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Sample records for large navy hospital

  1. Navy Hospital ships in history

    Directory of Open Access Journals (Sweden)

    Sougat Ray

    2017-01-01

    Full Text Available Hospital ships are operated by the Naval forces in or near war zones to provide medical assistance to the wounded personnel of all nationalities and not be used for any military purpose. Hospital ships possibly existed in ancient times and the Athenian Navy had a ship named Therapia. However, it was only during the 17th century that it became a common practice for the naval squadrons to be accompanied by large ships with the facilities of carrying the wounded after each engagement. In 1860, the steamships HMS Melbourne and HMS Mauritius were equipped with genuine medical facilities. They were manned by the Medical Staff Corps and provided services to the British expedition to China. During the World War I and World War II, passenger ships were converted for use as hospital ships and were started to be used on a massive scale. RMS Aquitania and HMHS Britannic were two famous examples of hospital ships used extensively. Modern US hospital ships USNS Mercy and USNS Comfort are operated by Military Sealift Command of the US Navy. Their primary mission is to provide emergency on-site care for US combatant forces deployed in war or other operations.

  2. Predicting Attrition, Performance, Reenlistment, and Hospitalizations from the Smoking History of Women Prior to Entering the Navy

    National Research Council Canada - National Science Library

    Conway, Terry L

    2006-01-01

    This study of women sailors examined whether tobacco use prior to entering the Navy predicted subsequent career outcomes related to length of service, early attrition, misconduct, and hospitalizations...

  3. Forecasting Advancement Rates to Petty Officer Third Class for U.S. Navy Hospital Corpsmen

    Science.gov (United States)

    2014-06-01

    Lastly, I would like to thank Dr. Tanja Blackstone and David Cashbaugh of Navy Personnel, Research, Studies, and Technology. Your guidance and...Corps, rendering emergency medical treatment to include initial treatment in a combat environment . Qualified Hospital Corpsmen may be assigned the...Retrieved from http://www.navy.mil/submit/display.asp?story_id=66091. R Development Core Team. (2013). R: A language and environment for statistical

  4. NaviCell: a web-based environment for navigation, curation and maintenance of large molecular interaction maps.

    Science.gov (United States)

    Kuperstein, Inna; Cohen, David P A; Pook, Stuart; Viara, Eric; Calzone, Laurence; Barillot, Emmanuel; Zinovyev, Andrei

    2013-10-07

    Molecular biology knowledge can be formalized and systematically represented in a computer-readable form as a comprehensive map of molecular interactions. There exist an increasing number of maps of molecular interactions containing detailed and step-wise description of various cell mechanisms. It is difficult to explore these large maps, to organize discussion of their content and to maintain them. Several efforts were recently made to combine these capabilities together in one environment, and NaviCell is one of them. NaviCell is a web-based environment for exploiting large maps of molecular interactions, created in CellDesigner, allowing their easy exploration, curation and maintenance. It is characterized by a combination of three essential features: (1) efficient map browsing based on Google Maps; (2) semantic zooming for viewing different levels of details or of abstraction of the map and (3) integrated web-based blog for collecting community feedback. NaviCell can be easily used by experts in the field of molecular biology for studying molecular entities of interest in the context of signaling pathways and crosstalk between pathways within a global signaling network. NaviCell allows both exploration of detailed molecular mechanisms represented on the map and a more abstract view of the map up to a top-level modular representation. NaviCell greatly facilitates curation, maintenance and updating the comprehensive maps of molecular interactions in an interactive and user-friendly fashion due to an imbedded blogging system. NaviCell provides user-friendly exploration of large-scale maps of molecular interactions, thanks to Google Maps and WordPress interfaces, with which many users are already familiar. Semantic zooming which is used for navigating geographical maps is adopted for molecular maps in NaviCell, making any level of visualization readable. In addition, NaviCell provides a framework for community-based curation of maps.

  5. Navy POD

    Science.gov (United States)

    Navy Personnel Command (NPC) Navy SAPR Navy EEO Inclusion And Diversity Navy Standard Integrated Operations Security (OPSEC) Navy Trademarks Military One Source USA.gov U.S. Office of Special Counsel Social Inclusion And Diversity Navy Standard Integrated Personnel System (NSIPS) My Navy Portal Board of

  6. Navy Directory

    Science.gov (United States)

    Youtube US Navy Flickr US Navy Instagram US Navy Snapchat US Navy Pinterest US Navy Periscope NAVY GROUPS Facebook Twitter Instagram EDIT Chief of Naval Operations Facebook Twitter YouTube Instagram EDIT Chief of Facebook Twitter YouTube Instagram EDIT Chief of Supply Corps Facebook EDIT CNE MPP 413 Twitter EDIT CNIC

  7. Navy Medicine - World Class Care... Anytime, Anywhere

    Science.gov (United States)

    Search Saturday, May 26th, 2018 Home About Disclaimer Search Navy Medicine Navy Medicine World Class Care... Anytime, Anywhere Home Disclaimer Navy Medicine WebSite About Leadership Readiness Health Partnerships Inside Navy Medicine Dental Corps Hospital Corps Medical Corps Medical Service Corps Nurse Corps

  8. Hospital ships adrift? Part 1: a systematic literature review characterizing US Navy hospital ship humanitarian and disaster response, 2004-2012.

    Science.gov (United States)

    Licina, Derek

    2013-06-01

    United States foreign policy is tied extensively to health initiatives, many related to the use of military assets. Despite substantial resource investment by the US Department of Defense (DoD) in hospital ship humanitarian assistance and disaster response missions, the impact of this investment is unclear. A systematic literature review of both peer-reviewed and grey literature using eight databases representing the international community and multiple sectors was conducted. Data on the characteristics of missions directly related to US Navy hospital ship humanitarian assistance and disaster response from 2004-2012 were extracted and documented. Of the 1445 sources reviewed, a total of 43 publications met criteria for review. Six (13.9%) met empirical documentation criteria and 37 (86.0%) were considered nonempirical expert opinions and anecdotal accounts that were primarily descriptive in nature. Overall, disaster response accounted for 67.4% (29/43) and humanitarian assistance 25.6% (11/43). Public and private sector participants produced 79.0% (34/43) and 20.9% (9/43) of the publications respectively. Of private sector publications, 88.9% (8/9) focused on disaster response compared to 61.8% (21/34) from the public sector. Of all publications meeting inclusion criteria, 81.4% (35/43) focused on medical care, 9.3% (4/43) discussed partnerships, 4.7% (2/43) training, and 4.7% (2/43) medical ethics and strategic utilization. No primary author publications from the diplomatic, development, or participating host nations were identified. One (2.3%) of the 43 publications was from a partner nation participant. Discussion Without rigorous research methods yielding valid and reliable data-based information pertaining to Navy hospital ship mission impact, policy makers are left with anecdotal reports to influence their decision-making processes. This is inadequate considering the frequency of hospital ship deployments used as a foreign policy tool and the considerable

  9. Large Variability in the Diversity of Physiologically Complex Surgical Procedures Exists Nationwide Among All Hospitals Including Among Large Teaching Hospitals.

    Science.gov (United States)

    Dexter, Franklin; Epstein, Richard H; Thenuwara, Kokila; Lubarsky, David A

    2017-11-22

    Multiple previous studies have shown that having a large diversity of procedures has a substantial impact on quality management of hospital surgical suites. At hospitals with substantial diversity, unless sophisticated statistical methods suitable for rare events are used, anesthesiologists working in surgical suites will have inaccurate predictions of surgical blood usage, case durations, cost accounting and price transparency, times remaining in late running cases, and use of intraoperative equipment. What is unknown is whether large diversity is a feature of only a few very unique set of hospitals nationwide (eg, the largest hospitals in each state or province). The 2013 United States Nationwide Readmissions Database was used to study heterogeneity among 1981 hospitals in their diversities of physiologically complex surgical procedures (ie, the procedure codes). The diversity of surgical procedures performed at each hospital was quantified using a summary measure, the number of different physiologically complex surgical procedures commonly performed at the hospital (ie, 1/Herfindahl). A total of 53.9% of all hospitals commonly performed 3-fold larger diversity (ie, >30 commonly performed physiologically complex procedures). Larger hospitals had greater diversity than the small- and medium-sized hospitals (P 30 procedures (lower 99% CL, 71.9% of hospitals). However, there was considerable variability among the large teaching hospitals in their diversity (interquartile range of the numbers of commonly performed physiologically complex procedures = 19.3; lower 99% CL, 12.8 procedures). The diversity of procedures represents a substantive differentiator among hospitals. Thus, the usefulness of statistical methods for operating room management should be expected to be heterogeneous among hospitals. Our results also show that "large teaching hospital" alone is an insufficient description for accurate prediction of the extent to which a hospital sustains the

  10. Mental Disorder Hospitalizations among Submarine Personnel in the U.S. Navy.

    Science.gov (United States)

    1988-03-10

    hospitalization rates ( Lilienfeld , 1980). T- tests were used to assess statistical signi- ficance of differences in descriptive variables (McNemar, 1969... Lilienfeld , D. E. Foundations of epidemiology. 2nd ed. New York: Oxford University Press, 1980. McNemar, Q. Psychological statistics. 4th ed. New York: Wiley...0 5/S I milI’l 11 1 ; 𔃻 28 112.5 U-2 11112.2 II~.2.4~ 11111J.6 MICROCOPY RESOLUTION TEST CHART NADONAL BUJR[AU OF STANDARDS Ib3 A IvM Mental

  11. Predicting Attrition, Performance, Reenlistment, and Hospitalizations from the Smoking History of Women Prior to Entering the Navy

    National Research Council Canada - National Science Library

    Conway, Terry L

    2006-01-01

    ... over a possible 7-8 year follow-up. For almost 5,500 women entering the U.S. Navy between March 1996 - March 1997, who participated in Operation Stay Quit (OSQ) (USAMRMC Grant #DAMD17-95-1-5075...

  12. Navy.mil - Photo Galleries

    Science.gov (United States)

    Personnel Command (NPC) Navy SAPR Navy EEO Inclusion And Diversity Navy Standard Integrated Personnel System (OPSEC) Navy Trademarks Military One Source USA.gov U.S. Office of Special Counsel Social Media Directory Links Navy Reserve Navy.mil Underway Navy Personnel Command (NPC) Navy SAPR Navy EEO Inclusion And

  13. Hospitalizations for Accidents and Injuries in the U.S. Navy. I. Duty Station Assignment and Duty Status

    Science.gov (United States)

    1985-01-01

    unspecified. . ŗ %.. . . . . . . . . .. . . . Population data, for all male enlisted Navy personnel and for majur duty stations, were compiled from data files...01 aAll male enlisted personnel b nldsonly ship’s company personnel includes only personnel assigned to actual landing forces •’ •,d Significantly...N.S. 102 0.96 2.5. Construction Battalion 28 0.85 N.S. 111 1.05 M.S. Nuclear Cruiser 22 0.67 N.S. 97 0.92 N.S. Pleet Marinie Force 33 1.00 N.S. 71 0.66d

  14. Large Hospital 50% Energy Savings: Technical Support Document

    Energy Technology Data Exchange (ETDEWEB)

    Bonnema, E.; Studer, D.; Parker, A.; Pless, S.; Torcellini, P.

    2010-09-01

    This Technical Support Document documents the technical analysis and design guidance for large hospitals to achieve whole-building energy savings of at least 50% over ANSI/ASHRAE/IESNA Standard 90.1-2004 and represents a step toward determining how to provide design guidance for aggressive energy savings targets. This report documents the modeling methods used to demonstrate that the design recommendations meet or exceed the 50% goal. EnergyPlus was used to model the predicted energy performance of the baseline and low-energy buildings to verify that 50% energy savings are achievable. Percent energy savings are based on a nominal minimally code-compliant building and whole-building, net site energy use intensity. The report defines architectural-program characteristics for typical large hospitals, thereby defining a prototype model; creates baseline energy models for each climate zone that are elaborations of the prototype models and are minimally compliant with Standard 90.1-2004; creates a list of energy design measures that can be applied to the prototype model to create low-energy models; uses industry feedback to strengthen inputs for baseline energy models and energy design measures; and simulates low-energy models for each climate zone to show that when the energy design measures are applied to the prototype model, 50% energy savings (or more) are achieved.

  15. Case study: improving efficiency in a large hospital laboratory.

    Science.gov (United States)

    Bartel, Marilynn

    2004-01-01

    Saint Francis Health System (SFHS) consists of three hospitals and one clinic: Saint Francis Hospital (SFH); Broken Arrow Medical Center; Laureate Psychiatric Hospital; and Warren Clinic. SFHS has 670 physicians on staff and serves medical (oncology, orthopedic, neurology, and renal), surgical, cardiac, women and infant, pediatric, transplant, and trauma patients in Tulsa County, Oklahoma, which has a population of 660,000. SFH incorporates 706 staffed beds, including 126 pediatric beds and 119 critical care beds. Each year, the health system averages 38,000 admissions, 70,000 emergency department visits, 25,000 surgeries, and 3,500 births. Saint Francis Laboratory is located within the main hospital facility (SFH) and functions as a core lab for the health system. The lab also coordinates lab services with Saint Francis Heart Hospital, a physician-system joint venture. The Optimal Equipment Configuration (OEC) Project was designed by the Clinical Laboratory Services division of Premier, a group purchasing organization, with the goal of determining whether laboratories could improve efficiency and decrease unit cost by using a single-source vendor. Participants included seven business partners (Abbott, Bayer, Beckman/Coulter, Dade/Behring, J&J/ Ortho, Olympus, and Roche) and 21 laboratory sites (a small, mid-sized, and large site for each vendor). SFH laboratory staff embraced Premier's concept and viewed the OEC project as an opportunity to "energize" laboratory operations. SFH partnered with Abbott, their primary equipment vendor, for the project. Using resources and tools made available through the project, the laboratory was re-engineered to simplify workflow, increase productivity, and decrease costs by adding automation and changing to centralized specimen processing. Abbott and SFH shared a common vision for the project and enhanced their partnership through increased communication and problem solving. Abbott's area representatives provided for third

  16. An Analysis of Current and Proposed Oversight Processes for the Acquisition of Large-Scale Services as Seen Through the Eyes of the Navy Marine Corps Intranet Program

    National Research Council Canada - National Science Library

    Rozier, JoCephas

    2002-01-01

    At approximately 56,9 billion, The Navy-Marine Corps Intranet (NMCI) was the largest service contract that DoD had ever awarded, The U'S, Navy viewed it as a typical multi-year, Performance Based Services Contract (PBSC...

  17. The adequacy of inhaler technique in patients with chronic obstructive pulmonary disease and asthma attending a tertiary care hospital in Navi Mumbai

    Directory of Open Access Journals (Sweden)

    Akanksha Das

    2016-01-01

    Full Text Available Objectives: Chronic obstructive pulmonary disease (COPD and asthma are major concerns to health-care system. Improper inhaler device used (metered dose inhaler/dry powder inhaler is one of the major causes associated with inadequate control of the disease. This study was performed to evaluate the inhaler technique among patients and to investigate factors associated with improper use and whether age or gender was associated with poor inhaler technique. Materials and Methods: A cross-sectional study of all patients who visited the chest outpatient department with asthma and COPD over a 6-month-period in a tertiary care hospital in Navi Mumbai. Information was collected about demographic data and inhaler technique was assessed using a standard checklist. Results: There were 107 patients, 71 with asthma and 36 with COPD. Inhaler techniques of 95% of patients were found to be inadequate in some form or the other as per checklist. Of all the patients interviewed, only about 60% of patients recalled that demonstration was done by doctors or other health-care professionals. Twelve percent were instructed by pharmacists and remaining followed their friend′s or relative′s suggestions along with insert literature. Conclusions: The inhaler technique is inadequate among most patients. On every visit, patient′s inhaler technique should be observed and adequate suggestions should be given to correct any deficiency.

  18. Hospitalizations for Accidents and Injuries in the U.S. Navy. III. Time in Assignment and Seniority.

    Science.gov (United States)

    1985-09-01

    MICROCOPY RESOLUTION TEST CHART NATIONAL BJREAU OF STANARDS 1963 A 2i ... ........................ . . . . . . . . . . . . AD-A161 677 HOSPITALIZATIONS FOR...formula ( Lilienfeld and Lilien- feld, 19801: p ± 1.96 (p)(l-P) N Relative risk levels were then computed as the ratio of these rates; 95% confidence...financial change, etc.) which bring about a significant change * in an individual’s ongoing life pattern may cause psychological turrmoil that can

  19. Technology and Navy Recruiting

    National Research Council Canada - National Science Library

    Golfin, Peggy

    1997-01-01

    Since November 1996, CNA has participated on a Technology Task Force established by the Commander, Navy Recruiting Command, to address several issues concerning the use of technology and Navy recruiting...

  20. Understanding end water quality in hospitals and other large buildings

    Science.gov (United States)

    Local hospitals are depending on the use of copper silver ionization treatment to control Legionella in premise plumbing. Discussion will show some results that speak to the effectiveness of this treatment to control opportunistic pathogens.

  1. Navy Geothermal Plan

    Energy Technology Data Exchange (ETDEWEB)

    1984-12-01

    Domestic geothermal resources with the potential for decreasing fossil fuel use and energy cost exist at a significant number of Navy facilities. The Geothermal Plan is part of the Navy Energy R and D Program that will evaluate Navy sites and provide a technical, economic, and environmental base for subsequent resource use. One purpose of the program will be to provide for the transition of R and D funded exploratory efforts into the resource development phase. Individual Navy geothermal site projects are described as well as the organizational structure and Navy decision network. 2 figs.

  2. Multimorbidity in a large district hospital: A descriptive cross ...

    African Journals Online (AJOL)

    Mitchell's Plain District Hospital, Western Cape Department of Health, Cape Town, South Africa. Corresponding author: E de .... group as a whole, 6.3% of patients had mental illness. .... be investigated, research can also be focused specifically on reducing .... strongly affected by social stigma, particularly in the case of illicit.

  3. The Epidemiology of Operation Stress during Continuing Promise 2011: A Humanitarian Response and Disaster Relief Mission aboard a US Navy Hospital Ship.

    Science.gov (United States)

    Scouten, William T; Mehalick, Melissa L; Yoder, Elizabeth; McCoy, Andrea; Brannock, Tracy; Riddle, Mark S

    2017-08-01

    /MH complaints increased as the mission progressed, were more prevalent in certain groups, and appeared to be related to ship's movement. These findings document the pattern of operational stress in a ship-based medical humanitarian mission and confirm unique ship-based stressors. This information may be used by planners of similar missions to develop mitigation strategies for known stressors and by preventive medicine, behavioral health specialists, and mission leaders to develop sensitive surveillance tools to better detect and manage operational stress while on mission. Scouten WT , Mehalick ML , Yoder E , McCoy A , Brannock T , Riddle MS . The epidemiology of operation stress during Continuing Promise 2011: a humanitarian response and disaster relief mission aboard a US Navy hospital ship. Prehosp Disaster Med. 2017;32(4):393-402.

  4. Navy Fuel Research Facility

    Data.gov (United States)

    Federal Laboratory Consortium — FUNCTION: Performs basic and applied research to understand the underlying chemistry that impacts the use, handling, and storage of current and future Navy mobility...

  5. Technical Support Document: Development of the Advanced Energy Design Guide for Large Hospitals - 50% Energy Savings

    Energy Technology Data Exchange (ETDEWEB)

    Bonnema, E.; Leach, M.; Pless, S.

    2013-06-01

    This Technical Support Document describes the process and methodology for the development of the Advanced Energy Design Guide for Large Hospitals: Achieving 50% Energy Savings Toward a Net Zero Energy Building (AEDG-LH) ASHRAE et al. (2011b). The AEDG-LH is intended to provide recommendations for achieving 50% whole-building energy savings in large hospitals over levels achieved by following Standard 90.1-2004. The AEDG-LH was created for a 'standard' mid- to large-size hospital, typically at least 100,000 ft2, but the strategies apply to all sizes and classifications of new construction hospital buildings. Its primary focus is new construction, but recommendations may be applicable to facilities undergoing total renovation, and in part to many other hospital renovation, addition, remodeling, and modernization projects (including changes to one or more systems in existing buildings).

  6. Argo Navis

    Science.gov (United States)

    Murdin, P.

    2000-11-01

    (the Ship) a large southern constellation representing the ship Argo of Jason and the Argonauts in Greek mythology whose brightest stars were cataloged by Ptolemy (c. AD 100-175) in the Almagest. It was divided up by the French astronomer Nicolas L de Lacaille (1713-62), who charted the southern sky in 1751-2, into the constellations Carina (the Keel), Vela (the Sails), Puppis (the Poop or Stern)...

  7. Welcome to Naval Hospital Jacksonville

    Science.gov (United States)

    . Transparency in Medicine See How We're Doing Compare Military Health System Hospitals and Clinics TRICARE Online | ICE | OWA | Suicide Prevention Lifeline | 1-800-USA-NAVY | Navy Medicine | Military Health Child Street, Jacksonville, Florida 32214 This is an official U.S. Navy website. This is a Department of

  8. United States Navy DL Perspective

    Science.gov (United States)

    2010-08-10

    United States Navy DL Perspective CAPT Hank Reeves Navy eLearning Project Director 10 August 2010 Report Documentation Page Form ApprovedOMB No...Marine Corps (USMC) Navy eLearning Ongoing Shared with USMC, Coast Guard 9 NeL Help Site https://ile-help.nko.navy.mil/ile/ https://s-ile

  9. Navy Lodge Environmental Assessment

    National Research Council Canada - National Science Library

    1999-01-01

    ... only. The Proposed Action would include constructing and operating a 2-story, 50-unit Navy Lodge, with lobby, front desk, offices, housekeeping space, guest laundromat, vending area, utility rooms...

  10. Pediatric disaster preparedness of a hospital network in a large metropolitan region.

    Science.gov (United States)

    Ferrer, Rizaldy R; Balasuriya, Darshi; Iverson, Ellen; Upperman, Jeffrey S

    2010-01-01

    We describe pediatric-related emergency experiences and responses, disaster preparation and planning, emergency plan execution and evaluation, and hospital pediatric capabilities and vulnerabilities among a disaster response network in a large urban county in the West Coast of the United States. Using semistructured key informant interviews, the authors conducted qualitative research between March and April 2008. Eleven hospitals and a representative from the community clinic association agreed to participate (86 percent response rate) and a total of 22 key informant interviews were completed. Data were analyzed using ATLAS.ti.v.5.0, a qualitative analytical software program. Although hospitals have infrastructure to respond in the event of a large-scale disaster, well-established disaster preparedness plans have not fully accounted for the needs of children. The general hospitals do not anticipate a surge of pediatric victims in the event of a disaster, and they expect that children will be transported to a children's hospital as their conditions become stable. Even hospitals with well-established disaster preparedness plans have not fully accounted for the needs of children during a disaster. Improved communication between disaster network hospitals is necessary as incorrect information still persists.

  11. Comparison of patient doses in interventional radiology procedures performed in two large hospitals in Greece

    International Nuclear Information System (INIS)

    Papageorgiou, E.; Tsapaki, V.; Tsalafoutas, I. A.; Maurikou, E.; Kottou, S.; Orfanos, A.; Karidas, G.; Fidanis, T.; Zafiriadou, E.; Neofotistou, V.

    2007-01-01

    Purpose of the study was to determine patient doses in the most common interventional radiology (IR) procedures performed in two large Greek hospitals. A total of 164 patients who underwent 4 types of IR procedures were studied. Fluoroscopy time, total exposure time, number of frames, number of runs, radiation field size, and cumulative dose-area product (DAP) were recorded. The median DAP values for carotid arteriography and lower limb arteriography were 66 and 123 Gy cm 2 for hospital 'A' and 21 and 49 Gy cm 2 for hospital 'B'. For the cerebral arteriographies performed in hospital 'A', the median DAP was 116 Gy cm 2 while for the hepatic embolizations performed in hospital 'B', it was 104 Gy cm 2 . The DAP values observed in hospital 'A' for carotid arteriography and lower limb arteriography were almost three times than those of hospital 'B'. From the data analysis, it is evident that dose optimization in hospital 'A' should be pursued through revision of the techniques used. (authors)

  12. Paradigms and nursing management, analysis of the current organizational structure in a large hospital.

    Science.gov (United States)

    Wilson, D

    1992-01-01

    Hospitals developed over the period of time when positivism become a predominant world view. Positivism was founded by four Western trends: preponderance of hierarchy and autocracy, popularization of bureaucracy, extensive application of a machine orientation to work and predominance of "scientific" inquiry. Organizational theory developed largely from quantitative research findings arising from a positivistic world view. A case study, analyzing a current nursing organizational structure at one large hospital, is presented. Nursing management was found to be based upon the positivistic paradigm. The predominance of a machine orientation, and an autocratic and bureaucratic structure are evidence of this. A change to shared governance had been attempted, indicating a shift to a more modern organizational structure based on a different paradigm. The article concludes by emphasizing that managers are largely responsible for facilitating change; change that will meet internal human resource needs and the cost-effectiveness crises of hospitals today through more effective use of human resources.

  13. Navy Advertising: Targeting Generation Z

    Science.gov (United States)

    2015-12-01

    NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA MBA PROFESSIONAL REPORT NAVY ADVERTISING : TARGETING GENERATION Z December......study recommends improvements for Navy advertising efficiency by examining characteristics of recruits defined as Generation Z. Data gathered from five

  14. Epidemiology of infective endocarditis in a large Belgian non-referral hospital.

    Science.gov (United States)

    Poesen, K; Pottel, H; Colaert, J; De Niel, C

    2014-06-01

    Guidelines for diagnosis of infective endocarditis are largely based upon epidemiological studies in referral hospitals. Referral bias, however, might impair the validity of guidelines in non-referral hospitals. Recent studies in non-referral care centres on infective endocarditis are sparse. We conducted a retrospective epidemiological study on infective endocarditis in a large non-referral hospital in a Belgian city (Kortrijk). The medical record system was searched for all cases tagged with a putative diagnosis of infective endocarditis in the period 2003-2010. The cases that fulfilled the modified Duke criteria for probable or definite infective endocarditis were included. Compared to referral centres, an older population with infective endocarditis, and fewer predisposing cardiac factors and catheter-related infective endocarditis is seen in our population. Our patients have fewer prosthetic valve endocarditis as well as fewer staphylococcal endocarditis. Our patients undergo less surgery, although mortality rate seems to be highly comparable with referral centres, with nosocomial infective endocarditis as an independent predictor of mortality. The present study suggests that characteristics of infective endocarditis as well as associative factors might differ among non-referral hospitals and referral hospitals.

  15. A Generic Discrete-Event Simulation Model for Outpatient Clinics in a Large Public Hospital

    Directory of Open Access Journals (Sweden)

    Waressara Weerawat

    2013-01-01

    Full Text Available The orthopedic outpatient department (OPD ward in a large Thai public hospital is modeled using Discrete-Event Stochastic (DES simulation. Key Performance Indicators (KPIs are used to measure effects across various clinical operations during different shifts throughout the day. By considering various KPIs such as wait times to see doctors, percentage of patients who can see a doctor within a target time frame, and the time that the last patient completes their doctor consultation, bottlenecks are identified and resource-critical clinics can be prioritized. The simulation model quantifies the chronic, high patient congestion that is prevalent amongst Thai public hospitals with very high patient-to-doctor ratios. Our model can be applied across five different OPD wards by modifying the model parameters. Throughout this work, we show how DES models can be used as decision-support tools for hospital management.

  16. Improving financial performance by modeling and analysis of radiology procedure scheduling at a large community hospital.

    Science.gov (United States)

    Lu, Lingbo; Li, Jingshan; Gisler, Paula

    2011-06-01

    Radiology tests, such as MRI, CT-scan, X-ray and ultrasound, are cost intensive and insurance pre-approvals are necessary to get reimbursement. In some cases, tests may be denied for payments by insurance companies due to lack of pre-approvals, inaccurate or missing necessary information. This can lead to substantial revenue losses for the hospital. In this paper, we present a simulation study of a centralized scheduling process for outpatient radiology tests at a large community hospital (Central Baptist Hospital in Lexington, Kentucky). Based on analysis of the central scheduling process, a simulation model of information flow in the process has been developed. Using such a model, the root causes of financial losses associated with errors and omissions in this process were identified and analyzed, and their impacts were quantified. In addition, "what-if" analysis was conducted to identify potential process improvement strategies in the form of recommendations to the hospital leadership. Such a model provides a quantitative tool for continuous improvement and process control in radiology outpatient test scheduling process to reduce financial losses associated with process error. This method of analysis is also applicable to other departments in the hospital.

  17. Evaluation of environmental sampling methods for detection of Salmonella enterica in a large animal veterinary hospital.

    Science.gov (United States)

    Goeman, Valerie R; Tinkler, Stacy H; Hammac, G Kenitra; Ruple, Audrey

    2018-04-01

    Environmental surveillance for Salmonella enterica can be used for early detection of contamination; thus routine sampling is an integral component of infection control programs in hospital environments. At the Purdue University Veterinary Teaching Hospital (PUVTH), the technique regularly employed in the large animal hospital for sample collection uses sterile gauze sponges for environmental sampling, which has proven labor-intensive and time-consuming. Alternative sampling methods use Swiffer brand electrostatic wipes for environmental sample collection, which are reportedly effective and efficient. It was hypothesized that use of Swiffer wipes for sample collection would be more efficient and less costly than the use of gauze sponges. A head-to-head comparison between the 2 sampling methods was conducted in the PUVTH large animal hospital and relative agreement, cost-effectiveness, and sampling efficiency were compared. There was fair agreement in culture results between the 2 sampling methods, but Swiffer wipes required less time and less physical effort to collect samples and were more cost-effective.

  18. Utilization of arterial blood gas measurements in a large tertiary care hospital.

    Science.gov (United States)

    Melanson, Stacy E F; Szymanski, Trevor; Rogers, Selwyn O; Jarolim, Petr; Frendl, Gyorgy; Rawn, James D; Cooper, Zara; Ferrigno, Massimo

    2007-04-01

    We describe the patterns of utilization of arterial blood gas (ABG) tests in a large tertiary care hospital. To our knowledge, no hospital-wide analysis of ABG test utilization has been published. We analyzed 491 ABG tests performed during 24 two-hour intervals, representative of different staff shifts throughout the 7-day week. The clinician ordering each ABG test was asked to fill out a utilization survey. The most common reasons for requesting an ABG test were changes in ventilator settings (27.6%), respiratory events (26.4%), and routine (25.7%). Of the results, approximately 79% were expected, and a change in patient management (eg, a change in ventilator settings) occurred in 42% of cases. Many ABG tests were ordered as part of a clinical routine or to monitor parameters that can be assessed clinically or through less invasive testing. Implementation of practice guidelines may prove useful in controlling test utilization and in decreasing costs.

  19. Navy Manpower Planning

    Science.gov (United States)

    2017-03-31

    enormously during the past 20 years. Female participation in the workforce has grown dramatically in the past 60 years: women were roughly 27...a Navy that’s about 25 percent women . At that level workplace relationships get normalized. 13 Ref: Stars & Stripes, May 2015 . 77 Progress in...nontraditional roles is now routine. A practical concern regarding women serving on sea duty is ensuring that there is female accommodation. Making

  20. Optimally Reorganizing Navy Shore Infrastructure

    National Research Council Canada - National Science Library

    Kerman, Mitchell

    1997-01-01

    ...), but infrastructure reductions continue to lag force structure reductions. The United States Navy's recent initiatives to reduce its shore infrastructure costs include "regionalization", "outsourcing," and "homebasing...

  1. The GROG: A Journal of Navy Medical History and Culture. Issue 38, 2013

    Science.gov (United States)

    2013-01-01

    military combat award in the United States. This select group of individuals have served as namesakes of hospitals and ships, in- spired artwork, and one...commands and facilities throughout Navy Medicine. The recipient of the awards have also been the subjects of paintings and namesakes of Navy ships...Corpsmen of Honor; Medal of Honor Robert Bush serves as the namesake of two of these facilities (Naval Hospital Twentynine Palms, Calif., and Bush

  2. Implementation of a large-scale hospital information infrastructure for multi-unit health-care services.

    Science.gov (United States)

    Yoo, Sun K; Kim, Dong Keun; Kim, Jung C; Park, Youn Jung; Chang, Byung Chul

    2008-01-01

    With the increase in demand for high quality medical services, the need for an innovative hospital information system has become essential. An improved system has been implemented in all hospital units of the Yonsei University Health System. Interoperability between multi-units required appropriate hardware infrastructure and software architecture. This large-scale hospital information system encompassed PACS (Picture Archiving and Communications Systems), EMR (Electronic Medical Records) and ERP (Enterprise Resource Planning). It involved two tertiary hospitals and 50 community hospitals. The monthly data production rate by the integrated hospital information system is about 1.8 TByte and the total quantity of data produced so far is about 60 TByte. Large scale information exchange and sharing will be particularly useful for telemedicine applications.

  3. Group Counseling for Navy Children.

    Science.gov (United States)

    Mitchum, Nancy Taylor

    1991-01-01

    Conducted six-session group counseling program for Navy children (n=22) enrolled in public schools whose fathers were on deployment. Pretest and posttest scores on the Coopersmith Self-Esteem Inventory suggest that participation in the group counseling unit positively affected self-esteem of Navy children whose fathers were on deployment. Found…

  4. Navy Multiband Terminal (NMT)

    Science.gov (United States)

    2015-12-01

    AEHF satellites and MILSTAR satellites in the backwards-compatible mode. Mission requirements specific to Navy operations, including threat levels and...Center for Cost Analysis (NCCA) Component Cost Position (CCP) memo dated December 18, 2015 Confidence Level Confidence Level of cost estimate for... Econ Qty Sch Eng Est Oth Spt Total 6.970 0.082 0.637 0.034 0.000 -1.210 0.000 -0.418 -0.875 6.095 Current SAR Baseline to Current Estimate (TY $M) PAUC

  5. Etiology and characteristics of large symptomatic pericardial effusion in a community hospital in the contemporary era.

    Science.gov (United States)

    Abdallah, R; Atar, S

    2014-05-01

    The etiology and laboratory characteristics of large symptomatic pericardial effusion (LSPE) in the Western world have evolved over the years, and vary between regions, community and tertiary hospitals. We reviewed data of 86 consecutive patients who underwent pericardiocentesis or pericardial window due to LSPE in a community hospital from 2001 to 2010. The characteristics of the PE including chemistry, hematology, bacteriology, serology and cytology have been analyzed. We correlated the etiologies of PE with age, gender and clinical presentation. The most frequent etiology of LSPE was idiopathic [36% (77% with a clinical diagnosis of pericarditis)], followed by malignancy (31.4%), ischemic heart disease (16.3%), renal failure (4.6%), trauma (4.6%) and autoimmune disease (4.6%). The average age of all the etiological groups excluding trauma was over 50 years. Laboratory tests did not modify the pre-procedure diagnosis in any of the patients. The most frequent presenting symptom was dyspnea (76.6%). Chest pain was mostly common in patients with idiopathic etiology (58.06%). The most frequent medical condition associated with LSPE was the use of anticoagulant or antiplatelet drugs (31.40%), especially aspirin, and in those, the PE tended to be bloody (73%, P = 0.11). Most of the effusions were exudates (70.9%). PE due to renal failure was the largest (1467 ± 1387 ml). The spectrum of etiologies of LSPE in a community hospital in the Western world in the contemporary era is continuously evolving. The most frequent etiology is now idiopathic, followed by malignancy. Routine laboratory testing still rarely modifies the pre-procedure diagnosis.

  6. Hospitals

    Data.gov (United States)

    Department of Homeland Security — This database contains locations of Hospitals for 50 states and Washington D.C. , Puerto Rico and US territories. The dataset only includes hospital facilities and...

  7. Neonatal Outcomes of Infants Admitted to a Large Government Hospital in Amman, Jordan

    Science.gov (United States)

    Sivasubramaniam, Priya G.; Quinn, Cristin E.; Blevins, Meridith; Hajajra, Ahmand Al; Khuri-Bulos, Najwa; Faouri, Samir; Halasa, Natasha

    2015-01-01

    Objective: To describe characteristics and outcomes of Jordanian newborns admitted to a large governmental neonatal intensive care unit (NICU). Methods: Newborns born at the government hospital, Al Bashir, in Amman, Jordan were prospectively enrolled. The study focused on newborns admitted to the NICU and a retrospective chart review was performed. Abstraction included in-hospital mortality, antibiotic days, ventilation, oxygen use, and CRP levels. Rank sum and chi-squared tests were used to compare across outcomes. Logistic regression of hypothesized risk factors with death adjusted for gestational age. Results: Of the 5,466 neonates enrolled from 2/10-2/11, medical records were available for 321/378(84.9%) infants admitted to the NICU. The median gestational age was 36 weeks, median birth weight was 2.3 kg, and 28(8.7%) infants died. The two most common reasons for admission and mortality were respiratory distress syndrome and prematurity. Low Apgar scores and positive CRP were predictors of mortality. Risk factors associated with increased use of antibiotics, oxygen hood, and mechanical ventilation included lower gestational age and prematurity. Conclusion: Infants admitted to the Jordanian NICU have significantly higher median gestational age and birth weights than in developed countries and were associated with significant morbidity and mortality. Continuations of global efforts to prevent prematurity are needed. PMID:25946927

  8. A Simulation of Rainwater Harvesting Design and Demand-Side Controls for Large Hospitals

    Directory of Open Access Journals (Sweden)

    Lawrence V. Fulton

    2018-05-01

    Full Text Available Inpatient health buildings in the United States are the most intensive users of water among large commercial buildings. Large facilities (greater than 1 million square feet consume an average of 90 million gallons per building per year. The distribution and treatment of water imposes a significant electrical power demand, which may be the single largest energy requirement for various states. Supply and demand-side solutions are needed, particularly in arid and semi-arid regions where water is scarce. This study uses continuous simulations based on 71 years of historical data to estimate how rainwater harvesting systems and demand-side interventions (e.g., low-flow devices, xeriscaping would offset the demand for externally-provided water sources in a semi-arid region. Simulations from time series models are used to generate alternative rainfall models to account for potential non-stationarity and volatility. Results demonstrate that hospital external water consumption might be reduced by approximately 25% using conservative assumptions and depending on the design of experiment parameters associated with rainfall capture area, building size, holding tank specifications, and conservation efforts.

  9. A stochastic mathematical model to locate field hospitals under disruption uncertainty for large-scale disaster preparedness

    Directory of Open Access Journals (Sweden)

    Nezir Aydin

    2016-03-01

    Full Text Available In this study, we consider field hospital location decisions for emergency treatment points in response to large scale disasters. Specifically, we developed a two-stage stochastic model that determines the number and locations of field hospitals and the allocation of injured victims to these field hospitals. Our model considers the locations as well as the failings of the existing public hospitals while deciding on the location of field hospitals that are anticipated to be opened. The model that we developed is a variant of the P-median location model and it integrates capacity restrictions both on field hospitals that are planned to be opened and the disruptions that occur in existing public hospitals. We conducted experiments to demonstrate how the proposed model can be utilized in practice in a real life problem case scenario. Results show the effects of the failings of existing hospitals, the level of failure probability and the capacity of projected field hospitals to deal with the assessment of any given emergency treatment system’s performance. Crucially, it also specifically provides an assessment on the average distance within which a victim needs to be transferred in order to be treated properly and then from this assessment, the proportion of total satisfied demand is then calculated.

  10. A Description of the Management Characteristics of Anesthesia Care Delivery in Small, Medium, Large, Teaching and Non-Teaching Hospitals in the U.S. Navy

    Science.gov (United States)

    1998-10-01

    6401-1. The opinions or assertions contained herein are the private opinions of the author and are not to be construed as official or reflecting the...practice anesthesia in the civilian sector must be met. Jordan (1994) listed the following requirements that must be met to become a CRNA: 1. Graduate...Department. A description of these characteristics may also be beneficial in relating how job responsibility, motivation, and quality of worklife

  11. Hospitals Participating In ACOs Tend To Be Large And Urban, Allowing Access To Capital And Data.

    Science.gov (United States)

    Colla, Carrie H; Lewis, Valerie A; Tierney, Emily; Muhlestein, David B

    2016-03-01

    Relationships between physicians and hospitals have changed considerably over the past decade, as hospitals and physician groups have integrated and new public and private payment policies have created financial interdependence. The extent to which accountable care organizations (ACOs) involve hospitals in their operations may prove to be vitally important, because managing hospital care is a key part of improving health care quality and lowering cost growth. Using primary data on ACO composition and capabilities paired with hospital characteristics, we found that 20 percent of US hospitals were part of an ACO in 2014. Hospitals that were in urban areas, were nonprofit, or had a smaller share of Medicare patients were more likely to participate in ACOs, compared to hospitals that were in more rural areas, were for-profit or government owned, or had a larger share of Medicare patients, respectively. Qualitative data identified the following advantages of including a hospital in an ACO: the availability of start-up capital, advanced data sharing, and engagement of providers across the care continuum. Although the 63 percent of ACOs that included hospitals offered more comprehensive services compared to ACOs without hospitals, we found no differences between the two groups in their ability to manage hospital-related aspects of patient care. Project HOPE—The People-to-People Health Foundation, Inc.

  12. Do large-scale hospital- and system-wide interventions improve patient outcomes: a systematic review.

    Science.gov (United States)

    Clay-Williams, Robyn; Nosrati, Hadis; Cunningham, Frances C; Hillman, Kenneth; Braithwaite, Jeffrey

    2014-09-03

    While health care services are beginning to implement system-wide patient safety interventions, evidence on the efficacy of these interventions is sparse. We know that uptake can be variable, but we do not know the factors that affect uptake or how the interventions establish change and, in particular, whether they influence patient outcomes. We conducted a systematic review to identify how organisational and cultural factors mediate or are mediated by hospital-wide interventions, and to assess the effects of those factors on patient outcomes. A systematic review was conducted and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Database searches were conducted using MEDLINE from 1946, CINAHL from 1991, EMBASE from 1947, Web of Science from 1934, PsycINFO from 1967, and Global Health from 1910 to September 2012. The Lancet, JAMA, BMJ, BMJ Quality and Safety, The New England Journal of Medicine and Implementation Science were also hand searched for relevant studies published over the last 5 years. Eligible studies were required to focus on organisational determinants of hospital- and system-wide interventions, and to provide patient outcome data before and after implementation of the intervention. Empirical, peer-reviewed studies reporting randomised and non-randomised controlled trials, observational, and controlled before and after studies were included in the review. Six studies met the inclusion criteria. Improved outcomes were observed for studies where outcomes were measured at least two years after the intervention. Associations between organisational factors, intervention success and patient outcomes were undetermined: organisational culture and patient outcomes were rarely measured together, and measures for culture and outcome were not standardised. Common findings show the difficulty of introducing large-scale interventions, and that effective leadership and clinical champions, adequate

  13. Large-volume paracentesis with indwelling peritoneal catheter and albumin infusion: a community hospital study

    Directory of Open Access Journals (Sweden)

    Daniel K. Martin

    2016-10-01

    Full Text Available Background: The management of ascites can be problematic. This is especially true in patients with diuretic refractory ascites who develop a tense abdomen. This often results in hypotension and decreased venous return with resulting renal failure. In this paper, we further examine the risks and benefits of utilizing an indwelling peritoneal catheter to remove large-volume ascites over a 72-h period while maintaining intravascular volume and preventing renal failure. Methods: We retrospectively reviewed charts and identified 36 consecutive patients undergoing continuous large-volume paracentesis with an indwelling peritoneal catheter. At the time of drain placement, no patients had signs or laboratory parameters suggestive of spontaneous bacterial peritonitis. The patients underwent ascitic fluid removal through an indwelling peritoneal catheter and were supported with scheduled albumin throughout the duration. The catheter was used to remove up to 3 L every 8 h for a maximum of 72 h. Regular laboratory and ascitic fluid testing was performed. All patients had a clinical follow-up within 3 months after the drain placement. Results: An average of 16.5 L was removed over the 72-h time frame of indwelling peritoneal catheter maintenance. The albumin infusion utilized correlated to 12 mg/L removed. The average creatinine trend improved in a statistically significant manner from 1.37 on the day of admission to 1.21 on the day of drain removal. No patients developed renal failure during the hospital course. There were no documented episodes of neutrocytic ascites or bacterial peritonitis throughout the study review. Conclusion: Large-volume peritoneal drainage with an indwelling peritoneal catheter is safe and effective for patients with tense ascites. Concomitant albumin infusion allows for maintenance of renal function, and no increase in infectious complications was noted.

  14. UK Royal Navy WWII Logbooks

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — In 2006, the UK and NOAA's Climate Database Modernization Program (CDMP) funded the imaging of approximately 8,000 Royal Navy logbooks in the UK National Archives...

  15. Navy fuel cell demonstration project.

    Energy Technology Data Exchange (ETDEWEB)

    Black, Billy D.; Akhil, Abbas Ali

    2008-08-01

    This is the final report on a field evaluation by the Department of the Navy of twenty 5-kW PEM fuel cells carried out during 2004 and 2005 at five Navy sites located in New York, California, and Hawaii. The key objective of the effort was to obtain an engineering assessment of their military applications. Particular issues of interest were fuel cell cost, performance, reliability, and the readiness of commercial fuel cells for use as a standalone (grid-independent) power option. Two corollary objectives of the demonstration were to promote technological advances and to improve fuel performance and reliability. From a cost perspective, the capital cost of PEM fuel cells at this stage of their development is high compared to other power generation technologies. Sandia National Laboratories technical recommendation to the Navy is to remain involved in evaluating successive generations of this technology, particularly in locations with greater environmental extremes, and it encourages their increased use by the Navy.

  16. Ship Observations - VOS and Navy

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Combination of Voluntary Observing Ship (VOS) and US Navy Ship weather observations. Obs generally taken 2-4 times daily at 00, 06, 12, and 18z.

  17. Roadmap for Navy Family Research.

    Science.gov (United States)

    1980-08-01

    09 NAVY FAMIILIES *11* I.- Study *conosical, psychological , and social " rank * duŕ military "areer " employment status . extent of of spouse family...Study ha o. thmfpeect of relocation o familis series with: I I a frequency and t iming of SBANCE *, acconpanied vs. umaccompaiad URE tours alevel of...UNDERSTANDING IMPACT OF RELOCATION ON NAVY FAMILIES AREA 1: STUDY ECONOMICAL, PSYCHOLOGICAL , AND SOCIAL IMPACT ON DIFFERENT FAMILY MEMBERS, FOR

  18. Collective response to public health emergencies and large-scale disasters: putting hospitals at the core of community resilience.

    Science.gov (United States)

    Paturas, James L; Smith, Deborah; Smith, Stewart; Albanese, Joseph

    2010-07-01

    Healthcare organisations are a critical part of a community's resilience and play a prominent role as the backbone of medical response to natural and manmade disasters. The importance of healthcare organisations, in particular hospitals, to remain operational extends beyond the necessity to sustain uninterrupted medical services for the community, in the aftermath of a large-scale disaster. Hospitals are viewed as safe havens where affected individuals go for shelter, food, water and psychosocial assistance, as well as to obtain information about missing family members or learn of impending dangers related to the incident. The ability of hospitals to respond effectively to high-consequence incidents producing a massive arrival of patients that disrupt daily operations requires surge capacity and capability. The activation of hospital emergency support functions provides an approach by which hospitals manage a short-term shortfall of hospital personnel through the reallocation of hospital employees, thereby obviating the reliance on external qualified volunteers for surge capacity and capability. Recent revisions to the Joint Commission's hospital emergency preparedness standard have impelled healthcare facilities to participate actively in community-wide planning, rather than confining planning exclusively to a single healthcare facility, in order to harmonise disaster management strategies and effectively coordinate the allocation of community resources and expertise across all local response agencies.

  19. The Role of Mental Health Disease in Potentially Preventable Hospitalizations: Findings From a Large State.

    Science.gov (United States)

    Medford-Davis, Laura N; Shah, Rohan; Kennedy, Danielle; Becker, Emilie

    2018-01-01

    Preventable hospitalizations are markers of potentially low-value care. Addressing the problem requires understanding their contributing factors. The objective of this study is to determine the correlation between specific mental health diseases and each potentially preventable hospitalization as defined by the Agency for Healthcare Research and Quality. The Texas Inpatient Public Use Data File, an administrative database of all Texas hospital admissions, identified 7,351,476 adult acute care hospitalizations between 2005 and 2008. A hierarchical multivariable logistic regression model clustered by admitting hospital adjusted for patient and hospital factors and admission date. A total of 945,280 (12.9%) hospitalizations were potentially preventable, generating $6.3 billion in charges and 1.2 million hospital days per year. Mental health diseases [odds ratio (OR), 1.25; 95% confidence interval (CI), 1.22-1.27] and substance use disorders (OR, 1.13; 95% CI, 1.12-1.13) both increased odds that a hospitalization was potentially preventable. However, each mental health disease varied from increasing or decreasing the odds of potentially preventable hospitalization depending on which of the 12 preventable hospitalization diagnoses were examined. Older age (OR, 3.69; 95% CI, 3.66-3.72 for age above 75 years compared with 18-44 y), black race (OR 1.44; 95% CI, 1.43-1.45 compared to white), being uninsured (OR 1.52; 95% CI, 1.51-1.54) or dual-eligible for both Medicare and Medicaid (OR, 1.23; 95% CI, 1.22-1.24) compared with privately insured, and living in a low-income area (OR, 1.20; 95% CI, 1.17-1.23 for lowest income quartile compared with highest) were other patient factors associated with potentially preventable hospitalizations. Better coordination of preventative care for mental health disease may decrease potentially preventable hospitalizations.

  20. AAA application in diagnosis exams in a large public hospital, RS, Brazil

    International Nuclear Information System (INIS)

    Bacelar, A.; Ferret, A.A.; Vanni, S.; Galhardi, M.P.; Lykawka, R.

    2013-01-01

    Objective: the initiative AAA - Awareness , Appropriateness and Audit , promotes consciousness ( Awareness) , fitness ( Appropriateness ) and Audit ( Audit) . This paper analyzes the application of the concept in the AAA requests and justifications examinations using ionizing radiation within a large public hospital. Materials and methods: we collected and analyzed data between the years 2011 and 2012, concerning the number of exams performed with the use of radiation and their justifications. After, we sought to raise awareness of the clinical team through training on the risks and benefits of the various modalities of the radiology department and the need to justify the use of ionizing radiation on health. After the data were collected again of test requests for verification of the effectiveness of training. Results: the mean requests that need to be appropriate to the AAA in the last quarter of 2011 was 75 % lower than the average demands of the first quarter, matched against the last two months of 2012 increased by up to four times the number requests that require improvements in relation to the excellent results obtained in July 2012. Conclusion: it is shown in this paper the need of implementing this initiative AAA continuously added to the clinical staff awareness about the risk of the use of ionizing radiation, the appropriateness of the requests of these tests , as well as the control of this process in order to optimize use of ionizing radiation on health

  1. Developing a pediatric palliative care service in a large urban hospital: challenges, lessons, and successes.

    Science.gov (United States)

    Edlynn, Emily S; Derrington, Sabrina; Morgan, Helene; Murray, Jennifer; Ornelas, Beatriz; Cucchiaro, Giovanni

    2013-04-01

    We report the process of creating a new palliative care service at a large, urban children's hospital. Our aim was to provide a detailed guide to developing an inpatient consultation service, along with reporting on the challenges, lessons, and evaluation. We examined the hiring process of personnel and marketing strategies, a clinical database facilitated ongoing quality review and identified trends, and a survey project assessed provider satisfaction and how referring physicians used the palliative care service. The pilot phase of service delivery laid the groundwork for a more effective service by creating documentation templates and identifying relevant data to track growth and outcomes. It also allowed time to establish a clear delineation of team members and distinction of roles. The survey of referring physicians proved a useful evaluation starting point, but conclusions could not be generalized because of the low response rate. It may be necessary to reconsider the survey technique and to expand the sample to include patients and families. Future research is needed to measure the financial benefits of a well-staffed inpatient pediatric palliative care service.

  2. Presentations and Preceding factors of Drug Overdose amongst adolescents admitted to a Large Regional Hospital.

    LENUS (Irish Health Repository)

    Maduemem, KE

    2018-04-01

    Suicide is the third most common cause of death among adolescents globally, and poisoning is the leading method of attempted suicide. Survival after self-poisoning or drug overdose (OD) is common, providing an opportunity for secondary prevention. The aim of this study was to highlight pattern of presentations and preceding factors of OD in an adolescent population. We retrospectively evaluated the data of 85 adolescents presenting to a large regional hospital with OD over a 3-year period. The female-to-male ratio was 4.3:1. The median age of adolescents was 15.83 (range: 11.32 – 16.98) years. History of deliberate self-harm (DSH) was documented in 44.7%. Twenty-eight (33%) patients had been under the care of the CAMHS prior to index admission. Acetaminophen was the commonest drug used. Depression was the most common cause of mental illness in the study group. Substance abuse and conduct disorder were significantly commoner in males (p<0.05). Self-poisoning including OD in adolescence is a strong predictor of suicide; understanding the probable triggers can be significant in establishing appropriate prevention strategies.

  3. After the Recall: Reexamining Multiple Magnet Ingestion at a Large Pediatric Hospital.

    Science.gov (United States)

    Rosenfield, Daniel; Strickland, Matt; Hepburn, Charlotte Moore

    2017-07-01

    To evaluate the effectiveness of a mandatory product recall on the frequency of multiple mini-magnet ingestion at a large tertiary pediatric hospital, and to examine the morbidity and mortality associated with these ingestions. In this retrospective chart review, we searched our institution's electronic patient record for patients aged magnetic foreign bodies between 2002 and 2015, a period that included the mandatory product recall. We compared the frequency and character of ingestions before and after the recall. Comparing the postrecall years (January 1, 2014, to December 31, 2015) with the 2 years immediately preceding the recall year (January 1, 2011, to December 31, 2012) yields an incidence rate ratio of 0.34 (95% CI, 0.18-0.64) for all magnet ingestions and 0.20 (95% CI, 0.08-0.53) for ingestion of multiple magnets. Based on the Fisher exact test, the incidence of both magnet ingestion (P magnet ingestion (P magnet ingestion decreased. There were no deaths in either study period. There was a significant decrease in multiple mini-magnet ingestion following a mandatory product recall. This study supports the effectiveness of the recall, which should bolster efforts to keep it in place in jurisdictions where it is being appealed. More broadly, the result provides general evidence of a recall helping decrease further harm from a product that carries a potential hazard. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. A large outbreak of Listeria monocytogenes infection with short incubation period in a tertiary care hospital.

