2005 Kansas Land Cover Patterns, Level I, State of Kansas (300m buffer)

Data.gov (United States)

Kansas Data Access and Support Center — The 2005 Kansas Land Cover Patterns map represents Phase 1 of a two-phase mapping initiative occurring over a three-year period. The map is designed to be explicitly...

2005 Kansas Land Cover Patterns, Level IV, Kansas River Watershed (1,000m buffer)

Data.gov (United States)

Kansas Data Access and Support Center — The 2005 Kansas Land Cover Patterns (KLCP) Mapping Initiative was a two-phase mapping endeavor that occurred over a three-year period (2007-2009). Note that while...

2005 Kansas Land Cover Patterns, Level I, Kansas River Watershed (1,000m buffer)

Data.gov (United States)

Kansas Data Access and Support Center — The 2005 Kansas Land Cover Patterns map represents Phase 1 of a two-phase mapping initiative occurring over a three-year period. The map is designed to be explicitly...

Kansas Road Centerline Fle (KRCF)

Data.gov (United States)

Kansas Data Access and Support Center — This version of the Kansas Road Centerline File (0801) represents the first effort to create a statewide roads layer from best available data sources. KGS integrated...

Kansas Non-State Road System

Data.gov (United States)

Kansas Data Access and Support Center — This dataset is a single centerline road network representation of 120,000 miles of the Kansas non-state highway system with limited attribution. It includes rural...

Baldrige Award cites two hospitals. Baptist, Saint Luke's hospitals honored for quality, performance.

Science.gov (United States)

Rees, Tom

2004-01-01

Baptist Hospital Inc., Pensacola, Fla.; and Saint Luke's Hospital, Kansas City, Mo., have received the prestigious Malcolm Baldrige National Quality Award in the category of healthcare. Named for a former secretary of commerce, the award recognizes efficiency, effectiveness and excellence. The two hospitals are among only seven companies in the U.S. to be so recognized this year.

Logistic and linear regression model documentation for statistical relations between continuous real-time and discrete water-quality constituents in the Kansas River, Kansas, July 2012 through June 2015

Science.gov (United States)

Foster, Guy M.; Graham, Jennifer L.

2016-04-06

The Kansas River is a primary source of drinking water for about 800,000 people in northeastern Kansas. Source-water supplies are treated by a combination of chemical and physical processes to remove contaminants before distribution. Advanced notification of changing water-quality conditions and cyanobacteria and associated toxin and taste-and-odor compounds provides drinking-water treatment facilities time to develop and implement adequate treatment strategies. The U.S. Geological Survey (USGS), in cooperation with the Kansas Water Office (funded in part through the Kansas State Water Plan Fund), and the City of Lawrence, the City of Topeka, the City of Olathe, and Johnson County Water One, began a study in July 2012 to develop statistical models at two Kansas River sites located upstream from drinking-water intakes. Continuous water-quality monitors have been operated and discrete-water quality samples have been collected on the Kansas River at Wamego (USGS site number 06887500) and De Soto (USGS site number 06892350) since July 2012. Continuous and discrete water-quality data collected during July 2012 through June 2015 were used to develop statistical models for constituents of interest at the Wamego and De Soto sites. Logistic models to continuously estimate the probability of occurrence above selected thresholds were developed for cyanobacteria, microcystin, and geosmin. Linear regression models to continuously estimate constituent concentrations were developed for major ions, dissolved solids, alkalinity, nutrients (nitrogen and phosphorus species), suspended sediment, indicator bacteria (Escherichia coli, fecal coliform, and enterococci), and actinomycetes bacteria. These models will be used to provide real-time estimates of the probability that cyanobacteria and associated compounds exceed thresholds and of the concentrations of other water-quality constituents in the Kansas River. The models documented in this report are useful for characterizing changes

1990 Kansas Land Cover Patterns Update

Data.gov (United States)

Kansas Data Access and Support Center — In 2008, an update of the 1990 Kansas Land Cover Patterns (KLCP) database was undertaken. The 1990 KLCP database depicts 10 general land cover classes for the State...

78 FR 50409 - Kansas Municipal Energy Agency v. Sunflower Electric Power Corporation, Mid-Kansas Electric...

Science.gov (United States)

2013-08-19

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket Nos. EL13-84-000] Kansas Municipal Energy Agency v. Sunflower Electric Power Corporation, Mid-Kansas Electric Company, LLC, Southwest... 306 of the Federal Power Act, 16 U.S.C. 824e and 825e and Rule 206 of the Federal Energy Regulatory...

Surface-water-quality assessment of the lower Kansas River basin, Kansas and Nebraska; results of investigations, 1987-90

Science.gov (United States)

Helgesen, J.O.

1995-01-01

Surface-water-quality conditions and trends were assessed in the lower Kansas River Basin, which drains about 15,300 square miles of mainly agricultural land in southeast Nebraska and northeast Kansas. On the basis of established water-quality criteria, most streams in the basin were suitable for uses such as public-water supply, irrigation, and maintenance of aquatic life. However, most concerns identified from a previous analysis of available data through 1986 are substantiated by analysis of data for May 1987 through April 1990. Less-than-normal precipitation and runoff during 1987-90 affected surface-water quality and are important factors in the interpretation of results.Dissolved-solids concentrations in the main stem Kansas River during May 1987 through April 1990 commonly exceeded 500 milligrams per liter, which may be of concern for public-water supplies and for the irrigation of sensitive crops. Large concentrations of chloride in the Kansas River are derived from ground water discharging in the Smoky Hill River Basin west of the study unit. Trends of increasing concentrations of some dissolved major ions were statistically significant in the northwestern part of the study unit, which could reflect substantial increases in irrigated acreage.The largest concentrations of suspended sediment in streams during May 1987 through April 1990 were associated with high-density cropland in areas of little local relief and medium-density irrigated cropland in more dissected areas. The smallest concentrations were measured downstream from large reservoirs and in streams draining areas having little or no row-crop cultivation. Mean annual suspended-sediment transport rates in the main stem Kansas River increased substantially in the downstream direction. No conclusions could be reached concerning the relations of suspended-sediment transport, yields, or trends to natural and human factors.The largest sources of nitrogen and phosphorus in the study unit were fertilizer

Kansas City Cardiomyopathy Questionnaire Utility in Prediction of 30-Day Readmission Rate in Patients with Chronic Heart Failure

Directory of Open Access Journals (Sweden)

Shengchuan Dai

2016-01-01

Full Text Available Background. Heart failure (HF is one of the most common diagnoses associated with hospital readmission. We designed this prospective study to evaluate whether Kansas City Cardiomyopathy Questionnaire (KCCQ score is associated with 30-day readmission in patients hospitalized with decompensated HF. Methods and Results. We enrolled 240 patients who met the study criteria. Forty-eight (20% patients were readmitted for decompensated HF within thirty days of hospital discharge, and 192 (80% patients were not readmitted. Compared to readmitted patients, nonreadmitted patients had a higher average KCCQ score (40.8 versus 32.6, P = 0.019 before discharge. Multivariate analyses showed that a high KCCQ score was associated with low HF readmission rate (adjusted OR = 0.566, P = 0.022. The c-statistic for the base model (age + gender was 0.617. The combination of home medication and lab tests on the base model resulted in an integrated discrimination improvement (IDI increase of 3.9%. On that basis, the KCQQ further increased IDI of 2.7%. Conclusions. The KCCQ score determined before hospital discharge was significantly associated with 30-day readmission rate in patients with HF, which may provide a clinically useful measure and could significantly improve readmission prediction reliability when combined with other clinical components.

Kansas Satellite Image Database (KSID) 2004-2005

Data.gov (United States)

Kansas Data Access and Support Center — The Kansas Satellite Image Database (KSID) 2004-2005 consists of terrain-corrected, precision rectified spring, summer, and fall Landsat 5 Thematic Mapper (TM)...

Site environmental report for calendar year 1992, Kansas City Plant, Kansas City, Missouri

International Nuclear Information System (INIS)

1993-05-01

The Kansas City Plant is a government-owned, contractor-operated facility. AlliedSignal and its predecessors have been the operating contractors since 1949. The principal operation performed at the Kansas City Plant is the manufacture of non-nuclear components for nuclear weapons. This activity involves metals and plastics machining, plastics fabrication, plating, microelectronics, and electrical and mechanical assembly. No radioactive materials are machined or processed. This report presents information and data pertaining to the environmental monitoring program and compliance with environmental standards

Kansas Water Quality Action Targeting System (KATS)

Data.gov (United States)

Kansas Data Access and Support Center — This system is a revision of the original KATS system developed in 1990 as a tool to aid resource managers target Kansas valuable and vulnerable water resources for...

Endangered Fish Species in Kansas: Historic vs Contemporary Distribution

Science.gov (United States)

Background/Question/Methods Kansas state has more freshwater fish species than other states in the west and northern US. Based on recent count, more than 140 fishes have been documented in Kansas rivers. And at least five are categorized as endangered species in Kansas (and thre...

History of natural flows--Kansas River

Science.gov (United States)

Leeson, Elwood R.

1958-01-01

Through its Water Resources Division, the United States Geological Survey has become the major water-resources historian for the nation. The Geological Survey's collection of streamflow records in Kansas began on a very small scale in 1895 in response to some early irrigation interest, Since that time the program has grown, and we now have about 21 350 station-years of record accumulated. A station-year of record is defined as a continuous record of flow collected at a fixed point for a period of one year. Volume of data at hand, however, is not in itself an, adequate measure of its usefullness. An important element in historical streamflow data which enhances its value as a tool for the prediction of the future is the length of continuous records available in the area being studied. The records should be of sufficient length that they may be regarded as a reasonable sample of what has gone before and may be expected in the future. Table 1 gives a graphical inventory of the available streamflow records in Kansas. It shows that, in general, there is a fair coverage of stations with records of about thirty-seven years in length, This is not a long period as history goes but it does include considerable experience with floods and droughts.Although a large quantity of data on Kansas streamflow has been accumulated, hydrologists and planning engineers find that stream flow information for many areas of the State is considerably less than adequate. The problem of obtaining adequate coverage has been given careful study by the Kansas Water Resources Board in cooperation with the U. S. Geological Survey and a report entitled "Development of A Balanced Stream-Gaging Program For Kansas", has been published by the Board as Bulletin No. 4, That report presents an analysis of the existing stream-gaging program and recommendations for a program to meet the rapidly expanding needs for more comprehensive basic data.The Kansas River is formed near Junction City, Kansas, by the

Kansas Adult Observational Safety Belt Usage Rates

Science.gov (United States)

2011-07-01

Methodology of Adult Survey - based on the federal guidelines in the Uniform Criteria manual. The Kansas survey is performed at 548 sites on 6 different road types in 20 randomly selected counties which encompass 85% of the population of Kansas. The ...

Ecoregions of Kansas

Data.gov (United States)

Kansas Data Access and Support Center — Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a...

My Kansas Library on the Web

Science.gov (United States)

Moreland, Sharon

2009-01-01

In this article, the author, a technology consultant for the Northeast Kansas Library System (NEKLS), shares the story of how the Kansas Library on the Web (KLOW) program was created. KLOW's story begins with the initial startup fund finding and the enthusiasm of the six pilot libraries. The middle of the story has to do with building a flexible,…

ASTER 2002-2003 Kansas Satellite Image Database (KSID)

Data.gov (United States)

Kansas Data Access and Support Center — The Kansas Satellite Image Database (KSID):2002-2003 consists of image data gathered by three sensors. The first image data are terrain-corrected, precision...

MODIS 2002-2003 Kansas Satellite Image Database (KSID)

Data.gov (United States)

Kansas Data Access and Support Center — The Kansas Satellite Image Database (KSID):2002-2003 consists of image data gathered by three sensors. The first image data are terrain-corrected, precision...

Improved oil recovery in fluvial dominated deltaic reservoirs of Kansas - Near-term, Class I

Energy Technology Data Exchange (ETDEWEB)

Green, D.W.; Willhite, G.P.; Reynolds, Rodney R.; McCune, A. Dwayne; Michnick, Michael J.; Walton, Anthony W.; Watney, W. Lynn

2000-06-08

This project involved two demonstration projects, one in a Marrow reservoir located in the southwestern part of the state and the second in the Cherokee Group in eastern Kansas. Morrow reservoirs of western Kansas are still actively being explored and constitute an important resource in Kansas. Cumulative oil production from the Morrow in Kansas is over 400,000,000 bbls. Much of the production from the Morrow is still in the primary stage and has not reached the mature declining state of that in the Cherokee. The Cherokee Group has produced about 1 billion bbls of oil since the first commercial production began over a century ago. It is a billion-barrel plus resource that is distributed over a large number of fields and small production units. Many of the reservoirs are operated close to the economic limit, although the small units and low production per well are offset by low costs associated with the shallow nature of the reservoirs (less than 1000 ft. deep).

Solar heating and cooling system installed at Leavenworth, Kansas. Final report

Energy Technology Data Exchange (ETDEWEB)

Perkins, R. M.

1980-06-01

The solar heating and cooling system installed at the headquarters of Citizens Mutual Savings Association in Leavenworth, Kansas, is described in detail. The project is part of the U.S. Department of Energy's solar demonstration program and became operational in March, 1979. The designer was TEC, Inc. Consulting Engineers, Kansas City, Missouri and contractor was Norris Brothers, Inc., Lawrence, Kansas. The solar system is expected to furnish 90 percent of the overall heating load, 70 percent of the cooling load and 100 percent of the domestic hot water load. The building has two floors with a total of 12,000 square feet gross area. The system has 120 flat-plate liquid solar panels with a net area of 2200 square feet. Five, 3-ton Arkla solar assisted absorption units provide the cooling, in conjunction with a 3000 gallon chilled water storage tank. Two, 3000 gallon storage tanks are provided with one designated for summer use, whereas both tanks are utilized during winter.

Serpentinization and the origin of hydrogen gas in Kansas

Energy Technology Data Exchange (ETDEWEB)

Coveney, R.M. Jr.; Goebel, E.D.; Zeller, E.J.; Dreschhoff, G.A.M.; Angino, E.E.

1987-01-01

Hydrogen gas occurs in ten Kansas wells near the Mid-Continent rift system. Since 1982, two wells have yielded small amounts of gases containing an average of 29-37 mole % H/sub 2/, the remainder being chiefly N/sub 2/ with only traces of hydrocarbons. Isotopic compositions for hydrogen (delta D = -740 to -836 per thousand) imply near-ambient (about 10/sup 0/C) equilibration temperatures for the gases, which are among the most deuterium-depleted in nature and resemble the H/sub 2/-rich gases described from ophiolites in Oman. Isotopic values for the Kansas N/sub 2/ differ slightly from those of the atmosphere, but not enough to rule out an atmospheric origin. Because they are low in CH/sub 4/ and CO/sub 2/, expected byproducts of biogenic activity, the gases are probably abiogenic in origin. The existence of such gases near a major rift system, containing mafic rocks, and not far from known kimberlites is consistent with an origin from reactions involving Fe/sup +2/ oxidation, for example during serpentinization. Because the gases may be associated with kimberlites and deep-seated rifting, mantle outgassing is possible, but such an origin would be difficult to reconcile with the low isotopic temperatures. The H/sub 2/ gases from Kansas (and elsewhere) seem to be too low in pressure to have commercial value. However, neither the Kansas gases nor those from other H/sub 2/ occurrences have been adequately examined to assess their importance as potential resources. 4 figures, 3 tables.

A Kansas Integrated Commercialization Information Network (KICIN).

Science.gov (United States)

Ambler, C.; And Others

A consortium of Kansas economic development service providers is building a web of virtual satellite offices that will demonstrate the delivery of economic development services in all areas of Kansas. These "offices" will use the Internet and a novel information delivery system to reach small and medium-sized businesses and individuals…

Aerial gamma ray and magnetic survey: Kansas City Quadrangle of Kansas and Missouri. Final report

International Nuclear Information System (INIS)

1980-11-01

The Kansas City quadrangle covers approximately 7400 square miles in northwestern Missouri and northeastern Kansas. It overlies the southeastern edge of the Forest City Basin, which contains predominantly Paleozoic sediments. Permian and Pennsylvanian formations cover much of the surface, but Quaternary sedimentation dominates certain regions of the quadrangle. A search of available literature revealed no known uranium deposits. A total of 102 uranium anomalies were detected and are discussed briefly. None were considered significant and all appear to be related to cultural features. Magnetic data appears to correlate directly with underlying Precambrian material

Catastrophic sinkhole formation in Kansas: A case study

Science.gov (United States)

Lambrecht, J.L.; Miller, R.D.

2006-01-01

Sinkholes represent a hazard to property and human safety in a wide variety of geologic settings across the globe. In most cases, the subsidence rate of a sinkhole represents the most significant potential impact and risk to public safety. Since 1979, the Kansas Geological Survey has studied numerous sinkholes using high-resolution seismic reflection in an attempt to better understand the mechanisms that control their formation. Most sinkholes in central Kansas form as a result of dissolution of the Permian Hutchinson salt (Figure 1). The fluid source and associated pathway responsible for leaching these bedded evaporites have been natural, anthropogenic, and a combination of both. Sinkholes have been a part of the landscape in the North American midcontinent long before modern oil, gas, and mineral exploration, but clearly the activities of man have played a significant role in both increasing the number of sinkholes and affecting their subsidence rates.

Landsat TM and ETM+ Kansas Satellite Image Database (KSID)

Data.gov (United States)

Kansas Data Access and Support Center — The Kansas Satellite Image Database (KSID):2000-2001 consists of terrain-corrected, precision rectified spring, summer, and fall Landsat 5 Thematic Mapper (TM) and...

Kansas Protects and Restores Wetlands, Streams and Riparian Areas

Science.gov (United States)

Wetland Program Development Grant (WPDG) in 2007 when the Kansas State Conservation Commission began identifying team members interested in developing a framework for a comprehensive Kansas Wetland and Aquatic Resources Conservation Plan.

40 CFR 81.251 - Northeast Kansas Intrastate Air Quality Control Region.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Northeast Kansas Intrastate Air... Air Quality Control Regions § 81.251 Northeast Kansas Intrastate Air Quality Control Region. The Northeast Kansas Intrastate Air Quality Control Region consists of the territorial area encompassed by the...

The Marketing Performance of Illinois and Kansas Wheat Farmers

OpenAIRE

Dietz, Sarah N.; Aulerich, Nicole M.; Irwin, Scott H.; Good, Darrel L.

2008-01-01

The purpose of this paper is to investigate the marketing performance of wheat farmers in Illinois and Kansas over 1982-2004. The results show that farmer benchmark prices for wheat in Illinois and Kansas fall in the middle-third of the price range about half to three-quarters of the time. Consistent with previous studies, this refutes the contention that Illinois and Kansas wheat farmers routinely market the bulk of their wheat crop in the bottom portion of the price range. Tests of the aver...

Kansas Wind Energy Consortium

Energy Technology Data Exchange (ETDEWEB)

Gruenbacher, Don [Kansas State Univ., Manhattan, KS (United States)

2015-12-31

This project addresses both fundamental and applied research problems that will help with problems defined by the DOE “20% Wind by 2030 Report”. In particular, this work focuses on increasing the capacity of small or community wind generation capabilities that would be operated in a distributed generation approach. A consortium (KWEC – Kansas Wind Energy Consortium) of researchers from Kansas State University and Wichita State University aims to dramatically increase the penetration of wind energy via distributed wind power generation. We believe distributed generation through wind power will play a critical role in the ability to reach and extend the renewable energy production targets set by the Department of Energy. KWEC aims to find technical and economic solutions to enable widespread implementation of distributed renewable energy resources that would apply to wind.

Pick-N-Pull Auto Dismantlers, Kansas City, LLC Inc.

Science.gov (United States)

The EPA is providing notice of a proposed Administrative Penalty Assessment against Pick-N-Pull Auto Dismantlers, Kansas City, LLC, a subsidiary of Schnitzer Steel Industries, Inc., for alleged violations at its facilities at 8012 East Truman Rd., Kansas C

Kansas's forests, 2005: statistics, methods, and quality assurance

Science.gov (United States)

Patrick D. Miles; W. Keith Moser; Charles J. Barnett

2011-01-01

The first full annual inventory of Kansas's forests was completed in 2005 after 8,868 plots were selected and 468 forested plots were visited and measured. This report includes detailed information on forest inventory methods and data quality estimates. Important resource statistics are included in the tables. A detailed analysis of Kansas inventory is presented...

Streamflow alteration at selected sites in Kansas

Science.gov (United States)

Juracek, Kyle E.; Eng, Ken

2017-06-26

An understanding of streamflow alteration in response to various disturbances is necessary for the effective management of stream habitat for a variety of species in Kansas. Streamflow alteration can have negative ecological effects. Using a modeling approach, streamflow alteration was assessed for 129 selected U.S. Geological Survey streamgages in the State for which requisite streamflow and basin-characteristic information was available. The assessment involved a comparison of the observed condition from 1980 to 2015 with the predicted expected (least-disturbed) condition for 29 streamflow metrics. The metrics represent various characteristics of streamflow including average flow (annual, monthly) and low and high flow (frequency, duration, magnitude).Streamflow alteration in Kansas was indicated locally, regionally, and statewide. Given the absence of a pronounced trend in annual precipitation in Kansas, a precipitation-related explanation for streamflow alteration was not supported. Thus, the likely explanation for streamflow alteration was human activity. Locally, a flashier flow regime (typified by shorter lag times and more frequent and higher peak discharges) was indicated for three streamgages with urbanized basins that had higher percentages of impervious surfaces than other basins in the State. The combination of localized reservoir effects and regional groundwater pumping from the High Plains aquifer likely was responsible, in part, for diminished conditions indicated for multiple streamflow metrics in western and central Kansas. Statewide, the implementation of agricultural land-management practices to reduce runoff may have been responsible, in part, for a diminished duration and magnitude of high flows. In central and eastern Kansas, implemented agricultural land-management practices may have been partly responsible for an inflated magnitude of low flows at several sites.

KANSAS KIDS COUNT Data Book, 2000: Kansas Children at Risk.

Science.gov (United States)

Kansas Action for Children, Inc., Topeka.

This KIDS COUNT Data Book provides state and county data on the well-being of Kansas' children. The statistical portrait is based on 22 indicators of well-being: (1) births to single teens; (2) children living in poverty; (3) children receiving free school meals; (4) children in families receiving economic assistance; (5) childhood deaths; (6)…

76 FR 63940 - Kansas; Major Disaster and Related Determinations

Science.gov (United States)

2011-10-14

... follows: I have determined that the damage in certain areas of the State of Kansas resulting from flooding... Act for Public Assistance and Hazard Mitigation will be limited to 75 percent of the total eligible... declaration of a major disaster for the State of Kansas (FEMA-4035-DR), dated September 23, 2011, and related...

Residential radon in Kansas City-black shales aren't the prime suspect

International Nuclear Information System (INIS)

Spencer, C.G.

1993-01-01

The US EPA preliminary assessment of potential radon risk (EPA, 1986) depicted a large area of the mid-continent in which radon levels might be elevated due to the presence of uranium-rich black shales. A preliminary study (Hilpman, Coveney ampersand Spencer, 1988) indicated that a significant percentage of homes in the greater Kansas City area had radon screening levels above 4 pCi/L. However, their lab tests with crushed black shale, and radon tests in limestone mines with black shale floors showed that the shale did not yield extremely high radon levels. This expanded study presents additional results of screening tests in homes, and correlates those results to bedrock geology and soil type. High radon levels in the Kansas city area are not due primarily to black shale sources. The highest readings are associated with limestone and non-organic shale. Mean radon level is higher in younger cyclothemic deposits, and a loessial soil. The EPA initial assessment overstated the radon risk attributable to black uraniferous shale sources. Assessment of the overall potential risk for the greater Kansas City area requires further evaluation of other sources

Landsat TM and ETM+ 2002-2003 Kansas Satellite Image Database (KSID)

Data.gov (United States)

Kansas Data Access and Support Center — The Kansas Satellite Image Database (KSID):2002-2003 consists of image data gathered by three sensors. The first image data are terrain-corrected, precision...

Kansas State Briefing Book on low-level radioactive waste management

International Nuclear Information System (INIS)

1981-07-01

The Kansas State Briefing Book is one of a series of state briefing books on low-level radioactive waste management practices. It has been prepared to assist state and federal agency officials in planning for safe low-level radioactive waste disposal. The report contains a profile of low-level radioactive waste generators in Kansas. The profile is the result of a survey of radioactive material licensees in Kansas. The briefing book also contains a comprehensive assessment of low-level radioactive waste management issues and concerns as defined by all major interested parties including industry, government, the media, and interest groups. The assessment was developed through personal communications with representatives of interested parties, and through a review of media sources. Lastly, the briefing book provides demographic and socioeconomic data and a discussion of relevant government agencies and activities, all of which may affect waste management practices in Kansas

Ramona, Kansas, Corrective Action Monitoring Report for 2015

Energy Technology Data Exchange (ETDEWEB)

LaFreniere, Lorraine M. [Argonne National Lab. (ANL), Argonne, IL (United States)

2016-04-01

This report describes groundwater monitoring in 2015 for the property at Ramona, Kansas, on which a grain storage facility was formerly operated by the Commodity Credit Corporation of the U.S. Department of Agriculture (CCC/USDA). The monitoring was implemented on behalf of the CCC/USDA by Argonne National Laboratory and was conducted as specified in the Long-Term Groundwater Monitoring Plan (Argonne 2012) approved by the Kansas Department of Health and Environment (KDHE 2012).

Residential Energy Efficiency Potential: Kansas

Energy Technology Data Exchange (ETDEWEB)

Wilson, Eric J [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

2017-11-02

Energy used by Kansas single-family homes that can be saved through cost-effective improvements. Prepared by Eric Wilson and Noel Merket, NREL, and Erin Boyd, U.S. Department of Energy Office of Energy Policy and Systems Analysis.

Hemoglobin Kansas found by electrophoretic diagnosis in Brazil Hemoglobina Kansas diagnosticada através de eletroforese no Brasil

Directory of Open Access Journals (Sweden)

Claudia R. Bonini-Domingos

2002-03-01

Full Text Available Some hemoglobin variants with abnormal oxygen affinity have been reported so far from various regions of the world. They can be classified by their oxygen affinity and 15 variants with low oxygen affinity have been reported. A number of hemoglobin mutants which show an abnormal affinity for oxygen have been reported, but only few cases of hemoglobin Kansas. All cases reported so far are from Japan or in Japanese families. In this paper we describe a Brazilian patient with cyanosis and hemoglobin Kansas diagnosed by an electrophoretical procedure.Hemoglobinas variantes com afinidade anormal ao oxigênio têm sido encontradas em várias partes do mundo. Pela sua afinidade ao oxigênio, estas hemoglobinas variantes têm sido classificadas e 15 variantes com baixa afinidade relatadas. Numerosas hemoglobinas mutantes com afinidade anormal têm também sido relatadas, mas somente poucos casos de Hemoglobina Kansas. Os casos são de pacientes procedentes do Japão, ou de famílias com descendentes japoneses. Neste relato descrevemos um paciente com manifestações de cianose que teve o seu diagnóstico confirmado através da eletroforese.

Uranium Yellow Cake accident - Wichita, Kansas

International Nuclear Information System (INIS)

Borchert, H.R.

1987-01-01

A tractor and semi trailer containing Uranium Yellow Cake, had overturned on I-235, Wichita, Kansas on Thursday, March 22, 1979. The truck driver and passenger were transported, with unknown injuries, to the hospital by ambulance. The shipment consisted of 54 drums of Uranium Ore Concentrate Powder. Half of the drums were damaged or had their lids off. Since it was raining at the time of the accident, plastic was used to cover the barrels and spilled material in an attempt to contain the yellow cake. A bulldozer was used to construct a series of dams in the median and the ditch to contain the run-off water from the contaminated area. Adverse and diverse weather conditions hampered the clean up operations over the next several days. The contaminated water and soil were shipped back to the mine for reintroduction into the milling process. The equipment was decontaminated prior to being released from the site. The clean up personnel wore protective clothing and respiratory protection equipment, if necessary. All individuals were surveyed and decontaminated prior to exiting the area

77 FR 24147 - Drawbridge Operation Regulation; Mile 359.4, Missouri River, Kansas City, MO

Science.gov (United States)

2012-04-23

... Operation Regulation; Mile 359.4, Missouri River, Kansas City, MO AGENCY: Coast Guard, DHS. ACTION: Notice... River, mile 359.4, at Kansas City, Missouri. The deviation is necessary to allow the replacement of... Railroad Drawbridge, across the Missouri River, mile 359.4, at Kansas City, Missouri to remain in the...

40 CFR 131.34 - Kansas.

Science.gov (United States)

2010-07-01

... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY STANDARDS Federally Promulgated Water Quality Standards § 131.34 Kansas. (a) In addition to the State-adopted use... Creek 10270102 88 Secondary Contact Recreation Sand Creek 10270102 65 Secondary Contact Recreation...

77 FR 72737 - Drawbridge Operation Regulation; Mile 359.4, Missouri River, Kansas City, MO

Science.gov (United States)

2012-12-06

... Operation Regulation; Mile 359.4, Missouri River, Kansas City, MO AGENCY: Coast Guard, DHS. ACTION: Notice... River, mile 359.4, at Kansas City, Missouri. The deviation is necessary to allow the replacement of 64... deviation for the Harry S. Truman Railroad Drawbridge, across the Missouri River, mile 359.4, at Kansas City...

Sexting in Kansas Schools

Science.gov (United States)

May, Dale R.

2011-01-01

This paper is an exploratory study about sexting, the sending of sexually explicit or illicit photos or video between cell phones, in Kansas public schools. An on-line survey asked superintendents to report if they have had an occurrence of sexting in their district. They were also asked if they felt sexting is currently a problem in their…

Kansas Kids Count Data Book, 1998. A Project of Kansas Action for Children.

Science.gov (United States)

Kansas Action for Children, Inc., Topeka.

The Kids Count Data Book examines trends in the well-being of Kansas children. The statistical portrait is based on trends in 22 indicators of child well-being, grouped into 5 areas: (1) economic well-being--births to single teens, free school meals, family economic assistance, child poverty rates; (2) physical health and safety--childhood deaths,…

Kansas Kids Count Data Book, 1999. A Project of Kansas Action for Children.

Science.gov (United States)

Kansas Action for Children, Inc., Topeka.

The Kids Count Data Book examines trends in the well-being of Kansas children. This statistical portrait is based on trends in 22 indicators of child well-being, grouped into 5 areas: (1) economic well-being--births to single teens, child poverty rates, free school meals, and family economic assistance; (2) physical health and safety--childhood…

Structural nature of the Humboldt fault zone in northeastern Nemaha County, Kansas

International Nuclear Information System (INIS)

Stander, T.W.

1989-01-01

The Kansas Geological Survey has conducted a major re-evaluation of the geology and seismicity of Kansas in connection with design criteria for dams, nuclear-power plants, and other earthquake-sensitive structures. Northeast Kansas was chosen as a study area because of the concentration of seismic activity and the stratigraphic evidence for the maximum amount of vertical displacement of the humboldt fault. This study determines the nature of the deformation on the Humboldt fault and resolves its lateral position and total vertical throw in the near-surface

Forests of Kansas, 2015

Science.gov (United States)

Dacia M. Meneguzzo

2016-01-01

This resource update provides an overview of forest resources in Kansas based on inventories conducted by the U.S. Forest Service, Forest Inventory and Analysis (FIA) program of the Northern Research Station. For annual inventory years 2001-2013, the sample length was equal to 5 years. Beginning in 2014, the cycle length was changed to 7 years. For the 2015 inventory,...

Forests of Kansas, 2016

Science.gov (United States)

Dacia M. Meneguzzo

2017-01-01

This resource update provides an overview of forest resources in Kansas based on inventories conducted by the U.S. Forest Service, Forest Inventory and Analysis (FIA) program of the Northern Research Station. For annual inventory years 2001-2013, the sample length was equal to 5 years. Beginning in 2014, the cycle length was changed to 7 years. For the 2016 inventory,...

Coccidioidomycosis-associated hospitalizations, California, USA, 2000-2011.

Science.gov (United States)

Sondermeyer, Gail; Lee, Lauren; Gilliss, Debra; Tabnak, Farzaneh; Vugia, Duc

2013-10-01

In the past decade, state-specific increases in the number of reported cases of coccidioidomycosis have been observed in areas of California and Arizona where the disease is endemic. Although most coccidioidomycosis is asymptomatic or mild, infection can lead to severe pulmonary or disseminated disease requiring hospitalization and costly disease management. To determine the epidemiology of cases and toll of coccidioidomycosis-associated hospitalizations in California, we reviewed hospital discharge data for 2000-2011. During this period, there were 25,217 coccidioidomycosis-associated hospitalizations for 15,747 patients and >$2 billion US in total hospital charges. Annual initial hospitalization rates increased from 2.3 initial hospitalizations/100,000 population in 2000 to 5.0 initial hospitalizations/100,000 population in 2011. During this period, initial hospitalization rates were higher for men than women, African Americans and Hispanics than Whites, and older persons than younger persons. In California, the increasing health- and cost-related effects of coccidioidomycosis-associated hospitalizations are a major public health challenge.

Final corrective action study for the former CCC/USDA facility in Ramona, Kansas.

Energy Technology Data Exchange (ETDEWEB)

LaFreniere, L. M. (Environmental Science Division)

2011-04-20

Past operations at a grain storage facility formerly leased and operated by the Commodity Credit Corporation of the U.S. Department of Agriculture (CCC/USDA) in Ramona, Kansas, resulted in low concentrations of carbon tetrachloride in groundwater that slightly exceed the regulatory standard in only one location. As requested by the Kansas Department of Health and Environment, the CCC/USDA has prepared a Corrective Action Study (CAS) for the facility. The CAS examines corrective actions to address groundwater impacted by the former CCC/USDA facility but not releases caused by other potential groundwater contamination sources in Ramona. Four remedial alternatives were considered in the CAS. The recommended remedial alternative in the CAS consists of Environmental Use Control to prevent the inadvertent use of groundwater as a water supply source, coupled with groundwater monitoring to verify the continued natural improvement in groundwater quality. The Commodity Credit Corporation of the U.S. Department of Agriculture (CCC/USDA) has directed Argonne National Laboratory to prepare a Corrective Action Study (CAS), consistent with guidance from the Kansas Department of Health and Environment (KDHE 2001a), for the CCC/USDA grain storage facility formerly located in Ramona, Kansas. This effort is pursuant to a KDHE (2007a) request. Although carbon tetrachloride levels at the Ramona site are low, they remain above the Kansas Tier 2 risk-based screening level (RBSL) and the U.S. Environmental Protection Agency (EPA) maximum contaminant level (MCL) of 5 {micro}g/L (Kansas 2003, 2004). In its request for the CAS, the KDHE (2007a) stated that, because of these levels, risk is associated with potential future exposure to contaminated groundwater. The KDHE therefore determined that additional measures are warranted to limit future use of the property and/or exposure to contaminated media as part of site closure. The KDHE further requested comparison of at least two corrective

78 FR 70934 - Trespassing on DOE Property: Kansas City Plant Facilities

Science.gov (United States)

2013-11-27

... than $5,000.' By operation of law, the Criminal Fine Improvements Act of 1987, Public Law 100-185, 101 Stat. 1279 (1987), increased the fine amounts from $1000/$5000 to $5000/$100,000. See, e.g., U.S. v..., Director, Security & Information Technology Systems, NNSA Kansas City Plant, 14520 Botts Road, Kansas City...

Hospital employs TQM principles to rework its evaluation system.

Science.gov (United States)

Burda, D

1992-02-24

One Kansas hospital has taken the traditional employee evaluation process--with all its performance criteria, point systems and rankings--and turned it on its head. The new system employs total quality management principles and promotes personal development, education and teamwork. And everyone gets the same raise.

Analysis of endangered Kansas fish species distribution during historical and contemporary periods (pre- and post-1969)

Science.gov (United States)

Background/Question/Methods Kansas has more freshwater fish species than other states in the west and northern US. More than 140 fishes have recently been documented in Kansas rivers; of these, at least five are categorized as endangered species in Kansas (and threatened species ...

Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Kansas

Energy Technology Data Exchange (ETDEWEB)

Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

2016-02-15

The 2015 IECC provides cost-effective savings for residential buildings in Kansas. Moving to the 2015 IECC from the 2009 IECC base code is cost-effective for residential buildings in all climate zones in Kansas.

77 FR 21760 - Atmos Energy Colorado/Kansas Division; Notice of Baseline Filing

Science.gov (United States)

2012-04-11

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. PR12-19-000] Atmos Energy Colorado/Kansas Division; Notice of Baseline Filing Take notice that on March 30, 2012, Atmos Energy Colorado/Kansas Division (Atmos) submitted a baseline filing of their Statement of Operating Conditions for...

Kansas City Transportation and Local-Scale Air Quality Study (KC-TRAQS) Fact Sheet

Science.gov (United States)

In fall 2017, the U.S. Environmental Protection Agency (EPA) launched the Kansas City Transportation Local-Scale Air Quality Study (KC-TRAQS) to learn more about local community air quality in three neighborhoods in Kansas City, KS.

Coalbed methane production base established in Southeast Kansas

International Nuclear Information System (INIS)

Stoeckinger, W.T.

1992-01-01

This paper reports that revenue from coalbed methane gas sales is growing and currently far exceeds that of what little conventional gas is produced in southeastern Kansas. And this only 2-1/2 years after Stroud Oil Properties, Wichita, brought in the first coalbed methane well in the Sycamore Valley in Montgomery County 6 miles north of Independence. Another operator contributing to the success is Conquest Oil, Greeley, Colo. Conquest acquired a lease with 20 old wells near Sycamore, recompleted five of them in Weir coal, and has installed a compressor. It hopes to being selling a combined 300 Mcfd soon. Great Eastern Energy, Denver, reportedly can move 2 MMcfd from its Sycamore Valley holdings. The fever is spreading into Northeast Kansas, where a venture headed by Duncan Energy Co. and Farleigh Oil Properties, also of Denver, plan 12 coalbed methane wildcats. The two companies received in October 1991 from the Kansas Corporation Commission (KCC) a 40 acre well spacing for seven counties and an exclusion from burdensome gas testing procedures. The test procedures are on the books but not applicable to coal gas wells

Routine environment audit of the Kansas City Plant, Kansas City, Missouri

Energy Technology Data Exchange (ETDEWEB)

NONE

1994-11-01

This report documents the results of the routine environmental audit of the Kansas City Plant, Kansas City, Missouri. During this audit the activities the audit team conducted included reviews of internal documents and reports from previous audits and assessments; interviews with U.S. Department of Energy (DOE) and contractor personnel; and inspections and observations of selected facilities and operations. The onsite portion of the audit was conducted October 24-November 4, 1994, by the DOE Office of Environmental Audit (EH-24), located within the Office of Environment, Safety, and Health (EH). DOE 5482.1 B, {open_quotes}Environment, Safety, and Health Appraisal Program,{close_quotes} establishes the mission of EH-24, which is to provide comprehensive, independent oversight of Department-wide environmental programs on behalf of the Secretary of Energy. The ultimate goal of EH-24 is enhancement of environmental protection and minimization of risk to public health and the environment. EH-24 accomplishes its mission by conducting systematic and periodic evaluations of the Department`s environmental programs within line organizations and by using supplemental activities that strengthen self-assessment and oversight functions within program, field, and contractor organizations. The audit evaluated the status of programs to ensure compliance with Federal, state, and local environmental laws and regulations; compliance with DOE Orders, guidance, and directives; and conformance with accepted industry practices and standards of performance. The audit also evaluated the status and adequacy of the management systems developed to address environmental requirements.

Sporotrichosis-Associated Hospitalizations, United States, 2000-2013.

Science.gov (United States)

Gold, Jeremy A W; Derado, Gordana; Mody, Rajal K; Benedict, Kaitlin

2016-10-01

To determine frequency and risk for sporotrichosis-associated hospitalizations, we analyzed the US 2000-2013 National (Nationwide) Inpatient Sample. An estimated 1,471 hospitalizations occurred (average annual rate 0.35/1 million persons). Hospitalizations were associated with HIV/AIDS, immune-mediated inflammatory diseases, and chronic obstructive pulmonary disease. Although rare, severe sporotrichosis should be considered for at-risk patients.

Sporotrichosis-Associated Hospitalizations, United States, 2000?2013

OpenAIRE

Gold, Jeremy A.W.; Derado, Gordana; Mody, Rajal K.; Benedict, Kaitlin

2016-01-01

To determine frequency and risk for sporotrichosis-associated hospitalizations, we analyzed the US 2000?2013 National (Nationwide) Inpatient Sample. An estimated 1,471 hospitalizations occurred (average annual rate 0.35/1 million persons). Hospitalizations were associated with HIV/AIDS, immune-mediated inflammatory diseases, and chronic obstructive pulmonary disease. Although rare, severe sporotrichosis should be considered for at-risk patients.

Distribution and Sources of Nitrate-Nitrogen in Kansas Groundwater

Directory of Open Access Journals (Sweden)

Margaret A. Townsend

2001-01-01

Full Text Available Kansas is primarily an agricultural state. Irrigation water and fertilizer use data show long- term increasing trends. Similarly, nitrate-N concentrations in groundwater show long-term increases and exceed the drinking-water standard of 10 mg/l in many areas. A statistical analysis of nitrate-N data collected for local and regional studies in Kansas from 1990 to 1998 (747 samples found significant relationships between nitrate-N concentration with depth, age, and geographic location of wells. Sources of nitrate-N have been identified for 297 water samples by using nitrogen stable isotopes. Of these samples, 48% showed fertilizer sources (+2 to +8 and 34% showed either animal waste sources (+10 to +15 with nitrate-N greater than 10 mg/l or indication that enrichment processes had occurred (+10 or above with variable nitrate-N or both. Ultimate sources for nitrate include nonpoint sources associated with past farming and fertilization practices, and point sources such as animal feed lots, septic systems, and commercial fertilizer storage units. Detection of nitrate from various sources in aquifers of different depths in geographically varied areas of the state indicates that nonpoint and point sources currently impact and will continue to impact groundwater under current land uses.

Indoor smoking ordinances in workplaces and public places in Kansas.

Science.gov (United States)

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

2010-08-01

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

En Garde: Fencing at Kansas City's Central Computers Unlimited/Classical Greek Magnet High School, 1991-1995

Science.gov (United States)

Poos, Bradley W.

2015-01-01

Central High School in Kansas City, Missouri is one of the oldest schools west of the Mississippi and the first public high school built in Kansas City. Kansas City's magnet plan resulted in Central High School being rebuilt as the Central Computers Unlimited/Classical Greek Magnet High School, a school that was designed to offer students an…

Flood-inundation maps for Indian Creek and Tomahawk Creek, Johnson County, Kansas, 2014

Science.gov (United States)

Peters, Arin J.; Studley, Seth E.

2016-01-25

Digital flood-inundation maps for a 6.4-mile upper reach of Indian Creek from College Boulevard to the confluence with Tomahawk Creek, a 3.9-mile reach of Tomahawk Creek from 127th Street to the confluence with Indian Creek, and a 1.9-mile lower reach of Indian Creek from the confluence with Tomahawk Creek to just beyond the Kansas/Missouri border at State Line Road in Johnson County, Kansas, were created by the U.S. Geological Survey in cooperation with the city of Overland Park, Kansas. The flood-inundation maps, which can be accessed through the U.S. Geological Survey Flood Inundation Mapping Science Web site at http://water.usgs.gov/osw/flood_inundation/, depict estimates of the areal extent and depth of flooding corresponding to selected water levels (stages) at the U.S. Geological Survey streamgages on Indian Creek at Overland Park, Kansas; Indian Creek at State Line Road, Leawood, Kansas; and Tomahawk Creek near Overland Park, Kansas. Near real time stages at these streamgages may be obtained on the Web from the U.S. Geological Survey National Water Information System at http://waterdata.usgs.gov/nwis or the National Weather Service Advanced Hydrologic Prediction Service at http://water.weather.gov/ahps/, which also forecasts flood hydrographs at these sites.Flood profiles were computed for the stream reaches by means of a one-dimensional step-backwater model. The model was calibrated for each reach by using the most current stage-discharge relations at the streamgages. The hydraulic models were then used to determine 15 water-surface profiles for Indian Creek at Overland Park, Kansas; 17 water-surface profiles for Indian Creek at State Line Road, Leawood, Kansas; and 14 water-surface profiles for Tomahawk Creek near Overland Park, Kansas, for flood stages at 1-foot intervals referenced to the streamgage datum and ranging from bankfull to the next interval above the 0.2-percent annual exceedance probability flood level (500-year recurrence interval). The

Association of Hospitalization for Neurosurgical Operations in Magnet Hospitals With Mortality and Length of Stay.

Science.gov (United States)

Missios, Symeon; Bekelis, Kimon

2018-03-01

The association of Magnet hospital status with improved surgical outcomes remains an issue of debate. To investigate whether hospitalization in a Magnet hospital is associated with improved outcomes for patients undergoing neurosurgical operations. A cohort study was executed using all patients undergoing neurosurgical operations in New York registered in the Statewide Planning and Research Cooperative System database from 2009 to 2013. We examined the association of Magnet status hospitalization after neurosurgical operations with inpatient case fatality and length of stay (LOS). We employed an instrumental variable analysis to simulate a randomized trial. Overall, 190 787 patients underwent neurosurgical operations. Of these, 68 046 (35.7%) were hospitalized in Magnet hospitals, and 122 741 (64.3%) in non-Magnet institutions. Instrumental variable analysis demonstrated that hospitalization in Magnet hospitals was associated with decreased case fatality (adjusted difference, -0.8%; -95% confidence interval, -0.7% to -0.6%), and LOS (adjusted difference, -1.9; 95% confidence interval, -2.2 to -1.5) in comparison to non-Magnet hospitals. These associations were also observed in propensity score adjusted mixed effects models. These associations persisted in prespecified subgroups of patients undergoing spine surgery, craniotomy for tumor resection, or neurovascular interventions. We identified an association of Magnet hospitals with lower case fatality, and shorter LOS in a comprehensive New York State patient cohort undergoing neurosurgical procedures. Copyright © 2017 by the Congress of Neurological Surgeons

77 FR 23244 - Atmos Energy Colorado/Kansas Division; Notice of Revised Baseline Filing

Science.gov (United States)

2012-04-18

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. PR12-22-000] Atmos Energy Colorado/Kansas Division; Notice of Revised Baseline Filing Take notice that on April 10, 2012, Atmos Energy Colorado/Kansas Division (Atmos) filed a revised baseline filing of their Statement of Operating...

Public and Opinion Leader Willingness to Fund Obesity-Focused Policies in Kansas.

Science.gov (United States)

Schmitt, Carol L; Curry, Laurel E; Homsi, Ghada; Williams, Pamela A; Glasgow, LaShawn M; Van Hersh, Deanna; Willett, Jeffrey; Rogers, Todd

2017-08-01

Obesity increases the risk for leading causes of death, including cardiovascular disease and some cancers. Midwestern and southern states have the highest obesity rates-in Kansas, one in every three adults is obese. We compared the willingness of Kansas adults and opinion leaders to pay more in taxes to fund obesity prevention policies. In 2014, we asked a representative sample of 2,203 Kansas adults (response rate 15.7%) and 912 opinion leaders (response rate 55%) drawn from elected office and other sectors, including business and health, whether they would pay an additional $50 in annual taxes to support five policies that improve access to healthy foods and opportunities for physical activity. We used adjusted Wald tests to compare public and opinion leaders' responses, and regression analysis to assess whether differences in respondents' gender, age, location (urban/rural), race/ethnicity, and political stance affected results. Adjusting for demographic differences, Kansas adults were more willing than opinion leaders to pay $50 in taxes for each of the five policy interventions. This study demonstrates a willingness among residents of a fiscally conservative state to pay increased taxes for policies that could reduce population obesity rates. Health professionals, including nurses, can use these findings to educate policy makers in Kansas and geopolitically similar states about widespread public support for obesity prevention policies. Public health and other nurses could also apply our methods to assess support for obesity prevention policies in their jurisdictions.

Environmental Survey preliminary report, Kansas City Plant, Kansas City, Missouri

Energy Technology Data Exchange (ETDEWEB)

1988-01-01

This report presents the preliminary findings from the first phase of the Environmental Survey of the United States Department of Energy (DOE), Kansas City Plant (KCP), conducted March 23 through April 3, 1987. The Survey is being conducted by a multidisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team members are outside experts being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with the KCP. The Survey covers all environmental media and all areas of environmental regulations. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data observations of the operations performed at the KCP, and interviews with site personnel. The Survey team developed a Sampling and Analysis Plan to assist in further assessing certain environmental problems identified during its on-site activities. The Sampling and Analysis Plan is being executed by DOE's Argonne National Laboratory. When completed, the results will be incorporated into the KCP Environmental Survey Interim Report. The Interim Report will reflect the final determinations of the KCP Survey. 94 refs., 39 figs., 55 tabs.

Environmental Survey preliminary report, Kansas City Plant, Kansas City, Missouri

International Nuclear Information System (INIS)

1988-01-01

This report presents the preliminary findings from the first phase of the Environmental Survey of the United States Department of Energy (DOE), Kansas City Plant (KCP), conducted March 23 through April 3, 1987. The Survey is being conducted by a multidisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team members are outside experts being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with the KCP. The Survey covers all environmental media and all areas of environmental regulations. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data observations of the operations performed at the KCP, and interviews with site personnel. The Survey team developed a Sampling and Analysis Plan to assist in further assessing certain environmental problems identified during its on-site activities. The Sampling and Analysis Plan is being executed by DOE's Argonne National Laboratory. When completed, the results will be incorporated into the KCP Environmental Survey Interim Report. The Interim Report will reflect the final determinations of the KCP Survey. 94 refs., 39 figs., 55 tabs

Pick-N-Pull Auto Dismantlers, Kansas City, LLC Inc. - Clean Water Act Public Notice

Science.gov (United States)

The EPA is providing notice of a proposed Administrative Penalty Assessment against Pick-N-Pull Auto Dismantlers, Kansas City, LLC, a subsidiary of Schnitzer Steel Industries, Inc., for alleged violations at its facilities at 8012 East Truman Rd., Kansas C

Risk factors associated with malnutrition in hospitalized patients

Directory of Open Access Journals (Sweden)

Roberta Flores Marquezini FRAGAS

2016-06-01

Full Text Available ABSTRACT Objective To identify factors associated with malnutrition in patients hospitalized in general public hospitals of the city of Manaus, Amazonas, Brazil. Methods This cross-sectional study included 397 patients of both sexes aged more than 18 years, staying at three public hospitals in Manaus, Amazonas. The patients were submitted to anthropometric and subjective global assessments, the latter being the main diagnostic method. For association analyses between malnutrition (dependent variable and other covariates, we used contingency table for variable selection and multiple logistic regression for independent effect test between exposure and outcome. The strength of association between the variables was expressed as odds ratio, with a 95% confidence interval. The analyses were performed by Epi Info 7.0. Results Among the risk factors associated with hospital malnutrition, hospital stays longer than 15 days, when analyzed alone, nearly tripled the odds of malnutrition. However, in the final model, the variables that remained associated were: persistent change in diet, presence of gastrointestinal symptoms, recent weight loss, weight loss in the last six months, cancer, and age higher than 60 years. Conclusion Malnutrition is recurrent in hospitals, and the factors associated with malnutrition can be identified on admission, allowing adequate monitoring during hospital stay. Therefore, a more effective performance of nutritional screening and monitoring programs is critical.

Psychometrics of the Kansas City Cardiomyopathy Questionnaire Adapted for Family Caregiver/Significant Other.

Science.gov (United States)

Tucker, Rebecca; Quinn, Jill R; Chen, Ding-Geng; Chen, Leway

2016-12-01

The Kansas City Cardiomyopathy Questionnaire (KCCQ) was adapted to be administered to the family caregiver/significant other (FC/SO) of hospitalized patients with heart failure (HF). The objective was to examine the psychometrics of the adapted scale (KCCQ-SO). Factor analysis, Cronbach's alpha, and correlations were used. A 5-factor solution was found that explained 67.9% of the variance. The internal consistency of the KCCQ-SO factors were all greater than .70. Patient and FC/SO perceived health status scores were significantly related. Because the scores were found to have high internal consistency and correlated with patient scores on the KCCQ, there is evidence that the FC/SOs' reports may be used in circumstances when the patient is unable or unwilling to answer questions.

Efforts of a Kansas foundation to increase physical activity and improve health by funding community trails, 2012.

Science.gov (United States)

Heinrich, Katie M; Lightner, Joseph; Oestman, Katherine B; Hughey, S Morgan; Kaczynski, Andrew T

2014-11-26

Trails are associated with increased physical activity; however, little is known about the process of building trails by various types of organizations. From 2005 through 2012 the Sunflower Foundation: Health Care for Kansans (Sunflower) funded multiple organizations to construct 70 trails of varying lengths and surfaces in municipalities, schools, and communities across Kansas. The purpose of this study was to assess the process of developing and implementing community trail projects across Kansas with funding from a public foundation. In 2012, we stratified funded organizations by type and conducted proportional random sampling to select 20 key informants from those organizations to participate in structured telephone interviews. Interviews were recorded and transcribed verbatim. Two researchers coded interview transcripts according to issues identified by participants. Issues associated with trail-building identified as important were collaboration among groups, unexpected construction costs, champions for the project, and level of difficulty of construction. Participants indicated that trails facilitated physical activity. Trails were integrated into communities through events such as walking events and other promotional efforts; these efforts were thought to increase trail use. The perceived outcomes of building the trails included providing the community with a physical activity resource, inspiring the community to start additional trail projects, and increasing the physical activity of local residents. Sunflower's funding was instrumental in developing trail projects to provide new physical activity resources across Kansas. Public health practitioners seeking to increase physical activity should seek funding from foundations that focus on health.

78 FR 13662 - Kansas Gas Service, a Division of ONEOK, Inc.; Notice of Petition

Science.gov (United States)

2013-02-28

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. PR13-18-001] Kansas Gas Service, a Division of ONEOK, Inc.; Notice of Petition Take notice that on February 6, 2013, Kansas Gas... fully detailed in the petition. Any person desiring to participate in this rate filing must file in...

Sporotrichosis-Associated Hospitalizations, United States, 2000–2013

Science.gov (United States)

Gold, Jeremy A.W.; Derado, Gordana; Mody, Rajal K.

2016-01-01

To determine frequency and risk for sporotrichosis-associated hospitalizations, we analyzed the US 2000–2013 National (Nationwide) Inpatient Sample. An estimated 1,471 hospitalizations occurred (average annual rate 0.35/1 million persons). Hospitalizations were associated with HIV/AIDS, immune-mediated inflammatory diseases, and chronic obstructive pulmonary disease. Although rare, severe sporotrichosis should be considered for at-risk patients. PMID:27648881

Association Between Community Social Capital and Hospital Readmission Rates.

Science.gov (United States)

Brewster, Amanda L; Lee, Suhna; Curry, Leslie A; Bradley, Elizabeth H

2018-05-31

Hospital readmissions remain frequent, and are partly attributable to patients' social needs. The authors sought to examine whether local community levels of social capital are associated with hospital readmission rates. Social capital refers to the connections among members of a society that foster norms of reciprocity and trust, which may influence the availability of support for postdischarge recovery after hospitalization. Associations between hospital-wide, risk-stratified readmission rates for hospitals in the United States (n = 4298) and levels of social capital in the hospitals' service areas were examined. Social capital was measured by an index of participation in associational activities and civic affairs. A multivariate linear regression model was used to adjust for hospital and community factors such as hospital financial performance, race, income, and availability of heath care services. Results showed that higher social capital was significantly associated with lower readmission rates (P social capital in its region, but in areas of low social capital, it may be possible for public or philanthropic sectors to buttress the types of institutions that address nonmedical causes of readmission.

Evaluation of Motorcycle Safety in Kansas : Technical Summary

Science.gov (United States)

2012-01-01

Over the past several years, motorcycle fatalities have increased at an alarming rate in the United States. Motorcycle safety issues in Kansas are no different from the national scenario. Accordingly, this study attempted to investigate motorcycle cr...

