: optical detectors and radio detectors. In this report the author describes work with one set of radio detectors that allow measurements of the total electron content (TEC) traversed by VHF radiation originating at an electromagnetic pulse (EMP) generator located at Los Alamos

Assessment of DoD Wounded Warrior Matters -- Fort Riley

Science.gov (United States)

2013-08-06

acceptable excuses included At Remote Care, Regular Leave, Maternity and Paternity Leave, Terminal Leave, Permanent Change of Station, and Transferred to...risk of negative medication interactions and reactions for Soldiers assigned to the Fort Riley WTB. B.2. Background The Joint Commission, an...reconciliation is to minimize medication errors such as omissions, duplications, dosing errors, and drug interactions . Medical reconciliation should

Tile forts of the Liesbeeck Frontier | Sleigh | Scientia Militaria: South ...

African Journals Online (AJOL)

Scientia Militaria: South African Journal of Military Studies. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 27 (1997) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Tile forts of the Liesbeeck Frontier.

77 FR 24579 - Establishment of the Fort Ord National Monument

Science.gov (United States)

2012-04-25

... 1775-1776, Anza established the first overland route from ``New Spain,'' as Mexico was then known, to..., approximately 6 miles of which pass through the Fort Ord area. Although much of the historic route currently... tourists and recreationalists from near and far, and enhance its unique natural resources, for the...

The Forte Kreis : an Attempt to Spiritual Leadership over Europe

NARCIS (Netherlands)

Poorthuis, Marcel

2017-01-01

Just before the outbreak of World War 1, a group of writers, artists and philosophers decided to establish a spiritual rule over Europe, the Forte Kreis. The group aimed at a reconciliation in Europe, by establishing pacifism, but also between East and West by creating a new language. Their thoughts

The role of community health centers in assessing the social determinants of health for planning and policy: the example of frontier New Mexico.

Science.gov (United States)

Bruna, Sean; Stone, Lisa Cacari; Wilger, Susan; Cantor, Jeremy; Guzman, Carolina

2014-01-01

This article examines the experience of a frontier-based community health center when it utilized the Tool for Health and Resilience in Vulnerable Environments (THRIVE) for assessing social determinants of health with a local health consortium. Community members (N = 357) rated safety, jobs, housing, and education among the top health issues. Community leaders integrated these health priorities in a countywide strategic planning process. This example of a frontier county in New Mexico demonstrates the critical role that community health centers play when engaging with local residents to assess community health needs for strategic planning and policy development.

Role of Nurses in Community Mental Health Centers: Example of England

Directory of Open Access Journals (Sweden)

Beyhan Bag

2012-12-01

Full Text Available The goal of the community mental health centers, which constitute the core of community based mental health service model, is to register the patients who live in a certain geographical region and have serious mental disorder in the center, to observe them regularly and to bring them back to community by providing their rehabilitation and treatment. The practice of community based mental health, which English health service carries out in one hand for the psychiatry patients’ treatment and care, has many benefits, such as minimizing the sequence of going to hospital. The community mental health nurse, who works as an incidence manager, takes on the responsibility of treatment and care of the patient in the place where he/she lives, and the directly protective effect of this responsibility is an unquestionable fact. With this practice, the process of taking cure in hospital and the cost of treatment and care decrease. In our country, this sub-field of psychiatry is still in its incipient stage. Being familiar with the successful model practices in different countries may constitute a good model for the community mental health nursing practices which are on the first level in our country. For this purpose, the role of the nurses who work for the community mental health service in England is presented in this study.

The Adolescent "Expanded Medical Home": School-Based Health Centers Partner with a Primary Care Clinic to Improve Population Health and Mitigate Social Determinants of Health.

Science.gov (United States)

Riley, Margaret; Laurie, Anna R; Plegue, Melissa A; Richarson, Caroline R

2016-01-01

Access to high-quality health care is a crucial social determinant of health. We describe the implementation of an "expanded medical home" partnering a primary care practice (the Ypsilanti Health Center [YHC]) with local school-based health centers (the Regional Alliance for Healthy Schools [RAHS]), and to assess whether this model improves access to and quality of care for shared patients. Using the Consolidated Framework for Implementation Research, we define the steps in, barriers to, and facilitating factors in implementing the expanded medical home model. Visits and quality measures were assessed for patients seen by YHC only versus YHC/RAHS at baseline and during the intervention. At baseline, patients seen at YHC/RAHS had higher compliance with most quality metrics compared with those seen at YHC only. The proportion of shared patients significantly increased because of the intervention (P partnership between primary care physicians and school-based health centers increases the number of shared high-risk adolescent patients. Shared patients have improved compliance with quality measures, which may lead to long-term improved health equity. © Copyright 2016 by the American Board of Family Medicine.

User-Centered Design and Interactive Health Technologies for Patients

Science.gov (United States)

De Vito Dabbs, Annette; Myers, Brad A.; Mc Curry, Kenneth R.; Dunbar-Jacob, Jacqueline; Hawkins, Robert P.; Begey, Alex; Dew, Mary Amanda

2010-01-01

Despite recommendations that patients be involved in the design and testing of health technologies, few reports describe how to involve patients in systematic and meaningful ways to ensure that applications are customized to meet their needs. User-centered design (UCD) is an approach that involves end-users throughout the development process so that technology support tasks, are easy to operate, and are of value to users. In this paper we provide an overview of UCD and use the development of Pocket Personal Assistant for Tracking Health (Pocket PATH), to illustrate how these principles and techniques were applied to involve patients in the development of this interactive health technology. Involving patient-users in the design and testing ensured functionality and usability, therefore increasing the likelihood of promoting the intended health outcomes. PMID:19411947

Measuring Efficiency of Knowledge Production in Health Research Centers Using Data Envelopment Analysis (DEA): A Case Study in Iran.

