WorldWideScience

Sample records for prevention unit san

  1. 75 FR 15611 - Safety Zone; United Portuguese SES Centennial Festa, San Diego Bay, San Diego, CA

    Science.gov (United States)

    2010-03-30

    ...-AA00 Safety Zone; United Portuguese SES Centennial Festa, San Diego Bay, San Diego, CA AGENCY: Coast... navigable waters of the San Diego Bay in support of the United Portuguese SES Centennial Festa. This... Centennial Festa, which will include a fireworks presentation originating from a tug and barge combination in...

  2. The San values of conflict prevention and avoidance in Platfontein

    Directory of Open Access Journals (Sweden)

    Nina Mollema

    2017-09-01

    Full Text Available The aim of this article is to identify measures that can prevent violent conflict through the maintenance of traditional cultural values that guide conflict avoidance. Moreover, the article focuses on the concepts of conflict prevention and conflict avoidance as applied by the San community of Platfontein. The causes of the inter-communal tensions between the San community members are also examined. A selected conflict situation, that of superstition and witchcraft, is assessed as factors increasing interpersonal conflict in the Platfontein community. This investigation is made to determine if the San preventive measures have an impact in the community, so as to prevent ongoing conflicts from escalating further.

  3. United to prevent emergencies

    International Nuclear Information System (INIS)

    Carta Petrolera

    2001-01-01

    The paper is about the national plan of contingencies, as tool of coordination inter-institutional that has allowed strengthening the actions of prevention and attention of spills of hydrocarbons and chemical substances in Colombia

  4. 76 FR 70480 - Otay River Estuary Restoration Project, South San Diego Bay Unit of the San Diego Bay National...

    Science.gov (United States)

    2011-11-14

    ... River Estuary Restoration Project, South San Diego Bay Unit of the San Diego Bay National Wildlife...), intend to prepare an environmental impact statement (EIS) for the proposed Otay River Estuary Restoration... any one of the following methods. Email: [email protected] . Please include ``Otay Estuary NOI'' in the...

  5. 78 FR 1246 - Otay River Estuary Restoration Project; South San Diego Bay Unit and Sweetwater Marsh Unit of the...

    Science.gov (United States)

    2013-01-08

    ...-FF08RSDC00] Otay River Estuary Restoration Project; South San Diego Bay Unit and Sweetwater Marsh Unit of the... scoping with regard to the environmental impact statement (EIS) for the proposed Otay River Estuary... one of the following methods. Email: [email protected] . Please include ``Otay Estuary NOI'' in the...

  6. Uniting to prevent unwanted pregnancies.

    Science.gov (United States)

    Lynch, D

    1994-02-18

    In reading the column of Cal Thomas entitled "Speaking Truth to Power" it becomes clear that the forces aligned against each other on the issue of reproductive choice should work together in order to reduce the number of unwanted pregnancies. An estimated 400 million women are unable to limit their family size for economic reasons. More are inhibited by social or religious constraints. When family planning (FP) services are available, and the status and education levels of women are raised, abortion rates decrease. This is demonstrated in the Netherlands, where legal abortions and contraception are available. The abortion rate is less than 5/1000 women there, one of the lowest worldwide. Latin America, where abortion is illegal and FP services are lacking, has abortion rates of 30-60/1000. Furthermore, these illegal abortions usually have a tragic effect on the woman's health. Of an estimated 6 million pregnancies annually in the United States, approximately half are unintended. Of these, about 1.6 million are aborted. Of the women in the United States who become pregnant annually, 82% are unmarried, 25% are under 20 years of age, and 33% make less than $11,000 yearly. If industrialized nations made contraceptives and FP services available to the poor worldwide, the quality of life on earth would increase. Human misery, anarchy, and resource depletion would decrease. State and local governments should increase support of domestic FP activities, while the federal government should raise its funding of international FP services. In order to reach the goals set by the 1989 Amsterdam Declaration, which was signed by the US, the annual contribution of the United States needs to be doubled. 4% of the US foreign aid budget, $720 million, is less than 0.1% of its $1.5 trillion budget. This amounts to less than $3 per US citizen.

  7. 76 FR 54800 - International Business Machines (IBM), Software Group Business Unit, Quality Assurance Group, San...

    Science.gov (United States)

    2011-09-02

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-74,554] International Business Machines (IBM), Software Group Business Unit, Quality Assurance Group, San Jose, California; Notice of Negative Determination on Reconsideration On January 21, 2011, the Department of Labor (Department) issued an Affirmative Determination Regarding...

  8. Hydrogeologic Assessment of the East Bear Creek Unit, San LuisNational Wildlife Refuge

    Energy Technology Data Exchange (ETDEWEB)

    Quinn, Nigel W.T.

    2007-07-15

    San Luis National Wildlife Refuge Complex to meetReclamation s obligations for Level 4 water supply under the CentralValley Project Improvement Act. Hydrogeological assessment of the EastBear Creek Unit of the San Luis National Wildlife Refuge was conductedusing a combination of field investigations and a survey of availableliterature from past US Geological Survey Reports and reports by localgeological consultants. Conservative safe yield estimates made using theavailable data show that the East Bear Creek Unit may have sufficientgroundwater resources in the shallow groundwater aquifer to meet aboutbetween 25 percent and 52 percent of its current Level II and between 17percent and 35 percent of its level IV water supply needs. The rate ofsurface and lateral recharge to the Unit and the design of the well fieldand the layout and capacity of pumped wells will decide both thepercentage of annual needs that the shallow aquifer can supply andwhether this yield is sustainable without affecting long-term aquiferquality. In order to further investigate the merits of pumping the nearsurface aquifer, which appears to have reasonable water quality for usewithin the East Bear Creek Unit -- monitoring of the potential sources ofaquifer recharge and the installation of a pilot shallow well would bewarranted. Simple monitoring stations could be installed both upstreamand downstream of both the San Joaquin River and Bear Creek and beinstrumented to measureriver stage, flow and electrical conductivity.Ideally this would be done in conjunction with a shallow pilot well,pumped to supply a portion of the Unit's needs for the wetland inundationperiod.

  9. 76 FR 77528 - Proposed CERCLA Administrative Cost Recovery Settlement; North Hollywood Operable Unit of the San...

    Science.gov (United States)

    2011-12-13

    ...In accordance with Section 122(i) of the Comprehensive Environmental Response, Compensation, and Liability Act, as amended (``CERCLA''), 42 U.S.C. 9622(i), notice is hereby given of a proposed administrative settlement for recovery of response costs concerning the North Hollywood Operable Unit of the San Fernando Valley Area 1 Superfund Site, located in the vicinity of Los Angeles, California, with the following settling parties: Pick-Your-Part Auto Wrecking; Hayward Associates, LLC; and PNM Properties, LLC. The settlement requires the settling parties to pay a total of $102,161 to the North Hollywood Operable Unit Special Account within the Hazardous Substance Superfund. The settlement also includes a covenant not to sue the settling parties pursuant to Section 107(a) of CERCLA, 42 U.S.C. 9607(a). For thirty (30) days following the date of publication of this notice, the Agency will receive written comments relating to the settlement. The Agency will consider all comments received and may modify or withdraw its consent to the settlement if comments received disclose facts or considerations which indicate that the settlement is inappropriate, improper, or inadequate. The Agency's response to any comments received will be available for public inspection at the City of Los Angeles Central Library, Science and Technology Department, 630 West 5th Street, Los Angeles, CA 90071 and at the EPA Region 9 Superfund Records Center, Mail Stop SFD-7C, 95 Hawthorne Street, Room 403, San Francisco, CA 94105.

  10. 76 FR 79678 - Proposed CERCLA Administrative Cost Recovery Settlement; North Hollywood Operable Unit of the San...

    Science.gov (United States)

    2011-12-22

    ...In accordance with Section 122(i) of the Comprehensive Environmental Response, Compensation, and Liability Act, as amended (``CERCLA''), 42 U.S.C. 9622(i), notice is hereby given of a proposed administrative settlement for recovery of response costs concerning the North Hollywood Operable Unit of the San Fernando Valley Area 1 Superfund Site, located in the vicinity of Los Angeles, California, with the following settling parties: Pick-Your-Part Auto Wrecking; Hayward Associates, LLC; and PNM Properties, LLC. The settlement requires the settling parties to pay a total of $102,161 to the North Hollywood Operable Unit Special Account within the Hazardous Substance Superfund. The settlement also includes a covenant not to sue the settling parties pursuant to Section 107(a) of CERCLA, 42 U.S.C. 9607(a). For thirty (30) days following the date of publication of this notice, the Agency will receive written comments relating to the settlement. The Agency will consider all comments received and may modify or withdraw its consent to the settlement if comments received disclose facts or considerations which indicate that the settlement is inappropriate, improper, or inadequate. The Agency's response to any comments received will be available for public inspection at the City of Los Angeles Central Library, Science and Technology Department, 630 West 5th Street, Los Angeles, CA 90071 and at the EPA Region 9 Superfund Records Center, Mail Stop SFD-7C, 95 Hawthorne Street, Room 403, San Francisco, CA 94105.

  11. 77 FR 123 - Proposed CERCLA Administrative Cost Recovery Settlement; North Hollywood Operable Unit of the San...

    Science.gov (United States)

    2012-01-03

    ...In accordance with Section 122(i) of the Comprehensive Environmental Response, Compensation, and Liability Act, as amended (``CERCLA''), 42 U.S.C. 9622(i), notice is hereby given of a proposed administrative settlement for recovery of response costs concerning the North Hollywood Operable Unit of the San Fernando Valley Area 1 Superfund Site, located in the vicinity of Los Angeles, California, with the following settling party: Waste Management Recycling & Disposal Services of California, Inc., dba Bradley Landfill & Recycling Center. The settlement requires the settling party to pay a total of $185,734 to the North Hollywood Operable Unit Special Account within the Hazardous Substance Superfund. The settlement also includes a covenant not to sue the settling party pursuant to Section 107(a) of CERCLA, 42 U.S.C. 9607(a). For thirty (30) days following the date of publication of this notice, the Agency will receive written comments relating to the settlement. The Agency will consider all comments received and may modify or withdraw its consent to the settlement if comments received disclose facts or considerations which indicate that the settlement is inappropriate, improper, or inadequate. The Agency's response to any comments received will be available for public inspection at the City of Los Angeles Central Library, Science and Technology Department, 630 West 5th Street, Los Angeles CA 90071 and at the EPA Region 9 Superfund Records Center, Mail Stop SFD-7C, 95 Hawthorne Street, Room 403, San Francisco, CA 94105.

  12. Loss of Power and Water Hammer Event at San Onofre, Unit 1, on November 21, 1985

    International Nuclear Information System (INIS)

    1986-01-01

    On November 21, 1985, Southern California Edison's Onofre Nuclear Generating Station, Unit 1, located south of San Clemente, California, experienced a partial loss of inplant ac electrical power while the plant was operating at 60% power. Following a manual reactor trip, the plant lost all inplant ac power for 4 minutes and experienced a severe incidence of water hammer in the feedwater system which caused a leak, damaged plant equipment, and challenged the integrity of the plant's heat sink. The most significant aspect of the event involved the failure of five safety-related check valves in the feed-water system whose failure occurred in less than year, without detection, and jeopardized the integrity of safety systems. The event involved a number of equipment malfunctions, operator errors, and procedural deficiencies. This report documents the findings and conclusions of an NRC Incident Investigation Team sent to San Onofre by the NRC Executive Director for Operations in conformance with NRC's recently established Incident Investigation Program

  13. Transient electromagnetic mapping of clay units in the San Luis Valley, Colorado

    Science.gov (United States)

    Fitterman, David V.; Grauch, V.J.S.

    2010-01-01

    Transient electromagnetic soundings were used to obtain information needed to refine hydrologic models of the San Luis Valley, Colorado. The soundings were able to map an aquitard called the blue clay that separates an unconfined surface aquifer from a deeper confined aquifer. The blue clay forms a conductor with an average resistivity of 6.9 ohm‐m. Above the conductor are found a mixture of gray clay and sand. The gray clay has an average resistivity of 21 ohm‐m, while the sand has a resistivity of greater than 100 ohm‐m. The large difference in resistivity of these units makes mapping them with a surface geophysical method relatively easy. The blue clay was deposited at the bottom of Lake Alamosa which filled most of the San Luis Valley during the Pleistocene. The geometry of the blue clay is influenced by a graben on the eastern side of the valley. The depth to the blue clay is greater over the graben. Along the eastern edge of valley the blue clay appears to be truncated by faults.

  14. Emergency operating instruction improvements at San Onofre Nuclear Generating Station Units 2 and 3

    International Nuclear Information System (INIS)

    Trillo, M.W.; Smith, B.H.

    1989-01-01

    In late 1987, San Onofre nuclear generating station (SONGS) began an extensive upgrade of the units 2 and 3 emergency operating instructions (EOIs). The original intent of this program was to incorporate revised generic guidance and to correct problems that were identified by operators. While this program was in progress, the US Nuclear Regulatory Commission (NRC) conducted a series of audits of emergency operating procedure (EOP) development and maintenance programs as 16 commercial nuclear facilities in the United States. These audits included four stations with Combustion Engineering-designed nuclear steam supply systems. (One of these audits included a review of preupgrade SONGS units 2 and 3 EOIs.) Significant industrywide comments resulted from these audits. The NRC has stated its intent to continue the review and audit of EOIs and the associated maintenance programs at all US commercial nuclear facilities. The units 2 and 3 EOI upgrade program developed procedural improvements and procedural program maintenance improvements that address many of the existing audit comments that have been received by the industry. Other resulting improvements may be useful in minimizing NRC comments in future such audits. Specific improvements are discussed. The upgrade program resulted in benefits that were not originally anticipated. The results of this program can be of significant use by other utilities in addressing the industrywide concerns that have been raised in recent NRC audits of EOP development and maintenance programs

  15. RETRAN analysis of San Onofre Unit 2 turbine trip from 100% power

    International Nuclear Information System (INIS)

    Ting, Y.P.

    1985-01-01

    During the San Onofre Nuclear Generating Station Unit (SONGS 2) startup test, the plant experienced a turbine trip from 100% power on June 16, 1983. The trip was initiated by the condenser pressure switch malfunctioning. The plant computers were operating and recorded many plant key parameters. The resulting trip behaved as if it has been manually initiated and it was considered equivalent to a preplanned turbine trip test. A RETRAN-02 model was developed to simulate the SONGS 2 June 16 turbine trip event. The RETRAN analysis of the trip is a continuing effort of in-house SONGS 2 RETRAN model development to benchmark the calculations against the plant startup test data. The overall agreement between measured data and the RETRAN calculations was very good, providing confidence in the capability of the model and the RETRAN program. Comparative data are presented

  16. BRICKS, BRANDING, AND THE EVERYDAY: DEFINING GREATNESS AT THE UNITED NATIONS PLAZA IN SAN FRANCISCO

    Directory of Open Access Journals (Sweden)

    Georgia Lindsay

    2017-07-01

    Full Text Available After over a decade of reports, designs, and public outreach, the United Nations Plaza in San Francisco was dedicated in 1976. Using historical documents such as government reports, design guidelines, letters, meeting minutes, and newspaper articles from archives, I argue that while the construction of the UN Plaza has failed to completely transform the social and economic life of the area, it succeeds in creating a genuinely public space. The history of the UN Plaza can serve both as a cautionary tale for those interested in changing property values purely through changing design, and as a standard of success in making a space used by a true cross-section of urban society.

  17. Lessons learned from the seismic reevaluation of San Onofre Nuclear Generating Station, Unit 1

    International Nuclear Information System (INIS)

    Russell, M.J.; Shieh, L.C.; Tsai, N.C.; Cheng, T.M.

    1987-01-01

    A seismic reevaluation program was conducted for the San Onofre Nuclear Generating Station, Unit No. 1 (SONGS 1). SEP was created by the NRC to provide (1) an assessment of the significance of differences between current technical positions on safety issues and those that existed when a particular plant was licensed, (2) a basis for deciding on how these differences should be resolved in an integrated plant review, and (3) a documented evaluation of plant safety. The Systematic Evaluation Program (SEP) seismic review for SONGS 1 was exacerbated by the results of an evaluation of an existing capable fault near the site during the design review for Units 2 and 3, which resulted in a design ground acceleration of 0.67g. Southern California Edison Company (SCE), the licensee for SONGS 1, realized that a uniform application of existing seismic criteria and methods would not be feasible for the upgrading of SONGS 1 to such a high seismic requirement. Instead, SCE elected to supplement existing seismic criteria and analysis methods by developing criteria and methods closer to the state of the art in seismic evaluation techniques

  18. Visitation in the intensive care unit: impact on infection prevention and control.

    Science.gov (United States)

    Adams, Sheila; Herrera, Amando; Miller, Laura; Soto, Rhonda

    2011-01-01

    Evidence-based practice has shown that open visitation in the intensive care setting positively impacts patient outcomes. However, many intensive care units continue to strictly limit visitation hours. One concern for nurses is that open visitation will expose their vulnerable patients to an increased risk of infection. This fear is unfounded in professional literature as well as in the experience of a busy intensive care unit in San Antonio, Texas. Keeping our patients safe from hospital-acquired infections requires vigilant attention to infection prevention procedures. Meanwhile, what may actually be bugging our patients is a health care culture that is based on tradition and is blind to the many benefits provided by a more liberal visitation policy rooted in patient-centered care.

  19. Critical evaluation of the nonradiological environmental technical specifications. Volume 4. San Onofre Nuclear Generating Station, Unit 1

    Energy Technology Data Exchange (ETDEWEB)

    Adams, S.M.; Cunningham, P.A.; Gray, D.D.; Kumar, K.D.

    1976-08-10

    A comprehensive study of the data collected as part of the environmental Technical Specifications program for Unit 1 of the San Onofre Nuclear Generating Station (SONGS 1) was conducted for the Office of Nuclear Regulatory Research of the U.S. Nuclear Regulatory Commission. The program included an analysis of the hydrothermal and ecological monitoring data collected during 1975. The hydrothermal analysis includes a discussion of models used in plume predictions prior to plant operation and an evaluation of the present hydrothermal monitoring program. The ecological evaluation was directed toward reviewing the strengths and weaknesses of the various sampling programs designed to monitor the planktonic, benthic, and nektonic communities inhabiting the inshore coastal area in the vicinity of San Onofre.

  20. Critical evaluation of the nonradiological environmental technical specifications. Volume 4. San Onofre Nuclear Generating Station, Unit 1

    International Nuclear Information System (INIS)

    Adams, S.M.; Cunningham, P.A.; Gray, D.D.; Kumar, K.D.

    1976-01-01

    A comprehensive study of the data collected as part of the environmental Technical Specifications program for Unit 1 of the San Onofre Nuclear Generating Station (SONGS 1) was conducted for the Office of Nuclear Regulatory Research of the U.S. Nuclear Regulatory Commission. The program included an analysis of the hydrothermal and ecological monitoring data collected during 1975. The hydrothermal analysis includes a discussion of models used in plume predictions prior to plant operation and an evaluation of the present hydrothermal monitoring program. The ecological evaluation was directed toward reviewing the strengths and weaknesses of the various sampling programs designed to monitor the planktonic, benthic, and nektonic communities inhabiting the inshore coastal area in the vicinity of San Onofre

  1. Steam, solarization, and tons of prevention: the San Francisco Public Utilities Commission's fight to contain Phytophthoras in San Francisco Bay area restoration sites

    Science.gov (United States)

    Greg Lyman; Jessica Appel; Mia Ingolia; Ellen Natesan; Joe Ortiz

    2017-01-01

    To compensate for unavoidable impacts associated with critical water infrastructure capital improvement projects, the San Francisco Public Utilities Commission (SFPUC) restored over 2,050 acres of riparian, wetland, and upland habitat on watershed lands in Alameda, Santa Clara, and San Mateo Counties. Despite strict bio-sanitation protocols, plant pathogens (...

  2. Hepatitis B and liver cancer knowledge and preventive practices among Asian Americans in the San Francisco Bay Area, California.

    Science.gov (United States)

    Wu, Charlotte A; Lin, Steven Y; So, Samuel K; Chang, Ellen T

    2007-01-01

    Chronic hepatitis B virus (HBV) infection causes liver cancer and disproportionately affects the Asian community in the U.S. In order to advance HBV and liver cancer awareness and prevention, it is important to identify existing gaps in knowledge and preventive practices among Asian Americans. Therefore, the authors administered a written questionnaire to 199 adults in the Asian-American community of the San Francisco Bay Area, California. Although the majority of adults had at least a college education, knowledge regarding HBV transmission, prevention, symptoms, risks, and occurrence was low. Fewer than 60% reported having been tested for HBV, only 31% reported having been vaccinated against HBV, and only 44% reported having had their children vaccinated. Asians, especially those born in China or Southeast Asia, had significantly poorer knowledge regarding HBV and liver cancer than non-Asians. Those with higher knowledge levels were significantly more likely to have been tested for HBV and to have had their children vaccinated. Younger adults, women, Caucasians, more highly educated individuals, those not born in China or Hong Kong, and those with a personal or family history of liver disease were more likely to have taken preventive action against HBV. Our results suggest that HBV and liver cancer knowledge among Asian Americans, especially Chinese Americans, is poor, and that better knowledge is associated with increased preventive practices. Thus, there is a need for increased HBV education and improved community-based interventions to prevent HBV-related liver disease in the high-risk Asian-American community.

  3. Social network characteristics and HIV vulnerability among transgender persons in San Salvador: identifying opportunities for HIV prevention strategies.

    Science.gov (United States)

    Barrington, Clare; Wejnert, Cyprian; Guardado, Maria Elena; Nieto, Ana Isabel; Bailey, Gabriela Paz

    2012-01-01

    The purpose of this study is to improve understanding of HIV vulnerability and opportunities for HIV prevention within the social networks of male-to-female transgender persons in San Salvador, El Salvador. We compare HIV prevalence and behavioral data from a sample of gay-identified men who have sex with men (MSM) (n = 279), heterosexual or bisexual identified MSM (n = 229) and transgender persons (n = 67) recruited using Respondent Driven Sampling. Transgender persons consistently reported higher rates of HIV risk behavior than the rest of the study population and were significantly more likely to be involved in sex work. While transgender persons reported the highest rates of exposure to HIV educational activities they had the lowest levels of HIV-related knowledge. Transgender respondents' social networks were homophilous and efficient at recruiting other transgender persons. Findings suggest that transgender social networks could provide an effective and culturally relevant opportunity for HIV prevention efforts in this vulnerable population.

  4. United Campuses to Prevent Nuclear War: Nuclear War Course Summaries.

    Science.gov (United States)

    Journal of College Science Teaching, 1983

    1983-01-01

    Briefly describes 46 courses on nuclear war available from United Campuses to Prevent Nuclear War (UCAM). These courses are currently being or have been taught at colleges/universities, addressing effects of nuclear war, arms race history, new weapons, and past arms control efforts. Syllabi (with assignments/reading lists) are available from UCAM.…

  5. Groundwater quality in the Western San Joaquin Valley study unit, 2010: California GAMA Priority Basin Project

    Science.gov (United States)

    Fram, Miranda S.

    2017-06-09

    Water quality in groundwater resources used for public drinking-water supply in the Western San Joaquin Valley (WSJV) was investigated by the USGS in cooperation with the California State Water Resources Control Board (SWRCB) as part of its Groundwater Ambient Monitoring and Assessment (GAMA) Program Priority Basin Project. The WSJV includes two study areas: the Delta–Mendota and Westside subbasins of the San Joaquin Valley groundwater basin. Study objectives for the WSJV study unit included two assessment types: (1) a status assessment yielding quantitative estimates of the current (2010) status of groundwater quality in the groundwater resources used for public drinking water, and (2) an evaluation of natural and anthropogenic factors that could be affecting the groundwater quality. The assessments characterized the quality of untreated groundwater, not the quality of treated drinking water delivered to consumers by water distributors.The status assessment was based on data collected from 43 wells sampled by the U.S. Geological Survey for the GAMA Priority Basin Project (USGS-GAMA) in 2010 and data compiled in the SWRCB Division of Drinking Water (SWRCB-DDW) database for 74 additional public-supply wells sampled for regulatory compliance purposes between 2007 and 2010. To provide context, concentrations of constituents measured in groundwater were compared to U.S. Environmental Protection Agency (EPA) and SWRCB-DDW regulatory and non-regulatory benchmarks for drinking-water quality. The status assessment used a spatially weighted, grid-based method to estimate the proportion of the groundwater resources used for public drinking water that has concentrations for particular constituents or class of constituents approaching or above benchmark concentrations. This method provides statistically unbiased results at the study-area scale within the WSJV study unit, and permits comparison of the two study areas to other areas assessed by the GAMA Priority Basin Project

  6. [Infection prevention and control in neonatal intensive care unit].

    Science.gov (United States)

    Lorenzini, Elisiane; Lorenzini, Elisiane; da Costa, Tatiane Costa; da Silva, Eveline Franco

    2013-12-01

    This study was aimed to identify the knowledge of the nursing team of a Neonatal Intensive Care Unit (NICU) on infection control, identijfying the factors that facilitate or hinder the prevention and control of Healthcare Associated Infections (HICAI). A descriptive study using a qualitative research method conducted with three nurses and 15 nurse technicians, who work in a NICU of a charitable organization, in southern Brazil. It became evident that the nursing staff had great knowledge about the factors that facilitate the prevention and control of HCAI in NICU, the most important factor being proper hand hygiene. Among the factors that hinder infection prevention and control are to overcrowding and excessive workload. The efficient performance of the nursing staff is an important part of the strategy for prevention and control of HCAI.