Building and Running a Collaborative Internet Filter Is Akin to a Kansas Barn Raising

Science.gov (United States)

Reddick, Thomas

2004-01-01

The Northeast Kansas Library System's filtering project started out as a response to the passage of CIPA, the Children's Internet Protection Act, in January 2001. Originally called "onGuard," it was a service that the Northeast Kansas Library System created for its members. When the Supreme Court ruling did uphold the constitutionality…

Kansas Nursing Home Medication Aide Curriculum. Revised.

Science.gov (United States)

Bartel, Myrna J.; Fornelli, Linda K.

This curriculum guide is designed to aid Kansas instructors in conducting a course for teaching nursing home medication aides. Covered first are various introductory topics such as the role and responsibilities of medication aides, pharmacodynamics, forms in which medication is now available, common medical abbreviations, mathematics and weights…

Kansas State University Libraries' OCR Labeling Project.

Science.gov (United States)

Thierer, Joyce; Bower, Merry

This publication describes the planning and implementation of an optical character recognition (OCR) labeling project, the first stage of Kansas State University (KSU) Libraries' program of conversion from a manual to an automated circulation system. It is noted that a telephone survey of libraries with automated circulation systems and…

Kansas City Metropolitan Community Colleges. Audit Report.

Science.gov (United States)

Missouri Office of the State Auditor, Jefferson City.

This audit report reviews the employment contracts, related compensation, and other benefits provided for the chancellor and other officers of the Kansas City Metropolitan Community Colleges (KCMCC) in Missouri. The chancellor is allowed to either solicit bids or negotiate for contracted services such as architects, construction managers,…

Kansas Advanced Semiconductor Project: Final Report

International Nuclear Information System (INIS)

Baringer, P.; Bean, A.; Bolton, T.; Horton-Smith, G.; Maravin, Y.; Ratra, B.; Stanton, N.; von Toerne, E.; Wilson, G.

2007-01-01

KASP (Kansas Advanced Semiconductor Project) completed the new Layer 0 upgrade for D0, assumed key electronics projects for the US CMS project, finished important new physics measurements with the D0 experiment at Fermilab, made substantial contributions to detector studies for the proposed e+e- international linear collider (ILC), and advanced key initiatives in non-accelerator-based neutrino physics.

Quantitative Assessment of Factors Related to Customer Satisfaction with MoDOT in the Kansas City Area.

Science.gov (United States)

2008-01-01

A mailed survey was sent to approximately twenty thousand citizens from District Four (Kansas City Area) residents in order to gather statistical evidence for : supporting or eliminating reasons for the satisfaction discrepancy between Kansas City Ar...

Characteristics of Child Abuse Homicides in the State of Kansas from 1994 to 2007

Science.gov (United States)

Kajese, Tanyaradzwa M.; Nguyen, Linh T.; Pham, Giao Q.; Pham, Van K.; Melhorn, Katherine; Kallail, K. James

2011-01-01

Objective: This study described the epidemiology of child abuse homicides in the state of Kansas from 1994 to 2007. It focused on obtaining significant details on all recorded child abuse homicides in Kansas during this time frame to provide critical information that can be used for future preventive measures. Methods: A retrospective case review…

Continuous real-time water information: an important Kansas resource

Science.gov (United States)

Loving, Brian L.; Putnam, James E.; Turk, Donita M.

2014-01-01

Continuous real-time information on streams, lakes, and groundwater is an important Kansas resource that can safeguard lives and property, and ensure adequate water resources for a healthy State economy. The U.S. Geological Survey (USGS) operates approximately 230 water-monitoring stations at Kansas streams, lakes, and groundwater sites. Most of these stations are funded cooperatively in partnerships with local, tribal, State, or other Federal agencies. The USGS real-time water-monitoring network provides long-term, accurate, and objective information that meets the needs of many customers. Whether the customer is a water-management or water-quality agency, an emergency planner, a power or navigational official, a farmer, a canoeist, or a fisherman, all can benefit from the continuous real-time water information gathered by the USGS.

Estadio de Kansas City (EE. UU.

Directory of Open Access Journals (Sweden)

Murphy, C. F.

1978-05-01

Full Text Available The Crosby Kemper stadium, located in the center of an industrial district of Kansas City, was designed for various uses which include activities ranging from music and sports competitions to equestrian sports. It has a capacity for approximately 16 to 18,000 people and parking for 4,000 cars. The outstanding feature of its architectonic conception is the solution adopted for building the roof, by means of enormous metal tubular beams, of triangular section and a height of 8.25 meters with pipe diameters reaching 120 cm.

El estadio Crosby Kemper, situado en el centro de un distrito industrial de Kansas, fue concebido para un funcionamiento diverso que comprende actividades que van desde la música y competiciones deportivas hasta pruebas hípicas. Tiene capacidad para unas 16.000 ó 18.000 personas, y plazas de aparcamiento para 4.000 coches. En su concepción arquitectónica sobresale la solución adoptada para la realización de la cubierta, mediante enormes vigas tubulares metálicas, de sección triangular y altura de 8,25 m, con diámetros de tubo que alcanzan los 120 cm.

Automated accountability of hazardous materials at AlliedSignal Inc., Kansas City Division

International Nuclear Information System (INIS)

Depew, P.L.

1993-12-01

The Department of Energy's (DOE) Kansas City Plant (KCP), currently operated by AlliedSignal Inc. has developed a comprehensive Hazardous Material Information System (HMIS). The purpose of this system is to provide a practical and automated method to collect, analyze and distribute hazardous material information to DOE, KCP associates, and regulatory agencies. The drivers of the HMIS are compliance with OSHA Hazard Communications, SARA reporting, pollution prevention, waste minimization, control and tracking of hazards, and emergency response. This report provides a discussion of this system

Final work plan : investigation of potential contamination at the former USDA facility in Powhattan, Kansas.

Energy Technology Data Exchange (ETDEWEB)

LaFreniere, L. M.; Environmental Science Division

2007-02-02

This Work Plan outlines the scope of work to be conducted to investigate the subsurface contaminant conditions at the property formerly leased by the Commodity Credit Corporation (CCC) in Powhattan, Kansas (Figure 1.1). Data obtained during this event will be used to (1) evaluate potential contaminant source areas on the property; (2) determine the vertical and horizontal extent of potential contamination; and (3) provide recommendations for future action, with the ultimate goal of assigning this site No Further Action status. The planned investigation includes groundwater monitoring requested by the Kansas Department of Health and Environment (KDHE), in accordance with Section V of the Intergovernmental Agreement between the KDHE and the Farm Service Agency of the U.S. Department of Agriculture (USDA). The work is being performed on behalf of the CCC/USDA by the Environmental Science Division of Argonne National Laboratory. A nonprofit, multidisciplinary research center operated by the University of Chicago for the U.S. Department of Energy, Argonne provides technical assistance to the CCC/USDA with environmental site characterization and remediation at former CCC/USDA grain storage facilities. Argonne issued a Master Work Plan (Argonne 2002) that has been approved by the KDHE. The Master Work Plan describes the general scope of all investigations at former CCC/USDA facilities in Kansas and provides guidance for these investigations. It should be consulted for the complete details of plans for work associated with the former CCC/USDA facility at Powhattan.

Developing Community-Focused Solutions using a Food-Energy-Water Calculator, with Initial Application to Western Kansas

Science.gov (United States)

Hill, M. C.; Pahwa, A.; Rogers, D.; Roundy, J. K.; Barron, R. W.

2017-12-01

Many agricultural areas are facing difficult circumstances. Kansas is one example, with problems that are typical. Past agricultural and hydrologic data document how irrigation in western Kansas has produced a multi-billion-dollar agricultural economy that is now threatened by pumping-induced declines in groundwater levels. Although reduced pumping could mitigate much of the threat and preserve much of Kansas' agricultural economy (albeit at a reduced level) in the long term, a primary disincentive for reducing pumping is the immediate economic impact of diminished irrigation. One alternative to continued unsustainable groundwater use is a water-energy tradeoff program that seeks to reduce pumping from the Ogallala aquifer to sustainable rates while maintaining local income levels. This program would allow development of the region's rich wind and solar energy resources in a way that focuses on local economic benefits, in exchange for water rights concessions from affected stakeholders. In considering this alternative, most citizens are currently unable to address a key question, "What could this mean for me?" Answering this question requires knowledge of agriculture, energy, water, economics, and drought probabilities, knowledge that is available at Kansas universities. This talk presents a joint University of Kansas - Kansas State University effort to address this need through development of the Food-Energy-Water Calculator. This talk will present the idea and discuss how the calculator would work. It is suggested that the framework created provides a powerful way to organize data and analysis results, and thus to seek solutions to difficult problems in many regions of the US and the world.

Association between value-based purchasing score and hospital characteristics

Directory of Open Access Journals (Sweden)

Borah Bijan J

2012-12-01

Full Text Available Abstract Background Medicare hospital Value-based purchasing (VBP program that links Medicare payments to quality of care will become effective from 2013. It is unclear whether specific hospital characteristics are associated with a hospital’s VBP score, and consequently incentive payments. The objective of the study was to assess the association of hospital characteristics with (i the mean VBP score, and (ii specific percentiles of the VBP score distribution. The secondary objective was to quantify the associations of hospital characteristics with the VBP score components: clinical process of care (CPC score and patient satisfaction score. Methods Observational analysis that used data from three sources: Medicare Hospital Compare Database, American Hospital Association 2010 Annual Survey and Medicare Impact File. The final study sample included 2,491 U.S. acute care hospitals eligible for the VBP program. The association of hospital characteristics with the mean VBP score and specific VBP score percentiles were assessed by ordinary least square (OLS regression and quantile regression (QR, respectively. Results VBP score had substantial variations, with mean score of 30 and 60 in the first and fourth quartiles of the VBP score distribution. For-profit status (vs. non-profit, smaller bed size (vs. 100–199 beds, East South Central region (vs. New England region and the report of specific CPC measures (discharge instructions, timely provision of antibiotics and beta blockers, and serum glucose controls in cardiac surgery patients were positively associated with mean VBP scores (p Conclusions Although hospitals serving the poor and the elderly are more likely to score lower under the VBP program, the correlation appears small. Profit status, geographic regions, number and type of CPC measures reported explain the most variation among scores.

Exploring leadership roles, goals, and barriers among Kansas registered nurses: a descriptive cross-sectional study.

Science.gov (United States)

Peltzer, Jill N; Ford, Debra J; Shen, Qiuhua; Fischgrund, Avery; Teel, Cynthia S; Pierce, Janet; Jamison, Marian; Waldon, Trynn

2015-01-01

The Institute of Medicine's Future of Nursing report advocates for full nurse leader representation across multiple settings to address current challenges in our health care system. The purpose of this study was to examine nursing leadership development needs among Kansas registered nurses (RNs). Data were collected through an online survey and analyzed using quantitative and qualitative methods. Nearly 1,000 Kansas RNs participated. Most reported holding one or more leadership positions. Prevalent leadership goals were health care organization volunteer administrative roles. The most frequently identified barrier to developing leadership roles was time constraints. Many wanted to develop skills to serve on a board, 20% were interested in personal leadership development, and 19% in policy development. Based on the findings, the Kansas Action Coalition leadership team is developing programs to address the leadership needs of Kansas RNs. By building capacity in advanced leadership roles, RNs will be better prepared serve as full partners and lead efforts to promote the health of Kansans. Copyright © 2015 Elsevier Inc. All rights reserved.

Indiana and the Kansas-Nebraska Act of 1854.

Science.gov (United States)

Medland, William J.; Rosenberg, Morton M.

1984-01-01

The Kansas-Nebraska Act, which repealed the ban against slavery in the North, served as a catalyst to activate numerous groups which were unhappy with the Indiana Democratic Party. From this period emerged the new Republican party and also a revitalized Democratic party with new leadership. (IS)

Assessment of Biomass Pelletization Options for Greensburg, Kansas

Energy Technology Data Exchange (ETDEWEB)

Haase, S.

2010-05-01

This report provides an overview of a technical report on an assessment NREL conducted in Greensburg, Kansas, to identify potential opportunities to develop a biomass pelletization or briquetting plant in the region. See NREL/TP-7A2-45843 for the Executive Summary of this report.

Unravelling the potential mechanisms behind hospitalization-associated disability in older patients : the hospital-associated disability and impact on daily Life (Hospital-ADL) cohort study protocol

NARCIS (Netherlands)

Reichardt, Lucienne A.; Aarden, Jesse J.; van Seben, Rosanne; van der Schaaf, Marike; Engelbert, Raoul H.H.; Bosch, Jos A.; Buurman, Bianca M.

2016-01-01

BACKGROUND: Over 30 % of older patients experience hospitalization-associated disability (HAD) (i.e., loss of independence in Activities of Daily Living (ADLs)) after an acute hospitalization. Despite its high prevalence, the mechanisms that underlie HAD remain elusive. This paper describes the

Unravelling the potential mechanisms behind hospitalization-associated disability in older patients : The Hospital-Associated Disability and impact on daily Life (Hospital-ADL) cohort study protocol

NARCIS (Netherlands)

Reichardt, L.A.; Aarden, J.J.; van Seben, R.; van der Schaaf, M.; Engelbert, R.H.H.; Bosch, J.A.; Buurman, B.M.

2016-01-01

BACKGROUND: Over 30 % of older patients experience hospitalization-associated disability (HAD) (i.e., loss of independence in Activities of Daily Living (ADLs)) after an acute hospitalization. Despite its high prevalence, the mechanisms that underlie HAD remain elusive. This paper describes the

Final work plan : environmental site investigation at Sylvan Grove, Kansas.

Energy Technology Data Exchange (ETDEWEB)

LaFreniere, L. M. (Environmental Science Division)

2012-07-15

In 1998, carbon tetrachloride was found above the maximum contaminant level (MCL) of 5 {micro}g/L in groundwater from one private livestock well at Sylvan Grove, Kansas, by the Kansas Department of Health and Environment (KDHE). The 1998 KDHE sampling was conducted under the U.S. Department of Agriculture (USDA) private well sampling program. The Commodity Credit Corporation (CCC), a USDA agency, operated a grain storage facility in Sylvan Grove from 1954 to1966. Carbon tetrachloride is the contaminant of primary concern at sites associated with former CCC/USDA grain storage operations. Sylvan Grove is located in western Lincoln County, approximately 60 mi west of Salina (Figure 1.1). To determine whether the former CCC/USDA facility at Sylvan Grove is a potential contaminant source and its possible relationship to the contamination in groundwater, the CCC/USDA has agreed to conduct an investigation, in accordance with the Intergovernmental Agreement between the KDHE and the Farm Service Agency (FSA) of the USDA. This Work Plan presents historical data related to previous investigations, grain storage operations, local private wells and public water supply (PWS) wells, and local geologic and hydrogeologic conditions at Sylvan Grove. The findings from a review of all available documents are discussed in Section 2. On the basis of the analyses of historical data, the following specific technical objectives are proposed for the site investigation at Sylvan Grove: (1) Evaluate the potential source of carbon tetrachloride at the former CCC/USDA facility; (2) Determine the relationship of potential contamination (if present) at the former CCC/USDA facility to contamination identified in 1998 in groundwater samples from one private well to the west; and (3) Delineate the extent of potential contamination associated with the former CCC/USDA facility. The detailed scope of work is outlined in Section 3. The results of the proposed work will provide the basis for determining

Dr. North and the Kansas City Newspaper War: Public Health Advocacy Collides with Main Street Respectability.

Science.gov (United States)

Kovarik, Bill

A case study examined a 1920 controversy between two newspapers. One of the last vestiges of the era of "yellow journalism" was the editorial "war" between the Kansas City "Star" and the Kansas City "Post" which culminated in a 1921 showdown. The "Star," a champion of main street interests and…

Pest Status and Distribution of the Stem Borer, Dectes texanus, in Kansas

Science.gov (United States)

Buschman, Lawrent L.; Sloderbeck, Phillip E.

2010-01-01

The Dectes stem borer, Dectes texanus LeConte (Coleoptera: Cerambycidae), is currently receiving increased attention as a pest of soybeans in the Great Plains of North America. Field surveys were conducted in 1999 and in 2008 to record the distribution of this pest in Kansas. These surveys documented an increase in the abundance of the pest and an expansion in the range of this insect westward and eastward. The percentage of fields with more than 50% of plants infested also increased from 4% in 1999 to 11% in 2008. The far eastern counties still had surprisingly few infested fields even though much of the Kansas soybean acreage is located in these counties. It is not clear if D. texanus simply haven't expanded into eastern Kansas yet or if there is an ecological barrier that keeps them from doing so. Field crop entomologists from across eastern North America were sent an email questionnaire and their responses indicate that this pest is now well established as a pest of soybeans in at least 14 states across eastern North America. PMID:21268702

Substantial shifts in ranking of California hospitals by hospital-associated methicillin-resistant Staphylococcus aureus infection following adjustment for hospital characteristics and case mix.

Science.gov (United States)

Tehrani, David M; Phelan, Michael J; Cao, Chenghua; Billimek, John; Datta, Rupak; Nguyen, Hoanglong; Kwark, Homin; Huang, Susan S

2014-10-01

States have established public reporting of hospital-associated (HA) infections-including those of methicillin-resistant Staphylococcus aureus (MRSA)-but do not account for hospital case mix or postdischarge events. Identify facility-level characteristics associated with HA-MRSA infection admissions and create adjusted hospital rankings. A retrospective cohort study of 2009-2010 California acute care hospitals. We defined HA-MRSA admissions as involving MRSA pneumonia or septicemia events arising during hospitalization or within 30 days after discharge. We used mandatory hospitalization and US Census data sets to generate hospital population characteristics by summarizing across admissions. Facility-level factors associated with hospitals' proportions of HA-MRSA infection admissions were identified using generalized linear models. Using state methodology, hospitals were categorized into 3 tiers of HA-MRSA infection prevention performance, using raw and adjusted values. Among 323 hospitals, a median of 16 HA-MRSA infections (range, 0-102) per 10,000 admissions was found. Hospitals serving a greater proportion of patients who had serious comorbidities, were from low-education zip codes, and were discharged to locations other than home were associated with higher HA-MRSA infection risk. Total concordance between all raw and adjusted hospital rankings was 0.45 (95% confidence interval, 0.40-0.51). Among 53 community hospitals in the poor-performance category, more than 20% moved into the average-performance category after adjustment. Similarly, among 71 hospitals in the superior-performance category, half moved into the average-performance category after adjustment. When adjusting for nonmodifiable facility characteristics and case mix, hospital rankings based on HA-MRSA infections substantially changed. Quality indicators for hospitals require adequate adjustment for patient population characteristics for valid interhospital performance comparisons.

Property Grids for the Kansas High Plains Aquifer from Water Well Drillers' Logs

Science.gov (United States)

Bohling, G.; Adkins-Heljeson, D.; Wilson, B. B.

2017-12-01

Like a number of state and provincial geological agencies, the Kansas Geological Survey hosts a database of water well drillers' logs, containing the records of sediments and lithologies characterized during drilling. At the moment, the KGS database contains records associated with over 90,000 wells statewide. Over 60,000 of these wells are within the High Plains aquifer (HPA) in Kansas, with the corresponding logs containing descriptions of over 500,000 individual depth intervals. We will present grids of hydrogeological properties for the Kansas HPA developed from this extensive, but highly qualitative, data resource. The process of converting the logs into quantitative form consists of first translating the vast number of unique (and often idiosyncratic) sediment descriptions into a fairly comprehensive set of standardized lithology codes and then mapping the standardized lithologies into a smaller number of property categories. A grid is superimposed on the region and the proportion of each property category is computed within each grid cell, with category proportions in empty grid cells computed by interpolation. Grids of properties such as hydraulic conductivity and specific yield are then computed based on the category proportion grids and category-specific property values. A two-dimensional grid is employed for this large-scale, regional application, with category proportions averaged between two surfaces, such as bedrock and the water table at a particular time (to estimate transmissivity at that time) or water tables at two different times (to estimate specific yield over the intervening time period). We have employed a sequence of water tables for different years, based on annual measurements from an extensive network of wells, providing an assessment of temporal variations in the vertically averaged aquifer properties resulting from water level variations (primarily declines) over time.

A review of Arbuckle Group strata in Kansas from a sedimentologic perspective: Insights for future research from past and recent studies

Science.gov (United States)

Franseen, E.K.

2000-01-01

karstic features from the post-Arbuckle subaerial exposure event. Although most production in Kansas is from the top of the Arbuckle, some early and recent studies indicate that the Arbuckle is not a simple homogeneous reservoir, that complex vertical and lateral heterogeneities exist including both nonporous and porous horizons in the formation, and that high probability exist of locating additional oil with improved reservoir characterization. Although fracture and vuggy porosity contribute importantly to the production of Arbuckle strata, recent observations indicate a significant amount of porosity (about 50%) in many cores is controlled by depositional facies and dolomitization. Studies of Arbuckle and equivalent-age strata from other areas indicate that Arbuckle strata and diagenetic processes are complex and that porosity/permeability patterns are related to a number of processes. These studies underscore the importance of continued study of Arbuckle rocks in Kansas for improved reservoir characterization. Ongoing and future geologic studies of Arbuckle rocks in Kansas are being directed toward: (1) Continued sedimentologic, stratigraphic, and sequence stratigraphic analyses incorporating core, well log, and seismic data; (2) petrophysical studies. Initial studies indicate that core plug petrophysical properties are controlled by matrix grain size and that upscalling from plug to whole-core and drill-stem test data can identify and quantify the relative contribution of karstic, fracture and matrix porosity and permeability: (3) Regional and local structural analyses and mapping of the upper Arbuckle surface to provide more details on the contribution of structural features and karst paleogeomorphology to reservoir character; and (4) diagenetic and geochemical studies focusing especially on the timing of, and processes associated with, dolomitization and karstification events and their contributions to creating or occluding porosity.

Benchmarking the Kansas 4-H Judging System

Directory of Open Access Journals (Sweden)

Amy M. Taylor

2009-12-01

Full Text Available This study investigated the methods and policies associated with 4-H project judging at the county level within the Kansas 4-H Program. Extension Agents surveyed about current 4-H judging processes indicated a variety of methods used. Data collected showed that 21.8% of the counties surveyed practiced some type of project judging without the 4-H member present. In regard to feedback received by the youth in non-livestock project judging, 64.1% of counties reported both verbal and written forms of feedback, with 25.6% receiving only verbal. In livestock project judging, 93.8% reported that youth receive feedback only verbally. The majority of non-livestock projects are judged using the Danish system, while the number of livestock projects judged are split among both the Danish system and peer system of competitive judging. It was concluded that a wide-variety of judging methods are used, resulting in incongruent programs offered to 4-H members.

D-cracking field performance of portland cement concrete pavements containing limestone in Kansas : phase 1 report : technical summary.

Science.gov (United States)

2012-05-01

Introduction: Premature deterioration of concrete pavement due to D-cracking has been a problem in Kansas since the 1930s. Limestone is the major source of coarse aggregate in eastern Kansas where the majority of the concrete pavements are constructe...

Final Corrective Action Study for the Former CCC/USDA Facility in Hanover, Kansas

Energy Technology Data Exchange (ETDEWEB)

LaFreniere, Lorraine M. [Argonne National Lab. (ANL), Argonne, IL (United States)

2013-11-01

Low concentrations of carbon tetrachloride in groundwater and vapor intrusion into a limited number of residences (attributable to the contaminant concentrations in groundwater) have been identified in Hanover, Kansas, at and near a grain storage facility formerly leased and operated by the Commodity Credit Corporation of the U.S. Department of Agriculture (CCC/USDA). At the request of the Kansas Department of Health and Environment (KDHE 2009h), the CCC/USDA has prepared this Corrective Action Study (CAS) for the facility. The CAS examines corrective actions to address the contamination in groundwater and soil vapor.

Measuring distance through dense weighted networks: The case of hospital-associated pathogens.

Directory of Open Access Journals (Sweden)

Tjibbe Donker

2017-08-01

Full Text Available Hospital networks, formed by patients visiting multiple hospitals, affect the spread of hospital-associated infections, resulting in differences in risks for hospitals depending on their network position. These networks are increasingly used to inform strategies to prevent and control the spread of hospital-associated pathogens. However, many studies only consider patients that are received directly from the initial hospital, without considering the effect of indirect trajectories through the network. We determine the optimal way to measure the distance between hospitals within the network, by reconstructing the English hospital network based on shared patients in 2014-2015, and simulating the spread of a hospital-associated pathogen between hospitals, taking into consideration that each intermediate hospital conveys a delay in the further spread of the pathogen. While the risk of transferring a hospital-associated pathogen between directly neighbouring hospitals is a direct reflection of the number of shared patients, the distance between two hospitals far-away in the network is determined largely by the number of intermediate hospitals in the network. Because the network is dense, most long distance transmission chains in fact involve only few intermediate steps, spreading along the many weak links. The dense connectivity of hospital networks, together with a strong regional structure, causes hospital-associated pathogens to spread from the initial outbreak in a two-step process: first, the directly surrounding hospitals are affected through the strong connections, second all other hospitals receive introductions through the multitude of weaker links. Although the strong connections matter for local spread, weak links in the network can offer ideal routes for hospital-associated pathogens to travel further faster. This hold important implications for infection prevention and control efforts: if a local outbreak is not controlled in time

To Green or Not to Green? Evaluation of Green Stormwater Infrastructure in Kansas City Middle Blue River Project

Science.gov (United States)

The City of Kansas City, Mo., Water Services Department is implementing a pilot project to measure and evaluate the performance of green infrastructure. Information obtained through this pilot project will be used to guide the design of green solutions throughout Kansas City und...

Improving safety of teenage and young adult drivers in Kansas.

Science.gov (United States)

2013-12-01

Statistics show that young drivers have higher motor vehicle crash rates compared to other age groups. This study investigated : characteristics, contributory causes, and factors which increase injury severity of young driver crashes in Kansas by com...

Improved Oil Recovery in Fluvial Dominated Deltaic Reservoirs of Kansas - Near-Term

International Nuclear Information System (INIS)

Green, Don W.; McCune, A.D.; Michnick, M.; Reynolds, R.; Walton, A.; Watney, L.; Willhite, G. Paul

1999-01-01

The objective of this project is to address waterflood problems of the type found in Morrow sandstone reservoirs in southwestern Kansas and in Cherokee Group reservoirs in southeastern Kansas. Two demonstration sites operated by different independent oil operators are involved in this project. The Stewart Field is located in Finney County, Kansas and is operated by PetroSantander, Inc. Te Nelson Lease is located in Allen County, Kansas, in the N.E. Savonburg Field and is operated by James E. Russell Petroleum, Inc. General topics to be addressed are (1) reservoir management and performance evaluation, (2) waterflood optimization, and (3) the demonstration of recovery processes involving off-the-shelf technologies which can be used to enhance waterflood recovery, increase reserves, and reduce the abandonment rate of these reservoir types. In the Stewart Project, the reservoir management portion of the project conducted during Budget Period 1 involved performance evaluation. This included (1) reservoir characterization and the development of a reservoir database, (2) volumetric analysis to evaluate production performance, (3) reservoir modeling, (4) laboratory work, (5) identification of operational problems, (6) identification of unrecovered mobile oil and estimation of recovery factors, and (7) Identification of the most efficient and economical recovery process. To accomplish these objectives the initial budget period was subdivided into three major tasks. The tasks were (1) geological and engineering analysis, (2) laboratory testing, and (3) unitization. Due to the presence of different operators within the field, it was necessary to unitize the field in order to demonstrate a field-wide improved recovery process. This work was completed and the project moved into Budget Period 2

Surface water-quality assessment of the lower Kansas River basin, Kansas and Nebraska; project description

Science.gov (United States)

Stamer, J.K.; Jordan, P.R.; Engberg, R.A.; Dugan, J.T.

1987-01-01

In 1986 the U.S. Geological Survey began a National Water-Quality Assessment Program to: (1) provide nationally consistent descriptions of the current status of water quality for a large, diverse, and geographically distributed part of the Nation 's surface water resources; (2) where possible, define trends in water quality; and (3) identify and describe the relation between water quality and natural and land use factors. This report describes the pilot study of the lower Kansas River basin, which is one of four surface water pilot studies that will be used to test, and modify as necessary, assessment concepts and approaches in preparation for future full implementation of the national program. Water quality issues in the lower Kansas River basin are dominated by possible nonpoint sources of contamination from agricultural land, with issues including: (1) large sediment discharge in the streams and sediment deposition in the reservoirs caused by intensive cultivation of row crops and subsequent erosion; (2) occurrence of pesticides in streams and reservoirs that could impair the suitability of water for aquatic life and has the potential for impairing the water 's suitability for public supply; (3) bacterial contamination caused by runoff from pastureland and feedlot operations and municipal wastewater discharges; and (4) nutrient enrichment of reservoirs. Data from fixed stations will be used to determine frequency distributions of constituent concentrations and mass balances of constituents between stations. Subbasin or river reach studies will provide a better understanding of the origin, movement, and fate of potential contaminants. (Lantz-PTT)

Leveraging community-academic partnerships to improve healthy food access in an urban, Kansas City, Kansas, community.

Science.gov (United States)

Mabachi, Natabhona M; Kimminau, Kim S

2012-01-01

Americans can combat overweight (OW) and obesity by eating unprocessed, fresh foods. However, all Americans do not have equal access to these recommended foods. Low-income, minority, urban neighborhoods in particular often have limited access to healthy resources, although they are vulnerable to higher levels of OW and obesity. This project used community-based participatory research (CBPR) principles to investigate the food needs of residents and develop a business plan to improve access to healthy food options in an urban, Kansas City, Kansas, neighborhood. Partner community organizations were mobilized to conduct a Community Food Assessment survey. The surveys were accompanied by flyers that were part of the communication engagement strategy. Statistical analysis of the surveys was conducted. We engaged low-income, minority population (40% Latino, 30% African American) urban communities at the household level. Survey results provided in-depth information about residents' food needs and thoughts on how to improve food access. Results were reported to community members at a town hall style meeting. Developing a strategic plan to engage a community and develop trust is crucial to sustaining a partnership particularly when working with underserved communities. This project demonstrates that, if well managed, the benefits of academic and community partnerships outweigh the challenges thus such relationships should be encouraged and supported by communities, academic institutions, local and national government, and funders. A CBPR approach to understanding an urban community's food needs and opinions is important for comprehensive food access planning.

Annual Report of Monitoring at Barnes, Kansas, in 2012

Energy Technology Data Exchange (ETDEWEB)

LaFreniere, Lorraine M. [Argonne National Lab. (ANL), Argonne, IL (United States)

2013-06-01

Barnes, Kansas, is a small rural community (population approximately 150) located in Washington County, in north-central Kansas (Figure 1.1). Barnes is located in Section 9, Township 4 South, Range 5 East, at approximate latitude 39°43'0'' north and longitude 96°52'25'' west (USGS 1968). The city lies in a transition zone between the Flint Hills and the glaciated region. The area’s topography consists of gently sloping hills of Pleistocene loess (< 20 ft) overlying a shale unit and interbedded shale, limestone, and siltstone of the Permian Chase Group. Groundwater for the public water supply is obtained from wells PWS2 and PWS3 at reported depths of 155 ft and 160 ft, respectively, located in the northwestern portion of the city. The water is produced from the bedrock aquifer of the Chase Group. Section 2 summarizes the hydrogeologic conceptual site model. This report summarizes findings for groundwater inspection in Barnes.

Estimated Flood-Inundation Mapping for the Upper Blue River, Indian Creek, and Dyke Branch in Kansas City, Missouri, 2006-08

Science.gov (United States)

Kelly, Brian P.; Huizinga, Richard J.

2008-01-01

In the interest of improved public safety during flooding, the U.S. Geological Survey, in cooperation with the city of Kansas City, Missouri, completed a flood-inundation study of the Blue River in Kansas City, Missouri, from the U.S. Geological Survey streamflow gage at Kenneth Road to 63rd Street, of Indian Creek from the Kansas-Missouri border to its mouth, and of Dyke Branch from the Kansas-Missouri border to its mouth, to determine the estimated extent of flood inundation at selected flood stages on the Blue River, Indian Creek, and Dyke Branch. The results of this study spatially interpolate information provided by U.S. Geological Survey gages, Kansas City Automated Local Evaluation in Real Time gages, and the National Weather Service flood-peak prediction service that comprise the Blue River flood-alert system and are a valuable tool for public officials and residents to minimize flood deaths and damage in Kansas City. To provide public access to the information presented in this report, a World Wide Web site (http://mo.water.usgs.gov/indep/kelly/blueriver) was created that displays the results of two-dimensional modeling between Hickman Mills Drive and 63rd Street, estimated flood-inundation maps for 13 flood stages, the latest gage heights, and National Weather Service stage forecasts for each forecast location within the study area. The results of a previous study of flood inundation on the Blue River from 63rd Street to the mouth also are available. In addition the full text of this report, all tables and maps are available for download (http://pubs.usgs.gov/sir/2008/5068). Thirteen flood-inundation maps were produced at 2-foot intervals for water-surface elevations from 763.8 to 787.8 feet referenced to the Blue River at the 63rd Street Automated Local Evaluation in Real Time stream gage operated by the city of Kansas City, Missouri. Each map is associated with gages at Kenneth Road, Blue Ridge Boulevard, Kansas City (at Bannister Road), U.S. Highway 71

A model technology transfer program for independent operators: Kansas Technology Transfer Model (KTTM)

Energy Technology Data Exchange (ETDEWEB)

Schoeling, L.G.

1993-09-01

This report describes the development and testing of the Kansas Technology Transfer Model (KTTM) which is to be utilized as a regional model for the development of other technology transfer programs for independent operators throughout oil-producing regions in the US. It describes the linkage of the regional model with a proposed national technology transfer plan, an evaluation technique for improving and assessing the model, and the methodology which makes it adaptable on a regional basis. The report also describes management concepts helpful in managing a technology transfer program. The original Tertiary Oil Recovery Project (TORP) activities, upon which the KTTM is based, were developed and tested for Kansas and have proved to be effective in assisting independent operators in utilizing technology. Through joint activities of TORP and the Kansas Geological Survey (KGS), the KTTM was developed and documented for application in other oil-producing regions. During the course of developing this model, twelve documents describing the implementation of the KTTM were developed as deliverables to DOE. These include: (1) a problem identification (PI) manual describing the format and results of six PI workshops conducted in different areas of Kansas, (2) three technology workshop participant manuals on advanced waterflooding, reservoir description, and personal computer applications, (3) three technology workshop instructor manuals which provides instructor material for all three workshops, (4) three technologies were documented as demonstration projects which included reservoir management, permeability modification, and utilization of a liquid-level acoustic measuring device, (5) a bibliography of all literature utilized in the documents, and (6) a document which describes the KTTM.

Digital Learning Compass: Distance Education State Almanac 2017. Kansas

Science.gov (United States)

Seaman, Julia E.; Seaman, Jeff

2017-01-01

This brief report uses data collected under the U.S. Department of Education's National Center for Educational Statistics (NCES) Integrated Postsecondary Education Data System (IPEDS) Fall Enrollment survey to highlight distance education data in the state of Kansas. The sample for this analysis is comprised of all active, degree-granting…

Salmonellosis Hospitalizations in the United States: Associated Chronic Conditions, Costs, and Hospital Outcomes, 2011, Trends 2000-2011.

Science.gov (United States)

Cummings, Patricia L; Kuo, Tony; Javanbakht, Marjan; Shafir, Shira; Wang, May; Sorvillo, Frank

2016-01-01

Hospitalized salmonellosis patients with concurrent chronic conditions may be at increased risk for adverse outcomes, increasing the costs associated with hospitalization. Identifying important modifiable risk factors for this predominantly foodborne illness may assist hospitals, physicians, and public health authorities to improve management of these patients. The objectives of this study were to (1) quantify the burden of salmonellosis hospitalizations in the United States, (2) describe hospitalization characteristics among salmonellosis patients with concurrent chronic conditions, and (3) examine the relationships between salmonellosis and comorbidities by four hospital-related outcomes. A retrospective analysis of salmonellosis discharges was conducted using the Agency for Healthcare Research and Quality's Nationwide Inpatient Sample for 2011. A supplemental trend analysis was performed for the period 2000-2011. Hospitalization characteristics were examined using multivariable regression modeling, with a focus on four outcome measures: in-hospital death, total amount billed by hospitals for services, length of stay, and disease severity. In 2011, there were 11,032 total salmonellosis diagnoses; 7496 were listed as the primary diagnosis, with 86 deaths (case-fatality rate = 1.2%). Multivariable regression analyses revealed a greater number of chronic conditions (≥4) among salmonellosis patients was associated with higher mean total amount billed by hospitals for services, longer length of stay, and greater disease severity (p ≤ 0.05). From 2000 to 2011, hospital discharges for salmonellosis increased by 27.2%, and the mean total amount billed by hospitals increased nearly threefold: $9,777 (2000) to $29,690 (2011). Observed increases in hospitalizations indicate the burden of salmonellosis remains substantial in the United States. The positive association between increased number of chronic conditions and the four hospital-related outcomes affirms

Kansas Consortium Plug-in Hybrid Medium Duty

Energy Technology Data Exchange (ETDEWEB)

None, None

2012-03-31

On September 30, 2008, the US Department of Energy (DoE), issued a cooperative agreement award, DE-FC26-08NT01914, to the Metropolitan Energy Center (MEC), for a project known as “Kansas Consortium Plug-in Hybrid Medium Duty Certification” project. The cooperative agreement was awarded pursuant to H15915 in reference to H. R. 2764 Congressionally Directed Projects. The original agreement provided funding for The Consortium to implement the established project objectives as follows: (1) to understand the current state of the development of a test protocol for PHEV configurations; (2) to work with industry stakeholders to recommend a medium duty vehicle test protocol; (3) to utilize the Phase 1 Eaton PHEV F550 Chassis or other appropriate PHEV configurations to conduct emissions testing; (4) and to make an industry PHEV certification test protocol recommendation for medium duty trucks. Subsequent amendments to the initial agreement were made, the most significant being a revised Scope of Project Objectives (SOPO) that did not address actual field data since it was not available as originally expected. This project was mated by DOE with a parallel project award given to the South Coast Air Quality Management District (SCAQMD) in California. The SCAQMD project involved designing, building and testing of five medium duty plug-in hybrid electric trucks. SCAQMD had contracted with the Electric Power Research Institute (EPRI) to manage the project. EPRI provided the required match to the federal grant funds to both the SCAQMD project and the Kansas Consortium project. The rational for linking the two projects was that the data derived from the SCAQMD project could be used to validate the protocols developed by the Kansas Consortium team. At the same time, the consortium team would be a useful resource to SCAQMD in designating their test procedures for emissions and operating parameters and determining vehicle mileage. The years between award of the cooperative

Wind farm turbulence impacts on general aviation airports in Kansas.

Science.gov (United States)

2014-01-01

Wind turbines and wind farms have become popular in the State of Kansas. Some general aviation pilots have expressed a concern about the : turbulence that the spinning blades are creating. If a wind farm is built near an airport, does this affect the...

Hospital-Level Factors Associated with Pediatric Emergency Department Return Visits.

Science.gov (United States)

Pittsenbarger, Zachary; Thurm, Cary; Neuman, Mark; Spencer, Sandra; Simon, Harold; Gosdin, Craig; Shah, Samir; McClead, Richard; Stack, Anne; Alpern, Elizabeth

2017-07-01

Return visits (RVs) and RVs with admission (RVAs) are commonly used emergency department quality measures. Visit- and patient-level factors, including several social determinants of health, have been associated with RV rates, but hospital-specific factors have not been studied. To identify what hospital-level factors correspond with high RV and RVA rates. Multicenter mixed-methods study of hospital characteristics associated with RV and RVA rates. Pediatric Health Information System with survey of emergency department directors. Adjusted return rates were calculated with generalized linear mixed-effects models. Hospitals were categorized by adjusted RV and RVA rates for analysis. Twenty-four hospitals accounted for 1,456,377 patient visits with an overall adjusted RV rate of 3.7% and RVA rate of 0.7%. Hospitals with the highest RV rates served populations that were more likely to have government insurance and lower median household incomes and less likely to carry commercial insurance. Hospitals in the highest RV rate outlier group had lower pediatric emergency medicine specialist staffing, calculated as full-time equivalents per 10,000 patient visits: median (interquartile range) of 1.9 (1.5-2.1) versus 2.9 (2.2-3.6). There were no differences in hospital population characteristics or staffing by RVA groups. RV rates were associated with population social determinants of health and inversely related to staffing. Hospital-level variation may indicate population-level economic factors outside the control of the hospital and unrelated to quality of care. © 2017 Society of Hospital Medicine

Field Demonstration of Carbon Dioxide Miscible Flooding in the Lansing-Kansas City Formation, Central Kansas

Energy Technology Data Exchange (ETDEWEB)

Alan Byrnes; G. Paul Willhite; Don Green; Richard Pancake; JyunSyung Tsau; W. Lynn Watney; John Doveton; Willard Guy; Rodney Reynolds; Dave Murfin; James Daniels; Russell Martin; William Flanders; Dave Vander Griend; Eric Mork; Paul Cantrell

2010-03-07

A pilot carbon dioxide miscible flood was initiated in the Lansing Kansas City C formation in the Hall Gurney Field, Russell County, Kansas. The reservoir zone is an oomoldic carbonate located at a depth of about 2900 feet. The pilot consists of one carbon dioxide injection well and three production wells. Continuous carbon dioxide injection began on December 2, 2003. By the end of June 2005, 16.19 MM lb of carbon dioxide was injected into the pilot area. Injection was converted to water on June 21, 2005 to reduce operating costs to a breakeven level with the expectation that sufficient carbon dioxide was injected to displace the oil bank to the production wells by water injection. By March 7,2010, 8,736 bbl of oil were produced from the pilot. Production from wells to the northwest of the pilot region indicates that oil displaced from carbon dioxide injection was produced from Colliver A7, Colliver A3, Colliver A14 and Graham A4 located on adjacent leases. About 19,166 bbl of incremental oil were estimated to have been produced from these wells as of March 7, 2010. There is evidence of a directional permeability trend toward the NW through the pilot region. The majority of the injected carbon dioxide remains in the pilot region, which has been maintained at a pressure at or above the minimum miscibility pressure. Estimated oil recovery attributed to the CO2 flood is 27,902 bbl which is equivalent to a gross CO2 utilization of 4.8 MCF/bbl. The pilot project is not economic.

Kansas nurse leader residency programme: advancing leader knowledge and skills.

Science.gov (United States)

Shen, Qiuhua; Peltzer, Jill; Teel, Cynthia; Pierce, Janet

2018-03-01

To evaluate the effectiveness of the Kansas Nurse Leader Residency (KNLR) programme in improving nurses' leadership knowledge and skills and its acceptability, feasibility and fidelity. The Future of Nursing Report (Institute of Medicine, 2011) calls for nurses to lead change and advance health. The 6-month KNLR programme was developed by the Kansas Action Coalition to support nurses' leadership development. Nurses (n = 36) from four nursing specialties (acute care, long-term care, public health and school health) participated in the programme. The adapted Leader Knowledge and Skill Inventory was used to assess leadership knowledge and skills. Programme acceptability, feasibility and implementation fidelity also were evaluated. The programme completion rate was 67.7% (n = 24). Programme completers had significantly improved self-assessed and mentor-assessed leadership knowledge and skills (p leaders are critical for successful transition into management positions. © 2017 John Wiley & Sons Ltd.

Spatial variability of harmful algal blooms in Milford Lake, Kansas, July and August 2015

Science.gov (United States)

Foster, Guy M.; Graham, Jennifer L.; Stiles, Tom C.; Boyer, Marvin G.; King, Lindsey R.; Loftin, Keith A.

2017-01-09

Cyanobacterial harmful algal blooms (CyanoHABs) tend to be spatially variable vertically in the water column and horizontally across the lake surface because of in-lake and weather-driven processes and can vary by orders of magnitude in concentration across relatively short distances (meters or less). Extreme spatial variability in cyanobacteria and associated compounds poses unique challenges to collecting representative samples for scientific study and public-health protection. The objective of this study was to assess the spatial variability of cyanobacteria and microcystin in Milford Lake, Kansas, using data collected on July 27 and August 31, 2015. Spatially dense near-surface data were collected by the U.S. Geological Survey, nearshore data were collected by the Kansas Department of Health and Environment, and open-water data were collected by U.S. Army Corps of Engineers. CyanoHABs are known to be spatially variable, but that variability is rarely quantified. A better understanding of the spatial variability of cyanobacteria and microcystin will inform sampling and management strategies for Milford Lake and for other lakes with CyanoHAB issues throughout the Nation.The CyanoHABs in Milford Lake during July and August 2015 displayed the extreme spatial variability characteristic of cyanobacterial blooms. The phytoplankton community was almost exclusively cyanobacteria (greater than 90 percent) during July and August. Cyanobacteria (measured directly by cell counts and indirectly by regression-estimated chlorophyll) and microcystin (measured directly by enzyme-linked immunosorbent assay [ELISA] and indirectly by regression estimates) concentrations varied by orders of magnitude throughout the lake. During July and August 2015, cyanobacteria and microcystin concentrations decreased in the downlake (towards the outlet) direction.Nearshore and open-water surface grabs were collected and analyzed for microcystin as part of this study. Samples were collected in the

Full depth bituminous recycling of I-70, Thomas County, Kansas

Science.gov (United States)

2004-01-01

In 1990, 13 full depth asphalt pavement test sections were built on a portion of I-70 in Thomas County, Kansas. Various combinations of hot mix and cold recycle mixes with different additives were used to build the test sections. Two of the test sect...

Factors associated with hypoglycemia episodes in hospitalized type ...

African Journals Online (AJOL)

during hospital stay were those admitted due to other causes but subsequently developed hypoglycemia ..... Table 3: Association between causes and severity of hypoglycemia episodes .... An animal study in ... American Diabetes Association.

Bendix Kansas City Division technological spinoff through 1978

International Nuclear Information System (INIS)

Barnes, H.T.

1979-02-01

The results of work of Bendix Kansas City Division are made available in the form of technical reports that are processed through the DOE Technical Information Center in Oak Ridge. The present report lists the documents released by the Division, along with author and subject indexes. Drawing sets released are also listed. Locations of report collections in the U.S., other countries, and international agencies are provided

EPA’s Summary Report of the Collaborative Green Infrastructure Pilot Project for the Middle Blue River in Kansas City, MO

Science.gov (United States)

The United States Environmental Protection Agency evaluated the performance of a hybrid green-gray infrastructure pilot project installed into the Marlborough Neighborhood by the Kansas City Water Services Department. Kansas City installed 135 vegetated SCMs, 24,290 square feet o...

Effects of Regulation on Induced Seismicity in Southern Kansas

Science.gov (United States)

Rubinstein, J. L.; Ellsworth, W. L.; Dougherty, S. L.

2016-12-01

The appearance of seismicity concurrent with the expansion of oil and gas activities in southern Kansas since September 2012 suggests that industrial operations are inducing earthquakes there. Much of the seismicity can be related to high-rate injection wells within 5 km of the earthquakes. There is significant complexity to the situation, though. Some of the seismicity, including the 2014 M4.8 Milan earthquake, the largest earthquake to occur in the area, lies at least 10km from high-rate injection wells. Additionally, the presence of high-rate wells does not guarantee that there will be nearby seismicity. Many of the highest-rate injection wells are located to the southwest of our study area, where there is minimal seismicity. We have also seen changes in earthquake rates shortly following the March 2015 enactment of new limits on the rate of wastewater disposal in five areas in southern Kansas. Overall, the earthquake rate has decreased significantly since these rules went into place. In more detail, however, earthquake rates within the five areas decreased, but the rate outside the five zones increased. It is likely that fluid-pressure diffusion is responsible for the migration of seismicity outside the areas of reduced injection because there is little injection in the areas unaffected by the new injection rules. This increase is also a reminder that seismicity can persist long after the reduction or cessation of injection. In addition to the effect of the new injection rules, it is possible that the reduction in injection may be partially caused by economic factors that have resulted in a decrease in the production of oil and gas. We have yet to disentangle the effects of the new injection rules and the low prices of oil and gas on the induced seismicity in southern Kansas.

Association Between the 2014 Medicaid Expansion and US Hospital Finances.

Science.gov (United States)

Blavin, Fredric

2016-10-11

The Affordable Care Act expanded Medicaid eligibility for millions of low-income adults. The choice for states to expand Medicaid could affect the financial health of hospitals by decreasing the proportion of patient volume and unreimbursed expenses attributable to uninsured patients while increasing revenue from newly covered patients. To estimate the association between the Medicaid expansion in 2014 and hospital finances by assessing differences between hospitals in states that expanded Medicaid and in those states that did not expand Medicaid. Observational study with analysis of data for nonfederal general medical or surgical hospitals in fiscal years 2011 through 2014, using data from the American Hospital Association Annual Survey and the Health Care Cost Report Information System from the US Centers for Medicare & Medicaid Services. Multivariable difference-in-difference regression analyses were used to compare states with Medicaid expansion with states without Medicaid expansion. Hospitals in states that expanded Medicaid eligibility before January 2014 were excluded. Medicaid expansion in 2014, accounting for variation in fiscal year start dates. Hospital-reported information on uncompensated care, uncompensated care as a percentage of total hospital expenses, Medicaid revenue, Medicaid as a percentage of total revenue, operating margins, and excess margins. The sample included between 1200 and 1400 hospitals per fiscal year in 19 states with Medicaid expansion and between 2200 and 2400 hospitals per fiscal year in 25 states without Medicaid expansion (with sample size varying depending on the outcome measured). Expansion of Medicaid was associated with a decline of $2.8 million (95% CI, -$4.1 to -$1.6 million; P policy change on hospitals' overall finances.

75 FR 34983 - Order (1) Pursuant to Section 4(c) of the Commodity Exchange Act, Permitting the Kansas City...

Science.gov (United States)

2010-06-21

... Act, Permitting the Kansas City Board of Trade Clearing Corporation To Clear Over-the-Counter Wheat Calendar Swaps and (2) Pursuant to Section 4d of the Commodity Exchange Act, Permitting Customer Positions... contract market, and its wholly- owned subsidiary corporation, the Kansas City Board of Trade Clearing...

Stream instability countermeasures applied at Kansas Department of Transportation highway structures.

Science.gov (United States)

2008-11-01

This project considered stream instability countermeasures used by the Kansas Department of Transportation (KDOT) to protect the highway infrastructure at stream crossings from changes due to the dynamic nature of streams. Site visits were made to 13...

Activity Limitation Stages Are Associated With Risk of Hospitalization Among Medicare Beneficiaries.

Science.gov (United States)

Na, Ling; Pan, Qiang; Xie, Dawei; Kurichi, Jibby E; Streim, Joel E; Bogner, Hillary R; Saliba, Debra; Hennessy, Sean

2017-05-01

Activity limitation stages based on activities of daily living (ADLs) and instrumental activities of daily living (IADLs) are associated with 3-year mortality in elderly Medicare beneficiaries, yet their associations with hospitalization risk in this population have not been studied. To examine the independent association of activity limitation stages with risk of hospitalization within a year among Medicare beneficiaries aged 65 years and older. Cohort study. Community. A total of 9447 community-dwelling elderly Medicare beneficiaries from the Medicare Current Beneficiary Survey for years 2005-2009. Stages were derived for ADLs and IADLs separately. Associations of stages with time to first hospitalization and time to recurrent hospitalizations within a year were assessed with Cox proportional hazards models, with which we accounted for baseline sociodemographics, smoking status, comorbidities, and the year of survey entry. Time to first hospitalization and time to recurrent hospitalizations within 1 year. The adjusted risk of first hospitalization increased with greater activity limitation stages (except stage III). The hazard ratios (95% confidence intervals) for ADL stages I-IV compared with stage 0 (no limitations) were 1.49 (1.36-1.63), 1.61 (1.44-1.80), 1.54 (1.35-1.76), and 2.06 (1.61-2.63), respectively. The pattern for IADL stages was similar. For recurrent hospitalizations, activity limitation stages were associated with the risk of the first hospitalization but not with subsequent hospitalizations. Activity limitation stages are associated with the risk of first hospitalization in the subsequent year among elderly Medicare beneficiaries. Stages capture clinically interpretable profiles of ADL and IADL functionality and describe preserved functions and activity limitation in an aggregated measure. Stage can inform interventions to ameliorate disability and thus reduce the risk of a subsequent hospitalization in this population. IV. Copyright © 2017

Hospitalization patterns associated with Appalachian coal mining.

Science.gov (United States)

Hendryx, Michael; Ahern, Melissa M; Nurkiewicz, Timothy R

2007-12-01

The goal of this study was to test whether the volume of coal mining was related to population hospitalization risk for diseases postulated to be sensitive or insensitive to coal mining by-products. The study was a retrospective analysis of 2001 adult hospitalization data (n = 93,952) for West Virginia, Kentucky, and Pennsylvania, merged with county-level coal production figures. Hospitalization data were obtained from the Health Care Utilization Project National Inpatient Sample. Diagnoses postulated to be sensitive to coal mining by-product exposure were contrasted with diagnoses postulated to be insensitive to exposure. Data were analyzed using hierarchical nonlinear models, controlling for patient age, gender, insurance, comorbidities, hospital teaching status, county poverty, and county social capital. Controlling for covariates, the volume of coal mining was significantly related to hospitalization risk for two conditions postulated to be sensitive to exposure: hypertension and chronic obstructive pulmonary disease (COPD). The odds for a COPD hospitalization increased 1% for each 1462 tons of coal, and the odds for a hypertension hospitalization increased 1% for each 1873 tons of coal. Other conditions were not related to mining volume. Exposure to particulates or other pollutants generated by coal mining activities may be linked to increased risk of COPD and hypertension hospitalizations. Limitations in the data likely result in an underestimate of associations.

Improving Accuracy of Influenza-Associated Hospitalization Rate Estimates

Science.gov (United States)

Reed, Carrie; Kirley, Pam Daily; Aragon, Deborah; Meek, James; Farley, Monica M.; Ryan, Patricia; Collins, Jim; Lynfield, Ruth; Baumbach, Joan; Zansky, Shelley; Bennett, Nancy M.; Fowler, Brian; Thomas, Ann; Lindegren, Mary L.; Atkinson, Annette; Finelli, Lyn; Chaves, Sandra S.

2015-01-01

Diagnostic test sensitivity affects rate estimates for laboratory-confirmed influenza–associated hospitalizations. We used data from FluSurv-NET, a national population-based surveillance system for laboratory-confirmed influenza hospitalizations, to capture diagnostic test type by patient age and influenza season. We calculated observed rates by age group and adjusted rates by test sensitivity. Test sensitivity was lowest in adults >65 years of age. For all ages, reverse transcription PCR was the most sensitive test, and use increased from 65 years. After 2009, hospitalization rates adjusted by test sensitivity were ≈15% higher for children 65 years of age. Test sensitivity adjustments improve the accuracy of hospitalization rate estimates. PMID:26292017

Characteristics of Hospitals Associated with Complete and Partial Implementation of Electronic Health Records.

Science.gov (United States)

Bhounsule, Prajakta; Peterson, Andrew M

2016-01-01

(1) To determine the proportion of hospitals with and without implementation of electronic health records (EHRs). (2) To examine characteristics of hospitals that report implementation of EHRs partially or completely versus those that report no implementation. (3) To identify hospital characteristics associated with nonimplementation to help devise future policy initiatives. This was a retrospective cross-sectional study using the 2012 American Hospital Association Annual Survey Database. The outcome variable was the implementation of EHRs completely or partially. Independent variables were hospital characteristics, such as staffing, organization structure, accreditations, ownership, and services and facilities provided at the hospitals. Descriptive frequencies were determined, and multinomial logistic regression was used to determine variables independently associated with complete or partial implementation of EHRs. In this study, 12.6 percent of hospitals reported no implementation of EHRs, while 43.9 percent of hospitals implemented EHRs partially and 43.5 percent implemented EHRs completely. Overall characteristics of hospitals with complete and partial implementation were similar. The multinomial regression model revealed a positive association between the number of licensed beds and complete implementation of EHRs. A positive association was found between children's general medical, surgical, and heart hospitals and complete implementation of EHRs. Conversely, psychiatric and rehabilitation hospitals, limited service hospitals, hospitals participating in a network, service hospitals, government nonfederal hospitals, and nongovernment not-for-profit hospitals showed less likelihood of complete implementation of EHRs. Study findings suggest a disparity of EHR implementation between larger, for-profit hospitals and smaller, not-for-profit hospitals. Low rates of implementation were observed with psychiatric and rehabilitation hospitals. EHR policy initiatives

Water quality of streams in Johnson County, Kansas, 2002-07

Science.gov (United States)

Rasmussen, T.J.