Science.gov (United States)

Amiri, Mohammad Meskarpour; Nasiri, Taha; Saadat, Seyed Hassan; Anabad, Hosein Amini; Ardakan, Payman Mahboobi

2016-11-01

Efficiency analysis is necessary in order to avoid waste of materials, energy, effort, money, and time during scientific research. Therefore, analyzing efficiency of knowledge production in health areas is necessary, especially for developing and in-transition countries. As the first step in this field, the aim of this study was the analysis of selected health research center efficiency using data envelopment analysis (DEA). This retrospective and applied study was conducted in 2015 using input and output data of 16 health research centers affiliated with a health sciences university in Iran during 2010-2014. The technical efficiency of health research centers was evaluated based on three basic data envelopment analysis (DEA) models: input-oriented, output-oriented, and hyperbolic-oriented. The input and output data of each health research center for years 2010-2014 were collected from the Iran Ministry of Health and Medical Education (MOHE) profile and analyzed by R software. The mean efficiency score in input-oriented, output-oriented, and hyperbolic-oriented models was 0.781, 0.671, and 0.798, respectively. Based on results of the study, half of the health research centers are operating below full efficiency, and about one-third of them are operating under the average efficiency level. There is also a large gap between health research center efficiency relative to each other. It is necessary for health research centers to improve their efficiency in knowledge production through better management of available resources. The higher level of efficiency in a significant number of health research centers is achievable through more efficient management of human resources and capital. Further research is needed to measure and follow the efficiency of knowledge production by health research centers around the world and over a period of time.

Educational Needs Assessment of Family Health Providers in Tabriz Health Care Centers in 2015

Directory of Open Access Journals (Sweden)

Faranak Ghoreyshyzadeh

2017-06-01

Full Text Available Background: This study intends to determine the educational needs of family health staff employed in health care centers in Tabriz, the provincial capital of east Azerbaijan, Iran in 2015. Methods: In this cross-sectional study 282 staff were enrolled, together with 22 managers, through census. The data collection tool was a researcher-designed questionnaire whose content validity were confirmed by 5 experts of health care and medical education centers. They self--evaluated their knowledge, skills and attitudes in 6 task processes including "integrated care for pregnant women", "women’s general and reproductive health", "child health care and breastfeeding", "vaccination skills", "teenagers’ and young adults’ health", and "common diseases prevention and control". Cronbach alpha coefficients were over 0.85. Data analysis was done using SPSS version 16 and descriptive statistics (mean and standard deviation and one-sample t tests were calculated to compare the mean of scores with midpoint criteria (=3. Results: Generally family health staff self-evaluated their knowledge, skills and attitudes in all task processes in higher than midpoint criteria level, which was consistent with the opinions of the managers, however, educational needs required by personnel in some processes or sub- process including "common diseases prevention and control" ( knowledge on referring thalassemia couples for genetic testing, mental health counseling, "vaccination skills" ( intradermal vaccination skills, "teenagers’ and young adults’ health" (Self-care training and parents education, "women’s general and reproductive health" (principles of family planning counseling and less needs stated in "integrated care for pregnant mothers" (except for diagnosis and management of ectopic pregnancy, placenta previa and abruption and "child health care" as compared to criteria (All P value <0.05. In contrast to self-assessment results, in interorganization evaluations

Locating of Rural Health Centers Equipped with Telehealth using GIS: A Case Study on Khorramabad City, Iran

Directory of Open Access Journals (Sweden)

Safdari Reza

2016-10-01

Full Text Available Residents of the rural and remote area always having limitations on accessing properly required service providers. In such condition, the establishment of rural health centers equipped with telehealth, and also the use of GIS for optimal site selection to the centers, would play an important role in facilitating the achievement of quality health services in desired time factor. This study intended to find the optimal sites for building the Rural Health Centers Equipped with remote health facilities in, Khorramabad City, using GIS. During the pilot study, we identified few effective locating criteria and sub-criteria for rural health centers equipped with telehealth, the priorities was also determined in that descriptive study. Further, we prepared a special layer for each criterion on the site selection, and by integrating such layers based on specified rules and patterns, about the spatial analysis , (like distance and density analysis were done. For such methods, we used Arc Map, Arc Catalog and Arc toolbox environments of Arc GIS (version 9.3. Finally, a map was prepared that indicated the possibility of appropriateness for establishing the centers in the study area. Considering a large number of areas, the research team selected the areas which were the appropriate location for build rural health centers which could be equipped with Telehealth.

Learning Curves: Making Quality Online Health Information Available at a Fitness Center

OpenAIRE

Dobbins, Montie T.; Tarver, Talicia; Adams, Mararia; Jones, Dixie A.

2012-01-01

Meeting consumer health information needs can be a challenge. Research suggests that women seek health information from a variety of resources, including the Internet. In an effort to make women aware of reliable health information sources, the Louisiana State University Health Sciences Center – Shreveport Medical Library engaged in a partnership with a franchise location of Curves International, Inc. This article will discuss the project, its goals and its challenges.

Learning Curves: Making Quality Online Health Information Available at a Fitness Center.

Science.gov (United States)

Dobbins, Montie T; Tarver, Talicia; Adams, Mararia; Jones, Dixie A

2012-01-01

Meeting consumer health information needs can be a challenge. Research suggests that women seek health information from a variety of resources, including the Internet. In an effort to make women aware of reliable health information sources, the Louisiana State University Health Sciences Center - Shreveport Medical Library engaged in a partnership with a franchise location of Curves International, Inc. This article will discuss the project, its goals and its challenges.