    Science.gov (United States)

    Johnsen, Bjørn Odd; Lingaas, Egil; Torfoss, Dag; Strøm, Erik H; Nordøy, Ingvild

    2010-12-01

    Listeria monocytogenes is a foodborne pathogen with a high mortality rate. We report a large, nosocomial outbreak of Listeria monocytogenes infection. Patients with L. monocytogenes isolated from a sterile site, or from faeces when diarrhoea and fever were present, were included. Clinical data were collected from the patient records. The incubation period was calculated as the time between exposure and start of symptoms. Seventeen patients (11 women, median age 64 years) were infected of whom 15 patients were at increased risk for listeriosis. Eleven patients received empiric antibiotic treatment, eight of them with cephalosporins. Three patients died with a resulting mortality rate of 18%. The source of the outbreak was a Camembert cheese made from pasteurised milk containing up to 360 million colony forming units per portion. The median incubation period was 3-4 days. The incubation period in this outbreak was significantly shorter than previously reported, a fact that may be due to the high number of ingested bacteria. Furthermore, food restrictions in hospitals seem warranted, as do treatment with antibiotics effective against L. monocytogenes in at-risk populations. Copyright © 2010 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  5. Performance Assessment in Management: an application to the health care system of the Brazilian Navy

    Directory of Open Access Journals (Sweden)

    Marcelino José Jorge

    2013-08-01

    Full Text Available Budgetary restrictions have become much more binding for the Brazilian Navy and both users’ access to health services provided by the Navy Health Service as well as hospitals’ access to new technologies appears to be endangered. This paper aims to evaluate the efficiency of naval hospitals in the light of these concerns, with a view toward designing better managerial tools to enhance health services in the Brazilian Navy. The paper presents an application of Data Envelopment Analysis (DEA to the study of productive efficiency in selected hospital units of the Brazilian Navy in order to suggest improvements on the use of productive resources by the Navy Health Service. Productive efficiency of hospital units located throughout the country are measured and compared. Data Envelopment Analysis models were used to calculate an efficient frontier for the seven naval hospitals assessed and to identify the group of relatively efficient naval hospitals which were used as benchmarks for calculating the pro-efficiency operation plans for the inefficient units.

  6. Extreme temperatures and out-of-hospital coronary deaths in six large Chinese cities.

    Science.gov (United States)

    Chen, Renjie; Li, Tiantian; Cai, Jing; Yan, Meilin; Zhao, Zhuohui; Kan, Haidong

    2014-12-01

    The seasonal trend of out-of-hospital coronary death (OHCD) and sudden cardiac death has been observed, but whether extreme temperature serves as a risk factor is rarely investigated. We therefore aimed to evaluate the impact of extreme temperatures on OHCDs in China. We obtained death records of 126,925 OHCDs from six large Chinese cities (Harbin, Beijing, Tianjin, Nanjing, Shanghai and Guangzhou) during the period 2009-2011. The short-term associations between extreme temperature and OHCDs were analysed with time-series methods in each city, using generalised additive Poisson regression models. We specified distributed lag non-linear models in studying the delayed effects of extreme temperature. We then applied Bayesian hierarchical models to combine the city-specific effect estimates. The associations between extreme temperature and OHCDs were almost U-shaped or J-shaped. The pooled relative risks (RRs) of extreme cold temperatures over the lags 0-14 days comparing the 1st and 25th centile temperatures were 1.49 (95% posterior interval (PI) 1.26-1.76); the pooled RRs of extreme hot temperatures comparing the 99th and 75th centile temperatures were 1.53 (95% PI 1.27-1.84) for OHCDs. The RRs of extreme temperature on OHCD were higher if the patients with coronary heart disease were old, male and less educated. This multicity epidemiological study suggested that both extreme cold and hot temperatures posed significant risks on OHCDs, and might have important public health implications for the prevention of OHCD or sudden cardiac death. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  7. The impact of a unique knowledge translation programme implemented in a large multisite paediatric hospital.

    Science.gov (United States)

    Christensen, Catie; Wessells, David; Byars, Michelle; Marrie, James; Coffman, Shaun; Gates, Erin; Selhorst, Mitch

    2017-04-01

    Physical therapists (PTs) display positive attitudes toward evidence-based practice (EBP), and implementing it can improve patient outcomes and reduce costs. However, barriers can lead to inconsistent use of EBP. The objectives of this manuscript are to (i) describe the initiation and revisions to a knowledge translation (KT) programme, (ii) assess staff participation in KT, and (iii) evaluate availability, internal use and external dissemination of evidence-based recommendations and research. The KT programme was implemented in a large paediatric hospital employing 66 PTs who provide services in the inpatient, outpatient developmental and sports and orthopaedics settings in 15 locations. The KT programme was initiated 9 years ago but underwent improvements over the past 3 years. Five key revisions included the subdivision of the EBP and Research Coordinator positions by area of practice, increasing the structure of the KT programme, implementing strategies to encourage use of local recommendations, obtaining leadership support to emphasize KT and providing staff education. With the revisions, staff participation in local recommendation development increased from 16.3-68.2%. Research involvement increased from 4.1-50%. The number of local recommendations increased from 1 to 9, and an overall compliance rate of 79% was achieved for the recommendations presented in an algorithm format. External dissemination increased from 1 to 44 for presentations and 0 to 7 for publications. Revisions to a KT programme improved PT engagement in KT activities, increased the availability of local recommendations, encouraged use of EBP and increased external dissemination of information. © 2016 John Wiley & Sons, Ltd.

  8. Anticholinergic burden and cognitive function in a large German cohort of hospitalized geriatric patients.

    Directory of Open Access Journals (Sweden)

    Barbara Pfistermeister

    Full Text Available Previous studies suggest an association between use of anticholinergic drugs in elderly patients and cognitive impairment. However, there are still limited data on the association of anticholinergic drug use and cognitive impairment as well as contribution of individual drugs to anticholinergic load using large, well-documented patient cohorts treated in geriatric units from Europe.We investigated 797,440 prescriptions to 89,579 hospitalized patients treated in geriatric units within the GiB-DAT database. Data of all patients discharged between 1 January 2013 and 30 June 2015 was included. The Anticholinergic Cognitive Burden (ACB scale was used to classify anticholinergic drugs as definite (score 2 or 3 and possible anticholinergics (score 1. Cognitive function was determined using Mini-Mental State Examination (MMSE and the standardized scale for dementia (4D+S.In two multivariable logistic regression models age, sex, number of drugs and ACB total scores were identified as variables independently associated with cognitive impairment as measured by MMSE (odds ratio per ACB unit 1.114, 95% CI 1.099-1.130 or the diagnosis dementia (odds ratio 1.159 per ACB unit, 95% CI 1.144-1.173, both p < 0.0001. High anticholinergic load was associated with patients with severe cognitive impairment (p < 0.05 for all pairwise comparisons. ACB score 3 anticholinergic drugs contributed 77.9% to the cumulative amount of ACB points in patients with an anticholinergic load of 3 and higher.Using a cross-sectional study design, a significant positive association between anticholinergic drug load and cognitive impairment in European patients treated in specialised geriatric units was found. The most frequently used definitve anticholinergic drugs were quetiapine, amitriptyline and carbamazepine.

  9. Implementation of Endovenous Laser Ablation for Varicose Veins in a Large Community Hospital : The First 400 Procedures

    NARCIS (Netherlands)

    van den Bremer, J.; Joosten, P. Ph. A. Hedeman; Hamming, J. F.; Moll, F. L.

    Endovenous Laser ablation (ELA) has become a standard treatment of the incompetent great saphenous vein (GSV). Our prospective audit examines the implementation of this new method in a large community hospital with special attention to obstacles, technical results, pain scores, failures and our

  10. Spread of Staphylococcus aureus between medical staff and high-frequency contact surfaces in a large metropolitan hospital

    Directory of Open Access Journals (Sweden)

    Li-sha Shi

    2015-12-01

    Conclusion: Cross-contamination of S. aureus or MRSA on medical workers' hands and contact surfaces was demonstrated within and between departments of a large metropolitan hospital. Improvements are needed in medical staff hygiene habits and in the cleaning of high-frequency contact surfaces to help prevent and control nosocomial infections.

  11. Evaluation of the Navy Master Planning Program

    Science.gov (United States)

    1976-05-01

    Navy planning directives, interviews with Navy planning personnel, researc " of applicable literature on planning and program evaluation, and the...master planning has absorbed the additional roles of program management and public relations marketing . The Navy planner is now deeply involved in...master planning 62conducted by NAVFAC headquarters in 1972, various Navy planning directives, a " Market Survey" of NAVFAC services and customer 63

  12. Hospitals

    DEFF Research Database (Denmark)

    Mullins, Michael

    2013-01-01

    The challenge could be briefly seen in these terms: hospitals as places for treatment where there’s a technology focus and hospitals for healing where there’s a human focus. In the 60s - 70s wave of new hospital building, an emphasis on technology can be seen. It’s time to move from the technology...... focus. It is not enough to consider only the factors of function within architecture, hygiene, economy and logistics. We also need to look at aspects of aesthetics, bringing nature into the building, art, color, acoustics, volume and space as we perceive them. Contemporary methods and advances...... placed, accessible, provided with plenty of greenery, and maximize sensory impressions, providing sounds, smells, sight and the possibility to be touched. This is a very well documented area I can say. Hygiene, in terms of architecture can give attention to hand wash facilities and their positioning...

  13. Occult large epidural hemorrhage in a newborn infant after in-hospital fall.

    Science.gov (United States)

    Sato, R

    2018-05-23

    Management of newborn infants fell in-hospital is especially challenging given the limited signs and symptoms of intracranial hemorrhage in this age group. We present a case of a four day old well appearing newborn infant found to have a severe epidural hemorrhage requiring emergent surgical drainage. Development of imaging protocols for newborn infants suffering in-hospital falls need to consider the potential consequences of missing actionable intracranial hemorrhage when relying on clinical observation as a management strategy.

  14. Skin cancer has a large impact on our public hospitals but prevention programs continue to demonstrate strong economic credentials.

    Science.gov (United States)

    Shih, Sophy T F; Carter, Rob; Heward, Sue; Sinclair, Craig

    2017-08-01

    While skin cancer is still the most common cancer in Australia, important information gaps remain. This paper addresses two gaps: i) the cost impact on public hospitals; and ii) an up-to-date assessment of economic credentials for prevention. A prevalence-based cost approach was undertaken in public hospitals in Victoria. Costs were estimated for inpatient admissions, using State service statistics, and outpatient services based on attendance at three hospitals in 2012-13. Cost-effectiveness for prevention was estimated from 'observed vs expected' analysis, together with program expenditure data. Combining inpatient and outpatient costs, total annual costs for Victoria were $48 million to $56 million. The SunSmart program is estimated to have prevented more than 43,000 skin cancers between 1988 and 2010, a net cost saving of $92 million. Skin cancer treatment in public hospitals ($9.20∼$10.39 per head/year) was 30-times current public funding in skin cancer prevention ($0.37 per head/year). At about $50 million per year for hospitals in Victoria alone, the cost burden of a largely preventable disease is substantial. Skin cancer prevention remains highly cost-effective, yet underfunded. Implications for public health: Increased funding for skin cancer prevention must be kept high on the public health agenda. Hospitals would also benefit from being able to redirect resources to non-preventable conditions. © 2017 The Authors.

  15. Comparing Outcomes of Coronary Artery Bypass Grafting Among Large Teaching and Urban Hospitals in China and the United States.

    Science.gov (United States)

    Zheng, Zhe; Zhang, Heng; Yuan, Xin; Rao, Chenfei; Zhao, Yan; Wang, Yun; Normand, Sharon-Lise; Krumholz, Harlan M; Hu, Shengshou

    2017-06-01

    Coronary artery disease is prevalent in China, with concomitant increases in the volume of coronary artery bypass grafting (CABG). The present study aims to compare CABG-related outcomes between China and the United States among large teaching and urban hospitals. Observational analysis of patients aged ≥18 years, discharged from acute-care, large teaching and urban hospitals in China and the United States after hospitalization for an isolated CABG surgery. Data were obtained from the Chinese Cardiac Surgery Registry in China and the National Inpatient Sample in the United States. Analysis was stratified by 2 periods: 2007, 2008, and 2010; and 2011 to 2013 periods. The primary outcome was in-hospital mortality, and the secondary outcome was length of stay. The sample included 51 408 patients: 32 040 from 77 hospitals in the China-CABG group and 19 368 from 303 hospitals in the US-CABG group. In the 2007 to 2008, 2010 period and for all-age and aged ≥65 years, the China-CABG group had higher mortality than the US-CABG group (1.91% versus 1.58%, P =0.059; and 3.12% versus 2.20%, P =0.004) and significantly higher age-, sex-, and comorbidity-adjusted odds of death (odds ratio, 1.58; 95% confidential interval, 1.22-2.04; and odds ratio, 1.73; 95% confidential interval, 1.24-2.40). There were no significant mortality differences in the 2011 to 2013 period. For preoperative, postoperative, and total hospital stay, respectively, the median (interquartile range) length of stay across the entire study period between China-CABG and US-CABG groups were 9 (8) versus 1 (3), 9 (6) versus 6 (3), and 20 (12) versus 7 (5) days (all P China and the United States. The longer length of stay in China may represent an opportunity for improvement. © 2017 The Authors.

  16. Variations in the Quality of Care at Large Public Hospitals in Beijing, China: A Condition-Based Outcome Approach.

    Science.gov (United States)

    Xu, Ye; Liu, Yuanli; Shu, Ting; Yang, Wei; Liang, Minghui

    2015-01-01

    Public hospitals deliver over ninety percent of all outpatient and inpatient services in China. Their quality is graded into three levels (A, B, and C) largely based on structural resources, but empirical evidence on the quality of process and outcome of care is extremely scarce. As expectations for quality care rise with higher living standards and cost of care, such evidence is urgently needed and vital to improve care and to inform future health reforms. We compiled and analyzed a multicenter database of over 4 million inpatient discharge summary records to provide a comprehensive assessment of the level and variations in clinical outcomes of hospitalization at 39 tertiary hospitals in Beijing. We assessed six outcome measures of clinical quality: in-hospital mortality rates (RSMR) for AMI, stroke, pneumonia and CABG, post-procedural complication rate (RS-CR), and failure-to-rescue rate (RS-FTR). The measures were adjusted for pre-admission patient case-mix using indirect standardization method with hierarchical linear mixed models. We found good overall quality with large variations by hospital and condition (mean/range, in %): RSMR-AMI: 6.23 (2.37-14.48), RSMR-stroke: 4.18 (3.58-4.44), RSMR-pneumonia: 7.78 (7.20-8.59), RSMR-CABG: 1.93 (1.55-2.23), RS-CR: 11.38 (9.9-12.88), and RS-FTR: 6.41 (5.17-7.58). Hospital grade was not significantly associated with any risk-adjusted outcome measures. Going to a higher grade public hospital does not always lead to better patient outcome because hospital grade only contains information about hospital structural resources. A hospital report card with some outcome measures of quality would provide valuable information to patients in choosing providers, and for regulators to identify gaps in health care quality. Reducing the variations in clinical practice and patient outcome should be a focus for policy makers in the next round of health sector reforms in China.

  17. Rotator cuff tears in children and adolescents: experience at a large pediatric hospital

    International Nuclear Information System (INIS)

    Zbojniewicz, Andrew M.; Emery, Kathleen H.; Maeder, Matthew E.; Salisbury, Shelia R.

    2014-01-01

    Prior literature, limited to small case series and case reports, suggests that rotator cuff tears are rare in adolescents. However, we have identified rotator cuff tears in numerous children and adolescents who have undergone shoulder MRI evaluation. The purpose of this study is to describe the prevalence and characteristics of rotator cuff tears in children and adolescents referred for MRI evaluation of the shoulder at a large pediatric hospital and to correlate the presence of rotator cuff tears with concurrent labral pathology, skeletal maturity and patient activity and outcomes. We reviewed reports from 455 consecutive non-contrast MRI and magnetic resonance arthrogram examinations of the shoulder performed during a 2-year period, and following exclusions we yielded 205 examinations in 201 patients (ages 8-18 years; 75 girls, 126 boys). Rotator cuff tears were classified by tendon involved, tear thickness (partial or full), surface and location of tear (when partial) and presence of delamination. We recorded concurrent labral pathology when present. Physeal patency of the proximal humerus was considered open, closing or closed. Statistical analysis was performed to evaluate for a relationship between rotator cuff tears and degree of physeal patency. We obtained patient activity at the time of injury, surgical reports and outcomes from clinical records when available. Twenty-five (12.2%) rotator cuff tears were identified in 17 boys and 7 girls (ages 10-18 years; one patient had bilateral tears). The supraspinatus tendon was most frequently involved (56%). There were 2 full-thickness and 23 partial-thickness tears with articular-side partial-thickness tears most frequent (78%). Insertional partial-thickness tears were more common (78%) than critical zone tears (22%) and 10 (43%) partial-thickness tears were delamination tears. Nine (36%) patients with rotator cuff tears had concurrent labral pathology. There was no statistically significant relationship between

  18. Rotator cuff tears in children and adolescents: experience at a large pediatric hospital

    Energy Technology Data Exchange (ETDEWEB)

    Zbojniewicz, Andrew M.; Emery, Kathleen H. [University of Cincinnati College of Medicine, Department of Radiology, Cincinnati Children' s Hospital Medical Center, Cincinnati, OH (United States); Maeder, Matthew E. [University of Cincinnati College of Medicine, Department of Radiology, Cincinnati Children' s Hospital Medical Center, Cincinnati, OH (United States); Lenox Hill Hospital, Department of Radiology, New York, NY (United States); Salisbury, Shelia R. [University of Cincinnati College of Medicine, Division of Biostatistics and Epidemiology, Cincinnati Children' s Hospital Medical Center, Cincinnati, OH (United States)

    2014-06-15

    Prior literature, limited to small case series and case reports, suggests that rotator cuff tears are rare in adolescents. However, we have identified rotator cuff tears in numerous children and adolescents who have undergone shoulder MRI evaluation. The purpose of this study is to describe the prevalence and characteristics of rotator cuff tears in children and adolescents referred for MRI evaluation of the shoulder at a large pediatric hospital and to correlate the presence of rotator cuff tears with concurrent labral pathology, skeletal maturity and patient activity and outcomes. We reviewed reports from 455 consecutive non-contrast MRI and magnetic resonance arthrogram examinations of the shoulder performed during a 2-year period, and following exclusions we yielded 205 examinations in 201 patients (ages 8-18 years; 75 girls, 126 boys). Rotator cuff tears were classified by tendon involved, tear thickness (partial or full), surface and location of tear (when partial) and presence of delamination. We recorded concurrent labral pathology when present. Physeal patency of the proximal humerus was considered open, closing or closed. Statistical analysis was performed to evaluate for a relationship between rotator cuff tears and degree of physeal patency. We obtained patient activity at the time of injury, surgical reports and outcomes from clinical records when available. Twenty-five (12.2%) rotator cuff tears were identified in 17 boys and 7 girls (ages 10-18 years; one patient had bilateral tears). The supraspinatus tendon was most frequently involved (56%). There were 2 full-thickness and 23 partial-thickness tears with articular-side partial-thickness tears most frequent (78%). Insertional partial-thickness tears were more common (78%) than critical zone tears (22%) and 10 (43%) partial-thickness tears were delamination tears. Nine (36%) patients with rotator cuff tears had concurrent labral pathology. There was no statistically significant relationship between

  19. Frequency of medication errors in an emergency department of a large teaching hospital in southern Iran

    Directory of Open Access Journals (Sweden)

    Vazin A

    2014-12-01

    Full Text Available Afsaneh Vazin,1 Zahra Zamani,1 Nahid Hatam2 1Department of Clinical Pharmacy, Faculty of Pharmacy, 2School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran Abstract: This study was conducted with the purpose of determining the frequency of medication errors (MEs occurring in tertiary care emergency department (ED of a large academic hospital in Iran. The incidence of MEs was determined through the disguised direct observation method conducted by a trained observer. A total of 1,031 medication doses administered to 202 patients admitted to the tertiary care ED were observed over a course of 54 6-hour shifts. Following collection of the data and analysis of the errors with the assistance of a clinical pharmacist, frequency of errors in the different stages was reported and analyzed in SPSS-21 software. For the 202 patients and the 1,031 medication doses evaluated in the present study, 707 (68.5% MEs were recorded in total. In other words, 3.5 errors per patient and almost 0.69 errors per medication are reported to have occurred, with the highest frequency of errors pertaining to cardiovascular (27.2% and antimicrobial (23.6% medications. The highest rate of errors occurred during the administration phase of the medication use process with a share of 37.6%, followed by errors of prescription and transcription with a share of 21.1% and 10% of errors, respectively. Omission (7.6% and wrong time error (4.4% were the most frequent administration errors. The less-experienced nurses (P=0.04, higher patient-to-nurse ratio (P=0.017, and the morning shifts (P=0.035 were positively related to administration errors. Administration errors marked the highest share of MEs occurring in the different medication use processes. Increasing the number of nurses and employing the more experienced of them in EDs can help reduce nursing errors. Addressing the shortcomings with further research should result in reduction

  20. Large scale organisational intervention to improve patient safety in four UK hospitals: mixed method evaluation

    Science.gov (United States)

    Benning, Amirta; Ghaleb, Maisoon; Suokas, Anu; Dixon-Woods, Mary; Dawson, Jeremy; Barber, Nick; Franklin, Bryony Dean; Girling, Alan; Hemming, Karla; Carmalt, Martin; Rudge, Gavin; Naicker, Thirumalai; Nwulu, Ugochi; Choudhury, Sopna

    2011-01-01

    Objectives To conduct an independent evaluation of the first phase of the Health Foundation’s Safer Patients Initiative (SPI), and to identify the net additional effect of SPI and any differences in changes in participating and non-participating NHS hospitals. Design Mixed method evaluation involving five substudies, before and after design. Setting NHS hospitals in the United Kingdom. Participants Four hospitals (one in each country in the UK) participating in the first phase of the SPI (SPI1); 18 control hospitals. Intervention The SPI1 was a compound (multi-component) organisational intervention delivered over 18 months that focused on improving the reliability of specific frontline care processes in designated clinical specialties and promoting organisational and cultural change. Results Senior staff members were knowledgeable and enthusiastic about SPI1. There was a small (0.08 points on a 5 point scale) but significant (Porganisational climate). Qualitative evidence showed only modest penetration of SPI1 at medical ward level. Although SPI1 was designed to engage staff from the bottom up, it did not usually feel like this to those working on the wards, and questions about legitimacy of some aspects of SPI1 were raised. Of the five components to identify patients at risk of deterioration—monitoring of vital signs (14 items); routine tests (three items); evidence based standards specific to certain diseases (three items); prescribing errors (multiple items from the British National Formulary); and medical history taking (11 items)—there was little net difference between control and SPI1 hospitals, except in relation to quality of monitoring of acute medical patients, which improved on average over time across all hospitals. Recording of respiratory rate increased to a greater degree in SPI1 than in control hospitals; in the second six hours after admission recording increased from 40% (93) to 69% (165) in control hospitals and from 37% (141) to 78% (296

  1. Large scale organisational intervention to improve patient safety in four UK hospitals: mixed method evaluation.

    Science.gov (United States)

    Benning, Amirta; Ghaleb, Maisoon; Suokas, Anu; Dixon-Woods, Mary; Dawson, Jeremy; Barber, Nick; Franklin, Bryony Dean; Girling, Alan; Hemming, Karla; Carmalt, Martin; Rudge, Gavin; Naicker, Thirumalai; Nwulu, Ugochi; Choudhury, Sopna; Lilford, Richard

    2011-02-03

    To conduct an independent evaluation of the first phase of the Health Foundation's Safer Patients Initiative (SPI), and to identify the net additional effect of SPI and any differences in changes in participating and non-participating NHS hospitals. Mixed method evaluation involving five substudies, before and after design. NHS hospitals in the United Kingdom. Four hospitals (one in each country in the UK) participating in the first phase of the SPI (SPI1); 18 control hospitals. The SPI1 was a compound (multi-component) organisational intervention delivered over 18 months that focused on improving the reliability of specific frontline care processes in designated clinical specialties and promoting organisational and cultural change. Senior staff members were knowledgeable and enthusiastic about SPI1. There was a small (0.08 points on a 5 point scale) but significant (P organisational climate). Qualitative evidence showed only modest penetration of SPI1 at medical ward level. Although SPI1 was designed to engage staff from the bottom up, it did not usually feel like this to those working on the wards, and questions about legitimacy of some aspects of SPI1 were raised. Of the five components to identify patients at risk of deterioration--monitoring of vital signs (14 items); routine tests (three items); evidence based standards specific to certain diseases (three items); prescribing errors (multiple items from the British National Formulary); and medical history taking (11 items)--there was little net difference between control and SPI1 hospitals, except in relation to quality of monitoring of acute medical patients, which improved on average over time across all hospitals. Recording of respiratory rate increased to a greater degree in SPI1 than in control hospitals; in the second six hours after admission recording increased from 40% (93) to 69% (165) in control hospitals and from 37% (141) to 78% (296) in SPI1 hospitals (odds ratio for "difference in difference" 2

  2. Did the Navy Get Taken

    Science.gov (United States)

    2015-10-01

    into a museum , the Navy decided in 2010 that none of the applications to turn it into a public display was up to par. In addition to its pivotal role in...it formerly cost the Navy a bundle to turn around the Constitution. But then the winner of the competition started to advertise that it had won... Museum , which could not do so, but, referred me to the U.S. Navy’s Public Affairs Officer for the USS Constitution. He was unable to verify the

  3. Epidemiology of Endometriosis in France: A Large, Nation-Wide Study Based on Hospital Discharge Data

    Directory of Open Access Journals (Sweden)

    Peter von Theobald

    2016-01-01

    Full Text Available We aimed to assess the prevalence of hospitalization for endometriosis in the general population in France and in each French region and to describe temporal trends, rehospitalization rates, and prevalence of the different types of endometriosis. The analyses were carried out on French hospital discharge data and covered the period 2008–2012 and a population of 14,239,197 women of childbearing age. In this population, the prevalence of hospitalization for endometriosis was 0.9%, ranging from 0.4% to 1.6% between regions. Endometriosis affected 1.5% of hospitalized women of childbearing age, ranging from 1.0% to 2.4% between regions. The number of patients hospitalized for endometriosis significantly increased over the study period (p<0.01. Of these, 4.2% were rehospitalized at least once at one year: ranging from 2.7% to 6.3% between regions. The cumulative rehospitalization rate at 3 years was 6.9%. The types of endometriosis according to the procedures performed were as follows: ovarian (40–50%, peritoneal (20–30%, intestinal (10–20%, and ureteral or bladder (<10%, with significant differences between regions. This is the first detailed epidemiological study of endometriosis in France. Further studies are needed to assess the reasons for the increasing prevalence of endometriosis and for the significant differences in regional prevalence of this disease.

  4. Necessity of Internal Monitoring for Nuclear Medicine Staff in a Large Specialized Chinese Hospital.

    Science.gov (United States)

    Wang, Hong-Bo; Zhang, Qing-Zhao; Zhang, Zhen; Hou, Chang-Song; Li, Wen-Liang; Yang, Hui; Sun, Quan-Fu

    2016-04-12

    This work intends to quantify the risk of internal contaminations in the nuclear medicine staff of one hospital in Henan province, China. For this purpose, the criteria proposed by the International Atomic Energy Agency (IAEA) to determine whether it is necessary to conduct internal individual monitoring was applied to all of the 18 nuclear medicine staff members who handled radionuclides. The activity of different radionuclides used during a whole calendar year and the protection measures adopted were collected for each staff member, and the decision as to whether nuclear medicine staff in the hospital should be subjected to internal monitoring was made on the basis of the criteria proposed by IAEA. It is concluded that for all 18 members of the nuclear medicine staff in the hospital, internal monitoring is required. Internal exposure received by nuclear medicine staff should not be ignored, and it is necessary to implement internal monitoring for nuclear medicine staff routinely.

  5. Multiple challenges of antibiotic use in a large hospital in Ethiopia - a ward-specific study showing high rates of hospital-acquired infections and ineffective prophylaxis.

    Science.gov (United States)

    Gutema, Girma; Håkonsen, Helle; Engidawork, Ephrem; Toverud, Else-Lydia

    2018-05-03

    This project aims to study the use of antibiotics in three clinical wards in the largest tertiary teaching hospital in Ethiopia for a period of 1 year. The specific aims were to assess the prevalence of patients on antibiotics, quantify the antibiotic consumption and identify the main indications of use. The material was all the medical charts (n = 2231) retrieved from three clinical wards (internal medicine, gynecology/obstetrics and surgery) in Tikur Anbessa Specialized Hospital (TASH) in Addis Ababa between September 2013 and September 2014. Data collection was performed manually by four pharmacists. Each medical chart represented one patient. About 60% of the patients were admitted to internal medicine, 20% to each of the other two wards. The number of bed days (BD) was on average 16.5. Antibiotics for systemic use were prescribed to 73.7% of the patients (on average: 2.1 antibiotics/patient) of whom 86.6% got a third or fourth generation cephalosporin (mainly ceftriaxone). The average consumption of antibiotics was 81.6 DDD/100BD, varying from 91.8 in internal medicine and 71.6 in surgery to 47.6 in gynecology/obstetrics. The five most frequently occurring infections were pneumonia (26.6%), surgical site infections (21.5%), neutropenic fever (6.9%), sepsis (6.4%) and urinary tract infections (4.7%). About one fourth of the prescriptions were for prophylactic purposes. Hospital acquired infections occurred in 23.5% of the patients (353 cases of surgical site infection). The prescribing was based on empirical treatment and sensitivity testing was reported in only 3.8% of the cases. In the present study from three wards in the largest tertiary teaching hospital in Ethiopia, three out of four patients were prescribed antibiotics, primarily empirically. The mean antibiotic consumption was 81.6 DDD/100BD. Surgical site infections constituted a large burden of the infections treated in the hospital, despite extensive prescribing of prophylaxis. The findings show

  6. Catering in a large hospital--does serving from a buffet system meet the patients' needs?

    DEFF Research Database (Denmark)

    Hansen, M.F.; Nielsen, M.A.; Biltz, C.

    2008-01-01

    BACKGROUND & AIMS: It has been suggested that serving from a buffet system may increase food intake. This observational study estimates the energy intake in a representative group of patients admitted to a hospital, where the food is served from a buffet system. MATERIAL: One hundred and sixteen ...

  7. Bedside practice of blood transfusion in a large teaching hospital in Uganda : an observational study

    NARCIS (Netherlands)

    de Graaf, J D; Kajja, I; Bimenya, G S; Postma, Maarten; Smit Sibinga, C.Th.

    BACKGROUND: Adverse transfusion reactions can cause morbidity and death to patients who receive a blood transfusion. Blood transfusion practice in Mulago Hospital, Kampala, Uganda is analyzed to see if and when these practices play a role in the morbidity and mortality of patients. MATERIALS AND

  8. WHY NOT A SUPERMARKET NAVY?

    African Journals Online (AJOL)

    being called upon to carry out that same role once carried out by the ... World War II tradition of being properly Navy-like and seen to be so. ... preferable for us to build our future warships right .... in the Gulf of Mexico for servicing oil rigs and.

  9. Department of the Navy Innovation

    Science.gov (United States)

    branding guides; the rope represents the ships' rigging, used for many years; etc.). Manufacturing Cost(s the trophy designer(s). Example submission package can be found here Branding Guide for U.S. Navy can be found here Branding Guide for U.S. Marine Corps can be found here Design(s) may be modified by the

  10. Effciency of HIV-infected patients detection in neurological hospitals of large industrial center

    Directory of Open Access Journals (Sweden)

    Shmelev V.V.

    2012-06-01

    Full Text Available

    Aim of the study: to evaluate the effciency of detection for HIV-infection in patients of neurological departments of Saratov. Materials and methods. We retrospectively analyzed 25 250 medical histories of patients hospitalized into neurological departments of Saratov hospitals between January 2007 and April 2012. Results. Blood samples of 2010 patients (7,96 % were tested for the presence of HIV-antibodies. 37 patients were HIV-positive (1,84 % of examined patients and 0,15 % of the total number of patients. Conclusion. Increasing popularity and variety of clinical manifestations of HIV-infection requires the expansion of neurological patients whom serum test for antibodies against HIV is needed.

  11. Nurses exposure to workplace violence in a large teaching hospital in Iran.

    Science.gov (United States)

    Teymourzadeh, Ehsan; Rashidian, Arash; Arab, Mohammad; Akbari-Sari, Ali; Hakimzadeh, Seyyed Mostafa

    2014-11-01

    Workplace violence is one of the factors which can strongly reduce job satisfaction and the quality of working life of nurses. The aim of this study was to measure nurses' exposure to workplace violence in one of the major teaching hospitals in Tehran in 2010. We surveyed the nurses in a cross-sectional design in 2010. The questionnaire was adapted from a standardized questionnaire designed collaboratively by the International Labor Office (ILO), the International Health Organization (IHO), the International Council of Nurses (ICN), and the Public Services International (PSI). Finally, in order to analyze the relationships among different variables in the study, T-test and Chi-Square test were used. Three hundred and one nurses responded to the questionnaire (a response rate of 73%). Over 70% of the nurses felt worried about workplace violence. The participants reported exposure to verbal abuse (64% CI: 59-70%), bullying-mobbing (29% CI: 24-34%) and physical violence (12% CI: 9-16%) at least once during the previous year. Relatives of hospital patients were responsible for most of the violence. Nurses working in the emergency department and outpatient clinics were more likely to report having experienced violence. Nurses were unlikely to report violence to hospital managers, and 40% of nurses were unaware of any existing policies within the hospital for reducing violence. We observed a considerable level of nurse exposure to workplace violence. The high rate of reported workplace violence demonstrates that the existing safeguards that aim to protect the staff from abusive patients and relatives are inadequate.

  12. Nurses exposure to workplace violence in a large teaching hospital in Iran

    OpenAIRE

    Teymourzadeh, Ehsan; Rashidian, Arash; Arab, Mohammad; Akbari-Sari, Ali; Hakimzadeh, Seyyed Mostafa

    2014-01-01

    Background Workplace violence is one of the factors which can strongly reduce job satisfaction and the quality of working life of nurses. The aim of this study was to measure nurses’ exposure to workplace violence in one of the major teaching hospitals in Tehran in 2010. Methods We surveyed the nurses in a cross-sectional design in 2010. The questionnaire was adapted from a standardized questionnaire designed collaboratively by the International Labor Office (ILO), the Inter...

  13. Health Coaching in Severe COPD After a Hospitalization: A Qualitative Analysis of a Large Randomized Study.

    Science.gov (United States)

    Benzo, Roberto P; Kirsch, Janae L; Hathaway, Julie C; McEvoy, Charlene E; Vickers, Kristin S

    2017-11-01

    We recently demonstrated in a randomized study the feasibility and effectiveness of telephone-based health coaching using motivational interviewing on decreasing hospital readmissions and improving quality of life at 6 and 12 months after hospital discharge. In this qualitative study, we sought to explore the health-coaching intervention as seen from the perspective of the participants who received the intervention and the coaches who delivered it. Semistructured participant interviews ( n = 24) and a focus group of all health coaches ( n = 3) who participated in this study were conducted. Interviews and focus group were recorded and transcribed verbatim. Transcripts were analyzed using coding and categorizing techniques and thematic analysis. Mixed-method triangulation was used to merge quantitative and qualitative data. Content analysis revealed 4 predominant themes of the coaching intervention: health-coaching relationship, higher participant confidence and reassurance (most related to improvement in physical quality of life), improved health-care system access (most related to decreased hospital readmissions), and increased awareness of COPD symptoms (most related to improvement in emotional quality of life). The strongest theme was the relationship with the health coach, including coach style and motivational interviewing approach. Health coaches' focus group also noted the importance of the coaching relationship as the most significant theme. This study provided themes to further inform the delivery and implementation of health-coaching interventions in patients with COPD after hospital discharge. Health coaching forged partnerships and created a platform for patient engagement, which was confirmed by both participants and health coaches. Copyright © 2017 by Daedalus Enterprises.

  14. Nurses Exposure to Workplace Violence in a Large Teaching Hospital in Iran

    Directory of Open Access Journals (Sweden)

    Ehsan Teymourzadeh

    2014-11-01

    Full Text Available Background Workplace violence is one of the factors which can strongly reduce job satisfaction and the quality of working life of nurses. The aim of this study was to measure nurses’ exposure to workplace violence in one of the major teaching hospitals in Tehran in 2010. Methods We surveyed the nurses in a cross-sectional design in 2010. The questionnaire was adapted from a standardized questionnaire designed collaboratively by the International Labor Office (ILO, the International Health Organization (IHO, the International Council of Nurses (ICN, and the Public Services International (PSI. Finally, in order to analyze the relationships among different variables in the study, T-test and Chi-Square test were used. Results Three hundred and one nurses responded to the questionnaire (a response rate of 73%. Over 70% of the nurses felt worried about workplace violence. The participants reported exposure to verbal abuse (64% CI: 59-70%, bullying-mobbing (29% CI: 24-34% and physical violence (12% CI: 9-16% at least once during the previous year. Relatives of hospital patients were responsible for most of the violence. Nurses working in the emergency department and outpatient clinics were more likely to report having experienced violence. Nurses were unlikely to report violence to hospital managers, and 40% of nurses were unaware of any existing policies within the hospital for reducing violence. Conclusion We observed a considerable level of nurse exposure to workplace violence. The high rate of reported workplace violence demonstrates that the existing safeguards that aim to protect the staff from abusive patients and relatives are inadequate.

  15. Bedside practice of blood transfusion in a large teaching hospital in Uganda: An observational study

    Directory of Open Access Journals (Sweden)

    de Graaf J

    2009-01-01

    Full Text Available Background: Adverse transfusion reactions can cause morbidity and death to patients who receive a blood transfusion. Blood transfusion practice in Mulago Hospital, Kampala, Uganda is analyzed to see if and when these practices play a role in the morbidity and mortality of patients. Materials and Methods: An observational study on three wards of Mulago Hospital. Physicians, paramedics, nurses, medical students and nurse students were observed using two questionnaires. For comparison, a limited observational study was performed in the University Medical Centre Groningen (UMCG in Groningen, The Netherlands. Results: In Mulago Hospital guidelines for blood transfusion practice were not easily available. Medical staff members work on individual professional levels. Students perform poorly due to inconsistency in their supervision. Documentation of blood transfusion in patient files is scarce. There is no immediate bedside observation, so transfusion reactions and obstructions in the blood transfusion flow are not observed. Conclusion: The poor blood transfusion practice is likely to play a role in the morbidity and mortality of patients who receive a blood transfusion. There is a need for a blood transfusion policy and current practical guidelines.

  16. A Performance Analysis of Long-term Acute-Care Hospitals Owned by Large, Multistate Investor-Owned Companies.

    Science.gov (United States)

    Nayar, Preethy; Liu, Xinliang; McCue, Michael J

    2016-01-01

    This study provides a descriptive assessment of the operating performance of for-profit long-term acute-care hospitals owned by multistate, investor-owned companies (large FP LTCHs) compared with FP LTCHs owned by smaller FP companies (small FP LTCHs) and nonprofit LTCHs (NP LTCHs). The study used the Centers for Medicare & Medicaid Services cost report data for 290 LTCHs from 2010 through 2012 to compare the financial performance of large and small FP LTCHs and NP LTCHs. The study found that the median operating profit margin for large FP LTCHs was 8.06%, which was twice as high as that of the small FP LTCHs and NP LTCHs (4.78% and 2.80%, respectively). Larger size, serving a greater proportion of private pay and more complex patients and incurring lower operating expenses, including salary expenses, may account for the higher operating margin of the large FP LTCHs.

  17. A fast method for large-scale isolation of phages from hospital ...

    African Journals Online (AJOL)

    This plaque-forming method could be adopted to isolate E. coli phage easily, rapidly and in large quantities. Among the 18 isolated E. coli phages, 10 of them had a broad host range in E. coli and warrant further study. Key words: Escherichia coli phages, large-scale isolation, drug resistance, biological properties.

  18. The medicine selection process in four large university hospitals in Brazil: Does the DTC have a role?

    Directory of Open Access Journals (Sweden)

    Elisangela da Costa Lima-Dellamora

    2015-03-01

    Full Text Available Knowledge about evidence-based medicine selection and the role of the Drug and Therapeutics Committee (DTC is an important topic in the literature but is scarcely discussed in Brazil. Our objective, using a qualitative design, was to analyze the medicine selection process performed in four large university hospitals in the state of Rio de Janeiro. Information was collected from documents, interviews with key informants and direct observations. Two dimensions were analyzed: the structural and organizational aspects of the selection process and the criteria and methods used in medicine selection. The findings showed that the DTC was active in two hospitals. The structure for decision-making was weak. DTC members had little experience in evidence-based selection, and their everyday functions did not influence their participation in DTC activities. The methods used to evaluate evidence were inadequate. The uncritical adoption of new medicines in these complex hospital facilities may be hampering pharmaceutical services, with consequences for the entire health system. Although the qualitative approach considerably limits the extent to which the results can be extrapolated, we believe that our findings may be relevant to other university hospitals in the country.

  19. Comparison of the Navy Working Capital Fund and Mission Funding as Applied to Navy Shipyards

    National Research Council Canada - National Science Library

    Cain, Andrew M

    2006-01-01

    .... Specifically, the Navy has shifted two of its four shipyards, with authorization to shift the other two in FY07, from the Navy Working Capital Fund to mission funding through direct congressional appropriations...

  20. Malnutrition risk in hospitalized children: use of 3 screening tools in a large European population.

    Science.gov (United States)

    Chourdakis, Michael; Hecht, Christina; Gerasimidis, Konstantinos; Joosten, Koen Fm; Karagiozoglou-Lampoudi, Thomais; Koetse, Harma A; Ksiazyk, Janusz; Lazea, Cecilia; Shamir, Raanan; Szajewska, Hania; Koletzko, Berthold; Hulst, Jessie M

    2016-05-01

    Several malnutrition screening tools have been advocated for use in pediatric inpatients. We evaluated how 3 popular pediatric nutrition screening tools [i.e., the Pediatric Yorkhill Malnutrition Score (PYMS), the Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP), and the Screening Tool for Risk of Impaired Nutritional Status and Growth (STRONGKIDS)] compared with and were related to anthropometric measures, body composition, and clinical variables in patients who were admitted to tertiary hospitals across Europe. The 3 screening tools were applied in 2567 inpatients at 14 hospitals across 12 European countries. The classification of patients into different nutritional risk groups was compared between tools and related to anthropometric measures and clinical variables [e.g., length of hospital stay (LOS) and infection rates]. A similar rate of completion of the screening tools for each tool was achieved (PYMS: 86%; STAMP: 84%; and STRONGKIDS: 81%). Risk classification differed markedly by tool, with an overall agreement of 41% between tools. Children categorized as high risk (PYMS: 25%; STAMP: 23%; and STRONGKIDS: 10%) had a longer LOS than that of children at low risk (1.4, 1.4, and 1.8 d longer, respectively; P malnutrition risk varied across the pediatric tools used. A considerable portion of children with subnormal anthropometric measures were not identified with all of the tools. The data obtained do not allow recommending the use of any of these screening tools for clinical practice. This study was registered at clinicaltrials.gov as NCT01132742. © 2016 American Society for Nutrition.

  1. A pediatric death audit in a large referral hospital in Malawi.

    Science.gov (United States)

    Fitzgerald, Elizabeth; Mlotha-Mitole, Rachel; Ciccone, Emily J; Tilly, Alyssa E; Montijo, Jennie M; Lang, Hans-Joerg; Eckerle, Michelle

    2018-02-21

    Death audits have been used to describe pediatric mortality in under-resourced settings, where record keeping is often a challenge. This information provides the cornerstone for the foundation of quality improvement initiatives. Malawi, located in sub-Saharan Africa, currently has an Under-5 mortality rate of 64/1000. Kamuzu Central Hospital, in the capital city Lilongwe, is a busy government referral hospital, which admits up to 3000 children per month. A study published in 2013 reported mortality rates as high as 9%. This is the first known audit of pediatric death files conducted at this hospital. A retrospective chart review on all pediatric deaths that occurred at Kamuzu Central Hospital (excluding deaths in the neonatal nursery) during a 13-month period was done using a standardized death audit form. A descriptive analysis was completed, including patient demographics, HIV and nutritional status, and cause of death. Modifiable factors were identified that may have contributed to mortality, including a lack of vital sign collection, poor documentation, and delays in the procurement or results of tests, studies, and specialist review. Seven hundred forty three total pediatric deaths were recorded and 700 deceased patient files were reviewed. The mortality rate by month ranged from a low of 2.2% to a high of 4.4%. Forty-four percent of deaths occurred within the first 24 h of admission, and 59% occurred within the first 48 h. The most common causes of death were malaria, malnutrition, HIV-related illnesses, and sepsis. The mortality rate for this pediatric referral center has dramatically decreased in the 6 years since the last published mortality data, but remains high. Areas identified for continued development include improved record keeping, improved patient assessment and monitoring, and more timely and reliable provision of testing and treatment. This study demonstrates that in low-resource settings, where reliable record keeping is often difficult

  2. Prevalence of Musculoskeletal Disorders among Paramedics Working in a Large Hospital in Ahwaz, Southwestern Iran in 2010

    Directory of Open Access Journals (Sweden)

    KR Shafizadeh

    2011-06-01

    Full Text Available Background: Musculoskeletal disorders (MSDs are common among employees throughout the world, particularly in high risk groups such as nurses. Objective: To determine the prevalence of MSDs among nurses in a large hospital in Ahwaz, southwestern Iran, and to examine its correlation with gender, age, shift working, years at service and smoking. Methods: Using a self-reported questionnaire-based cross-sectional study, Nordic questionnaire for MSDs was disseminated to all inpatient hospital paramedics (n=195 in a large hospital in Ahwaz. Results: Questionnaires of 161 participants were completed and returned back for analysis (response rate of 83%. The reported prevalence of MSDs was very high in the studied paramedics so that more than 90% of them reported at least one MSD in last week. The most prevalent site affected was that of neck (64% followed by head (62.1%, knees (54.7% and wrists/hands (49.7%; the least frequent disorder was that of elbows (14.3%. MSD was more common in females and increased with age and years of service. Non-shift workers reported more neck and elbows MSDs than shift workers. Conclusion: Considering the very high prevalence of MSDs among paramedics, it is suggested that they engage in an exercise program at their work place to lower the risk of MSDs and promote working efficiency.

  3. Diarrhoea in slum children: observation from a large diarrhoeal disease hospital in Dhaka, Bangladesh.

    Science.gov (United States)

    Ferdous, Farzana; Das, Sumon Kumar; Ahmed, Shahnawaz; Farzana, Fahmida Dil; Malek, Mohammad Abdul; Das, Jui; Latham, Jonathan Ross; Faruque, Abu Syed Golam; Chisti, Mohammod Jobayer

    2014-10-01

    To determine and compare socio-demographic, nutritional and clinical characteristics of children under five with diarrhoea living in slums with those of children who do not live in slums of Dhaka, Bangladesh. From 1993 to 2012, a total of 28 948 under fives children with diarrhoea attended the Dhaka Hospital of icddr,b. Data were extracted from the hospital-based Diarrhoea Disease Surveillance System, which comprised 17 548 under fives children from slum and non-slum areas of the city. Maternal illiteracy [aOR = 1.57; 95% confidence interval (1.36, 1.81), P-value slum-dwelling children after controlling for co-variates. Measles immunisation [0.52 (0.47, 0.59) P slum dwellers than other children in univarate analysis only. Slum-dwelling children are more malnourished, have lower immunisation rates (measles vaccination and vitamin A supplementation) and higher rates of measles, are more susceptible to diarrhoeal illness due to V. cholerae and suffer from severe dehydration more often than children from non-slum areas. Improved health and nutrition strategies should give priority to children living in urban slums. © 2014 John Wiley & Sons Ltd.

  4. Elaboration of a program for monitoring the ionizing radiations in a large hospital

    International Nuclear Information System (INIS)

    Carreira, Mauricio Costa

    1996-11-01

    Personnel monitoring data collected in the Radiotherapy, Diagnostic Radiology and Hemodynamics Departments of the Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto - USP during the interval from 1986 to 1995 were analyzed. The data were classified according to the profession of the workers and compared to those collected in a previous period (1973-1982). Internationally established criteria, published published in the ICRP 35 and 60 were used together with additional Brazilian criteria (CNEN NE 3.01) to optimize personnel monitoring such that the required radioprotection is provided. The results show that 80% of the workers need not be monitored because their doses will not exceed 3/10 the annual limits. An economy of about US$10,200 in monitoring cost per year could be realized as well as reduction in the hospital clerical costs expended to maintain the records. The improvements gaining by reducing the number of monitored persons will not compromise the safety standard required for radiation protection. (author)

  5. An Analysis of the Performance-Based Service Acquisition (PBSA) and Its Applicability to Hellenic Navy Service Acquisition Activities

    Science.gov (United States)

    2012-12-01

    potential offeror in response to its request must not be disclosed if doing so would reveal the potential offeror’s confidential business strategy...also the Navy Academy and the Navy hospital have and operate kitchen facilities. Ships have their own kitchen facilities too and dedicated personnel...abandoned. Now the HN dedicates personnel, has kitchen facilities to provide the food services and doing the whole process. The HN could outsource

  6. Accelerating Best Care in Pennsylvania: adapting a large academic system's quality improvement process to rural community hospitals.

    Science.gov (United States)

    Haydar, Ziad; Gunderson, Julie; Ballard, David J; Skoufalos, Alexis; Berman, Bettina; Nash, David B

    2008-01-01

    Industrial quality improvement (QI) methods such as continuous quality improvement (CQI) may help bridge the gap between evidence-based "best care" and the quality of care provided. In 2006, Baylor Health Care System collaborated with Jefferson Medical College of Thomas Jefferson University to conduct a QI demonstration project in select Pennsylvania hospitals using CQI techniques developed by Baylor. The training was provided over a 6-month period and focused on methods for rapid-cycle improvement; data system design; data management; tools to improve patient outcomes, processes of care, and cost-effectiveness; use of clinical guidelines and protocols; leadership skills; and customer service skills. Participants successfully implemented a variety of QI projects. QI education programs developed and pioneered within large health care systems can be adapted and applied successfully to other settings, providing needed tools to smaller rural and community hospitals that lack the necessary resources to establish such programs independently.

  7. A Large-Scale Community-Based Outbreak of Paratyphoid Fever Caused by Hospital-Derived Transmission in Southern China.

    Directory of Open Access Journals (Sweden)

    Meiying Yan

    Full Text Available Since the 1990s, paratyphoid fever caused by Salmonella Paratyphi A has emerged in Southeast Asia and China. In 2010, a large-scale outbreak involving 601 cases of paratyphoid fever occurred in the whole of Yuanjiang county in China. Epidemiological and laboratory investigations were conducted to determine the etiology, source and transmission factors of the outbreak.A case-control study was performed to identify the risk factors for this paratyphoid outbreak. Cases were identified as patients with blood culture-confirmed S. Paratyphi A infection. Controls were healthy persons without fever within the past month and matched to cases by age, gender and geography. Pulsed-field gel electrophoresis and whole-genome sequencing of the S. Paratyphi A strains isolated from patients and environmental sources were performed to facilitate transmission analysis and source tracking. We found that farmers and young adults were the populations mainly affected in this outbreak, and the consumption of raw vegetables was the main risk factor associated with paratyphoid fever. Molecular subtyping and genome sequencing of S. Paratyphi A isolates recovered from improperly disinfected hospital wastewater showed indistinguishable patterns matching most of the isolates from the cases. An investigation showed that hospital wastewater mixed with surface water was used for crop irrigation, promoting a cycle of contamination. After prohibition of the planting of vegetables in contaminated fields and the thorough disinfection of hospital wastewater, the outbreak subsided. Further analysis of the isolates indicated that the origin of the outbreak was most likely from patients outside Yuanjiang county.This outbreak is an example of the combined effect of social behaviors, prevailing ecological conditions and improper disinfection of hospital wastewater on facilitating a sustained epidemic of paratyphoid fever. This study underscores the critical need for strict treatment

  8. Prevalence of AmpC and other beta-lactamases in enterobacteria at a large urban university hospital in Brazil

    Science.gov (United States)

    Dias, Rubens Clayton da Silva; Borges-Neto, Armando Alves; Ferraiuoli, Giovanna Ianini D’Almeida; de-Oliveira, Márcia P.; Riley, Lee W.; Moreira, Beatriz Meurer

    2010-01-01

    Production of extended-spectrum β-lactamases (ESBL) has been reported in virtually all species of Enterobacteriaceae, which greatly complicates the therapy of infections caused by these organisms. However, the frequency of isolates producing AmpC β-lactamases, especially plasmid mediated AmpC (pAmpC), is largely unknown. These β-lactamases confer resistance to extended spectrum cephalosporins and aztreonam, a multidrug-resistant (MDR) profile. The aim of the present study was to determine the occurrence of ESBL and pAmpC β-lactamases in a hospital where MDR enterobacterial isolates recently emerged. A total of 123 consecutive enterobacterial isolates obtained from 112 patients at a university hospital in Rio de Janeiro, Brazil during March-June 2001 were included in the study. ESBL was detected by the addition of clavulanate to cephalosporin containing disks and by double diffusion. AmpC production was evaluated by a modified tridimensional test and a modified Hodge test. The presence of plasmid-mediated ampC β-lactamase genes was evaluated by multiplex-PCR. Sixty-five (53%) of 123 enterobacterial isolates were MDR, obtained from 56 patients. ESBL production was detected in 35 isolates; 5 clonal E. coli isolates exhibited high levels of chromosomal AmpC and ESBL production. However, no isolates contained pAmpC genes. Infection or colonization by MDR enterobacteria was not associated with any predominant resistant clones. A large proportion of hospital infections caused by ESBL-producing enterobacteria identified during the study period were due to sporadic infections rather than undetected outbreaks. This observation emphasizes the need to improve our detection methods for ESBL- and AmpC-producing organisms in hospitals where extended-spectrum cephalosporins are in wide use. PMID:17900845

  9. Six year trend of neonatal septicaemia in a large Malaysian maternity hospital.

    Science.gov (United States)

    Boo, N Y; Chor, C Y

    1994-02-01

    A study carried out in the Maternity Hospital, Kuala Lumpur over a 6 year period from 1986 to 1991, showed that the annual rates of septicaemia ranged from 5.2 to 10.2/100 admissions. Septicaemia accounted for between 11.0 to 30.4% of all neonatal deaths. The case fatality ratios ranged from 23.0 to 52.2%, being highest in 1989 when basic facilities were compromised. Low birthweight neonates accounted for 55.5% of those with septicaemia. The most common causative organisms were Staphylococcus epidermidis and Staphylococcus aureus in 1986 and 1987, but from 1988 Klebsiella species became the most common. More than 50% of neonatal septicaemia occurred after the age of 2 days. The results of the study demonstrated the dynamism of infection control: when control measures introduced earlier were not sustained, outbreaks of nosocomial infection recurred or worsened.