2009-01-01

Water quality of streams in Johnson County, Kansas was evaluated from October 2002 through December 2007 in a cooperative study between the U.S. Geological Survey and the Johnson County Stormwater Management Program. Water quality at 42 stream sites, representing urban and rural basins, was characterized by evaluating benthic macroinvertebrates, water (discrete and continuous data), and/or streambed sediment. Point and nonpoint sources and transport were described for water-quality constituents including suspended sediment, dissolved solids and major ions, nutrients (nitrogen and phosphorus), indicator bacteria, pesticides, and organic wastewater and pharmaceutical compounds. The information obtained from this study is being used by city and county officials to develop effective management plans for protecting and improving stream quality. This fact sheet summarizes important results from three comprehensive reports published as part of the study and available on the World Wide Web at http://ks.water.usgs.gov/Kansas/studies/qw/joco/. ?? 2009 ASCE.

Quality-assurance and data management plan for groundwater activities by the U.S. Geological Survey in Kansas, 2014

Science.gov (United States)

Putnam, James E.; Hansen, Cristi V.

2014-01-01

As the Nation’s principle earth-science information agency, the U.S. Geological Survey (USGS) is depended on to collect data of the highest quality. This document is a quality-assurance plan for groundwater activities (GWQAP) of the Kansas Water Science Center. The purpose of this GWQAP is to establish a minimum set of guidelines and practices to be used by the Kansas Water Science Center to ensure quality in groundwater activities. Included within these practices are the assignment of responsibilities for implementing quality-assurance activities in the Kansas Water Science Center and establishment of review procedures needed to ensure the technical quality and reliability of the groundwater products. In addition, this GWQAP is intended to complement quality-assurance plans for surface-water and water-quality activities and similar plans for the Kansas Water Science Center and general project activities throughout the USGS. This document provides the framework for collecting, analyzing, and reporting groundwater data that are quality assured and quality controlled. This GWQAP presents policies directing the collection, processing, analysis, storage, review, and publication of groundwater data. In addition, policies related to organizational responsibilities, training, project planning, and safety are presented. These policies and practices pertain to all groundwater activities conducted by the Kansas Water Science Center, including data-collection programs, interpretive and research projects. This report also includes the data management plan that describes the progression of data management from data collection to archiving and publication.

Factors associated with the risk of falls in hospitalized adult patients

Directory of Open Access Journals (Sweden)

Vivian Lemes Lobo Bittencourt

Full Text Available Abstract OBJECTIVE Analyzing factors related to the risk of falls in hospitalized adult patients. METHOD A cross-sectional, analytical and quantitative study, developed in Clinical and Surgical Hospitalization Units from June to August 2015. Data collection instruments were sociodemographic and clinical forms, and the Morse Scale. Data were obtained with the patients and from medical records. Absolute and relative frequencies were used in the univariate statistical analysis, and chi-square test in the bivariate analysis. RESULTS 612 patients participated in the study. An association (p<0.001 was found between the high risk of falls and clinical neurological hospitalization, surgical trauma (hospitalization and comorbidities such as diabetes mellitus, systemic arterial hypertension, visual impairment, vertigo and fear of falling. CONCLUSION An association between the risk of falls was found due to hospitalization, comorbidities and intrinsic factors. Regarding extrinsic factors, an association between mats/carpets and risk of falls was found. No association between the risk of falls with other extrinsic factors was found.

Solar-Energy System for a Commercial Building--Topeka, Kansas

Science.gov (United States)

1982-01-01

Report describes a solar-energy system for space heating, cooling and domestic hot water at a 5,600 square-foot (520-square-meter) Topeka, Kansas, commercial building. System is expected to provide 74% of annual cooling load, 47% of heating load, and 95% of domestic hot-water load. System was included in building design to maximize energy conservation.

Epidemiology of Hospitalizations Associated with Invasive Candidiasis, United States, 2002-20121.

Science.gov (United States)

Strollo, Sara; Lionakis, Michail S; Adjemian, Jennifer; Steiner, Claudia A; Prevots, D Rebecca

2016-01-01

Invasive candidiasis is a major nosocomial fungal disease in the United States associated with high rates of illness and death. We analyzed inpatient hospitalization records from the Healthcare Cost and Utilization Project to estimate incidence of invasive candidiasis-associated hospitalizations in the United States. We extracted data for 33 states for 2002-2012 by using codes from the International Classification of Diseases, 9th Revision, Clinical Modification, for invasive candidiasis; we excluded neonatal cases. The overall age-adjusted average annual rate was 5.3 hospitalizations/100,000 population. Highest risk was for adults >65 years of age, particularly men. Median length of hospitalization was 21 days; 22% of patients died during hospitalization. Median unadjusted associated cost for inpatient care was $46,684. Age-adjusted annual rates decreased during 2005-2012 for men (annual change -3.9%) and women (annual change -4.5%) and across nearly all age groups. We report a high mortality rate and decreasing incidence of hospitalizations for this disease.

Economic burden associated with hospital postadmission dehydration.

Science.gov (United States)

Pash, Elizabeth; Parikh, Niraj; Hashemi, Lobat

2014-11-01

Development of dehydration after hospital admission can be a measure of quality care, but evidence describing the incidence, economic burden, and outcomes of dehydration in hospitalized patients is lacking. The objective of this study was to compare costs and resource utilization of U.S. patients experiencing postadmission dehydration (PAD) with those who do not in a hospital setting. All adult inpatient discharges, excluding those with suspected dehydration present on admission (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] codes for dehydration: 276.0, 276.1, 276.5), were identified from the Premier database using ICD-9-CM codes. PAD and no-PAD (NPAD) groups were matched on propensity score adjusting for demographics (age, sex, race, medical, elective patients), patient severity (All Patient Refined Diagnosis-Related Groups severity scores), and hospital characteristics (geographic location, bed size, teaching and urban hospital). Costs, length of stay (LOS), and incidence of mortality and catheter-associated urinary tract infection (CAUTI) were compared between groups using the t test for continuous variables and the χ(2) test for categorical variables. In total, 86,398 (2.1%) of all the selected patients experienced PAD. Postmatching mean total costs were significantly higher for the PAD group compared with the NPAD group ($33,945 vs $22,380; P < .0001). Departmental costs were also significantly higher for the PAD group (all P < .0001). Compared with the NPAD group, the PAD group had a higher mean LOS (12.9 vs 8.2 days), a higher incidence of CAUTI (0.6% vs 0.5%), and higher in-hospital mortality (8.6% vs 7.8%) (all P < .05). The results for subgroup analysis also showed significantly higher total cost and longer LOS days for patients with PAD (all P < .05). The economic burden associated with hospital PAD in medical and surgical patients was substantial. © 2014 American Society for Parenteral and Enteral

A rare moderate‐sized (Mw 4.9) earthquake in Kansas: Rupture process of the Milan, Kansas, earthquake of 12 November 2014 and its relationship to fluid injection

Science.gov (United States)

Choy, George; Rubinstein, Justin L.; Yeck, William; McNamara, Daniel E.; Mueller, Charles; Boyd, Oliver

2016-01-01

The largest recorded earthquake in Kansas occurred northeast of Milan on 12 November 2014 (Mw 4.9) in a region previously devoid of significant seismic activity. Applying multistation processing to data from local stations, we are able to detail the rupture process and rupture geometry of the mainshock, identify the causative fault plane, and delineate the expansion and extent of the subsequent seismic activity. The earthquake followed rapid increases of fluid injection by multiple wastewater injection wells in the vicinity of the fault. The source parameters and behavior of the Milan earthquake and foreshock–aftershock sequence are similar to characteristics of other earthquakes induced by wastewater injection into permeable formations overlying crystalline basement. This earthquake also provides an opportunity to test the empirical relation that uses felt area to estimate moment magnitude for historical earthquakes for Kansas.

Hospital Clostridium difficile infection (CDI) incidence as a risk factor for hospital-associated CDI.

Science.gov (United States)

Miller, Aaron C; Polgreen, Linnea A; Cavanaugh, Joseph E; Polgreen, Philip M

2016-07-01

Environmental risk factors for Clostridium difficile infections (CDIs) have been described at the room or unit level but not the hospital level. To understand the environmental risk factors for CDI, we investigated the association between institutional- and individual-level CDI. We performed a retrospective cohort study using the Healthcare Cost and Utilization Project state inpatient databases for California (2005-2011). For each patient's hospital stay, we calculated the hospital CDI incidence rate corresponding to the patient's quarter of discharge, while excluding each patient's own CDI status. Adjusting for patient and hospital characteristics, we ran a pooled logistic regression to determine individual CDI risk attributable to the hospital's CDI rate. There were 10,329,988 patients (26,086 cases and 10,303,902 noncases) who were analyzed. We found that a percentage point increase in the CDI incidence rate a patient encountered increased the odds of CDI by a factor of 1.182. As a point of comparison, a 1-percentage point increase in the CDI incidence rate that the patient encountered had roughly the same impact on their odds of acquiring CDI as a 55.8-day increase in their length of stay or a 60-year increase in age. Patients treated in hospitals with a higher CDI rate are more likely to acquire CDI. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Geoscience Education Opportunities: Partnerships to Advance TeacHing and Scholarship (GEOPATHS): A Kansas City Minority Student Recruitment Initiative

Science.gov (United States)

Adegoke, J. O.; Niemi, T. M.

2009-12-01

Geoscience Education Opportunities: Partnerships to Advance TeacHing and Scholarship (GEOPATHS) is a multi-year project funded by the National Science Foundation to address gaps in teacher preparation, improve teacher content in geosciences and help raise enrollment in the Geosciences, especially among populations that are traditionally underrepresented in the discipline. The project is a partnership between the University of Missouri Kansas City (UMKC) and the Kansas City Missouri School District (KCMSD). In this presentation we discuss strategies that we have successfully used to provide credible pathways into the discipline for minorities that have led to a significant increase in the number of underrepresented minority students who are interested in and majoring in geoscience fields at the University of Missouri-Kansas City.

Aerial gama ray and magnetic survey: Lawrence Quadrangle of Kansas and Missouri. Final report

International Nuclear Information System (INIS)

1980-11-01

The Lawrence quadrangle covers approximately 7500 square miles in Kansas and Missouri over the western edge of the Ozark Uplift. Sediments in this area are mostly Pennsylvanian and Permian sandstone, shale, limestone, and coal. As mapped, these are the dominant units in the quadrangle. A search of available literature revealed no known uranium deposits. A total of 94 uranium anomalies were detected and are discussed briefly. Most appear to be related to cultural features. Those associated with coal mine tailings appear to be most significant. Magnetic data appears to relate to complexities in the Precambrian basement

Kansas Department of Transportation research & technology news, vol. 6 #2, December 2013.

Science.gov (United States)

2013-12-01

Research & Technology News is a newsletter published by the Kansas Department of : Transportation, Bureau of Researchs Technology Transfer Section, in cooperation with : the Federal Highway Administration and the U.S. Department of Transportation.

Optimizing Fracture Treatments in a Mississippian "Chat" Reservoir, South-Central Kansas

Energy Technology Data Exchange (ETDEWEB)

K. David Newell; Saibal Bhattacharya; Alan Byrnes; W. Lynn Watney; Willard Guy

2005-10-01

This project is a collaboration of Woolsey Petroleum Corporation (a small independent operator) and the Kansas Geological Survey. The project will investigate geologic and engineering factors critical for designing hydraulic fracture treatments in Mississippian ''chat'' reservoirs. Mississippian reservoirs, including the chat, account for 159 million m3 (1 billion barrels) of the cumulative oil produced in Kansas. Mississippian reservoirs presently represent {approx}40% of the state's 5.6*106m3 (35 million barrels) annual production. Although geographically widespread, the ''chat'' is a heterogeneous reservoir composed of chert, cherty dolomite, and argillaceous limestone. Fractured chert with micro-moldic porosity is the best reservoir in this 18- to 30-m-thick (60- to 100-ft) unit. The chat will be cored in an infill well in the Medicine Lodge North field (417,638 m3 [2,626,858 bbls] oil; 217,811,000 m3 [7,692,010 mcf] gas cumulative production; discovered 1954). The core and modern wireline logs will provide geological and petrophysical data for designing a fracture treatment. Optimum hydraulic fracturing design is poorly defined in the chat, with poor correlation of treatment size to production increase. To establish new geologic and petrophysical guidelines for these treatments, data from core petrophysics, wireline logs, and oil-field maps will be input to a fracture-treatment simulation program. Parameters will be established for optimal size of the treatment and geologic characteristics of the predicted fracturing. The fracturing will be performed and subsequent wellsite tests will ascertain the results for comparison to predictions. A reservoir simulation program will then predict the rate and volumetric increase in production. Comparison of the predicted increase in production with that of reality, and the hypothetical fracturing behavior of the reservoir with that of its actual behavior, will serve as tests of

Original Research Factors associated with hospital arrival time after ...

African Journals Online (AJOL)

Original Research. Factors associated with hospital arrival time after the onset of stroke symptoms: A cross-sectional study at two teaching hospitals in Harare, Zimbabwe .... hypertension causing small vessel disease which outweigh the causes of ..... Stroke Mechanism in Atherosclerotic Middle Cerebral Artery Disease:.

Kansas State University: DOE/KEURP Site Operator Program. Year 4, fourth quarterly report, April 1, 1995--June 30, 1995

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-08-01

Kansas State University, in support of a DOE and Kansas Electric Utilities Research Program subject contract, continues to test, evaluate, demonstrate, and develop electric vehicle and infrastructure technology. K-State is operating two Soleq EVcort vehicles. During this reporting period both vehicles were brought back to full operational status after warranty service was completed by Soleq. Vehicle failures occurred due to three unrelated battery cable failures in addition to the replacement of one battery. Both vehicles are being operated on a routine basis. K-State, along with York Technical College, has established a relationship with Troy Design and Manufacturing (TDM) Redford, Michigan. K-State has ordered no less than four Ford Ranger electric trucks from TDM. K-State is involved in the steering committee that is monitoring and refining information to direct the design and testing of these new technology vehicles. TDM should become the first automotive manufacturer certified by one of the Big Three under their Quality Vehicle Manufacturer program. Kansas State University and the Kansas Electric Utility Research Program look forward to working with TDM on their new EV program.

Factors associated with financial distress of nonprofit hospitals.

Science.gov (United States)

Kim, Tae Hyun

2010-01-01

Financial distress can have a detrimental influence on the performance of hospitals. Hospital management needs to monitor potential financial distress effectively and know how it will respond depending on the severity of the circumstances. This study examined the multiple factors that may explain the financial distress of nonprofit hospitals during 1998 to 2001 and discussed their importance. To obtain more robust results, financial distress was assessed in 2 ways: first, financial strength index was used to incorporate 4 financial dimensions including profitability, liquidity, leverage, and physical facilities; second, cash flow (CF) was used to address the issues of accrual-based accounting in hospitals. This study finds that decrease in occupancy rate and increase in Medicaid payer mix, health maintenance organization penetration, market competition, physician supply, and percentage of the elderly are associated with increased likelihood of financial distress of urban hospitals. Increases in both Medicare and Medicaid payer mix, however, are related to higher likelihood of financial distress of rural hospitals.

[Historical origins between National Medical Association of China and Boji Hospital in Guangzhou].

Science.gov (United States)

Liu, Pinming

2015-09-01

In 2015, National Medical Association of China, now being called the Chinese Medical Association, celebrates its centennial and Boji Hospital in Guangzhou ( also known as Canton Hospital, or the Canton Pok Tsai Hospital, and now Sun Yat-sen Memorial Hospital of Sun Yat-sen University ) marks its 180th anniversary. Three major historical events establish the role of Boji Hospital in the founding and development of the National Medical Association of China during the last 100 years, viz.: ①hosting and participating in the establishment of the Medical Missionary Association of China and its official journal: the China Medical Missionary Journal; ②holding the 11th scientific sessions of the National Medical Association of China; ③nominating Dr. Wu Lien-teh as a candidate for the Nobel Prize in Physiology or Medicine in 1935 by William Warder Cadbury, the president of Boji Hospital.

Differences in microbiological profile between community-acquired, healthcare-associated and hospital-acquired infections.

Science.gov (United States)

Cardoso, Teresa; Ribeiro, Orquídea; Aragão, Irene; Costa-Pereira, Altamiro; Sarmento, António

2013-01-01

Microbiological profiles were analysed and compared for intra-abdominal, urinary, respiratory and bloodstream infections according to place of acquisition: community-acquired, with a separate analysis of healthcare-associated, and hospital-acquired. Prospective cohort study performed at a university tertiary care hospital over 1 year. Inclusion criteria were meeting the Centers for Disease Control definition of intra-abdominal, urinary, respiratory and bloodstream infections. A total of 1035 patients were included in the study. More than 25% of intra-abdominal infections were polymicrobial; multi-drug resistant gram-negatives were 38% in community-acquired, 50% in healthcare-associated and 57% in hospital-acquired. E. coli was the most prevalent among urinary infections: 69% in community-acquired, 56% in healthcare-associated and 26% in hospital-acquired; ESBL producers' pathogens were 10% in healthcare-associated and 3% in community-acquired and hospital-acquired. In respiratory infections Streptococcus pneumoniae was the most prevalent in community-acquired (54%) and MRSA in healthcare-associated (24%) and hospital-acquired (24%). A significant association was found between MRSA respiratory infection and hospitalization in the previous year (adjusted OR = 6.3), previous instrumentation (adjusted OR = 4.3) and previous antibiotic therapy (adjusted OR = 5.7); no cases were documented among patients without risk factors. Hospital mortality rate was 10% in community-acquired, 14% in healthcare-associated and 19% in hospital-acquired infection. This study shows that healthcare-associated has a different microbiologic profile than those from community or hospital acquired for the four main focus of infection. Knowledge of this fact is important because the existing guidelines for community-acquired are not entirely applicable for this group of patients.

Sustainable environmental flow management in an agricultural watershed in northeast Kansas

Science.gov (United States)

Background/Question/Methods The Delaware watershed, an area of land in northeast Kansas of over 1110 square miles, has degraded water quality due to intensive cultivation of crops and subsequent nutrient enrichment and erosion. The current conditions may be further aggravated by ...

Delirium in Hospitalized Children with Cancer: Incidence and Associated Risk Factors.

Science.gov (United States)

Traube, Chani; Ariagno, Sydney; Thau, Francesca; Rosenberg, Lynne; Mauer, Elizabeth A; Gerber, Linda M; Pritchard, David; Kearney, Julia; Greenwald, Bruce M; Silver, Gabrielle

2017-12-01

To assess the incidence of delirium and its risk factors in hospitalized children with cancer. In this cohort study, all consecutive admissions to a pediatric cancer service over a 3-month period were prospectively screened for delirium twice daily throughout their hospitalization. Demographic and treatment-related data were collected from the medical record after discharge. A total of 319 consecutive admissions, including 186 patients and 2731 hospital days, were included. Delirium was diagnosed in 35 patients, for an incidence of 18.8%. Risk factors independently associated with the development of delirium included age Delirium was associated with increased hospital length of stay, with median length of stay for delirious patients of 10 days compared with 5 days for patients who were not delirious during their hospitalization (P delirium was a frequent complication during admissions for childhood cancer, and was associated with increased hospital length of stay. Multi-institutional prospective studies are warranted to further characterize delirium in this high-risk population and identify modifiable risk factors to improve the care provided to hospitalized children with cancer. Copyright © 2017 Elsevier Inc. All rights reserved.

Flood-inundation maps and wetland restoration suitability index for the Blue River and selected tributaries, Kansas City, Missouri, and vicinity, 2012

Science.gov (United States)

Heimann, David C.; Kelly, Brian P.; Studley, Seth E.

2015-01-01

Digital flood-inundation maps for a 39.7-mile reach of the Blue River and selected tributaries (Brush Creek, Indian Creek, and Dyke Branch) at Kansas City, Missouri, and vicinity, were created by the U.S. Geological Survey (USGS) in cooperation with the City of Kansas City, Missouri. The flood-inundation maps, accessed through the USGS Flood-Inundation Mapping Science Web site at http://water.usgs.gov/osw/flood_inundation/, depict estimates of the spatial extent and depth of flooding corresponding to selected water levels (stages) at 15 reference streamgages and associated stream reaches in the Blue River Basin. Near-real-time stage data from the streamgages may be obtained from the USGS National Water Information System at http://waterdata.usgs.gov/ or the National Weather Service (NWS) Advanced Hydrologic Prediction Service (AHPS) at http://water.weather.gov/ahps/, which also forecasts flood hydrographs at selected sites.

Trouble Sleeping Associated with Lower Work Performance and Greater Healthcare Costs: Longitudinal Data from Kansas State Employee Wellness Program

Science.gov (United States)

Hui, Siu-kuen Azor; Grandner, Michael A.

2015-01-01

Objective To examine the relationships between employees’ trouble sleeping and absenteeism, work performance, and healthcare expenditures over a two year period. Methods Utilizing the Kansas State employee wellness program (EWP) dataset from 2008–2009, multinomial logistic regression analyses were conducted with trouble sleeping as the predictor and absenteeism, work performance, and healthcare costs as the outcomes. Results EWP participants (N=11,698 in 2008; 5,636 followed up in 2009) who had higher levels of sleep disturbance were more likely to be absent from work (all p performance ratings (all p performance, and healthcare costs. PMID:26461857

The University of Kansas High-Throughput Screening Laboratory. Part II: enabling collaborative drug-discovery partnerships through cutting-edge screening technology.

Science.gov (United States)

McDonald, Peter R; Roy, Anuradha; Chaguturu, Rathnam

2011-07-01

The University of Kansas High-Throughput Screening (KU HTS) core is a state-of-the-art drug-discovery facility with an entrepreneurial open-service policy, which provides centralized resources supporting public- and private-sector research initiatives. The KU HTS core was established in 2002 at the University of Kansas with support from an NIH grant and the state of Kansas. It collaborates with investigators from national and international academic, nonprofit and pharmaceutical organizations in executing HTS-ready assay development and screening of chemical libraries for target validation, probe selection, hit identification and lead optimization. This is part two of a contribution from the KU HTS laboratory.

Kansas Vocational Agriculture Education. Basic Core Curriculum Project, Horticulture II.

Science.gov (United States)

Albracht, James, Ed.

This second horticulture guide is one of a set of three designated as the basic core of instruction for horticulture programs in Kansas. Units of instruction are presented in eight sections: (1) Leadership, (2) Supervised Occupational Experience, (3) Plant Propagation, (4) Soil and Plant Growth Media, (5) Fertilizers, (6) Greenhouse, (7) Plant…

Kansas Vocational Agriculture Education. Basic Core Curriculum Project, Horticulture III.

Science.gov (United States)

Albracht, James, Ed.

This secondary horticulture curriculum guide is one of a set of three designated as the basic core of instruction for horticulture programs in Kansas. Units of instruction are presented in eight sections: (1) Human Relations, (2) Business Operations, (3) Greenhouse, (4) Retail Flowershop Operation, (5) Landscape Nursery, (6) Lawn Maintenance, (7)…

FInal Report: Site Investigation Results, 2009-2011, at Inman, Kansas

Energy Technology Data Exchange (ETDEWEB)

LaFreniere, Lorraine M. [Argonne National Lab. (ANL), Argonne, IL (United States). Environmental Sciences Div.

2015-05-01

The Commodity Credit Corporation of the U.S. Department of Agriculture (CCC/USDA) operated a grain storage facility at the southern edge of the city of Inman, Kansas, from 1954 to 1965. During this time, commercial grain fumigants containing carbon tetrachloride were in common use by the grain storage industry to preserve grain in their facilities. In 1997, trace to low levels of carbon tetrachloride (below the maximum contamination level [MCL] of 5.0 μg/L) were detected in three private wells near the former grain storage facility at Inman, as part of a statewide USDA private well sampling program that was implemented by the Kansas Department of Health and Environment (KDHE) near former CCC/USDA facilities. No public water supply wells were identified in 1998 by the KDHE within 1 mi of the town. Carbon tetrachloride is the contaminant of primary concern at sites associated with grain storage operations. To determine whether the former CCC/USDA facility at Inman is a potential contaminant source and its possible relationship to the contamination in groundwater, the CCC/USDA agreed to conduct investigations at Inman. The investigations were performed by the Environmental Science Division of Argonne National Laboratory in accordance with the Intergovernmental Agreement between the KDHE and the Farm Service Agency of the USDA. Argonne, on behalf of the CCC/USDA, developed a Work Plan (Argonne 2007) and subsequently a Summary of Investigation Results and Proposed Work Plan (Appendix A) for a phased site investigation. The proposed work was approved by the KDHE (2007, 2011). The investigations were conducted from November 2009 to September 2011, as proposed in the two work plans. This report presents the findings of the 2009-2011 investigations at Inman.

Sediment Quality and Comparison to Historical Water Quality, Little Arkansas River Basin, South-Central Kansas, 2007

Science.gov (United States)

Juracek, Kyle E.; Rasmussen, Patrick P.

2008-01-01

. The largest copper, lead, silver, and zinc concentrations, measured for a sample collected from Sand Creek downstream from Newton, Kansas, likely were related to urban sources of contamination. Radionuclide activities and bacterial densities in the streambed sediment varied throughout the basin. Variability in the former may be indicative of subbasin differences in the contribution of sediment from surface-soil and channel-bank sources. Streambed sediment may be useful for reconnaissance purposes to determine sources of particulate nitrogen, phosphorus, organic carbon, and other sediment-associated constituents in the basin. If flow conditions prior to streambed-sediment sampling and during water-quality sampling are considered, it may be possible to use streambed sediment as an indicator of water quality for nitrogen, phosphorus, and organic carbon. Flow conditions affect sediment-associated constituent concentrations in streambed-sediment and water samples, in part, because the sources of sediment (surface soils, channel banks) can vary with flow as can the size of the particles transported.

Association of emergency department and hospital characteristics with elopements and length of stay.

Science.gov (United States)

Handel, Daniel A; Fu, Rongwei; Vu, Eugene; Augustine, James J; Hsia, Renee Y; Shufflebarger, Charles M; Sun, Benjamin

2014-06-01

As the Centers for Medicare & Medicaid Services (CMS) core measures in 2013 compare Emergency Department (ED) treatment time intervals, it is important to identify ED and hospital characteristics associated with these metrics to facilitate accurate comparisons. The objective of this study is to assess differences in operational metrics by ED and hospital characteristics. ED-level characteristics included annual ED volume, percentage of patients admitted, percentage of patients presenting by ambulance, and percentage of pediatric patients. Hospital-level characteristics included teaching hospital status, trauma center status, hospital ownership (nonprofit or for-profit), inpatient bed capacity, critical access status, inpatient bed occupancy, and rural vs. urban location area. Data from the ED Benchmarking Alliance from 2004 to 2009 were merged with the American Hospital Association's Annual Survey Database to include hospital characteristics that may impact ED throughput. Overall median length of stay (LOS) and left before treatment is complete (LBTC) were the primary outcome variables, and a linear mixed model was used to assess the association between outcome variables and ED and hospital characteristics, while accounting for correlations among multiple observations within each hospital. All data were at the hospital level on a yearly basis. There were 445 EDs included in the analysis, from 2004 to 2009, with 850 observations over 6 years. Higher-volume EDs were associated with higher rates of LBTC and LOS. For-profit hospitals had lower LBTC and LOS. Higher inpatient bed occupancies were associated with a higher LOS. Increasing admission percentages were positively associated with overall LOS for EDs, but not with rates of LBTC. Higher-volume EDs are associated with higher LBTC and LOS, and for-profit hospitals appear more favorably in these metrics compared with their nonprofit counterparts. It is important to appreciate that hospitals have different baselines

Patients' perceptions of interactions with hospital staff are associated with hospital readmissions: a national survey of 4535 hospitals.

Science.gov (United States)

Yang, Lianping; Liu, Chaojie; Huang, Cunrui; Mukamel, Dana B

2018-01-29

Reducing 30-day hospital readmissions has become a focus of the current national payment policies. Medicare requires that hospitals collect and report patients' experience with their care as a condition of payment. However, the extent to which patients' experience with hospital care is related to hospital readmission is unknown. We established multivariate regression models in which 30-day risk-adjusted readmission rates were the dependent variables and patients' perceptions of the responsiveness of the hospital staff and communication (as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores) were the independent variables of interest. We selected six different clinical conditions for analyses, including acute myocardial infarction (AMI), chronic obstructive pulmonary disease (COPD), heart failure, hip/knee surgery, pneumonia, and stroke. Data included all acute care hospitals reporting in Hospital Compare in 2014. The number of hospitals with reported readmissions ranged from 2234 hospitals for AMI to 3758 hospitals for pneumonia. The average 30-day readmission rates ranged from 5.19% for knee/hip surgery to 22.7% for COPD. Patient experience of hospital-staff responsiveness as "top-box" ranged from 64% to 67% across the six clinical conditions, communication with nurses ranged from 77% to 79% and communication with doctors ranged from 80% to 81% (higher numbers are better). Our finding suggests that hospitals with better staff responsiveness were significantly more likely to have lower 30-day readmissions for all conditions. The effect size depended on the baseline readmission rates, with the largest effect on hospitals in the upper 75th quartile. A ten-percentage-point increase in staff responsiveness led to a 0.03-0.18 percentage point decrease in readmission rates. We found that neither communication with physicians nor communication with nurses was significantly associated with hospital readmissions. Our findings

Healthcare-associated infection in Burkina Faso: an assessment in a district hospital

Directory of Open Access Journals (Sweden)

Hervé Hien

2012-12-01

Full Text Available In developing countries, few data are available on healthcare-associated infections. In Burkina Faso, there has been a failure to take into account risk management and patient safety in the quality assurance program. The main objective of our study was to carry out an assessment of healthcare-associated infection in a first level hospital. We conducted a crosssectional study in June 2011 in the care units of Ziniaré District Hospital (Ziniaré, Burkina Faso. The hospital has been divided in three components: i hospital population (care providers, in-patients and patients’ guardians; ii healthcare and services organization; iii hospital environment. We included: care providers of the clinical services, hospital inpatients and patients’ guardians, hospitalization infrastructure and nursing units, and all the documents relating to standards and protocols. Data collection has been done by direct observation, interviews and biological samples taken at different settings. In hospital population, care providers and patients’ guardians represented a high source of infection: adherence to hygiene practice on the part of care providers was low (12/19, and no patients’ guardian experienced good conditions of staying in the hospital. In healthcare and services organization, healthcare waste management represented a high-risk source of infection. In hospital environment, hygiene level of the infrastructure in the hospital rooms was low (6.67%. Prevalence of isolated bacteria was 71.8%. Urinary-tract catheters infections were the most significant in our sample, followed by surgical-site infections. In total, 56.26% (9/19 of germs were -Lactamase producers (ESBL. They were represented by Escherichia coli and Klebsiella pneumoniae. Our analysis identified clearly healthcare-associated infection as a problem in Ziniaré district hospital. Hence, a national program of quality assurance in the hospitals should now integrate the risk infectious management

Changing trends in hospitalization rates associated with psychosis: Spain, 1980-2009.

Science.gov (United States)

Medel-Herrero, Alvaro; Amate, J M; Saz-Parkinson, Z; Gómez-Beneyto, M

2015-12-01

To analyze the prevalence of hospitalization attributable to psychosis in Spain over the last three decades. Longitudinal analysis (1980-2009) of age-adjusted hospital discharges rates associated with psychosis (ICD9 290-8) in all Spanish hospitals. Spanish Hospital Morbidity Survey. The hospitalization rate associated with psychotic episodes had been gradually increasing since 1980 until 2004; an abrupt turnaround observed in 2004 marks the beginning of a steady decline in the rate. The turning point described is not observed for each of the psychotic diagnoses separately analyzed. However, it is clearly seen when data are grouped in diagnosis-related groups (organic-psychosis, functional psychosis and substance-induced psychosis) since the time course of the diseases within the major diagnostic groups are interrelated as evidenced by shared turning points which collectively display a common time course pattern. Main hospital indicators and antipsychotic drug prescriptions were analyzed for any possible turning point in mid-2000s. Psychiatric hospital beds and length of stays remained stable by 2004; the hospitalizations associated with non-psychotic psychiatric pathologies show no turning point in 2004. However, an abrupt change on antipsychotic drug prescriptions is precisely observed in 2004. After decades of linear growth, hospitalizations for psychotic patients begin to decline in 2004, coinciding with the start of last generation atypical antipsychotic drug consumption in Spain. Some of the psychotic diagnostic rates evolve in an interrelated manner which calls into question the diagnosis and nosological boundaries between some of these pathologies.

Assessing urban forest effects and values: Douglas County, Kansas

Science.gov (United States)

David J. Nowak; Allison R. Bodine; Robert E. Hoehn; Alexis Ellis; Kim Bomberger; Daniel E. Crane; Theodore A. Endreny; Thomas Taggert; Emily. Stephan

2014-01-01

An analysis of trees in Douglas County, Kansas, reveals that this area has about 14,164,000 trees with tree and shrub canopy that covers 25.2 percent of the county. The most common tree species are American elm, northern hackberry, eastern redcedar, Osage-orange, and honeylocust. Trees in Douglas County currently store about 1.7 million tons of carbon (6.4 million tons...

Dissolution of Kansas evaporites: the radioactive waste disposal problem

International Nuclear Information System (INIS)

Smith, B.J.

1977-01-01

The radioactive waste repository at Lyons, Kansas, focused attention on the problem of evaporite dissolution. More study is needed in the determination of the mechanisms responsible for deterioration. Also, recent water-use policies have been questioned with the need pointed out for increased effectiveness in planning. Good water planning has to take into account the role of evaporite dissolution in water quality. 23 references

Physics Incubator at Kansas State University

Science.gov (United States)

Flanders, Bret; Chakrabarti, Amitabha

Funded by a major private endowment, the physics department at Kansas State University has recently started a physics incubator program that provides support to research projects with a high probability of commercial application. Some examples of these projects will be discussed in this talk. In a parallel effort, undergraduate physics majors and graduate students are being encouraged to work with our business school to earn an Entrepreneurship minor and a certification in Entrepreneurship. We will discuss how these efforts are promoting a ``culture change'' in the department. We will also discuss the advantages and the difficulties in running such a program in a Midwest college town.

Update on Kansas City Middle Blue River Green Infrastructure Pilot Project

Science.gov (United States)

In 2010, Kansas City, MO (KCMO) signed a consent degree with EPA on combined sewer overflows. The City decided to use adaptive management in order to extensively utilize green infrastructure (GI) in lieu of, and in addition to, gray structural controls. KCMO installed 130 GI sto...

Use of relational databases to evaluate regional petroleum accumulation, groundwater flow, and CO2 sequestration in Kansas

Science.gov (United States)

Carr, T.R.; Merriam, D.F.; Bartley, J.D.

2005-01-01

Large-scale relational databases and geographic information system tools are used to integrate temperature, pressure, and water geo-chemistry data from numerous wells to better understand regional-scale geothermal and hydrogeological regimes of the lower Paleozoic aquifer systems in the mid-continent and to evaluate their potential for geologic CO2 sequestration. The lower Paleozoic (Cambrian to Mississippian) aquifer systems in Kansas, Missouri, and Oklahoma comprise one of the largest regional-scale saline aquifer systems in North America. Understanding hydrologic conditions and processes of these regional-scale aquifer systems provides insight to the evolution of the various sedimentary basins, migration of hydrocarbons out of the Anadarko and Arkoma basins, and the distribution of Arbuckle petroleum reservoirs across Kansas and provides a basis to evaluate CO2 sequestration potential. The Cambrian and Ordovician stratigraphic units form a saline aquifer that is in hydrologic continuity with the freshwater recharge from the Ozark plateau and along the Nemaha anticline. The hydrologic continuity with areas of freshwater recharge provides an explanation for the apparent underpressure in the Arbuckle Group. Copyright ?? 2005. The American Association of Petroleum Geologists. All rights reserved.

Knowledge, Attitudes and Practices of Law Enforcement Officers on Rabies and Animal Control Issues in Kansas.

Science.gov (United States)

Straily, A; Trevino-Garrison, I

2017-03-01

Rabies is a deadly zoonoses endemic in the United States, including Kansas. Animal control programmes that emphasize vaccination of dogs and cats, removal of stray animals and enforcement of licensure programmes have historically been essential in reducing the risk of rabies exposures to humans (Beran, 1991). Kansas does not mandate the use of animal control officers [ACOs] and in areas where there is no designated animal control officer, law enforcement officers [LEOs] are required to fill that role. Little is known about LEOs' knowledge of rabies, their current practices in responding to animal-related calls or if they receive any specialized training to perform the duties of an ACO. A web-based, voluntary and anonymous survey was sent to law enforcement officers in Kansas in January 2014. The survey included questions about animal control practices and a self-assessment of rabies knowledge. The response rate was 16.2%. All respondents indicated LEOs will respond to animal-related calls, even if there was an ACO available in their department or jurisdiction. A majority of respondents indicated they had not received training on safe animal handling (62.9%, 61/97) or zoonoses prevention (85.6%, 83/97), even though a strong majority considered such training important (89.7% and 79.4%, respectively). Most respondents (>80%) were able to correctly identify animals capable of transmitting rabies but were less aware of how rabies was transmitted or the severity of rabies in humans. Our results demonstrate that Kansas LEOs perform animal control duties, many without the proper training, even though most consider such training to be important to be able to perform their duties safely. Training on safe animal handling and zoonoses prevention should be provided to all LEOs in Kansas to enable them to safely execute their duties and provide timely and accurate information to citizens regarding rabies prevention. © 2016 Blackwell Verlag GmbH.

Data breach locations, types, and associated characteristics among US hospitals.

Science.gov (United States)

Gabriel, Meghan Hufstader; Noblin, Alice; Rutherford, Ashley; Walden, Amanda; Cortelyou-Ward, Kendall

2018-02-01

The objectives of this study were to describe the locations in hospitals where data are breached, the types of breaches that occur most often at hospitals, and hospital characteristics, including health information technology (IT) sophistication and biometric security capabilities, that may be predicting factors of large data breaches that affect 500 or more patients. The Office of Civil Rights breach data from healthcare providers regarding breaches that affected 500 or more individuals from 2009 to 2016 were linked with hospital characteristics from the Health Information Management Systems Society and the American Hospital Association Health IT Supplement databases. Descriptive statistics were used to characterize hospitals with and without breaches, data breach type, and location/mode of data breaches in hospitals. Multivariate logistic regression analysis explored hospital characteristics that were predicting factors of a data breach affecting at least 500 patients, including area characteristics, region, health system membership, size, type, biometric security use, health IT sophistication, and ownership. Of all types of healthcare providers, hospitals accounted for approximately one-third of all data breaches and hospital breaches affected the largest number of individuals. Paper and films were the most frequent location of breached data, occurring in 65 hospitals during the study period, whereas network servers were the least common location but their breaches affected the most patients overall. Adjusted multivariate results showed significant associations among data breach occurrences and some hospital characteristics, including type and size, but not others, including health IT sophistication or biometric use for security. Hospitals should conduct routine audits to allow them to see their vulnerabilities before a breach occurs. Additionally, information security systems should be implemented concurrently with health information technologies. Improving

Economic burden of influenza-associated hospitalizations and outpatient visits in Bangladesh during 2010.

Science.gov (United States)

Bhuiyan, Mejbah U; Luby, Stephen P; Alamgir, Nadia I; Homaira, Nusrat; Mamun, Abdullah A; Khan, Jahangir A M; Abedin, Jaynal; Sturm-Ramirez, Katharine; Gurley, Emily S; Zaman, Rashid U; Alamgir, A S M; Rahman, Mahmudur; Widdowson, Marc-Alain; Azziz-Baumgartner, Eduardo

2014-07-01

Understanding the costs of influenza-associated illness in Bangladesh may help health authorities assess the cost-effectiveness of influenza prevention programs. We estimated the annual economic burden of influenza-associated hospitalizations and outpatient visits in Bangladesh. From May through October 2010, investigators identified both outpatients and inpatients at four tertiary hospitals with laboratory-confirmed influenza infection through rRT-PCR. Research assistants visited case-patients' homes within 30 days of hospital visit/discharge and administered a structured questionnaire to capture direct medical costs (physician consultation, hospital bed, medicines and diagnostic tests), direct non-medical costs (food, lodging and travel) and indirect costs (case-patients' and caregivers' lost income). We used WHO-Choice estimates for routine healthcare service costs. We added direct, indirect and healthcare service costs to calculate cost-per-episode. We used median cost-per-episode, published influenza-associated outpatient and hospitalization rates and Bangladesh census data to estimate the annual economic burden of influenza-associated illnesses in 2010. We interviewed 132 outpatients and 41 hospitalized patients. The median cost of an influenza-associated outpatient visit was US$4.80 (IQR = 2.93-8.11) and an influenza-associated hospitalization was US$82.20 (IQR = 59.96-121.56). We estimated that influenza-associated outpatient visits resulted in US$108 million (95% CI: 76-147) in direct costs and US$59 million (95% CI: 37-91) in indirect costs; influenza-associated hospitalizations resulted in US$1.4 million (95% CI: 0.4-2.6) in direct costs and US$0.4 million (95% CI: 0.1-0.8) in indirect costs in 2010. In Bangladesh, influenza-associated illnesses caused an estimated US$169 million in economic loss in 2010, largely driven by frequent but low-cost outpatient visits. © 2014 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons

Economic burden of influenza-associated hospitalizations and outpatient visits in Bangladesh during 2010

Science.gov (United States)

Bhuiyan, Mejbah U; Luby, Stephen P; Alamgir, Nadia I; Homaira, Nusrat; Mamun, Abdullah A; Khan, Jahangir A M; Abedin, Jaynal; Sturm-Ramirez, Katharine; Gurley, Emily S; Zaman, Rashid U; Alamgir, ASM; Rahman, Mahmudur; Widdowson, Marc-Alain; Azziz-Baumgartner, Eduardo

2014-01-01

Objective Understanding the costs of influenza-associated illness in Bangladesh may help health authorities assess the cost-effectiveness of influenza prevention programs. We estimated the annual economic burden of influenza-associated hospitalizations and outpatient visits in Bangladesh. Design From May through October 2010, investigators identified both outpatients and inpatients at four tertiary hospitals with laboratory-confirmed influenza infection through rRT-PCR. Research assistants visited case-patients' homes within 30 days of hospital visit/discharge and administered a structured questionnaire to capture direct medical costs (physician consultation, hospital bed, medicines and diagnostic tests), direct non-medical costs (food, lodging and travel) and indirect costs (case-patients' and caregivers' lost income). We used WHO-Choice estimates for routine healthcare service costs. We added direct, indirect and healthcare service costs to calculate cost-per-episode. We used median cost-per-episode, published influenza-associated outpatient and hospitalization rates and Bangladesh census data to estimate the annual economic burden of influenza-associated illnesses in 2010. Results We interviewed 132 outpatients and 41 hospitalized patients. The median cost of an influenza-associated outpatient visit was US$4.80 (IQR = 2.93–8.11) and an influenza-associated hospitalization was US$82.20 (IQR = 59.96–121.56). We estimated that influenza-associated outpatient visits resulted in US$108 million (95% CI: 76–147) in direct costs and US$59 million (95% CI: 37–91) in indirect costs; influenza-associated hospitalizations resulted in US$1.4 million (95% CI: 0.4–2.6) in direct costs and US$0.4 million (95% CI: 0.1–0.8) in indirect costs in 2010. Conclusions In Bangladesh, influenza-associated illnesses caused an estimated US$169 million in economic loss in 2010, largely driven by frequent but low-cost outpatient visits. PMID:24750586

Actualizing culture change: The Promoting Excellent Alternatives in Kansas Nursing Homes (PEAK 2.0) program.

Science.gov (United States)

Doll, Gayle A; Cornelison, Laci J; Rath, Heath; Syme, Maggie L

2017-08-01

Nursing homes have been challenged in their attempts to achieve deep, organizational change (i.e., culture change) aimed at providing quality of care and quality of life for nursing home residents through person-centered care. To attain deep change, 2 well-defined components must be in place: a shared understanding of (a) the what, or content goals, and (b) the how, or process of change. However, there are few examples of this at a macro or micro level in long-term care. In an effort to enact true culture change in nursing homes statewide, the Kansas Department for Aging and Disability Services implemented the Promoting Excellent Alternatives in Kansas Nursing Homes program. This program is a Medicaid, pay-for-performance program that formalizes the content and process of achieving culture change through person-centered care principles. This article aims to detail the content (what) and process (how) of a model macro-level program of culture change throughout the State of Kansas. Applications to the micro level (individual homes) are presented, and implications for psychologists' roles in facilitating culture change are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Wind farm turbulence impacts on general aviation airports in Kansas : [technical summary].

Science.gov (United States)

2014-01-01

Wind turbines and wind farms have become popular in the State of Kansas. Some general aviation : pilots have expressed a concern about the turbulence that the spinning blades are creating. If a : wind farm is built near an airport, does this affect t...

Environmental market factors associated with electronic health record adoption among cancer hospitals.

Science.gov (United States)

Tarver, Will L; Menachemi, Nir

2017-02-22

Although recent literature has explored the relationship between various environmental market characteristics and the adoption of electronic health records (EHRs) among general, acute care hospitals, no such research currently exists for specialty hospitals, including those providing cancer care. The aim of the study was to examine the relationship between market characteristics and the adoption of EHRs among Commission on Cancer (CoC)-accredited hospitals. Secondary data on EHR adoption combined with hospital and environmental market characteristics were analyzed using logistic regression. Using the resource dependence theory, we examined how measures of munificence, complexity, and dynamism are related to the adoption of EHRs among CoC-accredited hospitals and, separately, hospitals not CoC-accredited. In a sample of 2,670 hospitals, 141 (0.05%) were academic-based CoC-accredited hospitals and 562 (21%) were community-based CoC-accredited hospitals. Measures of munificence such as cancer incidence rates (OR = 0.99, CI [0.99, 1.00], p = .020) and percentage population aged 65+ (OR = 0.99, CI [0.99, 1.00], p = .001) were negatively associated with basic EHR adoption, whereas urban location was positively associated with comprehensive EHR adoption (OR = 3.07, CI [0.89, 10.61], p = .076) for community-based CoC-accredited hospitals. Measures of complexity such as hospitals in areas with less competition were less likely to adopt a basic EHR (OR = 0.33, CI [0.19, 0.96], p = .005), whereas Medicare Managed Care penetration was positively associated with comprehensive EHR adoption (OR = 1.02, CI [1.00, 1.05], p = .070) among community-based CoC-accredited hospitals. Lastly, dynamism, measured as population change, was negatively associated with the adoption of comprehensive EHRs (OR = 0.99, CI [0.99, 1.00], p = .070) among academic-based CoC-accredited hospitals. A greater understanding of the environment's relationship to health information technology adoption in

Evaluation of heavy-oil and tar sands in Bourbon, Crawford, and Cherokee Counties, Kansas. Final report

Energy Technology Data Exchange (ETDEWEB)

Ebanks, W.J. Jr.; James, G.W.; Livingston, N.D.

1977-12-01

The current national energy-resource situation has provided the incentive to investigate more fully deposits of heavy-oil bearing sandstone in southeastern Kansas, as part of a larger, three-state study. The results of this study indicate that the size of the heavy-oil resource in the three Kansas counties studied is smaller than earlier estimates suggested. A resource of 200 to 225 million barrels of oil in-place is estimated to be present in areas of ''known oil occurrence,'' as established by this study. The amount of this in-place resource which may be considered to be reserves, that is, recoverable under existing technology and economics, is zero. The estimates of resource-size are severely downgraded from earlier estimates mainly because of the discontinuous nature of the potential reservoir sandstone bodies and because of the thinness and shaliness of some of these sandstones. The earlier impression of these heavy-oil reservoirs, at least in Kansas, as being widespread, heavily oil saturated, ''blanket'' sandstones unfortunately is not correct. There are areas, shown on maps, which may warrant further investigation because of locally good oil-saturation, i.e., more than 400 barrels per acre foot, in trends of sandstone thicker than 20 feet. It is concluded that there will be no widespread exploitation of subsurface heavy-oil sandstones within the areas of Bourbon, Crawford, and Cherokee Counties, Kansas. Smaller areas indicated here may warrant further drilling and investigation, but the potential size of the heavy-oil resource is severely downgraded from earlier estimates.

A review of hospital characteristics associated with improved performance.

Science.gov (United States)

Brand, Caroline A; Barker, Anna L; Morello, Renata T; Vitale, Michael R; Evans, Sue M; Scott, Ian A; Stoelwinder, Johannes U; Cameron, Peter A

2012-10-01

The objective of this review was to critically appraise the literature relating to associations between high-level structural and operational hospital characteristics and improved performance. The Cochrane Library, MEDLINE (Ovid), CINAHL, proQuest and PsychINFO were searched for articles published between January 1996 and May 2010. Reference lists of included articles were reviewed and key journals were hand searched for relevant articles. and data extraction Studies were included if they were systematic reviews or meta-analyses, randomized controlled trials, controlled before and after studies or observational studies (cohort and cross-sectional) that were multicentre, comparative performance studies. Two reviewers independently extracted data, assigned grades of evidence according to the Australian National Health and Medical Research Council guidelines and critically appraised the included articles. Data synthesis Fifty-seven studies were reported within 12 systematic reviews and 47 observational articles. There was heterogeneity in use and definition of performance outcomes. Hospital characteristics investigated were environment (incentives, market characteristics), structure (network membership, ownership, teaching status, geographical setting, service size) and operational design (innovativeness, leadership, organizational culture, public reporting and patient safety practices, information technology systems and decision support, service activity and planning, workforce design, staff training and education). The strongest evidence for an association with overall performance was identified for computerized physician order entry systems. Some evidence supported the associations with workforce design, use of financial incentives, nursing leadership and hospital volume. There is limited, mainly low-quality evidence, supporting the associations between hospital characteristics and healthcare performance. Further characteristic-specific systematic reviews are

Associations of hospital staff training and policies with early breastfeeding practices.

Science.gov (United States)

Li, Chuan-Ming; Li, Ruowei; Ashley, Cindy G; Smiley, Janice M; Cohen, Jennifer H; Dee, Deborah L

2014-02-01

In 2009, the Centers for Disease Control and Prevention implemented the Maternity Practices in Infant Nutrition and Care (mPINC) survey in all US birth facilities to assess breastfeeding-related maternity practices. Maternity practices and hospital policies are known to influence breastfeeding, and Alabama breastfeeding rates are very low. Our objective was to assess whether staff training and structural-organizational aspects of care, such as policies, were associated with infants' breastfeeding behaviors 24 to 48 hours postpartum. We linked 2009 mPINC data from 48 Alabama hospitals with birth certificate and newborn screening databases. We used data collected 24 to 48 hours postpartum to classify 41 536 healthy, term, singleton infants as breastfed (any breast milk) or completely formula fed and examined associations with hospitals' mPINC scores in comparison with the state mean. We conducted multilevel analyses to assess infants' likelihood of being breastfed if their birth hospital scores were lower versus at least equal to the Alabama mean, accounting for hospital clustering, demographics, payment method, and prenatal care. The odds of breastfeeding were greater in hospitals with a higher-than-state-mean score on the following: new employees' breastfeeding education, nurses' receipt of breastfeeding education in the past year, prenatal breastfeeding classes offered, having a lactation coordinator, and having a written breastfeeding policy. The number of recommended elements included in hospitals' written breastfeeding policies was positively associated with newborn breastfeeding rates. Educating hospital staff to improve breastfeeding-related knowledge, attitudes, and skills; implementing a written hospital breastfeeding policy; and ensuring continuity of prenatal and postnatal breastfeeding education and support may improve newborn breastfeeding rates.

Changes in Patient and Nurse Outcomes Associated with Magnet Hospital Recognition

Science.gov (United States)

Kutney-Lee, Ann; Stimpfel, Amy Witkoski; Sloane, Douglas M.; Cimiotti, Jeannie P.; Quinn, Lisa W.; Aiken, Linda H.

2015-01-01

Background Research has documented an association between Magnet hospitals and better outcomes for nurses and patients. However, little longitudinal evidence exists to support a causal link between Magnet recognition and outcomes. Objective To compare changes over time in surgical patient outcomes, nurse-reported quality, and nurse outcomes in a sample of hospitals that attained Magnet recognition between 1999 and 2007 with hospitals that remained non-Magnet. Research Design Retrospective, two-stage panel design using four secondary data sources. Subjects 136 Pennsylvania hospitals (11 “emerging” Magnets and 125 non-Magnets) Measures American Nurses Credentialing Center Magnet recognition; risk-adjusted rates of surgical 30-day mortality and failure-to-rescue, nurse-reported quality measures, and nurse outcomes; the Practice Environment Scale of the Nursing Work Index Methods Fixed effects difference models were used to compare changes in outcomes between emerging Magnet hospitals and hospitals that remained non-Magnet. Results Emerging Magnet hospitals demonstrated markedly greater improvements in their work environments than other hospitals. On average, the changes in 30-day surgical mortality and failure-to-rescue rates over the study period were more pronounced in emerging Magnet hospitals than in non-Magnet hospitals, by 2.4 fewer deaths per 1000 patients (pMagnet hospitals and non-Magnet hospitals were observed in nurse-reported quality of care and nurse outcomes. Conclusions In general, Magnet recognition is associated with significant improvements over time in the quality of the work environment, and in patient and nurse outcomes that exceed those of non-Magnet hospitals. PMID:25906016

Epidemiology of Hospitalizations Associated with Invasive Candidiasis, United States, 2002–20121

Science.gov (United States)

Strollo, Sara; Lionakis, Michail S.; Adjemian, Jennifer; Steiner, Claudia A.

2017-01-01

Invasive candidiasis is a major nosocomial fungal disease in the United States associated with high rates of illness and death. We analyzed inpatient hospitalization records from the Healthcare Cost and Utilization Project to estimate incidence of invasive candidiasis–associated hospitalizations in the United States. We extracted data for 33 states for 2002–2012 by using codes from the International Classification of Diseases, 9th Revision, Clinical Modification, for invasive candidiasis; we excluded neonatal cases. The overall age-adjusted average annual rate was 5.3 hospitalizations/100,000 population. Highest risk was for adults >65 years of age, particularly men. Median length of hospitalization was 21 days; 22% of patients died during hospitalization. Median unadjusted associated cost for inpatient care was $46,684. Age-adjusted annual rates decreased during 2005–2012 for men (annual change –3.9%) and women (annual change –4.5%) and across nearly all age groups. We report a high mortality rate and decreasing incidence of hospitalizations for this disease. PMID:27983497

Are Facebook user ratings associated with hospital cost, quality and patient satisfaction? A cross-sectional analysis of hospitals in New York State.

