Sample records for large navy hospital

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


    Cesarean sections . Navy CRNAs and anesthesiologist are assigned to cover the OB Department daily. Obstetrical services are offered in 18 of the 23...Program, reported in the Navy Nurse Corps Director’s Update that the United States is currently short 6,000 CRNAs and that the Navy Nurse Corps is short of...described in relation to the major research questions outlined in Chapter 1. The first section provides demographic and background data necessary to

  2. Trends and occupational associations in incidence of hospitalized pulmonary sarcoidosis and other lung diseases in Navy personnel: a 27-year historical prospective study, 1975-2001

    Gorham, Edward D; Garland, Cedric F; Garland, Frank C; Kaiser, Kevin; Travis, William D; Centeno, Jose A


    This study examines long-term trends in incidence rates of hospitalized pulmonary sarcoidosis in a large cohort of Navy personnel, and evaluates the possible relationship of sarcoidosis with occupation...

  3. Project HOPE volunteers and the Navy Hospital Ship Mercy.

    Timboe, Harold L; Holt, G Richard


    This article describes, from the perspective of Project HOPE volunteers, the precedent-setting, military-civilian partnership in staffing the USNS Mercy as part of the rapid response of the United States to the overwhelming devastation and loss of life resulting from the tsunami off the coast of Indonesia. The article discusses the designation of Project HOPE as the non-governmental organization to be the single source of volunteers for the USNS Mercy mission (providing approximately 100 volunteers for each of two 30-day rotations), some issues facing Project HOPE and the contingent of volunteers in recruiting, orienting, training, and preparing for the mission, steps taken to make this a successful mission despite the ambiguity and uncertainties involved in arriving in the relief area 1 month after the disaster, and some recommendations for similar future missions. The Project HOPE volunteers quickly integrated with the cadre of Navy health professionals to deliver a broad range of high-quality care, including tertiary care, attesting to the professionalism and standards common to military and civilian medicine. The combined success of all organizations involved truly heralds a new era of medical diplomacy and goodwill in which the United States can take great pride.

  4. Hospital ships adrift? Part 2: the role of US Navy hospital ship humanitarian assistance missions in building partnerships.

    Licina, Derek; Mookherji, Sangeeta; Migliaccio, Gene; Ringer, Cheryl


    US Navy hospital ships are used as a foreign policy instrument to achieve various objectives that include building partnerships. Despite substantial resource investment by the Department of Defense (DoD) in these missions, their impact is unclear. The purpose of this study was to understand how and why hospital ship missions influence partnerships among the different participants. An embedded case study was used and included the hospital ship Mercy's mission to Timor-Leste in 2008 and 2010 with four units of analysis: the US government, partner nation, host nation, and nongovernmental organizations. Key stakeholders representing each unit were interviewed using open-ended questions that explored the experiences of each participant and their organization. Findings were analyzed using a priori domains from a proposed partnership theoretical framework. A documentary review of key policy, guidance, and planning documents was also conducted. Fifteen themes related to how and why hospital ship missions influence partnerships emerged from the 37 interviews and documentary review. The five most prominent included: developing relationships, developing new perspectives, sharing resources, understanding partner constraints, and developing credibility. Facilitators to joining the mission included partner nations seeking a regional presence and senior executive relationships. Enablers included historical relationships and host nation receptivity. The primary barrier to joining was the military leading the mission. Internal constraints included the short mission duration, participant resentment, and lack of personnel continuity. External constraints included low host nation and United States Agency for International Development (USAID) capacity. The research finds the idea of building partnerships exists among most units of analysis. However, the results show a delay in downstream effects of generating action and impact among the participants. Without a common partnership

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


    34sPt(11e UNCLASSIFIED .L*..u4iy CLASSiFiCATION oF THItS PA _( w Doe Ent.etd) currently designated Navy enlisted occupations, 20 Naval Enlisted Classi... EDUCAION AND TRAINING. APPfN-Y Cl,,jAUG ඒ N001 69 ’ -0 Ś UNCLASSIF EDUL NC 5 - IIl.IIIII -II-I fl25 IllU 1. I~ L.8 1.25 .4 .6__ MICRfl t n I UR l~ therapy; giving chest physical therapy; suctioning nasal and oral pas - sages and trachea and giving tracheotomy care. 9. Precautionary measures

  6. The Epidemiology of Back-Related Hospitalizations Among U.S. Navy Personnel


    Sacroiliac Joint (12.5%), and Fracture/Fracture- Dislocation of Vertebral Column Without Spinal Cord Lesion (12.0%). Table 1 Demographic Summary of Navy...Other or Unspecified 2,302 17.6 Back Part Sprain/Strain Sacroiliac Joint 1,636 12.5 Fracture/Fracture-Dislocation of 1,575 12.0 Vertebral Column...Without Spinal Cord Lesion Affection of Sacroiliac Joint 197 1.5 Fracture/Fracture-Dislocation of 115 .9 Vertebral Column With Spinal Cord Lesion Open

  7. Depression during pregnancy: Prevalence and obstetric risk factors among pregnant women attending a tertiary care hospital in Navi Mumbai

    Shaunak Ajinkya


    Full Text Available Context: Depression affects about 20% of women during their lifetime, with pregnancy being a period of high vulnerability. Prevalence of depression during pregnancy ranges from 4% to 20%. Several risk factors predispose to depression during pregnancy including obstetric factors. Depression during pregnancy is not only the strongest risk factor for post-natal depression but also leads to adverse obstetric outcomes. Aims: To study the prevalence of depression during pregnancy and its associated obstetric risk factors among pregnant women attending routine antenatal checkup. Settings and Design: Cross-sectional observational survey done at the outpatient department (OPD of the department of obstetrics of a tertiary care hospital in Navi Mumbai. Materials and Methods: One hundred and eighty-five pregnant women were randomly administered the Beck Depression Inventory (BDI for detecting depression. Additional socio-demographic and obstetric history was recorded and analyzed. Results: Prevalence of depression during pregnancy was found to be 9.18% based upon BDI, and it was significantly associated with several obstetric risk factors like gravidity (P = 0.0092, unplanned pregnancy (P = 0.001, history of abortions (P = 0.0001, and a history of obstetric complications, both present (P = 0.0001 and past (P = 0.0001. Conclusions: Depression during pregnancy is prevalent among pregnant women in Navi-Mumbai, and several obstetric risk factors were associated to depression during pregnancy. Future research in this area is needed, which will clearly elucidate the potential long-term impact of depression during pregnancy and associated obstetric risk factors so as to help health professionals identify vulnerable groups for early detection, diagnosis, and providing effective interventions for depression during pregnancy.

  8. NAVIS-An UGV Indoor Positioning System Using Laser Scan Matching for Large-Area Real-Time Applications

    Jian Tang


    Full Text Available Laser scan matching with grid-based maps is a promising tool for real-time indoor positioning of mobile Unmanned Ground Vehicles (UGVs. While there are critical implementation problems, such as the ability to estimate the position by sensing the unknown indoor environment with sufficient accuracy and low enough latency for stable vehicle control, further development work is necessary. Unfortunately, most of the existing methods employ heuristics for quick positioning in which numerous accumulated errors easily lead to loss of positioning accuracy. This severely restricts its applications in large areas and over lengthy periods of time. This paper introduces an efficient real-time mobile UGV indoor positioning system for large-area applications using laser scan matching with an improved probabilistically-motivated Maximum Likelihood Estimation (IMLE algorithm, which is based on a multi-resolution patch-divided grid likelihood map. Compared with traditional methods, the improvements embodied in IMLE include: (a Iterative Closed Point (ICP preprocessing, which adaptively decreases the search scope; (b a totally brute search matching method on multi-resolution map layers, based on the likelihood value between current laser scan and the grid map within refined search scope, adopted to obtain the global optimum position at each scan matching; and (c a patch-divided likelihood map supporting a large indoor area. A UGV platform called NAVIS was designed, manufactured, and tested based on a low-cost robot integrating a LiDAR and an odometer sensor to verify the IMLE algorithm. A series of experiments based on simulated data and field tests with NAVIS proved that the proposed IMEL algorithm is a better way to perform local scan matching that can offer a quick and stable positioning solution with high accuracy so it can be part of a large area localization/mapping, application. The NAVIS platform can reach an updating rate of 12 Hz in a feature

  9. Rating of Patient Satisfaction Factors in a Clinical Hyperbaric Centre of a Greek Navy Hospital

    Angeliki Chandrinou


    Full Text Available Background: Modern medical technology has promoted the creation and improved the organization of Diving and Hyperbaric Medical Units (DHMU.Objective: This study evaluates patient satisfaction regarding services provided by the DHMU’s in Attica, Greece.Material and Method: This is a descriptive study, its sample constitutes of 91 patients admitted at the DHMU of Navy for Hyperbaric Oxygen (HBO therapy. For the collection of data an anonymous selfadministered, 2-part questionnaire was utilized. The first part consisted of questions recording sociodemographicdata, while the second constituted of questions investigating the satisfaction of patients from the DHMU with a five-point Likert scale. The data was analyzed using SPSS (ver 17.Results: A total of 91 patients (53 male, 38 female with a mean age of 35.5 years, sd=+/-7.245 participated in the study. Most of them 44% were university graduates. Patients’ satisfaction from theservices provided at DHMU was up to 85.7%, while 87.6% of them highly appreciated the prompt initiating and availability of sessions and rated telephone communication with the DHMU as exceptional. Personnel were described by patients as polite (94.4%, respectful (95.6% and discrete (94.5%. The 92% of patients understood the importance of abiding by the rules of safety from nurses. Gender, age and the number or treatments were the characteristics that correlated statistically withpatients’ satisfaction from the services provided at a Greek Diving and Hyperbaric Medical Unit.Conclusion: The patients rated care and access to the particular D.H.M.U. as most excellent. Greek patients experience great satisfaction from the Naval Diving and Hyperbaric Medical Unit.

  10. The Navy Needs More Comprehensive Guidance for Evaluating and Supporting CostEffectiveness of LargeScale Renewable Energy Projects (REDACTED)


    project cost to current dollar value. 15 According to REPO personnel, the minimum kilowatt-hours represents less than 5 percent of the Navy’s total...No. DODIG-2016-130 The Navy Needs More Comprehensive Guidance for Evaluating and Supporting Cost -Effectiveness of Large-Scale Renewable Energy...Defense that supports the warfighter; promotes accountability , integrity, and efficiency; advises the Secretary of Defense and Congress; and informs

  11. Navy and Marine Corps Medical News. Issue 24


    Recognized as Navy Internist of the Year Navy Medicine is Committed to All We Are Honored to Serve NASA Trains Rota Med Personnel to Support Shuttle...December 19, 2008 Page 7 NHB Internal Med Dept Head Recognized as Navy Internist of the Year By Douglas H Stutz, Naval Hospital Bremerton Public...lected as the top Navy Internist of the Year by receiving the Sparks Award for Outstanding Internist of the Year at a Family Medicine or Non

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


    Groton, Connecticut, is the only submarine museum operated by the United States Navy and today serves as the primary repository for artifacts ...all of the large non-combatant ship missions such as command ships, tenders, hospital ships, ground vehicle delivery, and logistics; and

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

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


    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.

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

    Bartel, Marilynn


    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

  15. Recurrence of inguinal hernias repaired in a large hernia surgical specialty hospital and general hospitals in Ontario, Canada.

    Malik, Atiqa; Bell, Chaim M; Stukel, Thérèse A; Urbach, David R


    The effect of hospital specialization on the risk of hernia recurrence after inguinal hernia repair is not well described. We studied Ontario residents who had primary elective inguinal hernia repair at an Ontario hospital between 1993 and 2007 using population-based, administrative health data. We compared patients from a large hernia specialty hospital (Shouldice Hospital) with those from general hospitals to determine the risk of recurrence. We studied 235 192 patients, 27.7% of whom had surgery at Shouldice hospital. The age-standardized proportion of patients who had a recurrence ranged from 5.21% (95% confidence interval [CI] 4.94%-5.49%) among patients who had surgery at the lowest volume general hospitals to 4.79% (95% CI 4.54%-5.04%) who had surgery at the highest volume general hospitals. In contrast, patients who had surgery at the Shouldice Hospital had an age-standardized recurrence risk of 1.15% (95% CI 1.05%-1.25%). Compared with patients who had surgery at the lowest volume hospitals, hernia recurrence among those treated at the Shouldice Hospital was significantly lower after adjustment for the effects of age, sex, comorbidity and income level (adjusted hazard ratio 0.21, 95% CI 0.19-0.23, p hernia repair at Shouldice Hospital was associated with a significantly lower risk of subsequent surgery for recurrence than repair at a general hospital. While specialty hospitals may have better outcomes for treatment of common surgical conditions than general hospitals, these benefits must be weighed against potential negative impacts on clinical care and the financial sustainability of general hospitals.

  16. Preparedness planning for pandemic influenza among large US maternity hospitals

    A Akers


    Full Text Available The objective of this investigation was to determine the state of pandemic influenza preparedness and to delineate commonly reported challenges among a sample of larger US national maternity hospitals. This was done given the recent emphasis on hospital disaster planning and the disproportionate morbidity and mortality that pregnant women have suffered in previous influenza pandemics. An internet-based survey was sent to all 12 members of the Council of Women's and Infants' Specialty Hospitals. Questions addressed hospital demographics and overall pandemic preparedness planning, including presence of a pandemic planning committee and the existence of written plans addressing communications, surge capacity, degradation of services, and advance supply planning. Nine of 12 (75% hospitals responded. All had active pandemic planning committees with identified leadership. The majority (78% had written formal plans regarding back-up communications, surge/overflow capacity, and degradation of services. However, fewer (44% reported having written plans in place regarding supply-line/stockpiling of resources. The most common challenges noted were staff and supply coordination, ethical distribution of limited medical resources, and coordination with government agencies. In conclusion, the majority of the Council of Women's and Infants' Specialty Hospitals maternity hospitals have preliminary infrastructure for pandemic influenza planning, but many challenges exist to optimize maternal and fetal outcomes during the next influenza pandemic.

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


    NAVY ADDITIVE MANUFACTURING TECHNOLOGIES The Navy currently operates AM machines in depots, labs, hospitals and other warfare centers. Four major...Lorincz, J. (2014). Additive Joins Subtractive on Advanced All-in-One Machines . Manufacturing Engineering, 152(4), 67–69,71–72,74–77. McNulty, C. M...NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA MBA PROFESSIONAL REPORT NAVY ADDITIVE MANUFACTURING : POLICY ANALYSIS FOR FUTURE

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

    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.

  19. Navy Geothermal Plan


    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.

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

    Kuperstein, Inna; Cohen, David PA; POOK, Stuart; Viara, Eric; Calzone, Laurence; Barillot, Emmanuel; Zinovyev, Andrei


    International audience; BACKGROUND: 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 capabi...

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

    Kuperstein, Inna; Cohen, David PA; POOK, Stuart; Calzone, Laurence; Barillot, Emmanuel; Zinovyev, Andrei


    Molecular biology knowledge can be systematically represented in a computer-readable form as a comprehensive map of molecular interactions. There exist a number of maps of molecular interactions containing detailed description of various cell mechanisms. It is difficult to explore these large maps, to comment their content and to maintain them. Though there exist several tools addressing these problems individually, the scientific community still lacks an environment that combines these three...

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

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


    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).

  3. Navy Fuel Research Facility

    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...

  4. United States Navy DL Perspective


    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://s-ile

  5. [The organization of system of quality management in large multitype hospital].

    Taĭts, B M; Krichmar, G N; Stvolinskiĭ, I Iu; Grandilevskaia, O L


    The article presents the characteristics and assessment of functioning of model of quality management in large multitype hospital. The results of work of the municipal hospital of Saint Venerable martyr Elizabeth of St Petersburg concerning the implementation of system of quality management in 2001-2011 of the foundation of principles of total quality management of medical service and principles of quality management according international standards ISO and their Russian analogues.

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

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


    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.

  7. 海军飞行人员住院疾病谱及停飞疾病谱分析%Analysis of the hospitalizing and grounding related disease spectrums of Navy flying personnel

    李鸣皋; 马贵喜; 李靖; 蒙果; 刘玉


    目的 分析2001-2006年海军飞行人员住院和医学停飞的主要疾病构成及其变迁特点,并对突出问题提出对策建议.方法 对2001-2006年海军总医院收治的飞行人员全部病例和2001-2006年海军飞行人员医学停飞的全部资料进行统计分析,并同以往不同时期海军飞行人员主要疾病和医学停飞疾病资料进行对比研究.结果 ①飞行人员颈椎腰椎疾病明显增多,其疾病构成比达19.1%,医学停飞构成比达140.0%,均位居第1位;②头痛、自主神经功能紊乱等功能性疾病仍然是飞行人员住院和医学停飞的主要原因之一,疾病构成比分别为18.3%与11.3%,医学停飞构成比分别为11.0%与10.0%;③晕厥(包括加速度耐力性晕厥),在住院疾病构成比仅为4.2%,但其医学停飞构成比达13.0%;④消化系统疾病和传染性疾病无论是住院还是医学停飞构成比均逐渐降低,排序亦逐渐靠后,但出现个别性传播性疾病值得重视.结论 飞行人员住院和医学停飞主要疾病与飞行职业因素密切相关,针对飞行人员的职业特点采取合理锻炼和有效装备防护,积极心理学干预和心血管疾病预防等措施,对降低飞行人员患病率和医学停飞率具有重要意义.%Objective To investigate the spectrum of principal diseases that caused flying personnel hospitalized and then grounded from 2001 to 2006, as well as the changes in spectrum in order to provide countermeasure suggestions. Methods The case history data of hospitalized and grounded navy flying personnel from 2001 to 2006 were reviewed and compared to those during other periods. Results ① The incidence of cervical and lumbar spine disorder rose remarkably in navy flying personnel and its constituent ratios that resulted in flying personnel hospitalized and grounded reached 19.1% and 14.0% respectively. Both constituent ratios ranked the first in hospitalization and grounding reasons. ② Headache, neurasthenia

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

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


    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.

  9. Navy superconductivity efforts

    Gubser, D. U.


    Both the new high temperature superconductors (HTS) and the low temperature superconductors (LTS) are important components of Navy's total plan to integrate superconductivity into field operational systems. Fundamental research is an important component of the total Navy program and focuses on the HTS materials. Power applications (ship propulsion, etc.) use LTS materials while space applications (MMW electronics, etc.) use HTS materials. The Space Experiment being conducted at NRL will involve space flight testing of HTS devices built by industry and will demonstrate the ability to engineer and space qualify these devices for systems use. Another important component of the Navy's effort is the development of Superconducting Quantum Interference Device (SQUID) magnetometers. This program will use LTS materials initially, but plans to implement HTS materials as soon as possible. Hybrid HTS/LTS systems are probable in many applications. A review of the status of the Navy's HTS materials research is given as well as an update on the Navy's development efforts in superconductivity, with particular emphasis on the related SDIO sponsored program on HTS applications.

  10. US Navy superconductivity program

    Gubser, Donald U.


    Both the new high temperature superconductors (HTS) and the low temperature superconductors (LTS) are important components of the Navy's total plan to integrate superconductivity into field operational systems. Fundamental research is an important component of the total Navy program and focuses on the HTS materials. Power applications (ship propulsion) use LTS materials while space applications (millimeter wave electronics) use HTS materials. The Space Experiment to be conducted at NRL will involve space flight testing of HTS devices built by industry and will demonstrate the ability to engineer and space qualify these devices for systems use. Another important component of the Navy's effort is the development of Superconducting Quantum Interference Device (SQUID) magnetometers. This program will use LTS materials initially, but plans to implement HTS materials as soon as possible. Hybrid HTS/LTS systems are probable in many applications. A review of the status of the Navy's HTS materials research is given as well as an update on the Navy's development efforts in superconductivity.

  11. Navy superconductivity efforts

    Gubser, D. U.


    Both the new high temperature superconductors (HTS) and the low temperature superconductors (LTS) are important components of Navy's total plan to integrate superconductivity into field operational systems. Fundamental research is an important component of the total Navy program and focuses on the HTS materials. Power applications (ship propulsion, etc.) use LTS materials while space applications (MMW electronics, etc.) use HTS materials. The Space Experiment being conducted at NRL will involve space flight testing of HTS devices built by industry and will demonstrate the ability to engineer and space qualify these devices for systems use. Another important component of the Navy's effort is the development of Superconducting Quantum Interference Device (SQUID) magnetometers. This program will use LTS materials initially, but plans to implement HTS materials as soon as possible. Hybrid HTS/LTS systems are probable in many applications. A review of the status of the Navy's HTS materials research is given as well as an update on the Navy's development efforts in superconductivity, with particular emphasis on the related SDIO sponsored program on HTS applications.

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

    Waressara Weerawat


    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.

  13. A generic discrete-event simulation model for outpatient clinics in a large public hospital.

    Weerawat, Waressara; Pichitlamken, Juta; Subsombat, Peerapong


    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.

  14. [Aspects of development of surgical service of modem Navy].

    Kabanov, M Iu; Gaĭdash, A A; Rukhliada, N V; Solov'ev, I A; Titov, R V; Utochkin, A P; Smirnov, S I; Smolin, N V; Tiurin, M V


    The article is devoted to the aspects of a current state of surgical service in the Navy, prospects of development of professianl training for navy surgeons, formation of modern training comlex, united electronic library, containig the issues about combat surgical trauma, software technologies, realizing of the application methodology during the process of training and practical activity for the development of the training system for surgeons of Navy and improvement of effectiveness. Formation of normative technical documents, regulating activity of navy surgians is also among the expectations. The authors also touched on the issues of development of modern technologies in bone grafting with the help of domestic implants based on the osteoinductive nanostructured nonorganic matrices (titanium) with defined structure and composition. Department of navy and hospital surgery participate in this debelopment. Due to increased amount of oncologic patients, it was decided to establish the Cancer Center of the Ministry of Defense based on department of navy and hospital surgery of the Kirov Military Medical Academy. It makes possible to perform the following procedures: canser surgery; surgical repair; plastic repair of major vessels, bone and soft tissue grafting, removal of residual cancer cells with the help of loco-regional methods of hyperthermic intracavitary and intravascular chemoperfusion; diagnostics and treatment of recurrent tumors (surgical and radiation treatment, systemic chemotherapy, loco-regional chemoembolization. Each of the given methods help to develop and improve the innovation technologies.

  15. HIV-infected women delivering without antenatal care in a large Bangkok hospital, 1997.

    Bennetts, A; Inneam, B; Krajangthong, R; Bhengsri, S; Jetsawang, B; Siriwasin, W; Simond, R J; Shaffer, N


    The aim was to estimate the proportion of HIV-infected women giving birth at a large Bangkok hospital who had not received antenatal care (ANC) and to identify predictors of not receiving ANC. At Rajavithi Hospital, Bangkok, women with ANC are routinely tested for HIV at their first antenatal visit; women without ANC are routinely tested at delivery. Hospital staff interview all HIV-infected women and record sociodemographic and HIV risk factor information in a delivery room log book. We abstracted and analyzed data recorded in this log book for all HIV-infected women who gave birth at Rajavithi Hospital in 1997. Of 303 HIV-infected women who gave birth, 75% had received ANC at Rajavithi Hospital, 10% had received ANC at other locations, and 15% had not received ANC. On multivariate analysis, HIV-infected women who had received ANC were more likely to work or have partners who worked in construction (25% vs 11%; adjusted odds ratio [AOR]; 2.6; p = 0.03) or have a history of injection drug use (4% vs 0.4%; AOR = 20.8; p = 0.02) than those who had not received ANC, but were less likely to report their current partner as a risk factor for acquiring HIV infection (22% vs. 40%; AOR = 0.4; p = 0.05). Because a substantial number of HIV-infected women give birth in this large Bangkok hospital without receiving ANC, interventions are needed to increase the number of HIV-infected women who receive ANC and to prevent perinatal HIV transmission from HIV-infected pregnant women who have not received ANC.

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

    Lu, Lingbo; Li, Jingshan; Gisler, Paula


    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. Cruiser Navy of Poland

    Igor V. Yurin


    Full Text Available This article is dedicated to the description of the history of appearance in the Navy of Poland the ships of class cruiser. The brief characteristic of the Polish fleet before World War II is given. There is given the history of the acquisition in Belgium of the former French cruiser «D’Entrecasteaux», converted into the training ship «Baltyk». Is told about the appearance in the composition of Polish Navy of the former British cruisers HMS «Dragon» and HMS «Danaya», renamed in «Conrad», their technical characteristics are given, is described the history of their building and service in the British fleet, target run in the composition of Polish Navy is outlined. There is described the sinking cruiser «Conrad» by the German guided torpedo «Neger».

  18. A Market, Operation, and Mission Assessment of Large Rural For-Profit Hospitals with Positive Cash Flow

    McCue, Michael J.


    Context: National benchmark data for 2002 indicate that large rural for-profit hospitals have a median cash flow margin of 19.5% compared to 9.2% for their nonprofit counterparts. Purpose: This study aims to gain insight regarding the driving factors behind the high cash flow performance of large rural for-profit hospitals. Methods: Using 3 annual…

  19. Comparative analysis of ECGs in navy personnel onboard large and small vessels during prolonged deployment at sea%海军护航不同舰艇官兵的心电图对比分析

    杨翅; 蒋建华; 柳兵; 陈文; 彭焕亭


    目的:观察海军大、小不同类型舰艇亚丁湾护航返回官兵心电图特点。方法对赴亚丁湾海域护航返回的某补给舰(简称大舰组)140名官兵、某护卫舰(简称小舰组)79名官兵,分别在2艘舰艇返回靠泊的当天,行常规体表12导联心电图检测,比较心电图异常及心率、各波间期的变化情况。结果小舰组官兵室性早搏发生率高于大舰组官兵,差异有统计学意义(P<0.05);心率、左心室高电压、ST-T改变、早期复极、间歇性Ⅰ度或Ⅱ度Ⅰ型房室传导阻滞及各波形的间期差异均无统计学意义(P>0.05)。结论小舰官兵心律失常发生率高于大舰官兵,可能与小舰官兵自主神经功能失衡程度高,造成交感神经兴奋性增高有关。%Objective To observe the change features of ECG in navy personnel onboard large and small vessels after they re -turn from prolonged deployment to the Gulf of Aden .Methods One hundred and forty navy personnel onboard the auxiliary ship ( sim-ply designated as the large vessel ) and 79 people onboard the escort ( simply called the small vessel ) respectively received routine body surface 12-lead ECG detection , on the day they returned to the homeport , following prolonged deployment at sea .Abnormality in ECG and changes in heart rate and wave intervals were compared between the 2 ship crews.Results The incidence of premature ventricular contraction for the afloat personnel onboard the small vessel was higher than that for those onboard the large vessel (P0.05).Conclusion The incidence of arrhythmia for the afloat personnel onboard small vessel was evidently higher than that for the afloat personnel onboard the large ves -sel, which might be related with autonomic nervous system dysfunction and increased sympathetic nerve excitability .

  20. Navy Expeditionary Support


    are issued the credit cards in their name by a central bank, currently Citibank for the Navy. By regulation, the purchase cardholder makes to eliminate these disparities. The rapid development of new technologies , especially in response to changing enemy tactics, does present a valid

  1. Outbreak of Salmonella infantis infection in a large animal veterinary teaching hospital.

    Tillotson, K; Savage, C J; Salman, M D; Gentry-Weeks, C R; Rice, D; Fedorka-Cray, P J; Hendrickson, D A; Jones, R L; Nelson, W; Traub-Dargatz, J L


    During the past 11 years, there have been numerous reports of outbreaks of salmonellosis involving horses in veterinary teaching hospitals. Some of these outbreaks have been associated with Salmonella serotypes not commonly associated with infection of horses. Salmonella infantis is among the more common Salmonella serotypes isolated from human beings, and is an important pathogen in the broiler chicken industry. However, it was not commonly isolated from horses or cattle on a national basis between 1993 and 1995. In this report, we describe an outbreak of S infantis infection among large animals, primarily horses, in a veterinary teaching hospital and the control measures that were implemented. Factors that appeared to be key in control of this outbreak in this hospital included providing biosecurity training sessions for hospital personnel, adopting a standard operating procedure manual for biosecurity procedures, installing additional handwashing sinks throughout the facility, painting the interior of the facility with a nontoxic readily cleanable paint, replacing the dirt flooring in 4 stalls with concrete flooring, and removing noncleanable surfaces such as rubber stall mats, wooden hay storage bins, and open grain bins. Our experience with this outbreak suggests that although it is virtually impossible to eliminate Salmonella organisms from the environment, minimizing contamination is possible. Prevention of nosocomial infection must be approached in a multifaceted manner and care must be taken to search out covert sources of contamination, especially if standard intervention procedures do not prevent spread of the disease.

  2. [Prevalence of burnout syndrome in nursing staff in a large hospital in south of Brazil].

    Moreira, Davi de Souza; Magnago, Renata Faverzani; Sakae, Thiago Mamôru; Magajewski, Flávio Ricardo Liberali


    Burnout syndrome is a chronic adaptive disorder that affects workers and is characterized by three forms of psychological distress: emotional exhaustion, depersonalization, and a sense of low personal fulfillment. A cross-sectional quantitative design was used to apply questionnaires including socio-cultural data and the Maslach Burnout Inventory in 151 nurses and nurse technicians, representing 54.1% of this professional category in a large general hospital in Tubarão, Santa Catarina State, Brazil. Mean scores were: emotional exhaustion (17), depersonalization (7.79), and low personal fulfillment (36.6). According to the criterion proposed by Ramirez et al., no cases of burnout were diagnosed. According to the criteria by Grunfeld et al., 35.7% of the interviewees displayed burnout. The standard profile of workers with burnout identified in the study was: nurse technicians, female gender, age 26-35 years, married, with no children, and with five or more years in the profession. Hospital wards or areas with the highest proportion of nursing staff with burnout were the grouped hospital sectors (42.6%), ICU (25.9%), and neonatal ICU (18.5%). There was no statistically significant association between ward or hospital area and burnout.

  3. A market, operation, and mission assessment of large rural for-profit hospitals with positive cash flow.

    McCue, Michael J


    National benchmark data for 2002 indicate that large rural for-profit hospitals have a median cash flow margin of 19.5% compared to 9.2% for their nonprofit counterparts. This study aims to gain insight regarding the driving factors behind the high cash flow performance of large rural for-profit hospitals. Using 3 annual periods of Centers for Medicare and Medicaid cost report data with the last fiscal year ending between September 30, 2002, and August 30, 2003, the study found a cash flow margin of 21.5% for the large rural for-profit hospitals. All these facilities were owned by hospital management companies. To assess their underlying market, operational, and mission factors, these hospitals were compared to a similar comparison group of large rural nonprofit hospitals that are system owned and have positive cash flows. Using logistic regression analysis, the study found lower operating expense per adjusted discharge and salary expense as a percentage of total operating expense among large rural for-profit, system-owned hospitals with positive cash flows relative to nonprofits with similar traits. Overall, the findings of this study reflect how these for-profit hospitals, which are owned by hospital management companies, focus on controlling their labor costs as well as operating costs per discharge in order to achieve a greater positive cash flow position.

  4. Hospitals

    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...

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

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


    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.

  6. Survey Evaluation of the Indoor Environment Quality in a Large Romanian Hospital

    Cristiana CROITORU


    Full Text Available The medical units represent a challenge for the building services engineers who are often put in difficulty to ensure the indoor optimal conditions. The destination variety of the indoor environment in such buildings and the different internal thermal loads lead to discomfort zones, for all involved users. The requirements imposed by standards lead often to dissatisfaction for the users: while some of the medical staff asks for low temperatures, others feel discomfort and often the patients have thermoregulatory problems due to this non-homogeneity of thermal conditions found.Several sets of survey studies were made in a large emergency hospital located in Romania of 1070 beds. Medical and non-medical team participated in this study regarding the indoor quality from different work-zones of this hospital. The zones studied were: internal medicine, cardiology, gastroenterology, hematology, neurology, neurological recovery, the emergency unit, and also functional and auxiliary areas: dietetics, administrative, statistics, etc.All the queried persons had to response to a 15 minutes questionnaire, where local and global comfort questions were asked, in addition to specific characteristics like gender, age etc.The results have shown high differences from one zone to another and more of that, high differences between the categories of personnel. Uncomfortable thermal sensations, lack of fresh air and important level of polluted air, noise or lack of space are just some of the problems met in hospital environment.

  7. Birth of U.S. Naval Aeronautics and the Navy’s Aerodynamics Laboratory


    by the Aerodynamics Laboratory. In late 1918, the Navy requested funding for four large Zeppelin-type rigid airships . Table 1 shows that testing...U.S. Naval Aeronautics and the Navy’s Aerodynamics Laboratory by | David J. Haas, Eric J. Silberg w ^*+*<^r Approved for Public Release...REPORT TYPE Final 3. DATES COVERED (From - To) 14. TITLE AND SUBTITLE Sirth of U.S. Naval Aeronautics and the Navy’s Aerodynamics

  8. Navy Lithium Battery Safety


    lithium -sulfur dioxide (Li-SO2), lithium - thionyl chloride (Li- SOCL2), and lithium -sulfuryl chloride (Li-S02CL2...and 1980’s with active primary cells: Lithium -sulfur dioxide (Li-SO2) Lithium - thionyl chloride (Li-SOCL2) Lithium -sulfuryl chloride (Li-S0 CL ) 2 2...DISTRIBUTION A. Approved for public release; distribution unlimited. NAVY LITHIUM BATTERY SAFETY John Dow1 and Chris Batchelor2 Naval

  9. The changing landscape of hospital capacity in large cities and suburbs: implications for the safety net in metropolitan America.

    Andrulis, Dennis P; Duchon, Lisa M


    An analysis of trends in hospital use and capacity by ownership status and community poverty levels for large urban and suburban areas was undertaken to examine changes that may have important implications for the future of the hospital safety net in large metropolitan areas. Using data on general acute care hospitals located in the 100 largest cities and their suburbs for the years 1996, 1999, and 2002, we examined a number of measures of use and capacity, including staffed beds, admissions, outpatient and emergency department visits, trauma centers, and positron emission tomography scanners. Over the 6-year period, the number of for-profit, nonprofit, and public hospitals declined in both cities and suburbs, with public hospitals showing the largest percentage of decreases. By 2002, for-profit hospitals were responsible for more Medicaid admissions than public hospitals for the 100 largest cities combined. Public hospitals, however, maintained the longest Medicaid average length of stay. The proportion of urban hospital resources located in high poverty cities was slightly higher than the proportion of urban population living in high poverty cities. However, the results demonstrate for the first time, a highly disproportionate share of hospital resources and use among suburbs with a low poverty rate compared to suburbs with a high poverty rate. High poverty communities represented the greatest proportion of suburban population in 2000 but had the smallest proportion of hospital use and specialty care capacity, whereas the opposite was true of low poverty suburbs. The results raise questions about the effects of the expanding role of private hospitals as safety net providers, and have implications for poor residents in high poverty suburban areas, and for urban safety net hospitals that care for poor suburban residents in surrounding communities.

  10. [Analysis of the educational requirements and planning in a large public hospital].

    Degan, Mario; Bragato, Laura; Duminuco, Leonardo; Bagno, Carla; Genova, Valeria; Sansoni, Julita


    The educational needs in a large hospital in the Venice region were analysed in order to plan continuing education programs for 2005-2006. The reference model was the analysis of the educational waiting lists in both operative and managerial professions. Two identical questionnaires were used: the first was distributed to all the professional staff of the hospital with university qualifications and asked them to give their opinion regarding educational priorities. The second was given to staff with managerial roles, asking them to indicate the educational priorities for the staff under their direction. Analysis of the data collected focused on : the priority given to the various areas and topics of education; differences of opinion identified between the various working environments between professional groups and between staff/managers; influence of social and personal factors on the opinions expressed. The fact that the fields of interest indicated varied according to the role and working activities of staff involved, indicate the need to offer educational procedures tailored to the requirements of each group.

  11. Large-eddy simulation of airflow and heat transfer in a general ward of hospital

    Hasan, Md. Farhad; Himika, Taasnim Ahmed; Molla, Md. Mamun


    In this paper, a very popular alternative computational technique, the Lattice Boltzmann Method (LBM) has been used for Large-Eddy Simulation (LES) of airflow and heat transfer in general ward of hospital. Different Reynolds numbers have been used to study the airflow pattern. In LES, Smagorinsky turbulence model has been considered and a discussion has been conducted in brief. A code validation has been performed comparing the present results with benchmark results for lid-driven cavity problem and the results are found to agree very well. LBM is demonstrated through simulation in forced convection inside hospital ward with six beds with a partition in the middle, which acted like a wall. Changes in average rate of heat transfer in terms of average Nusselt numbers have also been recorded in tabular format and necessary comparison has been showed. It was found that partition narrowed the path for airflow and once the air overcame this barrier, it got free space and turbulence appeared. For higher turbulence, the average rate of heat transfer increased and patients near the turbulence zone released maximum heat and felt more comfortable.

  12. Rehabilitative management of oropharyngeal dysphagia in acute care settings: data from a large Italian teaching hospital.

    Schindler, Antonio; Vincon, Elena; Grosso, Elena; Miletto, Anna Maria; Di Rosa, Rosalba; Schindler, Oskar


    A high incidence of oropharyngeal dysphagia (OD) in acute-care settings has been reported; however, no data on its management are found in the literature. Here we report the experience with rehabilitative management of OD in a large Italian hospital. The characteristics of inpatients with OD during 2004 have been studied prospectively. For each patient, demographic data, the department referring the patient, the disease causing OD, and the presence of a communication disorder were registered. The swallowing level at the beginning and at the end of rehabilitation were recorded. Of the 35,590 inpatients admitted to San Giovanni Battista Hospital of Turin during 2004, 222 of them were referred for the assessment and rehabilitation of OD. The inpatients with OD came from different departments and mainly had a neurologic disease. In 110 patients a communication disorder was present. The swallowing impairment was moderate to severe at the moment of referral, while on average patients were able to eat by mouth after swallowing therapy. Dysphagia rehabilitation in an acute care setting is requested from different departments because of its prevalence and severity; skilled specialists are needed for early assessment and the best management.

  13. Evaluation of hospitalization of children aged 0 to 5 years admitted for respiratory infections at a large hospital

    Tatiana Gandolfi de Oliveira; Juliana da Silva Bemfeito de Moraes; Flávia Thomé Moreira; Raquel Coris Arrelaro; Viviane Alves Ricardi; José Ricardo Dias Bertagnon; Yara Juliano


    ABSTRACT Objective: To evaluate the admission of children aged 0 to 5 years due to respiratory infections at a major hospital in the Southern region of the city of São Paulo. Methods: A total of 4,240 clinical records of children hospitalized and diagnosed with pneumonia, bronchopneumonia, bronchiolitis and bronchitis were evaluated for the 2008-2009 period, based on age, gender and year season. Results: Out of this total of children aged 0 to 60-months, 139 (3.2%) presented with pneumonia...