Trace element, semivolatile organic, and chlorinated organic compound concentrations in bed sediments of selected streams at Fort Gordon, Georgia, February-April 2010

Science.gov (United States)

Thomas, Lashun K.; Journey, Celeste A.; Stringfield, Whitney J.; Clark, Jimmy M.; Bradley, Paul M.; Wellborn, John B.; Ratliff, Hagan; Abrahamsen, Thomas A.

2011-01-01

A spatial survey of streams was conducted from February to April 2010 to assess the concentrations of major ions, selected trace elements, semivolatile organic compounds, organochlorine pesticides, and polychlorinated biphenyls associated with the bed sediments of surface waters at Fort Gordon military installation near Augusta, Georgia. This investigation expanded a previous study conducted in May 1998 by the U.S. Geological Survey, in cooperation with the U.S. Department of the Army Environmental and Natural Resources Management Office of the U.S. Army Signal Center and Fort Gordon, that evaluated the streambed sediment quality of selected surface waters at Fort Gordon. The data presented in this report are intended to help evaluate bed sediment quality in relation to guidelines for the protection of aquatic life, and identify temporal trends in trace elements and semivolatile organic compound concentrations at streambed sites previously sampled. Concentrations of 34 major ions and trace elements and 102 semivolatile organic, organochlorine pesticide, and polychlorinated biphenyl compounds were determined in the fine-grained fraction of bed sediment samples collected from 13 of the original 29 sites in the previous study, and 22 additional sites at Fort Gordon. Three of the sites were considered reference sites as they were presumed to be located away from potential sources of contaminants and were selected to represent surface waters flowing onto the fort, and the remaining 32 nonreference sites were presumed to be located within the contamination area at the fort. Temporal trends in trace elements and semivolatile organic compound concentrations also were evaluated at 13 of the 32 nonreference sites to provide an assessment of the variability in the number of detections and concentrations of constituents in bed sediment associated with potential sources, accumulation, and attenuation processes. Major ion and trace element concentrations in fine-grained bed

Improving patient-centered communication while using an electronic health record: Report from a curriculum evaluation.

Science.gov (United States)

Fogarty, Colleen T; Winters, Paul; Farah, Subrina

2016-05-01

Researchers and clinicians are concerned about the impact of electronic health record use and patient-centered communication. Training about patient-centered clinical communication skills with the electronic health record may help clinicians adapt and remain patient-centered. We developed an interactive workshop eliciting challenges and opportunities of working with the electronic health record in clinical practice, introduction of specific patient-centered behaviors and mindful practice techniques, and video demonstrating contrasts in common behavior and "better practices." One hundred thirty-nine resident physicians and faculty supervisors in five residency training programs at the University of Rochester Medical Center participated in the workshops. Participants were asked to complete an 11-item survey of behaviors related to their use of the electronic health record prior to training and after attending training. We used paired t-tests to assess changes in self-reported behavior from pre-intervention to post-intervention. We trained 139 clinicians in the workshops; 110 participants completed the baseline assessment and 39 completed both the baseline and post-intervention assessment. Data from post-curriculum respondents found a statistically significant increase in "I told the patient when turning my attention from the patient to the computer," from 60% of the time prior to the training to 70% of the time after. Data from our program evaluation demonstrated improvement in one communication behavior. Sample size limited the detection of other changes; further research should investigate effective training techniques for patient-centered communication while using the electronic health record. © The Author(s) 2016.

Chemistry, toxicology, and persistence of particulates during and after the 2016 Fort McMurray Wildfires in Alberta, Canada

Science.gov (United States)

Kohl, L.; Chan, A. W. H.; Cooke, C. A.; Hustins, S.; Jackson, B.; Wang, S.; Jing, X.; Meng, M.

2017-12-01

The Horse River Fire in May 2016 forced the evacuation of 88,000 Fort McMurray residents, and led to the destruction of over 2000 houses. After re-entry to homes, there is significant concern about exposures to residual fire-derived contaminants in residential houses. Wildfire research, however, provides little guidance on how long ashes and pollutants persist in household dust after major fires. The FACET project studies the chemistry and toxicology of samples of urban and forest ashes and airborne particles collected during the fire, as well as over 500 house dust samples collected in July 2017 (14 months after the fire). Here we present results on the chemical composition of the urban and forest ash samples collected during the fire along with initial results from house dust samples. Wildfire ashes contained elevated concentrations of polycyclic aromatic hydrocarbons (PAH), heavy metals, and dioxin like compounds (DLC). Relative to EPA reference doses, As and Sb constitute the greatest non-carcinogenic health hazard, whereas PAHs Benzo(a)pyrene and Indeno(1,2,3-cd)pyrene are the most relevant carcinogens. Ashes from urban locations contained higher concentrations of heavy metals and DLC than samples collected from forested areas outside of the City of Fort McMurray. Urban samples furthermore had a greater potential for generating oxidative stress than rural samples, as determined by dithiothreitol (DTT) consumption assays. The oxidative potential was positively correlated to Al, Cu, As, and V concentrations. Airborne particulate matter samples from the smoke plume contained consistent concentrations of levoglucosan (99 ± 5 mg g-1), along with other tracers for biomass burning (free lignin monomers, retene). Together these results will serve as proxies for understanding the contribution and the persistence of fire-derived pollutants in house dust in Fort McMurray homes.

Women-Centered and Culturally Responsive Heart Health Promotion Among Indigenous Women in Canada.