  7. Takotsubo Cardiomyopathy in Intensive Care Unit: Prevention, Diagnosis and Management

    Directory of Open Access Journals (Sweden)

    Hannah Masoud

    2016-01-01

    Full Text Available Accurate diagnosis of Takotsubo Cardiomyopathy has substantial prognostic implications in an intensive care unit, given its increased mortality risk and association with life-threatening complications. This report seeks to discuss diagnostic modalities that can be useful in accurately differentiating Takotsubo Cardiomyopathy from Acute Coronary Syndrome, and also briefly discuss prevention and management of this cardiomyopathy in an intensive care unit. For critically ill Takotsubo patients, intensive clinicians can consider establishment of diagnosis by specific electrocardiograph changes, distinctive marked release of cardiac enzymes, characteristic echocardiograph findings, as well as invasive coronary angiography or noninvasive cardiac magnetic imaging.

  8. Ground-Water Quality Data in the San Fernando-San Gabriel Study Unit, 2005 - Results from the California GAMA Program

    Science.gov (United States)

    Land, Michael; Belitz, Kenneth

    2008-01-01

    Ground-water quality in the approximately 460 square mile San Fernando-San Gabriel study unit (SFSG) was investigated between May and July 2005 as part of the Priority Basin Assessment Project of the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The GAMA Priority Basin Assessment Project was developed in response to the Groundwater Quality Monitoring Act of 2001 and is being conducted by the U.S. Geological Survey (USGS) in cooperation with the California State Water Resources Control Board (SWRCB). The San Fernando-San Gabriel study was designed to provide a spatially unbiased assessment of raw ground-water quality within SFSG, as well as a statistically consistent basis for comparing water quality throughout California. Samples were collected from 52 wells in Los Angeles County. Thirty-five of the wells were selected using a spatially distributed, randomized grid-based method to provide statistical representation of the study area (grid wells), and seventeen wells were selected to aid in the evaluation of specific water-quality issues or changes in water chemistry along a historic ground-water flow path (understanding wells). The ground-water samples were analyzed for a large number of synthetic organic constituents [volatile organic compounds (VOCs), pesticides and pesticide degradates], constituents of special interest [perchlorate, N-nitrosodimethylamine (NDMA), 1,2,3-trichloropropane (1,2,3-TCP), and 1,4-dioxane], naturally occurring inorganic constituents (nutrients, major and minor ions, and trace elements), radioactive constituents, and microbial indicators. Naturally occurring isotopes (tritium, and carbon-14, and stable isotopes of hydrogen, oxygen, and carbon), and dissolved noble gases also were measured to help identify the source and age of the sampled ground water. Quality-control samples (blanks, replicates, samples for matrix spikes) were collected at approximately one-fifth (11 of 52) of the wells, and the results for these

  9. United States Air Force Personalized Medicine and Advanced Diagnostics Program Panel: Representative Research at the San Antonio Military Medical Center

    Science.gov (United States)

    2016-05-20

    health system. dedicated to excellence in global care PROCESSING OF PROFESSIONAL MEDICAL RESEARCH PUBLICATIONS/PRESENTATIONS INSTRUCTIONS 1. The...present this research at the University of Texas at San Antonio/SAMHS & Universities Research Forum, SURF 2016 in San Antonio, TX, on 20 May 2016. The...at San Antonio/SAMHS & Universities Research Forum, SURF 2016 in San Antonio, TX, on 20 May 2016. 3. LAWS AND REGULATIONS: DoD 5500.07-R, Joint

  10. Seismic structural fragility investigation for the San Onofre Nuclear Generating Station, Unit 1 (Project I); SONGS-1 AFWS Project

    International Nuclear Information System (INIS)

    Wesley, D.A.; Hashimoto, P.S.

    1982-04-01

    An evaluation of the seismic capacities of several of the San Onofre Nuclear Generating Station, Unit 1 (SONGS-1) structures was conducted to determine input to the overall probabilistic methodology developed by Lawrence Livermore National Laboratory. Seismic structural fragilities to be used as input consist of median seismic capacities and their variabilities due to randomness and uncertainty. Potential failure modes were identified for each of the SONGS-1 structures included in this study by establishing the seismic load-paths and comparing expected load distributions to available capacities for the elements of each load-path. Particular attention was given to possible weak links and details. The more likely failure modes were screened for more detailed investigation

  11. A Chinese Herbal Medicine, Jia-Wei-Xiao-Yao-San, Prevents Dimethylnitrosamine-Induced Hepatic Fibrosis in Rats

    Directory of Open Access Journals (Sweden)

    Shu-Chen Chien

    2014-01-01

    Full Text Available Jia-wei-xiao-yao-san (JWXYS is a traditional Chinese herbal medicine that is widely used to treat neuropsychological disorders. Only a few of the hepatoprotective effects of JWXYS have been studied. The aim of this study was to investigate the hepatoprotective effects of JWXYS on dimethylnitrosamine- (DMN- induced chronic hepatitis and hepatic fibrosis in rats and to clarify the mechanism through which JWXYS exerts these effects. After the rats were treated with DMN for 3 weeks, serum glutamic oxaloacetic transaminase (SGOT and serum glutamic pyruvic transaminase (SGPT levels were significantly elevated, whereas the albumin level decreased. Although DMN was continually administered, after the 3 doses of JWXYS were orally administered, the SGOT and SGPT levels significantly decreased and the albumin level was significantly elevated. In addition, JWXYS treatment prevented liver fibrosis induced by DMN. JWXYS exhibited superoxide-dismutase-like activity and dose-dependently inhibited DMN-induced lipid peroxidation and xanthine oxidase activity in the liver of rats. Our findings suggest that JWXYS exerts antifibrotic effects against DMN-induced chronic hepatic injury. The possible mechanism is at least partially attributable to the ability of JWXYS to inhibit reactive-oxygen-species-induced membrane lipid peroxidation.

  12. Availability and cost functions for periodically inspected preventively maintained units

    International Nuclear Information System (INIS)

    Vaurio, J.K.

    1999-01-01

    Unavailability and cost rate functions are developed for components whose failures can occur randomly but they are detected only by periodic testing or inspections. If a failure occurs between consecutive inspections, the unit remains failed until the next inspection. Components are renewed by preventive maintenance periodically, or by repair or replacement after a failure, whichever occurs first (age-replacement). The model takes into account finite repair and maintenance durations as well as costs due to testing, repair, maintenance and lost production or accidents. For normally operating units the time-related penalty is loss of production. For standby safety equipment it is the expected cost of an accident that can happen when the component is down due to a dormant failure, repair or maintenance. The objective of maintenance optimization is to minimize the total cost rate by proper selection of two intervals, one for inspections and one for replacements. General conditions and techniques are developed for solving optimal test and maintenance intervals, with and without constraints on the production loss or accident rate. Insights are gained into how the optimal intervals depend on various cost parameters and reliability characteristics

  13. Nickel release from earrings purchased in the united states: the San Francisco earring study

    DEFF Research Database (Denmark)

    Maibach, H.I.; Thyssen, Jacob Pontoppidan

    2008-01-01

    Background: Nickel sensitization is frequent among US patients with dermatitis and in the general population. In Europe, decreasing prevalences of nickel sensitization are observed as a result of the European Union Nickel Directive. However, no directive exists in the United States. Objectives: We...... sought to examine nickel release from inexpensive earrings and discuss possible methods of reducing nickel exposure among consumers. Methods: A total of 34 different stores and artists were visited. A total of 277 earrings were purchased and examined with the dimethylglyoxitne (DMG) test. Results: DMG......-positive earrings were identified from local artists (69%) and tourist stores (42.9%) but also chain stores targeting young (24.1%) and mature (1.7%) women. No correlation between price and outcome of DMG testing was identified. Limitations. Our study does not reflect buying trends in the United States...

  14. Project management with regulatory constraints: Return to service of San Onofre Unit 1

    International Nuclear Information System (INIS)

    Hosmer, J.

    1986-01-01

    Station acceptance of the RTS work was completed in early November, 1984. The unit completed a successful integrated leak rate test, hot function test, and 200 hour warranty run in December, 1984 six weeks ahead of the CPUC mandate. Capital expenditures, although greater than the initial forecast, were two million dollars less than the 37.5 million dollar CPUC cap. The unit has run essentially trouble-free at current rated power until the current 1985 outage. Strategies and lessons learned that contributed to a successful RTS (e.g., all regulatory and economic constraints were met) included the use of numerous brainstorm sessions between SCE, Bechtel, and other consultants; innovative state of the art technical criterion (e.g., realistic versus overly conservative engineering); and budget and schedule contingencies consistent with the known and unknown risks

  15. Ground-Water Quality Data in the San Francisco Bay Study Unit, 2007: Results from the California GAMA Program

    Science.gov (United States)

    Ray, Mary C.; Kulongoski, Justin T.; Belitz, Kenneth

    2009-01-01

    Ground-water quality in the approximately 620-square-mile San Francisco Bay study unit (SFBAY) was investigated from April through June 2007 as part of the Priority Basin project of the Ground-Water Ambient Monitoring and Assessment (GAMA) Program. The GAMA Priority Basin project was developed in response to the Groundwater Quality Monitoring Act of 2001, and is being conducted by the U.S. Geological Survey (USGS) in cooperation with the California State Water Resources Control Board (SWRCB). The study was designed to provide a spatially unbiased assessment of raw ground-water quality, as well as a statistically consistent basis for comparing water quality throughout California. Samples in SFBAY were collected from 79 wells in San Francisco, San Mateo, Santa Clara, Alameda, and Contra Costa Counties. Forty-three of the wells sampled were selected using a spatially distributed, randomized grid-based method to provide statistical representation of the study unit (grid wells). Thirty-six wells were sampled to aid in evaluation of specific water-quality issues (understanding wells). The ground-water samples were analyzed for a large number of synthetic organic constituents (volatile organic compounds [VOC], pesticides and pesticide degradates, pharmaceutical compounds, and potential wastewater-indicator compounds), constituents of special interest (perchlorate and N-nitrosodimethylamine [NDMA]), naturally occurring inorganic constituents (nutrients, major and minor ions, trace elements, chloride and bromide isotopes, and uranium and strontium isotopes), radioactive constituents, and microbial indicators. Naturally occurring isotopes (tritium, carbon-14 isotopes, and stable isotopes of hydrogen, oxygen, nitrogen, boron, and carbon), and dissolved noble gases (noble gases were analyzed in collaboration with Lawrence Livermore National Laboratory) also were measured to help identify the source and age of the sampled ground water. Quality-control samples (blank samples

  16. Winters-Domengine Total Petroleum System—Northern Nonassociated Gas Assessment Unit of the San Joaquin Basin Province: Chapter 21 in Petroleum systems and geologic assessment of oil and gas in the San Joaquin Basin Province, California

    Science.gov (United States)

    Hosford Scheirer, Allegra; Magoon, Leslie B.

    2008-01-01

    The Northern Nonassociated Gas Assessment Unit (AU) of the Winters-Domengine Total Petroleum System of the San Joaquin Basin Province consists of all nonassociated gas accumulations in Cretaceous, Eocene, and Miocene sandstones located north of township 15 South in the San Joaquin Valley. The northern San Joaquin Valley forms a northwest-southeast trending asymmetrical trough. It is filled with an alternating sequence of Cretaceous-aged sands and shales deposited on Franciscan Complex, ophiolitic, and Sierran basement. Eocene-aged strata unconformably overlie the thick Cretaceous section, and in turn are overlain unconformably by nonmarine Pliocene-Miocene sediments. Nonassociated gas accumulations have been discovered in the sands of the Panoche, Moreno, Kreyenhagen, andDomengine Formations and in the nonmarine Zilch formation of Loken (1959) (hereafter referred to as Zilch formation). Most hydrocarbon accumulations occur in low-relief, northwest-southeast trending anticlines formed chiefly by differential compaction of sediment and by northeast southwest directed compression during the Paleogene (Bartow, 1991) and in stratigraphic traps formed by pinch out of submarine fan sands against slope shales. To date, 176 billion cubic feet (BCF) of nonassociated recoverable gas has been found in fields within the assessment unit (table 21.1). A small amount of biogenic gas forms near the surface of the AU. Map boundaries of the assessment unit are shown in figures 21.1 and 21.2; in plan view, this assessment unit is identical to the Northern Area Nonassociated Gas play 1007 considered by the U.S. Geological Survey (USGS) in its 1995 National Assessment (Beyer, 1996). The AU is bounded on the east by the mapped limits of Cretaceous sandstone reservoir rocks and on the west by the east flank of the Diablo Range. The southern limit of the AU is the southernmost occurrence of nonassociated thermogenic-gas accumulations. The northern limit of the AU corresponds to the

  17. Technical evaluation report on the proposed design modifications and technical-specification changes on grid voltage degradation for the San Onofre Nuclear Genetating Station, Unit 1

    International Nuclear Information System (INIS)

    Selan, J.C.

    1982-01-01

    This report documents the technical evaluation of the proposed design modifications and Technical Specification changes for protection of Class 1E equipment from grid voltage degradation for the San Onofre Nuclear Generating Station, Unit 1. The review criteria are based on several IEEE standards and the Code of Federal Regulations. The evaluation finds that the proposed design modifications and Technical Specification changes will ensure that the Class 1E equipment will be protected from sustained voltage degradation

  18. Status of wildland fire prevention evaluation in the United States.

    Science.gov (United States)

    Larry Doolittle; Linda R. Donoghue

    1991-01-01

    Presents findings of an assessment of the evaluation of wildland prevention efforts by all U.S. Wildland fire management agencies, and offers recommendations for improvements in prevention valuation techniques and procedures.

  19. Changing the Direction of Suicide Prevention in the United States.

    Science.gov (United States)

    Reidenberg, Dan; Berman, Alan L

    2017-08-01

    It is axiomatic that the goal of suicide prevention is the prevention of suicide. Yet in spite of significant efforts to this end since the middle of the last century, and most notably in the last decade, the rate of suicide in the U.S. has not declined; rather, it has increased. To address this issue, Suicide Awareness Voices of Education (SAVE) brought together leading prevention specialists from other public health problems where successes have been achieved, representatives from countries where suicide rates have declined, and U.S. based suicide prevention researchers and program directors, to "think outside the box" and propose innovative, scalable approaches that might better drive success in achieving desired results from U.S. suicide prevention efforts. The recommendations should challenge our preconceptions and force us outside our own mental constraints to broaden our perspectives and suggest catalysts for real change in suicide prevention. © 2016 The American Association of Suicidology.

  20. STD Prevention Policies in the United States: Evidence and Opportunities

    OpenAIRE

    Leichliter, Jami S.; Seiler, Naomi; Wohlfeiler, Dan

    2016-01-01

    Policies are an important part of public health interventions, including in the area of STD prevention. Similar to other tools used in public health, policies are often evaluated to determine their usefulness. Therefore, we conducted a non-systematic review of policy evidence for sexually transmitted disease prevention. Our review considers assessments or evaluations of STD prevention-specific policies, health care system policies, and other, broader policies that have the potential to impact...

  1. Violence Prevention in United States Society of Jesus Secondary Schools

    Science.gov (United States)

    Simonds, Thomas Andrew

    2009-01-01

    Using data from a representative number of Society of Jesus secondary schools, the researcher reports what these schools are doing to prevent violence, and tests an explanatory model of school violence he created. The researcher proposes that this model can be used to explain and prevent school violence by identifying and addressing the…

  2. Groundwater-quality data in the Western San Joaquin Valley study unit, 2010 - Results from the California GAMA Program

    Science.gov (United States)

    Mathany, Timothy M.; Landon, Matthew K.; Shelton, Jennifer L.; Belitz, Kenneth

    2013-01-01

    Groundwater quality in the approximately 2,170-square-mile Western San Joaquin Valley (WSJV) study unit was investigated by the U.S. Geological Survey (USGS) from March to July 2010, as part of the California State Water Resources Control Board (SWRCB) Groundwater Ambient Monitoring and Assessment (GAMA) Program's Priority Basin Project (PBP). The GAMA-PBP was developed in response to the California Groundwater Quality Monitoring Act of 2001 and is being conducted in collaboration with the SWRCB and Lawrence Livermore National Laboratory (LLNL). The WSJV study unit was the twenty-ninth study unit to be sampled as part of the GAMA-PBP. The GAMA Western San Joaquin Valley study was designed to provide a spatially unbiased assessment of untreated-groundwater quality in the primary aquifer system, and to facilitate statistically consistent comparisons of untreated groundwater quality throughout California. The primary aquifer system is defined as parts of aquifers corresponding to the perforation intervals of wells listed in the California Department of Public Health (CDPH) database for the WSJV study unit. Groundwater quality in the primary aquifer system may differ from the quality in the shallower or deeper water-bearing zones; shallow groundwater may be more vulnerable to surficial contamination. In the WSJV study unit, groundwater samples were collected from 58 wells in 2 study areas (Delta-Mendota subbasin and Westside subbasin) in Stanislaus, Merced, Madera, Fresno, and Kings Counties. Thirty-nine of the wells were selected by using a spatially distributed, randomized grid-based method to provide statistical representation of the study unit (grid wells), and 19 wells were selected to aid in the understanding of aquifer-system flow and related groundwater-quality issues (understanding wells). The groundwater samples were analyzed for organic constituents (volatile organic compounds [VOCs], low-level fumigants, and pesticides and pesticide degradates

  3. Groundwater-quality data in the Santa Cruz, San Gabriel, and Peninsular Ranges Hard Rock Aquifers study unit, 2011-2012: results from the California GAMA program

    Science.gov (United States)

    Davis, Tracy A.; Shelton, Jennifer L.

    2014-01-01

    Groundwater quality in the 2,400-square-mile Santa Cruz, San Gabriel, and Peninsular Ranges Hard Rock Aquifers (Hard Rock) study unit was investigated by the U.S. Geological Survey (USGS) from March 2011 through March 2012, as part of the California State Water Resources Control Board (SWRCB) Groundwater Ambient Monitoring and Assessment (GAMA) Program’s Priority Basin Project (PBP). The GAMA-PBP was developed in response to the California Groundwater Quality Monitoring Act of 2001 and is being conducted in collaboration with the SWRCB and Lawrence Livermore National Laboratory (LLNL). The Hard Rock study unit was the 35th study unit to be sampled as part of the GAMA-PBP.

  4. Groundwater-quality data in the North San Francisco Bay Shallow Aquifer study unit, 2012: results from the California GAMA Program

    Science.gov (United States)

    Bennett, George L.; Fram, Miranda S.

    2014-01-01

    Groundwater quality in the 1,850-square-mile North San Francisco Bay Shallow Aquifer (NSF-SA) study unit was investigated by the U.S. Geological Survey (USGS) from April to August 2012, as part of the California State Water Resources Control Board (SWRCB) Groundwater Ambient Monitoring and Assessment (GAMA) Program’s Priority Basin Project (PBP). The GAMA-PBP was developed in response to the California Groundwater Quality Monitoring Act of 2001 and is being conducted in collaboration with the SWRCB and Lawrence Livermore National Laboratory (LLNL). The NSF-SA study unit was the first study unit to be sampled as part of the second phase of the GAMA-PBP, which focuses on the shallow aquifer system.

  5. Forging an agenda for suicide prevention in the United States.

    Science.gov (United States)

    Caine, Eric D

    2013-05-01

    Suicide prevention must be transformed by integrating injury prevention and mental health perspectives to develop a mosaic of common risk public health interventions that address the diversity of populations and individuals whose mortality and morbidity contribute to the burdens of suicide and attempted suicide. Emphasizing distal preventive interventions, strategies must focus on people and places--and on related interpersonal factors and social contexts--to alter the life trajectories of people before they become suicidal. Attention also must be paid to those in the middle years--the age with the greatest overall burden. We need scientific and social processes that define priorities and assess their potential for reducing what has been a steadily increasing rate of suicide during the past decade.

  6. Forging an Agenda for Suicide Prevention in the United States

    Science.gov (United States)

    2013-01-01

    Suicide prevention must be transformed by integrating injury prevention and mental health perspectives to develop a mosaic of common risk public health interventions that address the diversity of populations and individuals whose mortality and morbidity contribute to the burdens of suicide and attempted suicide. Emphasizing distal preventive interventions, strategies must focus on people and places—and on related interpersonal factors and social contexts—to alter the life trajectories of people before they become suicidal. Attention also must be paid to those in the middle years—the age with the greatest overall burden. We need scientific and social processes that define priorities and assess their potential for reducing what has been a steadily increasing rate of suicide during the past decade. PMID:23488515

  7. Sexual Behavior, Risk Compensation, and HIV Prevention Strategies Among Participants in the San Francisco PrEP Demonstration Project: A Qualitative Analysis of Counseling Notes.

    Science.gov (United States)

    Carlo Hojilla, J; Koester, Kimberly A; Cohen, Stephanie E; Buchbinder, Susan; Ladzekpo, Deawodi; Matheson, Tim; Liu, Albert Y

    2016-07-01

    Pre-exposure prophylaxis (PrEP) is a viable HIV prevention strategy but risk compensation could undermine potential benefits. There are limited data that examine this phenomenon outside of clinical trials. We conducted a qualitative analysis of counseling notes from the San Francisco site of the US PrEP demonstration project to assess how men who have sex with men used PrEP as a prevention strategy and its impact on their sexual practices. Four major themes emerged from our analysis of 130 distinct notes associated with 26 participants. Prevention strategy decision-making was dynamic, often influenced by the context and perceived risk of a sexual encounter. Counselors noted that participants used PrEP in conjunction with other health promotion strategies like condoms, asking about HIV status of their sex partners, and seroadaptation. With few exceptions, existing risk reduction strategies were not abandoned upon initiation of PrEP. Risk-taking behavior was 'seasonal' and fluctuations were influenced by various personal, psychosocial, and health-related factors. PrEP also helped relieve anxiety regarding sex and HIV, particularly among serodiscordant partners. Understanding sexual decision-making and how PrEP is incorporated into existing prevention strategies can help inform future PrEP implementation efforts.

  8. Balancing preventive and corrective maintenance in Cernavoda Unit 1 NPP

    International Nuclear Information System (INIS)

    Riedel, M.; Marinescu, S.

    2000-01-01

    The paper presents a short reminder of Romania's Cernavoda NPP entering commercial operation and a brief description of the CANDU-6 project on which Unit 1 is based. The short term objectives of the maintenance management, the status of the existing maintenance programmes as well as future predictable maintenance programmes are outlined together with the Government plan to complete the balance of NPP. (author)

  9. The challenges of preventive diplomacy: The United Nations' post ...

    African Journals Online (AJOL)

    In Africa, however, where international borders are porous and state organs are sometimes not in .... the media, and information dissemination form part of the options available to the United .... National boundaries are blurred by ..... and arrangements for the free flow of information, including the monitoring of regional arms ...

  10. Preventing Terrorist Bombings on United States Subway Systems

    Science.gov (United States)

    2006-09-01

    cleanup, and structural assessment.5 The economic impact of the attack would cost millions in repairs and lost revenue, and public trust would be...houses over a dozen restaurants and other businesses and serves as the “ basement level” for the major high-rise buildings in Philadelphia. An... Arabian Peninsula and Northern Africa, the “profiling appearance” is not a viable solution. As a result, prevention efforts must emphasize the

  11. Ground-Water Flow Model of the Sierra Vista Subwatershed and Sonoran Portions of the Upper San Pedro Basin, Southeastern Arizona, United States, and Northern Sonora, Mexico

    Science.gov (United States)

    Pool, D.R.; Dickinson, Jesse

    2007-01-01

    A numerical ground-water model was developed to simulate seasonal and long-term variations in ground-water flow in the Sierra Vista subwatershed, Arizona, United States, and Sonora, Mexico, portions of the Upper San Pedro Basin. This model includes the simulation of details of the groundwater flow system that were not simulated by previous models, such as ground-water flow in the sedimentary rocks that surround and underlie the alluvial basin deposits, withdrawals for dewatering purposes at the Tombstone mine, discharge to springs in the Huachuca Mountains, thick low-permeability intervals of silt and clay that separate the ground-water flow system into deep-confined and shallow-unconfined systems, ephemeral-channel recharge, and seasonal variations in ground-water discharge by wells and evapotranspiration. Steady-state and transient conditions during 1902-2003 were simulated by using a five-layer numerical ground- water flow model representing multiple hydrogeologic units. Hydraulic properties of model layers, streamflow, and evapotranspiration rates were estimated as part of the calibration process by using observed water levels, vertical hydraulic gradients, streamflow, and estimated evapotranspiration rates as constraints. Simulations approximate observed water-level trends throughout most of the model area and streamflow trends at the Charleston streamflow-gaging station on the San Pedro River. Differences in observed and simulated water levels, streamflow, and evapotranspiration could be reduced through simulation of climate-related variations in recharge rates and recharge from flood-flow infiltration.

  12. Support for disease management, depression, self-care, and clinical indicators among Hispanics with type 2 diabetes in San Diego County, United States of America.

    Science.gov (United States)

    Fortmann, Addie L; Gallo, Linda C; Walker, Chris; Philis-Tsimikas, Athena

    2010-09-01

    This study used a social-ecological framework to examine predictors of depression, diabetes self-management, and clinical indicators of health risk among Hispanics with type 2 diabetes residing in the United States (U.S.)-Mexico border region in San Diego County, California, United States of America. Important links were observed between greater social-environmental support for disease management and less depression, better diabetes self-management, and lower body mass index and serum triglyceride concentrations. Less depressive symptomatology was also related to lower hemoglobin A1c levels. Findings suggest that programs aiming to improve diabetes self-management and health outcomes in Hispanics with type 2 diabetes should consider multilevel, social, and environmental influences on health, behavior, and emotional well-being.