  14. Tuberculosis management continues to utilize a large amount of hospital resources in the United States.

    Allareddy, Veerasathpurush; Rampa, Sankeerth; Allareddy, Veerajalandhar; Nalliah, Romesh P


    The objective of this study is to examine longitudinal trends in hospital admissions attributed to tuberculosis and resulting hospitalization outcomes in the United States for the years 2000-2010. We used the Nationwide Inpatient Sample, which is the largest all-payer and nationally representative in-hospital dataset in the United States. All hospitalizations that had a primary diagnosis for tuberculosis were selected for analysis. Patient characteristics and outcomes including discharge status following hospitalization, length of stay in hospital and hospitalization charges were examined. During the study period, a total of 96 431 hospitalizations occurred due to tuberculosis. The mean age of hospitalizations was 48.6 years. Males comprised 64.2% of all hospitalizations; 24.8% were Whites, 25.5% Blacks, 26.5% Hispanics, 14.3% Asians/Pacific Islanders, 1% Native Americans, and 7.9% other/mixed races. Following hospitalization, 72.1% were discharged routinely, 3.4% were transferred to another acute-care hospital, 10.7% to long-term care facilities including skilled nursing facilities, 7.6% to home health care, and 2.1% were discharged against medical advice. There were 3815 patients who died (4% of hospitalizations). The total hospitalization charge for this cohort of patients admitted due to tuberculosis across the United States was $6.96 billion and the total hospitalization days over study period was 1 419 605 days. High-risk cohorts who are likely to be hospitalized due to tuberculosis included Blacks and Hispanics. Majority of hospitalization comprised of males. Even though the annual number of hospitalizations reduced over the study period, substantial amounts of resources are used in hospital settings to manage tuberculosis. © 2015 John Wiley & Sons Ltd.

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

    Nezir Aydin


    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.

  16. hospital

    Pattern of congenital orthopaedic malformations in an African teaching hospital ... malformation in this environment while congenital hip dislocation (CDH) is rare when .... malformations of radial dysplasia and other congenital malformations.

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

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


    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.

  18. Pseudomembranous colitis on aytopsy materials of large multi-type hospital

    E. I. Belinskaya


    Full Text Available As a result of wide and irrational antibiotics using the problem of AAC has become an issue. According to medical sources Clostridium difficile-associated diarrhea (pseudomembranous colitis is not registered and its clinical diagnostics is unsatisfactory.The purpose of the research is to study the pseudomembranouscolitis incidence on autopsy material in a multi-type hospital and to give its clinical and morphological characteristics.Methods and materials: the medical records (autopsy protocols, patients’ histories of the deceased with pseudomembranous colitis diagnosed on autopsy for the period of 2008–2013 yy were analyzed. The macroscopic changes of small and large bowel (size and pseudomembrane location, lesion focus, other colonic wall variations were assessed on autopsy. The stainings by hematoxylin-eozin, azur, PAS-reaction were used for histological diagnostics. The bacteriological testing was conducted in 2 cases.The results. The growing tendency of the pseudomembranous colitis frequency as well as its parts in the autopsy structures were revealed. Six cases of pseudomembranous colitis are detected on autopsy (0,28% of all performed autopsies in Irkutsk hospital №1 for 2008–2010 y.y. Twenty cases of pseudomembranous colitis were registered for 2011–2013 y.y., that was 1,52% in the autopsy structure. The risk factors of pseudomembranous colitis development, its clinical and morphological presentations were identified. Low lifetime diagnostics of this disease was remarked and its causes were analyzed.Conclusion. The problem of antibiotic-associated diarrhea with pseudomembranous colitis development is an issue because of the growing incidence of this disease and its unsatisfactory clinical diagnostics.

  19. Determinants of job stress and job satisfaction among supervisory and non-supervisory employees in a large Canadian teaching hospital.

    Brown, J A; Woodward, C A; Shannon, H S; Cunningham, C E; Lendrum, B; McIntosh, J; Rosenbloom, D


    This article explores the extent to which hospital workers at a large teaching hospital at different managerial/supervisory levels (designated and non-designated supervisors, and non-supervisory staff), experienced job stress and job satisfaction prior to the re-engineering of hospital services. For all groups, increased levels of job demands were associated with higher levels of stress. Lower levels of decision latitude were associated with increased job stress for designated supervisors. Increasing levels of decision latitude were associated with both job stress and satisfaction for the other two groups. Co-worker support and teamwork contributed to increased job satisfaction for all groups.

  20. Factor analysis of the Hospital Anxiety and Depression Scale from a large cancer population.

    Smith, Adam B; Selby, Peter J; Velikova, Galina; Stark, Dan; Wright, E Penny; Gould, Ann; Cull, Ann


    The Hospital Anxiety and Depression Scale (HADS) is widely used as a tool for assessing psychological distress in patients and non-clinical groups. Previous studies have demonstrated conflicting results regarding the factor structure of the questionnaire for different groups of patients, and the general population. This study investigated the factor structure of the HADS in a large heterogeneous cancer population of 1474 patients. It also sought to investigate emerging evidence that the HADS conforms to the tripartite model of anxiety and depression (Clark & Watson, 1993), and to test the proposal that detection rates for clinical cases of anxiety and depression could be enhanced by partialling out the effects of higher order factors from the HADS (Dunbar et al., 2000). The results demonstrated a two-factor structure corresponding to the Anxiety and Depression subscales of the questionnaire. The factor structure remained stable for different subgroups of the sample, for males and females, as well as for different age groups, and a subgroup of metastatic cancer patients. The two factors were highly correlated (r =.52) and subsequent secondary factor analyses demonstrated a single higher order factor corresponding to psychological distress or negative affectivity. We concluded that the HADS comprises two factors corresponding to anhedonia and autonomic anxiety, which share a common variance with a primary factor namely psychological distress, and that the subscales of the HADS, rather than the residual scores (e.g. Dunbar et al., 2000) were more effective at detecting clinical cases of anxiety and depression.

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

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


    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 ingested 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 ingestion (P 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.

  2. Ship Observations - VOS and Navy

    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.

  3. UK Royal Navy WWII Logbooks

    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...

  4. Navy Advertising: Targeting Generation Z


    study recommends improvements for Navy advertising efficiency by examining characteristics of recruits defined as Generation Z . Data gathered from five...improvements for Navy advertising efficiency by examining characteristics of recruits defined as Generation Z . Data gathered from five waves of the New...ranging in age from 17 to 21, it is time to move past the 2 millennial generation and start to focus on the characteristics of Generation Z . While

  5. 2005 Navy MWR Customer Survey


    Asian (e.g., Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese) gfedc Black or African-American gfedc Native Hawaiian or other Pacific...nmlkj nmlkj Catering (e.g., meetings, Navy Balls, Wedding Receptions, Retirements) nmlkj nmlkj nmlkj nmlkj nmlkj Child development programs (e.g...facilities nmlkj nmlkj nmlkj Catering (e.g., meetings, Navy Balls, Wedding Receptions, Retirements) nmlkj nmlkj nmlkj Child development programs

  6. Patient satisfaction with the laborist model of care in a large urban hospital

    Srinivas SK


    Full Text Available Sindhu K Srinivas,1 Anna O Jesus,1 Elene Turzo,1 Dominic A Marchiano,2 Harish M Sehdev,2 Jack Ludmir2 1Maternal and Child Health Research Program, Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; 2Pennsylvania Hospital, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA Background: The obstetric practice environment is evolving to include more laborists staffing obstetric units, with the hope of improving quality of care and provider satisfaction, yet there are scant data on the impact of a laborist care model on patient satisfaction or delivery outcomes. We sought to assess patient satisfaction after implementation of the laborist model of obstetric care in a large urban teaching hospital. Methods: Postpartum patients were asked to complete an anonymous survey assessing their satisfaction with care, particularly with regard to the laborist model. Survey questions included rating the overall experience of labor and delivery. All responses were based on a five-point Likert scale. Press-Ganey results were compared from before and after initiation of the model. Descriptive statistics were used to analyze the results. Results: Post-laborist implementation obstetric and delivery experience surveys were collected from 4166 patients, representing a 54% response rate. Ninety percent of patients reported that they were highly satisfied with the overall experience in the labor and delivery unit. A subgroup was asked to rate their experience with the practitioner for their current delivery. Of the 687 respondents, 75% answered excellent, 18% answered good/very good, and 3.4% answered neutral. Eighty-five percent of this subgroup stated that they were informed during prenatal care that they may be delivered by someone other than the practitioner or group that they saw during the pregnancy. Thirty-seven percent (n = 1553 of the total respondents reported that

  7. Are We Missing the Boat? The U.S. Navy’s Support of 21st Century Amphibious Operations


    strategy changing and the guidance of the QDR, an ideal opportunity for the Navy to reassess its fleet structure is present. Current the Navy the opportunity to leverage greater standar ~ization within the fleet and provide reliable and experienced support networks... Structure FY2011-15 35 Department of the Navy: 1 0- 11 aircraft carriers and 1 0 carrier air wings 84- 88 large surface combatants, including 21 - 32

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

    Marcelino José Jorge


    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.

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

    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 lear

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

    Li-sha Shi


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

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


    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.

  12. Awareness, perceived relevance, and acceptance of large animal hospital surveillance and infection control practices by referring veterinarians and clients.

    Ekiri, Abel B; House, Amanda M; Krueger, Traci M; Hernandez, Jorge A


    To assess awareness, perceived relevance, and acceptance of surveillance and infection control practices at a large animal referral hospital among referring veterinarians and clients who sent horses to the facility for veterinary care. Survey. 57 referring veterinarians and 594 clients. A 15-question survey targeting Salmonella enterica as an important pathogen of interest in horses was sent to clients who sent ≥ 1 horse to the University of Florida Large Animal Hospital for veterinary care during July 1, 2007, through July 1, 2011, and to veterinarians who had referred horses to the same hospital prior to July 1, 2011. Responses were summarized with descriptive statistics. The χ(2) test and the Wilcoxon rank sum test were used to examine associations among variables of interest. Survey response rates were low (57/467 [12%] for veterinarians and 594/3,095 [19%] for clients). Significantly more (35/56 [63%]) veterinarians than clients (227/585 [39%]) were aware that the hospital operates a surveillance and infection control program. Most veterinarians (56/57 [98%]) and clients (554/574 [97%]) indicated that sampling and testing of horses to detect Salmonella shedding in feces at admission and during hospitalization was justified. In addition, on a scale of 1 (not important) to 10 (very important), veterinarians and clients indicated it was very important (median score, 10 [interquartile range, 8 to 10] for both groups) that a referral hospital operates a surveillance and infection control program. Survey results indicated that awareness of hospital surveillance and infection control practices was higher among veterinarians than clients, and these practices were considered relevant and well-accepted among participant veterinarians and clients.

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

    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


    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

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

    Vazin A


    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

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

    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)


    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

  16. Reducing red cell transfusion by audit, education and a new guideline in a large teaching hospital.

    Garrioch, M; Sandbach, J; Pirie, E; Morrison, A; Todd, A; Green, R


    Safety concerns combined with the greatly increased costs and difficulties of maintaining the blood supply are major considerations for transfusion services. Previous local surveys demonstrated that hospital blood use at our hospital could be improved. Excessive cross-matching, unnecessary transfusion and high return rates of unused blood were commonplace. Transfusion practice was audited over a 3-month period. An education package with guidelines for transfusion was delivered to all clinician groups within the hospital, over the following 9 months. The audit was repeated exactly 1 year later at the same time period. During the second audit, inpatient hospital numbers increased by 1.02% (from n = 7262 to n = 7336) but no differences in length of stay, cardiovascular morbidity or mortality were demonstrated. Twenty percent (n = 254, 2002; n = 316, 2001) fewer patients received blood, and the number of red cell packs used reduced by 19% (from n = 1093 to n = 880). Total number of patients transfused reduced from 4.4% to 3.5% which, as an absolute difference, is a reduction of 0.9% (CI 0.3-1.5, P = 0.006). The audit, guideline and education package had a major impact on red cell use within the hospital with no adverse effects. Blood use can be improved by the implementation of a suitable education package and guideline. If it is possible to replicate the results of this education programme nationwide, the effect on blood use, with subsequent savings and enhanced patient safety could be significant.

  17. Filmless in 60 days: the impact of picture archiving and communications systems within a large urban hospital.

    Hayt, D B; Alexander, S; Drakakis, J; Berdebes, N


    Many large urban hospitals converting to filmless radiography use a phased approach for digital imaging implementation. In fact, this strategy often is recommended by picture archival communication systems (PACS) experts and vendors alike for large, busy hospitals installing PACS in existing physical facilities. The concern is that comprehensive conversion from film-based to digital imaging may be too overwhelming an adjustment in operations for a medical staff to effectively handle without serious disruption of workflow for patient treatment and care. Elmhurst Hospital Center is a 543-bed hospital located in the Borough of Queens in New York City. Owned by the New York City Health and Hospitals Corporation, this municipal teaching hospital provides services to a patient mix that is 38% indigent with no insurance, 50% covered by Medicaid or Medicare, and 12% affiliated with HMOs. Most inpatients are admitted through the emergency department. Forty-five percent of all radiology procedures conducted are for emergency patients. Historically, up to 25% of all diagnostic imaging examinations were never reported formally by radiologists. Report turnaround time for the remaining 75% was unacceptable, with only 3% of all imaging examinations reported within a 12-hour period in 1996. Both situations existed in great part because physicians and residents who felt they needed access to films simply took them. Many were never located or returned days after they were taken. In 1998, Elmhurst Hospital Center replaced its RIS and added voice recognition dictation capabilities in January 1999. A hospitalwide PACS was deployed 10 months later. With the exception of mammography, the hospital converted to filmless radiography within 60 days. The critical objectives to maintain control of films and radically improve the reporting process were achieved immediately. Over 99% of all examinations now are formally reviewed and reported. Only 7% of all reports take 1 or more days to

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

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


    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.

  19. Patient safety culture in a large teaching hospital in Riyadh: baseline assessment, comparative analysis and opportunities for improvement.

    El-Jardali, Fadi; Sheikh, Farheen; Garcia, Nereo A; Jamal, Diana; Abdo, Ayman


    In light of the immense attention given to patient safety, this paper details the findings of a baseline assessment of the patient safety culture in a large hospital in Riyadh and compares results with regional and international studies that utilized the Hospital Survey on Patient Safety Culture. This study also aims to explore the association between patient safety culture predictors and outcomes, considering respondent characteristics and facility size. This cross sectional study adopted a customized version of the HSOPSC and targeted hospital staff fitting sampling criteria (physicians, nurses, clinical and non-clinical staff, pharmacy and laboratory staff, dietary and radiology staff, supervisors, and hospital managers). 3000 questionnaires were sent and 2572 were returned (response rate of 85.7%). Areas of strength were Organizational Learning and Continuous Improvement and Teamwork within units whereas areas requiring improvement were hospital non-punitive response to error, staffing, and Communication Openness. The comparative analysis noted several areas requiring improvement when results on survey composites were compared with results from Lebanon, and the United States. Regression analysis showed associations between higher patient safety aggregate score and greater age (46 years and above), longer work experience, having a Baccalaureate degree, and being a physician or other health professional. Patient safety practices are crucial toward improving overall performance and quality of services in healthcare organizations. Much can be done in the sampled organizations and in the context of KSA in general to improve areas of weakness and further enhance areas of strength.

  20. Large-Scale Damage Control Facility

    Federal Laboratory Consortium — FUNCTION: Performs large‑scale fire protection experiments that simulate actual Navy platform conditions. Remote control firefighting systems are also tested....

  1. An automated ECG system in a large hospital: coding, storage and retrieval of tracings

    Meijler, F.L.; Robles de Medina, E.O.; Helder, J.C.


    This paper describes an automated ECG-system as it is used in the 1000-bed University Hospital Utrecht, The Netherlands. The system involves a "hybride" approach, combining computer analysis of the ECG by means of the Pipberger program with the reading by a cardiologist via a specially developed cod

  2. An automated ECG system in a large hospital: coding, storage and retrieval of tracings

    Meijler, F.L.; Robles de Medina, E.O.; Helder, J.C.


    This paper describes an automated ECG-system as it is used in the 1000-bed University Hospital Utrecht, The Netherlands. The system involves a "hybride" approach, combining computer analysis of the ECG by means of the Pipberger program with the reading by a cardiologist via a specially developed cod

  3. Trends in and socio-demographic factors associated with caesarean section at a large Tanzanian hospital, 2000 to 2013


    Introduction: Caesarean section (CS) can prevent maternal or fetal complications. Sub-Saharan Africa has the lowest CS levels in the world but large variations are seen between and within countries. The tertiary hospital, Kilimanjaro Christian Medical Centre (KCMC) in Tanzania has had a high level of CS over years. Objectives: To examine trends in the socio-demographic background of babies born at KCMC from year 2000 to 2013, and trends in the CS percentage, and to identify socio-demographic ...

  4. Establishment of a Somali doula program at a large metropolitan hospital.

    Dundek, Lora Harding


    To meet the unique cultural needs of Somali childbearing women in the United States, a doula support program was implemented at a major midwestern teaching hospital in the spring of 2002. To date, 123 Somali women who have been served by a Somali doula have given birth to live infants at this hospital. Cesarean birth rates in Somali women who had a doula present at birth were lower than the cesarean birth rate for Somali women not attended by a doula. Surveys with the nursing staff indicate that the nurses who have worked with a doula 3 or more times felt more confident caring for Somali women than nurses who have not worked with a doula at least 3 times. Patient feedback indicates positive attitudes about the doula service. Further research needs and suggestions for establishing such a program in other institutions are included.

  5. Impact on carbon footprint: a life cycle assessment of disposable versus reusable sharps containers in a large US hospital.

    Grimmond, Terry; Reiner, Sandra


    Hospitals are striving to reduce their greenhouse gas (GHG) emissions. Targeting supply chain points and replacing disposable with reusable items are among recommendations to achieve this. Annually, US hospitals use 35 million disposable (DSC) or reusable sharps containers (RSC) generating GHG in their manufacture, use, and disposal. Using a life cycle assessment we assessed the global warming potential (GWP) of both systems at a large US hospital which replaced DSC with RSC. GHG emissions (CO(2), CH(4), N(2)O) were calculated in metric tons of CO(2) equivalents (MTCO(2)eq). Primary energy input data was used wherever possible and region-specific conversions used to calculate the GWP of each activity. Unit process GHGs were collated into manufacture, transport, washing, and treatment and disposal. The DSC were not recycled nor had recycled content. Chemotherapy DSC were used in both systems. Emission totals were workload-normalized per 100 occupied beds-yr and rate ratio analyzed using Fisher's test with P ≤0.05 and 95% confidence level. With RSC, the hospital reduced its annual GWP by 127 MTCO(2)eq (-83.5%) and diverted 30.9 tons of plastic and 5.0 tons of cardboard from landfill. Using RSC reduced the number of containers manufactured from 34,396 DSC annually to 1844 RSC in year one only. The study indicates sharps containment GWP in US hospitals totals 100,000 MTCO(2)eq and if RSC were used nationally the figure could fall by 64,000 MTCO(2)eq which, whilst only a fraction of total hospital GWP, is a positive, sustainable step.

  6. [Nurses of large public hospitals in Rio de Janeiro: socio demographic and work related characteristics].

    Griep, Rosane Härter; da Fonseca, Maria de Jesus Mendes; Melo, Enirtes Caetano Prates; Portela, Luciana Fernandes; Rotenberg, Lucia


    The study aimed at analyzing socio-demographic and working characteristics of nurses from public hospitals. It was carried out a cross-sectional study, involving 3.229 nurses from the eighteen largest public hospitals of the city of Rio de Janeiro. It was observed a feminine predominance (87.3%), with mean age of 39.9 ± 10 years. Around 7% referred having master or doctorate degree, 58.5% got their degree from public institutions and 24.5% used to work at the health sector before becoming nurses. Half the group has thought of abandoning their career, and almost a quarter is unsatisfied with their profession. Around 10% searched for a job outside nursing area in the previous month and 30% searched for a job in the same working area. Night work, engagement in more than one job and long professional work hours were more frequently found among men. The study has pointed challengeable aspects of nurses' profession. Results can subsidize support strategies to improve the working conditions in public hospitals due to their comprehensiveness.

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

    de Graaf J


    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.

  8. Analysis of laboratory repeat critical values at a large tertiary teaching hospital in China.

    Dagan Yang

    Full Text Available CONTEXT: As a patient safety measure, laboratories are required to have a critical values policy by regulatory agencies. Unfortunately, little information is available on repeat critical values for the same analyte(s on the same patient. OBJECTIVE: To investigate the occurrence and distribution of repeat critical values and the relationship between the frequency of such values and patient outcome to provide information for hospitals on improving reporting policies. METHODS: Eleven laboratory critical value lists, including chemistry and hematology analytes, were selected from a tertiary hospital in China in the year 2010. The distribution and interval time for each repeat critical value were calculated. Serum potassium and platelet count were used as examples to illustrate the relationship between the frequency of the repeat critical values and patient outcome. RESULTS: All test items on the critical value list were prone to the occurrence of repeat critical values. On average, each patient who experienced critical values had 2.10 occurrences. The median interval time for each repeat critical value varied, with most being longer than 8 hours. For those patients who had repeat critical values of serum potassium and platelet count, along with the increased frequency, the patients had a longer hospital stay and a generally worse outcome. CONCLUSIONS: Patient can have a number of repeat critical values and the frequency of these values is closely related to patient outcome. A careful evaluation is warranted if a laboratory chooses to adopt a policy of not reporting each repeat critical value.


    The South African Navy has inherited many customs and traditions from its predecessors and one of these is that 'a ... submarine has become the capital ship of the future and ever ... theY'come to the end of the period of life for which they were ...

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

    Elisangela da Costa Lima-Dellamora


    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.

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

    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


    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 as NCT01132742. © 2016 American Society for Nutrition.

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

    KR Shafizadeh


    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.

  13. Pseudomembranous colitis on aytopsy materials of large multi-type hospital


    As a result of wide and irrational antibiotics using the problem of AAC has become an issue. According to medical sources Clostridium difficile-associated diarrhea (pseudomembranous colitis) is not registered and its clinical diagnostics is unsatisfactory.The purpose of the research is to study the pseudomembranouscolitis incidence on autopsy material in a multi-type hospital and to give its clinical and morphological characteristics.Methods and materials: the medical records (autopsy protoco...

  14. Evaluating the quality of interaction between medical students and nurses in a large teaching hospital

    Cushing Herbert E


    Full Text Available Abstract Background Effective health care depends on multidisciplinary collaboration and teamwork, yet little is known about how well medical students and nurses interact in the hospital environment, where physicians-in-training acquire their first experiences as members of the health care team. The objective of this study was to evaluate the quality of interaction between third-year medical students and nurses during clinical rotations. Methods We surveyed 268 Indiana University medical students and 175 nurses who worked at Indiana University Hospital, the School's chief clinical training site. The students had just completed their third year of training. The survey instrument consisted of 7 items that measured "relational coordination" among members of the health care team, and 9 items that measured psychological distress. Results Sixty-eight medical students (25.4% and 99 nurses (56.6% completed the survey. The relational coordination score (ranked 1 to 5, low to high, which provides an overall measure of interaction quality, showed that medical students interacted with residents the best (4.16 and with nurses the worst (2.98; p Conclusion The quality of interaction between medical students and nurses during third-year clinical rotations is poor, which suggests that medical students are not receiving the sorts of educational experiences that promote optimal physician-nurse collaboration. Medical students and nurses experience different levels of psychological distress, which may adversely impact the quality of their interaction.

  15. Change in physiotherapy management of children with cystic fibrosis in a large urban hospital.

    Farbotko, Katrina; Wilson, Christine; Watter, Pauline; MacDonald, Julie


    A retrospective audit was conducted in 1998 and 2000 to review the physiotherapy management of hospitalized children with cystic fibrosis (CF) at the Brisbane Royal Children's Hospital (RCH). The objective was to detect and explore possible changes in patient management in this time period and investigate whether these changes reflected changes in the current theory of CF management. All children over two years of age with CF admitted during 1998 and 2000 with pulmonary manifestation and who satisfied set criteria were included (n = 249). Relative frequency of each of six treatment modalities used were examined on two occasions, revealing some degree of change in practice reflecting the changes in current theory. There was a significant decrease in the frequency of usage of postural drainage with head-down tilt (p autogenic drainage (p drainage without head-down tilt (p < 0.001), and positive expiratory pressure devices (p < 0.001) were used more frequently in 2000 (p < 0.001). No significant changes were identified in the use of Flutter VRP1 (p = 0.145) and exercise (p = 0.763). No significant differences were found in population demographics or occurrence of concomitant factors that may influence patient management.

  16. A structured approach to transforming a large public hospital emergency department via lean methodologies.

    Naik, Trushar; Duroseau, Yves; Zehtabchi, Shahriar; Rinnert, Stephan; Payne, Rosamond; McKenzie, Michele; Legome, Eric


    Emergency Departments (EDs) face significant challenges in providing efficient, quality, safe, cost-effective care. Lean methodologies are a proposed framework to redesign ED practices and processes to meet these challenges. We outline a systematic way that lean principles can be applied across the entire ED patient experience to transform a high volume ED in a safety net hospital. We review the change in ED performance metrics prior to and after lean implementation. We discuss critical insights and key lessons learned from our lean transformation to date. The steps to implementing lean principles across the patient's ED experience are described with specific attention to executive planning of rapid improvement experiments and the subsequent roll-out of lean transformation over an 18-month time frame. Basic ED performance data were compared to the year prior. Results of the exploratory analysis (using median and interquartile ranges and nonparametric tests for group comparisons) have shown improvement in several performance metrics after initiating lean transformation. The approach, lessons learned, and early data of our transformation can provide critical insights for EDs seeking to incorporate continuous improvement strategies. Key lessons and unique challenges encountered in safety net hospitals are discussed.

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

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


    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.

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

    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

  19. Manager Experiences with the Return to Work Process in a Large, Publically Funded, Hospital Setting

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


    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. Methods Nineteen Danish hospital managers......Purpose 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...... 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...

  20. Neurocysticercosis: declining incidence among patients admitted to a large public hospital in Guayaquil, Ecuador

    Alarcón, Tomas A; Del Brutto, Oscar H


    It has been stated that new cases of neurocysticercosis (NCC) are declining in some endemic regions over the past years. To confirm this assertion, we evaluated all NCC patients (n = 362) admitted to the Neurological Service of our Hospital from 1982 to 2011, and we noted a significant reduction in the incidence of NCC, when compared with the total number of patients admitted to the Service over the study years (6.4% of 2,723 patients from 1982 to 1991, 2.7% of 3,056 patients from 1992 to 2001, and 3.5% of 2,996 patients from 2002 to 2012; p < 0.0001). It is likely that improved sanitation, together with increased availability of neuroimaging machines which allow prompt recognition and management of NCC cases avoiding disease progression, were the main responsibles for our findings. PMID:23265556

  1. [Primary colorectal lymphoma of diffuse large B-cells: an experience at a general hospital].

    Beltran Gárate, Brady; Morales Luna, Domingo; Quiñones Avila, Pilar; Hurtado de Mendoza, Fernando; Riva Gonzales, Luis; Yabar, Alejandro; Portugal Meza, Karem


    Primary colorectal lymphoma is a very rare disease. Primary colorectal lymphoma of diffuse large B-cells is a more frequent subtype representing 1% of all colon diseases. In a retrospective study, the clinical characteristics and treatment course of primary colorectal lymphoma of diffuse large B-cells between 1997 and 2003 were reviewed. According to Dawson's criteria, fourteen cases were identified. The average age was 65 and the ratio of men to women was 1:3. The most frequent signs and symptoms were abdominal pain (78%), diarrhea (49%) and abdominal tumor (35%). The most frequently involved regions were the cecum (42%), ascending colon (21%) and rectum (21%). Six were in Stage I, four in Stage II and four in Stage III. The 5-year survival per stage was 26, 11 and 5 months, respectively. Primary colorectal lymphoma of diffuse large B-cells usually affects the right part of the colon in an aggressive manner.

  2. Prevalence and Associated Risk Factors of Asymptomatic Bacteriuria in Ante-Natal Clients in a Large Teaching Hospital in Ghana.

    Labi, A-K; Yawson, A E; Ganyaglo, G Y; Newman, M J


    Asymptomatic bacteriuria, the presence of bacteria in urine without symptoms of acute urinary tract infection, predisposes pregnant women to the development of urinary tract infections and pyelonephritis, with an attendant pregnancy related complications. To measure the prevalence of asymptomatic bacteriuria among ante-natal clients at the Korle-Bu Teaching Hospital in Ghana and its' associated risk factors. A cross-sectional study involving 274 antenatal clients was conducted over a period of 4 weeks. A face to face questionnaire was completed and midstream urine collected for culture and antimicrobial susceptibility testing. The prevalence of asymptomatic bacteriuria was 5.5%. It was associated with sexual activity during pregnancy (Fisher's Exact 5.871, p-value 0.0135), but not with sexual frequency. There were no significant associations with educational status, parity, gestational age, marital status and the number of foetuses carried. The commonest organism isolated was Enterococcus spp (26.7%) although the enterobacteriaceae formed the majority of isolated organisms (46.7%). Nitrofurantoin was the antibiotic with the highest sensitivity to all the isolated organisms. The prevalence of asymptomatic bacteriuria among ante-natal clients at this large teaching hospital in Ghana is 5.5%, which is lower than what has been found in other African settings. Enterococcus spp was the commonest causative organism. However, due to the complications associated with asymptomatic bacteriuria, a policy to screen and treat- all pregnant women attending the hospital, is worth considering.

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

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


    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

  4. Management of non-tubal ectopic pregnancies at a large tertiary hospital.

    Hunt, Sarah P; Talmor, Alon; Vollenhoven, Beverley


    There are limited data on the management of non-tubal ectopic pregnancies (NTEP). We reviewed the management of these cases at a tertiary centre with a dedicated institutional protocol. All cases of confirmed NTEP were retrospectively identified from 2006 to 2014. Records were reviewed for presenting features, mode and success of initial management, preservation of fertility and length of hospital stay. The main outcome measure was the success rate of medical management with methotrexate. The 60 cases identified included 34 cornual, 14 Caesarean section scar, nine cervical and three cervical involving previous Caesarean scar. Primary surgical management was performed in 22 patients. Thirty-eight patients received medical therapy with single or multidose methotrexate. Successful medical management was observed in 33 (87%); however, length of stay was significantly longer compared with surgical patients (mean 14 ± 12 days versus 5 ± 2 days, P < 0.01). Hysterectomy was performed in three patients (one surgical group, two medical group). There was one case of methotrexate toxicity with no long-term adverse outcome. Medical management of NTEP is a safe first-line therapy for clinically stable patients desiring preservation of fertility despite a longer period of inpatient monitoring and follow-up. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  5. Roadmap for Navy Family Research.


    ad family status . service. ad pl ce of seig m uot. AMA 2: Ancona the potential evailability of evicee, a. Analyse comunication endto Very families...procedures during deployment ABOUIT NW (e.g.. *ship-tinily comunications , pay differ- entials. us. of smrgency Ile, and identify To ZSELOP alternative...09 NAVY FAMIILIES *11* I.- Study *conosical, psychological , and social " rank * duŕ military "areer " employment status . extent of of spouse family

  6. Navy advertising: targeting Generation Z

    Anderson, David; Conover, Kenneth; Jackson, Jason; Santibanez, Edwin


    Approved for public release; distribution is unlimited This study recommends improvements for Navy advertising efficiency by examining characteristics of recruits defined as Generation Z. Data gathered from five waves of the New Recruit Survey covering September 2012 to April 2015 were separated into two groups by age, with ages 17–21 representing Generation Z recruits and those over 21 as the Other generation. Four main analysis questions centered on parental influences, social media habi...

  7. Navy officer manpower optimization revisited

    Wheeler, Michael G.


    Approved for public release; distribution is unlimited This work develops and tests RCMOP-2, an extension of the Requirements-Driven, Cost-Based, Manpower Optimization (RCMOP) model introduced by Clark. Like its predecessor, RCMOP-2 simultaneously guides monthly values for U.S. Navy officer manpower variables, including inventory, promotions, accessions, designator transfers, and forced and natural losses, in order to minimize a "gap index" reflecting the lack of fit between a given per...

  8. Your Navy in the Southwest


    El Centro San Diego Seal Beach Fallon Ventura County Monterey China Lake Train Locally, Operate Globally All carrier air wings train in...readiness  lifecycle   NRSW Lines of Operation 6 • Rebalance – Near, Mid, Long • Energy –  Culture – Efficiency – Sustainability – Security...Efficiency Renewable Energy & Sustainability ENERGY SECURITY & COMPLIANCE Navy Energy Culture Energy Efficiency First “Compliance” is Unique to

  9. Interhospital patient transfers between Ontario's academic and large community hospitals increase the risk of Clostridium difficile infection.

    DiDiodato, Giulio; McArthur, Leslie


    The objective of this study is to determine the impact of interhospital patient transfers on the risk of Clostridium difficile infection (CDI). The number of interhospital patient transfers and CDI cases for 11 academic and 40 large community hospitals (LCHs) were available from 2010-2015. These data were used to compute a CDI score for each sending facility as a measure of CDI pressure on the receiving facility. This CDI score was included as a variable in a multilevel mixed-effect Poisson regression model of CDI cases. Other covariates included year, CDI testing strategy, antimicrobial stewardship program (ASP), and criteria used for patient isolation. Hospital-specific random effects were estimated for the baseline rate of CDI (intercept) and ASP effect (slope). The CDI score ranged from 0-103, with a mean score ± SD of 20.4 ± 21.8. Every 10-point increase in the CDI score was associated with a 4.5% increase in the incidence of CDI in the receiving academic hospital (95% confidence interval [CI], 0.9-8.5) and 3.6% increase in the receiving LCHs (95% CI, 0.3-7). The random components of the model varied significantly, with a strong negative correlation of -0.85 (95% CI, -0.94 to -0.65). Our results suggest interhospital patient transfers increase the risk of CDI. ASPs appear to reduce this risk; however, these ASP effects demonstrate significant heterogeneity across hospitals. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  10. Transforming Health Care Coalitions From Hospitals to Whole of Community: Lessons Learned From Two Large Health Care Organizations.

    Cormier, Scott; Wargo, Michael; Winslow, Walter


    A health care emergency preparedness coalition (coalition) is a group of health care organizations, public safety agencies, and public health partners that join forces for the common cause of making their communities safer, healthier, and more resilient. Coalitions have been characterized as being focused on hospital systems instead of the health care of the community as a whole. We discuss 2 examples of coalition partners that use a more inclusive approach to planning, response, and recovery. The first is a large health care system spread across 23 states, and the other is a public safety agency in northeast Pennsylvania that took the lead to address the preparedness and response toward a large influx of burn patients and grew to encompass all aspects of community health care.

  11. HOMER Economic Models - US Navy

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


    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.

  12. Comparison of two culture techniques used to detect environmental contamination with Salmonella enterica in a large-animal hospital

    Catriona H. Lyle


    Full Text Available Salmonellosis is a common healthcare-associated infection in large-animal hospitals, and surveillance for Salmonella is an integral part of comprehensive infection control programmes in populations at risk. The present study compares the effectiveness of two culture techniques for recovery of Salmonella from environmental samples obtained in a large-animal referral veterinary hospital during a Salmonella outbreak. Environmental samples were collected using household cleaning cloths that were incubated overnight in buffered peptone water (BPW. Aliquots of BPW were then processed using two different selective enrichment and culture techniques. In the first technique (TBG-RV-XLT4 samples were incubated at 43 °C in tetrathionate broth and then Rappaport-Vassiliadis broth before plating on XLT4 agar. The second technique (SEL-XLD involved incubation at 37 °C in selenite broth before plating on XLD agar. Salmonella was recovered from 49.7% (73/147 of samples using the TBG-RV-XLT4 technique, but only 10.2% (15/147 of samples using the SEL-XLD method. Fourteen samples (9.5% were culture-positive using both methods, and 73 (49.7% were culture-negative using both techniques. There were discordant results for 60 samples, including 59 that were only culture-positive using the TBG-RV-XLT4 method, and one sample that was only culturepositive using the SEL-XLD method. Salmonella was much more likely to be recovered using the TBG-RV-XLT4 method, and there appeared to be five times more false-negative results using the SEL-XLD technique. Environmental contamination with Salmonella may be underestimated by certain culture techniques, which may impair efforts to control spread in veterinary hospitals.

  13. Comparison of two culture techniques used to detect environmental contamination with Salmonella enterica in a large-animal hospital.

    Lyle, Catriona H; Annandale, Cornelius H; Gouws, Johan; Morley, Paul S


    Salmonellosis is a common healthcare-associated infection in large-animal hospitals, and surveillance for Salmonella is an integral part of comprehensive infection control programmes in populations at risk. The present study compares the effectiveness of two culture techniques for recovery of Salmonella from environmental samples obtained in a large-animal referral veterinary hospital during a Salmonella outbreak. Environmental samples were collected using household cleaning cloths that were incubated overnight in buffered peptone water (BPW). Aliquots of BPW were then processed using two different selective enrichment and culture techniques. In the first technique (TBG-RV-XLT4) samples were incubated at 43 °C in tetrathionate broth and then Rappaport-Vassiliadis broth before plating on XLT4 agar. The second technique (SEL-XLD) involved incubation at 37 °C in selenite broth before plating on XLD agar. Salmonella was recovered from 49.7% (73/147) of samples using the TBG-RV-XLT4 technique, but only 10.2% (15/147) of samples using the SEL-XLD method. Fourteen samples (9.5%) were culture-positive using both methods, and 73 (49.7%) were culture-negative using both techniques. There were discordant results for 60 samples, including 59 that were only culture-positive using the TBG-RV-XLT4 method, and one sample that was only culture-positive using the SEL-XLD method. Salmonella was much more likely to be recovered using the TBG-RV-XLT4 method, and there appeared to be five times more false-negative results using the SEL-XLD technique. Environmental contamination with Salmonella may be underestimated by certain culture techniques, which may impair efforts to control spread in veterinary hospitals.




    Full Text Available Abruption placenta is a serious condition affecting survival of pregnant mother and baby. This study on fetal outcome with respect to survival in mothers with abruptio placentae in a large referral hospital is a observational study . Study involved about 100 cases out of 19000 deliveries, which were managed according to standard protocols in a resource limited large referral hospital. The incidence of APH was 0.89% in the present study, t he i ncidence of abruption was highest in parity 2 to 5 as majority of deliveries were in the same age group. Based on the grading of abruption 49% were grade 2. Acceleration of labour was done using different methods . Syntocin was used in 21 cases. LSCS was do ne in 16 cases, 6 among them for maternal indications and 10 cases LSCS was done immediately without trial of labour with a live foetus of more than 34 weeks gestation. Fetal fate based on the grading of abruption, with grade 0, two cases delivered vaginal ly and both survived. In grade 2 abruptio placenta, 17 fetuses were live at admission among which 15 delivered vaginally and 2 delivered by LSCS. Out of the 17 aforesaid cases 14 died intrapartum and 2 died due to perinatal asphyxia. With grade 3 abruption none of the fetuses survived. Foetal deaths were probably due to foetal bradycardia and asphyxia and early timely intervention like blood transfusion and LSCS could have saved the foetus.