Science.gov (United States)

Ziabakhsh, Shabnam; Pederson, Ann; Prodan-Bhalla, Natasha; Middagh, Diane; Jinkerson-Brass, Sharon

2016-11-01

Most women in Canada confront a combination of bio-psychosocial factors that put them at risk for cardiovascular disease. The challenge for health planners is to address these factors while contextualizing interventions that meet the specific needs of particular social and cultural groupings. The article will discuss a women-centered, group-based heart health pilot initiative designed to engage with indigenous approaches to healing. The nurse practitioners co-led the group with a representative from the indigenous community to balance women-centered practices with more traditional and culturally appropriate ones. In particular, indigenous processes, such as a Talking Circle, combined with indigenous knowledge/content were integrated into the pilot program. The project was evaluated to investigate its outcomes (how the intervention impacted the participants) and processes (how participants perceived the intervention). Evaluation involved analysis of the Talking Circle's content, a focus group, field observations, and self-completed surveys. Most women made changes regarding their diet, some began physical activities, and others focused on better managing their emotional health. Women viewed the group as successful because it embraced both women-centered and culturally appropriate health promotion practices. The intervention created a culturally safe space for learning and transformation. The findings confirm the need for employing culturally relevant, gender-specific approaches to heart health promotion that are situated in and responsive to community needs. © 2016 Society for Public Health Education.

Laboratory electrical resistivity analysis of geologic samples from Fort Irwin, California: Chapter E in Geology and geophysics applied to groundwater hydrology at Fort Irwin, California

Science.gov (United States)

Bloss, Benjamin R.; Bedrosian, Paul A.

2015-01-01

Correlating laboratory resistivity measurements with geophysical resistivity models helps constrain these models to the geology and lithology of an area. Throughout the Fort Irwin National Training Center area, 111 samples from both cored boreholes and surface outcrops were collected and processed for laboratory measurements. These samples represent various lithologic types that include plutonic and metamorphic (basement) rocks, lava flows, consolidated sedimentary rocks, and unconsolidated sedimentary deposits that formed in a series of intermountain basins. Basement rocks, lava flows, and some lithified tuffs are generally resistive (≥100 ohm-meters [Ω·m]) when saturated. Saturated unconsolidated samples are moderately conductive to conductive, with resistivities generally less than 100 Ω·m, and many of these samples are less than 50 Ω·m. The unconsolidated samples can further be separated into two broad groups: (1) younger sediments that are moderately conductive, owing to their limited clay content, and (2) older, more conductive sediments with a higher clay content that reflects substantial amounts of originally glassy volcanic ash subsequently altered to clay. The older sediments are believed to be Tertiary. Time-domain electromagnetic (TEM) data were acquired near most of the boreholes, and, on the whole, close agreements between laboratory measurements and resistivity models were found. 

Relationship of Interpersonal Behaviors and Health-Related Control Appraisals to Patient Satisfaction and Compliance in a University Health Center

Science.gov (United States)

Campbell, Thomas A.; Auerbach, Stephen M.; Kiesler, Donald J.

2007-01-01

Objective: The authors' aim was to evaluate patient-provider relationships in a college health center. Participants: Eighty student patients and their health-care providers. Methods: Patients completed a measure of perceived health competence before a consultation and measures of provider participatory behavior and interpersonal behavior before…

22nd Spring Research Festival Showcases Fort Detrick Science | Poster

Science.gov (United States)

Rainy weather couldn’t dampen the spirits of visitors to the 2018 Spring Research Festival, which brought together scientists from the Frederick National Laboratory (FNL), NCI at Frederick, and the U.S. Army Medical Research and Materiel Command (USAMRMC) and showcased the important research that takes place every day at Fort Detrick.

How confident is Fort McKay that industry can reclaim oil sand development

Energy Technology Data Exchange (ETDEWEB)

Fitzpatrick, C. [Fort McKay First Nations, AB (Canada)

2004-02-05

This presentation described how traditional environmental knowledge (TEK) can provide valuable information for both the reclamation design and assessment of oil sand development in Fort McKay. Conservation is valued by the Fort McKay First Nations communities who claim that current reclamation methods are too slow, and that the land is not being brought back to its original use with the uniqueness of the boreal landscape. Elders have noted that each year the water level in the Athabasca River is lower. The blowing tailings and coke dust are causing trees to dye and driving animals away. There is concern that the animals that remain may not be safe to eat. The Fort McKay First Nation community has stated that it will view reclamation as a success only when it functions with proof over many generations. The major concerns include: salt in the water draining from reclaimed areas; salt in the soils of reclaimed area; muskeg cannot be recreated; and, the issue of whether cranberry, blueberry and streambank forest areas can be recreated, along with traditional medicinal plants. Other concerns include the loss of rivers such as the Beaver Creek and Tar River, and that the water in reclaimed areas may not be suitable for animals to live in or to drink. tabs., figs.

How confident is Fort McKay that industry can reclaim oil sand development

International Nuclear Information System (INIS)

Fitzpatrick, C.

2004-01-01

This presentation described how traditional environmental knowledge (TEK) can provide valuable information for both the reclamation design and assessment of oil sand development in Fort McKay. Conservation is valued by the Fort McKay First Nations communities who claim that current reclamation methods are too slow, and that the land is not being brought back to its original use with the uniqueness of the boreal landscape. Elders have noted that each year the water level in the Athabasca River is lower. The blowing tailings and coke dust are causing trees to dye and driving animals away. There is concern that the animals that remain may not be safe to eat. The Fort McKay First Nation community has stated that it will view reclamation as a success only when it functions with proof over many generations. The major concerns include: salt in the water draining from reclaimed areas; salt in the soils of reclaimed area; muskeg cannot be recreated; and, the issue of whether cranberry, blueberry and streambank forest areas can be recreated, along with traditional medicinal plants. Other concerns include the loss of rivers such as the Beaver Creek and Tar River, and that the water in reclaimed areas may not be suitable for animals to live in or to drink. tabs., figs

Healthcare waste generation and management practice in government health centers of Addis Ababa, Ethiopia.