  13. Improving Pediatric Cancer Care Disparities Across the United States–Mexico Border: Lessons Learned from a Transcultural Partnership between San Diego and Tijuana

    Science.gov (United States)

    Aristizabal, Paula; Fuller, Spencer; Rivera, Rebeca; Beyda, David; Ribeiro, Raul C.; Roberts, William

    2015-01-01

    In 2007, the 5-year survival rate for children with acute leukemia in Baja California, Mexico was estimated at 10% (vs. 88% in the United States). In response, stakeholders at St. Jude Children’s Research Hospital, Rady Children’s Hospital San Diego, and the Hospital General de Tijuana (HGT) implemented a transcultural partnership to establish a pediatric oncology program. The aim was to improve clinical outcomes and overall survival for children in Baja California. An initial needs assessment evaluation was performed and a culturally sensitive, comprehensive, 5-year plan was designed and implemented. After six years, healthcare system accomplishments include the establishment of a fully functional pediatric oncology unit with 60 new healthcare providers (vs. five in 2007). Patient outcome improvements include a rise in 5-year survival for leukemia from 10 to 43%, a rise in new cases diagnosed per year from 21 to 70, a reduction in the treatment abandonment rate from 10% to 2%, and a 45% decrease in the infection rate. More than 600 patients have benefited from this program. Knowledge sharing has taken place between teams at the HGT and Rady Children’s Hospital San Diego. Further, one of the most significant outcomes is that the HGT has transitioned into a regional referral center and now mentors other hospitals in Mexico. Our results show that collaborative initiatives that implement long-term partnerships along the United States–Mexico border can effectively build local capacity and reduce the survival gap between children with cancer in the two nations. Long-term collaborative partnerships should be encouraged across other disciplines in medicine to further reduce health disparities across the United States–Mexico border. PMID:26157788

  14. Improving Pediatric Cancer Care Disparities Across the United States-Mexico Border: Lessons Learned from a Transcultural Partnership between San Diego and Tijuana.

    Science.gov (United States)

    Aristizabal, Paula; Fuller, Spencer; Rivera, Rebeca; Beyda, David; Ribeiro, Raul C; Roberts, William

    2015-01-01

    In 2007, the 5-year survival rate for children with acute leukemia in Baja California, Mexico was estimated at 10% (vs. 88% in the United States). In response, stakeholders at St. Jude Children's Research Hospital, Rady Children's Hospital San Diego, and the Hospital General de Tijuana (HGT) implemented a transcultural partnership to establish a pediatric oncology program. The aim was to improve clinical outcomes and overall survival for children in Baja California. An initial needs assessment evaluation was performed and a culturally sensitive, comprehensive, 5-year plan was designed and implemented. After six years, healthcare system accomplishments include the establishment of a fully functional pediatric oncology unit with 60 new healthcare providers (vs. five in 2007). Patient outcome improvements include a rise in 5-year survival for leukemia from 10 to 43%, a rise in new cases diagnosed per year from 21 to 70, a reduction in the treatment abandonment rate from 10% to 2%, and a 45% decrease in the infection rate. More than 600 patients have benefited from this program. Knowledge sharing has taken place between teams at the HGT and Rady Children's Hospital San Diego. Further, one of the most significant outcomes is that the HGT has transitioned into a regional referral center and now mentors other hospitals in Mexico. Our results show that collaborative initiatives that implement long-term partnerships along the United States-Mexico border can effectively build local capacity and reduce the survival gap between children with cancer in the two nations. Long-term collaborative partnerships should be encouraged across other disciplines in medicine to further reduce health disparities across the United States-Mexico border.

  15. Youth United through Health Education: Building Capacity through a Community Collaborative Intervention to Prevent HIV/STD in Adolescents Residing in a High STD Prevalent Neighborhood

    Science.gov (United States)

    Sieverding, John; Boyer, Cherrie B.; Siller, Jacqueline; Gallaread, Alonzo; Krone, Melissa; Chang, Y. Jason

    2005-01-01

    The early detection and treatment of STDs is an effective strategy for slowing the sexual transmission of HIV. The goal of the YUTHE (Youth United Through Health Education) program, a collaborative effort between the San Francisco Department of Public Health (SFDPH) and the University of California, San Francisco, is to increase sexually…

  16. Prevention of nosocomial infections in intensive care unit and nursing practices

    Directory of Open Access Journals (Sweden)

    Sevilay Yüceer

    2009-01-01

    Full Text Available Nosocomial infections which are considered as the primary indicator of the quality of care in hospitals, cause to prolong hospitalization at intensive care unit and hospital, increase morbidity, mortality, and the cost of treatment. Although only 5-10% of the patients are treated in the intensive care units, 20-25% of all nosocomial infections are seen in these units. Preventing nosocomial infections in intensive care units is a process started at the patient acceptance to unit that requires an interdisciplinary team approach of intensive care staffs’ and Infection Control Committee members.Intensive care nurses who are in constant contact with patients have important responsibilities in preventing nosocomial infections. Intensive care nurses should be aware that the nosocomial infections can be prevented. They should have current knowledge about universal precautions related to prevention and control of infections, which are accepted by the entire world and they reinforce this knowledge by practice and should provide the most effective care to patients.In this article, nursing practices for prevention of nosocomial infections in intensive care units are discussed based on universal precautions.

  17. 77 FR 35108 - Gulf, Colorado & San Saba Railway; Emergency Order To Prevent Operation of Trains Over the...

    Science.gov (United States)

    2012-06-12

    ... potentially deadly accident can be prevented. See 49 CFR part 234. U.S. Highway 87 is a busy four-lane highway... approximately 16 school buses currently traverse the crossing daily, Monday through Friday. The track adjacent...

  18. Integrated plant safety assessment: Systematic Evaluation Program, San Onofre Nuclear Generating Station, Unit 1 (Docket No. 50-206): Final report

    International Nuclear Information System (INIS)

    1986-12-01

    The Systematic Evaluation Program was initiated in February 1977 by the US Nuclear Regulatory Commission to review the designs of older operating nuclear reactor plants to reconfirm and document their safety. The review provides: (1) an assessment of how these plants compare with current licensing safety requirements relating to selected issues; (2) a basis for deciding on how these differences should be resolved in an integrated plant review; and (3) a documented evaluation of plant safety. This report documents the review of San Onofre Nuclear Generating Station, Unit 1, operated by Southern California Edison Company. The San Onofre plant is one of ten plants reviewed under Phase II of this program. This report indicates how 137 topics selected for review under Phase I of the program were addressed. Equipment and procedural changes have been identified as a result of the review. This report will be one of the bases in considering the issuance of a full-term operating license in place of the existing provisional operating license. This report also addresses the comments and recommendations made by the Advisory Committee on Reactor Safeguards in connection with its review of the draft report issued in April 1985

  19. Youth-violence prevention in the aftermath of the San Diego East county school shootings: a qualitative assessment of community explanatory models.

    Science.gov (United States)

    Palinkas, Lawrence A; Prussing, Erica; Landsverk, John; Reznik, Vivian

    2003-01-01

    In March, 2001, 2 separate incidents of school shootings occurred within the same school district in San Diego's East County. To examine community explanatory models of the causes of the school shootings and strategies for preventing such events. A qualitative study was undertaken in 4 East County communities over a 6-month period following the 2 events. Semistructured interviews were conducted with 85 community residents identified through maximum variation sampling. Interview transcripts were analyzed by coding consensus, co-occurrence and comparison, using NVivo text analysis software. Four sets of theories as to the cause of these events were identified, based on the following: 1) unique or idiosyncratic characteristics of the 2 shooters (newcomer to community who was a victim of bullying, victim of child abuse with a history of mental illness), 2) universal factors (culture of violence, violence in the media), 3) family-centered characteristics (single-parent households, dysfunctional relationships), and 4) community-specific characteristics (reputation for social intolerance, widespread access to guns). Beliefs in family-centered and community-centered theories of etiology were associated with optimism in preventing such events from occurring in the future through increased recognition and response to problem behaviors, while beliefs in idiosyncratic or universal determinants of youth violence were associated with pessimistic assessments of prevention. In this community, youth-violence-prevention programs that focus on taking responsibility for recognizing and responding to problem behaviors in at-risk youth are more likely to gain community support and participation than programs that focus on increased security, surveillance, or behavior change.

  20. Assessment of goods and valuation of ecosystem services (AGAVES) San Pedro River Basin, United States and Mexico

    Science.gov (United States)

    Semmens, Darius; Kepner, William; Goodrich, David

    2010-01-01

    A consortium of federal, academic, and nongovernment organization (NGO) partners have established a collaborative research enterprise in the San Pedro River Basin to develop methods, standards, and tools to assess and value ecosystem goods and services. The central premise of ecosystem services research is that human condition is intrinsically linked to the environment. Human health and well-being (including economic prosperity) depend on important supporting, regulating, provisioning, and cultural services that we derive from our surrounding ecosystems. The AGAVES project is intended as a demonstration study for incorporating ecosystem services information into resource management policy and decisionmaking. Accordingly, a nested, multiscale project design has been adopted to address a range of stakeholder information requirements. This design will further facilitate an evaluation of how well methods developed in this project can be transferred to other areas.

  1. Congenital rubella syndrome and autism spectrum disorder prevented by rubella vaccination - United States, 2001-2010

    Directory of Open Access Journals (Sweden)

    Omer Saad B

    2011-05-01

    Full Text Available Abstract Background Congenital rubella syndrome (CRS is associated with several negative outcomes, including autism spectrum disorders (ASDs. The objective of this study was to estimate the numbers of CRS and ASD cases prevented by rubella vaccination in the United States from 2001 through 2010. Methods Prevention estimates were calculated through simple mathematical modeling, with values of model parameters determined from published literature. Model parameters included pre-vaccine era CRS incidence, vaccine era CRS incidence, the number of live births per year, and the percentage of CRS cases presenting with an ASD. Results Based on our estimates, 16,600 CRS cases (range: 8300-62,250 were prevented by rubella vaccination from 2001 through 2010 in the United States. An estimated 1228 ASD cases were prevented by rubella vaccination in the United States during this time period. Simulating a slight expansion in ASD diagnostic criteria in recent decades, we estimate that a minimum of 830 ASD cases and a maximum of 6225 ASD cases were prevented. Conclusions We estimate that rubella vaccination prevented substantial numbers of CRS and ASD cases in the United States from 2001 through 2010. These findings provide additional incentive to maintain high measles-mumps-rubella (MMR vaccination coverage.

  2. The Traditional Herbal Medicine, Dangkwisoo-San, Prevents Cerebral Ischemic Injury through Nitric Oxide-Dependent Mechanisms

    Directory of Open Access Journals (Sweden)

    Ji Hyun Kim

    2011-01-01

    Full Text Available Dangkwisoo-San (DS is an herbal extract that is widely used in traditional Korean medicine to treat traumatic ecchymosis and pain by promoting blood circulation and relieving blood stasis. However, the effect of DS in cerebrovascular disease has not been examined experimentally. The protective effects of DS on focal ischemic brain were investigated in a mouse model. DS stimulated nitric oxide (NO production in human brain microvascular endothelial cells (HBMECs. DS (10–300 μg/mL produced a concentration-dependent relaxation in mouse aorta, which was significantly attenuated by the nitric oxide synthase (NOS inhibitor L-NAME, suggesting that DS causes vasodilation via a NO-dependent mechanism. DS increased resting cerebral blood flow (CBF, although it caused mild hypotension. To investigate the effect of DS on the acute cerebral injury, C57/BL6J mice received 90 min of middle cerebral artery occlusion followed by 22.5 h of reperfusion. DS administered 3 days before arterial occlusion significantly reduced cerebral infarct size by 53.7% compared with vehicle treatment. However, DS did not reduce brain infarction in mice treated with the relatively specific endothelial NOS (eNOS inhibitor, N5-(1-iminoethyl-L-ornithine, suggesting that the neuroprotective effect of DS is primarily endothelium-dependent. This correlated with increased phosphorylation of eNOS in the brains of DS-treated mice. DS acutely improves CBF in eNOS-dependent vasodilation and reduces infarct size in focal cerebral ischemia. These data provide causal evidence that DS is cerebroprotective via the eNOS-dependent production of NO, which ameliorates blood circulation.

  3. Long-term decrease in satellite vegetation indices in response to environmental variables in an iconic desert riparian ecosystem: the Upper San Pedro, Arizona, United States

    Science.gov (United States)

    Nguyen, Uyen; Glenn, Edward P.; Nagler, Pamela L.; Scott, Russell L.

    2015-01-01

    The Upper San Pedro River is one of the few remaining undammed rivers that maintain a vibrant riparian ecosystem in the southwest United States. However, its riparian forest is threatened by diminishing groundwater and surface water inputs, due to either changes in watershed characteristics such as changes in riparian and upland vegetation, or human activities such as regional groundwater pumping. We used satellite vegetation indices to quantify the green leaf density of the groundwater-dependent riparian forest from 1984 to 2012. The river was divided into a southern, upstream (mainly perennial flow) reach and a northern, downstream (mainly intermittent and ephemeral flow) reach. Pre-monsoon (June) Landsat normalized difference vegetation index (NDVI) values showed a 20% drop for the northern reach (P  0·05). NDVI and enhanced vegetation index values were positively correlated (P deterioration of the riparian forest in the northern reach.

  4. Status and understanding of groundwater quality in the two southern San Joaquin Valley study units, 2005-2006 - California GAMA Priority Basin Project

    Science.gov (United States)

    Burton, Carmen A.; Shelton, Jennifer L.; Belitz, Kenneth

    2012-01-01

    Groundwater quality in the southern San Joaquin Valley was investigated from October 2005 through March 2006 as part of the Priority Basin Project of the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The GAMA Priority Basin Project is conducted by the U.S. Geological Survey (USGS) in collaboration with the California State Water Resources Control Board and the Lawrence Livermore National Laboratory. There are two study units located in the southern San Joaquin Valley: the Southeast San Joaquin Valley (SESJ) study unit and the Kern County Subbasin (KERN) study unit. The GAMA Priority Basin Project in the SESJ and KERN study units was designed to provide a statistically unbiased, spatially distributed assessment of untreated groundwater quality within the primary aquifers. The status assessment is based on water-quality and ancillary data collected in 2005 and 2006 by the USGS from 130 wells on a spatially distributed grid, and water-quality data from the California Department of Public Health (CDPH) database. Data was collected from an additional 19 wells for the understanding assessment. The aquifer systems (hereinafter referred to as primary aquifers) were defined as that part of the aquifer corresponding to the perforation interval of wells listed in the CDPH database for the SESJ and KERN study units. The status assessment of groundwater quality used data from samples analyzed for anthropogenic constituents such as volatile organic compounds (VOCs) and pesticides, as well as naturally occurring inorganic constituents such as major ions and trace elements. The status assessment is intended to characterize the quality of untreated groundwater resources within the primary aquifers in the SESJ and KERN study units, not the quality of drinking water delivered to consumers. Although the status assessment applies to untreated groundwater, Federal and California regulatory and non-regulatory water-quality benchmarks that apply to drinking water are used

  5. A document analysis of drowning prevention education resources in the United States.

    Science.gov (United States)

    Katchmarchi, Adam Bradley; Taliaferro, Andrea R; Kipfer, Hannah Joy

    2018-03-01

    There have been long-standing calls to better educate the public at large on risks of drowning; yet limited evaluation has taken place on current resources in circulation. The purpose of this qualitative research is to develop an understanding of the content in currently circulated drowning prevention resources in the United States. Data points (n = 451) consisting of specific content within 25 different drowning prevention educational resources were analyzed using document analysis methods; a grounded theory approach was employed to allow for categorical development and indexing of the data. Results revealed six emerging categories, including safety precautions (n = 152), supervision (n = 109), preventing access (n = 57), safety equipment (n = 46), emergency procedures (n = 46), and aquatic education (n = 41). Results provide an initial insight into the composition of drowning prevention resources in the United States and provide a foundation for future research.

  6. Concordance among remission and admission diagnoses at intensive care unit, Hospital Universitario San José, Popayán, 2011

    Directory of Open Access Journals (Sweden)

    Victor Daniel Montenegro

    2012-03-01

    Full Text Available There are few published studies about diagnostic concordance in hospital services. The objective of this study was to calculate the concordance among remission and admission diagnoses from Hospital Universitario San José adult intensive care unit (I.C.U. of Popayán, 2011. Methods: Descriptive and retrospective study about concordance between the main remission and admission diagnoses from patients admitted in the Hospital adult intensive care unit; 914 patients were studied from the intensive care unit database, months January to December 2011. Statistical analysis about sociodemographic variables was performed, and Kappa index according to Landis and Koch scale among remission and admission diagnoses defined as priority was calculated. Results: It was found al almost perfect level of concordance in the diagnoses pancreatitis and intoxication, a substantial level of concordance in the diagnoses acute coronary syndrome, convulsive status, gastric cancer and eclampsia, a moderate level of concordance in the diagnoses stroke, head trauma, politraumatism and cardiac failure, and a fair level of concordance in the diagnoses sepsis, pneumonia, chronic obstructive pulmonary disease (COPD, gastrointestinal bleeding, acute respiratory infection and acute respiratory distress syndrome. Conclusion: Six of the seventeen studied diagnoses presented an outstanding concordance level; this can be related to factors such as: physicians’, diagnostic ability, provenance of the patients remitted to the I.C.U. and diagnostic coding made by health staff.

  7. Suicide Prevention Training: Policies for Health Care Professionals Across the United States as of October 2017.

    Science.gov (United States)

    Graves, Janessa M; Mackelprang, Jessica L; Van Natta, Sara E; Holliday, Carrie

    2018-06-01

    To identify and compare state policies for suicide prevention training among health care professionals across the United States and benchmark state plan updates against national recommendations set by the surgeon general and the National Action Alliance for Suicide Prevention in 2012. We searched state legislation databases to identify policies, which we described and characterized by date of adoption, target audience, and duration and frequency of the training. We used descriptive statistics to summarize state-by-state variation in suicide education policies. In the United States, as of October 9, 2017, 10 (20%) states had passed legislation mandating health care professionals complete suicide prevention training, and 7 (14%) had policies encouraging training. The content and scope of policies varied substantially. Most states (n = 43) had a state suicide prevention plan that had been revised since 2012, but 7 lacked an updated plan. Considerable variation in suicide prevention training for health care professionals exists across the United States. There is a need for consistent polices in suicide prevention training across the nation to better equip health care providers to address the needs of patients who may be at risk for suicide.

  8. 8 CFR 215.2 - Authority of departure-control officer to prevent alien's departure from the United States.

    Science.gov (United States)

    2010-01-01

    ... prevent alien's departure from the United States. 215.2 Section 215.2 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS CONTROLS OF ALIENS DEPARTING FROM THE UNITED STATES § 215.2 Authority of departure-control officer to prevent alien's departure from the United States. (a) No alien...

  9. San Francisco District Laboratory (SAN)

    Data.gov (United States)

    Federal Laboratory Consortium — Program CapabilitiesFood Analysis SAN-DO Laboratory has an expert in elemental analysis who frequently performs field inspections of materials. A recently acquired...

  10. Role of oral care to prevent VAP in mechanically ventilated Intensive Care Unit patients

    Directory of Open Access Journals (Sweden)

    A Gupta

    2016-01-01

    Full Text Available Ventilator associated pneumonia (VAP is the most common nosocomial infection in Intensive Care Unit. One major factor causing VAP is the aspiration of oral colonization because of poor oral care practices. We feel the role of simple measure like oral care is neglected, despite the ample evidence of it being instrumental in preventing VAP.

  11. Role of oral care to prevent VAP in mechanically ventilated Intensive Care Unit patients.

    Science.gov (United States)

    Gupta, A; Gupta, A; Singh, T K; Saxsena, A

    2016-01-01

    Ventilator associated pneumonia (VAP) is the most common nosocomial infection in Intensive Care Unit. One major factor causing VAP is the aspiration of oral colonization because of poor oral care practices. We feel the role of simple measure like oral care is neglected, despite the ample evidence of it being instrumental in preventing VAP.

  12. Role of oral care to prevent VAP in mechanically ventilated Intensive Care Unit patients

    OpenAIRE

    A Gupta; A Gupta; T K Singh; A Saxsena

    2016-01-01

    Ventilator associated pneumonia (VAP) is the most common nosocomial infection in Intensive Care Unit. One major factor causing VAP is the aspiration of oral colonization because of poor oral care practices. We feel the role of simple measure like oral care is neglected, despite the ample evidence of it being instrumental in preventing VAP.

  13. Nosocomial infections in hospitalized patients in the burn unit of Hospital Universitario San José, Popayán - Colombia

    Directory of Open Access Journals (Sweden)

    Yeni Arroyave

    2014-08-01

    Full Text Available Objective. To determine the prevalence and microbiological behavior of the infections in hospitalized patients in the burn unit of the University Hospital San José ( HUSJ at Popayan, Colombia, 2010-2011. Methods: A retrospective cross-sectional study was conducted in patients admitted to the burn unit of HUSJ between the years 2010–2011. Patients were characterized sociodemographic and clinically. The prevalence of nosocomial infections was estimated. Frequency and antibiotic resistance of microorganisms isolated was described. Data were analyzed using SPSS version 15. Results. 113 patients was enrolled, the average age was 17.7 years and male gender predominated (55.8%. Hot liquids (64.6% were the principal cause, the average of body surface area burned was 11.3% and the average hospital stay was 19.8 days. 13.3% of the patients had some nosocomial infection. The most frequently diagnosed infections were sepsis (24%, urinary tract infection (20% and pneumonia (20%. Staphylococcus aureus was the most frequent bacteria (41.7% followed by Staphylococcus epidermidis, mostly meticilino-resistant. The mean length of hospital stay and burned surface area (BSA in patients with diagnosis of infection was 36.6 days and 17.3% respectively. Conclusions. The prevalence of infection is similar to that reported in Colombia. The resistance of the isolates was high. The meticilinoresistance of Staphylococcus was associated with clindamicina resistance.

  14. [Screening for the risk of allergy and prevention in French maternity units: A survey].

    Science.gov (United States)

    Chouraqui, J-P; Simeoni, U; Tohier, C; Nguyen, F; Kempf, C; Beck, L; Lachambre, E

    2015-09-01

    Allergy has been on the rise for half a century and concerns nearly 30% of children; it has now become a real public health problem. The guidelines on prevention of allergy set up by the French Society of Paediatrics (SFP) and the European Society of Paediatric Allergology and Clinical Immunology (ESPACI) are based on screening children at risk through a systematic search of the family history and recommend, for children at risk, exclusive breastfeeding whenever possible or otherwise utilization of hypoallergenic infant formula, which has demonstrated efficacy. The AllerNaiss practice survey assessed the modes of screening and prevention of allergy in French maternity units in 2012. The SFP guidelines are known by 82% of the maternity units that took part in the survey, and the ESPACI guidelines by 55% of them. A screening strategy is in place in 59% of the participating maternity wards, based on local consensus for 36% of them, 13% of the units having a written screening procedure. Screening is based on the search for a history of allergy in first-degree relatives (99%) during pregnancy (51%), in the delivery room (50%), and after delivery (89%). A mode of prevention of the risk of allergy exists in 62% of the maternity units, most often in writing (49%). A hypoallergenic infant formula is prescribed for non-breastfed children in 90% of the units. The survey shows that there is a real need for formalization of allergy risk screening and prevention of allergy in newborns in French maternity units. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  15. Use of tobacco tax stamps to prevent and reduce illicit tobacco trade--United States, 2014.

    Science.gov (United States)

    Chriqui, Jamie; DeLong, Hillary; Gourdet, Camille; Chaloupka, Frank; Edwards, Sarah Matthes; Xu, Xin; Promoff, Gabbi

    2015-05-29

    Tobacco use is the leading cause of preventable disease and death in the United States. Increasing the unit price on tobacco products is the most effective tobacco prevention and control measure. Illicit tobacco trade (illicit trade) undermines high tobacco prices by providing tobacco users with cheaper-priced alternatives. In the United States, illicit trade primarily occurs when cigarettes are bought from states, jurisdictions, and federal reservation land with lower or no excise taxes, and sold in jurisdictions with higher taxes. Applying tax stamps to tobacco products, which provides documentation that taxes have been paid, is an important tool to combat illicit trade. Comprehensive tax stamping policy, which includes using digital, encrypted ("high-tech") stamps, applying stamps to all tobacco products, and working with tribes on stamping agreements, can further prevent and reduce illicit trade. This report describes state laws governing tax stamps on cigarettes, little cigars (cigarette-sized cigars), roll-your-own tobacco (RYOT), and tribal tobacco sales across the United States as of January 1, 2014, and assesses the extent of comprehensive tobacco tax stamping in the United States. Forty-four states (including the District of Columbia [DC]) applied traditional paper ("low-tech") tax stamps to cigarettes, whereas four authorized more effective high-tech stamps. Six states explicitly required stamps on other tobacco products (i.e., tobacco products other than cigarettes), and in approximately one third of states with tribal lands, tribes required tax stamping to address illicit purchases by nonmembers. No U.S. state had a comprehensive approach to tobacco tax stamping. Enhancing tobacco tax stamping across the country might further prevent and reduce illicit trade in the United States.

  16. Food insecurity, chronic illness, and gentrification in the San Francisco Bay Area: An example of structural violence in United States public policy.