  10. The Experience of a District General Hospital with a Large Outdoor Music Festival in England.

    Science.gov (United States)

    Kamour, A; Yardley, R; Longshaw, M; Stuart, J

    2017-01-01

    To assess the impact of the Parklife annual music festival on the local hospital, North Manchester General. Data was obtained retrospectively by analysis of emergency department records during the weekend of Parklife 2015. 32 patients were identified, 56% reported taking drugs. 34% were admitted for overnight observation. 4 patients presented with methaemoglobinaemia following oral ingestion of amyl nitrate. One patient had a methaemoglobin fraction of 90.6%, which is amongst the most extreme recorded in literature. Music festivals can impose a burden on local health services. Organisers should operate an efficient surveillance system in order to prevent the sale and use of recreational drugs, providing adequate on-site health services and working in collaboration with local emergency services.

  11. Navy MANTECH 2008 Project Book

    Science.gov (United States)

    2008-01-01

    and Shipbuilding Company (NASSCO) to design and build a hybrid laser / GMAW system that combines the deep keyhole pen- etration of laser welding with...ance that the weapon system PM is truly committed to the successful outcome of the ManTech project. In addition, this close working relationship...will reduce the cost and time to build and repair Navy ships. The Center works closely with the Navy’s acquisition community and the shipbuilding

  12. Importation, Mitigation, and Genomic Epidemiology of Candida auris at a Large Teaching Hospital.

    Science.gov (United States)

    Lesho, Emil P; Bronstein, Melissa Z; McGann, Patrick; Stam, Jason; Kwak, Yoon; Maybank, Rosslyn; McNamara, Jodi; Callahan, Megan; Campbell, Jean; Hinkle, Mary K; Walsh, Edward E

    2018-01-01

    OBJECTIVE Candida auris (CA) is an emerging multidrug-resistant pathogen associated with increased mortality. The environment may play a role, but transmission dynamics remain poorly understood. We sought to limit environmental and patient CA contamination following a sustained unsuspected exposure. DESIGN Quasi-experimental observation. SETTING A 528-bed teaching hospital. PATIENTS The index case patient and 17 collocated ward mates. INTERVENTION Immediately after confirmation of CA in the bloodstream and urine of a patient admitted 6 days previously, active surveillance, enhanced transmission-based precautions, environmental cleaning with peracetic acid-hydrogen peroxide and ultraviolet light, and patient relocation were undertaken. Pre-existing agreements and foundational relationships among internal multidisciplinary teams and external partners were leveraged to bolster detection and mitigation efforts and to provide genomic epidemiology. RESULTS Candida auris was isolated from 3 of 132 surface samples on days 8, 9, and 15 of ward occupancy, and from no patient samples (0 of 48). Environmental and patient isolates were genetically identical (4-8 single-nucleotide polymorphisms [SNPs]) and most closely related to the 2013 India CA-6684 strain (~200 SNPs), supporting the epidemiological hypothesis that the source of environmental contamination was the index case patient, who probably acquired the South Asian strain from another New York hospital. All isolates contained a mutation associated with azole resistance (K163R) found in the India 2105 VPCI strain but not in CA-6684. The index patient remained colonized until death. No surfaces were CA-positive 1 month later. CONCLUSION Compared to previous descriptions, CA dissemination was minimal. Immediate access to rapid CA diagnostics facilitates early containment strategies and outbreak investigations. Infect Control Hosp Epidemiol 2018;39:53-57.

  13. Navy Telemedicine: Current Research and Future Directions

    National Research Council Canada - National Science Library

    Reed, Cheryl

    2002-01-01

    .... This report reviews military and civilian models for evaluating telemedicine systems in order to determine future directions for Navy telemedicine research within the current funding environment...

  14. Navy Professional Reading Program: Results of the 2007 Survey

    National Research Council Canada - National Science Library

    Uriell, Zannette A; Johnson, J. S

    2008-01-01

    In 2007, the Navy instituted the Navy Professional Reading Program (NPRP), designed to empower Sailors to grow professionally by improving critical thinking and stimulating discussion through professional reading...

  15. HOMER Economic Models - US Navy

    Energy Technology Data Exchange (ETDEWEB)

    Bush, Jason William [Idaho National Lab. (INL), Idaho Falls, ID (United States); Myers, Kurt Steven [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-02-01

    This LETTER REPORT has been prepared by Idaho National Laboratory for US Navy NAVFAC EXWC to support in testing pre-commercial SIREN (Simulated Integration of Renewable Energy Networks) computer software models. In the logistics mode SIREN software simulates the combination of renewable power sources (solar arrays, wind turbines, and energy storage systems) in supplying an electrical demand. NAVFAC EXWC will create SIREN software logistics models of existing or planned renewable energy projects at five Navy locations (San Nicolas Island, AUTEC, New London, & China Lake), and INL will deliver additional HOMER computer models for comparative analysis. In the transient mode SIREN simulates the short time-scale variation of electrical parameters when a power outage or other destabilizing event occurs. In the HOMER model, a variety of inputs are entered such as location coordinates, Generators, PV arrays, Wind Turbines, Batteries, Converters, Grid costs/usage, Solar resources, Wind resources, Temperatures, Fuels, and Electric Loads. HOMER's optimization and sensitivity analysis algorithms then evaluate the economic and technical feasibility of these technology options and account for variations in technology costs, electric load, and energy resource availability. The Navy can then use HOMER’s optimization and sensitivity results to compare to those of the SIREN model. The U.S. Department of Energy (DOE) Idaho National Laboratory (INL) possesses unique expertise and experience in the software, hardware, and systems design for the integration of renewable energy into the electrical grid. NAVFAC EXWC will draw upon this expertise to complete mission requirements.

  16. Systematic implementation of clinical risk management in a large university hospital: the impact of risk managers.

    Science.gov (United States)

    Sendlhofer, Gerald; Brunner, Gernot; Tax, Christa; Falzberger, Gebhard; Smolle, Josef; Leitgeb, Karina; Kober, Brigitte; Kamolz, Lars Peter

    2015-01-01

    For health care systems in recent years, patient safety has increasingly become a priority issue. National and international strategies have been considered to attempt to overcome the most prominent hazards while patients are receiving health care. Thereby, clinical risk management (CRM) plays a dominant role in enabling the identification, analysis, and management of potential risks. CRM implementation into routine procedures within complex hospital organizations is challenging, as in the past, organizational change strategies using a top-down approach have often failed. Therefore, one of our main objectives was to educate a certain number of risk managers in facilitating CRM using a bottom-up approach. To achieve our primary purpose, five project strands were developed, and consequently followed, introducing CRM: corporate governance, risk management (RM) training, CRM process, information, and involvement. The core part of the CRM process involved the education of risk managers within each organizational unit. To account for the size of the existing organization, we assumed that a minimum of 1 % of the workforce had to be trained in RM to disseminate the continuous improvement of quality and safety. Following a roll-out plan, CRM was introduced in each unit and potential risks were identified. Alongside the changes in the corporate governance, a hospital-wide CRM process was introduced resulting in 158 trained risk managers correlating to 2.0 % of the total workforce. Currently, risk managers are present in every unit and have identified 360 operational risks. Among those, 176 risks were scored as strategic and clustered together into top risks. Effective meeting structures and opportunities to share information and knowledge were introduced. Thus far, 31 units have been externally audited in CRM. The CRM approach is unique with respect to its dimension; members of all health care professions were trained to be able to identify potential risks. A network of risk

  17. The clinical pattern of diabetes Insipidus in a large university hospital in the Middle East.

    Science.gov (United States)

    Babiker, Amir M I; Al Jurayyan, Nasir A M; Al Jurayyan, Rushaid N A; Al Gadi, Iman; Drop, Stenvert L S

    2015-04-01

    Diabetes insipidus is a rare but serious endocrine disorder. Paediatric patients were evaluated for polyuria at King Khalid University Hospital, Riyadh, Saudi Arabia, over a decade (2000-13). Relevant clinical examination and/or a triad of high serum osmolality, hypernatremia and low urine osmolality due to increased urine output confirmed the diagnosis. Water deprivation test was required in some cases with non-classic presentations. Appropriate brain imaging was performed whenever central diabetes insipidus (CDI) was suspected. Twenty-eight patients, 15 males (53.6%) and 13 females (46.4%), aged 0-17 years (mean: 6 years) were included. The calculated period prevalence was 7 in 10,000. In our cohort, 60.7% (17 of 28 patients) had CDI, 21.4% (6 of 28) were diagnosed with nephrogenic diabetes insipidus (NDI) and 17.9% (5 of 30) had psychogenic polydipsia. CDI was due to variable aetiology. Though CDI was the commonest, NDI was not a rare encounter in our community, possibly because of high consanguineous marriages. © The Author [2015]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  18. Environmental dose level survey of radiotherapy center in large cancer hospital

    International Nuclear Information System (INIS)

    Wan Bin; Zhong Hailuo; Wu Dake; Li Jian; Wang Pei; Qi Guohai; Huang Renbing; Lang Jinyi

    2009-01-01

    Objective: To investigate and analyze the radiation dosage around the working environment in radiotherapy centre affiliated to Sichuan cancer hospital in the western China. Methods: In 60 days, we have continuously monitored the accumulated dose that absorbed by doctors, nurses, technicians, physicists and engineers, and investigated the working environment ( 60 Co unit, accelerator, after loading unit, X-ray simulator, CT simulator, gamma knife, MRI and doctor's office) and external environment by using TLD, and compared our results to those released by relevant departments. Results: The average dosage in the working environment is 1.96 μC ·kg -1 ·month -1 , 1.61 μC ·kg -1 ·month -1 in external environment. Conclusion: In the past 25 years, the radiotherapy center constructed strictly by the criterions of environment and protection departments required, so the radiation dosage in or outside the radiotherapy center has reached the national standard, which is safe for the staff and patients. Its instatement that the radiotherapy sites constructed by the related laws well accorded with the safety standards regulated. (authors)

  19. Retrospective audit of antimicrobial prescribing practices for acute exacerbations of chronic obstructive pulmonary diseases in a large regional hospital.

    Science.gov (United States)

    Brownridge, D J; Zaidi, S T R

    2017-06-01

    Chronic obstructive pulmonary disease (COPD) is associated with significant morbidity and mortality, and frequent exacerbations are associated with an increased risk of death, deterioration in lung function and reduced quality of life. Current Australian guidelines developed by the Lung Foundation of Australia (the COPD-X Plan) recommends the use of a short course of corticosteroids and oral antibiotics (amoxycillin or doxycycline) as part of the treatment of an AECOPD; however, it was noted that clinical practice at the study hospital had deviated from these guidelines. To evaluate the antibiotic prescribing practices in acute exacerbations of chronic obstructive pulmonary disease (AECOPD) patients, and to compare the differences in clinical outcomes (primarily mean length of stay and the rate of unplanned readmissions) between patients who received broad- vs. narrow-spectrum antibiotics in a large regional hospital. Retrospective audit of medical records for patients admitted with uncomplicated AECOPD during January-September, 2014 in a 224 acute bed regional hospital in Victoria, Australia. Fifty-nine per cent of patients received broad-spectrum antibiotics (ceftriaxone), whereas only 10% of prescriptions were concordant with current Australian guideline recommendations. Patients receiving a broad-spectrum regimen were more likely to be older (74·9 vs. 69·9 years; P = 0·009), have a higher COPD severity score (i.e. BAP-65 score, 1·55 vs. 1·06; P = 0·002) and a higher CRP (59·2 vs. 25·5 mg/L; P = 0·003) on admission. The mean LOS was not significantly different between those who received ceftriaxone and those who did not (5·09 vs. 4·55 days; P = 0·47). There was no significant difference between the groups in rates of readmissions. The antibiotic prescribing patterns for AECOPD in rural and regional Australian hospitals have not previously been examined in the current literature. In the study hospital, the majority of patients received broad

  20. Treatment of patients with a history of penicillin allergy in a large tertiary-care academic hospital.

    Science.gov (United States)

    Picard, Matthieu; Bégin, Philippe; Bouchard, Hugues; Cloutier, Jonathan; Lacombe-Barrios, Jonathan; Paradis, Jean; Des Roches, Anne; Laufer, Brian; Paradis, Louis

    2013-01-01

    Prescribing antibiotics to patients with a history of penicillin allergy is common in clinical practice. Opting for non-beta-lactam antibiotics has its inconveniences and is often unnecessary, because most of these patients are in fact not allergic. This study aimed to determine how physicians in a large Canadian tertiary-care academic hospital without allergists on staff treat patients with a history of penicillin allergy. A retrospective study was conducted during a 1-year period among all patients hospitalized in the intensive care unit, coronary care unit, and internal medicine wards. Files of patients with a record of penicillin allergy were reviewed to assess the need for antibiotics during their hospitalization and the decision-making process underlying the choice of antibiotic. The additional costs of alternative antibiotics were calculated. The files of 1738 patients admitted over a 1-year period were hand reviewed. A history of penicillin allergy was found in 172 patients (9.9%). The allergic reaction was described in only 30% of cases and left unmentioned in 20.7%. Beta-lactam antibiotics were used on 56 occasions despite a history of penicillin allergy. The use of alternative antibiotics in place of the beta-lactam standard of care carried an additional cost of $15,672 Canadian. Alleged penicillin allergy is common among hospitalized patients and leads to substantial additional costs. Poor documentation of penicillin allergy likely reflects a lack of knowledge on this issue in the medical community, which impairs optimal treatment of these patients. Increased education on this matter is needed, and allergists on staff could be part of the solution. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  1. Evaluation of a Web-based Error Reporting Surveillance System in a Large Iranian Hospital.

    Science.gov (United States)

    Askarian, Mehrdad; Ghoreishi, Mahboobeh; Akbari Haghighinejad, Hourvash; Palenik, Charles John; Ghodsi, Maryam

    2017-08-01

    Proper reporting of medical errors helps healthcare providers learn from adverse incidents and improve patient safety. A well-designed and functioning confidential reporting system is an essential component to this process. There are many error reporting methods; however, web-based systems are often preferred because they can provide; comprehensive and more easily analyzed information. This study addresses the use of a web-based error reporting system. This interventional study involved the application of an in-house designed "voluntary web-based medical error reporting system." The system has been used since July 2014 in Nemazee Hospital, Shiraz University of Medical Sciences. The rate and severity of errors reported during the year prior and a year after system launch were compared. The slope of the error report trend line was steep during the first 12 months (B = 105.727, P = 0.00). However, it slowed following launch of the web-based reporting system and was no longer statistically significant (B = 15.27, P = 0.81) by the end of the second year. Most recorded errors were no-harm laboratory types and were due to inattention. Usually, they were reported by nurses and other permanent employees. Most reported errors occurred during morning shifts. Using a standardized web-based error reporting system can be beneficial. This study reports on the performance of an in-house designed reporting system, which appeared to properly detect and analyze medical errors. The system also generated follow-up reports in a timely and accurate manner. Detection of near-miss errors could play a significant role in identifying areas of system defects.

  2. Faces of the Fleet | Navy Live

    Science.gov (United States)

    Little Creek. (U.S. Navy photo by Mass Communication Specialist 2nd Class Charles Oki/Released) Explosive Expeditionary Base Little Creek. (U.S. Navy photo by Mass Communication Specialist 2nd Class Charles Oki /spLckijogJ12 hours ago MT @CNORichardson: Congratulations to the @NavalAcademy #ClassOf2018! A lot will be

  3. 32 CFR 631.16 - Navy policy.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Navy policy. 631.16 Section 631.16 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL...-Installation Operations (Military Patrols and Investigative Activities) and Policy § 631.16 Navy policy. The...

  4. U.S. Navy Energy Plan

    Science.gov (United States)

    1977-01-01

    plans) be assessed to determine environ- mental effects. If these assessments show "significant effect on the human environment," or are, in any way...specific energy conservation and management areas for review by the Inspector General of the Navy. (II) Act as Program and Resourec Sponsor for Navy

  5. Modern American scurvy - experience with vitamin C deficiency at a large children's hospital

    International Nuclear Information System (INIS)

    Golriz, Farahnaz; Donnelly, Lane F.; Krishnamurthy, Raj; Devaraj, Sridevi

    2017-01-01

    Until recently scurvy has been viewed in developed countries as a disease of the past. More recently there have been reports of case series of children with scurvy who have had a delayed diagnosis after an extensive diagnostic workup that included imaging. Most of these children have had underlying neurologic conditions such as autism. To review the medical records of children diagnosed with vitamin C (ascorbic acid) deficiency based on serum ascorbic acid levels at a large pediatric health care system, to determine imaging findings and utility of imaging in management, and to identify at-risk pediatric populations. We retrospectively identified cases of vitamin C deficiency in children tested for serum ascorbic acid levels during the last 5 years. We used the criteria of normal ascorbic acid >23 μmol/L and included children with ascorbic acid levels <23 μmol/L. We evaluated their clinical history, underlying medical condition, imaging studies obtained and imaging findings. We identified 32 children with vitamin C deficiency. All of these children had underlying medical conditions, most commonly iron overload from multiple transfusions related to sickle cell anemia or thalassemia (20), neurologic disorders (4) and bone marrow transplant/chemotherapy (3). No cases of scurvy from dietary deficiency in otherwise normal children were identified. All except two children had multiple imaging studies, primarily related to their underlying conditions. Three of these children had extensive imaging workups related to diffuse musculoskeletal pain. Imaging findings included ill-defined sclerotic and lucent metaphyseal bands (mainly at the knee) on radiography and MRI studies that showed diffuse increased T2-weighted signal in the bilateral lower-extremity long-bone metaphyses, periosteal reaction and adjacent soft-tissue edema. Vitamin C deficiency is not uncommon in large pediatric health care facilities, and it is frequently missed on clinical evaluation and diagnostic

  6. Modern American scurvy - experience with vitamin C deficiency at a large children's hospital

    Energy Technology Data Exchange (ETDEWEB)

    Golriz, Farahnaz; Donnelly, Lane F.; Krishnamurthy, Raj [Texas Children' s Hospital, Department of Radiology, Houston, TX (United States); Devaraj, Sridevi [Texas Children' s Hospital, Department of Pathology and Laboratory Medicine, Houston, TX (United States)

    2017-02-15

    Until recently scurvy has been viewed in developed countries as a disease of the past. More recently there have been reports of case series of children with scurvy who have had a delayed diagnosis after an extensive diagnostic workup that included imaging. Most of these children have had underlying neurologic conditions such as autism. To review the medical records of children diagnosed with vitamin C (ascorbic acid) deficiency based on serum ascorbic acid levels at a large pediatric health care system, to determine imaging findings and utility of imaging in management, and to identify at-risk pediatric populations. We retrospectively identified cases of vitamin C deficiency in children tested for serum ascorbic acid levels during the last 5 years. We used the criteria of normal ascorbic acid >23 μmol/L and included children with ascorbic acid levels <23 μmol/L. We evaluated their clinical history, underlying medical condition, imaging studies obtained and imaging findings. We identified 32 children with vitamin C deficiency. All of these children had underlying medical conditions, most commonly iron overload from multiple transfusions related to sickle cell anemia or thalassemia (20), neurologic disorders (4) and bone marrow transplant/chemotherapy (3). No cases of scurvy from dietary deficiency in otherwise normal children were identified. All except two children had multiple imaging studies, primarily related to their underlying conditions. Three of these children had extensive imaging workups related to diffuse musculoskeletal pain. Imaging findings included ill-defined sclerotic and lucent metaphyseal bands (mainly at the knee) on radiography and MRI studies that showed diffuse increased T2-weighted signal in the bilateral lower-extremity long-bone metaphyses, periosteal reaction and adjacent soft-tissue edema. Vitamin C deficiency is not uncommon in large pediatric health care facilities, and it is frequently missed on clinical evaluation and diagnostic

  7. Data-driven CT protocol review and management—experience from a large academic hospital.

    Science.gov (United States)

    Zhang, Da; Savage, Cristy A; Li, Xinhua; Liu, Bob

    2015-03-01

    Protocol review plays a critical role in CT quality assurance, but large numbers of protocols and inconsistent protocol names on scanners and in exam records make thorough protocol review formidable. In this investigation, we report on a data-driven cataloging process that can be used to assist in the reviewing and management of CT protocols. We collected lists of scanner protocols, as well as 18 months of recent exam records, for 10 clinical scanners. We developed computer algorithms to automatically deconstruct the protocol names on the scanner and in the exam records into core names and descriptive components. Based on the core names, we were able to group the scanner protocols into a much smaller set of "core protocols," and to easily link exam records with the scanner protocols. We calculated the percentage of usage for each core protocol, from which the most heavily used protocols were identified. From the percentage-of-usage data, we found that, on average, 18, 33, and 49 core protocols per scanner covered 80%, 90%, and 95%, respectively, of all exams. These numbers are one order of magnitude smaller than the typical numbers of protocols that are loaded on a scanner (200-300, as reported in the literature). Duplicated, outdated, and rarely used protocols on the scanners were easily pinpointed in the cataloging process. The data-driven cataloging process can facilitate the task of protocol review. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  8. Navy Quality of Life Survey: Structural Equation Modeling

    National Research Council Canada - National Science Library

    Craiger, J

    1997-01-01

    ...: conflict between being in the Navy and one's personal life, Navy life compared with civilian life, and the extent to which Navy experiences matched expectations. Computer software was developed for the first model, so that Navy managers could predict the impact of life domain experiences on perceived QOL.

  9. AAA application in diagnosis exams in a large public hospital, RS, Brazil; Aplicacao do AAA na realizacao de exames diagnosticos em um hospital publico de grande porte

    Energy Technology Data Exchange (ETDEWEB)

    Bacelar, A.; Ferret, A.A.; Vanni, S.; Galhardi, M.P.; Lykawka, R., E-mail: abacelar@hepa.ufrgs.br, E-mail: allferret@gmail.com, E-mail: svanni@hepa.ufrgs.br, E-mail: mpgalhardi@gmail.com, E-mail: rlykawka@hepa.ufrgs.br [Hospital de Clinicas de Porto Alegre (HCPA), Porto Alegre, RS (Brazil)

    2013-10-01

    Objective: the initiative AAA - Awareness , Appropriateness and Audit , promotes consciousness ( Awareness) , fitness ( Appropriateness ) and Audit ( Audit) . This paper analyzes the application of the concept in the AAA requests and justifications examinations using ionizing radiation within a large public hospital. Materials and methods: we collected and analyzed data between the years 2011 and 2012, concerning the number of exams performed with the use of radiation and their justifications. After, we sought to raise awareness of the clinical team through training on the risks and benefits of the various modalities of the radiology department and the need to justify the use of ionizing radiation on health. After the data were collected again of test requests for verification of the effectiveness of training. Results: the mean requests that need to be appropriate to the AAA in the last quarter of 2011 was 75 % lower than the average demands of the first quarter, matched against the last two months of 2012 increased by up to four times the number requests that require improvements in relation to the excellent results obtained in July 2012. Conclusion: it is shown in this paper the need of implementing this initiative AAA continuously added to the clinical staff awareness about the risk of the use of ionizing radiation, the appropriateness of the requests of these tests , as well as the control of this process in order to optimize use of ionizing radiation on health.

  10. Trends and Weekly Cycles in a Large Swiss Emergency Centre: A 10 Year Period at the University Hospital of Bern

    Directory of Open Access Journals (Sweden)

    Christian T. Braun

    2017-10-01

    Full Text Available Popular demand for high quality care has increased in recent years. This is also the case for medical services and support at all times of the day and night is nowadays required. During the last ten years, there has been a marked increase in the demands on hospital emergency hospitals, particularly in the Western industrialized countries. The present retrospective study investigates how the demands on a large Swiss university centre have changed over a period of 10 years. Patient numbers are differentiated by age, gender, nationality, weekday and mode of referral. A retrospective analysis was performed of the data of the patients admitted to the Emergency Centre of Bern University Medical Hospital (Inselspital during the ten-year period from 2004 up to and including 2013 and who were treated as emergencies. A total of 264,272 patients were included in the study. It was shown that there was an uninterrupted annual increase from 23,555 patients in 2004 to 34,918 patients in 2013 (+48%. Most patients came to the Emergency Centre on Mondays, followed by Fridays. Because of the marked increase in life expectancy and the resulting demographic changes, there has been a marked increase in the number of older patients coming to the Emergency Centre for acute medical care. It was found that there were disproportionately high numbers of patients aged 20 to 49 years who were not Swiss citizens. In contrast, most patients over 60 were Swiss. In the coming years, emergency centres will have to adapt to the continued increase in patient numbers. This trend will continue, so that it is essential to consider the sociodemographic structure of a region when planning the availability of emergency medical care.

  11. Optimizing patient flow in a large hospital surgical centre by means of discrete-event computer simulation models.

    Science.gov (United States)

    Ferreira, Rodrigo B; Coelli, Fernando C; Pereira, Wagner C A; Almeida, Renan M V R

    2008-12-01

    This study used the discrete-events computer simulation methodology to model a large hospital surgical centre (SC), in order to analyse the impact of increases in the number of post-anaesthetic beds (PABs), of changes in surgical room scheduling strategies and of increases in surgery numbers. The used inputs were: number of surgeries per day, type of surgical room scheduling, anaesthesia and surgery duration, surgical teams' specialty and number of PABs, and the main outputs were: number of surgeries per day, surgical rooms' use rate and blocking rate, surgical teams' use rate, patients' blocking rate, surgery delays (minutes) and the occurrence of postponed surgeries. Two basic strategies were implemented: in the first strategy, the number of PABs was increased under two assumptions: (a) following the scheduling plan actually used by the hospital (the 'rigid' scheduling - surgical rooms were previously assigned and assignments could not be changed) and (b) following a 'flexible' scheduling (surgical rooms, when available, could be freely used by any surgical team). In the second, the same analysis was performed, increasing the number of patients (up to the system 'feasible maximum') but fixing the number of PABs, in order to evaluate the impact of the number of patients over surgery delays. It was observed that the introduction of a flexible scheduling/increase in PABs would lead to a significant improvement in the SC productivity.

  12. Strategic, political, and cultural aspects of IT implementation: improving the efficacy of an IT system in a large hospital.

    Science.gov (United States)

    Wurster, Christina J; Lichtenstein, Benyamin B; Hogeboom, Tasha

    2009-01-01

    Healthcare spending will exceed $4 trillion by 2017, a trend that is leading executives to implement information technology (IT) systems to contain these rising costs. Studies show that numerous factors determine the outcome and net benefits of IT in healthcare. However, what happens when a newly implemented IT system results in negative outcomes? We explore this question by examining a newly implemented IT system in a large hospital that was yielding none of the benefits for which its designers had hoped. Using an expanded set of analytic lenses, our in-depth study found that political issues were a major stumbling block to the implementation of this IT system, as the interests of IT managers were different from those of the system's users. In addition, cultural values among these stakeholders were not aligned. The new IT system carried very different meanings for these two key groups. These political and cultural issues, which reflect a broader set of factors than is commonly applied in IT or in management, led to specific recommendations designed to improve the system's viability and benefits. In a follow-up analysis we found that these alternative lenses helped increase the intended usage of the IT system by 16 percent in the first year, yielding a 20 percent improvement in performance. By better understanding the cultural and political significance of IT implementation, managers may thus improve the effectiveness of new information technologies for containing costs in hospitals.

  13. Utilization of Workflow Process Maps to Analyze Gaps in Critical Event Notification at a Large, Urban Hospital.

    Science.gov (United States)

    Bowen, Meredith; Prater, Adam; Safdar, Nabile M; Dehkharghani, Seena; Fountain, Jack A

    2016-08-01

    Stroke care is a time-sensitive workflow involving multiple specialties acting in unison, often relying on one-way paging systems to alert care providers. The goal of this study was to map and quantitatively evaluate such a system and address communication gaps with system improvements. A workflow process map of the stroke notification system at a large, urban hospital was created via observation and interviews with hospital staff. We recorded pager communication regarding 45 patients in the emergency department (ED), neuroradiology reading room (NRR), and a clinician residence (CR), categorizing transmissions as successful or unsuccessful (dropped or unintelligible). Data analysis and consultation with information technology staff and the vendor informed a quality intervention-replacing one paging antenna and adding another. Data from a 1-month post-intervention period was collected. Error rates before and after were compared using a chi-squared test. Seventy-five pages regarding 45 patients were recorded pre-intervention; 88 pages regarding 86 patients were recorded post-intervention. Initial transmission error rates in the ED, NRR, and CR were 40.0, 22.7, and 12.0 %. Post-intervention, error rates were 5.1, 18.8, and 1.1 %, a statistically significant improvement in the ED (p workflow process maps. The workflow process map effectively defined communication failure parameters, allowing for systematic testing and intervention to improve communication in essential clinical locations.

  14. Impact of a smoke-free policy in a large psychiatric hospital on staff attitudes and patient behavior.

    Science.gov (United States)

    Voci, Sabrina; Bondy, Susan; Zawertailo, Laurie; Walker, Louise; George, Tony P; Selby, Peter

    2010-01-01

    The objectives of this work were to examine changes over time in degree of staff support for the implementation of a smoke-free policy in Canada's largest public mental health and addiction teaching hospital and to assess the impact of the policy on patient behavior. Staff completed an anonymous survey, which assessed views toward the smoke-free policy and perceived change in patient behavior, 2-7 and 31-33 months after an indoor smoke-free policy was implemented (September 21, 2005). Objective indicators of patient behavior were also collected in the form of number of emergency code whites (aggressive behavior) and that of code reds (fire) called 1 year prior to and 2 years following policy implementation. Survey response rates were 19.0% (n=481) and 18.1% (n=500) at 2-7 and 31-33 months, respectively. The proportion of staff who supported the policy increased from pre-implementation (82.6%) to post-implementation (89.1%), and a high level of support was maintained 2 years after policy enactment (90.1%). The number of emergency codes did not significantly change after policy implementation, and staff did not perceive a change in most forms of patient behavior. A smoke-free policy can be implemented in a large psychiatric hospital with a high degree of support from staff and no substantial negative impact on patient behavior. Copyright © 2010 Elsevier Inc. All rights reserved.

  15. Incidence of trampoline related pediatric fractures in a large district general hospital in the United Kingdom: lessons to be learnt.

    Science.gov (United States)

    Bhangal, K K; Neen, D; Dodds, R

    2006-04-01

    To test the observation that the incidence of trampoline related pediatric fractures is increasing-both nationally and in a large district general hospital. A retrospective analysis was undertaken of patient records establishing mechanism of injury of pediatric fractures over three consecutive summers from 2000-03. Theatre records of fractures treated operatively were used as the initial data source. A statistically significant increase in trampoline related injuries was discovered. This reflects the rising incidence of injuries from national data and furthermore corresponds to the growing popularity of domestic use trampolines in the UK. The incidence of injuries is increasing. There are lessons to be learnt from existing work from countries where trampoline prevalence has been greater for longer. The authors recommend various safety measures that may reduce children's injuries.

  16. Through the lens of the clinician: autopsy services and utilization in a large teaching hospital in Ghana.

    Science.gov (United States)

    Yawson, Alfred E; Tette, Edem; Tettey, Yao

    2014-12-23

    Declining hospital autopsy rates in many countries have generated considerable concern. The survey determined challenges of the autopsy service in a large Teaching Hospital in Ghana, from the perspective of clinicians. This was a cross-sectional study of doctors at the Korle-Bu Teaching Hospital (KBTH) over in 2012. The data was collected using a 69 item self-administered structured questionnaire. In all a total of 215 questionnaires were sent out and 119 doctors responded. Data was collected on the challenges of the autopsy services and barriers to autopsy request from the perspectives of clinicians. Survey data were analyzed by simple descriptive statistics (i.e. proportions, ratios and percentages. Data from survey was analyzed with SPSS version 21. The most common reasons for requesting autopsies were to answer clinical questions, 55 (46.2%) and in cases of uncertain diagnosis, 54 (45.4%). Main demand side barriers to the use of autopsy services by clinicians were reluctance of family to give consent for autopsy 100 (84%), due to cultural and religious objections 89 (74.8%), extra funeral cost to family53 (44.5%) and increased duration of stay of body in the morgue 19 (16%). Health system barriers included delayed feedback from autopsy service 54 (45.4%), difficulties following up the autopsy process 40 (33.6%) due to uncertainties in the timing of particular events in the autopsy process, and long waiting time for autopsy reports 81 (68.1%). More than a third of clinicians 43 (36.2%), received full autopsy report beyond three weeks and 75 (63.1%) clinicians had concerns with the validity of reports issued by the autopsy service (i.e. reports lack specificity or at variance with clinical diagnosis, no toxicological, histological or tissue diagnoses are performed). The autopsy service should restructure itself efficiently and management should support the provision of histological and toxicological services. Strengthening internal and external quality

  17. Navy Reserve: Not Ready for OLC

    Science.gov (United States)

    2010-06-11

    Navy. Additionally, the need for qualified personnel inspired the Navy to create a new reserve program, the Women Accepted for Volunteer Emergency...Service (WAVES), which peaked at 86,000 women serving in stateside assignments. The Korean War required the mobilization of over 182,000 Navy...Office of Naval Intelligence 3348 3427 1590 47.49 24.50 ONR - NRL 211 231 0 0.00 0.00 Selective Service 42 29 0 0.00 0.00 Space & Warfare Systems Command

  18. Factors associated with willingness to accept a routine offer of HIV test in a large referral hospital in Western Kenya.

    Science.gov (United States)

    Mangeni, J N; Ballidawa, J B; Ndege, S

    2012-03-01

    Although Voluntary Counseling and Testing (VCT) has existed for more than 10 years, majority of Kenyans still do not know their HIV status, thus necessitating the introduction of other testing strategies to increase the number of people taking the test. The routine offer of an HIV test to all patients in health-care settings has been proposed to increase access to care. The main objective of this study was to identify factors associated with willingness to accept a routine offer of an HIV test. This was a cross sectional study. The Setting was in the Outpatient department at a large Referral Hospital in Western Kenya. A total of 384 adult patients (both males and females) were recruited using systematic random sampling. Information was collected on basic socio demographic characteristics, knowledge about the routine offer of an HIV test, attitudes towards the testing and HIV testing practise. Of the 384 respondents, 64.3% were unaware about the routine offer of HIV testing in Health facilities. Multivariate analysis identified the main predictors of willingness to accept an HIV test offered in hospital as the age (OR 3.7, C.I 0.068-1.075), level of education (OR 3.4, C.I 0.186-62.602), Knowledge about the routine HIV testing (OR 4.6,C.I 2.118-9.847), self-perception of HIV risk (OR 8.4,C.I 3.424-20.496) and attitude towards routine offer of HIV testing (OR 9.2, C.I 0.042-0.284). There is a need to come up with tailored training on the routine offer of an HIV test and devising strategies to address the main factors that influence the decision for patients to test as identified above.

  19. Medication Errors in an Internal Intensive Care Unit of a Large Teaching Hospital: A Direct Observation Study

    Directory of Open Access Journals (Sweden)

    Saadat Delfani

    2012-06-01

    Full Text Available Medication errors account for about 78% of serious medical errors in intensive care unit (ICU. So far no study has been performed in Iran to evaluate all type of possible medication errors in ICU. Therefore the objective of this study was to reveal the frequency, type and consequences of all type of errors in an ICU of a large teaching hospital. The prospective observational study was conducted in an 11 bed internal ICU of a university hospital in Shiraz. In each shift all processes that were performed on one selected patient was observed and recorded by a trained pharmacist. Observer would intervene only if medication error would cause substantial harm. The data was evaluated and then were entered in a form that was designed for this purpose. The study continued for 38 shifts. During this period, a total of 442 errors per 5785 opportunities for errors (7.6% occurred. Of those, there were 9.8% administration errors, 6.8% prescribing errors, 3.3% transcription errors and, 2.3% dispensing errors. Totally 45 interventions were made, 40% of interventions result in the correction of errors. The most common causes of errors were observed to be: rule violations, slip and memory lapses and lack of drug knowledge. According to our results, the rate of errors is alarming and requires implementation of a serious solution. Since our system lacks a well-organize detection and reporting mechanism, there is no means for preventing errors in the first place. Hence, as the first step we must implement a system where errors are routinely detected and reported.

  20. Management of benign stenoses of the large airways in the university hospital in Prague, Czech Republic, in 1998-2003.

    Science.gov (United States)

    Marel, Miloslav; Pekarek, Zdenek; Spasova, Irena; Pafko, Pavel; Schutzner, Jan; Betka, Jan; Pospisil, Ronald

    2005-01-01

    Clinically significant benign stenoses of the large airways develop in about 1% of patients after intubation. The management of benign stenoses is not unified around the world, nor are there any accepted methods for their screening. The purpose of this study is to describe and compare results of interventional bronchoscopy and surgical therapy of benign stenoses as well as to propose an algorithm for the management of this airways disorder. Prospective study on 80 consecutive patients with benign stenoses of the large airways admitted to the Pulmonary Department of the University Hospital of Prague-Motol. Sixty-two patients developed stenoses after endotracheal intubation or tracheostomy, in 18 patients the stenosis was caused by other diseases or pathological situations. Thirty-eight patients were sent for surgical resection of the stenotic part of the airways. 2 surgically treated patients developed recurrence of the stenosis and had to be reoperated on. Narrowing of the trachea at the site of end-to-end anastomosis developed in 6 other patients and was cured by interventional bronchoscopy. The remaining 42 patients were treated by interventional bronchoscopy (Nd-YAG laser, electrocautery, stent) which was curative in 35 patients. Sixty-five patients were alive at the time of evaluation, 15 patients died. Five of them died between 3 and 14 (median 4) months after surgery from a disease other than airway stenosis. Ten nonresected patients also died, with 1 exception, due to a disease other than airway stenosis; the median survival was 9 months. We recommend to assess the patient for surgery after the initial diagnosis and therapeutic bronchoscopy with dilatation of the stenosis. If the patient is not a suitable candidate for resection, interventional bronchoscopy is an appropriate alternative for the management of benign stenoses of the large airways. Copyright (c) 2005 S. Karger AG, Basel.

  1. Navy Inventory Management Decision-Making

    National Research Council Canada - National Science Library

    MacDonald, Steven

    1997-01-01

    .... This thesis asserts that Navy inventory managers do not have a general tendency to overbuy items, but rather make rational purchasing decisions influenced and motivated by the environment of rewards...

  2. A Navy Escrow Account: Increasing Financial Flexibility

    National Research Council Canada - National Science Library

    Pritchard, Marcus

    2003-01-01

    .... To that end, transforming the current financial practices within the DoN/DoD is required. This paper addresses the proposed Navy escrow account, a mechanism for eliminating wasteful spending while maximizing all available financial resources...

  3. Navy Telemedicine: Current Research and Future Directions

    National Research Council Canada - National Science Library

    Reed, Cheryl

    2002-01-01

    .... An assessment of Navy telemedicine as a complex healthcare support system is needed to demonstrate how current practices, training, equipment, and expenditures measure up to the emerging needs of the Fleet...

  4. Navy Ship Names: Background for Congress

    Science.gov (United States)

    2016-09-14

    Secretary considers these nominations , along with others he receives as well as his own thoughts in this matter. At appropriate times, he selects names...Research Service 16 “ nomination ” process is often fiercely contested as differing groups make the case that “their” ship name is the most fitting...and practices of the Navy for naming vessels of the Navy, and an explanation for such variances;  Assesses the feasibility and advisability of

  5. The HAZWRAP/Navy Radon Project

    International Nuclear Information System (INIS)

    Otten, J.A.; Wilson, D.L.

    1992-01-01

    In 1987, the Naval Facilities Engineering Command (NAVFACENGCOM) was assigned the responsibility of identifying potential hazards from exposure to naturally occurring indoor radon to personnel in Naval facilities and prioritizing corrective actions. In response to this request, NAVFACENGCOM established the Navy Radon Assessment and Mitigation Program (NAVRAMP), which evaluates problems associated with radon levels above current Environmental Protection Agency (EPA)-guidelines (EPA-520/1-86-04) of 4pCi/L. NAVRAMP consists of four phases: screening, assessment, mitigation, and postmitigation. Approximately 300,000 alpha track detectors (ATDs) will be used during the screening and assessment phases. Several unique approaches were developed to verify the quality of the information collected during this large program. To guarantee chain-of-custody, a computerized data management system was developed to track each ATD from initial purchase through field implementation to final analysis and was also used to track and identify quality control (QC) problems related to the manufacture and analysis of ATDs. The QC program addressed potential problems that could occur using ATDs. The potential errors associated with the use of ATDs included (1) lot-to-lot variation, (2) chemical process variation, (3) pouch leakage, and (4) background. The data management and QC programs ensured the quality and integrity of the samples, the accuracy and precision of the analyses, the representatives of the results, and the completeness of the information

  6. Health and economic effects from linking bedside and outpatient tobacco cessation services for hospitalized smokers in two large hospitals: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Fellows Jeffrey L

    2012-08-01

    Full Text Available Abstract Background Extended smoking cessation follow-up after hospital discharge significantly increases abstinence. Hospital smoke-free policies create a period of ‘forced abstinence’ for smokers, thus providing an opportunity to integrate tobacco dependence treatment, and to support post-discharge maintenance of hospital-acquired abstinence. This study is funded by the National Heart, Lung, and Blood Institute (1U01HL1053231. Methods/Design The Inpatient Technology-Supported Assisted Referral study is a multi-center, randomized clinical effectiveness trial being conducted at Kaiser Permanente Northwest (KPNW and at Oregon Health & Science University (OHSU hospitals in Portland, Oregon. The study assesses the effectiveness and cost-effectiveness of linking a practical inpatient assisted referral to outpatient cessation services plus interactive voice recognition (AR + IVR follow-up calls, compared to usual care inpatient counseling (UC. In November 2011, we began recruiting 900 hospital patients age ≥18 years who smoked ≥1 cigarettes in the past 30 days, willing to remain abstinent postdischarge, have a working phone, live within 50 miles of the hospital, speak English, and have no health-related barriers to participation. Each site will randomize 450 patients to AR + IVR or UC using a 2:1 assignment strategy. Participants in the AR + IVR arm will receive a brief inpatient cessation consult plus a referral to available outpatient cessation programs and medications, and four IVR follow-up calls over seven weeks postdischarge. Participants do not have to accept the referral. At KPNW, UC participants will receive brief inpatient counseling and encouragement to self-enroll in available outpatient services. The primary outcome is self-reported thirty-day smoking abstinence at six months postrandomization for AR + IVR participants compared to usual care. Additional outcomes include self-reported and biochemically confirmed

  7. Health and economic effects from linking bedside and outpatient tobacco cessation services for hospitalized smokers in two large hospitals: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Fellows, Jeffrey L; Mularski, Richard; Waiwaiole, Lisa; Funkhouser, Kim; Mitchell, Julie; Arnold, Kathleen; Luke, Sabrina

    2012-08-01

    Extended smoking cessation follow-up after hospital discharge significantly increases abstinence. Hospital smoke-free policies create a period of 'forced abstinence' for smokers, thus providing an opportunity to integrate tobacco dependence treatment, and to support post-discharge maintenance of hospital-acquired abstinence. This study is funded by the National Heart, Lung, and Blood Institute (1U01HL1053231). The Inpatient Technology-Supported Assisted Referral study is a multi-center, randomized clinical effectiveness trial being conducted at Kaiser Permanente Northwest (KPNW) and at Oregon Health & Science University (OHSU) hospitals in Portland, Oregon. The study assesses the effectiveness and cost-effectiveness of linking a practical inpatient assisted referral to outpatient cessation services plus interactive voice recognition (AR + IVR) follow-up calls, compared to usual care inpatient counseling (UC). In November 2011, we began recruiting 900 hospital patients age ≥18 years who smoked ≥1 cigarettes in the past 30 days, willing to remain abstinent postdischarge, have a working phone, live within 50 miles of the hospital, speak English, and have no health-related barriers to participation. Each site will randomize 450 patients to AR + IVR or UC using a 2:1 assignment strategy. Participants in the AR + IVR arm will receive a brief inpatient cessation consult plus a referral to available outpatient cessation programs and medications, and four IVR follow-up calls over seven weeks postdischarge. Participants do not have to accept the referral. At KPNW, UC participants will receive brief inpatient counseling and encouragement to self-enroll in available outpatient services. The primary outcome is self-reported thirty-day smoking abstinence at six months postrandomization for AR + IVR participants compared to usual care. Additional outcomes include self-reported and biochemically confirmed seven-day abstinence at six months, self-reported seven

  8. A survey of the prevalence of smoking and smoking cessation advice received by inpatients in a large teaching hospital in Ireland.

    LENUS (Irish Health Repository)

    Bartels, C

    2012-01-06

    BACKGROUND: The adverse effects of smoking are well documented and it is crucial that this modifiable risk factor is addressed routinely. Professional advice can be effective at reducing smoking amongst patients, yet it is not clear if all hospital in-patient smokers receive advice to quit. AIMS: To explore smoking prevalence amongst hospital in-patients and smoking cessation advice given by health professionals in a large university teaching hospital. METHODS: Interviews were carried out over 2 weeks in February 2011 with all eligible in-patients in Beaumont Hospital. RESULTS: Of the 205 patients who completed the survey, 61% stated they had been asked about smoking by a healthcare professional in the past year. Only 44% of current\\/recent smokers stated they had received smoking cessation advice from a health professional within the same timeframe. CONCLUSIONS: Interventions to increase rates of healthcare professional-provided smoking cessation advice are urgently needed.

  9. Brief introduction about radiation hygiene in Russian navy

    International Nuclear Information System (INIS)

    Li Yu; Min Rui; Pan Zhen

    2005-01-01

    During long-time radiation working practice, there have been established comprehensive radiation hygiene system of technique and regulation in Russian navy. Brief introduction about radiation hygiene in Russian navy are as follows. (authors)

  10. Tudo Pela Patria: The Brazilian Navy's Drive to Blue Water

    National Research Council Canada - National Science Library

    Conners, Michael E

    2005-01-01

    The Brazilian Navy is unique among most world navies today. Since the end of the Cold War, most nations have reduced their naval power, yet Brazil has maintained a determination to possess a blue-water fleet...

  11. Efficient Mechanisms to Allocate Assignment Incentives in the Navy

    National Research Council Canada - National Science Library

    Nimon, R. W; Hall, Ricky D; Zaki, Hossam

    2005-01-01

    .... All assignments, however, may not necessarily be voluntary. These assignments (jobs) have been labeled as "hard to fill" by Navy leadership, and the Navy has implemented market-based, cash stipends to attract Sailors to these jobs...

  12. Evaluation of hospital outcomes: the relation between length-of-stay, readmission, and mortality in a large international administrative database.

    Science.gov (United States)

    Lingsma, Hester F; Bottle, Alex; Middleton, Steve; Kievit, Job; Steyerberg, Ewout W; Marang-van de Mheen, Perla J

    2018-02-14

    Hospital mortality, readmission and length of stay (LOS) are commonly used measures for quality of care. We aimed to disentangle the correlations between these interrelated measures and propose a new way of combining them to evaluate the quality of hospital care. We analyzed administrative data from the Global Comparators Project from 26 hospitals on patients discharged between 2007 and 2012. We correlated standardized and risk-adjusted hospital outcomes on mortality, readmission and long LOS. We constructed a composite measure with 5 levels, based on literature review and expert advice, from survival without readmission and normal LOS (best) to mortality (worst outcome). This composite measure was analyzed using ordinal regression, to obtain a standardized outcome measure to compare hospitals. Overall, we observed a 3.1% mortality rate, 7.8% readmission rate (in survivors) and 20.8% long LOS rate among 4,327,105 admissions. Mortality and LOS were correlated at the patient and the hospital level. A patient in the upper quartile LOS had higher odds of mortality (odds ratio = 1.45, 95% confidence interval 1.43-1.47) than those in the lowest quartile. Hospitals with a high standardized mortality had higher proportions of long LOS (r = 0.79, p < 0.01). Readmission rates did not correlate with either mortality or long LOS rates. The interquartile range of the standardized ordinal composite outcome was 74-117. The composite outcome had similar or better reliability in ranking hospitals than individual outcomes. Correlations between different outcome measures are complex and differ between hospital- and patient-level. The proposed composite measure combines three outcomes in an ordinal fashion for a more comprehensive and reliable view of hospital performance than its component indicators.

  13. Large-scale deployment of the Global Trigger Tool across a large hospital system: refinements for the characterisation of adverse events to support patient safety learning opportunities.

    Science.gov (United States)

    Good, V S; Saldaña, M; Gilder, R; Nicewander, D; Kennerly, D A

    2011-01-01

    The Institute for Healthcare Improvement encourages use of the Global Trigger Tool to objectively determine and monitor adverse events (AEs). Baylor Health Care System (BHCS) is an integrated healthcare delivery system in North Texas. The Global Trigger Tool was applied to BHCS's eight general acute care hospitals, two inpatient cardiovascular hospitals and two rehabilitation/long-term acute care hospitals. Data were collected from a monthly random sample of charts for each facility for patients discharged between 1 July 2006 and 30 June 2007 by external professional nurse auditors using an MS Access Tool developed for this initiative. In addition to the data elements recommended by Institute for Healthcare Improvement, BHCS developed fields to permit further characterisation of AEs to identify learning opportunities. A structured narrative description of each identified AE facilitated text mining to further characterise AEs. INITIAL FINDINGS: Based on this sample, AE rates were found to be 68.1 per 1000 patient days, or 50.8 per 100 encounters, and 39.8% of admissions were found to have ≥1 AE. Of all AEs identified, 61.2% were hospital-acquired, 10.1% of which were associated with a National Coordinating Council - Medical Error Reporting and Prevention harm score of "H or I" (near death or death). To enhance learning opportunities and guide quality improvement, BHCS collected data-such as preventability and AE source-to characterise the nature of AEs. Data are provided regularly to hospital teams to direct quality initiatives, moving from a general focus on reducing AEs to more specific programmes based on patterns of harm and preventability.

  14. Comparison of fasting and non-fasting lipid profiles in a large cohort of patients presenting at a community hospital.

    Science.gov (United States)

    Cartier, Louis-Jacques; Collins, Charlene; Lagacé, Mathieu; Douville, Pierre

    2018-02-01

    To compare the fasting and non-fasting lipid profile including ApoB in a cohort of patients from a community setting. Our purpose was to determine the proportion of results that could be explained by the known biological variation in the fasting state and to examine the additional impact of non-fasting on these same lipid parameters. 1093 adult outpatients with fasting lipid requests were recruited from February to September 2016 at the blood collection sites of the Moncton Hospital. Participants were asked to come back in the next 3-4days after having eaten a regular breakfast to have their blood drawn for a non-fasting lipid profile. 91.6% of patients in this study had a change in total cholesterol that fell within the biological variation expected for this parameter. Similar results were seen for HDL-C (94.3%) non-HDL-C (88.8%) and ApoB (93.0%). A smaller number of patients fell within the biological variation expected for TG (78.8%) and LDL-C (74.6%). An average TG increase of 0.3mmol/L was observed in fed patients no matter the level of fasting TG. A gradual widening in the range of change in TG concentration was observed as fasting TG increased. Similar results were seen in diabetic patients. Outside of LDL-C and TG, little changes were seen in lipid parameters in the postprandial state. A large part of these changes could be explained by the biological variation. We observed a gradual widening in the range of increase in TG for patients with higher fasting TG. Non-HDL-C and ApoB should be the treatment target of choice for patients in the non-fasting state. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  15. Analysis of Survival Rates Following Primary Surgery of 178 Consecutive Patients with Oral Cancer in a Large District General Hospital.

    Science.gov (United States)

    Stathopoulos, Panagiotis; Smith, William P

    2017-06-01

    The aim of this study is to present the survival rates in patients treated for oral cancer with primary surgery in a large district general hospital. We discuss the influence of the most significant prognostic factors on survival and compare our results with larger centres specializing in the management of oral cancer. All patients diagnosed with oral cancer from 1995 to 2006 and were treated in the Department had their details entered prospectively onto a computerized database. Demographic details of patients, type of treatment, pathological stage of tumor (TNM), local and regional recurrence rate, overall survival, disease specific survival and incidence of involved margins were recorded and calculated. Of the 178 patients, 96 (54 %) were alive and free of oral cancer 5 years after surgery. Forty-four patients died of oral cancer (24.7 %) but 38 (21.3 %) died of other causes. The overall survival rate after primary surgery in relation to stage was: I 84 %, II 71 %, III 36 % and IV 28 %. As almost half of our patients presented with advanced cancer and had discouraging survival rates, we emphasize the need for early recognition of the disease. Advanced disease signifies difficulty in obtaining clear margins which actually indicates a higher recurrence rate. 25 % of our patients died of oral cancer within 5 years of surgery which highlights the poor prognosis that recurrence carries after treatment. Effective educational campaign with purpose to raise oral cancer awareness and earlier referral may result in improvement of survival.

  16. Molecular characterisation of methicillin-resistant Staphylococcus aureus (MRSA) isolated at a large referral hospital in Zambia.