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

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


    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.

  16. Granulocyte colony-stimulating factor use in a large British hospital: comparison with published experience

    Pérez Velasco R


    Full Text Available Granulocyte colony-stimulating factors (G-CSF are high-cost agents recommended as prophylaxis of febrile neutropenia or as adjunctive treatment of severe neutropenic sepsis. Their use in high-risk situations such as acute myeloid leukaemia, acute lymphocytic leukaemia, myelodysplastic syndrome and stem cell transplantation is also indicated. Objective: This audit assessed the use of G-CSF within the Oncology and Haematology Service Delivery Unit at Guy’s and St. Thomas’ hospital (London, United Kingdom.Methods: Patients who received G-CSF in April-May 2008 were identified retrospectively from the pharmacy labelling system, and chemotherapy front sheets, clinic letters and transplantation protocols were reviewed. Patients on lenograstim, in clinical trials or under non-approved chemotherapy protocols were excluded.Results: A total of 104 G-CSF treatments were assessed. The most commonly treated malignancy was breast cancer (41.3%, with docetaxel 100 mg/m2 (34.6% being the most frequent chemotherapy regimen. The chemotherapy intent was curative in 66.3 % of cases. Pegfilgrastim was used in 73.1 % of cases and primary prophylaxis was the most common indication (54.8%. Stem cell transplantation was the first indication to meet the audit criterion (93.3%, followed by primary prophylaxis (89.5%. There was a considerable non-adherence for secondary prophylaxis (6.7%.Conclusion: The overall level of compliance with the audit criteria was 72.1%. The results for primary and secondary prophylaxis would have been different if FEC100 (fluorouracil, epirubicin, cyclophosphamide and docetaxel 100 mg/m2 had been considered a single chemotherapy regimen. Also, the lack of access to medical notes may have affected the reliability of the results for ‘therapeutic’ use.

  17. Cardiac rehabilitation in the Navy.

    Bruzek-Kohler, C M; Love, V; Hendrickson, R; Branford, M; Gates, A; Telvick, C


    Cardiac rehabilitation has been effective in the management and recovery of the post-myocardial infarction population for almost 40 years. During that time, the fundamental components of rehabilitation have changed to reflect a growing complexity and number of cardiac patients. Great Lakes Naval Hospital has instituted a structured outpatient cardiac rehabilitation program. It is based on the needs of a large cardiac population with modifiable risk factors identified through quality improvement studies. Future implications and research in the area of cardiac rehabilitation include measurements of self-efficacy, long-term risk factor modification, cost effectiveness, gender-related differences, or morbidity and mortality.

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

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


    .... 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...

  19. Nursing burnout: cross-sectional study at a large Army hospital.

    Lang, Gary Morris; Pfister, Elizabeth A; Siemens, Michelle J


    The purpose of this study was to examine the levels of burnout among U.S. Army and civilian nursing personnel assigned to a large military treatment facility. Using a cross-sectional design, a convenience sample of eligible participants (n = 364) completed the Maslach Burnout Inventory. T-test and ordinal logistic regression were used to analyze data. Findings suggest that both groups were experiencing a moderate level of burnout. However, civilian nursing personnel demonstrated statistical lower levels of emotional exhaustion and depersonalization. Findings suggest that nursing personnel who worked the day shift, no more than 8 hours a day and had fewer patient care contacts with military personnel injured in Iraq or Afghanistan reported lower levels of emotional exhaustion and depersonalization. This study provides ideas for policy changes at medical treatment facilities that are experiencing similar challenges.

  20. Modified components separation technique: experience treating large, complex ventral hernias at a University Hospital.

    Torregrosa-Gallud, A; Sancho Muriel, J; Bueno-Lledó, J; García Pastor, P; Iserte-Hernandez, J; Bonafé-Diana, S; Carreño-Sáenz, O; Carbonell-Tatay, F


    An increasing number of patients have large or complex abdominal wall defects. Component separation technique (CST) is a very effective method for reconstructing complex midline abdominal wall defects in a manner that restores innervated muscle function without excessive tension. Our goal is to show our results by a modified CST for treating large ventral hernias. A total of 351 patients with complex ventral hernias have been treated over a 10-year period. Pre- and postoperative CT scans were performed in all patients. All ventral hernias were W3, according to the EHS classification 1. We analyzed demographic variables, co-morbidities, hernia characteristics, operative, and postoperative variables. One hundred and seventy patients (48.4%) were men; the average age of the study population was 51.6 ± 23.2 years with an average BMI of 32.3 ± 1.3. The hernia was located in the midline in 321 cases (91.5%) versus the flank in 30 (8.5%). In 45 patients, preoperative botulinum toxin (BT) and progressive pneumoperitoneum (PPP) were needed due to giant hernia defects when the VIH/VAC ratio was >20%. Postoperative complications related to the surgical site were seroma (35.1%), hematoma (9.1%), infection (7.2%), and wound necrosis (8.8%). Complications related to the repair were evisceration in 3 patients (1.1%), small bowel fistula in 4 patients (1.5%), 11 cases of mesh infection (2.9%), and abdominal compartment syndrome (ACS) in 2 patients. There were 29 hernia recurrences (8.2%) with a mean follow-up of 31.6 ± 8.1 months. The modified CST is an effective strategy for managing complex ventral hernias that enables primary fascial closure with low rates of morbidity and hernia recurrence.

  1. 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

    Bacelar, A.; Ferret, A.A.; Vanni, S.; Galhardi, M.P.; Lykawka, R., E-mail:, E-mail:, E-mail:, E-mail:, E-mail: [Hospital de Clinicas de Porto Alegre (HCPA), Porto Alegre, RS (Brazil)


    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.

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

    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)


    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

  3. Navy Plastics Dialogue, Modification Number 2


    the oppor- The PRESIDING OFFICER. Is there Mr. President. our amendment is tunlty to continue to work with the Navy further debate ? If not. the...sterilizing or washing plastics waste are not practical 0 on board Navy ships until PWPs are installed. The existing auto- claves on board ships are

  4. Intravenous thrombolysis before endovascular therapy for large vessel strokes can lead to significantly higher hospital costs without improving outcomes.

    Rai, Ansaar T; Boo, SoHyun; Buseman, Chelsea; Adcock, Amelia K; Tarabishy, Abdul R; Miller, Maurice M; Roberts, Thomas D; Domico, Jennifer R; Carpenter, Jeffrey S


    Limited efficacy of IV recombinant tissue plasminogen activator (rt-PA) for large vessel occlusions (LVO) raises doubts about its utility prior to endovascular therapy. To compare outcomes and hospital costs for anterior circulation LVOs (middle cerebral artery, internal carotid artery terminus (ICA-T)) treated with either primary endovascular therapy alone (EV-Only) or bridging therapy (IV+EV)). A single-center retrospective analysis was performed. Clinical and demographic data were collected prospectively and relevant cost data were obtained for each patient in the study. 90 consecutive patients were divided into EV-Only (n=52) and IV+EV (n=38) groups. There was no difference in demographics, stroke severity, or clot distribution. The mean (SD) time to presentation was 5:19 (4:30) hours in the EV-Only group and 1:46 (0:52) hours in the IV+EV group (pIV+EV 31 (81.6%) (p=0.12). Favorable outcome: EV-Only 26 (50%) versus IV+EV 22 (58%) (p=0.45). For patients presenting within 4.5 hours (n=64): Recanalization: EV-Only 21/26 (81%) versus IV+EV 31/38 (81.6%) (p=0.93). Favorable outcome: EV-Only 14/26 (54%) versus IV+EV 22/38 (58%) (p=0.75). There was no significant difference in rates of hemorrhage, mortality, home discharge, or length of stay. A stent retriever was used in 67 cases (74.4%), with similar recanalization, outcomes, and number of passes in the EV-Only and IV+EV groups. The mean (SD) total hospital cost was $33 810 (13 505) for the EV-Only group and $40 743 (17 177) for the IV+EV group (p=0.02). The direct cost was $23 034 (8786) for the EV-Only group and $28 711 (11 406) for the IV+EV group (p=0.007). These significantly higher costs persisted for the subgroup presenting in IV rt-PA administration independently predicted higher hospital costs. IV rt-PA did not improve recanalization, thrombectomy efficacy, functional outcomes, or length of stay. Combined therapy was associated with significantly higher total and direct hospital costs

  5. 2017 Outlook for Navy Shipbuilding


    UDGE T O F F IC E Outline ■ The Navy’s 2017 shipbuilding plan ■ CBO’s estimate of the cost of the 2017 plan ■ The problem of cost growth in lead ships...E Average Annual Shipbuilding Costs Under the Navy’s 2017 Plan Near Term (2017-2021) Midterm (2022-2026) Far Term (2027-2046) 30-Year Average Navy...Estimates (Billions of 2016 Dollars) New-Ship Construction 15.0 18.6 17.1 17.0 Plus Carrier Refuelings 16.5 19.6 18.0 18.0 Plus All Other Items 17.6

  6. Clinical utility and impact of autopsies on clinical practice among doctors in a large teaching hospital in Ghana

    Edem Tette


    : Strengthening the interaction between doctors and pathologists is essential in improving the autopsy process and utilization in the hospital. KBTH should create opportunities for doctors to attend autopsy demonstrations and for pathologists to attend clinicopathological meetings in the hospital.

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

    Saadat Delfani


    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.

  8. Analysis of the effect of medical insurance on cancer inpatients:A 10-year retrospective study on a large hospital in Northeast China

    Zhendong Zheng; Lu Wang; Quanwei Fu; Tao Han; Xiaodong Xie


    Objective The aim of the study was to analyze hospital costs for cancer inpatients availing dif erent methods of payment and the influencing factors, to provide inputs to improve the medical insurance pay-ment policy. Methods We analyzed the information related to length of hospital stay, hospitalization cost, and self-pay cost, col ected from one large-scale, Grade A, Class Three hospital in Shenyang, China, during 2004–2013. Results The number of cancer inpatients with dif erent payment types (medical insurance group and non-medical insurance group) presented a rising trend. Further, the ratio of medical insurance inpatients increased rapidly (from 22.2% to 48.7%); however, this group was stil a minority. The length of hospital stay became shorter (21 d vs. 17 d; P = 0.000) while the gap got narrower; the hospitalized expense showed an upward trend and the dif erence was remarkable (¥24048.6 ± ¥4376.28 vs. ¥20544.36 ± ¥4057.01; P = 0.000). Conclusion Along with normalization of cancer therapy, the influence of payment on treatment has been getting weak, the policy has impact on control ing hospitalization cost, lightening burden of cancer patient, as wel as al ocating medical resources in a reasonable way, becoming an important defray pattern of hospitalization cost.

  9. Reasons for routine episiotomy: A mixed-methods study in a large maternity hospital in Phnom Penh, Cambodia.

    Schantz, Clémence; Sim, Kruy Leang; Ly, Ek Meng; Barennes, Hubert; Sudaroth, So; Goyet, Sophie


    First documented in 1741, the practice of episiotomy substantially increased worldwide during the 20th century. However, research shows that episiotomy is not effective in reducing severe perineal trauma and may be harmful. Using a mixed-methods approach, we conducted a study in 2013-14 on why obstetricians and midwives in a large maternity hospital in Phnom Penh, Cambodia, still do routine episiotomies. The study included the extent of the practice, based on medical records; a retrospective analysis of the delivery notes of a random sample of 365 patients; and 22 in-depth interviews with obstetricians, midwives and recently delivered women. Of the 365 women, 345 (94.5%, 95% CI: 91.7-96.6) had had an episiotomy. Univariate analysis showed that nulliparous women underwent episiotomy more frequently than multiparous women (OR 7.1, 95% CI 2.0-24.7). The reasons given for this practice by midwives and obstetricians were: fear of perineal tears, the strong belief that Asian women have a shorter and harder perineum than others, lack of time in overcrowded delivery rooms, and the belief that Cambodian women would be able to have a tighter and prettier vagina through this practice. A restrictive episiotomy policy and information for pregnant women about birthing practices through antenatal classes should be implemented as soon as possible.


    Silvano Esposito


    Full Text Available Objectives: Surgical infections represent an increasingly important problem for the National Health System. In this study we retrospectively evaluated the bacterial epidemiology and antimicrobial susceptibility of the microorganisms concerned as well as the utilization of antibiotics in the General and Emergency Surgery wards of a large teaching hospital in southern Italy in the period 2011-2013. Methods: Data concerning bacterial isolates and antimicrobial susceptibility were retrieved from the Vitek II database. The pharmacy provided data about the consumption of antibiotics in the above reported wards. Chi-square or Fisher’s exact test were used to analyze categorical variables. Results: In all, 94 Gram-negative were isolated in 2011, 77 in 2012, and 125 in 2013, Escherichia coli, Acinetobacter baumannii and Pseudomonas aeruginosa always being the most frequently isolated microorganisms. In the same years, there were respectively 105, 93, and 165 Gram-positive isolated, Enterococcus faecalis, Staphylococcus epidermidis and Staphylococcus aureus being the most commonly found. No significant variation in the antibiotic susceptibility pattern was observed, either among Gram-negative or among Gram-positive pathogens; carbapenems (especially meropenem consumption remained stable over time. Conclusions: Our results show no significant increase in antimicrobial resistance over the period in question, and a higher rate of both MRSA isolates and resistance to carbapenems in A. baumannii compared with other European data.

  11. Asthma in the Navy and Marine Corps.

    Connolly, J P; Baez, S A


    Today, asthma is an increasing health problem in young Americans. In some cases, it can be quite difficult to diagnose. Many individuals enter military service each year with undiagnosed asthma, which subsequently limits their performance of duty. We review the patterns of asthma in children and young adults and relate this to Navy and Marine Corps personnel. We also review the current evaluation of this disease in the U.S. Navy Medical Department and suggest future improvements in this evaluation.

  12. Navy Ship Names: Background for Congress


    particular ship names. Secretaries also routinely receive formal suggestions for ship names from concerned citizens, active and retired service members...were named for battles, but one (CG-51) was named for Thomas S . Gates, a former Secretary of the Navy and Secretary of Defense. 13 Department of the...been chosen and announced by the Secretary of the Navy, under the direction of the President and in accordance with rules prescribed by Congress

  13. Navy Collaborative Integrated Information Technology Initiative


    Information Technology Initiative (NAVCIITI, pronounced "NAV city") by creating an Advanced Communication and Information Technology Center (ACITC), on campus at Virginia Tech, integrating and leveraging the efforts of more than 60 investigators currently under contract to the Navy by providing equipment and facilities for their effort, and using the collective capabilities of NAVCIITI to support Navy initiatives in distributed computing, integrated services training, education, information dissemination, and simulation, especially for purposes

  14. Adopting Cloud Computing in the Pakistan Navy


    trafficking, arms smuggling, and piracy . In addition, the Pakistan Navy is participating in various multinational exercises and hosting exercises of...The Pakistan Navy is still in the process of modernization and is upgrading its equipment to conduct counter- piracy and counterterrorism operations...drives from its data center will be sold on some online store like eBay or Amazon, thus causing consumers to lose control over their data. Data

  15. Navy Medicine Professional Development Center (NMPDC)


    July 15, 2012 1 Navy Medicine Professional Development Center (NMPDC) Mission: Vision: Global leaders in health education and...COVERED 00-00-2012 to 00-00-2012 4. TITLE AND SUBTITLE Navy Medicine Professional Development Center (NMPDC) 5a. CONTRACT NUMBER 5b. • Scholarly research • Leadership and professional development courses Note: Hyperlinks provided throughout brief to more detailed

  16. 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

    Fellows Jeffrey L


    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

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

    Bartels, C


    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.

  18. Capabilities Developments and Key Technologies of Large-Caliber Gun Weapon System of U.S. Navy under Conditions of Informatization%信息化条件下美军大口径舰炮武器系统发展技术

    石章松; 孙世岩; 王航宇


    随着国际形势的变化和战争实践的深入,世界海军战略思想和海战模式发生了相应的变化,濒海作战逐渐成为一些国家海军的作战重点,大口径舰炮开始在为地面部队提供火力支援中扮演重要的角色。近年来发生的几场高技术局部战争表明,精确打击已成为现代战争的主要作战样式。根据大口径舰炮在现代海战中的作战任务,并结合打击目标类型及其特性,重点分析了大口径舰炮对目标进行精确打击所需的主要关键技术,最后阐述了大口径舰炮的发展趋势。%With changing of the international situation and the practice of war,the world naval strategic thinking and naval battle mode developed. The Littoral Combat mode gradually become the operational focus of national navy in some countries,so large-caliber guns begin to play an important role in providing ground troops with fire support. Several high-tech local wars which occurred in recent years showed that precision strike become the main combat style in modern warfare. Missions in modern naval combat of Large-caliber guns,combat target types and their characteristics are analyzed. Then analysis of the key technologies required by the large-caliber guns on target precision strike is done. Finally the future of large caliber guns development trends is elaborated.

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

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


    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 perfor

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

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


    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

  1. An Analysis of Navy Managed Child Development Centers


    NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA MBA PROFESSIONAL REPORT AN ANALYSIS OF NAVY MANAGED CHILD DEVELOPMENT CENTERS......return on investment for the Navy and its members. 14. SUBJECT TERMS: Child Care, CDC, Child Development Center, subsidy, cost analysis

  2. Two-Bin Kanban: Ordering Impact at Navy Medical Center San Diego


    degree in Supply Chain Management . Lieutenant Hill’s personal awards include the Defense Meritorious Service Medal, Navy and Marine care include poor management support, poorly aligned incentives, poor data analytics, lack of supply chain education, and weak purchasing...expenditures are attributed to the supply chain (McKone-Sweet, Hamilton, & Willis, 2005). Lean management practices began to emerge in hospitals between

  3. 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

    Carreira, Mauricio Costa


    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)

  4. Effect of hydrocolloids on functional properties of navy bean starch

    The effects of hydrocolloid replacement on the pasting properties of navy bean starch and on the properties of navy bean starch gels were studied. Navy bean starch was isolated, and blends were prepared with beta-glucan, guar gum, pectin and xanthan gum solutions. The total solids concentration was ...

  5. Navy Mobility Fuels Forecasting System report: Navy fuel production in the year 2000

    Hadder, G.R.; Davis, R.M.


    The Refinery Yield Model of the Navy Mobility Fuels Forecasting System has been used to study the feasibility and quality of Navy JP-5 jet fuel and F-76 marine diesel fuel for two scenarios in the year 2000. Both scenarios account for environmental regulations for fuels produced in the US and assume that Eastern Europe, the USSR, and the People`s Republic of China have free market economies. One scenario is based on business-as-usual market conditions for the year 2000. The second scenario is similar to first except that USSR crude oil production is 24 percent lower. During lower oil production in the USSR., there are no adverse effects on Navy fuel availability, but JP-5 is generally a poorer quality fuel relative to business-as-usual in the year 2000. In comparison with 1990, there are two potential problems areas for future Navy fuel quality. The first problem is increased aromaticity of domestically produced Navy fuels. Higher percentages of aromatics could have adverse effects on storage, handling, and combustion characteristics of both JP-5 and F-76. The second, and related, problem is that highly aromatic light cycle oils are blended into F-76 at percentages which promote fuel instability. It is recommended that the Navy continue to monitor the projected trend toward increased aromaticity in JP-5 and F-76 and high percentages of light cycle oils in F-76. These potential problems should be important considerations in research and development for future Navy engines.

  6. Navy Mobility Fuels Forecasting System report: Navy fuel production in the year 2000

    Hadder, G.R.; Davis, R.M.


    The Refinery Yield Model of the Navy Mobility Fuels Forecasting System has been used to study the feasibility and quality of Navy JP-5 jet fuel and F-76 marine diesel fuel for two scenarios in the year 2000. Both scenarios account for environmental regulations for fuels produced in the US and assume that Eastern Europe, the USSR, and the People's Republic of China have free market economies. One scenario is based on business-as-usual market conditions for the year 2000. The second scenario is similar to first except that USSR crude oil production is 24 percent lower. During lower oil production in the USSR., there are no adverse effects on Navy fuel availability, but JP-5 is generally a poorer quality fuel relative to business-as-usual in the year 2000. In comparison with 1990, there are two potential problems areas for future Navy fuel quality. The first problem is increased aromaticity of domestically produced Navy fuels. Higher percentages of aromatics could have adverse effects on storage, handling, and combustion characteristics of both JP-5 and F-76. The second, and related, problem is that highly aromatic light cycle oils are blended into F-76 at percentages which promote fuel instability. It is recommended that the Navy continue to monitor the projected trend toward increased aromaticity in JP-5 and F-76 and high percentages of light cycle oils in F-76. These potential problems should be important considerations in research and development for future Navy engines.

  7. A 10-Year Retrospective Review of Nephrolithiasis in the Navy and Navy Pilots.

    Masterson, James H; Phillips, Christopher J; Crum-Cianflone, Nancy F; Krause, Robert J; Sur, Roger L; L'Esperance, James O


    Little is known about the incidence of nephrolithiasis in the United States Navy. Navy pilots must be kidney stone-free and are often referred for treatment of small asymptomatic stones. The primary objectives of this study were to determine the incidence of nephrolithiasis and computerized tomography, proportion undergoing treatment and incidence of stone related mishaps in Navy pilots compared with other Navy personnel. We retrospectively studied the records of all Navy service members from 2002 to 2011 for nephrolithiasis based on ICD-9 stone codes to determine the mentioned rates. We also reviewed NSC (Naval Safety Center) data for a history of accidents associated with nephrolithiasis. Rates of disease were calculated using person-years of followup and inferential statistics were done using univariable and multivariable analyses. We evaluated 667,840 Navy personnel with a total of 3,238,331 person-years of followup. The annual incidence of nephrolithiasis was 240/100,000 person-years with a 5-year recurrence rate of 35.3%. On multivariable analysis pilots had nephrolithiasis incidence and treatment rates similar to those of the overall Navy population. Women had a higher incidence of nephrolithiasis compared with men (OR 1.17, p <0.0001). The rate of computerized tomography was lower in pilots than in the rest of the Navy (39 vs 66/10,000 person-years, p <0.0001). No recorded accidents were associated with kidney stones. Navy pilots had a similar incidence of nephrolithiasis and were no more likely to undergo a surgical procedure. Given that no accidents were associated with nephrolithiasis, this study suggests reconsidering current military policies necessitating pilots to be completely stone-free. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  8. NaviCom: a web application to create interactive molecular network portraits using multi-level omics data.

    Dorel, Mathurin; Viara, Eric; Barillot, Emmanuel; Zinovyev, Andrei; Kuperstein, Inna


    Human diseases such as cancer are routinely characterized by high-throughput molecular technologies, and multi-level omics data are accumulated in public databases at increasing rate. Retrieval and visualization of these data in the context of molecular network maps can provide insights into the pattern of regulation of molecular functions reflected by an omics profile. In order to make this task easy, we developed NaviCom, a Python package and web platform for visualization of multi-level omics data on top of biological network maps. NaviCom is bridging the gap between cBioPortal, the most used resource of large-scale cancer omics data and NaviCell, a data visualization web service that contains several molecular network map collections. NaviCom proposes several standardized modes of data display on top of molecular network maps, allowing addressing specific biological questions. We illustrate how users can easily create interactive network-based cancer molecular portraits via NaviCom web interface using the maps of Atlas of Cancer Signalling Network (ACSN) and other maps. Analysis of these molecular portraits can help in formulating a scientific hypothesis on the molecular mechanisms deregulated in the studied disease. NaviCom is available at




    Public hospital is a public medical institutions , but at the present, the government's financial abil-ity is limited, which input for the hospital is symbolic .In fact, in order to survive and develop , the hospital debts be-come the main means of financing of public hospital .The liabilities of hospital mainly include two aspects : one is the current liabilities, such as the credit payment which is formed by the drug ; the other is the long term liabilities, such as the borrowing from financial institutions , which is used to construct the fixed asset of the hospital .Now, the man-agement of the debts has become an important means for the development of hospital , although, the hospital can solve the problem of the shortage of the funds to expand the scale of development and the power of competing , but inevita-bly, which will accompany by some risks , at the same time of indebtedness .So, hospital should carry on the scientif-ic decision, and make the early warning and management about the necessary financial risk .%医院负债主要由两方面构成:一是流动性负债,包括医院赊购药品等的货款;另一种是长期负债,主要是医疗机构为购建固定资产等由金融机构贷出的借款。负债经营已经成了目前医院发展的重要手段,虽然医院通过负债可以解决其面临的资金短缺问题,并以此扩大发展规模和竞争实力,但在负债经营的同时,势必会伴随一定的风险。因而,医院在实施负债经营时应进行负债风险评估,并进行必要的财务风险预警与管理。

  10. Parenting Stress After Deployment in Navy Active Duty Fathers.

    Yablonsky, Abigail M; Yan, Guofen; Bullock, Linda


    Military fathers are being deployed, and leaving their families, for greater lengths of time and more frequently than ever before. The purpose of this study was to examine the impact of recent deployment on parenting stress in U.S. Navy fathers with young children. Of the 111 participants who completed the one-time study questionnaire at a large military outpatient clinic on the Eastern seaboard, 67.6% had returned from a ship-based deployment. Regression analyses were performed, using the Parenting Stress Index as the outcome variable, deployment elements (such as time away from home in the past 5 years) as predictors, and adjusting for other factors such as post-traumatic stress disorder (PTSD) and depression. Higher perceived threat and greater warfare exposure were both associated with increased parenting stress (p < 0.05) in the unadjusted model. These associations were greatly attenuated and no longer significant after adjustment for depression. In addition, rates of positive screens for PTSD and depression (17.1%) in this sample were higher than in other recent studies. In summary, these data indicate that various deployment factors are associated with increased parenting stress in Navy fathers back from deployment within the past year; these relationships are largely explained by depressive symptoms. Clinical implications are discussed.

  11. Objective allergy markers and risk of cancer mortality and hospitalization in a large population-based cohort

    Taghizadeh, Niloofar; Vonk, Judith M; Hospers, Jeannette J; Postma, Dirkje S; de Vries, Elisabeth G. E.; Schouten, Jan P; Boezen, H Marike


    PURPOSE: There are indications that a history of allergy may offer some protection against cancer. We studied the relation of three objectively determined allergy markers with cancer mortality and hospitalization risk. METHODS: Associations between three allergy markers (number of peripheral blood e

  12. Large variation between hospitals in immediate breast reconstruction rates after mastectomy for breast cancer in the Netherlands

    van Bommel, A C M; Mureau, M A M; Schreuder, K; van Dalen, T; Vrancken Peeters, M T F D; Schrieks, M; Maduro, J H; Siesling, S


    BACKGROUND: The present study aimed to describe the use of immediate breast reconstruction (IBR) after mastectomy for invasive breast cancer and ductal carcinoma in situ (DCIS) in hospitals in the Netherlands and determine whether patient and tumor factors account for the variation. METHODS: Patient

  13. Impact of a hospital-wide multifaceted programme for reducing carbapenem-resistant Enterobacteriaceae infections in a large teaching hospital in northern Italy.

    Viale, P; Tumietto, F; Giannella, M; Bartoletti, M; Tedeschi, S; Ambretti, S; Cristini, F; Gibertoni, C; Venturi, S; Cavalli, M; De Palma, A; Puggioli, M C; Mosci, D; Callea, E; Masina, R; Moro, M L; Lewis, R E


    We performed a quasi-experimental study of a multifaceted infection control programme for reducing carbapenem-resistant Enterobacteriaceae (CRE) transmission and bloodstream infections (BSIs) in a 1420-bed university-affiliated teaching hospital during 2010-2014, with 30 months of follow-up. The programme consisted of the following: (a) rectal swab cultures were performed in all patients admitted to high-risk units (intensive-care units, transplantation, and haematology) to screen for CRE carriage, or for any room-mates of CRE-positive patients in other units; (b) cohorting of carriers, managed with strict contact precautions; (c) intensification of education, cleaning and hand-washing programmes; and (d) promotion of an antibiotic stewardship programme carbapenem-sparing regimen. The 30-month incidence rates of CRE-positive rectal cultures and BSIs were analysed with Poisson regression. Following the intervention, the incidence rate of CRE BSI (risk reduction 0.96, 95% CI 0.92-0.99, p 0.03) and CRE colonization (risk reduction 0.96, 95% CI 0.95-0.97, p accounting for changes in monthly census and percentage of externally acquired cases (positive at ≤72 h), the average institutional monthly rate of compliance with CRE screening procedures was the only independent variable associated with a declining monthly incidence of CRE colonization (p 0.002). The monthly incidence of CRE carriage was predictive of BSI (p 0.01). Targeted screening and cohorting of CRE carriers and infections, combined with cleaning, education, and antimicrobial stewardship measures, significantly decreased the institutional incidence of CRE BSI and colonization, despite endemically high CRE carriage rates in the region.

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

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


    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

  15. Introduction to Sonar, Navy Training Course.

    Naval Personnel Program Support Activity, Washington, DC.

    Fundamentals of sonar systems are presented in this book, prepared for both regular navy and naval reserve personnel who are seeking advancement in rating. An introductory description is first made of submarines and antisubmarine units. Determination of underwater targets is analyzed from the background of true and relative bearings, true and…

  16. Department of the Navy Small Business Programs


    small business concerns and to women -owned small business concerns eligible under the Women -Owned Small Business Program. The dollar...2014 For All US-Based Women Owned Small Business Awards Over $ 200M Over $ 100M Over...Department of the Navy Small Business Programs Gold Coast August 13, 2014 Report Documentation Page Form ApprovedOMB No. 0704-0188

  17. Contemporary Sexism in the South African Navy

    Van Wijk, Charles H.


    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…

  18. Navy Research, Development, and Acquisition Management Guide


    processes, fluids , materials, and safety fire than 50 products and services from NTIS. hazards. Also includes data from ALERT’s as well including as...launchrs. amnition , guis. E-6 an G4.)launchers, ammunition. guided missiles. E-6 and G4.) mines, and torpedoes. "* Navy and Marine Corps aircraft

  19. Roadmap for Navy Civilian Personnel Research


    Steinhauer Head, Staffing and Pay Systems Branch Civilian Personnel Policy Division "Mr. Joseph K. Taussig , Jr. Deputy Assistant Secretary of the Navy...Society of Naval Engineers, 1953, 65, 9-22. Frank, Michael . "Position Classification: A State of the Art Review and Analysis," Public Personnel

  20. Secretary of the Navy, Processor of Oceanography


    9500 Gilman Drive La Jolla.CA 92093-0210 8. PERFORMING ORGANIZATION 9. SPONSORING/MONrTORlNG AGENCY NAME(S) AND ADDRESS(ES) Office of Naval... Goodman , D. Hammer, J. Katz, D. Meiron, A. Mulliken, W. Munk, W. Press, and J. Sullivan) (2007) Navy Ship Underwater Shock Prediction and Testing

  1. Training the Navy Preventive Medicine Technician

    Janoski, Tom


    This article gives the history and purpose of the Navy Preventive Medicine Technician (PMT) School, overviews the program's goals, and summarizes the program of study. PMT students receive 26 weeks of intensive didactic and practical instruction in preventive medicine and environmental health. Graduates receive 421/2 semester hours of college…

  2. 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

    Boyd, Lauren Becnel; Atmar, Robert L; Randall, Graham L; Hamill, Richard J; Steffen, David; Zechiedrich, Lynn


    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. PMID:18197977

  3. 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

    Hamill Richard J


    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.

  4. [Feasibility of consultation - liaison psychiatry in a large general hospital: quantitative description of services and personnel expenditure].

    Windhager, Elmar; Thaler, Katharina; Selberis-Vahl, Wilia Vasiliki; Friedl-Wörgetter, Petra; Windhager, Isabella; Zauner, Katharina


    The integration of psychiatric departments in general hospitals lead to an increasing demand of psychiatric consultation, which often overstrains personnel resources of short staffed psychiatric services. To provide consulting service, as it is demanded by guidelines, a multidisciplinary consulting team could be a possible solution. A retrospective descriptive analysis of all consultations made by the psychosocial consultation and liaison service at the general hospital Wels-Grieskirchen in the years 2012 and 2013. There was an increase in referrals overall of 22 % from 2012 to 2013. The largest increase was observed in the group of psychiatrists, who carried out 33.1 % of all consultations. Most consultations, 39.5 %, were done by the group of clinical psychologists, partly substituting medical attendance. Taking together both occupational groups, the expected number of consultations of at least 3 % of all admissions could be achieved. A multidisciplinary consulting team consisting of psychiatrists, psychologists, psychosomatic physicians and social workers staffed with 5.11-6.79 full-time personnel is able to provide psychosocial consultation service at a quantitative level required by international guidelines.

  5. [Air and biomonitoring of occupational exposure to anesthetic gases in the health care workers of a large hospital in Milan].

    Fustinoni, S; Pasini, R; Strangi, F; Valla, C; Missineo, P; Margonari, M; Denaro, R; Bertazzi, P A


    In this study exposure to anesthetic gases in health care workers of a hospital of Milan was investigated. The evaluation focused on the period 2007-2010 and was performed by environmental monitoring (20 operating rooms and 54 samples) and biological monitoring (180 workers and 242 urine samples). Mean airborne exposure was 3:15 and 0.34 ppm for nitrogen protoxide (N2O) and sevorane; in end-of-exposure urine samples the concentration of N2O and hexafluoroisopropanol, metabolite of sevorane, were 4.85 mg/L and 0.21 mg/L, with 80 and 21% of values below the quantification limit. Sevorane monitoring exceeded or equaled the environmental limit value of 0.5 ppm and the biological exposure index in 17 and 11% of measures. There were no observed exceedances of the limit for N2O. The anesthetist and scrub nurse were tasks with greater exposure. There was a significant correlation between airborne halogenated gases and urinary hexafluoroisopropanol. The results of this study indicates that further efforts are needed to improve the hygienic conditions in the investigated hospital.

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

    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


    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.

  7. discussion on Structure Modes of LIS in Large-scale Hospitals%大型医院检验信息系统架构模式探讨

    徐玲; 刘长兴


      针对大型医院的实验室,比较检验信息系统C/S和B/S两种架构的特点和不同,并结合本院实际讨论B/S模式下系统的优点。%Comparisons are made in this paper between two structure modes of LIS(Laboratory Information Management System) in large-scale hospitals - C/S(client/server) and B/S(browser/server) in the aspects of characteristics and differences. Advantages of B/S mode is also discussed in combination of the actual practice in General Hospital of Jinan Military Command.


    程勇; 蔡建强; 王兴宇; 胡建华


    文章介绍了中国医学科学院肿瘤医院的供电系统概况;针对发生大范围停电的几种可能性,制订了针对四种情况的处置方法;列举了应对"大范围停电"需要准备的物资;阐述了针对"大范围停电"情景演练的意义.%The article briefly introduces the power supply system of Chinese Academy of Medical Sciences Cancer Hospital; developed disposal measures for the four possibilities for large-scale power outage; listed materials need to prepare for the "large-scale power outages"; elaborated the significance of the "large-scale power outages" dril.

  9. Representações de adoecimento e cura de pacientes do Centro de Dependência Química do Hospital Central da Marinha Representations on patient illness and cure at the Chemical Dependency Center of the Central Navy Hospital

    Elizabeth Espindola Halpern


    Full Text Available Este artigo apresenta um dos segmentos de uma pesquisa etnográfica feita ao longo de dois anos, por meio da observação participante, no Centro de Dependência Química (CEDEQ da Marinha do Brasil (MB. Pacientes de dois grupos terapêuticos foram observados durante 24 sessões de grupoterapia. Entrevistas individuais após as sessões ocorreram com 13 pacientes escolhidos aleatoriamente dentre os 22 militares dos dois grupos. Objetivou-se examinar suas representações de adoecimento e cura relacionadas aos seus diagnósticos de transtorno mental e comportamental devido ao uso de drogas, além de investigar a influência do ambiente de trabalho no envolvimento dos pacientes com drogas, em particular com o álcool. Resultados apontam que os pacientes passam a crer que são os principais responsáveis pelo seu adoecimento e alcance da sobriedade, e que nunca serão curados. Todavia, eles nem sempre aderem ao discurso médico vigente e à visão dos Alcoólicos Anônimos de que são doentes alcoólicos em recuperação, construindo percepções sobre seus diagnósticos, prognósticos e tratamentos. Concluiu-se que traços culturais peculiares à vida naval indicam que as categorias analisadas são, sobretudo, sociais e que certas condições laborativas colaboram para a emergência do alcoolismo de muitos pacientes, apesar do uso de drogas geralmente ser abordado pelo viés administrativo.This article presents one of the segments of ethnographic research which was conducted over a two-year period, by means of participant observation, at the Chemical Dependency Center of the Brazilian Navy. Patients of 2 treatment groups were observed during 24 sessions of group therapy. Among the 22 existing patients of the two groups, 13 patients were randomly selected for individual interviews. Their illness and healing representations related to mental and behavioral disorders caused by drugs were examined, and also the influence of the work environment on

  10. Assigning a team-based pager for on-call physicians reduces paging errors in a large academic hospital.

    Shieh, Lisa; Chi, Jeffrey; Kulik, Carol; Momeni, Arash; Shelton, Andrew; DePorte, Cynthia; Hopkins, Joseph


    As complexity of care of hospitalized patients has increased, the need for communication and collaboration among members of the team caring for the patient has become increasingly important. This often takes the form of a nurse's need to contact a patient's physician to discuss some aspect of care and modify treatment plans. Errors in communication delay care and can pose risk to patients. This report describes the successful implementation of a standardized team-based paging system at an academic center. Results showed a substantial improvement in nurses' perceptions of knowing how to contact the correct physician when discussion of the patient's care is needed. This improvement was found across multiple medical and surgical specialties and was particularly effective for services with the greatest communication problems.

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

    Moore, Robert J.; Hand, Elizabeth O.; Howell, Crystal K.


    Introduction 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. Methods 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. Results 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. Conclusions Although MRSA was the causative pathogen in a small number of DFI, antibiotic coverage targeted against MRSA was unnecessarily

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

    Guinea, Jesús; Escribano, Pilar; Vena, Antonio; Muñoz, Patricia; Martínez-Jiménez, María Del Carmen; Padilla, Belén; Bouza, Emilio


    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; PPatients 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. Navys Contract/Vendor Pay Process Was Not Auditable


    Naval Research, and Navy ERP transactions processed by NAVAIR. 15 DoD Regulation 7000.14-R, “DoD Financial Management Regulation,” volume 4, chapter 9...CVP universe. This occurred because Navy FMO did not design its financial management systems to identify CVP transactions and support an audit...affected. Recommendations We recommend that the Deputy Assistant Secretary of the Navy (Financial Management and Comptroller) develop a reconciliation

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


    Robert F. Baumann, Ph.D. The opinions and conclusions expressed herein are those of the student author and do not necessarily represent the views...nefarious state and non-state actors acquiring low cost threat weapons, Navy ID has no room for failure . Navy ID needs to ensure they have constant...austere budgetary constraints and the rise of nefarious state and non-state actors acquiring low cost threat weapons, Navy ID has no room for failure

  15. Navy Officials Justified the MQ-4C Triton Procurement Quantity


    Naval Air Systems Command internal controls over Triton quantity requirements were effective as they applied to the audit objectives, because Navy...Visit us at September 16, 2015 Objective This is the first in a series of audits on the Navy MQ-4C Triton (Triton) Unmanned Aircraft...System (UAS) Program. Our overall objective for the series of audits was to determine whether the Navy effectively managed the Triton UAS

  16. Navy Community of Practice for Programmers and Developers


    design and sustainment of a Navy CoP for programmers and developers ? D. BENEFITS OF STUDY Organizations that have instituted well-designed and effective...Navy CoP for programmers and developers in order to make the Navy more combat effective. 5 E. ORGANIZATION OF STUDY Chapter II introduces...will refer to individuals who engage in this practice as programmers and developers . 9 Communities of Practice may self- organize or be sponsored

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

    Meek, Gordon E.