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Tadesse, Menelik Legesse; Kumie, Abera

2014-11-25

Healthcare wastes are hazardous organic and inorganic wastes. The waste disposal management in Addis Ababa city is seen unscientific manner. The waste management practice in the health facilities are poor and need improvement. This study will help different organizations, stakeholders and policy makers to correct and improve the existing situation of healthcare waste legislation and enforcement and training of staff in the healthcare facilities in Addis Ababa. The study aimed to assess the existing generation and management practice of healthcare waste in selected government health centers of Addis Ababa. The cross-sectional study was conducted to quantify waste generation rate and evaluate its management system. The study area was Addis Ababa. The sample size was determined by simple random sampling technique, the sampling procedure involved 10 sub-cities of Addis Ababa. Data were collected using both waste collecting and measuring equipment and check list. The Data was entered by EPI INFO version 6.04d and analyzed by and SPSS for WINDOW version15. The mean (±SD) healthcare waste generation rate was 9.61 ± 3.28 kg/day of which (38%) 3.64 ± 1.45 kg/day was general or non-hazardous waste and (62%) 5.97 ± 2.31 kg/day was hazardous. The mean healthcare waste generation rate between health centers was a significant different with Kurskal-Wallis test (χ2 = 21.83, p-value = 0.009). All health centers used safety boxes for collection of sharp wastes and all health centers used plastic buckets without lid for collection and transportation of healthcare waste. Pre treatment of infectious wastes was not practiced by any of the health centers. All health centers used incinerators and had placenta pit for disposal of pathological waste however only seven out of ten pits had proper covering material. Segregation of wastes at point of generation with appropriate collection materials and pre- treatment of infectious waste before disposal should be practiced

Water quality and hydrology in the Fort Belvoir area, Virginia, 1954-55

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Durfor, Charles N.

1961-01-01

This report summarizes the results of an investigation of water quality and hydrology in the Fort Belvoir, Va., area for the period August 1954 to September 1955. It summarizes and evaluates information about the water resources of this area that are pertinent to the choice of location and operation of an Army nuclear power reactor. The quantity, quality, nature, and use of the local water that might be affected by the location and operation of a reactor in the area were subjects of investigation. Variations in the quality of the water caused by variation in streamflow, tidal effects, and pollution were important facets of the investigation. During extended periods of low streamflow in the Potomac River (usually in the late summer months), salty water moves upstream from Chesapeake Bay and increases the dissolved solids content of the surface waters adjacent to Fort Belvoir. When the streamflow is low the concentration of dissolved solids in the water near the river bottom exceeds that near the surface. The waters in Gunston Cove usually contain more dissolved oxygen than those in the Potomac River. During the summer, the content of dissolved oxygen in the cove waters frequently exceeds 100 percent of saturation. Surface floats that were released on a flood tide in Gunston Cove moved toward the inner portion of the cove in the same direction as the wind and the tide. The maximum average velocity of these floats was 0.65 feet per second. On an ebb tide, many surface floats that were released in Gunston Cove moved toward the inner portion of the cove in the direction of the wind, in opposition to the direction of the tidal movement. Floats released near the mouth of the cove on the same tide, moved with the tide out of the cove through a narrow pass at the end of a submerged sandbar extending from the Fort Belvoir shoreline. The maximum average velocity of the floats in the pass on this ebb tide was 0.85 feet per second. Measurements of subsurface flow direction

Nursing schools and academic health centers: toward improved alignment and a synergistic partnership

Directory of Open Access Journals (Sweden)

Emami A

2017-08-01

Full Text Available Azita Emami,1 Darcy Jaffe,2 Paula Minton-Foltz,3 Grace Parker,4 Susan Manfredi,5 Theresa Braungardt,6 Kelly W Marley,1 Laura Cooley,1 Staishy Bostick Siem7 1University of Washington School of Nursing, Seattle, WA, USA; 2Harborview Medical Center, University of Washington Medicine, Seattle, WA, USA; 3Patient Care Services, Harborview Medical Center, University of Washington Medicine, Seattle, WA, USA; 4University of Washington Medical Center, Seattle, WA, USA; 5Patient Care Services, Northwest Hospital and Medical Center, Seattle, WA, USA; 6Valley Medical Center, Seattle, WA, USA; 7Marketing and Communications, University of Washington School of Nursing, Seattle, WA, USA Abstract: This paper presents the findings from a national survey which the University of Washington conducted among leaders of 32 US academic nursing institutions that are part of academic health centers (AHCs and complements these findings with results from a separate report by the American Association of Colleges of Nursing. While expressing overall satisfaction with their AHC relationships, these leaders find that nursing is often given greater parity in matters of education and research than in mission setting, financial, and governance matters. AHCs are being asked to meet new health care challenges in new ways, starting with the education of health care professionals. AHCs need to be restructured to give nursing full parity if the nation’s and world’s needs for preventive and clinical care are to be best met.Keywords: nursing parity, academic nursing institutions, nurse leaders, institutional alignment

2009 Federal Emergency Management Agency (FEMA) Topographic LiDAR: Fort Kent, Maine

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Camp Dresser McKee Inc. contracted with Sanborn Map Company to provide LiDAR mapping services for Fort Kent, Maine. Utilizing multi-return systems, Light Detection...