    Science.gov (United States)

    Samutela, Mulemba Tillika; Kalonda, Annie; Mwansa, James; Lukwesa-Musyani, Chileshe; Mwaba, John; Mumbula, Enoch Mulowa; Mwenya, Darlington; Simulundu, Edgar; Kwenda, Geoffrey

    2017-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is globally recognized as an important public health problem. Whereas comprehensive molecular typing data of MRSA strains is available, particularly in Europe, North America and Australia, similar information is very limited in sub-Saharan Africa including Zambia. In this study, thirty two clinical isolates of Staphylococcus aureus , collected at a large referral hospital in Lusaka, Zambia between June 2009 and December 2012 were analysed by Staphylococcal cassette chromosome mec (SCCmec), Staphylococcus protein A gene typing (spa) and detection of the Panton-Valentine Leukocidin genes (pvl) . Three SCC mec types were identified namely SCC mec type IV (65.6%), SCCmec type III (21.9%), SCC mec type I (3.1%). Nine point four percent (9.4%) of the isolates were untypable. Five spa types, which included a novel type, were detected and the most prevalent spa type was t064 (40.6%). Other spa types included spa types t2104 (31.3%), t355 (3.1%) and t1257 (21.9%). The pvl genes were detected in 3 out of 32 isolates. These molecular typing data indicated that the MRSA strains collected in Lusaka were diverse. Although the source of these MRSA was not established, these results stress the need for assessing infection prevention and control procedures at this health-care facility in order to curtail possible nosocomial infections. Furthermore, country-wide surveillance of MRSA in both the community and health-care facilities is recommended for infection prevention and control. To our knowledge, this represents the first study to characterise MRSA using molecular tools in Zambia.

  17. The evaluation of the introduction of a quality management system. A process-oriented case study in a large rehabilitation hospital

    NARCIS (Netherlands)

    van Harten, Willem H.; Casparie, Ton F.; Fisscher, O.A.M.

    2002-01-01

    Objectives: So far, there is limited proof concerning the effects of the introduction of quality management systems (QMS) on organisational level. This study concerns the introduction of a QMS in a large rehabilitation hospital. Methods: Using an observational framework, a process-analysis is

  18. 32 CFR 705.29 - Navy Art Collection.

    Science.gov (United States)

    2010-07-01

    ...-sponsored show, certification that 24-hour security will be provided for the paintings while in custody. (vi... Information, Navy Department, Washington, DC 20350. (d) Exhibition of Navy Art: (1) Operation Palette I” is a... World War II. The schedule of “Operation Palette I” is promulgated by the Officer-in-Charge, Navy...

  19. Evaluation of low-level solid radioactive waste generated by a large hospital and disposed of with ordinary refuse

    International Nuclear Information System (INIS)

    Conte, L.; Pedroli, G.; Monciardini, M.; Bianchi, L.; Novario, R.; Beretta, A.

    1996-01-01

    In the Lombardy region some hospitals have recently been reported to the local authorities because of the presence of radioactivity in hospital refuse sent to the municipal tips for incineration. On various occasions the refuse collectors coming from the hospitals had to return with their refuse as traces of radioactivity were detected at the entrance to the tips equipped with monitoring systems. Hospitals administering radioactive substances for diagnostic or therapeutic purposes produce radioactive waste mainly in solid and liquid form. This waste is principally present in patient excreta and in contaminated materials. Radioactive waste present in patient excreta is normally disposed of through the sewage system provided that the concentration limits and annual activity stipulated by law are respected. The contaminated materials coming from the departments that carry out radioisotopic investigations and therapy with unsealed sources can be collected separately and sent to a tip after a period of storage to permit radioactive decay. However, part of the radioactive waste escapes all checks and inevitably mixes with normal refuse or with special hospital refuse that is not considered radioactive. This occurs in the case of: 1. excreta from patients who are not hospitalised after a radioisotopic investigation and materials contaminated by the excreta; 2. excreta from hospitalised patients which are eliminated outside the nuclear medicine and radiotherapy departments; 3. contaminated materials produced with unsealed sources in hospital departments other than those of nuclear medicine and radiotherapy; The waste indicated in point 1 is probably the main problem in ecological terms as the patients who are not hospitalised eliminate radioactive excreta into domestic sewage systems and can also contaminate materials that are disposed of with normal household refuse. In this case any solution to the problem would seriously affect diagnostic activities carried out in the

  20. Elaboration of a program for monitoring the ionizing radiations in a large hospital; Elaboracao de um programa de monitoracao das radiacoes ionizantes num hospital de grande porte

    Energy Technology Data Exchange (ETDEWEB)

    Carreira, Mauricio Costa

    1996-11-01

    Personnel monitoring data collected in the Radiotherapy, Diagnostic Radiology and Hemodynamics Departments of the Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto - USP during the interval from 1986 to 1995 were analyzed. The data were classified according to the profession of the workers and compared to those collected in a previous period (1973-1982). Internationally established criteria, published published in the ICRP 35 and 60 were used together with additional Brazilian criteria (CNEN NE 3.01) to optimize personnel monitoring such that the required radioprotection is provided. The results show that 80% of the workers need not be monitored because their doses will not exceed 3/10 the annual limits. An economy of about US$10,200 in monitoring cost per year could be realized as well as reduction in the hospital clerical costs expended to maintain the records. The improvements gaining by reducing the number of monitored persons will not compromise the safety standard required for radiation protection. (author)

  1. Frequency and Severity of Parenteral Nutrition Medication Errors at a Large Children's Hospital After Implementation of Electronic Ordering and Compounding.

    Science.gov (United States)

    MacKay, Mark; Anderson, Collin; Boehme, Sabrina; Cash, Jared; Zobell, Jeffery

    2016-04-01

    The Institute for Safe Medication Practices has stated that parenteral nutrition (PN) is considered a high-risk medication and has the potential of causing harm. Three organizations--American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.), American Society of Health-System Pharmacists, and National Advisory Group--have published guidelines for ordering, transcribing, compounding and administering PN. These national organizations have published data on compliance to the guidelines and the risk of errors. The purpose of this article is to compare total compliance with ordering, transcription, compounding, administration, and error rate with a large pediatric institution. A computerized prescriber order entry (CPOE) program was developed that incorporates dosing with soft and hard stop recommendations and simultaneously eliminating the need for paper transcription. A CPOE team prioritized and identified issues, then developed solutions and integrated innovative CPOE and automated compounding device (ACD) technologies and practice changes to minimize opportunities for medication errors in PN prescription, transcription, preparation, and administration. Thirty developmental processes were identified and integrated in the CPOE program, resulting in practices that were compliant with A.S.P.E.N. safety consensus recommendations. Data from 7 years of development and implementation were analyzed and compared with published literature comparing error, harm rates, and cost reductions to determine if our process showed lower error rates compared with national outcomes. The CPOE program developed was in total compliance with the A.S.P.E.N. guidelines for PN. The frequency of PN medication errors at our hospital over the 7 years was 230 errors/84,503 PN prescriptions, or 0.27% compared with national data that determined that 74 of 4730 (1.6%) of prescriptions over 1.5 years were associated with a medication error. Errors were categorized by steps in the PN process

  2. Department of the Navy Correspondence Manual

    Science.gov (United States)

    2010-03-01

    if (name of institution) without doctoral degree) (local address) 00000-0000 Sincerely, Other Addressees An Unmarried Woman Ms. (or Miss) (full name...CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ...ORGANIZATION NAME(S) AND ADDRESS(ES) Office of the Secretary of the Navy,1000 Navy Pentagon Room 4D652,Washington,DC,20350-1000 8. PERFORMING

  3. Preventing pollution from US Navy ships

    International Nuclear Information System (INIS)

    Bentley, R.; Edgar, V.E.

    1999-01-01

    In executing its military mission, the United States Navy is required to be 'on station' for extended periods of time. The demands of a sustained military presence pose a serious dilemma in meeting international environmental mandates. On one hand, the Navy must conduct protracted peacetime operations in a relatively confined area in order to fulfill military needs in support of national interests. Yet, on the other hand, naval operations in that area may be constrained by requirements to refrain from disposing of solid waste in order to be in compliance with foreign laws and international treaties

  4. Microvascular free-flap reconstruction of a large defect of the scalp. Experience in a community hospital

    International Nuclear Information System (INIS)

    Singer, J.B.; Gulin, S.P.; Needham, C.W.

    1990-01-01

    The authors present a patient who had postradiation necrosis of the skull and scalp measuring over 300 cm square which was reconstructed with a free latissimus dorsi muscle flap with overlying skin grafts. The procedure was performed in a community hospital with a team comprising two plastic surgeons and a neurosurgeon, with backup from physicians assistants and nursing staff. The successful outcome of this procedure was a direct result of the concerted effort of the surgical team. We believe that microvascular free-flap reconstruction, although a complicated procedure, can be performed at the community hospital as long as appropriate measures for the care of the patient are planned and carried out

  5. A Minority of Patients Newly Diagnosed with AIDS Are Started on Antiretroviral Therapy at the Time of Diagnosis in a Large Public Hospital in the Southeastern United States.

    Science.gov (United States)

    Goswami, Neela D; Colasanti, Jonathan; Khoubian, Jonathan J; Huang, Yijian; Armstrong, Wendy S; Del Rio, Carlos

    Prompt antiretroviral therapy (ART) initiation after AIDS diagnosis, in the absence of certain opportunistic infections such as tuberculosis and cryptococcal meningitis, delays disease progression and death, but system barriers to inpatient ART initiation at large hospitals in the era of modern ART have been less studied. We reviewed hospitalizations for persons newly diagnosed with AIDS at Grady Memorial Hospital in Atlanta, Georgia in 2011 and 2012. Individual- and system-level variables were collected. Logistic regression models were used to estimate the odds ratios (ORs) for ART initiation prior to discharge. With Georgia Department of Health surveillance data, we estimated time to first clinic visit, ART initiation, and viral suppression. In the study population (n = 81), ART was initiated prior to discharge in 10 (12%) patients. Shorter hospital stay was significantly associated with lack of ART initiation at the time of HIV diagnosis (8 versus 24 days, OR: 1.14, 95% confidence interval: 1.04-1.25). Reducing barriers to ART initiation for newly diagnosed HIV-positive patients with short hospital stays may improve time to viral suppression.

  6. Contemporary Sexism in the South African Navy

    Science.gov (United States)

    Van Wijk, Charles H.

    2011-01-01

    The military traditionally embraces highly sexist attitudes. Over the past decade, the South African Navy (SAN) has been exposed to an increasingly progressive political environment. This study investigated contemporary expressions of sexism in the SAN. A representative sample of 476 sailors completed the Ambivalent Sexism Inventory, Modern Sexism…

  7. Registration of ‘Alpena' navy bean

    Science.gov (United States)

    ‘Alpena’ navy bean (Phaseolus vulgaris L.) (Reg. no. CV- , PI -), developed by Michigan State University AgBioResearch was released in 2014 as an upright, midseason cultivar with uniform dry down and excellent canning quality. Alpena was developed using pedigree breeding method to the F3 generation ...

  8. Effort-reward and work-life imbalance, general stress and burnout among employees of a large public hospital in Switzerland

    OpenAIRE

    Hämmig, Oliver; Brauchli, Rebecca; Bauer, Georg F

    2012-01-01

    INTRODUCTION: Effort-reward imbalance (ERI) and work-life imbalance (WLI) are recognised risk factors for work stress and burnout but have not been investigated conjointly so far and compared with each other in this regard. The present cross-sectional study provides initial evidence by studying associations of ERI and WLI with general stress and burnout simultaneously. METHODS: The study was based on survey data collected in 2007 among the personnel of a large public hospital in the canton...

  9. Frequency of tuberculosis at autopsies in a large hospital in Zagreb, Croatia: a 10-year retrospective study

    Science.gov (United States)

    Pavić, Ivana; Radulović, Petra; Bujas, Tatjana; Perić Balja, Melita; Ostojić, Jelena; Baličević, Drinko

    2012-01-01

    Aim To assess the frequency and forms of pulmonary tuberculosis at autopsy in a high-traffic hospital in the capital city of a country with a low tuberculosis incidence. Methods We performed a retrospective search of autopsy data from the period 2000 to 2009 at Sestre Milosrdnice University Hospital Center, Zagreb, Croatia. We also examined patients’ records and histological slides. Results Of 3479 autopsies, we identified 61 tuberculosis cases, corresponding to a frequency of 1.8%. Active tuberculosis was found in 33 cases (54%), 23 of which (70%) were male. Of the 33 active cases, 25 (76%) were clinically unrecognized and 19 (76%) of these were male. Conclusion Clinically undiagnosed tuberculosis accounted for a substantial proportion of active tuberculosis cases diagnosed at autopsy. Autopsy data may be an important complement to epidemiological data on tuberculosis frequency. PMID:22351578

  10. A qualitative study into the impact of fasting within a large tertiary hospital in Australia--the patients' perspective.

    Science.gov (United States)

    Carey, Sharon K; Conchin, Simone; Bloomfield-Stone, Susan

    2015-07-01

    This qualitative study aims to explore the physical and emotional impact of fasting from the patients' perspective. Fasting patients in hospital is common practice and generally viewed as necessary for symptom management or for safety of healthcare provision. Negative impacts of repeated or prolonged fasting on nutritional status have been well researched, but little is documented as to how fasting impacts an individual patient's psyche. Qualitative descriptive design within a tertiary hospital in Sydney, Australia. Twelve patients having had prolonged periods of continuous or intermittent fasting were invited to participate in a semi-structured interview between January-September 2012. Questions for interview explored each patient's experience of fasting, including physical and emotional impacts, interpretation of communication regarding fasting and the process of recommencing on fluids or foods. An inductive thematic analysis approach was used. Analyses showed six main themes: physical impacts; emotional impacts; food as structure; nil by mouth as jargon; fear of food re-introduction; and dissatisfaction regarding unnecessary fasting. Overwhelmingly, thirst was reported as the worst physical effect of fasting. In the first few days of fasting, patients became emotionally fixated on food. This quickly dissipated leading to a lack of appetite and fear of starting to eat again. Discomfort experienced by patients coupled with lack of appetite resulting from prolonged fasting and difficulty with food re-introduction strengthens the argument for reducing fasting times in hospital. When patients are fasted, proper hydration and establishing alternate routes of medication administration should be a priority. It is well recognised that fasting for prolonged periods is detrimental to health outcomes, but this study also shows the distress that fasting can cause. Inadequate hospital systems and out-dated practices need to be replaced with evidence-based, patient

  11. Major surgery in south India: a retrospective audit of hospital claim data from a large community health insurance programme.

    Science.gov (United States)

    Shaikh, Maaz; Woodward, Mark; Rahimi, Kazem; Patel, Anushka; Rath, Santosh; MacMahon, Stephen; Jha, Vivekanand

    2015-04-27

    Information about use of major surgery in India is scarce. This study aims to bridge this gap by auditing hospital claims from the Rajiv Aarogyasri Community Health Insurance Scheme (RACHIS) that provides access to free tertiary care for major surgery through state-funded insurance to 68 million beneficiaries with limited household incomes-81% of population in states of Telangana and Andhra Pradesh (combined Human Development Index 0·485). Beneficiary households receive an annual coverage of INR 200 000 (US$3333) for admissions to any empanelled public or private hospital. Publicly available deidentified hospital claim data for all surgical procedures conducted between mid-2008 and mid-2012 were compiled across all 23 districts in Telangana and Andhra Pradesh. 677 332 surgical admissions (80% at private hospitals) were recorded at a mean annual rate of 259 per 100 000 beneficiaries (95% CI 235-283), excluding cataract and caesarean sections as these were not covered under the insurance programme. Men accounted for 56% of admissions. Injury was the most common cause for surgical admission (185 733; 27%) with surgical correction of long bone fractures being the most common procedure (144 997; 20%) identified in the audit. Diseases of digestive (110 922; 16%), genitourinary (82 505; 12%), and musculoskeletal system (70 053; 10%) were other leading causes for surgical admissions. Most hospital bed-days were used for injuries (584 days per 100 000 person years; 31%), digestive diseases (314 days; 17%), and musculoskeletal system (207 days; 11%), costing 19% (INR 4·4 billion), 13% (3·03 billion), and 11% (2·5 billion) of claims, respectively. Cardiovascular surgeries (53 023; 8%) alone accounted for 21% (INR 4·9 billion) of cost. Annual per capita cost of surgical claims was US$1·49 (95% CI 1·32-1·65). Our findings are limited to a population socioeconomically representative of India and other countries with low-income and middle

  12. Navy Role in Global War on Terrorism (GWOT) -- Background and Issues for Congress

    National Research Council Canada - National Science Library

    O'Rourke, Ronald

    2006-01-01

    ...). The Navy's role in the GWOT raises several potential oversight issues for Congress, including the need for an increased Navy role, and the amount of Navy personnel and funding associated with GWOT-related activities...

  13. Annotated Bibliography of Diversity Research Issues in the Navy and U. S. Military

    National Research Council Canada - National Science Library

    Burress, Landrus; Uriell, Zannette A; Kee, Amanda R; Rosenfeld, Paul; Alderton, David L

    2008-01-01

    ... and parenthood in the Navy. Recently, top Navy leadership has expressed support for an encompassing diversity framework to guide Navy policy in these areas with the goals being to maximize teamwork and productivity so as to...

  14. Potential Navy Force Structure and Shipbuilding Plans: Background and Issues for Congress

    National Research Council Canada - National Science Library

    O'Rourke, Ronald

    2005-01-01

    In February 2005, the Navy testified that the Navy in future years may require a total of 260 to 325 ships, or possibly 243 to 302 ships, depending on how much the Navy uses new technologies and a new...

  15. Adverse events associated with meropenem versus imipenem/cilastatin therapy in a large retrospective cohort of hospitalized infants.

    Science.gov (United States)

    Hornik, Christoph P; Herring, Amy H; Benjamin, Daniel K; Capparelli, Edmund V; Kearns, Gregory L; van den Anker, John; Cohen-Wolkowiez, Michael; Clark, Reese H; Smith, P Brian

    2013-07-01

    Carbapenems are commonly used in hospitalized infants despite a lack of complete safety data and associations with seizures in older children. We compared the incidence of adverse events in hospitalized infants receiving meropenem versus imipenem/cilastatin. We conducted a retrospective cohort study of 5566 infants treated with meropenem or imipenem/cilastatin in neonatal intensive care units managed by the Pediatrix Medical Group between 1997 and 2010. Multivariable conditional logistic regression was performed to evaluate the association between carbapenem therapy and adverse events, controlling for infant factors and severity of illness. Adverse events were more common with use of meropenem compared with imipenem/cilastatin (62.8/1000 infant days versus 40.7/1000 infant days, P imipenem/cilastatin (adjusted odds ratio 0.96; 95% confidence interval: 0.68, 1.32). The incidence of death, as well as the combined outcome of death or seizure, was lower with meropenem use-odds ratio 0.68 (0.50, 0.88) and odds ratio 0.77 (0.62, 0.95), respectively. In this cohort of infants, meropenem was associated with more frequent but less severe adverse events when compared with imipenem/cilastatin.

  16. Hospitalization and mortality among primarily nonbreastfed children during a large outbreak of diarrhea and malnutrition in Botswana, 2006.

    Science.gov (United States)

    Creek, Tracy L; Kim, Andrea; Lu, Lydia; Bowen, Anna; Masunge, Japhter; Arvelo, Wences; Smit, Molly; Mach, Ondrej; Legwaila, Keitumetse; Motswere, Catherine; Zaks, Laurel; Finkbeiner, Thomas; Povinelli, Laura; Maruping, Maruping; Ngwaru, Gibson; Tebele, Goitebetswe; Bopp, Cheryl; Puhr, Nancy; Johnston, Stephanie P; Dasilva, Alexandre J; Bern, Caryn; Beard, R S; Davis, Margarett K

    2010-01-01

    In 2006, a pediatric diarrhea outbreak occurred in Botswana, coinciding with heavy rains. Surveillance recorded a 3 times increase in cases and a 25 fold increase in deaths between January and March. Botswana has high HIV prevalence among pregnant women (33.4% in 2005), and an estimated 35% of all infants under the age of 6 months are not breastfed. We followed all children <5 years old with diarrhea in the country's second largest referral hospital at the peak of the outbreak by chart review, interviewed mothers, and conducted laboratory testing for HIV and enteric pathogens. Of 153 hospitalized children with diarrhea, 97% were <2 years old; 88% of these were not breastfeeding. HIV was diagnosed in 18% of children and 64% of mothers. Cryptosporidium and enteropathogenic Escherichia coli were common; many children had multiple pathogens. Severe acute malnutrition (kwashiorkor or marasmus) developed in 38 (25%) patients, and 33 (22%) died. Kwashiorkor increased risk for death (relative risk 2.0; P = 0.05); only one breastfeeding child died. Many children who died had been undersupplied with formula. Most of the severe morbidity and mortality in this outbreak occurred in children who were HIV negative and not breastfed. Feeding and nutritional factors were the most important determinants of severe illness and death. Breastfeeding is critical to infant survival in the developing world, and support for breastfeeding among HIV-negative women, and HIV-positive women who cannot formula feed safely, may prevent further high-mortality outbreaks.

  17. Ambient air pollution and hospitalization for congestive heart failure among elderly people in seven large US cities

    Energy Technology Data Exchange (ETDEWEB)

    Morris, R.D.; Naumova, E.N.; Munasinghe, R.L.

    1996-01-01

    Several recent studies show that the air pollution noxious effects on the cardiovascular system are certainly as more and even more important than those on the respiratory system diseases. The aim of this work is to study the contribution of the air pollution to the aggravation of the pre-existing heart diseases by the elderly persons in USA. More particularly, the co-variations between the daily hospital admissions for heart diseases and the pollution levels series by carbon monoxide, sulfur dioxide, nitrogen dioxide and ozone have been studied in several American towns. The statistical analysis used is a variant of the Poisson regression: a negative binomial distribution modeling. All the regressions are adjusted for the highest temperature, the yearly, seasonal and weekly trends. A time-lag of 0 to 7 days between the pollution and the hospital admissions have been studied. A risk calculation due to heart diseases is achieved for each town from relative risk estimations. The obtained results (mono-pollutant modeling) show that the carbon monoxide is the best correlated pollutant with the heart diseases incidence. The fact that the other pollutants are taken into account (multi-pollutants modeling) do not modify these results. (O.M.).

  18. Increased fluoroquinolone resistance with time in Escherichia coli from >17,000 patients at a large county hospital as a function of culture site, age, sex, and location

    Directory of Open Access Journals (Sweden)

    Hamill Richard J

    2008-01-01

    Full Text Available Abstract Background Escherichia coli infections are common and often treated with fluoroquinolones. Fluoroquinolone resistance is of worldwide importance and is monitored by national and international surveillance networks. In this study, we analyzed the effects of time, culture site, and patient age, sex, and location on fluoroquinolone resistance in E. coli clinical isolates. Methods To understand how patient factors and time influenced fluoroquinolone resistance and to determine how well data from surveillance networks predict trends at Ben Taub General Hospital in Houston, TX, we used Perl to parse and MySQL to house data from antibiograms (n ≅ 21,000 for E. coli isolated between 1999 to 2004 using Chi Square, Bonferroni, and Multiple Linear Regression methods. Results Fluoroquinolone resistance (i increased with time; (ii exceeded national averages by 2- to 4-fold; (iii was higher in males than females, largely because of urinary isolates from male outpatients; (iv increased with patient age; (v was 3% in pediatric patients; (vi was higher in hospitalized patients than outpatients; (vii was higher in sputum samples, particularly from inpatients, than all other culture sites, including blood and urine, regardless of patient location; and (viii was lowest in genital isolates than all other culture sites. Additionally, the data suggest that, with regard to susceptibility or resistance by the Dade Behring MicroScan system, a single fluoroquinolone suffices as a "surrogate marker" for all of the fluoroquinolone tested. Conclusion Large surveillance programs often did not predict E. coli fluoroquinolone resistance trends at a large, urban hospital with a largely indigent, ethnically diverse patient population or its affiliated community clinics.

  19. Center for Navy Business Excellence a catalyst for business transformation

    OpenAIRE

    Meek, Gordon E.

    2005-01-01

    In order to remain relevant in the face of both national and global challenges, the U.S. Navy must recognize that its once useful organizational constructs and business operations that fought the Cold War must be supplanted by significantly more nimble and effective organizations and business models. To realize the Force Transformation vision as outlined by Sea Power 21, the Navy must be vigilant in transforming its business operations. The Navy has devised several business improvement strate...

  20. The impact of turn around time in Brazilian Navy inventories

    OpenAIRE

    Casagrande, Mauricio

    2000-01-01

    Approved for public release; distribution is unlimited. This thesis analyzes how the operation of helicopters produced and supported by manufacturers in various countries affect Brazilian Navy repairable inventories levels and costs. The research is based on a scenario where the Brazilian Navy operates 68 helicopters, manufactured by contractors in USA, France, England and Italy, and the Brazilian Navy relies on these manufacturers for depot-level maintenance. We develop a simulation model...

  1. Hospital staffing and hospital costs.

    Science.gov (United States)

    Andrew, R R

    1976-08-07

    A comparative study of costs per bed per day in teaching hospitals affiliated with Monash University compared with large non-teaching metropolitan hospitals (1964 to 1974) shows they are much higher in teaching hospitals. There is no evidence that this is due to the additional costs arising from the clinical schools. Research in the teaching hospitals and the accompanying high professional standards and demands on services are major factors accounting for the difference. Over the decade studied, the resident staff have increased by 77% and other salaried staff by 24%. The index of expenditure for the three teaching hospitals in the decade has increased by 386%.

  2. Navy Future Fleet Platform Architecture Study

    Science.gov (United States)

    2016-07-01

    Corporation and should not be construed as an official government position, policy, or decision, unless designated by other documentation. ©2016 The...MITRE Corporation . All rights reserved. Sponsor: Department of the Navy Department No.: J63A Contract No.: W56KGU-15-C-0010 Project No.: 0716V150...attack against Sony Pictures in retaliation for the production of a movie [13]. Recent investigations into hacking of the Society of Worldwide

  3. Microbial Fuel Cells for Powering Navy Devices

    Science.gov (United States)

    2014-01-20

    specific MFC being analyzed. Figure 3 depicts simulated voltage vs. current plots (black curves) and corresponding power vs. current...Powering Navy Devices 7     Fig. 3 – Simulated voltage vs current and power vs current polarization plots for a two- chamber MFC in which membrane...the anode is generated by fermentation of glucose by other microorganisms in the sediment represented by clostridium in Fig. 4. The products of the

  4. Navy Operational Planner - Undersea Warfare Module

    Science.gov (United States)

    2016-09-01

    concepts are considered in NOP–USW that are not in previous research: time phasing of missions, mutually exclusive missions, and asset availability...operational planning efforts. NOP–USW suggests the correct allocation of assets across a wide theater of operation to accomplish missions in the...Master’s thesis 4. TITLE AND SUBTITLE NAVY OPERATIONAL PLANNER – UNDERSEA WARFARE MODULE 5. FUNDING NUMBERS 6. AUTHOR(S) Guy A. Molina 7

  5. Excellence within the Navy Health Care System.

    Science.gov (United States)

    1984-12-01

    in the Navy Medical Department. 13y-- Ia Sc ." . ’Eq’ Im T _ _ _ _ _ 2 SECURITY CASFAIN f !iy.i Di~tribut;-/ _.-, Availabilit Codes DcTAvail a"d/or jp...overwillingness to hand out awards as a weakness, that this waters down the meaning of the awards. 52 • . - Whether you agree or not with the past and

  6. System Design for Navy Occupational Standards Development

    Science.gov (United States)

    2014-07-01

    including, Mr. Thomas Crain, Deputy Director, Workforce Classifications Department, LCDR Juan Carrasco, Michele Jackson, and Johnny Powell. David...and Carrasco, Juan ; Navy Job Analysis Management Project Description, NAVMAC, January 2010. 34  Lists of validated tasks, sorted by Functional...34 runat="server"> <div> <rsweb:ReportViewer ID="ReportViewerSample" runat="server" Font -Names="Verdana" Font -Size=Ŝpt

  7. 2009 Navy ManTech Project Book

    Science.gov (United States)

    2009-01-01

    build a hybrid laser / GMAW system that combined deep keyhole penetration of laser welding with the high metal deposition rate of GMAW, enabling...committed to the successful outcome of the ManTech project. In addition, this close working relationship between the parties provides ManTech with a longer...the cost and time to build and repair Navy ships. The Center works closely with the Navy’s acquisition community and the shipbuilding industry to

  8. U.S. Navy Climate Change Roadmap

    Science.gov (United States)

    2010-04-01

    Climate change is a national security challenge with strategic implications for the Navy. Climate change will lead to increased tensions in nations...with weak economies and political institutions. While climate change alone is not likely to lead to future conflict, it may be a contributing factor... Climate change is affecting, and will continue to affect, U.S. military installations and access to natural resources worldwide. It will affect the

  9. Adopting Cloud Computing in the Pakistan Navy

    Science.gov (United States)

    2015-06-01

    making. In the aftermath of the 9/11 attacks and following the U.S. invasions of Iraq and Afghanistan, Pakistan joined the Global War on Terror. Since...6,000 casualties were from the military forces. The Pakistan Navy, which is a medium to smaller size force, is fighting this war on multiple fronts...disaster, complete loss of data and infrastructure may occur. Trojan Horses and Malware Emails containing Trojan horses and other malware from

  10. Effective dose calculations in conventional diagnostic X-ray examinations for adult and paediatric patients in a large Italian hospital

    International Nuclear Information System (INIS)

    Compagnone, G.; Pagan, L.; Bergamini, C.

    2005-01-01

    The effective dose E is an efficient and powerful parameter to study the radioprotection of the patient. In our hospital, eight radiological departments and more than 100 radiological X-ray tubes are present. The effective doses were calculated for adults and paediatric patients in 10 standard projections. To calculate E, first the entrance skin dose (ESD) was evaluated by a mathematical model that was validated by >400 direct measurements taken with an ionisation chamber on four different phantoms: the overall accuracy of the model was better than 12%. Second, to relate ESD to E, conversion coefficients calculated by Monte Carlo techniques were used. The E-values obtained were of the same order as those presented in the literature. Finally, we analysed how the study of E distributions among the various radiological departments can help to optimise the procedures, by identifying the most critical examinations or sub-optimal clinical protocols. (authors)

  11. Epidemiology of Methicillin-Resistant Staphylococcus aureus Diabetic Foot Infections in a Large Academic Hospital: Implications for Antimicrobial Stewardship.

    Directory of Open Access Journals (Sweden)

    Kelly R Reveles

    Full Text Available Diabetic foot infections (DFIs are the leading cause of non-traumatic lower extremity amputations in the United States. Antimicrobials active against methicillin-resistant Staphylococcus aureus (MRSA are recommended in patients with associated risk factors; however, limited data exist to support these recommendations. Due to the changing epidemiology of MRSA, and the consequences of unnecessary antibiotic therapy, guidance regarding the necessity of empirical MRSA coverage in DFIs is needed. We sought to 1 describe the prevalence of MRSA DFIs at our institution and compare to the proportion of patients who receive MRSA antibiotic coverage and 2 identify risk factors for MRSA DFI.This was a retrospective cohort study of all adult, culture-positive DFI patients managed at University Hospital, San Antonio, TX between January 1, 2010 and September 1, 2014. Patient eligibility included a principal ICD-9-CM discharge diagnosis code for foot infection and a secondary diagnosis of diabetes. The primary outcome was MRSA identified in the wound culture. Independent variables assessed included patient demographics, comorbidities, prior hospitalization, DFI therapies, prior antibiotics, prior MRSA infection, and laboratory values. Multivariable logistic regression was used to identify risk factors for MRSA DFI.Overall, 318 patients met inclusion criteria. Patients were predominantly Hispanic (79% and male (69%. Common comorbidities included hypertension (76%, dyslipidemia (52%, and obesity (49%. S. aureus was present in 46% of culture-positive DFIs (MRSA, 15%. A total of 273 patients (86% received MRSA antibiotic coverage, resulting in 71% unnecessary use. Male gender (OR 3.09, 95% CI 1.37-7.99 and bone involvement (OR 1.93, 1.00-3.78 were found to be independent risk factors for MRSA DFI.Although MRSA was the causative pathogen in a small number of DFI, antibiotic coverage targeted against MRSA was unnecessarily high.

  12. Increasing incidence of mucormycosis in a large Spanish hospital from 2007 to 2015: Epidemiology and microbiological characterization of the isolates.

    Directory of Open Access Journals (Sweden)

    Jesús Guinea

    Full Text Available We studied 19 cases of proven/probable mucormycosis diagnosed from 2007 to 2015 in our hospital and assessed the microbiological characteristics of the isolates. We recorded the incidence of mucormycosis and clinical and microbiological data of infected patients. Isolates were identified to molecular level and tested for their antifungal susceptibility to azoles, amphotericin B, and liposomal amphotericin B according to the CLSI M-38 A2 procedure. The incidence of mucormycosis in cases/100,000 hospital admissions during 2007-2015 increased significantly with respect to that reported in 1988-2006 (3.3 vs. 1.2; P<0.05. Patients mainly had hematological malignancies (52.6% and/or trauma/surgical wounds (52.6% and had received antifungal agents before the diagnosis of mucormycosis in 68% of cases. Diagnosis was by isolation (n = 17/19 and/or direct staining (n = 17/18 of Mucorales fungi in clinical samples. Identification was by panfungal PCR in patients with negative results in culture and in direct staining. The microorganisms identified were Lichtheimia spp. (42%, Rhizopus spp. (21%, Cunninghamella bertholletiae (16%, and others (21%. Liposomal amphotericin B was always more active than the other drugs against all the microorganisms except C. bertholletiae. All patients received antifungal treatment with 1 or more antifungal agents, mainly liposomal amphotericin B (17/19. Mortality was 47.4%, although this was significantly lower in the 11 patients in whom debridement was performed (18% vs. 87.5% (P = 0.015. The incidence of mucormycosis has risen in recent years. The proportion of cases with soft tissue involvement was high, and Lichtheimia was the most frequently involved species. The highest antifungal activity was observed with liposomal amphotericin B.

  13. Porpoises Among the Whales: Small Navies in Asia and the Pacific

    Science.gov (United States)

    1994-03-01

    Maverick 14 miles 300 lbs. 800+ mph Air-to-surface vessels) may decide the outcome. (U.S.) Military analysts generally maintain Silkworm 59-93 miles...Sarawak with Malaysia,* and, despite the fact into the newly formed Malaysian federation. that the two countries are ASEAN ISee also Morgan and Fryer 1985...4its constabulary and coastal-defense Fast-attack hydrofoils 5 6 Large patrol craft 18 1 roles. The Malaysian navy is only Coastal patrol craft 18

  14. VIM-positive Pseudomonas aeruginosa in a large tertiary care hospital: matched case-control studies and a network analysis.

    Science.gov (United States)

    Voor In 't Holt, Anne F; Severin, Juliëtte A; Hagenaars, Margot B H; de Goeij, Inge; Gommers, Diederik; Vos, Margreet C

    2018-01-01

    Emergence of multidrug-resistant Pseudomonas aeruginosa is of global concern. We aimed to identify epidemiological relationships, the most common way of transmission, and risk factors for presence of Verona Integron-encoded Metallo-β-lactamase (VIM)-positive P. aeruginosa (VIM-PA). We conducted a network analysis and matched case-control studies (1:2:2). Controls were hospital-based and matched with cases for ward, day of admission (control group 1 and 2) and time between admission and the identification of VIM-PA (control group 1). The network was visualized using Cytoscape, and risk factors were determined using conditional logistic regression. Between August 2003 and April 2015, 144 case patients and 576 control patients were recruited. We identified 307 relationships in 114 out of these 144 patients, with most relationships (84.7%) identified at the same department ratio [OR] = 4.40, 95% confidence interval [CI] = 2.00 to 9.65 and OR = 2.47; 95% CI = 1.12 to 5.49), > 10 day use of selective digestive tract decontamination (SDD) (OR = 2.97; 95% CI = 1.02 to 8.68 and OR = 4.61; 95% CI = 1.22 to 17.37), and use of quinolones (OR = 3.29; 95% CI = 1.34 to 8.10 and OR = 3.95; 95% CI = 1.13 to 13.83 and OR = 4.47; 95% CI = 1.75 to 11.43) were identified as risk factors when using both control groups. The network analysis indicated that the majority of transmissions occurred on the wards, but through unidentified and presumably persistent sources, which are most likely in the innate hospital environment. Previous use of certain antibiotic regimens made patients prone to VIM-PA carriage. Additionally, gastroscopy could be considered as a high-risk procedure in patients with risk factors. Our results add to the growing body of evidence that infection control measures targeting VIM-PA should be focused on reducing antibiotics and eliminating sources in the environment.

  15. Women doctors and their careers in a large university hospital in Spain at the beginning of the 21st century.

    Science.gov (United States)

    Arrizabalaga, Pilar; Abellana, Rosa; Viñas, Odette; Merino, Anna; Ascaso, Carlos

    2015-03-29

    The feminization of medicine has risen dramatically over the past decades. The aim of this article was to compare the advance of women with that of men and determine the differences between hierarchical status and professional recognition achieved by women in medicine. A retrospective study was carried out in the Hospital Clinic Barcelona, Spain, of the period from 1996 to 2008. Data relating to temporary and permanent positions, hierarchy and career promotion achieved, specialty, age and the sex of the participants were analysed with the ANOVA test and logistic regression using the generalized estimated equation. After completion of specialist training, fewer women than men doctors obtained permanent positions. The ratios between the proportions of women and men remained 1.2 for permanent non-hierarchal medical positions and below 0.2 for higher hierarchal levels. Fewer women than men with hierarchy and fewer women than men achieved the rank of consultant. Promotion to consultant and senior consultant was lower than that to senior specialist, being higher in specialties with gender parity and in masculinised specialties. On comparing the two genders using a statistical model, the probability of continuous promotion decreased with the year of the application and the age of the applicant, except in women. Despite the number of women training as specialists having increased to 50%, women remained in temporary positions twofold longer than men. Compared to women, men showed significant representation in hierarchal medical positions, and women showed a lower adjusted probability of internal professional promotion throughout the study period.

  16. Manager Experiences with the Return to Work Process in a Large, Publically Funded, Hospital Setting: Walking a Fine Line.

    Science.gov (United States)

    Stochkendahl, Mette Jensen; Myburgh, Corrie; Young, Amanda Ellen; Hartvigsen, Jan

    2015-12-01

    Previous research on the role of managers in the return to work (RTW) process has primarily been conducted in contexts where the workplace has declared organizational responsibility for the process. While this is a common scenario, in some countries, including Denmark, there is no explicit legal obligation on the workplace to accommodate RTW. The aim of this study was to gain knowledge about the potential roles and contributions of managers in supporting returning employees in a context where they have no legal obligation to actively support RTW. Nineteen Danish hospital managers participated in a one-on-one interview or focus group discussions aimed at identifying barriers and facilitators for supporting employees in their RTW. Five individual interviews and two focus group discussions were conducted. Transcripts were analysed using thematic content analysis. Four main themes were identified: (1) 'Coordinator and collaborator'; (2) 'Dilemmas of the RTW policy enforcer'; (3) 'The right to be sick and absent'; and (4) 'Keep the machinery running…'. Our findings indicated that supervisors' capacity to support returning workers was related to individual, communication, organizational, and policy factors. Instances were observed where supervisors faced the dilemma of balancing ethical and managerial principles with requirements of keeping staffing budgets. Although it is not their legislative responsibility, Danish managers play a key role in the RTW process. As has been observed in other contexts, Danish supervisors struggle to balance considerations for the returning worker with those of their teams.

  17. Hospital Ship Replacement

    Science.gov (United States)

    2011-08-01

    serious contender. Although it is a proven hull design for stability, integrating the ability to quickly transfer patients aboard is challenging . The...Waste management afloat is a constant challenge for the Navy. It is even more so when designing a hospital ship. In addition to the typical waste...0.97 Optbrs: Corrmon rail fuellrijacllon,crude oil. Rated power generating sets 61:ili:ln()q;to~ 50Htl760rpm &.gne type -1801.\\ Vlc )l ~W.’/cyl SI;O k

  18. Prevalence of AmpC and other beta-lactamases in enterobacteria at a large urban university hospital in Brazil

    OpenAIRE

    Dias, Rubens Clayton da Silva; Borges-Neto, Armando Alves; Ferraiuoli, Giovanna Ianini D’Almeida; de-Oliveira, Márcia P.; Riley, Lee W.; Moreira, Beatriz Meurer

    2007-01-01

    Production of extended-spectrum β-lactamases (ESBL) has been reported in virtually all species of Enterobacteriaceae, which greatly complicates the therapy of infections caused by these organisms. However, the frequency of isolates producing AmpC β-lactamases, especially plasmid mediated AmpC (pAmpC), is largely unknown. These β-lactamases confer resistance to extended spectrum cephalosporins and aztreonam, a multidrug-resistant (MDR) profile. The aim of the present study was to determine the...

  19. Intravenous thrombolysis of large vessel occlusions is associated with higher hospital costs than small vessel strokes: a rationale for developing stroke severity-based financial models.

    Science.gov (United States)

    Rai, Ansaar T; Evans, Kim; Riggs, Jack E; Hobbs, Gerald R

    2016-04-01

    Owing to their severity, large vessel occlusion (LVO) strokes may be associated with higher costs that are not reflected in current coding systems. This study aimed to determine whether intravenous thrombolysis costs are related to the presence or absence of LVO. Patients who had undergone intravenous thrombolysis over a 9-year period were divided into LVO and no LVO (nLVO) groups based on admission CT angiography. The primary outcome was hospital cost per admission. Secondary outcomes included admission duration, 90-day clinical outcome, and discharge destination. 119 patients (53%) had LVO and 104 (47%) had nLVO. Total mean±SD cost per LVO patient was $18,815±14,262 compared with $15,174±11,769 per nLVO patient (p=0.04). Hospital payments per admission were $17,338±13,947 and $15,594±16,437 for LVO and nLVO patients, respectively (p=0.4). A good outcome was seen in 33 LVO patients (27.7%) and in 69 nLVO patients (66.4%) (OR 0.2, 95% CI 0.1 to 0.3, pregression analysis after controlling for comorbidities showed the presence of LVO to be an independent predictor of higher total hospital costs. The presence or absence of LVO is associated with significant differences in hospital costs, outcomes, admission duration, and home discharge. These differences can be important when developing systems of care models for acute ischemic stroke. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  20. Clinico-psycho-social profile of patients brought under consultation-liaison psychiatry care in a large tertiary care referral hospital

    Directory of Open Access Journals (Sweden)

    P Patra

    2017-01-01

    Full Text Available Objective: The aim of this study was to access the clinico-psycho-social profile of patients brought under consultation-liaison (CL psychiatry care in a large tertiary care referral hospital. Materials and Methods: This study included all patients who were referred for CL psychiatry from among the inpatients in the hospital and the emergency department (during off working hours of the hospital over a period of 1 year. Data were obtained and analyzed in terms of where was the referral placed, by whom, the reason for placing the referral, the primary medical/surgical diagnosis of the patient, the presenting complaints, any past psychiatric history, the psychiatric diagnosis (as per the International Classification of Diseases, Tenth Edition, the investigations advised and their reports, the treatment advised (psychotherapeutic and psychopharmacological, the sociodemographic profile of the patients, and the follow-up details. Results: A total of 157 patients were referred to the CL unit over the study period. Out of these, 125 patients were referred among the inpatients and 32 from the emergency department of the hospital. Majority of the patients were in the age group of 25–50 years and were male. The majority of the referrals were made by general physician; most of the referrals were placed from emergency department. The most common reason for referral was for altered sensorium and behavioral abnormalities. The most common diagnosis was delirium followed by depressive episode and alcohol dependence syndrome. Conclusion: There was higher representation of delirium and alcohol-related cases in our study compared to older studies.

  1. Epidemiology, disease burden and outcomes of cirrhosis in a large secondary care hospital in South Auckland, New Zealand.

    Science.gov (United States)

    Hsiang, J C; Bai, W W; Raos, Z; Stableforth, W; Upton, A; Selvaratnam, S; Gane, E J; Gerred, S J

    2015-02-01

    Liver cirrhosis is an important cause of morbidity and mortality; however, little is known about its impact in New Zealand. We aim to determine the disease burden, epidemiology and outcomes of cirrhotic patients. This is a retrospective study of cirrhosis patients under secondary public hospital care in a geographically defined region, between the years 2000 and 2011. Cirrhosis complications and mortality was recorded. Poisson log-linear regression analysis was performed for incidence rate ratio (IRR) and Cox regression analysis was used to analyse time-related events. Seven hundred and forty-six cirrhotic patients were analysed; most were European/Other (39.9%), Pacific islanders (21.6%), Southeast Asian/Chinese (17.8%) and Maori (12.3%). 68.4% were male. The common primary aetiologies for cirrhosis were chronic hepatitis B (CHB) cirrhosis (37.3%), alcoholic liver disease (ALD) cirrhosis (24.1%), chronic hepatitis C (CHC) cirrhosis (22.3%) and non-alcoholic fatty liver disease (NAFLD) cirrhosis (16.4%). The hepatocellular carcinoma (HCC) mortality rates were highest in NAFLD and CHB cirrhosis groups (3.0 and 3.1 per 100 patient-year respectively), compared with ALD and CHC groups (2.2 and 1.4 per 100 patient-year, all P < 0.05 respectively). Patients with ALD and NAFLD cirrhosis had the highest all-cause and non-HCC mortality rate compared with viral hepatitis cirrhosis groups. The IRR for HCC incidence, liver-related mortality and HCC mortality were 1.087, 1.098 and 1.114, respectively (all P < 0.001), suggesting increasing incidence and disease burden over the study period. The number of cirrhotic patients in secondary care is increasing steadily. Cirrhosis complications and mortality rates are also rising, particularly the incidence and mortality of HCC. © 2014 Royal Australasian College of Physicians.

  2. Energy Conservation: Heating Navy Hangars

    Science.gov (United States)

    1984-07-01

    temperature, IF Tf Inside air temperature 1 foot above the floor, OF T. Inside design temperature, IF To Hot water temperature setpoint , OF TON Chiller ...systems capable of optimizing energy usage base-wide. An add-on to an existing large scale EMCS is probably the first preference, followed by single...the building comfort conditions are met during hours of building occupancy. 2. Optimized Start/Stop turns on equipment at the latest possible time and

  3. Navy Additive Manufacturing: Policy Analysis for Future DLA Material Support

    Science.gov (United States)

    2014-12-01

    of the requirements for the degree of MASTER OF BUSINESS ADMINISTRATION from the NAVAL POSTGRADUATE SCHOOL December 2014 Author...15 3. Vat Photopolymerization...................................................................16 4. Jetting...this: how should DLA best support AM efforts in the Navy in order for the Navy to achieve its goals using 3D printing? What is the most cost

  4. Expert Graphics System Research in the Department of the Navy.

    Science.gov (United States)

    Duff, Jon M.

    1987-01-01

    Presents current trends in the development of expert systems within the Department of the Navy, particularly research into expert graphics systems intended to support the Authoring Instructional Methods (AIM) research project. Defines artificial intelligence and expert systems. Discusses the operations and functions of the Navy's intelligent…

  5. 32 CFR 705.16 - Navy produced public information material.

    Science.gov (United States)

    2010-07-01

    ... STATES NAVY REGULATIONS AND OFFICIAL RECORDS PUBLIC AFFAIRS REGULATIONS § 705.16 Navy produced public... information or to acquire photos for official use, including public affairs. Photographs taken by bystanders... significant photos for public affairs use. (v) Photos made by naval personnel, with either personal cameras...

  6. Data Access and Usage Practices Across a Cohort of Researchers at a Large Tertiary Pediatric Hospital: Qualitative Survey Study.

    Science.gov (United States)

    Ho, Hoi Ki Kiki; Görges, Matthias; Portales-Casamar, Elodie

    2018-05-14

    Health and health-related data collected as part of clinical care is a foundational component of quality improvement and research. While the importance of these data is widely recognized, there are many challenges faced by researchers attempting to use such data. It is crucial to acknowledge and identify barriers to improve data sharing and access practices and ultimately optimize research capacity. To better understand the current state, explore opportunities, and identify barriers, an environmental scan of investigators at BC Children's Hospital Research Institute (BCCHR) was conducted to elucidate current local practices around data access and usage. The Clinical and Community Data, Analytics and Informatics group at BCCHR comprises over 40 investigators with diverse expertise and interest in data who share a common goal of facilitating data collection, usage, and access across the community. Semistructured interviews with 35 of these researchers were conducted, and data were summarized qualitatively. A total impact score, considering both frequency with which a problem occurs and the impact of the problem, was calculated for each item to prioritize and rank barriers. Three main themes for barriers emerged: the lengthy turnaround time before data access (18/35, 51%), inconsistent and opaque data access processes (16/35, 46%), and the inability to link data (15/35, 43%) effectively. Less frequent themes included quality and usability of data, ethics and privacy review barriers, lack of awareness of data sources, and efforts required duplicating data extraction and linkage. The two main opportunities for improvement were data access facilitation (14/32, 44%) and migration toward a single data platform (10/32, 31%). By identifying the current state and needs of the data community onsite, this study enables us to focus our resources on combating the challenges having the greatest impact on researchers. The current state parallels that of the national landscape. By

  7. Navy and Coast Guard Shipbuilding: Navy Should Reconsider Approach to Warranties for Correcting Construction Defects

    Science.gov (United States)

    2016-03-01

    As noted in the report, we found that different stakeholders within the Navy used the guaranty to accomplish differing and, at times, contradictory...staff members made key contributions to this report: Diana Moldafsky, Assistant Director; Laurier Fish; Joseph Franzwa; Ronald Freeman ; Laura

  8. Ambient air pollution and hospitalization for congestive heart failure among elderly people in seven large US cities; Pollution atmospherique ambiante et hospitalisations pour insuffisance cardiaque congestive chez les personnes agees dans sept grandes villes des Etats-Unis

    Energy Technology Data Exchange (ETDEWEB)

    Morris, R.D.; Naumova, E.N.; Munasinghe, R.L.M.

    2001-01-01

    The aim of this study is the temporal associations between the urban atmospheric pollution, in particular the carbon monoxide, and the hospitalization for congestive heart failure in elderly people, in seven large US cities. (A.L.B.)

  9. Impact of a novel training experience on the development of a customer service culture in a large hospital trust.

    Science.gov (United States)

    Eales-Reynolds, Lesley-Jane; Clarke, Colin

    2012-01-01

    This study was designed with the intention of exploring the effectiveness of a novel approach to training health services workers to meet the aims of raising awareness of their customer care framework and encouraging a culture of customer service throughout their organisation. The impact of the educational intervention was examined using a mixed methods approach involving pre- and post-workshop questionnaires and one-to-one, semi-structured interviews. The paper finds that the approach adopted was effective in raising awareness of the customer care framework and in enhancing participant's self-efficacy in relation to the principles of customer care. Transference to the workplace was dependent on personality and departments having sufficient numbers of staff participating. Time and resources for the project limited the follow-up interviews designed to explore if, and to what extent, the learning had had a lasting impact on participants and if it had enabled transference to the workplace. In addition, complications in releasing people from work in order to take part meant that a number of volunteers had to withdraw. This limits the range of data obtained. This paper describes a novel research-informed approach to training, involving participants in high fidelity, error-based simulations and in a research process which facilitated their repeated reflection on the learning. As a result the paper demonstrates large-scale training of customer care can effectively impact on practice.

  10. Employee designation and health care worker support of an influenza vaccine mandate at a large pediatric tertiary care hospital.

    Science.gov (United States)

    Feemster, Kristen A; Prasad, Priya; Smith, Michael J; Feudtner, Chris; Caplan, Arthur; Offit, Paul; Coffin, Susan E

    2011-02-17

    Determine predictors of support of a mandatory seasonal influenza vaccine program among health care workers (HCWs). Cross-sectional anonymous survey of 2443 (out of 8093) randomly selected clinical and non-clinical HCWs at a large pediatric network after implementation of a mandatory vaccination program in 2009-10. 1388 HCWs (58.2%) completed the survey and 75.2% of respondents reported agreeing with the new mandatory policy. Most respondents (72%) believed that the policy was coercive but >90% agreed that the policy was important for protecting patients and staff and was part of professional ethical responsibility. When we adjusted for attitudes and beliefs regarding influenza and the mandate, there was no significant difference between clinical and nonclinical staff in their support of the mandate (OR 1.08, 95% C.I. 0.94, 1.26). Attitudes and beliefs regarding influenza and the mandate may transcend professional role. Targeted outreach activities can capitalize on beliefs regarding patient protection and ethical responsibility. Copyright © 2011 Elsevier Ltd. All rights reserved.

  11. Navy Network Dependability: Models, Metrics, and Tools

    Science.gov (United States)

    2010-01-01

    surveillance; TCDL = Tactical Common Data Link; UHF = ultra high frequency; UFO = ultra-high-frequency follow-on; WGS = Wideband Gapfiller Satellite. RAND...VOICE (DMR VALUES) UFO OE-82 UHF LOS VOICE (DMR VALUES) UHF SATCOM VOICE DMR UHF LOS VOICE DMR TVs ADMS KIV-7 COMSEC ADNS SW ADNS II HW ISNS SW ISNS HW...Data Link; UHF = ultra high frequency; UFO = ultra-high-frequency follow-on; WGS = Wideband Gapfiller Satellite. RAND MG1003-1.1 4 Navy Network

  12. 32 CFR 700.323 - The Assistant Secretary of the Navy (Financial Management).

    Science.gov (United States)

    2010-07-01

    ... Assistants § 700.323 The Assistant Secretary of the Navy (Financial Management). The Assistant Secretary of the Navy (Financial Management) is the Comptroller of the Navy, and is responsible for all matters related to the financial management of the Department of the Navy, including: (a) Budgeting; (b...

  13. Ten-Year Trends and Independent Risk Factors for Unplanned Readmission Following Elective Total Joint Arthroplasty at a Large Urban Academic Hospital.