Science.gov (United States)

Campbell, Lauren; Li, Yue

2018-02-01

Hospital care costs are high while quality varies across hospitals. Patient satisfaction may be associated with better clinical quality, and social media ratings may offer another opportunity to measure patient satisfaction with care. To test if Facebook user ratings of hospitals are associated with existing measures of patient satisfaction, cost and quality. Data were obtained from Centers for Medicare and Medicaid Services Hospital Compare, the Hospital Inpatient Prospective Payment System impact files and the Area Health Resource File for 2015. Information from hospitals' Facebook pages was collected in July 2016. Multivariate linear regression was used to test if there is an association between Facebook user ratings (star rating and adjusted number of 'likes') and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction measures, the 30-day all-cause readmission rate, and the Medicare spending per beneficiary (MSPB) ratio. One hundred and thirty-six acute care hospitals in New York State in 2015. An increase in the Facebook star rating is associated with significant increases in 21/23 HCAHPS measures (p≤0.003). An increase in the adjusted number of 'likes' is associated with very small increases in 3/23 HCAHPS measures (pFacebook user ratings are not associated with the 30-day all-cause readmission rate or the Medicare spending per beneficiary ratio. Results demonstrate an association between HCAHPS patient satisfaction measures and Facebook star ratings. Adjusted number of 'likes' may not be a useful measure of patient satisfaction. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Urinary incontinence in hospital patients: prevalence and associated factors

Directory of Open Access Journals (Sweden)

Jaqueline Betteloni Junqueira

2018-01-01

Full Text Available ABSTRACT Objectives: to analyze the prevalence of urinary incontinence and its associated factors in hospital patients. Method: this is a cross-sectional epidemiological study whose data were collected using the instruments Sociodemographic and Clinical Data, Characteristics of Urinary Leakage and International Consultation on Incontinence Questionnaire - Short Form. Prevalence was surveyed on a single day for four consecutive months. Data were analyzed using Chi-square test, Fisher’s exact test, Student t-test, Mann-Whitney test and logistic regression (forward stepwise. Results: the final sample consisted of 319 hospital adults (57.1% female, mean age of 47.9 years (SD=21.1. The prevalence of urinary incontinence was 22.9% (28% in women and 16.1% in men and the associated factors were: female sex (OR=3.89, age (OR=1.03, asthma (OR=3.66, use of laxatives (OR=3.26, use of diaper during the evaluation (OR=2.75, use of diaper at home (OR=10.29, and use of diaper at some point during the hospital stay (OR=6.74. Conclusion: the findings of this study differ from those found in the scarce existing literature on the subject in hospital patients. There is a need for previous studies such as this before proposing the implementation of preventive and therapeutic actions during the hospital stay.

Are Hospital Workers Healthy?: A Study of Cardiometabolic, Behavioral, and Psychosocial Factors Associated With Obesity Among Hospital Workers.

Science.gov (United States)

Sharma, Shreela V; Upadhyaya, Mudita; Karhade, Mandar; Baun, William B; Perkison, William B; Pompeii, Lisa A; Brown, Henry S; Hoelscher, Deanna M

2016-12-01

This study evaluated the cardiometabolic, behavioral, and psychosocial factors associated with weight status among hospital employees. A total of n = 924 employees across the six hospitals in Texas participated in this cross-sectional study, 2012 to 2013. Association between weight status and waist circumference, blood pressure, biomarkers, diet, physical activity, sedentary behaviors, and psychosocial factors was assessed. About 78.1% of employees were overweight/obese. Obese participants (body mass index [BMI] ≥30.0 kg/m) had higher consumption of potatoes, fats, sugary beverages, and spent more time watching television, playing computer games, and sitting than those having normal weight. Being obese was positively associated with blood pressure, blood glucose, low-density lipoprotein, and negatively associated with high-density lipoprotein. Finally, 78.8% of workers were dissatisfied with their worksite wellness with dissatisfaction being higher among obese employees. Being overweight (BMI 25.0 to 29.9 kg/m) was positively associated with blood pressure, but not other variables. Understanding the risk profile of hospital workers is critical to developing effective interventions.

Update on Kansas City Middle Blue River Green Infrastructure Pilot Project - seminar

Science.gov (United States)

In 2010, Kansas City, MO (KCMO) signed a consent degree with EPA on combined sewer overflows. The City decided to use adaptive management in order to extensively utilize green infrastructure (GI) in lieu of, and in addition to, structural controls. KCMO installed 130 GI storm con...

Lithofacies analysis of the Simpson Group in south-central Kansas

International Nuclear Information System (INIS)

Doveton, J.H.; Charpentier, R.R.; Metzger, E.P.

1990-01-01

This book discusses detailed stratigraphy and lithofacies of the oil-productive Middle Ordovician Simpson Group in south-central Kansas. The report presents results of studies of the Simpson Group in Barber, Comanche, Kiowa, and Pratt counties. The high density of exploration holes and their associated logs allowed a detailed stratigraphic subdivision to be made of shale, sandstone, and sandy carbonate units. The lateral changes in these units are depicted in a series of maps and cross sections and show distinctive lithofacies patterns that reflect a history of northward-moving marine transgression. Working with digital data from gamma-ray logs, the geologists used computer methods to generate a series of cross sections of the Simpson Group, based on the statistical moments of the log traces. Automated mapping displayed the shapes and disposition of shale and non-shale units as continuous features in three dimensions. The ground truth information from drill cuttings further refined interpretations of stratigraphy, lithofacies, and depositional history implied by these computer models

Temporal association between hospitalization and rate of falls after discharge.

Science.gov (United States)

Mahoney, J E; Palta, M; Johnson, J; Jalaluddin, M; Gray, S; Park, S; Sager, M

2000-10-09

Evidence suggests that acute illness and hospitalization may increase the risk for falls. To evaluate the rate of falls, and associated risk factors, for 90 days following hospital discharge. We consecutively enrolled 311 patients, aged 65 years and older, discharged from the hospital after an acute medical illness and receiving home-nursing services. Patients were assessed within 5 days of discharge for prehospital and current functioning by self-report, and balance, vision, cognition, and delirium by objective measures. Patients were followed up weekly for 13 weeks for falls, injuries, and health care use. The rate of falls was significantly higher in the first 2 weeks after hospitalization (8.0 per 1000 person-days) compared with 3 months later (1.7 per 1000 person-days) (P =.002). Fall-related injuries accounted for 15% of all hospitalizations in the first month after discharge. Independent prehospital risk factors significantly associated with falls included dependency in activities of daily living, use of a standard walker, 2 or more falls, and more hospitalizations in the year prior. Posthospital risk factors included use of a tertiary amine tricyclic antidepressant, probable delirium, and poorer balance, while use of a cane was protective. The rate of falls is substantially increased in the first month after medical hospitalization, and is an important cause of injury and morbidity. Posthospital risk factors may be potentially modifiable. Efforts to assess and modify risk factors should be integral to the hospital and posthospital care of older adults (those aged >/=65 years).

Decentralization and centralization of healthcare resources: investigating the associations of hospital competition and number of cardiologists per hospital with mortality and resource utilization in Japan.

Science.gov (United States)

Park, Sungchul; Lee, Jason; Ikai, Hiroshi; Otsubo, Tetsuya; Imanaka, Yuichi

2013-11-01

To investigate the associations of hospital competition and number of cardiologists per hospital (indicating the decentralization and centralization of healthcare resources, respectively) with 30-day in-hospital mortality, healthcare spending, and length of stay (LOS) among patients with acute myocardial infarction (AMI) in Japan. We collected data from 23,197 AMI patients admitted to 172 hospitals between 2008 and 2011. Hospital competition and number of cardiologists per hospital were analyzed as exposure variables in multilevel regression models for in-hospital mortality, healthcare spending, and LOS. Other covariates included patient, hospital, and regional variables; as well as the use of percutaneous coronary intervention (PCI). Hospitals in competitive regions and hospitals with a higher number of cardiologists were both associated lower in-hospital mortality. Additionally, hospitals in competition regions were also associated with longer LOS durations, whereas hospitals with more cardiologists had higher spending. The use of PCI was also associated with reduced mortality, increased spending and increased LOS. Centralization of cardiologists at the hospital level and decentralization of acute hospitals at the regional level may be contributing factors for improving the quality of care in Japan. Policymakers need to strike a balance between these two approaches to improve healthcare provision and quality. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Can National Healthcare-Associated Infections (HAIs) Data Differentiate Hospitals in the United States?

Science.gov (United States)

Masnick, Max; Morgan, Daniel J; Sorkin, John D; Macek, Mark D; Brown, Jessica P; Rheingans, Penny; Harris, Anthony D

2017-10-01

OBJECTIVE To determine whether patients using the Centers for Medicare and Medicaid Services (CMS) Hospital Compare website (http://medicare.gov/hospitalcompare) can use nationally reported healthcare-associated infection (HAI) data to differentiate hospitals. DESIGN Secondary analysis of publicly available HAI data for calendar year 2013. METHODS We assessed the availability of HAI data for geographically proximate hospitals (ie, hospitals within the same referral region) and then analyzed these data to determine whether they are useful to differentiate hospitals. We assessed data for the 6 HAIs reported by hospitals to the Centers for Disease Control and Prevention (CDC). RESULTS Data were analyzed for 4,561 hospitals representing 88% of registered community and federal government hospitals in the United States. Healthcare-associated infection data are only useful for comparing hospitals if they are available for multiple hospitals within a geographic region. We found that data availability differed by HAI. Clostridium difficile infections (CDI) data were most available, with 82% of geographic regions (ie, hospital referral regions) having >50% of hospitals reporting them. In contrast, 4% of geographic regions had >50% of member hospitals reporting surgical site infections (SSI) for hysterectomies, which had the lowest availability. The ability of HAI data to differentiate hospitals differed by HAI: 72% of hospital referral regions had at least 1 pair of hospitals with statistically different risk-adjusted CDI rates (SIRs), compared to 9% for SSI (hysterectomy). CONCLUSIONS HAI data generally are reported by enough hospitals to meet minimal criteria for useful comparisons in many geographic locations, though this varies by type of HAI. CDI and catheter-associated urinary tract infection (CAUTI) are more likely to differentiate hospitals than the other publicly reported HAIs. Infect Control Hosp Epidemiol 2017;38:1167-1171.

Factors of U.S. Hospitals Associated with Improved Profit Margins: An Observational Study.

Science.gov (United States)

Ly, Dan P; Cutler, David M

2018-02-14

Hospitals face financial pressure from decreased margins from Medicare and Medicaid and lower reimbursement from consolidating insurers. The objectives of this study are to determine whether hospitals that became more profitable increased revenues or decreased costs more and to examine characteristics associated with improved financial performance over time. The design of this study is retrospective analyses of U.S. non-federal acute care hospitals between 2003 and 2013. There are 2824 hospitals as subjects of this study. The main measures of this study are the change in clinical operating margin, change in revenues per bed, and change in expenses per bed between 2003 and 2013. Hospitals that became more profitable had a larger magnitude of increases in revenue per bed (about $113,000 per year [95% confidence interval: $93,132 to $133,401]) than of decreases in costs per bed (about - $10,000 per year [95% confidence interval: - $28,956 to $9617]), largely driven by higher non-Medicare reimbursement. Hospitals that improved their margins were larger or joined a hospital system. Not-for-profit status was associated with increases in operating margin, while rural status and having a larger share of Medicare patients were associated with decreases in operating margin. There was no association between improved hospital profitability and changes in diagnosis related group weight, in number of profitable services, or in payer mix. Hospitals that became more profitable were more likely to increase their admissions per bed per year. Differential price increases have led to improved margins for some hospitals over time. Where significant price increases are not possible, hospitals will have to become more efficient to maintain profitability.

Parcels and Land Ownership, Parcel boundaries for Johnson County Kansas based off of legal description. Used to show spatial reference to parcel boundaries of Johnson County Kansas., Published in 2007, Johnson County Government.

Data.gov (United States)

NSGIC Local Govt | GIS Inventory — Parcels and Land Ownership dataset current as of 2007. Parcel boundaries for Johnson County Kansas based off of legal description. Used to show spatial reference to...

Contextual factors associated with hospitals' decision to operate freestanding emergency departments.

Science.gov (United States)

Patidar, Nitish; Weech-Maldonado, Robert; O'Connor, Stephen J; Sen, Bisakha; Trimm, J M Mickey; Camargo, Carlos A

Freestanding emergency departments (FSEDs) are fast growing entities in health care, delivering emergency care outside of hospitals. Hospitals may benefit in several ways by opening FSEDs. The study used the resource dependence theory as a means to analyze the relationship between market and organizational factors and the likelihood of hospitals to operate FSEDs. All acute care hospitals in 14 states with FSEDs present during the study period from 2002 to 2011. Data on FSEDs were merged with American Hospital Association Annual Survey, Centers for Medicare and Medicaid Services' Cost Reports, and Area Resource File data. The outcome variable consists of whether or not the hospital operates an FSED. Independent variables include per capita income, percent population over age of 65 years, primary care and specialist physicians per capita, urban location, change in the unemployment rate, change in the population, change in poverty level, market competition, total satellite and autonomous FSEDs in the market, Medicare-managed care penetration rate, hospital beds, total margin, and system membership. We used logistic regression analysis with state and year fixed effects. Standard errors in the regression were clustered by hospital. The number of hospitals operating satellite FSEDs increased from 32 (2.33%) in 2002 to 91 (5.76%) hospitals in 2011 among the 14 states included in the study sample. The results support the hypothesis that hospitals located in munificent environments and more competitive environments (presence of other FSEDs) are more likely to operate an FSED. Organizational level factors such as bed size and system membership are associated with a hospital operating an FSED. The findings may be used by policy makers in developing regulations for hospitals opening FSEDs. Also, study findings of this study may be used by hospitals to make informed decisions when formulating strategies regarding FSEDs.

US hydropower resource assessment for Kansas

Energy Technology Data Exchange (ETDEWEB)

Francfort, J.E.

1993-12-01

The Department of Energy is developing an estimate of the hydropower development potential in this country. The Hydropower Evaluation Software (HES) is a computer model that was developed by the Idaho National Engineering Laboratory for this purpose. The HES measures the potential hydropower resources available in the United States, using uniform criteria for measurement. The software was developed and tested using hydropower information and data provided by the Southwestern Power Administration. It is a dBASE menu-driven software application that allows the personal computer user to assign environmental attributes to potential hydropower sites, calculate development suitability factors for each site based on the environmental attributes present, and generate reports based on these suitability factors. This report details the resource assessment results for the state of Kansas.

Healthcare-associated infection in Burkina Faso: an assessment in a district hospital

OpenAIRE

Hervé Hien; Koiné Maxime Darbo; Laurent Ouédraogo; Salifou Konfé; Sylvain Zeba; Lassana Sangaré; Sidzabda C. Compaoré; Jean Bosco Ouédraogo; Edgard M. Ouendo; Michel Makoutodé; Nicolas Meda

2012-01-01

In developing countries, few data are available on healthcare-associated infections. In Burkina Faso, there has been a failure to take into account risk management and patient safety in the quality assurance program. The main objective of our study was to carry out an assessment of healthcare-associated infection in a first level hospital. We conducted a crosssectional study in June 2011 in the care units of Ziniaré District Hospital (Ziniaré, Burkina Faso). The hospital has been divided in t...

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

Science.gov (United States)

Hui, Siu-kuen Azor; Grandner, Michael A

2015-10-01

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

Suicidal behaviour characteristics and factors associated with mortality in the hospital setting.

Science.gov (United States)

Sendra-Gutiérrez, Juan Manuel; Esteban-Vasallo, María; Domínguez-Berjón, M Felicitas

2016-04-29

Suicide is a major public health problem worldwide, and an approach is necessary due to its high potential for prevention. This paper examines the main characteristics of people admitted to hospitals in the Community of Madrid (Spain) with suicidal behaviour, and the factors associated with their hospital mortality. A study was conducted on patients with E950-E959 codes of suicide and self-inflicted injuries of the International Classification of Diseases, Ninth Revision, Clinical Modification, contained in any diagnostic field of the minimum basic data set at hospital discharge between 2003 and 2013. Sociodemographic, clinical and health care variables were assessed by uni- and multivariate logistic regression analysis in the evaluation of factors associated with hospital mortality. Hospital suicidal behaviour predominates in women (58.7%) and in middle-age. Hospital mortality is 2.2% (1.6% in women and 3.2% in men), increasing with age. Mental disorders are detected 3-4 times more in secondary diagnoses. The main primary diagnosis (>74%) is poisoning with substances, with lower mortality (∼1%) than injury by hanging and jumping from high places (≥12%), which have the highest numbers. Other factors associated with increased mortality include different medical comorbidities and severity of the injury, while length of stay and mental disorders are protective factors. Type of hospital, poisoning, and Charlson index are associated differently with mortality in men and women. Hospitalised suicidal acts show a low mortality, mainly related to comorbidities and the severity of injuries. Copyright © 2016 SEP y SEPB. Published by Elsevier España. All rights reserved.

Safety Evaluation Report related to the renewal of the operating license for the research reactor at the University of Kansas (Docket No. 50-148)

International Nuclear Information System (INIS)

1984-05-01

This Safety Evaluation Report for the application filed by the University of Kansas (KU) for a renewal of Operating License R-78 to continue to operate the KU 250-kW open-pool training reactor has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is owned and operated by the University of Kansas and is located on the KU campus in Lawrence, Douglas County, Kansas. The staff concludes that the reactor facility can continue to be operated by KU without endangering the health and safety of the public. 17 references, 11 figures, 4 tables

Quality-assurance and data-management plan for water-quality activities in the Kansas Water Science Center, 2014

Science.gov (United States)

Rasmussen, Teresa J.; Bennett, Trudy J.; Foster, Guy M.; Graham, Jennifer L.; Putnam, James E.

2014-01-01

As the Nation’s largest water, earth, and biological science and civilian mapping information agency, the U.S. Geological Survey is relied on to collect high-quality data, and produce factual and impartial interpretive reports. This quality-assurance and data-management plan provides guidance for water-quality activities conducted by the Kansas Water Science Center. Policies and procedures are documented for activities related to planning, collecting, storing, documenting, tracking, verifying, approving, archiving, and disseminating water-quality data. The policies and procedures described in this plan complement quality-assurance plans for continuous water-quality monitoring, surface-water, and groundwater activities in Kansas.

Characterization of veterinary hospital-associated isolates of Enterococcus species in Korea.

Science.gov (United States)

Chung, Yeon Soo; Kwon, Ka Hee; Shin, Sook; Kim, Jae Hong; Park, Yong Ho; Yoon, Jang Won

2014-03-28

Possible cross-transmission of hospital-associated enterococci between human patients, medical staff, and hospital environments has been extensively studied. However, limited information is available for veterinary hospital-associated Enterococcus isolates. This study investigated the possibility of cross-transmission of antibiotic-resistant enterococci between dog patients, their owners, veterinary staff, and hospital environments. Swab samples (n =46 5) were obtained from five veterinary hospitals in Seoul, Korea, during 2011. Forty-three Enterococcus strains were isolated, representing seven enterococcal species. E. faecalis and E. faecium were the most dominant species (16 isolates each, 37.2%). Although slight differences in the antibiotic resistance profiles were observed between the phenotypic and the genotypic data, our antibiogram analysis demonstrated high prevalence of the multiple drug-resistant (MDR) isolates of E. faecalis (10/16 isolates, 62.5%) and E. faecium (12/16 isolates, 75.0%). Pulsed-field gel electrophoretic comparison of the MDR isolates revealed three different clonal sets of E. faecalis and a single set of E. faecium, which were isolated from different sample groups or dog patients at the same or two separate veterinary hospitals. These results imply a strong possibility of cross-transmission of the antibiotic-resistant enterococcal species between animal patients, owners, veterinary staff, and hospital environments.

“... And Gladly Teach”: The American Hospital Association's Experience in Conducting Institutes on Hospital Librarianship

Science.gov (United States)

Yast, Helen

1964-01-01

As part of its overall educational program, the American Hospital Association has since 1959 conducted three institutes on hospital librarianship to meet the demand for more competent librarians in medical, nursing school, and patients' libraries. The purpose of such institutes is to teach the basic elements of library science to untrained personnel in hospital libraries. Discussed are steps in initiating an institute; factors determining length, date, and place; financing; publicity; choice and responsibility of local advisory committee; program content; qualifications of instructors; characteristics of registrants; materials for distribution; evaluations. Details of the most recent institute are outlined. A summary of problems still facing this type of educational program and suggestions for future improvements conclude the paper. PMID:14119309

76 FR 79192 - Patient Safety Organizations: Voluntary Relinquishment From the Georgia Hospital Association...

Science.gov (United States)

2011-12-21

... Organizations: Voluntary Relinquishment From the Georgia Hospital Association Research and Education Foundation Patient Safety Organization (GHA-PSO) AGENCY: Agency for Healthcare Research and Quality (AHRQ), HHS... The Georgia Hospital Association Research and Education Foundation Patient Safety Organization (GHA...

Structure for prevention of health care-associated infections in Brazilian hospitals: A countrywide study.

Science.gov (United States)

Padoveze, Maria Clara; Fortaleza, Carlos Magno Castelo Branco; Kiffer, Carlos; Barth, Afonso Luís; Carneiro, Irna Carla do Rosário Souza; Giamberardino, Heloisa Ilhe Garcia; Rodrigues, Jorge Luiz Nobre; Santos Filho, Lauro; de Mello, Maria Júlia Gonçalves; Pereira, Milca Severino; Gontijo Filho, Paulo; Rocha, Mirza; de Medeiros, Eduardo Alexandrino Servolo; Pignatari, Antonio Carlos Campos

2016-01-01

Minimal structure is required for effective prevention of health care-associated infection (HAI). The objective of this study was to evaluate the structure for prevention of HAI in a sample of Brazilian hospitals. This was a cross-sectional study from hospitals in 5 Brazilian regions (n = 153; total beds: 13,983) classified according to the number of beds; 11 university hospitals were used as reference for comparison. Trained nurses carried out the evaluation by using structured forms previously validated. The evaluation of conformity index (CI) included elements of structure of the Health Care-Associated Prevention and Control Committee (HAIPCC), hand hygiene, sterilization, and laboratory of microbiology. The median CI for the HAIPCC varied from 0.55-0.94 among hospital categories. Hospitals with >200 beds had the worst ratio of beds to sinks (3.9; P hospitals with hospitals (3.3; P hospitals were more likely to have their own laboratory of microbiology than other hospitals. This study highlights the need for public health strategies aiming to improve the structure for HAI prevention in Brazilian hospitals. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Frequency of sarcopenia and associated factors among hospitalized elderly patients.

Science.gov (United States)

Martinez, Bruno Prata; Batista, Anne Karine Menezes Santos; Gomes, Isabela Barboza; Olivieri, Flávia Milholo; Camelier, Fernanda Warken Rosa; Camelier, Aquiles Assunção

2015-05-06

Sarcopenia is an important public health problem that affects mainly elders, and has negative consequences, such as disability and even death. Due to the lack of studies evaluating sarcopenia in elderly persons hospitalized in Brazil, the aim of the present study was to describe the frequency of sarcopenia and associated factors among elders in a hospital in the city of Salvador-Brazil. This cross-sectional study included 110 hospitalized elderly patients in a multi-specialty hospital in Salvador-BA, Brazil. Inclusion criteria: were elders aged ≥60 years between the first and fifth day of hospitalization; who were able to walk without external assistance; with medical permission to walk, and who did not take vasoactive and inotropic drugs. The diagnosis of sarcopenia was determined by combining the reduction in skeletal muscle mass with muscle weakness (women, sarcopenia was described in percentages with their respective confidence intervals and logistic regression was performed for multivariate analysis of factors associated with sarcopenia. Among the 110 patients included, the frequency of sarcopenia was 21.8%, with 10.0% being of the severe type. There was a predominance of clinical profile (59.1%), such as heart disease (20.0%), pneumonia (13.6%) and skin infections (9.1%), with a Charlson index of 5.4 ± 1.8. The factors associated with sarcopenia were age (OR = 1.14; 95% CI = 1.06 to 1.23), clinical profile on admission (OR = 5.15; 95% CI = 1.16-22.9) and smoking (OR = 7.8; 95% CI = 1.53-39.9). The frequency of sarcopenia in elderly hospitalized patients was high (1 in 5 elderly) and anthropometric equation can be a viable and inexpensive alternative to screening and programming intervention in this population.

From safe yield to sustainable development of water resources - The Kansas experience

Science.gov (United States)

Sophocleous, M.

2000-01-01

This paper presents a synthesis of water sustainability issues from the hydrologic perspective. It shows that safe yield is a flawed concept and that sustainability is an idea that is broadly used but perhaps not well understood. In general, the sustainable yield of an aquifer must be considerably less than recharge if adequate amounts of water are to be available to sustain both the quantity and quality of streams, springs, wetlands, and ground-water-dependent ecosystems. To ensure sustainability, it is imperative that water limits be established based on hydrologic principles of mass balance. To establish water-use policies and planning horizons, the transition curves of aquifer systems from ground-water storage depletion to induced recharge of surface water need to be developed. Present-day numerical models are capable of generating such transition curves. Several idealized examples of aquifer systems show how this could be done. Because of the complexity of natural systems and the uncertainties in characterizing them, the current philosophy underlying sustainable management of water resources is based on the interconnected systems approach and on adaptive management. Examples of water-resources management from Kansas illustrate some of these concepts in a real-world setting. Some of the hallmarks of Kansas water management are the formation of local ground-water management districts, the adoption of minimum streamflow standards, the use of modified safe-yield policies in some districts, the implementation of integrated resource planning by the City of Wichita, and the subbasin water-resources management program in potential problem areas. These are all appropriate steps toward sustainable development. The Kansas examples show that local decision-making is the best way to fully account for local variability in water management. However, it is imperative that public education and involvement be encouraged, so that system complexities and constraints are better

The associations between organizational culture, organizational structure and quality management in European hospitals.

Science.gov (United States)

Wagner, C; Mannion, R; Hammer, A; Groene, O; Arah, O A; Dersarkissian, M; Suñol, R

2014-04-01

To better understand associations between organizational culture (OC), organizational management structure (OS) and quality management in hospitals. A multi-method, multi-level, cross-sectional observational study. As part of the DUQuE project (Deepening our Understanding of Quality improvement in Europe), a random sample of 188 hospitals in 7 countries (France, Poland, Turkey, Portugal, Spain, Germany and Czech Republic) participated in a comprehensive questionnaire survey and a one-day on-site surveyor audit. Respondents for this study (n = 158) included professional quality managers and hospital trustees. Extent of implementation of quality management systems, extent of compliance with existing management procedures and implementation of clinical quality activities. Among participating hospitals, 33% had a clan culture as their dominant culture type, 26% an open and developmental culture type, 16% a hierarchical culture type and 25% a rational culture type. The culture type had no statistically significant association with the outcome measures. Some structural characteristics were associated with the development of quality management systems. The type of OC was not associated with the development of quality management in hospitals. Other factors (not culture type) are associated with the development of quality management. An OS that uses fewer protocols is associated with a less developed quality management system, whereas an OS which supports innovation in care is associated with a more developed quality management system.

Prevalence of malnutrition and associated factors among hospitalized elderly patients in King Abdulaziz University Hospital, Jeddah, Saudi Arabia.

Science.gov (United States)

Alzahrani, Sami H; Alamri, Sultan H

2017-07-03

Malnutrition is a nutritional disorder that adversely affects the body from a functional or clinical perspective. It is very often observed in the elderly population. This study aimed to estimate the prevalence of malnutrition among hospitalized elderly patients and its associated factors and outcomes in terms of length of stay and mortality in King Abdulaziz University Hospital, Jeddah, Saudi Arabia. In a cross-sectional study, we evaluated the nutritional status of hospitalized elderly patients using the most recent version of the short form of Mini Nutritional Assessment (MNA-SF). A total of 248 hospitalized patients were included (70.0 ± 7.7 years; 60% female). According to the MNA-SF, a total of 76.6% patients were either malnourished or at risk of malnutrition. Malnourished patients had significantly lower levels of serum albumin (28.2 ± 7.7), hemoglobin (10.5 ± 1.8), and lymphocyte (1.7 ± 0.91). They had increased tendency to stay in the hospital for longer durations (IQR, 5-11 days; median = 7 days) and had a mortality rate of 6.9%. Malnutrition was highly prevalent among hospitalized elderly and was associated with increased length of stay and mortality.

Aerial gamma ray and magnetic survey: Fremont Quadrangle, Nebraska, Iowa; Lincoln Quadrangle, Nebraska; Manhattan Quadrangle, Kansas; Hutchinson Quadrangle, Kansas. Final report. Volume I

International Nuclear Information System (INIS)

1977-11-01

A high sensitivity airborne radiometric and magnetic survey of the East Salina Basin Area (Kansas and Nebraska) was conducted. The project area, the Hutchinson and Manhattan, Kansas sheets, consists of approximately 30,800 square miles. A total of 11,287 line miles of high sensitivity radiometric and magnetic data were collected. All data were collected utilizing a fixed wing aircraft, and over 3,500 cubic inches of NaI crystal detector. Magnetometer data were collected utilizing a high sensitivity 0.25 gamma, proton magnetometer. All field data were returned to GeoMetrics, Sunnyvale, California computer facilities for processing, statistical analysis and interpretation. As an integral part of this final report, other data are presented which include corrected profiles of all radiometric variables (total count, K, U, Th, U/Th, U/K, and Th/K, ratios), magnetic data, radar altimeter data, barometric altimeter data, air temperature and airborne Bi contributions. Radiometric data presented are corrected for Compton Scatter, altitude dependence and atmospheric Bismuth. These data are presented in the form of strip charts as averaged one second samples using a 5 second moving average window, microfiche and digital magnetic tapes containing raw spectral data, single record data, averaged record data, and statistical analysis results. In addition, computer generated anomaly maps and interpretation maps are presented relating known geology or soil distribution to the corrected radiometric data

Associations between Dengue Hospitalizations and Climate in Can Tho, Vietnam, 2001-2011

Directory of Open Access Journals (Sweden)

Nguyen P. Toai

2016-07-01

Full Text Available In Vietnam, dengue fever is a major cause of hospitalization with over one million cases reported between 1991 and 2004. Changes in the incidence of dengue in Can Tho city due to increased temperature and changes in precipitation, are anticipated. In an effort to better characterize the relationship between climate and dengue, we examine the associations between weather variables and dengue hospitalizations in Can Tho between 2001 and 2011. Monthly data on hospitalized dengue cases and means of temperature, rainfall and humidity were recorded from 2001 to 2011. We used the Box-Jenkins approach to modelling of time series to assess the association between these factors. This model was validated by the Portmanteau test. Our results revealed that the highest dengue incidences in Can Tho occur between July and December. After adjusting for seasonality, the rate of dengue hospitalizations was significantly associated with relative humidity with a lag of one month. Rainfall and temperature were not predictors of dengue hospitalization rate. In conclusion, these data suggest that maximum relative humidity (with a one month lag is an important determinant of dengue hospitalizations. Enhanced vector control during months with high humidity may be an important approach to prevent dengue transmission.

78 FR 43842 - State of Kansas; Authorization of State Hazardous Waste Management Program

Science.gov (United States)

2013-07-22

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 271 [EPA-R07-RCRA-2013-0447; FRL-9833-6] State of Kansas; Authorization of State Hazardous Waste Management Program AGENCY: Environmental Protection Agency... its hazardous waste program under the Resource Conservation and Recovery Act (RCRA). EPA proposes to...

Pilot instrumentation of a Superpave test section at the Kansas Accelerated Testing laboratory

Science.gov (United States)

2003-04-01

Two Superpave test sections were constructed at the Kansas Accelerated Testing Laboratory (K-ATL) with 12.5 mm (2 in) nominal maximum size Superpave mixture (SM-2A) with varying percentages (15 and 30 percent) of river sand. A 150 kN (34 kip) tandem ...

Protein Chemistry: A Graduate Course in Pharmaceutical Biotechnology at the University of Kansas.

Science.gov (United States)

Manning, Mark C.; Mitchell, James W.

1991-01-01

The University of Kansas course in pharmaceutical biotechnology aims at providing students with an understanding of the basic chemical and structural characteristics making protein pharmaceuticals unique and distinct. In addition, stability and analysis of proteins are emphasized. Attention given to molecular biology, drug delivery, and…

Organizational and market factors associated with leadership development programs in hospitals: a national study.

Science.gov (United States)

Kim, Tae Hyun; Thompson, Jon M

2012-01-01

Effective leadership in hospitals is widely recognized as the key to organizational performance. Clinical, financial, and operational performance is increasingly being linked to the leadership practices of hospital managers. Moreover, effective leadership has been described as a means to achieve competitive advantage. Recent environmental forces, including reimbursement changes and increased competition, have prompted many hospitals to focus on building leadership competencies to successfully address these challenges. Using the resource dependence theory as our conceptual framework, we present results from a national study of hospitals examining the association of organizational and market factors with the provision of leadership development program activities, including the presence of a leadership development program, a diversity plan, a program for succession planning, and career development resources. The data are taken from the American Hospital Association's (AHA) 2008 Survey of Hospitals, the Area Resource File, and the Centers for Medicare & Medicaid Services. The results of multilevel logistic regressions of each leadership development program activity on organizational and market factors indicate that hospital size, system and network affiliation, and accreditation are significantly and positively associated with all leadership development program activities. The market factors significantly associated with all leadership development activities include a positive odds ratio for metropolitan statistical area location and a negative odds ratio for the percentage of the hospital's service area population that is female and minority. For-profit hospitals are less likely to provide leadership development program activities. Additional findings are presented, and the implications for hospital management are discussed.

Piezoelectric motor development at AlliedSignal Inc., Kansas City Division

Science.gov (United States)

Pressly, Robert B.; Mentesana, Charles P.

1994-11-01

The Kansas City Division of AlliedSignal Inc. has been investigating the fabrication and use of piezoelectric motors in mechanisms for United States Department of Energy (DOE) weapons applications for about four years. These motors exhibit advantages over solenoids and other electromagnetic actuators. Prototype processes have been developed for complete fabrication of motors from stock materials, including abrasive machining of piezoelectric ceramics and more traditional machining of other motor components, electrode plating and sputtering, electric poling, cleaning, bonding and assembly. Drive circuits have been fabricated and motor controls are being developed. Laboratory facilities have been established for electrical/mechanical testing and evaluation of piezo materials and completed motors. Recent project efforts have focused on the potential of piezoelectric devices for commercial and industrial use. A broad range of various motor types and application areas has been identified, primarily in Japan. The Japanese have been developing piezo motors for many years and have more recently begun commercialization. Piezoelectric motor and actuator technology is emerging in the United States and quickly gaining in commercial interest. The Kansas City Division is continuing development of piezoelectric motors and actuators for defense applications while supporting and participating in the commercialization of piezoelectric devices with private industry through various technology transfer and cooperative development initiatives.

Association Between Medicare Summary Star Ratings for Patient Experience and Clinical Outcomes in US Hospitals

Directory of Open Access Journals (Sweden)

Stephen Trzeciak MD, MPH

2016-03-01

Full Text Available Objective: In 2015, the Centers for Medicare and Medicaid Services (CMS released new summary star ratings for US hospitals based on patient experience. We aimed to test the association between CMS patient experience star ratings and clinical outcomes. Methods: We analyzed risk-adjusted data for more than 3000 US hospitals from CMS Hospital Compare using linear regression. Results: We found that better patient experience was associated with favorable clinical outcomes. Specifically, a higher number of stars for patient experience had a statistically significant association with lower rates of many in-hospital complications. A higher patient experience star rating also had a statistically significant association with lower rates of unplanned readmissions to the hospital within 30 days. Conclusion: Better patient experience according to the CMS star ratings is associated with favorable clinical outcomes. These results support the inclusion of patient experience data in the framework of how hospitals are paid for services.

The AAHA Computer Program. American Animal Hospital Association.

Science.gov (United States)

Albers, J W

1986-07-01

The American Animal Hospital Association Computer Program should benefit all small animal practitioners. Through the availability of well-researched and well-developed certified software, veterinarians will have increased confidence in their purchase decisions. With the expansion of computer applications to improve practice management efficiency, veterinary computer systems will further justify their initial expense. The development of the Association's veterinary computer network will provide a variety of important services to the profession.

Socio-environmental factors associated with diabetes mellitus among patients hospitalized with schizophrenia in Japan.

Science.gov (United States)

Sado, Junya; Kitamura, Tetsuhisa; Noma, Norio; Saito, Makiko; Azuma, Hitoshi; Azuma, Tsukasa; Sobue, Tomotaka; Kitamura, Yuri

2016-11-01

This study aimed to examine epidemiologically socio-environmental factors associated with diabetes mellitus among patients hospitalized with schizophrenia in Japan. This was a cross-sectional study from a single psychiatric hospital. Study patients were adults aged ≥20 years who were hospitalized with schizophrenia one or more times between January 2013 and December 2014. From electronic medical records or health insurance claims, we extracted schizophrenia patients with an F2 code according to ICD-10, and assessed the association of various factors with diabetes mellitus among these patients in a multivariable analysis. During the 2-year period, there were 1899 patients hospitalized with a psychiatric disorder one or more times. Of them, a total of 770 adults with schizophrenia (285 men and 485 women) were eligible for our analysis. The standardized prevalence ratio of diabetes mellitus was 2.0 [95 % confidence interval (CI) 1.6-2.5] among men and 3.0 (95 % CI 2.5-3.6) among women in this hospital. There were no socio-environmental factors associated with diabetes mellitus among men. Among women, factors such as a 730-day hospitalization [adjusted odds ratio (OR) 3.82: 95 % confidence interval (CI) 1.52-9.64], and a medical protection/compulsory/discrimination hospitalization (adjusted OR 0.60, 95 % CI 0.36-0.99) were associated with diabetes mellitus. Compared with women living alone, those who were unmarried and lived together with someone had a significantly lower adjusted OR (0.41, 95 % CI 0.21-0.81). Socio-environmental factors such as length of hospitalization, type of hospitalization, and marital status and living arrangement were associated with diabetes mellitus among hospitalized women with schizophrenia.

The association of debt financing with not-for-profit hospitals' provision of uncompensated care.

Science.gov (United States)

Magnus, Stephen A; Smith, Dean G; Wheeler, John R C

2004-01-01

Not-for-profit hospitals undertook unprecedented amounts of debt in the mid to late 1990s. Corporate finance theory and the literature on hospital financing suggest that debt may constrain hospitals' capacity to deliver uncompensated care. Using data from audited financial statements for a sample of hospitals, this article explores whether debt financing is associated with hospitals' provision of uncompensated care, an output central to many hospitals' service missions. Contrary to expectations, our analysis finds that higher debt is associated with higher levels of uncompensated care. However, the results may reflect the unusual economic and stock-market conditions prevailing in the mid 1990s, and they are consistent with the views of hospital financial managers and other practitioners whom we interviewed.

Patient, hospital, and local health system characteristics associated with the use of observation stays in veterans health administration hospitals, 2005 to 2012.

Science.gov (United States)

Wright, Brad; OʼShea, Amy M J; Glasgow, Justin M; Ayyagari, Padmaja; Vaughan-Sarrazin, Mary

2016-09-01

Recent studies have documented that a significant increase in the use of observation stays along with extensive variation in patterns of use across hospitals.The objective of this longitudinal observational study was to examine the extent to which patient, hospital, and local health system characteristics explain variation in observation stay rates across Veterans Health Administration (VHA) hospitals.Our data came from years 2005 to 2012 of the nationwide VHA Medical SAS inpatient and enrollment files, American Hospital Association Survey, and Area Health Resource File. We used these data to estimate linear regression models of hospitals' observation stay rates as a function of hospital, patient, and local health system characteristics, while controlling for time trends and Veterans Integrated Service Network level fixed effects.We found that observation stay rates are inversely related to hospital bed size and that hospitals with a greater proportion of younger or rural patients have higher observation stay rates. Observation stay rates were nearly 15 percentage points higher in 2012 than 2005.Although we identify several characteristics associated with variation in VHA hospital observation stay rates, many factors remain unmeasured.

Geochemical Tracing of Potential Hydraulic Connections between Groundwater and Run-Off Water in Northeastern Kansas, USA

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Norbert Clauer

2017-11-01

Full Text Available This study is focused on establishing the extent of potential hydraulic connections of local lowland aquifers with the run-off waters of a nearby creek and two major rivers in and around Fort Riley in northeastern Kansas, USA. It is based on collective evidence by combining the contents of several major and trace elements of the waters with their oxygen, hydrogen and Sr isotopic compositions. The area of investigation is located a few miles to the west of the Kansas Konza Prairie, which is a United States designated site for regular monitoring of ecological and environmental configurations. The δ18O and δD of the run-off waters from the two rivers and the creek, and of the ground waters from local aquifers are almost identical. Relative to the General Meteoric Water Line, the δ18O-δD data have a tendency to deviate towards relatively lower δ18O values, as do generally the sub-surface waters of intra-continental basins. The observed stable isotope compositions for these waters preclude any significant impact by either an evapo-transpiration process by the vegetation, or an interaction with immediate mineral-rock matrices. The 87Sr/86Sr ratios of the aquifer waters collected from wells close to the Kansas River were markedly different from those of the river waters, confirming a lack of hydraulic interactions between the aquifers and the river. On the contrary, ground waters from wells at a relative distance from the Kansas River have 87Sr/86Sr ratios, Sr contents and Sr/Ca ratios that are similar to those of the river water, suggesting a hydraulic connection between these aquifers and the river, as well as a lack of any impact of the vegetation. An underground water supply from nearby Summer Hill located to the north of the study area has also been detected, except for its western border where no interactions occurred apparently between the aquifer waters and the reservoir rocks, or with the creek and river waters. The 87Sr/86Sr signatures

Epidemiology and burden of rotavirus-associated hospitalizations in Ferrara, Italy.

Science.gov (United States)

Gabutti, G; Marsella, M; Lazzara, C; Fiumana, E; Cavallaro, A; Borgna-Pignatti, C

2007-03-01

Objective of this study was to provide data on hospitalizations for rotavirus gastroenteritis (RVGE) in Ferrara, Italy. The study was conducted analyzing the hospital discharge forms of all children admitted to the Pediatric Department of the University of Ferrara, Arcispedale Sant'Anna, from January 2001 through December 2005. The database was searched for all gastrointestinal diseases and in particular RVGE. During the period under study 3277 children, of which 2038 <60 months of age, were hospitalized; 247 children < 5 years old were admitted for acute gastroenteritis and 89 (4.4% of all and 36% of gastroenteritis-related hospitalizations) had rapid screening tests positive for rotavirus. A seasonal pattern was observed for RVGE with an increase in winter and early spring. The average length of hospital stay was 5.7 days. The median cost of each hospitalized case of RVGE ranged between 1417 and 1595 Euros. The present research confirms that rotavirus gastroenteritis represents an important cause of hospitalization in children and is responsible for significant costs for the Public Health Care System. An effective vaccination program could significantly reduce the incidence of hospitalization and the associated costs.

Development of new precipitation frequency tables for counties in Kansas using NOAA Atlas 14.

Science.gov (United States)

2014-12-01

This report documents the development of KDOTs new rainfall tables for counties in Kansas based on : NOAA Atlas 14 Volume 8. These new tables provide rainfall depths and intensities for durations from 5 : minutes to 24 hours and recurrence interva...

Ecohydrological index, native fish, and climate trends and relationships in the Kansas River basin

Science.gov (United States)

This study sought to quantify climatological and hydrological trends and their relationship to presence and distribution of two native aquatic species in the Kansas River Basin over the past half century. Trend analyses were applied to indicators of hydrologic alteration (IHAs) ...

Association of bystander interventions and hospital length of stay and admission to intensive care unit in out-of-hospital cardiac arrest survivors.

Science.gov (United States)

Riddersholm, Signe; Kragholm, Kristian; Mortensen, Rikke Nørmark; Pape, Marianne; Hansen, Carolina Malta; Lippert, Freddy K; Torp-Pedersen, Christian; Christiansen, Christian F; Rasmussen, Bodil Steen

2017-10-01

The impact of bystander interventions on post-arrest hospital course is sparsely studied. We examined the association between bystander interventions and length of hospital stay and admission to intensive care unit (ICU) in one-day survivors after OHCA. This cohort study linked data of 4641 one-day OHCA survivors from 2001 to 2014 to data on hospital length of stay and ICU admission. We examined associations between bystander efforts and outcomes using regression, adjusted for age, sex, comorbidities, calendar year and witnessed status. We divided bystander efforts into three categories: 1. No bystander interventions; 2.Bystander CPR only; 3. Bystander defibrillation with or without bystander CPR. For patients surviving to hospital discharge, hospital length of stay was 20days for patients without bystander interventions, compared to 16 for bystander CPR, and 13 for bystander defibrillation. 82% of patients without bystander interventions were admitted to ICU compared to 77.2% for bystander CPR, and 61.2% for bystander defibrillation. In-hospital mortality was 60% in the first category compared to 40.5% and 21.7% in the two latter categories. In regression models, bystander CPR and bystander defibrillation were associated with a reduction of length of hospital stay of 21% (Estimate: 0.79 [95% CI: 0.72-0.86]) and 32% (Estimate: 0.68 [95% CI: 0.59-0.78]), respectively. Both bystander CPR (OR: 0.94 [95% CI: 0.91-0.97]) and bystander defibrillation (OR: 0.81 [0.76-0.85]), were associated with lower risk of ICU admission. Bystander interventions were associated with reduced hospital length of stay and ICU admission, suggesting that these efforts improve recovery in OHCA survivors. Copyright © 2017 Elsevier B.V. All rights reserved.

Factors associated with hypoglycemia episodes in hospitalized type ...

African Journals Online (AJOL)

Purpose: To determine the factors associated with severity of hypoglycemia in hospitalized type 2 diabetes mellitus patients in a tertiary health facility in Malaysia. Methods: This retrospective study involved 207 hospitalised T2DM patients with hypoglycaemia episodes from January 2008 to December 2012 and was ...

Respiratory hospitalizations in association with fine PM and its ...

Science.gov (United States)

Despite observed geographic and temporal variation in particulate matter (PM)-related health morbidities, only a small number of epidemiologic studies have evaluated the relation between PM2.5 chemical constituents and respiratory disease. Most assessments are limited by inadequate spatial and temporal resolution of ambient PM measurements and/or by their approaches to examine the role of specific PM components on health outcomes. In a case-crossover analysis using daily average ambient PM2.5 total mass and species estimates derived from the Community Multiscale Air Quality (CMAQ) model and available observations, we examined the association between the chemical components of PM (including elemental and organic carbon, sulfate, nitrate, ammonium, and other remaining) and respiratory hospitalizations in New York State. We evaluated relationships between levels (low, medium, high) of PM constituent mass fractions, and assessed modification of the PM2.5–hospitalization association via models stratified by mass fractions of both primary and secondary PM components. In our results, average daily PM2.5 concentrations in New York State were generally lower than the 24-hr average National Ambient Air Quality Standard (NAAQS). Year-round analyses showed statistically significant positive associations between respiratory hospitalizations and PM2.5 total mass, sulfate, nitrate, and ammonium concentrations at multiple exposure lags (0.5–2.0% per interquartile range [IQR

Association between payer mix and costs, revenues and profitability: a cross-sectional study of Lebanese hospitals.

Science.gov (United States)

Saleh, S; Ammar, W; Natafgi, N; Mourad, Y; Dimassi, H; Harb, H

2015-09-08

This study aimed to examine the association between the payer mix and the financial performance of public and private hospitals in Lebanon. The sample comprised 24 hospitals, representing the variety of hospital characteristics in Lebanon. The distribution of the payer mix revealed that the main sources of revenue were public sources (61.1%), out-of-pocket (18.4%) and private insurance (18.2%). Increases in the percentage of revenue from public sources were associated with lower total costs and revenues, but not profit margins. An inverse association was noted between increased revenue from private insurance and profitability, attributed to increased costs. Increased percentage of out of- pocket payments was associated with lower costs and higher profitability. The study provides evidence that payer mix is associated with hospital costs, revenues and profitability. This should initiate/inform discussions between public and private payers and hospitals about the level of payment and its association with hospital sector financial viability.

Association of In-Hospital Mortality and Dysglycemia in Septic Patients.

Directory of Open Access Journals (Sweden)

Hsiao-Yun Chao

Full Text Available The associations between dysglycemia and mortality in septic patients with and without diabetes are yet to be confirmed. Our aim was to analyze the association of diabetes and sepsis mortality, and to examine how dysglycemia (hyperglycemia, hypoglycemia and glucose variability affects in-hospital mortality of patients with suspected sepsis in emergency department (ED and intensive care units.Clinically suspected septic patients admitted to ED were included, and stratified into subgroups according to in-hospital mortality and the presence of diabetes. We analyzed patients' demographics, comorbidities, clinical and laboratory parameters, admission glucose levels and severity of sepsis. Odds ratio of mortality was assessed after adjusting for possible confounders. The correlations of admission glucose and CoV (blood glucose coefficients of variation and mortality in diabetes and non-diabetes were also tested.Diabetes was present in 58.3% of the patients. Diabetic patients were older, more likely to have end-stage renal disease and undergoing hemodialysis, but had fewer malignancies, less sepsis severity (lower Mortality in Emergency Department Sepsis Score, less steroid usage in emergency department, and lower in-hospital mortality rate (aOR:0.83, 95% CI 0.65-0.99, p = 0.044. Hyperglycemia at admission (glucose≥200 mg/dL was associated with higher risks of in-hospital mortality among the non-diabetes patients (OR:1.83 vs. diabetes, 95% CI 1.20-2.80, p = 0.005 with the same elevated glucose levels at admission. In addition, CoV>30% resulted in higher risk of death as well (aOR:1.88 vs. CoV between 10 and 30, 95%CI 1.24-2.86 p = 0.003.This study indicates that while diabetes mellitus seems to be a protective factor in sepsis patients, hyper- or hypoglycemia status on admission, and increased blood glucose variation during hospital stays, were independently associated with increased odds ratio of mortality.

Potentially Preventable Hospitalizations and the Burden of Healthcare-Associated Infections

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Andrea L. Lorden

2017-08-01

Full Text Available Background: An estimated 4% of hospital admissions acquired healthcare-associated infections (HAIs and accounted for $9.8 (USD billion in direct cost during 2011. In 2010, nearly 140 000 of the 3.5 million potentially preventable hospitalizations (PPHs may have acquired an HAI. There is a knowledge gap regarding the co-occurrence of these events. Aims: To estimate the period occurrences and likelihood of acquiring an HAI for the PPH population. Methods: Retrospective, cross-sectional study using logistic regression analysis of 2011 Texas Inpatient Discharge Public Use Data File including 2.6 million admissions from 576 acute care hospitals. Agency for Healthcare Research and Quality Prevention Quality Indicator software identified PPH, and existing administrative data identification methodologies were refined for Clostridium difficile infection, central line–associated bloodstream infection, catheter-associated urinary tract infection, and ventilator-associated pneumonia. Odds of acquiring HAIs when admitted with PPH were adjusted for demographic, health status, hospital, and community characteristics. Findings: We identified 272 923 PPH, 14 219 HAI, and 986 admissions with PPH and HAI. Odds of acquiring an HAI for diabetic patients admitted for lower extremity amputation demonstrated significantly increased odds ratio of 2.9 (95% confidence interval: 2.16-3.91 for Clostridium difficile infection. Other PPH patients had lower odds of acquiring HAI compared to non-PPH patients, and results were frequently significant. Conclusions: Clinical implications include increased risk of HAI among diabetic patients admitted for lower extremity amputation. Methodological implications include identification of rare events for inpatient subpopulations and the need for improved codification of HAIs to improve cost and policy analyses regarding allocation of resources toward clinical improvements.

Mineralogy and petrology of cretaceous subsurface lamproite sills, southeastern Kansas, USA

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Cullers, R.L.; Dorais, M.J.; Berendsen, P.; Chaudhuri, Sambhudas

1996-01-01

Cores and cuttings of lamproite sills and host sedimentary country rocks in southeastern Kansas from up to 312 m depth were analyzed for major elements in whole rocks and minerals, certain trace elements in whole rocks (including the REE) and Sr isotopic composition of the whole rocks. The lamproites are ultrapotassic (K2O/Na2O = 2.0-19.9), alkalic [molecular (K2O/Na2O)/Al2O3 = 1.3-2.8], enriched in mantle-incompatible elements (light REE, Ba, Rb, Sr, Th, Hf, Ta) and have nearly homogeneous initial Sr isotopic compositions (0.707764-0.708114). These lamproites could have formed by variable degrees of partial melting of harzburgite country rock and cross-cutting veins composed of phlogopite, K-Ti richterite, titanite, diopside, K-Ti silicates, or K-Ba-phosphate under high H2O/CO2 ratios and reducing conditions. Variability in melting of veins and wall rock and variable composition of the metasomatized veins could explain the significantly different composition of the Kansas lamproites. Least squares fractionation models preclude the derivation of the Kansas lamproites by fractional crystallization from magmas similar in composition to higher silica phlogopite-sanidine lamproites some believe to be primary lamproite melts found elsewhere. In all but one case, least squares fractionation models also preclude the derivation of magmas similar in composition to any of the Kansas lamproites from one another. A magma similar in composition to the average composition of the higher SiO2 Ecco Ranch lamproite (237.5-247.5 m depth) could, however, have marginally crystallized about 12% richterite, 12% sanidine, 7% diopside and 6% phlogopite to produce the average composition of the Guess lamproite (305-312 m depth). Lamproite from the Ecco Ranch core is internally fractionated in K2O, Al2O3, Ba, MgO, Fe2O3, Co and Cr most likely by crystal accumulation-removal of ferromagnesian minerals and sanidine. In contrast, the Guess core (305-312 m depth) has little fractionation

Comparison of Modeled Results for Kansas City Middle Blue River Green Infrastructure Pilot Project

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The Water Services Department (WSD) in Kansas City, Missouri (KCMO) has conducted extensive modeling and economic studies of its combined sewer system (CSS) over the last several years. A number of green infrastructure (GI) solutions were identified and constructed to reduce dis...

History of the Kansas Extension Service From 1868 to 1964; (Vol. I, II, III).

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Teagarden, Earl H., Comp.

The comprehensive history of the Kansas Extension Service from 1868 is presented in three volumes and includes administration, information dissemination, club work, special area reports, personnel training, and continuing education. Administration involves such aspects as personnel, finances, organizational changes, cooperation with other agencies…

Sample Archaeological Survey of Public Use Areas, Milford Lake, Kansas

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1982-09-01

especially ceramics); Middle "" Mississippian, Middle Woodland and Central Plains archaeology ; the engineering and building technology of the Maya ...Sample Archaeological Survey of Public Use Areas -- 0C 0 awo (L" . .614 4.- -. 1?CNOV 1 40484 * , "n. O ji - 0" By Laura S. Schwiekhard Thn ’.iint haUs...RECIPIENT’S CATALOG NUMBER 4. TITLE (and Subtitle) 5. TYPE OF REPORT & PERIOD COVERED Milford Lake, Kansas Sample Archaeological Survey of Public Use

Hospitalization for partial nephrectomy was not associated with intrathecal opioid analgesia: Retrospective analysis.

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Weingarten, Toby N; Del Mundo, Serena B; Yeoh, Tze Yeng; Scavonetto, Federica; Leibovich, Bradley C; Sprung, Juraj

2014-10-01

The aim of this retrospective study is to test the hypothesis that the use of spinal analgesia shortens the length of hospital stay after partial nephrectomy. We reviewed all patients undergoing partial nephrectomy for malignancy through flank incision between January 1, 2008, and June 30, 2011. We excluded patients who underwent tumor thrombectomy, used sustained-release opioids, or had general anesthesia supplemented by epidural analgesia. Patients were grouped into "spinal" (intrathecal opioid injection for postoperative analgesia) versus "general anesthetic" group, and "early" discharge group (within 3 postoperative days) versus "late" group. Association between demographics, patient physical status, anesthetic techniques, and surgical complexity and hospital stay were analyzed using multivariable logistic regression analysis. Of 380 patients, 158 (41.6%) were discharged "early" and 151 (39.7%) were "spinal" cases. Both spinal and early discharge groups had better postoperative pain control and used less postoperative systemic opioids. Spinal analgesia was associated with early hospital discharge, odds ratio 1.52, (95% confidence interval 1.00-2.30), P = 0.05, but in adjusted analysis was no longer associated with early discharge, 1.16 (0.73-1.86), P = 0.52. Early discharge was associated with calendar year, with more recent years being associated with early discharge. Spinal analgesia combined with general anesthesia was associated with improved postoperative pain control during the 1(st) postoperative day, but not with shorter hospital stay following partial nephrectomy. Therefore, unaccounted practice changes that occurred during more recent times affected hospital stay.

Dementia in older people admitted to hospital: a regional multi-hospital observational study of prevalence, associations and case recognition

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Timmons, Suzanne; Manning, Edmund; Barrett, Aoife; Brady, Noeleen M.; Browne, Vanessa; O’Shea, Emma; Molloy, David William; O'Regan, Niamh A.; Trawley, Steven; Cahill, Suzanne; O'Sullivan, Kathleen; Woods, Noel; Meagher, David; Ni Chorcorain, Aoife M.; Linehan, John G.

