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...

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...

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...

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.

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...

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...

Science programs in Kansas

Science.gov (United States)

Kramer, Ariele R.; Kelly, Brian P.

2017-05-08

The U.S. Geological Survey (USGS) is a non-regulatory Earth science agency within the Department of the Interior that provides impartial scientific information to describe and understand the health of our ecosystems and environment; minimize loss of life and property from natural disasters; manage water, biological, energy, and mineral resources; and enhance and protect our quality of life. The USGS cooperates with Federal, State, tribal, and local agencies in Kansas to deliver long-term data in real-time and interpretive reports describing what those data mean to the public and resource management agencies. USGS science programs in Kansas provide real-time groundwater monitoring at more than 23 locations; streamflow monitoring at more than 218 locations; water-quality and trends in the Little Arkansas and Kansas Rivers; inflows and outflows of sediment to/from reservoirs and in streams; harmful algal bloom research in the Kansas River, Milford Lake, and Cheney Reservoir; water-quantity and water-quality effects of artificial groundwater recharge for the Equus Beds Aquifer Storage and Recovery project near Wichita, Kansas; compilation of Kansas municipal and irrigation water-use data statewide; the occurrence, effects, and movement of environmental pesticides, antibiotics, algal toxins, and taste-and-odor compounds; and funding to the Kansas Water Resources Research Institute to further research and education through Kansas universities.

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.

Introducing Kansas Lava

Science.gov (United States)

Gill, Andy; Bull, Tristan; Kimmell, Garrin; Perrins, Erik; Komp, Ed; Werling, Brett

Kansas Lava is a domain specific language for hardware description. Though there have been a number of previous implementations of Lava, we have found the design space rich, with unexplored choices. We use a direct (Chalmers style) specification of circuits, and make significant use of Haskell overloading of standard classes, leading to concise circuit descriptions. Kansas Lava supports both simulation (inside GHCi), and execution via VHDL, by having a dual shallow and deep embedding inside our Signal type. We also have a lightweight sized-type mechanism, allowing for MATLAB style matrix based specifications to be directly expressed in Kansas Lava.

Medical service plans in academic medical centers.

Science.gov (United States)

Siegel, B

1978-10-01

Medical service plans are of major importance to academic medical centers and are becoming increasingly so each year as evidenced by growing dependence of medical schools on resulting funds. How these funds are generated and used varies among schools. The procedures may affect the governance of the institution, modifying the authority of the central administration or the clinical departments. Recent developments in federal legislation, such as health maintenance organizations and amendments (Section 227) to the Social Security Act, and the future development of national health insurance will certainly have an effect on how academic medical centers organize their clinical activities. How successfully various medical schools deal with the dynamic problem may well determine their future survival.

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…

Advertising by academic medical centers.

Science.gov (United States)

Larson, Robin J; Schwartz, Lisa M; Woloshin, Steven; Welch, H Gilbert

2005-03-28

Many academic medical centers have increased their use of advertising to attract patients. While the content of direct-to-consumer pharmaceutical advertisements (ads) has been studied, to our knowledge, advertising by academic medical centers has not. We aimed to characterize advertising by the nation's top academic medical centers. We contacted all 17 medical centers named to the US News & World Report 2002 honor roll of "America's Best Hospitals" for a semistructured interview regarding their advertising practices. In addition, we obtained and systematically analyzed all non-research-related print ads placed by these institutions in their 5 most widely circulating local newspapers during 2002. Of the 17 institutions, 16 reported advertising to attract patients; 1 stated, "We're just word of mouth." While all 17 centers confirmed the presence of an institutional review board process for approving advertising to attract research subjects, none reported a comparable process for advertising to attract patients. We identified 127 unique non-research-related print ads for the 17 institutions during 2002 (mean, 7.5; range, 0-39). Three ads promoted community events with institution sponsorship, 2 announced genuine public services, and 122 were aimed at attracting patients. Of the latter group, 36 ads (29.5%) promoted the medical center as a whole, while 65 (53.3%) promoted specific clinical departments and 21 (17.2%) promoted single therapeutic interventions or diagnostic tests. The most commonly used marketing strategies included appealing to emotions (61.5%), highlighting institution prestige (60.7%), mentioning a symptom or disease (53.3%), and promoting introductory lectures or special offers likely to lead to further business (47.5%). Of the 21 ads for single interventions, most were for unproved (38.1%) or cosmetic (28.6%) procedures. While more than half of these ads presented benefits, none quantified their positive claims and just 1 mentioned potential harms

Kansas Energy Sources: A Geological Review

Science.gov (United States)

Merriam, D.F.; Brady, L.L.; Newell, K.D.

2012-01-01

Kansas produces both conventional energy (oil, gas, and coal) and nonconventional (coalbed gas, wind, hydropower, nuclear, geothermal, solar, and biofuels) and ranks the 22nd in state energy production in the U. S. Nonrenewable conventional petroleum is the most important energy source with nonrenewable, nonconventional coalbed methane gas becoming increasingly important. Many stratigraphic units produce oil and/or gas somewhere in the state with the exception of the Salina Basin in north-central Kansas. Coalbed methane is produced from shallow wells drilled into the thin coal units in southeastern Kansas. At present, only two surface coal mines are active in southeastern Kansas. Although Kansas has been a major exporter of energy in the past (it ranked first in oil production in 1916), now, it is an energy importer. ?? 2011 International Association for Mathematical Geology.

Characterizing customers at medical center farmers' markets.

Science.gov (United States)

Kraschnewski, Jennifer L; George, Daniel R; Rovniak, Liza S; Monroe, Diana L; Fiordalis, Elizabeth; Bates, Erica

2014-08-01

Approximately 100 farmers' markets operate on medical center campuses. Although these venues can uniquely serve community health needs, little is known about customer characteristics and outreach efforts. Intercept survey of markets and market customers between August 2010 and October 2011 at three medical centers in different geographic regions of the US (Duke University Medical Center, Cleveland Clinic, and Penn State Hershey Medical Center) were conducted. Markets reported serving 180-2,000 customers per week and conducting preventive medicine education sessions and community health programs. Customers (n = 585) across markets were similar in sociodemographic characteristics--most were middle-aged, white, and female, who were employees of their respective medical center. Health behaviors of customers were similar to national data. The surveyed medical center farmers' markets currently serve mostly employees; however, markets have significant potential for community outreach efforts in preventive medicine. If farmers' markets can broaden their reach to more diverse populations, they may play an important role in contributing to community health.

Expanding Local Cancer Clinical Trial Options: Analysis of the Economic Impact of the Midwest Cancer Alliance in Kansas.

Science.gov (United States)

Gafford, J Atlee; Gurley-Calvez, Tami; Krebill, Hope; Lai, Sue Min; Christiadi; Doolittle, Gary C

2017-09-01

Patients benefit from receiving cancer treatment closer to home when possible and at high-volume regional centers when specialized care is required. The purpose of this analysis was to estimate the economic impact of retaining more patients in-state for cancer clinical trials and care, which might offset some of the costs of establishing broader cancer trial and treatment networks. Kansas Cancer Registry data were used to estimate the number of patients retained in-state for cancer care following the expansion of local cancer clinical trial options through the Midwest Cancer Alliance based at the University of Kansas Medical Center. The 2014 economic impact of this enhanced local clinical trial network was estimated in four parts: Medical spending was estimated on the basis of National Cancer Institute cost-of-care estimates. Household travel cost savings were estimated as the difference between in-state and out-of-state travel costs. Trial-related grant income was calculated from administrative records. Indirect and induced economic benefits to the state were estimated using an economic impact model. The authors estimated that the enhanced local cancer clinical trial network resulted in approximately $6.9 million in additional economic activity in the state in 2014, or $362,000 per patient retained in-state. This estimate includes $3.6 million in direct spending and $3.3 million in indirect economic activity. The enhanced trial network also resulted in 45 additional jobs. Retaining patients in-state for cancer care and clinical trial participation allows patients to remain closer to home for care and enhances the state economy.

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

Kansas Agents Study Grain Marketing

Science.gov (United States)

Schoeff, Robert W.

1973-01-01

Author is an extension specialist in feed and grain marketing for Kansas State University. He describes a tour set up to educate members of the Kansas Grain and Feed Dealers' Association in the area of grain marketing and exporting. (GB)

A Comparative Analysis of Patient Access Modes at Wilford Hall United States Air Force Medical Center and Selected Civilian Medical Centers

Science.gov (United States)

1983-12-01

In A COMPARATIVE ANALYSIS OF PATIENT ACCESS MODES AT WILFORD HALL UNITED STATES AIR FORCE MEDICAL CENTER N AND SELECTED CIVILIAN MEDICAL CENTERS0 N...current patient access modes at WHMC and several civilian medical centers of comparable size. This project has pursued the subject of patient access in...selected civilian medical centers which are comparable to WHMC in size, specialty mix, workload, and mission, providing responsive and efficient patient

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.

Academic Medical Centers as digital health catalysts.

Science.gov (United States)

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

2014-09-01

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

Characterizing customers at medical center farmers’ markets1

Science.gov (United States)

Kraschnewski, Jennifer L.; George, Daniel R.; Rovniak, Liza S.; Monroe, Diana L.; Fiordalis, Elizabeth; Bates, Erica

2014-01-01

Approximately 100 farmers’ markets operate on medical center campuses. Although these venues can uniquely serve community health needs, little is known about customer characteristics and outreach efforts. Intercept survey of markets and market customers between August 2010-October 2011 at three medical centers in different geographic regions of the US: Duke University Medical Center, Cleveland Clinic, and Penn State Hershey Medical Center were conducted. Markets reported serving 180–2000 customers per week and conducting preventive medicine education sessions and community health programs. Customers (n=585) across markets were similar in sociodemographic characteristics – most were middle-aged, white, and female, who were employees of their respective medical center. Health behaviors of customers were similar to national data. The surveyed medical center farmers’ markets currently serve mostly employees; however, markets have significant potential for community outreach efforts in preventive medicine. If farmers’ markets can broaden their reach to more diverse populations, they may play an important role in contributing to community health. PMID:24421001

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).

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...

Enactment of mandatory pharmacy technician certification in Kansas.

Science.gov (United States)

Lucas, Amber; Massey, Lindsay; Gill, Taylor; Burger, Gregory; Little, Jeff D

2016-02-01

The successful enactment of mandatory pharmacy technician certification in Kansas is described. In 2004, Kansas began requiring registration of all pharmacy technicians with the state board of pharmacy. Registration identified individuals working as pharmacy technicians but did not require any specific education or certification. In September 2012, the Kansas Board of Pharmacy created a task force of key stakeholders including pharmacists from multiple areas of practice, the University of Kansas School of Pharmacy, organizational leaders from the Kansas Council of Health-System Pharmacists (KCHP) and Kansas Pharmacists Association, and professional lobbyists. The goals of this task force were to research practices of technician certification in other states and to make recommendations to the state board of pharmacy on how Kansas could accomplish mandatory technician certification. The task force outlined the steps needed to achieve legislation that could be supported by the members. These topics included the creation of a technician trainee category, grandfathering certain technicians who had been practicing for a designated period of time, state board-approved exemptions, training requirements, age and education requirements, continuing-education requirements, and pharmacist:technician ratio. The recommendations were finalized at the August 2013 Kansas Pharmacy Summit, and the proposed legislation was introduced and passed during the 2014 legislative session. KCHP members learned many valuable lessons about advocacy and the legislative process with this initiative, including building relationships, working with legislators, and working with other professional organizations. The formation of a task force led to the successful passage of a bill granting the Kansas Board of Pharmacy the authority to issue regulations regarding mandatory pharmacy technician certification. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Medical Waste Management in Community Health Centers.

Science.gov (United States)

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

2018-02-01

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

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

Estate of Behringer v. Medical Center at Princeton.

Science.gov (United States)

1991-04-25

Dr. William Behringer, a staff member at the Medical Center at Princeton, was diagnosed with AIDS. Afterwards, Behringer received numerous phone calls from various people expressing awareness of his illness, and his surgical privileges at the Center were suspended. He sued the Medical Center, alleging a breach of confidentiality and discrimination. The Superior Court of New Jersey, Mercer County, held that the Medical Center had breached its duty of confidentiality when it failed to take reasonable precautions to prevent Behringer's AIDS diagnosis from becoming public knowledge. Nevertheless, although New Jersey's anti-discrimination statutes protected Dr. Behringer from having his surgical privileges revoked, the Medical Center demonstrated a reasonable risk to patients that justified suspending Dr. Behringer's privileges, or alternatively, requiring his patients' informed consent before operating. The court found that the risk included not only actual HIV transmission, but also the possibility of surgical accidents.

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 ...

Johnson Space Center Health and Medical Technical Authority

Science.gov (United States)

Fogarty, Jennifer A.

2010-01-01

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

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,…

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

Science.gov (United States)

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…

Medical waste management in Jordan: A study at the King Hussein Medical Center

International Nuclear Information System (INIS)

Oweis, Rami; Al-Widyan, Mohamad; Al-Limoon, Ohood

2005-01-01

As in many other developing countries, the generation of regulated medical waste (RMW) in Jordan has increased significantly over the last few decades. Despite the serious impacts of RMW on humans and the environment, only minor attention has been directed to its proper handling and disposal. This study was conducted in the form of a case study at one of Jordan's leading medical centers, namely, the King Hussein Medical Center (KHMC). Its purpose was to report on the current status of medical waste management at KHMC and propose possible measures to improve it. In general, it was found that the center's administration was reasonably aware of the importance of medical waste management and practiced some of the measures to adequately handle waste generated at the center. However, it was also found that significant voids were present that need to be addressed in the future including efficient segregation, the use of coded and colored bags, better handling and transfer means, and better monitoring and tracking techniques, as well as the need for training and awareness programs for the personnel

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…

An Artist in the University Medical Center. Review.

Science.gov (United States)

James, A. Everette, Jr.

1991-01-01

Reviews "An Artist in the University Medical Center" (M. Lesser, New Orleans: Tulane University Press, 1989), in which the artist captures the human side of the complex Tulane Medical Center in New Orleans (Louisiana). The interplay of drawings, etchings, watercolors, and prose conveys traditions of nurturing in the hospital. (SLD)

Public-supply water use in Kansas, 1990-2012

Science.gov (United States)

Kenny, Joan F.

2014-01-01

This fact sheet describes water-use data collection and quantities of surface water and groundwater diverted for public supply in Kansas for the years 1990 through 2012. Data used in this fact sheet are from the Kansas Department of Agriculture’s Division of Water Resources and the Kansas Water Office. Water used for public supply represents about 10 percent of all reported water withdrawals in Kansas. Between 1990 and 2012, annual withdrawals for public supply ranged from a low of 121 billion gallons in 1993 to a high of 159 billion gallons in 2012. Differences in annual withdrawals were associated primarily with climatic fluctuations. Six suppliers distributed about one-half of the total water withdrawn for public supply, and nearly three-quarters of the surface water. Surface water represented between 52 and 61 percent of total annual withdrawals for public supply. The proportion of surface water obtained through contracts from Federal reservoirs increased from less than 5 percent in the 1990s to 8 percent in 2011 and 2012. More than 99 percent of the reported water withdrawn for public supply in Kansas in 2012 was metered, which was an increase from 92 percent in 1990. State population increased steadily from 2.5 million people in 1990 to 2.9 million in 2012. Recent estimates indicate that about 95 percent of the total population was served by public water supply; the remainder obtained water from other sources such as private wells. Average per capita water use as calculated for State conservation planning purposes varied by region of the State. The smallest regional average water use for the years 1990–2012 was 98 gallons per person per day in easternmost Kansas, and the largest regional average water use was 274 gallons per person per day in westernmost Kansas.

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

Science.gov (United States)

Guo, K

1999-06-01

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

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

An academic medical center under prolonged rocket attack--organizational, medical, and financial considerations.

Science.gov (United States)

Bar-El, Yaron; Michaelson, Moshe; Hyames, Gila; Skorecki, Karl; Reisner, Shimon A; Beyar, Rafael

2009-09-01

The Rambam Medical Center, the major academic health center in northern Israel, serving a population of two million and providing specialized tertiary care, was exposed to an unprecedented experience during the Second Lebanon War in the summer of 2006. For more than one month, it was subjected to continuous rocket attacks, but it continued to provide emergency and routine medical services to the civilian population and also served the military personnel who were evacuated from the battlefront. To accomplish the goals of serving the population while itself being under fire, the Rambam Medical Center had to undertake major organizational decisions, which included maximizing safety within the hospital by shifting patients and departments, ensuring that the hospital was properly fortified, managing the health professional teams' work schedules, and providing needed services for the families of employees. The Rambam Medical Center's Level I trauma center expertise included multidisciplinary teams and extensive collaborations; modern imaging modalities usually reserved for peacetime medical practice were frequently used. The function of the hospital teams during the war was efficient and smooth, based on the long-term actions taken to prepare for disasters and wartime conditions. Routine hospital services continued, although at 60% of normal occupancy. Financial losses incurred were primarily due to the decrease in revenue-generating activity. The two most important components of managing the hospital under these conditions are (1) the ability to arrive at prompt and meaningful decisions with respect to the organizational and medical hospital operations and (2) the leadership and management of the professional staff and teams.

[NEURO-ONCOLOGY A NEW FIELD IN DAVIDOFF CANCER CENTER AT RABIN MEDICAL CENTER].

Science.gov (United States)

Yust-Katz, Shlomit; Limon, Dror; Abu-Shkara, Ramez; Siegal, Tali

2017-08-01

Neuro-oncology is a subspecialty attracting physicians from medical disciplines such as neurology, neurosurgery, pediatrics, oncology, and radiotherapy. It deals with diagnosis and management of primary brain tumors, as well as metastatic and non-metastatic neurological manifestations that frequently affect cancer patients including brain metastases, paraneoplastic syndromes and neurological complications of cancer treatment. A neuro-oncology unit was established in Davidoff Cancer Center at Rabin Medical Center. It provides a multidisciplinary team approach for management of brain tumors and services, such as expert outpatient clinics and inpatient consultations for the departments of oncology, hematology, bone marrow transplantation and other departments in the Rabin Medical Center. In addition, expert consultation is frequently provided to other hospitals that treat cancer patients with neurological manifestations. The medical disciplines that closely collaborate for the daily management of neuro-oncology patients include radiotherapy, hematology, oncology, neuro-surgery, neuro-radiology and neuro-pathology. The neuro-oncology center is also involved in clinical and laboratory research conducted in collaboration with researchers in Israel and abroad. The new service contributes substantially to the improved care of cancer patients and to the advance of research topics in the field of neuro-oncology.

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

Science.gov (United States)

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...

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.

[Patient-centered medicine for tuberculosis medical services].

Science.gov (United States)

Fujita, Akira; Narita, Tomoyo

2012-12-01

The 2011 edition of Specific Guiding Principles for Tuberculosis Prevention calls for a streamlined medical services system capable of providing medical care that is customized to the patient's needs. The new 21st Century Japanese version of the Directly Observed Treatment Short Course (DOTS) expands the indication of DOTS to all tuberculosis (TB) patients in need of treatment. Hospital DOTS consists of comprehensive, patient-centered support provided by a DOTS care team. For DOTS in the field, health care providers should select optimal administration support based on patient profiles and local circumstances. In accordance with medical fee revisions for 2012, basic inpatient fees have been raised and new standards for TB hospitals have been established, the result of efforts made by the Japanese Society for Tuberculosis and other associated groups. It is important that the medical care system be improved so that patients can actively engage themselves as a member of the team, for the ultimate goal of practicing patient-centered medicine. We have organized this symposium to explore the best ways for practicing patient-centered medicine in treating TB. It is our sincere hope that this symposium will lead to improved medical treatment for TB patients. 1. Providing patient-centered TB service via utilization of collaborative care pathway: Akiko MATSUOKA (Hiroshima Prefectural Tobu Public Health Center) We have been using two types of collaborative care pathway as one of the means of providing patient-centered TB services since 2008. The first is the clinical pathway, which is mainly used by TB specialist doctors to communicate with local practitioners on future treatment plan (e.g. medication and treatment duration) of patients. The clinical pathway was first piloted in Onomichi district and its use was later expanded to the whole of Hiroshima prefecture. The second is the regional care pathway, which is used to share treatment progress, test results and other

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...

Consumerism: forcing medical practices toward patient-centered care.

Science.gov (United States)

Ozmon, Jeff

2007-01-01

Consumerism has been apart of many industries over the years; now consumerism may change the way many medical practices deliver healthcare. With the advent of consumer-driven healthcare, employers are shifting the decision-making power to their employees. Benefits strategies like health savings accounts and high-deductible insurance plans now allow the patients to control how and where they spend their money on medical care. Practices that seek to attract the more affluent and informed consumers are beginning to institute patient-centered systems designs that invite patients to actively participate in their healthcare. This article will outline the changes in the healthcare delivery system facing medical practices, the importance of patient-centered care, and six strategies to implement to change toward more patient-centered care.

Implementing the patient-centered medical home in complex adaptive systems: Becoming a relationship-centered patient-centered medical home.

Science.gov (United States)

Flieger, Signe Peterson

This study explores the implementation experience of nine primary care practices becoming patient-centered medical homes (PCMH) as part of the New Hampshire Citizens Health Initiative Multi-Stakeholder Medical Home Pilot. The purpose of this study is to apply complex adaptive systems theory and relationship-centered organizations theory to explore how nine diverse primary care practices in New Hampshire implemented the PCMH model and to offer insights for how primary care practices can move from a structural PCMH to a relationship-centered PCMH. Eighty-three interviews were conducted with administrative and clinical staff at the nine pilot practices, payers, and conveners of the pilot between November and December 2011. The interviews were transcribed, coded, and analyzed using both a priori and emergent themes. Although there is value in the structural components of the PCMH (e.g., disease registries), these structures are not enough. Becoming a relationship-centered PCMH requires attention to reflection, sensemaking, learning, and collaboration. This can be facilitated by settings aside time for communication and relationship building through structured meetings about PCMH components as well as the implementation process itself. Moreover, team-based care offers a robust opportunity to move beyond the structures to focus on relationships and collaboration. (a) Recognize that PCMH implementation is not a linear process. (b) Implementing the PCMH from a structural perspective is not enough. Although the National Committee for Quality Assurance or other guidelines can offer guidance on the structural components of PCMH implementation, this should serve only as a starting point. (c) During implementation, set aside structured time for reflection and sensemaking. (d) Use team-based care as a cornerstone of transformation. Reflect on team structures and also interactions of the team members. Taking the time to reflect will facilitate greater sensemaking and learning and

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.

Lessons learned: mobile device encryption in the academic medical center.

Science.gov (United States)

Kusche, Kristopher P

2009-01-01

The academic medical center is faced with the unique challenge of meeting the multi-faceted needs of both a modern healthcare organization and an academic institution, The need for security to protect patient information must be balanced by the academic freedoms expected in the college setting. The Albany Medical Center, consisting of the Albany Medical College and the Albany Medical Center Hospital, was challenged with implementing a solution that would preserve the availability, integrity and confidentiality of business, patient and research data stored on mobile devices. To solve this problem, Albany Medical Center implemented a mobile encryption suite across the enterprise. Such an implementation comes with complexities, from performance across multiple generations of computers and operating systems, to diversity of application use mode and end user adoption, all of which requires thoughtful policy and standards creation, understanding of regulations, and a willingness and ability to work through such diverse needs.

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)…

Characteristics of medical teachers using student-centered teaching methods.

Science.gov (United States)

Kim, Kyong-Jee; Hwang, Jee-Young

2017-09-01

This study investigated characteristics of medical teachers who have adopted student-centered teaching methods into their teaching. A 24-item questionnaire consisted of respondent backgrounds, his or her use of student-centered teaching methods, and awareness of the school's educational objectives and curricular principles was administered of faculty members at a private medical school in Korea. Descriptive statistics and chi-square analysis were conducted to compare faculty use of student-centered approaches across different backgrounds and awareness of curricular principles. Overall response rate was 70% (N=140/200), approximately 25% (n=34) of whom were using student-centered teaching methods. Distributions in the faculty use of student-centered teaching methods were significantly higher among basic sciences faculty (versus clinical sciences faculty), with teaching experiences of over 10 years (versus less than 10 years), and who were aware of the school's educational objectives and curricular principles. Our study indicates differences in medical faculty's practice of student-centered teaching across disciplines, teaching experiences, and their understanding of the school's educational objectives curricular principles. These findings have implications for faculty development and institutional support to better promote faculty use of student-centered teaching approaches.

Measuring the efficiency of dental departments in medical centers: a nonparametric analysis approach.

Science.gov (United States)

Wang, Su-Chen; Tsai, Chi-Cheng; Huang, Shun-Te; Hong, Yu-Jue

2002-12-01

Data envelopment analysis (DEA), a cross-sectional study design based on secondary data analysis, was used to evaluate the relative operational efficiency of 16 dental departments in medical centers in Taiwan in 1999. The results indicated that 68.7% of all dental departments in medical centers had poor performance in terms of overall efficiency and scale efficiency. All relatively efficient dental departments were in private medical centers. Half of these dental departments were unable to fully utilize available medical resources. 75.0% of public medical centers did not take full advantage of medical resources at their disposal. In the returns to scale, 56.3% of dental departments in medical centers exhibited increasing returns to scale, due to the insufficient scale influencing overall hospital operational efficiency. Public medical centers accounted for 77.8% of the institutions affected. The scale of dental departments in private medical centers was more appropriate than those in public medical centers. In the sensitivity analysis, the numbers of residents, interns, and published papers were used to assess teaching and research. Greater emphasis on teaching and research in medical centers has a large effect on the relative inefficiency of hospital operation. Dental departments in private medical centers had a higher mean overall efficiency score than those in public medical centers, and the overall efficiency of dental departments in non-university hospitals was greater than those in university hospitals. There was no information to evaluate the long-term efficiency of each dental department in all hospitals. A different combination of input and output variables, using common multipliers for efficiency value measurements in DEA, may help establish different pioneering dental departments in hospitals.

Opportunity for Collaboration Between Radiation Injury Treatment Network Centers and Medical Toxicology Specialists.

Science.gov (United States)

Davlantes, Elizabeth; Shartar, Samuel; Venero, Jennifer; Steck, Alaina; Langston, Amelia; Kazzi, Ziad N

2017-08-01

The Radiation Injury Treatment Network (RITN) comprises >50 centers across the United States that are poised to care for victims of a radiation emergency. The network is organized around bone marrow transplant centers because these facilities excel in both radiation medicine and the care of patients with severe bone marrow depression. A radiation emergency may cause not only irradiation from an external source but also internal contamination with radioactive material. Because medical toxicologists are trained in radiation injury management and have expertise in the management of internal contamination, RITN centers may benefit from partnerships with medical toxicology resources, which may be located at academic medical centers, hospital inpatient clinical services, outpatient clinics, or poison control centers. We determined the locations of existing RITN centers and assessed their proximity to various medical toxicology resources, including medical toxicology fellowship programs, inpatient toxicology services, outpatient toxicology clinics, and poison control centers. Data were derived from publicly available Internet sources in March 2015. The majority of RITN centers do not have a medical toxicology fellowship, an inpatient toxicology service, or an outpatient toxicology clinic within the same institution. Fifty-seven percent of RITN centers have at least one of these resources located in the same city, however, and 73% of centers have at least one of these resources or a poison control center within the same city. Ninety-five percent of RITN centers have at least one medical toxicology resource within the state. Most RITN centers are located in the same city as at least one medical toxicology resource. Establishing relationships between RITN centers and medical toxicologists needs to be explored further.

Academic medical center libraries on the Web.

Science.gov (United States)

Tannery, N H; Wessel, C B

1998-10-01

Academic medical center libraries are moving towards publishing electronically, utilizing networked technologies, and creating digital libraries. The catalyst for this movement has been the Web. An analysis of academic medical center library Web pages was undertaken to assess the information created and communicated in early 1997. A summary of present uses and suggestions for future applications is provided. A method for evaluating and describing the content of library Web sites was designed. The evaluation included categorizing basic information such as description and access to library services, access to commercial databases, and use of interactive forms. The main goal of the evaluation was to assess original resources produced by these libraries.

St. Luke's Medical Center: technologizing health care

International Nuclear Information System (INIS)

Tumanguil, S.S.

1994-01-01

The computerization of the St. Luke's Medical Center improved the hospital administration and management, particularly in nuclear medicine department. The use of computer-aided X-ray simulator machine and computerized linear accelerator machine in diagnosing and treating cancer are the most recent medical technological breakthroughs that benefited thousands of Filipino cancer patients. 4 photos

Patient Workload Profile: National Naval Medical Center (NNMC), Bethesda, MD.

Science.gov (United States)

1980-06-01

AD-A09a 729 WESTEC SERVICES NC SAN DIEGOCA0S / PATIENT WORKLOAD PROFILE: NATIONAL NAVAL MEDICAL CENTER NNMC),- ETC(U) JUN 80 W T RASMUSSEN, H W...provides site workload data for the National Naval Medical Center (NNMC) within the following functional support areas: Patient Appointment...on managing medical and patient data, thereby offering the health care provider and administrator more powerful capabilities in dealing with and

Defining the medical imaging requirements for a rural health center

CERN Document Server

2017-01-01

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

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...

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

Federal Grant "Seed Money"--Sprouted, Growing and Blooming in the Kansas Sandhills: Interdisciplinary Studies--Their "Place in the Sun."

Science.gov (United States)

Bogner, Donna

The Outdoor Research Project of Hutchinson Senior High School in Hutchinson, Kansas, was funded in 1977 to conduct a scientific baseline study of an outdoor education center and a state park. Gifted students used initial limnology tests, fish population studies, and groundcover analyses to produce management recommendations and a computer…

Assessing the Academic Medical Center as a Supportive Learning Community

Science.gov (United States)

Gannon, Sam C.

2011-01-01

Academic medical centers are well-known for their emphasis on teaching, research and public service; however, like most large, bureaucratic organizations, they oftentimes suffer from an inability to learn as an organization. The role of the research administrator in the academic medical center has grown over time as the profession itself has…

Fate and transport of cyanobacteria and associated toxins and taste-and-odor compounds from upstream reservoir releases in the Kansas River, Kansas, September and October 2011

Science.gov (United States)

Graham, Jennifer L.; Ziegler, Andrew C.; Loving, Brian L.; Loftin, Keith A.

2012-01-01

Cyanobacteria cause a multitude of water-quality concerns, including the potential to produce toxins and taste-and-odor compounds. Toxins and taste-and-odor compounds may cause substantial economic and public health concerns and are of particular interest in lakes, reservoirs, and rivers that are used for drinking-water supply, recreation, or aquaculture. The Kansas River is a primary source of drinking water for about 800,000 people in northeastern Kansas. Water released from Milford Lake to the Kansas River during a toxic cyanobacterial bloom in late August 2011 prompted concerns about cyanobacteria and associated toxins and taste-and-odor compounds in downstream drinking-water supplies. During September and October 2011 water-quality samples were collected to characterize the transport of cyanobacteria and associated compounds from upstream reservoirs to the Kansas River. This study is one of the first to quantitatively document the transport of cyanobacteria and associated compounds during reservoir releases and improves understanding of the fate and transport of cyanotoxins and taste-and-odor compounds downstream from reservoirs. Milford Lake was the only reservoir in the study area with an ongoing cyanobacterial bloom during reservoir releases. Concentrations of cyanobacteria and associated toxins and taste-and-odor compounds in Milford Lake (upstream from the dam) were not necessarily indicative of outflow conditions (below the dam). Total microcystin concentrations, one of the most commonly occurring cyanobacterial toxins, in Milford Lake were 650 to 7,500 times higher than the Kansas Department of Health and Environment guidance level for a public health warning (20 micrograms per liter) for most of September 2011. By comparison, total microcystin concentrations in the Milford Lake outflow generally were less than 10 percent of the concentrations in surface accumulations, and never exceeded 20 micrograms per liter. The Republican River, downstream from

Genes encoding chimeras of Neurospora crassa erg-3 and human ...

Indian Academy of Sciences (India)

Unknown

(FGSC), University of Kansas Medical Center, Kansas. City, KS 66103, USA. .... pCH1-Hph digested with the same enzymes to produce ..... Wheat coding sequences are characterized by a high GC content and by a related strong bias of codon ...

["AGAINST ALL ODDS" - PROMOTING RESEARCH, CLINICAL DEVELOPMENT AND MEDICAL SERVICES OF THE CONFLICT IN THE GALILEE MEDICAL CENTER].

Science.gov (United States)

Bornstein, Jacob

2017-05-01

The Galilee Medical Center (GMC) is unique in several aspects. Firstly, in the clinical aspect: In recent years, led by the Director of Medical Center, Dr. Masad Barhoum, a considerable momentum of development has taken place to reduce health discrepancies between the center and the periphery. Despite the under- financing of the health system in the Galilee, the GMC opened new clinical departments, introduced advanced medical technology and key staff members were added. This approach is depicted in publications presented in the current issue. Secondly, the aspect of medicine standoff: The GMC is the nearest hospital to the border with neighboring countries. It is also a tertiary center for trauma, due to the establishment of the Department of Neurosurgery, Department of Oral and Maxillofacial Surgery and the Departments of Orthopedic Surgery, general invasive radiology and invasive radiology of the brain. In recent years, the medical center treated hundreds of victims of the civil war in Syria, a third of them - women and children. The injured patients presented unique medical problems that are described in the papers in this issue. Thirdly, the research aspect: The medical center is the main teaching facility of medical students of the Faculty of Medicine in the Galilee of Bar-Ilan University. The Faculty of Medicine, led by the Dean, Prof. Ran Tur-Kaspa, promotes research and teaching in the medical center. Even before the establishment of the Faculty of Medicine, former hospital director, Prof. Shaul Shasha, not only extolled the importance of research, but established a research laboratory years ago. The laboratory continues to pursue translational research by the physicians of the medical center, led by Dr. Shifra Sela and Prof. Batya Kristal, and supported by the current medical center director, Dr. Masad Barhoum. Several studies conducted in this research laboratory are published herewith. With these unique aspects and despite the discrimination in funding

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).

Kansas business plan for commercial vehicle operations using intelligent transportation systems

Science.gov (United States)

1998-04-29

This state business plan is the product of a cooperative effort between state agencies, the Federal Highway Administration, Kansas Turnpike Authority, and the Kansas Motor Carrier Association. The plan represents a shared commitment to move forward w...

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.

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

Science.gov (United States)

Larson, Satu A; Chapman, Susan A

2013-01-01

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

[Patient-centered care. Improvement of communication between university medical centers and general practitioners for patients in neuro-oncology].

Science.gov (United States)

Renovanz, M; Keric, N; Richter, C; Gutenberg, A; Giese, A

2015-12-01

Communication between university medical centers and general practitioners (GP) is becoming increasingly more important in supportive patient care. A survey among GPs was performed with the primary objective to assess their opinion on current workflow and communication between GPs and the university medical center. The GPs were asked to score (grades 1-6) their opinion on the current interdisciplinary workflow in the care of patients with brain tumors, thereby rating communication between a university medical center in general and the neuro-oncology outpatient center in particular. Questionnaires were sent to1000 GPs and the response rate was 15 %. The mean scored evaluation of the university medical center in general was 2.62 and of the neuro-oncological outpatient clinic 2.28 (range 1-6). The most often mentioned issues to be improved were easier/early telephone information (44 %) and a constantly available contact person (49 %). Interestingly, > 60 % of the GPs indicated they would support web-based tumor boards for interdisciplinary and palliative neuro-oncological care. As interdisciplinary care for neuro-oncology patients is an essential part of therapy, improvement of communication between GPs and university medical centers is indispensable. Integrating currently available electronic platforms under data protection aspects into neuro-oncological palliative care could be an interesting tool in order to establish healthcare networks and could find acceptance with GPs.