    Science.gov (United States)

    Whittle, Henry J; Palar, Kartika; Hufstedler, Lee Lemus; Seligman, Hilary K; Frongillo, Edward A; Weiser, Sheri D

    2015-10-01

    Food insecurity continues to be a major challenge in the United States, affecting 49 million individuals. Quantitative studies show that food insecurity has serious negative health impacts among individuals suffering from chronic illnesses, including people living with HIV/AIDS (PLHIV). Formulating effective interventions and policies to combat these health effects requires an in-depth understanding of the lived experience and structural drivers of food insecurity. Few studies, however, have elucidated these phenomena among people living with chronic illnesses in resource-rich settings, including in the United States. Here we sought to explore the experiences and structural determinants of food insecurity among a group of low-income PLHIV in the San Francisco Bay Area. Thirty-four semi-structured in-depth interviews were conducted with low-income PLHIV receiving food assistance from a local non-profit in San Francisco and Alameda County, California, between April and June 2014. Interview transcripts were coded and analysed according to content analysis methods following an inductive-deductive approach. The lived experience of food insecurity among participants included periods of insufficient quantity of food and resultant hunger, as well as long-term struggles with quality of food that led to concerns about the poor health effects of a cheap diet. Participants also reported procuring food using personally and socially unacceptable strategies, including long-term dependence on friends, family, and charity; stealing food; exchanging sex for food; and selling controlled substances. Food insecurity often arose from the need to pay high rents exacerbated by gentrification while receiving limited disability income--​a situation resulting in large part from the convergence of long-standing urban policies amenable to gentrification and an outdated disability policy that constrains financial viability. The experiences of food insecurity described by participants in this

  17. San Francisco folio, California, Tamalpais, San Francisco, Concord, San Mateo, and Haywards quadrangles

    Science.gov (United States)

    Lawson, Andrew Cowper

    1914-01-01

    The five sheets of the San Francisco folio the Tamalpais, Ban Francisco, Concord, Ban Mateo, and Haywards sheets map a territory lying between latitude 37° 30' and 38° and longitude 122° and 122° 45'. Large parts of four of these sheets cover the waters of the Bay of San Francisco or of the adjacent Pacific Ocean. (See fig. 1.) Within the area mapped are the cities of San Francisco, Oakland, Berkeley, Alameda, Ban Rafael, and San Mateo, and many smaller towns and villages. These cities, which have a population aggregating about 750,000, together form the largest and most important center of commercial and industrial activity on the west coast of the United States. The natural advantages afforded by a great harbor, where the railways from the east meet the ships from all ports of the world, have determined the site of a flourishing cosmopolitan, commercial city on the shores of San Francisco Bay. The bay is encircled by hilly and mountainous country diversified by fertile valley lands and divides the territory mapped into two rather contrasted parts, the western part being again divided by the Golden Gate. It will therefore be convenient to sketch the geographic features under four headings (1) the area east of San Francisco Bay; (2) the San Francisco Peninsula; (3) the Marin Peninsula; (4) San Francisco Bay. (See fig. 2.)

  18. San Marino.

    Science.gov (United States)

    1985-02-01

    San Marino, an independent republic located in north central Italy, in 1983 had a population of 22,206 growing at an annual rate of .9%. The literacy rate is 97% and the infant mortality rate is 9.6/1000. The terrain is mountainous and the climate is moderate. According to local tradition, San Marino was founded by a Christian stonecutter in the 4th century A.D. as a refuge against religious persecution. Its recorded history began in the 9th century, and it has survived assaults on its independence by the papacy, the Malatesta lords of Rimini, Cesare Borgia, Napoleon, and Mussolini. An 1862 treaty with the newly formed Kingdom of Italy has been periodically renewed and amended. The present government is an alliance between the socialists and communists. San Marino has had its own statutes and governmental institutions since the 11th century. Legislative authority at present is vested in a 60-member unicameral parliament. Executive authority is exercised by the 11-member Congress of State, the members of which head the various administrative departments of the goverment. The posts are divided among the parties which form the coalition government. Judicial authority is partly exercised by Italian magistrates in civil and criminal cases. San Marino's policies are tied to Italy's and political organizations and labor unions active in Italy are also active in San Marino. Since World War II, there has been intense rivalry between 2 political coalitions, the Popular Alliance composed of the Christian Democratic Party and the Independent Social Democratic Party, and the Liberty Committee, coalition of the Communist Party and the Socialist Party. San Marino's gross domestic product was $137 million and its per capita income was $6290 in 1980. The principal economic activities are farming and livestock raising, along with some light manufacturing. Foreign transactions are dominated by tourism. The government derives most of its revenue from the sale of postage stamps to

  19. Strategies for the prevention of hospital-acquired infections in the neonatal intensive care unit.

    Science.gov (United States)

    Borghesi, A; Stronati, M

    2008-04-01

    Nosocomial infections are among the leading causes of mortality and morbidity in neonatal intensive care units. Prevention of healthcare-associated infections is based on strategies that aim to limit susceptibility to infections by enhancing host defences, interrupting transmission of organisms by healthcare workers and by promoting the judicious use of antimicrobials. Several strategies are available and include: hand hygiene practices; prevention of central venous catheter-related bloodstream infections; judicious use of antimicrobials for therapy and prophylaxis; enhancement of host defences; skin care; and early enteral feeding with human milk.

  20. Present status of Tomari No.3 unit construction and efforts for preventing global warming

    International Nuclear Information System (INIS)

    Ouchi, Tamotsu; Sakai, Ichiro; Makino, Takeshi

    2009-01-01

    Hokkaido Electric Power Company, Inc. (HEPCO) supplies electricity to almost all area of Hokkaido. Its service area accounts for about one-fifth of Japan's area, on the other hand, the population of the service area only accounts for 4.4% of the nation. This means Hokkaido's nature is precious, and one of HEPCO's missions is to protect such environment, with providing stable electricity. Therefore, nuclear power, which does not emit greenhouse effect gas for generation, is becoming more important. HEPCO's operating nuclear power stations are Tomari No.1 unit and No.2 unit. Their generation capacity is 579 MW respectively. Now, No.3 unit is under construction. Its generation capacity is 912 MW and it will be operational in December 2009. In Hokkaido, about one fourth of electricity is now produced by nuclear power, however, after Tomari No.3 is completed, more than 40% of electricity will be produced by nuclear. So, Tomari No.3 unit will contribute stable supply of electricity in the first half of 21st century and prevent global warming in Hokkaido. This paper describes the present status of Tomari No.3 unit construction with major specifications and our efforts to prevent global warming. (author)

  1. Present status of Tomari No.3 unit construction and efforts for preventing global warming

    International Nuclear Information System (INIS)

    Ouchi, Tamotsu

    2008-01-01

    Hokkaido Electric Power Company, Inc. (HEPCO) supplies electricity to almost all area of Hokkaido. Its service area accounts for about one-fifth of Japan's area, on the other hand, the population of the service area only accounts for 4.4% of the nation. This means Hokkaido's nature is precious, and one of HEPCO's missions is to protect such environment, with providing stable electricity. Therefore, nuclear power, which does not emit greenhouse effect gas for generation, is becoming more important. HEPCO's operating nuclear power stations are Tomari No.1 unit and No.2 unit. Their generation capacity is 579 MW respectively. Now, No.3 unit is under construction. Its generation capacity is 912 MW and it will be operational in December 2009. In Hokkaido, about one fourth of electricity is now produced by nuclear power, however, after Tomari No.3 is completed, about 40% of electricity will be produced by nuclear. So, Tomari No.3 unit will contribute stable supply of electricity in the first half of 21st century and prevent global warming in Hokkaido. This paper describes the present status of Tomari No.3 unit construction with major specifications and our efforts to prevent global warming. (author)

  2. [Antibiotics utilization in the Intensive Care Unit of the Hospital Dr, Guillermo Rawson-San Juan, Argentina].

    Science.gov (United States)

    Vega, Elena María; Fontana, Daniela; Iturrieta, Martha; Segovia, Liliana; Rodríguez, Gabriela; Agüero, Sandra

    2015-06-01

    To achieve rational use of antibiotics (ATB), is necessary to know its use and prescription patterns over time, Objective: To describe and analyze the characteristics of the use of ATB in the Guillermo Rawson Hospital (GRH) adult intensive care unit (ICU). Observational, descriptive, longitudinal and retrospective study (2008-2011). Pharmacy and Statistics records were consulted, ATC code was used, the group analyzed was J01, Oral or parenteral DDD were assigned, Data was processed with Excel 2007, Unit of measure: DDD/100 bed-days, for each ATB per year and an average of use. Over 4 years, 48 different medicines were dispensed (33 drugs), The average consumption of ATB was 177,07 DDD/100 bed-days and distribution per year was: 183,10, 165,90, 180,94, 178,34, The DDD/100 bed-days average for treatment groups more used were: penicillin (57.10), other β-lactam antibacterials (48.01), other antibacterials (21.07), trimethoprim and sulfonamides (19,54), quinolones (15,64), macrolides/azalides and lincosamides (6,53), aminoglycosides (5,65) and tetracyclines (3,53), There were changes in consumption without clear pattern of increase or decrease. ATB used in the ICU and its variation in use between 2008-2011 were described, The ATB most used were penicillins and other β-lactams and 2008 was the year that more ATB was dispensed. Understanding these patterns of consumption will be useful to develop a founded antibiotic policy reached by consensus and beneficial to the patients.

  3. Allocating HIV prevention funds in the United States: recommendations from an optimization model.

    Directory of Open Access Journals (Sweden)

    Arielle Lasry

    Full Text Available The Centers for Disease Control and Prevention (CDC had an annual budget of approximately $327 million to fund health departments and community-based organizations for core HIV testing and prevention programs domestically between 2001 and 2006. Annual HIV incidence has been relatively stable since the year 2000 and was estimated at 48,600 cases in 2006 and 48,100 in 2009. Using estimates on HIV incidence, prevalence, prevention program costs and benefits, and current spending, we created an HIV resource allocation model that can generate a mathematically optimal allocation of the Division of HIV/AIDS Prevention's extramural budget for HIV testing, and counseling and education programs. The model's data inputs and methods were reviewed by subject matter experts internal and external to the CDC via an extensive validation process. The model projects the HIV epidemic for the United States under different allocation strategies under a fixed budget. Our objective is to support national HIV prevention planning efforts and inform the decision-making process for HIV resource allocation. Model results can be summarized into three main recommendations. First, more funds should be allocated to testing and these should further target men who have sex with men and injecting drug users. Second, counseling and education interventions ought to provide a greater focus on HIV positive persons who are aware of their status. And lastly, interventions should target those at high risk for transmitting or acquiring HIV, rather than lower-risk members of the general population. The main conclusions of the HIV resource allocation model have played a role in the introduction of new programs and provide valuable guidance to target resources and improve the impact of HIV prevention efforts in the United States.

  4. Stress-reducing preventive maintenance model for a unit under stressful environment

    International Nuclear Information System (INIS)

    Park, J.H.; Chang, Woojin; Lie, C.H.

    2012-01-01

    We develop a preventive maintenance (PM) model for a unit operated under stressful environment. The PM model in this paper consists of a failure rate model and two cost models to determine the optimal PM scheduling which minimizes a cost rate. The assumption for the proposed model is that stressful environment accelerates the failure of the unit and periodic maintenances reduce stress from outside. The failure rate model handles the maintenance effect of PM using improvement and stress factors. The cost models are categorized into two failure recognition cases: immediate failure recognition and periodic failure detection. The optimal PM scheduling is obtained by considering the trade-off between the related cost and the lifetime of a unit in our model setting. The practical usage of our proposed model is tested through a numerical example.

  5. Prevention of overweight in the school arena

    DEFF Research Database (Denmark)

    Lissau, Inge

    2007-01-01

    studies were performed in Germany and in the United Kingdom. The studies, which had a significant effect on overweight were 'Dance for Health', 'Planet Health', 'San Jose Study', 'Kiel Obesity Prevention Study', 'Healthy Schools' programme, 'El Paso Catch', and 'Medical College of Georgia FitKid Project...

  6. 8 CFR 215.4 - Procedure in case of alien prevented from departing from the United States.

    Science.gov (United States)

    2010-01-01

    ... departing from the United States. 215.4 Section 215.4 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS CONTROLS OF ALIENS DEPARTING FROM THE UNITED STATES § 215.4 Procedure in case of alien prevented from departing from the United States. (a) Any alien, other than an enemy alien, whose departure...

  7. Music intervention to prevent delirium among older patients admitted to a trauma intensive care unit and a trauma orthopaedic unit.

    Science.gov (United States)

    Johnson, Kari; Fleury, Julie; McClain, Darya

    2018-08-01

    Evaluate music listening for delirium prevention among patients admitted to a Trauma Intensive Care and Trauma Orthopaedic Unit. The Roy Adaptation Model provided the theoretical framework focusing on modifying contextual stimuli. Randomised controlled trial, 40 patients aged 55 and older. Participants randomly assigned to receive music listening or usual care for 60 minutes, twice a day, over three days. Pre-recorded self-selected music using an iPod and headsets, with slow tempo, low pitch and simple repetitive rhythms to alter physiologic responses. Heart rate, respiratory rate, systolic and diastolic blood pressure, confusion assessment method. Repeated measures ANOVA, F(4, 134) = 4.75, p = .001, suggested statistically significant differences in heart rate pre/post music listening, and F(1, 37) = 10.44, p = .003 in systolic blood pressure pre/post music listening. Post-hoc analysis reported changes at three time periods of statistical significance; (p = .010), (p = .005) and (p = .039) and a change in systolic blood pressure pre/post music listening; (p = .001) of statistical significance. All participants screened negative for delirium. Music addresses pathophysiologic mechanisms that contribute to delirium; neurotransmitter imbalance, inflammation and acute physiologic stressors. Music to prevent delirium is one of few that provide support in a critical care setting. Copyright © 2018 Elsevier Ltd. All rights reserved.

  8. Pressure ulcers and prevention among acute care hospitals in the United States.

    Science.gov (United States)

    Bergquist-Beringer, Sandra; Dong, Lei; He, Jianghua; Dunton, Nancy

    2013-09-01

    Most pressure ulcers can be prevented with evidence-based practice. Many studies describe the implementation of a pressure ulcer prevention program but few report the effect on outcomes across acute care facilities. Data on hospital-acquired pressure ulcers and prevention from the National Database of Nursing Quality Indicators 2010 Pressure Ulcer Surveys were linked to hospital characteristics and nurse staffing measures within the data set. The sample consisted of 1,419 hospitals from across the United States and 710,626 patients who had been surveyed for pressure ulcers in adult critical care, step-down, medical, surgical, and medical/surgical units. Hierarchical logistic regression analysis was performed to identify study variables associated with hospital-acquired pressure ulcers among patients at risk for these ulcers. The rate of hospital-acquired pressure ulcers was 3.6% across all surveyed patients and 7.9% among those at risk. Patients who received a skin and pressure ulcer risk assessment on admission were less likely to develop a pressure ulcer. Additional study variables associated with lower hospital-acquired pressure ulcer rates included a recent reassessment of pressure ulcer risk, higher Braden Scale scores, a recent skin assessment, routine repositioning, and Magnet or Magnet-applicant designation. Variables associated with a higher likelihood of hospital-acquired pressure ulcers included nutritional support, moisture management, larger hospital size, and academic medical center status. Results provide empirical support for pressure ulcer prevention guideline recommendations on skin assessment, pressure ulcer risk assessment, and routine repositioning, but the 7.9% rate of hospital-acquired pressure ulcers among at-risk patients suggests room for improvement in pressure ulcer prevention practice.

  9. Migraine-preventive prescription patterns by physician specialty in ambulatory care settings in the United States.

    Science.gov (United States)

    Takaki, Hiroko; Onozuka, Daisuke; Hagihara, Akihito

    2018-03-01

    Many adults with migraine who require preventive therapy are often not prescribed the proper medications. The most likely reason is that primary care physicians are unacquainted with preventive medications for migraine. The present study assessed the migraine-preventive prescription patterns in office visits using data from the National Ambulatory Medical Care Survey from 2006 to 2009 in the United States. Patients who were 18 years or older and diagnosed with migraine were included in the analysis. In accordance with the recommendations of the headache guidelines, we included beta-blockers, antidepressants, triptans for short-term prevention of menstrual migraine, and other triptans for acute treatment. Weighted visits of adults with migraine prescribed with preventive medication ranged from 32.8% in 2006 to 38.6% in 2009. Visits to primary care physicians accounted for 72.6% of the analyzed adult migraine visits. Anticonvulsants (odds ratio [OR] 0.29, 95% confidence interval [CI] 0.14-0.57, p  < 0.001) and triptans for menstrual migraine (OR 0.50, 95% CI 0.28-0.91, p  = 0.025) were less frequently prescribed by primary care physicians compared with specialty care physicians, such as neurologists and psychiatrists. There were no significant differences in the prescription patterns of antidepressants and beta-blockers between primary and specialty care physicians. Beta-blockers were prescribed to patients with comorbidity of hypertension, and antidepressants were used by patients with comorbidity of depression. There are differences in the prescription patterns of certain type of preventive medications between primary care physicians and specialty care physicians.

  10. Migraine-preventive prescription patterns by physician specialty in ambulatory care settings in the United States

    Directory of Open Access Journals (Sweden)

    Hiroko Takaki

    2018-03-01

    Full Text Available Many adults with migraine who require preventive therapy are often not prescribed the proper medications. The most likely reason is that primary care physicians are unacquainted with preventive medications for migraine. The present study assessed the migraine-preventive prescription patterns in office visits using data from the National Ambulatory Medical Care Survey from 2006 to 2009 in the United States. Patients who were 18 years or older and diagnosed with migraine were included in the analysis. In accordance with the recommendations of the headache guidelines, we included beta-blockers, antidepressants, triptans for short-term prevention of menstrual migraine, and other triptans for acute treatment. Weighted visits of adults with migraine prescribed with preventive medication ranged from 32.8% in 2006 to 38.6% in 2009. Visits to primary care physicians accounted for 72.6% of the analyzed adult migraine visits. Anticonvulsants (odds ratio [OR] 0.29, 95% confidence interval [CI] 0.14–0.57, p < 0.001 and triptans for menstrual migraine (OR 0.50, 95% CI 0.28–0.91, p = 0.025 were less frequently prescribed by primary care physicians compared with specialty care physicians, such as neurologists and psychiatrists. There were no significant differences in the prescription patterns of antidepressants and beta-blockers between primary and specialty care physicians. Beta-blockers were prescribed to patients with comorbidity of hypertension, and antidepressants were used by patients with comorbidity of depression. There are differences in the prescription patterns of certain type of preventive medications between primary care physicians and specialty care physicians.

  11. [The activity of local health units in agriculture: promotion, prevention, control].

    Science.gov (United States)

    Angotzi, G; Ariano, E; Quercia, A

    2010-01-01

    Agriculture shows an high proportion of injuries, mostly by machineries and instruments, and the highest proportion between fatal and total injuries. The Conference of Regions has adopted the National Agriculture and Forestry Prevention Plan, in application of the "Pact for health and safety in workplaces". The plan gives priority to actions improving the safety of agricultural machines, specially if more frequently involved in serious and fatal injuries. Goal is to achieve an homogenous intervention standard all over in the country, composed by a mix of information, support and control, addressed to farms and agricultural machines traders. Public prevention organizations of Local Health Units moreover will record homogenously the happen modality of fatal and serious accidents, will collaborate in joining prevention objectives with Rural Develop Plans and in drawing up good practices. At another level in some regions have been developed prevention activities for other risk factors: definition of exposition profiles of pesticides, development of professionally exposed workers formation, control of buildings and cattle breeding, medical and epidemiological periodic survey of employees.

  12. Infection control in intensive care units and prevention of ventilator-associated pneumonia.

    Science.gov (United States)

    Bonten, M J; Weinstein, R A

    2000-12-01

    Ventilator-associated pneumonia (VAP) is considered the most frequent infection in the intensive care unit (ICU), although incidence rates depend on the diagnostic methods. Because VAP has been associated with increased mortality and greater costs for medical care, prevention remains an important goal for intensive care medicine. Selective digestive decontamination (SDD), the most frequently studied method of infection prevention, is still controversial despite more than 30 prospective randomized trials and 6 metaanalyses. SDD reduces the incidence of VAP diagnoses, but beneficial effects on duration of ventilation or ICU stay, antibiotic use, and patient survival have not been shown unequivocally. Although recent metaanalyses suggest a 20% to 40% decrease in ICU mortality for SDD used with systemic prophylaxis, this benefit should be confirmed in a large, prospective, randomized study, preferably with a cost-benefit analysis. Selection of pathogens resistant to the antibiotics used in SDD remains the most important drawback of SDD, rendering SDD contraindicated in wards with endemic resistant problems. Other methods of infection prevention that do not create a selective growth advantage for resistant microorganisms may be more useful. Among these are the use of endotracheal tubes with the possibility of continuous aspiration of subglottic secretions, oropharyngeal decontamination with antiseptics, or the semirecumbent treatment position of patients. Although these methods were successful in single studies, more data are needed. Notwithstanding the potential benefits of these interventions, such classic infection control measures as handwashing remain the cornerstone of infection prevention.

  13. Evaluation of the knowledge regarding prevention of cervical cancer among women from a Health Unit

    Directory of Open Access Journals (Sweden)

    Ernandes Gonçalves Dias

    2015-07-01

    Full Text Available Background and objectives: Cervical cancer is a disease with high degree of morbidity and mortality, but has early detection by performing screening test which allows healing. This study aimed to evaluate the knowledge regarding prevention of Cervical Cancer among women in a Basic Health Unit in Minas Gerais. Methods: This is a study descriptive with approach qualitative with 44 women. Was used as the data collection instrument of a semistructured script consisting of subjective questions. Data were collected between March April 2014. Results: The women had age of 40-57 years old, 33 (75% were married, 43(97,73% had children, 20 (45,45% had incomplete primary education, 36 (81,82% were responsible for all financial income of the family and lived with up to the minimum wage. As for the Pap smear, considered important, however showed little clarity as to the meaning of prevention. Performed the test as means of prevention and early diagnosis of Cervical Cancer. Among women who did not perform the preventive the cause was discouragement. Conclusion: We conclude that although the Pap smear be offered for free, there is still women who do not have adequate knowledge about the same and not makes periodically, fitting to health services intensify health education programs to seeking to raise awareness about the importance of regular practice of the Pap smear. Keywords: Cervix Uteri. Uterine Cervical Neoplasms. Health centers.

  14. Status and understanding of groundwater quality in the North San Francisco Bay Shallow Aquifer study unit, 2012; California GAMA Priority Basin Project (ver. 1.1, February 2018)

    Science.gov (United States)

    Bennett, George L.

    2017-07-20

    Groundwater quality in the North San Francisco Bay Shallow Aquifer study unit (NSF-SA) was investigated as part of the Priority Basin Project of the California Groundwater Ambient Monitoring and Assessment (GAMA) Program. The study unit is in Marin, Mendocino, Napa, Solano, and Sonoma Counties and included two physiographic study areas: the Valleys and Plains area and the surrounding Highlands area. The NSF-SA focused on groundwater resources used for domestic drinking water supply, which generally correspond to shallower parts of aquifer systems than that of groundwater resources used for public drinking water supply in the same area. The assessments characterized the quality of untreated groundwater, not the quality of drinking water.This study included three components: (1) a status assessment, which characterized the status of the quality of the groundwater resources used for domestic supply for 2012; (2) an understanding assessment, which evaluated the natural and human factors potentially affecting water quality in those resources; and (3) a comparison between the groundwater resources used for domestic supply and those used for public supply.The status assessment was based on data collected from 71 sites sampled by the U.S. Geological Survey for the GAMA Priority Basin Project in 2012. To provide context, concentrations of constituents measured in groundwater were compared to U.S. Environmental Protection Agency (EPA) and California State Water Resources Control Board Division of Drinking Water regulatory and non-regulatory benchmarks for drinking-water quality. The status assessment used a grid-based method to estimate the proportion of the groundwater resources that has concentrations of water-quality constituents approaching or above benchmark concentrations. This method provides statistically unbiased results at the study-area scale and permits comparisons to other GAMA Priority Basin Project study areas.In the NSF-SA study unit as a whole, inorganic

  15. [Surface disinfection in the context of infection prevention in intensive care units].

    Science.gov (United States)

    Kossow, A; Schaber, S; Kipp, F

    2013-03-01

    The highest proportion of nosocomial infections occurs on intensive care units (ICU) and infections with multiresistant pathogens are an ever increasing problem. Preventative measures should consist of a bundle of different measures including measures that address a specific problem and standard hygiene measures that are relevant in all areas. Specific measures in ICUs primarily aim at the prevention of ventilator associated pneumonia, blood vessel catheter associated infections and nosocomial urinary tract infections. Surface disinfection belongs to the standard hygiene measures and plays an inferior role compared to hand hygiene; however, surfaces come into focus in outbreak situations. The Commission on Hospital Hygiene (KRINKO) at the Robert Koch Institute (the German health protection agency) published recommendations regarding the cleaning and disinfection of surfaces. The frequency with which cleaning and/or disinfection is required varies according to defined areas of risk. The frequency and the disinfection agents used are documented in the disinfection plan.

  16. Effectiveness of Pressure Ulcer Prevention Strategies for Adult Patients in Intensive Care Units: A Systematic Review.