2015-01-01

Background: previous studies have indicated a prevalence of dementia in older admissions of ∼42% in a single London teaching hospital, and 21% in four Queensland hospitals. However, there is a lack of published data from any European country on the prevalence of dementia across hospitals and between patient groups. Objective: to determine the prevalence and associations of dementia in older patients admitted to acute hospitals in Ireland. Methods: six hundred and six patients aged ≥70 years were recruited on admission to six hospitals in Cork County. Screening consisted of Standardised Mini-Mental State Examination (SMMSE); patients with scores dementia; with 29% in public hospitals. Prevalence varied between hospitals (P dementia had a previous diagnosis. Patients with dementia were older and frailer, with higher co-morbidity, malnutrition and lower functional status (P dementia (57%) on admission. Conclusion: dementia is common in older people admitted to acute hospitals, particularly in acute medical admissions, and rural hospitals, where services may be less available. Most dementia is not previously diagnosed, emphasising the necessity for cognitive assessment in older people on presentation to hospital. PMID:26420638

Opportunity Knocks: Closing the Gaps between Leaders and the Public on Math, Science, & Technology Education--A Qualitative Research Report on the Kansas City Region

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Kadlec, Alison; Friedman, Will

2010-01-01

The Kansas City region is in many ways representative of the larger national economy. As with many cities of its size, the largest area of employment, other than in government, is in the healthcare sector. While biomedical research is a major growth area across the nation, Kansas City is also the national leader in the animal healthcare industry,…

Risk factors for hospital-associated venous thromboembolism in critically ill children following cardiothoracic surgery or therapeutic cardiac catheterisation.

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Atchison, Christie M; Amankwah, Ernest; Wilhelm, Jean; Arlikar, Shilpa; Branchford, Brian R; Stock, Arabela; Streiff, Michael; Takemoto, Clifford; Ayala, Irmel; Everett, Allen; Stapleton, Gary; Jacobs, Marshall L; Jacobs, Jeffrey P; Goldenberg, Neil A

2018-02-01

Paediatric hospital-associated venous thromboembolism is a leading quality and safety concern at children's hospitals. The aim of this study was to determine risk factors for hospital-associated venous thromboembolism in critically ill children following cardiothoracic surgery or therapeutic cardiac catheterisation. We conducted a retrospective, case-control study of children admitted to the cardiovascular intensive care unit at Johns Hopkins All Children's Hospital (St. Petersburg, Florida, United States of America) from 2006 to 2013. Hospital-associated venous thromboembolism cases were identified based on ICD-9 discharge codes and validated using radiological record review. We randomly selected two contemporaneous cardiovascular intensive care unit controls without hospital-associated venous thromboembolism for each hospital-associated venous thromboembolism case, and limited the study population to patients who had undergone cardiothoracic surgery or therapeutic cardiac catheterisation. Odds ratios and 95% confidence intervals for associations between putative risk factors and hospital-associated venous thromboembolism were determined using univariate and multivariate logistic regression. Among 2718 admissions to the cardiovascular intensive care unit during the study period, 65 met the criteria for hospital-associated venous thromboembolism (occurrence rate, 2%). Restriction to cases and controls having undergone the procedures of interest yielded a final study population of 57 hospital-associated venous thromboembolism cases and 76 controls. In a multiple logistic regression model, major infection (odds ratio=5.77, 95% confidence interval=1.06-31.4), age ⩽1 year (odds ratio=6.75, 95% confidence interval=1.13-160), and central venous catheterisation (odds ratio=7.36, 95% confidence interval=1.13-47.8) were found to be statistically significant independent risk factors for hospital-associated venous thromboembolism in these children. Patients with all three

Pre-hospital National Early Warning Score (NEWS is associated with in-hospital mortality and critical care unit admission: A cohort study

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Tom E.F. Abbott

2018-03-01

Conclusion: Pre-hospital NEWS was associated with death or critical care unit escalation within 48 h of hospital admission. NEWS could be used by ambulance crews to assist in the early triage of patients requiring hospital treatment or rapid transport. Further cohort studies or trials in large samples are required before implementation.

Hospital Costs Associated With Agitation in the Acute Care Setting.

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Cots, Francesc; Chiarello, Pietro; Pérez, Victor; Gracia, Alfredo; Becerra, Virginia

2016-01-01

The study determined hospital costs associated with a diagnosis of agitation among patients at 14 general hospitals in Spain. Data from discharge records of adult patients (2008-2012) with a diagnosis of agitation (ICD-9-CM code 293.0) were analyzed. Incremental hospital costs for agitated patients and a control group of patients without agitation were quantified, and the adjusted cost and incremental cost for both groups were compared by use of a recycled-predictions approach. The analysis included 355,496 hospital discharges, 5,334 of which were of patients with a diagnosis of agitation. Among patients with a diagnosis of agitation, hospital stays were significantly longer (12 days versus nine days). A significant difference in mean costs of €472 (95% confidence interval [CI]=€351-€593) was noted between patients with agitation and those in the control group. A recycled-predictions approach showed a difference of €1,593(CI=€1,556-€1,631). Findings indicate that agitation increased the use of hospital resources by at least 8%.

Salt dissolution in oil and gas test holes in central Kansas. Part I. Salt beds in the subsurface in Russell, Lincoln, Ellsworth, Barton, and Rice Counties, central Kansas

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Walters, R.F.

1975-06-01

The Hutchinson Salt Member of the Permian Wellington Formation is described in a five-county study area of 4,000 square miles. Most of the 22,200 oil and gas test holes in the study area were drilled with fresh water, causing dissolution of the salt during drilling, commonly resulting in borehole enlargement to three times the diameter of the drill bit (some older rotary drilled holes have borehole enlargement up to 10 ft). After drilling ceases, no salt dissolution occurs in oil and gas test holes which have properly cemented surface casing protecting all aquifers above the salt. The conclusion is reached that extensive dissolution of the Hutchinson Salt in oil and gas test holes in central Kansas is a rare and unusual event in the 50-year history since the discovery of oil in Russell County in 1923. In only seven known instances (six of which are within the study area) did such dissolution lead to collapse and surface subsidence. With an estimated 72,000 holes drilled through the Hutchinson Salt Member within the State of Kansas, this is a ratio of approximately one occurrence for every 10,000 oil and gas test holes

The economics of potential reduction of the rural road system in Kansas : technical summary.

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2011-11-01

The increasing size of farms in Kansas has led to increasing farm vehicle size as well. Tractor and combine weight and width has increased and the majority of farmers deliver their grain in semi-trucks. Tandem axle trucks are used to deliver farm sup...

Direct costs associated with the appropriateness of hospital stay in elderly population

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Sánchez-García Sergio

2009-08-01

Full Text Available Abstract Background Ageing of Mexican population implies greater demand of hospital services. Nevertheless, the available resources are used inadequately. In this study, the direct medical costs associated with the appropriateness of elderly populations hospital stay are estimated. Methods Appropriateness of hospital stay was evaluated with the Appropriateness Evaluation Protocol (AEP. Direct medical costs associated with hospital stay under the third-party payer's institutional perspective were estimated, using as information source the clinical files of 60 years of age and older patients, hospitalized during year 2004 in a Regional Hospital from the Mexican Social Security Institute (IMSS, in Mexico City. Results The sample consisted of 724 clinical files, with a mean of 5.3 days (95% CI = 4.9–5.8 of hospital stay, of which 12.4% (n = 90 were classified with at least one inappropriate patient day, with a mean of 2.2 days (95% CI = 1.6 – 2.7. The main cause of inappropriateness days was the inexistence of a diagnostic and/or treatment plan, 98.9% (n = 89. The mean cost for an appropriate hospitalization per patient resulted in US$1,497.2 (95% CI = US$323.2 – US$4,931.4, while the corresponding mean cost for an inappropriate hospitalization per patient resulted in US$2,323.3 (95% CI = US$471.7 – US$6,198.3, (p Conclusion Elderly patients who were inappropriately hospitalized had a higher rate of inappropriate patient days. The average of inappropriate patient days cost is considerably higher than appropriate days. In this study, inappropriate hospital-stay causes could be attributable to physicians and current organizational management.

Schools in Kansas with Tornado Protection. Shawnee Mission Public Schools--District No. 512.

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Ward, Delbert B.

Kansas and nearby Missouri are among the half-dozen states in America having the greatest frequency of tornadoes of any region in the world. This booklet describes a districtwide approach of designing and constructing tornado-resistant shelters as integrated parts of the school facilities. The design criteria for tornado protection also resulted…

Frequency and risk factors associated with emergency medical readmissions in Galway University Hospitals.

LENUS (Irish Health Repository)

Gorman, J

2010-06-01

Unplanned readmissions of medical hospital patients have been increasing in recent years. We examined the frequency and associates of emergency medical readmissions to Galway University Hospitals (GUH).

Outcomes and Risk Factors Associated with Clostridium difficile Diarrhea in Hospitalized Adult Patients

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Daniela Zilio Larentis

2015-01-01

Full Text Available Background. The epidemiology of Clostridium difficile infection has changed over time. Therefore, it is essential to monitor the characteristics of patients at risk of infection and factors associated with poor prognosis. Objective. To evaluate factors associated with C. difficile infection and with poor prognosis in those with documented C. difficile colitis. Methods. A retrospective case-control study of 75 patients with documented C. difficile colitis and 75 controls with hospital-acquired diarrhea of other causes. Stepwise multiple logistic regression was used to identify factors associated with C. difficile infection among patients with hospital-acquired diarrhea. Results. Previous antibiotic treatment (odds ratio (OR, 13.3; 95% confidence interval (CI, 1.40–126.90, abdominal distension (OR, 3.85; 95% CI, 1.35–10.98, and fecal leukocytes (OR, 8.79; 95% CI, 1.41–54.61 are considered as predictors of C. difficile colitis; anorexia was negatively associated with C. difficile infection (OR, 0.15; 95% CI, 0.03–0.66. Enteral tube feeding was independently associated with a composite outcome that included in-hospital mortality, intensive care unit admission, and treatment failure (OR, 3.75; 95%CI, 1.24–11.29. Conclusions. Previous antibiotic use and presence of fecal leukocytes in patients with hospital-acquired diarrhea are associated with C. difficile colitis and enteral tube support with complications associated with C. difficile colitis.

Association of Electroconvulsive Therapy With Psychiatric Readmissions in US Hospitals.

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Slade, Eric P; Jahn, Danielle R; Regenold, William T; Case, Brady G

2017-08-01

Although electroconvulsive therapy (ECT) is considered the most efficacious treatment available for individuals with severe affective disorders, ECT's availability is limited and declining, suggesting that information about the population-level effects of ECT is needed. To examine whether inpatient treatment with ECT is associated with a reduction in 30-day psychiatric readmission risk in a large, multistate sample of inpatients with severe affective disorders. A quasi-experimental instrumental variables probit model of the association correlation of ECT administration with patient risk of 30-day readmission was estimated using observational, longitudinal data on hospital inpatient discharges from US general hospitals in 9 states. From a population-based sample of 490 252 psychiatric inpatients, a sample was drawn that consisted of 162 691 individuals with a principal diagnosis of major depressive disorder (MDD), bipolar disorder, or schizoaffective disorder. The key instrumental variable used in the analysis was ECT prevalence in the prior calendar year at the treating hospital. To examine whether ECT's association with readmissions was heterogeneous across population subgroups, analyses included interactions of ECT with age group, sex, race/ethnicity, and diagnosis group. The study was conducted from August 27, 2015, to March 7, 2017. Readmission within 30 days of being discharged. Overall, 2486 of the 162 691 inpatients (1.5%) underwent ECT during their index admission. Compared with other inpatients, those who received ECT were older (mean [SD], 56.8 [16.5] vs 45.9 [16.5] years; P Electroconvulsive therapy may be associated with reduced short-term psychiatric inpatient readmissions among psychiatric inpatients with severe affective disorders. This potential population health effect may be overlooked in US hospitals' current decision making regarding the availability of ECT.

Association of Financial Integration Between Physicians and Hospitals With Commercial Health Care Prices.

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Neprash, Hannah T; Chernew, Michael E; Hicks, Andrew L; Gibson, Teresa; McWilliams, J Michael

2015-12-01

Financial integration between physicians and hospitals may help health care provider organizations meet the challenges of new payment models but also may enhance the bargaining power of provider organizations, leading to higher prices and spending in commercial health care markets. To assess the association between recent increases in physician-hospital integration and changes in spending and prices for outpatient and inpatient services. Using regression analysis, we estimated the relationship between changes in physician-hospital integration from January 1, 2008, through December 31, 2012, in 240 metropolitan statistical areas (MSAs) and concurrent changes in spending. Adjustments were made for patient, plan, and market characteristics, including physician, hospital, and insurer market concentration. The study population included a cohort of 7,391,335 nonelderly enrollees in preferred-provider organizations or point-of-service plans included in the Truven Health MarketScan Commercial Database during the study period. Data were analyzed from December 1, 2013, through July 13, 2015. Physician-hospital integration, measured using Medicare claims data as the share of physicians in an MSA who bill for outpatient services with a place-of-service code indicating employment or practice ownership by a hospital. Annual inpatient and outpatient spending per enrollee and associated use of health care services, with utilization measured by price-standardized spending (the sum of annual service counts multiplied by the national mean of allowed charges for the service). Among the 240 MSAs, physician-hospital integration increased from 2008 to 2012 by a mean of 3.3 percentage points, with considerable variation in increases across MSAs (interquartile range, 0.8-5.2 percentage points). For our study sample of 7,391,335 nonelderly enrollees, an increase in physician-hospital integration equivalent to the 75th percentile of changes experienced by MSAs was associated with a mean

The role of the American Hospital Association in combating AIDS.

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McCarthy, C

1988-01-01

The American Hospital Association (AHA) has taken a leadership role in assisting health care providers in dealing effectively with the challenges of AIDS. Early work focused on preventing infection in the health care setting with the use of the Centers for Disease Control's recommended precautions concerning blood and body fluids. Supporting this effort were a number of live teleconferences, videotapes, and publications that addressed the use of precautions with AIDS patients, community issues associated with the disease, and the development of employee policies. In July 1987, a Special Committee on AIDS/HIV Infection Policy was formed by the AHA Board of Trustees and charged with developing recommendations on the issues that needed to be addressed if hospitals were to continue to meet the challenge of AIDS effectively. The committee's first set of recommendations, approved in November 1987, reaffirmed the use of universal precautions, provided guidance on the appropriate uses and application of HIV testing, and stated that the delivery of care should not be conditioned on the willingness of a patient to undergo testing. The second set of recommendations, which were approved in January 1988, focused on the need to distribute the responsibility for AIDS care among a wide variety of health care providers, to seek creative financing approaches that involve both the private and public sectors, and called on hospitals to provide leadership in ensuring that a continuum of services is available to AIDS patients. Continuing efforts to assist hospitals in the care delivery issues associated with AIDS are described.

The Development of Visual Aids for Training Student Employees in Certain Dishroom Procedures in a College Cafeteria

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1951-09-01

irianagement Kansas State College Manhatten, Kansas Ul. Hospitals Major Elizabeth Carloss, WIMSC Mdss Marqareý_ King, hospital Food Servicc Director of...scruboed with a stiff bristled brus ,., We scrubbed dishes are When taken to Whe operator a :-he soiled disk, table whio racks these dishes irato the open

Factors associated with readmission to the hospital within 30 days in patients with inflammatory bowel disease

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Gaetano, John N.; Rubin, Jonah N.; Cohen, Russell D.; Sakuraba, Atsushi; Rubin, David T.; Pekow, Joel

2017-01-01

Background Management of inpatients with inflammatory bowel disease (IBD) requires increasing resources. We aimed to identify factors associated with hospital readmissions among individuals with IBD. Materials & methods We collected data from the Healthcare Cost and Utilization Project Nationwide Readmissions Database 2013. We identified individuals with index hospitalizations for IBD. Patient-specific factors, comorbidities and hospitalization characteristics were extracted for the index hospitalization. We performed logistic regression modeling to create adjusted odds ratios (ORs) for 30-day hospital readmission. Subgroup analysis was performed based on disease type and performance of surgery. Results We analyzed a total of 55,942 index hospital discharges; 3037 patients (7.0%) were readmitted to the hospital within 30 days. Increasing patient age (> 65: OR: 0.45; 95% CI 0.39–0.53) was associated with a decreased risk of readmission, while a diagnosis of Crohn’s disease (OR: 1.09; 95% CI 1.00–1.18) and male sex (OR: 1.16; 95% CI 1.07–1.25) were associated with an increased risk of readmission. The comorbidities of smoking (OR: 1.09; 95% CI 1.00–1.19), anxiety (OR: 1.17; 95% CI 1.01–1.36) and opioid dependence (OR: 1.40; 95% CI 1.06–1.86) were associated with an increased risk of 30-day readmission. Individual hospitalization characteristics and disease complications were significantly associated with readmission. Performance of a surgery during the index admission was associated with a decreased risk of readmission (OR: 0.57; 95% CI 0.33–0.96). Conclusion Analyzing data from a US publicly available all-payer inpatient healthcare database, we identified patient and hospitalization risk factors associated with 30-day readmission. Identifying patients at high risk for readmission may allow for interventions during or after the index hospitalization to decrease this risk. PMID:28837634

Factors associated with readmission to the hospital within 30 days in patients with inflammatory bowel disease.

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Dejan Micic

Full Text Available Management of inpatients with inflammatory bowel disease (IBD requires increasing resources. We aimed to identify factors associated with hospital readmissions among individuals with IBD.We collected data from the Healthcare Cost and Utilization Project Nationwide Readmissions Database 2013. We identified individuals with index hospitalizations for IBD. Patient-specific factors, comorbidities and hospitalization characteristics were extracted for the index hospitalization. We performed logistic regression modeling to create adjusted odds ratios (ORs for 30-day hospital readmission. Subgroup analysis was performed based on disease type and performance of surgery.We analyzed a total of 55,942 index hospital discharges; 3037 patients (7.0% were readmitted to the hospital within 30 days. Increasing patient age (> 65: OR: 0.45; 95% CI 0.39-0.53 was associated with a decreased risk of readmission, while a diagnosis of Crohn's disease (OR: 1.09; 95% CI 1.00-1.18 and male sex (OR: 1.16; 95% CI 1.07-1.25 were associated with an increased risk of readmission. The comorbidities of smoking (OR: 1.09; 95% CI 1.00-1.19, anxiety (OR: 1.17; 95% CI 1.01-1.36 and opioid dependence (OR: 1.40; 95% CI 1.06-1.86 were associated with an increased risk of 30-day readmission. Individual hospitalization characteristics and disease complications were significantly associated with readmission. Performance of a surgery during the index admission was associated with a decreased risk of readmission (OR: 0.57; 95% CI 0.33-0.96.Analyzing data from a US publicly available all-payer inpatient healthcare database, we identified patient and hospitalization risk factors associated with 30-day readmission. Identifying patients at high risk for readmission may allow for interventions during or after the index hospitalization to decrease this risk.

Estimated hospital costs associated with preventable health care-associated infections if health care antiseptic products were unavailable

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Schmier JK

2016-05-01

Full Text Available Jordana K Schmier,1 Carolyn K Hulme-Lowe,1 Svetlana Semenova,2 Juergen A Klenk,3 Paul C DeLeo,4 Richard Sedlak,5 Pete A Carlson6 1Health Sciences, Exponent, Inc., Alexandria, VA, 2EcoSciences, Exponent, Inc., Maynard, MA, 3Health Sciences, Exponent, Inc., Alexandria, VA, 4Environmental Safety, 5Technical and International Affairs, American Cleaning Institute, Washington, DC, 6Regulatory Affairs, Ecolab, Saint Paul, MN, USA Objectives: Health care-associated infections (HAIs pose a significant health care and cost burden. This study estimates annual HAI hospital costs in the US avoided through use of health care antiseptics (health care personnel hand washes and rubs; surgical hand scrubs and rubs; patient preoperative and preinjection skin preparations. Methods: A spreadsheet model was developed with base case inputs derived from the published literature, supplemented with assumptions when data were insufficient. Five HAIs of interest were identified: catheter-associated urinary tract infections, central line-associated bloodstream infections, gastrointestinal infections caused by Clostridium difficile, hospital- or ventilator-associated pneumonia, and surgical site infections. A national estimate of the annual potential lost benefits from elimination of these products is calculated based on the number of HAIs, the proportion of HAIs that are preventable, the proportion of preventable HAIs associated with health care antiseptics, and HAI hospital costs. The model is designed to be user friendly and to allow assumptions about prevention across all infections to vary or stay the same. Sensitivity analyses provide low- and high-end estimates of costs avoided. Results: Low- and high-end estimates of national, annual HAIs in hospitals avoided through use of health care antiseptics are 12,100 and 223,000, respectively, with associated hospital costs avoided of US$142 million and US$4.25 billion, respectively. Conclusion: The model presents a novel

Prevalence of antibiotic-resistant Gram-negative bacteria associated with the red-eared slider (Trachemys scripta elegans).

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Liu, Dandan; Wilson, Cailin; Hearlson, Jodie; Singleton, Jennifer; Thomas, R Brent; Crupper, Scott S

2013-09-01

Free-ranging Red-eared Sliders (Trachemys scripta elegans) were captured from farm ponds located in the Flint Hills of Kansas and a zoo pond in Emporia, Kansas, USA, to evaluate their enteric bacterial flora and associated antibiotic resistance. Bacteria obtained from cloacal swabs were composed of six different Gram-negative genera. Although antibiotic resistance was present in turtles captured from both locations, 40 and 49% of bacteria demonstrated multiple antibiotic resistance to four of the antibiotics tested from the zoo captured and Flint Hills ponds turtles, respectively. These data illustrate environmental antibiotic resistance is widespread in the bacterial flora obtained from Red-eared Sliders in east central Kansas.

Association of Unfinished Root Canal Treatments with the Risk of Pneumonia Hospitalization.

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Lin, Po-Yen; Chiang, Yu-Chih; Chou, Yu-Ju; Chang, Hong-Ji; Chi, Lin-Yang

2017-01-01

The objective of root canal treatments (RCTs) is to control pulpal diseases and salvage infected teeth by eradicating microorganisms within the root canal system. However, an unfinished RCT can leave a space for bacterial accumulation, which can leak into the oral cavity and then aspirate into the lower respiratory tract and the lungs, causing infection. This study investigated the association of unfinished RCTs with the possible risk of pneumonia hospitalization using a nationwide population-based database. After a matching process, we recruited 116,490 subjects who received an initiated RCT and had no history of pneumonia before 2005 and observed until the end of 2011. An unfinished RCT was operationally defined as an endodontic session that was started on a tooth but had no subsequent completion records. Cox proportional hazards models and subgroup analyses were used to estimate the association of unfinished RCTs on the risk of pneumonia hospitalization. In total, 1285 subjects were hospitalized for pneumonia during 2005 to 2011 with an overall pneumonia hospitalization incidence rate of 0.22% per person year. After adjusting for confounding factors, the adjusted pneumonia hospitalization hazard ratio for subjects who had unfinished RCTs was 1.40 (95% confidence interval, 1.24-1.59) compared with subjects without unfinished RCTs (P endodontic treatments once started. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Clinical response and hospital costs associated with the empirical use of vancomycin and linezolid for hospital-acquired pneumonia in a Chinese tertiary care hospital: a retrospective cohort study

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Song Y

2014-10-01

Full Text Available Yuanlin Song,1,* Yicheng Yang,2,* Wendong Chen,3,4 Wei Liu,2 Kai Wang,2 Xuehai Li,5 Ke Wang,2 Manny Papadimitropoulos,3,6 William Montgomery7 1Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, 2Lilly Suzhou Pharmaceutical Co, Ltd, Shanghai Branch, Shanghai, People's Republic of China; 3Division of Social and Administrative Pharmacy, Leslie Dan Faculty of Pharmacy, University of Toronto, 4Normin Health, Toronto, ON, Canada; 5VitalStrategic Research Institute, Shanghai, People's Republic of China; 6Global Health Outcomes Research, Eli Lilly, Indianapolis, IN, USA; 7Eli Lilly Australia Pty Ltd, West Ryde, NSW, Australia *These authors contributed equally to this work Aims: To evaluate clinical outcomes and allocation of hospital costs associated with empirical use of vancomycin or linezolid for hospital-acquired pneumonia (HAP in the People's Republic of China. Methods: Hospital episodes including HAP treated by vancomycin or linezolid between 2008 and 2012 in a Chinese tertiary care hospital were retrospectively identified from hospital administrative databases. Propensity score methods created best-matched pairs for the antibiotics. The matched pairs were used for adjusted comparisons on clinical response and allocation of hospital costs. Multiple regression analyses adjusting residual imbalance after matching were performed to confirm adjusted comparisons. Results: Sixty matched pairs were created. Adjusted comparisons between vancomycin and linezolid showed similar clinical response rates (clinical cure: 30.0% versus 31.7%, respectively; P=0.847; treatment failure: 55.0% versus 45.0%, respectively; P=0.289 but a significantly lower in-hospital mortality rate for vancomycin (3.3% versus 18.3%, respectively; P=0.013. After further adjusting for the imbalanced variables between matched treatment groups, the risks of treatment failure associated with the two antibiotics were comparable (odds ratio: 1.139; P=0.308 and there was

Streamflow characteristics and trends along Soldier Creek, Northeast Kansas

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Juracek, Kyle E.

2017-08-16

Historical data for six selected U.S. Geological Survey streamgages along Soldier Creek in northeast Kansas were used in an assessment of streamflow characteristics and trends. This information is required by the Prairie Band Potawatomi Nation for the effective management of tribal water resources, including drought contingency planning. Streamflow data for the period of record at each streamgage were used to assess annual mean streamflow, annual mean base flow, mean monthly flow, annual peak flow, and annual minimum flow.Annual mean streamflows along Soldier Creek were characterized by substantial year-to-year variability with no pronounced long-term trends. On average, annual mean base flow accounted for about 20 percent of annual mean streamflow. Mean monthly flows followed a general seasonal pattern that included peak values in spring and low values in winter. Annual peak flows, which were characterized by considerable year-to-year variability, were most likely to occur in May and June and least likely to occur during November through February. With the exception of a weak yet statistically significant increasing trend at the Soldier Creek near Topeka, Kansas, streamgage, there were no pronounced long-term trends in annual peak flows. Annual 1-day, 30-day, and 90-day mean minimum flows were characterized by considerable year-to-year variability with no pronounced long-term trend. During an extreme drought, as was the case in the mid-1950s, there may be zero flow in Soldier Creek continuously for a period of one to several months.

Indian Creek-AML: Coal slurry reclamation (Kansas case history)

International Nuclear Information System (INIS)

Witthar, S.R.

1998-01-01

Black and Veatch, assisted by Jack Nawrot, developed conceptual and final designs and provided construction assistance to create grasslands and wetlands in order to reclaim an abandoned coal mine for the state of Kansas. The mine included spoils, a coal refuse dump, and slurry pond in the Indian Creek drainage basin in east central Kansas. The Indian Creek flowed from an off-site abandoned mine and through the coal slurry pond where its waters became more polluted. The intent of the reclamation project was to improve water quality and create a wildlife refuge. The coal refuse was covered and seeded with a diversity of vegetation including several grasses and legume. The slurry pond was developed into a series of large wetland cells to improve water quality. Prior to reclamation, the water leaving the site had a typical pH of 3.3, ranging from 2.4 to 5.6, an iron content which typically over 22 mg/L and ranging over 100 mg/L, and contained large amounts of coal slurry. The acid sediment in the slurry killed fish and caused visible damage to a new large concrete box culvert several miles downstream of the site. Post-reclamation water quality leaving the Indian Creek site showed immediate improvement even before vegetation was reestablished. The existing wetland treatment systems have been successfully treating water for over seven years with the pH of the water leaving the wetlands above 7 and soluble iron content less than 1 mg/L. Fish in the constructed wetlands support waterfowl which now nest onsite

Educating for Success: The Legacy of an All-Black School in Southeast Kansas

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Patterson, Jean A.; Mickelson, Kathryn A.; Petersen, Jan L.; Gross, Diane S.

2008-01-01

The authors present findings from an oral history of the all-Black Douglass School, which existed in Parsons, Kansas from 1908-1958. The oral history of the school is significant for several reasons: (a) it adds to our understanding of segregated schools outside the South and northern urban centers, (b) the school was razed in 1962, and very…

Association of Hospital Market Concentration With Costs of Complex Hepatopancreaticobiliary Surgery.

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Cerullo, Marcelo; Chen, Sophia Y; Dillhoff, Mary; Schmidt, Carl; Canner, Joseph K; Pawlik, Timothy M

2017-09-20

Trade-offs involved with market competition, overall costs to payers and consumers, and quality of care have not been well defined. Less competition within any given market may enable provider-driven increases in charges. To examine the association between regional hospital market concentration and hospital charges for hepatopancreaticobiliary surgical procedures. This study included all patients undergoing hepatic or pancreatic resection in the Nationwide Inpatient Sample from January 1, 2003, through December 31, 2011. Hospital market concentration was assessed using a variable-radius Herfindahl-Hirschman Index (HHI) in the 2003, 2006, and 2009 Hospital Market Structure files. Data were analyzed from November 19, 2016, through March 2, 2017. Hepatic or pancreatic resection. Multivariable mixed-effects log-linear models were constructed to determine the association between HHI and total costs and charges for hepatic or pancreatic resection. Weighted totals of 38 711 patients undergoing pancreatic resection (50.8% men and 49.2% women; median age, 65 years [interquartile range, 55-73 years]) and 52 284 patients undergoing hepatic resection (46.8% men and 53.2% women; median age, 59 years [interquartile range, 49-69 years]) were identified. Higher institutional volume was associated with lower cost of pancreatic resection (-5.4%; 95% CI, -10.0% to -0.5%; P = .03) and higher cost of hepatic resection (13.4%; 95% CI, 8.2% to 18.8%; P markets relative to moderately concentrated markets, although overall charges were 8.3% lower (95% CI, -14.0% to -2.3%; P = .008) in highly concentrated markets. For hepatic resections, hospitals in highly concentrated markets had 8.4% lower costs (95% CI, -13.0% to -3.6%; P = .001) compared with those in unconcentrated markets and charges that were 13.4% lower (95% CI, -19.3% to -7.1%; P markets and 10.5% lower (95% CI, -16.2% to -4.4%; P = .001) compared with unconcentrated markets. Higher market concentration was

Medical Device-Associated Candida Infections in a Rural Tertiary Care Teaching Hospital of India

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Sachin C. Deorukhkar

2016-01-01

Full Text Available Health care associated infections (HCAIs add incrementally to the morbidity, mortality, and cost expected of the patient’s underlying diseases alone. Approximately, about half all cases of HCAIs are associated with medical devices. As Candida medical device-associated infection is highly drug resistant and can lead to serious life-threatening complications, there is a need of continuous surveillance of these infections to initiate preventive and corrective measures. The present study was conducted at a rural tertiary care hospital of India with an aim to evaluate the rate of medical device-associated Candida infections. Three commonly encountered medical device-associated infections (MDAI, catheter-associated urinary tract infection (CA-UTI, intravascular catheter-related blood stream infections (CR-BSI, and ventilator-associated pneumonia (VAP, were targeted. The overall rate of MDAI in our hospital was 2.1 per 1000 device days. The rate of Candida related CA-UTI and CR-BSI was noted as 1.0 and 0.3, respectively. Untiring efforts taken by team members of Hospital Acquired Infection Control Committee along with maintenance of meticulous hygiene of the hospital and wards may explain the low MDAI rates in our institute. The present surveillance helped us for systematic generation of institutional data regarding MDAI with special reference to role of Candida spp.

Association of frailty in hospitalized and institutionalized elderly in the community-dwelling

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Suzele Cristina Coelho Fabrício-Wehbe

2016-08-01

Full Text Available ABSTRACT Objective: to investigate the association between frailty with hospitalization and institutionalization in a follow-up study of elderly residents. Method: the follow-up study was performed in 2008 and 2013 with elderly of both genders, aged 65 years and older who were living in the community-dwelling. The sampling procedure performed was probabilistic, with dual-stage clustering. In 2008, 515 elderly people were interviewed and, in 2013, 262. We used the socioeconomic and demographic data, self-reported morbidity, specific data of hospitalization and institutionalization. Frailty was measured by the Edmonton Frail Scale (EFS, and functional capacity through the Functional Independence Measure. Results: we found the mean gross EFS score was higher among resident elderly who were hospitalized and institutionalized and was statistically significant in both investigated years. Conclusion: the confirmation of association between frailty and hospitalization and institutionalization reinforces the importance of the subject, and highlights frailty as an important tool for risk estimates for these adverse events.

Geology, hydrology, thickness and quality of salt at three alternate sites for disposal of radioactive waste in Kansas

International Nuclear Information System (INIS)

Bayne, C.K.; Brinkley, C.

1972-09-01

The three sites selected by the AEC for additional study for the disposal of radioactive wastes in Kansas are; Site A located in south-central Lincoln County, Site D-2 located in south-central Wichita County, and Site A-1 located in north-western Lincoln County. Results of the study show that all sites failed to meet the detailed criteria. Areas A and A-1 fail to meet the criteria concerning thickness and quality. Area D-2 fails to meet the criteria concerning quality and mineability of the salt. Areas west of Site A-1 and in south-central Harper County, in the authors' opinion, appear to be the best prospects for future study in Kansas

[Factors associated with involuntary hospital admissions in technology-dependent children].

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Okido, Aline Cristiane Cavicchioli; Pina, Juliana Coelho; Lima, Regina Aparecida Garcia

2016-02-01

To identify the factors associated with involuntary hospital admissions of technology-dependent children, in the municipality of Ribeirão Preto, São Paulo State, Brazil. A cross-sectional study, with a quantitative approach. After an active search, 124 children who qualified under the inclusion criteria, that is to say, children from birth to age 12, were identified. Data was collected in home visits to mothers or the people responsible for the children, through the application of a questionnaire. Analysis of the data followed the assumptions of the Generalized Linear Models technique. 102 technology-dependent children aged between 6 months and 12 years participated in the study, of whom 57% were male. The average number of involuntary hospital admissions in the previous year among the children studied was 0.71 (±1.29). In the final model the following variables were significantly associated with the outcome: age (OR=0.991; CI95%=0.985-0.997), and the number of devices (OR=0.387; CI95%=0.219-0.684), which were characterized as factors of protection and quantity of medications (OR=1.532; CI95%=1.297-1.810), representing a risk factor for involuntary hospital admissions in technology-dependent children. The results constitute input data for consideration of the process of care for technology-dependent children by supplying an explanatory model for involuntary hospital admissions for this client group.

75 FR 68755 - Agenda and Notice of Public Meeting of the Kansas Advisory Committee

Science.gov (United States)

2010-11-09

... Committee (SAC) orientation and planning meeting of the Kansas Advisory Committee to the Commission will..., 2010. The purpose of this meeting is to provide SAC orientation and continue planning a civil rights... impairments may also follow the proceedings by first calling the Federal Relay Service at 1-800-977-8339 and...

Come to the "Champagne Air": Changing Promotional Images of the Kansas Climate, 1854-1900

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De Bres, Karen

2003-01-01

Promotional materials, which portrayed the Kansas climate, resources, and landscape in optimistic tones, were a common medium used to smooth the rough edges of the physical environment to Euro-American settlers in the second half of the nineteenth century. This article examines promotional literature of that era and evaluates the strategies…

The hospital resource utilization associated with osteoporotic hip fractures in Kermanshah, Iran.

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Saeb, Morteza; Beyranvand, Mandana; Basiri, Zahra; Haghparast-Bidgoli, Hassan

2014-01-01

Hip fracture is the most serious complication of osteoporosis and imposes a significant financial burden on countries' economy. This study aimed to assess the hospitalization costs and length of stay associated with osteoporosis hip fractures and identify the major cost components in a referral hospital in Kermanshah city, Iran. In a prospective study, from May 21 2007 to May 21 2008, all patients with osteoporotic hip fracture admitted to a referral hospital for operation were recruited as the study sample. For each patient, information such as age, gender, length of stay (LOS) in hospital and intensive care unit (ICU), medical and diagnostic procedures and cost of surgery and implant were collected both through interview with the patient or a family member and the patients' hospital records. A total of 103 patients (56 men and 47 women) were studied. The average hospital length of stay (LOS) for the patients was 9.7 days, ranging from 5 to 38 days. The average total hospitalization costs was 7,208,588 IRR (US$774). The main components of the costs were ward stay (16.3%), operative (54.6%), implant (26%) and medical and diagnostic procedures (3.1%). The results of this study demonstrate that the hospital resource burden associated with osteoporotic hip fractures in Iran is substantial and expected to rise with the projected increase of life expectancy and the number of elderly in Iran. Estimating the economic burden of osteoporotic hip fractures provide information that can be of importance in the planning and design of preventive strategies. © 2014 KUMS, All rights reserved.

The hospital resource utilization associated with osteoporotic hip fractures in Kermanshah, Iran

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Morteza Saeb

2014-01-01

Full Text Available Abstract: Background: Hip fracture is the most serious complication of osteoporosis and imposes a significant financial burden on countries' economy. This study aimed to assess the hospitalization costs and length of stay associated with osteoporosis hip fractures and identify the major cost components in a referral hospital in Kermanshah city, Iran. Methods: In a prospective study, from May 21 2007 to May 21 2008, all patients with osteoporotic hip fracture admitted to a referral hospital for operation were recruited as the study sample. For each patient, information such as age, gender, length of stay (LOS in hospital and intensive care unit (ICU, medical and diagnostic procedures and cost of surgery and implant were collected both through interview with the patient or a family member and the patients’ hospital records. Results: A total of 103 patients (56 men and 47 women were studied. The average hospital length of stay (LOS for the patients was 9.7 days, ranging from 5 to 38 days. The average total hospitalization costs was 7,208,588 IRR (US$774. The main components of the costs were ward stay (16.3%, operative (54.6%, implant (26% and medical and diagnostic procedures (3.1%. Conclusions: The results of this study demonstrate that the hospital resource burden associated with osteoporotic hip fractures in Iran is substantial and expected to rise with the projected increase of life expectancy and the number of elderly in Iran. Estimating the economic burden of osteoporotic hip fractures provide information that can be of importance in the planning and design of preventive strategies.

Vulnerability to extreme-heat-associated hospitalization in three counties in Michigan, USA, 2000-2009

Science.gov (United States)

Ogbomo, Adesuwa S.; Gronlund, Carina J.; O'Neill, Marie S.; Konen, Tess; Cameron, Lorraine; Wahl, Robert

2017-05-01

With climate change, extreme heat (EH) events are increasing, so it is important to understand who is vulnerable to heat-associated morbidity. We determined the association between EH and hospitalizations for all natural causes; cardiovascular, respiratory, and renal diseases; diabetes mellitus; and acute myocardial infarction in Michigan, USA, at different intensities and durations. We assessed confounding by ozone and how individual characteristics and health insurance payer (a proxy for income) modified these associations. We obtained Michigan Inpatient Database, National Climatic Data Center, and US Environmental Protection Agency ozone data for May-September, 2000-2009 for three Michigan counties. We employed a case-crossover design and modeled EH as an indicator for temperature above the 95th, 97th, or 99th percentile thresholds for 1, 2, 3, or 4 days. We examined effect modification by patient age, race, sex, and health insurance payer and pooled the county results. Among non-whites, the pooled odds ratio for hospitalization on EH (97th percentile threshold) vs. non-EH days for renal diseases was 1.37 (95 % CI = 1.13-1.66), which increased with increasing EH intensity, but was null among whites (OR = 1.00, 95 % CI = 0.81, 1.25). We observed a null association between EH and cardiovascular hospitalization. EH (99th percentile threshold) was associated with myocardial infarction hospitalizations. Confounding by ozone was minimal. EH was associated with hospitalizations for renal disease among non-whites. This information on vulnerability to heat-associated morbidity helps characterize the public health burden of EH and target interventions including patient education.

Associations between environmental factors and hospital admissions for sickle cell disease

Science.gov (United States)

Piel, Frédéric B.; Tewari, Sanjay; Brousse, Valentine; Analitis, Antonis; Font, Anna; Menzel, Stephan; Chakravorty, Subarna; Thein, Swee Lay; Inusa, Baba; Telfer, Paul; de Montalembert, Mariane; Fuller, Gary W.; Katsouyanni, Klea; Rees, David C.

2017-01-01

Sickle cell disease is an increasing global health burden. This inherited disease is characterized by a remarkable phenotypic heterogeneity, which can only partly be explained by genetic factors. Environmental factors are likely to play an important role but studies of their impact on disease severity are limited and their results are often inconsistent. This study investigated associations between a range of environmental factors and hospital admissions of young patients with sickle cell disease in London and in Paris between 2008 and 2012. Specific analyses were conducted for subgroups of patients with different genotypes and for the main reasons for admissions. Generalized additive models and distributed lag non-linear models were used to assess the magnitude of the associations and to calculate relative risks. Some environmental factors significantly influence the numbers of hospital admissions of children with sickle cell disease, although the associations identified are complicated. Our study suggests that meteorological factors are more likely to be associated with hospital admissions for sickle cell disease than air pollutants. It confirms previous reports of risks associated with wind speed (risk ratio: 1.06/standard deviation; 95% confidence interval: 1.00–1.12) and also with rainfall (1.06/standard deviation; 95% confidence interval: 1.01–1.12). Maximum atmospheric pressure was found to be a protective factor (0.93/standard deviation; 95% confidence interval: 0.88–0.99). Weak or no associations were found with temperature. Divergent associations were identified for different genotypes or reasons for admissions, which could partly explain the lack of consistency in earlier studies. Advice to patients with sickle cell disease usually includes avoiding a range of environmental conditions that are believed to trigger acute complications, including extreme temperatures and high altitudes. Scientific evidence to support such advice is limited and

DUQuE quality management measures: associations between quality management at hospital and pathway levels.

Science.gov (United States)

Wagner, Cordula; Groene, Oliver; Thompson, Caroline A; Dersarkissian, Maral; Klazinga, Niek S; Arah, Onyebuchi A; Suñol, Rosa

2014-04-01

The assessment of integral quality management (QM) in a hospital requires measurement and monitoring from different perspectives and at various levels of care delivery. Within the DUQuE project (Deepening our Understanding of Quality improvement in Europe), seven measures for QM were developed. This study investigates the relationships between the various quality measures. It is a multi-level, cross-sectional, mixed-method study. As part of the DUQuE project, we invited a random sample of 74 hospitals in 7 countries. The quality managers of these hospitals were the main respondents. Furthermore, data of site visits of external surveyors assessing the participating hospitals were used. Three measures of QM at hospitals level focusing on integral systems (QMSI), compliance with the Plan-Do-Study-Act quality improvement cycle (QMCI) and implementation of clinical quality (CQII). Four measures of QM activities at care pathway level focusing on Specialized expertise and responsibility (SER), Evidence-based organization of pathways (EBOP), Patient safety strategies (PSS) and Clinical review (CR). Positive significant associations were found between the three hospitals level QM measures. Results of the relationships between levels were mixed and showed most associations between QMCI and department-level QM measures for all four types of departments. QMSI was associated with PSS in all types of departments. By using the seven measures of QM, it is possible to get a more comprehensive picture of the maturity of QM in hospitals, with regard to the different levels and across various types of hospital departments.

Methods for estimating annual exceedance-probability streamflows for streams in Kansas based on data through water year 2015

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Painter, Colin C.; Heimann, David C.; Lanning-Rush, Jennifer L.

2017-08-14

A study was done by the U.S. Geological Survey in cooperation with the Kansas Department of Transportation and the Federal Emergency Management Agency to develop regression models to estimate peak streamflows of annual exceedance probabilities of 50, 20, 10, 4, 2, 1, 0.5, and 0.2 percent at ungaged locations in Kansas. Peak streamflow frequency statistics from selected streamgages were related to contributing drainage area and average precipitation using generalized least-squares regression analysis. The peak streamflow statistics were derived from 151 streamgages with at least 25 years of streamflow data through 2015. The developed equations can be used to predict peak streamflow magnitude and frequency within two hydrologic regions that were defined based on the effects of irrigation. The equations developed in this report are applicable to streams in Kansas that are not substantially affected by regulation, surface-water diversions, or urbanization. The equations are intended for use for streams with contributing drainage areas ranging from 0.17 to 14,901 square miles in the nonirrigation effects region and, 1.02 to 3,555 square miles in the irrigation-affected region, corresponding to the range of drainage areas of the streamgages used in the development of the regional equations.

Pre-hospital aspiration is associated with increased pulmonary complications.

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Fawcett, Vanessa J; Warner, Keir J; Cuschieri, Joseph; Copass, Michael; Grabinsky, Andreas; Kwok, Heemun; Rea, Thomas; Evans, Heather L

2015-04-01

Rates of ventilator-associated pneumonia (VAP) are highest among patients intubated on an emergency basis following trauma. We reported previously a retrospective analysis demonstrating an association between subjective aspiration and VAP after pre-hospital intubation. We hypothesize that by directing paramedics to note features of aspiration at intubation, we will confirm prospectively the association between pre-hospital aspiration and subsequent pneumonia in trauma patients. Paramedics collected data regarding aspiration at the time of intubation. All intubated patients admitted to a level 1 trauma center intensive care unit (ICU) were included. Data comprised a clinical impression of pre-hospital aspiration, as well as the presence and timing of blood and emesis in the airway. Injury severity, co-morbidities, and outcomes were collected from the trauma registry. Healthcare-associated pneumonia (HAP) was identified by medical record review of both bronchoalveolar lavage culture results and discharge diagnosis. Descriptive statistics and univariate analysis of outcomes by aspiration status, as well as covariable adjustment using propensity scores, were performed. Of the 228 patients, 89 (39%) were determined by paramedics to have aspirated. The majority of those who aspirated (84 [94%]) did so prior to intubation. Patients who aspirated had higher Injury Severity Scores than those who did not aspirate (25.0 ± 1.7 vs. 21.9 ± 1.5 points; p=0.04) and lower preintubation Glasgow Coma Scale scores (8.2 ± 0.50 vs. 9.6 ± 0.40; p=0.02). Of the 89 patients who aspirated around the time of intubation, 14 (16%) developed HAP vs. five (3.6%) of those who did not aspirate (paspiration (deaths: 21 [23.6%] vs. 23 [16.6%]; p=0.19; ICU LOS: 5.3 ± 0.9 vs. 4.1 ± 0.5 days; p=0.13; duration of mechanical ventilation: 5.3 ± 1.2 vs. 3.2 ± 0.5 days; p=0.10). Aspiration prior to intubation was reported commonly by paramedics and was associated with a higher risk of HAP.

Geoscience Education Opportunities: Partnerships to Advance TeacHing and Scholarship (GEOPATHS) in the Kansas City Metropolitan Area

Science.gov (United States)

Niemi, T. M.; Adegoke, J.; Stoddard, E.; Odom, L.; Ketchum, D.

2007-12-01

The GEOPATHS project is a partnership between the University of Missouri Kansas City (UMKC) and the Kansas City Missouri School District (KCMSD). The goal of GEOPATHS is to raise enrollment in the Geosciences, especially among populations that are traditionally underrepresented in the discipline. We are addressing this goal by expanding dual-credit and Advanced Placement (AP) opportunities for high school students and also by serving teachers through enhancing their understanding of geoscience content and inquiry teaching methods using GLOBE resources and protocols. Our focus in the first two years of the project is to increase the number of teachers that are certified to teach AP Environmental Science by offering specially designed professional development workshops for high school teachers in the Kansas City Metropolitan Area. The structure of the workshop for each year is divided into two weeks of content knowledge exploration using the learning cycle and concept mapping, and one week of inquiry-based experiments, field projects, and exercises. We are also supporting teachers in their use of these best-practice methods by providing materials and supplies along with lesson plans for inquiry investigations for their classes. The lesson plans include activities and experiments that are inquiry-based. The last two years of the project will include direct engagement/recruiting of promising minority high school students via paid summer research internships and scholarship offers.

Clinical Predictors of Hospital-acquired Pneumonia Associated with Acute Ischemic

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Alexis Suárez Quesada

2015-06-01

Full Text Available Background: hospital-acquired pneumonia is a constant challenge given the current microbiological spectrum, antimicrobial resistance together with its high mortality, morbidity and hospital costs. Objective: to identify the clinical predictors of pneumonia associated with acute ischemic stroke. Methods: a prospective cohort study was conducted in 201 patients diagnosed with acute ischemic stroke consecutively admitted to the stroke unit of the General Carlos Manuel de Céspedes Teaching Hospital during the first seven days after the onset, from January 2012 through December 2013. The independent predictors of hospital-acquired pneumonia were obtained using multivariable logistic regression. Results: fifty six point seven percent were male. The mean age was 64.17 ± 14.33 years. Cases of hospital-acquired pneumonia associated with stroke accounted for 19, 9 %. Subjects who developed pneumonia were older (68.55 ± 13.51 vs. 63.08 ± 14.36 years, had a lower score in the Glasgow Coma Scale (8.00 ± 2.60 vs. 14.00 ± 2.82, and an increased number of leukocytes at admission (10.888 ± 3.487 vs. 9.233 ± 2.539 × 109/L. The following independent factors were identified: Glasgow Coma Scale ≤ 11 (OR: 26.099; 95 % CI 7.164-85.075, history of chronic obstructive pulmonary disease (OR: 8.896; 95 % CI 1.203-65.779, dysphagia (OR: 7.652; 95 % CI 2.369- 24.720, history of heart failure (OR: 4.583; 95 % CI 1.240- 16.932 and dysarthria/severe motor aphasia (OR: 4.222; 95 % CI 1.374- 12.975. Conclusions: the resulting logistic regression model is valid for predicting post-stroke pneumonia based on data routinely acquired.

Mortality Associated with Severe Sepsis Among Age-Similar Women with and without Pregnancy-Associated Hospitalization in Texas: A Population-Based Study.

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Oud, Lavi

2016-06-10

BACKGROUND The reported mortality among women with pregnancy-associated severe sepsis (PASS) has been considerably lower than among severely septic patients in the general population, with the difference being attributed to the younger age and lack of chronic illness among the women with PASS. However, no comparative studies were reported to date between patients with PASS and age-similar women with severe sepsis not associated with pregnancy (NPSS). MATERIAL AND METHODS We used the Texas Inpatient Public Use Data File to compare the crude and adjusted hospital mortality between women with severe sepsis, aged 20-34 years, with and without pregnancy-associated hospitalizations during 2001-2010, following exclusion of those with reported chronic comorbidities, as well as alcohol and drug abuse. RESULTS Crude hospital mortality among PASS vs. NPSS hospitalizations was lower for the whole cohort (6.7% vs. 14.1% [p<0.0001]) and those with ≥3 organ failures (17.6% vs. 33.2% [p=0.0100]). Adjusted PASS mortality (odds ratio [95% CI]) was 0.57 (0.38-0.86) [p=0.0070]. CONCLUSIONS Hospital mortality was unexpectedly markedly and consistently lower among women with severe sepsis associated with pregnancy, as compared with contemporaneous, age-similar women with severe sepsis not associated with pregnancy, without reported chronic comorbidities. Further studies are warranted to examine the sources of the observed differences and to corroborate our findings.

The causal direction in the association between respiratory syncytial virus hospitalization and asthma

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Stensballe, Lone Graff; Simonsen, Jacob Brunbjerg; Thomsen, Simon Francis

2009-01-01

BACKGROUND: Earlier studies have reported an increased risk of asthma after respiratory syncytial virus (RSV) hospitalization. Other studies found that asthmatic disposition and propensity to wheeze increase the risk of RSV hospitalization. OBJECTIVE: The current study examined the causal direction......; and asthma is associated with a long-term increased susceptibility for severe RSV disease, suggesting a host factor being responsible for the severe response to RSV infection. This suggests that severe RSV infection and asthma may share a common genetic predisposition and/or environmental exposure....... was increased as much as 6-fold to 8-fold during the first 2 months after RSV hospitalization but was no longer increased 1 year later. Asthma increased the risk of RSV hospitalization by 3-fold, and the risk was not time-dependent. Analyzing these associations on the basis of asthma defined from use of inhaled...

Cost analysis of hospitalized Clostridium difficile-associated diarrhea (CDAD

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Hübner, Claudia

2015-10-01

Full Text Available Aim: -associated diarrhea (CDAD causes heavy financial burden on healthcare systems worldwide. As with all hospital-acquired infections, prolonged hospital stays are the main cost driver. Previous cost studies only include hospital billing data and compare the length of stay in contrast to non-infected patients. To date, a survey of actual cost has not yet been conducted.Method: A retrospective analysis of data for patients with nosocomial CDAD was carried out over a 1-year period at the University Hospital of Greifswald. Based on identification of CDAD related treatment processes, cost of hygienic measures, antibiotics and laboratory as well as revenue losses due to bed blockage and increased length of stay were calculated.Results: 19 patients were included in the analysis. On average, a CDAD patient causes additional costs of € 5,262.96. Revenue losses due to extended length of stay take the highest proportion with € 2,555.59 per case, followed by loss in revenue due to bed blockage during isolation with € 2,413.08 per case. Overall, these opportunity costs accounted for 94.41% of total costs. In contrast, costs for hygienic measures (€ 253.98, pharmaceuticals (€ 22.88 and laboratory (€ 17.44 are quite low.Conclusion: CDAD results in significant additional costs for the hospital. This survey of actual costs confirms previous study results.

78 FR 70580 - Apria Healthcare LLC, Billing Department, Overland Park, Kansas; Notice of Negative Determination...

Science.gov (United States)

2013-11-26

... responsibilities, and the assertion that the worker's separation was due to outsourcing to ``Emdeon and India... Reconsideration By application dated September 19, 2013, a former worker of Apria Healthcare LLC, Billing...), applicable to workers and former workers of Apria Healthcare LLC, Billing Department, Overland Park, Kansas...

Vertical integration: hospital ownership of physician practices is associated with higher prices and spending.

Science.gov (United States)

Baker, Laurence C; Bundorf, M Kate; Kessler, Daniel P

2014-05-01

We examined the consequences of contractual or ownership relationships between hospitals and physician practices, often described as vertical integration. Such integration can reduce health spending and increase the quality of care by improving communication across care settings, but it can also increase providers' market power and facilitate the payment of what are effectively kickbacks for inappropriate referrals. We investigated the impact of vertical integration on hospital prices, volumes (admissions), and spending for privately insured patients. Using hospital claims from Truven Analytics MarketScan for the nonelderly privately insured in the period 2001-07, we constructed county-level indices of prices, volumes, and spending and adjusted them for enrollees' age and sex. We measured hospital-physician integration using information from the American Hospital Association on the types of relationships hospitals have with physicians. We found that an increase in the market share of hospitals with the tightest vertically integrated relationship with physicians--ownership of physician practices--was associated with higher hospital prices and spending. We found that an increase in contractual integration reduced the frequency of hospital admissions, but this effect was relatively small. Taken together, our results provide a mixed, although somewhat negative, picture of vertical integration from the perspective of the privately insured.

Low Health Literacy Is Associated with Increased Transitional Care Needs in Hospitalized Patients.

Science.gov (United States)

Boyle, Joseph; Speroff, Theodore; Worley, Katherine; Cao, Aize; Goggins, Kathryn; Dittus, Robert S; Kripalani, Sunil

2017-11-01

To examine the association of health literacy with the number and type of transitional care needs (TCN) among patients being discharged to home. A cross-sectional analysis of patients admitted to an academic medical center. Nurses administered the Brief Health Literacy Screen and documented TCNs along 10 domains: caregiver support, transportation, healthcare utilization, high-risk medical comorbidities, medication management, medical devices, functional status, mental health comorbidities, communication, and financial resources. Among the 384 patients analyzed, 113 (29%) had inadequate health literacy. Patients with inadequate health literacy had needs in more TCN domains (mean = 5.29 vs 4.36; P literacy were significantly more likely to have TCNs in 7 out of the 10 domains. In multivariate analyses, inadequate health literacy remained significantly associated with inadequate caregiver support (odds ratio [OR], 2.61; 95% confidence interval [CI], 1.37-4.99) and transportation barriers (OR, 1.69; 95% CI, 1.04-2.76). Among hospitalized patients, inadequate health literacy is prevalent and independently associated with other needs that place patients at a higher risk of adverse outcomes, such as hospital readmission. Screening for inadequate health literacy and associated needs may enable hospitals to address these barriers and improve postdischarge outcomes. © 2017 Society of Hospital Medicine

Development of new precipitation frequency tables for counties in Kansas using NOAA Atlas 14 : [technical summary].