    Science.gov (United States)

    Varacallo, Matthew A; Herzog, Leah; Toossi, Nader; Johanson, Norman A

    2017-06-01

    Total joint arthroplasty procedures continue to provide consistent, long-term success and high patient satisfaction scores. However, early unplanned readmission to the hospital imparts significant financial risks to individual institutions as we shift away from the traditional fee-for-service payment model. Using a combination of our hospital's administrative database and retrospective chart reviews, we report the 30-day and 90-day readmission rates and all causes of readmission following all unilateral, primary elective total hip and knee arthroplasty procedures at a large, urban, academic hospital from 2004 to 2013. In total, 1165 primary total hip (511) and knee (654) arthroplasty procedures were identified, and the 30-day and 90-day unplanned readmission rates were 4.6% and 7.3%, respectively. A multivariate regression model controlled for a variety of potential clinical and surgical confounders. Increasing body mass index levels, an American Society of Anesthesiologists score of ≥3, and discharge to an inpatient rehab facility each independently correlated with risk of both 30-day and 90-day unplanned readmission to our institution. Additionally, use of general anesthesia during the procedure independently correlated with risk of readmission at 30 days only, while congestive heart failure independently correlated with risk of 90-day unplanned readmission. Readmissions related directly to the surgical site accounted for 47% of the cases, and collectively totaled more than any single medical or clinical complication leading to unplanned readmission within the 90-day period. Increasing body mass index values, general anesthesia, an American Society of Anesthesiologists score of ≥3, and discharge to an inpatient rehab facility each were independent risk factors for early unplanned readmission. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. MANAGEMENT OF SPECIALIZED AUDIOLOGIC MEDICAL CARE AND SIMULTANEOUS MEDICAL AND EDUCATIONAL FOLLOW-UP OF PREMATURE CHILDREN IN THE OUT-PATIENT DEPARTMENT OF A LARGE HOSPITAL

    Directory of Open Access Journals (Sweden)

    I. V. Rakhmanova

    2014-01-01

    Full Text Available Background: The authors set a goal to analyze the problem of management of simultaneous medical and educational follow-up of premature children during the 1st year of life under the conditions of out-patient department of a large hospital (by the example of consulting and diagnostic centre of Morozov Children Municipal Clinical Hospital. Patients and methods: Audiologic examination was performed in 293 premature children. Ninety three children with the consequences of perinatal central nervous system damage were included into the program of correctional diagnostic medical and educational rehabilitation (they were examined by otolaryngologist-audiologist, neurologist and logopedist. Results: Premature children even with normal hearing function at the age of 3 months have very high level of prespeech development retardation (from 75 to 96%, depending on their gestation age. Conclusion: Logopedics examination of premature children at the age of 3 months allows to reveal signs of their mental retardation (motor activity, aural perception, communicative, cognitive and emotional spheres, prespeech activity in the overwhelming majority of cases.

  15. Survey of doses and frequency of X-ray examinations on children at the intensive care unit of a large reference pediatric hospital

    International Nuclear Information System (INIS)

    Pedrosa de Azevedo, Ana Cecilia; Osibote, Adelaja Otolorin; Bastos Boechat, Marcia Cristina

    2006-01-01

    Objective: This work aims to evaluate the entrance surface dose (ESD), the body organ dose (BOD) and the effective dose (E) resulting from pediatric radiological procedures with the use of portable X-ray equipments. Materials and methods: The software DoseCal was used to evaluate the doses imparted to patients. The children were classified according to their weight and age groups, and the study included three sectors of the intensive care unit of a large reference pediatric hospital in Rio de Janeiro. Results: A total of 518 radiographs have been performed (424 for chest and 94 for abdomen). The statistical data were compared with previously published results. The BOD is presented for the most exposed organs. Conclusion: The mean value of ESD and E varied widely among neonates. The highest number of radiographs per infant peaked 33 for chest examination in the age group 0-1 year

  16. Limited Documentation and Treatment Quality of Glycemic Inpatient Care in Relation to Structural Deficits of Heterogeneous Insulin Charts at a Large University Hospital.

    Science.gov (United States)

    Kopanz, Julia; Lichtenegger, Katharina M; Sendlhofer, Gerald; Semlitsch, Barbara; Cuder, Gerald; Pak, Andreas; Pieber, Thomas R; Tax, Christa; Brunner, Gernot; Plank, Johannes

    2018-02-09

    Insulin charts represent a key component in the inpatient glycemic management process. The aim was to evaluate the quality of structure, documentation, and treatment of diabetic inpatient care to design a new standardized insulin chart for a large university hospital setting. Historically grown blank insulin charts in use at 39 general wards were collected and evaluated for quality structure features. Documentation and treatment quality were evaluated in a consecutive snapshot audit of filled-in charts. The primary end point was the percentage of charts with any medication error. Overall, 20 different blank insulin charts with variable designs and significant structural deficits were identified. A medication error occurred in 55% of the 102 audited filled-in insulin charts, consisting of prescription and management errors in 48% and 16%, respectively. Charts of insulin-treated patients had more medication errors relative to patients treated with oral medication (P international standards, a new insulin chart was developed to overcome these quality hurdles.

  17. Adolescent Linkage to Care After a Large-scale Transfer From a Hospital-based HIV Clinic to the Public Sector in South Africa.

    Science.gov (United States)

    Ramirez-Avila, Lynn; Regan, Susan; Cloete, Christie; Crankshaw, Tamaryn; Rabideau, Dustin J; Freedberg, Kenneth A; Parker, Robert A; Walensky, Rochelle P; Losina, Elena; Bassett, Ingrid V

    2017-03-01

    HIV clinics formerly supported by the President's Emergency Plan for AIDS Relief are transferring patients to public-sector clinics. We evaluated adolescent linkage to care after a large-scale transfer from a President's Emergency Plan for AIDS Relief-subsidized pediatric HIV clinic in Durban, South Africa. All adolescents (11-18 years) in care at a pediatric state-subsidized, hospital-based clinic (HBC) were transferred, from May to June 2012, to government sites [primary health care (PHC) clinic; community health center (CHC); and HBCs] or private clinics. Caregivers were surveyed 7-8 months after transfer to assess their adolescents' linkage to care and their reports were validated by clinic record audits in a subset of randomly selected clinics. Of the 309 (91%) caregivers reached, only 5 (2%) reported that their adolescent did not link. Of the 304 adolescents who linked, 105 (35%) were referred to a PHC, 73 (24%) to a CHC and 106 (35%) to a HBC. A total of 146 (48%) linked adolescents attended a different clinic than that assigned. Thirty-five (20%) of the 178 who linked and were assigned to a PHC or CHC ultimately attended a HBC. Based on clinic validation, the estimated transfer success was 88% (95% confidence interval: 77%-97%). The large majority of adolescents successfully transferred to a new HIV clinic, although nearly half attended a clinic other than that assigned.

  18. A text messaging intervention to improve heart failure self-management after hospital discharge in a largely African-American population: before-after study.

    Science.gov (United States)

    Nundy, Shantanu; Razi, Rabia R; Dick, Jonathan J; Smith, Bryan; Mayo, Ainoa; O'Connor, Anne; Meltzer, David O

    2013-03-11

    There is increasing interest in finding novel approaches to reduce health disparities in readmissions for acute decompensated heart failure (ADHF). Text messaging is a promising platform for improving chronic disease self-management in low-income populations, yet is largely unexplored in ADHF. The purpose of this pre-post study was to assess the feasibility and acceptability of a text message-based (SMS: short message service) intervention in a largely African American population with ADHF and explore its effects on self-management. Hospitalized patients with ADHF were enrolled in an automated text message-based heart failure program for 30 days following discharge. Messages provided self-care reminders and patient education on diet, symptom recognition, and health care navigation. Demographic and cell phone usage data were collected on enrollment, and an exit survey was administered on completion. The Self-Care of Heart Failure Index (SCHFI) was administered preintervention and postintervention and compared using sample t tests (composite) and Wilcoxon rank sum tests (individual). Clinical data were collected through chart abstraction. Of 51 patients approached for recruitment, 27 agreed to participate and 15 were enrolled (14 African-American, 1 White). Barriers to enrollment included not owning a personal cell phone (n=12), failing the Mini-Mental exam (n=3), needing a proxy (n=2), hard of hearing (n=1), and refusal (n=3). Another 3 participants left the study for health reasons and 3 others had technology issues. A total of 6 patients (5 African-American, 1 White) completed the postintervention surveys. The mean age was 50 years (range 23-69) and over half had Medicaid or were uninsured (60%, 9/15). The mean ejection fraction for those with systolic dysfunction was 22%, and at least two-thirds had a prior hospitalization in the past year. Participants strongly agreed that the program was easy to use (83%), reduced pills missed (66%), and decreased salt intake

  19. Assessment of healthcare personnel knowledge of stroke care at a large referral hospital in sub-Saharan Africa - A survey based approach.

    Science.gov (United States)

    Lin, Chen; Vakani, Ravi; Kussin, Peter; Guhwe, Mary; Farjat, Alfredo E; Choudhury, Kingshuk; Renner, David; Oduor, Chrispine; Graffagnino, Carmelo

    2017-08-01

    There is no published literature regarding sub-Saharan health-care providers' understanding of stroke management patterns. Understanding current stroke management knowledge is important in formulating future education opportunities for providers to optimize patient outcomes. A cross-sectional survey of acute stroke diagnosis, hospital management, and secondary prevention questions was administered to health-care providers working in one large Kenyan acute referral hospital. Due to the prevalence of medical students (61.8%), an experienced-focused analysis contrasted students with more experienced providers. Providers (n=199) anonymously responded to the surveys. Among the acute diagnosis most respondents stated that stroke scales should always used (58.3% of respondents), 3h was the time period for alteplase (t-PA) (53.8% of respondents), and CT scan should be always be obtained prior to administration of anticoagulant therapy (61.3% of respondents). Neither VTE prophylaxis nor dysphagia/swallowing screening were considered to be done a majority of time. Secondary prevention results were variable. The respondent's level of clinical experience made the most difference in correctly answering the most appropriate IV Fluid to use in stroke patients (adjusted p=0.003) and the ideal initiation time for antithrombotic therapy (adjusted p=0.0017). Healthcare providers demonstrated a wide variability in their responses. Future efforts to improve stroke care in sub-Saharan Africa should include education and process improvement initiatives to focus on more specific aspects of stroke management based on the results from this survey. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Large Outbreak Caused by Methicillin Resistant Staphylococcus pseudintermedius ST71 in a Finnish Veterinary Teaching Hospital – From Outbreak Control to Outbreak Prevention

    Science.gov (United States)

    Grönthal, Thomas; Moodley, Arshnee; Nykäsenoja, Suvi; Junnila, Jouni; Guardabassi, Luca; Thomson, Katariina; Rantala, Merja

    2014-01-01

    Introduction The purpose of this study was to describe a nosocomial outbreak caused by methicillin resistant Staphylococcus pseudintermedius (MRSP) ST71 SCCmec II-III in dogs and cats at the Veterinary Teaching Hospital of the University of Helsinki in November 2010 – January 2012, and to determine the risk factors for acquiring MRSP. In addition, measures to control the outbreak and current policy for MRSP prevention are presented. Methods Data of patients were collected from the hospital patient record software. MRSP surveillance data were acquired from the laboratory information system. Risk factors for MRSP acquisition were analyzed from 55 cases and 213 controls using multivariable logistic regression in a case-control study design. Forty-seven MRSP isolates were analyzed by pulsed field gel electrophoresis and three were further analyzed with multi-locus sequence and SCCmec typing. Results Sixty-three MRSP cases were identified, including 27 infections. MRSPs from the cases shared a specific multi-drug resistant antibiogram and PFGE-pattern indicated clonal spread. Four risk factors were identified; skin lesion (OR = 6.2; CI95% 2.3–17.0, P = 0.0003), antimicrobial treatment (OR = 3.8, CI95% 1.0–13.9, P = 0.0442), cumulative number of days in the intensive care unit (OR = 1.3, CI95% 1.1–1.6, P = 0.0007) or in the surgery ward (OR = 1.1, CI95% 1.0–1.3, P = 0.0401). Tracing and screening of contact patients, enhanced hand hygiene, cohorting and barrier nursing, as well as cleaning and disinfection were used to control the outbreak. To avoid future outbreaks and spread of MRSP a search-and-isolate policy was implemented. Currently nearly all new MRSP findings are detected in screening targeted to risk patients on admission. Conclusion Multidrug resistant MRSP is capable of causing a large outbreak difficult to control. Skin lesions, antimicrobial treatment and prolonged hospital stay increase the probability of acquiring

  1. Large outbreak caused by methicillin resistant Staphylococcus pseudintermedius ST71 in a Finnish Veterinary Teaching Hospital--from outbreak control to outbreak prevention.

    Directory of Open Access Journals (Sweden)

    Thomas Grönthal

    Full Text Available INTRODUCTION: The purpose of this study was to describe a nosocomial outbreak caused by methicillin resistant Staphylococcus pseudintermedius (MRSP ST71 SCCmec II-III in dogs and cats at the Veterinary Teaching Hospital of the University of Helsinki in November 2010 - January 2012, and to determine the risk factors for acquiring MRSP. In addition, measures to control the outbreak and current policy for MRSP prevention are presented. METHODS: Data of patients were collected from the hospital patient record software. MRSP surveillance data were acquired from the laboratory information system. Risk factors for MRSP acquisition were analyzed from 55 cases and 213 controls using multivariable logistic regression in a case-control study design. Forty-seven MRSP isolates were analyzed by pulsed field gel electrophoresis and three were further analyzed with multi-locus sequence and SCCmec typing. RESULTS: Sixty-three MRSP cases were identified, including 27 infections. MRSPs from the cases shared a specific multi-drug resistant antibiogram and PFGE-pattern indicated clonal spread. Four risk factors were identified; skin lesion (OR = 6.2; CI95% 2.3-17.0, P = 0.0003, antimicrobial treatment (OR = 3.8, CI95% 1.0-13.9, P = 0.0442, cumulative number of days in the intensive care unit (OR = 1.3, CI95% 1.1-1.6, P = 0.0007 or in the surgery ward (OR = 1.1, CI95% 1.0-1.3, P = 0.0401. Tracing and screening of contact patients, enhanced hand hygiene, cohorting and barrier nursing, as well as cleaning and disinfection were used to control the outbreak. To avoid future outbreaks and spread of MRSP a search-and-isolate policy was implemented. Currently nearly all new MRSP findings are detected in screening targeted to risk patients on admission. CONCLUSION: Multidrug resistant MRSP is capable of causing a large outbreak difficult to control. Skin lesions, antimicrobial treatment and prolonged hospital stay increase the probability of acquiring MRSP. Rigorous control

  2. Tests on thirteen navy type model propellers

    Science.gov (United States)

    Durand, W F

    1927-01-01

    The tests on these model propellers were undertaken for the purpose of determining the performance coefficients and characteristics for certain selected series of propellers of form and type as commonly used in recent navy designs. The first series includes seven propellers of pitch ratio varying by 0.10 to 1.10, the area, form of blade, thickness, etc., representing an arbitrary standard propeller which had shown good results. The second series covers changes in thickness of blade section, other things equal, and the third series, changes in blade area, other things equal. These models are all of 36-inch diameter. Propellers A to G form the series on pitch ratio, C, N. I. J the series on thickness of section, and K, M, C, L the series on area. (author)

  3. Discourse Analysis of Navy Leaders' Attitudes About Mental Health Problems

    National Research Council Canada - National Science Library

    Westphal, Richard J

    2004-01-01

    .... Semi-structured interviews and military policies were used as data sources to analyze the language, knowledge, and attitudes of Navy surface fleet leaders about mental illness and mental health...

  4. Navy Integration into the Air Force-Dominated JFACC

    National Research Council Canada - National Science Library

    Mongillo, Nicholas

    2000-01-01

    ...) unity of effort and command and control. Furthermore, it specifically identifies Navy shortcomings in doctrine, training, manning, and hardware that when coupled with service parochialism hinders suocessful joint air operations...

  5. Body Composition Analysis in U.S. Navy Divers

    National Research Council Canada - National Science Library

    Gummin, D. D

    2000-01-01

    Physical readiness and body makeup are considered fundamental attributes of U.S. Navy divers. Methods to objectively determine body makeup are fraught with shortcomings and can be technically challenging, particularly in field operations...

  6. Body Composition Analysis in U.S. Navy Divers

    National Research Council Canada - National Science Library

    Gummin, David

    2001-01-01

    Physical readiness and body makeup are considered fundamental attributes of U.S. Navy divers. Methods to objectively determine body makeup are fraught with shortcomings and can be technically challenging, particularly in field operations...

  7. An Analysis of Sabbatical Leaves for Navy Surface Warfare Officers

    National Research Council Canada - National Science Library

    Yardley, Roland J; Thie, Harry J; Brancato, Kevin; Abbott, Megan

    2004-01-01

    ... or to attend to other personal needs. In response to these retention concerns, the Navy is considering several programs that allow greater accommodation of the personal needs of its SWOs, particularly through the increased use of sabbatical leaves...

  8. Hearing loss in the Royal Norwegian Navy: A longitudinal study.

    Science.gov (United States)

    Irgens-Hansen, Kaja; Baste, Valborg; Bråtveit, Magne; Lind, Ola; Koefoed, Vilhelm F; Moen, Bente E

    2016-01-01

    The aims of this longitudinal study were to investigate a significant threshold shift (STS) among personnel working on board the Royal Norwegian Navy's (RNoN) vessels between 2012 and 2014 and to identify possible determinants of STS. Hearing thresholds were measured by pure tone audiometry in two consecutive examinations (n = 226). STS was defined as an average change in hearing thresholds ≥ + 10 dB at 2,000 Hz, 3,000 Hz, and 4,000 Hz in either ear. Determinants of STS were assessed through a questionnaire. The incidence of STS was 23.0%. Significant determinants of STS were the number of episodes of temporary threshold shifts (TTS) in the Navy, exposure to continuous loud noise during work on board, and the number of gun shots (in the Navy, hunting, and sports). This study indicated a significant association between noise exposure on board Navy vessels and development of STS.

  9. The Navy's Program in Nanoscience and Nanotechnology - A Look Ahead

    National Research Council Canada - National Science Library

    Kavetsky, Robert

    2004-01-01

    ... to many of these opportunities at the frontiers of science and technology. The Navy continues to provide leadership in the arenas of nanoscience and nanotechnology through its coordination and collaboration with other government agencies...

  10. Commercialization of Navy Advanced Wood Composites (CD-ROM)

    National Research Council Canada - National Science Library

    2005-01-01

    .... This work also demonstrated their useful application in marine structures. These research products solve many problems that the US Navy currently face with repairing and building timber structures on their waterfront...

  11. Status, challenges and marketing opportunities for canning navy ...

    African Journals Online (AJOL)

    Status, challenges and marketing opportunities for canning navy bean in Kenya. ... improve incomes of smallholder farmers in Kenya; its production and marketing has, however, stagnated. ... EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT

  12. the south african navy and its predecessors, 1910–2010

    African Journals Online (AJOL)

    Abel

    became more isolated internationally because of the National Party ..... commencement of political negotiations and the first truly democratic election of. 1994 .... comparable to the navies of Malaysia (two submarines and four frigates) and.

  13. Factors Affecting Organizational Commitment in Navy Corpsmen.

    Science.gov (United States)

    Booth-Kewley, Stephanie; Dell'Acqua, Renée G; Thomsen, Cynthia J

    2017-07-01

    Organizational commitment is a psychological state that has a strong impact on the likelihood that employees will remain with an organization. Among military personnel, organizational commitment is predictive of a number of important outcomes, including reenlistment intentions, job performance, morale, and perceived readiness. Because of the unique challenges and experiences associated with military service, it may be that organizational commitment is even more critical in the military than in civilian populations. Despite the essential role that they play in protecting the health of other service members, little is known about the factors that influence Navy Corpsmen's organizational commitment. This study investigated demographic and psychosocial factors that may be associated with organizational commitment among Corpsmen. Surveys of organizational commitment and possible demographic and psychosocial correlates of organizational commitment were completed by 1,597 male, active duty Navy Corpsmen attending Field Medical Training Battalion-West, Camp Pendleton, California. Bivariate correlations and hierarchical multiple regression analyses were used to determine significant predictors of organizational commitment. Of the 12 demographic and psychosocial factors examined, 6 factors emerged as significant predictors of organizational commitment in the final model: preservice motivation to be a Corpsman, positive perceptions of Corpsman training, confidence regarding promotions, occupational self-efficacy, social support for a Corpsman career, and lower depression. Importantly, a number of the factors that emerged as significant correlates of organizational commitment in this study are potentially modifiable. These factors include confidence regarding promotions, positive perceptions of Corpsman training, and occupational self-efficacy. It is recommended that military leaders and policy-makers take concrete steps to address these factors, thereby strengthening

  14. Comparative Research of Navy Voluntary Education at Operational Commands

    Science.gov (United States)

    2017-03-01

    into a national and international market. This is especially effects land-grant institutions who can educate the citizens within their state by...RESEARCH OF NAVY VOLUNTARY EDUCATION AT OPERATIONAL COMMANDS by Christopher B. Veenhuis March 2017 Thesis Co-Advisors: William Hatch Chad...COVERED Master’s thesis 4. TITLE AND SUBTITLE COMPARATIVE RESEARCH OF NAVY VOLUNTARY EDUCATION AT OPERATIONAL COMMANDS 5. FUNDING NUMBERS 6. AUTHOR(S

  15. U.S. Navy: A History of Stagnation and Innovation

    Science.gov (United States)

    2014-09-01

    nuclear missiles on submarines that the Navy would it reemerge from its funk. The last cycle would be, in part, a product of Vietnam Syndrome and...priorities and austerity, and addresses the way the Navy dealt with the Vietnam Syndrome , the institutional rankness racism and eroded prestige. Chapter...of expensive coal burning ships---a simple fact today easily forgotten as to how the advent of the machine ushered in a very different political and

  16. Cost analysis of LEED certified United States navy buildings

    OpenAIRE

    Kirar, Carl V.

    2011-01-01

    CIVINS (Civilian Institutions) Thesis document A study was completed at UW-Madison in 2010 that reviewed the energy consumption of US Navy buildings which earned Leadership in Energy and Environmental Design (LEED) certification by the United States Green Building Council (USGBC). The research compared LEED certified buildings to a commercial counterpart within the US Navy inventory against Executive Order (EO) 13423. The EO mandated that all federal agencies meet a 30 percent reduction of...

  17. An analysis of Navy Recruiting Command's officer goaling models

    OpenAIRE

    Senter, Robert R.

    1990-01-01

    Approved for public release; distribution unlimited. This study examines the goaling models used by the Navy Recruiting Command for the Nurse Corps and Nuclear Propulsion Officer Candidate (NUPOC) programs. These two programs serve as representative samples for the numerous officer recruitment programs administered by the Navy Recruiting Command. The intent of the study is to analyze and validate the accuracy of the current goaling models, to ascertain factors which could improve the accur...

  18. Sensitivity analysis of navy aviation readiness based sparing model

    Science.gov (United States)

    2017-09-01

    2012). ............8 Figure 3. Results from SA of CV AVCAL. Source: Sax (2012). .............................15 Figure 4. Research design flowchart ...Supply Systems Command Weapons System Support (NAVSUP WSS) mission “is to provide Navy, Marine Corps, Joint and Allied Forces program and supply...used to develop pack-up kits for the SH-60B light airborne multipurpose system, a program used by the U.S. Navy for anti-submarine warfare. (House

  19. Post-ERCP infection and its epidemiological and clinical characteristics in a large Chinese tertiary hospital: a 4-year surveillance study

    Directory of Open Access Journals (Sweden)

    Mingmei Du

    2017-12-01

    Full Text Available Abstract Background Endoscopic retrograde cholangiopancreatography (ERCP is widely performed as a treatment for biliary and pancreatic illness in China; however, there are few data available regarding post-ERCP infections. This study aimed to describe the overall incidence of post-ERCP infections and the epidemiological characteristics of infected patients in a large tertiary-care hospital in China. Methods Real-time surveillance was performed from 2012 through 2015 to identify all healthcare-associated infections (HAIs that occurred after ERCP, using an automatic system. All HAIs (e.g., cholangtitis, bacteremia were identified by infection control practitioners and doctors. Inpatient data were automatically collected by the surveillance system. Results A total of 1743 ERCP operations were included in the study, among these, 132 (7.57% HAIs were identified. ERCP postoperative infections occurred following different surgical procedures, with infection rates ranging from 3.58 to 13.51%. The most prevalent HAI was biliary tract infection (4.02%, followed by transient bacteremia (1.14%. Overall, 62 cases of bacteremia occurred following ERCP surgery and 34 (54.84% cases occurred on the day of the operation or 1-day post-surgery. The most prevalent isolates detected during bacteremia were Enterococcus faecium (12/58 and Escherichia coli (11/58. A large proportion (72.73% of the E. coli isolates and all of the E. faecium isolates were resistant to ciprofloxacin. In addition, only 37.50% of the E. coli isolates were susceptible to ceftriaxone. Conclusions The high incidence of post-ERCP infection and the prevalence of drug resistance suggests that employing second generation cephalosporin or ceftriaxone as the antibiotic of choice for prophylaxis before ERCP, as recommended by the Chinese clinical application of antibacterial drugs guidelines, may not be effective.

  20. Using an evidence-based approach for system selection at a large academic medical center: lessons learned in selecting an ambulatory EMR at Mount Sinai Hospital.

    Science.gov (United States)

    Kannry, Joseph; Mukani, Sonia; Myers, Kristin

    2006-01-01

    The experience of Mount Sinai Hospital is representative of the challenges and problems facing large academic medical centers in selecting an ambulatory EMR. The facility successfully revived a stalled process in a challenging financial climate, using a framework of science and rigorous investigation. The process incorporated several innovations: 1) There was a thorough review of medical informatics literature to develop a mission statement, determine practical objectives and guide the demonstration process; 2) The process involved rigorous investigation of vendor statements, industry statements and other institution's views of vendors; 3) The initiative focused on user-centric selection, and the survey instrument was scientifically and specifically designed to assess user feedback; 4) There was scientific analysis of validated findings and survey results at all steering meetings; 5) The process included an assessment of vendors' ability to support research by identifying funded and published research; 6) Selection involved meticulous total cost of ownership analysis to assess and compare real costs of implementing a vendor solution; and finally, 7) There were iterative meetings with stakeholders, executives and users to understand needs, address concerns and communicate the vision.

  1. Effort-reward and work-life imbalance, general stress and burnout among employees of a large public hospital in Switzerland.

    Science.gov (United States)

    Hämmig, Oliver; Brauchli, Rebecca; Bauer, Georg F

    2012-05-31

    Effort-reward imbalance (ERI) and work-life imbalance (WLI) are recognised risk factors for work stress and burnout but have not been investigated conjointly so far and compared with each other in this regard. The present cross-sectional study provides initial evidence by studying associations of ERI and WLI with general stress and burnout simultaneously. The study was based on survey data collected in 2007 among the personnel of a large public hospital in the canton of Zurich covering a random sample of 502 employees of all professions and positions. Prevalence rates, correlation coefficients, standardised regression coefficients and odds ratios were calculated as measures of association. Concerning the main research question and relating to the entire study sample, WLI was found to be more strongly associated with general stress and burnout than ERI. As stratified analyses with regard to burnout have shown, this applied especially to nursing, technical care and emergency staffs who account for more than three fifths of the study population. But for other professional categories like physicians, therapists and medical-technical personnel the opposite of a stronger association of ERI with burnout was found. Results also suggested that general stress plays a (rather minor) mediating role in the relationships between ERI and burnout and particularly between WLI and burnout. For the prevention of chronic stress and burnout one should consider both high efforts put into work as well as all job demands that are competing and interfering with family responsibilities or other private activities should be considered.

  2. A pioneering healthcare model applying large-scale production concepts: Principles and performance after more than 11,000 transplants at Hospital do Rim

    Directory of Open Access Journals (Sweden)

    José Medina Pestana

    Full Text Available Summary The kidney transplant program at Hospital do Rim (hrim is a unique healthcare model that applies the same principles of repetition of processes used in industrial production. This model, devised by Frederick Taylor, is founded on principles of scientific management that involve planning, rational execution of work, and distribution of responsibilities. The expected result is increased efficiency, improvement of results and optimization of resources. This model, almost completely subsidized by the Unified Health System (SUS, in the Portuguese acronym, has been used at the hrim in more than 11,000 transplants over the last 18 years. The hrim model consists of eight interconnected modules: organ procurement organization, preparation for the transplant, admission for transplant, surgical procedure, post-operative period, outpatient clinic, support units, and coordination and quality control. The flow of medical activities enables organized and systematic care of all patients. The improvement of the activities in each module is constant, with full monitoring of various administrative, health care, and performance indicators. The continuous improvement in clinical results confirms the efficiency of the program. Between 1998 and 2015, an increase was noted in graft survival (77.4 vs. 90.4%, p<0.001 and patient survival (90.5 vs. 95.1%, p=0.001. The high productivity, efficiency, and progressive improvement of the results obtained with this model suggest that it could be applied to other therapeutic areas that require large-scale care, preserving the humanistic characteristic of providing health care activity.

  3. Development and Implementation of a Combined Master of Science and PGY1/PGY2 Health-System Pharmacy Administration Residency Program at a Large Community Teaching Hospital.

    Science.gov (United States)

    Gazda, Nicholas P; Griffin, Emily; Hamrick, Kasey; Baskett, Jordan; Mellon, Meghan M; Eckel, Stephen F; Granko, Robert P

    2018-04-01

    Purpose: The purpose of this article is to share experiences after the development of a health-system pharmacy administration residency with a MS degree and express the need for additional programs in nonacademic medical center health-system settings. Summary: Experiences with the development and implementation of a health-system pharmacy administration residency at a large community teaching hospital are described. Resident candidates benefit from collaborations with other health-systems through master's degree programs and visibility to leaders at your health-system. Programs benefit from building a pipeline of future pharmacy administrators and by leveraging the skills of residents to contribute to projects and department-wide initiatives. Tools to assist in the implementation of a new pharmacy administration program are also described and include rotation and preceptor development, marketing and recruiting, financial evaluation, and steps to prepare for accreditation. Conclusion: Health-system pharmacy administration residents provide the opportunity to build a pipeline of high-quality leaders, provide high-level project involvement, and produce a positive return on investment (ROI) for health-systems. These programs should be explored in academic and nonacademic-based health-systems.

  4. A pioneering healthcare model applying large-scale production concepts: Principles and performance after more than 11,000 transplants at Hospital do Rim.

    Science.gov (United States)

    Pestana, José Medina

    2016-10-01

    The kidney transplant program at Hospital do Rim (hrim) is a unique healthcare model that applies the same principles of repetition of processes used in industrial production. This model, devised by Frederick Taylor, is founded on principles of scientific management that involve planning, rational execution of work, and distribution of responsibilities. The expected result is increased efficiency, improvement of results and optimization of resources. This model, almost completely subsidized by the Unified Health System (SUS, in the Portuguese acronym), has been used at the hrim in more than 11,000 transplants over the last 18 years. The hrim model consists of eight interconnected modules: organ procurement organization, preparation for the transplant, admission for transplant, surgical procedure, post-operative period, outpatient clinic, support units, and coordination and quality control. The flow of medical activities enables organized and systematic care of all patients. The improvement of the activities in each module is constant, with full monitoring of various administrative, health care, and performance indicators. The continuous improvement in clinical results confirms the efficiency of the program. Between 1998 and 2015, an increase was noted in graft survival (77.4 vs. 90.4%, p<0.001) and patient survival (90.5 vs. 95.1%, p=0.001). The high productivity, efficiency, and progressive improvement of the results obtained with this model suggest that it could be applied to other therapeutic areas that require large-scale care, preserving the humanistic characteristic of providing health care activity.

  5. A booming economy means a bursting trauma system: association between hospital admission for major injury and indicators of economic activity in a large Canadian health region.

    Science.gov (United States)

    Roberts, Derek J; Das, Debanjana; Mercado, Michelle; Vis, Christine; Kortbeek, John B; Kirkpatrick, Andrew W; Ball, Chad G

    2014-05-01

    Injury epidemiology fluctuates with economic activity in many countries. These relationships remain unclear in Canada. The annual risk of admission for major injury (Injury Severity Score ≥12) to a high-volume, level-1 Canadian trauma center was compared with indicators of economic activity over a 16-year period using linear regression. An increased risk of injured patient admissions was associated with rising mean gross domestic product (GDP [millions of chained 2002 dollars]) (.36 person increase per 100,000 population/$1,000 increase in GDP; P = .001) and annual gasoline prices (.47 person increase per 100,000 population/cent increase in gasoline price; P = .001). Recreation-related vehicle injuries were also associated with economic affluence. The risk of trauma patient mortality with increasing mean annual GDP (P = .72) and gasoline prices (P = .32) remained unchanged. Hospital admissions for major injury, but not trauma patient mortality, were associated with economic activity in a large Canadian health care region. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. NaviSE: superenhancer navigator integrating epigenomics signal algebra.

    Science.gov (United States)

    Ascensión, Alex M; Arrospide-Elgarresta, Mikel; Izeta, Ander; Araúzo-Bravo, Marcos J

    2017-06-06

    Superenhancers are crucial structural genomic elements determining cell fate, and they are also involved in the determination of several diseases, such as cancer or neurodegeneration. Although there are pipelines which use independent pieces of software to predict the presence of superenhancers from genome-wide chromatin marks or DNA-interaction protein binding sites, there is not yet an integrated software tool that processes automatically algebra combinations of raw data sequencing into a comprehensive final annotated report of predicted superenhancers. We have developed NaviSE, a user-friendly streamlined tool which performs a fully-automated parallel processing of genome-wide epigenomics data from sequencing files into a final report, built with a comprehensive set of annotated files that are navigated through a graphic user interface dynamically generated by NaviSE. NaviSE also implements an 'epigenomics signal algebra' that allows the combination of multiple activation and repression epigenomics signals. NaviSE provides an interactive chromosomal landscaping of the locations of superenhancers, which can be navigated to obtain annotated information about superenhancer signal profile, associated genes, gene ontology enrichment analysis, motifs of transcription factor binding sites enriched in superenhancers, graphs of the metrics evaluating the superenhancers quality, protein-protein interaction networks and enriched metabolic pathways among other features. We have parallelised the most time-consuming tasks achieving a reduction up to 30% for a 15 CPUs machine. We have optimized the default parameters of NaviSE to facilitate its use. NaviSE allows different entry levels of data processing, from sra-fastq files to bed files; and unifies the processing of multiple replicates. NaviSE outperforms the more time-consuming processes required in a non-integrated pipeline. Alongside its high performance, NaviSE is able to provide biological insights, predicting cell

  7. Association between use of pre-hospital ECG and 30-day mortality: A large cohort study of patients experiencing chest pain.

    Science.gov (United States)

    Rawshani, Nina; Rawshani, Araz; Gelang, Carita; Herlitz, Johan; Bång, Angela; Andersson, Jan-Otto; Gellerstedt, Martin

    2017-12-01

    In the assessment of patients with chest pain, there is support for the use of pre-hospital ECG in the literature and in the care guidelines. Using propensity score methods, we aim to examine whether the mere acquisition of a pre-hospital ECG among patients with chest pain affects the outcome (30-day mortality). The association between pre-hospital ECG and 30-day mortality was studied in the overall cohort (n=13151), as well as in the one-to-one matched cohort with 2524 patients not examined with pre-hospital ECG and 2524 patients examined with pre-hospital ECG. In the overall cohort, 21% (n=2809) did not undergo an ECG tracing in the pre-hospital setting. Among those who had pain during transport, 14% (n=1159) did not undergo a pre-hospital ECG while 32% (n=1135) of those who did not have pain underwent an ECG tracing. In the overall cohort, the OR for 30-day mortality in patients who had a pre-hospital ECG, as compared with those who did not, was 0.63 (95% CI 0.05-0.79; pECG was used. The PH-ECG is underused among patients with chest discomfort and the mere acquisition of a pre-hospital ECG may reduce mortality. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. [Assessing deinstitutionalization of the nursing home area of a large state mental hospital from the point of view of patients and staff].

    Science.gov (United States)

    Kallert, T W; Stoll, A; Leisse, M; Winiecki, P

    2004-08-01

    Within the deinstitutionalization process of a large psychiatric hospital, the development of two cohorts of patients with chronic schizophrenia is compared over a two-year period: patients living in the hospital's nursing-home area (n = 50) vs. patients already released to two social therapeutic hostels (n = 51). Results of the cohort study were compared with assessments of nurses working in the nursing home (n = 55), focusing on their subjective views of the deinstitutionalization process and its impact on their working conditions. Patients are assessed through yearly home-visits in their place of residence. The instruments used measure several outcome parameters: psychopathology, social disabilities, subjective quality of life, and normative needs for care. Concurrent staff assessments were conducted using standardized survey instruments focusing on current working conditions and quality of teamwork. Nineteen nurses participated in qualitative interviews evaluating the deinstitutionalization process. For all measures, patients living in the nursing home show significantly worse outcomes. Furthermore, during the study period 34 % experienced a change in their living situation with which they were dissatisfied. Needs for care and the number of areas of "unmet" need increased significantly for this subgroup. Patients living in social therapeutic hostels demonstrate stable levels of psychopathological symptoms, social disabilities, and needs for care. Assessments indicating a deterioration in patients' subjective quality of life focus mainly on areas important for social contacts. Regarding "personal concerns" and "insecurity at work", ratings from nursing home staff were significantly worse than those of a reference group from several other health care institutions (n = 224). Staff showed a tendency to give higher ratings for their opportunities to participate in decisions, in contrast with the low ratings for chances to improve their knowledge in the workplace, a

  9. Safety and efficacy of large balloon sphincteroplasty in a third care hospital Dilatación con balón asociada a esfinterotomía, evaluación de eficacia y seguridad en un hospital terciario

    Directory of Open Access Journals (Sweden)

    Eduardo Martín-Arranz

    2012-07-01

    Full Text Available Background and aims: large balloon sphincteroplasty (LBS associated with sphincterotomy (ES has gained acceptance as a useful tool in extracting difficult bile duct stones. Our purpose was to evaluate the efficacy and safety of LBS with balloons ≥ 10 mm in clinical practice setting. Patients and methods: unicentre prospective study in a tertiary care hospital. All patients who underwent LBS associated with ES between July 2007 and March 2011 were included prospectively in a database recording clinical aspects, procedure data, outcome and complications. Success is the main outcome defined as complete stone removal documented by absence of any filling defect during a final occlusion cholangiogram and absence of clinical or radiological findings after the ERCP consistent with remaining stones. Complications as pancreatitis, cholangitis, post-ERCP bleeding, perforation and others were also measured. Results: one hundred twenty procedures were made in 109 patients with balloons ranging from 10 to 20 mm. Success rate was 91% in the first attempt and 96.7% after two procedures. Mechanical lithotripsy was only needed in one case (0.8%. Complication rate was 4.2% due to five cases of post-ERCP bleeding in high risk patients. Conclusion: large balloon sphincteroplasty associated to sphincterotomy in clinical practice is a very effective and safe technique.Introducción y objetivos: la dilatación con balón de gran tamaño asociada a esfinterotomía es un recurso cada vez más utilizado en la extracción de coledocolitiasis de gran tamaño. El objetivo de este estudio es evaluar la eficacia y seguridad de la dilatación con balones mayores de 10 mm en un entorno de práctica clínica habitual. Pacientes y métodos: estudio prospectivo en un hospital terciario. Todos los pacientes en los que se realizó dilatación con balón mayor de 10 mm asociado a esfinterotomía entre julio de 2007 y marzo de 2011 se incluyeron prospectivamente en una base de datos

  10. A Survey of Nursing Home Organizational Characteristics Associated with Potentially Avoidable Hospital Transfers and Care Quality in One Large British Columbia Health Region

    Science.gov (United States)

    McGregor, Margaret J.; Baumbusch, Jennifer; Abu-Laban, Riyad B.; McGrail, Kimberlyn M.; Andrusiek, Dug; Globerman, Judith; Berg, Shannon; Cox, Michelle B.; Salomons, Kia; Volker, Jan; Ronald, Lisa

    2011-01-01

    Hospitalization of nursing home residents can be futile as well as costly, and now evidence indicates that treating nursing home residents in place produces better outcomes for some conditions. We examined facility organizational characteristics that previous research showed are associated with potentially avoidable hospital transfers and with…

  11. An offer they can't refuse. As mergers and acquisitions make a comeback, hospitals large and small are choosing consolidation over competition.

    Science.gov (United States)

    Galloro, Vince

    2004-07-12

    Hospital deals are heating up as summer settles in, fueled in part by Medicare reform and the "Tenet effect." One recent move by Christus Health made Alice, Texas, a one-hospital town again. Christus' Peter Maddox, left, denies that the consolidation means prices will rise. "It's not a retail world anymore," he says.

  12. Navy Speciality Physician Study: Historical Overview, Retention Analysis, and Synopsis of Current Civilian-Sector Practices

    National Research Council Canada - National Science Library

    Christensen, Eric

    2002-01-01

    .... The objective of the study was to further explore retention of Navy physicians, by identifying and tracking critical indicators of Navy physician retention, to provide BUMED information for improving...

  13. Iraqi Navy: Capability Requirements and Force Structure Recommendations for 2015 and Beyond

    National Research Council Canada - National Science Library

    Lawlor, Alison C; Thompson, Eric V

    2008-01-01

    .... The goal of this study is two-fold: to provide Iraqi and Coalition personnel with a common assessment of capability requirements and force structure recommendations for the Iraqi Navy, and to provide the Iraqi Navy leadership...

  14. Navy Ship Procurement: Alternative Funding Approaches - Background and Options for Congress

    National Research Council Canada - National Science Library

    O'Rourke, Ronald

    2005-01-01

    Some observers have proposed procuring Navy ships using incremental funding or advance appropriations rather than the traditional full funding approach that has been used to procure most Navy ships...

  15. Navy Ship Procurement: Alternative Funding Approaches - Background and Options for Congress

    National Research Council Canada - National Science Library

    O'Rourke, Ronald

    2006-01-01

    Some observers have proposed procuring Navy ships using incremental funding or advance appropriations rather than the traditional full funding approach that has been used to procure most Navy ships...

  16. New Approaches for Navy Technical Training and Job Performance Aiding Using Expanded IETM Technology

    National Research Council Canada - National Science Library

    Jorgensen, Eric L; Fuller, Joseph J

    1996-01-01

    ...) began to develop better ways to present Technical Information (TI) to Navy Fleet users needed for purposes of operating, maintaining, training, and logistically supporting the Navy's inventory of weapon systems...

  17. Navy Ship Propulsion Technologies: Options for Reducing Oil Use - Background for Congress

    National Research Council Canada - National Science Library

    O'Rourke, Ronald

    2006-01-01

    ...; and using sail and solar power. Reducing energy use on Navy ships. A 2001 study concluded that fitting a Navy cruiser with more energy-efficient electrical equipment could reduce the ship's fuel use by 10% to 25...

  18. Employing Service Oriented Architecture Technologies to Bind a Thousand Ship Navy

    National Research Council Canada - National Science Library

    Rothenhaus, Kurt; Michael, James B

    2008-01-01

    .... Navy with partners from around the globe. A critical requirement to join various Navies from such diverse backgrounds and technology levels is a simple, flexible, and economical Command and Control (C2...

  19. High Resolution Modeling of Coastal Inundation: User Requirements and Current Practice, A Navy Perspective

    National Research Council Canada - National Science Library

    Blain, Cheryl Ann; Preller, Ruth H

    2007-01-01

    The impact of coastal flooding and inundation on Navy operational missions and the existing Navy requirements for resolution and accuracy relevant to coastal inundation are presented. High resolution (less than 500 m...

  20. Fleet Numerical Meteorology and Oceanography Center (FNMOC) Navy Operational Global Atmospheric Prediction System (NOGAPS)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Navy Operational Global Atmospheric Prediction System (NOGAPS) provides numerical guidance and products in support of a wide range of Navy oceanographic and...

  1. Compilation of the FY 1999 Department of the Navy Working Capital Fund Financial Statements

    National Research Council Canada - National Science Library

    2000-01-01

    ...) Cleveland Center consistently and accurately compiled and consolidated financial data received from Navy field organizations and other sources to prepare the FY 1999 Navy Working Capital Fund financial statements...

  2. Information Technology Management: The Development of the Navy Standard Integrated Personnel System

    National Research Council Canada - National Science Library

    Granetto, Paul

    2003-01-01

    ... Information Systems Review Council (Council) approved Milestone 0 for the Navy System. While approving the milestone, the Council also stated that the Navy System should incorporate the core capabilities of a common DoD-wide military personnel system...

  3. Chemistry and Properties of Slags from Navy Solid Waste Destruction in the Plasma Arc System

    National Research Council Canada - National Science Library

    Talmy, Inna

    1999-01-01

    The U.S. Navy is currently developing a highly efficient shipboard system which employs a plasma torch to process Navy solid wastes primarily consisting of cardboard, paper, steel, aluminum, glass, and food waste...

  4. Navy Radon Assessment and Mitigation Program: Work/quality assurance project plan screening phase

    International Nuclear Information System (INIS)

    1991-03-01

    In 1987, the military services of the United States were tasked to take appropriate action to establish an indoor radon assessment and mitigation program. As a result, the Naval Facilities Engineering Command (NAVFACENGCOM) was assigned the responsibility of identifying potential hazards to personnel from exposure to naturally occurring radon gas and prioritizing corrective actions and to coordinating these actions with the major claimants. NAVRAMP is based upon current US Environmental Protection Agency (EPA) guidelines. The program has been separated into four phases. The screening phase will concentrate on evaluating radon levels, based on statistical samples, in those buildings that have been determined to be at most at risk to elevated levels of radon, such as base housing, schools, day-care centers, hospitals, brigs, Base Officer Quarters, and Base Enlisted Quarters. During the assessment phase, every building that contains personnel for over 4 h/day will be evaluated. Mitigation work will be accomplished by Navy or Navy-contracted personnel. HAZWRAP services during the mitigation phase will consist of determining the extent of reduction in radon levels after the mitigation effort. 7 refs., 11 figs

  5. The Field Assessment Stroke Triage for Emergency Destination (FAST-ED): a Simple and Accurate Pre-Hospital Scale to Detect Large Vessel Occlusion Strokes

    Science.gov (United States)

    Lima, Fabricio O.; Silva, Gisele S.; Furie, Karen L.; Frankel, Michael R.; Lev, Michael H.; Camargo, Érica CS; Haussen, Diogo C.; Singhal, Aneesh B.; Koroshetz, Walter J.; Smith, Wade S.; Nogueira, Raul G.

    2016-01-01

    Background and Purpose Patients with large vessel occlusion strokes (LVOS) may be better served by direct transfer to endovascular capable centers avoiding hazardous delays between primary and comprehensive stroke centers. However, accurate stroke field triage remains challenging. We aimed to develop a simple field scale to identify LVOS. Methods The FAST-ED scale was based on items of the NIHSS with higher predictive value for LVOS and tested in the STOPStroke cohort, in which patients underwent CT angiography within the first 24 hours of stroke onset. LVOS were defined by total occlusions involving the intracranial-ICA, MCA-M1, MCA-2, or basilar arteries. Patients with partial, bi-hemispheric, and/or anterior + posterior circulation occlusions were excluded. Receiver operating characteristic (ROC) curve, sensitivity, specificity, positive (PPV) and negative predictive values (NPV) of FAST-ED were compared with the NIHSS, Rapid Arterial oCclusion Evaluation (RACE) scale and Cincinnati Prehospital Stroke Severity Scale (CPSSS). Results LVO was detected in 240 of the 727 qualifying patients (33%). FAST-ED had comparable accuracy to predict LVO to the NIHSS and higher accuracy than RACE and CPSS (area under the ROC curve: FAST-ED=0.81 as reference; NIHSS=0.80, p=0.28; RACE=0.77, p=0.02; and CPSS=0.75, p=0.002). A FAST-ED ≥4 had sensitivity of 0.60, specificity 0.89, PPV 0.72, and NPV 0.82 versus RACE ≥5 of 0.55, 0.87, 0.68, 0.79 and CPSS ≥2 of 0.56, 0.85, 0.65, 0.78, respectively. Conclusions FAST-ED is a simple scale that if successfully validated in the field may be used by medical emergency professionals to identify LVOS in the pre-hospital setting enabling rapid triage of patients. PMID:27364531

  6. Navy Shipboard Hazardous Material Minimization Program

    Energy Technology Data Exchange (ETDEWEB)

    Bieberich, M.J. [Naval Surface Warfare Center, Annapolis, MD (United States). Carderock Div.; Robinson, P. [Life Cycle Engineering, Inc., Charleston, SC (United States); Chastain, B.

    1994-12-31

    The use of hazardous (and potentially hazardous) materials in shipboard cleaning applications has proliferated as new systems and equipments have entered the fleet to reside alongside existing equipments. With the growing environmental awareness (and additional, more restrictive regulations) at all levels/echelon commands of the DoD, the Navy has initiated a proactive program to undertake the minimization/elimination of these hazardous materials in order to eliminate HMs at the source. This paper will focus on the current Shipboard Hazardous Materials Minimization Program initiatives including the identification of authorized HM currently used onboard, identification of potential substitute materials for HM replacement, identification of new cleaning technologies and processes/procedures, and identification of technical documents which will require revision to eliminate the procurement of HMs into the federal supply system. Also discussed will be the anticipated path required to implement the changes into the fleet and automated decision processes (substitution algorithm) currently employed. The paper will also present the most recent technologies identified for approval or additional testing and analysis including: supercritical CO{sub 2} cleaning, high pressure blasting (H{sub 2}O + baking soda), aqueous and semi-aqueous cleaning materials and processes, solvent replacements and dedicated parts washing systems with internal filtering capabilities, automated software for solvent/cleaning process substitute selection. Along with these technological advances, data availability (from on-line databases and CDROM Database libraries) will be identified and discussed.

  7. Navy definitions of leadership and LMET/NAVLEAD competency clusters compared to selected leadership theories

    OpenAIRE

    Al Harbi, Toraiheeb

    1995-01-01

    This study examines the leadership training model used in the US Navy and investigates the way the Navy looks at and defines leadership in general. The emphasis is placed on leadership training for commissioned officers. The objective is dual; first, to make explicit the Navy's concept and definition of leadership, and second, to examine and analyze the leadership training program LMET/NAVLEAD content, as designed by McBer. Then, both the Navy definition of leadership and ...

  8. 32 CFR 700.325 - The Assistant Secretary of the Navy (Installations and Environment).

    Science.gov (United States)

    2010-07-01

    ... (Installations and Environment). 700.325 Section 700.325 National Defense Department of Defense (Continued... Assistants § 700.325 The Assistant Secretary of the Navy (Installations and Environment). The Assistant Secretary of the Navy (Installations and Environment) is responsible for: (a) Policy relating to Navy...

  9. 32 CFR 700.326 - The Assistant Secretary of the Navy (Research, Development and Acquisition).

    Science.gov (United States)

    2010-07-01

    ... Assistants § 700.326 The Assistant Secretary of the Navy (Research, Development and Acquisition). The Assistant Secretary of the Navy (Research, Development and Acquisition) is responsible for: (a) Research... 32 National Defense 5 2010-07-01 2010-07-01 false The Assistant Secretary of the Navy (Research...

  10. 32 CFR 776.32 - Department of the Navy as client.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Department of the Navy as client. 776.32 Section... Rules of Professional Conduct § 776.32 Department of the Navy as client. (a) Department of Navy as client: (1) Except when representing an individual client pursuant to paragraph (a)(6) of this section, a...

  11. Changes in utilization and peri-operative outcomes of bariatric surgery in large U.S. hospital database, 2011-2014.

    Directory of Open Access Journals (Sweden)

    Lu Zhang

    Full Text Available With the epidemic of morbid obesity, bariatric surgery has been accepted as one of the most effective treatments of obesity.To investigate recent changes in the utilization of bariatric surgery, patients and hospital characteristics, and in-hospital complications in a nationwide hospital database in the United States.This is a secondary data analysis of the Premier Perspective database.ICD-9 codes were used to identify bariatric surgeries performed between 2011 and 2014. Descriptive statistics were computed and regression was used.A total of 74,774 bariatric procedures were identified from 436 hospitals between 2011 and 2014. During this time period, the proportion of gastric bypass (from 44.8% to 31.3%; P for trend < 0.0001 and gastric banding (from 22.8% to 5.2%; P for trend < 0.0001 decreased, while the proportion of sleeve gastrectomy (from 13.7% to 56.9%; P for trend < 0.0001 increased substantially. The proportion of bariatric surgery performed for outpatients decreased from 17.15% in 2011 to 8.11% in 2014 (P for trend < 0.0001. The majority of patients undergoing surgery were female (78.5%, white (65.6%, younger than 65 years (93.8%, and insured with managed care (53.6%. In-hospital mortality rate and length of hospital stay remained stable. The majority of surgeries were performed in high-volume (71.8% and urban (91.6% hospitals.Results based on our study sample indicated that the popularity of various bariatric surgery procedures changed significantly from 2011 to 2014. While the rates of in-hospital complications were stable, disparities in the use of bariatric surgery regarding gender, race, and insurance still exist.

  12. Prevalence and possible causes of anemia in the elderly: a cross-sectional analysis of a large European university hospital cohort

    Directory of Open Access Journals (Sweden)

    Bach V

    2014-07-01

    Full Text Available Veronika Bach,1 Guenter Schruckmayer,1 Ines Sam,1 Georg Kemmler,2 Reinhard Stauder11Department of Internal Medicine V (Hematology and Oncology, 2Department of Biological Psychiatry, Innsbruck Medical University, Innsbruck, AustriaBackground: Anemia in later life is associated with increased morbidity and mortality. The purpose of this study was to evaluate the prevalence and possible causes of anemia in the elderly in a well defined hospital cohort.Methods: Participants in this cross-sectional, retrospective analysis included all inpatients and outpatients aged ≥64 years with complete blood counts treated at Innsbruck Medical University Hospital between October 1, 2004 and September 29, 2005 (n=19,758, median age 73 years.Results: According to World Health Organization criteria, 21.1% of these patients were anemic, ie, 30.7% and 37.0% at 80+ years and 90+ years, respectively. The prevalence of anemia was significantly correlated with advanced age (r=0.21; P<0.001 and male sex (P<0.001. In anemic patients, renal insufficiency with a glomerular filtration rate <30 mL/min/1.73 m2 (11.3% versus 2.1%, hyperinflammation (62.1% versus 31.4%, absolute (14.4% versus 6.9% or functional (28.2% versus 11.8% iron deficiency, and folate deficiency (6.7% versus 3.0% were observed significantly more often than in nonanemic subjects (P<0.001. The pathogenesis of anemia was multifactorial, with decreased renal function (glomerular filtration rate <60 mL/min/1.73 m2, signs of inflammation, and functional iron deficiency detected in 11.4% of anemic patients. Hemoglobin was significantly correlated with elevated C-reactive protein (r=–0.296; P<0.001 and low transferrin saturation (r=0.313; P<0.001. Mean corpuscular volume correlated only weakly with the various anemia subtypes. Cytopenias and morphologic alterations suggestive of underlying myelodysplastic syndromes were found in a substantial proportion of anemic patients, including thrombocytopenia (5

  13. Hearing loss in the Royal Norwegian Navy: A longitudinal study

    Directory of Open Access Journals (Sweden)

    Kaja Irgens-Hansen

    2016-01-01

    Full Text Available The aims of this longitudinal study were to investigate a significant threshold shift (STS among personnel working on board the Royal Norwegian Navy′s (RNoN vessels between 2012 and 2014 and to identify possible determinants of STS. Hearing thresholds were measured by pure tone audiometry in two consecutive examinations (n = 226. STS was defined as an average change in hearing thresholds ≥ + 10 dB at 2,000 Hz, 3,000 Hz, and 4,000 Hz in either ear. Determinants of STS were assessed through a questionnaire. The incidence of STS was 23.0%. Significant determinants of STS were the number of episodes of temporary threshold shifts (TTS in the Navy, exposure to continuous loud noise during work on board, and the number of gun shots (in the Navy, hunting, and sports. This study indicated a significant association between noise exposure on board Navy vessels and development of STS.