    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...

  18. Epidemiology and treatment of paediatric burns in a large children’s hospital in Morocco: Analysis of 394 cases

    H. Droussi


    Discussion: This large case series highlights the current epidemiology, management and outcome of paediatric burn victims in Morocco. Current burn management in low resources settings can be challenging and several additional measures should be taken to reduce morbidity among paediatric burn victims.

  19. Navy Prototype Optical Interferometer observations of geosynchronous satellites.

    Hindsley, Robert B; Armstrong, J Thomas; Schmitt, Henrique R; Andrews, Jonathan R; Restaino, Sergio R; Wilcox, Christopher C; Vrba, Frederick J; Benson, James A; DiVittorio, Michael E; Hutter, Donald J; Shankland, Paul D; Gregory, Steven A


    Using a 15.9  m baseline at the Navy Prototype Optical Interferometer (NPOI), we have successfully detected interferometric fringes in observations of the geosynchronous satellite (geosat) DirecTV-9S while it glinted on two nights in March 2009. The fringe visibilities can be fitted by a model consisting of two components, one resolved (≳3.7  m) and one unresolved (∼1.1  m). Both the length of the glint and the specular albedos are consistent with the notion that the glinting surfaces are not completely flat and scatter reflected sunlight into an opening angle of roughly 15°. Enhancements to the NPOI that would improve geosat observations include adding an infrared capability, which could extend the glint season, and adding larger, adaptive-optics equipped telescopes. Future work may test the feasibility of observing geosats with aperture-masked large telescopes and of developing an array of six to nine elements.

  20. Navy Organizational Commitment and Non-response


    Journal of Applied Psychology, 85(2), 284–293. Uriell, Z. A., & Burress, L. (2007). Results of the 2005 Pregnancy and Parenthood Survey (NPRST-AB... single individual. PARTICIPATION: Providing information is completely voluntary. Failure to respond to any of the questions will NOT result in any...the Navy’s MWR facilities to others. d. MWR programs contribute to my readiness. e. MWR programs are a benefit I consider when deciding whether to

  1. Investigating Navy officer retention using data farming

    DeHollan, Aurel N.


    Approved for public release; distribution is unlimited The allocation of nearly 30% of the Navy’s budget to personnel costs, and the importance of manning fleet requirements to maintain operational readiness create a critical need for the Navy to effectively manage the size of the force. The Navy’s personnel planners use the Officer Strategic Analysis Model (OSAM) to project officer end-strength based on policies, plans, and historical loss rates. The application of data farming to this mo...

  2. A Software Engineering Environment for the Navy.


    require- ments on a Navy SEE. X A -.1.2Fo s’i Lity Az sp,: 23-s bi lity as’j32, sient 1&* ktm~ines r.C’w ~f :on s+-a !nts a nd evalu at )ri cr >r.t~~ Z...isua.LLy shorter than a computer worl ; a byte ;sually contains eignt, and sometimes six, bilts. c-apacity - a measure of processing rate; tne amount of

  3. Navy Future Fleet Platform Architecture Study


    weapon systems , in addition to more of what the Navy already has in the inventory. The development of these new weapons and procuring them in numbers... system comprised of interdependent networks of trade, finance , information, law, people, and governance [10]. U.S. Maritime Strategy The U.S... developed the vertical launch system (VLS) as part of the Aegis combat system . VLS canisters can be equipped with land attack, anti-ship, and anti

  4. Navy Water Conservation Guide for Shore Activities.


    water overuse, abuse, and apa - tation of the principles of water con- thy. DOE estimates that water use servation at your Navy facility will in the...Sacramento, CA: 1994. Camacho, Norma , et. al. Water Conservation Technology Guide. NEESA-1 - 040. Naval Energy and Environmental Support Activity...Conservation Technology Document, Naval Civil Engineering Laboratory, page 7-8. Port Hueneme, CA: 1985. Figure 4-7: Camacho, Norma , et. al. NEESA 1-040

  5. Navy Ship Names: Background for Congress


    direction of the President and in accordance with rules prescribed by Congress. For most of the 19th century, U.S. law included language Defense Acquisition : Background and Issues for Congress, by Ronald O’Rourke and Moshe Schwartz. 25 Department of the Navy, A Report on Policies...submarine SSN-793 was being named for Oregon stated that the previous USS Oregon “was a battleship best known for its roles in the Spanish American War

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

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


    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.

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


    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

  8. Sociodemographic determinants of knowledge on the figure of radiologist: results of a survey in large university hospital

    Giuseppe Cicchetti


    Full Text Available IntroductionDespite overlaying an irreplaceable role as a key diagnostic tool in modern medicine, the role of radiologist still appears to be unclear to patients.Methods We conducted a survey in outpatient clinic of Radiological Sciences Department of the University Hospital “A. Gemelli” in Rome, aiming to assess how correct patients identify the figure of the radiologist. The patients were interviewed by the trained physician using structured questionnaire.Results We included the number of 259 patients. Majority were female 63.3%, most were 60-69 years old (24.3%, have finished second grade secondary school (35.1% and were subjected to magnetic resonance (28.6% while the least were subjected to chest X-ray (8.1%. Only 38.7% answered correctly to question No 1 “Who performed your examination?”, and only 30.9% correctly identified the radiologist as a person interpreting the exam (question No 2 “Who is going to interpret your radiological examination?”. Overall, 16.8% responded correctly to the both questions. Significantly less patients with primary school (OR: 0.18, CI 95% 0.06-0.49 and first grade secondary school (OR: 0.37, CI 95% 0.18-0.75 correctly addressed the question No 1 in compare to those with second grade secondary school. The first grade secondary education (OR: 0.43, CI 95% 0.20-0.92 was inversely associated with correct answer to question No 2.  Patients with primary education were significantly less prone to give both correct answers (OR: 0.12, CI 95% 0.02-0.60.Conclusion We report insufficient knowledge among patients on radiologist’s role in healthcare system. The level of knowledge is associated with level of education.

  9. Evaluation of antivenom therapy for Vipera palaestinae bites in children: experience of two large, tertiary care pediatric hospitals.

    Pivko-Levy, Dikla; Munchnak, Itamar; Rimon, Ayelet; Balla, Uri; Scolnik, Dennis; Hoyte, Christopher; Voliovitch, Yair; Glatstein, Miguel


    Antivenom has been successfully used to treat systemic and progressive, local manifestations of envenomation inflicted by Vipera (V.) palaestinae, the most common venomous snake in Israel. The objective of this study was to evaluate the fixed dose V. palaestinae monovalent (equine) immunoglobulin G antivenom used in two pediatric emergency departments. In particular, we wanted to assess the need for repeated antivenom administration and the rate of adverse antivenom effects in children. A retrospective chart review was performed for all children admitted with definite or probable signs of V. palaestinae envenomation to Chaim Sheba Medical Center and Kaplan Medical Center between 1 March 2008 and 1 March 2014. Extracted data included: age, location of bite, time to hospital arrival, time to antivenom administration if indicated, outcomes, and complications of the envenomation and adverse effects to the antivenom. 57 patients met inclusion criteria; they ranged from 1 to 17 years in age and median age was 9.5 years. Clinical manifestations were evident in 55 (96.4%) of victims: 18 presented with minimal local signs and 37 showed marked progressive, local features (rapidly progressing edema) and signs of systemic envenomation: tachycardia (20), vomiting (17), abdominal pain (11) and hypotension (6). Two patients developed compartment syndrome and underwent surgical decompression (both received only a loading dose of antivenom with no subsequent maintenance dose). One patient developed thrombocytopenia and three patients presented with mild coagulopathy. Antivenom was administered to 25 (42%) children. Indications for antivenom administration included moderate to severe local signs (19 patients) and systemic signs (6 patients). None of these patients developed adverse reactions, serum sickness, or other side effects to the antivenom. One patient received a single additional 30mL dose of antivenom, due to hypotension and syncope, with good response. In children, 50

  10. Five-year investigation of a large orthodontic patient population at a dental hospital in South Korea

    Piao, Yongxu; Kim, Sung-Jin; Yu, Hyung-Seog; Cha, Jung-Yul


    Objective The purpose of this study was to investigate the characteristics of orthodontic patients at Yonsei Dental Hospital from 2008 to 2012. Methods We evaluated Angle's classification from molar relationships, classification of skeletal malocclusion from the A point-nasion-B point angle, facial asymmetry, and temporomandibular joint disorders (TMDs) from the records of 7,476 patients who received an orthodontic diagnosis. The orthognathic surgery rate, extraction rate, and extraction sites were determined from the records of 4,861 treated patients. Results The patient number increased until 2010 and gradually decreased thereafter. Most patients were aged 19−39 years, with a gradual increase in patients aged ≥ 40 years. Angle's Class I, Class II divisions 1 and 2, and Class III malocclusions were observed in 27.7%, 25.6%, 10.6%, and 36.1% patients, respectively, with a gradual decrease in the frequency of Class I malocclusion. The proportion of patients with skeletal Class I, Class II, and Class III malocclusions was 34.3%, 34.3%, and 31.4%, respectively, while the prevalence of facial asymmetry and TMDs was 11.0% and 24.9%, respectively. The orthognathic surgery rate was 18.5%, with 70% surgical patients exhibiting skeletal Class III malocclusion. The overall extraction rate among nonsurgical patients was 35.4%, and the maxillary and mandibular first premolars were the most commonly extracted teeth. Conclusions The most noticeable changes over time included a decrease in the patient number after 2010, an increase in the average patient age, and a decrease in the frequency of Angle's Class I malocclusion. Our results suggest that periodic characterization is necessary to meet the changing demands of orthodontic patients. PMID:27226959

  11. 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

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


    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.)

  12. Heuristic Route Generation for the Navy Mission Planner


    SCENARIO, ANALYSIS, AND CONCLUSION ...................................................27  A.  ORIGINAL NAVY MISSION PLANNER MODEL ... Modeling System Intel Intelligence JFMCC Joint Force Maritime Component Commander JP Joint Publication MCM Mine Countermeasures MHQ...Ballistic Missile Defense VBA Visual Basic for Applications xiv THIS PAGE INTENTIONALLY LEFT BLANK xv EXECUTIVE SUMMARY Navy Mission Planner

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

    Duff, Jon M.


    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…

  14. 32 CFR 705.16 - Navy produced public information material.


    ....16 Section 705.16 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY UNITED... information material. (a) Still photo—(1) General. (i) The policy and procedures given for media produced still photos in § 705.10, apply to Navy produced photos. (ii) The Office of Information does not...

  15. Synchronization of IM and HC: The Navy Perspective


    exploit this new technology and make "Insensitive Ordnance" available to the Fleet. Though he is probably unaware of it, Admiral James D. Watkins, who...Requests Lead COMM (301) 744-6045 DSN 354-6045 Kathleen Sterba Test Plans Lead COMM (301) 744-6024 DSN

  16. Trends and Issues in U.S. Navy Manpower


    0Kk PERSPECTIVES ON NAVY MANPOWER TTHE CENTER FOR NAVAL ANALYSES The Center for Naval Analyses (CNA) is a not-for-profit Federally Funded Research...ST (Sonar Technician), SW (Steelwodker), SK (Storekeeper). TM (Torpedoman’s Mate). TD (Tradevmian), UT (Utilitiesman), YN O’eomirn). Figure 6. Navy

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

    Eales-Reynolds, Lesley-Jane; Clarke, Colin


    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.

  18. Quiet Short-Haul Research Aircraft Joint Navy/NASA Sea Trials

    Queen, S.; Cochrane, J.


    The Quiet Short-Haul Research Aircraft (QSRA) is a flight facility which Ames Research Center is using to conduct a broad program of terminal area and low-speed, propulsive-life flight research. A joint Navy/NASA flight research program used the QSRA to investigate the application of advanced propulsive-lift technology to the naval aircraft-carrier environment. Flight performance of the QSRA is presented together with the results or the joint Navy/NASA flight program. During the joint program, the QSRA operated aboard the USS Kitty Hawk for 4 days, during which numerous unarrested landings and free deck takeoffs were accomplished. These operations demonstrated that a large aircraft incorporating upper-surface-blowing, propulsive-life technology can be operated in the aircraft-carrier environment without any unusual problems.

  19. Short-run and long-run elasticities of electricity demand in the public sector: A case study of the United States Navy bases

    Choi, Jino

    Numerous studies have examined the elasticities of electricity demand---residential as well as commercial and industrial---in the private sector. However, no one appears to have examined the behavior of the public sector demand. This study aims to fill that gap and to provide insights into the electricity demand in the public sector, using the U.S. Navy bases as a case study. This study examines electricity demand data of 38 Navy activities within the United States for a 16-year time period from 1985 through 2000. The Navy maintains a highly diverse shore infrastructure to conduct its mission and to support the fleet. The types of shore facilities include shipyards, air stations, aviation depots, hospital, and many others. These Navy activities are analogous to commercial or industrial organizations in the private sector. In this study, I used a number of analytical approaches to estimate short-run and long-run elasticities of electricity demand. Estimation using pooled data was rejected because it failed the test for homogeneity. Estimation using the time series data of each Navy activity had several wrong signs for coefficients. The Stein-rule estimator did not differ significantly from the separate cross-section estimates because of the strong rejection of the homogeneity assumption. The iterative Bayesian shrinkage estimator provided the most reasonable results. The empirical findings from this study are as follows. First, the Navy's electricity demand is price elastic. Second, the price elasticities appear to be lower than those of the private sector. The short-run price elasticities for the Navy activities ranged from -0.083 to -0.157. The long-run price elasticities ranged from -0.151 to -0.769.

  20. 32 CFR 700.323 - The Assistant Secretary of the Navy (Financial Management).


    ... 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...

  1. 32 CFR 700.322 - Assistant Secretaries of the Navy; statutory authorization.


    ... 32 National Defense 5 2010-07-01 2010-07-01 false Assistant Secretaries of the Navy; statutory... The Secretary of the Navy The Office of the Secretary of the Navy/the Civilian Executive Assistants § 700.322 Assistant Secretaries of the Navy; statutory authorization. There are four Assistant...

  2. 32 CFR 701.2 - Navy FOIA website/FOIA handbook.


    ... 32 National Defense 5 2010-07-01 2010-07-01 false Navy FOIA website/FOIA handbook. 701.2 Section...) Program § 701.2 Navy FOIA website/FOIA handbook. (a) The Navy FOIA website ( It features a FOIA Handbook which provides: guidance on how and where to submit requests; what's...

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

    Pedrosa de Azevedo, Ana Cecilia [Fundacao Oswaldo Cruz-FIOCRUZ, Escola Nacional de Saude Publica Sergio Arouca, Centro de Estudos da Saude do Trabalhador e Ecologia Humana-CESTEH, Rua Leopoldo Bulhoes 1480, Manguinhos 21041-210, Rio de Janeiro (Brazil)]. E-mail:; Osibote, Adelaja Otolorin [Fundacao Oswaldo Cruz-FIOCRUZ, Escola Nacional de Saude Publica Sergio Arouca, Centro de Estudos da Saude do Trabalhador e Ecologia Humana-CESTEH, Rua Leopoldo Bulhoes 1480, Manguinhos 21041-210, Rio de Janeiro (Brazil); Bastos Boechat, Marcia Cristina [Instituto Fernandes Figueira, Fundacao Oswaldo Cruz-FIOCRUZ (Brazil)


    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.

  4. Department of the Navy Correspondence Manual


    Correspondence 2-6 9 Outgoing Correspondence Controls 2-7 10 Limit Use of Social Security Numbers (SSN) 2-7 11 Identifying Navy and Marine Corps Personnel 2-7 12...the correspondence was originally sent to by phone or via e-mail. 10. Limit Use of Social Security Numbers (SSN) a. Corresponding Within the...Stravenue STRA Cove CV Loaf LF Stream STRM Creek CRK Locks LCKS Street ST Crescent CRES Lodge LDG Summit SMT Crossing XING Loop LOOP Terrace TER Dale DL

  5. Resource Management Strategy in the French Navy


    O&M), and special subsidies (e.g., Navy Museum). the human capital inputs (Lland L2) are subsumed under TITLE IlI. (loi de finances ) 4TITLE III, in...pose tremendous problems for recruitment and financing , as will become evident. Conscription has its own drawbacks and benefits, and some of these are...when the husband loses sea pay.[Ref. 73] Since march 1991 the minimum wage (or salaire minimum interprofessonel de croissance (SMIC)) in France is 31.94

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


    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

  7. The Interaction Management between Large-scale Hospitals and Community Information%大型医院与社区信息互动的管理



    目的 探讨如何加强大型医院与社区信息互动的管理,更好实现区域卫生信息化建设.方法 针对福建省目前卫生信息化建设现状,通过人才培养、加强卫生信息标准化和居民健康信息系统建设、医院加大病案管理力度等方法,实现区域卫生信息化.结果 只有加强大型医院与社区信息互动管理,才能实现区域卫生信息的共享.结论 做到多个医疗卫生信息系统的无缝衔接,实现大型医院与社区医疗卫生体系的互补、双赢,对医疗体制改革有重要意义.%Objective To explore how to strengthen the interaction management between large-scale hospitals and community information, and the better construction of regional health information . Methods Analyzing the current situation of health information in Fujian Province . Results Only by personnel training, enhancing the construction of health information standardization and residents health information system , and strengthening the management of medical records, to achieve regional health information sharing . Conclusion The association of medical and health information system s can achieve complementary and win-win of large-scale hospitals and community health care system , and is also importrant for health care reform .

  8. Study on the Scale of Market Orientation of Large General Hospitals%综合医院市场导向测评量表的研制

    郭蕊; 宗洁; 孔奕翼


    Objective To explore and develop the scale of market orientation of large general hospitals, and understand the current situation of culture and operations in hospital service model.Methods Through using the rating scale of medical organizational culture established by research group, 20 tertiary general hospitals' market orientation has been investigated.Results The scale contains three dimensions: customer satisfaction, market intelligence generation and dissemination, and responsiveness of market intelligence.The scale's Cronbach was 0.898.Through using factor analysis to test the construct validity, 67.81% of variation could be explained by the three dimensions; the customer satisfaction dimension got higher marks than responsiveness of market intelligence, and market intelligence generation and dissemination got the lowest marks; the scores with the employees of different positions on the concept of market orientation was statistically significant different.Conclusion The rating scale had good reliability and validity, and could reflect the status and differences of hospital market orientation.%目的 探索和开发我国医院市场导向测评量表,了解医院服务模式在理念和行动方面的现状.方法 课题组采用外部引进、内部调整的方法形成我国综合医院市场导向的测评量表,对20家三级综合医院展开现场调查.结果 量表包含3个维度:顾客满意、市场信息的产生和传播、对市场信息的反应;内部一致性信度为0.898,运用因子分析检验建构效度,前3个因子累积解释了67.81%的信息;顾客满意维度评分高于对市场信息的反应,市场信息的产生和传播评分较低;不同岗位的员工对市场导向观念评分差异存在统计学意义.结论 研制的量表具有较好的信度、内容效度和建构效度,能较好地反映不同医疗机构的市场导向现状和差异.

  9. Do Gender and Race/Ethnicity Influence Acute Myocardial Infarction Quality of Care in a Hospital with a Large Hispanic Patient and Provider Representation?

    Tomás Romero


    Full Text Available Background. Disparities in acute myocardial infarction (AMI care for women and minorities have been extensively reported in United States but with limited information on Hispanics. Methods. Medical records of 287 (62% Hispanic and 176 (38% non-Hispanic white (NHW patients and 245 women (53% admitted with suspected AMI to a southern California nonprofit community hospital with a large Hispanic patient and provider representation were reviewed. Baseline characteristics, outcomes (mortality, CATH, PCI, CABG, and use of pertinent drug therapy, and medical insurance were analyzed according to gender, Hispanic and NHW race/ethnicity when AMI was confirmed. For categorical variables, 2×2 chi-square analysis was conducted. Odds ratio and 95% confidence interval for outcomes adjusted for gender, race/ethnicity, cardiovascular risk factors, and insurance were obtained. Results. Women and Hispanics had similar drug therapy, CATH, PCI, and mortality as men and NHW when AMI was confirmed (n=387. Hispanics had less private insurance than NHW (31.4% versus 56.3%, P<0.001; no significant differences were found according to gender. Conclusions. No differences in quality measures and outcomes were found for women and between Hispanic and NHW in AMI patients admitted to a facility with a large Hispanic representation. Disparities in medical insurance showed no influence on these findings.

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

    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

  11. Excellence in Navy Recruiting: A Look at High Performing Navy Recruiting Districts


    III F. RZ NAVY AND TIIE RETIRED NETWORK ............... 112 C. PROPENSITY TO ENIAST? ......................... ..... 112 XVII. W E CAN GET BETTER...the building ical. An Education Specialist added onl kiocks that form the foundation of to these thoughts that thle Competition ixcellence . We will...newspapers, and the newsletters keepthe entire staf"within the district. the communication network going, up The telephone is often the and down and

  12. Department of the Navy Justification of Estimates for Fiscal Year 1984 Submitted to Congress January 1983. Operation & Maintenance, Navy. Book 2. Budget Activity 7: Central Supply & Maintenance.



  13. Protein nutritional quality of cowpea and navy bean residue fractions ...

    and navy bean residue-wheat diets was determined using in-vivo and in-vitro protein ... Phytohemagglutinin activity was only detectable in the raw cowpea ... Legume residues after protein extraction could be recommended for human food if

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


    meantime (until 1959), the Australian Navy acquired two aircraft carriers (1948 and ... Commonwealth, and their attitude towards South Africa hardened. .... apartheid's shades, the RSA as a whole was still firmly under the control of the NP.

  15. Conceptual Design of Navy Floating Pier.


    which do not have existing flood basins or dry dock facilities. 3.1.3 The Advantages As Navy Piers The floating pier provides a structure well suited to...Bureau of Yards and Docks built 13 reinforced concrete floating repair docks each of 280 ton lift capacity. Bach dock was 390 ft. long, 80 ft. wide and...4 176CK ApoQ &LLKHC-AP6, COLUMNN AND eAr4b V~JricAL- roA~~scN LY T’B 4OPr~C-. I200-+0k 𔄀 CELLO £TNAT STRUCTUARAL EN4GINEERING " NrE FZ IR MJUə

  16. Computer virus security in the Department of the Navy

    Salters, Michael Jerome


    Approved for public release; distribution is unlimited This thesis discusses the growing threat of computer viruses and their impact on Automated Information Systems. In particular, it attempts to show a need to establish sound security programs that properly address computer viruses. A major area of the thesis focuses on current guidance by the Department of Defense and the Department of the Navy and provides recommendation for an effective Navy organization to effectively ...

  17. The Navy at a Tipping Point: Maritime Dominance at Stake?


    dominance and influence (the ability to deter and reassure on a global scale) as a " global navy." 15. SUBJECT TERMS Navy Force Posture and Structure...forces have been postured globally as combat credible and forward present for the past 60 years. It has operated from the premise that forward presence...would be able to continue its global posture with the support of USAF forward basing and access. In addition, BMD demand would be limited to meeting a

  18. Navy Entomologists Assist CDC’s Fight Against Malaria


    ORGANIZATION NAME(S) AND ADDRESS(ES) Medical Services Corps,Navy and Marine Corps Public Health Center Detachment,Centers for Disease Control and...the Navy Entomology Center of Excellence sprays panels, made of materials typically found in African houses, with residual insecticide for longevity...iates and RTI International. A year ago. the lead author was assigned as the entomology con- sultant to PMI teams in Uganda, Liberia, and Nigeria

  19. Parathyroid gland involvement by thyroid cancer: results from a large series of thyroidectomies performed in two italian university hospitals and review of the literature.

    Papi, Giampaolo; Corrado, Stefania; Fadda, Guido; Maiorana, Antonino; Maccio, Livia; Corsello, Salvatore Maria; Pontecorvi, Alfredo


    Objectives.Parathyroid involvement by thyroid cancer (TC) has not been frequently investigated in thyroidectomy-based studies. We aimed to detect cases of parathyroid invasion by TC in a large series of thyroidectomies and to review the literature on this topic. Study Design. A 10-yr period database research was made from the files of the Section of Pathology of two Italian University Hospitals. Out of 22,310 thyroidectomies, 10 patients with parathyroid involvement by TC were found. Results. The 10 patients, 7 females and 3 males, aged 55 ± 14 years (range 34-76, median 56) had papillary thyroid carcinoma and accounted for 0.4% of subjects affected by all TCs and submitted to thyroidectomy. The tumor invaded perithyroid soft tissues in 6 patients and central neck (level VI) lymph nodes in 3. Parathyroid involvement by TC occurred by infiltration in 6 cases, extension through an intervening pseudocapsule in 1, and both patterns in 3. All patients are alive and disease free at 5.6 ± 3-yr follow-up. Conclusion. Limited to thyroidectomy series, our results and literature data suggest that parathyroid involvement by TC has a 0.4-3.9% incidence rate; mainly affects women in their sixth-seventh decade of life; is associated to a good prognosis, unless massive extrathyroid extension of TC occurs.

  20. Parathyroid Gland Involvement by Thyroid Cancer: Results from a Large Series of Thyroidectomies Performed in Two Italian University Hospitals and Review of the Literature

    Giampaolo Papi


    Full Text Available Objectives.Parathyroid involvement by thyroid cancer (TC has not been frequently investigated in thyroidectomy-based studies. We aimed to detect cases of parathyroid invasion by TC in a large series of thyroidectomies and to review the literature on this topic. Study Design. A 10-yr period database research was made from the files of the Section of Pathology of two Italian University Hospitals. Out of 22,310 thyroidectomies, 10 patients with parathyroid involvement by TC were found. Results. The 10 patients, 7 females and 3 males, aged 55±14 years (range 34–76, median 56 had papillary thyroid carcinoma and accounted for 0.4% of subjects affected by all TCs and submitted to thyroidectomy. The tumor invaded perithyroid soft tissues in 6 patients and central neck (level VI lymph nodes in 3. Parathyroid involvement by TC occurred by infiltration in 6 cases, extension through an intervening pseudocapsule in 1, and both patterns in 3. All patients are alive and disease free at 5.6±3-yr follow-up. Conclusion. Limited to thyroidectomy series, our results and literature data suggest that parathyroid involvement by TC has a 0.4–3.9% incidence rate; mainly affects women in their sixth-seventh decade of life; is associated to a good prognosis, unless massive extrathyroid extension of TC occurs.

  1. Lack of association between genotypes and haematogenous seeding infections in a large cohort of patients with methicillin-resistant Staphylococcus aureus bacteraemia from 21 Spanish hospitals.

    Gasch, O; Camoez, M; Dominguez, M A; Padilla, B; Pintado, V; Almirante, B; Martín-Gandul, C; López-Medrano, F; de Gopegui, E Ruiz; Ramón Blanco, J; García-Pardo, G; Calbo, E; Horcajada, J P; Granados, A; Jover-Sáenz, A; Dueñas, C; Pujol, M


    There is increasing concern regarding the association between certain methicillin-resistant Staphylococcus aureus (MRSA) genotypes and poor clinical outcome. To assess this issue, a large cohort of 579 subjects with MRSA bacteraemia was prospectively followed from June 2008 to December 2009, in 21 hospitals in Spain. Epidemiology, clinical data, therapy, and outcome were recorded. All MRSA strains were analysed in a central laboratory. Presence of a haematogenous seeding infection was the dependent variable in an adjusted logistic regression model. Of the 579 patients included in the study, 84 (15%) had haematogenous seeding infections. Microdilution vancomycin median MIC (IQR) was 0.73 (0.38-3) mg/L. Most MRSA isolates (n = 371; 67%) belonged to Clonal Complex 5 (CC5) and carried an SCCmec element type IV and agr type 2. Isolates belonging to ST8-agr1-SCCmecIV, ST22-agr1-SCCmecIV and ST228-agr2-SCCmecI--a single locus variant of ST5--accounted for 8%, 9% and 9% of the isolates, respectively. After adjusting by clinical variables, any of the clones was associated with increased risk of haematogenous seeding infections. Higher vancomycin MIC was not identified as an independent risk factor, either. In contrast, persistent bacteraemia (OR 4.2; 2.3-7.8) and non-nosocomial acquisition (3.0; 1.7-5.6) were associated with increased risk.

  2. Syphilis serology in pregnancy: an eight-year study (2005-2012) in a large teaching maternity hospital in Dublin, Ireland.

    McGettrick, Padraig; Ferguson, Wendy; Jackson, Valerie; Eogan, Maeve; Lawless, Mairead; Ciprike, Vaneta; Varughese, Alan; Coulter-Smith, Sam; Lambert, John S


    All cases of positive syphilis serology detected in antenatal and peripartum screening in a large teaching maternity hospital in inner city Dublin, Ireland over an eight-year period (2005-2012 inclusive) were reviewed and included in our study. Demographic, antenatal registration, laboratory (including co-infections), partner serology, treatment and delivery data were recorded in our database. Infant follow-up, treatment and outcome data were also collected. During this period, 194 women had positive syphilis serology, of which 182 completed their pregnancies at the institution. This accounts for 0.28% of the total number of women completing their pregnancies during this time (N = 66038); 79 had no previous diagnosis of infection. There was one case of re-infection during pregnancy. Thirty-two women were co-infected with human immunodeficiency virus, hepatitis B or hepatitis C. There was one case suggestive of congenital syphilis infection. Our study is a comprehensive analysis of the diagnosis, management and clinical outcomes of women testing positive for syphilis infection in pregnancy. It reveals the relatively high prevalence of syphilis infection in the population utilising the maternity services in north inner-city Dublin. It re-enforces the importance of continued active surveillance to prevent morbidity and mortality associated with maternal syphilis infection. It also highlights the importance of strategies such as re-testing high-risk groups and definitive screening of spouse serology.

  3. 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.

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


    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.

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

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


    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.

  5. 76 FR 4870 - Taking and Importing Marine Mammals; U.S. Navy Training in the Southern California Range Complex


    ...-frequency acoustic recording package (HARP) recordings before, during, and after ] Navy training exercises.... Navy Training in the Southern California Range Complex AGENCY: National Marine Fisheries Service (NMFS... mammals incidental to Navy training, maintenance, and research, development, testing, and evaluation (RDT...

  6. 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

    Eduardo Martín-Arranz


    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

  7. A Cost Benefit Analysis of the Navy Flight Demonstration Team and the U.S. Navy Band


    AGENCY USE ONLY (Leave blank) 2. REPORT DATE June 2012 3. REPORT TYPE AND DATES COVERED MBA Professional Report 4. TITLE AND SUBTITLE A Cost...It is composed of 172 members who make up the Concert Band and six ensembles which play a variety of music from Jazz to Country to Bluegrass. The...the Navy Recruiting budget. For FY11, fuel costs were $9,319,000 (Department of the Navy, 2011). Maintenance teams for the aircraft are covered

  8. 基于负载均衡技术的大型医院 PACS系统建设%To Construct a PACS which Based on Load Balance Technology for a Large Hospital



    objective: To study the construction of large General Hospital technology architecture of PACS. Methods: For the actual situation of the construction project of PACS of Hainan Provincial people's Hospital, presented a set of load balance technology of PACS of large general hospital. Results: systems technical framework stable and viable, ful y able to meet the practical needs of large comprehensive hospital information construction. Conclusion: based on technology of load balance General Hospital PACS construction scheme is feasible.%  目的:探讨建设大型综合医院PACS系统技术架构。方法:针对海南省人民医院PACS建设工程的实际情况,提出了一套基于负载均衡技术的大型综合医院PACS系统的建设方案。结果:系统技术架构稳定可行,完全能够满足大型综合医院PACS系统建设的实际需求。结论:基于负载均衡技术的大型综合医院PACS系统建设方案是可行的。

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

    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


    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…

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

    Galloro, Vince


    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.

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

    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


    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…

  12. NaviSE: superenhancer navigator integrating epigenomics signal algebra.

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


    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

  13. User’s Manual for the Navy Coastal Ocean Model (NCOM) Version 4.0


    Manual for the Navy Coastal Ocean Model (NCOM) Version 4.0 Paul J. Martin Charlie n. Barron luCy F. SMedStad tiMothy J. CaMPBell alan J. WallCraFt...Timothy J. Campbell, Alan J. Wallcraft, Robert C. Rhodes, Clark Rowley, Tamara L. Townsend, and Suzanne N. Carroll* Naval Research Laboratory...1997- 1998 ENSO event. Bound.-Layer Meteor. 103: 439-458. Large, W.G., J.C. McWilliams , and S. Doney, (1994). Oceanic vertical mixing: a review and

  14. Navy Coastal Ocean Model (NCOM) Version 4.0 (User’s Manual)


    Manual for the Navy Coastal Ocean Model (NCOM) Version 4.0 Paul J. Martin Charlie n. Barron luCy F. SMedStad tiMothy J. CaMPBell alan J. WallCraFt...Timothy J. Campbell, Alan J. Wallcraft, Robert C. Rhodes, Clark Rowley, Tamara L. Townsend, and Suzanne N. Carroll* Naval Research Laboratory...the 1997- 1998 ENSO event. Bound.-Layer Meteor. 103: 439-458. Large, W.G., J.C. McWilliams , and S. Doney, (1994). Oceanic vertical mixing: a review

  15. Caffeine consumption in a long-term psychiatric hospital: Tobacco smoking may explain in large part the apparent association between schizophrenia and caffeine use.

    Arrojo-Romero, Manuel; Armas Barbazán, Carmen; López-Moriñigo, Javier D; Ramos-Ríos, Ramón; Gurpegui, Manuel; Martínez-Ortega, José M; Jurado, Dolores; Diaz, Francisco J; de Leon, Jose


    This study further explores the association between schizophrenia and caffeine use by combining two prior published Spanish samples (250 schizophrenia outpatients and 290 controls from the general population) with two Spanish long-term inpatient samples from the same hospital (145 with schizophrenia and 64 with other severe mental illnesses). The specific aims were to establish whether or not, after controlling for confounders including tobacco smoking, the association between schizophrenia and caffeine is consistent across schizophrenia samples and across different definitions of caffeine use. The frequency of caffeine use in schizophrenia inpatients was not significantly higher than that in non-schizophrenia inpatients (77%, 111/145 vs. 75%, 48/64) or controls but was significantly higher than in schizophrenia outpatients. The frequency of high caffeine users among caffeine users in schizophrenia inpatients was not significantly higher than in non-schizophrenia inpatients (45%, 50/111 vs. 52%, 25/48) or controls, but was significantly lower than in schizophrenia outpatients. Smoking was significantly associated with caffeine use across all samples and definitions. Between 2 and 3% of schizophrenia inpatients, schizophrenia outpatients and non-schizophrenia inpatients showed caffeinism (>700 mg/day in smokers). Several of these smoking patients with caffeinism were also taking other inducers, particularly omeprazole. The lack of consistent association between schizophrenia and caffeine use is surprising when compared with the very consistent association between tobacco smoking and caffeine use across all of our analyses (use and high use in users) and all our samples. The confounding effects of tobacco smoking may explain in large part the apparent association between schizophrenia and caffeine use. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. A retrospective analysis of ultrasound-guided large core needle biopsies of breast lesions at a regional public hospital in Durban, KwaZulu-Natal, South Africa

    Schene Bhayroo


    Full Text Available Background: Histological confirmation of a breast lesion is an important step to determine the aetiology and direct further management. Evidence supports ultrasound-guided large core needle biopsy (US-LCNB (14 gauge as the preferred diagnostic method over traditional open surgical biopsy.Objective: To assess the influence of technical variables on the diagnostic yield of breast specimens obtained by using US-LCNB, and the sensitivity of detecting malignancy during the study period.Methods: A retrospective chart review was conducted of all patients who had US-LCNBs from March 2011 – September 2012 at Addington Hospital in Durban, KwaZulu-Natal. Histopathological findings were correlated to the size of the breast lesion, rank of the radiologist performing the procedure and the number of cores obtained. The sensitivity of the technique was determined.Results: During the study period, 147 biopsies were performed. The majority of lesions were>5 mm (85.5%. The average number of cores was 4, and 79.5% of the biopsies were performed by the senior radiologist. Of the 147 biopsies, 132 specimens were eligible for inclusion in the study. Histopathology revealed 71 malignant lesions of which 60 were confirmed histologically at excision. In 11 patients, no excision was performed. Therefore, the sensitivity of detecting malignancy was 100%.Conclusion: Although the study did not establish a statistically significant relationship between the above mentioned technical variables and the histological outcome, the overall diagnostic yield and the sensitivity of detecting malignancy using US-LCNB is comparable to other similar international studies. A prospective study with long-term follow-up of patients would be of value.

  17. Workshop Report: The Future of ROK Navy-US Navy Cooperation


    U)> a) 0 CcCUE.C I-. c 0 co -(f _ Cu 0U 0 cc) wEd E --j 7WOE cU E 0: cu 0OU E3) 0 0 cu (In a ) - 0: CL ~E 0 cu0 0E Cn (1o D4- 00 C(U 4-4-0 o. E cu0 c...peninsula, it was quite a challenge to the ROK navy to participate a lengthy exercise in Hawaiian area where its own maintenance facility was not available

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

    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...

  19. Navy Ohio Replacement (SSBN[X]) Ballistic Missile Submarine Program: Background and Issues for Congress


    lives at a rate of roughly one ship per year thereafter, with the 14 th reaching the end of its service life in 2040. The Navy has initiated a... life cycle. 15 14 Navy budget submissions show that Ohio-class mid- life nuclear refueling overhauls...Challenges,” Jane’s Navy International, December 2011: 15 and 16. 23 Sydney J. Freedberg, “ Navy Seeks Sub Replacement Savings: From NASA Rocket Boosters To

  20. An Analysis of Personal and Professional Development in the United States Navy


    PERSONAL AND PROFESSIONAL DEVELOPMENT IN THE UNITED STATES NAVY by Caner Filiz Markelly Jean-Pierre March 2012 Thesis Advisor: Stephen L...States Navy 5. FUNDING NUMBERS 6. AUTHOR(S) Caner Filiz, Markelly Jean-Pierre 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Naval Postgraduate...DEVELOPMENT IN THE UNITED STATES NAVY Caner Filiz Lieutenant, Turkish Navy B.S., Turkish Naval Academy, 2002 Markelly Jean-Pierre Lieutenant

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


    Order Code RL33360 Navy Ship Propulsion Technologies: Options for Reducing Oil Use — Background for Congress Updated December 11, 2006 Ronald...SUBTITLE Navy Ship Propulsion Technologies: Options for Reducing Oil Use Background for Congress 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM...19 1 Government Accountability Office, Propulsion Systems for Navy Ships and Submarines, GAO-06-789R, July 6, 2006. Navy Ship Propulsion Technologies

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

    Bach V


    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

  3. 32 CFR 700.201 - Origin and authority of the Department of the Navy.