Supply chain optimization at an academic medical center.

Science.gov (United States)

Labuhn, Jonathan; Almeter, Philip; McLaughlin, Christopher; Fields, Philip; Turner, Benjamin

2017-08-01

A successful supply chain optimization project that leveraged technology, engineering principles, and a technician workflow redesign in the setting of a growing health system is described. With continued rises in medication costs, medication inventory management is increasingly important. Proper management of central pharmacy inventory and floor-stock inventory in automated dispensing cabinets (ADCs) can be challenging. In an effort to improve control of inventory costs in the central pharmacy of a large academic medical center, the pharmacy department implemented a supply chain optimization project in collaboration with the medical center's inhouse team of experts on process improvement and industrial engineering. The project had 2 main components: (1) upgrading and reconfiguring carousel technology within an expanded central pharmacy footprint to generate accurate floor-stock inventory replenishment reports, which resulted in efficiencies within the medication-use system, and (2) implementing a technician workflow redesign and algorithm to right-size the ADC inventory, which decreased inventory stockouts (i.e., incidents of depletion of medication stock) and improved ADC user satisfaction. Through a multifaceted approach to inventory management, the number of stockouts per month was decreased and ADC inventory was optimized, resulting in a one-time inventory cost savings of $220,500. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

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.

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

The Manned Spacecraft Center and medical technology

Science.gov (United States)

Johnston, R. S.; Pool, S. L.

1974-01-01

A number of medically oriented research and hardware development programs in support of manned space flights have been sponsored by NASA. Blood pressure measuring systems for use in spacecraft are considered. In some cases, complete new bioinstrumentation systems were necessary to accomplish a specific physiological study. Plans for medical research during the Skylab program are discussed along with general questions regarding space-borne health service systems and details concerning the Health Services Support Control Center.

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...

Connecticut Children's Medical Center multi-year branding campaign.

Science.gov (United States)

Botvin, J

2000-01-01

As the only children's hospital in the state, Connecticut Children's Medical Center was challenged by the inherent complacency of parents. It met the challenge through a multi-level marketing effort which included television and radio, community outreach and strong media relations. By emphasizing the unique nature of children, the campaign affirms the need for a specialized children's health center.

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

Patient-Centered Tools for Medication Information Search.

Science.gov (United States)

Wilcox, Lauren; Feiner, Steven; Elhadad, Noémie; Vawdrey, David; Tran, Tran H

2014-05-20

Recent research focused on online health information seeking highlights a heavy reliance on general-purpose search engines. However, current general-purpose search interfaces do not necessarily provide adequate support for non-experts in identifying suitable sources of health information. Popular search engines have recently introduced search tools in their user interfaces for a range of topics. In this work, we explore how such tools can support non-expert, patient-centered health information search. Scoping the current work to medication-related search, we report on findings from a formative study focused on the design of patient-centered, medication-information search tools. Our study included qualitative interviews with patients, family members, and domain experts, as well as observations of their use of Remedy, a technology probe embodying a set of search tools. Post-operative cardiothoracic surgery patients and their visiting family members used the tools to find information about their hospital medications and were interviewed before and after their use. Domain experts conducted similar search tasks and provided qualitative feedback on their preferences and recommendations for designing these tools. Findings from our study suggest the importance of four valuation principles underlying our tools: credibility, readability, consumer perspective, and topical relevance.

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,...

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.

Military Construction: Renovation Plans at the Portsmouth Naval Medical Center

National Research Council Canada - National Science Library

1997-01-01

The Portsmouth Naval Medical Center is a teaching hospital that provides comprehensive health care services to active duty forces and, when space is available, provides medical services to other DOD beneficiaries (i.e...

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...

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

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.

Die Ärztliche Zentralbibliothek des Universitätsklinikums Hamburg-Eppendorf / The Medical Library of the University Medical Center Hamburg-Eppendorf

Directory of Open Access Journals (Sweden)

Kintzel, Melanie

2009-12-01

Full Text Available This article introduces the Medical Library of the University Medical Center Hamburg-Eppendorf. Firstly, history, role and status of the library within the University Medical Center are illustrated, followed by a description of the library’s facilities and services. Finally, recent projects are presented as well as a selection of key figures.

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.

Marketing the academic medical center group practice.

Science.gov (United States)

Eudes, J A; Divis, K L

1992-01-01

From a marketing perspective, there are many differences between private and academic medical center (AMC) group practices. Given the growing competition between the two, write John Eudes and Kathy Divis, it is important for the AMC group practice to understand and use these differences to develop a competitive market advantage.

Using Technology, Clinical Workflow Redesign, and Team Solutions to Achieve the Patient Centered Medical Home

Science.gov (United States)

2011-01-01

Redesign, and Team Solutions to Achieve the Patient Centered Medical Home LTC Nicole Kerkenbush, MHA, MN Army Medical Department, Office of the...TITLE AND SUBTITLE Using Technology, Clinical Workflow Redesign, and Team Solutions to Achieve the Patient Centered Medical Home 5a. CONTRACT...Describe how these tools are being used to implement the Patient Centered Medical Home care model 2 2011 MHS Conference MEDCOM AHLTA Provider Satisfaction

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

An Analysis of Medication Errors at the Military Medical Center: Implications for a Systems Approach for Error Reduction

National Research Council Canada - National Science Library

Scheirman, Katherine

2001-01-01

An analysis was accomplished of all inpatient medication errors at a military academic medical center during the year 2000, based on the causes of medication errors as described by current research in the field...

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.

Investigating Medication Errors in Educational Health Centers of Kermanshah

Directory of Open Access Journals (Sweden)

Mohsen Mohammadi

2015-08-01

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

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

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.

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...

Project THEMIS: A Center for Remote Sensing.

Science.gov (United States)

This report summarizes the technical work accomplished under Project THEMIS, A Center for Remote Sensing at the University of Kansas during the...period 16 September 1967 through 15 September 1973. The highlights of the four major areas forming the remote sensing system are presented. A detailed description of the latest radar spectrometer results is presented.

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.

Operation of medical accelerator PATRO at Hyogo Ion Beam Medical Center

International Nuclear Information System (INIS)

Itano, A.; Akagi, T.; Higashi, A.; Fukushima, S.; Fujita, A.; Honda, Y.; Isa, H.; Nishikigouri, K.

2004-01-01

PATRO (Particle Accelerator for Therapy, Radiology and Oncology) is a medical accelerator facility for hadrontherapy of cancer at Hyogo Ion Beam Medical Center (HIBMC). Beam particles are proton (230 MeV) and carbon (320 MeV/u). After the beam commissioning and the tuning of irradiation system in 2000, we performed the clinical trials with proton and carbon beams from May 2001 until July 2002. We operated the accelerator for about 11,000 hours since the beginning of the beam tuning until the end of the clinical trials and for about 5,000 hours during the clinical trials. No serious troubles happened during the clinical trials. The stability and the reproducibility of the beams were well proved. (author)

A management plan for hospitals and medical centers facing radiation incidents.

Science.gov (United States)

Davari, Fereshteh; Zahed, Arash

2015-09-01

Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary.

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

Early experiences with big data at an academic medical center.

Science.gov (United States)

Halamka, John D

2014-07-01

Beth Israel Deaconess Medical Center (BIDMC), an academic health care institution affiliated with Harvard University, has been an early adopter of electronic applications since the 1970s. Various departments of the medical center and the physician practice groups affiliated with it have implemented electronic health records, filmless imaging, and networked medical devices to such an extent that data storage at BIDMC now amounts to three petabytes and continues to grow at a rate of 25 percent a year. Initially, the greatest technical challenge was the cost and complexity of data storage. However, today the major focus is on transforming raw data into information, knowledge, and wisdom. This article discusses the data growth, increasing importance of analytics, and changing user requirements that have shaped the management of big data at BIDMC. Project HOPE—The People-to-People Health Foundation, Inc.

Trends in the Use of Medical Imaging to Diagnose Appendicitis at an Academic Medical Center.

Science.gov (United States)

Repplinger, Michael D; Weber, Andrew C; Pickhardt, Perry J; Rajamanickam, Victoria P; Svenson, James E; Ehlenbach, William J; Westergaard, Ryan P; Reeder, Scott B; Jacobs, Elizabeth A

2016-09-01

To quantify the trends in imaging use for the diagnosis of appendicitis. A retrospective study covering a 22-year period was conducted at an academic medical center. Patients were identified by International Classification of Diseases-9 diagnosis code for appendicitis. Medical record data extraction of these patients included imaging test used (ultrasound, CT, or MRI), gender, age, and body mass index (BMI). The proportion of patients undergoing each scan was calculated by year. Regression analysis was performed to determine whether age, gender, or BMI affected imaging choice. The study included a total of 2,108 patients, including 967 (43.5%) females and 599 (27%) children (imaging used for the diagnosis of appendicitis decreased over time (P medical center, CT use increased more than 20-fold. However, no statistically significant trend was found for increased use of ultrasound or MRI. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Patient-centered medical homes for patients with disabilities.

Science.gov (United States)

Hernandez, Brigida; Damiani, Marco; Wang, T Arthur; Driscoll, Carolyn; Dellabella, Peter; LePera, Nicole; Mentari, Michael

2015-01-01

The patient-centered medical home is an innovative approach to improve health care outcomes. To address the unique needs of patients with intellectual and developmental disabilities (IDDs), a large health care provider reevaluated the National Committee for Quality Assurance's 6 medical home standards: (a) enhance access and continuity, (b) identify and manage patient populations, (c) plan and manage care, (d) provide self-care and community support, (e) track and coordinate care, and (f) measure and improve performance. This article describes issues to consider when serving patients with IDDs.

97 Medical Apparatuses tested at the Academic Medical Center (AMC) Amsterdam for interference by WLAN/WiFi signals

NARCIS (Netherlands)

Hensbroek, R.

2009-01-01

This research describes the influence of WLAN 1 signals on medical apparatuses in the Academic Medical Center (AMC) Amsterdam. The results in this report were obtained by testing medical equipment with WLAN signals. A comparable research was reported earlier. See TNO report KvL/P&Z 2007.117 dated

PASTE: patient-centered SMS text tagging in a medication management system.

Science.gov (United States)

Stenner, Shane P; Johnson, Kevin B; Denny, Joshua C

2012-01-01

To evaluate the performance of a system that extracts medication information and administration-related actions from patient short message service (SMS) messages. Mobile technologies provide a platform for electronic patient-centered medication management. MyMediHealth (MMH) is a medication management system that includes a medication scheduler, a medication administration record, and a reminder engine that sends text messages to cell phones. The object of this work was to extend MMH to allow two-way interaction using mobile phone-based SMS technology. Unprompted text-message communication with patients using natural language could engage patients in their healthcare, but presents unique natural language processing challenges. The authors developed a new functional component of MMH, the Patient-centered Automated SMS Tagging Engine (PASTE). The PASTE web service uses natural language processing methods, custom lexicons, and existing knowledge sources to extract and tag medication information from patient text messages. A pilot evaluation of PASTE was completed using 130 medication messages anonymously submitted by 16 volunteers via a website. System output was compared with manually tagged messages. Verified medication names, medication terms, and action terms reached high F-measures of 91.3%, 94.7%, and 90.4%, respectively. The overall medication name F-measure was 79.8%, and the medication action term F-measure was 90%. Other studies have demonstrated systems that successfully extract medication information from clinical documents using semantic tagging, regular expression-based approaches, or a combination of both approaches. This evaluation demonstrates the feasibility of extracting medication information from patient-generated medication messages.

The Patient-Centered Medical Home Neighbor: A Critical Concept for a Redesigned Healthcare Delivery System

Science.gov (United States)

2011-01-25

Sharing Knowledge: Achieving Breakthrough Performance 2010 Military Health System Conference The Patient -Centered Medical Home Neighbor: A Critical...DATE 25 JAN 2011 2. REPORT TYPE 3. DATES COVERED 00-00-2011 to 00-00-2011 4. TITLE AND SUBTITLE The Patient -Centered Medical Home Neighbor: A...Conference What is the Patient -Centered Medical Home?  …a vision of health care as it should be  …a framework for organizing systems of care at both the

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

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).

Access to patient-centered medical home among Ohio's Children with Special Health Care Needs.

Science.gov (United States)

Conrey, Elizabeth J; Seidu, Dazar; Ryan, Norma J; Chapman, Dj Sam

2013-06-01

Medical homes deliver primary care that is accessible, continuous, comprehensive, family centered, coordinated, compassionate and culturally effective. Children with special health care needs (CSHCN) require a wide range of support to maintain health, making medical home access particularly important. We sought to understand independent risk factors for lacking access. We analyzed Ohio, USA data from the National Survey of Children with Special Health Care Needs (2005-2006). Among CSHCN, 55.6% had medical home access. The proportion achieving each medical home component was highest for having a personal doctor/nurse and lowest for receiving coordinated care, family-centered care and referrals. Specific subsets of CSHCN were significantly and independently more likely to lack medical home access: Hispanic (AOR=3.08), moderate/high severity of difficulty (AOR=2.84), and any public insurance (AOR=1.60). Efforts to advance medical home access must give special attention to these CSHCN populations and improvements must be made to referral access, family-centered care, and care coordination.

A management plan for hospitals and medical centers facing radiation incidents

Directory of Open Access Journals (Sweden)

Fereshteh Davari

2015-01-01

Full Text Available Background: Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. Materials and Methods: In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. Results: We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. Conclusion: With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary.

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.

The patient-centered medical home neighbor: A primary care physician's view.

Science.gov (United States)

Sinsky, Christine A

2011-01-04

The American College of Physicians' position paper on the patient-centered medical home neighbor (PCMH-N) extends the work of the patient-centered medical home (PCMH) as a means of improving the delivery of health care. Recognizing that the PCMH does not exist in isolation, the PCMH-N concept outlines expectations for comanagement, communication, and care coordination and broadens responsibility for safe, effective, and efficient care beyond primary care to include physicians of all specialties. As such, it is a fitting follow-up to the PCMH and moves further down the road toward improved care for complex patients. Yet, there is more work to be done. Truly transforming the U.S. health care system around personalized medical homes embedded in highly functional medical neighborhoods will require better staffing models; more robust electronic information tools; aligned incentives for quality and efficiency within payment and regulatory policies; and a culture of greater engagement of patients, their families, and communities.

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...

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...

76 FR 71045 - Center for Biologics Evaluation and Research Report of Scientific and Medical Literature and...

Science.gov (United States)

2011-11-16

...] Center for Biologics Evaluation and Research Report of Scientific and Medical Literature and Information... period for the notice on its report of scientific and medical literature and information concerning the... ``Center for Biologics Evaluation and Research Report of Scientific and Medical Literature and Information...

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…

Walter Reed Army Medical Center's Internet-based electronic health portal.

Science.gov (United States)

Abbott, Kevin C; Boocks, Carl E; Sun, Zhengyi; Boal, Thomas R; Poropatich, Ronald K

2003-12-01

Use of the World Wide Web (WWW) and electronic media to facilitate medical care has been the subject of many reports in the popular press. However, few reports have documented the results of implementing electronic health portals for essential medical tasks, such as prescription refills and appointments. At Walter Reed Army Medical Center, "Search & Learn" medical information, Internet-based prescription refills and patient appointments were established in January 2001. A multiphase retrospective analysis was conducted to determine the use of the "Search & Learn" medical information and the relative number of prescription refills and appointments conducted via the WWW compared with conventional methods. From January 2001 to May 2002, there were 34,741 refills and 819 appointments made over the Internet compared with 2,275,112 refills and approximately 500,000 appointments made conventionally. WWW activity accounted for 1.52% of refills and 0.16% of appointments. There was a steady increase in this percentage over the time of the analysis. In April of 2002, the monthly average of online refills had risen to 4.57% and online appointments were at 0.27%. Online refills were projected to account for 10% of all prescriptions in 2 years. The "Search & Learn" medical information portion of our web site received 147,429 unique visits during this same time frame, which was an average of 326 visitors per day. WWW-based methods of conducting essential medical tasks accounted for a small but rapidly increasing percentage of total activity at Walter Reed Army Medical Center. Subsequent phases of analysis will assess demographic and geographic factors and aid in the design of future systems to increase use of the Internet-based systems.

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,…

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

Science.gov (United States)

2013-12-10

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

78 FR 10610 - TRICARE; Demonstration Project for Participation in Maryland Multi-Payer Patient Centered Medical...

Science.gov (United States)

2013-02-14

... National Committee on Quality Assurance Patient Centered Medical Home (PPC-PCMH) recognition criteria... quality improvements. TMA Defense Health Cost Assessment and Evaluation (DHCAPE) staff will calculate... Maryland Multi-Payer Patient Centered Medical Home Program (MMPCMHP) Demonstration AGENCY: Department of...

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.

Roles of Medical Record and Statistic Staff on Research at the Tawanchai Center.

Science.gov (United States)

Pattaranit, Rumpan; Chantachum, Vasana; Lekboonyasin, Orathai; Pradubwong, Suteera

2015-08-01

The medical record and statistic staffs play a crucial role behind the achievements of treatment and research of physicians, nurses and other health care professionals. The medical record and statistic staff are in charge of keeping patient medical records; creating databases; presenting information; sorting patient's information; providing patient medical records and related information for various medical teams and researchers; Besides, the medical record and statistic staff have collaboration with the Center of Cleft Lip-Palate, Khon Kaen University in association with the Tawanchai Project. The Tawanchai Center is an organization, involving multidisciplinary team which aims to continuing provide care for patients with cleft lip and palate and craniofacial deformities who need a long term of treatment since newborns until the age of 19 years. With support and encouragement from the Tawanchai team, the medical record and statistic staff have involved in research under the Tawanchai Centre since then and produced a number of publications locally and internationally.

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...

Critical Care Organizations in Academic Medical Centers in North America: A Descriptive Report.

Science.gov (United States)

Pastores, Stephen M; Halpern, Neil A; Oropello, John M; Kostelecky, Natalie; Kvetan, Vladimir

2015-10-01

With the exception of a few single-center descriptive reports, data on critical care organizations are relatively sparse. The objectives of our study were to determine the structure, governance, and experience to date of established critical care organizations in North American academic medical centers. A 46-item survey questionnaire was electronically distributed using Survey Monkey to the leadership of 27 identified critical care organizations in the United States and Canada between September 2014 and February 2015. A critical care organization had to be headed by a physician and have primary governance over the majority, if not all, of the ICUs in the medical center. We received 24 responses (89%). The majority of the critical care organizations (83%) were called departments, centers, systems, or operations committees. Approximately two thirds of respondents were from larger (> 500 beds) urban institutions, and nearly 80% were primary university medical centers. On average, there were six ICUs per academic medical center with a mean of four ICUs under critical care organization governance. In these ICUs, intensivists were present in-house 24/7 in 49%; advanced practice providers in 63%; hospitalists in 21%; and telemedicine coverage in 14%. Nearly 60% of respondents indicated that they had a separate hospital budget to support data management and reporting, oversight of their ICUs, and rapid response teams. The transition from the traditional model of ICUs within departmentally controlled services or divisions to a critical care organization was described as gradual in 50% and complete in only 25%. Nearly 90% indicated that their critical care organization governance structure was either moderately or highly effective; a similar number suggested that their critical care organizations were evolving with increasing domain and financial control of the ICUs at their respective institutions. Our survey of the very few critical care organizations in North American

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…

Development of a longitudinal integrated clerkship at an academic medical center.

Science.gov (United States)

Poncelet, Ann; Bokser, Seth; Calton, Brook; Hauer, Karen E; Kirsch, Heidi; Jones, Tracey; Lai, Cindy J; Mazotti, Lindsay; Shore, William; Teherani, Arianne; Tong, Lowell; Wamsley, Maria; Robertson, Patricia

2011-04-04

In 2005, medical educators at the University of California, San Francisco (UCSF), began developing the Parnassus Integrated Student Clinical Experiences (PISCES) program, a year-long longitudinal integrated clerkship at its academic medical center. The principles guiding this new clerkship were continuity with faculty preceptors, patients, and peers; a developmentally progressive curriculum with an emphasis on interdisciplinary teaching; and exposure to undiagnosed illness in acute and chronic care settings. Innovative elements included quarterly student evaluation sessions with all preceptors together, peer-to-peer evaluation, and oversight advising with an assigned faculty member. PISCES launched with eight medical students for the 2007/2008 academic year and expanded to 15 students for 2008/2009. Compared to UCSF's traditional core clerkships, evaluations from PISCES indicated significantly higher student satisfaction with faculty teaching, formal didactics, direct observation of clinical skills, and feedback. Student performance on discipline-specific examinations and United States Medical Licensing Examination step 2 CK was equivalent to and on standardized patient examinations was slightly superior to that of traditional peers. Participants' career interests ranged from primary care to surgical subspecialties. These results demonstrate that a longitudinal integrated clerkship can be implemented successfully at a tertiary care academic medical center.

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.

Business Case Analysis of the Walter Reed Army Medical Center Medical/Surgical Prime Vendor Generation III Service Level Electron Program

National Research Council Canada - National Science Library

Markot, Peter B

2007-01-01

...) staffing and medical/surgical services offered under the Prime Vendor (PV) Generation III contract would provide the best supply chain management solution for Walter Reed Army Medical Center (WRAMC...

Patient-Centered Medical Home in chronic obstructive pulmonary disease

Directory of Open Access Journals (Sweden)

Ortiz G

2011-10-01

Full Text Available Gabriel Ortiz1, Len Fromer21Pediatric Pulmonary Services, El Paso, TX; 2Department of Family Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, USAAbstract: Chronic obstructive pulmonary disease (COPD is a progressive and debilitating but preventable and treatable disease characterized by cough, phlegm, dyspnea, and fixed or incompletely reversible airway obstruction. Most patients with COPD rely on primary care practices for COPD management. Unfortunately, only about 55% of US outpatients with COPD receive all guideline-recommended care. Proactive and consistent primary care for COPD, as for many other chronic diseases, can reduce hospitalizations. Optimal chronic disease management requires focusing on maintenance rather than merely acute rescue. The Patient-Centered Medical Home (PCMH, which implements the chronic care model, is a promising framework for primary care transformation. This review presents core PCMH concepts and proposes multidisciplinary team-based PCMH care strategies for COPD.Keywords: Patient-Centered Medical Home, chronic care model, chronic obstructive pulmonary disease, patient education, physician assistants, nurse practitioners

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.

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.

DOE Center of Excellence in Medical Laser Applications. Final report, December 1, 1994--November 30, 1997

Energy Technology Data Exchange (ETDEWEB)

Jacques, S.L.

1998-01-01

An engineering network of collaborating medical laser laboratories are developing laser and optical technologies for medical diagnosis and therapy and are translating the engineering into medical centers in Portland OR, Houston TX, and Galveston TX. The Center includes the University of Texas M.D. Anderson Cancer Center, the University of Texas-Austin, Texas A and M University, Rice University, the University Texas Medical Branch-Galveston, Oregon Medical Laser Center (Providence St. Vincent Medical Center, Oregon Health Sciences University, and Oregon Graduate Institute, Portland, OR), and the University of Oregon. Diagnostics include reflectance, fluorescence, Raman IR, laser photoacoustics, optical coherence tomography, and several new video techniques for spectroscopy and imaging. Therapies include photocoagulation therapy, laser welding, pulsed laser ablation, and light-activated chemotherapy of cancer (photodynamic therapy, or PDT). Medical applications reaching the clinic include optical monitoring of hyperbilirubinemia in newborns, fluorescence detection of cervical dysplasia, laser thrombolysis of blood clots in heart attack and brain stroke, photothermal coagulant of benign prostate hyperplasia, and PDT for both veterinary and human cancer. New technologies include laser optoacoustic imaging of breast tumors and hemorrhage in head trauma and brain stroke, quality control monitoring of dosimetry during PDT for esophageal and lung cancer, polarization video reflectometry of skin cancer, laser welding of artificial tissue replacements, and feedback control of laser welding.

Relating calls to US poison centers for potential exposures to medications to Centers for Disease Control and Prevention reporting of influenza-like illness.

Science.gov (United States)

Beauchamp, Gillian A; McKeown, Nathanael J; Rodriguez, Sergio; Spyker, Daniel A

2016-03-01

The Centers for Disease Control (CDC) monitors influenza like illness (ILI) and the National Poison Data System (NPDS) warehouses call data uploaded by US poison centers regarding reported exposures to medication. We examined the relationship between calls to poison centers regarding reported exposures to medications commonly used to treat ILI and weekly reports of ILI. The CDC reports ILI, by age group, for each of 10 Health and Human Services (HHS) regions. We examined NPDS summary data from calls reported to poison centers regarding reported exposures to acetaminophen, cough/cold medications, and promethazine, for the same weeks, age groups, and HHS regions for influenza seasons 2000-2013. ILI and NPDS exposures were examined using graphical plots, descriptive statistics, stepwise regression analysis, and Geographic Information Systems (GIS). About 5,101,841 influenza-like illness cases were reported to the CDC, and 2,122,940 calls regarding reported exposures to medications commonly used to treat ILI, were reported by poison centers to the NPDS over the 13 flu seasons. Analysis of stepwise models of the linear untransformed data involving 24 NPDS data groups and for 60 ILI measures, over the 13 influenza seasons, demonstrated that reported exposures to medications used to treat ILI correlated with reported cases of ILI with a median R(2 )=( )0.489 (min R(2 )=( )0.248, max R(2 )=( )0.717), with mean ± SD of R(2 )=( )0.494 ± 0.121. Median number of parameters used (degrees of freedom - 1) was 7. NPDS data regarding poison center calls for selected ILI medication exposures were highly correlated with CDC ILI data. Since NPDS data are available in real time, it provides complimentary ILI monitoring. This approach may provide public health value in predicting other illnesses which are not currently as thoroughly monitored.

Hospital CIO Explains Blockchain Potential: An Interview with Beth Israel Deaconess Medical Center's John Halamka.

Science.gov (United States)

Mertz, Leslie

2018-01-01

Work is already underway to bring blockchain technology to the healthcare industry, and hospital administrators are trying to figure out what it can do for them, their clinicians, and their patients. That includes administrators at Beth Israel Deaconess Medical Center, a leading academic medical center located in Boston.

A Study to Determine Patient Waiting Time at the Outpatient Pharmacy at Wilford Hall USAF Medical Center

Science.gov (United States)

1988-06-01

at Wilford Hall USAF Medical Center significantly reduced the patient wait time at the main outpatient pharmacy. Satellite pharmacies have been ).’l...PRESENTING TO WINDOW 1, 19 MAR 88. 47 C:. A’.’E-:A: -ESCRIRTIONS PER PATIENT ...........48 H. WILFORD HALL MEDICAL CENTER OUTPATIENT QUESTIONNAIRE...that wait times at tne outpatient pharmacy were excessive. It was this concern that motivated the Medical Center Administrator to request that patient

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.

Development of a longitudinal integrated clerkship at an academic medical center

Directory of Open Access Journals (Sweden)

Ann Poncelet

2011-04-01

Full Text Available In 2005, medical educators at the University of California, San Francisco (UCSF, began developing the Parnassus Integrated Student Clinical Experiences (PISCES program, a year-long longitudinal integrated clerkship at its academic medical center. The principles guiding this new clerkship were continuity with faculty preceptors, patients, and peers; a developmentally progressive curriculum with an emphasis on interdisciplinary teaching; and exposure to undiagnosed illness in acute and chronic care settings. Innovative elements included quarterly student evaluation sessions with all preceptors together, peer-to-peer evaluation, and oversight advising with an assigned faculty member. PISCES launched with eight medical students for the 2007/2008 academic year and expanded to 15 students for 2008/2009. Compared to UCSF's traditional core clerkships, evaluations from PISCES indicated significantly higher student satisfaction with faculty teaching, formal didactics, direct observation of clinical skills, and feedback. Student performance on discipline-specific examinations and United States Medical Licensing Examination step 2 CK was equivalent to and on standardized patient examinations was slightly superior to that of traditional peers. Participants’ career interests ranged from primary care to surgical subspecialties. These results demonstrate that a longitudinal integrated clerkship can be implemented successfully at a tertiary care academic medical center.

Integration of pharmacists into a patient-centered medical home.

Science.gov (United States)

Scott, Mollie Ashe; Hitch, Bill; Ray, Lisa; Colvin, Gaye

2011-01-01

To define the joint principles of the patient-centered medical home (PCMH) and describe the integration of pharmacists into a PCMH. Family medicine residency training program in North Carolina from 2001 to 2011. Mountain Area Health Education Family Health Center is a family medicine residency training program that is part of the North Carolina Area Health Education Center system. The goal of the organization is to train and retain health care students and residents. The practice is recognized as a level III PCMH by the National Committee for Quality Assurance (NCQA) and seeks to provide quality, safe, patient-centered care according to the joint principles of PCMH. Pharmacists, nurses, nutritionists, care managers, Spanish translators, and behavioral medicine specialists work collaboratively with physicians to provide seamless, comprehensive care. The Department of Pharmacotherapy is embedded in the family medicine clinic. Three pharmacists and two pharmacy residents are involved in providing direct patient care services, ensuring access to community resources, assisting patients with transitions of care, providing interprofessional education, and participating in continuous quality improvement initiatives. The pharmacists serve as clinical pharmacist practitioners and provide medication therapy management services in a pharmacotherapy clinic, anticoagulation clinics, and an osteoporosis clinic and via an inpatient family medicine service. Multiple learners such as student pharmacists, pharmacy residents, and family medicine residents rotate through the various pharmacy clinics to learn about pharmacotherapeutic principles and the role of the pharmacist in PCMH. PCMH is a comprehensive, patient-centered, team-based approach to population management in the primary care setting. Pharmacists play a vital role in PCMH and make fundamental contributions to patient care across health care settings. Such innovations in the ambulatory care setting create a unique niche

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.

Early Lessons on Bundled Payment at an Academic Medical Center.

Science.gov (United States)

Jubelt, Lindsay E; Goldfeld, Keith S; Blecker, Saul B; Chung, Wei-Yi; Bendo, John A; Bosco, Joseph A; Errico, Thomas J; Frempong-Boadu, Anthony K; Iorio, Richard; Slover, James D; Horwitz, Leora I

2017-09-01

Orthopaedic care is shifting to alternative payment models. We examined whether New York University Langone Medical Center achieved savings under the Centers for Medicare and Medicaid Services Bundled Payments for Care Improvement initiative. This study was a difference-in-differences study of Medicare fee-for-service patients hospitalized from April 2011 to June 2012 and October 2013 to December 2014 for lower extremity joint arthroplasty, cardiac valve procedures, or spine surgery (intervention groups), or for congestive heart failure, major bowel procedures, medical peripheral vascular disorders, medical noninfectious orthopaedic care, or stroke (control group). We examined total episode costs and costs by service category. We included 2,940 intervention episodes and 1,474 control episodes. Relative to the trend in the control group, lower extremity joint arthroplasty episodes achieved the greatest savings: adjusted average episode cost during the intervention period decreased by $3,017 (95% confidence interval [CI], -$6,066 to $31). For cardiac procedures, the adjusted average episode cost decreased by $2,999 (95% CI, -$8,103 to $2,105), and for spinal fusion, it increased by $8,291 (95% CI, $2,879 to $13,703). Savings were driven predominantly by shifting postdischarge care from inpatient rehabilitation facilities to home. Spinal fusion index admission costs increased because of changes in surgical technique. Under bundled payment, New York University Langone Medical Center decreased total episode costs in patients undergoing lower extremity joint arthroplasty. For patients undergoing cardiac valve procedures, evidence of savings was not as strong, and for patients undergoing spinal fusion, total episode costs increased. For all three conditions, the proportion of patients referred to inpatient rehabilitation facilities upon discharge decreased. These changes were not associated with an increase in index hospital length of stay or readmission rate

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.

Dealing With Deans and Academic Medical Center Leadership: Advice From Leaders.

Science.gov (United States)

Sanfilippo, Fred; Powell, Deborah; Folberg, Robert; Tykocinski, Mark

2018-01-01

The 2017 Association of Pathology Chairs Annual Meeting included a session for department chairs and other department leaders on "how to deal with deans and academic medical center leadership." The session was focused on discussing ways to foster positive relationships with university, medical school, and health system leaders, and productively address issues and opportunities with them. Presentations and a panel discussion were provided by 4 former pathology chairs who subsequently have served as medical deans and in other leadership positions including university provost, medical center CEO, and health system board chair. There was a strong consensus among the participants on how best to deal with superiors about problems, conflicts, and requests for additional resources and authority. The importance of teamwork and accountability in developing a constructive and collaborative relationship with leaders and peers was discussed in detail. Effectiveness in communication, negotiation, and departmental advocacy were highlighted as important skills. As limited resources and increased regulations have become growing problems for universities and health systems, internal stress and competition have increased. In this rapidly changing environment, advice on how chairs can interact most productively with institutional leaders is becoming increasingly important.

Physician Payment Methods and the Patient-Centered Medical Home: Comment on "A Troubled Asset Relief Program for the Patient-Centered Medical Home".

Science.gov (United States)

Quinn, Kevin

This commentary analyzes the patient-centered medical home (PCMH) model within a framework of the 8 basic payment methods in health care. PCMHs are firmly within the fee-for-service tradition. Changes to the process and structure of the Resource Based Relative Value Scale, which underlies almost all physician fee schedules, could make PCMHs more financially viable. Of the alternative payment methods being considered, shared savings models are unlikely to transform medical practice whereas capitation models place unrealistic expectations on providers to accept epidemiological risk. Episode payment may strike a feasible balance for PCMHs, with newly available episode definitions presenting opportunities not previously available.

Home medication support for childhood cancer: family-centered design and testing.

Science.gov (United States)

Walsh, Kathleen E; Biggins, Colleen; Blasko, Deb; Christiansen, Steven M; Fischer, Shira H; Keuker, Christopher; Klugman, Robert; Mazor, Kathleen M

2014-11-01

Errors in the use of medications at home by children with cancer are common, and interventions to support correct use are needed. We sought to (1) engage stakeholders in the design and development of an intervention to prevent errors in home medication use, and (2) evaluate the acceptability and usefulness of the intervention. We convened a multidisciplinary team of parents, clinicians, technology experts, and researchers to develop an intervention using a two-step user-centered design process. First, parents and oncologists provided input on the design. Second, a parent panel and two oncology nurses refined draft materials. In a feasibility study, we used questionnaires to assess usefulness and acceptability. Medication error rates were assessed via monthly telephone interviews with parents. We successfully partnered with parents, clinicians, and IT experts to develop Home Medication Support (HoMeS), a family-centered Web-based intervention. HoMeS includes a medication calendar with decision support, a communication tool, adverse effect information, a metric conversion chart, and other information. The 15 families in the feasibility study gave HoMeS high ratings for acceptability and usefulness. Half recorded information on the calendar to indicate to other caregivers that doses were given; 34% brought it to the clinic to communicate with their clinician about home medication use. There was no change in the rate of medication errors in this feasibility study. We created and tested a stakeholder-designed, Web-based intervention to support home chemotherapy use, which parents rated highly. This tool may prevent serious medication errors in a larger study. Copyright © 2014 by American Society of Clinical Oncology.

Tracking Active Learning in the Medical School Curriculum: A Learning-Centered Approach.