Bastion on the Border: Fort Bliss, 1854-1943

Science.gov (United States)

1993-01-01

Journals , Record Group (RG) 165, Records of the War Department General and Special Staffs, National Archives, Washington, D.C. "’Richard Estrada, Border...it was the Fort Bliss garrison and the other troops deployed by Steever in the El Paso Patrol District that would have to provide the figurative glue ...little military value. For example, on March 30 three carloads of oats, flour , corn, and hay were dispatched; on April 7 fourteen carloads of hay, gasoline

The US CDC Centers for public health preparedness : building a nationwide exemplar network

Energy Technology Data Exchange (ETDEWEB)

Harris, D.A.; Paulson, G.; Perry, E. [New Jersey Univ. of Medicine and Dentistry, New Brunswick, NJ (United States). School of Public Health

2005-07-01

The network of Centers for Public Health Preparedness (CPHP) was created by the United States Centers for Disease Control and Prevention in response to the perception that public health professionals were inadequately prepared to respond to terrorism incidents, natural disasters and similar major events. The events of September 11, 2001 and the subsequent anthrax attacks confirmed the wisdom of a concerted approach to emergency preparedness. This paper provides an outline of the network's recent activities as well as a review of the rationale, history and progress of the network to date. In the most recent grant cycle, each center was required to allocate 20 per cent of its resources to network-wide activities, including contribution of CPHP-developed materials to a central resource center maintained by the Association of Schools of Public Health. The materials are publicly available and are to be used in the development of training programs; the establishment of 19 or more exemplar groups that focus on specific preparedness-related knowledge domains such as mental health, educational evaluation methods and field epidemiology, who are also expected to develop tool kits of validated and fully described training materials for use by any CPHP person or group. The outcome of the CPHP network activities is the development of a more comprehensive and robust core of preparedness training materials that aim to facilitate rapid and effective training, while at the same time eliminating redundancy and duplication of effort. It was concluded that the expenditure of 20 per cent of center funds on network development activities is forcing the academically based CPHPs to adopt a new collaborative paradigm in order to ensure effective nationwide preparedness. 3 refs.

76 FR 77684 - Establishment of the Fort Ross-Seaview Viticultural Area

Science.gov (United States)

2011-12-14

...; Treasury decision. SUMMARY: This Treasury decision establishes the 27,500-acre ``Fort Ross-Seaview... may purchase. DATES: Effective Date: January 13, 2012. FOR FURTHER INFORMATION CONTACT: Elisabeth C... may purchase. Establishment of a viticultural area is neither an approval nor an endorsement by TTB of...

Innovation in patient-centered care: lessons from a qualitative study of innovative health care organizations in Washington State

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Reed Peter

2012-12-01

Full Text Available Abstract Background Growing interest in the promise of patient-centered care has led to numerous health care innovations, including the patient-centered medical home, shared decision-making, and payment reforms. How best to vet and adopt innovations is an open question. Washington State has been a leader in health care reform and is a rich laboratory for patient-centered innovations. We sought to understand the process of patient-centered care innovation undertaken by innovative health care organizations – from strategic planning to goal selection to implementation to maintenance. Methods We conducted key-informant interviews with executives at five health plans, five provider organizations, and ten primary care clinics in Washington State. At least two readers of each interview transcript identified themes inductively; final themes were determined by consensus. Results Innovation in patient-centered care was a strategic objective chosen by nearly every organization in this study. However, other goals were paramount: cost containment, quality improvement, and organization survival. Organizations commonly perceived effective chronic disease management and integrated health information technology as key elements for successful patient-centered care innovation. Inertia, resource deficits, fee-for-service payment, and regulatory limits on scope of practice were cited as barriers to innovation, while organization leadership, human capital, and adaptive culture facilitated innovation. Conclusions Patient-centered care innovations reflected organizational perspectives: health plans emphasized cost-effectiveness while providers emphasized health care delivery processes. Health plans and providers shared many objectives, yet the two rarely collaborated to achieve them. The process of innovation is heavily dependent on organizational culture and leadership. Policymakers can improve the pace and quality of patient-centered innovation by setting targets

Dimensions of Velopharyngeal Space following Maxillary Advancement with Le Fort I Osteotomy Compared to Zisser Segmental Osteotomy: A Cephalometric Study

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Furkan Erol Karabekmez

2015-01-01

Full Text Available The objectives of this study are to assess the velopharyngeal dimensions using cephalometric variables of the nasopharynx and oropharynx as well as to compare the Le Fort I osteotomy technique to Zisser’s anterior maxillary osteotomy technique based on patients’ outcomes within early and late postoperative follow-ups. 15 patients with severe maxillary deficiency treated with Le Fort I osteotomy and maxillary segmental osteotomy were assessed. Preoperative, early postoperative, and late postoperative follow-up lateral cephalograms, patient histories, and operative reports are reviewed with a focus on defined cephalometric landmarks for assessing velopharyngeal space dimension and maxillary movement (measured for three different tracing points. A significant change was found between preoperative and postoperative lateral cephalometric measurements regarding the distance between the posterior nasal spine and the posterior pharyngeal wall in Le Fort I osteotomy cases. However, no significant difference was found between preoperative and postoperative measurements in maxillary segmental osteotomy cases regarding the same measurements. The velopharyngeal area calculated for the Le Fort I osteotomy group showed a significant difference between the preoperative and postoperative measurements. Le Fort I osteotomy for advancement of upper jaw increases velopharyngeal space. On the other hand, Zisser’s anterior maxillary segmental osteotomy does not alter the dimension of the velopharyngeal space significantly.

Non-listening and self centered leadership--relationships to socioeconomic conditions and employee mental health.