    ... detailed statements of the roles of the Secretary of the Navy, the Chief of Naval Operations, the... Congress established a separate Department of the Navy with the Secretary of the Navy as its chief officer... Goldwater-Nichols Department of Defense Reorganization Act of 1986 further defined the roles of the military...

  4. 32 CFR 705.11 - Supplying photographs and services to other than Navy and Marine Corps.


    ...) DEPARTMENT OF THE NAVY UNITED STATES NAVY REGULATIONS AND OFFICIAL RECORDS PUBLIC AFFAIRS REGULATIONS § 705..., subparts A-D. (d) Navy aerial photography released for sale to the public is transferred to the United..., a report of the circumstances will be made to the Chief of Naval Operations. (c) This policy...

  5. Forward . . . From the Start: The U.S. Navy & Homeland Defense: 1775-2003


    increasing numbers of patrol craft and land-based blimps and patrol planes off American coasts and forward.36 The central U.S. Navy operational approach to...Navy; Captain Patrick Roth, U.S. Navy (Retired); Alexia Suma; and Daniel Swartz.

  6. 32 CFR 700.326 - The Assistant Secretary of the Navy (Research, Development and Acquisition).


    ... 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...

  7. 33 CFR 165.1328 - Regulated Navigation Area; U.S. Navy submarines, Hood Canal, WA.


    .... Navy submarines, Hood Canal, WA. 165.1328 Section 165.1328 Navigation and Navigable Waters COAST GUARD... § 165.1328 Regulated Navigation Area; U.S. Navy submarines, Hood Canal, WA. (a) Location. The following... whenever any U.S. Navy submarine is operating in the Hood Canal and is being escorted by the Coast...

  8. Large Eddy Simulation of Air Escape through a Hospital Isolation Room Single Hinged Doorway--Validation by Using Tracer Gases and Simulated Smoke Videos.

    Saarinen, Pekka E; Kalliomäki, Petri; Tang, Julian W; Koskela, Hannu


    The use of hospital isolation rooms has increased considerably in recent years due to the worldwide outbreaks of various emerging infectious diseases. However, the passage of staff through isolation room doors is suspected to be a cause of containment failure, especially in case of hinged doors. It is therefore important to minimize inadvertent contaminant airflow leakage across the doorway during such movements. To this end, it is essential to investigate the behavior of such airflows, especially the overall volume of air that can potentially leak across the doorway during door-opening and human passage. Experimental measurements using full-scale mock-ups are expensive and labour intensive. A useful alternative approach is the application of Computational Fluid Dynamics (CFD) modelling using a time-resolved Large Eddy Simulation (LES) method. In this study simulated air flow patterns are qualitatively compared with experimental ones, and the simulated total volume of air that escapes is compared with the experimentally measured volume. It is shown that the LES method is able to reproduce, at room scale, the complex transient airflows generated during door-opening/closing motions and the passage of a human figure through the doorway between two rooms. This was a basic test case that was performed in an isothermal environment without ventilation. However, the advantage of the CFD approach is that the addition of ventilation airflows and a temperature difference between the rooms is, in principle, a relatively simple task. A standard method to observe flow structures is dosing smoke into the flow. In this paper we introduce graphical methods to simulate smoke experiments by LES, making it very easy to compare the CFD simulation to the experiments. The results demonstrate that the transient CFD simulation is a promising tool to compare different isolation room scenarios without the need to construct full-scale experimental models. The CFD model is able to reproduce

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

    Rosalyn R. Porle


    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.

  10. [Comparison of conventional culture methods and quantitative real-time PCR methods for the detection of Legionella pneumophila in water samples in a large University teaching hospital in Rome, Italy].

    Boccia, Stefania; Laurenti, Patrizia; Leoncini, Emanuele; Amore, Rosarita; Vincenti, Sara; Arzani, Dario; Berloco, Filippo; Boninti, Federica; Bruno, Stefania; Celani, Fabrizio; Damiani, Gianfranco; Di Giannantonio, Paolo; Moscato, Umberto; Posteraro, Brunella; Sezzatini, Romina; Vecchioni, Alessia; Wachocka, Malgorzata; Ricciardi, Walter; Quaranta, Gianluigi; Ficarra, Maria Giovanna


    The aims of this study were to identify the best threshold value for the real-time PCR method in detecting the presence of Legionella pneumophila in water samples, and to evaluate the prognostic significance of negative results obtained with the molecular method. From 2011 to 2014, 77 water samples were collected from hospital wards of a large University teaching hospital in Rome (Italy) and screened for L.pneumophila by the standard culture method and by real-time PCR. The high sensitivity and negative predictive value of real-time PCR make this method suitable as a quick screening tool to exclude the presence of L. pneumophila in water samples in the hospital setting.

  11. NaviCell Web Service for network-based data visualization.

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


    Data visualization is an essential element of biological research, required for obtaining insights and formulating new hypotheses on mechanisms of health and disease. NaviCell Web Service is a tool for network-based visualization of 'omics' data which implements several data visual representation methods and utilities for combining them together. NaviCell Web Service uses Google Maps and semantic zooming to browse large biological network maps, represented in various formats, together with different types of the molecular data mapped on top of them. For achieving this, the tool provides standard heatmaps, barplots and glyphs as well as the novel map staining technique for grasping large-scale trends in numerical values (such as whole transcriptome) projected onto a pathway map. The web service provides a server mode, which allows automating visualization tasks and retrieving data from maps via RESTful (standard HTTP) calls. Bindings to different programming languages are provided (Python and R). We illustrate the purpose of the tool with several case studies using pathway maps created by different research groups, in which data visualization provides new insights into molecular mechanisms involved in systemic diseases such as cancer and neurodegenerative diseases.

  12. Modeling Weather in the Ionosphere using the Navy's Highly Integrated Thermosphere and Ionosphere Demonstration System (HITIDES)

    McDonald, S. E.; Sassi, F.; Zawdie, K.; McCormack, J. P.; Coker, C.; Huba, J.; Krall, J.


    The Naval Research Laboratory (NRL) has recently developed a ground-to-space atmosphere-ionosphere prediction capability, the Highly Integrated Thermosphere and Ionosphere Demonstration System (HITIDES). HITIDES is the U.S. Navy's first coupled, physics-based, atmosphere-ionosphere model, one in which the atmosphere extends from the ground to the exobase ( 500 km altitude) and the ionosphere reaches several 10,000 km in altitude. HITIDES has been developed by coupling the extended version of the Whole Atmosphere Community Climate Model (WACCM-X) with NRL's ionospheric model, Sami3 is Another Model of the Ionosphere (SAMI3). Integrated into this model are the effects of drivers from atmospheric weather (day-to-day meteorology), the Sun, and the changing high altitude composition. To simulate specific events, HITIDES can be constrained by data analysis products or observations. We have performed simulations of the ionosphere during January-February 2010 in which lower atmospheric weather patterns have been introduced using the Navy Operational Global Atmospheric Prediction System-Advanced Level Physics High Altitude (NOGAPS-ALPHA) data assimilation products. The same time period has also been simulated using the new atmospheric forecast model, the NAVy Global Environmental Model (NAVGEM), which has replaced NOGAPS-ALPHA. The two simulations are compared with each other and with observations of the low latitude ionosphere. We will discuss the importance of including lower atmospheric meteorology in ionospheric simulations to capture day-to-day variability as well as large-scale longitudinal structure in the low-latitude ionosphere. In addition, we examine the effect of the variability on HF radio wave propagation by comparing simulated ionograms calculated from the HITIDES ionospheric specifications to ionosonde measurements.

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

    Guoth, Maroš


    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...

  14. Life Path Analysis and Performance: Factors Relating to Success Among Minority Enlisted Personnel in the Navy.


    0650 .1438* b. Career Expectation V39 Confident of ability to succeed -.0552 .1198* -V85 Heard Navy schools are good .0486 .0686* V86 Thought Navy...a b. Career Expectation Model V39 Confident of ability to succeed. V88 Felt Navy give me satisfaction. V92 Promised advance after boot camp. V98 V89 Educational requirements of profession. b. Career Expectation Model V39 Confident of ability to succeed. V85 Heard Navy schools are good. V92

  15. FacilitiesHospitals_HOSPITAL

    Vermont Center for Geographic Information — This data layer contains point locations of all major community, regional, comprehensive health, and healthcare provider hospitals in the state of Vermont. The...

  16. Hospitals; hospitals13

    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....

  17. An analysis of the return on investment of Navy Enterprise Resource Planning as implemented Navy-wide FY04-FY15

    Kovack, Robert G.; Lindley, Philip R.


    MBA Professional Report Since 2003, the United States Navy has invested hundreds of millions of dollars into the Enterprise Resource Planning (ERP) Program. ERP evolved from four pilot programs into a single solution. Furthermore, the Navy has invested approximately 2 billion dollars for ERP implementation and developed several programs to streamline the financial reporting practices. This thesis project analyzes the evolution and development of ERP, identifies the Navy's projections f...

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

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


    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.

  19. [The historical experience of therapeutic service in the Army and Navy during the Great Patriotic War].

    Ovchinnikov, Yu V


    The author presents the experience of therapeutic services of the army and navy during the Great Patriotic War (1941-1945) and its importance for the present. This experience became a-general methodological framework-for the development of principles for the organization of work of military physicians in a modern warfare and the application of new weapons. The history of development, aims and objectives of the new section of Military Medicine--the Military Field Therapy as a unified system of organization and delivery of health care to servicemen based on the principles of a unified military field medical doctrine. A problem of organization of new health facilities (hospitals, hospital databases), their acquisition of trained personnel, especially the structure of internal medicine in the war years, the treatment and the early rehabilitation of wounded and sick, between the military and civilian medical institutions-is highlighted. There is an information that 90.6%, or more than 6.5 million soldiers and officers who were treated in hospitals with various diseases, were returned to duty. The experience of the medical service in World War II and the actual demand and is now planning for a package of measures aimed at further improvement of the health status of military-personnel.

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


    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

  1. A Simulation Analysis of Work Based Navy Manpower Requirements


    Hill, L. Monch, O. Rose, T. Jefferson, J.W. Fowler (eds.), Proceedings of the 2008 Winter Simulation Conference (pp 73–84). Miami, FL: Thomson Reuters ...Conference (pp 541–544). Atlanta, GA: Thomson Reuters . U.S. Government Accountability Office. (2010). Navy Needs to Reassess Its Metrics and Assumptions

  2. 32 CFR 705.29 - Navy Art Collection.


    ... area. (3) The Curator Navy Combat Art Center, in coordination with the Chief of Information, will: (i.... (2) The Chief of Information has established liaison with the Salmagundi Club in order to maintain a... through the world. The Chief of Information reviews the nominations, and issues SECNAV invitational...

  3. Spanish Navy Up to Date Data in DCS


    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

  4. The Acquisition of Sonobuoys for the U. S. Navy


    firns became paramout.t. The transfer of this technoloty base ;nFs effectively coordinated by RC. The Ntaval Air Develop-ent Center however, maintained...the Navy will iurnish to any interested raanufacturer, upon request, a specification, model and drawings for a particular model sonobuoy. This firm

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

    Nørby, Søren; Seerup, Jakob


    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...

  6. Navy Shipbuilding: Opportunities Exist to Improve Practices Affecting Quality


    Organization for Standardization’s ISO 9001 (quality), 14001 (environmental), and 18001 (occupational health and safety) series of management systems...10In particular, ISO 9001 certification is... ISO 9000 quality management standards. Page 52 GAO-14-122 Navy Shipbuilding commercial shipbuilders we visited did not report having

  7. Supply Management Analysis of the Chilean Navy Acquisition System


    1. Generic supply chain diagram (from Sanders, 2012) ......................................11 Figure 2. Chilean Navy Logistics Organization...Sanders, 2012). Supply chain management involves the following activities (Monczka et al., 2009, pp. 17–19). • Purchasing or procurement • Inbound will be measured, and how the data obtained will be used (Monczka et al., 2009). Some examples of indicators used inside the military logistics

  8. Cash Management Improvement in the Navy Stock Fund.


    rhistor^n’.; N. performance in BP28 budget -e-tiration, FPSO hat adoptec practice of adding a contingency dollar amount of $30 miln 1,’ their budget...Comotrollers Handbook, 4th edition, Module G, July 1983. 15. Morris, John G., Is the Navy Stock Fund Concept Feasible for Management of !nventory Soares

  9. Decision making in the Navy Budget Office.


    susceptible to the effects of a black market (theft) and to acts of terrorism. An example concerns the prepos-.. tioninx of hospital medical ’vans...justifca.,onz na i _.e ;,er inf~uence3 and effects- on the ovez’ai: ou6’a-3t nd, wtiexception of" ’Approvai for Producto i and r Year Performance, witni

  10. Little hospital has big ideas.

    Friedman, E


    Many hospitals have been looking at diversification of services with increased interest in recent years, and a small hospital in rural Wisconsin has shown that the concept need not be limited to large, urban institutions.

  11. Hospital Compare

    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...

  12. HCAHPS - Hospital

    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...

  13. Research on of Construction and Application of Mobile Payment Platform in Large Hospitals%大型医院移动支付平台的构建与应用

    周常蓉; 朱海嘉


    本文在分析大型医院现行支付结算模式的基础上,对比研究了支付宝“服务窗”和“趣医院”APP两种不同的医保结算方式。比较了3种移动支付平台构建方式的优缺点,建议选择加入相对成熟的支付平台构建移动支付平台。同时提出通过移动支付平台即时扣费、预授权两种结算方式来改进医院支付流程,提高患者就医效率。%This paper compares different ways of medical insurance settlement between Alipay "service window" and "fun hospital" APP based on the analysis of the present mode of payment and settlement in large hospitals. It suggests that large hospitals should join the relatively ma ̄ture payment platform to build the mode of payment and settlement by comparing three different ways of building mobile payment platform. Also,it puts forward two methods of payment such as real-time settlement and pre-authorization settlement through mobile payment platform to improve the process of payment and the efficiency of patient seeking medical advice.

  14. Impact and Countermeasure of New Health Care Reform Policy on Large-Scale Integrated Military Hospital%新医改政策对军队大型综合医院的影响及对策探讨

    吴娅利; 周峰; 陈黎明; 蔡耘菲; 袁蕾; 刘国祥


    通过分析某地三所军队大型综合医院2008年~2011年的经济收入及收治病种数据,探讨“新医改”政策对军队大型综合医院的影响,指出军队医院要调整学科发展方向,加强与地方行政卫生部门沟通,积极争取地方政府经费支持及做好顶层经费规划等.%Through the analysis of economic income and data on categories of treated diseases in three large -scale integrated military hospitals from 2008 to 2011, the paper investigated the impact of implementation of the new health care reform policy in large -scale integrated military hospitals , and pointed out that the military hospitals need adjust the technology development direction of discipline, strengthen communication with the district health administration, actively seek the financial support of the local government and make good top -level financial planning.

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

    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

  16. 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.

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


    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

  17. Norovirus - hospital

    Gastroenteritis - norovirus; Colitis - norovirus; Hospital acquired infection - norovirus ... fluids ( dehydration ). Anyone can become infected with norovirus. Hospital patients who are very old, very young, or ...

  18. Dynamic monitoring of disinfection and sterilization efficacy in large general hospitals%大型综合医院消毒灭菌效果动态监测分析

    韩佳音; 林锦炎; 钟昱文; 黄旭和; 陈惠珍; 王冰妹; 王雅静; 沈秀婷


    目的 了解大型综合医院的消毒灭菌工作质量和薄弱环节,加强医院消毒与感染控制工作.方法 2008至2009年每月采取现场随机抽取样品和实验室检测的方法,对医院重点部门开展消毒灭菌效果的连续监测分析.结果 2年对2所大型综合医院共抽检样品987份,合格样品数为621份,总合格率为62.9%;其中手术室医护人员手、门诊医务人员手、内镜的监测合格率分别为94.5%、61.2%、87.1%,口腔科手机喷水、口腔治疗冲洗水合格率为33.8%和45.4%,污水的合格率为42.9%.结论 医院应加强对口腔科诊疗用水的消毒处理,对手卫生设施增加投入,并加强医务人员手卫生的培训教育.%OBJECTIVE To understand the disinfection and sterilization work quality in two large general hospitals in Guangdong Province and to find out the problems existing in the course of control nosocomial infection.METHODS Every month in 2008~2009, field selective examination and bacteriological examination method were used to carry out about the efficacy of disinfection and sterilization in priority departments in hospital.RESULTS In the 987 samples from two large general hospitals in two years, the qualification rate was 62.9%.The qualified rate of surgical hand, hygiene hand and endoscopy were 94.5 %, 61.2% and 87.1% ,respectively.The qualified rates of water from dental handpieces and dental unit waterlines were 33.8% and 45.4%, the qualified rate of sewage in hospital was 42.9%.CONCLUSION Hospital need enhance the survillance and disinfection of dental unit waterline, add more device of hand hygiene and enhance the hand hygiene education for hospital staffs.

  19. Large Comprehensive Hospital Drug Separation of Purchasing and Supply Management Mode of Exploration%大型综合性医院药品采购与供应分离管理模式探索



    With the deepening reform of public large comprehensive hospital, in order to achieve the purpose of lowering the operating costs for the hospital, the hospital has drugs zero sales rate. Therefore, through the establishment of many large comprehensive hospital drug separation and supply and supply management mode, further clarify the responsibilities of each department, responsibility to the people, improve the work efficiency, increase the economic benefit and social benefit, and in combating corruption has played a very important role. And information technology of fast, accurate and flexible fea-tures, such as help contact separation of purchasing and supply of both communication not smooth flaws, and effectively op-timize drug management process, improve the efficiency of management. In this paper, the information technology in large comprehensive hospitals drug separation of purchasing and supply management mode of use as a starting point, probe into the management model in the drug management and service improvements in the quality of the meaning of existence.%随着大型综合性医院公改革的不断深化,为了实现降低医院运营成本的目的,医院实行药品零差率销售。为此,不少大型综合性医院通过建立药品采供与供应分离管理的模式,进一步明确各个部门的职责,使得责任到人,有效提高了工作效率,增加了经济效益和社会效益,并在防治腐败滋生方面起到了非常重要的作用。而信息技术的快捷、精确、灵活等特性,有助于联系采购与供应分离带来的两者沟通不顺畅的缺点,并有效优化药品管理流程,提升管理效率。为此,该研究以信息技术在大型综合性医院药品采购与供应分离管理模式中的运用为出发点,探究该管理模式在对药品管理和服务的质量的改进方面存在的意义。

  20. Large city Hospital Vacuum Suction System Design%城市大型医院的负压吸引系统设计



    医院医用气体作为生命支持系统,发挥着重要的作用.医用气体系统包括氧气、压缩空气、特殊气体及负压吸引等系统.作者对城市大型医院负压吸引系统的整体构成,工作流程及设备配置都进行了介绍和分析.%Hospital medical gas as a life-support systems, in the treatment to be widely applied, and play an important role. Medical gas systems include oxygen, compressed air, special gas and vacuum suction systems. Vacuum suction system for easy introduction and analysis.

  1. Feasibility of Chlamydia trachomatis screening and treatment in low-risk pregnant women in Lima, Peru: a prospective study in two large urban hospitals

    Cabeza, J; García, PJ; Segura, ER; García, P; Escudero, F; La Rosa, S; León, S; Klausner, JD


    Objectives Chlamydia trachomatis, which is asymptomatic in most women, causes significant adverse effects for pregnant women and neonates. No programmes conduct antenatal screening in Latin America. We determined chlamydia prevalence, the feasibility and acceptability of chlamydia screening, and adherence to treatment in pregnant women in two urban public hospitals in Lima, Peru. Methods We offered chlamydia screening using self-collected vaginal swabs to pregnant women ≥ 16 years during their first antenatal visit. Chlamydia-infected women were contacted within 14 days and asked to bring partners for counselling and directly observed therapy with oral azithromycin. Unaccompanied women received counselling, directly observed therapy, and azithromycin to take to partners. Test of cure was performed ≥ 3 weeks after treatment. Results We approached 640 women for the study and enrolled 600 (93.7%). Median age was 27.3 years (range 16–47), median lifetime partners 2.3 (range 1–50), and median gestational age 26.1 weeks (range 4–41). Chlamydia prevalence was 10% (95% CI: 7.7% – 12.7%). Of 60 infected patients, 59 (98%) were treated with one dose of azithromycin. Fifty-two of 59 (88%) returned for test of cure, all of whom were treated successfully, with 46 (86%) achieving negative test of cure with one dose of azithromycin and 6 (12%) after retreatment with a second dose. Conclusions C. trachomatis screening and treatment in pregnancy was feasible and highly acceptable in two urban hospitals in Peru. Chlamydia prevalence was high. Clinical trials to evaluate efficacy and cost-effectiveness of chlamydia screening and treatment of pregnant women to prevent adverse pregnancy outcomes in low-resource settings are warranted. PMID:25107711

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

    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

  3. Potential Applicability of Just-In-Time Inventory Management Within the Navy.


    Naval Postgraduate School, Monterey, CA, 1992. 7. Heizer & Render, PRODUCTION AND OPERATION MANAGEMENT (3rd ED), Massachusetts, Simon & Schuster, Inc...Navy inventory management system to the elements of a JIT resupply system. An assessment is made to determine eligibility of Navy operations for a JIT...determine eligibility of Navy operations for a JIT inventory management system. Finally, a case study of Naval Aviation Depot North Island, an

  4. A case study of the United States Navy's enterprise resource planning system

    Carver, Harold; Jackson, William


    MBA Professional Report This project was conducted as a case analysis of the Navy's ERP efforts, from the decision to adopt ERP up to the current Navy ERP program. The objective of the report was to develop a singlesource document which provides the reader with enough information to have an understanding of the ERP efforts within the Navy. This study analyzes the history of ERP systems and the lessons learned from the commercial sector. The revolution in business affairs motivated the ...

  5. Perceived Strengths and Weaknesses of Highly Realistic Training and Live Tissue Training for Navy Corpsmen


    Naval Health Research Center Perceived Strengths and Weaknesses of Highly Realistic Training and Live Tissue Training for Navy Corpsmen Stephanie...Highly Realistic and Live Tissue Training 1 Perceived Strengths and Weaknesses of Highly Realistic Training and Live Tissue...Highly Realistic and Live Tissue Training 2 ABSTRACT The U.S. Navy currently employs two types of trauma care training for Navy corpsmen: highly

  6. Navy Irregular Warfare and Counterterrorism Operations: Background and Issues for Congress


    APS) were Navy ships, such as amphibious ships or high- speed sealift ships, that deployed to the Caribbean and to waters off Africa, respectively...drove in a convoy from Mogadishu, Somalia, to the seaside town of Baraawe. But that plan was scrubbed at the last minute, and instead a Navy SEALs 14...The Southern Partnership Station (SPS) and the Africa Partnership Station (APS) were Navy ships, such as amphibious ships or high- speed sealift

  7. An analysis of the relative importance of the comptroller billet across Navy activities

    McPadden, Russell P.


    Approved for public release; distribution is unlimited This study examines the level of correlation between the billet requirements for Navy comptrollers and the organizational importance of their respective commands within the Navy hierarchy. Data were collected on the comptroller­ billets at 148 Navy shore activities which have military comptrollers. Each comptroller billet was ranked on pay grade, required education and experience. Commands were ranked according to overall command c...

  8. Navy Working Capital Fund: Budgeting for Carryover at Fleet Readiness Centers Could Be Improved


    NAVY WORKING CAPITAL FUND Budgeting for Carryover at Fleet Readiness Centers Could Be Improved Report to...00-00-2015 4. TITLE AND SUBTITLE Navy Working Capital Fund: Budgeting for Carryover at Fleet Readiness Centers Could Be Improved 5a. CONTRACT...Accountability Office Highlights of GAO-15-462, a report to congressional requesters June 2015 NAVY WORKING CAPITAL FUND Budgeting for Carryover at

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

    Glenn A. Melnick PhD


    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.


    André Wessels


    Full Text Available In this article, the history of the South African Navy (SAN and itspredecessors is reviewed, as well as the interaction with other Commonwealthnavies during the years 1910 to 2010. Although the Union Defence Forces wereestablished in 1912, the Union only acquired its first naval force in 1922, when theSouth African Naval Service (SANS was formed. In the meantime, the country’snaval defence was conducted by the Royal Navy (RN. During World War I, 164members of the South African Division of the Royal Naval Volunteer Reserveserved in the RN. The SANS’s three small ships were withdrawn from service in1933 to 1934, and when World War II broke out, the country’s naval forces had tobe built up from scratch – but soon played an important role in patrolling the Capesea route (and also saw action in the Mediterranean. After the war, South Africa’snaval forces were rationalised, but – in the context of the Cold War and the Sovietthreat to the Cape sea route – the SAN then gradually grew in size and importance,albeit that it was (and today still is small in comparison to major Commonwealthnavies. In 1957, the SAN acquired the RN’s Simon’s Town Naval Base. Manyexercises were held with the RN and other navies, but gradually South Africabecame more isolated internationally because of the National Party government’sracially-based policy of apartheid. In due course, this impacted negatively on the SAN and its interaction with other navies. In 1975, the Simon’s Town Agreementwas abrogated and in 1977, the United Nations imposed a mandatory arms embargoagainst South Africa. In the meantime, the Republic of South Africa (RSA becameembroiled in the Namibian War of Independence (1966–1989 – a war that spilledover into Angola. The SAN played a small, albeit important, role in the war, but theconflict affected the navy negatively. The advent of the truly democratic RSA in1994 opened new opportunities for the SAN, and since then, the SAN

  11. Insuficiência cardíaca em grande hospital terciário de São Paulo Heart failure in a large tertiary hospital of São Paulo

    Antonio Carlos Pereira Barretto


    Full Text Available OBJETIVO: Verificar a incidência, principais causas, fatores desencadeantes ou de piora da insuficiência cardíaca (IC no ano de 1995, no Instituto do Coração de São Paulo. MÉTODOS: Foram analisados os registros referentes a pacientes internados, obtidos do banco de dados da PRODESP. Analisaram-se nos pacientes com IC os dados: idade, sexo, diagnóstico principal e secundários, procedimentos executados e óbitos. Para fim de análise, construíram-se tabelas de distribuição conforme o sexo, idade e diagnóstico principal. Análise de variância e teste do qui-quadrado foram empregados para verificar diferença entre os grupos estudados. RESULTADOS: Dos pacientes internados (903 de 9620 9,38% apresentaram IC. As idades variaram de 2 dias a 98 (média 52,6 anos e a maioria era do sexo masculino (60,4%. Miocardiopatia isquêmica (32,6%, miocardiopatia dilatada (25,8% e valvopatias (22,0% foram as principais causas de IC. Foram submetidos à cirurgia, angioplastia, ou implante de marcapasso, 32,1% dos pacientes, sendo os valvopatas na maioria submetidos à correção de sua cardiopatia de base (63,3%. Houve maior incidência de múltiplos diagnósticos secundários com o aumento da idade. A mortalidade foi maior nos com idade 80 anos. CONCLUSÃO: A incidência de IC foi de 9,38%, sendo miocardiopatia isquêmica a causa mais freqüente. Foi possível corrigir a causa da IC em 32,1%. A mortalidade foi maior nas crianças provavelmente pela maior complexidade de sua cardiopatia e nos mais idosos devido à maior associação de diagnósticos secundários ou fatores agravantes.PURPOSE: To study the incidence, main causes, aggravating factors and secondary diagnoses of heart failure (HF during 1995 at the Instituto do Coração of São Paulo. METHODS: Data from hospitalized patients according to the PRODESP data base were analyzed. The following data were studied: age, sex, principal and secondary diagnoses, surgical procedures and mortality. To

  12. Financial planning for district heating: The Brooklyn Navy Yard project: A project report


    Financial planning for the Brooklyn Navy Cogeneration and District Heating Project involved the establishment of three distinct potential markets, a determination of economic feasibility and the development of a financial structure that could accommodate the diverse social objectives of the project and the nature of the markets to be served. The Brooklyn Navy Yard (BNY) is owned by the City of New York (City) and managed by the non-profit Brooklyn Navy Yard Development Corporation for operation as an industrial park. Development of a cogeneration/district heating facility at the Navy Yard was undertaken to meet multiple community and economic development objectives.

  13. Research and Development Support for Surface Preparation, Modification and Characterization for Navy Applications

    Green, W


    ..., modification and characterization of materials and processes for Navy applications. The work accomplished encompassed a broad range of research in biotechnology, chemistry, materials science, and corrosion engineering...

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

    Marszal Jacek


    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.

  15. Parasitic Disease in the U.S. Navy


    diseases in the third world, schistosomiasis and trypanosomi- men were 50 percent more likely to come down with a para- asis were unobserved in Navy...both sexes, and simultaneous confidence intervals were con- dition, the prevalence of infected individuals may not be a structed by the methods of Gold...and Goodman (10-11). For good indicator of the intensity of infection for some types of seven diseases, only one sex was affected. For these cases the

  16. Strategic Acquisition of Navy Unmanned Systems: Analysis and Options


    dissertation which analyzed the creation of the now ubiquitous EPC (Electronic Product Code). His other areas of research have included studies of the...PSC industry (Private Security Contractors ), innovation initiatives in the Navy, and technology transfer activities at DARPA. Professor Dew has a...producers of products and services;  secondary suppliers and intermediaries, such as service firms, sales and marketing channels, and contractors that

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

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


    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.

  18. Behind the Periscope: Leadership in China’s Navy


    territory between China and Vietnam, Indonesia, Malaysia , Brunei, and the Philippines  Disputes over the control of the Spratly Islands between China...and Vietnam, Malaysia , and the Philippines  Disputes over the Paracel Islands between China and and our people need and love peace. If anyone bullies us, we will not be frightened by going to war and will surely win.” 428 RADM Leng

  19. Iranian Naval Forces: A Tale of Two Navies


    the western military concepts that formed its foundation, with some ideological tenets. The doctrine also adopted some Russian and Chinese concepts...Additionally, Iran’s navies have been supplemented by its other military branches through acquisition of air-launched cruise missiles and antiship ballistic...trireme of the Persian era 8 by the Eastern Roman Empire. Despite having a strong military force in general and territories with shores along both

  20. Victualling for Future Royal Australia Navy Platforms - Alternative Technologies


    Electric Field QL Quick Look RAN Royal Australian Navy RPDE Rapid Prototyping, Development and Evaluation program SFE Supercritical Fluid ...however, to be suited to liquid or ‘pumpable’ foods such as milk , juices, sauces and soups. Many are used in the treatment of waste water in the food...the liquid, killing the cells and rendering them harmless. • Supercritical Fluids [8] – carbon dioxide is often used as a supercritical fluid . The

  1. Organization of an Oceanographic Data Bank for the Peruvian Navy.


    Nino" (Ecuador, Chile , Peru and Colombia) under programs such as ERFEN (Regional Study of the "El Nino" Phenomenon). 22 B. THE NAVY The onset of "El...and Gilmartin, M., 1961: The Peru- Chile Undercurrent, J. Mar. Res., 19 (13):97-122. Wyrtki, K., 1963: The Horizontal and Vertical Fipld of Motion in...Oceanographic Station Data, Informal Report #67-X NAVOCEANO. Zarate, A., 1555: Historia del Descubrimiento y Conquista del Peru, con las Cosas Naturales que

  2. Doctrine and Fleet Tactics in the Royal Navy.


    embarrassed the Turks that it was diplomatically inexpedient and he was recalled and his career ruined. During the long wars with the continental powers in...amphibious operations, the Royal Navy fell somewhat short. A landing in German East Africa was successfully neutralized. The disastrous attempt at...Madrid, SP: Instituto de Historia y Cultura Naval, 1983 [original version written from 1520-1538]. 5. "Traditional tactics, 1530: ’A book of orders for the

  3. Optimizing the Navy’s Investment in Space Professionals


    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

  4. The Effects of Local Economic Conditions on Navy Enlistments.


    there remains the question of how this infor- mation can be exploited to improve recruiting performance. The identification of practical management...economic conditions on Navy enlistments has resulted in the identification of a number of questions which suggest further lines of investigation. It is felt...South Bend, Ind.- 115. 7840 Spokane, Wash. I/ 116. 8000 Springfield-Chicopee- Holyoke , Mass.- 117. 8120 Stockton, Calif. 118. 8160 Syracuse, N.Y. 119

  5. Plan of Action and Milestones for Navy Combustion Toxicity.


    commercial hotel fires have reemphasized the danger of toxic gas generation by combustible materials. Many of these materials are present in U.S. Navy order of planned action. Since the subject matter involves the partici- pation of a number of Naval R&D activities, coordinated mangement ...of death by toxic gases are the MGM Hotel fire in Las j Vegas, Nevada, and the Stouffer’s Hotel fire in New York; over 100 lives were lost in these

  6. Handbook for Construction of Task Inventories for Navy Enlisted Ratings


    OCCUPATIONAL DDEVELOPMENT AND ANALYSIS g~D C -il o c u m nt hsen app fo ulcrelease and sale , itsdistfbution is unlxnitecL 0 * NAVY OCCUPATIONAL TASK...the case. In a study of the readability of the Position Analysis Questionnaire (Ash & Edgell , 1975),I. the directions were measured by four...A., & Edgell , S. L. A note on the readability of the Position Analysis Questionnaire (PAQ). Journal of Applied Psychology, 1975, 60(6), 765-766. The

  7. Improving the signal for U.S. Navy officer productivity

    Ellison, Joshua C.


    Approved for public release; distribution is unlimited The U.S. Navy’s answer for many future manpower and financial policy questions rests on the ability of the individual performance appraisal system to optimally signal officer productivity. This paper utilizes the economics literature on individual performance appraisals and promotion systems as the lens through which to conduct a comparative analysis between the Navy and Marine performance appraisal systems. Rating accuracy, differenti...

  8. Clinical Practice Experiences in Diagnosis and Treatment of Traumatic Brain Injury in Children: A Survey among Clinicians at 9 Large Hospitals in China.

    Di, Fei; Gao, Qi; Xiang, Joe; Zhang, Di; Shi, Xiuquan; Yan, Xueqiang; Zhu, Huiping


    Proper diagnosis and treatment of traumatic brain injury (TBI) in children is becoming an increasingly problematic issue in China. This study investigated Chinese clinicians to provide information about their knowledge and experiences in diagnosis and treatment of pediatric TBI. We conducted a questionnaire survey among clinicians in the emergency departments and neurosurgery departments at 9 major hospitals in China. The questionnaire included demographic information, and knowledge and experiences regarding the diagnosis and treatment of pediatric TBI. A total of 235 clinicians completed questionnaires. 43.8% of the surveyed clinicians reported children with only scalp hematoma without any other signs and symptoms of concussion as TBI cases. Most clinicians (85.1%) reported no existing uniform diagnostic criteria for children with TBI in China. The majority of clinicians (91.9%) reported that CT scans were performed in all patients with suspected head injury as a routine procedure in their hospitals. Only 20.9% of clinicians believed that radiation from CT scanning may increase cancer risk in children. About 33.6% of the clinicians reported that they ordered CT scans to investigate suspected head injury due to the poor doctor-patient relationship in China, and to protect themselves against any medical lawsuits in the future. About 80% of the clinicians reported that there are no existing pediatric TBI treatment guidelines in China. Instead a senior doctor's advice is the most reported guidelines regarding treating pediatric TBI (66.0%). All of the surveyed clinicians reported that the lack of diagnosis and/or treatment standard is the biggest problem in effectively diagnosing and treating pediatric TBI in China. Developing guidelines for the diagnosis and treatment of children with TBI is a high priority in China. The extremely high usage of CT for pediatric TBI in China suggests that it is important to establish evidence-based clinical decision rules to help

  9. Development of the 24/7 Nurse Practitioner Model on the Inpatient Pediatric General Surgery Service at a Large Tertiary Care Children's Hospital and Associated Outcomes.

    Rejtar, Marketa; Ranstrom, Lee; Allcox, Christina

    Nurse practitioners (NPs) have been providing high-quality and safe patient care for a few decades, and evidence showing the extent of their impact is emerging. This article describes the implementation of a 24/7 NP patient care model on an inpatient pediatric general surgery service in a tertiary free-standing Children's Hospital in the Northeastern United States. The literature shows that there is limited evidence regarding NP models of care and their effect on patient outcomes. In response to policy changes leading to reduction of resident work hours and a more acute and complex inpatient pediatric general surgery patient population, our existing NP model evolved into a 24/7 NP Model in June 2011. The results from two quality improvement projects showed positive registered nurse and attending surgeon staff satisfaction with the 24/7 NP Model of care and a decreased trend of unplanned intensive care unit patient transfers after the 24/7 NP Model implementation. These findings further support the evidence in the literature that NPs provide safe and quality patient care. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  10. Management of HIV-related stigma and adherence to HAART: evidence from a large representative sample of outpatients attending French hospitals (ANRS-EN12-VESPA 2003).

    Peretti-Watel, P; Spire, B; Pierret, J; Lert, F; Obadia, Y


    This study investigated patterns of HIV disclosure to significant others (parents, siblings, children, other relatives, friends and colleagues) and describe them in terms of socio-demographic background and other characteristics, including experiences of AIDS-related discrimination. It also assessed the relationship between disclosure patterns and adherence to HAART. We used a cross-sectional survey conducted among a national representative sample of 2,932 HIV-infected people recruited in French hospitals. HIV disclosure patterns were both selective and cumulative: disclosure was more frequent for friends and siblings, while concealment prevailed concerning children, other relatives, and colleagues; but patients who disclosed their seropositivity to one significant other were also more likely to disclose it to other significant others. Patients reporting experiences of discrimination from sexual partners were less likely to be highly adherent, and we also found a significant relationship between uncontrolled disclosure and non-adherence. Patients who have opted for concealment probably consider non-adherence and uncontrolled disclosure as competing risks, but among them a significant minority loses on both counts. Counselling provided to HIV-infected people should not separate the adherence and disclosure issues, and adherence interventions should seek to help patients to manage concurrently disclosure/concealment of their seropositivity and its consequences.

  11. 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

    Lance S. Ballester


    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.

  12. 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.

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


    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.

  13. 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

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


    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

  14. Comparison of clinical and laboratory characteristics of intestinal amebiasis with shigellosis among patients visiting a large urban diarrheal disease hospital in Bangladesh.