Science.gov (United States)

McCoy, Lise; Pettit, Robin K; Kellar, Charlyn; Morgan, Christine

2018-01-01

Medical education is moving toward active learning during large group lecture sessions. This study investigated the saturation and breadth of active learning techniques implemented in first year medical school large group sessions. Data collection involved retrospective curriculum review and semistructured interviews with 20 faculty. The authors piloted a taxonomy of active learning techniques and mapped learning techniques to attributes of learning-centered instruction. Faculty implemented 25 different active learning techniques over the course of 9 first year courses. Of 646 hours of large group instruction, 476 (74%) involved at least 1 active learning component. The frequency and variety of active learning components integrated throughout the year 1 curriculum reflect faculty familiarity with active learning methods and their support of an active learning culture. This project has sparked reflection on teaching practices and facilitated an evolution from teacher-centered to learning-centered instruction.

Genetics Home Reference: pyruvate carboxylase deficiency

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... of Kansas Medical Center: Metabolic Conditions United Mitochondrial Disease Foundation GeneReviews (1 ... Sources for This Page Carbone MA, MacKay N, Ling M, Cole DE, Douglas C, Rigat B, Feigenbaum A, Clarke ...

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…

United States academic medical centers: priorities and challenges amid market transformation.

Science.gov (United States)

Thompson, Irene M; Anason, Barbara

2012-01-01

United States academic medical centers (AMCs) have upheld their long-standing reputation for excellence by teaching and training the next generation of physicians, supporting medical research, providing world-class medical care, and offering breakthrough treatments for highly complex medical cases. In recent years, the pace and direction of change reshaping the American health care industry has created a set of new and profound challenges that AMC leaders must address in order to sustain their institutions. University HealthSystem Consortium (UHC) is an alliance of 116 leading nonprofit academic medical centers and 276 of their affiliated hospitals, all of which are focused on delivering world-class patient care. Formed in 1984, UHC fosters collaboration with and among its members through its renowned programs and services in the areas of comparative data and analytics, performance improvement, supply chain management, strategic research, and public policy. Each year, UHC surveys the executives of its member institutions to understand the issues they view as most critical to sustaining the viability and success of their organizations. The results of UHC's most recent 2011 member survey, coupled with a 2012 Strategic Health Perspectives Harris Interactive presentation, based in parton surveys of major health care industry stakeholders reveal the most important and relevant issues and opportunities that hospital leaders face today, as the United States health care delivery system undergoes a period of unprecedented transformation.

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

Results of an Institutional LGBT Climate Survey at an Academic Medical Center.

Science.gov (United States)

Chester, Sean D; Ehrenfeld, Jesse M; Eckstrand, Kristen L

2014-12-01

The purpose of this study was to characterize the climate and culture experienced by lesbian, gay, bisexual, and transgender (LGBT) employees and students at one large academic medical center. An anonymous, online institutional climate survey was used to assess the attitudes and experiences of LGBT employees and students. There were 42 LGBT and 14 non-LGBT survey participants. Results revealed that a surprisingly large percentage of LGBT individuals experienced pressure to remain "closeted" and were harassed despite medical center policies of non-discrimination. Continuing training, inclusive policies and practices, and the development of mechanisms to address LGBT-specific harassment are necessary for improving institutional climate.

Genetics Home Reference: oculodentodigital dysplasia

Science.gov (United States)

... likely interferes with normal cell growth and cell specialization, processes that determine the shape and function of ... NORD) The Foundation Fighting Blindness University of Kansas Medical Center Resource List: Hard of Hearing/Deafness Scientific ...

Genetics Home Reference: autosomal dominant cerebellar ataxia, deafness, and narcolepsy

Science.gov (United States)

... may help regulate nerve cell (neuron) maturation and specialization (differentiation), the ability of neurons to move (migrate) ... Ataxia Foundation National Sleep Foundation University of Kansas Medical Center Resource List: Deafness and Hard of Hearing ...

Marion duPont Scott Equine Medical Center uses innovative lameness treatment

OpenAIRE

Lee, Kate

2009-01-01

Virginia Tech's Marion duPont Scott Equine Medical Center is now offering an equine lameness therapy that prevents further degeneration of the affected joint and offers a longer-lasting benefit than traditional steroid treatment.

Meeting changing conditoins at the Rhode Island Medical Center cogeneration plant

International Nuclear Information System (INIS)

Galamaga, D.P.; Bowen, P.T.

1993-01-01

The Rhode Island Department of Mental Health, Retardation and Hospitals is one state department in Rhode Island whose basic function is to provide services to seriously disabled individuals throughout the state. Savings in operating expenses from the Rhode Island Medical Center Central Power Plant have accruded to provide operating funds for the major programs. Operating under a Director who reports to the Governor of Rhode Island, the Department has three major divisions, approximately 2500 employees, and a budget of 200 million dollars. Its operations extend throughout the state and the major focus for hospital or institutional levels of care reside in three major locations, the Dr. U.E. Zambarano Memorial Hospital in northern Rhode Island, the Dr. Joseph Ladd Center in southern Rhode Island, and the Rhode Island Medical Center in the middle of the state. Besides these institution-based operations, the Department sponsors a wide range of rehabilitative programming in the community other through direct operations of facilities such as group homes or through contracts with private non-profit providers of service

Tracking Active Learning in the Medical School Curriculum: A Learning-Centered Approach

Science.gov (United States)

McCoy, Lise; Pettit, Robin K; Kellar, Charlyn; Morgan, Christine

2018-01-01

Background: Medical education is moving toward active learning during large group lecture sessions. This study investigated the saturation and breadth of active learning techniques implemented in first year medical school large group sessions. Methods: Data collection involved retrospective curriculum review and semistructured interviews with 20 faculty. The authors piloted a taxonomy of active learning techniques and mapped learning techniques to attributes of learning-centered instruction. Results: Faculty implemented 25 different active learning techniques over the course of 9 first year courses. Of 646 hours of large group instruction, 476 (74%) involved at least 1 active learning component. Conclusions: The frequency and variety of active learning components integrated throughout the year 1 curriculum reflect faculty familiarity with active learning methods and their support of an active learning culture. This project has sparked reflection on teaching practices and facilitated an evolution from teacher-centered to learning-centered instruction. PMID:29707649

A User-Centered Cooperative Information System for Medical Imaging Diagnosis.

Science.gov (United States)

Gomez, Enrique J.; Quiles, Jose A.; Sanz, Marcos F.; del Pozo, Francisco

1998-01-01

Presents a cooperative information system for remote medical imaging diagnosis. General computer-supported cooperative work (CSCW) problems addressed are definition of a procedure for the design of user-centered cooperative systems (conceptual level); and improvement of user feedback and optimization of the communication bandwidth in highly…

The financial management of research centers and institutes at U.S. medical schools: findings from six institutions.

Science.gov (United States)

Mallon, William T

2006-06-01

To explore three questions surrounding the financial management of research centers and institutes at U.S. medical schools: How do medical schools allocate institutional funds to centers and institutes? How and by whom are those decisions made? What are the implications of these decision-making models on the future of the academic biomedical research enterprise? Using a qualitative research design, the author and associates interviewed over 150 faculty members and administrators at six medical schools and their parent universities in 2004. Interview data were transcribed, coded, and analyzed using a grounded theory approach. This methodology generated rich descriptions and explanations of the six medical schools, which can produce extrapolations to, but not necessarily generalizable findings to, other institutions and settings. An examination of four dimensions of financial decision-making-funding timing, process, structure, and culture-produces two essential models of how medical schools approach the financial management of research centers. In the first, a "charity" model, center directors make hat-in-hand appeals directly to the dean, the result of which may depend on individual negotiation skills and personal relationships. In the second, a "planned-giving" model, the process for obtaining and renewing funds is institutionalized, agreed upon, and monitored. The ways in which deans, administrators, department chairs, and center directors attend to, decide upon, and carry out financial decisions can influence how people throughout the medical school think about interdisciplinary and collaborative activities marshalled though centers and institutes.

Satellite medical centers project

Science.gov (United States)

Aggarwal, Arvind

2002-08-01

World class health care for common man at low affordable cost: anywhere, anytime The project envisages to set up a national network of satellite Medical centers. Each SMC would be manned by doctors, nurses and technicians, six doctors, six nurses, six technicians would be required to provide 24 hour cover, each SMC would operate 24 hours x 7 days. It would be equipped with the Digital telemedicine devices for capturing clinical patient information and investigations in the form of voice, images and data and create an audiovisual text file - a virtual Digital patient. Through the broad band connectivity the virtual patient can be sent to the central hub, manned by specialists, specialists from several specialists sitting together can view the virtual patient and provide a specialized opinion, they can see the virtual patient, see the examination on line through video conference or even PCs, talk to the patient and the doctor at the SMC and controlle capturing of information during examination and investigations of the patient at the SMC - thus creating a virtual Digital consultant at the SMC. Central hub shall be connected to the doctors and consultants in remote locations or tertiary care hospitals any where in the world, thus creating a virtual hub the hierarchical system shall provide upgradation of knowledge to thedoctors in central hub and smc and thus continued medical education and benefit the patient thru the world class treatment in the smc located at his door step. SMC shall be set up by franchisee who shall get safe business opportunity with high returns, patients shall get Low cost user friendly worldclass health care anywhere anytime, Doctors can get better meaningful selfemplyment with better earnings, flexibility of working time and place. SMC shall provide a wide variety of services from primary care to world class Global consultation for difficult patients.

Impact of a pharmacy technician-centered medication reconciliation program on medication discrepancies and implementation of recommendations.

Science.gov (United States)

Kraus, Sarah K; Sen, Sanchita; Murphy, Michelle; Pontiggia, Laura

2017-01-01

To evaluate the impact of a pharmacy-technician centered medication reconciliation (PTMR) program by identifying and quantifying medication discrepancies and outcomes of pharmacist medication reconciliation recommendations. A retrospective chart review was performed on two-hundred patients admitted to the internal medicine teaching services at Cooper University Hospital in Camden, NJ. Patients were selected using a stratified systematic sample approach and were included if they received a pharmacy technician medication history and a pharmacist medication reconciliation at any point during their hospital admission. Pharmacist identified medication discrepancies were analyzed using descriptive statistics, bivariate analyses. Potential risk factors were identified using multivariate analyses, such as logistic regression and CART. The priority level of significance was set at 0.05. Three-hundred and sixty-five medication discrepancies were identified out of the 200 included patients. The four most common discrepancies were omission (64.7%), non-formulary omission (16.2%), dose discrepancy (10.1%), and frequency discrepancy (4.1%). Twenty-two percent of pharmacist recommendations were implemented by the prescriber within 72 hours. A PTMR program with dedicated pharmacy technicians and pharmacists identifies many medication discrepancies at admission and provides opportunities for pharmacist reconciliation recommendations.

Impact of a pharmacy technician-centered medication reconciliation program on medication discrepancies and implementation of recommendations

Directory of Open Access Journals (Sweden)

Kraus SK

2017-06-01

Full Text Available Objectives: To evaluate the impact of a pharmacy-technician centered medication reconciliation (PTMR program by identifying and quantifying medication discrepancies and outcomes of pharmacist medication reconciliation recommendations. Methods: A retrospective chart review was performed on two-hundred patients admitted to the internal medicine teaching services at Cooper University Hospital in Camden, NJ. Patients were selected using a stratified systematic sample approach and were included if they received a pharmacy technician medication history and a pharmacist medication reconciliation at any point during their hospital admission. Pharmacist identified medication discrepancies were analyzed using descriptive statistics, bivariate analyses. Potential risk factors were identified using multivariate analyses, such as logistic regression and CART. The priority level of significance was set at 0.05. Results: Three-hundred and sixty-five medication discrepancies were identified out of the 200 included patients. The four most common discrepancies were omission (64.7%, non-formulary omission (16.2%, dose discrepancy (10.1%, and frequency discrepancy (4.1%. Twenty-two percent of pharmacist recommendations were implemented by the prescriber within 72 hours. Conclusion: A PTMR program with dedicated pharmacy technicians and pharmacists identifies many medication discrepancies at admission and provides opportunities for pharmacist reconciliation recommendations.

An Architecture for Continuous Data Quality Monitoring in Medical Centers.

Science.gov (United States)

Endler, Gregor; Schwab, Peter K; Wahl, Andreas M; Tenschert, Johannes; Lenz, Richard

2015-01-01

In the medical domain, data quality is very important. Since requirements and data change frequently, continuous and sustainable monitoring and improvement of data quality is necessary. Working together with managers of medical centers, we developed an architecture for a data quality monitoring system. The architecture enables domain experts to adapt the system during runtime to match their specifications using a built-in rule system. It also allows arbitrarily complex analyses to be integrated into the monitoring cycle. We evaluate our architecture by matching its components to the well-known data quality methodology TDQM.

Genetics Home Reference: Weyers acrofacial dysostosis

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... This pathway plays roles in cell growth, cell specialization, and the normal shaping (patterning) of many parts ... Syndrome Resource list from the University of Kansas Medical Center: Dwarfism / Short Stature Scientific Articles on PubMed ( ...

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

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...

The economic impact and multiplier effect of a family practice clinic on an academic medical center.

Science.gov (United States)

Schneeweiss, R; Ellsbury, K; Hart, L G; Geyman, J P

1989-07-21

Academic medical centers are facing the need to expand their primary care referral base in an increasingly competitive medical environment. This study describes the medical care provided during a 1-year period to 6304 patients registered with a family practice clinic located in an academic medical center. The relative distribution of primary care, secondary referrals, inpatient admissions, and their associated costs are presented. The multiplier effect of the primary care clinic on the academic medical center was substantial. For every $1 billed for ambulatory primary care, there was $6.40 billed elsewhere in the system. Each full-time equivalent family physician generated a calculated sum of $784,752 in direct, billed charges for the hospital and $241,276 in professional fees for the other specialty consultants. The cost of supporting a primary care clinic is likely to be more than offset by the revenues generated from the use of hospital and referral services by patients who received care in the primary care setting.

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.

Promoting cancer screening within the patient centered medical home.

Science.gov (United States)

Sarfaty, Mona; Wender, Richard; Smith, Robert

2011-01-01

While consensus has grown that primary care is the essential access point in a high-performing health care system, the current model of primary care underperforms in both chronic disease management and prevention. The Patient Centered Medical Home model (PCMH) is at the center of efforts to reinvent primary care practice, and is regarded as the most promising approach to addressing the burden of chronic disease, improving health outcomes, and reducing health spending. However, the potential for the medical home to improve the delivery of cancer screening (and preventive services in general) has received limited attention in both conceptualization and practice. Medical home demonstrations to date have included few evidence-based preventive services in their outcome measures, and few have evaluated the effect of different payment models. Decreasing use of hospitals and emergency rooms and an emphasis on improving chronic care represent improvements in effective delivery of healthcare, but leave opportunities for reducing the burden of cancer untouched. Data confirm that what does or does not happen in the primary care setting has a substantial impact on cancer outcomes. Insofar as cancer is the leading cause of death before age 80, the PCMH model must prioritize adherence to cancer screening according to recommended guidelines, and systems, financial incentives, and reimbursements must be aligned to achieve that goal. This article explores capacities that are needed in the medical home model to facilitate the integration of cancer screening and other preventive services. These capacities include improved patient access and communication, health risk assessments, periodic preventive health exams, use of registries that store cancer risk information and screening history, ability to track and follow up on tests and referrals, feedback on performance, and payment models that reward cancer screening. Copyright © 2011 American Cancer Society, Inc.

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...

Towards a person-centered medical education: challenges and imperatives (I

Directory of Open Access Journals (Sweden)

Andrew Miles

2015-01-01

Full Text Available It is increasingly claimed that modern medicine has entered into crisis —a crisis of knowledge (uncertainty over what counts as “evidence” for decision-making and what does not, care (a deficit in sympathy, empathy, compassion, dignity, autonomy, patient safety (neglect, iatrogenic injury, malpractice, excess deaths, economic costs (which threaten to bankrupt health systems worldwide and clinical and institutional governance (a failure of basic and advanced management, inspirational and transformational leadership. We believe such a contention to be essentially correct. In the current article, we ask how the delineated components of the crisis can be individually understood in order to allow them to be collectively addressed. We ask how a transition can be effected away from impersonal, decontextualized and fragmented services in the direction of newer models of service provision that are personalized, contextualized and integrated. How, we ask, can we improve healthcare outcomes while simultaneously containing or lowering their costs? In initial answer to such questions —which are of considerable political as well as clinical significance— we assert that a new approach has become necessary, particularly in the context of the current epidemic of multi-morbid and socially complex long term illness. This new approach, we argue, is represented by the development and application of the concepts and methods of person-centered healthcare (PCH, a philosophy and technique in the care of the sick that enables clinicians and health systems to re-introduce humanistic ideals into clinical practice alongside continuing scientific advance, thereby restoring to medicine the humanism it has lost in over a century of empiricism. But the delivery of a person-centered healthcare within health systems requires a person-centered education and training. In this article we consider, then, why person-centered teaching innovations in the undergraduate medical

Genetics Home Reference: Peters anomaly

Science.gov (United States)

... Disease Patient Support and Advocacy Resources (3 links) Children's Eye Foundation Contact a Family Resource List from the University of Kansas Medical Center: Blind/Visual Impairment ClinicalTrials.gov (1 link) ClinicalTrials.gov Scientific Articles ...

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

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

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.

Selection and construction of nuclear and radiation emergency medical center in a region

International Nuclear Information System (INIS)

Wang Guojun; He Xu; Liao Li; Gao Dong

2014-01-01

Three level of first-class comprehensive hospital is an important force of nuclear and radiation accident rescue, has a very rich experience in response to nuclear and radiation accidents and deal with large quantities of the sick and wounded. With the foundation and the ability of the construction and operation of medical emergency rescue center. This paper according to the median model location theory of emergency center, combined with the specific situation of the nuclear and radiation accident in Hunan Province, reference location, rescue experience, emergency allocation of resources, teaching and research capacity, establish regional medical emergency center of nuclear and radiation accidents based on three level of first-class comprehensive hospital, break the traditional concept that the center must be provincial capital,form a multi-level, three-dimensional, network of emergency hospital rescue system. The main duties of the center are accident emergency response, on-site treatment and technical guidance of accident, psychological grooming. The author propose building measures according to the duties of the center: increase national and provincial financial investment, carry out training, drills and first aid knowledge missionaries regularly, innovative materials management, speed up the construction of information platform, establish and improve the hospital rescue system, improve organization institution and system of plans, reengineering rescue process. (authors)

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.

Cost-Benefit Analysis of Radiation Therapy Services at Tripler Army Medical Center

National Research Council Canada - National Science Library

Diehl, Diane S

2004-01-01

The purpose of this analysis was to examine the costs and benefits associated with continuance of "in-house" radiation therapy services to eligible beneficiaries at Tripler Army Medical Center (TAMC...

Key Elements of Clinical Physician Leadership at an Academic Medical Center

Science.gov (United States)

Dine, C. Jessica; Kahn, Jeremy M; Abella, Benjamin S; Asch, David A; Shea, Judy A

2011-01-01

Background A considerable body of literature in the management sciences has defined leadership and how leadership skills can be attained. There is considerably less literature about leadership within medical settings. Physicians-in-training are frequently placed in leadership positions ranging from running a clinical team or overseeing a resuscitation effort. However, physicians-in-training rarely receive such training. The objective of this study was to discover characteristics associated with effective physician leadership at an academic medical center for future development of such training. Methods We conducted focus groups with medical professionals (attending physicians, residents, and nurses) at an academic medical center. The focus group discussion script was designed to elicit participants' perceptions of qualities necessary for physician leadership. The lead question asked participants to imagine a scenario in which they either acted as or observed a physician leader. Two independent reviewers reviewed transcripts to identify key domains of physician leadership. Results Although the context was not specified, the focus group participants discussed leadership in the context of a clinical team. They identified 4 important themes: management of the team, establishing a vision, communication, and personal attributes. Conclusions Physician leadership exists in clinical settings. This study highlights the elements essential to that leadership. Understanding the physician attributes and behaviors that result in effective leadership and teamwork can lay the groundwork for more formal leadership education for physicians-in-training. PMID:22379520

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.

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

Energy Technology Data Exchange (ETDEWEB)

LaFreniere, L. M. (Environmental Science Division)

2012-07-15

what future CCC/USDA actions may be necessary, with the ultimate goal of achieving classification of the Sylvan Grove site at no further action status. The proposed activities are to be performed on behalf of the CCC/USDA by the Environmental Science Division of Argonne National Laboratory, a nonprofit, multidisciplinary research center operated by the UChicago Argonne, LLC, for the U.S. Department of Energy. Argonne provides technical assistance to the CCC/USDA concerning environmental site characterization and remediation at former 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. That document should be consulted for the complete details of plans for work associated with the former CCC/USDA facility at Sylvan Grove.

Gender Disparities in Faculty Rank: Factors that Affect Advancement of Women Scientists at Academic Medical Centers

Directory of Open Access Journals (Sweden)

Cristina M. López

2018-04-01

Full Text Available While a significant portion of women within academic science are employed within medical schools, women faculty in these academic medical centers are disproportionately represented in lower faculty ranks. The medical school setting is a critical case for both understanding and advancing women in basic sciences. This study highlights the findings from focus groups conducted with women faculty across Assistant, Associate, and Full Professor ranks (n = 35 in which they discussed barriers and facilitators for advancement of women basic scientists at an academic medical center. Qualitative analysis demonstrated several emergent themes that affect women’s advancement, including gendered expectation norms (e.g., good citizenship, volunteerism, work-life balance, mentorship/sponsorship, adoption of a team science approach, tenure process milestones, soft money research infrastructure, institution specific policies (or lack thereof, and operating within an MD-biased culture. These findings are compared with the extant literature of women scientists in STEM institutions. Factors that emerged from these focus groups highlight the need for evidence-based interventions in the often overlooked STEM arena of academic medical centers.

Estimated flood-inundation maps for Cowskin Creek in western Wichita, Kansas

Science.gov (United States)

Studley, Seth E.

2003-01-01

The October 31, 1998, flood on Cowskin Creek in western Wichita, Kansas, caused millions of dollars in damages. Emergency management personnel and flood mitigation teams had difficulty in efficiently identifying areas affected by the flooding, and no warning was given to residents because flood-inundation information was not available. To provide detailed information about future flooding on Cowskin Creek, high-resolution estimated flood-inundation maps were developed using geographic information system technology and advanced hydraulic analysis. Two-foot-interval land-surface elevation data from a 1996 flood insurance study were used to create a three-dimensional topographic representation of the study area for hydraulic analysis. The data computed from the hydraulic analyses were converted into geographic information system format with software from the U.S. Army Corps of Engineers' Hydrologic Engineering Center. The results were overlaid on the three-dimensional topographic representation of the study area to produce maps of estimated flood-inundation areas and estimated depths of water in the inundated areas for 1-foot increments on the basis of stream stage at an index streamflow-gaging station. A Web site (http://ks.water.usgs.gov/Kansas/cowskin.floodwatch) was developed to provide the public with information pertaining to flooding in the study area. The Web site shows graphs of the real-time streamflow data for U.S. Geological Survey gaging stations in the area and monitors the National Weather Service Arkansas-Red Basin River Forecast Center for Cowskin Creek flood-forecast information. When a flood is forecast for the Cowskin Creek Basin, an estimated flood-inundation map is displayed for the stream stage closest to the National Weather Service's forecasted peak stage. Users of the Web site are able to view the estimated flood-inundation maps for selected stages at any time and to access information about this report and about flooding in general. Flood

38 CFR 17.351 - Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center.

Science.gov (United States)

2010-07-01

... replacement and upgrading of equipment at Veterans Memorial Medical Center. 17.351 Section 17.351 Pensions... Philippines § 17.351 Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center. Grants to assist the Republic of the Philippines in the replacement and upgrading of equipment and in...

Clinical skill center: a review of present situation and importance in medical education curriculum

Directory of Open Access Journals (Sweden)

Haleh Talaei

2002-07-01

Full Text Available Clinical skill centers were designed in 1960, offers innovative, more effective clinical health care and treatment curriculum. Clinical skill center (CSC can provide a special facility for clinical and communication skills practice in a setting outside hospital wards in order to train students with enough confidence of confronting real patients. Learning clinical skills in these centers are not patient-dependent and by practicing on manikins and simulated models errors in real patients can be prevented. Moreover, possible feedback of this method can be used for evaluation and can improve quality and quantity of the education. This review intends to determine the purpose, undertaking, and structure of CSC. The study emphasizes the importance of integrating the clinical skill centers into the teaching curriculum of medical universities. Apparently, organizing clinical skill centers can play an important role for improving the quality and quantity of the educational system and consequently post-graduate performance. The authors recommend this program can be a solution for having both the knowledge and skill of diagnosis and treatment seasonal and rare diseases. Key words clinical skill center, medical education, curriculum

Adoptive Cell Therapies: One Cancer at a Time | Center for Cancer Research

Science.gov (United States)

After completing medical school and a general surgery residency at the University of Missouri, Kansas City, Christian Hinrichs, M.D., planned on doing cancer research at the start of his fellowship at Roswell Park Cancer Institute in 1996. However, a detour sent him into surgical oncology, and Hinrichs only returned to his research interests through a subsequent surgical

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...

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.

Quantitative Analysis of Contributing Factors Affecting Patient Satisfaction in Family Medicine Service Clinics at Brooke Army Medical Center

Science.gov (United States)

2008-06-06

Predictors of patient satisfaction for Brooke Army Medical Center Family Medicine Service primary care clinics was performed. Data was obtained from...Factors Affecting Patient Satisfaction in Family Medicine Service Clinics at Brooke Army Medical Center Presented to MAJ Eric Schmacker, Ph.D. In...study. All patients ’ medical information was protected at all times and under no circumstances will be discussed or released to any outside agency

[HIGH VELOCITY PENETRATING HEAD AND NECK INJURIES OF SYRIAN CIVIL WAR CASUALTIES TREATED IN THE GALILEE MEDICAL CENTER].

Science.gov (United States)

Ronen, Ohad; Assadi, Nidal; Sela, Eyal

2017-05-01

For two years the State of Israel has been treating casualties from the Syrian civil war. The Galilee Medical Center in Nahariya is the main hospital for this humanitarian mission. Objectives: To evaluate the demographic and clinical characteristics of the casualties that were treated in our department. Information from medical records of all Syrian casualties evacuated to the Galilee Medical Center were evaluated. Between March 2013 and December 2014, 450 casualties were evacuated to the Galilee Medical Center. Of those, 45 were treated in the Department of Otolaryngology - Head and Neck Surgery. Of the 45 cases, 43 were male (95.5%) and the mean age was 30.4 years (range 1-79 years). There was a significant difference in terms of gender (p Syria, and 12 died. Of all Syrian injured treated in the ENT department, the vast majority were young men. The main cause of injury was gunshot wounds. It is likely that the lack of protective gear that exist in western armies is a factor in the complex injuries treated at the Galilee Medical Center.

A 5-year scientometric analysis of research centers affiliated to Tehran University of Medical Sciences

Science.gov (United States)

Yazdani, Kamran; Rahimi-Movaghar, Afarin; Nedjat, Saharnaz; Ghalichi, Leila; Khalili, Malahat

2015-01-01

Background: Since Tehran University of Medical Sciences (TUMS) has the oldest and highest number of research centers among all Iranian medical universities, this study was conducted to evaluate scientific output of research centers affiliated to Tehran University of Medical Sciences (TUMS) using scientometric indices and the affecting factors. Moreover, a number of scientometric indicators were introduced. Methods: This cross-sectional study was performed to evaluate a 5-year scientific performance of research centers of TUMS. Data were collected through questionnaires, annual evaluation reports of the Ministry of Health, and also from Scopus database. We used appropriate measures of central tendency and variation for descriptive analyses. Moreover, uni-and multi-variable linear regression were used to evaluate the effect of independent factors on the scientific output of the centers. Results: The medians of the numbers of papers and books during a 5-year period were 150.5 and 2.5 respectively. The median of the "articles per researcher" was 19.1. Based on multiple linear regression, younger age centers (p=0.001), having a separate budget line (p=0.016), and number of research personnel (p<0.001) had a direct significant correlation with the number of articles while real properties had a reverse significant correlation with it (p=0.004). Conclusion: The results can help policy makers and research managers to allocate sufficient resources to improve current situation of the centers. Newly adopted and effective scientometric indices are is suggested to be used to evaluate scientific outputs and functions of these centers. PMID:26157724

The Institute for Safe Medication Practices and Poison Control Centers: Collaborating to Prevent Medication Errors and Unintentional Poisonings.

Science.gov (United States)

Vaida, Allen J

2015-06-01

This article provides an overview on the Institute for Safe Medication Practices (ISMP), the only independent nonprofit organization in the USA devoted to the prevention of medication errors. ISMP developed the national Medication Errors Reporting Program (MERP) and investigates and analyzes errors in order to formulate recommendations to prevent further occurrences. ISMP works closely with the US Food and Drug Administration (FDA), drug manufacturers, professional organizations, and others to promote changes in package design, practice standards, and healthcare practitioner and consumer education. By collaborating with ISMP to share and disseminate information, Poison Control centers, emergency departments, and toxicologists can help decrease unintentional and accidental poisonings.

Patient-centered medical homes in Louisiana had minimal impact on Medicaid population's use of acute care and costs.

Science.gov (United States)

Cole, Evan S; Campbell, Claudia; Diana, Mark L; Webber, Larry; Culbertson, Richard

2015-01-01

The patient-centered medical home model of primary care has received considerable attention for its potential to improve outcomes and reduce health care costs. Yet little information exists about the model's ability to achieve these goals for Medicaid patients. We sought to evaluate the effect of patient-centered medical home certification of Louisiana primary care clinics on the quality and cost of care over time for a Medicaid population. We used a quasi-experimental pre-post design with a matched control group to assess the effect of medical home certification on outcomes. We found no impact on acute care use and modest support for reduced costs and primary care use among medical homes serving higher proportions of chronically ill patients. These findings provide preliminary results related to the ability of the patient-centered medical home model to improve outcomes for Medicaid beneficiaries. The findings support a case-mix-adjusted payment policy for medical homes going forward. Project HOPE—The People-to-People Health Foundation, Inc.

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...

76 FR 59407 - Center for Biologics Evaluation and Research Report of Scientific and Medical Literature and...

Science.gov (United States)

2011-09-26

...] Center for Biologics Evaluation and Research Report of Scientific and Medical Literature and Information... Administration (FDA) is announcing the availability of its report of scientific and medical literature and... Research Report of Scientific and Medical Literature and Information on Non-Standardized Allergenic...

Activities of an ethics consultation service in a Tertiary Military Medical Center.

Science.gov (United States)

Waisel, D B; Vanscoy, S E; Tice, L H; Bulger, K L; Schmelz, J O; Perucca, P J

2000-07-01

The Joint Commission on Accreditation of Healthcare Organizations requires hospitals to have a mechanism to address issues of medical ethics. Most hospitals, especially those in the military, have an ethics committee composed solely of members who serve as an additional duty. To enhance the ethics consultation service, the 59th Medical Wing created a position under the chief of the medical staff for a full-time, fellowship-trained, medical ethicist. After establishment of this position, the number of consultations increased, a systematic program for caregiver education was developed and delivered, and an organizational presence was achieved by instituting positions on the institutional review board, the executive committee of the medical staff, and the credentials committee. Issues in medical care are becoming increasingly complicated, due in large part to financial stresses and technological advancements. Ethics consultation can help prevent and resolve many of these problems. This report discusses the activities of the first year of a full-time ethicist in a tertiary military medical center.

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.

Implementation of epic beaker anatomic pathology at an academic medical center

Directory of Open Access Journals (Sweden)

John Larry Blau

2017-01-01

Full Text Available Background: Beaker is a relatively new laboratory information system (LIS offered by Epic Systems Corporation as part of its suite of health-care software and bundled with its electronic medical record, EpicCare. It is divided into two modules, Beaker anatomic pathology (Beaker AP and Beaker Clinical Pathology. In this report, we describe our experience implementing Beaker AP version 2014 at an academic medical center with a go-live date of October 2015. Methods: This report covers preimplementation preparations and challenges beginning in September 2014, issues discovered soon after go-live in October 2015, and some post go-live optimizations using data from meetings, debriefings, and the project closure document. Results: We share specific issues that we encountered during implementation, including difficulties with the proposed frozen section workflow, developing a shared specimen source dictionary, and implementation of the standard Beaker workflow in large institution with trainees. We share specific strategies that we used to overcome these issues for a successful Beaker AP implementation. Several areas of the laboratory-required adaptation of the default Beaker build parameters to meet the needs of the workflow in a busy academic medical center. In a few areas, our laboratory was unable to use the Beaker functionality to support our workflow, and we have continued to use paper or have altered our workflow. In spite of several difficulties that required creative solutions before go-live, the implementation has been successful based on satisfaction surveys completed by pathologists and others who use the software. However, optimization of Beaker workflows has continued to be an ongoing process after go-live to the present time. Conclusions: The Beaker AP LIS can be successfully implemented at an academic medical center but requires significant forethought, creative adaptation, and continued shared management of the ongoing product by

Burnout among nurses working in medical and educational centers in Shahrekord, Iran

Science.gov (United States)

Moghaddasi, Jaefar; Mehralian, Hossein; Aslani, Yousef; Masoodi, Reza; Amiri, Masoud

2013-01-01

Background: Nursing burnout is the main characteristic of job stress that is a delayed reaction to chronic stressful situations in the workplace which could affect nurses who do not have sufficient emotional energy to cope and communicate with different types of patients. There is also sometimes this belief that they do not have the required capabilities for their jobs. The aim of this study was the evaluation of burnout among nurses working in medical and educational centers in Shahrekord. Materials and Methods: This descriptive study was performed on 340 nurses working in medical and educational centers in Shahrekord in 2009. Samples were selected using proportionate random sampling. Demographic information and the Maslach Burnout Inventory (MBI) were filled in for all nurses. Results: Burnout was considerable among nurses. The results showed that 34.6, 28.8, and 95.7% of the nurses had emotional exhaustion (EE), high depersonalization (DP), and high reduced personal accomplishment (PA), respectively. The mean scores (± standard deviation) for EE, DP, and PA were 22.77 (12.44), 6.99 (6.23), and 32.20 (9.26), respectively. Conclusions: Our results showed that burnout was noticeable among nurses working in medical and educational centers in Shahrekord. Disproportionate relationship between the number of nurses, workload, and income was the most important factor affecting nursing burnout. Due to the importance of nursing in the health-care system, policy makers should adopt suitable strategies for increasing the satisfaction of nurses. PMID:24403925

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...

User-centered design of a mobile medication management.

Science.gov (United States)

Sedlmayr, Brita; Schöffler, Jennifer; Prokosch, Hans-Ulrich; Sedlmayr, Martin

2018-03-05

The use of a nationwide medication plan has been promoted as an effective strategy to improve patient safety in Germany. However, the medication plan only exists as a paper-based version, which is related to several problems, that could be circumvented by an electronic alternative. The main objective of this study was to report on the development of a mobile interface concept to support the management of medication information. The human-centered design (UCD) process was chosen. First the context of use was analyzed, and personas and an interaction concept were designed. Next, a paper prototype was developed and evaluated by experts. Based on those results, a medium-fidelity prototype was created and assessed by seven end-users who performed a thinking-aloud test in combination with a questionnaire based on the System Usability Scale (SUS). Initially for one persona/user type, an interface design concept was developed, which received an average SUS-Score of 92.1 in the user test. Usability problems have been solved so that the design concept could be fixed for a future implementation. Contribution: The approach of the UCD process and the methods involved can be applied by other researchers as a framework for the development of similar applications.