Science.gov (United States)

Theorell, Töres; Nyberg, Anna; Leineweber, Constanze; Magnusson Hanson, Linda L; Oxenstierna, Gabriel; Westerlund, Hugo

2012-01-01

The way in which leadership is experienced in different socioeconomic strata is of interest per se, as well as how it relates to employee mental health. Three waves of SLOSH (Swedish Longitudinal Occupational Survey of Health, a questionnaire survey on a sample of the Swedish working population) were used, 2006, 2008 and 2010 (n = 5141). The leadership variables were: "Non-listening leadership" (one question: "Does your manager listen to you?"--four response categories), "Self centered leadership" (sum of three five-graded questions--"non-participating", "asocial" and "loner"). The socioeconomic factors were education and income. Emotional exhaustion and depressive symptoms were used as indicators of mental health. Non-listening leadership was associated with low income and low education whereas self-centered leadership showed a weaker relationship with education and no association at all with income. Both leadership variables were significantly associated with emotional exhaustion and depressive symptoms. "Self centered" as well as "non-listening" leadership in 2006 significantly predicted employee depressive symptoms in 2008 after adjustment for demographic variables. These predictions became non-significant when adjustment was made for job conditions (demands and decision latitude) in the "non-listening" leadership analyses, whereas predictions of depressive symptoms remained significant after these adjustments in the "self-centered leadership" analyses. Our results show that the leadership variables are associated with socioeconomic status and employee mental health. "Non-listening" scores were more sensitive to societal change and more strongly related to socioeconomic factors and job conditions than "self-centered" scores.

Opening remarks for the Fort Valley Centennial Celebration (P-53)

Science.gov (United States)

G. Sam Foster

2008-01-01

The Rocky Mountain Research Station recognizes and values the contributions of our scientists and collaborators for their work over the past century at Fort Valley Experimental Forest. With the help of our partners and collaborators, Rocky Mountain Research Station is working to improve coordination across its research Program Areas and Experimental Forests and Ranges...

A Multidimensional Data Warehouse for Community Health Centers.

Science.gov (United States)

Kunjan, Kislaya; Toscos, Tammy; Turkcan, Ayten; Doebbeling, Brad N

2015-01-01

Community health centers (CHCs) play a pivotal role in healthcare delivery to vulnerable populations, but have not yet benefited from a data warehouse that can support improvements in clinical and financial outcomes across the practice. We have developed a multidimensional clinic data warehouse (CDW) by working with 7 CHCs across the state of Indiana and integrating their operational, financial and electronic patient records to support ongoing delivery of care. We describe in detail the rationale for the project, the data architecture employed, the content of the data warehouse, along with a description of the challenges experienced and strategies used in the development of this repository that may help other researchers, managers and leaders in health informatics. The resulting multidimensional data warehouse is highly practical and is designed to provide a foundation for wide-ranging healthcare data analytics over time and across the community health research enterprise.

Perceived Impacts of a Public Health Training Center Field Placement Program Among Trainees

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Patrik eJohansson

2014-07-01

Full Text Available There is heightened interest in identifying the impact of the federally-funded Public Health Training Center (PHTC program. Although evaluation studies have been conducted of public health training in general, evaluations of PHTC programs are rare. Field placement components are Congressionally-mandated requirements of PHTCs. Field placements are typically intensive, supervised externships for students to gain public health experience with local health departments or non-profit organizations. We have found no published evaluations of PHTC field placement components. This may be because of their small size and unique nature. We designed and evaluated a 200-hour field placement program at an established Public Health Training Center. The evaluation included pre/post surveys measuring public health core competencies, and post-experience interviews. We found significant increases in three competency domains among trainees: policy development and program planning, communication skills, and community dimensions of practice. These outcomes contribute to an evidence base on the efficacy of PHTC field placement programs, and underscore their role in public health training.

UC Berkeley/Stanford Children’s Environment Health Center

Data.gov (United States)

Federal Laboratory Consortium — The overall goal of this Center is to better understand the effects of exposure in the womb to air pollutants and airborne bacteria on newborn health, immune system...

Evaluation of a Person-Centered, Theory-Based Intervention to Promote Health Behaviors.

Science.gov (United States)

Worawong, Chiraporn; Borden, Mary Jo; Cooper, Karen M; Pérez, Oscar A; Lauver, Diane

Effective promotion of health behaviors requires strong interventions. Applying person-centered approaches and concepts synthesized from two motivational theories could strengthen the effects of such interventions. The aim of the study was to report the effect sizes, fidelity, and acceptability of a person-centered, health behavior intervention based on self-regulation and self-determination theories. Using a pre- and postintervention design, with a 4-week follow-up, advanced practice registered nurses made six weekly contacts with 52 volunteer participants. Most participants were educated White women. Advanced practice registered nurses elicited participant motives and particular goals for either healthy diet or physical activity behaviors. Minutes and type of activity and servings of fat and fruit/vegetables were assessed. Effect sizes for engaging in moderate aerobic activity and in fruit/vegetable and fat intake were 0.53, 0.82, and -0.57, respectively. The fidelity of delivery was 80-97% across contacts, and fidelity of participants' receipt of intervention components was supported. Participant acceptance of the intervention was supported by positive ratings on aspects of relevance and usefulness. To advance the science of health behavior change and improve client health status, person-centered approaches and concepts synthesized from motivational theories can be applied and tested with a randomized, controlled design and diverse samples to replicate and extend this promising behavioral intervention.