    Das, Sumon Kumar; Chisti, Mohammod Jobayer; Malek, Mohammad Abdul; Salam, Mohammed Abdus; Ahmed, Tahmeed; Faruque, Abu Syed Golam; Mondal, Dinesh


    Between 1993 and 2011, a total of 371 intestinal amebiasis (IA), caused by Entamoeba histolytica cases were compared with 1,113 shigellosis (randomly selected) patients of icddr,b, excluding co-infections (rotavirus and Vibrio cholerae) in two age stratums: 0-14 years of age and ≥ 15 years of age. The number of IA and shigellosis cases gradually reduced over the study period. In multivariate analysis, individuals 0-14 years of age, slum dwellers (odds ratio [OR] 3.51; 95% confidence interval [CI] 1.69-7.24; P < 0.001), red blood cell (0.44 [0.24-0.86] 0.016), fecal leukocytes (0.17 [0.07-0.33] < 0.001), and alkaline stool (0.16 [0.07-0.36] < 0.001) were independently associated with IA; and among individuals ≥ 15 years of age, living in the slum area (1.88 [1.12-3.14] 0.016), watery stool (2.21 [1.37-3.55] 0.001), use of antimicrobials before visiting hospital (0.67 [0.46-0.99] 0.047), red blood cell (0.45 [0.22-0.94] 0.036), and fecal leukocytes (0.21 [0.12-0.35] < 0.001) in stool were independently associated with IA. Socio-demographic and clinical characteristics of IA and shigellosis varied distantly from each other.

  15. Pregnancy Outcomes of Mothers with Detectable CMV-Specific IgM Antibodies: A Three-Year Review in a Large Irish Tertiary Referral Maternity Hospital

    Drew, Richard J.; Stapleton, Patrick; Abu, Hala; Healy, Eibhlín; Ferguson, Wendy; De Gascun, Cillian; O'Gorman, Joanne; Eogan, Maeve


    A retrospective audit was performed for all obstetric patients who had positive CMV IgM results between January 2012 and December 2014 in the Rotunda Hospital, Ireland. In total, 622 CMV IgM positive tests were performed on samples from 572 patients. Thirty-seven patients had a positive CMV IgM result (5.9%) on the Architect system as part of the initial screening. Three patients were excluded as they were not obstetric patients. Of the 34 pregnant women with CMV IgM positive results on initial screening, 16 (47%) had CMV IgM positivity confirmed on the second platform (VIDAS) and 18 (53%) did not. In the 16 patients with confirmed positive CMV IgM results, four (25%) had acute infection, two (12.5%) had infection of uncertain timing, and ten (62.5%) had infection more than three months prior to sampling as determined by the CMV IgG avidity index. Two of the four neonates of women with low avidity IgG had CMV DNA detected in urine. Both these cases had severe neurological damage and the indication for testing their mothers was because the biparietal diameter (BPD) was less than the 5th centile at the routine 20-week gestation anomaly scan. PMID:26696757

  16. Community engagement and pediatric disaster readiness in a large urban disaster resource hospital network: the case of "The Great California ShakeOut".

    Balasuriya, Darshi; Iverson, Ellen; Burke, Rita V; Upperman, Jeffrey S


    We examined the response of 11 Los Angeles County (LAC) hospitals designated as Disaster Resource Centers (DRCs) to a statewide, earthquake preparedness drill, LAC's most comprehensive earthquake disaster drill to date. Semistructured interviews were conducted with the coordinators of 11 of the 14 LAC DRCs within 3 weeks of the drill. Interviews were transcribed and thematic analysis was supported by analytical software (Atlas.ti). Except for one pediatric specialty DRC, most DRCs did little to fully test their institutions' capacity to manage pediatric patients. Few DRCs included children as mock victims. Little or no attention was focused on pediatric triage and other pediatric clinical, psychosocial, and resource issues. Respondents maintained that community readiness is hampered by compartmentalizing the preparedness planning, training, and drilling. Without a mandate to coordinate with other agencies, few DRCs reported coordination with other community entities. Those that did were in smaller submunicipalities within LAC. Community coordination is critical to effective response to disasters, yet disaster preparedness planning and drills are most often uncoordinated and compartmentalized. Drills and training need to be transdisciplinary and coordinated with other community entities likely to play a role in pediatric disaster management.


    杨慧宁; 王鲜平; 吕晓丽; 高敏; 曹力; 张娜


    Objective To study control measures for H1N1 influenza nosocomial infections in a large general hospital.Methods The key management and integrated intervention measures, such as protective isolation and strict disinfection measures, were implemented according to the epidemiologie survey.Results lsolation and protective measures for patients and medical staff respectively and strict disinfection measures were taken.386 cases (including 29 cases that diagnosed in hospital) were accepted as H1N1 influenza in 2009 in the hospital.There was no horizontal propagation among patients and no nosocomial infections among hospital staff.Conclusion Zero target of H1N1 influenza nosocomial infections is achieved through integrated management measures.%目的 研究大型综合医院甲型H1N1流感院内感染控制措施.方法 根据流行病学调查资料,有针对性地采取重点管理和消毒隔离综合措施.结果 通过对病人和医护人员分别隔离保护措施以及严格执行消毒隔离措施,本院2009年度共接诊甲型 H1N1 流感确诊病例386例(含住院确诊29例),未发生病人间横向传播,亦没有医院内工作人员感染.结论 通过实施感染综合管理措施,实现了大量接诊甲型H1N1流感病人的医院内零感染目标.

  18. Department of the Navy Justification of Estimates for Fiscal Year 1984 Submitted to Congress January 1983. Procurement. Aircraft Procurement, Navy


    increase in the survivability for Navy tactical aircraft 1gainst radar directed air detcnse system. Development Stitis: Northroo Corporation is under...9H and AIM-9L iiterfaee comnatibility ; (5) deleting the visual target icquisition svstem (VTAS) back up power supply to make room for a new shop...5, 16$5,162 Unstallation Data: Component modification will be accoamplished via an avionics change (AVc) 3ubmitte from anhe aircra ft Corporation and

  19. Development of the personalized criteria for microscopic review following four different series of hematology analyzer in a Chinese large scale hospital

    CUI Wei; XIANG Xue-fang; SI Yong-zhen; CHEN Qian; CAI Hao; LI Tan; SHEN Han; SHANG Kun; ZHANG Yong-qiang; WU Wei; WANG Xin; WANG Geng; HAO Ying-ying; CHEN Yu; LUO Dan; SHOU Wei-ling; ZHANG Shuo


    Background A generally accepted guideline ("41 rules") published by the lnternational Consensus Group for Hematology Review (ICGHR) can not be suitable for all the laboratories because the facility type, laboratory requirements, sample volume, review rate, turn around time, instrument model and characters etc. are quite different from each other, which may cause a higher workload for microscopy review or lead to false or misleading results.Therefore, we decided to develop the personalized review criteria for 4 series of hematology analyzers in the same hospital, and describe all the implement procedures in detail.Methods The total 1770 blood samples were collected from Peking Union Medical College Hospital. Referring to the suggested criteria by international consensus group for hematology review ("41 rules"), the personalized review criteria for 4 series of hematology analyzers including Siemens Advia 2120, Sysmex XE-2100, Sysmex XT-1800i and Sysmex XS-800i were established and validated by adjusting the rules in order to reduce the false positive rate and keep the false negative acceptable by clinical.Results Using the "41 rules", high review rates of 37.94%, 35.56%, 33.44% and 37.94% were got respectively in Siemens Advia 2120, Sysmex XE-2100, Sysmex XT-1800i and Sysmex XS-800i. Three false positive rules mainly were observed in all of 4 analyzers: white blood cell <3×109/L or >30×109/L, platelet <100x109/L or >1000×109/L and immature granulocyte. Specialized rules were observed in different series of analyzers, atypical/variant lymphs flag were found mainly in Sysmex XE-2100, Aniso-RBC were found mainly in Sysmex XT-1800i, flag of "immature granulocyte" mainly in Sysmex XS-800i, Micro-RBC, Macro-RBC and Aniso-RBC mainly in Siemens Advia 2120. Rules of immature granulocyte,blast, and NRBC flag would be mainly triggered by hematology malignant tumor. We could not delete these rules due to the risk of false negative of serious disease, other rules were

  20. History of high-risk HPV and Pap test results in a large cohort of patients with invasive cervical carcinoma: experience from the largest women's hospital in China.

    Tao, Xiang; Griffith, Christopher C; Zhou, Xiangrong; Wang, Zhiheng; Yan, Yabin; Li, Zaibo; Zhao, Chengquan


    Current cervical cancer screening guidelines recommend screening with a Papanicolaou (Pap) test or by cotesting (Pap and human papillomavirus [HPV]). Given the importance of high-risk HPV (hrHPV) infection in the development of cervical cancer, some studies are now suggesting the use of primary hrHPV testing as a possible screening modality. To gain further insight into the role of both Pap testing and hrHPV testing, the authors examined prior screening results in a population of Chinese patients with invasive cervical carcinoma. Cases with a histologic diagnosis of invasive cervical carcinoma were retrieved from the Obstetrics and Gynecology Hospital of Fudan University from January 2011 to October 2014. Prior hrHPV testing and Pap test results within 3 years before the cancer diagnosis were recorded. Of 3714 patients with invasive cervical carcinoma, over a 46-month period, 525 had prior hrHPV testing using Hybrid Capture 2 within 3 years and 238 patients had Pap cytology testing within 1 year before the histological diagnosis. Within the 1-year period before diagnosis, the overall hrHPV-negative rate was 15.5% (74 of 477 patients) and the Pap-negative rate was also 15.5% (37 of 238 patients). Only 9 of 231 patients with both hrHPV testing and Pap testing (3.9%) had a double-negative result. Compared with squamous cell carcinoma, adenocarcinoma has significantly higher rates of prior negative results with both hrHPV and Pap cytology. The results of the current study demonstrated prior results of hrHPV testing and Pap cytology in a population of women in China who had not undergone intensive prior screening. Both hrHPV testing and Pap cytology were found to have similar negative rates in this population and, not surprisingly, there were fewer women who had negative testing results using both testing modalities. © 2015 American Cancer Society.

  1. Strategic market planning for hospitals.

    Zallocco, R L; Joseph, W B; Doremus, H


    The application of strategic market planning to hospital management is discussed, along with features of the strategic marketing management process. A portfolio analysis tool, the McKinsey/G.E. Business Screen, is presented and, using a large urban hospital as an example, discussed in detail relative to hospital administration. Finally, strategic implications of the portfolio analysis are examined.

  2. Navy Perspective on Joint Force Interdependence


    force, we are committed to revitalizing our skills as America’s mobile, forward-engaged “away team” and “first responders.” Building and maintaining...between themselves and with other global maritime partners. The Services writ large are not unfa- miliar with the notion of cross-domain synergy

  3. The Socio-Demographic and Clinical Factors Associated with Quality of Life among Patients with Haematological Cancer in a Large Government Hospital in Malaysia.

    Priscilla, Das; Hamidin, Awang; Azhar, Md Zain; Noorjan, Kon; Salmiah, Md Said; Bahariah, Khalid


    The paper examined the quality of life of haematological cancer patients according to their socio-demographic profiles and clinical diagnoses. This cross-sectional study was conducted at the tertiary referral centre of Ampang Hospital, Kuala Lumpur, involving 105 patients. The European Organisation for Research and Treatment of Cancer Quality of Life (EORTC QLQ-C30) questionnaire was used to measure their quality of life. The study involved patients diagnosed with all types of haematological cancer, including non-Hodgkin lymphoma (NHL), acute myelogenous leukaemia (AML), acute lymphoblastic leukaemia (ALL), Hodgkin lymphoma (HL), and multiple myeloma (MM), with a response rate of 83.3%. The patients with ALL, HL, without NHL, and without MM were younger than other patients. There were significant differences in quality of life scores in different socio-demographic groups and types of cancer diagnosis. The global quality of life of the female patients was much better than that of the male patients. Patients who were 40 years old or younger had a better global quality of life and physical functioning, as well as fewer symptoms of constipation, nausea, and vomiting. Employed patients were in less pain but showed greater impairments of cognitive function than did unemployed patients. Patients who earned a monthly wage of RM1000 or less had reduced physical function, more symptoms of pain, and more financial difficulties compared with patients who earned more. Patients with AML tended to have better physical functioning than did patients with MM, whose physical functioning was impaired. Comparatively, more symptoms of dyspnoea were found in ALL and HL patients than in other types of lymphoma. Compared with other patients, those with ALL had a greater loss of appetite, and other lymphoma patients had fewer symptoms of pain. Patients with NHL had impaired role functioning and more constipation compared with other patients. The results were all statistically significant (P

  4. hospital's perspective

    Cost effectiveness of autologous blood transfusion - A developing country hospital's ... 4Military Hospital, Lagos. Summary. An autologous blood donation program was set up at. National .... risk of infection for autologous patients was 5.06.

  5. 75 FR 12245 - Program Comment for the Department of the Navy for the Disposition of Historic Vessels


    ...); iii. In addition to the standard curator items removed from the vessel upon decommissioning in... characteristics of the vessel, the Navy would make the vessel available to the Navy Curator and eligible non... the historical significance of the vessel. Items removed by the Navy Curator will be maintained and...

  6. 76 FR 3095 - Taking and Importing Marine Mammals; U.S. Navy Training in the Hawaii Range Complex


    ... ordering and purchasing acoustic recording devices to be used to gather data in subsequent years. The Navy... information regarding marine mammal populations in the Navy exercise areas. Passive Acoustics Four Ecological... monitoring sub-goals under the major goals that have been identified; (2) Characterizing Navy Range...

  7. 33 CFR 100.1105 - San Francisco Bay Navy Fleetweek Parade of Ships and Blue Angels Demonstration.


    ... Parade of Ships and Blue Angels Demonstration. 100.1105 Section 100.1105 Navigation and Navigable Waters... WATERS § 100.1105 San Francisco Bay Navy Fleetweek Parade of Ships and Blue Angels Demonstration. (a... Navy Ships and Navy Blue Angels and other airshow activities held annually in early October,...

  8. 78 FR 3408 - Notice of Intent to Prepare a Supplement to the Gulf of Alaska Navy Training Activities...


    ... Department of the Navy Notice of Intent to Prepare a Supplement to the Gulf of Alaska Navy Training... Training Activities Environmental Impact Statement (EIS)/ Overseas Environmental Impact Statement (OEIS.../OEIS will also analyze data using an acoustic model not available for the 2011 EIS/OEIS, the Navy...

  9. 77 FR 76170 - Presumption of Exposure to Herbicides for Blue Water Navy Vietnam Veterans Not Supported


    ..., 7, 8-Tetrachlorodibenzo-p-Dioxin (TCDD). Numerous adverse health effects in veterans who served in... Brown Water Navy Veterans had qualitatively more pathways of exposure to Agent Orange-associated TCDD... to Agent Orange-associated TCDD and, therefore, that exposure of Blue Water Navy Vietnam Veterans...

  10. 32 CFR 700.325 - The Assistant Secretary of the Navy (Installations and Environment).


    ... 32 National Defense 5 2010-07-01 2010-07-01 false The Assistant Secretary of the Navy (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...

  11. 32 CFR 700.324 - The Assistant Secretary of the Navy (Manpower and Reserve Affairs).


    ... 32 National Defense 5 2010-07-01 2010-07-01 false The Assistant Secretary of the Navy (Manpower and Reserve Affairs). 700.324 Section 700.324 National Defense Department of Defense (Continued... Assistants § 700.324 The Assistant Secretary of the Navy (Manpower and Reserve Affairs). The Assistant...

  12. DEFENSE INFRASTRUCTURE: Opportunities Exist to Improve the Navy’s Basing Decision Process and DOD Oversight


    Ranking Member Committee on Armed Services United States Senate The Honorable Daniel K. Inouye Chairman The Honorable Thad Cochran Ranking...underutilized facilities since the USS John F. Kennedy was retired in 2007. According to Navy officials, the Navy used its strategic dispersal

  13. Navy Lasers, Railgun, and Hypervelocity Projectile: Background and Issues for Congress


    Navy Declares Laser Weapon ‘Operational,’” Politico Pro (Pro Defense Report), December 10, 2014.) The Navy testified on February 24, 2016, that the... personally talk with the transition team and explain to them what we have pursued and why we have pursued it, and let them make their own decisions

  14. 77 FR 49412 - Takes of Marine Mammals Incidental to Specified Activities; Navy Research, Development, Test and...


    ... Specified Activities; Navy Research, Development, Test and Evaluation Activities at the Naval Surface... (Navy) to take marine mammals, by harassment, incidental to conducting research, development, test and... hearing sensitivity as a simple function of development and aging has been observed in marine mammals, as...

  15. An Analysis Of Personalized Learning Systems For Navy Training And Education Settings


    virtually all of its schoolhouses and learning environments. This “one size fits all” system is dated and inefficient, and the Navy could potentially...BLANK v ABSTRACT The U.S. Navy employs a single approach to education and training in virtually all of its schoolhouses and learning...Management Systems..................................................29 6. Digital Teaching Platform

  16. 78 FR 57781 - Honoring the Victims of the Tragedy at the Washington Navy Yard


    ... America the two hundred and thirty- eighth. (Presidential Sig.) [FR Doc. 2013-23015 Filed 9-18-13; 11:15... Washington Navy Yard By the President of the United States of America A Proclamation As a mark of respect for... Navy Yard, by the authority vested in me as President of the United States by the Constitution and...

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


    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

  18. 33 CFR 334.950 - Pacific Ocean at San Clemente Island, California; Navy shore bombardment areas.


    ... Island, California; Navy shore bombardment areas. 334.950 Section 334.950 Navigation and Navigable Waters... REGULATIONS § 334.950 Pacific Ocean at San Clemente Island, California; Navy shore bombardment areas. (a) The... degrees true, 5.35 nautical miles; thence 040.4 degrees true to the beach. (3) The waters of the...

  19. The Families of U.S. Navy Prisoners of War from Vietnam Five Years after Reunion.

    Nice, D. Stephen; And Others


    Investigated marital stability and perceptions of marital adjustment and family environment among Navy prisoners of war repatriated from Vietnam (RPWs) and a Navy comparison group. Results indicated that the post-repatriation divorce rate among the RWP group was significantly higher than for the comparison group. (Author)

  20. 75 FR 1706 - Regulated Navigation Area; U.S. Navy Submarines, Hood Canal, WA


    ... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA11 Regulated Navigation Area; U.S. Navy Submarines, Hood... be in effect whenever any U.S. Navy submarine is operating in the Hood Canal and being escorted by the Coast Guard. The RNA is necessary to help ensure the safety and security of the submarines,...

  1. 75 FR 27638 - Regulated Navigation Area; U.S. Navy Submarines, Hood Canal, WA


    ... No. USCG-2009-1058] RIN 1625-AA11 Regulated Navigation Area; U.S. Navy Submarines, Hood Canal, WA... whenever any U.S. Navy submarine is operating in that area and is being escorted by the Coast Guard. The RNA is necessary to help ensure the safety and security of the submarines, their Coast Guard...

  2. Microbial Fuel Cells for Powering Navy Devices


    length × width for a planar electrode of negligible thickness) to capture a larger flux of reactant. Very large anodes, however, are difficult to...Monterey BMFC was constructed from a piece of plastic sewer pipe and included a 3-m-long carbon brush anode (6); a 4-m-long carbon brush cathode (7); two...features on the seafloor that exhibit high rates of fuel mass transport (e.g., at methane hydrate outcrops), which may constitute BMFC hotspots where

  3. Western European and NATO Navies, 1981.


    continuing the process of disposing of its large surface ships in favor of submarines, fast patrol craft, and minecraft . Of its three remaining destroyers...Mainland. Robert G., -A Somehat Different View of The Appliad Mathetics and Statistics, University of British Optimal Novel Posture," 37 pp., Jun... University of BrItish Colle, Russell C., "Comntu on: Principles of Information Columbia, Vancouver, Canada. Retrieval by Menfred Kochen,"f 10 pp., Mar 78

  4. Hospitality within hospital meals –

    Justesen, Lise; Gyimóthy, Szilvia; Mikkelsen, Bent Egberg


    Hospital meals and their role in nutritional care have been studied primarily from a life and natural science perspective. This article takes a different approach and explores the idea of hospitality inspired by Jacques Derrida’s work on the ontology of hospitality. By drawing on ethnographic...... fieldwork in a Danish hospital, hospitality practices were studied using a socio-material assemblage approach. The study showed that rethinking the meal event could change the wards into temporary “pop-up-restaurants,” transcending the hospital context and providing a scene for shifting host...... and management involved in hospital food service and in nutritional care to work more systematically with the environment for improved hospital meal experiences in the future...

  5. Medical radiation exposure and justification at a large teaching hospital. Comparison of radiation-related and disease-related risks; Medizinische Strahlenexposition und ihre Rechtfertigung an einem Grossklinikum. Vergleich von strahlungs- und krankheitsbedingtem Risiko

    Loose, R.W.; Popp, U.; Adamus, R. [Klinikum Nuernberg-Nord (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Wucherer, M. [Klinikum Nuernberg (Germany). Inst. fuer Medizinische Physik


    The medical X-ray exposure was determined in a 2400-bed hospital. The radiation-related risk was compared with the severity of disease (ICD) to verify the justification for X-ray procedures. A model to estimate radiation and disease-related ''loss of lifetime'' was applied. X-ray exposure from radiography, fluoroscopy and CT was determined for diagnostic and interventional procedures during one hospital stay of 403 patients (0.5 % of all 80 000 patients/year). CTDI and DLP in CT, DAP in fluoroscopy or SED in radiography were used to calculate the effective dose (ED). The disease and radiation-related risk were compared with a simple ''loss of lifetime'' model. The mean age of all patients was 60. Only a subgroup of 170 patients (42 %) with a mean age of 67.6 had one or more X-ray procedures. The average ED of these exposed patients was 5.12 mSv. 14.4 % CT examinations had a dose contribution of 52.5 % followed by 5.3 % radiology and cardiology procedures at 37.2 %. 90 % of ED was applied to only 44 patients (11 %) and 50 % of ED was applied to only 10 patients (2.5 %) with a mean age of 71.2. 4 of these 10 patients had malignant tumors, the other 6 suffered from pulmonary embolism, pneumonia, stentgraft infection, CAD, Crohn's disease and severe hypertension. The ratio of disease vs. radiation-related risk was between 2.1:1 and 1800:1. In this study referral for justified X-ray procedures in a large hospital with high level medical care offers a significant patient benefit. (orig.)

  6. 大型综合医院在门诊工作中落实医改政策实践探讨%Practice on implementation of healthcare reform in outpatient work in large general hospital

    姚峥; 赵国光; 王香平


      医改新形势下,大型综合医院门诊工作量、患者构成及就诊需求均发生很大变化,医院管理者和医务人员应转变管理理念和服务方式。门诊是落实医改政策、体现医院公益性、优化服务模式和流程的窗口。首都医科大学宣武医院通过突出门诊服务的公益性、保障门诊患者的安全、优化门诊服务流程和提高门诊服务质量等系列措施,落实医改政策。%The outpatient workload, the patient composition and medical demands have been changed in large general hospital after implementing healthcare reform. The hospital administrators and medical stuffs should change the management concept and service provision mode. The outpatient service is the window of implementing healthcare reform policy, showing public welfare and optimizing service mode and process. By series of measures such as strengthening public welfare of outpatient service, securing patient safety, optimizing outpatient service process and promoting outpatient service quality, the healthcare policy is implemented.

  7. The application of clients' relationship management in large general hospital physical examination centre%客户关系管理在大型综合性医院体检中心的应用

    唐兰; 张元贤; 曾凡玲


    With the economic development, more and more people concerned about health. Institution and people engaged in physical examination is springing up. Facing increasingly less obvious advantages of product homogeneity, and the growing market which must cater to different customers, as a large general hospital medical center, we should make good management of customer relationship, improve customers' satisfaction, increase their loyalty, provide the most effective health protection for the physical examination so as to improve market competitiveness and bring social and economic benefits to the hospitals, thus achieving a win-win objective.%随着社会经济的发展,健康越来越受到人们的关注,从事健康体检行业的机构和人员逐渐增多。针对体检业务同质化、客户个性化需求日趋强烈等市场特点,作为大型综合性医院的体检中心,应做好客户关系管理,提高客户满意度,增加客户忠诚度,为体检客户提供更有力的健康保障,从而提高市场竞争力,为医院带来良好的社会效益和经济效益。

  8. 中切口白内障摘除术在基层医院大规模防盲手术中的应用%Application of sutureless large-incision manual extraction of cataract in large-scale at primary hospital



    目的 探讨中切口白内障手术中基层医院大规模防盲手术中的应用效果.方法 回顾性分析2011年到2012年在我院进行白内障手术的患者270例(312只眼),术式采用中切口白内障手术联合人工晶状体植入.结果 术后随访1个月,287只眼(92.0%)达到0.3以上的视力,并发症较少,主要为后囊膜破裂(2.24%)、角膜水肿(1.92%)、前房积血(1.60%)、瞳孔变形(2.24%)等,手术医师没有复杂的学习曲线.结论 中切口白内障手术适合在基层大规模防盲手术中应用.%Objective To investigate the outcomes of large-scale practicing of sutureless large-incision manual extractions of cataract at primary hospitals. Methods Retrospective analysis of 270 cataract cases (312 eyes) that underwent sutureless large-incision manual cataract extraction and intraocular lens implantation from 2011 to 2012. Results Visual acuity improved to 0.3 or above in 287 eyes (92. 0% ) at 1 month after the surgery. The complications included rupture of posterior capsular (2. 24% ) , corneal edema ( 1. 92% ), hyphema ( 1. 60% ) , and pupil deformation (2.24% ). The surgical procedure is easy to leam for surgeons. Conclusion Sutureless large-incision manual cataract extraction is recommended for cataract treatment at primary care hospitals and its practice should be promoted to a large-scale.

  9. Options for the Navy’s Future Fleet


    Access to a Specific Area number of battle force ships has varied significantly (see The more generic threat that motivates U.S. naval plan- Figure decade, the ship const r aln. efl in o lear-po red ship construction alone. Refuelings of nuclear-powered Navy plans to replace the P-3 aircraft...year in additional shipbuilding years). funds would provide a total of $15 billion over the 30- year period of this analysis. That sum, roughly speaking

  10. The Navy Biofuel Initiative Under the Defense Production Act


    the end of 2012, and “Great Green Fleet” by 2016 fueled in part with a 50/50 blend of hydrotreated renewable jet fuel (biofuel). The Navy proposes to...Osprey, and the MH-60S Seahawk to operate on HRJ-5, a 50/50 blend of hydrotreated renewable fuel (HRJ) and conventional JP-5.5 Hydrotreated refers...propellant ranged from $1.55 to $2.87 per gallon.14 In 2009, DLA awarded small contracts for hydrotreated renewable fuel (HRJ-5 jet fuel) that ranged in

  11. Operational Planning Tools for U.S. Navy Maritime Commanders

    Gerald G. Brown; Carlyle, Matthew W.; Kelton, David; Kline, Jeffrey; Salmeron, Javier


    Brown, G., Carlyle, W.M., Kelton, D., Kline, J. and Salmerón, J., 2009, “Operational Planning Tools for U.S. Navy Maritime Commanders,” in refereed conference proceedings of International Conference on Harbor, Maritime and Multimodal Logistics Modeling and Simulation, Bruzzone, A., Cunha, G. Martínez, R. and Merkuryev, Y., eds., Universidad de La Laguna, Tenerife, Spain. ISBN 978-84-692-5416-5. This work presents recent research to develop a series of optimization- and simulation-based dec...


    谭西平; 梁建岚; 陈海勇; 黄晓群; 曾勇


    The article explains the large general hospital multiple districts development planning principles, overal development and construction planning key points, based on the development direction and objectives, defines reasonable preposition, proper size and location of each district;combining fund raising capacity and medical business premises turnaround plan, makes rational phase implementation plan.%文章结合参加大型综合医院多院区总体发展建设规划的实践,系统阐述了大型综合医院多院区发展规划的原则、总体发展建设规划的编制要点。

  13. 大型综合医院门诊分诊优质护理的应用%Application of triage high quality nursing in the outpatient clinic of large general hospital



    目的:探讨大型综合医院门诊分诊优质护理的效果及应用价值。方法选择我院实施门诊分诊优质护理作为节点,通过对患者进行护理质量和满意度调查,观察实施门诊分诊优质护理实施前后的效果。结果实施门诊分诊优质护理后患者护理质量评分和护理满意度高于常规护理组,护理风险事故和护理投诉的发生低于常规护理组,组间资料比较,差异有统计学意义( P<0.05)。结论在大型综合医院开展门诊分诊优质化护理能够更好满足患者需求,带动门诊护士的积极性,减少了护理风险事故和护理投诉的发生,提高临床护理满意度,值得在临床上大力推广使用。%Objective To investigate the effect of triage high quality nursing and its application value in the the outpatient clinic of large general hospital .Methods In our hospital outpatient triage high quality care as a node , through the 228 cases of quality of care and patients'satisfaction surveys to observe the implementation of outpatient triage quality care results .Results After the implementation of triage high quality nursing the score of the quality of patient care and nursing satisfaction were higher than those of routine nursing group , the risk of accidents and the incidence of complaints were lower than those in the control group , the difference was statistically significant ( P<0.05 ) .Conclusions In a large general hospitals carrying out high quality nursing can better meet the needs of patients , reduce the risk of accidents and complaints occurrence , improve clinical care satisfaction .It is worthy promoting in clinic .

  14. Hospitality Industry

    Marian Ionel


    Full Text Available Development of accommodation, as basic services offered to tourists, led to the creation of a genuine hospitality industry. Currently, the hospitality industry is no longer just the accommodation service itself but also requires an atmosphere that ensures leisure tourists in the hotel. Thus, hospitable unit manager offers its service in addition to accommodation and catering services, leisure services, treatment services, business services required.. The existence of factors such as revenue growth, increasing leisure time, the development of transport services, the emergence of new tourist attractions have caused increasing international flows of tourists, with consequent development of units hospitable, and therefore a strong hospitality industry. In Romania, after 1990, the tourism sector experienced a true expansion, both through the development of the hotel sector, but also by developing rural hospitality units.

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

    Joseph J. Knapik


    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.

  16. Highly realistic, immersive training for navy corpsmen: preliminary results.

    Booth-Kewley, Stephanie; McWhorter, Stephanie K


    Highly realistic, immersive training has been developed for Navy corpsmen based on the success of the Infantry Immersion Trainer. This new training is built around scenarios that are designed to depict real-life, operational situations. Each scenario used in the training includes sights, sounds, smells, and distractions to simulate realistic and challenging combat situations. The primary objective of this study was to assess corpsmen participants' satisfaction with highly realistic training. The study sample consisted of 434 male Navy service members attending Field Medical Training Battalion-West, Camp Pendleton, California. Corpsmen participants completed surveys after receiving the training. Participants expressed high levels of satisfaction with the training overall and with several specific elements of the training. The element of the training that the corpsmen rated the highest was the use of live actors. The vast majority of the participants reported that the training had increased their overall confidence about being successful corpsmen and had strengthened their confidence in their ability to provide care under pressure. Additional research should extend highly realistic training to other military medical provider populations. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

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

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


    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.

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

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


    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.

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


    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.

  20. Employing U.S. Navy Hospital Ships in Support of Soft Power Projection


    relations with Association of Southeast Asia Nations (ASEAN) countries by means of finance, foreign aid, trade and tourism , and development of...operate in close proximity to the beach and gain access to shallow, and possibly littered , ports and estuaries.52 The location and proximity of

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


    in the military. It is administered annually to more than one million military applicants, high school, and post-secondary students ” (ASVAB, n.d...Pacific Northwest, Lemoore, Brunswick, Corpus Christi, Gulfport, Port Hueneme); non- fleet concentration area; international LOS Numerical Sailor’s...AFQT_BL + AFQT_BU + PMA_BL + PMA_BU, family = binomial, data = mdata41) Deviance Residuals: Min 1Q Median 3Q

  2. Collaborative Approach to the Creation of an Arteriovenous Fistula on a US Navy Hospital Ship.

    Thompson, Kimberly A; Krishnan, Amrish; Stehman, Charles; Hanling, Steven; Casey, Kevin


    Early creation of arteriovenous fistulas (AVFs) decreases morbidity and mortality in patients with end-stage renal disease and is the standard of care in the United States. However, this procedure is frequently not accessible in low- and middle-income countries (LMICs). We present the first reported case of successful AVF creation as part of a humanitarian assistance mission. The patient was a 51-year-old male with diabetes, hypertension, and end-stage renal disease on hemodialysis via a temporary dialysis catheter. Preoperative assessment and patient selection were coordinated with the host nation (HN) nephrologist and dialysis team. The visiting surgical team provided education on AVF anatomy, complications, and cannulation techniques to the HN dialysis team. A left brachiocephalic AVF was created under regional anesthesia performed by the visiting surgeon and anesthesiologists. There were no postoperative complications, and the AVF was matured and accessed successfully by the HN dialysis team 7 weeks after creation. Performing AVFs as part of humanitarian assistance missions has the potential to significantly reduce morbidity and mortality in LMICs.

  3. Clinical application value of hard nucleolus cataract surgery with sutureless large incision in primary hospitals%无缝线中切口硬核白内障手术在基层医院临床应用



    Objective To summarize and explore the effect of hard nuclcolus cataract surgery with sutureless large incision.Methods A retrospective analysis was made on the clinical data of 168 patients with hard nucleolus cataract received extracapsular cataract extraction with sutureless large incision from January 2009 to December 2013 in People's Hospital of Xuan'en County.Results Through comparing uncorrected visual acuity when one day, one week and three months after surgery with before surgery in 168 patients with cataract surgery, there were significant differences (x2=255.21, P =0.000;x2=431.46, P =0.000;x2=401.98, P =0.000).Conclusions Extracapsular cataract extraction with sutureless large incision is inexpensive, safe and easy to master, and the learning curve is short and the effect is good.It is suitable for development in the primary hospitals.%目的 总结并探讨无缝线中切口硬核白内障手术的效果.方法 回顾性分析2009年1月至2013年12月在宣恩县人民医院眼科就诊的168只眼硬核患者行无缝线中切口白内障囊外摘除术临床资料.结果 168只眼手术后1天、手术后1周、手术后3个月裸眼视力与术前比较,差异有统计学意义(x2=255.21,P=0.000;x2=431.46,P=0.000;x2=401.98,P=0.000).结论 无缝线中切口白内障囊外摘除术投资少、安全、容易掌握、学习曲线短、效果好,适合在基层医院开展.

  4. Optics research at the U.S. Navy System Commands Laboratories: introduction.

    Mullen, Linda


    The purpose of this feature issue is to highlight optics research being performed at the U.S. Navy System Commands. Contributed papers cover a range of topics related to the various components of optical systems, including the optical source, the intervening medium, and the optical receiver, and processing techniques that are used to obtain information from the detected signal. While research from only two of the Navy System Commands is represented in this feature issue, it will hopefully enlighten the readers to the variety and high caliber of research being conducted in our Navy's laboratories and pave the way for additional features in the future.

  5. Sleep and performance in simulated Navy watch schedules.

    Skornyakov, Elena; Shattuck, Nita L; Winser, Michael A; Matsangas, Panagiotis; Sparrow, Amy R; Layton, Matthew E; Gabehart, Rylie J; Van Dongen, Hans P A


    To operate Navy ships 24h per day, watchstanding is needed around the clock, with watch periods reflecting a variety of rotating or fixed shift schedules. The 5/15 watch schedule cycles through watch periods with 5h on, 15h off watch, such that watches occur 4h earlier on the clock each day - that is, the watches rotate backward. The timing of sleep varies over 4-day cycles, and sleep is split on some days to accommodate nighttime watchstanding. The 3/9 watch schedule cycles through watch periods with 3h on, 9h off watch, allowing for consistent sleep timing over days. In some sections of the 3/9 watch schedule, sleep may need to be split to accommodate nighttime watchstanding. In both the 5/15 and 3/9 watch schedules, four watch sections alternate to cover the 24h of the day. Here we compared sleep duration, psychomotor vigilance and subjective sleepiness in simulated sections of the 5/15 and 3/9 watch schedules. Fifteen healthy male subjects spent 6 consecutive days (5 nights) in the laboratory. Sleep opportunities were restricted to an average of 6.5h daily. Actigraphically estimated sleep duration was 5.6h per watch day on average, with no significant difference between watch sections. Sleep duration was not reduced when sleep opportunities were split. Psychomotor vigilance degraded over watch days, and tended to be more variable in the 5/15 than in the 3/9 watch sections. These laboratory-based findings suggest that Navy watch schedules are associated with cumulative sleep loss and a build-up of fatigue across days. The fixed watch periods of the 3/9 watch schedule appear to yield more stable performance than the backward rotating watch periods of the 5/15 watch schedule. Optimal performance may require longer and more consistent daily opportunities for sleep than are typically obtained in Navy operations. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Survey of Endangered Tree Snails on Navy-Owned Land in Guam

    US Fish and Wildlife Service, Department of the Interior — The objectives of this survey are to determine the location of Guam tree snails on Navy-owned lands in Guam and to identify the location of suitable habitat and...

  7. Navy's land and water use assessment : Section 206©- Public Law 101-618

    US Fish and Wildlife Service, Department of the Interior — This note is about an Environmental Assessment in which the Naval Air Station in Fallon, NV proposes an agricultural leasing program for Navy lands to reduce soil...

  8. 77 FR 30996 - Taking and Importing Marine Mammals: Taking Marine Mammals Incidental to Navy's Research...


    ... 2011 LOA. In fact, the number of RDT&E activities was below the Navy's proposed 2011 operations. A... after departing NBK Bangor and continued throughout the transit to and from Dabob Bay. Observers...

  9. Biodegradation of Navy N5RL1 carpet dye by Staphylococcus saprophyticus strain BHUSS X3

    Kumari, Lata; Verma, Ajay Kumar; Tiwary, Dhanesh; Giri, Deen Dayal; Nath, Gopal; Mishra, Pradeep Kumar


    Biodegradation of Navy N5RL1, a widely used acidic azo dye in carpet industry, was studied by bacterial strain isolated from the dye-contaminated soil collected from a carpet industry premises located...

  10. Navy Ford (CVN-78) Class Aircraft Carrier Program: Background and Issues for Congress


    Equipment ( CFE ) systems during lead ship design and construction. For material costs, the variance reflects challenges associated with a shrinking...additional optimal CFE material procurement strategies. Furthermore, the Navy has increased its oversight of contractor furnished material

  11. Patient involvement in hospital architecture

    Herriott, Richard


    This paper examines user-involvement in the process used to design new hospitals. Denmark is in the midst of a phase of hospital building. This recent experience is studied by means of expert interviews with senior practitioners involved in three projects. Examined thematically, the data covers......-studied area, design for hospitals. It highlights difficulties in applying the goals of user-centred design and Design for All in large projects....

  12. Personality determinants of health behaviours of merchant navy officers.

    Lipowski, Mariusz; Lipowska, Małgorzata; Peplińska, Aleksandra; Jeżewska, Maria


    An individual's health behaviours are highly correlated with selected areas of their personality as well as their values, needs and goals. However, this relationship may be modified by a number of objective factors associated with the individual's functioning, lifestyle or occupational activity. The main objective of the presented study was to investigate the relationship between personality profiles and health behaviours of merchant navy officers. The influences of personality on health behaviours were additionally compared between two groups: mariners and managers. Thirty-two seafarers of an officer rank and 45 managers aged between 29 and 48 took part in the study. Three research tools were used: NEO-Five Factor Inventory, Health Behaviour Inventory and Inventory of Physical Activity Objectives. Results suggest that selected personality variables are significant predictors of individual aspects of health behaviour, however the strength of their influence may differ, depending on the peculiarities of the performed work.