    Science.gov (United States)

    Tayyib, Nahla; Coyer, Fiona

    2016-12-01

    Pressure ulcers are associated with substantial health burden, but could be preventable. Hospital-acquired pressure ulcers (HAPUs) prevention has become a priority for all healthcare settings, as it is considered a sign of quality of care providing. Intensive care unit (ICU) patients are at higher risk for HAPUs development. Despite the availability of published prevention strategies, there is a little evidence about which strategies can be safely integrated into routine standard care and have an impact on HAPUs prevention. The aim was to synthesize the best available evidence regarding the effectiveness of single strategies designed to reduce the incidence and prevalence of HAPUs development in ICUs. The search strategy was designed to retrieve studies published in English across CINAHL, Medline, Cochrane Central Register of Controlled Trials, Embase, Scopus, and Mednar between 2000 and 2015. All adult ICU participants were aged 18 years or over. This review included randomized controlled trials, quasi-experimental and comparative studies. The studies that were selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical-appraisal instruments. The review included 25 studies, and the meta-analysis revealed a statistically significant effect of a silicon foam dressing strategy in reducing HAPUs incidence (effect size = 4.62; 95% CI: 0.05-0.29; p prevention of HAPUs development in the ICU was limited, which precludes strong conclusions. The review provides an evidence-based guide to future priorities for clinical practice. In particular, a silicone foam dressing has positive impact in reducing sacrum and heel HAPUs incidence in the ICU. © 2016 Sigma Theta Tau International.

  17. Safety evaluation report related to the full-term operating license for San Onofre Nuclear Generating Station, Unit 1 (Docket No. 50-206)

    International Nuclear Information System (INIS)

    1991-07-01

    The safety evaluation report for the full-term operating license application filed by the Southern California Edison Company and the San Diego Gas and Electric Company has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is located in San Diego County, California. The staff has evaluated the issues related to the conversion of the provisional operating license to a full-term operating license and concluded that the facility can continue to be operated without endangering the health and safety of the public following the license conversion. 43 refs., 3 figs., 3 tabs

  18. April 1906 San Francisco, USA Images

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The 1906 San Francisco earthquake was the largest event (magnitude 8.3) to occur in the conterminous United States in the 20th Century. Recent estimates indicate...

  19. Technical evaluation of the susceptibility of safety-related systems to flooding caused by the failure of non-category 1 systems for the San Onofre Nuclear Power Plant, Unit 1

    International Nuclear Information System (INIS)

    Latorre, V.R.; Victor, R.A.

    1980-11-01

    This report documents the technical evaluation of Southern California Edison Company's San Onofre Nuclear Power Plant, Unit 1, to determine whether the failure of any non-Category 1 (seismic) equipment could result in a condition, such as flooding, that might potentially adversely affect the performance of safety-related equipment required for the safe shutdown of the facility or to mitigate the consequences of an accident. Criteria developed by the US Nuclear Regulatory Commission were used to evaluate the acceptability of the existing protection as well as measures taken by Southern California Edison Company to minimize the danger of flooding and to protect safety-related equipment

  20. Prevention of Ventilator-Associated Pneumonia in the Intensive Care Unit: Beyond the Basics.

    Science.gov (United States)

    Larrow, Vickie; Klich-Heartt, Eira I

    2016-06-01

    Ventilated-associated pneumonia (VAP) is a major concern for hospitals and a major problem for ventilated patients in the intensive care unit. Included in the basics are hand hygiene, wearing gloves, endotracheal tube suctioning, head of bed at 30°, stress ulcer prophylaxis, turning patient side to side at least every two hours, and giving the patient a sedation vacation each morning. Beyond the basics included here are oral hygiene, oral suctioning, endotracheal tube cuff pressure, artificial humidification, the difference in practice between registered nurses and respiratory therapists, using the beach chair position and early mobilization, and the VAP bundle. The prevention of VAP becomes the focus for both nurses and respiratory therapists working with patients who are ventilated.

  1. Noise exposure and hearing loss prevention programmes after 20 years of regulations in the United States.

    Science.gov (United States)

    Daniell, W E; Swan, S S; McDaniel, M M; Camp, J E; Cohen, M A; Stebbins, J G

    2006-05-01

    To evaluate noise exposures and hearing loss prevention efforts in industries with relatively high rates of workers' compensation claims for hearing loss. Washington State workers' compensation records were used to identify up to 10 companies in each of eight industries. Each company (n = 76) was evaluated by a management interview, employee personal noise dosimetry (n = 983), and employee interviews (n = 1557). Full-shift average exposures were > or =85 dBA for 50% of monitored employees, using Occupational Safety and Health Administration (OSHA) parameters with a 5 dB exchange rate (L(ave)), but 74% were > or =85 dBA using a 3 dB exchange rate (L(eq)). Only 14% had L(ave) > or =90 dBA, but 42% had L(eq) > or =90 dBA. Most companies conducted noise measurements, but most kept no records, and consideration of noise controls was low in all industries. Hearing loss prevention programmes were commonly incomplete. Management interview scores (higher score = more complete programme) showed significant associations with percentage of employees having L(ave) > or =85 dBA and presence of a union (multiple linear regression; R2 = 0.24). Overall, 62% of interviewed employees reported always using hearing protection when exposed. Protector use showed significant associations with percentage of employees specifically required to use protection, management score, and average employee time spent > or =95 dBA (R2 = 0.65). The findings raise serious concerns about the adequacy of prevention, regulation, and enforcement strategies in the United States. The percentage of workers with excessive exposure was 1.5-3 times higher using a 3 dB exchange rate instead of the OSHA specified 5 dB exchange rate. Most companies gave limited or no attention to noise controls and relied primarily on hearing protection to prevent hearing loss; yet 38% of employees did not use protectors routinely. Protector use was highest when hearing loss prevention programmes were most complete, indicating that

  2. Modeling The Economic Burden Of Adult Vaccine-Preventable Diseases In The United States.

    Science.gov (United States)

    Ozawa, Sachiko; Portnoy, Allison; Getaneh, Hiwote; Clark, Samantha; Knoll, Maria; Bishai, David; Yang, H Keri; Patwardhan, Pallavi D

    2016-11-01

    Vaccines save thousands of lives in the United States every year, but many adults remain unvaccinated. Low rates of vaccine uptake lead to costs to individuals and society in terms of deaths and disabilities, which are avoidable, and they create economic losses from doctor visits, hospitalizations, and lost income. To identify the magnitude of this problem, we calculated the current economic burden that is attributable to vaccine-preventable diseases among US adults. We estimated the total remaining economic burden at approximately $9 billion (plausibility range: $4.7-$15.2 billion) in a single year, 2015, from vaccine-preventable diseases related to ten vaccines recommended for adults ages nineteen and older. Unvaccinated individuals are responsible for almost 80 percent, or $7.1 billion, of the financial burden. These results not only indicate the potential economic benefit of increasing adult immunization uptake but also highlight the value of vaccines. Policies should focus on minimizing the negative externalities or spillover effects from the choice not to be vaccinated, while preserving patient autonomy. Project HOPE—The People-to-People Health Foundation, Inc.

  3. Glutamine Supplemented Parenteral Nutrition to Prevent Ventilator-Associated Pneumonia in the Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Meltem Türkay Aydoğmuş

    2012-12-01

    Full Text Available Objective: Ventilator-associated pneumonia (VAP is a form of nosocomial pneumonia that increases patient morbidity and mortality, length of hospital stay, and healthcare costs. Glutamine preserves the intestinal mucosal structure, increases immune function, and reduces harmful changes in gut permeability in patients receiving total parenteral nutrition (TPN. We hypothesized that TPN supplemented by glutamine might prevent the development of VAP in patients on mechanical ventilator support in the intensive care unit (ICU. Material and Methods: With the approval of the ethics committee and informed consent from relatives, 60 patients who were followed in the ICU with mechanical ventilator support were included in our study. Patients were divided into three groups. The first group received enteral nutrition (n=20, and the second was prescribed TPN (n=20 while the third group was given glutamine-supplemented TPN (n=20. C-reactive protein (CRP, sedimentation rate, body temperature, development of purulent secretions, increase in the amount of secretions, changes in the characteristics of secretions and an increase in requirement of deep tracheal aspiration were monitored for seven days by daily examination and radiographs. Results: No statistically significant difference was found among groups in terms of development of VAP (p=0.622. Conclusion: Although VAP developed at a lower rate in the glutamine-supplemented TPN group, no statistically significant difference was found among any of the groups. Glutamine-supplemented TPN may have no superiority over unsupplemented enteral and TPN in preventing VAP.

  4. Glutamine supplemented parenteral nutrition to prevent ventilator-associated pneumonia in the intensive care unit.

    Science.gov (United States)

    Aydoğmuş, Meltem Türkay; Tomak, Yakup; Tekin, Murat; Katı, Ismail; Hüseyinoğlu, Urfettin

    2012-12-01

    Ventilator-associated pneumonia (VAP) is a form of nosocomial pneumonia that increases patient morbidity and mortality, length of hospital stay, and healthcare costs. Glutamine preserves the intestinal mucosal structure, increases immune function, and reduces harmful changes in gut permeability in patients receiving total parenteral nutrition (TPN). We hypothesized that TPN supplemented by glutamine might prevent the development of VAP in patients on mechanical ventilator support in the intensive care unit (ICU). With the approval of the ethics committee and informed consent from relatives, 60 patients who were followed in the ICU with mechanical ventilator support were included in our study. Patients were divided into three groups. The first group received enteral nutrition (n=20), and the second was prescribed TPN (n=20) while the third group was given glutamine-supplemented TPN (n=20). C-reactive protein (CRP), sedimentation rate, body temperature, development of purulent secretions, increase in the amount of secretions, changes in the characteristics of secretions and an increase in requirement of deep tracheal aspiration were monitored for seven days by daily examination and radiographs. No statistically significant difference was found among groups in terms of development of VAP (p=0.622). Although VAP developed at a lower rate in the glutamine-supplemented TPN group, no statistically significant difference was found among any of the groups. Glutamine-supplemented TPN may have no superiority over unsupplemented enteral and TPN in preventing VAP.

  5. Thalassemia in the United Arab Emirates: Why it can be prevented but not eradicated.

    Directory of Open Access Journals (Sweden)

    Sehjeong Kim

    Full Text Available Thalassemia is a genetic blood disorder that causes abnormal hemoglobin. Hemoglobin is a protein in red blood cells that carries oxygen and is made of two proteins from four α-globin genes and two β-globin genes. A defect in one or more of these genes causes thalassemia. The treatment of thalassemia mostly depends on life-long blood transfusions and removal of excessive iron from the blood stream. Such tremendous blood consumption puts pressure on the national blood stock in many countries. In particular, in the United Arab Emirates (UAE, various forms of thalassemia prevention have been used and hence, the substantial reduction of the thalassemia major population has been achieved. However, the thalassemia carrier population still remains high, which leads to the potential increase in the thalassemia major population through carrier-carrier marriages. In this work, we investigate the long-term impact and efficacy of thalassemia prevention measures via mathematical modeling at a population level. To our best knowledge, this type of assessment has not been done before and there is no mathematical model that has investigated such a problem for thalassemia or any blood disorders at a population level. By using UAE data, we perform numerical simulations of our model and conduct sensitivity analysis of parameter values to see which parameter values affect most the dynamics of our model. We discover that the prevention measures can contribute to reduce the prevalence of the disease only in the short term but not eradicate the disease in the long term.

  6. The effects of a tailored intensive care unit delirium prevention protocol: A randomized controlled trial.

    Science.gov (United States)

    Moon, Kyoung-Ja; Lee, Sun-Mi

    2015-09-01

    A decreased incidence of delirium following the application of non-pharmacologic intervention protocols to several patient populations has been previously reported. However, few studies have been conducted to examine the effects of their application to intensive care unit (ICU) patients. To examine the effects of applying a tailored delirium preventive protocol, developed by the authors, to ICU patients by analyzing its effects on delirium incidence, in-hospital mortality, ICU readmission, and length of ICU stay in a Korean hospital. A single-blind randomized controlled trial. A 1049-bed general hospital with a 105-bed ICU. Sixty and 63 ICU patients were randomly assigned to the intervention and control groups, respectively. The researchers applied the delirium prevention protocol to the intervention group every day for the first 7 days of ICU hospitalization. Delirium incidence, mortality, and re-admission to the ICU during the same hospitalization period were analyzed by logistic regression analysis; the 7- and 30-day in-hospital mortality by Kaplan-Meier survival and Cox proportional hazard regression analysis; and length of ICU stay was assessed by linear regression analysis. Application of the protocol had no significant effect on delirium incidence, in-hospital mortality, re-admission to the ICU, or length of ICU stay. Whereas the risk of 30-day in-hospital mortality was not significantly lower in the intervention than in the control group (OR: 0.33; 95% CI: 0.10-1.09), we found a significantly decreased 7-day in-hospital mortality in the intervention group after protocol application (HR: 0.09; 95% CI: 0.01-0.72). Application of a tailored delirium prevention protocol to acute stage patients during the first 7 days of ICU hospitalization appeared to reduce the 7-day in-hospital risk of mortality only for this patient population. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Impact of a bundle on prevention and control of healthcare associated infections in intensive care unit.

    Science.gov (United States)

    Gao, Fang; Wu, Yan-yan; Zou, Jun-ning; Zhu, Ming; Zhang, Jie; Huang, Hai-yan; Xiong, Li-juan

    2015-04-01

    Inpatients in the intensive care unit (ICU) are at high risk for healthcare-associated infections (HAIs). In the current study, a bundle of interventions and measures for preventing and controlling HAIs were developed and implemented in the ICU by trained personnel, and the impact of the bundle was evaluated. The incidence of HAIs, the adjusted daily incidence of HAIs and the incidence of three types of catheter-related infections before and after the bundle implementation were compared. The execution rate of the bundle for preventing and controlling ventilator-associated pneumonia (VAP) was increased from 82.06% in 2012 to 96.88% in 2013. The execution rate was increased from 83.03% in 2012 to 91.33% in 2013 for central line-associated bloodstream infection (CLABSI), from 87.00% to 94.40% for catheter-associated urinary tract infection (CAUTI), and from 82.05% to 98.55% for multidrug-resistant organisms (MDROs), respectively. In total, 136 cases (10.37%) in 2012 and 113 cases (7.72%) in 2013 involved HAIs, respectively. Patients suffered from infection of the lower respiratory tract, the most common site of HAIs, in 134 cases (79.29%) in 2012 and 107 cases (74.30%) in 2013 respectively. The incidence of VAP was 32.72‰ and 24.60‰, the number of strains of pathogens isolated was 198 and 173, and the number of MDROs detected in the ICU was 91 and 74 in 2012 and 2013, respectively. The percentage of MDROs among the pathogens causing HAIs was decreased in each quarter of 2013 as compared with the corresponding percentage in 2012. In 2013, the execution rate of the bundle for preventing and controlling HAIs was increased, whereas the incidence of HAIs and VAP decreased as compared with that in 2012.

  8. Compliance with the standards for prevention of ventilator-associated pneumonia by nurses in the intensive care units

    Directory of Open Access Journals (Sweden)

    Saiede Masomeh Tabaeian

    2017-01-01

    Full Text Available Introduction: Ventilator-associated pneumonia (VAP is the most common infection in the intensive care unit, and has many side effects such as increased mortality, increased length of hospital stay, and increased health costs. This study aimed to evaluate the compliance with the standards for prevention of VAP by nurses in the intensive care units. Materials and Methods: In this descriptive cross-sectional study, 120 nurses in 11 intensive care units of hospitals affiliated to Isfahan university of Medical Sciences, Iran, were assessed for 4 months from July to October 2014. The implementation of all measures for the prevention of VAP was investigated through observation and using a checklist. Results: The mean compliance with the standards for the prevention of VAP in the intensive care unit by the nurses was 56.32%; analysis of variance test showed significant difference between the hospitals (P < 0.001. Disposable ventilator circuit was performed for all patients; however, reviewing the patient readiness for separation from the ventilator was not conducted on a daily basis. Conclusions: Compliance with the standards for the prevention of VAP in the intensive care units was relatively acceptable; however, it still requires serious attention by the officials with training and sensitization of nurses in implementing preventive measures, especially through the provision of clinical guidelines and related protocols.

  9. Delivery Unit Costs for Antiretroviral Treatment and Prevention of Mother-to-Child-Transmission of HIV

    Science.gov (United States)

    Galárraga, Omar; Wirtz, Veronika J.; Figueroa-Lara, Alejandro; Santa-Ana-Tellez, Yared; Coulibaly, Ibrahima; Viisainen, Kirsi; Medina-Lara, Antonieta; Korenromp, Eline L.

    2013-01-01

    Background As antiretroviral treatment (ART) for HIV/AIDS is scaled-up globally, information on per-person costs is critical to improve efficiency in service delivery and maximize coverage and health impact. Objective To review studies on delivery unit costs for adult and pediatric ART provision per-patient-year, and prevention of mother-to-child transmission (PMTCT) interventions per mother-infant pair screened or treated, in low- and middle-income countries. Methods Systematic review of English, French and Spanish publications from 2001 to 2009, reporting empirical costing that accounted for at least antiretroviral (ARV) medicines, laboratory testing and personnel. Expenditures were analyzed by country income level and cost component. All costs were standardized to 2009 US dollars. Results Analyses covered 29 eligible, comprehensive costing studies. In the base case, in low-income countries (LIC), median, ART cost per patient-year was $792 (mean: $839, range: $682-$1089); for lower-middle-income countries (LMIC), the median was $932 (mean: $1246, range: $156-$3904); and for upper-middle-income countries (UMIC) the median was $1454 (mean: $2783, range: $1230-$5667). ARV drugs were largest component of overall ART cost in all settings (62%, 50% and 47% in LIC, LMIC and UMIC respectively). Out of 26 ART studies, 14 report which drug regimes were used, and only one study explicitly reported second line treatment costs. The second cost driver was laboratory cost in LIC and LMIC (14% and 19.5%) whereas it was personnel costs in UMIC (26%). Two studies specified the types of laboratory tests costed, and three studies specifically included above-facility-level personnel costs. Three studies reported detailed PMTCT costs, and two studies reported on pediatric ART. Conclusions There is a paucity of data on the full ART and PMTCT delivery unit costs, in particular for low-and middle-income countries. Heterogeneity in activities costed and insufficient detail regarding

  10. PENERAPAN MODEL PREVENTIVE MAINTENANCE SMITH DAN DEKKER DI PD. INDUSTRI UNIT INKABA

    Directory of Open Access Journals (Sweden)

    Hari Adianto

    2005-01-01

    Full Text Available The globalization era along with fast development of technology%2C industries must try to increase the quantity and quality of products that they have produced. The development of industrial products which have been increase continually need support from fluency of production process. In this case the industrial companies want a high availability system. PD Industri Unit Inkaba is one of the companies that moves in sector rubber technique industry. The company wants the production process go smoothly so that the company can keeps the existence and increases the product’s quality with cost efficiency and can competes with foreign markets. The smoothness of production process needs support from machines or production’s tools that have good condition. To keep the machines in good condition so that they will in the optimal condition when used%2C then the machines need to be maintained. M.A.J. Smith dan R. Dekker develop a model that combine availability model and preventive maintenance and consider the expected uptime and downtime of the system. This model is a 1 out of n system model%2C which has one operating machine and support by (n – 1 unit machine reserves. A 1 out of n system is also applicable to replaceable components. Smith and Dekker’s model gives the expected uptime and downtime of the system approximation that can gives good approximation of long term average operating cost. The results from decision of component preventive replacement age and optimal number of component reserve are expected to be able to keep the reliability system and be able to avoid the decease of availability system because of maintenance activity. Abstract in Bahasa Indonesia : Dalam era persaingan industri yang semakin global disertai perkembangan teknologi yang pesat%2C industri-industri terus berusaha meningkatkan kuantitas dan kualitas produk yang dihasilkannya. Perkembangan hasil industri yang semakin meningkat secara terus-menerus memerlukan dukungan

  11. Vascular access and infection prevention and control: a national survey of routine practices in Irish haemodialysis units.

    Science.gov (United States)

    McCann, Margaret; Clarke, Michael; Mellotte, George; Plant, Liam; Fitzpatrick, Fidelma

    2013-04-01

    National and international guidelines recommend the use of effective vascular access (VA) and infection prevention and control practices within the haemodialysis environment. Establishing an arterio-venous fistula (AVF) and preventing central venous catheter (CVC)-related infections are ongoing challenges for all dialysis settings. We surveyed VA and routine infection prevention and control practices in dialysis units, to provide national data on these practices in Ireland. A descriptive survey was emailed to nurse managers at all adult (n = 19) and children (n = 1) outpatient haemodialysis units in the Republic of Ireland. Data collected included AVF formation, CVC insertion and maintenance practices, VA use and surveillance of infection and screening protocols. Nineteen of the 20 units responded to the survey. The AVF prevalence was 49% for 1370 patients in 17 units who provided these data [mean prevalence per unit: 45.7% (SD 16.2)]; the CVC mean prevalence per unit was 52.5% (SD 16.0). Fourteen dialysis units experienced inadequate access to vascular surgical procedures either due to a lack of dedicated theatre time or hospital beds. Six units administered intravenous prophylactic antimicrobials prior to CVC insertion with only two units using a CVC insertion checklist at the time of catheter insertion. In general, dialysis units in Ireland show a strong adherence to national guidelines. Compared with the 12 countries participating in the Dialysis Outcomes Practice Patterns Study (DOPPS 4), in 2010, AVF prevalence in Irish dialysis units is the second lowest. Recommendations include establishing an AVF national prevalence target rate, discontinuing the administration of intravenous prophylactic antimicrobials prior to CVC insertion and promoting the use of CVC insertion checklists.

  12. San Onofre/Zion auxiliary feedwater system seismic fault tree modeling

    International Nuclear Information System (INIS)

    Najafi, B.; Eide, S.

    1982-02-01

    As part of the study for the seismic evaluation of the San Onofre Unit 1 Auxiliary Feedwater System (AFWS), a fault tree model was developed capable of handling the effect of structural failure of the plant (in the event of an earthquake) on the availability of the AFWS. A compatible fault tree model was developed for the Zion Unit 1 AFWS in order to compare the results of the two systems. It was concluded that if a single failure of the San Onofre Unit 1 AFWS is to be prevented, some weight existing, locally operated locked open manual valves have to be used for isolation of a rupture in specific parts of the AFWS pipings

  13. Drug education in bolivian schools: A feasibility study for cross-cultural application of a preventive curricular unit

    Science.gov (United States)

    Gonzalez, Gerardo M.; Moreno, Veronica Kaune

    1995-11-01

    The purpose of this study was to test the feasibility of adapting and implementing in La Paz, Bolivia a drug education course originally developed for use in the middle schools in the United States. On the basis of teacher and student evaluations, it was concluded that the unit is a viable, culturally relevant and effective method of drug education in the public and private schools in La Paz. Implications for the prevention of other health-related problems and for implementation of a demandreduction strategy to prevent drug abuse throughout the Americas are discussed.

  14. Operating room fire prevention: creating an electrosurgical unit fire safety device.

    Science.gov (United States)

    Culp, William C; Kimbrough, Bradly A; Luna, Sarah; Maguddayao, Aris J

    2014-08-01

    To reduce the incidence of surgical fires. Operating room fires represent a potentially life-threatening hazard and are triggered by the electrosurgical unit (ESU) pencil. Carbon dioxide is a fire suppressant and is a routinely used medical gas. We hypothesize that a shroud of protective carbon dioxide covering the tip of the ESU pencil displaces oxygen, thereby preventing fire ignition. Using 3-dimensional modeling techniques, a polymer sleeve was created and attached to an ESU pencil. This sleeve was connected to a carbon dioxide source and directed the gas through multiple precisely angled ports, generating a cone of fire-suppressive carbon dioxide surrounding the active pencil tip. This device was evaluated in a flammability test chamber containing 21%, 50%, and 100% oxygen with sustained ESU activation. The sleeve was tested with and without carbon dioxide (control) until a fuel was ignited or 30 seconds elapsed. Time to ignition was measured by high-speed videography. Fires were ignited with each control trial (15/15 trials). The control group median ± SD ignition time in 21% oxygen was 3.0 ± 2.4 seconds, in 50% oxygen was 0.1 ± 1.8 seconds, and in 100% oxygen was 0.03 ± 0.1 seconds. No fire was observed when the fire safety device was used in all concentrations of oxygen (0/15 trials; P fire ignition was 76% to 100%. A sleeve creating a cone of protective carbon dioxide gas enshrouding the sparks from an ESU pencil effectively prevents fire in a high-flammability model. Clinical application of this device may reduce the incidence of operating room fires.

  15. REFLECTIONS ON BEHAVIORAL CRISES PREVENTION AND INTERVENTION IN SPECIAL EDUCATION SCHOOLS IN THE UNITED STATES

    Directory of Open Access Journals (Sweden)

    Roland PAULAUSKAS

    2011-04-01

    Full Text Available The development of civilization made crises an inseparable part of our lives. Crises manifest themselves in almost all social areas and organizations, including educational institutions. The goals of the article are to present a theoretical model of normal, deviant and antisocial behaviors, and discuss the psycho-social characteristics of emotionally disturbed adolescents situated in a residential special education school in the United States. The article also gives an analysis of their most prevalent behavioral crises, escalation stages, as well as nonviolent crisis prevention and intervention strategies. The methods that were used include scientific literature review, analysis of statistical information supplied from different government sources, review and analysis of student records, as well as the author’s analytical reflections in working with emotionally disturbed youngsters in residential special education schools in the United States.The results of the study indicate that scientists from different fields use different terminology to describe socially nonconforming behaviors. The author presents a theoretical model of normal, deviant and antisocial behavior that could enhance better understanding and identification of high risk situations and conduct leading to serious crises. The analysis of student records revealed that most of the adolescents situated in special education residential schools are diagnosed with a number of mental health problems. This suggests that the currently prevailing care and education paradigm in the special education residential schools should shift to a more comprehensive treatment paradigm. The article also discusses the pros and cons of nonviolent crisis intervention. It is the author’s opinion that all special education schools serving children with emotional disorders should adopt one of the nonviolent crisis intervention models and develop and implement crisis management policies, plans and procedures.