Science.gov (United States)

2014-12-01

This report documents the development of KDOTs new rainfall tables for counties in : Kansas based on NOAA Atlas 14 Volume 8. These new tables provide rainfall depths : and intensities for durations from 5 minutes to 24 hours and recurrence interva...

Association of neighborhood-level factors with hospitalization for community-associated methicillin-resistant Staphylococcus aureus, New York City, 2006: a multilevel observational study.

Science.gov (United States)

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

2013-02-13

Hospitalizations with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection have increased in New York City, with substantial geographic variation across neighborhoods. While individual-level risk factors, such as age, sex, HIV infection, and diabetes have been described, the role of neighborhood-level factors (e.g., neighborhood HIV prevalence or income) has not been examined. To explore plausible neighborhood-level factors associated with CA-MRSA-related hospitalizations, a retrospective analysis was conducted using New York City hospital discharges from 2006 and New York City-specific survey and health department surveillance data. CA-MRSA-related hospitalizations were identified using diagnosis codes and admission information. Associations were determined by using sex-specific multilevel logistic regression. The CA-MRSA hospitalization rate varied by more than six-fold across New York City neighborhoods. Females hospitalized with CA-MRSA had more than twice the odds of residing in neighborhoods in the highest quintile of HIV prevalence (adjusted odds ratio [AOR](Q5 vs. Q1) 2.3, 95% CI: 1.2, 2.7). Both males and females hospitalized with CA-MRSA had nearly twice the odds of residing in neighborhoods with moderately high proportion of men who have sex with men (MSM) residing in the neighborhood (males: AOR(Q4 vs. Q1) 1.7, 95% CI: 1.1, 2.7; females: AOR(Q4 vs. Q1) 2.0, 95% CI: 1.1, 3.6); but this association did not hold for neighborhoods in the highest quintile (males: AOR(Q5 vs. Q1) 1.2, 95% CI: 0.76, 1.8; females: AOR(Q5 vs. Q1) 1.5, 95% CI: 0.82, 2.7). Neighborhood-level characteristics were associated with CA-MRSA hospitalization odds, independent of individual-level risk factors, and may contribute to the population-level burden of CA-MRSA infection.

American Hospital Association

Science.gov (United States)

... Central Office-Coding Resources AHA Team Training Health Career Center Health Forum Connect More Regulatory Relief The regulatory burden faced by hospitals is substantial and unsustainable. Read the report . More AHA Opioid Toolkit Stem the Tide: Addressing the Opioid Epidemic More ...

Delirium after lung transplantation: Association with recipient characteristics, hospital resource utilization, and mortality.

Science.gov (United States)

Sher, Yelizaveta; Mooney, Joshua; Dhillon, Gundeep; Lee, Roy; Maldonado, José R

2017-05-01

Delirium is associated with increased morbidity and mortality. The factors associated with post-lung transplant delirium and its impact on outcomes are under characterized. The medical records of 163 consecutive adult lung transplant recipients were reviewed for delirium within 5 days (early-onset) and 30 hospital days (ever-onset) post-transplantation. A multivariable logistic regression model assessed factors associated with delirium. Multivariable negative binomial regression and Cox proportional hazards models assessed the association of delirium with ventilator duration, intensive care unit (ICU) length of stay (LOS), hospital LOS, and one-year mortality. Thirty-six percent of patients developed early-onset, and 44% developed ever-onset delirium. Obesity (OR 6.35, 95% CI 1.61-24.98) and bolused benzodiazepines within the first postoperative day (OR 2.28, 95% CI 1.07-4.89) were associated with early-onset delirium. Early-onset delirium was associated with longer adjusted mechanical ventilation duration (P=.001), ICU LOS (Pdelirium was associated with longer ICU (Pdelirium was not significantly associated with one-year mortality (early-onset HR 1.65, 95% CI 0.67-4.03; ever-onset HR 1.70, 95% CI 0.63-4.55). Delirium is common after lung transplant surgery and associated with increased hospital resources. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Contingency interim measure for the public water supply at Barnes, Kansas.

Energy Technology Data Exchange (ETDEWEB)

LaFreniere, L. M.; Environmental Science Division

2009-07-09

This document presents a conceptual design for a contingency interim measure (IM) for treatment of the public water supply system at Barnes, Kansas, should this become necessary. The aquifer that serves the public water supply system at Barnes has been affected by trace to low concentrations of carbon tetrachloride and its degradation product, chloroform. Investigations conducted on behalf of the CCC/USDA by Argonne National Laboratory (Argonne 2008a) have demonstrated that groundwater at the Barnes site is contaminated with carbon tetrachloride at concentrations exceeding the Kansas Tier 2 risk-based screening level (RBSL) and the EPA maximum contaminant level (MCL) of 5.0 {micro}g/L for this compound. The Commodity Credit Corporation of the U.S. Department of Agriculture (CCC/USDA) formerly operated a grain storage facility in Barnes, approximately 800 ft east-southeast of the public water supply wells. Carbon tetrachloride was used in the treatment of grain. Another potential source identified in an investigation conducted for the KDHE (PRC 1996) is the site of a former agriculture building owned by the local school district (USD 223). This building is located immediately east of well PWS3. The potential contingency IM options evaluated in this report include the treatment of groundwater at the public water supply wellheads and the provision of an alternate water supply via Washington County Rural Water District No.2 (RWD 2). This document was developed in accordance with KDHE Bureau of Environmental Remediation (BER) Policy No.BER-RS-029 (Revised) (KDHE 2006a), supplemented by guidance from the KDHE project manager. Upon the approval of this contingency IM conceptual design by the KDHE, the CCC/USDA will prepare a treatment system design document that will contain the following elements: (1) Description of the approved contingency IM treatment method; (2) Drawings and/or schematics provided by the contractor and/or manufacturer of the approved technology; (3) A

78 FR 67333 - Foreign-Trade Zone 15-Kansas City, Missouri, Area; Application for Reorganization Under...

Science.gov (United States)

2013-11-12

... ``usage-driven'' FTZ sites for operators/users located within a grantee's ``service area'' in the context... City; Site 3 (9,667 acres total)--within the 10,000-acre Kansas City International Airport facility...,000 acres)--CARMAR Underground Business Park/CARMAR Industrial Park, No. 1 Civil War Road, Carthage...

Streamflow conditions along Soldier Creek, Northeast Kansas

Science.gov (United States)

Juracek, Kyle E.

2017-11-14

The availability of adequate water to meet the present (2017) and future needs of humans, fish, and wildlife is a fundamental issue for the Prairie Band Potawatomi Nation in northeast Kansas. Because Soldier Creek flows through the Prairie Band Potawatomi Nation Reservation, it is an important tribal resource. An understanding of historical Soldier Creek streamflow conditions is required for the effective management of tribal water resources, including drought contingency planning. Historical data for six selected U.S. Geological Survey (USGS) streamgages along Soldier Creek were used in an assessment of streamflow characteristics and trends by Juracek (2017). Streamflow data for the period of record at each streamgage were used to compute annual mean streamflow, annual mean base flow, mean monthly flow, annual peak flow, and annual minimum flow. Results of the assessment are summarized in this fact sheet.

Risk of hospitalization associated with anticholinergic medication for patients with dementia.

Science.gov (United States)

Watanabe, Shuichi; Fukatsu, Takahide; Kanemoto, Kosuke

2018-01-01

With the ageing of the general population, demand has grown for measures to prevent hospitalization for dementia, which can exacerbate problems associated with activities of daily living in elderly individuals. Anticholinergic medication has been shown to cause falls, delirium, and cognitive impairment in aged patients. However, the risk of hospitalization associated with the administration of anticholinergics is unclear. We analyzed the records of 61 outpatients (26 men, 35 women; mean age: 78 ± 7 years; mean follow-up period: 420 days) diagnosed with dementia (Alzheimer's disease: n = 45; dementia with Lewy bodies: n = 3; undifferentiated n = 13) and prescribed anti-dementia drugs between May 2013 and December 2014. Medication history was noted, and the patients were divided into two groups according to the Anticholinergic Risk Scale: with risk (n = 13) and without risk (n = 48). Outcome was judged based on an end-point of hospitalization or death. Kaplan-Meier survival and Cox proportional hazard analyses were performed. Eight patients with anticholinergic risk and 12 without anticholinergic risk reached the end-point (P dementia. The Anticholinergic Risk Scale findings were shown to be a strong predictor of hospitalization for patients with dementia. We should evaluate the anticholinergic burden before initiating anti-dementia therapy. © 2018 Japanese Psychogeriatric Society.

Psychosocial work conditions associated with sickness absence among hospital employees

DEFF Research Database (Denmark)

Suadicani, P; Olesen, K; Bonde, J P

2014-01-01

's salary database. RESULTS: A total of 1809 hospital employees took part with a response rate of 65%. The mean age was 43 (range: 20-69) and 75% were female. Totally, 363 study participants (20%) had at least 14 days sickness absence (defined as high absence) during the preceding year. Associations between...... essential covariates of sickness absence. METHODS: A cross-sectional questionnaire study of hospital employees which sought information on elements of the psychosocial work environment, general health status, life style, age, gender and profession. Data on sickness absence were obtained from the employer...

Hospital CEOs' priorities and perceptions regarding industry issues and the Virginia Hospital Association's activities.

Science.gov (United States)

McDermott, D R; Gerardo, E F; Duguid, D A; Cooning, P J

1991-01-01

Based on a survey of Virginia hospital CEOs, it was revealed that four industry issues are causing a high degree of concern, namely Medicare/Medicaid reimbursement policies, personnel shortages, indigent care, and increased operating expenses. Each of these issues will be discussed regarding the VHA's activities to devise possible solutions. Regarding Medicare, the VHA has worked closely with the American Hospital Association in their federal advocacy efforts encouraging members to write, call, and visit their Congressional representatives to persuade them to pass legislation increasing the Medicare budget. Regarding Medicaid, which is administered by each state and in Virginia involves a 50/50 sharing of the funding between the federal and state governments, the VHA has challenged what it believes to be an illegal hospital reimbursement system through the federal judicial system. While the process is continuing, the VHA is encouraged by the U.S. Supreme Court's decision (July 1990) affirming hospitals' and all other health care providers' right, to pursue via the judicial process their allegation that a state is violating federal law by setting inadequate and inequitable Medicaid reimbursement rates to hospitals. In order to address the personnel shortages issue, the VHA has actively addressed recruitment and retention challenges by establishing a Health Manpower Resource Center and hiring a full-time director. This office targets high school students, second-career adults, and current health care professionals through communication and education programs. The area of indigent care represents one of the VHA's most notable achievements to date. This entails the recent Virginia legislation creating the Indigent Care Trust Fund. This fund's initial amount is some $15 million and represents an approximate 60/40 contribution ratio involving both the State of Virginia and hospitals in Virginia. A formula has been developed for each hospital in Virginia to assess how

Preventing device-associated infections in US hospitals: national surveys from 2005 to 2013.

Science.gov (United States)

Krein, Sarah L; Fowler, Karen E; Ratz, David; Meddings, Jennifer; Saint, Sanjay

2015-06-01

Numerous initiatives have focused on reducing device-associated infections, contributing to an overall decrease in infections nationwide. To better understand factors associated with this decline, we assessed the use of key practices to prevent device-associated infections by US acute care hospitals from 2005 to 2013. We mailed surveys to infection preventionists at a national random sample of ∼600 US acute care hospitals in 2005, 2009 and 2013. Our survey asked about the use of practices to prevent the 3 most common device-associated infections: central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP) and catheter-associated urinary tract infection (CAUTI). Using sample weights, we estimated the per cent of hospitals reporting regular use (a score of 4 or 5 on a scale from 1 (never use) to 5 (always use)) of prevention practices from 2005 to 2013. The response rate was about 70% in all 3 periods. Use of most recommended prevention practices increased significantly over time. Among those showing the greatest increase were use of an antimicrobial dressing for preventing CLABSI (25-78%, ppreventing VAP (41-79%, ppreventing CAUTI (9-53%, pinfections. Practices for which little change was observed included use of antimicrobial catheters to prevent either CLABSI or CAUTI. US hospitals have responded to the call to reduce infection by increasing use of key recommended practices. Vigilance is needed to ensure sustained improvement and additional strategies may still be required, given an apparent continuing lag in CAUTI prevention efforts. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A compendium of strategies to prevent healthcare-associated infections in acute care hospitals: 2014 updates.

Science.gov (United States)

Yokoe, Deborah S; Anderson, Deverick J; Berenholtz, Sean M; Calfee, David P; Dubberke, Erik R; Ellingson, Katherine D; Gerding, Dale N; Haas, Janet P; Kaye, Keith S; Klompas, Michael; Lo, Evelyn; Marschall, Jonas; Mermel, Leonard A; Nicolle, Lindsay E; Salgado, Cassandra D; Bryant, Kristina; Classen, David; Crist, Katrina; Deloney, Valerie M; Fishman, Neil O; Foster, Nancy; Goldmann, Donald A; Humphreys, Eve; Jernigan, John A; Padberg, Jennifer; Perl, Trish M; Podgorny, Kelly; Septimus, Edward J; VanAmringe, Margaret; Weaver, Tom; Weinstein, Robert A; Wise, Robert; Maragakis, Lisa L

2014-08-01

Since the publication of "A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals" in 2008, prevention of healthcare-associated infections (HAIs) has become a national priority. Despite improvements, preventable HAIs continue to occur. The 2014 updates to the Compendium were created to provide acute care hospitals with up-to-date, practical, expert guidance to assist in prioritizing and implementing their HAI prevention efforts. They are the product of a highly collaborative effort led by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise, including the Centers for Disease Control and Prevention (CDC), the Institute for Healthcare Improvement (IHI), the Pediatric Infectious Diseases Society (PIDS), the Society for Critical Care Medicine (SCCM), the Society for Hospital Medicine (SHM), and the Surgical Infection Society (SIS).

Factors associated with induced abortion at selected hospitals in the Volta Region, Ghana.

Science.gov (United States)

Klutsey, Ellen Eyi; Ankomah, Augustine

2014-01-01

Induced abortion rates remained persistently high in the Volta Region of Ghana in the 5 years from 2006 to 2011. Some hospitals, both rural and urban, report induced abortion-related complications as one of the top ten conditions in hospital admissions. This study explored demographic and other factors associated with induced abortion, and also assessed awareness of abortion-related complications among women of reproductive age in the Volta Region. A quantitative, hospital-based, unmatched case-control study was performed. The Volta Region was stratified into two health administration zones, ie, north and south. For each zone, hospitals were stratified into government and private hospitals. Employing simple random sampling, one private and three government hospitals were selected from each zone. This study is therefore based on eight hospitals, ie, six government hospitals and two private hospitals. Marital status, employment status, number of total pregnancies, and knowledge about contraception were found to be associated with induced abortion. Multiple logistic regression showed a 4% reduction in the odds of induced abortion in married women compared with women who were single (odds ratio [OR] 0.11, 95% confidence interval [CI] 0.07-0.22). Unemployed women of reproductive age were found to be 0.35 times less likely to seek induced abortion compared with their employed counterparts (OR 0.35, CI 0.19-0.65). It was also observed that women with their second pregnancies were 3.8 times more likely to seek induced abortion and women with more than two pregnancies were 6.6 times more likely to do so (OR 3.81, CI 1.94-7.49 and OR 6.58, CI 2.58-16.79, respectively). Women with no knowledge of contraceptive methods were 4.6 times likely to seek induced abortion (OR 4.64, CI 1.39-15.4). Compared with women who had not had induced abortion, women with a high number of pregnancies and no contraceptive knowledge were more likely to have induced abortion. It was found that lack

Investigation of health promotion status in specialized hospitals associated with Hamadan University of Medical Sciences: health-promoting hospitals.

Science.gov (United States)

Hamidi, Yadollah; Hazavehei, Seyed Mohammad Mahdi; Karimi-Shahanjarini, Akram; SeifRabiei, Mohamad Ali; Farhadian, Maryam; Alimohamadi, Shohreh; Kharghani Moghadam, Seyedeh Melika

2017-12-01

The prophecy of health promoting hospitals (HPH) is bringing about a change and transition from treatment-oriented to health-oriented attitudes. In Iran, hospitals usually play the traditional roles. The present study was aimed at the evaluation of the health promotion status in specialized hospitals associated with Hamadan University of Medical Sciences (HUMS). This applied study was conducted in two Hamadan specialized hospitals in the Hamadan city. The health promotion status was evaluated using a self-assessment checklist designed by the World Health Organization's HPH. The evaluation was done in five standards including management policy, patient assessment, patient information and intervention, promotion of a healthy workplace and continuity and cooperation. The results showed that both the hospitals studied had a poor status in terms of promoting a healthy workplace (average = 31.24%) and management policy standards (average = 35.29%) in comparison with the other relevant standards: patient assessment (53.12%), patient information and intervention (62.5%), continuity and cooperation (65.78%)). The results of the standards and sub-standards status displayed better performance in the cardiovascular hospital (53.67%) compared to the women and parturition hospital (42.64%). The findings indicated that HPH standards are very low in the studied hospitals. The reason behind this wide gap might be due to the fact that hospitals in Iran are more treatment-oriented and patient-oriented and they do not play an active part in health promoting. It was found that management policy and promoting healthy workplace standards had the worst status and must be improved.

First report of phlebotomine sand flies (Diptera: Psychodidae) in Kansas and Missouri, and a PCR method to distinguish Lutzomyia shannoni from Lutzomyia vexator.

Science.gov (United States)

Weng, Ju-Lin; Young, Samantha L; Gordon, David M; Claborn, David; Petersen, Christine; Ramalho-Ortigao, Marcelo

2012-11-01

Sand flies Lutzomyia (Psathyromyia) shannoni (Dyar) and Lu. (Helcocyrtomyia) vexator (Coquillet) were collected for the first time in southwest Missouri and southeast Kansas, expanding the known range of these species in North America. Altogether, 680 sand flies (356 males and 324 females) were collected during trapping from May through October 2011 and identified using morphological characters. Of the total sand flies collected, 315 were identified as Lu. shannoni, with 181 individuals (or 26.6% of all sand flies) trapped in Missouri and 134 individuals (or 19.7%) trapped in Kansas. Whereas 358 Lu. vexator were identified from southwest Missouri, only a single specimen was trapped in southeast Kansas. One male Lu. vexator with asymmetric gonostyli was trapped in Missouri. We also developed a polymerase chain reaction protocol to consistently and accurately distinguish Lu. shannoni from Lu. vexator based on presence or absence of a 416 bp fragment from the cytochrome oxidase c subunit 1 gene.

Association between allergic rhinitis and hospital resource use among asthmatic children in Norway

DEFF Research Database (Denmark)

Sazonov Kocevar, V; Thomas, J; Jonsson, L

2005-01-01

of hospital admissions during a 2-year period, 1998-1999. Multivariate linear regression, adjusting for risk factors including age, gender, year of admission, urban/rural residence and severity of asthma episode, estimated the association between allergic rhinitis and total hospital days. A multivariate Cox...

Work ability among hospital food service professionals: multiple associated variables require comprehensive intervention.

Science.gov (United States)

Fischer, Frida Marina; Martinez, Maria Carmen

2012-01-01

The work of hospital food service is characterized by demands that can be associated with work ability--WA. The aim of this study was to evaluate factors associated with WA among hospital food service professionals and recommend intervention measures. This is a cross sectional study carried out in 2009, conducted in a hospital of São Paulo, Brazil. Participants were 76 (96.2%) of the eligible. They filled out a questionnaire including socio-demographic data, life styles, working conditions and WA. Multivariate linear regression analyses were performed. Factors associated with WA were age (p = 0.051), over commitment (p = 0.011), effort-reward ratio (p = 0.002) and work injuries (p work injuries is consistent with the theoretical model that demonstrated that health status is the basis to maintain the WA. The association of effort-reward imbalance shows that issues related with work organization are relevant for these workers. The association of overcommittment suggests that workers recognize their responsibility with the therapeutic processes of patients. Results showed a number of features of different nature that should be taken into account when implementing measures to improve the WA, to be applied at different levels: individual, task and institutional.

Direct transport to a PCI-capable hospital is associated with improved survival after adult out-of-hospital cardiac arrest of medical aetiology.

Science.gov (United States)

McKenzie, Nicole; Williams, Teresa A; Ho, Kwok M; Inoue, Madoka; Bailey, Paul; Celenza, Antonio; Fatovich, Daniel; Jenkins, Ian; Finn, Judith

2018-05-02

To compare survival outcomes of adults with out-of-hospital cardiac arrest (OHCA) of medical aetiology directly transported to a percutaneous-coronary-intervention capable (PCI-capable) hospital (direct transport) with patients transferred to a PCI-capable hospital via another hospital without PCI services available (indirect transport) by emergency medical services (EMS). This retrospective cohort study used the St John Ambulance Western Australia OHCA Database and medical chart review. We included OHCA patients (≥18 years) admitted to any one of five PCI-capable hospitals in Perth between January 2012 and December 2015. Survival to hospital discharge (STHD) and survival up to 12-months after OHCA were compared between the direct and indirect transport groups using multivariable logistic and Cox-proportional hazards regression, respectively, while adjusting for so-called "Utstein variables" and other potential confounders. Of the 509 included patients, 404 (79.4%) were directly transported to a PCI-capable hospital and 105 (20.6%) transferred via another hospital to a PCI-capable hospital; 274/509 (53.8%) patients STHD and 253/509 (49.7%) survived to 12-months after OHCA. Direct transport patients were twice as likely to STHD (adjusted odds ratio 1.97, 95% confidence interval [CI] 1.13-3.43) than those transferred via another hospital. Indirect transport was also associated with a possible increased risk of death, up to 12-months, compared to direct transport (adjusted hazard ratio 1.36, 95% CI 1.00-1.84). Direct transport to a PCI-capable hospital for post-resuscitation care is associated with a survival advantage for adults with OHCA of medical aetiology. This has implications for EMS transport protocols for patients with OHCA. Copyright © 2018 Elsevier B.V. All rights reserved.

THE COMMUNITY PLANNING PROCESS. KANSAS STATE UNIVERSITY SHORT COURSE SERIES ON COMMUNITY PLANNING AND DEVELOPMENT, 6.

Science.gov (United States)

WEISENBURGER, RAY B.

PART OF A KANSAS STATE UNIVERSITY SERIES ON COMMUNITY PLANNING AND DEVELOPMENT, THIS MONOGRAPH DISCUSSES THE STAGES IN THE PREPARATION AND IMPLEMENTATION OF COMPREHENSIVE URBAN SCHEMES. FIRST OF ALL, SOCIAL ACCEPTANCE, ECONOMIC, FEASIBILITY, POLITICAL RESPONSIBILITY, AND ENVIRONMENTAL SATISFACTION ARE VITAL TO SUCCESSFUL PLANNING. ORGANIZATION FOR…

In-hospital costs associated with chronic constipation in Belgium: a retrospective database study

OpenAIRE

Chevalier, P; Lamotte, M; Joseph, A; Dubois, D; Boeckxstaens, G

2013-01-01

Background Real-life data on the economic burden of chronic idiopathic constipation are scarce. The objectives of this study were to assess hospitalization resource use and costs associated with chronic constipation and its complications in Belgium. Methods This was a single country, retrospective study using the IMS Hospital Disease Database (2008), which comprises data on 34% of acute hospital beds in Belgium and contains information on patient demographics, length of stay (LOS), billed cos...

From Tragedy to Triumph: Rebuilding Greensburg, Kansas To Be a 100% Renewable Energy City; Preprint

Energy Technology Data Exchange (ETDEWEB)

Pless, S.; Billman, L.; Wallach, D.

2010-08-01

On May 4, 2007, Greensburg, Kansas, was hit by a 1.7-mile wide tornado with 200 mph-plus wind speeds. This tornado destroyed or severely damaged 90% of Greensburg?s structures. We discuss the progress made in rebuilding Greensburg, with a focus on the built environment and on meeting Greensburg?s goal of 100% renewable energy, 100% of the time. We also discuss key disaster recovery efforts that enabled Greensburg to reach this goal. Key strategies included a Sustainable Comprehensive Master Plan, an ordinance resolving that city-owned buildings achieve LEED Platinum and 42% energy savings, a strong focus on rebuilding 'right' with an integrated design process, attracting significant and sustained technical experts and national media attention, and linking renewable and energy efficiency technologies to business development. After three years, more than half the homes that have been rebuilt are rated at an average of 40% energy savings. All significant commercial buildings, including the school, hospital, banks, courthouse, and retail buildings, have been rebuilt to LEED Gold and Platinum standards and exceed 40% savings, with many exceeding 50% savings. Greensburg recently constructed a 12.5-MW community wind farm to provide all the remaining energy needed for its energy-efficient buildings and homes.

Market and organizational factors associated with hospital vertical integration into sub-acute care.

Science.gov (United States)

Hogan, Tory H; Lemak, Christy Harris; Hearld, Larry R; Sen, Bisakha P; Wheeler, Jack R C; Menachemi, Nir

2018-04-11

Changes in payment models incentivize hospitals to vertically integrate into sub-acute care (SAC) services. Through vertical integration into SAC, hospitals have the potential to reduce the transaction costs associated with moving patients throughout the care continuum and reduce the likelihood that patients will be readmitted. The purpose of this study is to examine the correlates of hospital vertical integration into SAC. Using panel data of U.S. acute care hospitals (2008-2012), we conducted logit regression models to examine environmental and organizational factors associated with hospital vertical integration. Results are reported as average marginal effects. Among 3,775 unique hospitals (16,269 hospital-year observations), 25.7% vertically integrated into skilled nursing facilities during at least 1 year of the study period. One measure of complexity, the availability of skilled nursing facilities in a county (ME = -1.780, p integration into SAC. Measures of munificence, percentage of the county population eligible for Medicare (ME = 0.018, p integration into SAC. Dynamism, when measured as the change county population between 2008 and 2011 (ME = 1.19e-06, p integration into SAC. Organizational resources, when measured as swing beds (ME = 0.069, p integration into SAC. Organizational resources, when measured as investor owned (ME = -0.052, p integration into SAC. Hospital adaption to the changing health care landscape through vertical integration varies across market and organizational conditions. Current Centers for Medicare and Medicaid reimbursement programs do not take these factors into consideration. Vertical integration strategy into SAC may be more appropriate under certain market conditions. Hospital leaders may consider how to best align their organization's SAC strategy with their operating environment.

Factors associated with hospitalization of children with acute odontogenic infections

Directory of Open Access Journals (Sweden)

Klačar Jelena

2012-01-01

Full Text Available The aim of this study was to compare the sociodemographic and clinical features of odontogenic infections between hospitalized and nonhospitalized children and to show what were the risk factors in children that could predict the course of odontogenic infection and indicate the need for hospital treatment. The design of our study was of the case-control type. The two study groups consisted of 70 inpatients and 35 outpatients with odontogenic infections who were treated at Department of Pediatric Dentistry and Department of Maxillofacial Surgery at Clinical Center in Kragujevac, Serbia. Clinical and sociodemographic data were collected retrospectively from patients' hospital records. The following characteristics were significantly associated with hospital treatment of children with acute odontogenic infection: living in a village (OR =7.26,[1.43-36.96], multi-spatial infection (OR =0.04, [0.00-0.91], and affection of upper face (OR = 0.01, [0.00-0.86]. Tooth extraction was important intervention in the treatment regimen and reduced frequency of hospitalization (OR=0.07, [0.01-0.70]. The differences between hospitalized and non-hospitalized children were not significant in regard to: ethnicity, employment of parents, anatomical region of infection, side of the facial infection, source of infection (posterior or anterior deciduous or permanent teeth, and treatment (drainage and incision, oral or parenteral antibiotics. In children with acute odontogenic infection it is necessary to do tooth extraction in timely manner, especially if the source of infection is tooth from upper jaw and if it is multi-spatial infection.

Health care costs associated with hospital acquired complications in patients with chronic kidney disease.

Science.gov (United States)

Bohlouli, Babak; Jackson, Terri; Tonelli, Marcello; Hemmelgarn, Brenda; Klarenbach, Scott

2017-12-28

Patients with CKD are at increased risk of potentially preventable hospital acquired complications (HACs). Understanding the economic consequences of preventable HACs, may define the scope and investment of initiatives aimed at prevention. Adult patients hospitalized from April, 2003 to March, 2008 in Alberta, Canada comprised the study cohort. Healthcare costs were determined and categorized into 'index hospitalization' including hospital cost and in-hospital physician claims, and 'post discharge' including ambulatory care cost, physician claims, and readmission costs from discharge to 90 days. Multivariable regression was used to estimate the incremental healthcare costs associated with potentially preventable HACs. In fully adjusted models, the median incremental index hospitalization cost was CAN-$6169 (95% CI; 6003-6336) in CKD patients with ≥1 potentially preventable HACs, compared with those without. Post-discharge incremental costs were 1471(95% CI; 844-2099) in those patients with CKD who developed potentially preventable HACs within 90 days after discharge compared with patients without potentially preventable HACs. Additionally, the incremental costs associated with ≥1 potentially preventable HACs within 90 days from admission in patients with CKD were $7522 (95% CI; 7219-7824). A graded relation of the incremental costs was noted with the increasing number of complications. In patients without CKD but with ≥1 preventable HACs incremental costs within 90 days from hospital admission was $6688 (95% CI: 6612-6723). Potentially preventable HACs are associated with substantial increases in healthcare costs in people with CKD. Investment in implementing targeted strategies to reduce HACs may have a significant benefit for patient and health system outcomes.

H2-rich and Hydrocarbon Gas Recovered in a Deep Precambrian Well in Northeastern Kansas

International Nuclear Information System (INIS)

Newell, K. David; Doveton, John H.; Merriam, Daniel F.; Lollar, Barbara Sherwood; Waggoner, William M.; Magnuson, L. Michael

2007-01-01

In late 2005 and early 2006, the WTW Operating, LLC (W.T.W. Oil Co., Inc.) no. 1 Wilson well (T.D. = 5772 ft; 1759.3 m) was drilled for 1826 ft (556.6 m) into Precambrian basement underlying the Forest City Basin in northeastern Kansas. Approximately 4500 of the 380,000 wells drilled in Kansas penetrate Precambrian basement. Except for two previous wells drilled into the arkoses and basalts of the 1.1-Ga Midcontinent Rift and another well drilled in 1929 in basement on the Nemaha Uplift east of the Midcontinent Rift, this well represents the deepest penetration into basement rocks in the state to date. Granite is the typical lithology observed in wells that penetrate the Precambrian in the northern Midcontinent. Although no cores were taken to definitively identify lithologies, well cuttings and petrophysical logs indicate that this well encountered basement metamorphic rocks consisting of schist, gneiss, and amphibolitic gneiss, all cut by aplite dikes.The well was cased and perforated in the Precambrian, and then acidized. After several days of swabbing operations, the well produced shows of low-Btu gas, dominated by the non-flammable component gases of nitrogen (20%), carbon dioxide (43%), and helium (1%). Combustible components include methane (26%), hydrogen (10%), and higher molecular-weight hydrocarbons (1%). Although Coveney and others [Am. Assoc. Petroleum Geologists Bull., v. 71, no, 1, p. 39-48, 1987] identified H 2 -rich gas in two wells located close to the Midcontinent Rift in eastern Kansas, this study indicates that high levels of H 2 may be a more widespread phenomenon than previously thought. Unlike previous results, the gases in this study have a significant component of hydrocarbon gas, as well as H 2 , N 2 , and CO 2 . Although redox reactions between iron-bearing minerals and groundwater are a possible source of H 2 in the Precambrian basement rocks, the hydrocarbon gas does not exhibit the characteristics typically associated with proposed

Factors Associated With the Likelihood of Hospitalization Following Emergency Department Visits for Behavioral Health Conditions.

Science.gov (United States)

Hamilton, Jane E; Desai, Pratikkumar V; Hoot, Nathan R; Gearing, Robin E; Jeong, Shin; Meyer, Thomas D; Soares, Jair C; Begley, Charles E

2016-11-01

Behavioral health-related emergency department (ED) visits have been linked with ED overcrowding, an increased demand on limited resources, and a longer length of stay (LOS) due in part to patients being admitted to the hospital but waiting for an inpatient bed. This study examines factors associated with the likelihood of hospital admission for ED patients with behavioral health conditions at 16 hospital-based EDs in a large urban area in the southern United States. Using Andersen's Behavioral Model of Health Service Use for guidance, the study examined the relationship between predisposing (characteristics of the individual, i.e., age, sex, race/ethnicity), enabling (system or structural factors affecting healthcare access), and need (clinical) factors and the likelihood of hospitalization following ED visits for behavioral health conditions (n = 28,716 ED visits). In the adjusted analysis, a logistic fixed-effects model with blockwise entry was used to estimate the relative importance of predisposing, enabling, and need variables added separately as blocks while controlling for variation in unobserved hospital-specific practices across hospitals and time in years. Significant predisposing factors associated with an increased likelihood of hospitalization following an ED visit included increasing age, while African American race was associated with a lower likelihood of hospitalization. Among enabling factors, arrival by emergency transport and a longer ED LOS were associated with a greater likelihood of hospitalization while being uninsured and the availability of community-based behavioral health services within 5 miles of the ED were associated with lower odds. Among need factors, having a discharge diagnosis of schizophrenia/psychotic spectrum disorder, an affective disorder, a personality disorder, dementia, or an impulse control disorder as well as secondary diagnoses of suicidal ideation and/or suicidal behavior increased the likelihood of hospitalization

Nosocomial transmission of community-associated methicillin-resistant Staphylococcus aureus in Danish Hospitals

NARCIS (Netherlands)

Hetem, D.J.; Westh, H.; Boye, K.; Jarlov, J.O.; Bonten, M.J.M.; Bootsma, M.C.J.

2012-01-01

Objectives The emergence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has changed the epidemiology of MRSA infections worldwide. In contrast to hospital-associated MRSA (HA-MRSA), CA-MRSA more frequently affects healthy individuals, both with and without recent

The Leavenworth Lamp: Symbol of the Command and General Staff College, Fort Leavenworth, Kansas, Presented 7 May 1956

National Research Council Canada - National Science Library

1956-01-01

On the occasion of the 75th Anniversary of the founding of the Command and General Staff College, Fort Leavenworth, Kansas, on 7 May 1956, the "Leavenworth Lamp" was officially adopted by the College...

Burden of Clostridium difficile infection: Associated hospitalization in a cohort of middle-aged and older adults.

Science.gov (United States)

Chen, Yingxi; Glass, Kathryn; Liu, Bette; Korda, Rosemary J; Riley, Thomas V; Kirk, Martyn D

2017-05-01

Clostridium difficile is the principal cause of infectious diarrhea in hospitalized patients. The aim of this study was to describe and compare length of stay (LOS), costs, and in-hospital deaths for C difficile infection (CDI) and non-CDI hospitalizations, in a cohort of middle-aged and older Australians. We used survey data from the 45 and Up Study, linked to hospitalization and death data. We calculated the average LOS and costs per hospitalization, and the proportion of in-hospital deaths for CDI and non-CDI hospitalizations. We then compared hospitalizations with CDI as a secondary diagnosis to non-CDI hospitalizations by stratifying hospitalizations based on principal diagnosis and then using generalized linear models to compare LOS and in-hospital costs, and logistic regression for in-hospital deaths, adjusting for age and sex. There were 641 CDI hospitalizations during 2006-2012. The average LOS was 17 days; the average cost per hospitalization was AUD 12,704; and in 7.3% of admissions (47 out of 641) the patient died. After adjusting for age and sex, hospitalizations with CDI were associated with longer LOS, higher costs, and a greater proportion of in-hospital deaths compared with hospitalizations with similar principal diagnosis but without CDI. CDI places additional burden on the Australian hospital system, with CDI patients having relatively lengthy hospital stays and high costs. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

The Impact of Poverty and School Size on the 2015-16 Kansas State Assessment Results

Science.gov (United States)

Carter, Ted

2017-01-01

Schools with higher percentages of students in poverty have lower student assessment results on the 2015-16 Kansas Math and ELA assessments, and larger schools have lower student achievement results than smaller schools. In addition, higher poverty schools are likely to have larger gaps in performance based on special education status and possibly…

Adverse health effects in Canada geese (Branta canadensis) associated with waste from zinc and lead mines in the Tri-State Mining District (Kansas, Oklahoma, and Missouri, USA).

Science.gov (United States)

van der Merwe, Deon; Carpenter, James W; Nietfeld, Jerome C; Miesner, John F

2011-07-01

Lead and zinc poisoning have been recorded in a variety of bird species, including migrating waterfowl such as Canada Geese (Branta canadensis), at sites contaminated with mine waste from lead and zinc mines in the Tri-State Mining District, Kansas, Oklahoma, and Missouri, USA. The adverse health impacts from mine waste on these birds may, however, be more extensive than is apparent from incidental reports of clinical disease. To characterize health impacts from mine waste on Canada Geese that do not have observable signs of poisoning, four to eight apparently healthy birds per site were collected from four contaminated sites and an uncontaminated reference site, and examined for physical and physiologic evidence of metals poisoning. Tissue concentrations of silver, aluminum, arsenic, barium, cadmium, cobalt, chromium, copper, iron, magnesium, manganese, molybdenum, nickel, lead, selenium, thallium, vanadium, and zinc were determined by inductively coupled plasma mass spectroscopy. Adverse health effects due to lead were characterized by assessing blood δ-aminolevulinic acid dehydratase (ALAD) enzyme activity. Adverse effects associated with zinc poisoning were determined from histologic examination of pancreas tissues. Elevated tissue lead concentrations and inhibited blood ALAD enzyme activities were consistently found in birds at all contaminated sites. Histopathologic signs of zinc poisoning, including fibrosis and vacuolization, were associated with elevated pancreatic zinc concentrations at one of the study sites. Adverse health effects associated with other analyzed elements, or tissue concentrations indicating potentially toxic exposure levels to these elements, were not observed.

Accuracy of different temperature reading techniques and associated stress response in hospitalized dogs.

Science.gov (United States)

Gomart, Samantha B; Allerton, Fergus J W; Gommeren, Kris

2014-01-01

To evaluate the accuracy and associated induced stress response of axillary, auricular, and rectal thermometry in hospitalized dogs. Prospective observational study from October 2011 to February 2012. University veterinary teaching hospital. Two hundred fifty hospitalized dogs. All hospitalized dogs were considered eligible unless their condition precluded measurement at one of the designated sites. A veterinary auricular infrared device for auricular temperature (OT) and an electronic predictive thermometer for rectal temperature (RT) and axillary temperature (AT) were used for temperature measurements. All recordings were obtained by the same investigator in a randomized fashion. Heart rate was noted before and immediately after each measurement. Stress behaviors (eg, vocalization, lip licking, shaking, panting, defensive behavior) were also recorded and graded from 0 (lowest) to 4 (highest). Signalment, analgesic therapy, and length of hospitalization were recorded. RT measurements were associated with greatest increase in heart rate (P 0.05). AT and to a lesser extent OT are reliable, less stressful alternatives to estimate RT in dogs. Further studies are needed to evaluate these techniques in hyperthermic dogs, and to evaluate the use of AT and OT as monitoring tools in intensive care patients. © Veterinary Emergency and Critical Care Society 2014.

Falls and Hospitalizations Among Persons With Dementia and Associated Caregiver Emotional Difficulties.

Science.gov (United States)

Leggett, Amanda N; Polenick, Courtney A; Maust, Donovan T; Kales, Helen C

2018-03-19

Falls and hospitalizations are adverse health events commonly experienced by persons with dementia (PWDs). These events often require urgent care from a family caregiver and may increase caregiver stress. We examine falls and hospitalizations among PWDs as predictors of caregivers' reported care-related emotional difficulty, in addition to care-related stressors. Cross-sectional telephone survey of 652 informal caregivers for PWDs. A multinomial logistic regression examined falls (last month) and hospitalizations (prior year) experienced by PWDs as predictors of caregivers' care-related emotional difficulty, accounting for demographic characteristics and primary and secondary caregiving stressors. Over 20% of caregivers reported high levels of care-related emotional difficulty. Controlling for demographic characteristics and primary and secondary caregiving stressors, the PWD's prior month fall was significantly associated with greater care-related emotional difficulty; the PWD's hospitalizations were not associated with care-related emotional difficulty. Approximately 30% of PWDs had experienced a past year hospitalization and prior month fall, and one in five caregivers reported high emotional difficulty related to care. Although secondary strains and resources of caregiving were strong predictors of care-related emotional difficulty, PWDs' falls represent a significant stressor that increases odds of caregiver emotional difficulty over and above other strains. Consequently, a fall experienced by a PWD may represent a key time for clinicians to assess caregiver well-being.

Tapping unsustainable groundwater stores for agricultural production in the High Plains Aquifer of Kansas, projections to 2110

Science.gov (United States)

Groundwater provides a reliable tap to sustain agricultural production, yet persistent aquifer depletion threatens future sustainability. The High Plains Aquifer supplies 30% of the nation’s irrigated groundwater, and the Kansas portion supports the congressional district with the highest market val...

Association between work-family conflict and musculoskeletal pain among hospital patient care workers.

Science.gov (United States)

Kim, Seung-Sup; Okechukwu, Cassandra A; Buxton, Orfeu M; Dennerlein, Jack T; Boden, Leslie I; Hashimoto, Dean M; Sorensen, Glorian

2013-04-01

A growing body of evidence suggests that work-family conflict is an important risk factor for workers' health and well-being. The goal of this study is to examine association between work-family conflict and musculoskeletal pain among hospital patient care workers. We analyzed a cross-sectional survey of 1,119 hospital patient care workers in 105 units in two urban, academic hospitals. Work-family conflict was measured by 5-item Work-Family Conflict Scale questionnaire. Multilevel logistic regression was applied to examine associations between work-family conflict and self-reported musculoskeletal pain in the past 3 months, adjusting for covariates including work-related psychosocial factors and physical work factors. In fully adjusted models, high work-family conflict was strongly associated with neck or shoulder pain (OR: 2.34, 95% CI: 1.64-3.34), arm pain (OR: 2.79, 95% CI: 1.64-4.75), lower extremity pain (OR: 2.20, 95% CI: 1.54-3.15) and any musculoskeletal pain (OR: 2.45, 95% CI: 1.56-3.85), and a number of body areas in pain (OR: 2.47, 95% CI: 1.82-3.36) in the past 3 months. The association with low back pain was attenuated and became non-significant after adjusting for covariates. Given the consistent associations between work-family conflict and self-reported musculoskeletal pains, the results suggest that work-family conflict could be an important domain for health promotion and workplace policy development among hospital patient care workers. Copyright © 2012 Wiley Periodicals, Inc.

Age and Sex Differences in Rates of Influenza-Associated Hospitalizations in Hong Kong.

Science.gov (United States)

Wang, Xi-Ling; Yang, Lin; Chan, Kwok-Hung; Chan, King-Pan; Cao, Pei-Hua; Lau, Eric Ho-Yin; Peiris, J S Malik; Wong, Chit-Ming

2015-08-15

Few studies have explored age and sex differences in the disease burden of influenza, although men and women probably differ in their susceptibility to influenza infections. In this study, quasi-Poisson regression models were applied to weekly age- and sex-specific hospitalization numbers of pneumonia and influenza cases in the Hong Kong SAR, People's Republic of China, from 2004 to 2010. Age and sex differences were assessed by age- and sex-specific rates of excess hospitalization for influenza A subtypes A(H1N1), A(H3N2), and A(H1N1)pdm09 and influenza B, respectively. We found that, in children younger than 18 years, boys had a higher excess hospitalization rate than girls, with the male-to-female ratio of excess rate (MFR) ranging from 1.1 to 2.4. MFRs of hospitalization associated with different types/subtypes were less than 1.0 for adults younger than 40 years except for A(H3N2) (MFR = 1.6), while all the MFRs were equal to or higher than 1.0 in adults aged 40 years or more except for A(H1N1)pdm09 in elderly persons aged 65 years or more (MFR = 0.9). No MFR was found to be statistically significant (P < 0.05) for hospitalizations associated with influenza type/subtype. There is some limited evidence on age and sex differences in hospitalization associated with influenza in the subtropical city of Hong Kong. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Longitudinal associations between stressors and work ability in hospital workers.

Science.gov (United States)

Carmen Martinez, Maria; da Silva Alexandre, Tiago; Dias de Oliveira Latorre, Maria do Rosario; Marina Fischer, Frida

This study sought to assess associations between work stressors and work ability in a cohort (2009-2012) of 498 hospital workers. Time-dependent variables associated with the Work Ability Index (WAI) were evaluated using general linear mixed models. Analyses included effects of individual and work characteristics. Except for work demands, the work stressors (job control, social support, effort-reward imbalance, overcommitment and work-related activities that cause pain/injury) were associated with WAI (p work and morning shift work were associated with decreased WAI (p Work stressors negatively affected work ability over time independently of other variables.

Goals of care discussions among hospitalized long-term care residents: Predictors and associated outcomes of care.

Science.gov (United States)

Wong, Hannah J; Wang, Jamie; Grinman, Michelle; Wu, Robert C

2016-12-01

There are limited data on the occurrence, predictors, and impact of goals of care (GOC) discussions during hospitalization for seriously ill elderly patients, particularly for long-term care (LTC) residents. The study was a retrospective chart review of 200 randomly sampled LTC residents hospitalized via the emergency department and admitted to the general internal medicine service of 2 Canadian academic hospitals, from January 2012 through December 2012. We applied logistic regression models to identify factors associated with, and outcomes of, these discussions. Overall, 9.4% (665 of 7084) of hospitalizations were patients from LTC. In the sample of 200 patients, 37.5% had a documented discussion. No baseline patient characteristic was associated with GOC discussions. Low Glasgow Coma Scale, high respiratory rate, and low oxygen saturation were associated with discussions. Patients with discussions had higher rates of orders for no resuscitation (80% vs 55%) and orders for comfort measures only (7% vs 0%). In adjusted analyses, patients with discussions had higher odds of in-hospital death (52.0, 95% confidence interval [CI]: 6.2-440.4) and 1-year mortality (4.1, 95% CI: 1.7-9.6). Nearly 75% of patients with a change in their GOC did not have this documented in the discharge summary. In hospitalized LTC patients, GOC discussions occurred infrequently and appeared to be triggered by illness severity. Orders for advance directives, in-hospital death, and 1-year mortality were associated with discussions. Rates of GOC documentation in the discharge summary were poor. This study provides direction for developing education and practice standards to improve GOC discussion rates and their communication back to LTC. Journal of Hospital Medicine 2015;11:824-831. © 2015 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

Associations between perceived crisis mode work climate and poor information exchange within hospitals.

Science.gov (United States)

Patterson, Mark E; Bogart, Miller S; Starr, Kathleen R

2015-03-01

Because hospital units operating in crisis mode could create unsafe transitions of care due to miscommunication, our objective was to estimate associations between perceived crisis mode work climate and patient information exchange problems within hospitals. Self-reported data from 247,140 hospital staff members across 884 hospitals were obtained from the 2010 Hospital Survey on Patient Safety Culture. Presence of a crisis mode work climate was defined as respondents agreeing that the hospital unit in which they work tries to do too much too quickly. Presence of patient information exchange problems was defined as respondents agreeing that problems often occur in exchanging patient information across hospital units. Multivariable ordinal regressions estimated the likelihood of perceived problems in exchanging patient information across hospital units, controlling for perceived levels of crisis mode work climate, skill levels, work climate, and hospital infrastructure. Compared to those disagreeing, hospital staff members agreeing that the hospital unit in which they work tries to do too much too quickly were 1.6 times more likely to perceive problems in exchanging patient information across hospital units (odds ratio: 1.6, 95% confidence interval: 1.58-1.65). Hospital staff members perceiving crisis mode work climates within their hospital unit are more likely to perceive problems in exchanging patient information across units, underscoring the need to improve communication during transitions of care. © 2014 Society of Hospital Medicine.

Place attachment among retirees in Greensburg, Kansas.

Science.gov (United States)

Smith, Jeffrey S; Cartlidge, Matthew R

2011-01-01

On 4 May 2007 an ef-5 tornado leveled 95 percent of Greensburg, Kansas. Because city leaders encouraged everyone to use “green” building techniques as they rebuilt their homes and businesses, not only has the return to normalcy been exceedingly slow, but some of the town's older residents feel that officials have overlooked their needs. These minor episodes of discord enabled us to learn what features are most important to people in retirement. The features include identifiable landmarks, a space in which to socialize, and age-specific businesses. We assert that the lessons learned in Greensburg are applicable to other communities with a sizable older population. As baby boomers rapidly enter retirement they will seek places to live that are elder friendly and enable them to effectively bond with place. As previous research attests, people who have a strong attachment to place commonly have a good quality of life.

Association between air pollution and hospital admission: Case study at three monitoring stations in Malaysia

Science.gov (United States)

Zahari, Marina; Zin@Ibrahim, Wan Zawiah Wan; Ismail, Noriszura; Ni, Tan Hui

2014-06-01

The relationships between the exposure of pollutants towards hospitalized admission and mortality have been identified in several studies on Asian cities such as Taipei, Bangkok and Tokyo. In Malaysia, evidence on the health risks associated with exposure to pollutants is limited. In this study, daily time-series data were analysed to estimate risks of cardiovascular and respiratory hospitalized admissions associated with particulate matter ≤ 10 μm (PM10), carbon monoxide (CO), nitrogen dioxide, sulphur dioxide, and ozone concentrations in Klang Valley during 2004-2009. Daily counts of hospital admissions for cardiovascular and respiratory outcomes were obtained from eleven hospitals while pollutants data were taken from several air quality monitoring stations located nearest to the hospitals. These data were fitted with Generalised Additive Poisson regression models. Additionally, temperature, humidity, and time data were also included to allow for potential effect of weather and time-varying influences on hospital admissions. CO showed the most significant (P Malaysia.

1972 preliminary safety analysis report based on a conceptual design of a proposed repository in Kansas

International Nuclear Information System (INIS)

Blomeke, J.O.

1977-08-01

This preliminary safety analysis report is based on a proposed Federal Repository at Lyons, Kansas, for receiving, handling, and depositing radioactive solid wastes in bedded salt during the remainder of this century. The safety analysis applies to a hypothetical site in central Kansas identical to the Lyons site, except that it is free of nearby salt solution-mining operations and bore holes that cannot be plugged to Repository specifications. This PSAR contains much information that also appears in the conceptual design report. Much of the geological-hydrological information was gathered in the Lyons area. This report is organized in 16 sections: considerations leading to the proposed Repository, design requirements and criteria, a description of the Lyons site and its environs, land improvements, support facilities, utilities, different impacts of Repository operations, safety analysis, design confirmation program, operational management, requirements for eventually decommissioning the facility, design criteria for protection from severe natural events, and the proposed program of experimental investigations

1972 preliminary safety analysis report based on a conceptual design of a proposed repository in Kansas

Energy Technology Data Exchange (ETDEWEB)

Blomeke, J.O.

1977-08-01

This preliminary safety analysis report is based on a proposed Federal Repository at Lyons, Kansas, for receiving, handling, and depositing radioactive solid wastes in bedded salt during the remainder of this century. The safety analysis applies to a hypothetical site in central Kansas identical to the Lyons site, except that it is free of nearby salt solution-mining operations and bore holes that cannot be plugged to Repository specifications. This PSAR contains much information that also appears in the conceptual design report. Much of the geological-hydrological information was gathered in the Lyons area. This report is organized in 16 sections: considerations leading to the proposed Repository, design requirements and criteria, a description of the Lyons site and its environs, land improvements, support facilities, utilities, different impacts of Repository operations, safety analysis, design confirmation program, operational management, requirements for eventually decommissioning the facility, design criteria for protection from severe natural events, and the proposed program of experimental investigations. (DLC)

Association of Expanded Medicaid Coverage With Hospital Length of Stay After Injury.

Science.gov (United States)

Holzmacher, Jeremy L; Townsend, Kerry; Seavey, Caleb; Gannon, Stephanie; Schroeder, Mary; Gondek, Stephen; Collins, Lois; Amdur, Richard L; Sarani, Babak

2017-10-01

The expansion of Medicaid eligibility under the Affordable Care Act is a state-level decision that affects how patients with traumatic injury (trauma patients) interact with locoregional health care systems. Washington, DC; Maryland; and Virginia represent 3 unique payer systems with liberal, moderate, and no Medicaid expansion, respectively, under the Affordable Care Act. Characterizing the association of Medicaid expansion with hospitalization after injury is vital in the disposition planning for these patients. To determine the association between expanded Medicaid eligibility under the Affordable Care Act and duration of hospitalization after injury. This retrospective cohort study included patients admitted from Virginia, Maryland, and Washington, DC, to a single level I trauma center. Data were collected from January 1, 2013, through March 6, 2016, in Virginia and Washington, DC, and from May 1, 2013, through March 6, 2016, in Maryland. All patients with Medicare or Medicaid coverage and all uninsured patients were included. Patients with private insurance, patients with severe head or pelvic injuries, and those who died during hospitalization were excluded. Hospital length of stay (LOS) and whether its association with patient insurance status varied by state of residence. A total of 2314 patients (1541 men [66.6%] and 773 women [33.4%]; mean [SD] age, 52.9 [22.8] years) were enrolled in the study. The uninsured rate in the Washington, DC, cohort (190 of 1699 [11.2%]) was significantly lower compared with rates in the Virginia (141 of 296 [47.6%]) or the Maryland (106 of 319 [33.2%]) cohort (P Medicaid vs non-Medicaid recipients varied significantly by state. For Medicaid recipients, mean LOS in Washington, DC, was significantly shorter (2.57 days; 95% CI, 2.36-2.79 days) than in Maryland (3.51 days; 95% CI, 2.81-4.38 days; P = .02) or Virginia (3.9 days; 95% CI, 2.79-5.45 days; P = .05). Expanded Medicaid eligibility is associated with shorter

Annual Report of Monitoring at Morrill, Kansas, in 2012

Energy Technology Data Exchange (ETDEWEB)

LaFreniere, Lorraine M. [Argonne National Lab. (ANL), Argonne, IL (United States)

2013-05-01

Carbon tetrachloride contamination in groundwater at Morrill, Kansas, was initially identified in 1985 during statewide testing of public water supply wells for volatile organic compounds (VOCs). High levels of nitrate were also present in the public water supply wells. The city of Morrill is located in Brown County in the northeastern corner of the state, about 7 mi east of Sabetha (Figure 1.1). The population of Morrill as of the 2010 Census was approximately 230 (down from 277 in 2000). All residents of Morrill now obtain their drinking water from the Sabetha municipal water system via a pipeline constructed in 1991. This document reports the findings concerning the groundwater in Morrill.

Association of Changing Hospital Readmission Rates With Mortality Rates After Hospital Discharge

Science.gov (United States)

Wang, Yongfei; Lin, Zhenqiu; Normand, Sharon-Lise T.; Ross, Joseph S.; Horwitz, Leora I.; Desai, Nihar R.; Suter, Lisa G.; Drye, Elizabeth E.; Bernheim, Susannah M.; Krumholz, Harlan M.