  14. Fuzzy-Rule-Based Object Identification Methodology for NAVI System

    Directory of Open Access Journals (Sweden)

    Yaacob Sazali

    2005-01-01

    Full Text Available We present an object identification methodology applied in a navigation assistance for visually impaired (NAVI system. The NAVI has a single board processing system (SBPS, a digital video camera mounted headgear, and a pair of stereo earphones. The captured image from the camera is processed by the SBPS to generate a specially structured stereo sound suitable for vision impaired people in understanding the presence of objects/obstacles in front of them. The image processing stage is designed to identify the objects in the captured image. Edge detection and edge-linking procedures are applied in the processing of image. A concept of object preference is included in the image processing scheme and this concept is realized using a fuzzy-rule base. The blind users are trained with the stereo sound produced by NAVI for achieving a collision-free autonomous navigation.

  15. Fuzzy-Rule-Based Object Identification Methodology for NAVI System

    Science.gov (United States)

    Nagarajan, R.; Sainarayanan, G.; Yaacob, Sazali; Porle, Rosalyn R.

    2005-12-01

    We present an object identification methodology applied in a navigation assistance for visually impaired (NAVI) system. The NAVI has a single board processing system (SBPS), a digital video camera mounted headgear, and a pair of stereo earphones. The captured image from the camera is processed by the SBPS to generate a specially structured stereo sound suitable for vision impaired people in understanding the presence of objects/obstacles in front of them. The image processing stage is designed to identify the objects in the captured image. Edge detection and edge-linking procedures are applied in the processing of image. A concept of object preference is included in the image processing scheme and this concept is realized using a fuzzy-rule base. The blind users are trained with the stereo sound produced by NAVI for achieving a collision-free autonomous navigation.

  16. NavyTime: Event and Time Ordering from Raw Text

    Science.gov (United States)

    2013-06-01

    time-time, and event-DCT (DCT is the doc- ument creation time). 74 Event Extraction F1 ATT-1 81.05 NavyTime 80.30 KUL 79.32 cleartk -4 & cleartk -3...71.88 KUL 70.17 cleartk 67.87 NavyTime 67.48 Temp:ESA 54.55 JU-CSE 52.69 Temp:WNet 50.00 FSS-TimEx 42.94 Tense and Aspect Attributes System Tense F1...Aspect F1 cleartk 62.18 70.40 NavyTime 61.67 72.43 ATT 59.47 73.50 JU-CSE 58.62 72.14 KUL 49.70 63.20 not all systems participated Figure 1: Complete

  17. The role of the French Navy in marine radioecology

    International Nuclear Information System (INIS)

    Quentric, Y.; Steiner, C.

    1980-01-01

    Faced with the increasing use of nuclear energy in the maritime area over the past twenty years, the French National Navy undertook initially to maintain a radiological watch of the ports of Cherbourg, Brest and Toulon and subsequently under contracts with the CEA and EDF extended its field of action, particularly in the Channel. The French Navy's own missions, that is those resulting from a contract with the CEA and EDF, the nautical means, as well as the personnel and equipment facilities are discussed in this paper [fr

  18. Evaluating Patient Activation Measure (PAM) Scores and Readmission Rates Following Implementation of a Nurse-Initiated Multi-Faceted Strategy for Patients on a U.S. Navy Inpatient Oncology Unit: A Quality Improvement Project

    Science.gov (United States)

    2016-06-30

    5b. GRANT NUMBER N/A of a Nurse-Initiated Multi-Faceted Strategy for Patients on a U.S. Navy Inpatient Oncology Unit: A Quality...13. SUPPLEMENTARY NOTES N/A 14. ABSTRACT Background: Chronically ill patients often experience multiple hospitalizations. Oncology patients...have been shown to have more readmissions to the hospital than non- oncology patients. Recent reports estimate a $17.4 billion cost burden is

  19. Defense Small Business Innovation Research Program (SBIR). Volume 2. Navy Abstracts of Phase 1 Awards 1992

    Science.gov (United States)

    1992-01-01

    The results of these studies will be used to identify the most promising strategies for minimizing or eliminating the sources of damage. MUDAWAR ...NAVY Topic#: 92-097 DARPA Topic#: 92-145 NOVA MANAGFMENT, INC. MUDAWAR THERMAL SYSTEM, INC. ARMY Topic#: 92-087 NAVY Topic#: 92-136 ARMY Topic#: 92-089...TECHNOLOGIES, INC. MUDAWAR THERMAL SYSTEM. INC. NAVY Topic#: 92-120 NAVY Topic#: 92-137 FOSTER-MILLER, INC. MOUNTAIN OPTECH, INC. MSNW, INC. NAVY Topic#: 92-138

  20. The Role of the Royal Navy in Counter-Insurgency Campaigns since 1945

    OpenAIRE

    Guoth, Maroš

    2014-01-01

    The aim of this work is to prove that a navy can play an important role during a counter-insurgency campaign and be involved in many different tasks both at sea and from sea, particularly due to its flexibility, mobility and versatility. The main research question of the thesis is: what role can a navy play in a counter-insurgency campaign? The decision to focus on the role of the Royal Navy is based on the fact, that the Royal Navy is probably the most experienced navy in the world in the fi...

  1. EQ6 Calculations for Chemical Degradation of Navy Waste Packages

    International Nuclear Information System (INIS)

    S. LeStrange

    1999-01-01

    The Monitored Geologic Repository Waste Package Operations of the Civilian Radioactive Waste Management System Management and Operating Contractor (CRWMS M and O) performed calculations to provide input for disposal of spent nuclear fuel (SNF) from the Navy (Refs. 1 and 2). The Navy SNF has been considered for disposal at the potential Yucca Mountain site. For some waste packages, the containment may breach (Ref. 3), allowing the influx of water. Water in the waste package may moderate neutrons, increasing the likelihood of a criticality event within the waste package. The water may gradually leach the fissile components and neutron absorbers out of the waste package. In addition, the accumulation of silica (SiO 2 ) in the waste package over time may further affect the neutronics of the system. This study presents calculations of the long-term geochemical behavior of waste packages containing the Enhanced Design Alternative (EDA) II inner shell, Navy canister, and basket components. The calculations do not include the Navy SNF in the waste package. The specific study objectives were to determine the chemical composition of the water and the quantity of silicon (Si) and other solid corrosion products in the waste package during the first million years after the waste package is breached. The results of this calculation will be used to ensure that the type and amount of criticality control material used in the waste package design will prevent criticality

  2. U.S. Navy Aeromedical Reference and Waiver Guide

    Science.gov (United States)

    2010-05-05

    Passion flower) – Piper methysticum (Kava-Kava) – Psilocybe semilanceata (magic mushrooms) – Rauwolfia serpentina (Indian snakeroot) – Rauwolfia... serpentina (Indian Snakeroot) – Scilla maritima (White Squill) – Scopolia carniolica (Scopolia)* U.S. Navy Aeromedical Reference and Waiver Guide...be sedatives: – Valeriana officinalis (Valerian) – Rauwolfia serpentina (Indian snakeroot) – Atropa belladonna (Deadly Nightshade)* – Chelidonium

  3. Real Time Analysis: Does Navy Have a Plan?

    Science.gov (United States)

    2015-06-12

    our militaries face. Peter Tran, senior director of the worldwide advanced cyber defense practice at RSA , commented that “Historically, the...should look like for analysis on the data Navy needs to analyze when he stated: Computers, communications links, encryption devices, and other IT allow

  4. A Model for Effective Performance in the Indonesian Navy.

    Science.gov (United States)

    1987-06-01

    NAVY LEADERSHIP AND MANAGEMENT COM PETENCY M ODEL .................................. 15 D. MCBER COMPETENT MANAGERS MODEL ................ IS E. SU M M... leadership and managerial skills which emphasize on effective performance of the officers in managing the human resources under their cormnand and...supervision. By effective performance we mean officers who not only know about management theories , but who possess the characteristics, knowledge, skill, and

  5. Productivity improvement opportunities at Navy public works activities

    OpenAIRE

    Dieffenbach, Richard Jacob

    1992-01-01

    Approved for public release; distribution is unlimited This study identifies six principal opportunities for productivity improvement at Navy Public Works in-house maintenance activities: improving work assignment, increasing shop supervisor effectiveness, reducing long lunches and early quits (through understanding of work impediments as demotivational contributors), improving service order management, improving job quality and miscellaneous opportunities. Activity "productivity opportu...

  6. The brazilian nuclear submarine dossier: Navy's priority and its application

    International Nuclear Information System (INIS)

    Rosa, L.P.

    1990-01-01

    This work discusses the feasibility of the brazilian nuclear submarine. It is related to navy's remodeling and is considered as a priority. It would bring Brazil closer to developed countries. It considers the slip, itself, the weapon's system as well as the nuclear propulsion. (author)

  7. Marketing the Naval Postgraduate School to Navy (URL) Officers

    Science.gov (United States)

    2003-06-01

    64 E. MARKETING MIX .......................................................................................69 1...the Navy and high prestige among the external environment that includes government, industry, and academia. E. MARKETING MIX Whether private or...challenges demand that admission departments recruit the best student in sufficient numbers to ensure financial stability. A marketing mix is a set

  8. Spanish Navy Up to Date Data in DCS

    Science.gov (United States)

    2001-06-01

    therapeutic measures. Final results are similar to another world navies diving centres Bibliography: 1.- Pujante, A.; Inoriza, J; Viqueira, A. Estudio de 121... casos de enfermedad descompresiva Medicina Clinica, vol . 94, n` 7, 1990 2.- Rivera, J.C. Decompression sickness among divers: An analysis of 935

  9. The Danish Navy 1850-1943 - Through the Lens

    DEFF Research Database (Denmark)

    Nørby, Søren; Seerup, Jakob

    2015-01-01

    With a coastline of more than 7,300 kilometers, Denmark has always been a proven maritime nation, and the Royal Danish Navy is an essential part of Danish history. The invention of the camera during the mid-1800s allowed this history to be documented in a novel way and to an extent not previously...

  10. A Role for Community Colleges in Navy Training.

    Science.gov (United States)

    Golfin, Peggy A.; White, John D.; Curtin, Lisa A.

    This document from the Center for Naval Analysis (CNA) discusses the role of community colleges in Navy training. CNA conducted a study to discover whether outsourcing courses such as air conditioning and refrigeration and information systems administration to community colleges was feasible and cost effective. Analyses focused on two community…

  11. The Language of Organizations: The Case of the Navy,

    Science.gov (United States)

    1980-01-01

    rating has a common nickname that only Navy folk know: A Radioman ,RM) is -.. ,...-. The Language of Organizatins 131 known as sparks. a Signalman (SM) is...er. ar aviator *.,s tailed a "’outnie. though this term is (iow wore (minmoriv tised to reter to thise ho favor Admiral Zutnwalt’s style ot leadership

  12. Navy Professional Reading Program: Results of the 2007 Survey

    National Research Council Canada - National Science Library

    Uriell, Zannette A; Johnson, J. S

    2008-01-01

    .... The program includes 60 books across 6 subject areas and 5 career states. Toward the end of the first year of implementation, a survey was conducted to look at reading habits of Navy personnel as well as opinions of the NPRP...

  13. The Education and Development of Strategic Planners in the Navy

    Science.gov (United States)

    1990-12-01

    Financial assistance programs exist iLncluding Tuition Assistance (TA) under the Navy Campus, plus many educational benefit programs for which the...area of Strategic Planning by the Naval Postgraluate School (NPS) or civilian instituitions (CIVINS) actually go on to ase their education? 0 41% NPS and

  14. Grouping of Environments for Testing Navy Bean in Ethiopia ...

    African Journals Online (AJOL)

    Kassaye

    bean (Phaseolus vulgaris L.) lines was tested in a multi-environment variety trial ... of methods available for the analysis of GEI and stability. .... parameters in the kth bilinear term are obtained as the kth component of the .... AMMI ANOVA of grain yield for 16 navy bean lines at fourteen environments during 2010 – 2011 main ...

  15. EQ6 Calculations for Chemical Degradation of Navy Waste Packages

    Energy Technology Data Exchange (ETDEWEB)

    S. LeStrange

    1999-11-15

    The Monitored Geologic Repository Waste Package Operations of the Civilian Radioactive Waste Management System Management & Operating Contractor (CRWMS M&O) performed calculations to provide input for disposal of spent nuclear fuel (SNF) from the Navy (Refs. 1 and 2). The Navy SNF has been considered for disposal at the potential Yucca Mountain site. For some waste packages, the containment may breach (Ref. 3), allowing the influx of water. Water in the waste package may moderate neutrons, increasing the likelihood of a criticality event within the waste package. The water may gradually leach the fissile components and neutron absorbers out of the waste package. In addition, the accumulation of silica (SiO{sub 2}) in the waste package over time may further affect the neutronics of the system. This study presents calculations of the long-term geochemical behavior of waste packages containing the Enhanced Design Alternative (EDA) II inner shell, Navy canister, and basket components. The calculations do not include the Navy SNF in the waste package. The specific study objectives were to determine the chemical composition of the water and the quantity of silicon (Si) and other solid corrosion products in the waste package during the first million years after the waste package is breached. The results of this calculation will be used to ensure that the type and amount of criticality control material used in the waste package design will prevent criticality.

  16. Use of major surgery in south India: A retrospective audit of hospital claim data from a large, community health insurance program.

    Science.gov (United States)

    Shaikh, Maaz; Woodward, Mark; Rahimi, Kazem; Patel, Anushka; Rath, Santosh; MacMahon, Stephen; Jha, Vivekanand

    2015-05-01

    Information on the use of major surgery in India is scarce. In this study we aimed to bridge this gap by auditing hospital claims from Rajiv Aarogyasri Community Health Insurance Scheme, which provides access to free hospital care through state-funded insurance to 68 million beneficiaries, an estimated 81% of population in the states of Telangana and Andhra Pradesh. Publicly available deidentified hospital claim data for all surgery procedures conducted between mid-2008 and mid-2012 were compiled across all 23 districts in Telangana and Andhra Pradesh. A total of 677,332 operative admissions (80% at private hospitals) were recorded at an annual rate of 259 per 100,000 beneficiaries, with male subjects accounting for 56% of admissions. Injury was the most common cause for operative admission (27%) with operative correction of long bone fractures being the most common procedure (20%) identified in the audit. Diseases of the digestive (16%), genitourinary (12%), and musculoskeletal (10%) systems were other leading causes for operative admissions. Most hospital bed-days were used by admissions for injuries (31%) and diseases of the digestive (17%) and musculoskeletal system (11%) costing 19%, 13%, and 11% of reimbursement. Operations on the circulatory system (8%) accounted for 21% of reimbursements. Annual per capita cost of operative claims was US$1.48. The use of surgery by an insured population in India continued to be low despite access to financing comparable with greater spending countries, highlighting need for strategies, beyond traditional health financing, that prioritize improvement in access, delivery, and use of operative care. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Features of dynamics of sanitary losses formation in case of large-scale radiation accidents and organization of hospital functioning when admitting the injured persons from the radiation focus

    International Nuclear Information System (INIS)

    Avetisov, G.M.; Vorontsov, I.V.; Goncharov, S.F.; Ivanov, V.B.

    1995-01-01

    Specific features of therapeutic-evacuation and sanitary-hygienic arrangements in case of large-scale radiation accidents are considered. The substantiation is given for the necessity of setting up to a field hospital near the focus of such an accident for rendering first medical aid and expert medical care, distribution of the injured and organization of their evacuation to specialized medical establishments in due time. 17 refs.; 1 tab

  18. Doses of emergency exposure to the USSR Navy personnel

    International Nuclear Information System (INIS)

    Skaletskiy, Yuriy

    2013-01-01

    Radiological consequences of the Soviet Navy accidents are significant and the number of acute radiation syndrome (ARS) cases is comparable to the number of ARS cases to Chernobyl catastrophe witness and clean-up workers in 1986. Results of a careful clinical-epidemiological examination of the personnel overexposed in the Navy accidents not only have value of radiobiology and radiation medicine specialists but can become a basis for the evaluation of the effectiveness of social protection strategy for the Chernobyl catastrophe clean-up workers. The officially registered exposure doses to persons affected by the Navy radiation accidents in some cases differ from the actual ones due to the imperfections of radiation monitoring facilities at the time of accidents. There was a tendency of clinical overstatement of the exposure doses resulting in diagnosis of 1st degree of ARS to persons who received external doses lower than 0.75. In some cases even 0.2 Gy was overstated as ARS severity for 2nd, 3rd, and 4th degrees. Exposure doses to the affected by the Navy accidents and their ARS severity degrees were evaluated with rather good accuracy. The use of modern method and approaches to the retrospective dose assessment allows more accurate evaluation of the submarine personnel exposure doses as well as verification of every ARS case, thus creating a necessary dosimetric basis for the organization of a correct radiation epidemiological investigation for persons of this contingent. Regretfully, tragic experience of nuclear power plants operation at the Navy vessels was not subject to analysis of specialists in order to improve nuclear safety, radiation protection, and emergency response organization in order to nuclear energy use in the USSR. (N.T.)

  19. Variations in clinicopathologic characteristics of thyroid cancer among racial ethnic groups: analysis of a large public city hospital and the SEER database.

    Science.gov (United States)

    Moo-Young, Tricia A; Panergo, Jessel; Wang, Chih E; Patel, Subhash; Duh, Hong Yan; Winchester, David J; Prinz, Richard A; Fogelfeld, Leon

    2013-11-01

    Clinicopathologic variables influence the treatment and prognosis of patients with thyroid cancer. A retrospective analysis of public hospital thyroid cancer database and the Surveillance, Epidemiology and End Results 17 database was conducted. Demographic, clinical, and pathologic data were compared across ethnic groups. Within the public hospital database, Hispanics versus non-Hispanic whites were younger and had more lymph node involvement (34% vs 17%, P ethnic groups. Similar findings were demonstrated within the Surveillance, Epidemiology and End Results database. African Americans aged ethnic groups. Such disparities persist within an equal-access health care system. These findings suggest that factors beyond socioeconomics may contribute to such differences. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. The impact of portable high-efficiency particulate air filters on the incidence of invasive aspergillosis in a large acute tertiary-care hospital.

    Science.gov (United States)

    Abdul Salam, Zakir-Hussain; Karlin, Rubiyah Binte; Ling, Moi Lin; Yang, Kok Soong

    2010-05-01

    Worldwide, the frequency of invasive fungal infections has been increasing, with a corresponding increase in the numbers of high-risk patients. Exposure reduction through the use of high-efficiency particulate air (HEPA) filters has been the preferred primary preventive strategy for these high-risk patients. Although the efficiency and benefits of fixed HEPA filters is well proven, the benefits of portable HEPA filters are still inconclusive. This was a retrospective study to assess the impact of 48 portable HEPA filter units deployed in selected wards in Singapore General Hospital, an acute tertiary-care hospital in Singapore. Data were extracted between December 2005 and June 2008 on the diagnoses at discharge and microbiological and histological laboratory findings. All patients with possible, probable, or proven invasive aspergillosis (IA) were included. In wards with portable HEPA filters, the incidence rate of IA of 34.61/100,000 patient-days in the pre-installation period was reduced to 17.51/100,000 patient-days in the post-installation period (P = .01), for an incidence rate ratio of 1.98 (95% confidence interval [CI], 1.10-2.97). In wards with no HEPA filters, there was no significant change in the incidence rate during the study period. Portable HEPA filters were associated with an adjusted odds ratio of 0.49 (95% CI, 0.28-0.85; P = .01), adjusted for diagnosis and length of hospital stay. Portable HEPA filters are effective in the prevention of IA. The cost of widespread portable HEPA filtration in hospitals will be more than offset by the decreases in nosocomial infections in general and in IA in particular. Copyright (c) 2010 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  1. Is the Current Management of Patients Presenting With Spinal Trauma to District General Hospitals Fit for Purpose? Our Experience of Delivering a Spinal Service Using an Electronic Referral Platform in a Large District General Teaching Hospital Without Onsite Spinal Services.

    Science.gov (United States)

    Hill, Daniel S; Marynissen, Hans

    2018-04-12

    A retrospective cross-sectional analysis. To describe the provision of a spinal service using an electronic platform to direct management from an external spinal unit, and quantify time taken to obtain definitive management plans whilst under prescribed spinal immobilization. Most attending district general hospitals following spinal trauma will have stable injuries and normal neurology, with only a small proportion requiring urgent transfer to a specialist centre. A retrospective review of 104 patients admitted following vertebral during a 12-month period. The British Orthopaedic Association Standards for Trauma consensus that "spinal immobilisation is not recommended for more than 48 hours" was the standard of care measured against. 100 patients occupied a total of 975 hospital inpatient bed days. 117 radiological investigations were requested after the point of external referral (47 CT-scans, 37 MRI-scans, and 33 weight bearing radiographs). The period between initial referral to the regional spinal service and then receiving a definitive final management had a median value of 72 hours and a range of 0 - 33 days. Patients will have been under some form of prescribed spinal immobilisation until the definitive management plan was communicated. 34 patients (34% of the overall cohort) had a definitive management plan in place within 48 hours. 80 patients had vertebral injuries (73 stable, 6 unstable), 3 patients had prolapsed intervertebral disks, 1 had metastatic disease, and 17 had not evidence of an acute injury following evaluation. Patients are being placed under prescribed immobilisation for longer than is recommended. Delays in obtaining radiological imaging were an important factor, together with the time taken to receive a definitive management plan. Limitations in social care provision and delays in arranging this were additional barriers to hospital discharge following the final management plan. 4.

  2. [Historical exploration of Acapulco hospitals, Guerrero, Mexico].

    Science.gov (United States)

    Fajardo-Ortiz, Guillermo; Salcedo-Alvarez, Rey Arturo

    2006-01-01

    This study attempts to recount the history of the main hospitals of the port of Acapulco from colonial times until the end of the 20th century. The Augustine friars began hospital care at the end of the first part of the 16th century. Later, Bernardino Alvarez (1514?-1584), with the support of the Spanish crown, founded the first formal hospital in Acapulco called Hospital de Nuestra Señora de la Consolación (Our Lady of Consolation Hospital). During the 16th and 17th centuries, the sick were attended by friars, and by the end of the 19th century there were physicians and surgeons. From the end of the Independence War until the end of the 19th century, the port did not have any true hospital. The first degreed physicians and surgeons arrived and resided in Acapulco in 1920. In 1938, the Hospital Civil Morelos (Morelos Civil Hospital) began providing services. It was replaced by the Hospital General de Acapulco (General Hospital of Acapulco). At the fourth decade of the past century the Cruz Roja (Red Cross) was created. In 1957 the hospital services of the Instituto Mexicano del Seguro Social (IMSS, Mexican Institute of Social Security), which was founded in 1963, was inaugurated with the Unidad Medico/Social (Medical and Social Unit) of the IMSS in Acapulco. This began the journey of modernity in Acapulco. In 1992, Hospital Regional Vicente Guerrero (Regional Hospital Vicente Guerrero) of the IMSS, initiated its services. In 1960, medical services for civil workers and their families were housed in the Hospital Civil Morelos (Morelos Civil Hospital). Shortly afterwards, the Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado (ISSSTE, Security and Social Services Institute for State Employees) had their own hospital. During the 20th century, Acapulco has added other hospital services to care for members of the navy and armed forces, as well as for those persons with financial resources for private care.

  3. Hospitals; hospitals13

    Data.gov (United States)

    University of Rhode Island Geospatial Extension Program — Hospital Facilities information was compiled from several various sources. Main source was the RI Department of Health Facilities Regulation database, License 2000....

  4. Monitoring of clinical strains and environmental fungal aerocontamination to prevent invasive aspergillosis infections in hospital during large deconstruction work: a protocol study.

    Science.gov (United States)

    Loeffert, Sophie Tiphaine; Melloul, Elise; Dananché, Cédric; Hénaff, Laetitia; Bénet, Thomas; Cassier, Pierre; Dupont, Damien; Guillot, Jacques; Botterel, Françoise; Wallon, Martine; Gustin, Marie-Paule; Vanhems, Philippe

    2017-11-25

    Monitoring fungal aerocontamination is an essential measure to prevent severe invasive aspergillosis (IA) infections in hospitals. One central block among 32 blocks of Edouard Herriot Hospital (EHH) was entirely demolished in 2015, while care activities continued in surrounding blocks. The main objective was to undertake broad environmental monitoring and clinical surveillance of IA cases to document fungal dispersion during major deconstruction work and to assess clinical risk. A daily environmental survey of fungal loads was conducted in eight wards located near the demolition site. Air was collected inside and outside selected wards by agar impact samplers. Daily spore concentrations were monitored continuously by volumetric samplers at a flow rate of 10 L.min -1 . Daily temperature, wind direction and speed as well as relative humidity were recorded by the French meteorological station Meteociel. Aspergillus fumigatus strains stored will be genotyped by multiple-locus, variable-number, tandem-repeat analysis. Antifungal susceptibility will be assessed by E-test strips on Roswell Park Memorial Institute medium supplemented with agar. Ascertaining the adequacy of current environmental monitoring techniques in hospital is of growing importance, considering the rising impact of fungal infections and of curative antifungal costs. The present study could improve the daily management of IA risk during major deconstruction work and generate new data to ameliorate and redefine current guidelines. This study was approved by the clinical research and ethics committees of EHH. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. Association between hospital procedure volume and early complications after pacemaker implantation: results from a large, unselected, contemporary cohort of the German nationwide obligatory external quality assurance programme.

    Science.gov (United States)

    Nowak, Bernd; Tasche, Karl; Barnewold, Linda; Heller, Günther; Schmidt, Boris; Bordignon, Stefano; Chun, K R Julian; Fürnkranz, Alexander; Mehta, Rajendra H

    2015-05-01

    Several studies demonstrated an inverse relationship between cardioverter-defibrillator implantation volume and complication rates, suggesting better outcomes for higher volume centres. However, the association of institutional procedural volume with patient outcomes for permanent pacemaker (PPM) implantation remains less known, especially in decentralized implantation systems. We performed retrospective examination of data on patients undergoing PPM from the German obligatory quality assurance programme (2007-12) to evaluate the relationship of hospital PPM volume (categorized into quintiles of their mean annual volume) with risk-adjusted in-hospital surgical complications (composite of pneumothorax, haemothorax, pericardial effusion, or pocket haematoma, all requiring intervention, or device infection) and pacemaker lead dislocation. Overall 430 416 PPM implantations were documented in 1226 hospitals. Systems included dual (72.8%) and single (25.8%) chamber PPM and cardiac resynchronization therapy (CRT) devices (1.1%). Complications included surgical (0.92%), and ventricular (0.99%), and atrial (1.22%) lead dislocation. Despite an increase in relatively complex procedures (dual chamber, CRT), there was a significant decrease in the procedural and fluoroscopy times and complications from lowest to highest implantation volume quintiles (P for trend <0.0001). The greatest difference was observed between the lowest (1-50 implantations/year-reference group) and the second-lowest (51-90 implantations/year) quintile: surgical complications [odds ratio (OR) 0.69; confidence interval (CI) 0.60-0.78], atrial lead dislocations (OR 0.69; CI 0.59-0.80), and ventricular lead dislocations (OR 0.73; CI 0.63-0.84). Hospital annual PPM volume was directly related to indication-based implantation of relatively more complex PPM and yet inversely with procedural times and rates of early surgical complications and lead dislocations. Thus, our data suggest better performance and lower

  6. Clinical characteristics, etiology and antimicrobial susceptibility among overweight and obese individuals with diarrhea: observed at a large diarrheal disease hospital, Bangladesh.

    Directory of Open Access Journals (Sweden)

    Sumon Kumar Das

    Full Text Available BACKGROUND: The present study aimed to determine the clinical characteristics and etiology of overweight and obese (OO individuals with diarrhea attending an urban Dhaka Hospital, International Centre for Diarrheal Disease Research (icddr,b, Bangladesh. METHODS: Total of 508 under-5 children, 96 individuals of 5-19 years and 1331 of >19 years were identified as OO from the Diarrheal Disease Surveillance System (DDSS between 1993-2011. Two comparison groups such as well-nourished and malnourished individuals from respective age stratums were selected. RESULTS: Isolation rate of rotavirus was higher among OO under-5 children compared to malnourished group (46% vs. 28%. Rotavirus infection among OO individuals aged 5-19 years (9% vs. 3% (9% vs. 3% and >19 years (6% vs. 4% (6% vs. 3% was higher compared to well-nourished and malnourished children. Conversely, Vibrio cholerae was lower among all OO age groups compared to well-nourished and malnourished ones. Shigella (4% vs. 6% (4% vs. 8%, and Campylobacter (3% vs. 5% (3% vs. 5% were lower only among OO in >19 years individuals compared to their counterparts of the same age stratum. Salmonella was similarly isolated in all age strata and nutritional groups. In multinomial logistic regression among under-5 children, significant association was observed only with use of antimicrobials at home [OR-1.97] and duration of hospital stay [OR-0.68]. For individuals aged 5-19 years, use of antimicrobials at home (OR-1.83, some or severe dehydration (OR-3.12, having received intravenous saline (OR-0.46 and rotavirus diarrhea (OR-2.96 were found to be associated with OO respectively. Moreover, significant associations were also found for duration of diarrhea before coming to hospital (>24 hours (OR-1.24, Shigella (OR-0.46, and Campylobacter (OR-0.58 among >19 years OO individuals along with other associated co-variates in 5-19 years group (all p<0.05. CONCLUSION AND SIGNIFICANCE: Higher proportion of OO were

  7. Effect of Adjunctive Thrombus Aspiration on In-Hospital and 3-Year Outcomes in Patients With ST-Segment Elevation Myocardial Infarction and Large Native Coronary Artery Thrombus Burden.

    Science.gov (United States)

    Keskin, Muhammed; Kaya, Adnan; Tatlısu, Mustafa Adem; Uzman, Osman; Börklü, Edibe Betül; Çinier, Göksel; Tekkeşin, Ahmet İlker; Türkkan, Ceyhan; Hayıroğlu, Mert İlker; Kozan, Ömer

    2017-11-15

    Although the long-term clinical benefit of adjunctive thrombus aspiration (TA) during primary percutaneous coronary intervention (PPCI) remains controversial, the impact of TA in patients with large thrombus has not been evaluated. The aim of the present study was to investigate the effect of adjunctive TA during PPCI on clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) and a large thrombus. We assessed the effect of adjunctive TA on in-hospital and 3-year clinical outcomes in 627 patients with STEMI and a large thrombus in the native coronary artery. The cumulative 3-year incidence of all-cause death was not significantly different between the 2 groups (91.5% vs 89.0%, log-rank test p = 0.347). After adjusting for confounders, the risk of all-cause death in the TA group was not significantly lower than that in the non-TA group (hazard ratio 1.11, 95% confidence interval 0.60 to 3.54, p = 0.674). The adjusted risks of target lesion revascularization, nonfatal acute myocardial infarction, and stent thrombosis were also not significantly different between the 2 groups. In conclusion, adjunctive TA during PPCI was not associated with better in-hospital and 3-year all-cause deaths in patients with STEMI and a large coronary artery thrombus. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Improving U.S. Navy Foodservice Management Training. Part 1. Evaluation of the Current System

    Science.gov (United States)

    1985-11-01

    Experience in civilian foodservice before joining Navy? FAST FOOD FRANCHISE BAKERY RESTAURANT COFFEE SHOP CAFETERIA DELICATESSEN NONE WORKED AS...civilian foodservice since joining Navy? FAST FOOD FRANCHISE 12 8 BAKERY 15 5 RESTAURANT 12 18 COFFEE SHOP 8 — CAFETERIA 8 — DELICATESSEN — NONE...food service before joining the Navy? (PLEASE CHECK l^ THAT APPLY TO WHERE YOU WORKED) Fast Food Franchise Cafeteria Bakery Delieateesan

  9. Organizational Analysis of Energy Manpower Requirements in the United States Navy

    Science.gov (United States)

    2013-06-01

    Since 1987, the Navy has been producing clean power through the use of geothermal power plants at the Naval Air Weapons Station China Lake. Figure 6...traditional petroleum-based fuel. (From Navy, 2011).....................................10  Figure 5.  The Navy 1 geothermal plant near COSO Hot Springs...photovoltaic, nuclear, biomass, geothermal , and intelligent design of facilities in an attempt to move away from traditional energy sources. Geographical

  10. Navy radon assessment and mitigation program: Final report

    International Nuclear Information System (INIS)

    1994-10-01

    This final report encompasses the events from the beginning of the Navy Radon Assessment and Mitigation Program to the closure of the program on October 31, 1994. Included in the report are discussions of the phases of the program including screening, assessment, mitigation, and post-mitigation. The primary discussion involves screening and assessment. The report addresses recommendations made to the Naval Facilities Engineering Command by the Hazardous Waste Remedial Actions Program of Martin Marietta Energy Systems, Inc., and the final decisions that were made. Special emphasis is placed on quality assurance/quality control (QA/QC), since QA/QC was given top priority during the implementation of this program. Included in the discussion on QA/QC are ana overview of the measurement process, positive and negative controls, replicated measurements, and application of chamber exposures to data calibration. The report concludes with a discussion of testing considerations for naval facilities and radon mitigation considerations for the Department of the Navy

  11. Russian Navy fresh fuel MPC and A training and regulations

    International Nuclear Information System (INIS)

    Forehand, H.M.; Rexroth, P.; Dove, A.; Shmelev, V.; Sukhoruchkin, V.; Roumiantsev, A.

    1998-01-01

    The Regulations and Training Projects are part of the US-Russian Federation Materials Protection, Control, and Accounting (MPC ampersand A) cooperative program to protect Russian Navy Fuels. This paper describes the general status of the projects, progress achieved to date, and long-term plans for further work in producing regulatory documents and training to support this effort. The regulatory development will result in a document set that will include general requirements and rules for the Russian Navy MPC ampersand A as well as specific instructions for operation and maintenance of each facility. The goals of the training program are to instill in managers a culture of sustainable commitment to MPC ampersand A through the understanding of its principles and philosophies. In addition, the training program will help ensure that upgrades are effectively utilized and maintained by training operators and maintenance personnel in MPC ampersand A principles as well in as the detailed operations of the systems

  12. Comparison of seropositivity of human immunodeficiency virus, hepatitis B virus, hepatitis C virus, and syphilis among Hospital Cornea Retrieval Programme-Donors versus voluntary cornea donors at a large eye bank in Eastern India.

    Science.gov (United States)

    Basak, Soham; Basak, Samar K; Biswas, Bani

    2017-11-01

    To compare the serology profile of donors from Hospital Cornea Retrieval Programme-donors (HCRP-D) and voluntary cornea donors (VC-D) from a large eye bank in Eastern India. This is a retrospective analysis of donor details from January 2011 to December 2016. Donor demographics, cause of death, and serology reports were compiled. Postmortem blood was tested for human immunodeficiency virus 1 and 2 (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis using government-approved kits as per the National Programme for Control of Blindness Standards of Eye Banking. Donors for whom serology was not possible were excluded. A total of 4300 of 4353 donors were included of which 74.3% were hospital donors and 25.7% were voluntary donors. A total of 93 (2.2%) donors with 94 seropositive reports were noted: 79 (84.9%) from HCRP-D and 14 (15.1%) from VC-D which was statistically significantly higher (P = 0.02). Among seropositive reports, HIV, HBV, HCV, and syphilis accounted for 12 (12.8%), 38 (40.4%), 36 (38.3%), and eight (8.5%), respectively. There was no correlation between the cause of death and seropositivity. A statistically significant decreasing trend in seroprevalence among hospital donors was observed over the years (5.3% in 2011 to 1.4% in 2016; P = 0.004). Two (0.47%) of 421 hospital donors with prior negative serology were found to be seropositive. Seropositive rates are significantly higher among hospital donors in spite of medical prescreening compared to nonscreened voluntary donors. Serology should be repeated even when prior reports are available.

  13. Comparison of seropositivity of human immunodeficiency virus, hepatitis B virus, hepatitis C virus, and syphilis among Hospital Cornea Retrieval Programme-Donors versus voluntary cornea donors at a large eye bank in Eastern India

    Directory of Open Access Journals (Sweden)

    Soham Basak

    2017-01-01

    Full Text Available Purpose: To compare the serology profile of donors from Hospital Cornea Retrieval Programme-donors (HCRP-D and voluntary cornea donors (VC-D from a large eye bank in Eastern India. Methods: This is a retrospective analysis of donor details from January 2011 to December 2016. Donor demographics, cause of death, and serology reports were compiled. Postmortem blood was tested for human immunodeficiency virus 1 and 2 (HIV, hepatitis B virus (HBV, hepatitis C virus (HCV, and syphilis using government-approved kits as per the National Programme for Control of Blindness Standards of Eye Banking. Donors for whom serology was not possible were excluded. Results: A total of 4300 of 4353 donors were included of which 74.3% were hospital donors and 25.7% were voluntary donors. A total of 93 (2.2% donors with 94 seropositive reports were noted: 79 (84.9% from HCRP-D and 14 (15.1% from VC-D which was statistically significantly higher (P = 0.02. Among seropositive reports, HIV, HBV, HCV, and syphilis accounted for 12 (12.8%, 38 (40.4%, 36 (38.3%, and eight (8.5%, respectively. There was no correlation between the cause of death and seropositivity. A statistically significant decreasing trend in seroprevalence among hospital donors was observed over the years (5.3% in 2011 to 1.4% in 2016; P = 0.004. Two (0.47% of 421 hospital donors with prior negative serology were found to be seropositive. Conclusion: Seropositive rates are significantly higher among hospital donors in spite of medical prescreening compared to nonscreened voluntary donors. Serology should be repeated even when prior reports are available.

  14. The Strategic Utility of U.S. Navy SEALs

    Science.gov (United States)

    2009-06-01

    USA Swimming, rugby organizations and wrestling organizations. In addition, while the demographics do not fully support it, the Navy and NSW put a... motivate Army SF to reinforce their UW roots and maintain it as their primacy (Rothstein 2006). The Rangers have a comparative advantage at larger...focused on defeating the ideologies or motivations that spawn terrorism by non-kinetic means. These could include, but are not limited to, PSYOP, IO

  15. Supply Management Analysis of the Chilean Navy Acquisition System

    Science.gov (United States)

    2014-12-01

    52 LIST OF REFERENCES Armada de Chile, N. (1986). Manual de Logistica de la Armada de Chile [Manual of logistics of the Chilean Navy]. Chile... transportation • Quality control • Demand and supply planning • Receiving, materials handling, and storage 11 • Material or inventory control...Order purchasing • Production planning, scheduling, and control • Warehousing and distribution • Shipping • Outbound transportation • Customer

  16. Cash management improvement in the Navy Stock Fund

    OpenAIRE

    Linquist, James E.; Evans, Timothy S.

    1986-01-01

    Approved for public release; distribution is unlimited The Navy Stock Fund (NSF) is a working capital fund used to purchase and hold designated inventories of supply items at various stock points until needed by a customer. The fund is currently comprised of ten separate Budget Projects with total collections and expenditures projected to be in excess of $ 1 8 bi 1 1 ion for Fiscal Year 1 986. The authors examined the background and current operation of the NSF with empha...

  17. An Anthropologist Examines the Navy’s Recruiting Process.

    Science.gov (United States)

    1981-12-01

    who come to these border towns primarily to pur- chase appliances, electrical and electronic goods, automobile parts, some kinds of clothing, and some...Am automobile in order to entice him away from the Navy. There are some relatively stringent security requirements for Cuban appli- cants. The...22217 Naval Military Personnel Command HRm Department (NMPC-6)Naval Research Laboratory Washington, DC 20350 Code 2627Codenon 262 WahigtnDC205 Washington

  18. Navy Job-Related Male-Female Differences: Annotated Bibliography.

    Science.gov (United States)

    1982-04-01

    and 50 female Caucasian South African healing sciences students and 44 male and 43 female American medical, dental, physiotherapy students were...lesser extent, even the primary differences. The subjects used in the cited research, especially in the cognitive areas, were usually college students ...that may make college students atypical of and noncomparable to Navy enlisted personnel of the same general age. This appears more likely for males

  19. An Exploratory Analysis of the Navy Personnel Support Delivery Model

    Science.gov (United States)

    2017-09-01

    and accurate information, and seamless customer relationship management (Department of the Navy, 2010). There will be field level support for when...of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC 20503. 1. AGENCY USE ONLY (Leave blank) 2. REPORT DATE September...through the Pay and Personnel Management Department (PERS-2). The current pay and personnel service delivery model is manpower heavy and relies on

  20. Iranian Naval Forces: A Tale of Two Navies

    Science.gov (United States)

    2017-02-01

    in the Persian Gulf and integrating more Persian leadership into the naval forces. During the reign of Xerxes (486–465 BCE), the fourth King of the...the Shah. In the current publication, we have provided a more comprehensive history, including Iran’s Persian imperial past, the spread of Islam...interests accordingly. The Islamic Revolutionary Guard Corps Navy (IRGCN) emphasizes an asymmetric doctrine to ensure national security in the Persian

  1. [Organisation of scientific and research work of Navy medical service].

    Science.gov (United States)

    Gavrilov, V V; Myznikov, I L; Kuz'minov, O V; Shmelev, S V; Oparin, M Iu

    2013-03-01

    The main issues of organization of scientific and research work of medical service in the North Fleet are considered in the present article. Analysis of some paragraphs of documents, regulating this work at army level is given. The authors give an example of successful experience of such work in the North Fleet, table some suggestions which allow to improve the administration of scientific and research work in the navy and also on the district scale.

  2. Optimizing the Navy’s Investment in Space Professionals

    Science.gov (United States)

    2011-09-01

    UFO Ultra High Frequency Follow-On UHF Ultra High Frequency URL Unrestricted Line USA United States Army USAF United States Air Force USCYBERCOM...LEASAT), and eight UHF Follow-On ( UFO ) satellites all flying in geostationary orbit (GEO). NAVSOC is the principle Navy command that operates, manages...and maintains the DoD’s narrowband UHF capability from five different ground stations. The replacement satellite for the aging UFO system is the

  3. The Unresourced Burden on United States Navy Sailors at Sea

    Science.gov (United States)

    2018-03-01

    widely. Some curricula were placed in a computer forum with no front-end analysis (as required by Navy instruction) while different government contractors ...discuss that, over time, the RMCs decreased military personnel, replacing the work with contractor support. The RMCs now primarily contract out maintenance...Billets Shore Billets 2004 to 2008 Sea Billets Change % RATING 2004 2008 2004 2008 SIMA/RMC ALNAV 2004 2008 Shore Sea HT 667 73 1856 846 -594 -1010

  4. Implications of AM for the Navy Supply Chain

    Science.gov (United States)

    2016-12-01

    Certification. He is a published author and an entrepreneur and co-founder of Prosiren Inc., a watersports apparel company. A s the U.S. Navy continues...delineating a single base price for manufacture and shipping while allowing for small annual increases due to inflation. Constraints As laid out, there are...least in the short run; AM is only supplanting a previous method of manufacture for a part, not increasing the draw. The government generally is

  5. Surface combatant readiness to confront a sea control navy

    OpenAIRE

    Wissel, Nicholas E.

    2008-01-01

    This thesis proposes to correct the shortfalls in the US Surface Combatants ability to counter a Sea-Control Navy. The concept counters this threat using unmanned aerial systems, decoys, and a layered defense. We analyze the performance with a Filtering Model of Salvo Warfare that is an extension of the Hughes Salvo Equations. The model incorporates the diluting effect of decoys upon enemy salvos and accounts for the historical reality of leakers. We conclude that in the absence of air suppor...

  6. Navy-wide Personnel Survey (NPS) 2003: Summary of Survey Results

    National Research Council Canada - National Science Library

    Whittam, Kimberly; Janega, Jessica; Olmsted, Murrey

    2005-01-01

    .... The NPS focuses on work-related issues such as job satisfaction, morale, leadership, advancement, promotion, career progression, and detailing and provides Navy leadership with valuable information...

  7. Hearing loss in the royal Norwegian Navy: a cross-sectional study.

    Science.gov (United States)

    Irgens-Hansen, Kaja; Sunde, Erlend; Bråtveit, Magne; Baste, Valborg; Oftedal, Gunnhild; Koefoed, Vilhelm; Lind, Ola; Moen, Bente Elisabeth

    2015-07-01

    Prior studies have indicated a high prevalence of noise-induced hearing loss (NIHL) among Navy personnel; however, it is not clear whether this is caused by work on board. The present study aimed to assess the prevalence of hearing loss among Navy personnel in the Royal Norwegian Navy (RNoN), and to investigate whether there is an association between work on board RNoN vessels and occurrence of hearing loss. Navy personnel currently working on board RNoN vessels were recruited to complete a questionnaire on noise exposure and health followed by pure tone audiometry. Hearing loss was defined as hearing threshold levels ≥25 dB in either ear at the frequencies 3,000, 4,000 or 6,000 Hz. Hearing thresholds were adjusted for age and gender using ISO 7029. The prevalence of hearing loss among Navy personnel was 31.4 %. The work exposure variables: years of work in the Navy, years on vessel(s) in the Navy and years of sailing in the Navy were associated with reduced hearing after adjusting for age, gender and otitis as an adult. Among the work exposure variables, years of sailing in the Navy was the strongest predictor of reduced hearing, and significantly reduced hearing was found at the frequencies 1,000, 3,000 and 4,000 Hz. Our results indicate that time spent on board vessels in the RNoN is a predictor of reduced hearing.

  8. Navy Acquisition Executive's Management Oversight and Procurement Authority Category I and II Programs

    National Research Council Canada - National Science Library

    2007-01-01

    .... This report discusses the management oversight and procurement authority within the Navy. Two other reports discussed the management oversight and procurement authority within the Army and Air Force...

  9. Digital Signal Processing Applied to the Modernization Of Polish Navy Sonars

    Directory of Open Access Journals (Sweden)

    Marszal Jacek

    2014-04-01

    Full Text Available The article presents the equipment and digital signal processing methods used for modernizing the Polish Navy’s sonars. With the rapid advancement of electronic technologies and digital signal processing methods, electronic systems, including sonars, become obsolete very quickly. In the late 1990s a team of researchers of the Department of Marine Electronics Systems, Faculty of Electronics, Telecommunications and Informatics, Gdansk University of Technology, began work on modernizing existing sonar systems for the Polish Navy. As part of the effort, a methodology of sonar modernization was implemented involving a complete replacement of existing electronic components with newly designed ones by using bespoke systems and methods of digital signal processing. Large and expensive systems of ultrasound transducers and their dipping and stabilisation systems underwent necessary repairs but were otherwise left unchanged. As a result, between 2001 and 2014 the Gdansk University of Technology helped to modernize 30 sonars of different types.

  10. NNEPEQ: Chemical equilibrium version of the Navy/NASA Engine Program

    Science.gov (United States)

    Fishbach, Laurence H.; Gordon, Sanford

    1988-01-01

    The Navy NASA Engine Program, NNEP, currently is in use at a large number of government agencies, commercial companies and universities. This computer code has bee used extensively to calculate the design and off-design (matched) performance of a broad range of turbine engines, ranging from subsonic turboprops to variable cycle engines for supersonic transports. Recently, there has been increased interest in applications for which NNEP was not capable of simulating, namely, high Mach applications, alternate fuels including cryogenics, and cycles such as the gas generator air-turbo-rocker (ATR). In addition, there is interest in cycles employing ejectors such as for military fighters. New engine component models had to be created for incorporation into NNEP, and it was found necessary to include chemical dissociation effects of high temperature gases. The incorporation of these extended capabilities into NNEP is discussed and some of the effects of these changes are illustrated.

  11. NNEPEQ - Chemical equilibrium version of the Navy/NASA Engine Program

    Science.gov (United States)

    Fishbach, L. H.; Gordon, S.

    1989-01-01

    The Navy NASA Engine Program, NNEP, currently is in use at a large number of government agencies, commercial companies and universities. This computer code has been used extensively to calculate the design and off-design (matched) performance of a broad range of turbine engines, ranging from subsonic turboprops to variable cycle engines for supersonic transports. Recently, there has been increased interest in applications for which NNEP was not capable of simulating, namely, high Mach applications, alternate fuels including cryogenics, and cycles such as the gas generator air-turbo-rocker (ATR). In addition, there is interest in cycles employing ejectors such as for military fighters. New engine component models had to be created for incorporation into NNEP, and it was found necessary to include chemical dissociation effects of high temperature gases. The incorporation of these extended capabilities into NNEP is discussed and some of the effects of these changes are illustrated.

  12. VOC contamination in hospital, from stationary sampling of a large panel of compounds, in view of healthcare workers and patients exposure assessment.

    Directory of Open Access Journals (Sweden)

    Vincent Bessonneau

    Full Text Available BACKGROUND: We aimed to assess, for the first time, the nature of the indoor air contamination of hospitals. METHODS AND FINDINGS: More than 40 volatile organic compounds (VOCs including aliphatic, aromatic and halogenated hydrocarbons, aldehydes, alcohols, ketones, ethers and terpenes were measured in a teaching hospital in France, from sampling in six sampling sites--reception hall, patient room, nursing care, post-anesthesia care unit, parasitology-mycology laboratory and flexible endoscope disinfection unit--in the morning and in the afternoon, during three consecutive days. Our results showed that the main compounds found in indoor air were alcohols (arithmetic means ± SD: 928±958 µg/m³ and 47.9±52.2 µg/m³ for ethanol and isopropanol, respectively, ethers (75.6±157 µg/m³ for ether and ketones (22.6±20.6 µg/m³ for acetone. Concentrations levels of aromatic and halogenated hydrocarbons, ketones, aldehydes and limonene were widely variable between sampling sites, due to building age and type of products used according to health activities conducted in each site. A high temporal variability was observed in concentrations of alcohols, probably due to the intensive use of alcohol-based hand rubs in all sites. Qualitative analysis of air samples led to the identification of other compounds, including siloxanes (hexamethyldisiloxane, octamethyltrisiloxane, decamethylcyclopentasiloxane, anesthetic gases (sevoflurane, desflurane, aliphatic hydrocarbons (butane, esters (ethylacetate, terpenes (camphor, α-bisabolol, aldehydes (benzaldehyde and organic acids (benzoic acid depending on sites. CONCLUSION: For all compounds, concentrations measured were lower than concentrations known to be harmful in humans. However, results showed that indoor air of sampling locations contains a complex mixture of VOCs. Further multicenter studies are required to compare these results. A full understanding of the exposure of healthcare workers and patients

  13. Mentorship and job satisfaction among Navy family physicians.

    Science.gov (United States)

    Saperstein, Adam K; Viera, Anthony J; Firnhaber, Gina C

    2012-08-01

    Among civilian academic physicians, having a mentor is associated with greater job satisfaction. Whether this is true for military physicians is unknown. We sought to examine whether having a mentor is associated with positive job satisfaction among Navy family physicians. A web-based survey was sent to all Navy family physicians in the Specialty leader's database in May 2008. Our main outcome variable was "positive job satisfaction," and our main exposure variable was being in a mentor relationship. Chi-square was used to test for difference in frequencies in categorical variables and logistic regression was used to adjust for covariates. The response rate was 60.2% (186/309). Among respondents, 73.7% reported positive job satisfaction. Factors associated with positive job satisfaction included having a mentor, being >9 years postresidency, spending <50% of time in patient care, higher rank, male gender, and being active in research. After adjustment for these factors, having a mentor remained significantly associated with positive job satisfaction (odds ratio 2.86, 95% confidence interval 1.22-6.71). Having a mentor is associated with positive job satisfaction among Navy family physicians, even after adjusting for multiple other factors. An implication is that a mentorship program may be a strategy for improving job satisfaction.

  14. Navy Mobility Fuels Forecasting System. Phase I report

    Energy Technology Data Exchange (ETDEWEB)

    Davis, R.M.; Hadder, G.R.; Singh, S.P.N.; Whittle, C.

    1985-07-01

    The Department of the Navy (DON) requires an improved capability to forecast mobility fuel availability and quality. The changing patterns in fuel availability and quality are important in planning the Navy's Mobility Fuels R and D Program. These changes come about primarily because of the decline in the quality of crude oil entering world markets as well as the shifts in refinery capabilities domestically and worldwide. The DON requested ORNL's assistance in assembling and testing a methodology for forecasting mobility fuel trends. ORNL reviewed and analyzed domestic and world oil reserve estimates, production and price trends, and recent refinery trends. Three publicly available models developed by the Department of Energy were selected as the basis of the Navy Mobility Fuels Forecasting System. The system was used to analyze the availability and quality of jet fuel (JP-5) that could be produced on the West Coast of the United States under an illustrative business-as-usual and a world oil disruption scenario in 1990. Various strategies were investigated for replacing the lost JP-5 production. This exercise, which was strictly a test case for the forecasting system, suggested that full recovery of lost fuel production could be achieved by relaxing the smoke point specifications or by increasing the refiners' gate price for the jet fuel. A more complete analysis of military mobility fuel trends is currently under way.