  16. Motivators and barriers for dog and cat owners and veterinary surgeons in the United Kingdom to using preventative medicines.

    Science.gov (United States)

    Belshaw, Zoe; Robinson, Natalie J; Dean, Rachel S; Brennan, Marnie L

    2018-06-01

    Routine use of preventative medicines is advocated as part of responsible dog and cat ownership. However, it has been suggested that the number of owners in the United Kingdom (UK) using preventative medicines to protect their pets is in decline. The aim of this novel study was to use a qualitative methodology to explore the attitudes of pet owners and veterinary surgeons in the UK to using preventative medicine products in dogs and cats. Preventative medicine was defined as "a drug or any other preparation used to prevent disease, illness or injury." Semi-structured interviews were conducted by telephone with owners and veterinary surgeons who had recently participated in a preventative healthcare consultation. Thematic analysis of transcribed recordings of these interviews identified four themes. This paper reports the theme related to motivators and barriers to using preventative medicines. Owners' understanding varied widely about the importance of preventative medicines for pets, as did their confidence in the safety of prescription products. A good relationship with their veterinary surgeon or practice, seeing adverts on the television about specific diseases, advice from a breeder and having personally seen infected animals appeared to be motivators for owners to use preventative medicines. Concern about adverse events and uncertainty about the necessity of using preventative medicines were barriers. Owners who trusted their veterinary surgeons to advise them on preventative medicine products described little use of alternative information sources when making preventative medicine choices. However, owners who preferred to do their own research described reading online opinions, particular in relation to the safety of preventative medicines, which they found confusing. In contrast, veterinary surgeons described broad confidence in the safety and efficacy of prescription preventative medicines and described protection of pet health as a strong motivator for

  17. Cervical cancer prevention: new guidelines in the United States and new opportunities for low- and middle-income countries.

    Science.gov (United States)

    Waxman, Alan G

    2013-06-01

    Developments from late 2011 to early 2013, including consensus conferences and the introduction of low-cost, rapid-turnaround testing of human papillomavirus, will change prevention strategies for cervical cancer in the United States and in low- and middle-income countries. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Qualitative exploration of practices to prevent medication errors in neonatal intensive care units

    DEFF Research Database (Denmark)

    Rishoej, Rikke Mie; Lai Nielsen, Henriette; Strzelec, Stina Maria

    2018-01-01

    to prevent MEs involved technology, procedures, education, skills and hospital pharmacy services. Potential future practices to prevent MEs included customizing the computerized physician order entry systems to support optimal prescribing, standardizing the double-check process, training of calculation...

  19. The Centers for Disease Control program to prevent primary and secondary disabilities in the United States.

    OpenAIRE

    Houk, V N; Thacker, S B

    1989-01-01

    The Disabilities Prevention Program builds on traditional Centers for Disease Control (CDC) strengths in public health surveillance, epidemiology, and technology transfer to State and local governments in translating the findings of research into prevention programs. The objectives of the CDC program are to provide a national focus for the prevention of primary and secondary disabilities, build capacity at the State and community levels to maintain programs to prevent disabilities, and increa...

  20. Interest in multipurpose prevention technologies to prevent HIV/STIs and unintended pregnancy among young women in the United States.

    Science.gov (United States)

    Hynes, Jenna S; Sales, Jessica M; Sheth, Anandi N; Lathrop, Eva; Haddad, Lisa B

    2018-03-01

    High rates of sexually transmitted infections (STIs) and unintended pregnancy suggest a role for multipurpose prevention technologies (MPTs) designed to combine contraception and infection prophylaxis into one unified method. This study aims to determine factors associated with interest in MPTs among US women. We administered a national cross-sectional survey via MTurk. Eligibility criteria included female gender, age 18-29 years, residence in the USA, and sexual activity with a male partner in the past three months. In total, 835 surveys were suitable for analysis. Bivariable and multivariable logistic regressions were performed to determine factors associated with interest in MPTs. Eighty-three percent of women were interested in MPTs. Factors associated with interest included oral sex in the past three months (aOR 1.87, 95% CI 1.07, 3.53), recent use of oral contraceptive pills (OCPs; aOR 1.78, 95% CI 1.08, 2.93), HIV test within one year (aOR 2.10, 95% CI 1.29, 3.40), and increased STI worry score (aOR 1.98, 95% CI 1.36, 2.86). No use of contraception in the past three months was associated with decreased interest in MPTs (aOR 0.31, 95% CI 0.17, 0.58). HIV risk factors including race were not associated with MPT interest. Our data show that young, sexually active, US women are interested in MPTs. Women who used contraception, specifically OCPs, or evidenced concern for infection were most likely to be interested in such a product. Women reporting unsafe sexual habits were less likely to be interested, highlighting the importance of HIV/STI prevention education. Women in the USA are interested in multipurpose prevention technologies, particularly those women who currently use contraception or are concerned about their risk of infection. Our results emphasize the importance of moving forward with MPT development as well as continued HIV/STI prevention education. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Pneumonia in the surgical intensive care unit: is every one preventable?

    Science.gov (United States)

    Wahl, Wendy L; Zalewski, Christy; Hemmila, Mark R

    2011-10-01

    Pneumonia is a major complication for hospitalized patients and has come under the scrutiny of health care regulating bodies, which propose that hospital-acquired pneumonia should not be reimbursed and potentially be a "never event." We hypothesized that many of our acutely injured patients develop pneumonia at the time of their initial traumatic event despite aggressive measures to prevent pneumonia during hospitalization. This retrospective review included all mechanically ventilated patients admitted to a mixed surgical intensive care units (ICU; trauma, general surgery, and burns) who developed pneumonia from 2006 to 2008. All pneumonia diagnosed by culture were obtained from bronchoalveolar lavage (BAL) specimens with ≥ 10(4) colony forming united (CFU)/mL considered a positive result. Criteria for ventilator-associated pneumonia (VAP) applied only to those patients ventilated mechanically for >48 hours at the time of a positive BAL culture. Aspiration organisms included Streptococcus species, methicillin-sensitive Staphylococcus aureus, Haemophilus influenzae, and oral flora. This was an institutional review board-approved study. There were 208 mechanically ventilated who patients underwent BAL, half of which were performed in the first 48 hours after admission for fever, infiltrate on chest radiograph, or increasing white blood cell count (early BAL group). Of these patients, 58% had positive BAL cultures (pneumonia) but did not have VAP. Only 10% of patients studied with early BAL had no growth on culture. Although the predominant organisms in the early BAL group were aspiration-type organisms, 17% had resistant pathogens, and 16% had other Gram-negative rods (GNR). This percentage was compared with the VAP group in whom 33% of patients had resistant organisms (P = .04) and 8% other GNR (P = NS). Twenty-five patients with ≤ 10(4) CFU/mL on early BAL underwent repeat BAL, and 16 (64%) were later diagnosed with VAP. Many intubated patients in the surgical

  2. Angelina Jolie's faulty gene: newspaper coverage of a celebrity's preventive bilateral mastectomy in Canada, the United States, and the United Kingdom.

    Science.gov (United States)

    Kamenova, Kalina; Reshef, Amir; Caulfield, Timothy

    2014-07-01

    This study investigates the portrayal of Angelina Jolie's preventive bilateral mastectomy in the news media. Content analysis of print news was conducted to identify major frames used in press coverage, the overall tone of discussions, how journalists report broader questions about BRCA1/2 testing and hereditary breast/ovarian cancer, and whether they raise concerns about the impact of celebrities on patients' choices and public opinion. The Factiva database was used to collect publications on Jolie's preventive mastectomy in elite newspapers in Canada, the United States, and the United Kingdom. The data set consisted of 103 newspaper articles published in the first month of media coverage. The results show that although the press discussed key issues surrounding predictive genetic testing and preventive options for women at high risk of hereditary breast/ovarian cancer, important medical information about the rarity of Jolie's condition was not communicated to the public. The results highlight the media's overwhelmingly positive slant toward Jolie's mastectomy, while overlooking the relative rarity of her situation, the challenges of "celebrity medicine," and how celebrities influence people's medical decisions. Future research is required to investigate whether the media hype has influenced demand and use of BRCA1/2 testing and preventive mastectomies.

  3. Support for disease management, depression, self-care, and clinical indicators among Hispanics with type 2 diabetes in San Diego County, United States of America Indicadores clínicos y apoyo para el manejo de la enfermedad, la depresión, el autocuidado en hispanos que padecen diabetes tipo 2 en el Condado de San Diego, Estados Unidos

    Directory of Open Access Journals (Sweden)

    Addie L. Fortmann

    2010-09-01

    Full Text Available This study used a social-ecological framework to examine predictors of depression, diabetes self-management, and clinical indicators of health risk among Hispanics with type 2 diabetes residing in the United States (U.S.-Mexico border region in San Diego County, California, United States of America. Important links were observed between greater social-environmental support for disease management and less depression, better diabetes self-management, and lower body mass index and serum triglyceride concentrations. Less depressive symptomatology was also related to lower hemoglobin A1c levels. Findings suggest that programs aiming to improve diabetes self-management and health outcomes in Hispanics with type 2 diabetes should consider multilevel, social, and environmental influences on health, behavior, and emotional well-being.En este estudio se utilizó un marco socioecológico para analizar los factores predictivos de la depresión, la autogestión de la diabetes y los indicadores clínicos de riesgo para la salud en hispanos que padecen diabetes tipo 2 residentes en la zona fronteriza entre México y los Estados Unidos del Condado de San Diego en California. Se observaron vínculos importantes entre un mayor apoyo socioambiental para el manejo de la enfermedad y una presencia menor de la depresión, una mejor autogestión de la diabetes, y menores índices de masa corporal y concentraciones de triglicéridos séricos. La presencia menor de síntomas depresivos también se relacionó con niveles inferiores de hemoglobina A1c. Estos resultados indican que los programas dirigidos a mejorar la autogestión de la diabetes y los resultados en materia de salud en los hispanos que padecen diabetes tipo 2 deben tener en cuenta las influencias sociales y ambientales sobre la salud, el comportamiento y el bienestar emocional.

  4. The economic burden of child maltreatment in the United States and implications for prevention.

    Science.gov (United States)

    Fang, Xiangming; Brown, Derek S; Florence, Curtis S; Mercy, James A

    2012-02-01

    To present new estimates of the average lifetime costs per child maltreatment victim and aggregate lifetime costs for all new child maltreatment cases incurred in 2008 using an incidence-based approach. This study used the best available secondary data to develop cost per case estimates. For each cost category, the paper used attributable costs whenever possible. For those categories that attributable cost data were not available, costs were estimated as the product of incremental effect of child maltreatment on a specific outcome multiplied by the estimated cost associated with that outcome. The estimate of the aggregate lifetime cost of child maltreatment in 2008 was obtained by multiplying per-victim lifetime cost estimates by the estimated cases of new child maltreatment in 2008. The estimated average lifetime cost per victim of nonfatal child maltreatment is $210,012 in 2010 dollars, including $32,648 in childhood health care costs; $10,530 in adult medical costs; $144,360 in productivity losses; $7,728 in child welfare costs; $6,747 in criminal justice costs; and $7,999 in special education costs. The estimated average lifetime cost per death is $1,272,900, including $14,100 in medical costs and $1,258,800 in productivity losses. The total lifetime economic burden resulting from new cases of fatal and nonfatal child maltreatment in the United States in 2008 is approximately $124 billion. In sensitivity analysis, the total burden is estimated to be as large as $585 billion. Compared with other health problems, the burden of child maltreatment is substantial, indicating the importance of prevention efforts to address the high prevalence of child maltreatment. Published by Elsevier Ltd.

  5. San Francisco urban partnership agreement, national evaluation : exogenous factors test plan.

    Science.gov (United States)

    2011-06-01

    This report presents the test plan for collecting and analyzing exogenous factors data for the San Francisco Urban : Partnership Agreement (UPA) under the United States Department of Transportation (U.S. DOT) UPA Program. : The San Francisco UPA proj...

  6. A systematic review of suicide prevention interventions targeting indigenous peoples in Australia, United States, Canada and New Zealand.

    Science.gov (United States)

    Clifford, Anton C; Doran, Christopher M; Tsey, Komla

    2013-05-13

    Indigenous peoples of Australia, Canada, United States and New Zealand experience disproportionately high rates of suicide. As such, the methodological quality of evaluations of suicide prevention interventions targeting these Indigenous populations should be rigorously examined, in order to determine the extent to which they are effective for reducing rates of Indigenous suicide and suicidal behaviours. This systematic review aims to: 1) identify published evaluations of suicide prevention interventions targeting Indigenous peoples in Australia, Canada, United States and New Zealand; 2) critique their methodological quality; and 3) describe their main characteristics. A systematic search of 17 electronic databases and 13 websites for the period 1981-2012 (inclusive) was undertaken. The reference lists of reviews of suicide prevention interventions were hand-searched for additional relevant studies not identified by the electronic and web search. The methodological quality of evaluations of suicide prevention interventions was assessed using a standardised assessment tool. Nine evaluations of suicide prevention interventions were identified: five targeting Native Americans; three targeting Aboriginal Australians; and one First Nation Canadians. The main intervention strategies employed included: Community Prevention, Gatekeeper Training, and Education. Only three of the nine evaluations measured changes in rates of suicide or suicidal behaviour, all of which reported significant improvements. The methodological quality of evaluations was variable. Particular problems included weak study designs, reliance on self-report measures, highly variable consent and follow-up rates, and the absence of economic or cost analyses. There is an urgent need for an increase in the number of evaluations of preventive interventions targeting reductions in Indigenous suicide using methodologically rigorous study designs across geographically and culturally diverse Indigenous

  7. Prevention

    DEFF Research Database (Denmark)

    Halken, S; Høst, A

    2001-01-01

    , breastfeeding should be encouraged for 4-6 months. In high-risk infants a documented extensively hydrolysed formula is recommended if exclusive breastfeeding is not possible for the first 4 months of life. There is no evidence for preventive dietary intervention neither during pregnancy nor lactation...... populations. These theories remain to be documented in proper, controlled and prospective studies. Breastfeeding and the late introduction of solid foods (>4 months) is associated with a reduced risk of food allergy, atopic dermatitis, and recurrent wheezing and asthma in early childhood. In all infants....... Preventive dietary restrictions after the age of 4-6 months are not scientifically documented....

  8. San-Huang-Xie-Xin-Tang Prevents Rat Hearts from Ischemia/Reperfusion-Induced Apoptosis through eNOS and MAPK Pathways

    Directory of Open Access Journals (Sweden)

    Shu-Fen Liou

    2011-01-01

    Full Text Available San-Huang-Xie-Xin-Tang (SHXT is a traditional Chinese medication consisting of three herbs, namely Coptidis rhizome, Scutellariae radix and Rhei rhizome. This study aimed to examine the cardioprotective effects of SHXT in a rat model of acute myocardial apoptosis induced by ischemia/reperfusion (I/R. Vehicle (intravenous saline or SHXT (intravenous or oral was administered prior to I/R (occlusion of left coronary artery for 45 min followed by reperfusion for 2 h. In the vehicle group, myocardial I/R caused myocardial infarction with increased plasma cardiac enzymes, severe arrhythmia and mortality. Myocardial apoptosis was induced by I/R as evidenced by DNA ladder and Bcl-2/Bax ratio. In the SHXT group, we found that SHXT significantly reduced plasma levels of cardiac enzymes, arrhythmia scores (from 5 ± 1 to 2 ± 1, P<.01 and mortality rate (from 53 to 0%, P<.01. In addition, pretreatment with intravenous SHXT reduced the infarct size dose-dependently when compared with the vehicle group (10 mg kg−1: 14.0 ± 0.2 versus 44.5 ± 5.0%, and 30 mg kg−1: 6.2 ± 1.2% versus 44.5 ± 5.0%, both P<.01. Similarly, oral administration of SHXT reduced the infarct size dose-dependently. Furthermore, SHXT markedly decreased the apoptosis induced by I/R with increased Bcl-2/Bax ratio. Finally, we found that SHXT counteracted the I/R-induced downstream signaling, resulting in increased myocardial eNOS expression and plasma nitrite, and decreased activation of ERK1/2, p38 and JNK. These data suggest that SHXT has cardioprotective effects against I/R-induced apoptosis, and that these effects are mediated, at least in part, by eNOS and MAPK pathways.

  9. Beyond Bullying: Consideration of Additional Research for the Assessment and Prevention of Potential Rampage School Violence in the United States

    Directory of Open Access Journals (Sweden)

    Evonn Welton

    2014-01-01

    Full Text Available For approximately 15 years there have been a number of episodes of rampage school violence in elementary/high school and higher education in the United States. Initial responses included implementation of antibullying programs, disciplinary measures, and increased law security measures. As the incidences have continued, it has become apparent that a more collaborative and interdisciplinary approach is needed for prevention. This paper offers a review of research literature as it applies to proposed innovative strategies for collaborative research, prevention, and intervention in the school setting.

  10. Exploring the Identity-Theft Prevention Efforts of Consumers in the United States

    Science.gov (United States)

    Lewis, Jacquelyne L.

    2011-01-01

    Identity theft is quite expensive and devastating for victims; unfortunately, it is also a rapidly growing crime. Much of the prior research on identity theft has focused on legislative efforts that may prevent the crime. However, limited research exists on what consumers perceive as identity prevention and the measures they take to prevent…

  11. Sexually Transmitted Disease Prevention Policies in the United States: Evidence and Opportunities.

    Science.gov (United States)

    Leichliter, Jami S; Seiler, Naomi; Wohlfeiler, Dan

    2016-02-01

    Policies are an important part of public health interventions, including in the area of sexually transmitted disease (STD) prevention. Similar to other tools used in public health, policies are often evaluated to determine their usefulness. Therefore, we conducted a nonsystematic review of policy evidence for STD prevention. Our review considers assessments or evaluations of STD prevention-specific policies, health care system policies, and other, broader policies that have the potential to impact STD prevention through social determinants of health. We also describe potential policy opportunity in these areas. It should be noted that we found gaps in policy evidence for some areas; thus, additional research would be useful for public health policy interventions for STD prevention.

  12. Comparing the effect of non-medical mechanical restraint preventive factors between psychiatric units in Denmark and Norway

    DEFF Research Database (Denmark)

    Bak, Jesper; Zoffmann, V.; Sestoft, D.M.

    2015-01-01

    was not supported by earlier research, the identification of the patient's crisis triggers; therefore, more research on the mechanisms involved is needed. CLINICAL IMPLICATIONS: None of the six MR preventive factors presents any adverse effects; therefore, units in Denmark and Norway may consider investigating......-medical origin may explain the differing number of MR episodes between Denmark and Norway. METHODS: This study is a cross-sectional survey of psychiatric units. Linear regression was used to assess the confounding effects of the MR preventive factors, i.e. whether a difference in the impact of these factors...... the effect of implementing, the identification of the patient's crisis triggers, an increased number of staff per patient, increased staff education, a better work environment and reduced use of substitute staff in practice....

  13. 30 January 2012 - Ecuadorian Ambassador Gallegos Chiriboga, Permanent Representative to the United Nations Office and other International Organisations at Geneva and San Francisco de Quito University Vice Chancellor C. Montùfar visiting CMS surface facilities and underground experimental area with CMS Collaboration L. Sulak and Collaboration Deputy Spokesperson T. Camporesi, throughout accompanied by Head of International Relations F. Pauss.

    CERN Multimedia

    Michael Hoch

    2012-01-01

    30 January 2012 - Ecuadorian Ambassador Gallegos Chiriboga, Permanent Representative to the United Nations Office and other International Organisations at Geneva and San Francisco de Quito University Vice Chancellor C. Montùfar visiting CMS surface facilities and underground experimental area with CMS Collaboration L. Sulak and Collaboration Deputy Spokesperson T. Camporesi, throughout accompanied by Head of International Relations F. Pauss.

  14. Prevention of ventilator-associated pneumonia in the intensive care unit: A review of the clinically relevant recent advancements

    Directory of Open Access Journals (Sweden)

    Holly Keyt

    2014-01-01

    Full Text Available Ventilator-associated pneumonia (VAP is one of the most commonly encountered hospital-acquired infections in intensive care units and is associated with significant morbidity and high costs of care. The pathophysiology, epidemiology, treatment and prevention of VAP have been extensively studied for decades, but a clear prevention strategy has not yet emerged. In this article we will review recent literature pertaining to evidence-based VAP-prevention strategies that have resulted in clinically relevant outcomes. A multidisciplinary strategy for prevention of VAP is recommended. Those interventions that have been shown to have a clinical impact include the following: (i Non-invasive positive pressure ventilation for able patients, especially in immunocompromised patients, with acute exacerbation of chronic obstructive pulmonary disease or pulmonary oedema, (ii Sedation and weaning protocols for those patients who do require mechanical ventilation, (iii Mechanical ventilation protocols including head of bed elevation above 30 degrees and oral care, and (iv Removal of subglottic secretions. Other interventions, such as selective digestive tract decontamination, selective oropharyngeal decontamination and antimicrobial-coated endotracheal tubes, have been tested in different studies. However, the evidence for the efficacy of these measures to reduce VAP rates is not strong enough to recommend their use in clinical practice. In numerous studies, the implementation of VAP prevention bundles to clinical practice was associated with a significant reduction in VAP rates. Future research that considers clinical outcomes as primary endpoints will hopefully result in more detailed prevention strategies.

  15. Estimated Human and Economic Burden of Four Major Adult Vaccine-Preventable Diseases in the United States, 2013

    OpenAIRE

    McLaughlin, John M.; McGinnis, Justin J.; Tan, Litjen; Mercatante, Annette; Fortuna, Joseph

    2015-01-01

    Low uptake of routinely recommended adult immunizations is a public health concern. Using data from the peer-reviewed literature, government disease-surveillance programs, and the US Census, we developed a customizable model to estimate human and economic burden caused by four major adult vaccine-preventable diseases (VPD) in 2013 in the United States, and for each US state individually. To estimate the number of cases for each adult VPD for a given population, we multiplied age-specific inci...

  16. A Cost-Benefit Analysis of Low-Dose Aspirin Prophylaxis for the Prevention of Preeclampsia in the United States.

    Science.gov (United States)

    Werner, Erika F; Hauspurg, Alisse K; Rouse, Dwight J

    2015-12-01

    To develop a decision model to evaluate the risks, benefits, and costs of different approaches to aspirin prophylaxis for the approximately 4 million pregnant women in the United States annually. We created a decision model to evaluate four approaches to aspirin prophylaxis in the United States: no prophylaxis, prophylaxis per American College of Obstetricians and Gynecologists (the College) recommendations, prophylaxis per U.S. Preventive Services Task Force recommendations, and universal prophylaxis. We included the costs associated with aspirin, preeclampsia, preterm birth, and potential aspirin-associated adverse effects. TreeAge Pro 2011 was used to perform the analysis. The estimated rate of preeclampsia would be 4.18% without prophylaxis compared with 4.17% with the College approach in which 0.35% (n=14,000) of women receive aspirin, 3.83% with the U.S. Preventive Services Task Force approach in which 23.5% (n=940,800) receive aspirin, and 3.81% with universal prophylaxis. Compared with no prophylaxis, the U.S. Preventive Services Task Force approach would save $377.4 million in direct medical care costs annually, and universal prophylaxis would save $365 million assuming 4 million births each year. The U.S. Preventive Services Task Force approach is the most cost-beneficial in 79% of probabilistic simulations. Assuming a willingness to pay of $100,000 per neonatal quality-adjusted life-year gained, the universal approach is the most cost-effective in more than 99% of simulations. Both the U.S. Preventive Services Task Force approach and universal prophylaxis would reduce morbidity, save lives, and lower health care costs in the United States to a much greater degree than the approach currently recommended by the College.

  17. Preventing an Improvised Explosive Device (IED) Terror Campaign in the United States

    National Research Council Canada - National Science Library

    Wehri, Matthew T

    2007-01-01

    .... This thesis will propose how to prevent a domestic IED terror campaign by utilizing the intelligence triggers indications and warnings and open source intelligence as well as placing increased...

  18. Use of Technology for HIV Prevention Among Adolescent and Adult Women in the United States.

    Science.gov (United States)

    Blackstock, Oni J; Patel, Viraj V; Cunningham, Chinazo O

    2015-12-01

    Although the proportion of new HIV infections in the USA among women has decreased over the last few years, still, approximately 20 % of new infections occur annually among adolescent and adult women. The development of effective evidence-based prevention interventions remains an important approach to further decreasing these numbers. Technology-delivered prevention interventions hold tremendous potential due, in part, to their ability to reach beyond the walls of brick-and-mortar intervention sites to engage individuals where they are. While most technology-delivered interventions have focused on adolescents and men who have sex with men, much fewer have specifically targeted adolescent or adult women despite evidence showing that interventions tailored to specific target populations are most effective. We summarize the recently published literature on technology-delivered HIV prevention interventions for US adolescent and adult women and provide suggestions for next steps in this nascent but emergent area of prevention research.

  19. Firm-Led Malaria Prevention in the United States, 1910-1920.

    Science.gov (United States)

    Carson, Byron

    2016-05-01

    In the absence of capable government services, a railroad company in Texas and multiple cotton mills in North Carolina successfully prevented malaria in the early twentieth century. This Article looks through the lens of economics to understand how and why people had the incentive to privately coordinate malaria prevention during this time, but not after. These firms, motivated by increases in productivity and profit, implemented extensive anti-malaria programs and used their hierarchical organizational structures to monitor performance. The factors underlying the decline of private prevention include a fall in the overall rate of malaria, the increasing presence of the federal government, and technological innovations that lowered exposure to mosquitoes. Understanding how, why, and when firms can prevent diseases has important implications for current disease policy, especially where governments, international organizations, and technologies are not enough.