Quality improvement in healthcare delivery utilizing the patient-centered medical home model.

Science.gov (United States)

Akinci, Fevzi; Patel, Poonam M

2014-01-01

Despite the fact that the United States dedicates so much of its resources to healthcare, the current healthcare delivery system still faces significant quality challenges. The lack of effective communication and coordination of care services across the continuum of care poses disadvantages for those requiring long-term management of their chronic conditions. This is why the new transformation in healthcare known as the patient-centered medical home (PCMH) can help restore confidence in our population that the healthcare services they receive is of the utmost quality and will effectively enhance their quality of life. Healthcare using the PCMH model is delivered with the patient at the center of the transformation and by reinvigorating primary care. The PCMH model strives to deliver effective quality care while attempting to reduce costs. In order to relieve some of our healthcare system distresses, organizations can modify their delivery of care to be patient centered. Enhanced coordination of services, better provider access, self-management, and a team-based approach to care represent some of the key principles of the PCMH model. Patients that can most benefit are those that require long-term management of their conditions such as chronic disease and behavioral health patient populations. The PCMH is a feasible option for delivery reform as pilot studies have documented successful outcomes. Controversy about the lack of a medical neighborhood has created concern about the overall sustainability of the medical home. The medical home can stand independently and continuously provide enhanced care services as a movement toward higher quality care while organizations and government policy assess what types of incentives to put into place for the full collaboration and coordination of care in the healthcare system.

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

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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.

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.

Cross-cultural medical education: can patient-centered cultural competency training be effective in non-Western countries?

Science.gov (United States)

Ho, Ming-Jung; Yao, Grace; Lee, Keng-Lin; Beach, Mary Catherine; Green, Alexander R

2008-01-01

No evidence addresses the effectiveness of patient-centered cultural competence training in non-Western settings. To examine whether a patient-centered cultural competency curriculum improves medical students' skills in eliciting the patients' perspective and exploring illness-related social factors. Fifty-seven medical students in Taiwan were randomly assigned to either the control (n = 27) or one of two intervention groups: basic (n = 15) and extensive (n = 15). Both intervention groups received two 2-hour patient-centered cultural competency workshops. In addition, the extensive intervention group received a 2-hour practice session. The control group received no training. At the end of the clerkship, all students were evaluated with an objective structured clinical examination (OSCE). Students in the extensive intervention group scored significantly higher than the basic intervention and control groups in eliciting the patient's perspective (F = 18.38, p social factors (F = 6.66, p = 0.003, eta(2) = 0.20). Patient-centered cultural competency training can produce improvement in medical students' cross-cultural communication skills in non-Western settings, especially when adequate practice is provided.

Spectrum of tablet computer use by medical students and residents at an academic medical center

Directory of Open Access Journals (Sweden)

Robert Robinson

2015-07-01

Full Text Available Introduction. The value of tablet computer use in medical education is an area of considerable interest, with preliminary investigations showing that the majority of medical trainees feel that tablet computers added value to the curriculum. This study investigated potential differences in tablet computer use between medical students and resident physicians.Materials & Methods. Data collection for this survey was accomplished with an anonymous online questionnaire shared with the medical students and residents at Southern Illinois University School of Medicine (SIU-SOM in July and August of 2012.Results. There were 76 medical student responses (26% response rate and 66 resident/fellow responses to this survey (21% response rate. Residents/fellows were more likely to use tablet computers several times daily than medical students (32% vs. 20%, p = 0.035. The most common reported uses were for accessing medical reference applications (46%, e-Books (45%, and board study (32%. Residents were more likely than students to use a tablet computer to access an electronic medical record (41% vs. 21%, p = 0.010, review radiology images (27% vs. 12%, p = 0.019, and enter patient care orders (26% vs. 3%, p < 0.001.Discussion. This study shows a high prevalence and frequency of tablet computer use among physicians in training at this academic medical center. Most residents and students use tablet computers to access medical references, e-Books, and to study for board exams. Residents were more likely to use tablet computers to complete clinical tasks.Conclusions. Tablet computer use among medical students and resident physicians was common in this survey. All learners used tablet computers for point of care references and board study. Resident physicians were more likely to use tablet computers to access the EMR, enter patient care orders, and review radiology studies. This difference is likely due to the differing educational and professional demands placed on

Community pharmacist collaboration with a patient-centered medical home: Establishment of a patient-centered medical neighborhood and payment model.

Science.gov (United States)

Luder, Heidi R; Shannon, Pam; Kirby, James; Frede, Stacey M

To determine the feasibility of a partnership between a community pharmacy and a patient-centered medical home (PCMH) by measuring the impact on office- and patient-level clinical outcomes. Kroger Pharmacy and a PCMH practice in Cincinnati, OH. The Kroger Co. is a large grocery store chain that operates 102 pharmacies in the Cincinnati-Dayton marketing area. The PCMH practice is an accredited PCMH office serving more than 9000 patients in the Cincinnati area. In a medical neighborhood, a PCMH coordinates care with other local specialty practices or partners. A partnership between the community pharmacy chain and the PCMH was established to create a medical neighborhood. The pharmacist spent 2 half-days per week at the PCMH. The pharmacist provided initial medication therapy management appointments in the PCMH and offered follow-up services in the office, the pharmacy, or both, depending on patient preference. The pharmacy received a capitated payment per patient per month for a predetermined number of 1000 high-risk patients. Office-level changes in clinical outcomes such as A1C, blood pressure, and lipid measures were collected and compared with those of a similar control office. In addition, patient-level outcomes such as change in A1C, blood pressure, lipids, and weight were measured. One hundred five patients were seen by the pharmacist during the study period, with 1.5% of the total managed at the office. There was a statistically significant increase in influenza vaccinations received. On a patient level, A1C and systolic blood pressure significantly improved. This project represents an exciting opportunity for community pharmacists to expand their scope of services through direct partnership with PCMHs and maintain a sustainable reimbursement structure. Copyright © 2018. Published by Elsevier Inc.

Development of a Hospital-based Massage Therapy Course at an Academic Medical Center.

Science.gov (United States)

Dion, Liza J; Cutshall, Susanne M; Rodgers, Nancy J; Hauschulz, Jennifer L; Dreyer, Nikol E; Thomley, Barbara S; Bauer, Brent

2015-03-01

Massage therapy is offered increasingly in US medical facilities. Although the United States has many massage schools, their education differs, along with licensure and standards. As massage therapy in hospitals expands and proves its value, massage therapists need increased training and skills in working with patients who have various complex medical concerns, to provide safe and effective treatment. These services for hospitalized patients can impact patient experience substantially and provide additional treatment options for pain and anxiety, among other symptoms. The present article summarizes the initial development and description of a hospital-based massage therapy course at a Midwest medical center. A hospital-based massage therapy course was developed on the basis of clinical experience and knowledge from massage therapists working in the complex medical environment. This massage therapy course had three components in its educational experience: online learning, classroom study, and a 25-hr shadowing experience. The in-classroom study portion included an entire day in the simulation center. The hospital-based massage therapy course addressed the educational needs of therapists transitioning to work with interdisciplinary medical teams and with patients who have complicated medical conditions. Feedback from students in the course indicated key learning opportunities and additional content that are needed to address the knowledge and skills necessary when providing massage therapy in a complex medical environment. The complexity of care in medical settings is increasing while the length of hospital stay is decreasing. For this reason, massage provided in the hospital requires more specialized training to work in these environments. This course provides an example initial step in how to address some of the educational needs of therapists who are transitioning to working in the complex medical environment.

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.

The patient-centered medical home: an ethical analysis of principles and practice.

Science.gov (United States)

Braddock, Clarence H; Snyder, Lois; Neubauer, Richard L; Fischer, Gary S

2013-01-01

The patient-centered medical home (PCMH), with its focus on patient-centered care, holds promise as a way to reinvigorate the primary care of patients and as a necessary component of health care reform. While its tenets have been the subject of review, the ethical dimensions of the PCMH have not been fully explored. Consideration of the ethical foundations for the core principles of the PCMH can and should be part of the debate concerning its merits. The PCMH can align with the principles of medical ethics and potentially strengthen the patient-physician relationship and aspects of health care that patients value. Patient choice and these ethical considerations are central and at least as important as the economic and practical arguments in support of the PCMH, if not more so. Further, the ethical principles that support key concepts of the PCMH have implications for the design and implementation of the PCMH. This paper explores the PCMH in light of core principles of ethics and professionalism, with an emphasis both on how the concept of the PCMH may reinforce core ethical principles of medical practice and on further implications of these principles.

Evaluation of the ASCO Value Framework for Anticancer Drugs at an Academic Medical Center.

Science.gov (United States)

Wilson, Leslie; Lin, Tracy; Wang, Ling; Patel, Tanuja; Tran, Denise; Kim, Sarah; Dacey, Katie; Yuen, Courtney; Kroon, Lisa; Brodowy, Bret; Rodondi, Kevin

2017-02-01

Anticancer drug prices have increased by an average of 12% each year from 1996 to 2014. A major concern is that the increasing cost and responsibility of evaluating treatment options are being shifted to patients. This research compared 2 value-based pricing models that were being considered for use at the University of California, San Francisco (UCSF) Medical Center to address the growing burden of high-cost cancer drugs while improving patient-centered care. The Medication Outcomes Center (MOC) in the Department of Clinical Pharmacy, University of California, San Francisco (UCSF), School of Pharmacy focuses on assessing the value of medication-related health care interventions and disseminating findings to the UCSF Medical Center. The High Cost Oncology Drug Initiative at the MOC aims to assess and adopt tools for the critical assessment and amelioration of high-cost cancer drugs. The American Society of Clinical Oncology (ASCO) Value Framework (2016 update) and a cost-effectiveness analysis (CEA) framework were identified as potential tools for adoption. To assess 1 prominent value framework, the study investigators (a) asked 8 clinicians to complete the ASCO Value Framework for 11 anticancer medications selected by the MOC; (b) reviewed CEAs assessing the drugs; (c) generated descriptive statistics; and (d) analyzed inter-rater reliability, convergence validity, and ranking consistency. On the scale of -20 to 180, the mean ASCO net health benefit (NHB) total score across 11 drugs ranged from 7.6 (SD = 7.8) to 53 (SD = 9.8). The Kappa coefficient (κ) for NHB scores across raters was 0.11, which is categorized as "slightly reliable." The combined κ score was 0.22, which is interpreted as low to fair inter-rater reliability. Convergent validity indicates that the correlation between NHB scores and CEA-based incremental cost-effectiveness ratios (ICERs) was low (-0.215). Ranking of ICERs, ASCO scores, and wholesale acquisition costs indicated different results

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.

Development of a Risk-Based Decision-Support-Model for Protecting an Urban Medical Center from a Nuclear Explosion

International Nuclear Information System (INIS)

Ben-Dor, G.; Shohet, I.M.; Ornai, D.; Brosh, B.

2014-01-01

Nuclear explosion is the worst man-made physical threat on the human society. The nuclear explosion includes several consequences, some of them are immediate and others are long term. The major influences are: long duration blast, extreme thermal release, nuclear radiations, and electro-magnetic pulse (EMP). Their damage range is very wide. When nuclear explosion occurs above or in an urban area it is possible that one or more medical centers will be affected. Medical centers include several layers of structures defined by their resistance capacity to the nuclear explosion influences, beginning with the structure's frame and ending with different systems and with vulnerable medical critical infrastructures such as communications, medical gas supply, etc. A comprehensive literature survey revealed that in spite of the necessity and the importance of medical centers in the daily life and especially in emergency and post nuclear explosion, there is a lack of research on this topic

Marion duPont Scott Equine Medical Center offers new treatment for lameness

OpenAIRE

Musick, Marjorie

2006-01-01

The Virginia-Maryland Regional College of Veterinary Medicine's Marion duPont Scott Equine Medical Center has begun offering a new therapy for treating lameness associated with osteoarthritis and cartilage damage in horses, a problem that affects all segments of the equine industry.

Creating and sustainable development of specialized centers as a way to improve quality of medical care

Directory of Open Access Journals (Sweden)

V. I. Guzeva

2016-01-01

Full Text Available Quality of care is evaluated on the completeness of the survey, the correct diagnosis, treatment efficacy, and its duration. Improving the quality and efficiency of medical care for children with paroxysmal disorders of consciousness is one of topical problems of neurology.Aim. The aim of the work is to justify the relationship between improving the quality of health care and sustainable development in the modern conditions of specialized medical centers on the example of the work on the identification and treatment of children with paroxysmal disorders of consciousness of the Center for diagnosis and treatment of epilepsy, and sleep disorders in children and adolescents at the department neurology, neurosurgery and medical genetics SPbGPMU.Materials and methods. For more accurate diagnosis and treatment at the Center conducted a comprehensive examination, including video-EEG оf 527 children aged 1 month to 18 years. A clinical trial study included medical cases, assessment of neurological and somatic status, the study of seizure types and forms of the disease. Instrumental methods of examination were determined by EEG and MRI studies of the brain.Main results. Comprehensive survey of sick children with monitoring video-EEG revealed that 317 children (60,1% had epileptic paroxysms and 210 children (39,8% – non-epileptic paroxysms. Correction treatment was performed in 284 (89,5% children with epileptic paroxysms and altered the treatment in 190 (90,4% children with epileptic paroxysms.Conclusion. The presented clinical data show the high effectiveness of the Centre in the diagnosis and treatment of children with paroxysmal disorders of consciousness. The accumulated experience in the Center confirms the relevance of the creation of the structure of scientific and educational institutions specialized centers in which patients will be given to high-quality medical care.

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

Factors that influence the choice to work in rural township health centers among 4,669 clinical medical students from five medical universities in Guangxi, China.

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Qing, Yunbo; Hu, Guijie; Chen, Qingyun; Peng, Hailun; Li, Kailan; Wei, Jinling; Yi, Yanhua

2015-01-01

To produce competent undergraduate-level medical doctors for rural township health centers (THCs), the Chinese government mandated that medical colleges in Central and Western China recruit rural-oriented, tuition-waived medical students (RTMSs) starting in 2010. This study aimed to identify and assess factors that influence the choice to work in rural township health centers among both RTMSs and other students from five medical universities in Guangxi, China. An internet-based self-administered questionnaire survey was conducted with medical students in Guangxi province. Multinomial logistic regression was used to identify factors related to the attitudes toward work in a rural township health center. Among 4,669 medical students, 1,523 (33%) had a positive attitude and 2,574 (55%) had a neutral attitude toward working in THCs. Demographic characteristics, personal job concerns, and knowledge of THCs were associated with the choice of a career in THCs. The factors related to a positive attitude included the following: three-year program, a rural-oriented medical program, being male, an expectation of working in a county or township, a focus on medical career development, some perceived difficulty of getting a job, having family support, sufficient knowledge of THCs, optimism toward THC development, seeking lower working pressure, and a lower expected monthly salary. Male students in a three-year program or a rural-oriented tuition-waived medical education program were more likely to work in THCs. Selecting medical students through interviews to identify their family support and intentions to work in THCs would increase recruitment and retention. Establishing favorable policies and financial incentives to improve living conditions and the social status of rural physicians is necessary.

Factors that influence the choice to work in rural township health centers among 4,669 clinical medical students from five medical universities in Guangxi, China

Directory of Open Access Journals (Sweden)

Yunbo Qing

2015-07-01

Full Text Available Purpose: To produce competent undergraduate-level medical doctors for rural township health centers (THCs, the Chinese government mandated that medical colleges in Central and Western China recruit rural-oriented, tuition-waived medical students (RTMSs starting in 2010. This study aimed to identify and assess factors that influence the choice to work in rural township health centers among both RTMSs and other students from five medical universities in Guangxi, China. Methods: An internet-based self-administered questionnaire survey was conducted with medical students in Guangxi province. Multinomial logistic regression was used to identify factors related to the attitudes toward work in a rural township health center. Results: Among 4,669 medical students, 1,523 (33% had a positive attitude and 2,574 (55% had a neutral attitude toward working in THCs. Demographic characteristics, personal job concerns, and knowledge of THCs were associated with the choice of a career in THCs. The factors related to a positive attitude included the following: three-year program, a rural-oriented medical program, being male, an expectation of working in a county or township, a focus on medical career development, some perceived difficulty of getting a job, having family support, sufficient knowledge of THCs, optimism toward THC development, seeking lower working pressure, and a lower expected monthly salary. Conclusion: Male students in a three-year program or a rural-oriented tuition-waived medical education program were more likely to work in THCs. Selecting medical students through interviews to identify their family support and intentions to work in THCs would increase recruitment and retention. Establishing favorable policies and financial incentives to improve living conditions and the social status of rural physicians is necessary.

Viewpoints of the members of the workers' retirement centers in Tehran about elderly day care centers (2012

Directory of Open Access Journals (Sweden)

Hosein Rohani

2014-02-01

Full Text Available Background: There is no documented evidence regarding elderly day care centers in Iran. This needs analysis study was conducted to investigate the demand for elderly day care centers in Tehran. Methods: This cross-sectional study was conducted recruiting 210 participants aged over 60 who were members of the elderly retirement centers in Tehran in 2012. Data were gathered by Kansas state university questionnaire and analyzed using Mann-Whitney and Kruskal-Wallis tests. Results: About 80% of participants were men with the mean age of 67.5±5.23 years. Results showed that male (P<0.001, married (P=0.01 and literate elderly (P<0.001, and those living in rental homes (P<0.001 expressed a greater need for elderly day care centers. There was no statistically significant relationship between the lifestyle (P=0.051 and income (P=0.08 of the participants and demand for elderly day care centers. Conclusion: Given the rising population of the elderly and their high demand for day care centers, it is necessary to establish well-equipped day care centers for this group of people. Also, these centers may reduce the burden of care for the aged people on public services and family care givers.

Prospects for rebuilding primary care using the patient-centered medical home.

Science.gov (United States)

Landon, Bruce E; Gill, James M; Antonelli, Richard C; Rich, Eugene C

2010-05-01

Existing research suggests that models of enhanced primary care lead to health care systems with better performance. What the research does not show is whether such an approach is feasible or likely to be effective within the U.S. health care system. Many commentators have adopted the model of the patient-centered medical home as policy shorthand to address the reinvention of primary care in the United States. We analyze potential barriers to implementing the medical home model for policy makers and practitioners. Among others, these include developing new payment models, as well as the need for up-front funding to assemble the personnel and infrastructure required by an enhanced non-visit-based primary care practice and methods to facilitate transformation of existing practices to functioning medical homes.

Collaborating to improve the global competitiveness of US academic medical centers.

Science.gov (United States)

Allen, Molly; Garman, Andrew; Johnson, Tricia; Hohmann, Samuel; Meurer, Steve

2012-01-01

President Obama announced the National Export Initiative in his 2010 State of the Union address and set the ambitious goal of doubling US exports by the end of 2014 to support millions of domestic jobs. Understanding the competitive position of US health care in the global market for international patients, University Health System Consortium (UHC), an alliance of 116 academic medical centers and 272 of their affiliated hospitals, representing 90 percent of the nation's non-profit academic medical centers partnered with Rush University, a private University in Chicago, IL and the International Trade Administration of the US Department of Commerce International Trade Administration (ITA) to participate in the Market Development Cooperator Program. The goal of this private-public partnership is to increase the global competitiveness of the US health care industry, which represents over 16 percent of the GDP, amongst foreign health care providers. This article provides an overview of the US health care market and outlines the aims of the US Cooperative for International Patient Programs, the end result of the partnership between UHC, ITA and Rush University.

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.

Syndrome surveillance of fentanyl-laced heroin outbreaks: Utilization of EMS, Medical Examiner and Poison Center databases.

Science.gov (United States)

Moore, P Quincy; Weber, Joseph; Cina, Steven; Aks, Steven

2017-11-01

Describe surveillance data from three existing surveillance systems during an unexpected fentanyl outbreak in a large metropolitan area. We performed a retrospective analysis of three data sets: Chicago Fire Department EMS, Cook County Medical Examiner, and Illinois Poison Center. Each included data from January 1, 2015 through December 31, 2015. EMS data included all EMS responses in Chicago, Illinois, for suspected opioid overdose in which naloxone was administered and EMS personnel documented other criteria indicative of opioid overdose. Medical Examiner data included all deaths in Cook County, Illinois, related to heroin, fentanyl or both. Illinois Poison Center data included all calls in Chicago, Illinois, related to fentanyl, heroin, and other prescription opioids. Descriptive statistics using Microsoft Excel® were used to analyze the data and create figures. We identified a spike in opioid-related EMS responses during an 11-day period from September 30-October 10, 2015. Medical Examiner data showed an increase in both fentanyl and mixed fentanyl/heroin related deaths during the months of September and October, 2015 (375% and 550% above the median, respectively.) Illinois Poison Center data showed no significant increase in heroin, fentanyl, or other opioid-related calls during September and October 2015. Our data suggests that EMS data is an effective real-time surveillance mechanism for changes in the rate of opioid overdoses. Medical Examiner's data was found to be valuable for confirmation of EMS surveillance data and identification of specific intoxicants. Poison Center data did not correlate with EMS or Medical Examiner data. Copyright © 2017 Elsevier Inc. All rights reserved.

Sustainable environmental flow management in an agricultural watershed in northeast Kansas

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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 ...

Program review of the USDA Center for Medical, Agricultural and Veterinary Entomology

Science.gov (United States)

The USDA-ARS Center for Medical, Agricultural and Veterinary Entomology (CMAVE) has a history that starts in 1932 in Orlando to develop methods to control mosquitoes, including malaria vectors under conditions simulating those of the south Pacific jungles, and other insects affecting man and animals...

Challenges and Opportunities to Improve Cervical Cancer Screening Rates in US Health Centers through Patient-Centered Medical Home Transformation

Directory of Open Access Journals (Sweden)

Olga Moshkovich

2015-01-01

Full Text Available Over the last 50 years, the incidence of cervical cancer has dramatically decreased. However, health disparities in cervical cancer screening (CCS persist for women from racial and ethnic minorities and those residing in rural and poor communities. For more than 45 years, federally funded health centers (HCs have been providing comprehensive, culturally competent, and quality primary health care services to medically underserved communities and vulnerable populations. To enhance the quality of care and to ensure more women served at HCs are screened for cervical cancer, over eight HCs received funding to support patient-centered medical home (PCMH transformation with goals to increase CCS rates. The study conducted a qualitative analysis using Atlas.ti software to describe the barriers and challenges to CCS and PCMH transformation, to identify potential solutions and opportunities, and to examine patterns in barriers and solutions proposed by HCs. Interrater reliability was assessed using Cohen’s Kappa. The findings indicated that HCs more frequently described patient-level barriers to CCS, including demographic, cultural, and health belief/behavior factors. System-level barriers were the next commonly cited, particularly failure to use the full capability of electronic medical records (EMRs and problems coordinating with external labs or providers. Provider-level barriers were least frequently cited.

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.

Medication therapy management clinic: perception of healthcare professionals in a University medical center setting

Directory of Open Access Journals (Sweden)

Shah M

2013-09-01

Full Text Available Objective: To determine the overall perception and utilization of the pharmacist managed medication therapy management (MTM clinic services, by healthcare professionals in a large, urban, university medical care setting.Methods: This was a cross-sectional, anonymous survey sent to 195 healthcare professionals, including physicians, nurses, and pharmacists at The University of Illinois Outpatient Care Center to determine their perception and utilization of the MTM clinic. The survey consisted of 12 questions and was delivered through a secure online application. Results: Sixty-two healthcare professionals (32% completed the survey. 82% were familiar with the MTM clinic, and 63% had referred patients to the clinic. Medication adherence and disease state management was the most common reason for referral. Lack of knowledge on the appropriate referral procedure was the prominent reason for not referring patients to the MTM clinic. Of the providers that were aware of MTM services, 44% rated care as ‘excellent’, 44% as ‘good’, 5% as ‘fair’, and 0% stated ‘poor’. Strengths of MTM clinic identified by healthcare providers included in-depth education to patients, close follow-up, and detailed medication reconciliation provided by MTM clinic pharmacists. Of those familiar with MTM clinic, recommendations included; increase marketing efforts to raise awareness of the MTM clinic service, create collaborative practice agreements between MTM pharmacists and physicians, and ensure that progress notes are more concise.Conclusion: In a large, urban, academic institution MTM clinic is perceived as a valuable resource to optimize patient care by providing patients with in-depth education as it relates to their prescribed medications and disease states. These identified benefits of MTM clinic lead to frequent patient referrals specifically for aid with medication adherence and disease state management.

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)…

Information technology leadership in academic medical centers: a tale of four cultures.

Science.gov (United States)

Friedman, C P

1999-07-01

Persons and groups within academic medical centers bring consistent and predictable viewpoints to planning and decision making. The varied professional and academic cultures of these individuals appear to account primarily for the diversity of their viewpoints. Understanding these professional cultures can help leaders achieve some predictability in the complex environments for which they are responsible. Leaders in information technology in particular, in order to be successful, must become part-time anthropologists, immersing themselves in the varied workplaces of their constituents to understand the work they do and the cultures that have grown up around this work. Only in this way will they be able to manage the challenges that arise continuously as the technology and the needs it can address change over time. In this article, the author briefly describes the concept of culture, portrays four specific professional cultures that typically coexist in academic medical centers, and argues that understanding these cultures is absolutely critical to effective management and use of information resources.

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.

Targeting the androgen receptor in triple-negative breast cancer: current perspectives

Directory of Open Access Journals (Sweden)

Mina A

2017-09-01

Full Text Available Alain Mina,1 Rachel Yoder,2 Priyanka Sharma1 1Division of Medical Oncology, Department of Internal Medicine, University of Kansas Medical Center, Westwood, 2University of Kansas Cancer Center, Kansas City, KS, USA Abstract: Triple-negative breast cancer (TNBC is an aggressive subtype associated with frequent recurrence and metastasis. Unlike hormone receptor-positive subtypes, treatment of TNBC is currently limited by the lack of clinically available targeted therapies. Androgen signaling is necessary for normal breast development, and its dysregulation has been implicated in breast tumorigenesis. In recent years, gene expression studies have identified a subset of TNBC that is enriched for androgen receptor (AR signaling. Interference with androgen signaling in TNBC is promising, and AR-inhibiting drugs have shown antitumorigenic activity in preclinical and proof of concept clinical studies. Recent advances in our understanding of androgenic signaling in TNBC, along with the identification of interacting pathways, are allowing development of the next generation of clinical trials with AR inhibitors. As novel AR-targeting agents are developed and evaluated in clinical trials, it is equally important to establish a robust set of biomarkers for identification of TNBC tumors that are most likely to respond to AR inhibition. Keywords: triple-negative breast cancer, androgen signaling, targeted therapy, biomarkers, prognosis 

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...

Patient-centered disease management (PCDM) for heart failure: study protocol for a randomised controlled trial.

Science.gov (United States)

Bekelman, David B; Plomondon, Mary E; Sullivan, Mark D; Nelson, Karin; Hattler, Brack; McBryde, Connor; Lehmann, Kenneth G; Potfay, Jonathan; Heidenreich, Paul; Rumsfeld, John S

2013-07-09

Chronic heart failure (HF) disease management programs have reported inconsistent results and have not included comorbid depression management or specifically focused on improving patient-reported outcomes. The Patient Centered Disease Management (PCDM) trial was designed to test the effectiveness of collaborative care disease management in improving health status (symptoms, functioning, and quality of life) in patients with HF who reported poor HF-specific health status. Patients with a HF diagnosis at four VA Medical Centers were identified through population-based sampling. Patients with a Kansas City Cardiomyopathy Questionnaire (KCCQ, a measure of HF-specific health status) score of patients were randomized to receive usual care or the PCDM intervention, which included: (1) collaborative care management by VA clinicians including a nurse, cardiologist, internist, and psychiatrist, who worked with patients and their primary care providers to provide guideline-concordant care management, (2) home telemonitoring and guided patient self-management support, and (3) screening and treatment for comorbid depression. The primary study outcome is change in overall KCCQ score. Secondary outcomes include depression, medication adherence, guideline-based care, hospitalizations, and mortality. The PCDM trial builds on previous studies of HF disease management by prioritizing patient health status, implementing a collaborative care model of health care delivery, and addressing depression, a key barrier to optimal disease management. The study has been designed as an 'effectiveness trial' to support broader implementation in the healthcare system if it is successful. Unique identifier: NCT00461513.

Outsourcing your medical practice call center: how to choose a vendor to ensure regulatory compliance.

Science.gov (United States)

Johnson, Bill

2014-01-01

Medical practices receive hundreds if not thousands of calls every week from patients, payers, pharmacies, and others. Outsourcing call centers can be a smart move to improve efficiency, lower costs, improve customer care, ensure proper payer management, and ensure regulatory compliance. This article discusses how to know when it's time to move to an outsourced call center, the benefits of making the move, how to choose the right call center, and how to make the transition. It also provides tips on how to manage the call center to ensure the objectives are being met.

An approach to human-centered design of nuclear medical equipment: the system of caption of the thyroid

International Nuclear Information System (INIS)

Santos, Isaac J.A. Luquetti; Silva, Carlos Borges da; Santana, Marcos; Carvalho, Paulo Victor R.; Oliveira, Mauro Vitor de; Mol, Antonio Carlos Mol; Grecco, Claudio Henrique; Augusto, Silas Cordeiro

2005-01-01

Technology plays an important role in modern medical centers, making health care increasingly complex, relying on complex technical equipment. This technical complexity is particularly noticeable in the nuclear medicine and can increase the risks for human error. Human error has many causes such as performance shaping factors, organizational factors and user interface design. Poorly design human system interfaces of nuclear medical equipment can increase the risks for human error. If all nuclear medical equipment had been designed with good user interfaces, incidents and accidents could be reduced as well as he time required to learn how to use the equipment. Although some manufacturers of nuclear medical equipment have already integrate human factors principles in their products, there is still a need to steer the development of nuclear medical technology toward more human-centered approach. The aim of this paper is to propose a methodology that contributes to the design, development and evaluation of nuclear medical equipment and human system interface, towards a human-centered approach. This methodology includes the ergonomic approach, based on the operator activity analysis, together with human factors standards and guidelines, questionnaires and user based testing. We describe a case study in which this methodology is being applied in evaluation of the thyroid uptake system, getting essential information and data, that ill be used in development of a new system. (author)

Creating a longitudinal integrated clerkship with mutual benefits for an academic medical center and a community health system.

Science.gov (United States)

Poncelet, Ann Noelle; Mazotti, Lindsay A; Blumberg, Bruce; Wamsley, Maria A; Grennan, Tim; Shore, William B

2014-01-01

The longitudinal integrated clerkship is a model of clinical education driven by tenets of social cognitive theory, situated learning, and workplace learning theories, and built on a foundation of continuity between students, patients, clinicians, and a system of care. Principles and goals of this type of clerkship are aligned with primary care principles, including patient-centered care and systems-based practice. Academic medical centers can partner with community health systems around a longitudinal integrated clerkship to provide mutual benefits for both organizations, creating a sustainable model of clinical training that addresses medical education and community health needs. A successful one-year longitudinal integrated clerkship was created in partnership between an academic medical center and an integrated community health system. Compared with traditional clerkship students, students in this clerkship had better scores on Clinical Performance Examinations, internal medicine examinations, and high perceptions of direct observation of clinical skills.Advantages for the academic medical center include mitigating the resources required to run a longitudinal integrated clerkship while providing primary care training and addressing core competencies such as systems-based practice, practice-based learning, and interprofessional care. Advantages for the community health system include faculty development, academic appointments, professional satisfaction, and recruitment.Success factors include continued support and investment from both organizations' leadership, high-quality faculty development, incentives for community-based physician educators, and emphasis on the mutually beneficial relationship for both organizations. Development of a longitudinal integrated clerkship in a community health system can serve as a model for developing and expanding these clerkship options for academic medical centers.

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.

Implementing the patient-centered medical home in residency education.

Science.gov (United States)

Doolittle, Benjamin R; Tobin, Daniel; Genao, Inginia; Ellman, Matthew; Ruser, Christopher; Brienza, Rebecca

2015-01-01

In recent years, physician groups, government agencies and third party payers in the United States of America have promoted a Patient-centered Medical Home (PCMH) model that fosters a team-based approach to primary care. Advocates highlight the model's collaborative approach where physicians, mid-level providers, nurses and other health care personnel coordinate their efforts with an aim for high-quality, efficient care. Early studies show improvement in quality measures, reduction in emergency room visits and cost savings. However, implementing the PCMH presents particular challenges to physician training programs, including institutional commitment, infrastructure expenditures and faculty training. Teaching programs must consider how the objectives of the PCMH model align with recent innovations in resident evaluation now required by the Accreditation Council of Graduate Medical Education (ACGME) in the US. This article addresses these challenges, assesses the preliminary success of a pilot project, and proposes a viable, realistic model for implementation at other institutions.

Diversity leadership: the Rush University Medical Center experience.

Science.gov (United States)

Clapp, J R

2010-01-01

Meeting the challenges of diversity is crucial, and within healthcare organizations a particularly strong case exists for a diversity strategy. Rush University Medical Center in 2006 was at an important juncture. Since its founding, the organization had made notable progress toward advancing diversity and inclusiveness. On the other hand, many diversity-related problems continued. Rush convened a committee to review the work of the institution in this area. The committee's report called for changes, and a Diversity Leadership Group (DLG) model was established. This article documents the progress made since 2006 through implementation of the DLG model. The changes prescribed for Rush are presented as recommendations and challenges that other healthcare organizations may find applicable to their own institutions.

SU-E-P-01: An Informative Review On the Role of Diagnostic Medical Physicist in the Academic and Private Medical Centers

International Nuclear Information System (INIS)

Weir, V; Zhang, J

2014-01-01

Purpose: The role of physicist in the academic and private hospital environment continues to evolve and expand. This becomes more obvious with the newly revised requirements of the Joint Commission (JC) on imaging modalities and the continued updated requirements of ACR accreditation for medical physics (i.e., starting in June 2014, a physicists test will be needed before US accreditation). We provide an informative review on the role of diagnostic medical physicist and hope that our experience will expedite junior physicists in understanding their role in medical centers, and be ready to more opportunities. Methods: Based on our experience, diagnostic medical physicists in both academic and private medical centers perform several clinical functions. These include providing clinical service and physics support, ensuring that all ionizing radiation devices are tested and operated in compliance with the State and Federal laws, regulations and guidelines. We also discuss the training and education required to ensure that the radiation exposure to patients and staff is as low as reasonably achievable. We review the overlapping roles of medical and health physicist in some institutions. Results: A detailed scheme on the new requirements (effective 7/1/2014) of the JC is provided. In 2015, new standards for fluoroscopy, cone beam CT and the qualifications of staff will be phased in. A summary of new ACR requirements for different modalities is presented. Medical physicist have other duties such as sitting on CT and fluoroscopy committees for protocols design, training of non-radiologists to meet the new fluoroscopy rules, as well as helping with special therapies such as Yittrium 90 cases. Conclusion: Medical physicists in both academic and private hospitals are positioned to be more involved and prominent. Diagnostic physicists need to be more proactive to involve themselves in the day to day activities of the radiology department

SU-E-P-01: An Informative Review On the Role of Diagnostic Medical Physicist in the Academic and Private Medical Centers

Energy Technology Data Exchange (ETDEWEB)

Weir, V [Baylor Health Care System, Dallas, TX (United States); Zhang, J [University of Kentucky, Lexington, KY (United States)

2014-06-01

Purpose: The role of physicist in the academic and private hospital environment continues to evolve and expand. This becomes more obvious with the newly revised requirements of the Joint Commission (JC) on imaging modalities and the continued updated requirements of ACR accreditation for medical physics (i.e., starting in June 2014, a physicists test will be needed before US accreditation). We provide an informative review on the role of diagnostic medical physicist and hope that our experience will expedite junior physicists in understanding their role in medical centers, and be ready to more opportunities. Methods: Based on our experience, diagnostic medical physicists in both academic and private medical centers perform several clinical functions. These include providing clinical service and physics support, ensuring that all ionizing radiation devices are tested and operated in compliance with the State and Federal laws, regulations and guidelines. We also discuss the training and education required to ensure that the radiation exposure to patients and staff is as low as reasonably achievable. We review the overlapping roles of medical and health physicist in some institutions. Results: A detailed scheme on the new requirements (effective 7/1/2014) of the JC is provided. In 2015, new standards for fluoroscopy, cone beam CT and the qualifications of staff will be phased in. A summary of new ACR requirements for different modalities is presented. Medical physicist have other duties such as sitting on CT and fluoroscopy committees for protocols design, training of non-radiologists to meet the new fluoroscopy rules, as well as helping with special therapies such as Yittrium 90 cases. Conclusion: Medical physicists in both academic and private hospitals are positioned to be more involved and prominent. Diagnostic physicists need to be more proactive to involve themselves in the day to day activities of the radiology department.