  13. Hospital Inspections

    U.S. Department of Health & Human Services — Welcome to, a website run by the Association of Health Care Journalists (AHCJ) that aims to make federal hospital inspection reports easier...

  14. Hospital Inspections

    U.S. Department of Health & Human Services — Welcome to, a website run by the Association of Health Care Journalists (AHCJ) that aims to make federal hospital inspection reports easier...

  15. Hospital marketing.

    Carter, Tony


    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.

  16. Navy Global Predictions for the Dynamo Time Period

    Reynolds, C. A.; Ridout, J. A.; Flatau, M. K.; Chen, J.; Richman, J. G.; Jensen, T. G.; Shriver, J. F.


    The performance of 30-day simulations of the Navy Global Environmental Model (NAVGEM) is evaluated under several metrics. The time period of interest is the DYNAMO (Dynamics of Madden Julian Oscillation) field experiment period, starting late October 2011. The NAVGEM experiments are run at an effective 37-km resolution with several different SST configurations. The in the first set of experiments, the initial SST analysis, provided by the NCODA (Navy Coupled Ocean Data Assimilation) system, is either held fixed to the initial value (fixed SST) or updated every 6 hours. These forecasts are compared with forecasts in which the SST is updated with 3-h analyses from the Hybrid Coordinate Ocean Model (HYCOM), and forecasts in which NAVGEM is interactively coupled to HYCOM. Experiments are also performed with different physical parameterization options. The extended integrations are verified using observed OLR, TRMM precipitation estimates, and global analyses. The use of fixed SSTs is clearly sub-optimal. Biases in monthly mean fields are far more pronounced in the simulations where the SST is held fixed as compared to those in simulations where updated SST analyses are used. Biases in the monthly mean fields are further reduced when NAVGEM is coupled to HYCOM. Differences in SST can "migrate" to substantial changes in the time-mean land-surface temperatures, illustrating the substantial impact of SSTs over the full domain. Concerning the simulation of the MJO, some improvement is noted when the system is fully coupled, although the simulations still exhibit deficiencies such as eastward propagation that is too slow, and difficulty propagating over the maritime continent. Simulations that are started every 5 days indicate that the NAVGEM uncoupled system has difficulty predicting MJO initiation, but simulations started when the MJO is active in the Indian Ocean are able to capture eastward propagation characteristics. The coupled NAVGEM-HYCOM system shows ability to

  17. The resignation of Secretary of the Navy James Webb: a perspective from the present

    Hanner, Bradly F.


    This thesis explains the resignation of James Webb as Secretary of the Navy in February 1988. Multiple interviews conducted by the author and several others revealed the combination of politics and personal motivation behind his departure. In an era when defense expenditures were beginning to wane, Webb's insistence on maintaining the United States Navy's force structure in the face of Secretary of Defense Carlucci's unwillingness to do the same, led to his resignation. His opposition to the ...

  18. The Navy Job Performance Measurement Program: Background, Inception, and Current Status


    This report details the inception and institutionalization of the Navy’s job performance measurement project, part of the Congressionally-mandated...Joint-Service Project. Specifically, this report traces the history of the Joint-Service effort to link enlistment standards to actual job performance measurement...project will provide the Navy with the capability to measure and predict job performance and will contribute to major improvements in personnel system functions and measurement technology.

  19. Navy LX(R) Amphibious Ship Program: Background and Issues for Congress


    Service Summary The LX(R) program is a program to build a new class of 11 amphibious ships for the Navy. The Navy wants to procure the first LX(R) in...accelerate the procurement of the first LX(R) from FY2020 to an earlier year, so as to reduce the gap in time between the end of LPD-17 production and the

  20. The Philippine Navy’s Strategic Sail Plan 2020: A Strong and Credible Force by 2020


    to political subordination and dependency.”38 Especially true of the Philippines is that “weakness and poverty coupled with a desire to improve...and aspirations’.”96 This definition may be useful in assisting with ranking these small navies, the more important question remains, is the difference...PN. Eric Grove, in chapter 1, “The Rankings of Smaller Navies Revisited,” explains the definitions that he used in his 1990 book, The Future of Sea

  1. Distributed Common Ground System-Navy Increment 2 (DCGS-N Inc 2)


    for MAIS Programs 3 Program Information 4 Responsible Office 4 References 4 Program Description 5 Business Case 5 Program Status...UNCLASSIFIED 4 Program Description Distributed Common Ground System - Navy (DCGS-N) is the Navy Service component of the DoD DCGS family of systems...partnerships and collaboration with the Defense Intelligence Information Enterprise, the DCGS Family of Systems, the broader IC, and existing Joint and

  2. Surface Ships: Status of the Navy’s Phased Modernization Plan


    The Honorable Thad Cochran Chairman The Honorable Richard Durbin Ranking Member Subcommittee on Defense Committee on Appropriations United States...conditions, and requires reporting on the modernization effort. • The Navy plans to induct USS Cowpens (CG-63) and USS Gettysburg (CG-64) into...modernization in fiscal year 2015 and USS Vicksburg (CG-69) and USS Chosin (CG-65) in fiscal year 2016. In 2014, the Navy placed the USS Gettysburg into

  3. U.S. Navy Health Surveillance. Part 1. Feasibility of a Health Promotion Tracking System.

    No systematic monitoring procedure is in place that can can provide information about successes or deficiencies in Navy health promotion efforts...This study tested the feasibility of using a brief Health Promotion Tracking Form (HPTF) as part of the periodic physical examinations required of all...collecting reliable data for an accurate, on-going assessment of Navy health: (a) collect health promotion data from diverse settings including ships, (b

  4. Inside the Sea Dragon: The Generations within the Current Peoples Liberation Army Navy Officer Corps


    force. This includes not just the physical aspects of warfighting but includes how to live in the barracks, interact with people of different ranks, the fact that Fujian was along the coast , and Navies are formed from regions where the people are “following the sea.”57 However, a map analysis...INSIDE THE SEA DRAGON: THE GENERATIONS WITHIN THE CURRENT PEOPLES LIBERATION ARMY NAVY OFFICER CORPS A thesis presented to

  5. Analysis of enlisted recruiting patterns within the Department of the Navy

    McGregor, James A


    Approved for public release; distribution is unlimited In order to improve business practices within the Department of the Navy, an analysis of the advantages and disadvantages of optimizing the schoolhouse and its effects upon recruiting, recruit training, and the fleet is currently underway. As part of this analysis, this thesis examines if there is an optimal recruiting pattern within both the Navy and the Marine Corps based upon historical data. With a data base consisting of 23,590 en...

  6. Navy Lasers, Railgun, and Hypervelocity Projectile: Background and Issues for Congress


    4; Mike McCarthy, “Navy Deploying Laser For Taking Out Drones ,” Defense Daily, April 9, 2013; Graham Warwick, “U.S. Navy Planning Gulf Deployment...testing recently by striking a fast attack boat and drone , Klunder said, adding that this marks the “historic” first ever operational deployment of a...Research seeks to continue the advancement of SSL weapon system designs , architectures, and component technologies. The government believes that

  7. Navy Dental Corps Contract or Uniform: Study of Factors Influencing Business Case Analyses


    Carroll Storrs Alden and Allan Westcott, The United States Navy: A History, (Chicago, Ill: J. B. Lippincott Company, 1943), 12. 18 Privateers were...Functions and Task Statement (MFT) or the Required Operational Capability/Projected Operational Environment (ROC/ POE ). For example, the OPNAVINST...of work hours and each command has a “standard Navy work week” that is defined in either the MFT or the ROC/ POE . For example, a shore activity has a

  8. Analysis of Suicide Behaviors in the Navy Active Duty and Reserve Component Population


    Hardships and Life Stressors Negative life events can greatly impact individual stress and precipitate behaviors associated with suicide across all... SUICIDE BEHAVIORS IN THE NAVY ACTIVE DUTY AND RESERVE COMPONENT POPULATION by Neeta Serena Blankenship Kristin M. Shepherd March 2015 Thesis...March 2015 3. REPORT TYPE AND DATES COVERED Master’s Thesis 4. TITLE AND SUBTITLE ANALYSIS OF SUICIDE BEHAVIORS IN THE NAVY ACTIVE DUTY AND

  9. Navy Force Structure: A Bigger Fleet Background and Issues for Congress


    facilities at the home port location .  Host-nation limits on use. The host nation might impose limits on how the forward-homeported Navy ships can be used...and possibly for additional basing and support facilities . If current constraints on defense spending are not lifted or relaxed, achieving and...Japan. Potential locations for homeporting additional Navy ships in the Mediterranean in coming years, at least in theory, include Spain (which

  10. Developing Navy Capability to Recover Forces in Chemical, Biological, and Radiological Hazard Environments


    damage control; LHD flight deck and well deck operations; fleet surgical team; Afloat Training Group; Assault Craft Unit; Naval Surface Warfare Center...contaminants. Hot spots are manually scrubbed . 18 3. Current Navy Capability The assessment of current Navy capability is structured around the...supplemented beyond their organic staffing, to include a fleet surgical team, of which there may be only one deployed with an amphibious assault

  11. Navy Ford (CVN-78) Class Aircraft Carrier Program: Background and Issues for Congress


    Names Next Aircraft Carrier USS John F. Kennedy,” Navy News Service, May 29, 2011, accessed online on June 1, 2011 at USS John F. Kennedy (CVN 79) come online ? A: The proposed plan matches the number of complete carrier air wings to the number of operationally...efficiently be performed. The CVN 79 build sequence installs 20 percent more parts in shop , and 30 percent more parts on the final assembly platen, as

  12. Budget execution (O and M,N) at Navy shore activities

    Donnelly, William Joseph


    Approved for public release; distribution is unlimited This thesis addresses the budget execution function at Navy shore commands in regards to the expenditure of Operations and Maintenance, Navy (O&M, N) appropriated funds. The paper discusses the basics of management control and links the budget execution function thereto. The discussion of management control includes an explanation of the Management by Objectives and Results (MOR) model. The thesis also discussed current budget exec...

  13. Adjusting First-Term Contract Lengths in the Navy: Implications and Recommendations


    Causes, Trends, and Differences. CNA Annotated Briefing D0016916.A2/Final. Nov. 2007. [21] Carol S. Moore and David L. Reese . Attrition of Navy Recruits...M. Jaditz, and David L. Reese . The Effect of Enlistment Bonuses on First-Term Tenure Among Navy Enlistees. CNA Research Memorandum D0006014.A2/Final...A2/Final. Sep. 2004. [25] Edward J. Schmitz and Michael J. Moskowitz with David Gre- gory and David L. Reese . Recruiting Budgets, Recruit Quality, and

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


    cost ) of this ship. The Navy appears to assume that the ship will use the current DDG-51 hull design, whereas CBO believes the growth potential of...observers regarding the current and future size and capabilities of the Navy. The Navy’s proposed FY2017 budget requests funding for the procurement...The Navy’s current force-structure goal, presented to Congress in 2015, is to achieve and maintain a future fleet of 308 ships of various kinds

  15. Effects of dietary cooked navy bean on the fecal microbiome of healthy companion dogs.

    Katherine R Kerr

    Full Text Available BACKGROUND: Cooked bean powders are a promising novel protein and fiber source for dogs, which have demonstrated potential to alter microbial composition and function for chronic disease control and prevention. This study aimed to determine the impact of cooked navy bean powder fed as a staple food ingredient on the fecal microbiome of healthy adult pet dogs. METHODOLOGY/PRINCIPAL FINDINGS: Fecal samples from healthy dogs prior to dietary control and after 4 wk of dietary treatment with macro- and micronutrient matched diets containing either 0 or 25% cooked navy beans (n = 11 and n = 10, respectively were analyzed by 454-pyrosequencing of the 16S rRNA gene. There were few differences between dogs fed the control and navy bean diets after 4 wk of treatment. These data indicate that there were no major effects of navy bean inclusion on microbial populations. However, significant differences due to dietary intervention onto both research diets were observed (i.e., microbial populations at baseline versus 4 wk of intervention with 0 or 25% navy bean diets. After 4 wk of dietary intervention on either control or navy bean diet, the Phylum Firmicutes was increased and the Phyla Actinobacteria and Fusobacteria were decreased compared to baseline. CONCLUSIONS: No negative alterations of microbial populations occurred following cooked navy bean intake in dogs, indicating that bean powders may be a viable protein and fiber source for commercial pet foods. The highly variable microbial populations observed in these healthy adult pet dogs at baseline is one potential reason for the difficulty to detect alterations in microbial populations following dietary changes. Given the potential physiological benefits of bean intake in humans and dogs, further evaluation of the impacts of cooked navy bean intake on fecal microbial populations with higher power or more sensitive methods are warranted.

  16. Dysbaric Osteonecrosis in Divers. 1. A Survey of 611 Selected U. S. Navy Divers


    DYSBARIC OSTEONECROSIS IN DIVERS I. A Survey of 611 Selected U. S. Navy Divers by C.A. Harvey, CDR, MC, USN and R.L. Sphar, CAPT, MC, USN...unlimited SUMMARY PAGE THE PROBLEM To determine the prevalence of dysbaric osteonecrosis in U.S. Navy divers and to develop epidemiological data for...insight into those aspects of the hyperbaric environment that contribute to the ultimate occurrence of dysbaric osteonecrosis . FINDINGS Twelve juxta

  17. An evaluation of the Navy Resale System's operating and financial statements

    Barnett, Michael Stephen


    Approved for public release; distribution unlimited This thesis contains an evaluation of the Navy Resale System financial and operating statements used to manage the sales activities from the headquarters, region, main, and branch levels. Navy Resale System (NRS) statements are compared to the National Retail Merchants Association's (NRMA) statements presented in the Retail Accounting Manual and to statements provided by major retailers. From the results of the evalua...

  18. Overview of Operational Ocean Forecasting in the U.S. Navy: Past, Present and Future


    teaching and research. Republication, systematic reproduction, or collective redistribution of any portion of this article by photocopy, and (2) use multilayer, open ocean boundary circulation and thermodynamic models to predict ocean state in a region where ocean fronts or...Dimensional Variational Data Assimilation (4DVAR) Circulation » Thermodynamic Ocean Prediction System (TOPS) » Navy Layered Ocean Model (NLOM) » Navy Coastal

  19. The Royal Navy’s New-Generation Type 45 Destroyer. Acquisition Options and Implications


    Future Offshore Patrol Vessel FPSO Floating Production, Storage and Offloading vessel xxiii xxiv The Royal Navy’s New-Generation Type 45 Destroyer FSC...the conversion of a Floating Production, Storage and Offloading ( FPSO ) vessel, and a naval order for two Alternative Landing Ships Logistics (ALSL...Frigates, various Marine (OPVs) for Royal Brunei design work Navy Offshore SupplyVessel, ALSL, Landing Craft Utility, miscellaneous module and Auxiliary

  20. Navy Ship Maintenance: Action Needed to Maximize New Contracting Strategys Potential Benefits


    and to capitalize on anticipated benefits, and (3) how the strategy will potentially affect the Navy’s ship repair industrial base. GAO analyzed...MAC-MO contracting strategy, (2) process changes the Navy has taken to address any challenges and to capitalize on anticipated benefits, and (3) how...Regulation (FAR) provisions and MSMO contracts. To assess process changes the Navy has taken to address challenges and to capitalize on intended

  1. Military Readiness: Progress and Challenges in Implementing the Navy’s Optimized Fleet Response Plan


    months. To accommodate the increase, the Navy reduced the ship’s employability to operational commanders by 3 weeks and compressed its scheduled...increased the amount of time that ships require to complete maintenance in the shipyards. Increased maintenance periods, in turn, compress the time during...ship maintenance work on time. We assessed the various sources of data by obtaining information and interviewing Navy officials about their data

  2. Best Practices: High Levels of Knowledge at Key Points Differentiate Commercial Shipbuilding from Navy Shipbuilding


    Figures Figure 1: Typical Shipbuilding Process 3 Figure 2: Cruise Ship Block Fabrication 5 Figure 3: Cruise Ship Block Outfitting 6 Figure 4: Cruise ... Ship Grand Block 7 Figure 5: Cruise Ship Blocks in Drydock after Keel Laying 8 Figure 6: Major Navy Shipbuilders and Associated Product Lines 11...Emma Maersk 20 Figure 10: Block Definition Plan for a Cruise Ship 26 Figure 11: Navy Practices: Significant Risks Remain Unresolved at Contract

  3. The Virtual Naval Hospital: the digital library as knowledge management tool for nomadic patrons*

    D'Alessandro, Michael P.; D'Alessandro, Donna M.; Bakalar, Richard S.; Ashley, Denis E.; Hendrix, Mary J. C.


    Objective: 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. Methods: 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. Results: 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. Conclusions: 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. PMID:15685269

  4. Brief hospitalizations of elderly patients

    Strømgaard, Sofie; Rasmussen, Søren Wistisen; Schmidt, Thomas Andersen


    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...

  5. Hospital evacuation : Exercise versus reality

    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, i

  6. A Report on Policies and Practices of the U.S. Navy for Naming the Vessels of the Navy


    amphibious ships  should be named in honor of famous Marine battles. As a result, they quietly  mounted  a campaign to change the convention. Their...variously  honoring Harvard, Yale, Mt.  Vesuvius , animals, National Parks and uniquely  American names such as Yankee and Dixie. Starting with the USS St...attack submarines. However, as a result of lessons  learned during the naval blockade  mounted  during the Cuban Missile Crisis, the  Navy decided to

  7. Optimizing Ship-to-Shore Movement for Hospital Ship Humanitarian Assistance Operations


    Programming – The Global Search.” (2007). ———. Xpress -MP Release 2007 (accessed March 21, 2008). Department of the Navy...of personnel between T-AH and watercraft. The T-AH HAT model is implemented in Xpress -MP, with a supporting MS- Access database. Our optimized...Governmental Organization (NGO) partners. It has been noted hospital ships may be viewed as offensive participants in the so-called Global War on

  8. Prevalência da síndrome de burnout em trabalhadores de enfermagem de um hospital de grande porte da Região Sul do Brasil Prevalence of burnout syndrome in nursing staff in a large hospital in south of Brazil

    Davi de Souza Moreira


    Full Text Available A síndrome de burnout é um transtorno adaptativo crônico que acomete trabalhadores e caracteriza-se por três expressões de sofrimento psíquico: cansaço emocional, despersonalização e baixa realização pessoal. Por meio de pesquisa quantitativa com delineamento transversal, foram aplicados questionários com dados sócio-culturais e o Maslach Burnout Inventory em 151 trabalhadores do serviço de enfermagem, correspondendo a 54,1% desta categoria profissional em hospital geral de grande porte localizado em Tubarão, Santa Catarina, Brasil. Foram encontradas pontuações médias em cansaço emocional (17, despersonalização (7,79 e em realização pessoal (36,6. Segundo o critério de Ramirez et al., não houve diagnóstico da síndrome. De acordo com os critérios de Grunfeld et al., 35,7% dos entrevistados apresentaram burnout. O perfil padrão do trabalhador com burnout encontrado pela pesquisa foi: cargo de técnico de enfermagem, sexo feminino, entre 26 e 35 anos, casado, sem filhos e com mais de cinco anos de profissão. Os locais de trabalho que concentraram maior número de trabalhadores com burnout foram os setores agrupados (42,6%, a UTI (25,9% e a UTI Neonatal (18,5%. Não houve associação estatística entre local de trabalho e burnout.Burnout syndrome is a chronic adaptive disorder that affects workers and is characterized by three forms of psychological distress: emotional exhaustion, depersonalization, and a sense of low personal fulfillment. A cross-sectional quantitative design was used to apply questionnaires including socio-cultural data and the Maslach Burnout Inventory in 151 nurses and nurse technicians, representing 54.1% of this professional category in a large general hospital in Tubarão, Santa Catarina State, Brazil. Mean scores were: emotional exhaustion (17, depersonalization (7.79, and low personal fulfillment (36.6. According to the criterion proposed by Ramirez et al., no cases of burnout were diagnosed

  9. Unmanned Carrier-based Aircraft System: Navy Needs to Demonstrate Match between Its Requirements and Available Resources


    UNMANNED CARRIER -BASED AIRCRAFT SYSTEM Navy Needs to Demonstrate Match between Its Requirements and Available...DATES COVERED 00-00-2015 to 00-00-2015 4. TITLE AND SUBTITLE Unmanned Carrier -based Aircraft System: Navy Needs to Demonstrate Match between Its...UNMANNED CARRIER -BASED AIRCRAFT SYSTEM Navy Needs to Demonstrate Match between Its Requirements and Available Resources Why GAO Did This Study The

  10. Monitoring of nosocomial infections in hospitalized patients in a large-scale general hospital during 2006-2010%某大型综合性医院2006-2010年住院患者医院感染监测分析

    陈翠敏; 赵先柱; 府伟灵


    OBJECTIVE To investigate and analyze the nosocomial infections characteristics, prevalence features and the related impact factors of the hospitalized patients in a large-scale comprehensive hospital so as to provide basis for development of effective management measures for nosocomial infections. METHODS A retrospective analysis of the related clinical data of the hospitalized patients in a large comprehensive hospital from 2006to 2010 was performed. RESULTS From 2006 to 2010, there were totally 266514 patients investigated, the incidence of nosocomial infections decreased year by year (χ2= 153. 25, P = 0. 000); the missing report rale of nosocomial infections declined year by year (χ2 = 194. 82, P= 0. 000); the lower respiratory tract ranked the first place (35. 52%) among the susceptible infection sites; the relationship between the nosocomial infections and the age of the patients presented as the irregular feature of U;August was the peak of nosocomial infections with the incidence rats of 3. 26% , May the lowest (2. 53 % ) ;there was a positive correlation between the hospital stay and the infection rate, the infection rate of the patients with the hospital stay more than 60 days increased significantly; there was a correlation between the surgery and the nosocomial infections (χ2 = 530. 54, P = 0. 00) ; the incidence rate of nosocomial infections varied in clinical departments, the incidence rate was highest in department of blood medicine (17. 25%); gram-negative bacilli were the predominant pathogens isolated.accounting for 69. 6%. CONCLUSION Nosocomial infection is correlated with the age, underlying diseases, invasive operation, and irrational use of antibiotics; it is an effective way to establish a rapid and accurate nosocomial infection surveillance system so as to control nosocomial infections and improve the efficiency of nosocomial infection management.%目的 调查分析某大型综合性医院住院患者的医院感染特点、流行特征

  11. Study of Large Hospital Medical Equipment Purchasing and Management%大型医院医疗设备采购流程精细化管理的探讨

    杨坤; 邵蕾


    The process of medical equipment procurement is complex. Because of the nature of their work,vetting and supervision can not be neglected,causing serious impact on the operating speed. This paper discusses a new model for the management of medical equipment procurement,project-based team mode. With this mode,barriers of procurement function among different departments are broken,an inter-departmental team for the procurement of medical equipments is established according to the principle of meticulous management. Thus the procurement of the medical equipments in large hospitals can be performed efficiently,quickly and of high quality.%医疗设备采购工作由于环节众多,过程复杂,且工作性质的特殊性、敏感性关系,很多的审批、监督环节无法省略,对工作速度造成了严重影响。该文探讨了一种基于项目团队模式的医疗设备采购管理新模式。打破了采购工作各相关部门的职能壁垒,按精细化管理的原则,构建了一个跨部门的医疗设备采购工作职能团队,快速、准确、高效地完成大型医院医疗设备购置工作,提高医疗设备采购工作的效率和质量,以充分发掘采购工作的效益。

  12. Academic Hospitality

    Phipps, Alison; Barnett, Ronald


    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…

  13. Hospitality Management.

    College of the Canyons, Valencia, CA.

    A project was conducted at College of the Canyons (Valencia, California) to initiate a new 2-year hospitality program with career options in hotel or restaurant management. A mail and telephone survey of area employers in the restaurant and hotel field demonstrated a need for, interest in, and willingness to provide internships for such a program.…

  14. Department of the Navy FY 1992/FY 1993 Budget Estimates Descriptive Summaries Submitted to Congress February 1991, Research, Development, Test and Evaluation, Navy



  15. Rechargeable lithium batteries in the Navy -- Policy and protocol

    Banner, J.A.; Winchester, C.S. [Naval Surface Warfare Center, Silver Spring, MD (United States). Carderock Div.


    Rechargeable lithium batteries are an emerging technology that is finding widespread use in myriad applications. These batteries are supplanting many others because of superior performance characteristics, including high energy density and improved cycle life. The newest model laptop computers, camcorders and cellular phones are using these systems to provide lighter products with longer battery life. Potential military-use scenarios for this technology range from propulsion power for autonomous unmanned vehicles to power sources for exercise mines. Current battery chemistries that might eventually be replaced by rechargeable lithium batteries include silver-zinc batteries, lithium-thionyl chloride batteries, and possibly lithium thermal batteries. The Navy is developing and implementing a universal test protocol for evaluating the safety characteristics of rechargeable lithium power sources, as discussed by Winchester et al (1995). Test plans based on this protocol are currently being used to evaluate both commercially available and developmental products. In this paper the authors will review the testing protocol that has been developed for evaluating the safety of rechargeable lithium batteries. Relevant data from current test programs will be presented.

  16. Diesel fuel to dc power: Navy & Marine Corps Applications

    Bloomfield, D.P. [Analytic Power Corp., Boston, MA (United States)


    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.

  17. Decolorization and biodegradation of textile dye Navy blue HER by Trichosporon beigelii NCIM-3326.

    Saratale, R G; Saratale, G D; Chang, J S; Govindwar, S P


    Navy blue HER was decolorized and degraded within 24h by Trichosporon beigelii NCIM-3326 under static condition. In the present study, we investigated various physicochemical parameters such as agitation, temperature, pH, cell concentration, initial dye concentration and different carbon and nitrogen sources to achieve maximum dye degradation by T. beigelii. Sequentially, decolorization and decrease in the total organic carbon (TOC) of Navy blue HER by T. beigelii were measured. Among five strains T. beigelii gave the better performance on the decolorization of Navy blue HER along with a 95% TOC reduction within 24h. A significant increase in the activities of NADH-DCIP (dichlorophenolindophenol) reductase and azoreductase in the cells obtained after complete decolorization presumably indicates involvement of these enzymes in decolorization process. UV-vis, TLC, HPLC and FTIR analysis of extracted products confirmed the biodegradation of Navy blue HER. Phytotoxicity study demonstrated no toxicity of the biodegraded products with respect to plants viz. Phaseolus mungo and Sorghum vulgare. In addition to Navy blue HER, this strain also shows ability to decolorize various industrial dyes, including Red HE7B, Golden yellow 4BD, Green HE4BD, Orange HE2R, Malachite green, Crystal violet and Methyl violet.

  18. Molecular characterization of Hepatitis A virus causing an outbreak among Thai navy recruits.

    Theamboonlers, A; Rianthavorn, P; Jiamsiri, S; Kumthong, S; Silaporn, P; Thongmee, C; Poovorawan, Y


    Hepatitis A virus (HAV) infection is a communicable disease, typically transmitted by faecal-oral contamination. HAV outbreaks usually occur in endemic areas. We report an outbreak of HAV from June to July, 2008 among Thai navy recruits who had received training at the Sattahip Navy Base, Chonburi province, Thailand. Upon conclusion of the training, the recruits were deployed to serve at several navy bases across the country. Secondary cases of HAV infection were reported among military personnel from these navy bases. To elucidate origin and distribution of these outbreaks, we characterized the genome and genotype of HAV isolated from the different navy bases. Sera and stool from the subjects were tested for antiHAV IgM, antiHAV IgG and HAV RNA. Subsequently, molecular characterization of HAV was performed by nucleotide sequencing of the VP1-P2A region, BLAST/FASTA and phylogenetic analysis. HAV RNA was detected in specimens obtained from different areas. All isolated strains clustered in the same lineage and belonged to genotype 1A. They shared nearly 100% genome homology indicating a single point source of this outbreak. This study provides essential baseline data as a reference for genetic analysis of HAV strains causing future outbreaks. Early detection of HAV infection and identification of the source by using molecular characterization and prompt preventive measures will hopefully prevent further outbreaks.

  19. 76 FR 5144 - Notice of Intent To Prepare an Environmental Impact Statement for U.S. Navy F-35C West Coast...


    ... the U.S. Navy F-35 West Coast Homebasing EIS, both written and oral, must be submitted or postmarked... Department of the Navy Notice of Intent To Prepare an Environmental Impact Statement for U.S. Navy F-35C West... facilities and functions to homebase the F-35C Joint Strike Fighter (JSF) aircraft on the West Coast of...

  20. 78 FR 19103 - Safety Zone; Spanish Navy School Ship San Sebastian El Cano Escort; Bahia de San Juan; San Juan, PR


    ... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA00 Safety Zone; Spanish Navy School Ship San Sebastian El... during the transit of the Spanish Navy School Ship San Sebastian El Cano, a public vessel, and during... board the Spanish Navy School Ship San Sebastian El Cano. The inbound escort is scheduled to take...

  1. 75 FR 3746 - Draft Program Comment for the Department of the Navy for the Disposition of Historic Vessels


    ... Records Administration (NARA) for pemanent retention); iii. In addition to the standard curator items... available to the Navy Curator and eligible non-profit organizations for removal of additional equipment... the Navy Curator will be maintained and considered for loan to qualified U.S. non-profit organizations...

  2. The Navy Job Performance Measurement (JPM) Program: Life-Cycle Automation Management Plan for a JPM Data Base.


    that may be used by operational Navy components not only to link job performance with enlistment standards but for other management purposes as well...for the development and implementation of a rating-specific data base that the Navy will use to manage job performance information. The tasks and

  3. Analysis of the U.S. Navy’s Goal-Based Awards System and Its Effect on Recruit Quality


    U.S. Army Recruiting Command USN U.S. Navy xiii ACKNOWLEDGMENTS I would like to thank God, my Savior and Jesus Christ , for all of his blessings...through March 2011 timeframe, which captures recruit contract activity for all enlisted Navy recruiters. The original data files contained 768,508

  4. 77 FR 841 - Taking and Importing Marine Mammals: Taking Marine Mammals Incidental to U.S. Navy Operations of...


    ... (equipment) danger that icebergs pose to SURTASS LFA sonar vessels. ] TP06JA12.000 The Navy must anticipate... models (updated every 12 hours or more frequently when meteorological or oceanographic conditions change... interests for this application. Because it is infeasible for the Navy to model enough representative...

  5. Expanding the Navy’s Managers Internal Control Program’s (MICP) Capability to Prepare for External Financial Audits


    Defense Inspector General DON Department of the Navy ERP enterprise resource planning FFMIA Federal Financial Management Improvement Act FIAR...As an illustration of how the templates are used, and how they interrelate, consider the case of the DOD IG report on ERP systems (DODIG, 2012...The DODIG recommended that the Navy ERP program implement Standard Financial Information Structure (SFIS) requirements (DODIG, 2012). This

  6. Portable Sensor for Detecting Microbubbles in Real Time to Prevent Decompression Sickness for Safe Diving During Subaquatic Navy Activities


    Contains Proprietary information Final Report: Portable Sensor for Detecting Microbubbles in Real Time to Prevent Decompression Sickness for Safe Diving ...Portable Sensor for Detecting Microbubbles in Real Time to Prevent Decompression Sickness for Safe Diving During Subaquatic Navy Activities Report Title The...Portable Sensor for Detecting Microbubbles in Real Time to Prevent Decompression Sickness for Safe Diving During Subaquatic Navy Activities Final

  7. 77 FR 59749 - Special Local Regulations for Marine Events; San Francisco Bay Navy Fleet Week Parade of Ships...


    ... Fleet Week Parade of Ships and Blue Angels Demonstration, San Francisco Bay, CA AGENCY: Coast Guard, DHS... sponsored Fleet Week Parade of Navy Ships, Blue Angels Flight Demonstrations, Ship Tours, and America's Cup... special local regulation for the annual San Francisco Bay Navy Fleet Week Parade of Ships and Blue...

  8. 75 FR 1709 - Security Zone; Escorted U.S. Navy Submarines in Sector Seattle Captain of the Port Zone


    ... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA87 Security Zone; Escorted U.S. Navy Submarines in Sector.... SUMMARY: The Coast Guard is establishing a moving security zone around any U.S. Navy submarine that is... to help ensure the security of the submarines, their Coast Guard security escorts, and the...

  9. 75 FR 28202 - Security Zone; Escorted U.S. Navy Submarines in Sector Seattle Captain of the Port Zone


    ... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA87 Security Zone; Escorted U.S. Navy Submarines in Sector... establishing a moving security zone around any U.S. Navy submarine that is operating in the Sector Seattle... of the submarines, their Coast Guard security escorts, and the maritime public in general....

  10. 75 FR 33701 - Security Zone; Escorted U.S. Navy Submarines in Sector Honolulu Captain of the Port Zone


    ... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA87 Security Zone; Escorted U.S. Navy Submarines in Sector.... SUMMARY: The Coast Guard is establishing a moving security zone around all U.S. Navy submarines that are... to help ensure the security of the submarines, their Coast Guard security escorts, and the...

  11. Dengue at the Doorstep: Small Outbreaks in Florida are a Warning Sign to US Navy Medical Personnel


    Warning Sign to US Navy Medical Personnel 5a. 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) Navy Entomology Center of Excellence,Naval Air Station

  12. The Rationale and Methodology for Development of a Competency Based Leadership Education and Training Program in the Navy.

    Scanland, Worth; Pepper, Dorothy

    Numerous attempts by the U.S. Navy to identify leadership potential within its ranks and to train for such leadership skills have been mostly unsuccessful since the efforts were based upon very subjective perceptions of good leadership qualities. To address this problem, the Navy, with the assistance of Dr. David McClelland, has described a set of…

  13. Barodontalgia and barotrauma in the human teeth: findings in navy divers, frogmen, and submariners of the Federal Republic of Germany.

    Goethe, W H; Bäter, H; Laban, C


    From 2,580 submariners, divers, and frogmen, 13,618 individual findings were evaluated from a total of about 50,000 dental findings of the Nautical Medical Institute of the German Navy, Kiel, West Germany. Trend analysis and statistical significance tests showed that the teeth of navy divers and frogmen had deteriorated very much more within a period of 9 years after their first dental examination than those of submariners. This negative tendency was verified through additional direct comparison between 37 navy divers and 37 submariners whose dental states were observed during a period of 10 years. Here as well, navy divers had significantly worse teeth. The cause of this distinctive dental deterioration among navy divers is probably due to the additional barometric stress they were subjected to for many years during their diving career. Delayed damages as a result of barotrauma may be assumed, a logical suspicion which should be verified by further scientific research.

  14. [About experience of medidine of the Navy during the Great Patriotic War].

    Chemnikorv, O G; Chernyi, V S; Zabrodskii, D S; Zaimagov, S V


    The article is devoted activity of the Medical Service of the Navy during the Great Patriotic War. During the war the Navy has performed as an integral part of the Armed Forces, played a major role in the defensive and offensive operations. From the first days of the war medical service fleet faced extreme difficulties, to demand from the medical staff of hard work. During the war many problems of medical support for combat operations of the Navy were successfully solved. It was also important to solve complex problems in organizing and conducting medical evacuations via sea. A great attention during: the war was played to the search for optimal system medical evacuation support of naval forces.

  15. Detection and analysis of HIV antibody in a large teaching hospital from 2008 to 2013%中国西南地区2008-2013年HIV抗体检测结果与分析

    朱思远; 李冬冬; 王婷婷; 严可宁; 杨廷富; 陶传敏


    目的 探讨中国西南地区大型综合性医院门诊及住院患者HIV感染的情况,为临床应对HIV感染提供科学依据.方法 2008年至2013年,采用梅里埃酶联免疫吸附法第三代抗体检测试剂或罗氏电化学发光第四代抗原抗体检测试剂为644 208例就诊患者行HIV抗体初筛,采用原检测试剂和丽珠酶联免疫吸附法抗体检测试剂行复检,阳性反应标本送往四川省疾病预防控制中心或四川大学华西医院HIV确证实验室采用免疫印迹法进行确证.结果 在检测的644208份标本中共1917例(0.30%)确证为HIV-1抗体阳性,其中599例(0.75%)来自门诊,住院患者1318例(0.23%),主要依次分布于门诊、感染中心、皮肤科、呼吸科、中西医科;男性1534例,女性383例,年龄分布主要集中于青壮年(1383例);以异性传播为主要传播方式(1228例),同性传播所占比例呈递增趋势.结论 HIV感染率呈逐年递增的趋势,异性传播为主要途径同性传播逐渐增多,医务人员应加强自我保护意识,减少职业暴露,避免医疗纠纷,加强全民普及HIV相关知识.%Objective To provide the scientific basis prevention of HIV infection in clinic,we studied the infection status and tendency of HIV among outpatients and inpatients in a large teaching hospital of southwest China.Methods From 2008 to 2013,the third generation Merieux enzyme-linked immunosorbent method of antibody or the fourth generation Roche electrochemiluminescence immunoassay were adopted in 644208 clinic patients for HIV antibody screening.The original detection method and Livzon enzyme-linked immunosorbent method of antibody were used for re-detection,and the positive specimens were sent to the local Center for Disease Control and Prevention or West China Hospital HIV confirmation laboratory for confirmation using western blot assay.Results A total of 1917 patients (0.30%) were confirmed as HIV-1 antibodies positive,of which,599 cases were

  16. Investigation on quality of spirometry in 36 large hospitals in China%中国大型综合性医院肺量计检查报告质量的多中心调查

    高怡; 郑劲平; 安嘉颖; 马锦芳; 刘文婷; 虞欣欣


    Objective To assess the current status of quality control of spirometry reports in China.Methods Spirometry case reports from January 2008 to October 2008 were collected from pulmonary function testing laboratories in 36 large hospitals (provincial or municipal) in China.The quality analysis was performed according to ATS/ERS standardization for measurement of spirometry.The number of reports that met the criteria for quality control was expressed as percentages.Results A total of 345 spirometry test reports were collected.82.5% (282/342) met the start-of-test criteria for quality control.333 reports could be analyzed for free of artifacts,of which 65.8% (219/333) were consistent with the criteria of smooth expiration;the remaining reports (114) failed to meet the criteria,for reasons including cough (29/333,8.7%),premature glottis closure (8/333,2.4%),gas leakage (29/333,8.7%),early termination of expiration (26/333,7.8%),mouthpiece obstruction (6/333,1.8%),and incomplete exertion of efforts (49/333,14.7%).235 reports were analyzed for end-of-test criteria,with 50.6% (119/235) complying to criteria.22.6% (78/345) of the reports were tested for more than 3 times,among which 65 reports with the data of each manoeuvre could be analyzed for repeatability.95.4% (62/65) of the reports met the repeatability criteria,which accounted for 18.0% (62/345)of the total reports collected.The rate of the 2 highest FVC (forced vital capacity) and FEV_1 (forced expiratory volume in one second) of less than 150 ml was 95.4% (62/65) and 100.0% (65/65),respectively.The rate of the 2 highest FVC and FEV_1 of less than 100 ml was 92.3% (60/65) and 87.7% (57/65),respectively.Only 7.2% of the reports (25/345)met all of the 4 criteria listed above.Conclusions The quality of spirometry tests in large (provincial or municipal) hospitals in China needs to be improved in the future.%目的 了解我国肺量计检查报告质最控制现状.方法 收集2008年1-10月我国36家大型综合

  17. Life Path as a Predictor of Performance in the Navy: A Longitudinal Study.


    other, Career Expectation , consisting of eleven items. The questionnaire items were: i ’ " Career Preparation Q 9. Decided on a career in the Navy. Q...V94 Learned about Navy before joining -.0472 .0681 Multiple R .0918* .14z99 b. Career Expectation V39 Confident of ability to succeed -.0301 .0659 V85...Educational requirements of profession 7 " IB- 1 Table B. I (con t i ’I ued 4. Vocational Maturity Scale Items (continued) b. Career Expectation Model V86

  18. Number of deployments, relationship satisfaction and perpetration of partner violence among U.S. Navy members.

    Kelley, Michelle L; Stambaugh, Leyla; Milletich, Robert J; Veprinsky, Anna; Snell, Alicia K


    The present brief report examined whether number of deployments, relationship satisfaction, and the interaction between number of deployments and relationship satisfaction predicted Navy members' reports of perpetrating physical partner violence. Participants were 80 U.S. Navy members assigned to an Arleigh Burke-class destroyer anticipating an 8-month deployment after Operation Enduring Freedom/Operation Iraqi Freedom. The effect that the number of deployments had on perpetrating physical partner violence diminished as relationship satisfaction increased. Results suggest the importance of designing domestic violence intervention and treatment efforts toward those who report high levels of deployment and low relationship satisfaction.