2017-01-01

Importance The Affordable Care Act has led to US national reductions in hospital 30-day readmission rates for heart failure (HF), acute myocardial infarction (AMI), and pneumonia. Whether readmission reductions have had the unintended consequence of increasing mortality after hospitalization is unknown. Objective To examine the correlation of paired trends in hospital 30-day readmission rates and hospital 30-day mortality rates after discharge. Design, Setting, and Participants Retrospective study of Medicare fee-for-service beneficiaries aged 65 years or older hospitalized with HF, AMI, or pneumonia from January 1, 2008, through December 31, 2014. Exposure Thirty-day risk-adjusted readmission rate (RARR). Main Outcomes and Measures Thirty-day RARRs and 30-day risk-adjusted mortality rates (RAMRs) after discharge were calculated for each condition in each month at each hospital in 2008 through 2014. Monthly trends in each hospital’s 30-day RARRs and 30-day RAMRs after discharge were examined for each condition. The weighted Pearson correlation coefficient was calculated for hospitals’ paired monthly trends in 30-day RARRs and 30-day RAMRs after discharge for each condition. Results In 2008 through 2014, 2 962 554 hospitalizations for HF, 1 229 939 for AMI, and 2 544 530 for pneumonia were identified at 5016, 4772, and 5057 hospitals, respectively. In January 2008, mean hospital 30-day RARRs and 30-day RAMRs after discharge were 24.6% and 8.4% for HF, 19.3% and 7.6% for AMI, and 18.3% and 8.5% for pneumonia. Hospital 30-day RARRs declined in the aggregate across hospitals from 2008 through 2014; monthly changes in RARRs were −0.053% (95% CI, −0.055% to −0.051%) for HF, −0.044% (95% CI, −0.047% to −0.041%) for AMI, and −0.033% (95% CI, −0.035% to −0.031%) for pneumonia. In contrast, monthly aggregate changes across hospitals in hospital 30-day RAMRs after discharge varied by condition: HF, 0.008% (95% CI, 0.007% to 0.010%); AMI, −0

Organisational characteristics associated with the use of daily interruption of sedation in US hospitals: a national study.

Science.gov (United States)

Miller, Melissa A; Krein, Sarah L; Saint, Sanjay; Kahn, Jeremy M; Iwashyna, Theodore J

2012-02-01

Daily interruption of sedation (DIS) has multiple proven benefits, but implementation is erratic. Past research on sedative interruption utilisation focused on individual clinicians, ignoring the role of organisations in shaping practice. The authors test the hypothesis that specific hospital organisational characteristics are associated with routine use of DIS. National, mailed survey to a stratified random sample of US hospitals in 2009. Respondents were the lead infection control professionals at each institution. Survey items enquired about DIS use, institutional structure, and organisational culture. Multivariable analysis was used to evaluate the independent association of these factors with DIS use. A total of 386 hospitals formed our final analytic sample; the response rate was 69.4%. Hospitals ranged in size from 25 to 1359 beds. 26% of hospitals were associated with a medical school. Almost 80% reported regular use of DIS for ventilated patients. While 75.4% of hospitals reported having leadership focus on safety culture, only 42.7% reported that their staff were receptive to changes in practice. In a multivariable logistic regression model, structural characteristics such as size and academic affiliation were not associated with use of DIS. However, leadership emphasis on safety culture (p=0.04), staff receptivity to change (p=0.02) and involvement in an infection prevention collaborative (p=0.04) were significantly associated with regular DIS use. Several elements of hospital organisational culture were associated with regular use of DIS in US hospitals. These findings emphasise the importance of combining specific administrative approaches with strategies to encourage receptivity to change among bedside clinicians in order to successfully implement complex evidence-based practices in the intensive care setting.

[Factors associated with the strength of organizational culture in a Beninese hospital].

Science.gov (United States)

Sopoh, Ghislain Emmanuel; Kouckodila Nzingoula, Michael Florian; Sossa Jérôme, Charles; Hessou Ahahanzo-Glèlè, Yolaine; Damienne Agueh, Victoire; Tinoaga Ouédraogo, Laurent; Makoutodé, Michel

Organizational culture, a frequently ignored concept, affects job satisfaction and productivity in organizations. To determine the factors associated with the strength of organizational culture (OC) in Mono / Couffo regional hospital in Lokossa in Benin. This cross-sectional and analytical study involved 121 workers of Mono/Couffo hospital in March 2015. Data on the strength of OC was collected using a questionnaire based on the validated tool proposed by Cameron and Quinn (2006). Logistic regression was performed to explore the nature of the relationship between the independent variables and OC using Odds ratios. 62% of the surveyed subjects had a positive perception of organizational culture. This perception was statistically associated with managerial factors (moral support of workers and type of relationship with the executive staff). The risk of perceiving a low strength of OC was sixfold higher OR = 3.78, 95% CI (1.08 - 13.22) among subjects who felt they did not have moral support from executive staff than in those who perceived this moral support. The risk of perceiving a weak OC was higher among subjects who considered relations with the staff to be uncordial [OR = 14.32, 95% CI (4.35 - 47.11)] compared to those who considered these relations to be cordial. Human resource management factors were more closely associated with the strength of organizational culture. Hospital managers should pay more attention to these factors in their hospitals to promote better institutional performance.

Small Wind Electric Systems: A Kansas Consumer's Guide

International Nuclear Information System (INIS)

O'Dell, K.

2001-01-01

The Kansas Consumer's Guide for Small Wind Electric Systems provides consumers with enough information to help them determine if a small wind electric system can provide all or a portion of the energy they need for their home or business based on their wind resource, energy needs, and their economics. Topics discussed in the guide include: how to make your home more energy efficient, how to choose the right size turbine, the parts of a wind electric system, determining if there is enough wind resource on your site, choosing the best site for your turbine, connecting your system to the utility grid, and if it's possible to become independent of the utility grid using wind energy. In addition, the cover of the guide contains a list of state incentives and state contacts for more information

Factors associated with induced abortion at selected hospitals in the Volta Region, Ghana

Directory of Open Access Journals (Sweden)

Klutsey EE

2014-08-01

Full Text Available Ellen Eyi Klutsey,1 Augustine Ankomah2 1School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Volta Region, 2Department of Population, Family and Reproductive Health School of Public Health, University of Ghana, Legon, Accra, Ghana Background: Induced abortion rates remained persistently high in the Volta Region of Ghana in the 5 years from 2006 to 2011. Some hospitals, both rural and urban, report induced abortion-related complications as one of the top ten conditions in hospital admissions. This study explored demographic and other factors associated with induced abortion, and also assessed awareness of abortion-related complications among women of reproductive age in the Volta Region. Methods: A quantitative, hospital-based, unmatched case-control study was performed. The Volta Region was stratified into two health administration zones, ie, north and south. For each zone, hospitals were stratified into government and private hospitals. Employing simple random sampling, one private and three government hospitals were selected from each zone. This study is therefore based on eight hospitals, ie, six government hospitals and two private hospitals. Results: Marital status, employment status, number of total pregnancies, and knowledge about contraception were found to be associated with induced abortion. Multiple logistic regression showed a 4% reduction in the odds of induced abortion in married women compared with women who were single (odds ratio [OR] 0.11, 95% confidence interval [CI] 0.07–0.22. Unemployed women of reproductive age were found to be 0.35 times less likely to seek induced abortion compared with their employed counterparts (OR 0.35, CI 0.19–0.65. It was also observed that women with their second pregnancies were 3.8 times more likely to seek induced abortion and women with more than two pregnancies were 6.6 times more likely to do so (OR 3.81, CI 1.94–7.49 and OR 6.58, CI 2.58–16.79, respectively

A fast semi-discrete Kansa method to solve the two-dimensional spatiotemporal fractional diffusion equation

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Sun, HongGuang; Liu, Xiaoting; Zhang, Yong; Pang, Guofei; Garrard, Rhiannon

2017-09-01

Fractional-order diffusion equations (FDEs) extend classical diffusion equations by quantifying anomalous diffusion frequently observed in heterogeneous media. Real-world diffusion can be multi-dimensional, requiring efficient numerical solvers that can handle long-term memory embedded in mass transport. To address this challenge, a semi-discrete Kansa method is developed to approximate the two-dimensional spatiotemporal FDE, where the Kansa approach first discretizes the FDE, then the Gauss-Jacobi quadrature rule solves the corresponding matrix, and finally the Mittag-Leffler function provides an analytical solution for the resultant time-fractional ordinary differential equation. Numerical experiments are then conducted to check how the accuracy and convergence rate of the numerical solution are affected by the distribution mode and number of spatial discretization nodes. Applications further show that the numerical method can efficiently solve two-dimensional spatiotemporal FDE models with either a continuous or discrete mixing measure. Hence this study provides an efficient and fast computational method for modeling super-diffusive, sub-diffusive, and mixed diffusive processes in large, two-dimensional domains with irregular shapes.

Increased hospital admissions associated with extreme-heat exposure in King County, Washington, 1990-2010.

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Isaksen, Tania Busch; Yost, Michael G; Hom, Elizabeth K; Ren, You; Lyons, Hilary; Fenske, Richard A

2015-01-01

Increased morbidity and mortality have been associated with extreme heat events, particularly in temperate climates. Few epidemiologic studies have considered the impact of extreme heat events on hospitalization rates in the Pacific Northwest region. This study quantifies the historic (May to September 1990-2010) heat-morbidity relationship in the most populous Pacific Northwest County, King County, Washington. A relative risk (RR) analysis was used to explore the association between heat and all non-traumatic hospitalizations on 99th percentile heat days, whereas a time series analysis using a piecewise linear model approximation was used to estimate the effect of heat intensity on hospitalizations, adjusted for temporal trends and day of the week. A non-statistically significant 2% [95% CI: 1.02 (0.98, 1.05)] increase in hospitalization risk, on a heat day vs. a non-heat day, was noted for all-ages and all non-traumatic causes. When considering the effect of heat intensity on admissions, we found a statistically significant 1.59% (95% CI: 0.9%, 2.29%) increase in admissions per degree increase in humidex above 37.4°C. Admissions stratified by cause and age produced statistically significant results with both relative risk and time series analyses for nephritis and nephrotic syndromes, acute renal failure, and natural heat exposure hospitalizations. This study demonstrates that heat, expressed as humidex, is associated with increased hospital admissions. When stratified by age and cause of admission, the non-elderly age groups (<85 years) experience significant risk for nephritis and nephrotic syndromes, acute renal failure, natural heat exposure, chronic obstructive pulmonary disease, and asthma hospitalizations.

Association of bystander interventions and hospital length of stay and admission to intensive care unit in out-of-hospital cardiac arrest survivors

DEFF Research Database (Denmark)

Riddersholm, Signe; Kragholm, Kristian; Mortensen, Rikke Nørmark

2017-01-01

for bystander defibrillation. 82% of patients without bystander interventions were admitted to ICU compared to 77.2% for bystander CPR, and 61.2% for bystander defibrillation. In-hospital mortality was 60% in the first category compared to 40.5% and 21.7% in the two latter categories. In regression models.......76-0.85]), were associated with lower risk of ICU admission. CONCLUSIONS: Bystander interventions were associated with reduced hospital length of stay and ICU admission, suggesting that these efforts improve recovery in OHCA survivors....

Factors associated with the risk of falls in hospitalized adult patients.

Science.gov (United States)

Bittencourt, Vivian Lemes Lobo; Graube, Sandra Leontina; Stumm, Eniva Miladi Fernandes; Battisti, Iara Denise Endruweit; Loro, Marli Maria; Winkelmann, Eliane Roseli

2017-07-20

Analyzing factors related to the risk of falls in hospitalized adult patients. A cross-sectional, analytical and quantitative study, developed in Clinical and Surgical Hospitalization Units from June to August 2015. Data collection instruments were sociodemographic and clinical forms, and the Morse Scale. Data were obtained with the patients and from medical records. Absolute and relative frequencies were used in the univariate statistical analysis, and chi-square test in the bivariate analysis. 612 patients participated in the study. An association (pdiabetes mellitus, systemic arterial hypertension, visual impairment, vertigo and fear of falling. An association between the risk of falls was found due to hospitalization, comorbidities and intrinsic factors. Regarding extrinsic factors, an association between mats/carpets and risk of falls was found. No association between the risk of falls with other extrinsic factors was found. Analisar os fatores relacionados ao risco de quedas em pacientes adultos internados em um hospital. Estudo transversal, analítico e quantitativo, desenvolvido em Unidades de Internação Clínica e Cirúrgica, no período de junho a agosto 2015. Os instrumentos de coleta de dados foram formulários sociodemográfico, clínico e Escala de Morse. Os dados foram obtidos com os pacientes e nos prontuários. Na análise estatística univariada utilizou-se de frequência absoluta e relativa, e na bivariada utilizou-se do teste de qui-quadrado. Participaram do estudo 612 pacientes. Foi encontrada associação (pdiabetes mellitus, hipertensão arterial sistêmica, dificuldade visual, vertigens e medo de cair. Existe associação entre o risco de quedas com motivo de internação, comorbidades e fatores intrínsecos. Em relação aos fatores extrínsecos, foi encontrada associação entre tapetes e risco de quedas. Não houve associação entre o risco de quedas com outros fatores extrínsecos.

Lead in drinking water: sampling in primary schools and preschools in south central Kansas.

Science.gov (United States)

Massey, Anne R; Steele, Janet E

2012-03-01

Studies in Philadelphia, New York City, Houston, Washington, DC, and Greenville, North Carolina, have revealed high lead levels in drinking water. Unlike urban areas, lead levels in drinking water in suburban and rural areas have not been adequately studied. In the study described in this article, drinking water in primary schools and preschools in five suburban and rural south central Kansas towns was sampled to determine if any exceeded the U.S. Environmental Protection Agency (U.S. EPA) guidance level for schools and child care facilities of 20 parts per billion (ppb). The results showed a total of 32.1% of the samples had detectable lead levels and 3.6% exceeded the U.S. EPA guidance level for schools and child care providers of 20 ppb. These results indicate that about one-third of the drinking water consumed by children age six and under in the five suburban and rural south central Kansas towns studied has some lead contamination, exposing these children to both short-term and long-term health risks. The authors suggest a need for increased surveillance of children's drinking water in these facilities.

A low body temperature on arrival at hospital following out-of-hospital-cardiac-arrest is associated with increased mortality in the TTM-study

DEFF Research Database (Denmark)

Hovdenes, Jan; Røysland, Kjetil; Nielsen, Niklas

2016-01-01

categorized according to their recorded body temperature on arrival and also categorized to groups of patients being actively cooled or passively rewarmed. RESULTS: OHCA patients having a temperature ≤34.0°C on arrival at hospital had a significantly higher mortality compared to the OHCA patients...... with a higher temperature on arrival. A low body temperature on arrival was associated with a longer time to return of spontaneous circulation (ROSC) and duration of transport time to hospital. Patients who were actively cooled or passively rewarmed during the first 4h had similar mortality. In a multivariate......AIM: To investigate the association of temperature on arrival to hospital after out-of-hospital-cardiac arrest (OHCA) with the primary outcome of mortality, in the targeted temperature management (TTM) trial. METHODS: The TTM trial randomized 939 patients to TTM at 33 or 36°C for 24h. Patients were...

The association of birth model with resilience variables and birth experience: Home versus hospital birth.

Science.gov (United States)

Handelzalts, Jonathan E; Zacks, Arni; Levy, Sigal

2016-05-01

to study home, natural hospital, and medical hospital births, and the association of these birth models to resilience and birth experience. cross-section retrospective design. participants were recruited via an online survey system. Invitations to participate were posted in five different Internet forums for women on maternity leave, from September 2014 to August 2015. the sample comprised 381 post partum healthy women above the age of 20, during their maternity leave. Of the participants: 22% gave birth at home, 32% gave birth naturally in a hospital, and 46% of the participants had a medical birth at the hospital. life Orientation Test Revised (LOT-R), General Self-Efficacy Scale, Sense of Mastery Scale, Childbirth Experience Questionnaire (CEQ). women having had natural births, whether at home or at the hospital, significantly differed from women having had medical births in all aspects of the birth experience, even when controlling for age and optimism. Birth types contributed to between 14% and 24% of the explained variance of the various birth experience aspects. home and natural hospital births were associated with a better childbirth experience. Optimism was identified as a resilience factor, associated both with preference as well as with childbirth experience. physically healthy and resilient women could be encouraged to explore the prospect of home or natural hospital births as a means to have a more positive birth experience. Copyright © 2016 Elsevier Ltd. All rights reserved.

Status of Groundwater Levels and Storage Volume in the Equus Beds Aquifer Near Wichita, Kansas, January 2009

Science.gov (United States)

Hansen, Cristi V.

2009-01-01

Beginning in the 1940s, the Wichita well field was developed in the Equus Beds aquifer in southwestern Harvey County and northwestern Sedgwick County to supply water to the city of Wichita (Williams and Lohman, 1949). In addition to supplying drinking water to the largest city in Kansas, the other primary use of water from the Equus Beds aquifer is to irrigate crops in this agriculture-dominated part of south-central Kansas (Rich Eubank, Kansas Department of Agriculture, Division of Water Resources, oral commun., 2008). The decline of water levels in the aquifer were noted soon after the development of the Wichita well field began (Williams and Lohman, 1949). As water levels in the aquifer decline, the volume of water stored in the aquifer decreases and less water is available to supply future needs. For many years the U.S. Geological Survey (USGS), in cooperation with the city of Wichita, has monitored these changes in water levels and the resulting changes in storage volume in the Equus Beds aquifer as part of Wichita's effort to effectively manage this resource. In 2007, the city of Wichita began using Phase I of the Equus Beds Aquifer Storage and Recovery (ASR) project for large-scale artificial recharge of the Equus Beds aquifer. The ASR project uses water from the Little Arkansas River - either pumped from the river directly or from wells in the riverbank that obtain their water from the river by induced infiltration - as the source of artificial recharge to the Equus Beds aquifer (City of Wichita, 2009).

Uncertainties in Life Cycle Greenhouse Gas Emissions from Advanced Biomass Feedstock Logistics Supply Chains in Kansas

Directory of Open Access Journals (Sweden)

Long Nguyen

2014-11-01

Full Text Available To meet Energy Independence and Security Act (EISA cellulosic biofuel mandates, the United States will require an annual domestic supply of about 242 million Mg of biomass by 2022. To improve the feedstock logistics of lignocellulosic biofuels in order to access available biomass resources from areas with varying yields, commodity systems have been proposed and designed to deliver quality-controlled biomass feedstocks at preprocessing “depots”. Preprocessing depots densify and stabilize the biomass prior to long-distance transport and delivery to centralized biorefineries. The logistics of biomass commodity supply chains could introduce spatially variable environmental impacts into the biofuel life cycle due to needing to harvest, move, and preprocess biomass from multiple distances that have variable spatial density. This study examines the uncertainty in greenhouse gas (GHG emissions of corn stover logistics within a bio-ethanol supply chain in the state of Kansas, where sustainable biomass supply varies spatially. Two scenarios were evaluated each having a different number of depots of varying capacity and location within Kansas relative to a central commodity-receiving biorefinery to test GHG emissions uncertainty. The first scenario sited four preprocessing depots evenly across the state of Kansas but within the vicinity of counties having high biomass supply density. The second scenario located five depots based on the shortest depot-to-biorefinery rail distance and biomass availability. The logistics supply chain consists of corn stover harvest, collection and storage, feedstock transport from field to biomass preprocessing depot, preprocessing depot operations, and commodity transport from the biomass preprocessing depot to the biorefinery. Monte Carlo simulation was used to estimate the spatial uncertainty in the feedstock logistics gate-to-gate sequence. Within the logistics supply chain GHG emissions are most sensitive to the

Factors Associated with Readmission of Patients with Congenital Heart Disease in a Swiss University Hospital.

Science.gov (United States)

Chave, Morgane; Marques-Vidal, Pedro

2017-04-01

Congenital heart defects (CHD) lead to extensive use of healthcare resources. Still, there is little information available regarding readmission rates or associated factors. We sought to evaluate readmission rates and their determinants among patients with CHD hospitalized in a Swiss university hospital. We conducted a retrospective study using data from all non-adult (readmissions, 83 (86.5%) were related to the CHD. Median time to readmission was 10 days (interquartile range 6-20) and median length of readmission was 12 days (interquartile range 6-20). After multivariate adjustment, foreign nationality, greater distance to hospital and length of index hospitalization readmission. Patients who underwent surgery were less likely to be readmitted (8.7%). We conclude that readmissions were frequent, almost 1 in 10 patients, and associated with several socio-clinical factors. Providing patients who live far from hospital with specialized care closer to home may help reduce the rate of readmission.

2003 Kansas City Plant Annual Illness and Injury Surveillance Report, Revised September 2007

Energy Technology Data Exchange (ETDEWEB)

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

2007-10-04

Annual Illness and Injury Surveillance Program report for 2003 for the Kansas City Plant. The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The IISP monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

Hospital evaluation of health literacy and associated outcomes in patients after acute myocardial infarction.

Science.gov (United States)

Rymer, Jennifer A; Kaltenbach, Lisa A; Anstrom, Kevin J; Fonarow, Gregg C; Erskine, Nathaniel; Peterson, Eric D; Wang, Tracy Y

2018-04-01

Low health literacy is common in the United States and may affect outcomes after myocardial infarction (MI). How often hospitals screen for low health literacy is unknown. We surveyed 122 hospitals in the TRANSLATE-ACS study and divided them into those that reported routinely (>75% of patients), selectively (1%-75%), or never (0%) screening MI patients for low health literacy prior to discharge. We performed logistic regression with random intercepts to compare 6-week and 6-month patient-reported medication adherence and multivariable Cox regression to compare 1-year major adverse cardiovascular events and all-cause readmission risks between hospital groups. Overall, 25 (20.5%), 47 (38.5%), and 50 (41.0%) hospitals reported routinely, selectively, or never screening patients for low health literacy, respectively. Patients discharged from hospitals that routinely screened were more likely to report 6-week medication adherence [routinely: adjusted odds ratio (OR) 1.26, 95% CI 1.01-1.57; selectively: adjusted OR 1.19, 95% CI 1.00-1.43, both referenced to those discharged from hospitals that never screened]. Compared with hospitals that never screened health literacy, 1-year major adverse cardiovascular events were similar for hospitals that reported routinely screening (adjusted HR 0.92, 95% CI 0.75-1.14) or selectively screening (adjusted HR 1.01, 95% CI 0.84-1.21). Hospitals that reported selectively screening health literacy were associated with a lower adjusted risk of 1-year all-cause readmission (adjusted HR 0.89, 95% CI 0.79-1.00, P=.041). Only a minority of US hospitals routinely screen MI patients for low health literacy. Hospital screening was associated with higher medication adherence and lower readmission risk. Further investigation is needed to understand how inpatient screening can be implemented to improve longitudinal post-MI care. Copyright © 2017 Elsevier Inc. All rights reserved.

Urbanization Impacts on Flooding in the Kansas River Basin and Evaluation of Wetlands as a Mitigation Measure

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This study evaluates the impacts of future land use changes on flooding in the Kansas River Basin. It also studies the impacts of wetlands on flood reduction. The study presents Hydrologic Engineering Centers-Hydrologic Modeling System (HEC-HMS) based runoff modeling and River A...

Increasing incidence of hospital-acquired and healthcare-associated bacteremia in northeast Thailand: a multicenter surveillance study.

Directory of Open Access Journals (Sweden)

Maliwan Hongsuwan

Full Text Available Little is known about the epidemiology of nosocomial bloodstream infections in public hospitals in developing countries. We evaluated trends in incidence of hospital-acquired bacteremia (HAB and healthcare-associated bacteremia (HCAB and associated mortality in a developing country using routinely available databases.Information from the microbiology and hospital databases of 10 provincial hospitals in northeast Thailand was linked with the national death registry for 2004-2010. Bacteremia was considered hospital-acquired if detected after the first two days of hospital admission, and healthcare-associated if detected within two days of hospital admission with a prior inpatient episode in the preceding 30 days.A total of 3,424 patients out of 1,069,443 at risk developed HAB and 2,184 out of 119,286 at risk had HCAB. Of these 1,559 (45.5% and 913 (41.8% died within 30 days, respectively. Between 2004 and 2010, the incidence rate of HAB increased from 0.6 to 0.8 per 1,000 patient-days at risk (p<0.001, and the cumulative incidence of HCAB increased from 1.2 to 2.0 per 100 readmissions (p<0.001. The most common causes of HAB were Acinetobacter spp. (16.2%, Klebsiella pneumoniae (13.9%, and Staphylococcus aureus (13.9%, while those of HCAB were Escherichia coli (26.3%, S. aureus (14.0%, and K. pneumoniae (9.7%. There was an overall increase over time in the proportions of ESBL-producing E. coli causing HAB and HCAB.This study demonstrates a high and increasing incidence of HAB and HCAB in provincial hospitals in northeast Thailand, increasing proportions of ESBL-producing isolates, and very high associated mortality.

The paradox of public holidays: Hospital-treated self-harm and associated factors.

Science.gov (United States)

Griffin, Eve; Dillon, Christina B; O'Regan, Grace; Corcoran, Paul; Perry, Ivan J; Arensman, Ella

2017-08-15

Recent research on the patterns of self-harm around public holidays is lacking. This study used national data to examine the patterns of hospital-treated self-harm during public holidays, and to examine associated factors. Data on self-harm presentations to all emergency departments were obtained from the National Self-Harm Registry Ireland. The association between self-harm presentations and public holidays was examined using univariate and multivariate Poisson regression analyses. A total of 104,371 presentations of self-harm were recorded between 2007 and 2015. The mean number of self-harm presentations was 32 on public holidays. St. Patrick's Day had the highest number of presentations compared to all other public holidays, with a daily mean of 44 presentations. Across all years, self-harm presentations during public holidays had a 24% increased risk of involving alcohol consumption compared to all other days and this effect was most pronounced during the Christmas period. The association with alcohol remained significant at a multivariate level. Presentations on public holidays were more likely to attend out of normal working hours. An increase in male presentations involving self-cutting was observed on public holidays and there was an over-representation of males presenting for the first time. It is likely that extent of alcohol involvement in self-harm presentations reported here is an underestimate, as it was dependent on the information being recorded by the attending clinician. Public holidays are associated with an elevated number of self-harm presentations to hospital, with presentations to hospital involving alcohol significantly increased on these days. Hospital resources should be targeted to address increases during public holidays, including during out-of-hours. Involvement of alcohol may delay delivery of care to these patients in emergency settings. Copyright © 2017 Elsevier B.V. All rights reserved.

Association of Dermatology Consultations With Patient Care Outcomes in Hospitalized Patients With Inflammatory Skin Diseases.

Science.gov (United States)

Milani-Nejad, Nima; Zhang, Myron; Kaffenberger, Benjamin H

2017-06-01

The value of inpatient dermatology consultations has traditionally been demonstrated with frequency in changes of diagnosis and management; however, the impact of dermatology consultations on metrics such as hospital length of stay and readmission rates remains unknown. To determine the association of dermatology consultations with patient care in hospitalized patients using objective values. We retrospectively queried the deidentified database of patients hospitalized between January 1, 2012, and December 31, 2014, at a single university medical center. A total of 413 patients with a primary inflammatory skin condition discharge diagnosis and 647 patients with primary inflammatory skin condition admission diagnosis were selected. Hospital length of stay and 1-year readmission with inflammatory skin conditions. The 413 patients with a primary inflammatory skin condition discharge diagnosis were 61.0% female and had a mean (SD) age of 55.1 (16.4) years. The 647 patients with primary inflammatory skin condition admission diagnosis were 50.8% female and had a mean (SD) age of 57.8 (15.9) years. Multivariable modeling showed that dermatology consultations were associated with a reduction of 1-year inflammatory skin condition readmissions among patients who were discharged primarily with an inflammatory skin condition (readmission probability, 0.0025; 95% CI, 0.00020-0.030 with dermatology consult vs 0.026; 95% CI, 0.0065-0.10 without; odds ratio, 0.093; 95% CI, 0.010-0.840; P = .03). No other confounding variable was associated with reduction in readmissions. Multivariable modeling also showed that dermatology consultations were associated with a reduction in the adjusted hospital length of stay by 2.64 days (95% CI, 1.75-3.53 days; P Dermatology consultations were associated with improvements of outcomes among hospitalized patients. The expansion of the role of dermatology consultation services may improve patient care in a cost-effective manner.

Occupational injury among hospital patient-care workers: what is the association with workplace verbal abuse?

Science.gov (United States)

Sabbath, Erika L; Hurtado, David A; Okechukwu, Cassandra A; Tamers, Sara L; Nelson, Candace; Kim, Seung-Sup; Wagner, Gregory; Sorenson, Glorian

2014-02-01

To test the association between workplace abuse exposure and injury risk among hospital workers. We hypothesized that exposed workers would have higher injury rates than unexposed workers. Survey of direct-care workers (n = 1,497) in two hospitals. Exposure to workplace abuse was assessed through self-report; occupational injury reports were extracted from employee records. We tested associations between non-physical workplace violence and injury using log-binomial regression and multilevel modeling. Adjusted prevalence ratio (PR) for injury associated with being yelled at was 1.52 (95% CI 1.19, 1.95); for experiencing hostile/offensive gestures 1.43 (1.11, 1.82); and for being sworn at 1.41 (1.09, 1.81). In analyses by injury subtypes, musculoskeletal injuries were more strongly associated with abuse than were acute traumatic injuries. Associations operated on group and individual levels and were most consistently associated with abuse perpetrated by patients. Exposure to workplace abuse may be a risk factor for injuries among hospital workers. © 2013 Wiley Periodicals, Inc.

Conservation Reserve Program mitigates grassland loss in the lesser prairie-chicken range of Kansas

Science.gov (United States)

Haukos, David A.; Spencer, David; Hagen, Christian A.; Daniels, Melinda D.; Goodin, Doug

2017-01-01

Since the beginning of the 20th century, the overall occupied range of the lesser prairie-chicken (Tympanuchus pallidicinctus) has declined by 84% commensurate with population trends. Much of this decline has been attributed to the loss and fragmentation of native grasslands throughout the lesser prairie-chicken range. However, quantification of changes in land cover in the distribution of the lesser prairie-chicken is lacking. Our objectives were to (1) document changes in the areal extent and connectivity of grasslands in the identified lesser prairie-chicken range in Kansas, USA, (>60% of extant lesser prairie-chicken population) from the 1950s to 2013 using remotely sensed data and (2) assess the potential of the Conservation Reserve Program (U.S. Department of Agriculture Program converting cropland to permanent cover; CRP) to mitigate grassland loss. Digital land cover maps were generated on a decadal time step through spectral classification of LANDSAT images and visual analysis of aerial photographs (1950s and 1960s). Landscape composition and configuration were assessed using FRAGSTATS to compute a variety of landscape metrics measuring changes in the amount of grassland present as well as changes in the size and configuration of grassland patches. With the exception of a single regional portion of the range, nearly all of the grassland converted to cropland in the lesser prairie-chicken range of Kansas occurred prior to the 1950s. Prior to the implementation of CRP, the amount of grassland decreased 3.6% between the 1950s and 1985 from 18,455 km2 to 17,788 km2. Since 1985, the overall amount of grassland in the lesser prairie-chicken range has increased 11.9% to 19,898 km2 due to implementation of CRP, although the area of grassland decreased between 1994 and 2013 as CRP contracts were not renewed by landowners. Since 1986 grassland in Kansas became more connected and less fragmented in response to the CRP. While the CRP has been successful in

Conservation Reserve Program mitigates grassland loss in the lesser prairie-chicken range of Kansas

Directory of Open Access Journals (Sweden)

David Spencer

2017-01-01

Full Text Available Since the beginning of the 20th century, the overall occupied range of the lesser prairie-chicken (Tympanuchus pallidicinctus has declined by 84% commensurate with population trends. Much of this decline has been attributed to the loss and fragmentation of native grasslands throughout the lesser prairie-chicken range. However, quantification of changes in land cover in the distribution of the lesser prairie-chicken is lacking. Our objectives were to (1 document changes in the areal extent and connectivity of grasslands in the identified lesser prairie-chicken range in Kansas, USA, (>60% of extant lesser prairie-chicken population from the 1950s to 2013 using remotely sensed data and (2 assess the potential of the Conservation Reserve Program (U.S. Department of Agriculture Program converting cropland to permanent cover; CRP to mitigate grassland loss. Digital land cover maps were generated on a decadal time step through spectral classification of LANDSAT images and visual analysis of aerial photographs (1950s and 1960s. Landscape composition and configuration were assessed using FRAGSTATS to compute a variety of landscape metrics measuring changes in the amount of grassland present as well as changes in the size and configuration of grassland patches. With the exception of a single regional portion of the range, nearly all of the grassland converted to cropland in the lesser prairie-chicken range of Kansas occurred prior to the 1950s. Prior to the implementation of CRP, the amount of grassland decreased 3.6% between the 1950s and 1985 from 18,455 km2 to 17,788 km2. Since 1985, the overall amount of grassland in the lesser prairie-chicken range has increased 11.9% to 19,898 km2 due to implementation of CRP, although the area of grassland decreased between 1994 and 2013 as CRP contracts were not renewed by landowners. Since 1986 grassland in Kansas became more connected and less fragmented in response to the CRP. While the CRP has been successful

Hospital variability in postoperative mortality after rectal cancer surgery in the Spanish Association of Surgeons project: The impact of hospital volume.

Science.gov (United States)

Ortiz, Héctor; Biondo, Sebastiano; Codina, Antonio; Ciga, Miguel Á; Enríquez-Navascués, José M; Espín, Eloy; García-Granero, Eduardo; Roig, José Vicente

2016-01-01

This multicentre observational study examines variation between hospitals in postoperative mortality after elective surgery in the Rectal Cancer Project of the Spanish Society of Surgeons and explores whether hospital volume and patient characteristics contribute to any variation between hospitals. Hospital variation was quantified using a multilevel approach on prospective data derived from the multicentre database of all rectal adenocarcinomas operated by an anterior resection or an abdominoperineal excision at 84 surgical departments from 2006 to 2013. The following variables were included in the analysis; demographics, American Society of Anaesthesiologists classification, tumour location and stage, administration of neoadjuvant treatment, and annual volume of surgical procedures. A total of 9809 consecutive patients were included. The rate of 30-day postoperative mortality was 1.8% Stratified by annual surgical volume hospitals varied from 1.4 to 2.0 in 30-day mortality. In the multilevel regression analysis, male gender (OR 1.623 [1.143; 2.348]; P<.008), increased age (OR: 5.811 [3.479; 10.087]; P<.001), and ASA score (OR 10.046 [3.390; 43.185]; P<.001) were associated with 30-day mortality. However, annual surgical volume was not associated with mortality (OR 1.309 [0.483; 4.238]; P=.619). Besides, there was a statistically significant variation in mortality between all departments (MOR 1.588 [1.293; 2.015]; P<.001). Postoperative mortality varies significantly among hospitals included in the project and this difference cannot be attributed to the annual surgical volume. Copyright © 2015 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Evaluating the time-dependent and bond characteristics of lightweight concrete mixes for Kansas prestressed concrete bridges : technical summary.

Science.gov (United States)

2011-07-01

The majority of the bridges in Kansas are in rural areas. Many of these are : becoming structurally deficient, and are in need of replacement. Due to the location of : these bridges, cost of transporting prestressed girders to these areas often makes...

Evaluation of repeatability of Kansas test method KT-73, "density, absorption and voids in hardened concrete," boil test.

Science.gov (United States)

2015-06-01

For years, the Kansas Department of Transportation (KDOT) and concrete producers in the state have used a : Rapid Chloride Test for concrete cylinders, AASHTO T277. This test has been thought of as an appropriate quality : control test to evaluate pe...

Health Policy, Ethics, and the Kansas Legislative Health Academy

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Maree, Gina; Schrandt, Suzanne; Soderquist, Chris; Steffensmeier, Tim; St. Peter, Robert

2015-01-01

We describe a unique program, the Kansas Legislative Health Academy, that brings together state legislators from across the political spectrum to build their capacity in advancing policies that can improve the health of Kansans. To that end, the academy helps legislators develop new skills to deliberate the ethics of health policy, use systems thinking to understand the long- and short-term effects of policy action and inaction, and engage in acts of civic leadership. The academy also seeks to foster an environment of respectful open dialogue and to build new cross-chamber and cross-party relationships. Among the most important outcomes cited by program participants is the value of sustained, personal interaction and problem solving with individuals holding differing political views. PMID:25607945

Health policy, ethics, and the Kansas Legislative Health Academy.

Science.gov (United States)

Blacksher, Erika; Maree, Gina; Schrandt, Suzanne; Soderquist, Chris; Steffensmeier, Tim; St Peter, Robert

2015-03-01

We describe a unique program, the Kansas Legislative Health Academy, that brings together state legislators from across the political spectrum to build their capacity in advancing policies that can improve the health of Kansans. To that end, the academy helps legislators develop new skills to deliberate the ethics of health policy, use systems thinking to understand the long- and short-term effects of policy action and inaction, and engage in acts of civic leadership. The academy also seeks to foster an environment of respectful open dialogue and to build new cross-chamber and cross-party relationships. Among the most important outcomes cited by program participants is the value of sustained, personal interaction and problem solving with individuals holding differing political views.

Prehistory and History of the El Dorado Lake Area, Kansas. Phase II.

Science.gov (United States)

1981-01-01

ae,()A5201018A520202,dosl ae (d) ~ ~ ~ ~ ~ , veta ae e 540100,dra ae f eta faeyg 510201 osa ae h eta ae(;~ 4308 Assuming that the sizes of edge...Anthropology Ŗ Project Rept..Xeries ’ e /-A. Number 47 Y / - REHISTORY AND HISTORY OF THE EL DORADO LAKE AREA, KANSAS (PHASE Z)/ ./-- °/ . 7 / Edited by...Mary J. dair Contributors: Mary J. Adair Joe Alan Artz Marie E . Brown Darrell Drew Ch4rie E . Haury Gary R. Leaf Ricky L. Roberts Matthew J. Root Mary

Characteristics and outcome among patients suffering from out-of-hospital cardiac arrest: Factors associated with survival

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Trpković S.

2014-01-01

Full Text Available The aim was to define factors associated with an improved outcome among patients suffering out-of-hospital cardiac arrest (OHCA using the Utstain style data collection. We examined 200 patients suffering from OHCA in a prospective study in a two years period. We determined survival from cardiac arrest (CA to discharge from hospital and the factors associated with survival. 78% of CA patients had a cardiac aetiology, 65% occurred at home, 3.7% received bystander CPR. 36% were found in VF/VT, 64% in asystole/PEA. 52% of patients were intubated in the field, survival to discharge from hospital was significantly higher among patients who were intubated in the field. The mean response time was 6.6 minutes. 66.7% of patients were given the shock after 4 minutes. 131 (65.5% were pronounced dead in the field, 69 patients were transported to the hospital. 53 (76.8% patients of them died during the transport or in the ED, 7 died after hospital admission and 9 survived to hospital discharge. Multivariate logistic regression analysis showed that variables significantly associated with survival to hospital discharge were: age, endotracheal intubation in the field and mean response time. The outcome of CPR was better in patients who were younger, who were intubated in the field and when the response time was shorter.

In-hospital costs associated with chronic constipation in Belgium: a retrospective database study.

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Chevalier, P; Lamotte, M; Joseph, A; Dubois, D; Boeckxstaens, G

2014-03-01

Real-life data on the economic burden of chronic idiopathic constipation are scarce. The objectives of this study were to assess hospitalization resource use and costs associated with chronic constipation and its complications in Belgium. This was a single country, retrospective study using the IMS Hospital Disease Database (2008), which comprises data on 34% of acute hospital beds in Belgium and contains information on patient demographics, length of stay (LOS), billed costs, drug use, diagnoses, and procedures. Stays with a primary diagnosis of constipation, or a secondary diagnosis of constipation and a concomitant diagnosis of a constipation-related complication, were selected. Patients with diagnoses of colorectal cancer, ulcerative colitis or Crohn's disease, or who had stays involving potentially constipation-inducing procedures, were excluded as having secondary constipation. Patients receiving opioids, calcium-antagonists, antipsychotics or antidepressants were excluded as having drug-induced constipation. In total, 1541 eligible patients were identified. The average unadjusted cost per day in hospital for idiopathic constipation was €441 (€311 ± 1.4 in day clinic visits without overnight stays; €711 ± 14.0 in full hospitalizations with complications). The average LOS in a full hospitalization setting was 7.0 and 4.0 days in stays with and without complications, respectively. The most frequent drug and procedural treatments were osmotically acting laxatives (with complications: 42.61%; without complications: 35.69%), and transanal enema (2.32% and 2.03%), respectively. The burden of constipation is often underestimated; it is a condition reflected by hospital-related costs comparable to such indications as migraine, which increase when associated with complications. © 2013 The Authors. Neurogastroenterology & Motility Published by John Wiley & Sons Ltd.

The Association Between Major Depressive Disorder and Outcomes in Older Veterans Hospitalized With Pneumonia.

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DeWaters, Ami L; Chansard, Matthieu; Anzueto, Antonio; Pugh, Mary Jo; Mortensen, Eric M

2018-01-01

Major depressive disorder ("depression") has been identified as an independent risk factor for mortality for many comorbid conditions, including heart failure, cancer and stroke. Major depressive disorder has also been linked to immune suppression by generating a chronic inflammatory state. However, the association between major depression and pneumonia has not been examined. The aim of this study was to examine the association between depression and outcomes, including mortality and intensive care unit admission, in Veterans hospitalized with pneumonia. We conducted a retrospective national study using administrative data of patients hospitalized at any Veterans Administration acute care hospital. We included patients ≥65 years old hospitalized with pneumonia from 2002-2012. Depressed patients were further analyzed based on whether they were receiving medications to treat depression. We used generalized linear mixed effect models to examine the association of depression with the outcomes of interest after controlling for potential confounders. Patients with depression had a significantly higher 90-day mortality (odds ratio 1.12, 95% confidence interval 1.07-1.17) compared to patients without depression. Patients with untreated depression had a significantly higher 30-day (1.11, 1.04-1.20) and 90-day (1.20, 1.13-1.28) mortality, as well as significantly higher intensive care unit admission rates (1.12, 1.03-1.21), compared to patients with treated depression. For older veterans hospitalized with pneumonia, a concurrent diagnosis of major depressive disorder, and especially untreated depression, was associated with higher mortality. This highlights that untreated major depressive disorder is an independent risk factor for mortality for patients with pneumonia. Published by Elsevier Inc.

Kansas environmental and resource study: A Great Plains model. [land use, image enhancement, winter wheat, agriculture, water resources, and pattern recognition

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Haralick, R. M.; Kanemasu, E. T.; Morain, S. A.; Yarger, H. L.; Ulaby, F. T.; Davis, J. C. (Principal Investigator); Bosley, R. J.; Williams, D. L.; Mccauley, J. R.; Mcnaughton, J. L.

1973-01-01

The author has identified the following significant results. Improvement in the land use classification accuracy of ERTS-1 MSS multi-images over Kansas can be made using two distances between neighboring grey tone N-tuples instead of one distance. Much more information is contained texturally than spectrally on the Kansas image. Ground truth measurements indicate that reflectance ratios of the 545 and 655 nm wavebands provide an index of plant development and possibly physiological stress. Preliminary analysis of MSS 4 and 5 channels substantiate the ground truth interpretation. Results of the land use mapping experiment indicate that ERTS-1 imagery has major potential in regionalization. The ways in which land is utilized within these regions may then be studied more effectively than if no adequate regionalization is available. A model for estimating wheat yield per acre has been applied to acreage estimates derived from ERTS-1 imagery to project the 1973 wheat yields for a ten county area in southwest Kansas. The results are within 3% of the preharvest estimates for the same area prepared by the USDA. Visual identification of winter wheat is readily achieved by using a temporal sequence of images. Identification can be improve by stratifying the project area into subregions having more or less homogeneous agricultural practices and crop mixes.

Molecular and phenotypic characteristics of healthcare- and community-associated methicillin-resistant Staphylococcus aureus at a rural hospital.

Directory of Open Access Journals (Sweden)

Amy E Peterson

Full Text Available BACKGROUND: While methicillin-resistant Staphylococcus aureus (MRSA originally was associated with healthcare, distinct strains later emerged in patients with no prior hospital contact. The epidemiology of MRSA continues to evolve. METHODS: To characterize the current epidemiology of MRSA-colonized patients entering a hospital serving both rural and urban communities, we interviewed patients with MRSA-positive admission nasal swabs between August 2009 and March 2010. We applied hospitalization risk factor, antimicrobial resistance phenotype, and multi-locus sequence genotype (MLST classification schemes to 94 case-patients. RESULTS: By MLST analysis, we identified 15 strains with two dominant clonal complexes (CCs-CC5 (51 isolates, historically associated with hospitals, and CC8 (27 isolates, historically of community origin. Among patients with CC5 isolates, 43% reported no history of hospitalization within the past six months; for CC8, 67% reported the same. Classification by hospitalization risk factor did not correlate strongly with genotypic classification. Sensitivity of isolates to ciprofloxacin, clindamycin, or amikacin was associated with the CC8 genotype; however, among CC8 strains, 59% were resistant to ciprofloxacin, 15% to clindamycin, and 15% to amikacin. CONCLUSIONS: Hospitalization history was not a strong surrogate for the CC5 genotype. Conversely, patients with a history of hospitalization were identified with the CC8 genotype. Although ciprofloxacin, clindamycin, and amikacin susceptibility distinguished CC8 strains, the high prevalence of ciprofloxacin resistance limited its predictive value. As CC8 strains become established in healthcare settings and CC5 strains disseminate into the community, community-associated MRSA definitions based on case-patient hospitalization history may prove less valuable in tracking community MRSA strains.

Colonization with hospital flora and its associated risk factors in neonates hospitalized in neonatal ward of a teaching center in Isfahan, Iran.

Science.gov (United States)

Shirani, Kiana; Mostafavizadeh, Kamyar; Ataei, Behrouz; Akhani, Khatere

2018-01-01

Due to the high incidence and prevalence of infection in neonatal ward, especially Neonatal Intensive Care Units (NICUs) reported by different studies and the important role of colonization with hospital germs in the development of nosocomial infections, we intended to evaluate the risk of colonization with hospital germs in neonates and its associated risk factors. This cross-sectional, descriptive-analytical study was conducted in 2016 in a Teaching Center in Iran. In total, 51 neonates were selected based on the inclusion criteria, and after recording their information in a checklist, samples were taken by swab from outer ear, axilla, and groin for culture. Neonates with negative culture from mentioned regions were enrolled in the study. The swab samples again were taken and sent for culture from mentioned regions in at least 3 days after hospitalization. Culture results from first and second sampling were collected and analyzed statistically. This study was conducted on 51 neonates. The mean gestational age among the neonates ranged from 35.25 (Week) ± 2.98. 22 girls (43.1%) and 29 boys (56.9%), most of them were born by cesarean. Based on the results of logistic regression, a significant association was found between the occurrence of colonization of hospital flora and the place hospitalization of the newborns (odds ratio (OR): 4.750; 95% confidence interval (CI): 1.26-17.85). This study revealed that the only risk factors of colonization with hospital flora in neonates are the type of delivery and place of hospitalization. Based on findings of the study, it is recommended to focus on efforts in increasing the rate of natural birth as well as improving conditions of infection control in NICUs to reduce the number of incidences of colonization with hospital flora in neonates.

Reconciling the Multiple Objectives of Prison Diversion Programs for Drug Offenders: Evidence from Kansas' Senate Bill 123

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Stemen, Don; Rengifo, Andres F.

2011-01-01

Background: In recent years, several states have created mandatory prison-diversion programs for felony drug possessors. These programs have both individual-level goals of reducing recidivism rates and system-level goals of reducing prison populations. Objective: This study examines the individual level and system level impact of Kansas' Senate…

Factors Associated with Length of Hospital Stay among HIV Positive and HIV Negative Patients with Tuberculosis in Brazil

Science.gov (United States)

Gonçalves, Maria Jacirema Ferreira; Ferreira, Alaidistania A.

2013-01-01

Objective Identify and analyze the factors associated to length of hospital stay among HIV positive and HIV negative patients with tuberculosis in Manaus city, state of Amazonas, Brazil, in 2010. Methods Epidemiological study with primary data obtained from monitoring of hospitalized patients with tuberculosis in Manaus. Data were collected by interviewing patients and analyzing medical records, according to the following study variables age, sex, co-morbidities, education, race, income, lifestyle, history of previous treatment or hospitalization due to tuberculosis, treatment regimen, adverse reactions, smear test, clinical form, type of discharge, and length of hospital stay. The associated factors were identified through chi-square or t-Student test at a 5% significance level. Results Income from 1 to 3 minimum wages (P = 0.028), pulmonary tuberculosis form (P = 0.011), negative smear test or no information in this regard (P = 0.014), initial 6-month treatment scheme (P = 0.029), and adverse drug reactions (P = 0.021) were associated to prolonged hospital stay in HIV positive patients. Conclusion We found out that although there were no significant differences in the length of hospital stay in HIV positive patients, all factors significantly associated to prolonged hospital stay occurred in this group of patients. This finding corroborates other studies indicating the severity of tuberculosis in HIV patients, which may also contribute to lengthen their hospital stay. PMID:23593227

Hospital Costs Associated With Laparoscopic and Open Inguinal Herniorrhaphy

OpenAIRE

Spencer Netto, Fernando; Quereshy, Fayez; Camilotti, Bruna G.; Pitzul, Kristen; Kwong, Josephine; Jackson, Timothy; Penner, Todd; Okrainec, Allan

2014-01-01

Purpose: The purpose of this study was to compare the total hospital costs associated with elective laparoscopic and open inguinal herniorrhaphy. Methods: A prospectively maintained database was used to identify patients who underwent elective inguinal herniorrhaphy from April 2009 to March 2011. A retrospective review of electronic patient records was performed along with a standardized case-costing analysis using data from the Ontario Case Costing Initiative. The main outcomes were operatin...

Groundwater-level and storage-volume changes in the Equus Beds aquifer near Wichita, Kansas, predevelopment through January 2015

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Whisnant, Joshua A.; Hansen, Cristi V.; Eslick, Patrick J.

2015-10-01

Development of the Wichita well field began in the 1940s in the Equus Beds aquifer to provide the city of Wichita, Kansas, a new water-supply source. After development of the Wichita well field began, groundwater levels began to decline. Extensive development of irrigation wells that began in the 1970s also contributed to substantial groundwater-level declines. Groundwater-level declines likely enhance movement of brine from past oil and gas production near Burrton, Kansas, and natural saline water from the Arkansas River into the Wichita well field. Groundwater levels reached a historical minimum in 1993 because of drought conditions, irrigation, and the city of Wichita’s withdrawals from the aquifer. In 1993, the city of Wichita adopted the Integrated Local Water Supply Program to ensure that Wichita’s water needs would be met through the year 2050 and beyond as part of its efforts to manage the part of the Equus Beds aquifer Wichita uses. A key component of the Integrated Local Water Supply Program was the Equus Beds Aquifer Storage and Recovery project. The Aquifer Storage and Recovery project’s goal is to store and eventually recover groundwater and help protect the Equus Beds aquifer from oil-field brine water near Burrton, Kansas, and saline water from the Arkansas River. Since 1940, the U.S. Geological Survey has monitored groundwater levels and storage-volume changes in the Equus Beds aquifer to provide data to the city of Wichita in order to better manage its water supply.

Blood Transfusion During Total Ankle Arthroplasty Is Associated With Increased In-Hospital Complications and Costs.

Science.gov (United States)

Ewing, Michael A; Huntley, Samuel R; Baker, Dustin K; Smith, Kenneth S; Hudson, Parke W; McGwin, Gerald; Ponce, Brent A; Johnson, Michael D

2018-04-01

Total ankle arthroplasty (TAA) is an increasingly used, effective treatment for end-stage ankle arthritis. Although numerous studies have associated blood transfusion with complications following hip and knee arthroplasty, its effects following TAA are largely unknown. This study uses data from a large, nationally representative database to estimate the association between blood transfusion and inpatient complications and hospital costs following TAA. Using the Nationwide Inpatient Sample (NIS) database from 2004 to 2014, 25 412 patients who underwent TAA were identified, with 286 (1.1%) receiving a blood transfusion. Univariate analysis assessed patient and hospital factors associated with blood transfusion following TAA. Patients requiring blood transfusion were more likely to be female, African American, Medicare recipients, and treated in nonteaching hospitals. Average length of stay for patients following transfusion was 3.0 days longer, while average inpatient cost was increased by approximately 50%. Patients who received blood transfusion were significantly more likely to suffer from congestive heart failure, peripheral vascular disease, hypothyroidism, coagulation disorder, or anemia. Acute renal failure was significantly more common among patients receiving blood transfusion ( P < .001). Blood transfusions following TAA are infrequent and are associated with multiple medical comorbidities, increased complications, longer hospital stays, and increased overall cost. Level III: Retrospective, comparative study.

Prognostic factors for influenza-associated hospitalization and death during an epidemic

NARCIS (Netherlands)

Hak, E; Verheij, T J; van Essen, G A; Lafeber, A B; Grobbee, D E; Hoes, A W

To predict which patients with current high-risk disease in the community may benefit most from additional preventive or therapeutic measures for influenza, we determined prognostic factors for influenza-associated hospitalization and death in a general practice-based case-control study among this

Hydrogeology and ground-water-quality conditions at the Linn County landfill, eastern Kansas, 1988-89

International Nuclear Information System (INIS)

Falwell, R.; Bigsby, P.R.; Myers, N.C.

1991-01-01

An investigation of the hydrogeology and groundwater quality conditions near the Linn County Landfill, eastern Kansas was conducted from July 1988 through June 1989. The landfill is located in an unreclaimed coal strip-mine area near Prescott. Analysis of water levels from nine temporary wells and from strip-mine ponds indicated that groundwater flows southwest through the present landfill. A county road west of the landfill acts as a barrier to shallow westerly groundwater flow. Seasonal variations in the direction of groundwater flow may occur. Water samples from monitoring wells and a strip-mine pond were analyzed for inorganic and organic compounds. Iron, manganese, and dissolved-organic-carbon concentrations were good indicators of the presence of landfill leachate in the groundwater. Benzene, carbon tetrachloride, 1,1-dichloroethane, and 1,1,1-trichloroethane were also detected. None of the inorganic or organic compounds detected exceeded Kansas primary drinking-water standards. Chemical concentrations and water levels in some nested wells indicate there is a hydraulic connection between the strip-mine spoil material and the underlying limestone. Leachate-contaminated groundwater has the potential to migrate southwest corner of the landfill through either strip-mine spoil material or through the underlying Pawnee Limestone

[Estimation of the excess of lung cancer mortality risk associated to environmental tobacco smoke exposure of hospitality workers].

Science.gov (United States)

López, M José; Nebot, Manel; Juárez, Olga; Ariza, Carles; Salles, Joan; Serrahima, Eulàlia

2006-01-14

To estimate the excess lung cancer mortality risk associated with environmental tobacco (ETS) smoke exposure among hospitality workers. The estimation was done using objective measures in several hospitality settings in Barcelona. Vapour phase nicotine was measured in several hospitality settings. These measurements were used to estimate the excess lung cancer mortality risk associated with ETS exposure for a 40 year working life, using the formula developed by Repace and Lowrey. Excess lung cancer mortality risk associated with ETS exposure was higher than 145 deaths per 100,000 workers in all places studied, except for cafeterias in hospitals, where excess lung cancer mortality risk was 22 per 100,000. In discoteques, for comparison, excess lung cancer mortality risk is 1,733 deaths per 100,000 workers. Hospitality workers are exposed to ETS levels related to a very high excess lung cancer mortality risk. These data confirm that ETS control measures are needed to protect hospital workers.

Assessing urban forest effects and values of the Great Plains: Kansas, Nebraska, North Dakota, South Dakota

Science.gov (United States)

David J. Nowak; Robert E. III Hoehn; Daniel E. Crane; Allison R. Bodine

2012-01-01

This report details the evaluation of the urban tree resources of the north-central Great Plains region of the United States. Specifically this report provides a more comprehensive understanding of the species composition and structural and functional benefits of the urban forests in the states of Kansas (33.1 million urban trees), Nebraska (13.3 million urban trees),...

Plasmodium malariae Infection Associated with a High Burden of Anemia: A Hospital-Based Surveillance Study.