Implementation of Patient-Centered Medical Homes in Adult Primary Care Practices.

Science.gov (United States)

Alexander, Jeffrey A; Markovitz, Amanda R; Paustian, Michael L; Wise, Christopher G; El Reda, Darline K; Green, Lee A; Fetters, Michael D

2015-08-01

There has been relatively little empirical evidence about the effects of patient-centered medical home (PCMH) implementation on patient-related outcomes and costs. Using a longitudinal design and a large study group of 2,218 Michigan adult primary care practices, our study examined the following research questions: Is the level of, and change in, implementation of PCMH associated with medical surgical cost, preventive services utilization, and quality of care in the following year? Results indicated that both level and amount of change in practice implementation of PCMH are independently and positively associated with measures of quality of care and use of preventive services, after controlling for a variety of practice, patient cohort, and practice environmental characteristics. Results also indicate that lower overall medical and surgical costs are associated with higher levels of PCMH implementation, although change in PCMH implementation did not achieve statistical significance. © The Author(s) 2015.

Integration of pharmacists into patient-centered medical homes in federally qualified health centers in Texas.

Science.gov (United States)

Wong, Shui Ling; Barner, Jamie C; Sucic, Kristina; Nguyen, Michelle; Rascati, Karen L

To describe the integration and implementation of pharmacy services in patient-centered medical homes (PCMHs) as adopted by federally qualified health centers (FQHCs) and compare them with usual care (UC). Four FQHCs (3 PCMHs, 1 UC) in Austin, TX, that provide care to the underserved populations. Pharmacists have worked under a collaborative practice agreement with internal medicine physicians since 2005. All 4 FQHCs have pharmacists as an integral part of the health care team. Pharmacists have prescriptive authority to initiate and adjust diabetes medications. The PCMH FQHCs instituted co-visits, where patients see both the physician and the pharmacist on the same day. PCMH pharmacists are routinely proactive in collaborating with physicians regarding medication management, compared with UC in which pharmacists see patients only when referred by a physician. Four face-to-face, one-on-one semistructured interviews were conducted with pharmacists working in 3 PCMH FQHCs and 1 UC FQHC to compare the implementation of PCMH with emphasis on 1) structure and workflow, 2) pharmacists' roles, and 3) benefits and challenges. On co-visit days, the pharmacist may see the patient before or after physician consultation. Pharmacists in 2 of the PCMH facilities proactively screen to identify diabetes patients who may benefit from pharmacist services, although the UC clinic pharmacists see only referred patients. Strengths of the co-visit model include more collaboration with physicians and more patient convenience. Payment that recognizes the value of PCMH is one PCMH principle that is not fully implemented. PCMH pharmacists in FQHCs were integrated into the workflow to address specific patient needs. Specifically, full-time in-house pharmacists, flexible referral criteria, proactive screening, well defined collaborative practice agreement, and open scheduling were successful strategies for the underserved populations in this study. However, reimbursement plans and provider

Energy Survey of Eisenhower Army Medical Center, Fort Gordon, Augusta, Georgia. Volume 2. Appendices

National Research Council Canada - National Science Library

1996-01-01

...) including low cost/no cost ECO's and perform complete evaluations of each. Energy equipment replacement projects already underway, approved, or planned by the Medical Center staff will be factored into the evaluations...

Communications and Collaboration Keep San Francisco VA Medical Center Project on Track

International Nuclear Information System (INIS)

Federal Energy Management Program

2001-01-01

This case study about energy saving performance contacts (ESPCs) presents an overview of how the Veterans Affairs Medical Center in San Francisco established an ESPC contract and the benefits derived from it. The Federal Energy Management Program instituted these special contracts to help federal agencies finance energy-saving projects at their facilities

Comparison and alignment of an academic medical center's strategic goals with ASHP initiatives.

Science.gov (United States)

Engels, Melanie J; Chaffee, Bruce W; Clark, John S

2015-12-01

An academic medical center's strategic goals were compared and aligned with the 2015 ASHP Health-System Pharmacy Initiative and the Pharmacy Practice Model Initiative (PPMI). The department's pharmacy practice model steering committee identified potential solutions to narrow prioritized gaps using a modified nominal group technique and a multivoting dot technique. Five priority solutions were identified and assigned to work groups to develop business plans, which included admission medication history and reconciliation for high-risk patients and those with complex medication regimens, pharmacist provision of discharge counseling to high-risk patients and those with complex medication regimens, improved measurement and reporting of the impact of PPMI programs on patient outcomes, implementation of a departmentwide formalized peer review and evaluation process, and the greeting of every patient at some time during his or her visit by a pharmacy team member. Stakeholders evaluated the business plans based on feasibility, financial return on investment, and anticipated safety enhancements. The solution that received the highest priority ranking and was subsequently implemented was "improved measurement and reporting of the impact of PPMI programs on patient outcomes." A defined process was followed for identifying gaps among current practices at an academic medical center and the 2015 ASHP Health-System Pharmacy Initiative and the PPMI. A key priority to better document the impact of pharmacists on patient care was identified for our department by using a nominal group technique brainstorming process and a multivoting dot technique and creating standardized business plans for five potential priority projects. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. 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...

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.

Development of a pharmacy student research program at a large academic medical center.

Science.gov (United States)

McLaughlin, Milena M; Skoglund, Erik; Bergman, Scott; Scheetz, Marc H

2015-11-01

A program to promote research by pharmacy students created through the collaboration of an academic medical center and a college of pharmacy is described. In 2009, Midwestern University Chicago College of Pharmacy and Northwestern Memorial Hospital (NMH) expanded their existing partnership by establishing a program to increase opportunities for pharmacy students to conduct clinical-translational research. All professional year 1, 2, or 3 students at the college, as well as professional year 4 students on rotation at NMH, can participate in the program. Central to the program's infrastructure is the mentorship of student leads by faculty- and hospital-based pharmacists. The mentors oversee the student research projects and guide development of poster presentations; student leads mentor junior students and assist with orientation and training activities. Publication of research findings in the peer-reviewed literature is a key program goal. In the first four years after program implementation, participation in a summer research program grew nearly 10-fold (mainly among incoming professional year 2 or 3 students, and student poster presentations at national pharmacy meetings increased nearly 20-fold; the number of published research articles involving student authors increased from zero in 2009 to three in 2012 and two in 2013. A collaborative program between an academic medical center and a college of pharmacy has enabled pharmacy students to conduct research at the medical center and has been associated with increases in the numbers of poster presentations and publications involving students. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Phased implementation of AT and T PACS at Duke University Medical Center

International Nuclear Information System (INIS)

Stockbridge, C.; Ravin, C.E.

1986-01-01

''Help me communicate more quickly and more effectively with referring clinicians''. This request was the driving behind the installation of the AT and T CommView System at Duke. The CommView System is a type of Digital Image Management System and Picture Archival Communication System whose chief purpose is to deliver interpolated diagnostic images to referring clinicians and attending physicians. The system acquires electronic images from modalities in a diagnostic imaging facility, stores these images in computer managed patient files and distributes these on demand over fiber optic cable to Display Consoles. The CommView System was designed at AT and T Bell Labs; it uses fiber optic ribbon cable between buildings fused to multistrand lightguide building cables to distribute images, typically around a medical center or campus at data transfer rates of 40 Mbps. This paper gives the rationale used in designing a start-up network and placing the initial equipment for a field of the AT and T CommView System in the Radiology Department of Duke University Medical Center

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.

Strategies for the Integration of Medical and Health Representation within Law Enforcement Intelligence Fusion Centers

National Research Council Canada - National Science Library

Morrissey, James F

2007-01-01

Terrorism-related intelligence gathering, analysis and information dissemination would be improved and enhanced by including a medical and health element in law enforcement intelligence fusion centers...

Parental Perceptions of Family Centered Care in Medical Homes of Children with Neurodevelopmental Disabilities.

Science.gov (United States)

Zajicek-Farber, Michaela L; Lotrecchiano, Gaetano R; Long, Toby M; Farber, Jon Matthew

2015-08-01

Life course theory sets the framework for strong inclusion of family centered care (FCC) in quality medical homes of children with neurodevelopmental disabilities (CNDD). The purpose of this study was to explore the perceptions of families with their experiences of FCC in medical homes for CNDD. Using a structured questionnaire, the Family-Centered Care Self-Assessment Tool developed by Family Voices, this study surveyed 122 parents of CNDD in a large urban area during 2010-2012. Data collected information on FCC in the provision of primary health care services for CNDD and focused on family-provider partnerships, care setting practices and policies, and community services. Frequency analysis classified participants' responses as strengths in the "most of the time" range, and weaknesses in the "never" range. Only 31 % of parents were satisfied with the primary health care their CNDD received. Based on an accepted definition of medical home services, 16 % of parents reported their CNDD had most aspects of a medical home, 64 % had some, and 20 % had none. Strengths in FCC were primarily evident in the family-provider partnership and care settings when focused on meeting the medical care needs of the child. Weaknesses in FCC were noted in meeting the needs of families, coordination, follow-up, and support with community resources. Improvements in key pediatric health care strategies for CNDD are recommended. CNDD and their families have multifaceted needs that require strong partnerships among parents, providers, and communities. Quality medical homes must include FCC and valued partnerships with diverse families and community-based providers.

On the scene: American University of Beirut Medical Center, Beirut, Lebanon.

Science.gov (United States)

Mouro, Gladys; Tashjian, Hera; Daaboul, Tania; Kozman, Katia; Alwan, Farah; Shamoun, Anthony

2011-01-01

American University of Beirut Medical Center is the first Magnet hospital in the Middle East. In this article, authors reflect back on the journey to excellence, specifically in establishing shared governance in a challenging cultural and organizational milieu. Perspectives from nurses at different levels are included to highlight their experiences throughout the journey. Evolution of the organization's shared governance model is described and initiatives of the councils are illustrated.

A new concept for medical imaging centered on cellular phone technology.

Directory of Open Access Journals (Sweden)

Yair Granot

2008-04-01

Full Text Available According to World Health Organization reports, some three quarters of the world population does not have access to medical imaging. In addition, in developing countries over 50% of medical equipment that is available is not being used because it is too sophisticated or in disrepair or because the health personnel are not trained to use it. The goal of this study is to introduce and demonstrate the feasibility of a new concept in medical imaging that is centered on cellular phone technology and which may provide a solution to medical imaging in underserved areas. The new system replaces the conventional stand-alone medical imaging device with a new medical imaging system made of two independent components connected through cellular phone technology. The independent units are: a a data acquisition device (DAD at a remote patient site that is simple, with limited controls and no image display capability and b an advanced image reconstruction and hardware control multiserver unit at a central site. The cellular phone technology transmits unprocessed raw data from the patient site DAD and receives and displays the processed image from the central site. (This is different from conventional telemedicine where the image reconstruction and control is at the patient site and telecommunication is used to transmit processed images from the patient site. The primary goal of this study is to demonstrate that the cellular phone technology can function in the proposed mode. The feasibility of the concept is demonstrated using a new frequency division multiplexing electrical impedance tomography system, which we have developed for dynamic medical imaging, as the medical imaging modality. The system is used to image through a cellular phone a simulation of breast cancer tumors in a medical imaging diagnostic mode and to image minimally invasive tissue ablation with irreversible electroporation in a medical imaging interventional mode.

Examining Health Information Technology Implementations: Case of the Patient-Centered Medical Home

Science.gov (United States)

Behkami, Nima A.

2012-01-01

It has been shown that the use of Health Information Technology (HIT) is associated with reduced cost and increased quality of care. This dissertation examined the use of registries in Patient Centered Medical Home (PCMH) practices. A survey questionnaire was sent to a nationwide group of clinics certified for being a PCMH. They were asked to…

Transformation of an academic medical center: lessons learned from restructuring and downsizing.

Science.gov (United States)

Woodard, B; Fottler, M D; Kilpatrick, A O

1999-01-01

This article reviews management literature on health care transformation and describes the processes, including restructuring, job redesign, and downsizing, involved in one academic medical center's experience. The article concludes with lessons learned at each of the stages of the transformation process: planning, implementation, and process continuation. Managerial implications for similar transformation efforts in other health care organizations are suggested.

Analysis of the drug formulary and the purchasing process at a Moroccan university medical center.

Science.gov (United States)

Lachhab, Z; Serragui, S; Hassar, M; Cherrah, Y; Errougani, A; Ahid, S

2018-05-31

To give an overview of the pharmaceutical policy in the largest medical center in Morocco, a developing country in socio-economic transition. This is an analytical descriptive study of the drug formulary and the purchasing process carried out at the Ibn Sina University Medical Center. Our formulary included 830 drugs belonging to 14 classes according to the Anatomical, Therapeutic and Chemical (ATC) Classification System. There was a respective predominance of class N (21.8%), class B (13.5%), and class J (12.6%). Injectable route was dominant (46%). Drugs had a significant actual benefit in 70% (according to the French Data), reimbursable in 42.8%, essential in 29.2% according to World Health Organization (WHO) list, and in 36.9% according to the Moroccan list. The calls for tenders included 542 drugs representing 65% of the formulary, and the attribution rate was 71%. The main reason for non-attribution was the lack of offers. Generics accounted for 45% by volume and 26.5% by value. With this first study, we were able to identify key indicators on drugs used in the largest medical center in Morocco. The current challenge is to introduce pharmacoeconomics in decision making concerning the updates of the drug formulary.

Analysis of the Service Quality of Medical Centers Using Servqual Model (Case:Shaheed Rahnemoon Hospital

Directory of Open Access Journals (Sweden)

H Zare Ahmadabadi

2007-07-01

Full Text Available Introduction: Many organizations, especially service oriented ones, relative to their goals and mission, have a special view towards quality phenomena and its management. Methods: This paper analyzes medical service quality in one case; The internal section of Shaheed Rahnemoon Hospital Based on the basis of gap analysis model and Servqual technique. A questionnaire was designed and applied to measure expectations and perceptions of patients and personnel of the hospital. Results: On application of non-parametric statistical tests, we propose certain recommendations. These tests drive on five conceptual dimensions of service quality including intangibility, responsiveness, reliability, assurance and empathy. Results show that patients in this section were satisfied from the service provider’s responsiveness, but there are significant differences between expectations and perceptions in other dimensions. Conclusion: The service quality analysis models are useful for managers of medical centers to distinguish gaps between the two sides of service representation; patients and medical centers personnel. Ultimately, they can reinforce strengths and control weaknesses.

75 FR 79079 - Notice of Intent to Rule on Request to Release Airport Property at New Century AirCenter, New...

Science.gov (United States)

2010-12-17

... to Release Airport Property at New Century AirCenter, New Century, Kansas AGENCY: Federal Aviation Administration, (FAA), DOT. ACTION: Notice of request to release airport property. SUMMARY: The FAA proposes to... Section 125 of the Wendell H. Ford Aviation Investment Reform Act for the 21st Century (AIR 21). DATES...

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.

Patient-centered communication in digital medical encounters.

Science.gov (United States)

Alpert, Jordan M; Dyer, Karen E; Lafata, Jennifer Elston

2017-10-01

Patients are increasingly using the secure messaging function available through online patient portals to communicate with their health care providers, yet little is known about the characteristics of conversations that occur. The goal of this study is to describe the types of messages initiated by patients communicating via patient portals and to assess whether providers employ patient-centered strategies in their electronic responses. A total of 193 messages from 58 message threads between patients and providers were collected during a one-week period in a large health care system. Content analysis of patient messages was conducted and deductive analysis of provider responses was employed for two types of patient-centered communication, provider use of supportive talk and partnership building. Patients sent nearly double the number of messages compared to providers (65% versus 35%). Patient messages expressed concern, sought medical solutions and requested assistance with administrative tasks. Over half (53.4%) of provider replies did not contain language reflective of either partnership building or supportive talk. Partnership building language and supportive talk occurred at lower rates than documented in the literature on in-person encounters. This may represent a lost opportunity to strengthen the patient-provider relationship. As secure messaging is increasingly utilized as a form of patient-provider communication, it is important to understand how aspects of this communication channel, including the patient-centeredness of the language used by providers, impact patient-provider relationships and patient outcomes. Copyright © 2017 Elsevier B.V. All rights reserved.

Patient-Centered Medical Home Undergraduate Internship, Benefits to a Practice Manager: Case Study.

Science.gov (United States)

Sasnett, Bonita; Harris, Susie T; White, Shelly

Health services management interns become practice facilitators for primary care clinics interested in pursuing patient-centered recognition for their practice. This experience establishes a collaborative relationship between the university and clinic practices where students apply their academic training to a system of documentation to improve the quality of patient care delivery. The case study presents the process undertaken, benefits, challenges, lessons learned, and recommendations for intern, practice mangers, and educators. The practice manager benefits as interns become Patient-Centered Medical Home facilitators and assist practice managers in the recognition process.

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

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...

Lessons Learned from Implementing the Patient-Centered Medical Home

Directory of Open Access Journals (Sweden)

Ellen P. Green

2012-01-01

Full Text Available The Patient-Centered Medical Home (PCMH is a primary care model that provides coordinated and comprehensive care to patients to improve health outcomes. This paper addresses practical issues that arise when transitioning a traditional primary care practice into a PCMH recognized by the National Committee for Quality Assurance (NCQA. Individual organizations' experiences with this transition were gathered at a PCMH workshop in Alexandria, Virginia in June 2010. An analysis of their experiences has been used along with a literature review to reveal common challenges that must be addressed in ways that are responsive to the practice and patients’ needs. These are: NCQA guidance, promoting provider buy-in, leveraging electronic medical records, changing office culture, and realigning workspace in the practice to accommodate services needed to carry out the intent of PCMH. The NCQA provides a set of standards for implementing the PCMH model, but these standards lack many specifics that will be relied on in location situations. While many researchers and providers have made critiques, we see this vagueness as allowing for greater flexibility in how a practice implements PCMH.

Medical-Legal Partnerships At Veterans Affairs Medical Centers Improved Housing And Psychosocial Outcomes For Vets.

Science.gov (United States)

Tsai, Jack; Middleton, Margaret; Villegas, Jennifer; Johnson, Cindy; Retkin, Randye; Seidman, Alison; Sherman, Scott; Rosenheck, Robert A

2017-12-01

Medical-legal partnerships-collaborations between legal professionals and health care providers that help patients address civil legal problems that can affect health and well-being-have been implemented at several Veterans Affairs (VA) medical centers to serve homeless and low-income veterans with mental illness. We describe the outcomes of veterans who accessed legal services at four partnership sites in Connecticut and New York in the period 2014-16. The partnerships served 950 veterans, who collectively had 1,384 legal issues; on average, the issues took 5.4 hours' worth of legal services to resolve. The most common problems were related to VA benefits, housing, family issues, and consumer issues. Among a subsample of 148 veterans who were followed for one year, we observed significant improvements in housing, income, and mental health. Veterans who received more partnership services showed greater improvements in housing and mental health than those who received fewer services, and those who achieved their predefined legal goals showed greater improvements in housing status and community integration than those who did not. Medical-legal partnerships represent an opportunity to expand cross-sector, community-based partnerships in the VA health care system to address social determinants of mental health.

An analytics approach to designing patient centered medical homes.

Science.gov (United States)

Ajorlou, Saeede; Shams, Issac; Yang, Kai

2015-03-01

Recently the patient centered medical home (PCMH) model has become a popular team based approach focused on delivering more streamlined care to patients. In current practices of medical homes, a clinical based prediction frame is recommended because it can help match the portfolio capacity of PCMH teams with the actual load generated by a set of patients. Without such balances in clinical supply and demand, issues such as excessive under and over utilization of physicians, long waiting time for receiving the appropriate treatment, and non-continuity of care will eliminate many advantages of the medical home strategy. In this paper, by using the hierarchical generalized linear model with multivariate responses, we develop a clinical workload prediction model for care portfolio demands in a Bayesian framework. The model allows for heterogeneous variances and unstructured covariance matrices for nested random effects that arise through complex hierarchical care systems. We show that using a multivariate approach substantially enhances the precision of workload predictions at both primary and non primary care levels. We also demonstrate that care demands depend not only on patient demographics but also on other utilization factors, such as length of stay. Our analyses of a recent data from Veteran Health Administration further indicate that risk adjustment for patient health conditions can considerably improve the prediction power of the model.

Research Strategies for Academic Medical Centers: A Framework for Advancements toward Translational Excellence

Science.gov (United States)

Haley, Rand; Champagne, Thomas J., Jr.

2017-01-01

This review article presents a simplified framework for thinking about research strategy priorities for academic medical centers (AMCs). The framework can serve as a precursor to future advancements in translational medicine and as a set of planning guideposts toward ultimate translational excellence. While market pressures, reform uncertainties,…

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...

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

Arbuckle Group and equivalent-age rocks (Cambrian and Lower Ordovician) represent an important record of sediment deposition in the history of the North American continent and they contain important accumulations of hydrocarbons (oil and gas) and base metal deposits. This is true for Kansas as well where Arbuckle strata account for approximately 40% of the volume of produced petroleum and known reserves. However, in comparison to their counterparts in other areas, such as the Ellenburger and Knox, Arbuckle rocks in Kansas remain relatively understudied, especially with respect to sedimentology and diagenesis. The Arbuckle is present in the subsurface in most of Kansas and is absent only in areas of northeastern and northwestern Kansas, and over ancient uplifts and buried Precambrian highs. Arbuckle rocks thicken from north to south and are up to 1,390 feet in the southeastern corner of Kansas. Arbuckle Group and equivalent-age rocks from Kansas and surrounding areas are similar, consisting of platform deposits dominated by ramp-type subtidal to peritidal carbonates (mostly dolomitized) which can be subdivided into cycles, less than 0.5 m to 40 m thick, based on facies type and depositional patterns. Recent studies from central Kansas show that major depositional facies consist of coarse-grained packstones/ grainstones, fine-grained packstones/wackestones/mudstones, stromatolites-thrombolites, intraclastic conglomerate and breccia, and shale. In addition, secondary features include dolomitization, breccia, fracture, and conglomerate related to early subaerial exposure and later karst, burial or structural processes, silicification, and local mineralization. Arbuckle and equivalent strata in the Midcontinent were affected by prolonged subaerial exposure that began immediately after Arbuckle deposition, forming the sub-Tippecanoe to sub-Absaroka unconformity. Favorable reservoir qualities generally are thought to be related directly to basement structural elements and

Joint marketing cites excellence: Fairview-University Medical Center advertises cooperatively with University of Minnesota Physicians.

Science.gov (United States)

Botvin, Judith D

2004-01-01

Fairview-University Medical Center and University of Minnesota Physicians, both in Minneapolis, are enjoying the benefits of a co-branded advertising campaign. It includes print ads, brochures, and other marketing devices.

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.

Master's Level Graduate Training in Medical Physics at the University of Colorado Health Sciences Center.

Science.gov (United States)

Ibbott, Geoffrey S.; Hendee, William R.

1980-01-01

Describes the master's degree program in medical physics developed at the University of Colorado Health Sciences Center. Required courses for the program, and requirements for admission are included in the appendices. (HM)

Stakeholder Perspectives on Changes in Hypertension Care Under the Patient-Centered Medical Home.

Science.gov (United States)

O'Donnell, Alison J; Bogner, Hillary R; Cronholm, Peter F; Kellom, Katherine; Miller-Day, Michelle; McClintock, Heather F de Vries; Kaye, Elise M; Gabbay, Robert

2016-02-25

Hypertension is a major modifiable risk factor for cardiovascular and kidney disease, yet the proportion of adults whose hypertension is controlled is low. The patient-centered medical home (PCMH) is a model for care delivery that emphasizes patient-centered and team-based care and focuses on quality and safety. Our goal was to investigate changes in hypertension care under PCMH implementation in a large multipayer PCMH demonstration project that may have led to improvements in hypertension control. The PCMH transformation initiative conducted 118 semistructured interviews at 17 primary care practices in southeastern Pennsylvania between January 2011 and January 2012. Clinicians (n = 47), medical assistants (n = 26), office administrators (n = 12), care managers (n = 11), front office staff (n = 7), patient educators (n = 4), nurses (n = 4), social workers (n = 4), and other administrators (n = 3) participated in interviews. Study personnel used thematic analysis to identify themes related to hypertension care. Clinicians described difficulties in expanding services under PCMH to meet the needs of the growing number of patients with hypertension as well as how perceptions of hypertension control differed from actual performance. Staff and office administrators discussed achieving patient-centered hypertension care through patient education and self-management support with personalized care plans. They indicated that patient report cards were helpful tools. Participants across all groups discussed a team- and systems-based approach to hypertension care. Practices undergoing PCMH transformation may consider stakeholder perspectives about patient-centered, team-based, and systems-based approaches as they work to optimize hypertension care.

Benefits of the effective dose equivalent concept at a medical center

International Nuclear Information System (INIS)

Vetter, R.J.; Classic, K.L.

1991-01-01

A primary objective of the recommendations of the International Committee on Radiological Protection Publication 26 is to insure that no source of radiation exposure is unjustified in relation to its benefits. This objective is consistent with goals of the Radiation Safety Committee and Institutional Review Board at medical centers where research may involve radiation exposure of human subjects. The effective dose equivalent concept facilitates evaluation of risk by those who have little or no knowledge of quantities or biological effects of radiation. This paper presents effective dose equivalent data used by radiation workers and those who evaluate human research protocols as these data relate to personal dosimeter reading, entrance skin exposure, and target organ dose. The benefits of using effective dose equivalent to evaluate risk of medical radiation environments and research protocols are also described

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

Health Care Provider Burnout in a United States Military Medical Center During a Period of War.

Science.gov (United States)

Sargent, Paul; Millegan, Jeffrey; Delaney, Eileen; Roesch, Scott; Sanders, Martha; Mak, Heather; Mallahan, Leonard; Raducha, Stephanie; Webb-Murphy, Jennifer

2016-02-01

Provider burnout can impact efficiency, empathy, and medical errors. Our study examines burnout in a military medical center during a period of war. A survey including the Maslach Burnout Inventory (MBI), deployment history, and work variables was distributed to health care providers. MBI subscale means were calculated and associations between variables were analyzed. Approximately 60% of 523 respondents were active duty and 34% had deployed. MBI subscale means were 19.99 emotional exhaustion, 4.84 depersonalization, and 40.56 personal accomplishment. Frustration over administrative support was associated with high emotional exhaustion and depersonalization; frustration over life/work balance was associated with high emotional exhaustion. Levels of burnout in our sample were similar to civilian medical centers. Sources of frustration were related to administrative support and life/work balance. Deployment had no effect on burnout levels. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Patient-centered medical home initiatives expanded in 2009-13: providers, patients, and payment incentives increased.

Science.gov (United States)

Edwards, Samuel T; Bitton, Asaf; Hong, Johan; Landon, Bruce E

2014-10-01

Patient-centered medical home initiatives are central to many efforts to reform the US health care delivery system. To better understand the extent and nature of these initiatives, in 2013 we performed a nationwide cross-sectional survey of initiatives that included payment reform incentives in their models, and we compared the results to those of a similar survey we conducted in 2009. We found that the number of initiatives featuring payment reform incentives had increased from 26 in 2009 to 114 in 2013. The number of patients covered by these initiatives had increased from nearly five million to almost twenty-one million. We also found that the proportion of time-limited initiatives--those with a planned end date--was 20 percent in 2013, a decrease from 77 percent in 2009. Finally, we found that the dominant payment model for patient-centered medical homes remained fee-for-service payments augmented by per member per month payments and pay-for-performance bonuses. However, those payments and bonuses were higher in 2013 than they were in 2009, and the use of shared-savings models was greater. The patient-centered medical home model is likely to continue both to become more common and to play an important role in delivery system reform. Project HOPE—The People-to-People Health Foundation, Inc.

Academic season does not influence cardiac surgical outcomes at US Academic Medical Centers.

Science.gov (United States)

Lapar, Damien J; Bhamidipati, Castigliano M; Mery, Carlos M; Stukenborg, George J; Lau, Christine L; Kron, Irving L; Ailawadi, Gorav

2011-06-01

Previous studies have demonstrated the influence of academic season on outcomes in select surgical populations. However, the influence of academic season has not been evaluated nationwide in cardiac surgery. We hypothesized that cardiac surgical outcomes were not significantly influenced by time of year at both cardiothoracic teaching hospitals and non-cardiothoracic teaching hospitals nationwide. From 2003 to 2007, a weighted 1,614,394 cardiac operations were evaluated using the Nationwide Inpatient Sample database. Patients undergoing cardiac operations at cardiothoracic teaching and non-cardiothoracic teaching hospitals were identified using the Association of American Medical College's Graduate Medical Education Tracking System. Hierarchic multivariable logistic regression analyses were used to estimate the effect of academic quarter on risk-adjusted outcomes. Mean patient age was 65.9 ± 10.9 years. Women accounted for 32.8% of patients. Isolated coronary artery bypass grafting was the most common operation performed (64.7%), followed by isolated valve replacement (19.3%). The overall incidence of operative mortality and composite postoperative complication rate were 2.9% and 27.9%, respectively. After accounting for potentially confounding risk factors, timing of operation by academic quarter did not independently increase risk-adjusted mortality (p = 0.12) or morbidity (p = 0.24) at academic medical centers. Risk-adjusted mortality and morbidity for cardiac operations were not associated with time of year in the US at teaching and nonteaching hospitals. Patients should be reassured of the safety of performance of cardiac operations at academic medical centers throughout a given academic year. Copyright © 2011 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

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

Current neurotrauma treatment practice in secondary medical service centers

International Nuclear Information System (INIS)

Suehiro, Eiichi; Yoshino, Hiroko; Koizumi, Hiroyasu; Yoneda, Hiroshi; Suzuki, Michiyasu

2011-01-01

Despite neurotrauma treatment practices comprising a significant amount of neurosurgical work for secondary medical service centers, little attention has been placed on neurotrauma cases and evaluation of current neurotrauma treatment practices is limited. Therefore we investigated current neurotrauma practices in our hospital located in a Japanese suburban city. We analyzed 439 patients with traumatic brain injury (TBI) admitted to our hospital between April 2004 and October 2010. Patients were divided into three groups based on the Glasgow Coma Scale (GCS) score on admission: mild TBI (GCS 14-15) in 252 patients (57.4%), moderate TBI (GCS 9-13) in 116 patients (26.4%), and severe TBI (GCS 3-8) in 71 patients (16.2%). Age, gender, alcohol consumption, cause of injury, cranial CT findings, neurosurgical procedure, length of hospital stay, and clinical outcome were analyzed. The average age of the patients was 59.2 years old. Male patients comprised 65%. Alcohol consumption was reported in 81 cases (18.5%), most of them with moderate TBI. Fall (208 cases, 47.4%) was the most frequent cause of injury, followed by traffic accident (115 cases, 26.2%) and high fall (73 cases, 16.6%). Acute subdural hematoma (174 cases, 39.6%) was most frequently seen in cranial CT findings on admission, which significantly increased with severity. A neurosurgical procedure was performed for 70 cases (15.9%), of which 15 (6.0%) were mild TBI and 18 (15.5%) were moderate TBI. The average hospital stay was 20.8 days, which significantly increased with severity. The overall rate of favorable outcome was 82.7%, and mortality was 8.2%; outcome deteriorated with severity. Some mild and moderate TBI cases had deteriorated and required surgery or resulted in death. These findings suggest that cautious treatment is necessary even in mild to moderate TBI cases which are often encountered in secondary medical service centers. (author)

Impact of Mobile Dose-Tracking Technology on Medication Distribution at an Academic Medical Center.

Science.gov (United States)

Kelm, Matthew; Campbell, Udobi

2016-05-01

Medication dose-tracking technologies have the potential to improve efficiency and reduce costs associated with re-dispensing doses reported as missing. Data describing this technology and its impact on the medication use process are limited. The purpose of this study is to assess the impact of dose-tracking technology on pharmacy workload and drug expense at an academic, acute care medical center. Dose-tracking technology was implemented in June 2014. Pre-implementation data were collected from February to April 2014. Post-implementation data were collected from July to September 2014. The primary endpoint was the percent of re-dispensed oral syringe and compounded sterile product (CSP) doses within the pre- and post-implementation periods per 1,000 discharges. Secondary endpoints included pharmaceutical expense generated from re-dispensing doses, labor costs, and staff satisfaction with the medication distribution process. We observed an average 6% decrease in re-dispensing of oral syringe and CSP doses from pre- to post-implementation (15,440 vs 14,547 doses; p = .047). However, when values were adjusted per 1,000 discharges, this trend did not reach statistical significance (p = .074). Pharmaceutical expense generated from re-dispensing doses was significantly reduced from pre- to post-implementation ($834,830 vs $746,466 [savings of $88,364]; p = .047). We estimated that $2,563 worth of technician labor was avoided in re-dispensing missing doses. We also saw significant improvement in staff perception of technology assisting in reducing missing doses (p = .0003), as well as improvement in effectiveness of resolving or minimizing missing doses (p = .01). The use of mobile dose-tracking technology demonstrated meaningful reductions in both the number of doses re-dispensed and cost of pharmaceuticals dispensed.

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

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

[Management of medical care for the victims of road accidents in traumatology centers of Saint-Petersburg].

Science.gov (United States)

Tulupov, A N; Afonchikov, V Iu; Chikin, A E; Taniia, S Sh; Ganin, A S

2014-01-01

The number of road accidents, fatal outcomes and victims exceeded in 1.5 times in Saint-Petersburg in comparison with Moscow. At the average, 600 victims were treated in each of 6 first-level traumatology centers every year. The quantity of patients, who were admitted to 3 second-level traumatology centers, numbered 10 times less. About 300 people entered to others hospitals. The lethality consisted of 15%, 20% and 37%, respectively. There are a lot of matters, that should be discussed, such as an importance of better treatment financing of multitrauma by using compulsory medical insurance system, an optimization of pre-admission treatment and a necessity of patient delivery by mobile medical team using the anaesthesiology and resuscitation.

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…

Publications in academic medical centers: technology-facilitated culture clash.