  15. Russian Navy Fresh Fuel MPC and A Training

    International Nuclear Information System (INIS)

    Forehand, Harry M.; O'Shell, Parker; Opanassiouk, Yuri R.; Rexroth, Paul E.; Shmelev, Vladimir; Sukhoruchkin, Vladimir K.

    1999-01-01

    The goal of the Russian Navy Fuels Program is to incorporate nuclear fuel that is in the custody of the Russian Navy into a materials protection, control and accounting program. In addition to applying MPC and A upgrades to existing facilities, a program is underway to train site personnel in MPC and A activities. The goal is to assure that the upgraded facilities are managed, operated and maintained in an effective, sustainable manner. Training includes both the conceptual and necessary operational aspects of the systems and equipment. The project began with a Needs Assessment to identify priorities and objectives of required training. This led to the creation of a series of classes developed by Kurchatov Institute. One course was developed to allow attendees to get a general understanding of goals and objectives of nuclear MPC and A systems in the context of the Russian Navy. A follow-on course provided the detailed skills necessary for the performance of specialized duties. Parallel sessions with hands-on exercises provided the specific training needed for different personnel requirements. The courses were presented at KI facilities in Moscow. This paper reviews the work to date and future plans for this program

  16. A Qualitative Descriptive Analysis of Collaboration Technology in the Navy

    Directory of Open Access Journals (Sweden)

    Ryan Wark

    2015-10-01

    Full Text Available Collaboration technologies enable people to communicate and use information to make organizational decisions. The United States Navy refers to this concept as information dominance. Various collaboration technologies are used by the Navy to achieve this mission. This qualitative descriptive study objectively examined how a matrix oriented Navy activity perceived an implemented collaboration technology. These insights were used to determine whether a specific collaboration technology achieved a mission of information dominance. The study used six collaboration themes as a foundation to include: (a Cultural intelligence, (b Communication, (c Capability, (d Coordination, (e Cooperation, and (f Convergence. It was concluded that collaboration technology was mostly perceived well and helped to achieve some levels of information dominance. Collaboration technology improvement areas included bringing greater awareness to the collaboration technology, revamping the look and feel of the user interface, centrally paying for user and storage fees, incorporating more process management tools, strategically considering a Continuity of Operations, and incorporating additional industry best practices for data structures. Emerging themes of collaboration were collected to examine common patterns identified in the collected data. Emerging themes included acceptance, awareness, search, scope, content, value, tools, system performance, implementation, training, support, usage, structure, complexity, approach, governance/configuration management/policy, and resourcing.

  17. Modeling Relevant to Safe Operations of U.S. Navy Vessels in Arctic Conditions: Physical Modeling of Ice Loads

    Science.gov (United States)

    2016-06-01

    Proceedings of the ASME 31st International Conference on Ocean, Offshore and Arctic Engineering, 1–6 July, Rio de Janeiro , Brazil, 6:495–505. New York...Arctic Engineering, 1–6 July, Rio de Janeiro , Brazil, 6:495–505. New York, NY: American Society of Mechanical Engineers. doi:10.1115/OMAE2012-83927...of ice impacts with Navy ships. These large-scale tests will provide important benchmark data to support the de - velopment of numerical testbeds

  18. “The sacrifices that the nation requires”. Military business management of public firms. The Argentinian Navy at the Rio Santiago Shipyard (1953-1973)

    OpenAIRE

    Barragán, Ivonne

    2018-01-01

    The management of public companies and the management of the industrial work force by the military regime will be studied in this article from the relevant observation. We propose to analyze the forms of corporate-military management in Astillero Rio Santiago (ARS) under the orbit of the Argentina Navy in order to observe some of the singularities in relation to other large state companies. In the ARS, the system of cooperation and simultaneous domain of the workers collective was founded on ...

  19. Efficacy and tolerability of a large scale change in regimen from latanoprost to travoprost in glaucoma patients at the Manhattan Veterans Administration Hospital

    Directory of Open Access Journals (Sweden)

    Edmund P Farris

    2008-06-01

    Full Text Available Edmund P FarrisNew York University, New York, NY; Manhattan Veterans Administration Hospital, New York, NY; New York Medical College, Valhalla, NY, USAObjective: This retrospective study was designed to investigate the efficacy and tolerability of travoprost 0.004% substituted for latanoprost 0.005% in glaucoma patients at the Manhattan Veterans Administration Hospital.Research design and methods: We conducted a chart review of patients with stable intraocular pressure (IOP undergoing a formulary change in regimen from latanoprost 0.005% to travoprost 0.004%. Diagnoses included primary open angle glaucoma, ocular hypertension, pigment dispersion glaucoma, and pseudoexfoliation glaucoma. Main outcome measures: The primary outcome measures were IOP change between baseline and 6 months and patient-reported adverse events throughout the study.Results: In the single therapy group (N = 60 eyes, the mean baseline IOP on latanoprost was 15.8 mmHg; after 6 months on travoprost, it was 14.9 mmHg (p < 0.1. In the concomitant therapy group (N = 126 eyes, the mean baseline IOP was 16.7 mmHg; after 6 months on travoprost, it was 15.9 mmHg (p < 0.01. A reduction of IOP ≥ 3 mmHg occurred in 28 eyes of 21 patients at 6 months. An increase of IOP ≥ 3 mmHg occurred in 5 eyes of 4 patients at 6 months. One patient was switched back to latanoprost due to irritation at 3 months. No other patient-reported adverse events, including increased hyperemia, were observed throughout the follow-up period.Conclusions: A change in therapeutic regimen from latanoprost 0.005% to travoprost 0.004% maintained IOP control in stable patients, and in some produced a further reduction in IOP. A change in therapy from latanoprost to travoprost was effective and well-tolerated for the glaucoma patients in this study.Keywords: glaucoma, intraocular pressure, prostaglandin analogue, retrospective studies, travoprost, latanoprost

  20. Recommendations and Requirements for Welding and Inspection of Titanium Piping for U.S. Navy Surface Ship Applications

    National Research Council Canada - National Science Library

    Wells, Michael

    1999-01-01

    The information contained in this report is intended to assist both Navy and shipyard/contractor personnel engaged in the welding and inspection of commercially pure titanium seawater piping systems for U.S. Navy surface ships...

  1. Acquisition: Implementation of the DoD Management Control Program for Navy Acquisition Category II and III Programs

    National Research Council Canada - National Science Library

    2004-01-01

    Who Should Read This Report and Why? Civil service and uniformed officers who are involved in the Navy acquisition decision making process should read this report because it provides an assessment of how the Navy can improve...

  2. Hospital Compare

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Compare has information about the quality of care at over 4,000 Medicare-certified hospitals across the country. You can use Hospital Compare to find...

  3. HCAHPS - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...

  4. Prevalence of Mycoplasma genitalium in men with urethritis in a large public hospital in Brussels, Belgium: An observational, cross-sectional study.

    Science.gov (United States)

    Libois, Agnès; Hallin, Marie; Crucitti, Tania; Delforge, Marc; De Wit, Stéphane

    2018-01-01

    Mycoplasma genitalium (MG) is a cause of urethritis. While resistance to azithromycin is increasing, routine detection of MG is not performed in Belgium, where its prevalence is unknown. The aim of this study is to determine prevalence of MG in men with urethritis. An "in-house" amplification assay detecting MG was performed on urine of men with complaints of urethritis who consulted the emergency unit or the Sexually Transmitted Infection clinic of our public hospital in Brussels. Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) were tested on the same sample. A total of 187 men were tested. Prevalence of MG was 9% (95% Confidence Interval: 5 to 13.2%). CT was detected in 20%, NG in 22% and 56% of samples were negative for these three pathogens. Neither age, ethnic origin, sexual orientation nor HIV infection were associated with MG urethritis. M. genitalium was identified in 9% of men with complaints of urethritis indicating that amplification assay detecting MG should be implemented in routine testing for those patients.

  5. Exploring Impacts of Taxes and Hospitality Bans on Cigarette Prices and Smoking Prevalence Using a Large Dataset of Cigarette Prices at Stores 2001–2011, USA

    Directory of Open Access Journals (Sweden)

    Lance S. Ballester

    2017-03-01

    Full Text Available In the USA, little is known about local variation in retail cigarette prices; price variation explained by taxes, bans, and area-level socio-demographics, and whether taxes and hospitality bans have synergistic effects on smoking prevalence. Cigarette prices 2001–2011 from chain supermarkets and drug stores (n = 2973 were linked to state taxes (n = 41, state and county bar/restaurant smoking bans, and census block group socio-demographics. Hierarchical models explored effects of taxes and bans on retail cigarette prices as well as county smoking prevalence (daily, non-daily. There was wide variation in store-level cigarette prices in part due to differences in state excise taxes. Excise taxes were only partially passed onto consumers (after adjustment, $1 tax associated with $0.90 increase in price, p < 0.0001 and the pass-through was slightly higher in areas that had bans but did not differ by area-level socio-demographics. Bans were associated with a slight increase in cigarette price (after adjustment, $0.09 per-pack, p < 0.0001. Taxes and bans were associated with reduction in smoking prevalence and taxes had a stronger association when combined with bans, suggesting a synergistic effect. Given wide variation in store-level prices, and uneven state/county implementation of taxes and bans, more federal policies should be considered.

  6. Exploring Impacts of Taxes and Hospitality Bans on Cigarette Prices and Smoking Prevalence Using a Large Dataset of Cigarette Prices at Stores 2001-2011, USA.

    Science.gov (United States)

    Ballester, Lance S; Auchincloss, Amy H; Robinson, Lucy F; Mayne, Stephanie L

    2017-03-20

    In the USA, little is known about local variation in retail cigarette prices; price variation explained by taxes, bans, and area-level socio-demographics, and whether taxes and hospitality bans have synergistic effects on smoking prevalence. Cigarette prices 2001-2011 from chain supermarkets and drug stores ( n = 2973) were linked to state taxes ( n = 41), state and county bar/restaurant smoking bans, and census block group socio-demographics. Hierarchical models explored effects of taxes and bans on retail cigarette prices as well as county smoking prevalence (daily, non-daily). There was wide variation in store-level cigarette prices in part due to differences in state excise taxes. Excise taxes were only partially passed onto consumers (after adjustment, $1 tax associated with $0.90 increase in price, p < 0.0001) and the pass-through was slightly higher in areas that had bans but did not differ by area-level socio-demographics. Bans were associated with a slight increase in cigarette price (after adjustment, $0.09 per-pack, p < 0.0001). Taxes and bans were associated with reduction in smoking prevalence and taxes had a stronger association when combined with bans, suggesting a synergistic effect. Given wide variation in store-level prices, and uneven state/county implementation of taxes and bans, more federal policies should be considered.

  7. Exploring Impacts of Taxes and Hospitality Bans on Cigarette Prices and Smoking Prevalence Using a Large Dataset of Cigarette Prices at Stores 2001–2011, USA

    Science.gov (United States)

    Ballester, Lance S.; Auchincloss, Amy H.; Robinson, Lucy F.; Mayne, Stephanie L.

    2017-01-01

    In the USA, little is known about local variation in retail cigarette prices; price variation explained by taxes, bans, and area-level socio-demographics, and whether taxes and hospitality bans have synergistic effects on smoking prevalence. Cigarette prices 2001–2011 from chain supermarkets and drug stores (n = 2973) were linked to state taxes (n = 41), state and county bar/restaurant smoking bans, and census block group socio-demographics. Hierarchical models explored effects of taxes and bans on retail cigarette prices as well as county smoking prevalence (daily, non-daily). There was wide variation in store-level cigarette prices in part due to differences in state excise taxes. Excise taxes were only partially passed onto consumers (after adjustment, $1 tax associated with $0.90 increase in price, p < 0.0001) and the pass-through was slightly higher in areas that had bans but did not differ by area-level socio-demographics. Bans were associated with a slight increase in cigarette price (after adjustment, $0.09 per-pack, p < 0.0001). Taxes and bans were associated with reduction in smoking prevalence and taxes had a stronger association when combined with bans, suggesting a synergistic effect. Given wide variation in store-level prices, and uneven state/county implementation of taxes and bans, more federal policies should be considered. PMID:28335533

  8. Awareness of interventional radiology among patients referred to the interventional radiology department: a survey of patients in a large Canadian community hospital.

    Science.gov (United States)

    Baerlocher, Mark O; Asch, Murray R; Puri, Gaurav; Vellahottam, Andrew; Myers, Andy; Andrews, Karen

    2007-05-01

    To quantify the level of knowledge about interventional radiology (IR) among patients referred for an IR procedure and to develop recommendations on how to increase public awareness of IR. Paper surveys were prospectively administered to consecutive patients scheduled to undergo an IR procedure at a community hospital. The study was terminated at the accrual of 100 completed surveys. Totals of 28% and 6% knew generally the job of a diagnostic radiologist and interventional radiologist, respectively, and 6% had heard of the field of IR before their referral (despite 21% having undergone a procedure previously). Before their arrival in the IR department, 87% had not received any information about IR. Three percent, 0%, 4%, 82%, and 82% had heard about uterine artery embolization, radiofrequency ablation, vertebroplasty, biopsy (any type), and angioplasty, respectively. After the procedures, 84% had a clearer view of what interventional radiologists do, but 98% believed that most others did not know what IR was. When asked how best to educate the public about IR, the responses were: unsure (39%), other (19%), pamphlets (12%), information from physicians (9%), television (8%), and Internet (7%). Overall, the mean satisfaction rate was 8.8 (with 0 representing the minimum and 10 representing the maximum), and 97% would choose IR over surgery for future treatments. These data quantify and strongly support the views that (1) even among patients specifically referred to IR for a procedure, the majority of people are unaware of what the field is or may offer; and (2) most patients were satisfied with their IR experience. Six results-based recommendations are made to increase public awareness about IR.

  9. Peripheral arterial disease among adult diabetic patients attending a large outpatient diabetic clinic at a national referral hospital in Uganda: a descriptive cross sectional study.

    Directory of Open Access Journals (Sweden)

    Raymond Mbayo Mwebaze

    Full Text Available BACKGROUND: Peripheral arterial disease (PAD is one of the recognised diabetic macro vascular complications. It is a marker of generalised systemic atherosclerosis and is closely associated with symptomatic coronary and cerebrovascular disease, hence significant morbidity and mortality. Among African adult diabetic populations, screening and diagnosis of PAD is frequently suboptimal. The aim of this study was to determine the prevalence and associated clinical factors of PAD in adult ambulatory diabetic patients attending the outpatient diabetic clinic of Mulago national referral and teaching hospital, Kampala Uganda. METHODS: In this descriptive cross sectional study, 146 ambulatory adult diabetic patients were studied. Information about their socio-demographic and clinical characteristics, fasting lipid profile status, blood pressure, glycated haemoglobin (HbA1c levels and presence of albuminuria was collected using a pre tested questionnaire. Measurement of ankle brachial index (ABI to assess for PAD, defined as a ratio less than 0.9 was performed using a portable 5-10 MHz Doppler device. Clinical factors associated with PAD were determined by comparing specific selected characteristics in patients with PAD and those without. RESULTS: The mean age/standard deviation of the study participants was 53.9/12.4 years with a male predominance (75, 51.4%. PAD was prevalent in 57 (39% study participants. Of these, 34 (59.6% had symptomatic PAD. The noted clinical factors associated with PAD in this study population were presence of symptoms of intermittent claudication and microalbuminuria. CONCLUSIONS: This study documents a high prevalence of PAD among adult ambulatory Ugandan diabetic patients. Aggressive screening for PAD using ABI measurement in adult diabetic patients should be emphasised in Uganda especially in the presence of symptoms of intermittent claudication and microalbuminuria.

  10. An Improved Inventory Control Model for the Brazilian Navy Supply System

    Science.gov (United States)

    2001-12-01

    Portuguese Centro de Controle de Inventario da Marinha, the Brazilian Navy Inventory Control Point (ICP) developed an empirical model called SPAADA...NAVAL POSTGRADUATE SCHOOL Monterey, California THESIS Approved for public release; distribution is unlimited AN IMPROVED INVENTORY CONTROL ...AN IMPROVED INVENTORY CONTROL MODEL FOR THE BRAZILIAN NAVY SUPPLY SYSTEM Contract Number Grant Number Program Element Number Author(s) Moreira

  11. 33 CFR 334.310 - Chesapeake Bay, Lynnhaven Roads; navy amphibious training area.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Chesapeake Bay, Lynnhaven Roads; navy amphibious training area. 334.310 Section 334.310 Navigation and Navigable Waters CORPS OF....310 Chesapeake Bay, Lynnhaven Roads; navy amphibious training area. (a) The restricted area. Beginning...

  12. 32 CFR 700.201 - Origin and authority of the Department of the Navy.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Origin and authority of the Department of the... The Department of the Navy § 700.201 Origin and authority of the Department of the Navy. (a) The naval... Executive Departments by the 1947 Act) as military departments within the Department of Defense. (c) The...

  13. 77 FR 2040 - Taking and Importing Marine Mammals: Taking Marine Mammals Incidental to Navy Training Exercises...

    Science.gov (United States)

    2012-01-13

    ... such data can be collected without unreasonable costs and impacts to training, the Navy will move forward in incorporating the measurements into its monitoring program for east coast mine neutralization... aircraft and logistical constraints, the use of additional Navy aircraft beyond those participating...

  14. 77 FR 46733 - Taking and Importing Marine Mammals: Taking Marine Mammals Incidental to Navy Training Exercises...

    Science.gov (United States)

    2012-08-06

    ... without unreasonable costs and impacts to training, the Navy will move forward in incorporating the... participating in the exercise was evaluated. Due to the limited availability of Navy aircraft and logistical... deemed impracticable. A primary logistical constraint includes coordinating the timing of the detonation...

  15. Determining How to Best Predict Navy Recruiting Using Various Economic Variables

    Science.gov (United States)

    2015-03-01

    Puerto Rico, and the Virgin Islands. 5 Figure 1. Regions and District Map (from CNRC, n.d.) c. Navy Recruiting District There are 26 Navy...Curtis (1983, March). The effects of the business cycle on the size and composition of the U.S. Army. Atlantic Economic Journal, 11(1), 42–53. Retrieved

  16. The design and development of a management information system for the Monterey Navy Flying Club.

    OpenAIRE

    George, Derek R.

    1986-01-01

    Approved for public release; distribution is unlimited This thesis provides a Management Information System for the Monterey Navy Flying Club. It supplies the tools necessary to enable the club manager to maintain all club records and generate required administrative and financial reports. http://archive.org/details/designdevelopmen00geor Commander, United States Navy

  17. Navy Enterprise Resource Planning Program: Governance Challenges in Deploying an Enterprise-Wide Information Technology System in the Department of the Navy

    Science.gov (United States)

    2010-12-01

    Douglas E. Brinkley, Support Advisor _____________________________________ William R. Gates, Dean Graduate School of Business and...Washington, DC: Assistant Secretary of the Navy for Research, Development and Acquisition. Blackstone , John H., and James F. Cox. 2005. APICS Dictionary

  18. Allocating Overhead Costs in a Navy Working Capital Fund Environment: An Analysis and Comparison of Current Navy Policy and Private Sector Practice

    National Research Council Canada - National Science Library

    Schulte, Steven

    1999-01-01

    .... The objective of this thesis was to evaluate the overhead allocation practices of five private sector organizations for the potential improvement of overhead allocation practices in Navy Working Capital Fund activities...

  19. Hospital Prices Increase in California, Especially Among Hospitals in the Largest Multi-hospital Systems

    Directory of Open Access Journals (Sweden)

    Glenn A. Melnick PhD

    2016-06-01

    Full Text Available A surge in hospital consolidation is fueling formation of ever larger multi-hospital systems throughout the United States. This article examines hospital prices in California over time with a focus on hospitals in the largest multi-hospital systems. Our data show that hospital prices in California grew substantially (+76% per hospital admission across all hospitals and all services between 2004 and 2013 and that prices at hospitals that are members of the largest, multi-hospital systems grew substantially more (113% than prices paid to all other California hospitals (70%. Prices were similar in both groups at the start of the period (approximately $9200 per admission. By the end of the period, prices at hospitals in the largest systems exceeded prices at other California hospitals by almost $4000 per patient admission. Our study findings are potentially useful to policy makers across the country for several reasons. Our data measure actual prices for a large sample of hospitals over a long period of time in California. California experienced its wave of consolidation much earlier than the rest of the country and as such our findings may provide some insights into what may happen across the United States from hospital consolidation including growth of large, multi-hospital systems now forming in the rest of the rest of the country.

  20. Optimizing the US Navy’s Combat Logistics Force

    Science.gov (United States)

    2008-01-01

    by some uniformed navy crew, “A” auxillary , “O” fuel oil, “E” explosive ord- nance, “F” refrigerated, and “K” general cargo. The respective crew...may govern the minimum or maximum days allowed between these planned events). 7.4. Decision Variables HITs,bg,d Binary indicator of shuttle s CONSOL...anticipating decisions to procure the T-AKE, shapes the fundamental questions: • How many T-AKEs will be enough? • What is the optimal T-AKE load of ordnance

  1. The Role of Leadership in Navy Program Offices. Executive Summary

    Science.gov (United States)

    1973-05-01

    PROGRAM MANAGEMENT COURSE- SSTUDENT STUDY PROGRAM Fort Beivoir, Virginia, 22060 THE ROLE OF LEADERSHIP IN NAVY PROGRAM OFFICES STUDY REPORT PMC 73-1...jLa I1 • 1. Men at the Top. Osborne kLliott 1 2. "Understanding Leadership ". W. 0. H. Prentice, HBR Sep- Oct 1966 j 3. "A Theory of Human Motivation...Drucker, IMI reprint 9. Technical Management Institute Thifnkpiece, " Leadership " 1 • 0. "The Effective Manager ". Peter Drucker, LMI r~print 11. Sur-ival In

  2. Caffeine Use among Active Duty Navy and Marine Corps Personnel

    Science.gov (United States)

    2016-10-09

    college students. Drug Alcohol Depend. 2012, 123, 167–172. [CrossRef] [PubMed] 50. Swan, G.E.; Carmelli, D.; Cardon , L.R. The consumption of tobacco...TITLE AND SUBTITLE 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 6...Surgery Naval Medical Research Center (MED 00), Navy Dept 503 Robert Grant Ave 7700 Arlington Blvd Ste 5113 Silver Spring, MD 20910-7500 Falls Church, VA

  3. Department of the Navy Justification of Estimates for Fiscal Year 1988/1989 Submitted to Congress. Procurement. Other Procurement, Navy.

    Science.gov (United States)

    1987-01-01

    7 7ZD- AISI 9721 PffARTMENT OF THE NAVY JUffjA~j HFC S A FO L/L U I (NAUil) WASHINC ON C JAN&LNCLASS IFI ED F/G 5/1 NL I M2 I12 5 coo~ LIFJ -I LII...0 4 4)-s.. -4 4J C: 00 + ,. LI0a 4)00&.4. 00a 4)CA.V f0 4- > 1 - 1 404- 4JLA. 0- =. i.- >, 0h0 a0 cn 4 (40 s.4 > 4 24*~ (-A *.eZ---. 0. .. ., tv 4140

  4. Acceptability and characterization of extruded pinto, navy and black beans.

    Science.gov (United States)

    Simons, Courtney W; Hall, Clifford; Tulbek, Mehmet; Mendis, Mihiri; Heck, Taylor; Ogunyemi, Samuel

    2015-08-30

    Consumption of dry beans has been relatively flat over the last decade. Creating new bean products may increase the consumption of beans and allow more consumers to obtain the health benefits of beans. In this study, pinto, navy and black beans were milled and the resulting flours extruded into puffs. Unflavored extruded puffs were evaluated by untrained panelists using a hedonic scale for appearance, flavor, texture and overall acceptability. The compositions of raw flours and extrudates were characterized. Sensory results indicated that all beans met or exceeded the minimum requirement for acceptability. Overall acceptability of navy and pinto beans was not significantly different, while acceptability of black bean puffs was significantly lower. Total protein (198-217 g kg(-1)) in extrudates was significantly different among the three beans. Total starch ranged from 398 to 406 g kg(-1) and was not significantly different. Resistant starch, total extractable lipid and raffinose contents were significantly reduced by extrusion. Extrusion did not affect crude fiber and phytic acid contents. The minimal effects on protein and fiber contents, the significant reduction in raffinose content and the acceptability of the unflavored extruded puffs support using various bean flours as ingredients in extruded puffed products. © 2014 Society of Chemical Industry.

  5. UNMANNED AERIAL VEHICLES IN THE NAVY: ITS BENEFITS

    Directory of Open Access Journals (Sweden)

    GONÇALO CASTANHEIRA ROSA

    2016-06-01

    Full Text Available Military investment in UAV research, systems, and applied technologies is increasing, and potential uses for UAVs in civil and military operations are in development. These developments, along with growing scientific interest in UAVs, are fueling commercial interest in the unmanned market. The growing enthusiasm for UAVs is not unfounded. The vehicles offer a unique range of features, most notably ultra-long endurance and high-risk mission acceptance, which cannot be reasonably performed by manned aircraft. Coupled with advances in automation and sensor technologies, and the potential for costs savings, it is understandable that interest in and demand for UAVs is on the rise. Organizations like the Navy have all the benefits to accompany the technological evolution that every day surprises and surpasses us. An introduction or technological evolution that this kind of organizations has already begun to implement is the autonomous vehicles as a mean to an end. This paper describes and lists the advantages of the introduction of Unmanned Aerial Vehicles in an organization like the navy and also the missions that such robots can perform and optimize.

  6. Caffeine Use among Active Duty Navy and Marine Corps Personnel

    Science.gov (United States)

    Knapik, Joseph J.; Trone, Daniel W.; McGraw, Susan; Steelman, Ryan A.; Austin, Krista G.; Lieberman, Harris R.

    2016-01-01

    Data from the National Health and Nutrition Examination Survey (NHANES) indicate 89% of Americans regularly consume caffeine, but these data do not include military personnel. This cross-sectional study examined caffeine use in Navy and Marine Corps personnel, including prevalence, amount of daily consumption, and factors associated with use. A random sample of Navy and Marine Corps personnel was contacted and asked to complete a detailed questionnaire describing their use of caffeine-containing substances, in addition to their demographic, military, and lifestyle characteristics. A total of 1708 service members (SMs) completed the questionnaire. Overall, 87% reported using caffeinated beverages ≥1 time/week, with caffeine users consuming a mean ± standard error of 226 ± 5 mg/day (242 ± 7 mg/day for men, 183 ± 8 mg/day for women). The most commonly consumed caffeinated beverages (% users) were coffee (65%), colas (54%), teas (40%), and energy drinks (28%). Multivariable logistic regression modeling indicated that characteristics independently associated with caffeine use (≥1 time/week) included older age, white race/ethnicity, higher alcohol consumption, and participating in less resistance training. Prevalence of caffeine use in these SMs was similar to that reported in civilian investigations, but daily consumption (mg/day) was higher. PMID:27735834

  7. Caffeine Use among Active Duty Navy and Marine Corps Personnel

    Directory of Open Access Journals (Sweden)

    Joseph J. Knapik

    2016-10-01

    Full Text Available Data from the National Health and Nutrition Examination Survey (NHANES indicate 89% of Americans regularly consume caffeine, but these data do not include military personnel. This cross-sectional study examined caffeine use in Navy and Marine Corps personnel, including prevalence, amount of daily consumption, and factors associated with use. A random sample of Navy and Marine Corps personnel was contacted and asked to complete a detailed questionnaire describing their use of caffeine-containing substances, in addition to their demographic, military, and lifestyle characteristics. A total of 1708 service members (SMs completed the questionnaire. Overall, 87% reported using caffeinated beverages ≥1 time/week, with caffeine users consuming a mean ± standard error of 226 ± 5 mg/day (242 ± 7 mg/day for men, 183 ± 8 mg/day for women. The most commonly consumed caffeinated beverages (% users were coffee (65%, colas (54%, teas (40%, and energy drinks (28%. Multivariable logistic regression modeling indicated that characteristics independently associated with caffeine use (≥1 time/week included older age, white race/ethnicity, higher alcohol consumption, and participating in less resistance training. Prevalence of caffeine use in these SMs was similar to that reported in civilian investigations, but daily consumption (mg/day was higher.

  8. Navy Bean Flour Particle Size and Protein Content Affect Cake Baking and Batter Quality(1).

    Science.gov (United States)

    Singh, Mukti; Byars, Jeffrey A; Liu, Sean X

    2015-06-01

    Whole navy bean flour and its fine and coarse particle size fractions were used to completely replace wheat flour in cakes. Replacement of wheat flour with whole bean flour significantly increased the protein content. The protein content was adjusted to 3 levels with navy bean starch. The effect of navy bean flour and its fractions at 3 levels of protein on cake batter rheology and cake quality was studied and compared with wheat flour samples. Batters prepared from navy bean flour and its fractions had higher viscosity than the cake flour. Reducing the protein content by addition of starch significantly lowered the viscosity of cake batters. The whole navy bean flour and coarse bean fraction cakes were softer than cakes made with wheat flour but had reduced springiness. Principal component analysis showed a clear discrimination of cakes according to protein. It also showed that low protein navy bean flour cakes were similar to wheat flour cakes. Navy bean flour with protein content adjusted to the level of cake (wheat) flour has potential as a healthy alternative in gluten-free cakes. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

  9. Evaluation of technology transferring: The experiences of the first Navy Domestic Technology Transfair. Final report

    Energy Technology Data Exchange (ETDEWEB)

    1989-12-31

    In August 1989 the Office of the Chief of Naval Research and the American Defense Preparedness Association conducted the first Navy Domestic Technology Transfair. The objective of the Transfair was to expose the US Navy`s years of solid experience across a broad span of technology to organizations outside of the Navy. It was an opportunity for private industry to capitalize on the Navy developed technology and this opening for industry was the primary focus of the Transfair. The event provided a unique forum to meet leading Navy scientific and engineering innovators face-to-face. Information was available concerning licensing of naval technology that was for sale to the private sector. Further, discussions covered opportunities for new cooperative research and development agreements with Navy laboratories and R&D activities. These agreements were authorized under the Federal Technology Transfer Act of 1986. The Transfair program was conducted in such a manner as to allow each Navy inventor, either scientist or engineer, to present a system, piece of hardware, or licensable concept in a formal paper presentation. Then, the Navy inventors were available in two, two-hour periods in which individual discussions were conducted, with attendees pursuing specific venues of cooperative agreements as desired. This report provides specifics concerning the technologies that were made available for transfer to the private sector during the Transfair. The Transfair concept sought to add special emphasis to the opening that the 1988 Technology Transfer Act brought to the marketplace. The experience was a step in the education of the possibilities for cooperation between the government and the private sector to share technology. Of additional significance is the economic enhancement for business expansion with the application of the technology to markets beyond defense.

  10. The Participation of the Danish Navy in Operation Maritime Monitor / Sharp Guard 1993-1996

    DEFF Research Database (Denmark)

    Nørby, Søren

    2015-01-01

    . Much has been much written about Olfert Fischer and its participation in the first Gulf War, causing the following and in many ways larger operation - the Navy's participation in the UN embargo against Serbia and Montenegro from 1993 to 1996 - to slip into the background. This is not fair as the Navy......’s participation in that conflict was an important step on the road from territorial defense of the Baltic Approaches to the contemporary international - global - profile of the Danish Navy. To date, historians have been focusing on the land war in the former Yugoslavia and not much has been written about...

  11. Navy Supply: Economic Order Quantity and Item Essentiality Need More Consideration.

    Science.gov (United States)

    1988-01-06

    Risk and Essentiality Need To compute safety levels, the Navy uses a set of mathematical formulas to Be Recognized that considers such factors as demand...OderQtia~tit ma Safty Lvel -" " Chapter 2 EOQ Principle Not Followed To reduce the purchase workload, the Navy adopted a policy in fiscal year 1985 that...than a minimum of 1 year’s supply. Navy Policy Overrides The EoQ principle is a mathematical technique for determining the pur- chase quantity that will

  12. On spaces of hospitality

    DEFF Research Database (Denmark)

    Greve, Anni

    Although specialists in hospitality have worked extensively on hospitality with respect to relations between different nations or between nations and individuals of a different nationality, for instance when they seek asylum, Jacques Derrida preferred to focus instead upon the relationship between...... the guest and the host. This has provided a much-needed rethinking of how to understand hospitality as a way of relating, as an ethics and as a politics. Within this work, there have often appeared discussions of ‘spaces of hospitality’, but these spaces have remained largely abstract. This is where...... this paper comes in: It will re open discussions of spaces of hospitality with an introduction into an on-going research project that studies the performative, structural and social dynamics of cultural encounters focusing on forms of hospitality that are related to particular sites in the city, namely...

  13. A System Approach to Navy Medical Education and Training. Appendix 30. Curriculum for General Hospital Corpsman.

    Science.gov (United States)

    1974-08-31

    individual patient needs; e.g., blind, bedridden , post ierative Make an unoccupied (standing) bed 340037 Change linens; e.g., bed, examination table...males, common in elderly people and alcoholics; excessive physical exertion in environment with high humidity and temperature, and cessation of sweating...drainage system with/without suction 150046 Arrange room/unit for individual patient’s needs, e.g., blind, bedridden , postoperative 250025 Read

  14. Nursing magnet hospitals have better CMS hospital compare ratings

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2017-11-01

    Full Text Available Background: There has been conflicting data on whether Nursing Magnet Hospitals (NMH provide better care. Methods: NMH in the Southwest USA (Arizona, California, Colorado, Hawaii, Nevada, and New Mexico were compared to hospitals not designated as NMH using the Centers for Medicare and Medicaid (CMS hospital compare star designation. Results: NMH had higher star ratings than non-NMH hospitals (3.34 + 0.78 vs. 2.86 + 0.83, p<0.001. The hospitals were mostly large, urban non-critical access hospitals. Academic medical centers made up a disproportionately large portion of the NMH. Conclusions: Although NMH had higher hospital ratings, the data may favor non-critical access academic medical centers which are known to have better outcomes.

  15. Navy-NGO Coordination for Health-Related HCA Missions: A Suggested Planning Framework

    Science.gov (United States)

    2008-11-01

    COCOMs have plans for several more de- ployments in the coming years. In 2006, USNS Mercy, a hospital ship with a white-painted hull bear - ing a large...facilities and health care equipment, medicines and vaccines, such health aides as eyeglasses and walking sticks, large-scale water purifi- cation systems

  16. Test and evaluation of the Navy half-watt RTG

    International Nuclear Information System (INIS)

    Rosell, F.E. Jr.; Eggers, P.E.; Gawthrop, W.E.; Rouklove, P.G.; Truscello, V.C.

    1976-01-01

    In the autumn of 1975 the Navy took delivery of eight small-sized, plutonium-fueled radioisotope thermoelectric generators (RTGs) from four contractors (each contractor provided two RTGs). The purpose of these demonstration models is to prove conclusively that it is possible with state-of-the-art technology and materials to produce a super-battery with a 15-year life for use in the form of distributed power sources for remote undersea applications. It is easy to determine the RTG's beginning-of-life performance by actual measurements, but to forecast accurately its end-of-life performance requires rigorous determination of its reliability. This article discusses the test and evaluation program (TEP) used and the results obtained in determining that reliability. The TEP is divided into three general areas: mechanical-electrical, thermochemical-physical, and thermoelectric

  17. Fuel property effects on Navy aircraft fuel systems

    Science.gov (United States)

    Moses, C. A.

    1984-01-01

    Problems of ensuring compatibility of Navy aircraft with fuels that may be different than the fuels for which the equipment was designed and qualified are discussed. To avoid expensive requalification of all the engines and airframe fuel systems, methodologies to qualify future fuels by using bench-scale and component testing are being sought. Fuel blends with increasing JP5-type aromatic concentration were seen to produce less volume swell than an equivalent aromatic concentration in the reference fuel. Futhermore, blends with naphthenes, decalin, tetralin, and naphthalenes do not deviate significantly from the correlation line of aromatic blends, Similar results are found with tensile strenth and elongation. Other elastomers, sealants, and adhesives are also being tested.

  18. Department of the Navy Suicide Incident Report (DONSIR): Summary of 1999-2000 Findings

    National Research Council Canada - National Science Library

    Hourani, Laurel

    2001-01-01

    ...)--and sponsored a pilot test of DONSIR's implementation in 1999. DONSIR represents the first systematic collection of epidemiological and risk factor data on suicides of active-duty Navy and Marine Corps personnel...

  19. A Model for Predicting the Repair Costs of U.S. Navy Inventory Items

    National Research Council Canada - National Science Library

    Tan, Jeffrey

    2003-01-01

    .... Navy inventory items. The thesis examines several prediction methodologies, including a ratio-estimator prediction method that is a modification of the methodology currently in use, as well as regression analysis...

  20. Maritime defence and the South African Navy to the cancellation of ...

    African Journals Online (AJOL)

    The Union of South Africa's declaration of war against Germany on 6. September 1939 ... available only address the history of the British Royal Navy, imperial defence ..... The effect of British naval mastery was also illustrated by the fact that the.

  1. Relationships Among Changes in Health Behaviors in a Six-Year U.S. Navy Cohort

    National Research Council Canada - National Science Library

    Hurtado, Suzzanne

    1997-01-01

    ... to practice healthy behaviors in general. This study utilized longitudinal data to examine the relationships among changes in five key lifestyle behaviors among a 6-year cohort of U.S. Navy personnel...

  2. The Mini-Trial: A Valuable Alternative Dispute Resolution Tool for the United States Navy

    National Research Council Canada - National Science Library

    Morgan, Steven

    1997-01-01

    In order to avoid unnecessary, time consuming, and costly litigation, the Department of Defense, and more specifically the United States Navy, has adopted the use of alternative dispute resolution (ADR...

  3. Department of the Navy Suicide Incident Report (DONSIR): Summary of 1999-2002 Findings

    National Research Council Canada - National Science Library

    Stander, Valerie A; Hilton, Susan M; Kennedy, Kevin R; Gaskin, Thomas

    2004-01-01

    ...) to collect data on completed suicides in the U.S. Navy (USN) and Marine Corps (USMC). The long-term goal of this program is to improve suicide prevention by identifying and modifying military-specific risk factors...

  4. Incremental Validity of New Computerized Aptitude Tests for Predicting Training Performance in Nine Navy Technical Schools

    National Research Council Canada - National Science Library

    Wolfe, John H; Larson, Gerald E; Alderton, David L

    2006-01-01

    During their second week of basic training, 4,989 Navy recruits assigned to one of nine technical training schools were administered a battery of six experimental computerized aptitude tests measuring four constructs...

  5. Review of Proposed Congressional Budget Exhibits for the Navy's Mission-Funded Shipyards

    National Research Council Canada - National Science Library

    Frisk, Daniel; Trunkey, R. D

    2006-01-01

    To improve shipyard reporting and address concerns about the decreased visibility of the operations and costs of mission-funded shipyards, the Congress asked the Navy to submit a report with proposed...

  6. Software Test Description (STD) for the Globally Relocatable Navy Tide/Atmospheric Modeling System (PCTides)

    National Research Council Canada - National Science Library

    Posey, Pamela

    2002-01-01

    The purpose of this Software Test Description (STD) is to establish formal test cases to be used by personnel tasked with the installation and verification of the Globally Relocatable Navy Tide/Atmospheric Modeling System (PCTides...

  7. Study of Navy Enlisted Attrition: Race, Ethnicity, and Type of Occupation

    National Research Council Canada - National Science Library

    Carroll, James M

    2008-01-01

    .... The study uses a special database developed by the Defense Manpower Data Center in Monterey, CA, that contains the records of 186,938 male recruits who enlisted in the Navy during calendar years 1996 through 2000...

  8. Department of the Navy Suicide Incident Report (DONSIR): Preliminary Findings January-June 1999

    National Research Council Canada - National Science Library

    Hourani, Laurel

    1999-01-01

    .... The purposes of the DONSIR are to standardize the review and reporting process on Navy and Marine Corps suicides, and to develop a database to be used to identify risk factors and improve prevention...

  9. Pregnancy and Single Parenthood in the Navy: Results of a 1997 Survey

    National Research Council Canada - National Science Library

    Thomas, Patricia

    1998-01-01

    .... The Navy's annual pregnancy rates parallel civilian rates for age cohorts. Half of the women experiencing an unplanned pregnancy were not using birth control, whereas the pill was the most failure-prone method of contraception...

  10. Study of Attrition Documentation at the U.S. Navy Recruit Training Command

    National Research Council Canada - National Science Library

    Condon, Nancy K; Eckenrode, John E

    2006-01-01

    .... Navy's Recruit Training Command (RTC). A random sample of 754 "retained files" from Customer Service Desk RTC was examined for attrition documentation and the information obtained was compared with attrition documentation contained...

  11. U.S. Navy Women's Satisfaction With Obstetric and Gynecologic Medical Care

    National Research Council Canada - National Science Library

    Burr, R

    1997-01-01

    There are more than 55,000 women on active duty in the U.S. Navy. Previous research has shown that women utilize health care services at higher rates than men, and that obstetric and gynecologic (OB/GYN...

  12. Analysis of Recruit Attrition from the Navy's Delayed Entry Program and Recruit Training Command

    National Research Council Canada - National Science Library

    Neuhalfen, Jon K

    2007-01-01

    .... The analysis uses the PRIDE database, provided by Commander, Navy Recruiting Command. Trend analyses are used to identify significant changes in enlistment and attrition behavior for recruits who joined from fiscal years 1998 through 2005...

  13. An Analysis of Automated Solutions for the Certification and Accreditation of Navy Medicine Information Assets

    National Research Council Canada - National Science Library

    Gonzales, Dominic V

    2005-01-01

    ... improve Navy Medicine's current C AND A security posture. The primary research reviewed C AND A policy and included a comparative analysis of two cutting edge automated C AND A tools namely, Xacta and eMASS...

  14. Non-response Assessment of a Web-based Navy Quick Poll

    National Research Council Canada - National Science Library

    Uriell, Zannette A; Whittam, Kimberly P; Newell, Carol E; Hargrove, Matthew J

    2007-01-01

    Quick Polls were developed to obtain attitudes and opinions of U.S. Navy personnel in a shorter time period than traditional mailed surveys using a new contact method and a web-based survey available for only a...

  15. Study of Navy Enlisted Attrition: Race, Ethnicity, and Type of Occupation

    National Research Council Canada - National Science Library

    Carroll, James M

    2008-01-01

    The primary objective of this study is to gain a better understanding of Navy first-term enlisted attrition among racial/ethnic minorities by comparing attrition rates in technical and nontechnical occupations...

  16. Combat Pair: The Evolution of Air Force-Navy Integration in Strike Warfare

    National Research Council Canada - National Science Library

    Lambeth, Benjamin

    2007-01-01

    This report documents the exceptional cross-service harmony that the U.S. Air Force and U.S. Navy have steadily developed in their conduct of integrated strike operations since the first Persian Gulf War in 1991...

  17. Information Technology (IT) Ethics: Training and Awareness Materials for the Department of the Navy

    National Research Council Canada - National Science Library

    Senter, Jasper

    2002-01-01

    Information ethics is a relatively new field of study that aims to identify and to analyze the impact technology has on society, personal values, and the application of ethics in cyberspace The Department of the Navy (DoN...

  18. Allocation of Recruiting Resources Across Navy Recruiting Stations and Metropolitan Areas

    National Research Council Canada - National Science Library

    Jarosz, Suzanne

    1999-01-01

    .... However, the allocation of these resources across the 31 Navy recruiting districts must be made based on the characteristics of each district, and recruiters must be placed in geographic locations...

  19. A 21st Century Navy Vision: Motivating Sailors to Achieve Maximum Warfighting Readiness

    National Research Council Canada - National Science Library

    Martins, John

    2001-01-01

    ... the organization to provide a flexible mix of enhanced motivators to the 21st Century warriors. This manuscript begins with a review of motivational theory before launching into an assessment of today's Navy...

  20. Navy DD(X) and LCS Ship Acquisition Programs: Oversight Issues and Options for Congress

    National Research Council Canada - National Science Library

    O'Rourke, Ronald

    2005-01-01

    The Navy in FY2006 and future years wants to procure no more Arleigh Burke (DDG-51) class destroyers and instead wants to begin procuring two new classes of surface combatants a new destroyer called the DD...

  1. Journal Vouchers for FY 2000 Department of the Navy General Fund Financial Reporting

    National Research Council Canada - National Science Library

    2001-01-01

    ...) General Fund Financial Statements. The previous reports discuss accounting entries supporting Marine Corps reporting and our endorsement of he Naval Audit Service disclaimer of opinion on the FY 2000 Navy General Fund financial statements...

  2. Navy Ships: Turning Over Auxiliary Ship Operations to the Military Sealift Command Could Save Millions

    National Research Council Canada - National Science Library

    1997-01-01

    .... One additional multiproduct ship of a new class is currently under construction. The Navy has delegated operational control of 27 of these ships to MSC, the military's single manager for sealift, to better...

  3. A Stakeholder Analysis of the Navy's Thirty-Year Shipbuilding Plan

    National Research Council Canada - National Science Library

    O'Loughlin, Patrick R

    2007-01-01

    Using a stakeholder management approach, this thesis helps the U.S. Navy understand who the external stakeholders are with respect to the Thirty-Year Shipbuilding Plan, the priority of differing stakeholder claims, and the nature...

  4. The Implication of the EBC Scorecard on the Skills, Roles, and Tools of Navy MTF Comptrollers

    National Research Council Canada - National Science Library

    Lucas, Jeannette

    1998-01-01

    .... The purpose of this thesis is to present a baseline assessment, describing new skills, roles and tools which comptrollers of Navy MTF are adopting to improve their MTF's performance under the indices of the EBC Scorecard.

  5. 77 FR 33718 - Taking and Importing Marine Mammals: Taking Marine Mammals Incidental to Navy Training Exercises...

    Science.gov (United States)

    2012-06-07

    ... (LOA) to take marine mammals, by harassment, incidental to conducting training exercises within the... issue an LOA to the Navy that includes the use of time delayed firing devices (TDFDs), which have not been explicitly addressed previously, to [[Page 33719

  6. Navy Ship Propulsion Technologies: Options for Reducing Oil Use - Background for Congress

    National Research Council Canada - National Science Library

    O'Rourke, Ronald

    2006-01-01

    ...%. The Navy has installed fuel-saving bulbous bows and stern flaps on many of its ships. Ship fuel use could be reduced by shifting to advanced turbine designs such as an intercooled recuperated (ICR) turbine...

  7. Defense Finance and Accounting Service Work on the Navy General Fund 1996 Financial Statements

    National Research Council Canada - National Science Library

    1998-01-01

    ... for the Marine Corps, and on the Defense Finance and Accounting Service Cleveland Center, which consolidated the financial information for Navy and Marine Corps and compiled the financial statements...

  8. A Study of Officer's use of Leadership Skills Learned in the Navy's Intermediate Officer Leadership Course

    National Research Council Canada - National Science Library

    Conroy, William

    2001-01-01

    The U.S. Navy's present-day leadership training program, referred to as the Leadership Continuum, provides for leadership training for all enlisted personnel and officers at initial entry into the naval...

  9. Financial Management: Financial Reporting of Deferred Maintenance Information on Navy Weapon Systems for FY 2002

    National Research Council Canada - National Science Library

    Granetto, Paul

    2003-01-01

    .... The Navy reported an estimated $ 1.3 billion of deterred maintenance at the beginning of FY 2002 on its aircraft, ships, missiles, combat vehicles, and other weapon systems national defense property, plant, and equipment (PP&E) commodities...

  10. Defense Inventory Improved Management Framework Needed to Guide Navy Best Practice Initiatives

    National Research Council Canada - National Science Library

    1999-01-01

    In this report, we discuss our evaluation of the Department of the Navy's best practices implementation schedule for the acquisition and distribution of secondary inventory items, which the Department...

  11. Navy Ordnance Analysis of Business Area Efforts to Streamline Operations and Reduce Costs

    National Research Council Canada - National Science Library

    1997-01-01

    .... The Navy reorganized this business area in 1993 in order to reduce costs and address various deficiencies in ordnance logistics management that were identified during Desert Shield/Desert Storm...

  12. Maintenance Practices for Emergency Diesel Generator Engines Onboard United States Navy Los Angeles Class Nuclear Submarines

    National Research Council Canada - National Science Library

    Hawks, Matthew A

    2006-01-01

    .... All underway Navy nuclear reactors are operated with diesel generators as a backup power system, able to provide emergency electric power for reactor decay heat removal as well as enough electric...

  13. Compilation of the FY 2000 Navy Working Capital Fund Financial Statements

    National Research Council Canada - National Science Library

    Granetto, Paul

    2001-01-01

    ... to the Office of Management and Budget. This is the fifth and final report on our audit work on the FY 2000 Navy Working Capital Fund Financial Statements and related controls and supporting financial data...

  14. Statement of Honorable Donald C. Winter Secretary of the Navy Before the House Armed Services Committee

    National Research Council Canada - National Science Library

    Winter, Donald C

    2007-01-01

    Mr. Chairman, Mr. Ranking Member, and Members of the Committee, it is an honor to appear before you representing the brave men and women of the United States Navy and the United States Marine Corps active, reserve...

  15. An Econometric Study of Recruitment Marketing in the U.S. Navy

    OpenAIRE

    Dominique M. Hanssens; Henry A. Levien

    1983-01-01

    Since the abolishment of the mandatory draft the U.S. Navy, along with the other services, has engaged in aggressive marketing strategies in order to attract a sufficient number of qualified individuals to volunteer enlistment. The purpose of this study is to investigate the effectiveness of these efforts, primarily advertising and personal selling, within the general framework of the recruiting environment. The study uses insights into the recruiting process, provided by the Navy Recruiting ...

  16. Navy Ohio Replacement (SSBN[X]) Ballistic Missile Submarine Program: Background and Issues for Congress

    Science.gov (United States)

    2016-04-05

    Navy Ohio Replacement (SSBN[X]) Ballistic Missile Submarine Program: Background and Issues for Congress Ronald O’Rourke Specialist in Naval...Affairs April 5, 2016 Congressional Research Service 7-5700 www.crs.gov R41129 Navy Ohio Replacement (SSBN[X]) Ballistic Missile Submarine...1,091.1 million in research and development funding for the Ohio replacement program (ORP), a program to design and build a new class of 12 ballistic

  17. Pregnancy and Parenthood in the Navy: Results of the 2012-2013 Survey

    Science.gov (United States)

    2016-05-12

    fathers and 6,000 single Navy mothers; most Sailors do use birth control, predominantly the birth control pill and/or the condom; women are most...with few women having orders to their next duty station when they become pregnant. 15. SUBJECT TERMS pregnancy, single parent, Navy parent, birth...pregnancies are planned, with 38% of enlisted and 14% of officer women being single at the time they became pregnant. Few women assigned to shore or

  18. Navy Shipboard Lasers for Surface, Air, and Missile Defense: Background and Issues for Congress

    Science.gov (United States)

    2013-06-27

    fiber SSL effort is called the Tactical Laser System ( TLS ). Among DOD’s multiple efforts to develop slab SSLs for military use was the Maritime Laser...Missile Defense Congressional Research Service 11 Tactical Laser System Another Navy fiber SSL effort is the Tactical Laser System ( TLS )—a laser...and DOD have conducted development work on three principal types of lasers for potential use on Navy surface ships—fiber solid state lasers ( SSLs

  19. An Analysis of the Navy Manpower, Personnel, Training and Education Architecture

    Science.gov (United States)

    2017-03-01

    Manpower Management Overview. Source: Hatch (2016b). ......... 21 Figure 5. Origin of Manpower Management . Source: Hatch (2016b). .......... 22 Figure...Whitney, Bradley, and Brown (WBB) Inc., a business management consultant in Reston, Virginia was contracted to teach the Navy MPT three-day course...Classification, Manpower Requirements Determination (MRD), Total Force Management , and Manpower Business Requirement Governance,” (“Navy Manpower

  20. An Analysis of Personal and Professional Development in the United States Navy

    OpenAIRE

    Filiz, Caner; Jean-Pierre, Markelly

    2012-01-01

    Employee development is among the most important functions of any organization. Since employees are arguably an organizations most important asset, organizations have an incentive to invest in, direct, and promote the development of their employees. As an organization, the U.S. Navy, too, provides for the personal and professional development of naval personnel. This thesis reviews the Navys personal and professional development program and examines possible use of 360-degree feedback in the ...