Directory of Open Access Journals (Sweden)

Siobhan Langford

2015-12-01

Full Text Available Plasmodium malariae is a slow-growing parasite with a wide geographic distribution. Although generally regarded as a benign cause of malaria, it has been associated with nephrotic syndrome, particularly in young children, and can persist in the host for years. Morbidity associated with P. malariae infection has received relatively little attention, and the risk of P. malariae-associated nephrotic syndrome is unknown.We used data from a very large hospital-based surveillance system incorporating information on clinical diagnoses, blood cell parameters and treatment to describe the demographic distribution, morbidity and mortality associated with P. malariae infection in southern Papua, Indonesia. Between April 2004 and December 2013 there were 1,054,674 patient presentations to Mitra Masyarakat Hospital of which 196,380 (18.6% were associated with malaria and 5,097 were with P. malariae infection (constituting 2.6% of all malaria cases. The proportion of malaria cases attributable to P. malariae increased with age from 0.9% for patients under one year old to 3.1% for patients older than 15 years. Overall, 8.5% of patients with P. malariae infection required admission to hospital and the median length of stay for these patients was 2.5 days (Interquartile Range: 2.0-4.0 days. Patients with P. malariae infection had a lower mean hemoglobin concentration (9.0 g/dL than patients with P. falciparum (9.5 g/dL, P. vivax (9.6g/dL and mixed species infections (9.3g/dL. There were four cases of nephrotic syndrome recorded in patients with P. malariae infection, three of which were in children younger than 5 years old, giving a risk in this age group of 0.47% (95% Confidence Interval; 0.10% to 1.4%. Overall, 2.4% (n = 16 of patients hospitalized with P. malariae infection subsequently died in hospital, similar to the proportions for the other endemic Plasmodium species (range: 0% for P. ovale to 1.6% for P. falciparum.Plasmodium malariae infection is

Methodology and application of combined watershed and ground-water models in Kansas

Science.gov (United States)

Sophocleous, M.; Perkins, S.P.

2000-01-01

Increased irrigation in Kansas and other regions during the last several decades has caused serious water depletion, making the development of comprehensive strategies and tools to resolve such problems increasingly important. This paper makes the case for an intermediate complexity, quasi-distributed, comprehensive, large-watershed model, which falls between the fully distributed, physically based hydrological modeling system of the type of the SHE model and the lumped, conceptual rainfall-runoff modeling system of the type of the Stanford watershed model. This is achieved by integrating the quasi-distributed watershed model SWAT with the fully-distributed ground-water model MODFLOW. The advantage of this approach is the appreciably smaller input data requirements and the use of readily available data (compared to the fully distributed, physically based models), the statistical handling of watershed heterogeneities by employing the hydrologic-response-unit concept, and the significantly increased flexibility in handling stream-aquifer interactions, distributed well withdrawals, and multiple land uses. The mechanics of integrating the component watershed and ground-water models are outlined, and three real-world management applications of the integrated model from Kansas are briefly presented. Three different aspects of the integrated model are emphasized: (1) management applications of a Decision Support System for the integrated model (Rattlesnake Creek subbasin); (2) alternative conceptual models of spatial heterogeneity related to the presence or absence of an underlying aquifer with shallow or deep water table (Lower Republican River basin); and (3) the general nature of the integrated model linkage by employing a watershed simulator other than SWAT (Wet Walnut Creek basin). These applications demonstrate the practicality and versatility of this relatively simple and conceptually clear approach, making public acceptance of the integrated watershed modeling

The association of emergency department administration of sodium bicarbonate after out of hospital cardiac arrest with outcomes.

Science.gov (United States)

Chen, Yi-Chuan; Hung, Ming-Szu; Liu, Chia-Yen; Hsiao, Cheng-Ting; Yang, Yao-Hsu

2018-03-05

Sodium bicarbonate administration is mostly restricted to in-hospital use in Taiwan. This study was conducted to investigate the effect of sodium bicarbonate on outcomes among patients with out-of-hospital cardiac arrest (OHCA). This population-based study used a 16-year database to analyze the association between sodium bicarbonate administration for resuscitation in the emergency department (ED) and outcomes. All adult patients with OHCA were identified through diagnostic and procedure codes. The primary outcome was survival to hospital admission and secondary outcome was the rate of death within the first 30days of incidence of cardiac arrest. Cox proportional-hazards regression, logistic regression, and propensity analyses were conducted. Among 5589 total OHCA patients, 15.1% (844) had survival to hospital admission. For all patients, a positive association was noted between sodium bicarbonate administration during resuscitation in the ED and survival to hospital admission (adjusted odds ratio [OR]: 4.47; 95% confidence interval [CI]: 3.82-5.22, p<0.001). In propensity-matched patients, a positive association was also noted (adjusted OR, 4.61; 95% CI: 3.90-5.46, p<0.001). Among patients with OHCA in Taiwan, administration of sodium bicarbonate during ED resuscitation was significantly associated with an increased rate of survival to hospital admission. Copyright © 2018. Published by Elsevier Inc.

National Uranium Resource Evaluation: Lamar quadrangle, Colorado and Kansas

International Nuclear Information System (INIS)

Maarouf, A.M.; Johnson, V.C.

1982-01-01

Uranium resources of the Lamar Quadrangle, Colorado and Kansas, were evaluated using National Uranium Resource Evaluation criteria. The environment favorable for uranium is the Lower Cretaceous Dakota Sandstone in the area east of John Martin Reservoir for south Texas roll-type sandstone deposits. Carbonaceous trash and sulfides are abundant in the Dakota Sandstone. The unit underlies a thick Upper Cretaceous section that contains bentonitic beds and uraniferous marine black shale. Water samples from the Dakota Sandstone aquifer contain as much as 122 ppB U 3 O 8 . Geologic units considered unfavorable include most of the Paleozoic rocks, except in the Brandon Fault area; the Upper Cretaceous rocks; and the Ogallala Formation. The Dockum Group, Morrison Formation, and Lytle Member of the Purgatoire Formation are unevaluated because of lack of data

Factors and models associated with the amount of hospital care services as demanded by hospitalized patients: a systematic review.

NARCIS (Netherlands)

Oostveen, C.J. van; Ubbink, D.T.; Huis in het Veld, J.G.; Bakker, P.J.; Vermeulen, H.

2014-01-01

Background: Hospitals are constantly being challenged to provide high-quality care despite ageing populations, diminishing resources, and budgetary restraints. While the costs of care depend on the patients' needs, it is not clear which patient characteristics are associated with the demand for care

Factors and models associated with the amount of hospital care services as demanded by hospitalized patients: a systematic review

NARCIS (Netherlands)

van Oostveen, Catharina J.; Ubbink, Dirk T.; Huis In Het Veld, Judith G.; Bakker, Piet J.; Vermeulen, Hester

2014-01-01

Hospitals are constantly being challenged to provide high-quality care despite ageing populations, diminishing resources, and budgetary restraints. While the costs of care depend on the patients' needs, it is not clear which patient characteristics are associated with the demand for care and

Association between Smokefree Legislation and Hospitalizations for Cardiac, Cerebrovascular and Respiratory Diseases: A Meta-Analysis

Science.gov (United States)

Tan, Crystal E.; Glantz, Stanton A.

2012-01-01

Background Secondhand smoke causes cardiovascular and respiratory disease. Smokefree legislation is associated with a lower risk of hospitalization and death from these diseases. Methods and Results Random effects meta-analysis was conducted by law comprehensiveness to determine the relationship between smokefree legislation and hospital admission or death from cardiac, cerebrovascular, and respiratory diseases. Studies were identified using a systematic search for studies published before November 30, 2011 using Science Citation Index, Google Scholar, PubMed, and Embase and references in identified papers. Change in hospital admissions (or deaths) in the presence of a smokefree law, duration of follow-up, and law comprehensiveness (workplaces only; workplaces and restaurants; or workplaces, restaurants, and bars) were recorded. Forty-five studies of 33 smokefree laws with median follow-up of 24 months (range 2–57 months) were included. Comprehensive smokefree legislation was associated with significantly lower rates of hospital admissions (or deaths) for all 4 diagnostic groups: coronary events (RR .848, 95% CI .816–.881), other heart disease (RR .610, 95% CI .440–.847), cerebrovascular accidents (RR .840, 95% CI .753–.936), and respiratory disease (RR .760, 95% CI .682–.846). The difference in risk following comprehensive smokefree laws does not change with longer follow-up. More comprehensive laws were associated with larger changes in risk. Conclusions Smokefree legislation was associated with a lower risk of smoking-related cardiac, cerebrovascular, and respiratory diseases, with more comprehensive laws associated with greater changes in risk. PMID:23109514

Kansas trends and changes in temperature, precipitation, drought, and frost-free days from the 1890s to 2015

Science.gov (United States)

Kansas extends 660 km from the moderate elevations and semi-humid conditions of the Lower Missouri Basin to the High Plains lying above the Ogallala aquifer and along the Rockies’ eastern slope. Such characteristics result in significant climate variability across the state, making timely and accura...

[Hospital mortality associated with upper gastrointestinal hemorrhage due to ruptured esophageal varices at the Lomé Campus Hospital in Togo].

Science.gov (United States)

Bouglouga, O; Bagny, A; Lawson-Ananissoh, L; Djibril, M

2014-01-01

To study hospital mortality associated with upper gastrointestinal hemorrhages due to variceal bleeding in the department of hepatology and gastroenterology at the Lome Campus University Hospital. This retrospective cross-sectional and analytic study examined the 55 patients admitted for variceal bleeding on upper endoscopies during the 3-year period from January 1, 2008, through December 31, 2010. These patients accounted for 4.1% of all hospitalizations during the study period in the department. Their average age was 35 years, and their sex-ratio 4. A history of chronic liver disease was found in 65.5%. Liver cirrhosis was the principal cause of the esophageal varices, complicated by hepatocellular carcinoma in 30.9% of them. The mortality rate was 25.5% and was not related to the cause of portal hypertension. All the patients with a recurrence of bleeding died. Mortality was associated with jaundice. Blood transfusion did not significantly improve the prognosis. the mortality rate among patients with upper gastrointestinal hemorrhage linked to variceal bleeding is high in our unit. The prevention of hepatitis virus B is important because it is the main cause of chronic liver disease causing portal hypertension in our department.

The Kansas Squat Test Modality Comparison: Free Weights vs. Smith Machine.

Science.gov (United States)

Luebbers, Paul E; Fry, Andrew C

2016-08-01

Luebbers, PE and Fry, AC. The Kansas squat test modality comparison: free weights vs. smith machine. J Strength Cond Res 30(8): 2186-2193, 2016-Standardized methods of testing power are instrumental in planning and implementing training regimens for many athletes, and also in tracking training adaptations. Previous work has demonstrated that the Kansas squat test (KST) is a valid test for measuring indices of mean and peak power when compared with the Wingate anaerobic cycle test. Although the KST was designed for use with a Smith machine (SM), many power athletes use free weights for training. The purpose of this study was to determine the feasibility of using free weights (FW) for the KST by comparing it with the SM modality. Twenty-three track and field athletes participated (mean ± SD; weight, 69.7 ± 10.6 kg; age, 20.1 ± 1.1 years) in this study. Each completed familiarization sessions with the FW and SM modalities before data collection. A 1-repetition maximum squat was also determined for both the FW and SM. Correlation coefficients indicated significant relationships between the FW KST and SM KST on measures of peak test power (r = 0.955; p 0.05) or posttest lactate (r = 0.109; p > 0.05). Paired samples t-tests indicated that the FW KST resulted in significantly higher measures of peak power and mean power (p ≤ 0.01), although no differences were observed for relative fatigue or lactate (p > 0.05). These data indicate that the FW KST is a valid and feasible alternative to the SM KST in measuring peak and mean power.

Final Report: Results of Environmental Site Investigation at Sylvan Grove, Kansas

Energy Technology Data Exchange (ETDEWEB)

LaFreniere, Lorraine M [Argonne National Lab. (ANL), Argonne, IL (United States)

2014-09-01

Sylvan Grove is located in western Lincoln County, approximately 60 mi west of Salina, Kansas (Figure 1.1). From 1954 to 1966, the Commodity Credit Corporation (CCC), an agency of the U.S. Department of Agriculture (USDA), operated a grain storage facility at the northeastern edge of Sylvan Grove. During this time, commercial grain fumigants containing carbon tetrachloride were in common use to preserve grain in storage. In 1998, the Kansas Department of Health and Environment (KDHE) found carbon tetrachloride above the maximum contaminant level (MCL) of 5 μg/L in groundwater from one private well used for livestock and lawn and garden watering. The 1998 KDHE sampling at Sylvan Grove was conducted under the USDA private well sampling program. To determine whether the former CCC/USDA facility at Sylvan Grove is a potential contaminant source and its possible relationship to the contamination in groundwater, the CCC/USDA proposed to conduct an environmental site investigation, in accordance with the Intergovernmental Agreement between the KDHE and the Farm Service Agency (FSA) of the USDA. Argonne National Laboratory, on behalf of the CCC/USDA, developed a work plan (Argonne 2012) for the site investigation and a supplemental work plan for indoor and ambient air sampling (Appendix A). The proposed work was approved by the KDHE (2012a, 2013). The investigations were performed by the Environmental Science Division of Argonne National Laboratory, on behalf of the CCC/USDA. The main activities for the site investigation were conducted in June 2012, and indoor and ambient air sampling was performed in February 2013. This report presents the findings of the investigations at Sylvan Grove.

Factors associated with Salmonella shedding among equine colic patients at a veterinary teaching hospital.

Science.gov (United States)

Kim, L M; Morley, P S; Traub-Dargatz, J L; Salman, M D; Gentry-Weeks, C

2001-03-01

To evaluate factors potentially associated with fecal Salmonella shedding among equine patients hospitalized for colic at a veterinary teaching hospital and to determine the effects of probiotic treatment on fecal Salmonella shedding and clinical signs. Longitudinal study and controlled trial. 246 equine colic patients. History and medical information were obtained from patient records. Fecal and environmental samples were submitted for aerobic bacterial culture for Salmonella enterica. Fifty-one patients were treated with a commercially available probiotic; 46 were treated with a placebo. Logistic regression was used to evaluate data. Salmonella organisms were detected in feces from 23 (9%) patients at least once during hospitalization. Patients were more likely to shed Salmonella organisms if diarrhea was evident equine patients hospitalized at a veterinary teaching hospital because of colic and that pathogen monitoring in patients and the hospital environment and use of barrier nursing precautions for equine colic patients are beneficial.

Hospital-acquired infections associated with poor air quality in air-conditioned environments

Directory of Open Access Journals (Sweden)

Daniela Pinheiro da Silva

2013-10-01

Full Text Available Backgound and Objectives: Individuals living in cities increasingly spend more time indoors in air-conditioned environments. Air conditioner contamination can be caused by the presence of aerosols from the external or internal environment, which may be associated with disease manifestations in patients present in this type of environment. Therefore, the aim of this review was to assess the air quality in air-conditioned hospital environments as a risk factor for hospital-acquired infections – HAI – as the air can be a potential source of infection, as well as assess the exposure of professionals and patients to different pollutants. Material and Methods: A literature review was performed in the LILACS, MEDLINE, SCIELO, SCIENCE DIRECT databases, CAPES thesis database and Ministry of Health – Brazil, including studies published between 1982 and 2008. The literature search was grouped according to the thematic focus, as follows: ventilation, maintenance and cleaning of systems that comprehend the environmental quality standard. Discussion and Conclusion: Outbreaks of hospital-acquired infections associated with Aspergillus, Acinetobacter, Legionella, and other genera such as Clostridium and Nocardia, which were found in air conditioners, were observed, thus indicating the need for air-conditioning quality control in these environments.

PKI solar thermal plant evaluation at Capitol Concrete Products, Topeka, Kansas

Science.gov (United States)

Hauger, J. S.; Borton, D. N.

1982-07-01

A system feasibility test to determine the technical and operational feasibility of using a solar collector to provide industrial process heat is discussed. The test is of a solar collector system in an industrial test bed plant at Capitol Concrete Products in Topeka, Kansas, with an experiment control at Sandia National Laboratories, Albuquerque. Plant evaluation will occur during a year-long period of industrial utilization. It will include performance testing, operability testing, and system failure analysis. Performance data will be recorded by a data acquisition system. User, community, and environmental inputs will be recorded in logs, journals, and files. Plant installation, start-up, and evaluation, are anticipated for late November, 1981.

Urban and community forests of the North Central West region: Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, South Dakota

Science.gov (United States)

David J. Nowak; Eric J. Greenfield

2010-01-01

This report details how land cover and urbanization vary within the states of Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, and South Dakota by community (incorporated and census designated places), county subdivision, and county. Specifically this report provides critical urban and community...

National Uranium Resource Evaluation: Manhattan Quadrangle, Kansas

International Nuclear Information System (INIS)

Fair, C.L.; Smit, D.E.

1982-08-01

Surface reconnaissance and detailed subsurface studies were conducted in the Manhattan Quadrangle, Kansas, to evaluate uranium favorability using National Uranium Resource Evaluation criteria. These studies were designed in part to follow up airborne radiometric and hydrogeochemical and stream-sediment surveys. More than 600 well records were examined in the subsurface phase of the study. Results of these investigations indicate environments favorable for channel-controlled peneconcordant sandstone uranium deposits in Cretaceous rocks and for Wyoming roll-type deposits in Pennsylvanian sandstones. The Cretaceous sandstone environments exhibit such favorable characteristics as a bottom unconformity, high bed load, braided fluvial channels, large-scale cross-bedding, and one anomalous outcrop. The Pennsylvanian sandstone environments exhibit such favorable characteristics as arkosic cross-bedded sandstones, included pyrite and organic debris, interbedded shales, and gamma-ray log anomalies. Environments considered unfavorable for uranium deposits are limestone and dolomite environments, marine black shale environments, evaporative precipitate environments, and some fluvial sandstone environments. Environments considered unevaluated because not enough data were available include Precambrian plutonic, metamorphic, and sedimentary rocks, even though a large number of thin sections were available for study

Estimation of potential runoff-contributing areas in the Kansas-Lower Republican River Basin, Kansas

Science.gov (United States)

Juracek, Kyle E.

1999-01-01

Digital soils and topographic data were used to estimate and compare potential runoff-contributing areas for 19 selected subbasins representing soil, slope, and runoff variability within the Kansas-Lower Republican (KLR) River Basin. Potential runoff-contributing areas were estimated separately and collectively for the processes of infiltration-excess and saturation-excess overland flow using a set of environmental conditions that represented high, moderate, and low potential runoff. For infiltration-excess overland flow, various rainfall intensities and soil permeabilities were used. For saturation-excess overland flow, antecedent soil-moisture conditions and a topographic wetness index were used. Results indicated that the subbasins with relatively high potential runoff are located in the central part of the KLR River Basin. These subbasins are Black Vermillion River, Clarks Creek, Delaware River upstream from Muscotah, Grasshopper Creek, Mill Creek (Wabaunsee County), Soldier Creek, Vermillion Creek (Pottawatomie County), and Wildcat Creek. The subbasins with relatively low potential runoff are located in the western one-third of the KLR River Basin, with one exception, and are Buffalo Creek, Little Blue River upstream from Barnes, Mill Creek (Washington County), Republican River between Concordia and Clay Center, Republican River upstream from Concordia, Wakarusa River downstream from Clinton Lake (exception), and White Rock Creek. The ability to distinguish the subbasins as having relatively high or low potential runoff was possible mostly due to the variability of soil permeability across the KLR River Basin.

Hospital costs associated with depression in a cohort of older men living in Western Australia

NARCIS (Netherlands)

Prina, A.M.; Huisman, M.; Yeap, B.B.; Hankey, G.J.; Flicker, L.; Brayne, C.; Almeida, O.P.

2014-01-01

Background: There is lack of information of the hospital costs related to depression. Here, we compare the costs associated with general hospital admissions over 2 years between older men with and without a documented past history of depression. Methods: A community-based cohort of older men living

75 FR 4138 - Open Meeting of the Area 5 Taxpayer Advocacy Panel (Including the States of Iowa, Kansas...

Science.gov (United States)

2010-01-26

... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 5 Taxpayer Advocacy Panel (Including the States of Iowa, Kansas, Minnesota, Missouri, Nebraska, Oklahoma, and Texas) AGENCY... the Federal Advisory Committee Act, 5 U.S.C. App. (1988) that a meeting of the Area 5 Taxpayer...

75 FR 39330 - Open Meeting of the Area 5 Taxpayer Advocacy Panel (Including the States of Iowa, Kansas...

Science.gov (United States)

2010-07-08

... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 5 Taxpayer Advocacy Panel (Including the States of Iowa, Kansas, Minnesota, Missouri, Nebraska, Oklahoma, and Texas) AGENCY... Federal Advisory Committee Act, 5 U.S.C. App. (1988) that a meeting of the Area 5 Taxpayer Advocacy Panel...

75 FR 62629 - Open Meeting of the Area 5 Taxpayer Advocacy Panel (Including the States of Iowa, Kansas...

Science.gov (United States)

2010-10-12

... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 5 Taxpayer Advocacy Panel (Including the States of Iowa, Kansas, Minnesota, Missouri, Nebraska, Oklahoma, and Texas) AGENCY... the Federal Advisory Committee Act, 5 U.S.C. App. (1988) that a meeting of the Area 5 Taxpayer...

75 FR 10864 - Open Meeting of the Area 5 Taxpayer Advocacy Panel (Including the States of Iowa, Kansas...

Science.gov (United States)

2010-03-09

... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 5 Taxpayer Advocacy Panel (Including the States of Iowa, Kansas, Minnesota, Missouri, Nebraska, Oklahoma, and Texas) AGENCY... Federal Advisory Committee Act, 5 U.S.C. App. (1988) that a meeting of the Area 5 Taxpayer Advocacy Panel...

75 FR 47061 - Open Meeting of the Area 5 Taxpayer Advocacy Panel (including the states of Iowa, Kansas...

Science.gov (United States)

2010-08-04

... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 5 Taxpayer Advocacy Panel (including the states of Iowa, Kansas, Minnesota, Missouri, Nebraska, Oklahoma, and Texas) AGENCY... the Federal Advisory Committee Act, 5 U.S.C. App. (1988) that a meeting of the Area 5 Taxpayer...

75 FR 55404 - Open Meeting of the Area 5 Taxpayer Advocacy Panel (Including the States of Iowa, Kansas...

Science.gov (United States)

2010-09-10

... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 5 Taxpayer Advocacy Panel (Including the States of Iowa, Kansas, Minnesota, Missouri, Nebraska, Oklahoma, and Texas) AGENCY... the Federal Advisory Committee Act, 5 U.S.C. App. (1988) that a meeting of the Area 5 Taxpayer...

Identification of "ever-cropped" land (1984-2010) using Landsat annual maximum NDVI image composites: Southwestern Kansas case study.

Science.gov (United States)

Maxwell, Susan K; Sylvester, Kenneth M

2012-06-01

A time series of 230 intra- and inter-annual Landsat Thematic Mapper images was used to identify land that was ever cropped during the years 1984 through 2010 for a five county region in southwestern Kansas. Annual maximum Normalized Difference Vegetation Index (NDVI) image composites (NDVI(ann-max)) were used to evaluate the inter-annual dynamics of cropped and non-cropped land. Three feature images were derived from the 27-year NDVI(ann-max) image time series and used in the classification: 1) maximum NDVI value that occurred over the entire 27 year time span (NDVI(max)), 2) standard deviation of the annual maximum NDVI values for all years (NDVI(sd)), and 3) standard deviation of the annual maximum NDVI values for years 1984-1986 (NDVI(sd84-86)) to improve Conservation Reserve Program land discrimination.Results of the classification were compared to three reference data sets: County-level USDA Census records (1982-2007) and two digital land cover maps (Kansas 2005 and USGS Trends Program maps (1986-2000)). Area of ever-cropped land for the five counties was on average 11.8 % higher than the area estimated from Census records. Overall agreement between the ever-cropped land map and the 2005 Kansas map was 91.9% and 97.2% for the Trends maps. Converting the intra-annual Landsat data set to a single annual maximum NDVI image composite considerably reduced the data set size, eliminated clouds and cloud-shadow affects, yet maintained information important for discriminating cropped land. Our results suggest that Landsat annual maximum NDVI image composites will be useful for characterizing land use and land cover change for many applications.

A Nationwide Assessment of the Association of Smoking Bans and Cigarette Taxes With Hospitalizations for Acute Myocardial Infarction, Heart Failure, and Pneumonia.

Science.gov (United States)

Ho, Vivian; Ross, Joseph S; Steiner, Claudia A; Mandawat, Aditya; Short, Marah; Ku-Goto, Meei-Hsiang; Krumholz, Harlan M

2017-12-01

Multiple studies claim that public place smoking bans are associated with reductions in smoking-related hospitalization rates. No national study using complete hospitalization counts by area that accounts for contemporaneous controls including state cigarette taxes has been conducted. We examine the association between county-level smoking-related hospitalization rates and comprehensive smoking bans in 28 states from 2001 to 2008. Differences-in-differences analysis measures changes in hospitalization rates before versus after introducing bans in bars, restaurants, and workplaces, controlling for cigarette taxes, adjusting for local health and provider characteristics. Smoking bans were not associated with acute myocardial infarction or heart failure hospitalizations, but lowered pneumonia hospitalization rates for persons ages 60 to 74 years. Higher cigarette taxes were associated with lower heart failure hospitalizations for all ages and fewer pneumonia hospitalizations for adults aged 60 to 74. Previous studies may have overestimated the relation between smoking bans and hospitalizations and underestimated the effects of cigarette taxes.

The origin and evolution of safe-yield policies in the Kansas groundwater management districts

Science.gov (United States)

Sophocleous, M.

2000-01-01

The management of groundwater resources in Kansas continues to evolve. Declines in the High Plains aquifer led to the establishment of groundwater management districts in the mid-1970s and reduced streamflows prompted the enactment of minimum desirable streamflow standards in the mid-1980s. Nonetheless, groundwater levels and streamflows continued to decline, although at reduced rates compared to premid-1980s rates. As a result, "safe-yield" policies were revised to take into account natural groundwater discharge in the form of stream baseflow. These policies, although a step in the right direction, are deficient in several ways. In addition to the need for more accurate recharge data, pumping-induced streamflow depletion, natural stream losses, and groundwater evapotranspiration need to be accounted for in the revised safe-yield policies. Furthermore, the choice of the 90% flow-duration statistic as a measure of baseflow needs to be reevaluated, as it significantly underestimates mean baseflow estimated from baseflow separation computer programs; moreover, baseflow estimation needs to be refined and validated. ?? 2000 International Association for Mathematical Geology.

Nursing skill mix in European hospitals: cross-sectional study of the association with mortality, patient ratings, and quality of care

Science.gov (United States)

Aiken, Linda H; Rafferty, Anne Marie; Bruyneel, Luk; McHugh, Matthew; Maier, Claudia B; Moreno-Casbas, Teresa; Ball, Jane E; Ausserhofer, Dietmar; Sermeus, Walter

2017-01-01

Objectives To determine the association of hospital nursing skill mix with patient mortality, patient ratings of their care and indicators of quality of care. Design Cross-sectional patient discharge data, hospital characteristics and nurse and patient survey data were merged and analysed using generalised estimating equations (GEE) and logistic regression models. Setting Adult acute care hospitals in Belgium, England, Finland, Ireland, Spain and Switzerland. Participants Survey data were collected from 13 077 nurses in 243 hospitals, and 18 828 patients in 182 of the same hospitals in the six countries. Discharge data were obtained for 275 519 surgical patients in 188 of these hospitals. Main outcome measures Patient mortality, patient ratings of care, care quality, patient safety, adverse events and nurse burnout and job dissatisfaction. Results Richer nurse skill mix (eg, every 10-point increase in the percentage of professional nurses among all nursing personnel) was associated with lower odds of mortality (OR=0.89), lower odds of low hospital ratings from patients (OR=0.90) and lower odds of reports of poor quality (OR=0.89), poor safety grades (OR=0.85) and other poor outcomes (0.80nurses is associated with an 11% increase in the odds of death. In our hospital sample, there were an average of six caregivers for every 25 patients, four of whom were professional nurses. Substituting one nurse assistant for a professional nurse for every 25 patients is associated with a 21% increase in the odds of dying. Conclusions A bedside care workforce with a greater proportion of professional nurses is associated with better outcomes for patients and nurses. Reducing nursing skill mix by adding nursing associates and other categories of assistive nursing personnel without professional nurse qualifications may contribute to preventable deaths, erode quality and safety of hospital care and contribute to hospital nurse shortages. PMID:28626086

Multi-state survey of healthcare-associated infections in acute care hospitals in Brazil.

Science.gov (United States)

Fortaleza, C Magno Castelo Branco; Padoveze, M C; Kiffer, C R Veiga; Barth, A L; Carneiro, Irna C do Rosário Souza; Giamberardino, H I Garcia; Rodrigues, J L Nobre; Santos Filho, L; de Mello, M J Gonçalves; Pereira, M Severino; Gontijo Filho, P Pinto; Rocha, M; Servolo de Medeiros, E A; Pignatari, A C Campos

2017-06-01

Healthcare-associated infections (HCAIs) challenge public health in developing countries such as Brazil, which harbour social inequalities and variations in the complexity of healthcare and regional development. To describe the prevalence of HCAIs in hospitals in a sample of hospitals in Brazil. A prevalence survey conducted in 2011-13 enrolled 152 hospitals from the five macro-regions in Brazil. Hospitals were classified as large (≥200 beds), medium (50-199 beds) or small sized (48 h of admission to the study hospitals at the time of the survey were included. Trained epidemiologist nurses visited each hospital and collected data on HCAIs, subjects' demographics, and invasive procedures. Univariate and multivariate techniques were used for data analysis. The overall HCAI prevalence was 10.8%. Most frequent infection sites were pneumonia (3.6%) and bloodstream infections (2.8%). Surgical site infections were found in 1.5% of the whole sample, but in 9.8% of subjects who underwent surgical procedures. The overall prevalence was greater for reference (12.6%) and large hospitals (13.5%), whereas medium- and small-sized hospitals presented rates of 7.7% and 5.5%, respectively. Only minor differences were noticed among hospitals from different macro-regions. Patients in intensive care units, using invasive devices or at extremes of age were at greater risk for HCAIs. Prevalence rates were high in all geographic regions and hospital sizes. HCAIs must be a priority in the public health agenda of developing countries. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Food intake, plate waste and its association with malnutrition in hospitalized patients.

Science.gov (United States)

Simzari, Kobra; Vahabzadeh, Davoud; Nouri Saeidlou, Sakineh; Khoshbin, Susan; Bektas, Yener

2017-11-16

Hospital malnutrition is a worldwide dilemma and challenge. High levels of plate waste contribute to malnutrition-related complications in hospital. We investigated the association between the levels of plate waste, food intake and patient satisfaction with nutritional risk and malnutrition prevalence in three hospital settings. The sample population of 120 patients, aged 18-65 year, admitted consecutively over a 12 month period to 3 different educational university hospitals was included. For all the patients, diet history, anthropometric measurements, body mass index and patient satisfaction with the hospital food service was evaluated. Weight plate waste for all daily meals was done and actual intakes computed individually for each day. Nutrition risk screening (NRS)-2002 (≥ 3) tool was used for estimating the nutritionally at-risk population. Results: From one hundred twenty non-critically ill patients with a mean 8.9 ± 3.5 day length of hospital stay, 40.8% (49) were men and 59.2% (71) were female. Mean energy and protein requirements were 2,030.3 ± 409.03 kcal/day and 76.13 ± 15.33 g/day respectively. Mean intakes were 1,326 ± 681.44 kcal/day and 66.81 ± 31.66 g/day respectively. The mean percent of plate waste for lunch and dinner were 37.7 ± 29.88 and 30.4 ± 23.61 respectively. In the total population, 25% of patients were satisfied and 75% patients were unsatisfied with hospital foods. Based on BMI ( 10%), malnutrition prevalence was 12.5% and 14.2% respectively during hospitalization. The prevalence of nutritionally at-risk population was 30% at admission time and reached 33.3% at discharge. Plate waste and hospital malnutrition were highly prevalent in accompanying with increasing nutritionally risk progression. So it should be addressed as an important health issue and appropriate strategies for stimulating governmental policies should be adopted.

Association of Hospital Costs With Complications Following Total Gastrectomy for Gastric Adenocarcinoma.

Science.gov (United States)

Selby, Luke V; Gennarelli, Renee L; Schnorr, Geoffrey C; Solomon, Stephen B; Schattner, Mark A; Elkin, Elena B; Bach, Peter B; Strong, Vivian E

2017-10-01

Postoperative complications are associated with increased hospital costs following major surgery, but the mechanism by which they increase cost and the categories of care that drive this increase are poorly described. To describe the association of postoperative complications with hospital costs following total gastrectomy for gastric adenocarcinoma. This retrospective analysis of a prospectively collected gastric cancer surgery database at a single National Cancer Institute-designated comprehensive cancer center included all patients undergoing curative-intent total gastrectomy for gastric adenocarcinoma between January 2009 and December 2012 and was conducted in 2015 and 2016. Ninety-day normalized postoperative costs. Hospital accounting system costs were normalized to reflect Medicare reimbursement levels using the ratio of hospital costs to Medicare reimbursement and categorized into major cost categories. Differences between costs in Medicare proportional dollars (MP $) can be interpreted as the amount that would be reimbursed to an average hospital by Medicare if it paid differentially based on types and extent of postoperative complications. In total, 120 patients underwent curative-intent total gastrectomy for stage I through III gastric adenocarcinoma between 2009 and 2012. Of these, 79 patients (65.8%) were men, and the median (interquartile range) age was 64 (52-70) years. The 51 patients (42.5%) who underwent an uncomplicated total gastrectomy had a mean (SD) normalized cost of MP $12 330 (MP $2500), predominantly owing to the cost of surgical care (mean [SD] cost, MP $6830 [MP $1600]). The 34 patients (28.3%) who had a major complication had a mean (SD) normalized cost of MP $37 700 (MP $28 090). Surgical care was more expensive in these patients (mean [SD] cost, MP $8970 [MP $2750]) but was a smaller contributor to total cost (24%) owing to increased costs from room and board (mean [SD] cost, MP $11 940 [MP $8820]), consultations (mean [SD

High-resolution seismic-reflection imaging 25 years of change in I-70 sinkhole, Russell County, Kansas

Science.gov (United States)

Miller, R.D.; Steeples, D.W.; Lambrecht, J.L.; Croxton, N.

2006-01-01

Time-lapse seismic reflection imaging improved our understanding of the consistent, gradual surface subsidence ongoing at two sinkholes in the Gorham Oilfield discovered beneath a stretch of Interstate Highway 70 through Russell and Ellis Counties in Kansas in 1966. With subsidence occurring at a rate of around 10 cm per year since discovery, monitoring has been beneficial to ensure public safety and optimize maintenance. A miniSOSIE reflection survey conducted in 1980 delineated the affected subsurface and successfully predicted development of a third sinkhole at this site. In 2004 and 2005 a high-resolution vibroseis survey was completed to ascertain current conditions of the subsurface, rate and pattern of growth since 1980, and potential for continued growth. With time and improved understanding of the salt dissolution affected subsurface in this area it appears that these features represent little risk to the public from catastrophic failure. However, from an operational perspective the Kansas Department of Transportation should expect continued subsidence, with future increases in surface area likely at a slightly reduced vertical rate. Seismic characteristics appear empirically consistent with gradual earth material compaction/settling. ?? 2005 Society of Exploration Geophysicists.

Kansas State University DOE/KEURP Site Operator Program. Year 5 second quarter report, October 1--December 31, 1995

Energy Technology Data Exchange (ETDEWEB)

Hague, J.R.

1995-12-31

Kansas State University is displaying, testing, and evaluating electric or hybrid vehicle technology. Data collection and a historical perspective are maintained on vehicle requirements. Two vehicles are electric conversion vehicles from Soleq Corporation of Chicago, Illinois, and four Ford Ranger EVs were procured from Troy Design and manufacturing of Redford, Michigan.

Association Between Hospital Admission Risk Profile Score and Skilled Nursing or Acute Rehabilitation Facility Discharges in Hospitalized Older Adults.

Science.gov (United States)

Liu, Stephen K; Montgomery, Justin; Yan, Yu; Mecchella, John N; Bartels, Stephen J; Masutani, Rebecca; Batsis, John A

2016-10-01

To evaluate whether the Hospital Admission Risk Profile (HARP) score is associated with skilled nursing or acute rehabilitation facility discharge after an acute hospitalization. Retrospective cohort study. Inpatient unit of a rural academic medical center. Hospitalized individuals aged 70 and older from October 1, 2013 to June 1, 2014. Participant age at the time of admission, modified Folstein Mini-Mental State Examination score, and self-reported instrumental activities of daily living 2 weeks before admission were used to calculate HARP score. The primary predictor was HARP score, and the primary outcome was discharge disposition (home, facility, deceased). Multivariate analysis was used to evaluate the association between HARP score and discharge disposition, adjusting for age, sex, comorbidities, and length of stay. Four hundred twenty-eight individuals admitted from home were screened and their HARP scores were categorized as low (n = 162, 37.8%), intermediate (n = 157, 36.7%), or high (n = 109, 25.5%). Participants with high HARP scores were significantly more likely to be discharged to a facility (55%) than those with low HARP scores (20%) (P risk of skilled nursing or acute rehabilitation facility discharge. Early identification for potential facility discharges may allow for targeted interventions to prevent functional decline, improve informed shared decision-making about post-acute care needs, and expedite discharge planning. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Economics within Social Studies: A Comparative Analysis of Student Performance on the 2012 Kansas History-Government Assessment

Science.gov (United States)

Deplazes, Svetlana P.

2014-01-01

The purpose of this study was to examine the overall level of student achievement on the 2012 Kansas History-Government Assessment in Grades 6, 8, and high school, with major emphasis on the subject area of economics. It explored four specific research questions in order to: (1) determine the level of student knowledge of assessed economic…

Evaluation of repeatability of Kansas test method KT-73, "density, absorption and voids in hardened concrete," boil test : [technical summary].

Science.gov (United States)

2015-06-01

For years, the Kansas Department of Transportation (KDOT) and concrete producers in : the state have used a Rapid Chloride Test for concrete cylinders, AASHTO T277. This : test has been thought of as an appropriate quality control test to evaluate pe...

Length of stay and associated costs of obesity related hospital admissions in Ireland.

LENUS (Irish Health Repository)

Vellinga, Akke

2008-01-01

BACKGROUND: Obesity is the cause of other chronic diseases, psychological problems, obesity shortens the lifespan and puts strain on health systems. The risk associated with childhood obesity in particular, which will accelerate the development of adult morbidity and mortality, has been identified as an emerging public health problem. METHODS: To estimate the length of stay and associated hospital costs for obesity related illnesses a cost of illness study was set up. All discharges from all acute hospitals in the Republic of Ireland from 1997 to 2004 with a principal or secondary diagnostic code for obesity for all children from 6 to 18 years of age and for adults were collected.A discharge frequency was calculated by dividing obesity related discharges by the total number of diagnoses (principal and secondary) for each year. The hospital costs related to obesity was calculated based on the total number of days care. RESULTS: The discharge frequency of obesity related conditions increased from 1.14 in 1997 to 1.49 in 2004 for adults and from 0.81 to 1.37 for children. The relative length of stay (number of days in care for obesity related conditions per 1000 days of hospital care given) increased from 1.47 in 1997 to 4.16 in 2004 for children and from 3.68 in 1997 to 6.74 in 2004 for adults.Based on the 2001 figures for cost per inpatient bed day, the annual hospital cost was calculated to be 4.4 Euromillion in 1997, increasing to 13.3 Euromillion in 2004. At a 20% variable hospital cost the cost ranges from 0.9 Euromillion in 1997 to 2.7 Euromillion in 2004; a 200% increase. CONCLUSION: The annual increase in the proportion of hospital discharges related to obesity is alarming. This increase is related to a significant increase in economic costs. This paper emphasises the need for action at an early stage of life. Health promotion and primary prevention of obesity should be high on the political agenda.

[Satisfaction of hospitalized patients in a hospital in Apurimac, Peru].

Science.gov (United States)

Sihuin-Tapia, Elsa Yudy; Gómez-Quispe, Oscar Elisban; Ibáñez-Quispe, Vladimiro

2015-01-01

In order to determine the satisfaction of hospitalized patients in the Sub-regional Hospital of Andahuaylas, 175 patients were surveyed using the Servqual multidimensional model. The estimate of variables associated with the satisfaction of the hospitalized patients was performed by using bivariate and multivariate logistic regression analysis. We found 25.0% satisfaction. Lower levels of satisfaction were associated with having a secondary level education (aOR: 0.05; 95% CI: 0.01 to 0.64) and with having been hospitalized in the surgery department (aOR 0.14, CI: 95%: 0.04 to 0.53). It was concluded that there was a low level of satisfaction with the quality of care received by hospitalized patients and this was associated with the level of education and type of hospital department.

Perceived coercion in inpatients with Anorexia nervosa: Associations with illness severity and hospital course.

Science.gov (United States)

Schreyer, Colleen C; Coughlin, Janelle W; Makhzoumi, Saniha H; Redgrave, Graham W; Hansen, Jennifer L; Guarda, Angela S

2016-04-01

The use of coercion in the treatment for anorexia nervosa (AN) is controversial and the limited studies to date have focused on involuntary treatment. However, coercive pressure for treatment that does not include legal measures is common in voluntarily admitted patients with AN. Empirical data examining the effect of non-legal forms of coerced care on hospital outcomes are needed. Participants (N = 202) with AN, Avoidant/Restrictive Food Intake Disorder (ARFID), or subthreshold AN admitted to a hospital-based behavioral specialty program completed questionnaires assessing illness severity and perceived coercion around the admissions process. Hospital course variables included inpatient length of stay, successful transition to a step-down partial hospitalization program, and achievement of target weight prior to program discharge. Higher perceived coercion at admission was associated with increased drive for thinness and body dissatisfaction, but not with admission BMI. Perceived coercion was not related to inpatient length of stay, rate of weight gain, or achievement of target weight although it was predictive of premature drop-out prior to transition to an integrated partial hospitalization program. These results, from an adequately powered sample, demonstrate that perceived coercion at admission to a hospital-based behavioral treatment program was not associated with rate of inpatient weight gain or achieving weight restoration, suggesting that coercive pressure to enter treatment does not necessarily undermine formation of a therapeutic alliance or clinical progress. Future studies should examine perceived coercion and long-term outcomes, patient views on coercive pressures, and the effect of different forms of leveraged treatment. © 2015 Wiley Periodicals, Inc.

An outbreak of Legionnaires disease associated with a decorative water wall fountain in a hospital.

Science.gov (United States)

Haupt, Thomas E; Heffernan, Richard T; Kazmierczak, James J; Nehls-Lowe, Henry; Rheineck, Bruce; Powell, Christine; Leonhardt, Kathryn K; Chitnis, Amit S; Davis, Jeffrey P

2012-02-01

To detect an outbreak-related source of Legionella, control the outbreak, and prevent additional Legionella infections from occurring. Epidemiologic investigation of an acute outbreak of hospital-associated Legionnaires disease among outpatients and visitors to a Wisconsin hospital. Patients with laboratory-confirmed Legionnaires disease who resided in southeastern Wisconsin and had illness onsets during February and March 2010. Patients with Legionnaires disease were interviewed using a hypothesis-generating questionnaire. On-site investigation included sampling of water and other potential environmental sources for Legionella testing. Case-finding measures included extensive notification of individuals potentially exposed at the hospital and alerts to area healthcare and laboratory personnel. Laboratory-confirmed Legionnaires disease was diagnosed in 8 patients, all of whom were present at the same hospital during the 10 days prior to their illness onsets. Six patients had known exposure to a water wall-type decorative fountain near the main hospital entrance. Although the decorative fountain underwent routine cleaning and maintenance, high counts of Legionella pneumophila serogroup 1 were isolated from cultures of a foam material found above the fountain trough. This outbreak of Legionnaires disease was associated with exposure to a decorative fountain located in a hospital public area. Routine cleaning and maintenance of fountains does not eliminate the risk of bacterial contamination. Our findings highlight the need to evaluate the safety of water fountains installed in any area of a healthcare facility.

Work factors associated with return to work in out-of-hospital cardiac arrest survivors.

Science.gov (United States)

Descatha, Alexis; Dumas, Florence; Bougouin, Wulfran; Cariou, Alain; Geri, Guillaume

2018-07-01

Although the survival rate after out-of-hospital cardiac arrest (OHCA) has increased over time, little is known about the return to work of OHCA survivors. We aim to evaluate prevalence and factors associated with return to work (RTW) in OHCA survivors. All consecutive OHCA survivors aged 18-65 years and discharged alive from a Paris tertiary intensive care unit between 2000 and 2013 were included. Pre-hospital care, in-hospital care, and after-hospital discharge data, such as work description (work location, job classification, nature of the job) were compared relative to work status and RTW. Factors associated with RTW were evaluated using multivariable logistic regression. 153 OHCA survivors were included in the analysis. Among them, 96 (62.8%) returned to work an average of 714 days after OHCA (SD 1031); mostly to the same job (n = 72, 75%). Six patients changed jobs (4%) and 12 reduced their activity (10.6%). Factors associated with RTW were younger age (adjusted odds ratio (aOR) 3.64 [1.10; 12.02]), being managers and professionals, and service and sales workers (compared to technicians and associate professionals, clerical support workers, respectively aOR 3.43 [1.05; 11.22] and 4.69 [1.14; 19.37]), and workplace occurrence (aOR 11.72 [1.37; 99.93]). Two thirds of OHCA survivors, in the present study, returned to work. Patients with a higher-level job, and with the arrest occurring in the workplace, were more likely to return to work. Further research should include more details of job contents, evolution, financial consequences, as well as prevention practices related to work location. Copyright © 2018 Elsevier B.V. All rights reserved.

Decreasing incidence and mortality among hospitalized patients suffering a ventilator-associated pneumonia: Analysis of the Spanish national hospital discharge database from 2010 to 2014.

Science.gov (United States)

de Miguel-Díez, Javier; López-de-Andrés, Ana; Hernández-Barrera, Valentín; Jiménez-Trujillo, Isabel; Méndez-Bailón, Manuel; Miguel-Yanes, José M de; Del Rio-Lopez, Benito; Jiménez-García, Rodrigo

2017-07-01

The aim of this study was to describe trends in the incidence and outcomes of ventilator-associated pneumonia (VAP) among hospitalized patients in Spain (2010-2014).This is a retrospective study using the Spanish national hospital discharge database from year 2010 to 2014. We selected all hospital admissions that had an ICD-9-CM code: 997.31 for VAP in any diagnosis position. We analyzed incidence, sociodemographic and clinical characteristics, procedures, pathogen isolations, and hospital outcomes.We identified 9336 admissions with patients suffering a VAP. Incidence rates of VAP decreased significantly over time (from 41.7 cases/100,000 inhabitants in 2010 to 40.55 in 2014). The mean Charlson comorbidity index (CCI) was 1.08 ± 0.98 and it did not change significantly during the study period. The most frequent causative agent was Pseudomonas and there were not significant differences in the isolation of this microorganism over time. Time trend analyses showed a significant decrease in in-hospital mortality (IHM), from 35.74% in 2010 to 32.81% in 2014. Factor associated with higher IHM included male sex, older age, higher CCI, vein or artery occlusion, pulmonary disease, cancer, undergone surgery, emergency room admission, and readmission.This study shows that the incidence of VAP among hospitalized patients has decreased in Spain from 2010 to 2014. The IHM has also decreased over the study period. Further investigations are needed to improve the prevention and control of VAP.

Event rates, hospital utilization, and costs associated with major complications of diabetes: a multicountry comparative analysis.

Directory of Open Access Journals (Sweden)

Philip M Clarke

2010-02-01

Full Text Available Diabetes imposes a substantial burden globally in terms of premature mortality, morbidity, and health care costs. Estimates of economic outcomes associated with diabetes are essential inputs to policy analyses aimed at prevention and treatment of diabetes. Our objective was to estimate and compare event rates, hospital utilization, and costs associated with major diabetes-related complications in high-, middle-, and low-income countries.Incidence and history of diabetes-related complications, hospital admissions, and length of stay were recorded in 11,140 patients with type 2 diabetes participating in the Action in Diabetes and Vascular Disease (ADVANCE study (mean age at entry 66 y. The probability of hospital utilization and number of days in hospital for major events associated with coronary disease, cerebrovascular disease, congestive heart failure, peripheral vascular disease, and nephropathy were estimated for three regions (Asia, Eastern Europe, and Established Market Economies using multiple regression analysis. The resulting estimates of days spent in hospital were multiplied by regional estimates of the costs per hospital bed-day from the World Health Organization to compute annual acute and long-term costs associated with the different types of complications. To assist, comparability, costs are reported in international dollars (Int$, which represent a hypothetical currency that allows for the same quantities of goods or services to be purchased regardless of country, standardized on purchasing power in the United States. A cost calculator accompanying this paper enables the estimation of costs for individual countries and translation of these costs into local currency units. The probability of attending a hospital following an event was highest for heart failure (93%-96% across regions and lowest for nephropathy (15%-26%. The average numbers of days in hospital given at least one admission were greatest for stroke (17-32 d across

Suboptimal Addiction Interventions for Patients Hospitalized with Injection Drug Use-Associated Infective Endocarditis.

Science.gov (United States)

Rosenthal, Elana S; Karchmer, Adolf W; Theisen-Toupal, Jesse; Castillo, Roger Araujo; Rowley, Chris F

2016-05-01

Infective endocarditis is a serious infection, often resulting from injection drug use. Inpatient treatment regularly focuses on management of infection without attention to the underlying addiction. We aimed to determine the addiction interventions done in patients hospitalized with injection drug use-associated infective endocarditis. This is a retrospective review of patients hospitalized with injection drug use-associated infective endocarditis from January, 2004 through August, 2014 at a large academic tertiary care center in Boston, Massachusetts. For the initial and subsequent admissions, data were collected regarding addiction interventions, including consultation by social work, addiction clinical nurse and psychiatry, documentation of addiction in the discharge summary plan, plan for medication-assisted treatment and naloxone provision. There were 102 patients admitted with injection drug use-associated infective endocarditis, 50 patients (49.0%) were readmitted and 28 (27.5%) patients had ongoing injection drug use at readmission. At initial admission, 86.4% of patients had social work consultation, 23.7% had addiction consultation, and 24.0% had psychiatry consultation. Addiction was mentioned in 55.9% of discharge summary plans, 7.8% of patients had a plan for medication-assisted treatment, and naloxone was never prescribed. Of 102 patients, 26 (25.5%) are deceased. The median age at death was 40.9 years (interquartile range 28.7-48.7). We found that patients hospitalized with injection drug use-associated infective endocarditis had high rates of readmission, recurrent infective endocarditis and death. Despite this, addiction interventions were suboptimal. Improved addiction interventions are imperative in the treatment of injection drug use-associated infective endocarditis. Copyright © 2016 Elsevier Inc. All rights reserved.

Organizational characteristics associated with cultural and linguistic service provision within Alabama hospitals.

Science.gov (United States)

Davis, Jullet A; Whitman, Marilyn V

2008-01-01

Like several states in the Southeast, Alabama is in the nascent stages of an increase in the population of foreign-born individuals for whom English is a second language. These individuals are also culturally different from the traditional southern population. Given the impact of culture and language on a person's service utilization, the introduction of new cultures may pose significant challenges for Alabama's health care providers if they are not prepared. The purpose of this project is to examine the organizational characteristics associated with the provision of culturally and linguistically appropriate services by Alabama hospitals. The data for the project come from a survey of all medical/surgical hospitals (N = 101). Fifty-nine surveys were returned, giving us a 58% response rate. The data were analyzed using correlations, analysis of variance, and logistic regression. Approximately 47% of the sample hospitals reported having a staff interpreter. Furthermore, hospitals that had staff interpreters did seem to be more aware of their community, which was reflected in their mission statements. In addition, directors who viewed their role as fulfilling the strategic plan accepted the task of providing staff interpreters. Thus, several hospitals in Alabama seemed to be ready to meet the cultural and language needs of their markets.

Association between delirium superimposed on dementia and mortality in hospitalized older adults: A prospective cohort study.

Directory of Open Access Journals (Sweden)

Thiago J Avelino-Silva

2017-03-01

Full Text Available Hospitalized older adults with preexisting dementia have increased risk of having delirium, but little is known regarding the effect of delirium superimposed on dementia (DSD on the outcomes of these patients. Our aim was to investigate the association between DSD and hospital mortality and 12-mo mortality in hospitalized older adults.This was a prospective cohort study completed in the geriatric ward of a university hospital in São Paulo, Brazil. We included 1,409 hospitalizations of acutely ill patients aged 60 y and over from January 2009 to June 2015. Main variables and measures included dementia and dementia severity (Informant Questionnaire on Cognitive Decline in the Elderly, Clinical Dementia Rating and delirium (Confusion Assessment Method. Primary outcomes were time to death in the hospital and time to death in 12 mo (for the discharged sample. Comprehensive geriatric assessment was performed at admission, and additional clinical data were documented upon death or discharge. Cases were categorized into four groups (no delirium or dementia, dementia alone, delirium alone, and DSD. The no delirium/dementia group was defined as the referent category for comparisons, and multivariate analyses were performed using Cox proportional hazards models adjusted for possible confounders (sociodemographic information, medical history and physical examination data, functional and nutritional status, polypharmacy, and laboratory covariates. Overall, 61% were women and 39% had dementia, with a mean age of 80 y. Dementia alone was observed in 13% of the cases, with delirium alone in 21% and DSD in 26% of the cases. In-hospital mortality was 8% for patients without delirium or dementia, 12% for patients with dementia alone, 29% for patients with delirium alone, and 32% for DSD patients (Pearson Chi-square = 112, p < 0.001. DSD and delirium alone were independently associated with in-hospital mortality, with respective hazard ratios (HRs of 2.14 (95% CI

Factors associated with asthma among under-fives in Mulago hospital, Kampala Uganda

DEFF Research Database (Denmark)

Nantanda, Rebecca; Ostergaard, Marianne S; Ndeezi, Grace

2013-01-01

Asthma is the most common chronic childhood illness, with rapidly increasing prevalence in low-income countries. Among young children, asthma is often under-diagnosed.We investigated the factors associated with asthma among under-fives presenting with acute respiratory symptoms at Mulago hospital...

Association between exposure to particulate matter and hospital admissions for respiratory disease in children

Science.gov (United States)

Cesar, Ana Cristina Gobbo; Nascimento, Luiz Fernando C; de Carvalho, João Andrade

2013-01-01

The aim of this study was to estimate the association between exposure to particulate matter less than 2.5 microns in diameter and hospitalization for respiratory disease. It was an ecological time series study with daily indicators of hospitalization for respiratory diseases in children up to 10 years old, living in Piracicaba, SP, Southeastern Brazil, between August 1, 2011 and July 31, 2012. A generalized additive Poisson regression model was used. The relative risks were RR = 1.008; 95%CI 1.001;1.016 for lag 1 and RR = 1.009; 95%CI 1.001;1.017 for lag 3. The increment of 10 μg/m3in particulate matter less than 2.5 microns in diameter implies increase in relative risk of between 7.9 and 8.6 percentage points. In conclusion, exposure to particulate matter less than 2.5 microns in diameter was associated with hospitalization for respiratory disease in children. PMID:24626559

Do HMO penetration and hospital competition impact quality of hospital care?

Science.gov (United States)

Rivers, P A; Fottler, M D

2004-11-01

This study examines the impact of HMO penetration and competition on hospital markets. A modified structure-conduct-performance paradigm was applied to the health care industry in order to investigate the impact of HMO penetration and competition on risk-adjusted hospital mortality rates (i.e. quality of hospital care). Secondary data for 1957 acute care hospitals in the USA from the 1991 American Hospital Association's Annual Survey of Hospitals were used. The outcome variables were risk-adjusted mortality rates in 1991. Predictor variables were market characteristics (i.e. managed care penetration and hospital competition). Control variables were environmental, patient, and institutional characteristics. Associations between predictor and outcome variables were investigated using statistical regression techniques. Hospital competition had a negative relationship with risk-adjusted mortality rates (a negative indicator of quality of care). HMO penetration, hospital competition, and an interaction effect of HMO penetration and competition were not found to have significant effects on risk-adjusted mortality rates. These findings suggest that when faced with intense competition, hospitals may respond in ways associated with reducing their mortality rates.

Comparing the cost-effectiveness of water conservation policies in a depleting aquifer:A dynamic analysis of the Kansas High Plains

Science.gov (United States)

This research analyzes two groundwater conservation policies in the Kansas High Plains located within the Ogallala aquifer: 1) cost-share assistance to increase irrigation efficiency; and 2) incentive payments to convert irrigated crop production to dryland crop production. To compare the cost-effec...

Factors associated with recommitment of NGRI acquittees to a forensic hospital.