Science.gov (United States)

Berner, Eta S

2014-05-01

Academic culture has a set of norms, expectations, and values that are sometimes tacit and sometimes very explicit. In medical school and other health professions educational settings, probably the most common norm includes placing a high value on peer-reviewed research publications, which are seen as the major evidence of scholarly productivity. Other features of academic culture include encouraging junior faculty and graduate students to share their research results at professional conferences and lecturing with slides as a major way to convey information. Major values that faculty share with journal editors include responsible conduct of research and proper attribution of others' words and ideas. Medical school faculty also value technology and are often quick to embrace technological advances that can assist them in their teaching and research. This article addresses the effects of technology on three aspects of academic culture: education, presentations at professional meetings, and research publications.The technologies discussed include online instruction, dissemination of conference proceedings on the Internet, plagiarism-detection software, and new technologies deployed by the National Center for Biotechnology Information, the home of PubMed. The author describes how the ease of deploying new technologies without faculty changing their norms and behavior in the areas of teaching and research can lead to conflicts of values among key stakeholders in the academic medical community, including faculty, journal editors, and professional associations. The implications of these conflicts and strategies for managing them are discussed.

Treatment of Post-Traumatic Stress Disorder Nightmares at a Veterans Affairs Medical Center

Science.gov (United States)

Detweiler, Mark B.; Pagadala, Bhuvaneshwar; Candelario, Joseph; Boyle, Jennifer S.; Detweiler, Jonna G.; Lutgens, Brian W.

2016-01-01

The effectiveness of medications for PTSD in general has been well studied, but the effectiveness of medicatio.ns prescribed specifically for post-traumatic stress disorder (PTSD) nightmares is less well known. This retrospective chart review examined the efficacy of various medications used in actual treatment of PTSD nightmares at one Veteran Affairs Hospital. Records at the Salem, VA Veterans Affairs Medical Center (VAMC) were examined from 2009 to 2013 to check for the efficacy of actual treatments used in comparis.on with treatments suggested in three main review articles. The final sample consisted of 327 patients and 478 separate medication trials involving 21 individual medications plus 13 different medication combinations. The three most frequently utilized medications were prazosin (107 trials), risperidone (81 trials), and quetiapine (72 trials). Five medications had 20 or more trials with successful results (partial to full nightmare cessation) in >50% of trials: risperidone (77%, 1.0–6.0 mg), clonidine (63%, 0.1–2.0 mg), quetiapine (50%, 12.5–800.0 mg), mirtazapine (50%; 7.5–30.0 mg), and terazosin (64%, 50.0–300.0 mg). Notably, olanzapine (2.5–10.0) was successful (full remission) in all five prescription trials in five separate patients. Based on the clinical results, the use of risperidone, clonidine, terazosin, and olanzapine warrants additional investigation in clinically controlled trials as medications prescribed specifically for PTSD nightmares. PMID:27999253

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.

Patient-Centered Medical Home and Family Burden in Attention-Deficit Hyperactivity Disorder.

Science.gov (United States)

Ronis, Sarah D; Baldwin, Constance D; Blumkin, Aaron; Kuhlthau, Karen; Szilagyi, Peter G

2015-01-01

Attention-deficit hyperactivity disorder (ADHD) can impair child health and functioning, but its effects on the family's economic burden are not well understood. The authors assessed this burden in US families of children with ADHD, and the degree to which access to a patient-centered medical home (PCMH) might reduce this burden. We conducted cross-sectional analyses of 2005-2006 and 2009-2010 National Surveys of Children with Special Health Care Needs, focusing on families of children with ADHD. They defined family economic burden as (1) family financial problems (annual expenses for the child's health care or illness-related financial problems for the family) and/or (2) family employment problems (job loss, work time loss, or failure to change jobs to avoid insurance loss). Relative risk models assessed associations between PCMH and family economic burden, adjusted for child age, sex, ethnicity, ADHD severity, poverty status, caregiver education, and insurance. In 2009, 26% of families reported financial problems because of the child's ADHD, 2.1% reported out-of-pocket expenses >5% of income, and 36% reported employment problems. Only 38% reported care that met all 5 criteria for a PCMH (similar to rates in 2005-2006). In multivariable analysis, care in a PCMH was associated with 48% lower relative risk (RR) of financial problems (RR = 0.52, p family-centered care and care coordination were more strongly associated with lower burden. The economic burdens of families with ADHD are significant but may be alleviated by family-centered care and care coordination in a medical home.

Treatment of secondary hyperparathyroidism in kidney disease: what we know and do not know about use of calcimimetics and vitamin D analogs

Directory of Open Access Journals (Sweden)

James B Wetmore

2008-11-01

Full Text Available James B Wetmore1, L Darryl Quarles1,21Department of Medicine, Division of Nephrology, University of Kansas Medical Center, Kansas City, KS, USA; 2The Kidney Institute, University of Kansas Medical Center, Kansas City, KS, USAAbstract: There is a growing understanding of the pathophysiology of secondary hyperparathyroidism (SHPT and a recent emergence of new agents for SHPT treatment in patients with advanced kidney disease. At the same time, appreciation that mineral metabolic derangements promote vascular calcification and contribute to excess mortality, along with recognition of potentially important “non-classical” actions of vitamin D, have prompted the nephrology community to reexamine the use of various SHPT treatments, such as activated vitamin D sterols, phosphate binders, and calcimimetics. In this review, the evidence for treatment of SHPT with calcimimetics and vitamin D analogs is evaluated, with particular consideration given to recent clinical trials that have reported encouraging findings with cinacalcet use. Additionally, several controversies in the pathogenesis and treatment of SHPT are explored. The proposition that calcitriol deficiency is a true pathological state is challenged, the relative importance of the vitamin D receptor and the calcium sensing receptor in parathyroid gland function is summarized, and the potential relevance of non-classical actions of vitamin D for patients with advanced renal disease is examined. Taken collectively, the balance of evidence now supports a treatment paradigm in which calcimimetics are the most appropriate primary treatment for SHPT in the majority of end stage renal disease patients, but which nevertheless acknowledges an important role for modest doses of activated vitamin D sterols.Keywords: secondary hyperparathyroidism, vitamin D, vitamin D receptor, calcium sensing receptor, calcimimetics, kidney disease

[Medical fault or professional negligence? Case studies in two recovery nutrition centers in Niger].

Science.gov (United States)

Halidou Doudou, M; Manzo, M L; Guero, D

2014-12-01

In developing countries such as Niger, the risk of medical malpractice is ubiquitous in health, jeopardizing patient safety. The aim of this work was to contribute to patients' safety and respect of code of ethics and conduct in the exercise of the medical profession. The reported cases involved two children under 5 years who were admitted to nutrition rehabilitation centers, died as a result of medical malpractice. In Niger, there are no statistics on this phenomenon and a few cases found have always been considered "accident" or "fate." The establishment of an observatory collections of such information should improve their frequency, consequences and propose a prevention plan. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Does Person-Centered Care Improve Residents' Satisfaction With Nursing Home Quality?

Science.gov (United States)

Poey, Judith L; Hermer, Linda; Cornelison, Laci; Kaup, Migette L; Drake, Patrick; Stone, Robyn I; Doll, Gayle

2017-11-01

Person-centered care (PCC) is meant to enhance nursing home residents' quality of life (QOL). Including residents' perspectives is critical to determining whether PCC is meeting residents' needs and desires. This study examines whether PCC practices promote satisfaction with QOL and quality of care and services (QOC and QOS) among nursing home residents. A longitudinal, retrospective cohort study using an in-person survey. Three hundred twenty nursing homes in Kansas enrolled or not enrolled in a pay-for-performance program, Promoting Excellent Alternatives in Kansas (PEAK 2.0), to promote PCC in nursing homes. A total of 6214 nursing home residents in 2013-2014 and 5538 residents in 2014-2015, with a Brief Interview for Mental Status score ≥8, participated in face-to-face interviews. Results were aggregated to the nursing home level. My InnerView developed a Resident Satisfaction Survey for Kansas composed of 32 questions divided into QOL, QOC, QOS, and global satisfaction subdomains. After controlling for facility characteristics, satisfaction with overall QOL and QOC was higher in homes that had fully implemented PCC. Although some individual measures in the QOS domain (eg, food) showed greater satisfaction at earlier levels of implementation, high satisfaction was observed primarily in homes that had fully implemented PCC. These findings provide evidence for the effectiveness of PCC implementation on nursing home resident satisfaction. The PEAK 2.0 program may provide replicable methods for nursing homes and states to implement PCC systematically. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Impact of a Patient-Centered Medical Home on Access, Quality, and Cost

Science.gov (United States)

2013-02-01

Effec- tiveness Data and Information Set metrics, and composite measures for access, patient satisfaction, provider communica- tion, and customer service...reduced health care costs. The patient -centered medical home (PCMH) concept is “an approach to providing comprehensive primary care [in] a health care... patient at the right place and right time” is vital to the appro- priate utilization of health care services across a broad spec- trum of patient needs

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

Directory of Open Access Journals (Sweden)

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

Measuring the Cost of the Patient-Centered Medical Home: A Cost-Accounting Approach.

Science.gov (United States)

Lieberthal, Robert D; Payton, Colleen; Sarfaty, Mona; Valko, George

To explore the cost for individual practices to become more patient-centered, we inventoried and calculated the cost of costly activities involved in implementing the Patient-Centered Medical Home (PCMH) as defined by the National Committee for Quality Assurance. There were 3 key findings. The cost of each PCMH-related clinical activity can be classified in 1 of 3 major categories. Cost offsets can be used to defray part of the cost recognition. The cost of PCMH transformation varied by practice with no clear level or pattern of costs. Our study suggests that small- and medium-sized practices may experience difficulty with the financial burden of PCMH recognition.

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) ...

[Medical centers--methods, purpose and benefits].

Science.gov (United States)

Schrappe, Matthias

2007-01-01

The German hospital sector is characterized by a profound deficit in organizational integration. The implementation of centers as one way to improve the situation is complicated by the heterogeneity of the concept and understanding of the term "center". The author proposes to distinguish between functional, divisional and process-oriented centers. In German hospitals where the transition from functional to divisional organization is under way matrix elements can be expected to be introduced into organizational practice. Process-oriented centers like breast centers represent matrix components by simultaneously applying functional and process-oriented perspectives. Matrix components map the complexity of clinical structures, but increase coordination and management load and should be applied only to a limited number of care processes.

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

Science.gov (United States)

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

Detecting Postpartum Depression in Referents to Medical and Health Centers in Hamadan City

Directory of Open Access Journals (Sweden)

F. Shobeiri

2007-10-01

Full Text Available Introduction & Objective: Pregnancy and childbirth are significant developmental excitable for most women. Physical, intrapersonal and relational adaptations are needed to adjust successfully to pregnancy and delivery. Postpartum depression is a serious psychiatric disorder and the adverse impact on infants has been noted. The purpose of this study was to detect postpartum depression in referents to medical and health centers in Hamadan city.Materials & Methods: A descriptive and cross-sectional study involving 400 women completed the Beck Depression Inventory (BDI within 2-8 weeks of delivery was conducted in urban health centers in Hamadan city, Iran. Data were collected through interviews with women in the clinics in the health centers. Data processing and statistical analysis were performed using SPSS 10.0.Results: The results revealed that majority of women (68.0% were considered normal. Depression was detected in 32.0% of women. Out of these 19.0, 4.0 and 9.0% were mild, moderate and severe depression, respectively. There were statistically significant differences between postpartum depression and age, number of delivery, education, job and husband's job (P=0.000.Conclusion: Nearly 32.0% of selected women had depression. Therefore, it is important for medical personnel to be well versed in the course and treatment of postpartum depression. Post partum depression should be screened and treated as early as possible for several reasons. It can cause significant suffering for the woman who experiences it, and it can have deleterious consequences for the newborn.

Strategi Public Relations Dalam Membangun Branding Rumah Sakit Telogorejo Menjadi Semarang Medical Center

OpenAIRE

Pertiwi, Rifka Ayu; Naryoso, Agus; Luqman, Yanuar

2013-01-01

ViiiSTRATEGI PUBLIC RELATIONS DALAM MEMBANGUN BRANDINGRUMAH SAKIT TELOGOREJO MENJADI SEMARANG MEDICALCENTERAbstrakPerubahan brand merupakan hal yang sering terjadi pada sebuah institusi atauperusahaan. Hal ini menjadi salah satu pekerjaan humas yang bersangkutan dalammendapatkan kesadaran target audiens terhadap Perubahan brand tersebut.RS Telogorejo melakukan Perubahan brand menjadi Semarang MedicalCenter. Sedangkan brand RS Telogorejo sudah melekat di benak target audienssebagai rumah sakit...

STRESSFUL SITUATIONS IN THE WORK OF A MULTIPROFILE PEDIATRIC MEDICAL FACILITY'S CALL CENTER

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I. M. Spivak

2015-01-01

Full Text Available Stressful situations in the work of a pediatric medical facility's call center are associated with patients' violation of social communication norms and aggressive behavior, as well as the operator's professional/maternal conflict. The following psychological resources facilitate better stress resistance of operators: self-confidence, mature and rational attitude, personal activity, inner satisfaction, optimism, emotional breadth and emotional colleague support. 

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

Science.gov (United States)

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).

Science.gov (United States)

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

Science.gov (United States)

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

Financial impact of hand surgery programs on academic medical centers.

Science.gov (United States)

Hasan, Jafar S; Chung, Kevin C; Storey, Amy F; Bolg, Mary L; Taheri, Paul A

2007-02-01

This study analyzes the financial performance of hand surgery in the Department of Surgery at the University of Michigan. This analysis can serve as a reference for other medical centers in the financial evaluation of a hand surgery program. Fiscal year 2004 billing records for all patients (n = 671) who underwent hand surgery procedures were examined. The financial data were separated into professional revenues and costs (relating to the hand surgery program in the Section of Plastic Surgery) and into facility revenues and costs (relating to the overall University of Michigan Health System). Professional net revenue was calculated by applying historical collection rates to procedural and clinic charges. Facility revenue was calculated by applying historical collection rates to the following charge categories: inpatient/operating room, clinic facility, neurology/electromyography, radiology facilities, and occupational therapy. Total professional costs were calculated by adding direct costs and allocated overhead costs. Facility costs were obtained from the hospital's cost accounting system. Professional and facility incomes were calculated by subtracting costs from revenues. The net professional revenue and total costs were 1,069,836 and 1,027,421 dollars, respectively. Professional operating income was 42,415 dollars, or 3.96 percent of net professional revenue. Net facility revenue and total costs were 5,500,606 and 4,592,534 dollars, respectively. Facility operating income was 908,071 dollars, or 16.51 percent of net facility revenues. While contributing to the academic mission of the institution, hand surgery is financially rewarding for the Department of Surgery. In addition, hand surgery activity contributes substantially to the financial well-being of the academic medical center.

Building Brains, Forging Futures: A Call to Action for the Family-Centered Medical Home

Science.gov (United States)

Kraft, Colleen

2013-01-01

The family-centered medical home describes an approach to providing comprehensive primary care. Research advances in developmental neuroscience, genetics, and epigenetics offer a framework for understanding the dynamic process of brain development. It is this process that sets the life-course trajectory for an individual; in turn, a child's…

Opportunities for social workers in the patient centered medical home.

Science.gov (United States)

Hawk, Mary; Ricci, Edmund; Huber, George; Myers, Marcella

2015-01-01

The Patient Centered Medical Home (PCMH) has been hailed as one method of improving chronic care outcomes in the United States. A number of studies have underscored the importance of the social work role within the PCMH, yet little existing research explores the social worker as a driver of improved patient care. The Pennsylvania Chronic Care Initiative was created with a primary goal of increasing the number of practices that were recognized as PCMH by the National Committee for Quality Assurance. This article describes findings from in-depth qualitative interviews with representatives from seven primary care practices, in which the authors examined barriers and facilitators to implementation of the initiative. Barriers to implementation included small practice size, payer-driven care, not having a strong physician champion, variability within patient populations, and high implementation costs. Facilitators included having a social worker coordinate behavioral health services, clinical nurse case managers, preexisting models of outcomes-driven care, and being part of an integrated health delivery and financing system. Recommendations strengthening the role of medical social workers in primary care practices are discussed.

Collaboration between a college of pharmacy and a for-profit health system at an academic medical center.

Science.gov (United States)

Bird, Matthew L; Dunn, Rebecca L; Hagemann, Tracy M; Burton, Michael E; Britton, Mark L; St Cyr, Mark B

2012-07-01

The genesis and growth of a successful 14-year partnership between the University of Oklahoma (OU) college of pharmacy and the OU Medical Center (OUMC) department of pharmacy are described. Pursuant to a 1998 joint operating agreement, the medical center and pharmacy school have achieved a high degree of collaboration on a wide range of educational and clinical initiatives. The close relationship has conferred a number of benefits on both institutions, including (1) expanded experiential education opportunities for pharmacy students, (2) joint faculty and staff funding arrangements that have facilitated the development and accreditation of OU pharmacy residency programs, and (3) patient care initiatives that have increased awareness of pharmacists' important contributions in areas such as venous thromboembolism prophylaxis, antibiotic stewardship, and core measures compliance. In addition to the formal integration of the college of pharmacy into the OUMC organizational structure, ongoing teamwork by clinicians and administrators at the two institutions has strengthened the 14-year partnership while helping to identify creative solutions to evolving communications, technology, and reimbursement challenges. Potential growth opportunities include the expansion of pharmacy services into additional service areas and greater involvement by OU pharmacy school faculty in the training of medical, nursing, and allied health professionals. A large for-profit academic medical center and a college of pharmacy developed a successful collaboration that is mutually beneficial and provides increased clinical, educational, and scholarly opportunities, advancing the mission of both institutions.

Melanoma and medical education: knowledge and sun safety practices amongst medical students

Directory of Open Access Journals (Sweden)

Nicolina Smith

2018-02-01

Full Text Available Introduction: Melanoma has become a public health problem; however, with proper education and the use of sun safety techniques, most cases can be prevented. The purpose of this study is to determine if medical students have safer sun practices than the general population. Material and Methods: An online survey was sent to all students enrolled in the three medical schools in the Kansas City metropolitan area. Surveys were sent to 1200 medical students with a 39.25% response rate (n=471. Results: Most of the student population (n=436; 92.6% indicated that over the past year they had used one or more forms of sun protection. Of the respondents, 60.7% (n=286 indicated they had, to this point in their medical training, been educated counseling patients about the risk factors for prevention of skin cancer. Respondents who indicated that they had been educated on the steps/procedures of a complete skin exam were significantly more likely to indicate they had used sun protective equipment in the past year (P=.024. Conclusions: The general population is in need of dermatologic education on the basic risk factors of skin cancer as well as ways to prevent skin cancer. As education increases in the general population one would anticipate that these individuals would engage in safe sun practices as seen in the medical student community.

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

Science.gov (United States)

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,…

Ontario pharmacists practicing in family health teams and the patient-centered medical home.

Science.gov (United States)

Dolovich, Lisa

2012-04-01

The patient-centered medical home (PCMH) approach continues to gather momentum in the United States and Canada as a broad approach to reform the delivery of the complete primary care system. The family health team (FHT) model implemented in Ontario, Canada, best mirrors the PCMH approach of the United States. The integration of pharmacists as key members of the health care team providing on-site, in-office coordinated care to FHT patients was included from the start of planning the FHT model and represents a substantial opportunity for pharmacists to realize their professional vision. Several research projects in Canada and elsewhere have contributed to providing evidence to support the integration of pharmacists into primary care practice sites. Two major research programs, the Seniors Medication Assessment Research Trial (SMART) cluster randomized controlled trial and the Integrating Family Medicine and Pharmacy to Advance Primary Care Therapeutics (IMPACT) multipronged demonstration project made substantial contributions to evidence-informed policy decisions supporting the integration of pharmacists into FHTs. These projects can provide useful information to support the integration of pharmacists into the PCMH and to encourage further research to better measure the effect of the pharmacist from the holistic patient-centered perspective.

[Medical equipment companies and their ties with technology development centers in Mexico].

Science.gov (United States)

Hernández, B; Arredondo, A; Cruz, C; Sánchez, E; Damián, T

1993-10-01

The purpose of this study was to determine the characteristics of the companies that produce, distribute, and service medical equipment in Mexico and the factors related to whether or not they had established ties with research and technology development centers. The data analyzed came from a survey of such companies carried out in Mexico City and environs in 1989. The information was updated in 1991. Multivariate analyses were carried out in order to identify the characteristics of companies that had established ties or wished to do so and the areas of interest of those companies. Of 208 companies surveyed, only 23% had ties with research centers. The companies that had such ties or were interested in establishing them tended to invest in research and to have made plans for expansion. The establishment of ties appeared to be a two-way process, with positive consequences for the companies involved, the research centers, and the health sector. It was concluded that it would be advantageous to design programs to promote ties with companies having the characteristics mentioned.

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

International Nuclear Information System (INIS)

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.

Science.gov (United States)

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...

Putting patients first: a novel patient-centered model for medical enterprise success.

Science.gov (United States)

Dhawan, Naveen

2014-01-01

This article introduces a new way of viewing patient-customers. It encourages a greater emphasis on patients' needs and the importance of considering dimensions of the patient experience to better serve them. It also draws from examples in the general business world as they can be applied to medical enterprises. The author introduces a model that directs all business activities toward the end consumer with an underlying guidance by patient needs. A business is advised to understand its customer, design a patient-directed vision, and focus on creating a unique customer experience. The article delineates key action items for physicians and administrators that will allow them to better meet their patient-customers' needs and develop loyalty. By practicing a patient-centered approach and following these guidelines, one may ensure greater success of the medical enterprise.

Final Phase II report : QuickSite(R) investigation, Everest, Kansas.

Energy Technology Data Exchange (ETDEWEB)

LaFreniere, L. M. (Environmental Research)

2003-11-01

this reason, the CCC/USDA is conducting an environmental site investigation to determine the source(s) and extent of the carbon tetrachloride contamination at Everest and to assess whether the contamination requires remedial action. The investigation at Everest is being performed by the Environmental Research Division of Argonne National Laboratory. Argonne is a nonprofit, multidisciplinary research center operated by the University of Chicago for the U.S. Department of Energy (DOE). The CCC/USDA has entered into an interagency agreement with DOE, under which Argonne provides technical assistance to the CCC/USDA with environmental site characterization and remediation at its former grain storage facilities. At these facilities, Argonne is applying its QuickSite{reg_sign} environmental site characterization methodology. This methodology has been applied successfully at a number of former CCC/USDA facilities in Kansas and Nebraska and has been adopted by the American Society for Testing and Materials (ASTM 1998) as standard practice for environmental site characterization. Phase I of the QuickSite{reg_sign} investigation examined the key geologic, hydrogeologic, and hydrogeochemical relationships that define potential contaminant migration pathways at Everest (Argonne 2001). Phase II of the QuickSite{reg_sign} investigation at Everest was undertaken with the primary goal of delineating and improving understanding of the distribution of carbon tetrachloride contamination in groundwater at this site and the potential source area(s) that might have contributed to this contamination. To address this goal, four specific technical objectives were developed to guide the Phase II field studies. Sampling of near-surface soils at the former Everest CCC/USDA facility that was originally planned for Phase I had to be postponed until October 2000 because of access restrictions. Viable vegetation was not available for sampling then. This period is termed the first session of Phase II

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

Science.gov (United States)

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…

Positioning academic medical centers and teaching hospitals to thrive in the next decade.

Science.gov (United States)

Morris, D E

1985-06-01

Market share for academic medical centers and teaching hospitals will decline over the next five years necessitating new strategies to ensure growth and profitability. These types of institutions are, however, in a strong position to compete and gain market share locally by building a defensible competitive advantage. This article offers three avenues for increasing market share: networking, brand name product differentiation, and business diversification.

A feasibility study for a manufacturing technology deployment center

Energy Technology Data Exchange (ETDEWEB)

1994-10-31

The Automation & Robotics Research Institute (ARRI) and the Texas Engineering Extension Service (TEEX) were funded by the U.S. Department of Energy to determine the feasibility of a regional industrial technology institute to be located at the Superconducting Super Collider (SSC) Central Facility in Waxahachie, Texas. In response to this opportunity, ARRI and TEEX teamed with the DOE Kansas City Plant (managed by Allied Signal, Inc.), Los Alamos National Laboratory (managed by the University of California), Vought Aircraft Company, National Center for Manufacturing Sciences (NCMS), SSC Laboratory, KPMG Peat Marwick, Dallas County Community College, Navarro Community College, Texas Department of Commerce (TDOC), Texas Manufacturing Assistance Center (TMAC), Oklahoma Center for the Advancement of Science and Technology, Arkansas Science and Technology Authority, Louisiana Productivity Center, and the NASA Mid-Continent Technology Transfer Center (MCTTC) to develop a series of options, perform the feasibility analysis and secure industrial reviews of the selected concepts. The final report for this study is presented in three sections: Executive Summary, Business Plan, and Technical Plan. The results from the analysis of the proposed concept support the recommendation of creating a regional technology alliance formed by the states of Texas, New Mexico, Oklahoma, Arkansas and Louisiana through the conversion of the SSC Central facility into a Manufacturing Technology Deployment Center (MTDC).

Cerebral angioplasty practice at major medical centers in the United States

International Nuclear Information System (INIS)

Chaturvedi, S.; St Pierre, M.E.; Bertasio, B.

2000-01-01

Concern has been expressed recently regarding the proliferation of angioplasty and/or stenting of cerebral vessels. However, little is known about the volume of angioplasties being performed or the number of experienced interventionalists. A questionnaire was mailed to directors of accredited radiology residency programs in the United States, to define the level of expertise available at teaching hospitals in terms of angioplasty and/or stenting. Of 200 programs surveyed, 111 responded (56 %). Of 111 program directors 47 (42 %) indicated that cerebral angioplasty was being performed at their center. The greatest experience is currently for angioplasty of post-subarachnoid hemorrhage vasospasm (mean 16 procedures performed) and the least experience for dilation of basilar artery atherosclerosis (mean five procedures performed). The reported stroke and/or death rate in centers performing angioplasty of the extracranial carotid system is 1.5 %. Comparisons with other medical specialties (e. g., cardiologists, neurologists, neurosurgeons) are necessary to determine the full scope of extracranial neurovascular procedures being performed and the corresponding complication rates. (orig.)

Functional status of persons with chronic fatigue syndrome in the Wichita, Kansas, population

Directory of Open Access Journals (Sweden)

Reyes Michele

2003-10-01

Full Text Available Abstract Background Scant research has adequately addressed the impact of chronic fatigue syndrome on patients' daily activities and quality of life. Enumerating specific problems related to quality of life in chronic fatigue syndrome patients can help us to better understand and manage this illness. This study addresses issues of functional status in persons with chronic fatigue syndrome and other fatiguing illnesses in a population based sample, which can be generalized to all persons with chronic fatigue. Methods We conducted a random telephone survey in Wichita, Kansas to identify persons with chronic fatigue syndrome and other fatiguing illnesses. Respondents reporting severe fatigue of at least 1 month's duration and randomly selected non-fatigued respondents were asked to participate in a detailed telephone interview. Participants were asked about symptoms, medical and psychiatric illnesses, and about physical, social, and recreational functioning. Those meeting the 1994 chronic fatigue syndrome case definition, as determined on the basis of their telephone responses, were invited for clinical evaluation to confirm a diagnosis of chronic fatigue syndrome. For this analysis, we evaluated unemployment due to fatigue, number of hours per week spent on work, chores, and other activities (currently and prior to the onset of fatigue, and energy level. Results There was no difference between persons with chronic fatigue syndrome and persons with a chronic fatigue syndrome-like illness that could be explained by a medical or psychiatric condition for any of the outcomes we measured except for unemployment due to fatigue (15% vs. 40%, P Conclusions Persons with chronic fatigue syndrome are as impaired as persons whose fatigue could be explained by a medical or psychiatric condition, and they have less energy than non-fatigued controls.

Impact on Seniors of the Patient-Centered Medical Home: Evidence from a Pilot Study

Science.gov (United States)

Fishman, Paul A.; Johnson, Eric A.; Coleman, Kathryn; Larson, Eric B.; Hsu, Clarissa; Ross, Tyler R.; Liss, David; Tufano, James; Reid, Robert J.

2012-01-01

Purpose: To assess the impact on health care cost and quality among seniors of a patient-centered medical home (PCMH) pilot at Group Health Cooperative, an integrated health care system in Washington State. Design and Methods: A prospective before-and-after evaluation of the experience of seniors receiving primary care services at 1 pilot clinic…

Radiation safety knowledge of medical center radiology technologists in southern Taiwan

Energy Technology Data Exchange (ETDEWEB)

Su Wen-Chuan; Huang Ying-Fong; Chen Cheng-Chung; Chang Pao-Shu [Kaohsiung Medical University, Taiwan (China)

2000-05-01

People who live in Taiwan are getting more and more afraid of radiation. Sometimes the phobia results from distorted knowledge. Radiology technologists, in one hand, are more well-educated in radiation and, in the other hand, have more chance to expose to radiation when they are operating radiation producing medical instruments in their daily life. So we are interested in whether they have enough knowledge to protect themselves. We pick up the radiology technology board examination to make the questionnaire for this study. The population is the radiology technologists who work at department of diagnostic radiology, of radiation therapy and nuclear medicine in medical centers. Statistics is then used to see the relationship between knowledge and the factors including gender, age and career period. Based on statistics, we find out that there is significant correlation between the knowledge with age or education level. Elder or lower education level ones has worse knowledge. Continued education may be highly recommended for radiology technologists to avoid occupational radiation injury. (author)

Radiation safety knowledge of medical center radiology technologists in southern Taiwan

International Nuclear Information System (INIS)

Su Wen-Chuan; Huang Ying-Fong; Chen Cheng-Chung; Chang Pao-Shu

2000-01-01

People who live in Taiwan are getting more and more afraid of radiation. Sometimes the phobia results from distorted knowledge. Radiology technologists, in one hand, are more well-educated in radiation and, in the other hand, have more chance to expose to radiation when they are operating radiation producing medical instruments in their daily life. So we are interested in whether they have enough knowledge to protect themselves. We pick up the radiology technology board examination to make the questionnaire for this study. The population is the radiology technologists who work at department of diagnostic radiology, of radiation therapy and nuclear medicine in medical centers. Statistics is then used to see the relationship between knowledge and the factors including gender, age and career period. Based on statistics, we find out that there is significant correlation between the knowledge with age or education level. Elder or lower education level ones has worse knowledge. Continued education may be highly recommended for radiology technologists to avoid occupational radiation injury. (author)

Surgeon leadership in the coding, billing, and contractual negotiations for fenestrated endovascular aortic aneurysm repair increases medical center contribution margin and physician reimbursement.

Science.gov (United States)

Aiello, Francesco; Durgin, Jonathan; Daniel, Vijaya; Messina, Louis; Doucet, Danielle; Simons, Jessica; Jenkins, James; Schanzer, Andres

2017-10-01

Fenestrated endovascular aneurysm repair (FEVAR) allows endovascular treatment of thoracoabdominal and juxtarenal aneurysms previously outside the indications of use for standard devices. However, because of considerable device costs and increased procedure time, FEVAR is thought to result in financial losses for medical centers and physicians. We hypothesized that surgeon leadership in the coding, billing, and contractual negotiations for FEVAR procedures will increase medical center contribution margin (CM) and physician reimbursement. At the UMass Memorial Center for Complex Aortic Disease, a vascular surgeon with experience in medical finances is supported to manage the billing and coding of FEVAR procedures for medical center and physician reimbursement. A comprehensive financial analysis was performed for all FEVAR procedures (2011-2015), independent of insurance status, patient presentation, or type of device used. Medical center CM (actual reimbursement minus direct costs) was determined for each index FEVAR procedure and for all related subsequent procedures, inpatient or outpatient, 3 months before and 1 year subsequent to the index FEVAR procedure. Medical center CM for outpatient clinic visits, radiology examinations, vascular laboratory studies, and cardiology and pulmonary evaluations related to FEVAR were also determined. Surgeon reimbursement for index FEVAR procedure, related adjunct procedures, and assistant surgeon reimbursement were also calculated. All financial analyses were performed and adjudicated by the UMass Department of Finance. The index hospitalization for 63 FEVAR procedures incurred $2,776,726 of direct costs and generated $3,027,887 in reimbursement, resulting in a positive CM of $251,160. Subsequent related hospital procedures (n = 26) generated a CM of $144,473. Outpatient clinic visits, radiologic examinations, and vascular laboratory studies generated an additional CM of $96,888. Direct cost analysis revealed that grafts

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.

Threatened & Endangered Species Occurrences

Data.gov (United States)

Kansas Data Access and Support Center — The database consists of a single statewide coverage of location records for 54 species contained in the Kansas Natural Heritage Inventory database of the Kansas...

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

A Study to Evaluate the Organization and the Operating Procedures of the Patient Assistance Function at Brooke Army Medical Center, Fort Sam Houston, Texas

Science.gov (United States)

1979-08-01

15 March 1979. 59Interview with Wendy L. Farace , Head Nurse, Obstetrics/Gynecology Clinic, Brooke Army Medical Center, Fort Sam Houston, Texas, 8...6 February 1979. Farace , Wendy L. Head Nurse, Obstetrica/Gynecology Clinic, Brooke Army Medical Center, Fort Sam Houston, Texas. Interview, 8 January

Streamflow characteristics and trends along Soldier Creek, Northeast Kansas

Science.gov (United States)

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

An Analysis of Information Technology Adoption by IRBs of Large Academic Medical Centers in the United States.

Science.gov (United States)

He, Shan; Botkin, Jeffrey R; Hurdle, John F

2015-02-01

The clinical research landscape has changed dramatically in recent years in terms of both volume and complexity. This poses new challenges for Institutional Review Boards' (IRBs) review efficiency and quality, especially at large academic medical centers. This article discusses the technical facets of IRB modernization. We analyzed the information technology used by IRBs in large academic institutions across the United States. We found that large academic medical centers have a high electronic IRB adoption rate; however, the capabilities of electronic IRB systems vary greatly. We discuss potential use-cases of a fully exploited electronic IRB system that promise to streamline the clinical research work flow. The key to that approach utilizes a structured and standardized information model for the IRB application. © The Author(s) 2014.

Improvements in self-efficacy for engaging in patient-centered communication following a course in peer-supervision and communication for medical students

DEFF Research Database (Denmark)

Lassesen, Berit; O Connor, Maja; Kjær, Louise Binow

and Department of Psychology and Behavioral Science, Aarhus University, Aarhus, Denmark; 3Center for Medical Education, Aarhus University, Aarhus, Denmark.; belas@clu.au.dk Aim: The aim was to evaluate the outcome of a training course in peer-supervision and communication with the aim of improving medical...... student self-efficacy for engaging in patient-centered communication and examine the influence of course-related motivation to learn, course-related self-efficacy, and medical student well-being at baseline. Methods: A total of 127 graduate school medical students in clinical clerkship who participated...... in a course in peer-supervision and communication completed a pre-course questionnaire package including: 1) The Patient-Centeredness Self-Efficacy Questionnaire (PCSEQ), 2) Course-Related Motivation to Learn (CRML), 3) Course-Related Self-Efficacy (CRSE), and 4) the Medical Student Well-Being Index (MSWBI...

STATE_SYSTEM

Data.gov (United States)

Kansas Data Access and Support Center — This dataset is a single centerline highway network representation of the 10,000 miles Kansas State Highway System (Interstate, U.S., and Kansas routes). The state...

GAP Analysis Program (GAP)

Data.gov (United States)

Kansas Data Access and Support Center — The Kansas GAP Analysis Land Cover database depicts 43 land cover classes for the state of Kansas. The database was generated using a two-stage hybrid classification...