    Ocean mode (or quasigeostrophic wave) analysis is one of the key data processing technique in Oceanic Acoustic Tomography Experiment. In this paper, a primary study on its application foreground in Navy Oceanography is put forward with CTD data and Carton oceanic assimilation data. It shows that the sound speed mode is not well orthogonal to each other, so that it is practically no use. However, the current mode calculated from the CTD data collected in summer at the position with weak stochastic processes and strong geostrophic balance is well orthogonal to each other, it can be used everywhere in the ocean of the similar water mass at any time as long as the basic condition serves. It can be used for decomposition and reconstruction of dynamic or quasi-dynamic factors such as seawater temperature, from which and average of salinity the sound speed profile can be composed. It also shows that the monthly James Carton assimilation data is well consistent with observation in subsurface layer in the region with weak current speed but not well below subsurface layer or near the Kuroshio in the western Pacific. By running a nested ocean general circulation model with adjusted vertical eddy diffusivity to do data assimilation again and applying current mode analysis to reconstruct or compose related factors, it is hopefully possible to improve the precision and space resolution of the oceanic assimilation data. So that, it is definitely possible to obtain the three dimensional high resolution distribution of ocean sound speed in real time with the satellite SST and surface wind fields only.

  20. Hydrothermal oxidation of Navy shipboard excess hazardous materials

    LaJeunesse, C.A.; Haroldsen, B.L.; Rice, S.F.; Brown, B.G.


    This study demonstrated effective destruction, using a novel supercritical water oxidation reactor, of oil, jet fuel, and hydraulic fluid, common excess hazardous materials found on-board Navy vessels. This reactor uses an advanced injector design to mix the hazardous compounds with water, oxidizer, and a supplementary fuel and it uses a transpiring wall to protect the surface of the reactor from corrosion and salt deposition. Our program was divided into four parts. First, basic chemical kinetic data were generated in a simple, tubular-configured reactor for short reaction times (<1 second) and long reaction times (>5 seconds) as a function of temperature. Second, using the data, an engineering model was developed for the more complicated industrial reactor mentioned above. Third, the three hazardous materials were destroyed in a quarter-scale version of the industrial reactor. Finally, the test data were compared with the model. The model and the experimental results for the quarter-scale reactor are described and compared in this report. A companion report discusses the first part of the program to generate basic chemical kinetic data. The injector and reactor worked as expected. The oxidation reaction with the supplementary fuel was initiated between 400 {degrees}C and 450 {degrees}C. The released energy raised the reactor temperature to greater than 600 {degrees}C. At that temperature, the hazardous materials were efficiently destroyed in less than five seconds. The model shows good agreement with the test data and has proven to be a useful tool in designing the system and understanding the test results. 16 refs., 17 figs., 11 tabs.

  1. High School Astronomical Research at the Army and Navy Academy

    Boyce, Pat; Boyce, Grady


    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

  2. Imaging of Stellar Surfaces with the Navy Precision Optical Interferometer

    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.

  3. Mechanical engineering in hospitals.

    Wallington, J W


    The design of a modern hospital owes more to engineering than the layman may realize. In this context, many engineers are in the position of laymen, being unfamiliar with the multitude of services that lies behind the impressive facade of a modern hospital. In recent years medicine and surgery themselves have taken on many of the characteristics of a technology. This has required a matching development of the services both mechanical and electrical that are required in modern health care buildings. In medical terms, if the architectural features provide the 'skin' of the hospital, the mechanical and electrical engineering services provide the nerves and sinews. If we take as an example the recently completed Freeman Hospital, Newcastle upon Tyne, (Fig. 1), which cost 10 million pounds at current cost, the service network was responsible for about half the total cost. About 400 miles (643 km) of electrical wiring and more than 40 mile (64.5 km) of copper and steel piping were used to service 3000 separate rooms. This compares with percentages of between 18 and 25 per cent for other large buildings such as office blocks, hotels and sports complexes.

  4. The viability of hearing protection device fit-testing at navy and marine corps accession points

    Jeremy Federman


    Full Text Available Introduction: The viability of hearing protection device (HPD verification (i.e., fit-testing on a large scale was investigated to address this gap in a military accession environment. Materials and Methods: Personal Attenuation Ratings (PARs following self-fitted (SELF-Fit HPDs were acquired from 320 US Marine Corps training recruits (87.5% male, 12.5% female across four test protocols (1-, 3-, 5-, and 7- frequency. SELF-Fit failures received follow-up to assess potential causes. Follow-up PARs were acquired (Experimenter fit [EXP-Fit], followed by Subject re-fit [SUB Re-Fit]. EXP-Fit was intended to provide a perception (dubbed “ear canal muscle memory” of what a correctly fitted HPD should feel like. SUB Re-Fit was completed following EXP-Fit to determine whether a training recruit could duplicate EXP-Fit on her/his own without assistance. Results: A one-way analysis of variance (ANOVA (N = 320 showed that SELF-Fit means differed significantly between protocols (P 60% pass rates. Results showed that once recruits experienced how HPDs should feel when inserted correctly, they were able to properly replicate the procedure with similar results to the expert fit suggesting “ear canal muscle memory” may be a viable training strategy concomitant with HPD verification. Fit-test duration was also measured to examine the tradeoff between results accuracy and time required to complete each protocol. Discussion: Results from this study showed the critical importance of initial selection and fitting of HPDs followed by verification (i.e., fit-testing at Navy and Marine Corps accession points. Achieving adequate protection from an HPD is fundamentally dependent on obtaining proper fit of the issued HPD as well as the quality of training recruits receive regarding HPD use.

  5. Pre-hospital emergency medicine.

    Wilson, Mark H; Habig, Karel; Wright, Christopher; Hughes, Amy; Davies, Gareth; Imray, Chirstopher H E


    Pre-hospital care is emergency medical care given to patients before arrival in hospital after activation of emergency medical services. It traditionally incorporated a breadth of care from bystander resuscitation to statutory emergency medical services treatment and transfer. New concepts of care including community paramedicine, novel roles such as emergency care practitioners, and physician delivered pre-hospital emergency medicine are re-defining the scope of pre-hospital care. For severely ill or injured patients, acting quickly in the pre-hospital period is crucial with decisions and interventions greatly affecting outcomes. The transfer of skills and procedures from hospital care to pre-hospital medicine enables early advanced care across a range of disciplines. The variety of possible pathologies, challenges of environmental factors, and hazardous situations requires management that is tailored to the patient's clinical need and setting. Pre-hospital clinicians should be generalists with a broad understanding of medical, surgical, and trauma pathologies, who will often work from locally developed standard operating procedures, but who are able to revert to core principles. Pre-hospital emergency medicine consists of not only clinical care, but also logistics, rescue competencies, and scene management skills (especially in major incidents, which have their own set of management principles). Traditionally, research into the hyper-acute phase (the first hour) of disease has been difficult, largely because physicians are rarely present and issues of consent, transport expediency, and resourcing of research. However, the pre-hospital phase is acknowledged as a crucial period, when irreversible pathology and secondary injury to neuronal and cardiac tissue can be prevented. The development of pre-hospital emergency medicine into a sub-specialty in its own right should bring focus to this period of care.

  6. Do hospital mergers reduce costs?

    Schmitt, Matt


    Proponents of hospital consolidation claim that mergers lead to significant cost savings, but there is little systematic evidence backing these claims. For a large sample of hospital mergers between 2000 and 2010, I estimate difference-in-differences models that compare cost trends at acquired hospitals to cost trends at hospitals whose ownership did not change. I find evidence of economically and statistically significant cost reductions at acquired hospitals. On average, acquired hospitals realize cost savings between 4 and 7 percent in the years following the acquisition. These results are robust to a variety of different control strategies, and do not appear to be easily explained by post-merger changes in service and/or patient mix. I then explore several extensions of the results to examine (a) whether the acquiring hospital/system realizes cost savings post-merger and (b) if cost savings depend on the size of the acquirer and/or the geographic overlap of the merging hospitals. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. 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

    Rubin, Juli I.; Reid, Jeffrey S.; Hansen, James A.; Anderson, Jeffrey L.; Collins, Nancy; Hoar, Timothy J.; Hogan, Timothy; Lynch, Peng; McLay, Justin; Reynolds, Carolyn A.; Sessions, Walter R.; Westphal, Douglas L.; Zhang, Jianglong


    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 through the ensemble data

  8. An Analysis of the Metrics Used in the United States Navy’s Enlisted Supply Chain As They Apply to the Royal Australian Navy


    Resource Management IT Information Technology NGN New Generation Navy NRC Naval Recruiting Centre PLM Production Line Manager PMO Production...Operations function of the PMO. Within the Operations function each Production Line Manager ( PLM ) has a number of ratings they are responsible for. The PLM ...will review the pipeline metrics and analyze them for trends and areas of possible inefficiencies. The PLM will then seek further data and drill down

  9. Association Between Teaching Status and Mortality in US Hospitals.

    Burke, Laura G; Frakt, Austin B; Khullar, Dhruv; Orav, E John; Jha, Ashish K


    Few studies have analyzed contemporary data on outcomes at US teaching hospitals vs nonteaching hospitals. To examine risk-adjusted outcomes for patients admitted to teaching vs nonteaching hospitals across a broad range of medical and surgical conditions. Use of national Medicare data to compare mortality rates in US teaching and nonteaching hospitals for all hospitalizations and for common medical and surgical conditions among Medicare beneficiaries 65 years and older. Hospital teaching status: major teaching hospitals (members of the Council of Teaching Hospitals), minor teaching hospitals (other hospitals with medical school affiliation), and nonteaching hospitals (remaining hospitals). Primary outcome was 30-day mortality rate for all hospitalizations and for 15 common medical and 6 surgical conditions. Secondary outcomes included 30-day mortality stratified by hospital size and 7-day mortality and 90-day mortality for all hospitalizations as well as for individual medical and surgical conditions. The sample consisted of 21 451 824 total hospitalizations at 4483 hospitals, of which 250 (5.6%) were major teaching, 894 (19.9%) were minor teaching, and 3339 (74.3%) were nonteaching hospitals. Unadjusted 30-day mortality was 8.1% at major teaching hospitals, 9.2% at minor teaching hospitals, and 9.6% at nonteaching hospitals, with a 1.5% (95% CI, 1.3%-1.7%; P hospitals and nonteaching hospitals. After adjusting for patient and hospital characteristics, the same pattern persisted (8.3% mortality at major teaching vs 9.2% at minor teaching and 9.5% at nonteaching), but the difference in mortality between major and nonteaching hospitals was smaller (1.2% [95% CI, 1.0%-1.4%]; P hospital size, 187 large (≥400 beds) major teaching hospitals had lower adjusted overall 30-day mortality relative to 76 large nonteaching hospitals (8.1% vs 9.4%; 1.2% difference [95% CI, 0.9%-1.5%]; P hospitals was observed for medium-sized (100-399 beds) hospitals (8.6% vs 9

  10. Grassland birds wintering at U.S. Navy facilities in southern Texas

    Woodin, Marc C.; Skoruppa, Mary Kay; Bryan, Pearce D.; Ruddy, Amanda J.; Hickman, Graham C.


    Grassland birds have undergone widespread decline throughout North America during the past several decades. Causes of this decline include habitat loss and fragmentation because of conversion of grasslands to cropland, afforestation in the East, brush and shrub invasion in the Southwest and western United States, and planting of exotic grass species to enhance forage production. A large number of exotic plant species, including grasses, have been introduced in North America, but most research on the effects of these invasions on birds has been limited to breeding birds, primarily those in northern latitudes. Research on the effects of exotic grasses on birds in winter has been extremely limited. This is the first study in southern Texas to examine and compare winter bird responses to native and exotic grasslands. This study was conducted during a period of six years (2003-2009) on United States Navy facilities in southern Texas including Naval Air Station-Corpus Christi, Naval Air Station-Kingsville, Naval Auxiliary Landing Field Waldron, Naval Auxiliary Landing Field Orange Grove, and Escondido Ranch, all of which contained examples of native grasslands, exotic grasslands, or both. Data from native and exotic grasslands were collected and compared for bird abundance and diversity; ground cover, vegetation density, and floristic diversity; bird and vegetation relationships; diversity of insects and arachnids; and seed abundance and diversity. Effects of management treatments in exotic grasslands were evaluated by comparing numbers and diversity of birds and small mammals in mowed, burned, and control areas. To determine bird abundance and bird species richness, birds were surveyed monthly (December-February) during the winters of 2003-2008 in transects (100 meter ? 20 meter) located in native and exotic grasslands distributed at all five U.S. Navy facilities. To compare vegetation in native and exotic grasslands, vegetation characteristics were measured during 2003

  11. The impact of software reuse on the cost of Navy sonar and fire control systems

    Wilson, Anthony M.


    Approved for public release, distribution unlimited E). Analysis focuses on the identification of trends associated with each of the costs for selected systems and programs. Identifying trends in funding could provide evidence of the cost-effectiveness of software reuse efforts within and across the surface, air, surveillance, and submarine communities. US Navy (USN) author.

  12. Cost Estimation for Surface Navy Investment in Arctic-capable Platform to Maintain National Security Interests


    perspective 24 China’s environment is significantly effected by Arctic weather patterns (International Studies on the Polar Region, 2014). for Arctic cold- weather gear, which translates into greater sustainability and an increased HADR capability. The possibility of incorporating...NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA MBA PROFESSIONAL REPORT COST ESTIMATION FOR SURFACE NAVY INVESTMENT IN ARCTIC

  13. The PLA Navy: Its Modernization and Sea Control in the East


    awakes, the world will quake...” - Napoleon Bonaparte This paper examines the nature and capabilities of today’s People’s Liberation underscore the economy’s importance to the political leadership, and consequently, to the PLA Navy. ECONOMIC GROWTH Lui Huaquing told

  14. Study of an Alternative Career Path for Deck Officers in the Hellenic Navy


    Hellenic Naval Academy HNDGS Hellenic National Defense General Staff HNGS Hellenic Navy General Staff MCM Minesweeper PHM Hydrofoil RHN Royal...guided missile frigate (FFGH) is considered command at sea. On the other hand command of a minesweeper (MCM) or a hydrofoil (PHM) is 11 not. At the

  15. Strategic performance management evaluation for the Navy's SPLICE local area networks

    Blankenship, David D.


    Approved for public release; distribution is unlimited This thesis investigates those aspects of network performance evaluation thought to pertain specifically to strategic performance management evaluation of the Navy's Stock Point Logistics Integrated Communications Environment (SPLICE) local area networks at stock point and inventory control point sites- Background is provided concerning the SPLICE Project, strategic management, computer performance evaluation tools...

  16. Evaluation of Soybean–Navy Bean Emulsions Using Different Processing Technologies

    Sean X. Liu


    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.

  17. Salient Mainstream and Hispanic Values in a Navy Training Environment: An Anthropological Description.


    begin the processes of resocialization and familiarization with Navy rules, regulations, traditions, terwinolopy, and decorum: skills ranging from hand...speaking communities (Ulibarri, 1970:35-36; Cohei., 1979:96-97). In a previous report (Rojas, 1981) I discussed the often- cited reluctance of Hispanic youth

  18. Navy Virginia (SSN 774) Class Attack Submarine Procurement: Background and Issues for Congress


    Service 2  covert insertion and recovery of SOF (on a smaller scale than possible with the SSGNs);  covert strikes against land targets with the......Congressional Research Service Summary The Navy has been procuring Virginia (SSN-774) class nuclear-powered attack submarines since FY1998. The two Virginia

  19. Development and Evaluation of Computer Assisted Instruction for Navy Electronics Training. Two, Inductance.

    Hurlock, Richard E.

    A computer-assisted instruction (CAI) curriculum module covering the area of electrical inductance was developed and evaluated. This module was a part of a program in which a series of CAI modules are being developed and tested for a Navy training course in basic electronics. After the module was written, it was given three tryout tests.…

  20. Recruiting Minorities: What Explains Recent Trends in the Army and Navy?

    Asch, Beth J.; Heaton, Paul; Savych, Bogdan


    Since 2000, black representation among high-quality recruits in the Army has decreased, while Hispanic representation has increased; in the Navy, black representation has remained stable and Hispanic representation has increased. (Recruits are considered to be high-quality if they have graduated high school and score above average on the Armed…

  1. China Naval Modernization: Implications for U.S. Navy Capabilities - Background and Issues for Congress


    electromagnetic railgun The budget request included $10.0 million in PE 602114N and $16.9 million in PE 603114N for the development of an electromagnetic... railgun . The Navy is developing an electromagnetic railgun (EMRG) for engagements of surface and air threats at long-ranges up to 200 nautical

  2. 77 FR 46733 - Taking and Importing Marine Mammals: Taking Marine Mammals Incidental to Navy Training Exercises...


    ... Navy stated that it will explore the value of adding field measurements during monitoring of a future... of killing marine life. Response: NMFS appreciates the commenter's concern for the marine mammals... awareness on the presence of marine mammals and sea turtles within the buffer zone to the best...

  3. Issues Facing Navy Contracting Organizations in Implementing OFPP Policy Letter 92-4


    Business (7); - Management (1); - Liberal Arts (1); - English Literature and History (1); - Engineering and Geology (1); and - No college degree (2...DID NOT RESPOND Activity Name: Navy Clothing and Textile Research Facility Address: 21 Strathmore Rd., Natick, MA 01760-2490 POC: Rudy Marcial Phone

  4. 75 FR 79342 - Taking and Importing Marine Mammals; Navy Training Activities Conducted Within the Northwest...


    ... Activities and Research, Development, Testing and Evaluation Conducted Within the Mariana Islands Range... (including Navy, USMC, and USAF) training and research, development, testing, and evaluation (RDT&E... Harassment, 2 individuals of 2 species by Level A Harassment annually, and 10 individual beaked whales...

  5. Navy Commercial Access Control System Did Not Effectively Mitigate Access Control Risks


    the capability to perform NCIC checks to vet contractor employees, and not all Navy installations nave the ability to access NCIC, NCACS is not...Management Corp 10,017 REA to contract N40085-06-D-1260 Goodwill Industries 199,148 Overhead charge to contract N00189-09- C-Z003 DynCorp international

  6. Maritime Domain Awareness: C4I for the 1000 Ship Navy


    C. Bachman , Commander, Space and Naval Warfare Systems Command gave further details on the TSN concept that aims to build a network of navies who...the Pax Americana period following the end of WWII with a migration of interconnected and competing global businesses throughout the world (Rowan 2006

  7. Real Property Maintenance Activity (RPMA) Programs: Analysis of Navy Manpower Requirements


    Commanding Officer Navy Personnel Research and Development Center San Diego, California 921 52 SC)IYCLASSIFICATION OF THIS PAGE (Utem Dato Natered...Alaska, Adak 141 California, Camp Pendleton 21 California, Centerville Beach 6 California, El Centro 83 *California. Lemoore 213 California, Long Beach 58

  8. 77 FR 12010 - Takes of Marine Mammals Incidental to Specified Activities; Navy Research, Development, Test and...


    ... Specified Activities; Navy Research, Development, Test and Evaluation Activities at the Naval Surface... research, development, test and evaluation (RDT&E) activities at the Naval Surface Warfare Center Panama... as a simple function of development and aging has been observed in marine mammals, as well as humans...

  9. 78 FR 47282 - Takes of Marine Mammals Incidental to Specified Activities; Navy Research, Development, Test and...


    ... Specified Activities; Navy Research, Development, Test and Evaluation Activities at the Naval Surface... marine mammals, by harassment, incidental to conducting research, development, test and evaluation (RDT&E..., but will research opportunities for leveraged work that could be added under an adaptive management...

  10. 78 FR 34047 - Takes of Marine Mammals Incidental to Specified Activities; Navy Research, Development, Test and...


    ... Specified Activities; Navy Research, Development, Test and Evaluation Activities at the Naval Surface... research, development, test and evaluation (RDT&E) activities at the Naval Surface Warfare Center Panama... visual surveys at this time, but will research opportunities for leveraged work that could be added under...

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

    Nørby, Søren


    When Danish corvette Olfert Fischer joined the UN operation against Iraq in 1990-1991, it was seen as the most significant sign of the changing security situation which Denmark and the Navy were facing following the fall of the Berlin Wall in 1989 and the subsequent collapse of the Warsaw Pact. M...

  12. Navy Warfare Development Command’s NEXT Magazine, Spring 2014 Edition. Volume 2, Number 1


    seventy- one players registered. contributing 2.868 idea card.s and 23 accion plans outlining Pl)(ential ideas. The action plans described Pl...weapons system. EWBM ensures the Navy remains unchallenged in seo..~ring freedom of accion ;lCI"’SS the fuiJ range of the EM<yber operations. The intent

  13. Navy John Lewis (TAO-205) Class Oiler Shipbuilding Program: Background and Issues for Congress


    Lowest Total Price For LHA, Oiler To Win Bulk Of LX(R),” Inside the Navy, February 23, 2015 (posted online February 20, 2015). 33 Government...counter- piracy , and improving adversary A2/AD capabilities cause strike groups and ready groups to disperse over more expansive areas. Additionally

  14. Navy TAO(X) Oiler Shipbuilding Program: Background and Issues for Congress


    Bulk Of LX(R),” Inside the Navy, February 23, 2015 (posted online February 20, 2015). 33 Government Accountability Office, Defense Acquisitions...smaller fleet, new missions, such as ballistic missile defense and counter- piracy , and improving adversary A2/AD capabilities cause strike groups

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


    about a fleet reduced to about 230-235 ships.” (As quoted in David Smalley, “ Leaner Navy Looking at Future Technology, Fleet Size and Sequestration... autonomy and control over when you use them. When you use land-based aircraft, you often have to have host-nation permission to use them.’. (5

  16. 76 FR 30024 - United States Navy Restricted Area, Menominee River, Marinette Marine Corporation Shipyard...


    ... Corporation, as shipbuilder of Littoral Combat Ships, has requested on behalf of the Department of Navy, that... this rule. List of Subjects in 33 CFR Part 334 Danger zones, Marine safety, Navigation (water... read as follows: PART 334--DANGER ZONE AND RESTRICTED AREA REGULATIONS 0 1. The authority citation for...

  17. Smart Power Partnership Initiative (SPPI): An Innovative Approach to Increasing Navy Energy Security


    installations into regional smart grids 1 Gigawatt Initiative Producing or purchasing enough renewable energy to power the equivalent of a quarter of a...Ventura County Coronado 3 MC Recruit Depot Balboa • Create Regional Smart Grids , groupings of Navy and Marine Corps installations capable of sharing

  18. Integrated CD-ROM and WORM Optical Disk Systems on the Navy's Paperless Ship.

    Thiel, Thomas J.


    The integration of optical disk systems employing WORM (Write Once Read Many) technology with CD-ROM systems can enhance information management. Two integrated system applications are the Paperless Ship Project of the U.S. Navy and the FEDLOG (Federal Logistics Data on CD-ROM) of the Defense Logistics Agency. These initiatives are described and…

  19. Navy Ford (CVN-78) Class Aircraft Carrier Program: Background and Issues for Congress


    provides berthing for visitors and Service members temporarily assigned to the ship. JPALS • As the Navy reformulates the JPALS Test and Evaluation Master... language —subsection (f) of Section 122 of P.L. 109-364, as amended by Section 121 of P.L. 113-66—states: (f) Requirements for CVN-79.-- (1) Quarterly

  20. 77 FR 31333 - Taking and Importing Marine Mammals: Taking Marine Mammals Incidental to Navy Training Exercises...


    ... VACAPES Range Complex, the Navy implemented vessel and aerial surveys and deployed passive acoustic... exercise (MINEX) W-50 box in conjunction with a MINEX event, and the Firing Exercise (FIREX) 7C/7D training boxes in junction with a FIREX event. A vessel survey was conducted on July 14, 2011, in...

  1. Active vibration control for underwater signature reduction of a navy ship

    Basten, T.G.H.; Berkhoff, Arthur P.; Vermeulen, Ruud


    Dutch navy ships are designed and built to have a low underwater signature. For low frequencies however, tonal vibrations of a gearbox can occur, which might lead to increased acoustic signatures. These vibrations are hard to reduce by passive means. To investigate the possibilities of active

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


    option is increasing reliance on deep- magazine directed energy systems, and on force-wide coordinated soft- kill and counter-targeting techniques...Cold War era and the transition to a new international security situation featuring renewed great power competition has intensified concerns among...Plan ........................................................ 8 Table 3. Navy FY2017-FY2046 30-Year Shipbuilding Plan

  3. Secure and Resilient Functional Modeling for Navy Cyber-Physical Systems


    release; distribution is unlimited. Page 1 of 4 Secure & Resilient Functional Modeling for Navy Cyber -Physical Systems FY17 Quarter 2 Technical defined the following attack models for cyber -physical systems: - 6 basic attacks targeting signals. - 1 basic attack targeting control... Cyber -Physical Systems” and submitted for publication to IEEE Conference on Automation Science and Engineering (CASE) 2017. Functional Editor (SCCT

  4. Results of metallographical diagnostic examination of Navy half-watt thermoelectric converters degraded by accelerated tests

    Rosell, F. E., Jr.; Rouklove, P. G.


    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. Skill Deterioration and Retraining Needs of Navy Individual Ready Reservists. Technical Report 86-007.

    Hall, Eugene R.; And Others

    Skill deterioration and retraining needed to support mobilization were determined for Individual Ready Reservists (IRRs) in 16 critical Navy ratings. Mailed questionnaire were used to obtain job performance information (tasks performed and proficiency associated with their performance) from IRRs and active duty personnel. Skill deterioration was…

  6. Assessing the Effects of Individual Augmentation (IA) on Active Component Navy Enlisted and Officer Retention


    who deployed to Iraq and Afghanistan, it further increased to 1.93. exp(0.426) 1.53= exp(0.659) 1.93= 22 23 Term Estimate Std Error ChiSquare ...comparing all enlisted IAers versus all other Navy enlisted with deployment experience. 24 Term Estimate Std Error ChiSquare Prob>ChiSq Intercept

  7. A Framework to Support S&T Planning for Royal Australian Navy Capability Acquisition


    United States (of America) USA United States of America USN United States Navy UUV Unmanned Undersea Vehicle VTT Valtion Teknillinen Tutkimuskeskus...Tutkimuskeskus ( VTT )2 defined the focus of their Foresight Planning exercise and roadmap towards innovative applications for Information and Communication...Australia. 16. Naumanen, M., 2005, ICT Foresight and Roadmap Towards Innovative Applications in the Nordic Countries, VTT Technology Studies, Finnish

  8. Accomplishing Shipyard Work for the United States Navy: Institutions, Systems and Operations. Volume I. Basic Report


    8217Standard Metropolitan Statistical Areas (SI4SAs) are 269 geographical areas making up the fifty states and Puerto Rico. These areas are defined by the U.S...8217 * (2) Development of revised basing policies to provide I~o ovrhals f telv mothsduration or longer, the Navy has a policy of teprrlycagn tesi ’ home

  9. The Role of Efficient XML Interchange (EXI) in Navy Wide-Area Network (WAN) Optimization


    Language (XML) (W3C, 2014). The rapid adoption of web applications and media-rich Internet applications has made XML a foundational pillar for data...side, Navy ships have the capability of connecting to WAN services provided over copper or possibly fiber optic connections. Once deployed, however

  10. Update on the Department of the Navy Systems Engineering Career Competency Model Acquisition Activities


    D. Burrow, Deputy Assistant Secretary of the Navy for Research, Development, Test, & Evaluation (DASN RDT&E) Rethinking the Systems Engineering... Process in Light of Design Thinking Ronald Giachetti, Chair and Professor, NPS Clifford Whitcomb, Professor, NPS Content Analysis in Systems...School (NPS) in Monterey, CA. Khan’s research interests include systems engineering competency (modeling and development), cognitive processing , and

  11. The U.S. Navy Healthy Back Program: Effect on Back Knowledge among Recruits


    Work Unit No. 63706N M0095.005-6106, Department of the Navy. The views expressed in this article are those of the authors and do not reflect the...exercise, traction, passive mobilization, physical strengthening, physiotherapy , drugs, surgery, hypnosis, psychotherapy, behavior modification, and skills

  12. Active vibration control for underwater signature reduction of a navy ship

    Basten, T.; Berkhoff, A.; Vermeulen, R.


    Dutch navy ships are designed and built to have a low underwater signature. For low frequencies however, tonal vibrations of a gearbox can occur, which might lead to increased acoustic signatures. These vibrations are hard to reduce by passive means. To investigate the possibilities of active vibrat

  13. Epidemic infectious gastrointestinal illness aboard U.S. Navy ships deployed to the Middle East during peacetime operations – 2000–2001

    Bresee Joseph S


    Full Text Available Abstract Background Infectious gastrointestinal illness (IGI outbreaks have been reported in U.S. Navy ships and could potentially have an adverse mission impact. Studies to date have been anecdotal. Methods We conducted a retrospective analysis of weekly reported disease and non-battle injury health data collected in 2000 – 2001 from 44 U.S. Navy ships while sailing in the 5th Fleet (Persian Gulf and nearby seas. Results During this period, 11 possible IGI outbreaks were identified. Overall, we found 3.3 outbreaks per 100 ship-weeks, a mean outbreak duration of 4.4 weeks, and a mean cumulative ship population attack rate of 3.6%. Morbidity, represented by days lost due to personnel being placed on sick-in-quarters status, was higher during outbreak weeks compared to non-outbreak weeks (p = 0.002. No clear seasonal distribution was identified. Conclusion Explosive outbreaks due to viruses and bacteria with the potential of incapacitating large proportions of the crew raise serious concerns of mission impact and military readiness.

  14. U.S. Navy Capstone Strategy Policy, Vision and Concept Documents. What to Consider Before You Write One


    Ret) Joe Bouchard OPNAVN513 (1995-7) ( Mar 2006 e-mail) • But. . . USN views CNO & OPNAV as more authoritative than NAVWARCOL; & certainly more that...audiences? Why? • What - if any - will be the roles of the CNO? The SECNAV? The OPSDEP? Other senior Navy flag officers? CHINFO? OLA ? The Naval...normally but not always in OPNAV N3/N5 - and the organization of the Chief of Navy Information (CHINFO). The Navy’s Office of Legislative affairs ( OLA

  15. Experiences and thoughts on large tertiary military hospital site accreditation%军队大型医院三甲等级现场评审体会与思考

    李小龙; 王文桥; 杨宏桥; 郭渝成


      对军队医院评审工作进行回顾思考,并提出建设性建议,即:军队医院评审要进一步健全评审体系,完善评审和促建畅销机制;进一步完善考核标准;改进评审方法,进一步提高检查效率。%Military hospital accreditation was reviewed and recommendations were presented. It shows that the accreditation system for military hospital needs to be further improved on accreditation and long-term effective mechanism, further improve accreditation standard and promote accreditation methods to improve efficient.

  16. Measuring nutritional risk in hospitals

    Henrik H Rasmussen


    Full Text Available Henrik H Rasmussen1,2, Mette Holst3, Jens Kondrup41Centre for Nutrition and Bowel Disease, Department of Medical Gastroenterology, Aarhus University Hospital, Aalborg, Denmark; 2Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 3Centre for Nutrition and Bowel Disease, Aarhus University Hospital, Aalborg, Denmark; 4Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Clinical Nutrition Unit, Rigshospitalet University Hospital, Copenhagen, DenmarkAbstract: About 20%–50% of patients in hospitals are undernourished. The number varies depending on the screening tool amended and clinical setting. A large number of these patients are undernourished when admitted to the hospital, and in most of these patients, undernutrition develops further during hospital stay. The nutrition course of the patient starts by nutritional screening and is linked to the prescription of a nutrition plan and monitoring. The purpose of nutritional screening is to predict the probability of a better or worse outcome due to nutritional factors and whether nutritional treatment is likely to influence this. Most screening tools address four basic questions: recent weight loss, recent food intake, current body mass index, and disease severity. Some screening tools, moreover, include other measurements for predicting the risk of malnutrition. The usefulness of screening methods recommended is based on the aspects of predictive validity, content validity, reliability, and practicability. Various tools are recommended depending on the setting, ie, in the community, in the hospital, and among elderly in institutions. The Nutrition Risk Screening (NRS 2002 seems to be the best validated screening tool, in terms of predictive validity ie, the clinical outcome improves when patients identified to be at risk are treated. For adult patients in hospital, thus, the NRS 2002 is recommended.Keywords: nutritional risk screening

  17. Evaluating the Impact of Hospital Efficiency on Wellness in the Military Health System.

    Bastian, Nathaniel D; Kang, Hyojung; Swenson, Eric R; Fulton, Lawrence V; Griffin, Paul M


    Like all health care delivery systems, the U.S. Department of Defense Military Health System (MHS) strives to achieve top preventative care and population health outcomes for its members while operating at an efficient level and containing costs. The objective of this study is to understand the overall efficiency performance of military hospitals and investigate the relationship between efficiency and wellness. This study uses data envelopment analysis and stochastic frontier analysis to compare the efficiency of 128 military treatment facilities from the Army, Navy, and Air Force during the period of 2011 to 2013. Fixed effects panel regression is used to determine the association between the hospital efficiency and wellness scores. The results indicate that data envelopment analysis and stochastic frontier analysis efficiency scores are congruent in direction. Both results indicate that the majority of the MHS hospitals and clinics can potentially improve their productive efficiency by managing their input resources better. When comparing the performance of the three military branches of service, Army hospitals as a group outperformed their Navy and Air Force counterparts; thus, best practices from the Army should be shared across service components. The findings also suggest no statistically significant, positive association between efficiency and wellness over time in the MHS.

  18. Radiofrequency field surveys in hospitals.

    Foster, K R; Soltys, M; Arnofsky, S; Doshi, P; Hanover, D; Mercado, R; Schleck, D


    The authors surveyed levels of radiofrequency (RF) fields in the frequency range 0.1-1,000 MHz in four hospitals in the Philadelphia area, to obtain background information related to the possible interference of radiofrequency fields with medical equipment. Two large center-city hospitals, a regional county hospital, and two suburban hospitals were surveyed. Measurements were made at six to 12 sites in each hospital, in each of the three frequency bands. More limited additional measurements were conducted in a fifth hospital as well. Sites were selected to include areas where strong RF signals from transmitting antennas might be expected to be present (e.g., locations close to windows in upper stories of buildings near paging antennas) as well as other representative sites in the hospital. The median RF field strengths were quite low (0.1-0.5 V/m), but at specific locations the RF signals from broadcast sources exceeded 1 V/m. Much stronger fields were recorded close to electrosurgical units and hand-held transmitters (cellular telephones and UHF transceivers).

  19. Accurate falls risk assessment and interventions for preventing falls in patients in the acute care setting within a private hospital in a large capital city: a best practice implementation project.

    Szymaniak, Samara


    Patient falls are a leading cause of adverse events in Australian hospitals. Most Australian hospitals have fall prevention policies, procedures and programs for preventing inpatient falls; however despite these resources many preventable falls continue to occur in Australian hospitals.It is imperative that clinicians understand the potential impact of inpatient falls, and what triggers can be identified and managed by a multifactorial team approach. Patients admitted to hospital often experience changes in physical and/or cognitive function which is then exacerbated by an unfamiliar environment and medical interventions. Adverse outcomes post falling can range from minor injuries such as skin tears to significant injuries such as intracranial hemorrhages and fractures which can ultimately result in permanent disability or death.In 2007, Calvary Wakefield Hospital implemented a Falls Minimization Program requiring routine assessment of all patients admitted using an Admission Risk Screening Tool in conjunction with completion of a detailed Falls Risk Assessment Tool when indicated. The aim of this implementation was to review current nursing practice against compliance with the Falls Minimization Program and also identify areas for improvement with a focus on preventative strategies. It was essential that the project and its outcomes also complement the National Safety and Quality Health Service Standards (standard 10 - Preventing Falls and Harm from Falls) that provide a benchmark for Calvary Wakefield Hospital. This was achieved by completing a baseline audit, implementing a corrective action plan post audit and then re-auditing in three months once strategies had been implemented This project used the pre- and post-implementation audit strategy made up of eight criteria using the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice. The audit, review, implementation and re-audit sequence was the strategy

  20. 某大型医院生活热水系统节能改造及优化措施分析%Energy-saving Retrofitting and Optimization Measures for the Domestic Hot Water System in a Large Hospital



    With the development of medical care service levels, both the amount and the quality requirement of domestic hot water in hospital increase with significant growth of hot water energy consumption. The energy-saving retrofitting for the hot water system in the existing hospital will be influenced vulnerably by power unbalance, investment cost, hot water reliability and the building area. By analyzing the actual situation of a hospital, increasing solar energy preheating system to the original electric furnace hot-water system is a reliable, economic and reasonable method. Optimized methods for improving actual utilization efficiency of solar energy are elaborated.%随着医疗机构服务层次的提高,医院生活热水用量增加且质量要求提高,热水能耗呈现明显的增长势头。既有医院热水系统的节能和节约性改造,易受电力不平衡、投资成本、热水可靠性以及用房用地面积等因素的影响。通过分析某医院的实际状况,在原电力锅炉热水系统的基础上增加太阳能预热系统,是一种既可靠又经济合理的组合运行方式;同时探讨了提高太阳能实际利用效率的措施。