  1. The Navy’s Moral Compass: Commanding Officers and Personal Misconduct

    Science.gov (United States)

    2016-07-01

    commanding officer corps and our service, to take positive action to develop each officer’s moral compass and establish an ethical standard. Step One...high moral ground in their discretionary judgments. Furthermore, the Army Operating Concept of 2010 includes three pages of ethical and behavioral...Journal of Business Ethics 12, no. 6 (1993), p. 265. 24. U.S. Navy Dept., U.S. Navy Regulations (Washington, D.C.: 1990), sec. 802, para. 1. 25

  2. Defense Small Business Innovation Research Program (SBIR). Volume 2. Navy Abstracts of Phase 1 Awards 1993

    Science.gov (United States)

    1993-01-01

    and toughness and strength will be evaluated by pressurized ring tensile tests. MUDAWAR THERMAL SYSTEM, INC. Topic#: 92-136 ID#: 92N40-240 1217...ARMY Topic#: 92-056 MTL SYSTEMS, INC. AF TopicS: 93-051 MIMS TECHNOLOGY DEVELOPMENT COMPANY AF Topic#: 93-111 AF Topic#: 93-011 MUDAWAR THERMAL SYSTEM...156 MUDAWAR THERMAL SYSTEM, INC. ANALYTICAL SERVICES & MATERIALS, INC. NAVY Topic#: 92-137 NAVY Topic#: 92-157 MOUNTAIN OPTECH, INC. DATAMAT SYSTEMS

  3. Drone Defense System Architecture for U.S. Navy Strategic Facilities

    Science.gov (United States)

    2017-09-01

    unlimited. DRONE DEFENSE SYSTEM ARCHITECTURE FOR U.S. NAVY STRATEGIC FACILITIES by David Arteche, Kenneth Chivers, Bryce Howard, Terrell Long, Walter...and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction...project report 4. TITLE AND SUBTITLE DRONE DEFENSE SYSTEM ARCHITECTURE FOR U.S. NAVY STRATEGIC FACILITIES 5. FUNDING NUMBERS 6. AUTHOR(S) David Arteche

  4. A Navy User’s Guide for Quality Assurance of New Concrete Construction

    Science.gov (United States)

    2012-06-01

    allowable concrete drying shrinkage for marine concrete in the U.S. Navy is 0.05%. does not predict some concrete properties and degradation mechanisms...service life modeling. A concrete mixture that meets the service life requirements using STADIUM® but fails the shrinkage tests is not acceptable for...TECHNICAL REPORT TR-NAVFAC ESC-CI-1215 A NAVY USER’S GUIDE FOR QUALITY ASSURANCE OF NEW CONCRETE CONSTRUCTION

  5. Study of Female Junior Officer Retention and Promotion in the U.S. Navy

    Science.gov (United States)

    2016-03-01

    thesis uses multivariate analytical techniques to examine the effects of demographics, pre- commissioning factors, and job performance on the retention ...JUNIOR OFFICER RETENTION AND PROMOTION IN THE U.S. NAVY by David J. Mundell March 2016 Thesis Advisor: Simona Tick Co-Advisor: Steve...3. REPORT TYPE AND DATES COVERED Master’s thesis 4. TITLE AND SUBTITLE STUDY OF FEMALE JUNIOR OFFICER RETENTION AND PROMOTION IN THE U.S. NAVY 5

  6. Navy Force Structure and Shipbuilding Plans: Background and Issues for Congress

    Science.gov (United States)

    2016-03-17

    industrial base. Detailed coverage of certain individual Navy shipbuilding programs can be found in the following CRS reports:  CRS Report RS20643...U.S. Offset Strategy and its Implications for Partners and Allies, As Delivered by Deputy Secretary of Defense Bob Work, Willard Hotel , January 28...Contracting in Defense Acquisition : Background and Issues for Congress, by Ronald O’Rourke and Moshe Schwartz. Navy Force Structure and Shipbuilding Plans

  7. China Naval Modernization: Implications for U.S. Navy Capabilities - Background and Issues for Congress

    Science.gov (United States)

    2013-09-05

    DefenseNews.com, January 6, 2011; Tony Capaccio, “China’s J-20 Stealth Fighter Meant to Counter F-22, F-35, U.S. Navy Says,” Bloomberg.com, January 6, 2011; David... Robbins , a Pentagon spokeswoman, said Tuesday. Hagel will factor the recommendations into the Pentagon’s 2015 budget guidance.... Throughout the SCMR...to pay off. 186 Tony Capaccio, “Navy Lacks Targets To Test U.S. Defenses Against China Missile

  8. Ignition Delay Properties of Alternative Fuels with Navy-Relevant Diesel Injectors

    Science.gov (United States)

    2014-06-01

    nozzle tip. 8 Figure 3 EMD injector cross-sectional view, after [15]. c. Sturman Injector A Sturman research diesel injector was used to validate...PROPERTIES OF ALTERNATIVE FUELS WITH NAVY-RELEVANT DIESEL INJECTORS by Andrew J. Rydalch June 2014 Thesis Advisor: Christopher M. Brophy...Navy’s Green Fleet Initiative, this thesis researched the ignition characteristics for diesel replacement fuels used with Navy-relevant fuel injectors

  9. U.S. Navy Shipboard Damage Control: Innovation and Implementation During the Interwar Period

    Science.gov (United States)

    2014-12-12

    an officer and torpedo artificer, after everybody else had left the ship, opened the torpedo tubes , and went down with the ship. The distinguished...another dreadnought battleship] was hit and although listing to starboard fired on the Turbulent, a British torpedo boat, exploding her boilers ...that influenced the U.S. Navy the most. By combining the successes of the German fleet and the failures of the British, the U.S. Navy was able to takes

  10. English language training for Navy enlisted personnel who speak English as a second language

    OpenAIRE

    Abalos, Aurora S.

    1990-01-01

    Approved for public release; distribution unlimited. Communication problems exist for English as a second language (ESL) personnel in Recruit Training Commands and Navy work places. Good English language programs could improve the communication problems in the training environment and in the work place by providing language instruction right after enlistment. In this study, the adequacy of the existing ESL training programs in the Navy and other ESL training programs currently used in the ...

  11. Further Improvements Needed in Navy’s Oversight and Management of Contracting for Facilities Construction on Diego Garcia.

    Science.gov (United States)

    1984-05-23

    1981, the Navy awarded a cost reimbursable contract to a joint venture to construct facility projects for fiscal years 1981 and 1982 with an estimated...through fiscal year 1986. In July 1981, the Navy awarded a cost reimburs - able contract (cost plus award fee) to Raymond, Brown & Root, Molem, a joint...Navy’s oversight and management of the acquisition of these facilities. A COST REIMBURSABLE CONTRACT MAKES STRONG CONTRACT ADMINISTRATION VITAL Under

  12. Infection prevention practices in adult intensive care units in a large community hospital system after implementing strategies to reduce health care-associated, methicillin-resistant Staphylococcus aureus infections.

    Science.gov (United States)

    Moody, Julia; Septimus, Edward; Hickok, Jason; Huang, Susan S; Platt, Richard; Gombosev, Adrijana; Terpstra, Leah; Avery, Taliser; Lankiewicz, Julie; Perlin, Jonathan B

    2013-02-01

    A range of strategies and approaches have been developed for preventing health care-associated infections. Understanding the variation in practices among facilities is necessary to improve compliance with existing programs and aid the implementation of new interventions. In 2009, HCA Inc administered an electronic survey to measure compliance with evidence-based infection prevention practices as well as identify variation in products or methods, such as use of special approach technology for central vascular catheters and ventilator care. Responding adult intensive care units (ICUs) were those considering participation in a clinical trial to reduce health care-associated infections. Responses from 99 ICUs in 55 hospitals indicated that many evidenced-based practices were used consistently, including methicillin-resistant Staphylococcus aureus (MRSA) screening and use of contact precautions for MRSA-positive patients. Other practices exhibited wide variability including discontinuation of precautions and use of antimicrobial technology or chlorhexidine patches for central vascular catheters. MRSA decolonization was not a predominant practice in ICUs. In this large, community-based health care system, there was substantial variation in the products and methods to reduce health care-associated infections. Despite system-wide emphasis on basic practices as a precursor to adding special approach technologies, this survey showed that these technologies were commonplace, including in facilities where improvement in basic practices was needed. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  13. Construction of a new model of job engagement, psychological empowerment and perceived work environment among Chinese registered nurses at four large university hospitals: implications for nurse managers seeking to enhance nursing retention and quality of care.

    Science.gov (United States)

    Fan, Yuying; Zheng, Qiulan; Liu, Shiqing; Li, Qiujie

    2016-07-01

    To explore the relationships among perceived work environment, psychological empowerment and job engagement of clinical nurses in Harbin, China. Previous studies have focused on organisational factors or nurses' personal characteristics contributing to job engagement. Limited studies have examined the effects of perceived work environment and psychological empowerment on job engagement among Chinese nurses. A cross-sectional quantitative survey with 923 registered nurses at four large university hospitals in China was carried out. Research instruments included the Chinese versions of the perceived nurse work environment scale, the psychological empowerment scale and the job engagement scale. The relationships of the variables were tested using structural equation modelling. Structural equation modelling revealed a good fit of the model, χ(2) /df = 4.46, GFI = 0.936, CFI = 0.957. Perceived work environment was a significant positive direct predictor of psychological empowerment and job engagement. Psychological empowerment was a significant positive direct contributor to job engagement and had a mediating effect on the relationship between perceived work environment and job engagement. Perceived work environment may result in increased job engagement by facilitating the development of psychological empowerment. For nurse managers wishing to increase nurse engagement and to achieve effective management, both perceived work environment and psychological empowerment are factors that need to be well controlled in the process of nurse administration. © 2016 John Wiley & Sons Ltd.

  14. The Virtual Naval Hospital: the digital library as knowledge management tool for nomadic patrons.

    Science.gov (United States)

    D'Alessandro, Michael P; D'Alessandro, Donna M; Bakalar, Richard S; Ashley, Denis E; Hendrix, Mary J C

    2005-01-01

    To meet the information needs of isolated primary care providers and their patients in the US Navy, a digital health sciences library, the Virtual Naval Hospital, was created through a unique partnership between academia and government. The creation of the digital library was heavily influenced by the principles of user-centered design and made allowances for the nomadic nature of the digital library's patrons and the heterogeneous access they have to Internet bandwidth. The result is a digital library that has been in operation since 1997, continues to expand in size, is heavily used, and is highly regarded by its patrons. The digital library is dedicated to delivering the right information at the right time to the right person so the right decision can be made, and therefore the Virtual Naval Hospital functions as a knowledge-management system for the US Navy Bureau of Medicine and Surgery.

  15. 76 FR 6699 - Taking and Importing Marine Mammals: U.S. Navy Training in the Hawaii Range Complex; U.S. Navy...

    Science.gov (United States)

    2011-02-08

    ..., the Navy realized that their evolving training programs, which are linked to real world events..., if the taking is limited to harassment and of no more than 1 year, to issue a notice of proposed...) (Pub. L. 108-136) removed the ``small numbers'' and ``specified geographical region'' limitations, and...

  16. Hospital Inspections

    Data.gov (United States)

    U.S. Department of Health & Human Services — Welcome to hospitalinspections.org, a website run by the Association of Health Care Journalists (AHCJ) that aims to make federal hospital inspection reports easier...

  17. Hospital marketing.

    Science.gov (United States)

    Carter, Tony

    2003-01-01

    This article looks at a prescribed academic framework for various criteria that serve as a checklist for marketing performance that can be applied to hospital marketing organizations. These guidelines are drawn from some of Dr. Noel Capon of Columbia University's book Marketing Management in the 21st Century and applied to actual practices of hospital marketing organizations. In many ways this checklist can act as a "marketing" balanced scorecard to verify performance effectiveness and develop opportunities for innovation.

  18. Occupational stress and strain in the Royal Navy 2007.

    Science.gov (United States)

    Bridger, R S; Brasher, K; Dew, A; Kilminster, S

    2008-12-01

    Previous surveys of psychological strain in the Naval Service (NS) have shown higher than expected levels of strain when compared to the general population. To repeat the survey last carried out in 2004 and to obtain further information on the nature of the occupational stressors associated with strain. General Health Questionnaire-12 strain rates and job/life stressors were measured using a Work and Well-Being Questionnaire. Models of strain were developed for male and female personnel in the Royal Navy (RN) and males in the Royal Marines (RM). The response rate was 57%. The psychological strain rate was 31.5% overall. Personnel suffering from strain tended to be 'overcommitted' to work, had low levels of commitment to the NS and had suffered stressful life events (SLEs) in the previous 12 months. Strain rates declined with age and rank in males, but not in females. Strain was significantly positively correlated with levels of overcommitment, effort-reward imbalance (ERI), role conflict, work-family conflict, organizational commitment and exposure to SLEs. Models of strain in the males and females in the RN and in the RM accounted for between 37 and 44% of the variance in strain. The survey provides evidence for both the demand control and ERI models-components of these models contribute independently to strain. High levels of commitment to the organization were associated with lower strain and exposure to SLEs to higher strain.

  19. Diesel fuel to dc power: Navy & Marine Corps Applications

    Energy Technology Data Exchange (ETDEWEB)

    Bloomfield, D.P. [Analytic Power Corp., Boston, MA (United States)

    1996-12-31

    During the past year Analytic Power has tested fuel cell stacks and diesel fuel processors for US Navy and Marine Corps applications. The units are 10 kW demonstration power plants. The USN power plant was built to demonstrate the feasibility of diesel fueled PEM fuel cell power plants for 250 kW and 2.5 MW shipboard power systems. We designed and tested a ten cell, 1 kW USMC substack and fuel processor. The complete 10 kW prototype power plant, which has application to both power and hydrogen generation, is now under construction. The USN and USMC fuel cell stacks have been tested on both actual and simulated reformate. Analytic Power has accumulated operating experience with autothermal reforming based fuel processors operating on sulfur bearing diesel fuel, jet fuel, propane and natural gas. We have also completed the design and fabrication of an advanced regenerative ATR for the USMC. One of the significant problems with small fuel processors is heat loss which limits its ability to operate with the high steam to carbon ratios required for coke free high efficiency operation. The new USMC unit specifically addresses these heat transfer issues. The advances in the mill programs have been incorporated into Analytic Power`s commercial units which are now under test.

  20. Risk factors for bruxism among Croatian navy employees.

    Science.gov (United States)

    Alajbeg, I Z; Zuvela, A; Tarle, Z

    2012-09-01

    The aim of the study was to evaluate the relationship between bruxism, and sociodemographic parameters, symptoms of temporomandibular disorders (TMD), personality and war experience among Croatian navy employees. The sample included 1092 subjects, aged 20-60 years (mean age 37·06 ± 7·85). An individual's bruxism status was based on clinical oral examination and participants' report of bruxism. Subjects with bruxism index values ≥ 90th percentile were included in severe bruxism group (n = 111), and those with scores below 90th percentile were labelled as negligible bruxism group (n = 981). No differences were found in gender distribution between the two groups. The proportion of military personnel presenting with bruxism is double the proportion of administrative employees with bruxism. A total of 23·34% subjects in negligible bruxism group and 48·65% in severe bruxism group participated in the war. Subjects in severe bruxism group presented more TMD-related signs and symptoms than those in negligible bruxism group. Higher prevalence of neuroticism and psychoticism was found in severe bruxism group. According to logistic regression, the probability of severe bruxism was significantly associated with marital status [Odds ratio (OR) 6·859, 95% confidence interval (CI) 3·869-12·158 P bruxism than non-smokers. Subjects who participated in war were more represented in severe bruxism group. Further studies, including other potential risk factors, are required to clarify these relationships. © 2012 Blackwell Publishing Ltd.

  1. Breaking emulsions in Navy bilge collection and treatment systems

    Energy Technology Data Exchange (ETDEWEB)

    Little, R.C.; Patterson, R.L.

    1978-05-01

    A new bilge waste collection and treatment system, which serves as the collector, transporter, and gravity separator for ship's bilge waste, was used as a medium for the application of chemical demulsification techniques to emulsified oily wastes that are reluctant to separate into the constituent phases. Laboratory tests on 27 demulsifying agents showed that three cation active quaternary ammonium salts were acceptable. They were effective in breaking 5% oil-in-sea-water emulsions over a 20 hr period at 4/sup 0/-45/sup 0/C. The demuslifier concentration required to break the emulsions generally ranged from 1-2% at 4/sup 0/C to 0.1-0.2% at 45/sup 0/C. At 4/sup 0/C, the oil concentration in the separated water was in the 100-500 ppm range; at 45/sup 0/C, no more than 55 ppm was observed with most oil level readings of the order of 25 ppm or less. The demulsifiers were useful in breaking emulsions of Navy distillate oil, used motor oil, turbine oil, and bilge wastes containing unknown oil mixtures. A field demonstration supported the laboratory tests.

  2. Hospital evacuation : Exercise versus reality

    NARCIS (Netherlands)

    Haverkort, J. J Mark; Biesheuvel, Tessa H.; Bloemers, Frank W.; de Jong, MB; Hietbrink, Falco; van Spengler, Lukas L.; Leenen, Luke P H

    Introduction: The Dutch Major Incident Hospital (MIH) is a standby, highly prepared, 200-bed hospital strictly reserved to provide immediate, large-scale, and emergency care for victims of disasters and major incidents. It has long-standing experience training for various major incident scenarios,

  3. Brief hospitalizations of elderly patients

    DEFF Research Database (Denmark)

    Strømgaard, Sofie; Rasmussen, Søren Wistisen; Schmidt, Thomas Andersen

    2014-01-01

    BACKGROUND: Crowded departments are a common problem in Danish hospitals, especially in departments of internal medicine, where a large proportion of the patients are elderly. We therefore chose to investigate the number and character of hospitalizations of elderly patients with a duration of less...

  4. 78 FR 19103 - Safety Zone; Spanish Navy School Ship San Sebastian El Cano Escort; Bahia de San Juan; San Juan, PR

    Science.gov (United States)

    2013-03-29

    ...-AA00 Safety Zone; Spanish Navy School Ship San Sebastian El Cano Escort; Bahia de San Juan; San Juan... temporary moving safety zone on the waters of Bahia de San Juan during the transit of the Spanish Navy... Channel entrance, and to protect the high ranking officials on board the Spanish Navy School Ship San...

  5. DOD Financial Management: Additional Efforts Needed to Improve Audit Readiness of Navy Military Pay and Other Related Activities

    Science.gov (United States)

    2015-09-01

    of Major Systems Involved in Processing and Reporting Navy Military Payroll 8 Figure 3: Management Representation Letter Timeline for the April 2013...Figure 3: Management Representation Letter Timeline for the April 2013 Military Payroll Examination Without a policy that addresses...DOD FINANCIAL MANAGEMENT Additional Efforts Needed to Improve Audit Readiness of Navy Military Pay and Other Related

  6. 32 CFR 705.15 - Employment of Navy personnel as correspondents or staff members of civilian news media.

    Science.gov (United States)

    2010-07-01

    ... or staff members of civilian news media. 705.15 Section 705.15 National Defense Department of Defense... REGULATIONS § 705.15 Employment of Navy personnel as correspondents or staff members of civilian news media. (a) A member of the naval service on active duty or Navy civilian may act as correspondent for a news...

  7. Hospital Acquisitions Before Healthcare Reform.

    Science.gov (United States)

    McCue, Michael J; Thompson, Jon M; Kim, Tae Hyun

    2015-01-01

    The hospital industry has experienced increased consolidation in the past 20 years. Since 2010, in particular, there has been a large rise in the number of hospital acquisitions, and observers have suggested this is due in part to the expected impact of federal healthcare reform legislation. This article reports on a study undertaken to identify the market, management, and financial factors affecting acute care, community hospitals acquired between 2010 and 2012. We identified 77 such hospitals and compared them to other acute care facilities. To assess how different factors were associated with acquisitions, the study used multiple logistic regressions whereby market factors were included first, followed by management and financial factors. Study findings show that acquired hospitals were located in markets with lower rates of preferred provider organization (PPO) penetration compared with nonacquired hospitals. Occupancy rate was found to be inversely related to acquisition rate; however, case-mix index was significantly and positively related to a hospital's being acquired. Financial factors negatively associated with a hospital's being acquired included age of plant and cash flow margin. In contrast to the findings from earlier studies of hospital acquisitions, our results showed that acquired hospitals possessed newer assets. However, similar to the findings of other studies, the cash flow margin of acquired hospitals was lower than that of nonacquired facilities.

  8. Nuclear or conventional power for surface combatant ships: Department of the Navy. Report to the Congress

    International Nuclear Information System (INIS)

    1977-01-01

    GAO reviewed the controversy over whether the Navy's major surface combatant ships should be all nuclear powered, all conventionally powered, or a mix of both. Nuclear ships are more capable but cost more and their relative cost-effectiveness cannot be measured because Navy analysts cannot quantify many benefits of nuclear power. The Congress, in reviewing Navy shipbuilding plans for surface combatant ships, should be cognizant that buying only conventional ships will maximize naval firepower; buying only nuclear ships will provide mobility and greater freedom from logistics support; and buying a mix is a third option providing, to varying degrees, the advantages and disadvantages of the all-nuclear and all-conventional options

  9. The Nuclear program of Navy: an approach from the budget

    International Nuclear Information System (INIS)

    Alves, Marco Antonio

    2014-01-01

    After the initiatives arising in the 50s, to conduct scientific research in Brazil, in the nuclear sector, the Brazilian government decided to invest resources in the early '70s, to provide the country with full training in the nuclear fuel cycle, producing reactors research and power and reprocessing of spent nuclear fuel in the reactors. This course of action was intended to guarantee the necessary to make stronger our energy matrix, with the use of natural resources (uranium and thorium mines whose reserves are among the largest in the world) for the production of electricity, within view particularly development programs in effect at the time. Meanwhile, the Navy of Brazil, identifying the need to operate nuclear-powered submarines in the security and defense of the South Atlantic, institutionalized in 1979, a nuclear program which aimed to the complete domination independently of the nuclear cycle. Since then, what is realized is that the trajectory of the development of this program, in addition to external difficulties imposed by countries holders of this technology, budget internal issue became relevant. The irregularity of financial transfers caused the delay and the lack of guarantees of future budgets led to the unpredictability of strategic planning, leading the program to the 'vegetative' state for nearly a decade. However, from the 2000s, the possibility of economic exploitation by the expansion of the Brazilian Continental Shelf and the new discoveries of oil in the pre-salt tier shifted the vision balance then attributed to the use of nuclear technology as an energy source only, or intended for research and development in areas such as health and agriculture, reinforced the argument that Brazil must have this technology to 'discourage the concentration of hostile forces within the limits of Brazilian territorial waters'. In this context, the paper describes and analyzes how the Navy Nuclear Program (PNM) amounted to the

  10. High School Astronomical Research at the Army and Navy Academy

    Science.gov (United States)

    Boyce, Pat; Boyce, Grady

    2016-06-01

    Establishment of a high school astronomy and research program is a difficult task to accomplish in an environment of state mandated high school educational curricula and the task saturation for many teachers today created by their class room and administrative requirements. This environment is most challenging for public schools. The astronomy program we will describe seems to be better suited at least at the present time for private or specialized schools. We will outline how a broad astronomy program was developed over two years at the Army and Navy Academy (ANA), a private boarding school in Carlsbad, California. Starting with no astronomy program in 2013, the Academy now has an astronomy club, a University of California a-g certified two semester high school course, and a college accredited astronomy research seminar with over 20 published high school authors.At ANA the development followed this path: finding a strong proponent at the school who can make actionable decisions; building interest and perceived value to other staff and faculty members; establishing an astronomy club to generate student interest and future student leaders; and designing the a-g certified high school course including the course length, structure and balance of teaching elements. Building on these foundations, the college level astronomy research seminar was then added to provide an avenue for inspired students to undertake actual research and publication of their work in scientific journals in their free time for college credit.Creating a sustainable program with supporting infrastructure comes next. Success with the three foundation steps builds confidence in the program with faculty and staff. Published, tangible successes highlight the value and enable advanced placement and scholarship opportunities for graduates. These successes build enthusiasm. The further keys to sustainability include addressing course credit, instructor compensation and rewards, and integration into the

  11. Imaging of Stellar Surfaces with the Navy Precision Optical Interferometer

    Science.gov (United States)

    Jorgensen, A.; Schmitt, H. R.; van Belle, G. T.; Hutter, Clark; Mozurkewich, D.; Armstrong, J. T.; Baines, E. K.; Restaino, S. R.

    The Navy Precision Optical Interferometer (NPOI) has a unique layout which is particularly well-suited for high-resolution interferometric imaging. By combining the NPOI layout with a new data acquisition and fringe tracking system we are progressing toward a imaging capability which will exceed any other interferometer in operation. The project, funded by the National Science Foundation, combines several existing advances and infrastructure at NPOI with modest enhancements. For optimal imaging there are several requirements that should be fulfilled. The observatory should be capable of measuring visibilities on a wide range of baseline lengths and orientations, providing complete UV coverage in a short period of time. It should measure visibility amplitudes with good SNR on all baselines as critical imaging information is often contained in low-amplitude visibilities. It should measure the visibility phase on all baselines. The technologies which can achieve this are the NPOI Y-shaped array with (nearly) equal spacing between telescopes and an ability for rapid configuration. Placing 6-telescopes in a row makes it possible to measure visibilities into the 4th lobe of the visibility function. By arranging the available telescopes carefully we will be able to switch, every few days, between 3 different 6-station chains which provide symmetric coverage in the UV (Fourier) plane without moving any telescopes, only by moving beam relay mirrors. The 6-station chains are important to achieve the highest imaging resolution, and switching rapidly between station chains provides uniform coverage. Coherent integration techniques can be used to obtain good SNR on very small visibilities. Coherently integrated visibilities can be used for imaging with standard radio imaging packages such as AIPS. The commissioning of one additional station, the use of new data acquisition hardware and fringe tracking algorithms are the enhancements which make this project possible.

  12. Physical Performance Measures of Flexibility, Hip Strength, Lower Limb Power and Trunk Endurance in Healthy Navy Cadets: Normative Data and Differences Between Sex and Limb Dominance.

    Science.gov (United States)

    Lopes, Thiago Jambo Alves; Simic, Milena; Alves, Daniel de Souza; Bunn, Priscila Dos Santos; Rodrigues, Allan Inoue; Terra, Bruno de Souza; Lima, Maicom da Silva; Ribeiro, Fabrício Miranda; Vilão, Patrick; Pappas, Evangelos

    2018-01-17

    The objectives were to provide normative data on commonly used physical performance tests that may be associated with musculoskeletal injuries in Navy cadets, and assess for sex and limb dominance differences. A large cohort of Navy cadets were assessed for physical performance tests of flexibility (ankle dorsiflexion range of motion and sit and reach), isometric hip strength, lower limb power (single leg hop), and trunk endurance (plank and side plank tests). Besides providing normative data tables, sex and limb dominance differences were assessed by a two-way mixed ANOVA. A total of 545 Brazilian Navy cadets (394 males) representing 79% of the cadets in the Academy participated. Normative reference values were reported as mean±SD, 95%CI and percentiles. For tests of muscle strength, power and endurance, males performed better than females (p<0.001). For flexibility tests, females achieved greater distances than males for the sit and reach test (p<0.001), but no difference for ankle dorsiflexion (p=0.51). Overall, there were no clinically relevant differences between limbs. In conclusion, normative data for commonly used physical performance tests were provided. Although no clinically relevant side-to-side differences were found, males presented higher values for lower limb strength and power, as well as trunk endurance than females, while females demonstrated increased flexibility. Valuable normative data are provided to professionals who work with young, active populations from the injury prevention or rehabilitation perspective; as the current study may help professionals to identify athletes or cadets whose performance is outside the normative values and may be at risk for injury.

  13. Navy Medicine. Volume 102, No. 4, Fall 2010

    Science.gov (United States)

    2010-01-01

    organizing, ingenuity and patience to equip a new state-of-the- art hospital. When that new hospital is in Kandahar, Afghanistan, the challenges increase...medical and flight surgeons were called to action to provide urgent state of the art medical care to underway operational forces. In the midst of...training ses- sion,” said Culinary Specialist 1st Class (SW) Ronnie Robinson of the NAS Jax Flight Line Café. "I learned about what warning signs to

  14. Analysis of the U.S. Navy Office of Women’s Policy Facebook Use

    Science.gov (United States)

    2015-06-01

    looking at a lot of different orders and my head is spinning but I’ve been considering a squadron. The third most common category was inspirational...click ‘Like’! At the DC Navy Memorial they celebrate 2013 as the Year of the Military Woman . Tribute to Aviation as well. Posts that reach out to...female diver? I spent the morning talking with a young woman who is thinking about joining the Navy and wants to be a diver. I would love for her to

  15. China Naval Modernization: Implications for U.S. Navy Capabilities - Background and Issues for Congress

    Science.gov (United States)

    2010-08-05

    waters that were engaged in activities that would impact on its security and interests. Foreign Ministry spokesman Qin Gang made the remarks in response...November 17, 2004. 63 Bill Gertz, “China Sub Secretly Stalked U.S. Fleet,” Washington Times, November 13, 2006: 13; Philip Creed, “Navy Confirms Chinese...2006; En-Lai Yeoh, “Fallon Confirms Chinese Stalked Carrier,” NavyTimes.com, November 14, 2006; Bill Gertz, “Admiral Says Sub Risked A Shootout

  16. Intelligent Processing Equipment Developments Within the Navy's Manufacturing Technology Centers of Excellence

    Science.gov (United States)

    Nanzetta, Philip

    1992-01-01

    The U.S. Navy has had an active Manufacturing Technology (MANTECH) Program aimed at developing advanced production processes and equipment since the late-1960's. During the past decade, however, the resources of the MANTECH program were concentrated in Centers of Excellence. Today, the Navy sponsors four manufacturing technology Centers of Excellence: the Automated Manufacturing Research Facility (AMRF); the Electronics Manufacturing Productivity Facility (EMPF); the National Center for Excellence in Metalworking Technology (NCEMT); and the Center of Excellence for Composites Manufacturing Technology (CECMT). This paper briefly describes each of the centers and summarizes typical Intelligent Equipment Processing (IEP) projects that were undertaken.

  17. Perceptions of HIV infected patients on the use of cell phone as a tool to support their antiretroviral adherence; a cross-sectional study in a large referral hospital in Kenya.

    Science.gov (United States)

    Kinyua, Florence; Kiptoo, Michael; Kikuvi, Gideon; Mutai, Joseph; Meyers, Adrienne F A; Muiruri, Peter; Songok, Elijah

    2013-10-21

    Clinical trials were conducted to assess the feasibility of using a cell phone text messaging-based system to follow up Human Immunodeficiency Virus (HIV) infected patients on antiretroviral (ARTs) and assess for improved adherence to their medication. However there is need to evaluate the perceptions of the HIV infected patients towards the use of these cell phones in an effort to better aid in the clinical management of their HIV infection. The objective of this study was therefore to determine the perceptions of HIV infected patients on the use of cell phone text messaging as a tool to support adherence to their ART medication. A cross sectional survey was conducted among patients receiving Highly Active Anti-Retroviral Therapy (HAART) at the Kenyatta National Hospital Comprehensive Care Clinic in Nairobi between May and July, 2011. Pre-tested questionnaires were used to collect the socio-demographic and perceptions data. The recruitment of the participants was done using the random probability sampling method and statistical analysis of data performed using Statistical Package for Social Sciences (SPSS) version 16.0. A total of 500 HIV infected patients (Male-107, Female-307) aged 19-72 years were interviewed. The majority of individuals (99%) had access to cell phones and 99% of the HIV infected patients interviewed supported the idea of cell phone use in management of their HIV infection. A large proportion (46%) claimed that they needed cell phone access for medical advice and guidance on factors that hinder their adherence to medication and only 3% of them needed it as a reminder to take their drugs. The majority (72%) preferred calling the healthcare provider with their own phones for convenience and confidential purposes with only 0.4% preferring to be called or texted by the health care provider. Most (94%), especially the older patients, had no problem with their confidentiality being infringed in the process of the conversation as per the bivariate

  18. Academic Hospitality

    Science.gov (United States)

    Phipps, Alison; Barnett, Ronald

    2007-01-01

    Academic hospitality is a feature of academic life. It takes many forms. It takes material form in the hosting of academics giving papers. It takes epistemological form in the welcome of new ideas. It takes linguistic form in the translation of academic work into other languages, and it takes touristic form through the welcome and generosity with…

  19. Hospitality and hostility in hospitals

    DEFF Research Database (Denmark)

    Jensen, Tina Blegind; Aanestad, Margunn

    2007-01-01

    The purpose of this paper is to discuss the adoption of healthcare information systems (HIS) from a user perspective. Our case study concerns how a group of orthopaedic surgeons experienced and reacted to the adoption and mandatory use of an Electronic Patient Record system in a Danish hospital. We...... propose to use the concepts of hospitality and hostility to turn our attention to the interaction between the host (the surgeons) and the guest (the information system) and consider how the boundaries between them evolved in the everyday work practices. As an alternative to previous studies on technology...

  20. [Long-term psychiatric hospitalizations].

    Science.gov (United States)

    Plancke, L; Amariei, A

    2017-02-01

    significantly less risk of long-term hospitalization than those of large cities. We found no influence of material and social deprivation in the long-term hospitalizations. Long-term hospitalization in psychiatry only concerns a minority of patients but represents the fifth of the total number of days of full-time hospitalization. The recent patients were significantly less exposed to the risk of having a long-term hospitalization. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  1. Comparing safety climate in naval aviation and hospitals: implications for improving patient safety.

    Science.gov (United States)

    Singer, Sara J; Rosen, Amy; Zhao, Shibei; Ciavarelli, Anthony P; Gaba, David M

    2010-01-01

    Evidence of variation in safety climate suggests the need for improvement among at least some hospitals. However, comparisons only among hospitals may underestimate the improvement required. Comparison of hospitals with analogous industries may provide a broader perspective on the safety status of our nation's hospitals. The purpose of this study was to compare safety climate among hospital workers with personnel from naval aviation, an organization that operates with high reliability despite intrinsically hazardous conditions. We surveyed a random sample of health care workers in 67 U.S. hospitals and, for generalizability, 30 veterans affairs hospitals using questions comparable with those posed at approximately the same time (2007) to a census of personnel from 35 squadrons of U.S. naval aviators. We received 13,841 (41%) completed surveys in U.S. hospitals, 5,511 (50%) in veterans affairs hospitals, and 14,854 (82%) among naval aviators. We examined differences in respondents' perceptions of safety climate at their institution overall and for 16 individual items. Safety climate was three times better on average among naval aviators than among hospital personnel. Naval aviators perceived a safer climate (up to seven times safer) than hospital personnel with respect to each of the 16 survey items. Compared with hospital managers, naval commanders perceived climate more like frontline personnel did. When contrasting naval aviators with hospital personnel working in comparably hazardous areas, safety climate discrepancies increased rather than decreased. One individual hospital performed as well as naval aviation on average, and at least one hospital outperformed the Navy benchmark for all but three individual survey items. Results suggest that hospitals have not sufficiently created a uniform priority of safety. However, if each hospital performed as well as the top-performing hospital in each area measured, hospitals could achieve safety climate levels comparable

  2. Development of the Ensemble Navy Aerosol Analysis Prediction System (ENAAPS and its application of the Data Assimilation Research Testbed (DART in support of aerosol forecasting

    Directory of Open Access Journals (Sweden)

    J. I. Rubin

    2016-03-01

    Full Text Available An ensemble-based forecast and data assimilation system has been developed for use in Navy aerosol forecasting. The system makes use of an ensemble of the Navy Aerosol Analysis Prediction System (ENAAPS at 1 × 1°, combined with an ensemble adjustment Kalman filter from NCAR's Data Assimilation Research Testbed (DART. The base ENAAPS-DART system discussed in this work utilizes the Navy Operational Global Analysis Prediction System (NOGAPS meteorological ensemble to drive offline NAAPS simulations coupled with the DART ensemble Kalman filter architecture to assimilate bias-corrected MODIS aerosol optical thickness (AOT retrievals. This work outlines the optimization of the 20-member ensemble system, including consideration of meteorology and source-perturbed ensemble members as well as covariance inflation. Additional tests with 80 meteorological and source members were also performed. An important finding of this work is that an adaptive covariance inflation method, which has not been previously tested for aerosol applications, was found to perform better than a temporally and spatially constant covariance inflation. Problems were identified with the constant inflation in regions with limited observational coverage. The second major finding of this work is that combined meteorology and aerosol source ensembles are superior to either in isolation and that both are necessary to produce a robust system with sufficient spread in the ensemble members as well as realistic correlation fields for spreading observational information. The inclusion of aerosol source ensembles improves correlation fields for large aerosol source regions, such as smoke and dust in Africa, by statistically separating freshly emitted from transported aerosol species. However, the source ensembles have limited efficacy during long-range transport. Conversely, the meteorological ensemble generates sufficient spread at the synoptic scale to enable observational impact

  3. A Walk in My Shoes: A Mixed-Method Study of the Role of Interprofessional Job Shadowing in Shaping Staff Attitudes at a Large Acute Care Hospital in Canada.

    Science.gov (United States)

    Piechnik, Melinda; Dempster, Linda

    2018-01-01

    Poor hospital unit culture and staff morale, and dysfunctional multidisciplinary cooperation leads to worse patient safety and satisfaction. The Walk in My Shoes research project aimed to understand how interprofessional job shadowing impacts the attitudes of colleagues. Thirty-three registered nurses at an acute care hospital observed the daily work of social workers. Nurses' attitudes towards social workers were measured by surveys and interviews. Quantitative data indicated a change in nurses' perception of social workers' communication, teamwork and autonomy. Qualitative data indicate that job shadowing helped participants identify personal misperceptions, provided new understanding of roles and gave insight into co-worker job similarities. © 2018 Longwoods Publishing.

  4. Consumer acceptance and aroma characterization of navy bean (Phaseolus vulgaris) powders prepared by extrusion and conventional processing methods.

    Science.gov (United States)

    Szczygiel, Edward J; Harte, Janice B; Strasburg, Gale M; Cho, Sungeun

    2017-09-01

    Food products produced with bean ingredients are gaining in popularity among consumers due to the reported health benefits. Navy bean (Phaseolus vulgaris) powder produced through extrusion can be considered as a resource-efficient alternative to conventional methods, which often involve high water inputs. Therefore, navy bean powders produced with extrusion and conventional methods were assessed for the impact of processing on consumer liking in end-use products and odor-active compounds. Consumer acceptance results reveal significant differences in flavor, texture and overall acceptance scores of several products produced with navy bean powder. Crackers produced with extruded navy bean powder received higher hedonic flavor ratings than those produced with commercial navy bean powder (P < 0.001). GC-O data showed that the commercial powder produced through conventional processing had much greater contents of several aliphatic aldehydes commonly formed via lipid oxidation, such as hexanal, octanal and nonanal with descriptors of 'grassy', 'nutty', 'fruity', 'dusty', and 'cleaner', compared to the extruded powder. Extrusion processed navy bean powders were preferred over commercial powders for certain navy bean powder applications. This is best explained by substantial differences in aroma profiles of the two powders that may have been caused by lipid oxidation. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

  5. Hospital Malnutrition

    OpenAIRE

    Asumadu-Sarkodie, Samuel

    2012-01-01

    Malnutrition seen in hospitals usually occurs as some form of protein-energy malnutrition (PEM). Primary PEM results from an acute or chronic deficiency of both protein and calories. Secondary PEM, or cachexia, results from a disease or medical condition such as cancer or gastrointestinal disease that alters requirements or impairs utilization of nutrients. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

  6. Evaluation of Soybean–Navy Bean Emulsions Using Different Processing Technologies

    Directory of Open Access Journals (Sweden)

    Sean X. Liu

    2017-05-01

    Full Text Available In this study, an innovative emulsion made from soybean and navy bean blends of different proportionalities was developed. In addition, two processing methods were used: traditional cooking and jet-cooking. The physical attributes and storage stability were measured and compared. This study found that the high content of starch and fiber in navy bean flour contributes to the increase in viscosity of the emulsions, at both room and refrigeration temperatures, as the proportion of navy bean flour in the blends increased. The steam jet-cooked emulsions with higher soybean content has better shelf life stability, smaller particle size, higher fat, lower starch, and lower viscosity, whereas the traditional kettle cooking method is better in reducing anti-nutritional components. No significant difference was found between the two cooking methods in terms of nutritional contents in the emulsions, such as protein, crude fat, and total starch. The traditional kettle cooking, with its longer cooking time, seems to reduce more trypsin inhibitor in the emulsions than those prepared with the steam jet-cooking. This exploratory study is the first to report soybean–navy bean beverage prototypes having desirable nutritional value and the potential for functional beverage market.

  7. The Advanced Navy Aerosol Model (ANAM) : Validation of small-particle modes

    NARCIS (Netherlands)

    Eijk, A.M.J. van; Kusmierczyk-Michulec, J.T.; Piazzola, J.P.

    2011-01-01

    The image quality of electro-optical sensors in the (lower-altitude marine) atmosphere is limited by aerosols, which cause contrast reduction due to transmission losses and impact on the thermal signature of objects by scattering solar radiation. The Advanced Navy Aerosol Model (ANAM) aims at

  8. U.S. Navy Employment Options for Unmanned Surface Vehicles (USVs)

    Science.gov (United States)

    2013-01-01

    the Navy had cleared in compliance with the Paris Peace Accords. The second condition under which minefield proofing is conducted is when there is...www.gdrs.com/about/profile/pdfs/UDTPacific2006_4A3_.pdf Bertram, Volker, “Unmanned Surface Vehicles: A Survey,” Brest , France: ENSIETA, 2008. As of

  9. A Survey of Accidental Hypothermia Knowledge among Navy Members in China and the Implications for Training

    Directory of Open Access Journals (Sweden)

    Shuang Li

    2016-03-01

    Full Text Available Objectives: Accidental hypothermia (AH is a potentially life-threatening condition that can lead to significant morbidity and life-long effects. Navy personnel are always at a greater risk of AH due to frequent outdoor work, wilderness exposure, prolonged immobility and exhaustion. The purpose of the survey was to assess Chinese Navy members’ awareness of AH and to make recommendations with regard to better measures for improving it. Methods: 111 Navy members completed a written questionnaire that was subsequently analyzed. Results: 30.6% of the respondents have experienced AH and 64.9% rated their knowledge of AH as “low” or “none”. Over half of them identified the initial symptom of AH as obvious shivering (69.4% and apathy (45.0%. As for the aggravate symptoms, 60.9% chose the wrong answer of more obvious shivering instead of the right one—absence of shivering (5.4%. In the case of the treatment of mild AH, more than half of the respondents chose the wrong answers. Conclusions: This study suggests that the basic skills of recognition and treatment of AH are inadequate in the Chinese Navy. Further work is required to develop a systematical, comprehensive and corresponding education method that would promote correct actions during AH.

  10. 77 FR 9628 - Taking and Importing Marine Mammals: Taking Marine Mammals Incidental to Navy's Mission...

    Science.gov (United States)

    2012-02-17

    ... revised LOA that is valid for two years, to take marine mammals by harassment incidental to the U.S. Navy... 3395). The application requested authorization, for a period of two years, to take, by harassment..., 2011 within the required timeframes and it is posted on NMFS Web site: http://www.nmfs.noaa.gov/pr...

  11. 77 FR 30996 - Taking and Importing Marine Mammals: Taking Marine Mammals Incidental to Navy's Research...

    Science.gov (United States)

    2012-05-24

    ... harassment incidental to its Research, Development, Test and Evaluation (RDT&E) activities at the NAVSEA... period of four years, to take, by harassment, marine mammals incidental to proposed training activities... Navy's 2011 RDT&E activities can be found in the exercise report posted on NMFS Web site: http://www...

  12. 78 FR 34047 - Takes of Marine Mammals Incidental to Specified Activities; Navy Research, Development, Test and...

    Science.gov (United States)

    2013-06-06

    ... levels for these animals may be estimated using TTS data from marine mammals and relationships between... Marine Mammals Incidental to Specified Activities; Navy Research, Development, Test and Evaluation Activities at the Naval Surface Warfare Center Panama City Division AGENCY: National Marine Fisheries Service...

  13. 75 FR 69295 - Taking and Importing Marine Mammals; Navy Training Activities Conducted Within the Northwest...

    Science.gov (United States)

    2010-11-10

    ..., Effects of Sound on Hearing of Marine Animals, and Passive Acoustic Detection, Classification, and... Taking and Importing Marine Mammals; Navy Training Activities Conducted Within the Northwest Training... Administration 50 CFR Part 218 [Docket No. 0906101030-0489-03] RIN 0648-AX88 Taking and Importing Marine Mammals...

  14. 78 FR 47282 - Takes of Marine Mammals Incidental to Specified Activities; Navy Research, Development, Test and...

    Science.gov (United States)

    2013-08-05

    ..., and location) and marine mammal and/or indicator presence, species, number of animals, their behavior... Marine Mammals Incidental to Specified Activities; Navy Research, Development, Test and Evaluation Activities at the Naval Surface Warfare Center Panama City Division AGENCY: National Marine Fisheries Service...

  15. Using Information Technology in the Navy Lessons Learned System to Improve Organizational Learning

    National Research Council Canada - National Science Library

    Garvey, Michael

    2001-01-01

    ... to support or enhance organizational learning in the Navy. The research concludes that NLLS has improved organizational learning but has not attained as widespread use as is possible. Recommendations are provide to improve the program and increase NLLS exposure to the fleet and to the potential users of the system.

  16. Return on Investment for the United States Navy’s Training with Industry Program

    Science.gov (United States)

    2017-06-01

    supply lines of operations: supply chain management , acquisition management , and operational logistics (NAVSUP, n.d...included logistics support. The Supply Corps’ overall mission today, “delivering sustained global logistics capabilities to the Navy and Joint Warfighter...exposure to managing logistics from the unit level to the strategic level. With each billet assigned, Supply Corps officers build

  17. Kinetic study of Saponins B stability in navy beans under different processing conditions

    Science.gov (United States)

    Saponins are rich in the legumes which are known to provide many health benefits for human beings. Saponins B is the main component in the saponins group present in navy beans. The stability of saponins B during food processing is a key issue to evaluating the quality and nutrition of food products....

  18. 32 CFR 705.11 - Supplying photographs and services to other than Navy and Marine Corps.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Supplying photographs and services to other than....11 Supplying photographs and services to other than Navy and Marine Corps. (a) To avoid competition with civilian photographic organizations, naval aircraft will not be used to take photographs for, nor...

  19. Navy-After-Next Contingency Producible Corvette (CPC): Emergency Production Historical Study

    National Research Council Canada - National Science Library

    McCarton, Matthew; Garzke, Bill

    2004-01-01

    ...?" Two approaches were tried by the U.S. Navy during World War One and Two. The first approach was to use an existing fleet destroyer design and attempt to accelerate production by increasing the number on order and the number of building yards...

  20. Secure and Resilient Functional Modeling for Navy Cyber-Physical Systems

    Science.gov (United States)

    2017-05-24

    control systems, it was determined that this project will employ the model of a Ship Chilled Water Distribution System as a central use case. This model...Siemens Corporation Corporate Technology Unrestricted. Distribution Statement A. Approved for public...release; distribution is unlimited. Page 1 of 4 Secure & Resilient Functional Modeling for Navy Cyber-Physical Systems FY17 Quarter 1 Technical Progress

  1. Leveraging ISI Multi-Model Prediction for Navy Operations: Proposal to the Office of Naval Research

    Science.gov (United States)

    2013-09-30

    Operations: Proposal to the Office of Naval Research” PI: Benjamin Kirtman University of Miami – RSMAS Meteorology and Physical Oceanography...Prediction for Navy Operations: Proposal to the Office of Naval Research 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d

  2. China Naval Modernization: Implications for U.S. Navy Capabilities -- Background and Issues for Congress

    Science.gov (United States)

    2008-09-12

    1995 the Spanish shipbuilder Empresa Nacional Bazan (now Navantia) offered to build for the PLAN a low-cost, lightweight conventional-takeoff-and...in one of China’s premier naval journals.172 These same observers stated that: Chinese researchers display intimate familiarity with all U.S. Navy

  3. China Naval Modernization: Implications for U.S. Navy Capabilities - Background and Issues for Congress

    Science.gov (United States)

    2008-11-19

    shipbuilder Empresa Nacional Bazan (now Navantia) offered to build for the PLAN a low-cost, lightweight conventional-takeoff-and-landing (CTOL) aircraft...observers stated that: Chinese researchers display intimate familiarity with all U.S. Navy submarine force programs, including the most cutting-edge

  4. Results of metallographical diagnostic examination of Navy half-watt thermoelectric converters degraded by accelerated tests

    International Nuclear Information System (INIS)

    Rosell, F.E. Jr.; Rouklove, P.G.

    1977-01-01

    To verify the 15-year reliability of the Navy half-watt radioisotope thermoelectric generator (RTG), bismuth--telluride thermoelectric converters were submitted to testing at high temperatures which accelerated the degradation and caused failure of the converters. Metallographic diagnostic examination of failed units verified failure mechanisms. Results of diagnostic examinations are presented

  5. The Philippine Navy’s Strategic Sail Plan 2020: A Strong and Credible Force by 2020

    Science.gov (United States)

    2017-06-09

    achieved by France and other NATO allies - where PME may well take twenty per cent of an officer’s career .”125 Why should it matter? Well, Till...small navies could use. These include: “work-shop based approaches,” toolkits (design interfaces), and “go-between” organizations.164 Mulqueen and

  6. A History of U.S. Navy Periscope Detection Radar, Sensor Design and Development

    Science.gov (United States)

    2014-12-31

    between horizontal and vertical polarization) is frequency- and depression -angle dependent. Both the “noisiness” of the spectra and the greater spectral...www.navy.mil/navydata/cno/n87/history.html Chief of Naval Operations. “n.d.” Submarine Warfare Division, Submarine Centennial Log Sheets. http

  7. The U.S. Navy’s Consultant Development and Qualification Program: Origin and Issues.

    Science.gov (United States)

    1984-03-01

    Navy-wide program, probably as part of an NMPC OE manual (Ref. 9]. a. Pcific Fleet The HRMSYSPACINST 1500.1 is an admirably brief instruction, thirty...profesional OD organizacion external. to USN. 5. The above guidance is not intended to preclude special activities or applications by individual Centers

  8. Navy John Lewis (TAO 205) Class Oiler Shipbuilding Program: Background and Issues for Congress

    Science.gov (United States)

    2016-08-18

    These wires are placed under tension to support fuel hoses for refueling operations or trolleys that move pallets of provisions, ammunition, or other...SECNAV Mabus Names First TAO(X) Next Generation Oiler After Rep. John Lewis,” USNI News, January 6, 2016. 6 Sam LaGrone, “Navy to Name Ship After Gay

  9. 77 FR 17033 - Taking and Importing Marine Mammals: Taking Marine Mammals Incidental to Navy's Training...

    Science.gov (United States)

    2012-03-23

    ... take marine mammals by harassment incidental to its training activities at the Gulf of Mexico (GOMEX... Importing Marine Mammals: Taking Marine Mammals Incidental to Navy's Training Activities at the Gulf of Mexico Range Complex AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric...

  10. A European Navy: Can it Complete European Political and Economic Integration?

    Science.gov (United States)

    2012-06-01

    would enjoy a comprehensive and complete defense structure, perhaps even more effective and cost-efficient than is possible with the current lineup ...malfunctions or operator error. A unified and unifying European Navy would standardize basic equipment and procedures , facilitating effective exercises

  11. Navy Virginia (SSN 774) Class Attack Submarine Procurement: Background and Issues for Congress

    Science.gov (United States)

    2016-10-25

    Implications for U.S. Navy Capabilities—Background and Issues for Congress, by Ronald O’Rourke. 45 Stephen J. Hadley and William J. Perry, co...Generally speaking, delays in maintenance periods will impact the overall operational availability of the submarine force,” Lt. Cmdr. Tim Hawkins

  12. Navy Force Structure and Shipbuilding Plans: Background and Issues for Congress

    Science.gov (United States)

    2017-02-02

    international relations and strategy of basic world geographic features such as the size and location of continents, oceans, and individual countries. From...Navy Force Structure and Shipbuilding Plans: Background and Issues for Congress Ronald O’Rourke Specialist in Naval Affairs February 2, 2017...

  13. A Case Study of Innovation and Change in the U.S. Navy Submarine Fleet

    Science.gov (United States)

    2012-12-01

    Speed thrills. Developing a corporate climate that thinks, moves and innovates fast can become addictive and lead to continuous improvements and...and their captions: Most Sailors entering the Navy can pick up a smartphone and handle it like an ace. They are familiar with the icons and display

  14. Navy Virginia (SSN-774) Class Attack Submarine Procurement: Background and Issues for Congress

    Science.gov (United States)

    2015-12-17

    acquisition strategy within Congress, and between Congress and the Department of Defense (DOD), that occurred in 1995-1997 (i.e., during the markup of...increasing demand for the unique capabilities they provide, could result in the Navy meeting an even smaller percentage of combatant commander

  15. Analysis Of Navy Hornet Squadron Mishap Costs With Regard To Previously Flown Flight Hours

    Science.gov (United States)

    2017-06-01

    Psychological Association ( APA ) manual guidelines for reporting statistics have recommended reporting exact p-values, and avoiding arbitrary...NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA THESIS Approved for public release. Distribution is unlimited. ANALYSIS OF NAVY...Advisor Kenneth Doerr THIS PAGE INTENTIONALLY LEFT BLANK i REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704-0188 Public reporting burden

  16. 77 FR 76170 - Presumption of Exposure to Herbicides for Blue Water Navy Vietnam Veterans Not Supported

    Science.gov (United States)

    2012-12-26

    ... during the Vietnam War. After careful review of the IOM report, the Secretary determines that the... served in deep-water naval vessels off the coast of Vietnam during the Vietnam War are referred to as... DEPARTMENT OF VETERANS AFFAIRS Presumption of Exposure to Herbicides for Blue Water Navy Vietnam...

  17. All-cause mortality and radar exposure among french navy personnel: a 30 years cohort study

    International Nuclear Information System (INIS)

    Dabouis, V.; Arvers, P.; Debouzy, J.C.; Perrin, A.; Hours, M.

    2006-01-01

    To improve operational performance in a modern navy force, radiofrequency (RF) and microwaves emitting devices are widely used. It has been suggested that exposure to electromagnetic fields could be associated with greater health hazards and higher mortality. The all-cause mortality of 39488 militaries of the French navy forces was studied over the period 1975-2001 with a cohort epidemiological study. They served from 1975 until 1995. In a first step, the mortality of radar exposed militaries was compared to a control group formed by militaries who served during the same period in the same environment but without radar exposure. Administrative procedures for identifying militaries and their vital status were equivalent in the radar and the control groups. The age standardized mortality ratio in the radar navy personnel was 0.70 (95% CI: 0.54-0.90). In professional militaries, no difference in mortality ratio was found according to duration of estimated exposure. During a 30 years period of observation, we found no increase in all-cause mortality in the French navy personnel who were close to radar equipments

  18. DefenseLink Feature: Navy Adm. Mike Mullen, New Chairman Lays Out Top

    Science.gov (United States)

    global risk to help us maintain a position of leadership and preserve our freedom of action to counter , Oct. 26, 2007 - In his first public speech as chairman of the Joint Chiefs of Staff, Navy Adm. Michael Posts About This Site DoD Inspector General Freedom of Information Privacy & Security External Link

  19. Combat Pair: The Evolution of Air Force-Navy Integration in Strike Warfare

    Science.gov (United States)

    2007-01-01

    a big ‘Bravo Zulu ’ [Navy vernacular for ‘well done’] for the terrific job they did. . . . We did not have a single complaint. We felt like our...another tribal representative, and reveal their hieroglyphics, which are translated by the other tribe into its own hieroglyphics and entered into

  20. A Comparative Analysis of the Budget Process in the Venezuelan and U.S. Navies.

    Science.gov (United States)

    1979-12-01

    accounting problems in particular agencies. The DINCA developed a document, Sistema de Contabilidad de la Ejecucion Financiera del Presupuesto para...orienta- tion of the "Plan Operativo Anual" (POA) - Operative Annual Plan. During the Navy’s mid-range planning process the POA is produced. By means of