Health information security: a case study of three selected medical centers in iran.

Science.gov (United States)

Hajrahimi, Nafiseh; Dehaghani, Sayed Mehdi Hejazi; Sheikhtaheri, Abbas

2013-03-01

Health Information System (HIS) is considered a unique factor in improving the quality of health care activities and cost reduction, but today with the development of information technology and use of internet and computer networks, patients' electronic records and health information systems have become a source for hackers. This study aims at checking health information security of three selected medical centers in Iran using AHP fuzzy and TOPSIS compound model. To achieve that security measures were identified, based on the research literature and decision making matrix using experts' points of view. Among the 27 indicators, seven indicators were selected as effective indicators and Fuzzy AHP technique was used to determine the importance of security indicators. Based on the comparisons made between the three selected medical centers to assess the security of health information, it is concluded that Chamran hospital has the most acceptable level of security and attention in three indicators of "verification and system design, user access management, access control system", Al Zahra Hospital in two indicators of "access management and network access control" and Amin Hospital in "equipment safety and system design". In terms of information security, Chamran Hospital ranked first, Al-Zahra Hospital ranked second and Al- Zahra hospital has the third place.

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

Survey on prevalence and causes of self-medication in women referring to health centers in Ahwaz, in 2013

Directory of Open Access Journals (Sweden)

Pourandoght Afshary

2015-11-01

Full Text Available Background: Today, considerable advances achieved in different scientific fields have led to an ever-increasing access of people to various medications and their unauthorized consumption, which negatively affects the healthcare and treatment system. Thus, this study was conducted to determine the Prevalence and causes of this phenomenon in the female population of Ahwaz. Material and Methods: In this Cross-sectional study364 Women referring to seven health centers in Ahwaz were selected randomly and based on the family medical file number and by proportional distribution to each center and semi-structured questionnaires were completed through interviews. The data were analyzed by Chi square test and logistic regression. P<0.05 was considered significant. Results: Self-medication was observed in 70.1% of women. The most frequent group  was those above the age of 30. The most common self-medication case was urogenitaldisorders (58.7%. there was a significant relation between education (p<0.003 and number of births (p=0.003 and unauthorized drug consumption. The most causes for synthetic drug use were previous illness background (48.6% and high medication costs (50.6%, and about herbal drugs were high medication costs (41.1%, and the effectiveness of these products about medicinal herbs (38.1 %. Conclusion: High rate of self-medication in the studied society necessitates training on proper use of drugs through the use of social media.

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

Science.gov (United States)

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…

Learning from Primary Health Care Centers in Nepal: reflective writings on experiential learning of third year Nepalese medical students

OpenAIRE

Dhital, Rolina; Subedi, Madhusudan; Prasai, Neeti; Shrestha, Karun; Malla, Milan; Upadhyay, Shambhu

2015-01-01

Background Medical education can play important role in cultivating the willingness among the medical students to work in underprivileged areas after their graduation. Experiential learning through early exposure to primary health care centers could help students better understand the opportunities and challenges of such settings. However, the information on the real experiences and reflections of medical students on the rural primary health care settings from low-income countries like Nepal ...

Teaching Health Center Graduate Medical Education Locations Predominantly Located in Federally Designated Underserved Areas.

Science.gov (United States)

Barclift, Songhai C; Brown, Elizabeth J; Finnegan, Sean C; Cohen, Elena R; Klink, Kathleen

2016-05-01

Background The Teaching Health Center Graduate Medical Education (THCGME) program is an Affordable Care Act funding initiative designed to expand primary care residency training in community-based ambulatory settings. Statute suggests, but does not require, training in underserved settings. Residents who train in underserved settings are more likely to go on to practice in similar settings, and graduates more often than not practice near where they have trained. Objective The objective of this study was to describe and quantify federally designated clinical continuity training sites of the THCGME program. Methods Geographic locations of the training sites were collected and characterized as Health Professional Shortage Area, Medically Underserved Area, Population, or rural areas, and were compared with the distribution of Centers for Medicare and Medicaid Services (CMS)-funded training positions. Results More than half of the teaching health centers (57%) are located in states that are in the 4 quintiles with the lowest CMS-funded resident-to-population ratio. Of the 109 training sites identified, more than 70% are located in federally designated high-need areas. Conclusions The THCGME program is a model that funds residency training in community-based ambulatory settings. Statute suggests, but does not explicitly require, that training take place in underserved settings. Because the majority of the 109 clinical training sites of the 60 funded programs in 2014-2015 are located in federally designated underserved locations, the THCGME program deserves further study as a model to improve primary care distribution into high-need communities.

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

Science.gov (United States)

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.

Systemic lupus erythematosus and thyroid disease - Experience in a single medical center in Taiwan.

Science.gov (United States)

Liu, Yu-Chuan; Lin, Wen-Ya; Tsai, Ming-Chin; Fu, Lin-Shien

2017-06-28

To investigate the association of systemic lupus erythematosus (SLE) with thyroid diseases in a medical center in central Taiwan. This is a retrospective cohort of 2796 SLE patients in a tertiary referral medical center from 2000 to 2013. We screened SLE by catastrophic illness registration from national insurance bureau; and thyroid diseases by ICD 9 codes, then confirmed by thyroid function test, auto-antibody, medical and/or surgical intervention. We compared the rate of hyperthyroidism, hypothyroidism and autoimmune thyroid disease (AITD) in SLE patients and the 11,184 match controls. We calculated the rate of these thyroid diseases and positive antibodies to thyroglobulin (ATGAb), thyroid peroxidase (TPOAb) in SLE patients grouped by the presence of overlap syndrome and anti-dsDNA antibody. We also compared the association of thyroid diseases to severe SLE conditions, including renal, central nervous system (CNS) involvement, and thrombocytopenia. Compared to the matched controls, the cumulative incidence of thyroid disease, including hyperthyroidism, hypothyroidism and AITD, were all higher in SLE patients (p hyperthyroidism. SLE patients with thyroid diseases also carry higher risk for severe complications such as renal involvement (p = 0.024) central nervous system involvement (p hyperthyroidism, hypothyroidism, and AITD than the matched control. Among lupus patients, the risks of thyroid diseases are even higher in the presence of overlap syndrome. SLE patients with thyroid diseases had higher risk of renal and CNS involvement. Copyright © 2017. Published by Elsevier B.V.

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

OpenAIRE

Morris, G. Scott

2015-01-01

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

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.

Midwest Clean Energy Application Center

Energy Technology Data Exchange (ETDEWEB)

Cuttica, John; Haefke, Cliff

2013-12-31

The Midwest Clean Energy Application Center (CEAC) was one of eight regional centers that promoted and assisted in transforming the market for combined heat and power (CHP), waste heat to power (WHP), and district energy (DE) technologies and concepts throughout the United States between October 1, 2009 and December 31, 2013. The key services the CEACs provided included: Market Opportunity Analyses – Supporting analyses of CHP market opportunities in diverse markets including industrial, federal, institutional, and commercial sectors. Education and Outreach – Providing information on the energy and non-energy benefits and applications of CHP to state and local policy makers, regulators, energy end-users, trade associations and others. Information was shared on the Midwest CEAC website: www.midwestcleanergy.org. Technical Assistance – Providing technical assistance to end-users and stakeholders to help them consider CHP, waste heat to power, and/or district energy with CHP in their facility and to help them through the project development process from initial CHP screening to installation. The Midwest CEAC provided services to the Midwest Region that included the states of Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, and Wisconsin.

An intelligent algorithm for identification of optimum mix of demographic features for trust in medical centers in Iran.

Science.gov (United States)

Yazdanparast, R; Zadeh, S Abdolhossein; Dadras, D; Azadeh, A

2018-06-01

Healthcare quality is affected by various factors including trust. Patients' trust to healthcare providers is one of the most important factors for treatment outcomes. The presented study identifies optimum mixture of patient demographic features with respect to trust in three large and busy medical centers in Tehran, Iran. The presented algorithm is composed of adaptive neuro-fuzzy inference system and statistical methods. It is used to deal with data and environmental uncertainty. The required data are collected from three large hospitals using standard questionnaires. The reliability and validity of the collected data is evaluated using Cronbach's Alpha, factor analysis and statistical tests. The results of this study indicate that middle age patients with low level of education and moderate illness severity and young patients with high level of education, moderate illness severity and moderate to weak financial status have the highest trust to the considered medical centers. To the best of our knowledge this the first study that investigates patient demographic features using adaptive neuro-fuzzy inference system in healthcare sector. Second, it is a practical approach for continuous improvement of trust features in medical centers. Third, it deals with the existing uncertainty through the unique neuro-fuzzy approach. Copyright © 2018 Elsevier B.V. All rights reserved.

76 FR 53525 - Final Environmental Impact Statement for the Proposed Keystone XL Project; Public Meetings

Science.gov (United States)

2011-08-26

..., September 26, 2011 Bob Bowers Civic Center, 3401 Cultural Center Drive, Port Arthur, Texas 77642, 4:30 p.m.-10 p.m. Kansas Expo Center, 1 Expocenter Drive, Topeka, Kansas 66612, 12 p.m.- 3:30 p.m., 4 p.m.-8 p.m. Tuesday, September 27, 2011 Dawson Community College, Toepke Center Auditorium, 300 Community...

Using Technology to Enhance Teaching of Patient-Centered Interviewing for Early Medical Students.

Science.gov (United States)

Kaltman, Stacey; Talisman, Nicholas; Pennestri, Susan; Syverson, Eleri; Arthur, Paige; Vovides, Yianna

2018-06-01

Effective strategies for teaching communication skills to health professions students are needed. This article describes the design and evaluation of immersive and interactive video simulations for medical students to practice basic communication skills. Three simulations were developed, focusing on patient-centered interviewing techniques such as using open-ended questions, reflections, and empathic responses while assessing a patient's history of present illness. First-year medical students were randomized to simulation or education-as-usual arms. Students in the simulation arm were given access to three interactive video simulations developed using Articulate Storyline, an e-learning authoring tool, to practice and receive feedback on patient-centered interviewing techniques to prepare for their Observed Structured Clinical Examination (OSCE). Trained raters evaluated videos of two OSCE cases for each participant to assess specific communication skills used during the history of present illness component of the interview. Eighty-seven percent of the students in the simulation arm interacted with at least one simulation during the history of present illness. For both OSCE cases, students in the simulation arm asked significantly more open-ended questions. Students in the simulation arm asked significantly fewer closed-ended questions and offered significantly more empathic responses in one OSCE case. No differences were found for reflections. Students reported that the simulations helped improve their communication skills. The use of interactive video simulations was found to be feasible to incorporate into the curriculum and was appealing to students. In addition, students in the simulation arm displayed more behaviors consistent with the patient-centered interviewing model practiced in the simulations. Continued development and research are warranted.

Multipayer patient-centered medical home implementation guided by the chronic care model.

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Gabbay, Robert A; Bailit, Michael H; Mauger, David T; Wagner, Edward H; Siminerio, Linda

2011-06-01

A unique statewide multipayer ini Pennsylvania was undertaken to implement the Patient-Centered Medical Home (PCMH) guided by the Chronic Care Model (CCM) with diabetes as an initial target disease. This project represents the first broad-scale CCM implementation with payment reform across a diverse range of practice organizations and one of the largest PCMH multipayer initiatives. Practices implemented the CCM and PCMH through regional Breakthrough Series learning collaboratives, supported by Improving Performance in Practice (IPIP) practice coaches, with required monthly quality reporting enhanced by multipayer infrastructure payments. Some 105 practices, representing 382 primary care providers, were engaged in the four regional collaboratives. The practices from the Southeast region of Pennsylvania focused on diabetes patients (n = 10,016). During the first intervention year (May 2008-May 2009), all practices achieved at least Level 1 National Committee for Quality Assurance (NCQA) Physician Practice Connections Patient-Centered Medical Home (PPC-PCMH) recognition. There was significant improvement in the percentage of patients who had evidence-based complications screening and who were on therapies to reduce morbidity and mortality (statins, angiotensin-converting enzyme inhibitors). In addition, there were small but statistically significant improvements in key clinical parameters for blood pressure and cholesterol levels, with the greatest absolute improvement in the highest-risk patients. Transforming primary care delivery through implementation of the PCMH and CCM supported by multipayer infrastructure payments holds significant promise to improve diabetes care.

[Work satisfaction, quality of life and leisure time of residents at the Soroka University Medical Center, Beer Sheba, Israel].

Science.gov (United States)

Acker, Asaf; Perry, Zvi; Reuveni, Haim; Toker, Asaf

2009-02-01

Work dissatisfaction among physicians worldwide continues to rise over the last few decades, mainly due to declining professional prestige, tack of self fulfillment, time pressure and tack of leisure time. Physicians' burnout is a major result of dissatisfaction, causing doctors to leave the medical profession, and to provide lower quality of care. To examine the work satisfaction, quality of life and leisure time of residents in the Soroka University Medical Center. A validated questionnaire was delivered during the second half of 2004 to 252 residents in the Soroka University Medical Center The data was analyzed using the SPSS 12 for windows program. Descriptive analysis, parametric Students' T Test [where pleisure time. Further attention must be given to these matters--a step which will eventually improve patient care, and delay, to some extent, the burnout of physicians.

Relationships among communication competence, self-efficacy, and job satisfaction in Korean nurses working in the emergency medical center setting.

Science.gov (United States)

Park, Min Sook; Jeoung, Yeonok; Lee, Hye Kyung; Sok, Sohyune R

2015-06-01

The communication competence of nurses working in emergency medical center settings is essential to establish a therapeutic nurse-patient relationship. Education and strategic development are required to improve the communication competence of emergency room (ER) nurses. This study was conducted to determine the relationships among individual communication competence, self-efficacy, and job satisfaction in Korean nurses in the emergency medical center setting. A cross-sectional descriptive design was adopted. The study sample included 214 nurses at 11 emergency medical centers in Seoul and Kyunggi-Do, Korea. Measures used included the Global Interpersonal Communication Competence, self-efficacy scale, and job satisfaction scale. The collected data were analyzed using the SPSS version 18.0 statistical software program and included descriptive statistics (frequency, percentage, mean, standard deviation, independent t test, analysis of variance, and Pearson's correlation coefficient). The degrees of communication competence and self-efficacy of ER nurses were good, with higher scores than the median values. However, the degree of job satisfaction was poor, indicating a lower score than the median value. Religious affiliation and previous participation in communication education each had a significant impact on communication competence. Religious affiliation and time of worse duty each had a significant impact on self-efficacy. Length of career (year) in the emergency medical center and type of hospital each had a significant impact on job satisfaction. Positive correlations were identified among communication competence, self-efficacy, and job satisfaction. This study supported the presence of significant correlations among communication competence, self-efficacy, and job satisfaction. Thus, it is necessary to develop training programs that are customized to individual characteristics such as self-efficacy and job satisfaction to improve the communicative competence

Using Learner-Centered, Simulation-Based Training to Improve Medical Students’ Procedural Skills

Directory of Open Access Journals (Sweden)

Serkan Toy

2017-03-01

Full Text Available Purpose: To evaluate the effectiveness of a learner-centered, simulation-based training developed to help medical students improve their procedural skills in intubation, arterial line placement, lumbar puncture, and central line insertion. Method: The study participants were second and third year medical students. Anesthesiology residents provided the training and evaluated students’ procedural skills. Two residents were present at each station to train the medical students who rotated through all 4 stations. Pre/posttraining assessment of confidence, knowledge, and procedural skills was done using a survey, a multiple-choice test, and procedural checklists, respectively. Results: In total, 24 students were trained in six 4-hour sessions. Students reported feeling significantly more confident, after training, in performing all 4 procedures on a real patient ( P < .001. Paired-samples t tests indicated statistically significant improvement in knowledge scores for intubation, t (23 = −2.92, P < .001, and arterial line placement, t (23 = −2.75, P < .001. Procedural performance scores for intubation ( t (23 = −17.29, P < .001, arterial line placement ( t (23 = −19.75, P < .001, lumbar puncture ( t (23 = −16.27, P < .001, and central line placement ( t (23 = −17.25, P < .001 showed significant improvement. Intraclass correlation coefficients indicated high reliability in checklist scores for all procedures. Conclusions: The simulation sessions allowed each medical student to receive individual attention from 2 residents for each procedure. Students’ written comments indicated that this training modality was well received. Results showed that medical students improved their self-confidence, knowledge, and skills in the aforementioned procedures.

Implementation of Epic Beaker Clinical Pathology at an academic medical center

Directory of Open Access Journals (Sweden)

Matthew D Krasowski

2016-01-01

Full Text Available Background: Epic Beaker Clinical Pathology (CP is a relatively new laboratory information system (LIS operating within the Epic suite of software applications. To date, there have not been any publications describing implementation of Beaker CP. In this report, we describe our experience in implementing Beaker CP version 2012 at a state academic medical center with a go-live of August 2014 and a subsequent upgrade to Beaker version 2014 in May 2015. The implementation of Beaker CP was concurrent with implementations of Epic modules for revenue cycle, patient scheduling, and patient registration. Methods: Our analysis covers approximately 3 years of time (2 years preimplementation of Beaker CP and roughly 1 year after using data summarized from pre- and post-implementation meetings, debriefings, and the closure document for the project. Results: We summarize positive aspects of, and key factors leading to, a successful implementation of Beaker CP. The early inclusion of subject matter experts in the design and validation of Beaker workflows was very helpful. Since Beaker CP does not directly interface with laboratory instrumentation, the clinical laboratories spent extensive preimplementation effort establishing middleware interfaces. Immediate challenges postimplementation included bar code scanning and nursing adaptation to Beaker CP specimen collection. The most substantial changes in laboratory workflow occurred with microbiology orders. This posed a considerable challenge with microbiology orders from the operating rooms and required intensive interventions in the weeks following go-live. In postimplementation surveys, pathology staff, informatics staff, and end-users expressed satisfaction with the new LIS. Conclusions: Beaker CP can serve as an effective LIS for an academic medical center. Careful planning and preparation aid the transition to this LIS.

Strom Thurmond Biomedical Research Center at the Medical Univesity for South Carolina Charleston, South Carolina

Energy Technology Data Exchange (ETDEWEB)

1994-02-01

The Department of Energy (DOE) has prepared an Environmental Assessment (EA) evaluating the proposed construction and operation of the Strom Thurmond Biomedical Research Center (Center) at the Medical University of South Carolina (MUSC), Charleston, SC. The DOE is evaluating a grant proposal to authorize the MUSC to construct, equip and operate the lower two floors of the proposed nine-story Center as an expansion of on-going clinical research and out-patient diagnostic activities of the Cardiology Division of the existing Gazes Cardiac Research Institute. Based on the analysis in the EA, the DOE has determined that the proposed action does not constitute a major federal action significantly affecting the quality of the human environment within the meaning of the NEPA. Therefore, the preparation of an Environmental Impact Statement is not required.

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...

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...

Patient-centered medical homes improve care for adults with chronic conditions.

Science.gov (United States)

Pourat, Nadereh; Lavarreda, Shana Alex; Snyder, Sophie

2013-05-01

The success of health care reform implementation in 2014 partly depends on more efficient delivery of care to the millions of California residents eligible to gain insurance. Emerging evidence supports the effectiveness of the patient-centered medical home (PCMH) as a potential model of care delivery, which improves health outcomes and reduces costs. Among other principles, PCMH entails receipt of care from a personal doctor, who coordinates the patient's care and develops an individualized treatment plan for the patient. These principles are particularly essential in delivery of care to those with chronic conditions who require more intensive care management. Using the 2009 California Health Interview Survey (CHIS 2009), this policy brief indicates that patients who reported meeting these fundamental PCMH principles were more likely to have visited the doctor and to have received flu shots, and they also had better communication with providers than those who did not report meeting these PCMH principles. The data also showed that uninsured individuals, Medi-Cal beneficiaries, those at or below 133% of the federal poverty level, Latinos, and Asian-Americans were less likely to report meeting all three PCMH principles. These findings highlight the population groups that would most benefit from the PCMH care delivery model, particularly Medi-Cal beneficiaries and those eligible for Covered California, the California health benefits exchange.

Using an expanded outcomes framework and continuing education evidence to improve facilitation of patient-centered medical home recognition and transformation.

Science.gov (United States)

Van Hoof, Thomas J; Kelvey-Albert, Michele; Katz, Matthew; Lalime, Ken; Sacks, Ken; Meehan, Thomas P

2014-01-01

The patient-centered medical home is a model for delivering primary care in the United States. Primary care clinicians and their staffs require assistance in understanding the innovation and in applying it to practice. The purpose of this article is to describe and to critique a continuing education program that is relevant to, and will become more common in, primary care. A multifaceted educational strategy prepared 20 primary care private practices to achieve National Committee for Quality Assurance Level 3 recognition as Patient-Centered Medical Homes. Eighteen (90%) practices submitted an application to the National Committee for Quality Assurance. On the first submission attempt, 13 of 18 (72%) achieved Level 3 recognition and 5 (28%) achieved Level 1 recognition. An interactive multifaceted educational strategy can be successful in preparing primary care practices for Patient-Centered Medical Homes recognition, but the strategy may not ensure transformation. Future educational activities should consider an expanded outcomes framework and the evidence of effective continuing education to be more successful with recognition and transformation.

Plastic Surgery Complications from Medical Tourism Treated in a U.S. Academic Medical Center.

Science.gov (United States)

Ross, Kimberly M; Moscoso, Andrea V; Bayer, Lauren R; Rosselli-Risal, Liliana; Orgill, Dennis P

2018-04-01

Medical tourism is a growing, multi-billion dollar industry fueled by improvements in the global transportation infrastructure. The authors studied patients living in the United States who travel to other countries for plastic surgical procedures and returned to have their complications treated in the authors' center. A retrospective patient evaluation was performed. Patients who had presented to an urban tertiary academic hospital plastic surgery service with complications or complaints associated with plastic surgery performed in a developing country were studied. The authors collected demographic information, types of surgery performed, destinations, insurance coverage, and complications. Seventy-eight patients were identified over 7 years. Most commonly, complications were seen following abdominoplasty (n = 35), breast augmentation (n = 25), and foreign body injections (n = 15). Eighteen patients underwent multiple procedures in one operative setting. The most common destination country was the Dominican Republic (n = 59). Complications included surgical-site infections (n = 14), pain (n = 14), and wound healing complications (n = 12). Eighty-six percent of patients (n = 67) relied on their medical insurance to pay for their follow-up care or manage their complications, with the most common type of health insurance coverage being Massachusetts Medicaid (n = 48). Cosmetic surgery performed in developing countries can carry substantial risks of complications that can be challenging to patients, primary care providers, insurers, and plastic surgical teams not associated with the original surgery. These complications pose significant burdens on our public health systems.

A Study of Civilian Registered Nurse Recruitment at Madigan Army Medical Center, Tacoma, Washington.

Science.gov (United States)

1982-06-01

34 May, 1981, "Nurse, Where Are You?" Judy Armstrong . 5 1nitial Report and Preliminary Recommendations, National Commission on Nursing (September 1981...Interview with Ms. R. Marsh, Staffing Specialist, Force Develop- ment Division, Madigan Army Medical Center, Tacoma, WA (Dec 81) 20Philip Kotler ...Marketing Management. Boston: Allyn and Bacon, Inc., 1980. Kotler , Philip. Marketing for Nonprofit Institutions. Englewood Cliffs, N.D.: Prentice-Hall

DEVELOPMENT OF SIMULATION CENTER AND TRAINING PROGRAMMES IN IVANO-FRANKIVSK PERINATAL CENTER

Directory of Open Access Journals (Sweden)

Zoryana Kocherga

2017-06-01

Full Text Available Current system of medical education in Ukraine needs improvement and reforms in order to enhance the proficiency of doctors and paramedics. Training of practical/technical skills, communication, as well as teamwork skills is considerably important.The use of simulation techniques and methods in medical education is called simulation training in medicine. Medical skills are acquired through cognitive (knowledge and psychomotor (practice skills. The first medical simulation centers appeared in Ukraine in 2006 according to the order of the Ministry of Health Care of Ukraine.On June 20, 2013, a new simulation training center was opened in Ivano-Frankivsk on the base of Regional Perinatal Center. Similar medical simulation centers were opened in the second half of 2013 in Volyn and Vinnytsia regions under the Ukrainian-Swiss Mother and Child Health Programme, which started in the area of perinatology. Their goal is to improve the teamwork of all specialists involved in the process of delivery and neonatal intensive care,as well as to engage internship doctors and senior medical students in clinical skills training programmes.The use of simulation techniques and training programs offers a powerful platform to study and practice clinical reasoning behaviors and patterns.

CAPITAL STRUCTURE ANALYSIS OF THE MEDICAL DIAGNOSTIC-CONSULTATIVE CENTERS IN VARNA (absolute indicators

Directory of Open Access Journals (Sweden)

Lyubomira Koeva-Dimitrova

2016-08-01

Full Text Available The capital structure analysis of medical institutions is related to the assessment of their financial sustainability. The degree of their financial sustainability indicates the extent to which the medical institution is exposed to financial risk. This financial risk is related to the use of foreign capital (debts, loans, etc. and it is defined as the probability of insolvency and possible bankruptcy due to the existence of debts which could not be repaid at some point in the foreseeable future. Objective: To analyze the capital structure of the medical diagnostic-consultative centers in Varna city and on this basis to assess their long-term solvency and existence of financial risk. Materials and Methods: The materials for the study are the published annual financial statements (up to 05. 01. 2016 in the Commercial Register for the period from year 2008 to 2014 of all MDCCs (Medical Diagnostic Consultative centers, registered in Varna - 9 in total. In the study are applied logical-mathematical methods (comparison, grouping, detail, graphical method; financial and accounting analysis (balance sheet analysis; analysis of absolute ratios for financial sustainability. Results: Upon analysis of the capital structure of MDCC's are studied the main absolute indicators characterizing the conditions for financial sustainability and the existence of financial risk regarding the solvency. A table represents the overall assessment of the degree of financial sustainability of the companies according to the type and structure of the fulfilled criteria. It was ascertained that for year 2014, DCC 3, 4, 5 and 8 have met all the conditions and according to them these hospitals have very high financial sustainability. DCC 7 has an average financial sustainability, DCC 1 and 2 are in a financial crisis and DCC 6 and 9 are facing bankruptcy. It must be emphasized that nearly half of the studied health care organizations (DCC 1, 2, 6 and 9 need urgent intervention by

Increasing Therapist Productivity: Using Lean Principles in the Rehabilitation Department of an Academic Medical Center.

Science.gov (United States)

Johnson, Diana; Snedeker, Kristie; Swoboda, Michael; Zalieckas, Cheryl; Dorsey, Rachel; Nohe, Cassandra; Smith, Paige; Roche, Renuka

The Department of Rehabilitation Services, within the University of Maryland Medical Center's 650-bed academic medical center, was experiencing difficulty in meeting productivity standards. Therapists in the outpatient division believed they were not spending enough time performing billable patient care activities. Therapists in the inpatient division had difficulty keeping pace with the volume of incoming referrals. Collectively, these issues caused dissatisfaction among referral sources and frustration among the staff within the rehabilitation department. The department undertook a phased approach to address these issues that included examining the evidence, using Lean process improvement principles, and employing transformational leadership strategies to drive improvements in productivity and efficiency. The lessons learned support the importance of having meaningful metrics appropriate for the patient population served, the use of Lean as an effective tool for improving productivity in rehabilitation departments, the impact of engaging staff at the grassroots level, and the importance of having commitment from leaders. The study findings have implications for not only rehabilitation and hospital leadership, but CEOs and managers of any business who need to eliminate waste or increase staff productivity.

DEVELOPMENT OF CLINICAL SCENARIO’S INFORMATION MODEL IN THE MEDICAL SIMULATION CENTER

Directory of Open Access Journals (Sweden)

I. V. Tolmachyov

2014-01-01

Full Text Available There is the big issue in medical education which is students don’t have enough skills. Often even with theoretical knowledge graduate medical students need to improve their skills by working with patients. Obviously it can be a risk for patients and takes quite long time. This situation could be changed with applying simulation technologies in medical education. Medical education with virtual simulators allows reducing the time of skills development and improving the quality of training. The aims of this work are developing informational model and creating clinical scenarios of emergency states in the Medical Simulation Center.Objectives:– to analyze the process of scenario conducting;– to create clinical scenarios of emergency states (anaphylactic shock, hypovolemic shock, obstructive shock with specialist’s help.The scenarios consist of sections such as main aim, skills, required mannequins, preparation of the mannequins, preparation of medical equipment and instruments for the scenario, preparation of special materials, scenario description, guide for operator, information for trainees.By analyzing the process of scenario conducting the key participants were defined who are operator, assistant, trainer, trainees. Also the main scenario stages were defined. Based on the stages diagram of variants of scenario conducting was designed.As an example there are fragments of scenario “Obstructive shock – a pulmonary embolism” in this article. Learn skills are cognitive, technical, social ones.Results. This paper presents an analysis of the clinical scenario conducting. Information model was developed which based on object-oriented decomposition. The model is the diagram of variants of scenario conducting. Scenario’s structure for emergency states was formulated. The scenarios are anaphylactic shock, hypovolemic shock, obstructive shock (pulmonary embolism, tension pneumothorax, pulmonary edema, hypertensive crisis, respiratory

Expansion of the consultation-liaison psychiatry paradigm at a university medical center: integration of diversified clinical and funding models.

Science.gov (United States)

Bourgeois, James A; Hilty, Donald M; Klein, Sally C; Koike, Alan K; Servis, Mark E; Hales, Robert E

2003-01-01

The perspective of the contemporary Consultation-Liason Service (CLS) psychiatrist is increasingly one of consultant to medical and surgical colleagues in models other than inpatient medical and surgical units. Simultaneously, the need for a clinically and educationally robust inpatient CLS persists despite funding pressures. The University of California, Davis Medical Center Department of Psychiatry has made use of creative organizational and financial models to accomplish the inpatient CLS clinical and educational missions in a fiscally responsible manner. In addition, the department has in recent years expanded the delivery of psychiatry consultation-liaison clinical and educational services to other models of care delivery, broadening the role and influence of the CLS. Several of the initiatives described in this paper parallel an overall evolution of the practice of consultation-liaison psychiatry in response to managed care influences and other systems pressures. This consultation-liaison paradigm expansion with diversified sources of funding support facilitates the development of consultation-liaison psychiatry along additional clinical, administrative, research, and educational dimensions. Other university medical centers may consider adaptation of some of the initiatives described here to their institutions.

75 FR 6401 - Medical Devices Regulated by the Center for Biologics Evaluation and Research; Availability of...

Science.gov (United States)

2010-02-09

... Biologics Evaluation and Research (HFM-17), Food and Drug Administration, suite 200N, 1401 Rockville Pike... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2009-M-0513] Medical Devices Regulated by the Center for Biologics Evaluation and Research; Availability of Summaries...

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...

Usual Primary Care Provider Characteristics of a Patient-Centered Medical Home and Mental Health Service Use.

Science.gov (United States)

Jones, Audrey L; Cochran, Susan D; Leibowitz, Arleen; Wells, Kenneth B; Kominski, Gerald; Mays, Vickie M

2015-12-01

The benefits of the patient-centered medical home (PCMH) over and above that of a usual source of medical care have yet to be determined, particularly for adults with mental health disorders. To examine qualities of a usual provider that align with PCMH goals of access, comprehensiveness, and patient-centered care, and to determine whether PCMH qualities in a usual provider are associated with the use of mental health services (MHS). Using national data from the Medical Expenditure Panel Survey, we conducted a lagged cross-sectional study of MHS use subsequent to participant reports of psychological distress and usual provider and practice characteristics. A total of 2,358 adults, aged 18-64 years, met the criteria for serious psychological distress and reported on their usual provider and practice characteristics. We defined "usual provider" as a primary care provider/practice, and "PCMH provider" as a usual provider that delivered accessible, comprehensive, patient-centered care as determined by patient self-reporting. The dependent variable, MHS, included self-reported mental health visits to a primary care provider or mental health specialist, counseling, and psychiatric medication treatment over a period of 1 year. Participants with a usual provider were significantly more likely than those with no usual provider to have experienced a primary care mental health visit (marginal effect [ME] = 8.5, 95 % CI = 3.2-13.8) and to have received psychiatric medication (ME = 15.5, 95 % CI = 9.4-21.5). Participants with a PCMH were additionally more likely than those with no usual provider to visit a mental health specialist (ME = 7.6, 95 % CI = 0.7-14.4) and receive mental health counseling (ME = 8.5, 95 % CI = 1.5-15.6). Among those who reported having had any type of mental health visit, participants with a PCMH were more likely to have received mental health counseling than those with only a usual provider (ME = 10.0, 95 % CI�

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.

Discharge against medical advice in a pediatric emergency center in the State of Qatar

Directory of Open Access Journals (Sweden)

Hala Abdulateef

2012-05-01

Full Text Available Objective: The objective of this study was to analyze cases that had left the Pediatric Emergency Center Al Sadd, Doha (PEC against medical advice, with the aim of developing policies to help reduce this occurrence. Methodology: All patients that were admitted to the main PEC observation room for treatment and/or investigation and subsequently left against medical advice from February 18, 2007 to June 18, 2007, were followed by a phone call, and a questionnaire, which was completed by the departmental patient representative. Results: 99,133 patients attended the facility during the study period. Of those, 106 left the facility against medical advice. Ninety-four guardians were successfully contacted. 90% of the cases were in children below 2 years of age. In 87% of the cases the mother was the main decision maker for leaving against medical advice. Domestic obligations were the leading cause of DAMA (discharge against medical advice, reported in 45% of the cases. Respondents reported that the consequences of DAMA were well explained by medical staff before they left the facility however, they had not met with the departmental patient representative during their stay. Conclusion:As the majority of DAMA cases occurred in infants, medical staff should address the concerns of this group early on in the course of treatment. Maintaining communication and providing support, in particular for mothers of higher risk groups may help to reduce the rate of DAMA cases.

Gatekeepers as Care Providers: The Care Work of Patient-centered Medical Home Clerical Staff.

Science.gov (United States)

Solimeo, Samantha L; Ono, Sarah S; Stewart, Kenda R; Lampman, Michelle A; Rosenthal, Gary E; Stewart, Greg L

2017-03-01

International implementation of the patient-centered medical home (PCMH) model for delivering primary care has dramatically increased in the last decade. A majority of research on PCMH's impact has emphasized the care provided by clinically trained staff. In this article, we report our ethnographic analysis of data collected from Department of Veterans Affairs staff implementing PACT, the VA version of PCMH. Teams were trained to use within-team delegation, largely accomplished through attention to clinical licensure, to differentiate staff in providing efficient, patient-centered care. In doing so, PACT may reinforce a clinically defined culture of care that countermands PCMH ideals. Such competing rubrics for care are brought into relief through a focus on the care work performed by clerks. Ethnographic analysis identifies clerks' care as a kind of emotional dirty work, signaling important areas for future anthropological study of the relationships among patient-centered care, stigma, and clinical authority. © 2016 by the American Anthropological Association.