  20. Investigating preventive-medicine consultations in first-opinion small-animal practice in the United Kingdom using direct observation.

    Science.gov (United States)

    Robinson, N J; Brennan, M L; Cobb, M; Dean, R S

    2016-02-01

    Preventive-medicine consultations account for a large proportion of the veterinary caseload and previous research has suggested these consultations are fundamentally different from those in which the animal is presented for a specific health problem. There has been recent controversy around some aspects of preventive medicine for cats and dogs, and the full health benefits of the preventive-medicine consultation remain unclear. The aim of this study was to compare characteristics of the consultation and the problems discussed during the consultation between preventive-medicine consultations and other types of consultations. Data were gathered during direct observation of small-animal consultations in seven first-opinion practices in the United Kingdom. Data collected included type of clinical examination performed, patient signalment, and details of all problems discussed (including whether the problem was presenting or non-presenting, new or pre-existing, who had raised the problem, body system affected and whether an action was taken). A two-level multivariable logistic-regression model was developed, with canine and feline patients at Level 1 nested within consulting veterinary surgeons at Level 2, and a binary outcome variable of preventive-medicine consultation versus specific health-problem consultation. A total of 1807 patients were presented, of which 690 (38.2%) presented for a preventive-medicine consultation. Dogs were the most frequently presented species (n=1168; 64.6%) followed by cats (n=510; 28.2%), rabbits (n=86; 4.8%) and patients of other species (n=43; 2.4%). The five variables remaining in the multi-level model were whether multiple patients were presented, patient age, clinical examination type, weighing and number of problems discussed. Species, breed, sex, neutering status and practice did not remain in the final model. Many non-presenting problems, including both preventive-medicine problems and specific-health problems, were discussed and

  1. Beneficial Reuse of San Ardo Produced Water

    Energy Technology Data Exchange (ETDEWEB)

    Robert A. Liske

    2006-07-31

    This DOE funded study was performed to evaluate the potential for treatment and beneficial reuse of produced water from the San Ardo oilfield in Monterey County, CA. The potential benefits of a successful full-scale implementation of this project include improvements in oil production efficiency and additional recoverable oil reserves as well as the addition of a new reclaimed water resource. The overall project was conducted in two Phases. Phase I identified and evaluated potential end uses for the treated produced water, established treated water quality objectives, reviewed regulations related to treatment, transport, storage and use of the treated produced water, and investigated various water treatment technology options. Phase II involved the construction and operation of a small-scale water treatment pilot facility to evaluate the process's performance on produced water from the San Ardo oilfield. Cost estimates for a potential full-scale facility were also developed. Potential end uses identified for the treated water include (1) agricultural use near the oilfield, (2) use by Monterey County Water Resources Agency (MCWRA) for the Salinas Valley Water Project or Castroville Seawater Intrusion Project, (3) industrial or power plant use in King City, and (4) use for wetlands creation in the Salinas Basin. All of these uses were found to have major obstacles that prevent full-scale implementation. An additional option for potential reuse of the treated produced water was subsequently identified. That option involves using the treated produced water to recharge groundwater in the vicinity of the oil field. The recharge option may avoid the limitations that the other reuse options face. The water treatment pilot process utilized: (1) warm precipitation softening to remove hardness and silica, (2) evaporative cooling to meet downstream temperature limitations and facilitate removal of ammonia, and (3) reverse osmosis (RO) for removal of dissolved salts, boron

  2. Falls prevention in hospitals and mental health units: an extended evaluation of the FallSafe quality improvement project.

    Science.gov (United States)

    Healey, Frances; Lowe, Derek; Darowski, Adam; Windsor, Julie; Treml, Jonathan; Byrne, Lisa; Husk, Janet; Phipps, Jill

    2014-07-01

    inpatient falls are a major patient safety issue causing distress, injury and death. Systematic review suggests multifactorial assessment and intervention can reduce falls by 20-30%, but large-scale studies of implementation are few. This paper describes an extended evaluation of the FallSafe quality improvement project, which presented key components of multifactorial assessment and intervention as a care bundle. : data on delivery of falls prevention processes were collected at baseline and for 18 months from nine FallSafe units and nine control units. Data on falls were collected from local risk management systems for 24 months, and data on under-reporting through staff surveys. : in FallSafe units, delivery of seven care bundle components significantly improved; most improvements were sustained after active project support was withdrawn. Twelve-month moving average of reported fall rates showed a consistent downward trend in FallSafe units but not controls. Significant reductions in reported fall rate were found in FallSafe units (adjusted rate ratio (ARR) 0.75, 95% confidence interval (CI) 0.68-0.84 P control units (ARR 0.91, 95% CI 0.81-1.03 P = 0.13). No significant changes in injurious fall rate were found in FallSafe units (ARR 0.86, 95% CI 0.71-1.03 P = 0.11), or controls (ARR 0.88, 95% CI 0.72-1.08 P = 0.13). In FallSafe units, staff certain falls had been reported increased from 60 to 77%. : introducing evidence-based care bundles of multifactorial assessment and intervention using a quality improvement approach resulted in improved delivery of multifactorial assessment and intervention and significant reductions in fall rates, but not in injurious fall rates. © The Author 2013. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  3. Report to the President of the United States on Sexual Assault Prevention and Response

    Science.gov (United States)

    2014-11-01

    mature, responsible, and trustworthy personnel to serve as unit SARCs and SAPR VAs. The Department created the D-SAACP Commander’s Guide107 to... trustworthy means to access support while maintaining confidentiality. Summary: Reports of sexual assault increased by 8% from FY13 to FY14. Report to...occurrences during FY14. Case 1 Continental United States: Victim reported being sexually assaulted by Subject after a night of celebrating with her

  4. Determinants of preventable readmissions in the United States: a systematic review

    Directory of Open Access Journals (Sweden)

    Slawson Kevin M

    2010-11-01

    Full Text Available Abstract Background Hospital readmissions are a leading topic of healthcare policy and practice reform because they are common, costly, and potentially avoidable events. Hospitals face the prospect of reduced or eliminated reimbursement for an increasing number of preventable readmissions under nationwide cost savings and quality improvement efforts. To meet the current changes and future expectations, organizations are looking for potential strategies to reduce readmissions. We undertook a systematic review of the literature to determine what factors are associated with preventable readmissions. Methods We conducted a review of the English language medicine, health, and health services research literature (2000 to 2009 for research studies dealing with unplanned, avoidable, preventable, or early readmissions. Each of these modifying terms was included in keyword searches of readmissions or rehospitalizations in Medline, ISI, CINAHL, The Cochrane Library, ProQuest Health Management, and PAIS International. Results were limited to US adult populations. Results The review included 37 studies with significant variation in index conditions, readmitting conditions, timeframe, and terminology. Studies of cardiovascular-related readmissions were most common, followed by all cause readmissions, other surgical procedures, and other specific-conditions. Patient-level indicators of general ill health or complexity were the commonly identified risk factors. While more than one study demonstrated preventable readmissions vary by hospital, identification of many specific organizational level characteristics was lacking. Conclusions The current literature on preventable readmissions in the US contains evidence from a variety of patient populations, geographical locations, healthcare settings, study designs, clinical and theoretical perspectives, and conditions. However, definitional variations, clear gaps, and methodological challenges limit translation of

  5. Penerapan Preventive Maintenance Untuk Meningkatkan Reliability Pada Boiler Feed Pump PLTU Tarahan Unit 3 & 4

    OpenAIRE

    Saputra, Melki

    2015-01-01

    Pemeliharaan dan perawatan merupakan kegiatan untuk menjamin mesin dapat bekerja sebagaimana mestinya. Pemeliharaan dan perawatan menyeluruh untuk meningkatkan produktivitas perusahaan dikenal dengan Preventive Maintenance. pemeliharaan keterlibatan operator melalui kegiatan autonomous maintenance. PT. PLN (Persero) Pembangkitan Sumatera Bagian Selatan Sektor Tarahan merupakan salah satu perusahaan penghasil listrik dan semua mesinnya beroperasi selama 24 jam. Beroperasinya mesin secara c...

  6. Infection prevention in the surgical intensive care unit using selective decontamination : epidemiology, bacteriology and clinical practice

    NARCIS (Netherlands)

    G.W.M. Tetteroo (Geert)

    1993-01-01

    textabstractIn Part A the extent of the problems in infection-prevention is described in Chapter 1 and nosocomial infections are defined in Chapter 2, in which also the difficulties of infection diagnosis in critically ill patients are reviewed. Chapter 3 describes the history of antibiotic

  7. Barriers and bridges to infection prevention and control: results of a qualitative case study of a Netherlands' surgical unit.

    Science.gov (United States)

    Backman, Chantal; Marck, Patricia B; Krogman, Naomi; Taylor, Geoff; Sales, Anne; Bonten, Marc J M; Gigengack-Baars, Ada C M

    2012-01-01

    The objectives of the study are to observe the overall work environment including infection prevention and control (IP&C) practices on the target surgical unit; to analyse the policies and procedures in the hospital and unit environments; to analyse the barriers and bridges to IP&C that practitioners identify in visual narratives of their unit environment and to collect monthly specific IP&C-related anonymised data. In this qualitative case study analysis, a socio-ecological approach on health systems informed the research design and provided a framework to better understand the complexity of implementing effective IP&C. The study was conducted on a surgical unit at a Netherlands' hospital that reported successful reductions in the prevalence of targeted multidrug-resistant organisms. Research methods included unit observations (n=3), review of relevant policies and procedures, five practitioner-led photo walkabouts of the unit (n=7), three photo elicitation focus groups with practitioners (n=13) and the review of related IP&C data. The findings indicate some conditions and processes present that may influence the low prevalence of multidrug-resistant organisms, including the 'search and destroy' active surveillance strategy, low occupancy rates, a centralised bed cleaning system and the presence of an active grass roots Hygiene in Practice group, which engages practitioners in several ongoing activities to promote IP&C on the units. Further research on the benefits of practitioner-led community of practices on IP&C practices such as the Hygiene in Practice group is also recommended. Additional case studies to compare theses practices with other acute care hospital around the world would be a valuable way to better understand what IP&C programmes are most effective in which contexts and for what reasons. Further data are available by contacting the primary author directly.

  8. United Nations - African Union Cooperation In Conflict Prevention, Peacekeeping and Peacebuildin

    Directory of Open Access Journals (Sweden)

    Liliya Igorevna Romadan

    2015-01-01

    Full Text Available The article addresses the cooperation between the United Nations and regional organizations, in particular the African Union in the sphere of security and settlement of conflicts. Over the last decade the role of the AU and sub regional organizations has dramatically increased. Through its agencies of ensuring peace and security the African Union is making significant contribution to strengthening stability and promotion of democracy and human rights in Africa. In the beginning of the article authors make a review of the level of security on the African continent and stress the sharpest conflict zones. According to researches one of the most turbulent regions on continent in terms of security is the North-East Africa. Continuing quarter-century war in Somalia, conflict relations between Somalia and Ethiopia, the border crises between Ethiopia and Eritrea, which in the late 20th century turned into the war between the two countries, finally, the number of armed clashes in Sudan attracted the special attention to the region of the entire world community. Authors pay the main attention to the cooperation between the United Nations and the African Union in the sphere of settling regional conflicts and holding peacekeeping operations. In the article the main mechanisms and methods that are used by the United Nations and the African Union to hold peacekeeping operations are analyzed in details. The situation in Somalia and efforts of the United Nations and the African Union that are making towards stabilization in this country are also studied. Authors reveal the basic elements and make a review of the mixed multicomponent peacekeeping operation of the United Nations and the African Union in Sudan. In the conclusion authors stress the measures that could strengthen the strategic cooperation between the United Nations and the African union. According to the authors the most important task is to solve problems of financing joint peacekeeping operations

  9. The incidence, root-causes, and outcomes of adverse events in surgical units: implication for potential prevention strategies

    Directory of Open Access Journals (Sweden)

    Groenewegen Peter P

    2011-05-01

    Full Text Available Abstract Background We need to know the scale and underlying causes of surgical adverse events (AEs in order to improve the safety of care in surgical units. However, there is little recent data. Previous record review studies that reported on surgical AEs in detail are now more than ten years old. Since then surgical technology and quality assurance have changed rapidly. The objective of this study was to provide more recent data on the incidence, consequences, preventability, causes and potential strategies to prevent AEs among hospitalized patients in surgical units. Methods A structured record review study of 7,926 patient records was carried out by trained nurses and medical specialist reviewers in 21 Dutch hospitals. The aim was to determine the presence of AEs during hospitalizations in 2004 and to consider how far they could be prevented. Of all AEs, the consequences, responsible medical specialty, causes and potential prevention strategies were identified. Surgical AEs were defined as AEs attributable to surgical treatment and care processes and were selected for analysis in detail. Results Surgical AEs occurred in 3.6% of hospital admissions and represented 65% of all AEs. Forty-one percent of the surgical AEs was considered to be preventable. The consequences of surgical AEs were more severe than for other types of AEs, resulting in more permanent disability, extra treatment, prolonged hospital stay, unplanned readmissions and extra outpatient visits. Almost 40% of the surgical AEs were infections, 23% bleeding, and 22% injury by mechanical, physical or chemical cause. Human factors were involved in the causation of 65% of surgical AEs and were considered to be preventable through quality assurance and training. Conclusions Surgical AEs occur more often than other types of AEs, are more often preventable and their consequences are more severe. Therefore, surgical AEs have a major impact on the burden of AEs during hospitalizations

  10. Preventive Antibiotics and Delayed Cerebral Ischaemia in Patients with Aneurysmal Subarachnoid Haemorrhage Admitted to the Intensive Care Unit.

    Science.gov (United States)

    Gathier, Celine S; Oostdijk, Evelien A; Rinkel, Gabriel J E; Dorhout Mees, Sanne M; Vergouwen, Mervyn D I; de Smet, Anne Marie G A; van de Beek, Diederik; Vandertop, W Peter; Verbaan, Dagmar; Algra, Ale; Bonten, Marc J M; van den Bergh, Walter M

    2016-02-01

    Delayed cerebral ischemia (DCI) is an important contributor to poor outcome after aneurysmal subarachnoid haemorrhage (aSAH). Development of DCI is multifactorial, and inflammation, with or without infection, is one of the factors independently associated with development of DCI and poor outcome. We thus postulated that preventive antibiotics might be associated with a reduced risk of DCI and subsequent poor outcome in aSAH patients. We performed a retrospective cohort-study in intensive care units (ICU) of three university hospitals in The Netherlands. We included consecutive aSAH patients with minimal ICU stay of 72 h who received either preventive antibiotics (SDD: selective digestive tract decontamination including systemic cefotaxime or SOD: selective oropharyngeal decontamination) or no preventive antibiotics. DCI was defined as a new hypodensity on CT with no other explanation than DCI. Hazard ratio's (HR) for DCI and risk ratio's (RR) for 28-day case-fatality and poor outcome at 3 months were calculated, with adjustment (aHR/aRR) for clinical condition on admission, recurrent bleeding, aneurysm treatment modality and treatment site. Of 459 included patients, 274 received preventive antibiotics (SOD or SDD) and 185 did not. With preventive antibiotics, the aHR for DCI was 1.0 (95% CI 0.6-1.8), the aRR for 28-day case-fatality was 1.1 (95% CI 0.7-1.9) and the aRR for poor functional outcome 1.2 (95% CI 1.0-1.4). Preventive antibiotics were not associated with reduced risk of DCI or poor outcome in aSAH patients in the ICU.

  11. Physician Attitudes Toward Adult Vaccines and Other Preventive Practices, United States, 2012.

    Science.gov (United States)

    Hurley, Laura P; Bridges, Carolyn B; Harpaz, Rafael; Allison, Mandy A; O' Leary, Sean T; Crane, Lori A; Brtnikova, Michaela; Stokley, Shannon; Beaty, Brenda L; Jimenez-Zambrano, Andrea; Kempe, Allison

    2016-01-01

    We described the following among U.S. primary care physicians: (1) perceived importance of vaccines recommended by the Advisory Committee on Immunization Practices relative to U.S. Preventive Services Task Force (USPSTF) preventive services, (2) attitudes toward the U.S. adult immunization schedule, and (3) awareness and use of Medicare preventive service visits. We conducted an Internet and mail survey from March to June 2012 among national networks of general internists and family physicians. We received responses from 352 of 445 (79%) general internists and 255 of 409 (62%) family physicians. For a 67-year-old hypothetical patient, 540/606 (89%, 95% confidence interval [CI] 87, 92) of physicians ranked seasonal influenza vaccine and 487/607 (80%, 95% CI 77, 83) ranked pneumococcal vaccine as very important, whereas 381/604 (63%, 95% CI 59, 67) ranked Tdap/Td vaccine and 288/607 (47%, 95% CI 43, 51) ranked herpes zoster vaccine as very important (pimportant than Tdap/Td and herpes zoster vaccines. For the hypothetical patient aged 30 years, the number and percentage of physicians who reported that the Tdap/Td vaccine (377/604; 62%, 95% CI 59, 66) is very important was greater than the number and percentage who reported that the seasonal influenza vaccine (263/605; 43%, 95% CI 40, 47) is very important (pimportant than was any vaccine. A total of 172 of 587 physicians (29%) found aspects of the adult immunization schedule confusing. Among physicians aware of "Welcome to Medicare" and annual wellness visits, 492/514 (96%, 95% CI 94, 97) and 329/496 (66%, 95% CI 62, 70), respectively, reported having conducted fewer than 10 such visits in the previous month. Despite lack of prioritization of vaccines by ACIP, physicians are prioritizing some vaccines over others and ranking some vaccines below other preventive services. These attitudes and confusion about the immunization schedule may result in missed opportunities for vaccination. Medicare preventive visits are not

  12. On the trail of preventing meningococcal disease: a survey of students planning to travel to the United States.

    Science.gov (United States)

    Huang, Hsien-Liang; Cheng, Shao-Yi; Lee, Long-Teng; Yao, Chien-An; Chu, Chia-Wei; Lu, Chia-Wen; Chiu, Tai-Yuan; Huang, Kuo-Chin

    2013-01-01

    College freshmen living in dormitories are at increased risk for meningococcal disease. Many students become a high-risk population when they travel to the United States. This study surveyed the knowledge, attitudes toward, and behavior surrounding the disease among Taiwanese college students planning to study in the United States, and to identify factors that may affect willingness to accept meningococcal vaccination. A cross-sectional survey of college students going to study in the United States was conducted in a medical center-based travel medicine clinic. Background information, attitudes, general knowledge, preventive or postexposure management, and individual preventive practices were collected through a structured questionnaire. A total of 358 students were included in the final analysis. More than 90% of participants believed that preventing meningococcal disease was important. However, fewer than 50% of students accurately answered six of nine questions exploring knowledge of the disease, and only 17.3% of students knew the correct management strategy after close contact with patients. Logistic regression analysis showed that students who understood the mode of transmission (odds ratio: 3.21, 95% CI = 1.117-9.229), medication management (1.88, 1.045-3.38), and epidemiology (2.735, 1.478-5.061) tended to be vaccinated. Despite an overall positive attitude toward meningococcal vaccination, there was poor knowledge about meningococcal disease. Promoting education on the mode of transmission, epidemiology, and pharmacological management of the disease could increase vaccination rates. Both the governments and travel medicine specialists should work together on developing an education program for this high-risk group other than just requiring vaccination. © 2013 International Society of Travel Medicine.

  13. Preventing China s Rise: Maintaining United States Hegemony in the Face of a Rising China

    Science.gov (United States)

    2014-12-04

    General Kofi Annan has even stated that the United 27 John Mearsheimer, The Tragedy of Great Power Politics (New York: W.W. Norton & Company, 2003...position as a hegemon in Europe. In a letter to Vergennes, Beaumarchais wrote, “The Americans will triumph , but they must be assisted in their...

  14. Mass Atrocities Prevention: The Role and Performance of the United States Army

    Science.gov (United States)

    2015-06-12

    advertise the progress made toward our national atrocity prevention strategy, highlights achievements made by the various departments within the...Atrocities, stated specifically “The faculty from the service academies will meet at the U.S. Holocaust Memorial Museum at the end of May 2012 to discuss how...a close working relationship with the US Holocaust Memorial Museum in Washington D.C., and provides educational opportunities for many Cadets to

  15. Determinants of preventable readmissions in the United States: a systematic review

    OpenAIRE

    Vest, Joshua R; Gamm, Larry D; Oxford, Brock A; Gonzalez, Martha I; Slawson, Kevin M

    2010-01-01

    Abstract Background Hospital readmissions are a leading topic of healthcare policy and practice reform because they are common, costly, and potentially avoidable events. Hospitals face the prospect of reduced or eliminated reimbursement for an increasing number of preventable readmissions under nationwide cost savings and quality improvement efforts. To meet the current changes and future expectations, organizations are looking for potential strategies to reduce readmissions. We undertook a s...

  16. Insider Threat: Preventing Direct Action Attacks Within the United States Army

    Science.gov (United States)

    2017-06-09

    Intelligence Agency, 2012. Joint Chiefs of Staff. Joint Publication (JP) 3-07.2, Antiterrorism. Washington, DC: Government Printing Office, 2010. 81...Federal Bureau of Investigation GEN General (Army rank, O-10) HIPAA Health Insurance Portability and Accountability Act of 1996 INSCOM Intelligence and...commanders, and the intelligence community to prevent insider threats from developing into direct action attacks, this study sought to answer the

  17. Impact of a prevention bundle on Clostridium difficile infection rates in a hospital in the Southeastern United States.

    Science.gov (United States)

    Davis, Bionca M; Yin, Jingjing; Blomberg, Doug; Fung, Isaac Chun-Hai

    2016-12-01

    We sought to assess the impact of a multicomponent prevention program on hospital-acquired Clostridium difficile infections in a hospital in the Southeastern United States. We collected retrospective data of 140 patients from years 2009-2014 and applied the Poisson regression model for analysis. We did not find any significant associations of increased risk of Clostridium difficile infections for the preintervention group. Further studies are needed to test multifaceted bundles in hospitals with high infection rates. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  18. Caribbean (English-Speaking) Women in the United States: Cooking for Diabetes Prevention and Management.

    Science.gov (United States)

    Thomas, Nigel Mark

    2018-01-22

    This study surveyed 152 Caribbean-American women about their acculturation levels; their health behaviors; and their perceptions about a website portal for diabetes prevention and management. Participants followed a study link to documents created via SurveyMonkey. The study link included seven edited videos each fewer than 2 min; the videos included ingredients; preparation/cooking instructions; and plating tips for modifying traditional Caribbean meals for diabetes management and prevention. Overall engagement in six healthy living behaviors was moderate Mean = 2.07; Minimum = 1 (Never); Maximum = 3.0 (Always). Self-efficacy for cooking 'healthy' before exploring the website was a mean 3.52 between 40 and 60% confident (SD = 1.509) versus the after Mean of 4.59 closest to 80% confident (SD = 1.154); t = - 10.353, df = 147 (P cooking meals more consistent with diabetes prevention and management.

  19. Prevention of methicillin-resistant Staphylococcus aureus infections in spinal cord injury units.

    Science.gov (United States)

    Evans, Martin E; Kralovic, Stephen M; Simbartl, Loretta A; Obrosky, D Scott; Hammond, Margaret C; Goldstein, Barry; Evans, Charlesnika T; Roselle, Gary A; Jain, Rajiv

    2013-05-01

    Methicillin-resistant Staphylococcus aureus (MRSA) health care-associated infections (HAIs) are a concern in the 22 acute care Veterans Affairs (VA) spinal cord injury units where patients with unique rehabilitation and medical needs and a high risk of infection are treated. A bundle was implemented in VA spinal cord injury units consisting of nasal surveillance for MRSA on admission/in-hospital transfer/discharge, contact precautions for patients colonized or infected with MRSA, an emphasis on hand hygiene, and an institutional culture change where infection control became everyone's responsibility. From October 2007, through June 2011, there were 51,627 admissions/transfers/discharges and 816,254 patient-days of care in VA spinal cord injury units. The percentage of patients screened increased to >95.0%. The mean admission MRSA prevalence was 38.6% ± 19.1%. Monthly HAI rates declined 81% from 1.217 per 1,000 patient-days to 0.237 per 1,000 patient-days (P < .001). Bloodstream infections declined by 100% (P = .002), skin and soft-tissue infections by 60% (P = .007), and urinary tract infections by 33% (P = .07). Universal surveillance, contact precautions, hand hygiene, and an institutional culture change was associated with significant declines in MRSA HAIs in a setting with a high prevalence of MRSA colonization and a high risk for infection. Published by Mosby, Inc.