Hypertension care at primary health care centers: A report from Abha, Saudi Arabia

Directory of Open Access Journals (Sweden)

Al-Homrany Mohammed

2008-01-01

Full Text Available It is well known that effective management of hypertension reduces the incidence of myo-cardial infarction, stroke and vascular complications. The Ministry of Health, Kingdom of Saudi Arabia, introduced the Quality Assurance Guidelines with the hope to improve the management of hypertension in its centers. We conducted an audit of two Primary Health Care Centers namely, Al-Manhal (MPHCC and Al-Numais (NPHCC, to evaluate how well hypertension was managened at these centers. A check list was derived from the Quality Assurance Manual to audit the process and to assess the health outcome. A retrospective study on a chosen sample of 120 files of hypertensive patients, out of 256 from both the Primary Health Care Centers was performed, during the last three months of the year 2000. Results showed that 61% of the patients were between 45-64 years of age, 56% were females, 85% were married, 54% were illiterate and 7.5% were smokers. A total of 92% of the patients had primary hypertension and 25% had a positive family history of hypertension. Beta-blockers were the most commonly used drugs in both the centers. Although the recording of the information was not perfect, there was no statistical difference in the socio-demongraphic data and also the means of the total score in both the centres. On the other hand, carrying out the important procedures for hypertensive patients was found to be better at MPHCC in com-parison to NPHCC (p < 0.05. The commonly missed procedures were chest x-rays, electrolytes and ECG. Hypertension was well controlled in 63% of the patients, 58% were found to have obesity, 9% suffered from hypertension-related complications while almost 50% had good compliance to appointment in both the centers. Our study reveals that the process of hypertension care at the two Primary Health Care Centres in Aseer region was not in accordance with the recommended national standards. The reasons include lack of updating systems, recall system and

ORNL's NRC-sponsored HTGR safety and licensing analysis activities for Fort St. Vrain and advanced reactors

International Nuclear Information System (INIS)

Ball, S.J.; Cleveland, J.C.; Harrington, R.M.

1985-01-01

The ORNL safety analysis program for the HTGR was established in 1974 to provide technical assistance to the USNRC on licensing questions for both Fort St. Vrain and advanced plant concepts. The emphasis has been on development of major component and system dynamic simulation codes, and use of these codes to analyze specific licensing-related scenarios. The program has also emphasized code verification, using Fort St. Vrain data where applicable, and comparing results with industry-generated codes. By the use of model and parameter adjustment routines, safety-significant uncertainties have been identified. A major part of the analysis work has been done for the Fort St. Vrain HTGR, and has included analyses of FSAR accident scenario re-evaluations, the core block oscillation problem, core support thermal stress questions, technical specification upgrade review, and TMI action plan applicability studies. The large, 2240-MW(t) cogeneration lead plant design was analyzed in a multi-laboratory cooperative effort to estimate fission product source terms from postulated severe accidents

Operational experience at Fort St. Vrain

International Nuclear Information System (INIS)

Bramblett, G.C.; Fisher, C.R.; Swart, F.E.

1981-01-01

The Fort St. Vrain (FSV) station, a 330-MW(e) single reheat steam cycle powered by a high-temperature gas-cooled reactor (HTGR), is the first HTGR to enter commercial operation. Designed and built by General Atomic Company (GA), the plant is owned and operated by Public Service Company of Colorado (PSC). Many unique design features have been incorporated into this reactor system, including high-pressure helium as the primary system coolant, a graphite-moderated prismatic block core design, fission-product-containing carbide coatings on both fissile and fertile fuel particles, steam-driven helium circulators turning on water bearings, and once-through steam generators. All of these systems are contained in a prestressed concrete reactor vessel (PCRV). Extensive testing has been conducted during the rise to power following first criticality early in 1974 to verify system design performance. During this period, the plant has operated at power levels up to 70% and produced over one billion kilowatt hours of electricity. In 1979, the first refueling was conducted in conjunction with an extensive in-core inspection, the addition of in-core instrumentation, and a planned removal of a circulator for inspection. Later in the year, a scheduled shutdown was undertaken for surveillance tests, insertion of core region constraint devices (RCDs), and other maintenance. Fort St. Vrain has encountered problems of the type that would be expected in a first-of-a-kind system. The plant is currently restricted to 70% of design power by the Nuclear Regulatory Commission (NRC) pending resolution of the core region gas outlet temperature fluctuation problem. Even so, the basic performance of the HTGR concept and all of the unique design features have been successfully demonstrated. The system has been characterized by low personnel radiation exposures, operational flexibility, and long time afforded for status evaluation and response. (author)

Health Self-Efficacy Among Populations with Multiple Chronic Conditions: the Value of Patient-Centered Communication.

Science.gov (United States)

Finney Rutten, Lila J; Hesse, Bradford W; St Sauver, Jennifer L; Wilson, Patrick; Chawla, Neetu; Hartigan, Danielle B; Moser, Richard P; Taplin, Stephen; Glasgow, Russell; Arora, Neeraj K

2016-08-01

Using cross-sectional survey data, we assessed the association between chronic illness burden and health-related self-efficacy, evaluating whether patient-centered communication is associated with self-efficacy and if that relationship varies by chronic illness burden. Data were from the Health Information National Trends Survey, a cross-sectional survey of the US adult population collected in 2012-2013 (n = 3630). Health-related self-efficacy was measured with the item: "Overall, how confident are you about your ability to take good care of your health?" and the prevalence of six chronic conditions and depression/anxiety was assessed. Patient-centered communication was measured as the frequency with which respondents perceived their healthcare providers allowed them to ask questions, gave attention to their emotions, involved them in decisions, made sure they understood how to take care of their health, helped them to deal with uncertainty, and if they felt they could rely on their healthcare providers to take care of their healthcare needs. Health-related self-efficacy was significantly lower among individuals with greater illness burden. In adjusted analysis, individuals who experienced more positive patient-centered communication reported higher levels of self-efficacy (β = 0.26, P self-efficacy were observed among patients reporting more positive patient-centered communication; the observed association was stronger among those with greater chronic illness burden.