Incorporating the principles of the patient- centered medical home into a student-run free clinic

Directory of Open Access Journals (Sweden)

Riddle MC

2014-09-01

Full Text Available Megan C Riddle,1,* Jiahui Lin,3,* Jonathan B Steinman,2 Joshua D Salvi,2 Margaret M Reynolds,3 Anne S Kastor,3,† Christina Harris,4 Carla Boutin-Foster3 1Department of Psychiatry and Behavioral Sciences, University of Washington, 2Weill Cornell/Rockefeller/Sloan-Kettering Tri-Institutional MD–PhD Program, 3Department of Internal Medicine, Weill Cornell Medical College, New York, NY, 4Department of Medicine, Division of General Internal Medicine, VA Greater Los Angeles Healthcare System, David Geffen School of Medicine at UCLA, LA, USA *These authors contributed equally to this work †Anne S Kastor passed away on July 5, 2013. Abstract: As the health care delivery landscape changes, medical schools must develop creative strategies for preparing future physicians to provide quality care in this new environment. Despite the growing prominence of the patient-centered medical home (PCMH as an effective model for health care delivery, few medical schools have integrated formal education on the PCMH into their curricula. Incorporating the PCMH model into medical school curricula is important to ensure that students have a comprehensive understanding of the different models of health care delivery and can operate effectively as physicians. The authors provide a detailed description of the process by which the Weill Cornell Community Clinic (WCCC, a student-run free clinic, has integrated PCMH principles into a service-learning initiative. The authors assessed patient demographics, diagnoses, and satisfaction along with student satisfaction. During the year after a PCMH model was adopted, 112 students and 19 licensed physicians volunteered their time. A review of the 174 patients seen from July 2011 to June 2012 found that the most common medical reasons for visits included management of hypertension, hyperlipidemia, diabetes, gastrointestinal conditions, arthritis, anxiety, and depression. During the year after the adoption of the PCMH model, 87

Statement of the American Psychological Association in response to the "joint principles: integrating behavioral health care into the patient-centered medical home".

Science.gov (United States)

Anderson, Norman B; Belar, Cynthia D; Cubic, Barbara A; Garrison, Ellen G; Johnson, Suzanne Bennett; Kaslow, Nadine J

2014-06-01

Comments on the article "Joint principles: Integrating behavioral health care into the patient-centered medical home" (see record 2014-24217-011), presented by the Working Party Group on Integrated Behavioral Healthcare. The American Psychological Association (APA) shares concerns about the lack of reference to behavioral health care in the original 2007 Joint Principles of the Patient-Centered Medical Home for which this new document is intended to supplement but not replace. The decision to support the supplemental Joint Principles was not an easy one for APA, as there is one area of significant concern. That concern is related to the use of the term "physician-directed medical practice"

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.

Using a Lego-based communications simulation to introduce medical students to patient-centered interviewing.

Science.gov (United States)

Harding, S R; D'Eon, M F

2001-01-01

Teaching patient-centered interviewing skills to medical students can be challenging. We have observed that 1st-year medical students, in particular, do not feel free to concentrate on the interviewing skills because they are preoccupied with complicated technical medical knowledge. The Lego simulation we use with our 1st-year students as part of a professional-skills course overcomes that difficulty. The Lego activity is a role play analogous to a doctor-patient interview that uses identical sets of Legos for the "doctor" and for the "patients" and a small construction that represents a patient history. With a simple questionnaire, data were collected from students at different points during instruction. Results indicate that the Lego activity was very effective in helping students learn the importance of open-ended questioning. It also was rated as highly as the very dynamic interactive part of the instructional session. The effectiveness of the Lego activity may be due to the properties of analogies.

Set up and operation for medical radiation exposure quality control system of health promotion center

Energy Technology Data Exchange (ETDEWEB)

Kim, Jung Su; Kim, Jung Min [Korea University,Seoul (Korea, Republic of); Jung, Hae Kyoung [Dept. of Diagnostic Radiology, CHA Bundang Medical Center, CHA University, Sungnam (Korea, Republic of)

2016-03-15

In this study, standard model of medical radiation dosage quality control system will be suggested and the useful of this system in clinical field will be reviewed. Radiation dosage information of modalities are gathered from digital imaging and communications in medicine(DICOM) standard data(such as DICOM dose SR and DICOM header) and stored in database. One CT scan, two digital radiography modalities and two mammography modalities in one health promotion center in Seoul are used to derive clinical data for one month. After 1 months research with 703 CT scans, the study shows CT 357.9 mGy·cm in abdomen and pelvic CT, 572.4 mGy·cm in brain without CT, 55.9 mGy·cm in calcium score/heart CT, screening CT at 54 mGy·cm in chest screening CT(low dose screening CT scan), 284.99 mGy·cm in C-spine CT and 341.85 mGy·cm in L-spine CT as health promotion center reference level of each exam. And with 1955 digital radiography cases, it shows 274.0 mGy·cm{sup 2} and for mammography 6.09 mGy is shown based on 536 cases. The use of medical radiation shall comply with the principles of justification and optimization. This quality management of medical radiation exposure must be performed in order to follow the principle. And the procedure to reduce the radiation exposure of patients and staff can be achieved through this. The results of this study can be applied as a useful tool to perform the quality control of medical radiation exposure.

Set up and operation for medical radiation exposure quality control system of health promotion center

International Nuclear Information System (INIS)

Kim, Jung Su; Kim, Jung Min; Jung, Hae Kyoung

2016-01-01

In this study, standard model of medical radiation dosage quality control system will be suggested and the useful of this system in clinical field will be reviewed. Radiation dosage information of modalities are gathered from digital imaging and communications in medicine(DICOM) standard data(such as DICOM dose SR and DICOM header) and stored in database. One CT scan, two digital radiography modalities and two mammography modalities in one health promotion center in Seoul are used to derive clinical data for one month. After 1 months research with 703 CT scans, the study shows CT 357.9 mGy·cm in abdomen and pelvic CT, 572.4 mGy·cm in brain without CT, 55.9 mGy·cm in calcium score/heart CT, screening CT at 54 mGy·cm in chest screening CT(low dose screening CT scan), 284.99 mGy·cm in C-spine CT and 341.85 mGy·cm in L-spine CT as health promotion center reference level of each exam. And with 1955 digital radiography cases, it shows 274.0 mGy·cm"2 and for mammography 6.09 mGy is shown based on 536 cases. The use of medical radiation shall comply with the principles of justification and optimization. This quality management of medical radiation exposure must be performed in order to follow the principle. And the procedure to reduce the radiation exposure of patients and staff can be achieved through this. The results of this study can be applied as a useful tool to perform the quality control of medical radiation exposure

Medical and Rehabilitation Centers in Children’s Houses — New Opportunities for Treatment and Rehabilitation of Children

Directory of Open Access Journals (Sweden)

I.V. Balychevtseva

2014-05-01

Full Text Available The article presents data on the opening of medical and rehabilitations centers at the children’s houses of Donetsk region. Approaches, terms, possibilities and methods of rehabilitations used during the treatment and restoration of disabled children are provided.

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.

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…

OPERATION OF THE CALL CENTER AT A HIGH-TECHNOLOGY PEDIATRIC MEDICAL INSTITUTION (WITH COMMENTARY BY A.A. MODESTOV

Directory of Open Access Journals (Sweden)

I. N. Chernomurov

2014-01-01

Full Text Available Introduction of modern information systems is one of the important objectives of medicine, as it contributes to higher availability of medical services for the population. Public relations of medical organizations involve websites of these organizations, outdoor advertising and other information sources. However, obtainment of competent inquiry answers by telephone remains a problem. People often choose between organizations depending on quality of the obtained information. Apparently, the issue can be resolved by establishing call centers that are not merely communications centers, but are staffed with competent trained personnel, who support the organization’s interaction with patients (or the legal representatives thereof. The article presents the authors’ experience of establishing a call center dedicated to the organization’s public image development, as well as higher demand of the available services and promotion thereof. The fulfilled modernization resulted in a sharp increase in the amount of calls received (1,500‑1,600 within the working hours; 900 – before modernization and reduction in the number of complaints of busy line. 

Humanities mini-course curricula for midcareer health professionals at the Penn State Milton S. Hershey Medical Center.

Science.gov (United States)

Myers, Kimberly R; George, Daniel R

2012-08-01

The field of medical humanities has traditionally focused on medical students and, more recently, on premedical undergraduates. Comparatively little formal humanities pedagogy has been dedicated to midcareer health professionals. To address this lack, the Department of Humanities at the Pennsylvania State University College of Medicine and the Milton S. Hershey Medical Center designed eight annual humanities mini-courses for faculty and staff throughout the college and medical center.These mini-courses fell into four categories: reading, reflection, and discussion; creative expression; technology; and ethics. They were geared toward midcareer health professionals who were seeking new intellectual and creative stimulation and variety in daily routine. They also provided humanities faculty the opportunity to devote attention to topics that capitalize on their professional training and that interest them personally.Participants indicated a high degree of satisfaction with the mini-courses for four principal reasons: (1) learning the tools and methodologies of a new discipline or domain other than biomedicine, (2) using their minds and training in uncustomary ways, (3) forming new alliances with colleagues (which served to lessen the sense of professional isolation), and (4) enjoying a respite from the stressful flow of the workday. Humanities faculty facilitators provided more mixed responses but agreed that conducting the mini-courses had been a positive overall experience.Although this article provides a foundational framework for the development of a humanities mini-course series, the authors encourage others to replicate these curricula in other medical settings as an important step toward a robust pedagogy designed for midcareer health care professionals.

The patient-centered medical home in oncology: from concept to reality.

Science.gov (United States)

Page, Ray D; Newcomer, Lee N; Sprandio, John D; McAneny, Barbara L

2015-01-01

In recent years, the cost of providing quality cancer care has been subject to an epic escalation causing concerns on the verge of a health care crisis. Innovative patient-management models in oncology based on patient-centered medical home (PCMH) principles, coupled with alternative payments to traditional fee for service (FFS), such as bundled and episodes payment are now showing evidence of effectiveness. These efforts have the potential to bend the cost curve while also improving quality of care and patient satisfaction. However, going forward with FFS alternatives, there are several performance-based payment options with an array of financial risks and rewards. Most novel payment options convey a greater financial risk and accountability on the provider. Therefore, the oncology medical home (OMH) can be a way to mitigate some financial risks by sharing savings with the payer through better global care of the patient, proactively preventing complications, emergency department (ED) visits, and hospitalizations. However, much of the medical home infrastructure that is required to reduced total costs of cancer care comes as an added expense to the provider. As best-of-practice quality standards are being elucidated and refined, we are now at a juncture where payers, providers, policymakers, and other stakeholders should work in concert to expand and implement the OMH framework into the variety of oncology practice environments to better equip them to assimilate into the new payment reform configurations of the future.

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...

Utilization of a Marketing Strategy at Naval Regional Medical Center Great Lakes, Great Lakes, Illinois

Science.gov (United States)

1983-06-01

22 Analysis of the Mare.....................22 Development of the Marketing Mix .. .......... 29 A Marketing Mix --Recommendations...problem. Marketing strategy, marketing mix and ultimately the marketing orientation will allow hospitals to persevere and possibly thrive in a somewhat...market are currently being met at Naval Regional Medical Center Great Lakes. The fourth objective is to demonstrate an appropriate marketing mix for

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…

Disruptive innovation in academic medical centers: balancing accountable and academic care.

Science.gov (United States)

Stein, Daniel; Chen, Christopher; Ackerly, D Clay

2015-05-01

Numerous academic medicine leaders have argued that academic referral centers must prepare for the growing importance of accountability-driven payment models by adopting population health initiatives. Although this shift has merit, execution of this strategy will prove significantly more problematic than most observers have appreciated. The authors describe how successful implementation of an accountable care health strategy within a referral academic medical center (AMC) requires navigating a critical tension: The academic referral business model, driven by tertiary-level care, is fundamentally in conflict with population health. Referral AMCs that create successful value-driven population health systems within their organizations will in effect disrupt their own existing tertiary care businesses. The theory of disruptive innovation suggests that balancing the push and pull of academic and accountable care within a single organization is achievable. However, it will require significant shifts in resource allocation and changes in management structure to enable AMCs to make the inherent difficult choices and trade-offs that will ensue. On the basis of the theories of disruptive innovation, the authors present recommendations for how academic health systems can successfully navigate these issues as they transition toward accountability-driven care.

Mandibular Fracture Patterns at a Medical Center in Central Taiwan: A 3-Year Epidemiological Review.

Science.gov (United States)

Lin, Fu-Yu; Wu, Chao-I; Cheng, Hsu-Tang

2017-12-01

Mandibular fractures constitute a major portion of maxillofacial trauma and may lead to considerable functional and aesthetic sequelae if treatment is inadequate or delayed. An epidemiology study on mandibular fractures may guide the preventive efforts of the Taiwan public health care system. Therefore, a retrospective review was conducted at a medical center in central Taiwan to evaluate the current mandibular fracture epidemiology.The medical records and digitized radiographs of 198 patients who received treatment for mandibular fractures during a 3-year period (from October 2010 to September 2013) at a medical center in central Taiwan were reviewed to obtain demographic and injury data.The average age was 29.4 years (3-82 years). Patients aged 21 to 30 years sustained the most mandibular fractures (62 patients, 31.3%). The overall sex distribution (male to female) ratio was 1.8. Motor-vehicle accidents (MVAs) were the most common mechanism of injury (162 patients, 82%), and scooter and motorcycle riders wearing partial-coverage helmets constituted the majority of patients. A chart review identified 198 patients with 335 mandibular fractures; 113 patients (57.1%) had multiple mandibular fractures. The most common fracture sites were the symphysis and parasymphysis regions (38.9%), followed by the condyle (26.0%), angle (14.3%), body (14.3%), and ramus (6.6%).MVAs are the major cause of mandibular fractures in central Taiwan, and patients aged Taiwan. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

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...

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.

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)

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.

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

Effects of internal marketing on nurse job satisfaction and organizational commitment: example of medical centers in Southern Taiwan.

Science.gov (United States)

Chang, Ching-Sheng; Chang, Hsin-Hsin

2007-12-01

As nurses typically represent the largest percentage of employees at medical centers, their role in medical care is exceptionally important and becoming more so over time. The quality and functions of nurses impact greatly on medical care quality. The concept of internal marketing, with origins in the field of market research, argues that enterprises should value and respect their employees by treating them as internal customers. Such a marketing concept challenges traditional marketing methods, which focus on serving external customers only. The main objective of internal marketing is to help internal customers (employees) gain greater job satisfaction, which should promote job performance and facilitate the organization accomplishing its ultimate business objectives. A question in the medical service industry is whether internal marketing can similarly increase the job satisfaction of nurses and enhance their commitment to the organization. This study aimed to explore the relational model of nurse perceptions related to internal marketing, job satisfaction, and organizational commitment by choosing nurses from two medical centers in Southern Taiwan as research subjects. Of 450 questionnaire distributed, 300 valid questionnaires were returned, giving a response rate of 66.7%. After conducting statistical analysis and estimation using structural equation modeling, findings included: (1) job satisfaction has positive effects on organizational commitment; (2) nurse perceptions of internal marketing have positive effects on job satisfaction; and (3) nurse perceptions of internal marketing have positive effects on organizational commitment.

A model for training medical student innovators: the Harvard Medical School Center for Primary Care Abundance Agents of Change program.

Science.gov (United States)

Duong, David B; Sullivan, Erin E; Minter-Jordan, Myechia; Giesen, Lindsay; Ellner, Andrew L

2016-01-01

In 2013, the Harvard Medical School Center for Primary Care established the Abundance Agents of Change (AoC) program to promote interprofessional learning and innovation, increase partnership between 15 academic and community health centers (CHCs) in Boston's most under-served communities, and increase medical student interest in primary care careers. The AoC is modeled in the form of a 'grants challenge', offering $20,000 to interprofessional student teams to develop an innovative solution that addresses a healthcare delivery need identified by CHCs. The program's initial two years were characterized by a four-stage process which included working with CHCs and crafting a request for proposals, forming interprofessional 20 student teams comprising students from across and outside of Harvard University, training students using a systems-based innovation curriculum, and performing program evaluation. Our evaluation data from cohorts 1 and 2 of the AoC program demonstrate that we succeeded in training students as innovators and members of interprofessional teams. We also learned valuable lessons regarding creating better alignment with CHC priorities, extending the program cycle from 12 to 18 months, and changing the way funding is disbursed to 25 students, which will be incorporated in later versions of the program. Based on our experience and evaluation data, we believe that this program is a replicable way to train students as innovators and members of interprofessional teams to address the current complex healthcare environment.

Improving access to care through the patient-centered medical home.

Science.gov (United States)

North, Stephen W; McElligot, James; Douglas, Gaye; Martin, Amanda

2014-02-01

School-based health centers (SBHCs) serve an essential role in providing access to high-quality, comprehensive care to underserved children and adolescents in more than 2,000 schools across the United States. SBHCs are an essential component of the health care safety net, and their role in the patient-centered medical home (PCMH) continues to evolve as both collaborating partners and, when fully functioning, independent PCMHs. The American Academy of Pediatrics (AAP) supports the use of SBHCs, citing the proven benefits and exciting potential as justification, but also offers caution and recommends a focus on communication within the community. Traditional "brick and mortar" SBHCs are more likely to be located in urban communities (54.2% urban versus 18.0% rural) and be in schools with more students, allowing for a greater return on investment. Current SBHCs are located in schools with an average population of 997 students. The need for a large school population to help an SBHC approach financial viability excludes children in rural communities who are more likely to attend a school with fewer than 500 students, be poor, and have difficulty accessing health care.2 The expansion of telehealth technologies allows the creation of solutions to decrease geographic barriers that have limited the growth of SBHCs in rural communities. Telehealth school-based health centers (tSBHCs) that exclusively provide services through telemedicine are operating and developing in communities where geographic barriers and financial challenges have prevented the establishment of brick and mortar SBHCs. TSBHCs are beginning to increase the number and variety of services they provide through the use of telehealth to include behavioral health, nutrition services, and pediatric specialists. Understanding the role of tSBHCs in the growth of the PCMH model is critical for using these tools to continue to improve child and adolescent health. Copyright 2014, SLACK Incorporated.

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

Science.gov (United States)

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.

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

A nationwide survey of patient centered medical home demonstration projects.

Science.gov (United States)

Bitton, Asaf; Martin, Carina; Landon, Bruce E

2010-06-01

The patient centered medical home has received considerable attention as a potential way to improve primary care quality and limit cost growth. Little information exists that systematically compares PCMH pilot projects across the country. Cross-sectional key-informant interviews. Leaders from existing PCMH demonstration projects with external payment reform. We used a semi-structured interview tool with the following domains: project history, organization and participants, practice requirements and selection process, medical home recognition, payment structure, practice transformation, and evaluation design. A total of 26 demonstrations in 18 states were interviewed. Current demonstrations include over 14,000 physicians caring for nearly 5 million patients. A majority of demonstrations are single payer, and most utilize a three component payment model (traditional fee for service, per person per month fixed payments, and bonus performance payments). The median incremental revenue per physician per year was $22,834 (range $720 to $91,146). Two major practice transformation models were identified--consultative and implementation of the chronic care model. A majority of demonstrations did not have well-developed evaluation plans. Current PCMH demonstration projects with external payment reform include large numbers of patients and physicians as well as a wide spectrum of implementation models. Key questions exist around the adequacy of current payment mechanisms and evaluation plans as public and policy interest in the PCMH model grows.

The outcome of the first 1000 cases of LASIK performed at the king Hussein Medical Center

Energy Technology Data Exchange (ETDEWEB)

Abdallat, W [King Hussein Medical Centre, Amman (Jordan). Dept. of Ophthalmology

2011-07-01

The current study evaluates the refractive and visual outcome of patients who had laser in situ keratomileusis (LASIK) performed at the refractive center at King Hussein Medical centre in Jordan. The predictability of LASIK surgery in terms of refractive and visual outcome results is very good with mild regression in refraction over time. (author).

The outcome of the first 1000 cases of LASIK performed at the king Hussein Medical Center

International Nuclear Information System (INIS)

Abdallat, W

2011-01-01

The current study evaluates the refractive and visual outcome of patients who had laser in situ keratomileusis (LASIK) performed at the refractive center at King Hussein Medical centre in Jordan. The predictability of LASIK surgery in terms of refractive and visual outcome results is very good with mild regression in refraction over time. (author).

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.

Patient-centered medical home transformation with payment reform: patient experience outcomes.

Science.gov (United States)

Heyworth, Leonie; Bitton, Asaf; Lipsitz, Stuart R; Schilling, Thad; Schiff, Gordon D; Bates, David W; Simon, Steven R

2014-01-01

To examine changes in patient experience across key domains of the patient-centered medical home (PCMH) following practice transformation with Lean quality improvement methodology inclusive of payment reform. Pre-intervention/post-intervention analysis of intervention with a comparison group, a quasi-experimental design. We surveyed patients following office visits at the intervention (n = 2502) and control (n = 1622) practices during the 15-month period before and 14-month period after PCMH Lean transformation (April-October 2009). We measured and compared pre-intervention and post-intervention levels of patient satisfaction and other indicators of patient-centered care. Propensity weights adjusted for potential case-mix differences in intervention and control groups; propensity-adjusted proportions accounted for physician-level clustering. More intervention patients were very satisfied with their care after the PCMH Lean intervention (68%) compared with pre-intervention (62%). Among control patients, there was no corresponding increase in satisfaction (63% very satisfied pre-intervention vs 64% very satisfied post-intervention). This comparison resulted in a statistical trend (P = .10) toward greater overall satisfaction attributable to the intervention. Post-intervention, patients in the intervention practice consistently rated indicators of patient-centered care higher than patients in the control practice, particularly in the personal physician and communication domain. In this domain, intervention patients reported superior provider explanations, time spent, provider concern, and follow-up instructions compared with control participants, whereas control group ratings fell in the post-intervention period (P for difference Lean enhancement with payment reform, patient experience was sustained or improved across key PCMH domains.

The role of advocacy in occasioning community and organizational change in a medical-legal partnership.

Science.gov (United States)

Anderson-Carpenter, Kaston D; Collie-Akers, Vicki; Colvin, Jeffrey D; Cronin, Katie

2013-01-01

Health disparities among low-income individuals remain a significant problem. A number of social determinants are associated with adverse health outcomes. Medical-legal partnerships address legal concerns of low-income individuals to improve health and wellness in adults and children. The Medical-Legal Partnership at Legal Aid of Western Missouri provides free direct legal services for patients with legal concerns affecting health. There is limited evidence regarding the association between advocacy-related efforts and changes within both the medical-legal partnership structure and in health-care facilities. Three health-care organizations in Kansas City, MO participated in implementing the medical-legal partnership model between 2007 and 2010. Advocacy efforts conducted by key medical-legal partnership personnel were strongly associated with changes in health-care organizations and within the medical-legal partnership structure. This study extends the current evidence base by examining the types of advocacy efforts required to bring about community and organizational changes.

Introducing quality assurance and medical audit into the UCSF medical center curriculum.

Science.gov (United States)

Barbaccia, J C

1976-05-01

The experience gained by a medical school faculty in developing and piloting a course for undergraduate medical students in medical care evaluation led to a similar effort for house staff. It is recognized that if the profession is to fulfill the demand by society for social accountability in the use of resources for health care, medical care assessment and quality assurance mechanisms must become an intimate part of the clinical experience of medical students and house officers. Teaching these subjects requires a theoretical framework; introduction of content and skills appropriate to the level of the student and continuation of progressively more advanced training throughout medical education; use of assessment and quality assurance techniques by clinician-teachers themselves to provide models for the student; and continued evolution of pedagogic approach and course content based on developments in the area.

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).

Fall Injuries and Related Factors of Elderly Patients at a Medical Center in Taiwan

OpenAIRE

Tsai, Li-Yun; Tsay, Shiow-Luan; Hsieh, Ruey-Kuen; Yu, Shu; Tsai, Jung-Mei; Chien, Hui-Hsien; Liu, Shu-Jung

2014-01-01

Background: Elderly patients have a high incidence of falls and injuries in hospitals due to various reasons. The aims of this study were to explore the characteristics and factors associated with fall injuries among elderly patients. Methods: A retrospective survey study was conducted. Data were retrieved from the patient safety reporting system of a medical center in Taiwan query for patient fall incidents of elderly patients aged 65 years or older between 2010 and 2012. Statistics were ...

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

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.

"Bacterial infections in visceral leishmaniasis in Children’s Medical Center 1966-2000 "

Directory of Open Access Journals (Sweden)

"Tabatabaei P "

2002-07-01

Full Text Available Background: Bacterial infections are seen in patients with visceral leishmaniasis. This study was conducted to determine the incidence of such infections and the more common infections agents. Materials and Methods: During the 15-years period in a prospective study from 1986 to 2000, 123 patients with visceral leishmaniasis were studied in the Children Medical Center. Results: From all the cases, 41 (33 percent patients had Also bacterial infections. Respiratory tract, urinary system, Middle ear were the most common sites of infection. Conclusion: When bacterial Infection is suspected in these patients, empiric antibiotic therapy should be started immediately after appropriate diagnostic procedures are taken.

Establishment of exposure dose assessment laboratory in National Radiation Emergency Medical Center (NREMC)

Energy Technology Data Exchange (ETDEWEB)

Yoo, Jae Ryong; Ha, Wi Ho; Yoon, Seok Won; Han, Eun Ae; Lee, Seung Sook [Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of)

2011-10-15

As unclear industry grown, 432 of the nuclear power plants are operating and 52 of NPPs are under construction currently. Increasing use of radiation or radioisotopes in the field of industry, medical purpose and research such as non-destructive examination, computed tomography and x-ray, etc. constantly. With use of nuclear or radiation has incidence possibility for example the Fukushima NPP incident, the Goiania accident and the Chernobyl Nuclear accident. Also the risk of terror by radioactive material such as Radiological Dispersal Device(RDD) etc. In Korea, since the 'Law on protection of nuclear facilities and countermeasure for radioactive preparedness was enacted in 2003, the Korean institute of Radiological and Medical Sciences(KIRAMS) was established for the radiation emergency medical response in radiological disaster due to nuclear accident, radioactive terror and so on. Especially National Radiation Emergency Medical Center(NREMC) has the duty that is protect citizens from nuclear, radiological accidents or radiological terrors through the emergency medical preparedness. The NREMC was established by the 39-article law on physical protection of nuclear material and facilities and measures for radiological emergencies. Dose assessment or contamination survey should be performed which provide the radiological information for medical response. For this reason, the NREMC establish and re-organized dose assessment system based on the existing dose assessment system of the NREMC recently. The exposure dose could be measured by physical and biological method. With these two methods, we can have conservative dose assessment result. Therefore the NREMC established the exposure dose assessment laboratory which was re-organized laboratory space and introduced specialized equipment for dose assessment. This paper will report the establishment and operation of exposure dose assessment laboratory for radiological emergency response and discuss how to enhance

78 FR 46926 - Procurement List Additions and Deletions

Science.gov (United States)

2013-08-02

... Oklahoma City Air Logistics Center (FA8126 AFSC PZIMB), Tinker Air Force Base, OK. Services Service Type..., Inc., Sedalia, MO Contracting Activity: Dept of the Army, W071 ENDIST Kansas City, Kansas City, MO... Contracting Activity: General Services Administration, Kansas City, MO Scarf, Headover NSN: 8440-01-291-5451...

Impact of type 1 diabetes mellitus on the family is reduced with the medical home, care coordination, and family-centered care.

Science.gov (United States)

Katz, Michelle L; Laffel, Lori M; Perrin, James M; Kuhlthau, Karen

2012-05-01

To examine whether the medical home, care coordination, or family-centered care was associated with less impact of type 1 diabetes mellitus (T1D) on families' work, finances, time, and school attendance. With the 2005 to 2006 National Survey of Children with Special Health Care Needs, we compared impact in children with T1D (n = 583) with that in children with other special health care needs (n = 39 944) and children without special health care needs (n = 4945). We modeled the associations of the medical home, care coordination, and family-centered care with family impact in T1D. Seventy-five percent of families of children with T1D reported a major impact compared with 45% of families of children with special health care needs (P families of children without special health care needs (P families of children with T1D, 35% reported restricting work, 38% reported financial impact, 41% reported medical expenses >$1000/year, 24% reported spending ≥11 hours/week caring or coordination care, and 20% reported ≥11 school absences/year. The medical home, care coordination, and family-centered care were associated with less work and financial impact. In childhood T1D, most families experience major impact. Better systems of health care delivery may help families reduce some of this impact. Copyright © 2012 Mosby, Inc. All rights reserved.

Commercial Crew Medical Ops

Science.gov (United States)

Heinbaugh, Randall; Cole, Richard

2016-01-01

Provide commercial partners with: center insight into NASA spaceflight medical experience center; information relative to both nominal and emergency care of the astronaut crew at landing site center; a basis for developing and sharing expertise in space medical factors associated with returning crew.

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.

A Three-Year Experience of Medical Thoracoscopy at A Tertiary Care Center of Himalayan Region

Directory of Open Access Journals (Sweden)

Rakhee Sodhi

2016-03-01

Full Text Available Introduction: Medical thoracoscopy is a minimally invasive procedure for diagnosing and treating pleural diseases. Despite its proven role in diagnostic and therapeutic purposes, it is infrequently used, which could be because of cost of equipment and lack of training. We analyzed our initial 3 years record of thoracoscopy at Himalayan Institute of Medical Sciences, a tertiary care center in Himalayan region of north India. Materials and Methods: This cross-sectional study was to analyze our experience of medical thoracoscopy which was started in Jan 2011 at our center. All patients who underwent thoracoscopy during the period between Jan 2011 to Dec 2013 were included in the study. Thoracoscopy was performed for diagnosis of undiagnosed pleural effusions. Clinical, radiological, cytological & histopathological data of the patients were collected prospectively and analysed. Results: The diagnostic yield for a pleuroscopic pleural biopsy in our study was 87.23% (41/47. Malignancy was diagnosed histopathologically in 70.2% (33/47 patients (both primary & metastatic pleural carcinoma and tuberculosis in 10.6% (5/47. There was no mortality related to procedure. Only three patients had minor complications like subcutaneous emphysema which was mild and resolved by second post-procedure day. Pain at intercostal drain site was observed in some patients. Conclusion: Thoracoscopy is an easy outpatient procedure and an excellent diagnostic tool for pleural effusion of uncertain etiology. It has low complication rate even in settings where the procedure is just started. It should be included in the armamentarium of tools for management of pleural effusion.

Financial impact of tertiary care in an academic medical center.

Science.gov (United States)

Huber, T S; Carlton, L M; O'Hern, D G; Hardt, N S; Keith Ozaki, C; Flynn, T C; Seeger, J M

2000-06-01

To analyze the financial impact of three complex vascular surgical procedures to both an academic hospital and a department of surgery and to examine the potential impact of decreased reimbursements. The cost of providing tertiary care has been implicated as one potential cause of the financial difficulties affecting academic medical centers. Patients undergoing revascularization for chronic mesenteric ischemia, elective thoracoabdominal aortic aneurysm repair, and treatment of infected aortic grafts at the University of Florida were compared with those undergoing elective infrarenal aortic reconstruction and carotid endarterectomy. Hospital costs and profit summaries were obtained from the Clinical Resource Management Office. Departmental costs and profit summary were estimated based on the procedural relative value units (RVUs), the average clinical cost per RVU ($33.12), surgeon charges, and the collection rate for the vascular surgery division (30.2%) obtained from the Faculty Group Practice. Surgeon work effort was analyzed using the procedural work RVUs and the estimated total care time. The analyses were performed for all payors and the subset of Medicare patients, and the potential impact of a 15% reduction in hospital and physician reimbursement was analyzed. Net hospital income was positive for all but one of the tertiary care procedures, but net losses were sustained by the hospital for the mesenteric ischemia and infected aortic graft groups among the Medicare patients. In contrast, the estimated reimbursement to the department of surgery for all payors was insufficient to offset the clinical cost of providing the RVUs for all procedures, and the estimated losses were greater for the Medicare patients alone. The surgeon work effort was dramatically higher for the tertiary care procedures, whereas the reimbursement per work effort was lower. A 15% reduction in reimbursement would result in an estimated net loss to the hospital for each of the tertiary

Photo-medical valley. 'Photo medical research center'

International Nuclear Information System (INIS)

Kawanishi, Shunichi; Daido, Hiroyuki; Tajima, Toshiki

2008-01-01

To develop a much more compact cancer diagnosis and therapeutic instrument using high intensity laser technology, Japan Atomic Energy Agency (JAEA) has successfully proposed this novel effort to the Ministry of Education, Culture, Sports, Science and Technology (MEXT) program as the creation of a 'photo-medical industrial valley' base in 2007 fiscal year. In this report, a new laser techniques to drive controlled ion beams is described. It is very important approach to realize a laser-driven ion accelerator. (author)

Patient experience in a coordinated care model featuring diabetes self-management education integrated into the patient-centered medical home.

Science.gov (United States)

Janiszewski, Debra; O'Brian, Catherine A; Lipman, Ruth D

2015-08-01

The purpose of this study is to gain insight about patient experience of diabetes self-management education in a patient-centered medical home. Six focus groups consisting of 37 people with diabetes, diverse in race and ethnicity, were conducted at 3 sites. Participants described their experience in the program and their challenges in diabetes self-management; they also suggested services to meet their diabetes care needs. The most common theme was ongoing concerns about care and support. There was much discussion about the value of the support provided by health navigators integrated in the diabetes health care team. Frequent concerns expressed by participants centered on personal challenges in engaging in healthy lifestyle behaviors. Ongoing programmatic support of self-management goals was widely valued. Individuals who received health care in a patient-centered medical home and could participate in diabetes self-management education with integrated support valued both activities. The qualitative results from this study suggest need for more formalized exploration of effective means to meet the ongoing support needs of people with diabetes. © 2015 The Author(s).

Performance test of electron cyclotron resonance ion sources for the Hyogo Ion Beam Medical Center

Science.gov (United States)

Sawada, K.; Sawada, J.; Sakata, T.; Uno, K.; Okanishi, K.; Harada, H.; Itano, A.; Higashi, A.; Akagi, T.; Yamada, S.; Noda, K.; Torikoshi, M.; Kitagawa, A.

2000-02-01

Two electron cyclotron resonance (ECR) ion sources were manufactured for the accelerator facility at the Hyogo Ion Beam Medical Center. H2+, He2+, and C4+ were chosen as the accelerating ions because they have the highest charge to mass ratio among ion states which satisfy the required intensity and quality. The sources have the same structure as the 10 GHz ECR source at the Heavy Ion Medical Accelerator in Chiba except for a few improvements in the magnetic structure. Their performance was investigated at the Sumitomo Heavy Industries factory before shipment. The maximum intensity was 1500 μA for H2+, 1320 μA for He2+, and 580 μA for C4+ at the end of the ion source beam transport line. These are several times higher than required. Sufficient performance was also observed in the flatness and long-term stability of the pulsed beams. These test results satisfy the requirements for medical use.

Characterizing complexity in socio-technical systems: a case study of a SAMU Medical Regulation Center.

Science.gov (United States)

Righi, Angela Weber; Wachs, Priscila; Saurin, Tarcísio Abreu

2012-01-01

Complexity theory has been adopted by a number of studies as a benchmark to investigate the performance of socio-technical systems, especially those that are characterized by relevant cognitive work. However, there is little guidance on how to assess, systematically, the extent to which a system is complex. The main objective of this study is to carry out a systematic analysis of a SAMU (Mobile Emergency Medical Service) Medical Regulation Center in Brazil, based on the core characteristics of complex systems presented by previous studies. The assessment was based on direct observations and nine interviews: three of them with regulator of emergencies medical doctor, three with radio operators and three with telephone attendants. The results indicated that, to a great extent, the core characteristics of complexity are magnified) due to basic shortcomings in the design of the work system. Thus, some recommendations are put forward with a view to reducing unnecessary complexity that hinders the performance of the socio-technical system.

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