  20. More attention to preventive health services needed for older persons in the United States of America

    Directory of Open Access Journals (Sweden)

    2003-06-01

    Full Text Available Medicare, el programa público estadounidense de seguro de salud que cubre a adultos mayores, debe concentrarse más en mantener a estos saludables y en ofrecer una gama más amplia de servicios sanitarios preventivos, en lugar de limitarse a atender a personas enfermas, de acuerdo con un informe publicado recientemente por Partnership for Prevention, una organización sin fines de lucro radicada en Washington, D.C. El informe, titulado A better Medicare for healthier seniors: recommendations to modernize Medicare's prevention policies, llama a que el programa de Medicare cubra más servicios capaces de prolongar la vida de personas de edad avanzada y de mejorar su calidad de vida. Hasta el momento, Medicare cubre solo 10 servicios preventivos. Tres de ellos son de inmunización (contra neumonía neumocócica, influenza y hepatitis B, y los siete restantes consisten en pruebas de tamizaje para diversos cánceres, osteoporosis y glaucoma. Medicare debe ampliar sus servicios preventivos habituales, según el informe, y abarcar la vacunación de refuerzo contra la difteria y el tétanos; el tamizaje de la agudeza visual, problemas auditivos, depresión y perfil de lípidos en suero; y el asesoramiento para abandonar el hábito de fumar, prevenir lesiones por accidentes automovilísticos y observar una dieta saludable. Algunos de los servicios preventivos propuestos por Partnership for Prevention podrían generar ahorros para Medicare. Otros no implicarían reducciones, pero ofrecerían a los beneficiarios más años de vida productivos a un costo razonable. Si Medicare hiciera mayor hincapié en los servicios preventivos, esto pudiera estimular a los servicios privados de salud a hacer lo mismo con las personas de cualquier edad en los Estados Unidos.

  1. Vital Signs: Preventing Antibiotic-Resistant Infections in Hospitals - United States, 2014.

    Science.gov (United States)

    Weiner, Lindsey M; Fridkin, Scott K; Aponte-Torres, Zuleika; Avery, Lacey; Coffin, Nicole; Dudeck, Margaret A; Edwards, Jonathan R; Jernigan, John A; Konnor, Rebecca; Soe, Minn M; Peterson, Kelly; McDonald, L Clifford

    2016-03-11

    there has been considerable progress in preventing some HAIs, many remaining infections could be prevented with implementation of existing recommended practices. Depending upon the setting, more than one in four of HAIs excluding CDI are caused by AR bacteria. Physicians, nurses, and health care leaders need to consistently and comprehensively follow all recommendations to prevent catheter- and procedure-related infections and reduce the impact of AR bacteria through antimicrobial stewardship and measures to prevent spread.

  2. Specialty education in periodontics in Japan and the United States: comparison of programs at Nippon Dental University Hospital and the University of Texas Health Science Center at San Antonio.

    Science.gov (United States)

    Osawa, Ginko; Nakaya, Hiroshi; Mealey, Brian L; Kalkwarf, Kenneth; Cochran, David L

    2014-03-01

    Japan has institutions that train qualified postdoctoral students in the field of periodontics; however, Japan does not have comprehensive advanced periodontal programs and national standards for these specialty programs. To help Japanese programs move toward global standards in this area, this study was designed to describe overall differences in periodontics specialty education in Japan and the United States and to compare periodontics faculty members and residents' characteristics and attitudes in two specific programs, one in each country. Periodontal faculty members and residents at Nippon Dental University (NDU) and the University of Texas Health Science Center at San Antonio (UTHSCSA) Dental School participated in the survey study: four faculty members and nine residents at NDU; seven faculty members and thirteen residents at UTHSCSA. Demographic data were collected as well as respondents' attitudes toward and assessment of their programs. The results showed many differences in curriculum structure and clinical performance. In contrast to the UTHSCSA respondents, for example, the residents and faculty members at NDU reported that they did not have enough subject matter and time to learn clinical science. Although the residents at NDU reported seeing more total patients in one month than those at UTHSCSA, they were taught fewer varieties of periodontal treatments. To provide high-quality and consistent education for periodontal residents, Japan needs to establish a set of standards that will have positive consequences for those in Japan who need periodontal treatment.

  3. San Francisco Accelerator Conference

    International Nuclear Information System (INIS)

    Southworth, Brian

    1991-01-01

    'Where are today's challenges in accelerator physics?' was the theme of the open session at the San Francisco meeting, the largest ever gathering of accelerator physicists and engineers

  4. [Prevention of ventilator-associated pneumonia: a comparison of level of knowledge in three critical care units].

    Science.gov (United States)

    Pujante-Palazón, I; Rodríguez-Mondéjar, J J; Armero-Barranco, D; Sáez-Paredes, P

    2016-01-01

    To determine the level of knowledge of the prevention of ventilator-associated pneumonia guidelines of nurses working in three intensive care units (ICU) in 3 university hospitals in a Spanish region, and evaluate the relationship between this level of knowledge and years worked in the ICU. A descriptive, prospective, cross-sectional, multicentre study was conducted using a validated and reliable questionnaire, made up by 9 questions with closed answers drawn from the EVIDENCE study. A total of 98 questionnaires were collected from ICU nurses of the three university hospitals (A, B, and C) from January to April 2014. The sample from hospital A responded the most, in contrast with the sample from hospital B, which was the one with the less participation. The Pearson correlation was calculated in order to determine the relationship between nurse years worked in ICU and level of knowledge. Hospital A obtained in the best mean score in the questionnaire, 6.33 (SD 1.4) points, followed by hospital C with 6.21 (SD 1.4), and finally, the hospital B with 6.06 (SD 1.5) points. A p=.08 was obtained on relating years worked with the level of knowledge. The results showed a high level of knowledge compared other studies. There was a tendency between the years worked in the unit and the level of knowledge in ventilator-associated pneumonia prevention. Copyright © 2016 Elsevier España, S.L.U. y SEEIUC. All rights reserved.

  5. The biology, prevention, diagnosis and treatment of dental caries: scientific advances in the United States.

    Science.gov (United States)

    Zero, Domenick T; Fontana, Margherita; Martínez-Mier, E Angeles; Ferreira-Zandoná, Andréa; Ando, Masatoshi; González-Cabezas, Carlos; Bayne, Stephen

    2009-09-01

    Scientific advances in cariology in the past 150 years have led to the understanding that dental caries is a chronic, dietomicrobial, site-specific disease caused by a shift from protective factors favoring tooth remineralization to destructive factors leading to demineralization. Epidemiologic data indicate that caries has changed in the last century; it now is distributed unequally in the U.S. population. People who are minorities, homeless, migrants, children with disabilities and of lower socioeconomic status suffer from the highest prevalence and severity of dental caries. Scientific advances have led to improvements in the prevention, diagnosis and treatment of dental caries, but there is a need for new diagnostic tools and treatment methods. and Future management of dental caries requires early detection and risk assessment if the profession is to achieve timely and cost-effective prevention and treatment for those who need it most. Dental professionals look forward to the day when people of all ages and backgrounds view dental caries as a disease of the past.

  6. Addendum Guidelines for the Prevention of Peanut Allergy in the United States

    Science.gov (United States)

    Togias, Alkis; Cooper, Susan F.; Acebal, Maria L.; Assa’ad, Amal; Baker, James R.; Beck, Lisa A.; Block, Julie; Byrd-Bredbenner, Carol; Chan, Edmond S.; Eichenfield, Lawrence F.; Fleischer, David M.; Fuchs, George J.; Furuta, Glenn T.; Greenhawt, Matthew J.; Gupta, Ruchi S.; Habich, Michele; Jones, Stacie M.; Keaton, Kari; Muraro, Antonella; Plaut, Marshall; Rosenwasser, Lanny J.; Rotrosen, Daniel; Sampson, Hugh A.; Schneider, Lynda C.; Sicherer, Scott H.; Sidbury, Robert; Spergel, Jonathan; Stukus, David R.; Venter, Carina; Boyce, Joshua A.

    2016-01-01

    Background Food allergy is an important public health problem because it affects children and adults, it may be severe and even life-threatening, and it may be increasing in prevalence. Beginning in 2008, the National Institute of Allergy and Infectious Diseases (NIAID), working with other organizations and advocacy groups, led the development of the first clinical guidelines for the diagnosis and management of food allergy. A recent landmark clinical trial and other emerging data suggest that peanut allergy can be prevented through introduction of peanut-containing foods beginning in infancy. Objectives Prompted by these findings, along with 25 professional organizations, federal agencies, and patient advocacy groups, NIAID facilitated development of Addendum Guidelines to specifically address the prevention of peanut allergy. Results The Addendum provides three separate guidelines for infants at various risk levels for development of peanut allergy and is intended for use by a wide variety of health care providers. Topics addressed include the definition of risk categories, appropriate use of testing (specific IgE, skin prick testing, and oral food challenge) and the timing and approaches for introduction of peanut-containing foods in the health care provider’s office or at home. The Addendum Guidelines provide the background, rationale, and strength of evidence for each recommendation. Conclusions Guidelines have been developed for early introduction of peanut-containing foods into the diets of infants at various risk levels for peanut allergy. PMID:28065278

  7. Evaluating the impact of Mexico's drug policy reforms on people who inject drugs in Tijuana, B.C., Mexico, and San Diego, CA, United States: a binational mixed methods research agenda.

    Science.gov (United States)

    Robertson, Angela M; Garfein, Richard S; Wagner, Karla D; Mehta, Sanjay R; Magis-Rodriguez, Carlos; Cuevas-Mota, Jazmine; Moreno-Zuniga, Patricia Gonzalez; Strathdee, Steffanie A

    2014-02-12

    Policymakers and researchers seek answers to how liberalized drug policies affect people who inject drugs (PWID). In response to concerns about the failing "war on drugs," Mexico recently implemented drug policy reforms that partially decriminalized possession of small amounts of drugs for personal use while promoting drug treatment. Recognizing important epidemiologic, policy, and socioeconomic differences between the United States-where possession of any psychoactive drugs without a prescription remains illegal-and Mexico-where possession of small quantities for personal use was partially decriminalized, we sought to assess changes over time in knowledge, attitudes, behaviors, and infectious disease profiles among PWID in the adjacent border cities of San Diego, CA, USA, and Tijuana, Baja California, Mexico. Based on extensive binational experience and collaboration, from 2012-2014 we initiated two parallel, prospective, mixed methods studies: Proyecto El Cuete IV in Tijuana (n = 785) and the STAHR II Study in San Diego (n = 575). Methods for sampling, recruitment, and data collection were designed to be compatible in both studies. All participants completed quantitative behavioral and geographic assessments and serological testing (HIV in both studies; hepatitis C virus and tuberculosis in STAHR II) at baseline and four semi-annual follow-up visits. Between follow-up assessment visits, subsets of participants completed qualitative interviews to explore contextual factors relating to study aims and other emergent phenomena. Planned analyses include descriptive and inferential statistics for quantitative data, content analysis and other mixed-methods approaches for qualitative data, and phylogenetic analysis of HIV-positive samples to understand cross-border transmission dynamics. Investigators and research staff shared preliminary findings across studies to provide feedback on instruments and insights regarding local phenomena. As a result, recruitment and data

  8. Implementation of central line-associated bloodstream infection prevention bundles in a surgical intensive care unit using peer tutoring.

    Science.gov (United States)

    Park, Sang-Won; Ko, Suhui; An, Hye-Sun; Bang, Ji Hwan; Chung, Woo-Young

    2017-01-01

    Central line-associated bloodstream infections (CLABSIs) can be prevented through well-coordinated, multifaceted programs. However, implementation of CLABSI prevention programs requires individualized strategies for different institutional situations, and the best strategy in resource-limited settings is uncertain. Peer tutoring may be an efficient and effective method that is applicable in such settings. A prospective intervention was performed to reduce CLABSIs in a surgical intensive care unit (SICU) at a tertiary hospital. The core interventions consisted of implementation of insertion and maintenance bundles for CLABSI prevention. The overall interventions were guided and coordinated by active educational programs using peer tutoring. The CLABSI rates were compared for 9 months pre-intervention, 6 months during the intervention and 9 months post-intervention. The CLABSI rate was further observed for three years after the intervention. The rate of CLABSIs per 1000 catheter-days decreased from 6.9 infections in the pre-intervention period to 2.4 and 1.8 in the intervention (6 m; P  = 0.102) and post-intervention (9 m; P  = 0.036) periods, respectively. A regression model showed a significantly decreasing trend in the infection rate from the pre-intervention period ( P  tutoring in a resource-limited setting was useful and effectively reduced CLABSIs. However, maintaining the reduced CLABSI rate will require further strategies.

  9. Specialist teams for neonatal transport to neonatal intensive care units for prevention of morbidity and mortality.

    Science.gov (United States)

    Chang, Alvin S M; Berry, Andrew; Jones, Lisa J; Sivasangari, Subramaniam

    2015-10-28

    Maternal antenatal transfers provide better neonatal outcomes. However, there will inevitably be some infants who require acute transport to a neonatal intensive care unit (NICU). Because of this, many institutions develop services to provide neonatal transport by specially trained health personnel. However, few studies report on relevant clinical outcomes in infants requiring transport to NICU. To determine the effects of specialist transport teams compared with non-specialist transport teams on the risk of neonatal mortality and morbidity among high-risk newborn infants requiring transport to neonatal intensive care. We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2015, Issue 7), MEDLINE (1966 to 31 July 2015), EMBASE (1980 to 31 July 2015), CINAHL (1982 to 31 July 2015), conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. randomised, quasi-randomised or cluster randomised controlled trials. neonates requiring transport to a neonatal intensive care unit. transport by a specialist team compared to a non-specialist team. any of the following outcomes - death; adverse events during transport leading to respiratory compromise; and condition on admission to the neonatal intensive care unit. The methodological quality of the trials was assessed using the information provided in the studies and by personal communication with the author. Data on relevant outcomes were extracted and the effect size estimated and reported as risk ratio (RR), risk difference (RD), number needed to treat for an additional beneficial outcome (NNTB) or number needed to treat for an additional harmful outcome (NNTH) and mean difference (MD) for continuous outcomes. Data from cluster randomised trials were not combined for analysis. One trial met the inclusion criteria of this review but was considered ineligible owing to

  10. Method and apparatus for preventing inadvertent criticality in a nuclear fueled electric power generating unit

    International Nuclear Information System (INIS)

    Tuley, C.R.; Bauman, D.A.; Neuner, J.A.; Feilchenfeld, M.M.; Greenberg, L.

    1984-01-01

    An inadvertent approach to criticality in a nuclear fueled electric power generating unit is detected and an alarm is generated through on-line monitoring of the neutron flux. The difficulties of accurately measuring the low levels of neutron flux in a subcritical reactor are overcome by the use of a microcomputer which continuously generates average flux count rate signals for incremental time periods from thousands of samples taken during each such period and which serially stores the average flux count rate signals for a preselected time interval. At the end of each incremental time period, the microcomputer compares the latest average flux count rate signal with the oldest, and preferably each of the intervening stored values, and if it exceeds any of them by at least a preselected multiplication factor, an alarm is generated. (author)

  11. Value of Public Health Funding in Preventing Hospital Bloodstream Infections in the United States.

    Science.gov (United States)

    Whittington, Melanie D; Bradley, Cathy J; Atherly, Adam J; Campbell, Jonathan D; Lindrooth, Richard C

    2017-11-01

    To estimate the association of 1 activity of the Prevention and Public Health Fund with hospital bloodstream infections and calculate the return on investment (ROI). The activity was funded for 1 year (2013). A difference-in-differences specification evaluated hospital standardized infection ratios (SIRs) before funding allocation (years 2011 and 2012) and after funding allocation (years 2013 and 2014) in the 15 US states that received the funding compared with hospital SIRs in states that did not receive the funding. We estimated the association of the funded public health activity with SIRs for bloodstream infections. We calculated the ROI by dividing cost offsets from infections averted by the amount invested. The funding was associated with a 33% (P < .05) reduction in SIRs and an ROI of $1.10 to $11.20 per $1 invested in the year of funding allocation (2013). In 2014, after the funding stopped, significant reductions were no longer evident. This activity was associated with a reduction in bloodstream infections large enough to recoup the investment. Public health funding of carefully targeted areas may improve health and reduce health care costs.

  12. Handwashing: a simple, economical and effective method for preventing nosocomial infections in intensive care units.

    Science.gov (United States)

    Akyol, A; Ulusoy, H; Ozen, I

    2006-04-01

    As most nosocomial infections are thought to be transmitted by the hands of healthcare workers, handwashing is considered to be the single most important intervention to prevent nosocomial infections. However, studies have shown that handwashing practices are poor, especially among medical personnel. This review gives an overview of handwashing in health care and in the community, including some aspects that have attracted little attention, such as hand drying and cultural issues determining hand hygiene behaviour. Hand hygiene is the most effective measure for interrupting the transmission of micro-organisms which cause infection, both in the community and in the healthcare setting. Using hand hygiene as a sole measure to reduce infection is unlikely to be successful when other factors in infection control, such as environmental hygiene, crowding, staffing levels and education, are inadequate. Hand hygiene must be part of an integrated approach to infection control. Compliance with hand hygiene recommendations is poor worldwide. While the techniques involved in hand hygiene are simple, the complex interdependence of factors that determine hand hygiene behaviour makes the study of hand hygiene complex. It is now recognized that improving compliance with hand hygiene recommendations depends on altering human behaviour. Input from behavioural and social sciences is essential when designing studies to investigate compliance. Interventions to increase compliance with hand hygiene practices must be appropriate for different cultural and social needs.

  13. Receipt of Selected Preventive Health Services for Women and Men of Reproductive Age - United States, 2011-2013.

    Science.gov (United States)

    Pazol, Karen; Robbins, Cheryl L; Black, Lindsey I; Ahrens, Katherine A; Daniels, Kimberly; Chandra, Anjani; Vahratian, Anjel; Gavin, Lorrie E

    2017-10-27

    Receipt of key preventive health services among women and men of reproductive age (i.e., 15-44 years) can help them achieve their desired number and spacing of healthy children and improve their overall health. The 2014 publication Providing Quality Family Planning Services: Recommendations of CDC and the U.S. Office of Population Affairs (QFP) establishes standards for providing a core set of preventive services to promote these goals. These services include contraceptive care for persons seeking to prevent or delay pregnancy, pregnancy testing and counseling, basic infertility services for those seeking to achieve pregnancy, sexually transmitted disease (STD) services, and other preconception care and related preventive health services. QFP describes how to provide these services and recommends using family planning and other primary care visits to screen for and offer the full range of these services. This report presents baseline estimates of the use of these preventive services before the publication of QFP that can be used to monitor progress toward improving the quality of preventive care received by women and men of reproductive age. 2011-2013. Three surveillance systems were used to document receipt of preventive health services among women and men of reproductive age as recommended in QFP. The National Survey of Family Growth (NSFG) collects data on factors that influence reproductive health in the United States since 1973, with a focus on fertility, sexual activity, contraceptive use, reproductive health care, family formation, child care, and related topics. NSFG uses a stratified, multistage probability sample to produce nationally representative estimates for the U.S. household population of women and men aged 15-44 years. This report uses data from the 2011-2013 NSFG. The Pregnancy Risk Assessment Monitoring System (PRAMS) is an ongoing, state- and population-based surveillance system designed to monitor selected maternal behaviors and experiences

  14. Neonatal pain and preventive strategies: an experience in a tertiary care unit

    International Nuclear Information System (INIS)

    Mahmud, S.

    2017-01-01

    Little is known about neonatal pain in Pakistan. So, to know about neonatal pain, its scoring and the effectiveness of oral dextrose in neonatal pain management we carried this study in neonatal intensive care unit (NICU) of military hospital (MH) Rawalpindi. Methods: This randomized control trial was carried out in NICU of MH, Rawalpindi from to Jan 2013 to Dec 2013. Total of 252 babies were enrolled in the study. We assessed neonatal pain by using Modified Behavioural Pain Scale (MBPS). Babies were given 10% dextrose and sterile water two minutes before a painful procedure and pain assessment was done after the procedure. The different painful procedures included, heel prick, nasogastric (NG) tube insertion, cannulation, catheterization and venepuncture for blood sampling. Results: A total of 252 babies were enrolled in the study. Of these 139(55%) were male and 113(45%) were female babies. Painful procedures included heel lancing 120(48%), I/V cannulations 60(24%), venepuncture 40 (16%), NG insertion 26 (10%) and Foley catheterization 6 (2%). Mean MBPS score with 10% dextrose and sterile water were 4.31 and 6.26 respectively and the difference between two was significant statically. Conclusion: Oral dextrose is a cheap and easily available solution and can be used in neonatal pain management during various painful procedures. (author)

  15. Albumin administration prevents the onset of pressure ulcers in intensive care unit patients.

    Science.gov (United States)

    Serra, Raffaele; Grande, Raffaele; Buffone, Gianluca; Gallelli, Luca; Caroleo, Santo; Tropea, Francesco; Amantea, Bruno; de Franciscis, Stefano

    2015-08-01

    Pressure ulcers (PUs) are a common problem in critically ill patients admitted to the intensive care units (ICUs) and they account for more than 70% of patients with low serum albumin at admission. The aim of this study was to test the efficacy of intravenous administration of albumin in patients with low serum albumin albumin albumin for the first 3 days within the first week of ICU stay (group A) and 10 patients did not receive albumin (group B). Three patients (27·27%) showed the onset of PUs in group A, whereas seven patients (70%) showed the onset of PUs within the first 7 days of stay in group B. Moreover, ulcers of group B were more severe than those of group A. This study shows that intravenous administration of albumin reduces the onset of PUs in patients admitted to the ICU and in some cases it also reduces the risk of progression to advanced stages of PUs. © 2013 The Authors. International Wound Journal © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  16. An Assessment of the Cocooning Strategy for Preventing Infant Pertussis—United States, 2011

    Science.gov (United States)

    Blain, Amy E.; Lewis, Melissa; Banerjee, Emily; Kudish, Kathy; Liko, Juventila; McGuire, Suzanne; Selvage, David; Watt, James; Martin, Stacey W.; Skoff, Tami H.

    2017-01-01

    Background Infants are at greatest risk for severe pertussis. In 2006, the Advisory Committee on Immunization Practices recommended that adolescents and adults, especially those with infant contact, receive a single dose of Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine). To assess the effectiveness of cocooning, we conducted a case-control evaluation of infant close contacts. Methods Pertussis cases aged <2 months with onset between 1 January 2011 and 31 December 2011 were identified in Emerging Infections Program Network sites. For each case, we recruited 3 controls from birth certificates and interviewed identified adult close contacts (CCs) or parents of CCs aged <18 years. Pertussis vaccination was verified through medical providers and/or immunization registries. Results Forty-two cases were enrolled, with 154 matched controls. Around enrolled infants, 859 CCs were identified (600 adult and 259 nonadult). An average of 5.4 CCs was identified per case and 4.1 CCs per control. Five hundred fifty-four (64.5%) CCs were enrolled (371 adult and 183 non-adult CCs); 119 (32.1% of enrolled) adult CCs had received Tdap. The proportion of Tdap-vaccinated adult CCs was similar between cases and controls (P = .89). The 600 identified adult CCs comprised 172 potential cocoons; 71 (41.3%) potential cocoons had all identified adult CCs enrolled. Of these, 9 were fully vaccinated and 43.7% contained no Tdap-vaccinated adults. The proportion of fully vaccinated case (4.8%) and control (10.0%) cocoons was similar (P = .43). Conclusions Low Tdap coverage among adult CCs reinforces the difficulty of implementing the cocooning strategy and the importance of vaccination during pregnancy to prevent infant pertussis. PMID:27838676

  17. A new approach to the prevention and treatment of delirium in elderly patients in the intensive care unit

    Directory of Open Access Journals (Sweden)

    Andrew B. Rosenzweig

    2015-09-01

    Full Text Available The pronounced prevalence of delirium in geriatric patients admitted to the intensive care unit (ICU and its increased morbidity and mortality is a well-established phenomenon. The purpose of this review is to explore the potential use of dexmedetomidine in preventing or managing ICU delirium in older patients. Articles used were identified and selected through multiple search engines, including Google Scholar, PubMed, and MEDLINE. Keywords such as dexmedetomidine, delirium, geriatric, ICU delirium, delirium in elderly, and palliative were used to obtain the specific articles used for this paper and restricted to articles published in 1990 or later. Articles specifically looking at the use of dexmedetomidine as compared to a study drug and its potential for use in ICU patients, as opposed to overall reviews of dexmedetomidine, were compared. When compared to benzodiazepines for the prevention or treatment of ICU delirium in the elderly, dexmedetomidine was associated with a reduction in delirium, as well as decreased morbidity and mortality. Dexmedetomidine has also been shown to be effective in limiting risk factors associated with ICU delirium such as length and depth of sedation. As opposed to benzodiazepines or opiates, dexmedetomidine provides effective analgesia, sympatholysis, and anxiolysis without causing respiratory depression and allows a patient to more effectively interact with practitioners. The review of these nine articles indicates that these favorable attributes and overall decreased duration and incidence of delirium make dexmedetomidine a viable option in preventing or reducing ICU delirium in high-risk geriatric patients and as a palliative adjunct to help control symptoms and stressors.

  18. Cost-effectiveness of strategies to prevent methicillin-resistant Staphylococcus aureus transmission and infection in an intensive care unit.

    Science.gov (United States)

    Gidengil, Courtney A; Gay, Charlene; Huang, Susan S; Platt, Richard; Yokoe, Deborah; Lee, Grace M

    2015-01-01

    OBJECTIVE To create a national policy model to evaluate the projected cost-effectiveness of multiple hospital-based strategies to prevent methicillin-resistant Staphylococcus aureus (MRSA) transmission and infection. DESIGN Cost-effectiveness analysis using a Markov microsimulation model that simulates the natural history of MRSA acquisition and infection. PATIENTS AND SETTING Hypothetical cohort of 10,000 adult patients admitted to a US intensive care unit. METHODS We compared 7 strategies to standard precautions using a hospital perspective: (1) active surveillance cultures; (2) active surveillance cultures plus selective decolonization; (3) universal contact precautions (UCP); (4) universal chlorhexidine gluconate baths; (5) universal decolonization; (6) UCP + chlorhexidine gluconate baths; and (7) UCP+decolonization. For each strategy, both efficacy and compliance were considered. Outcomes of interest were: (1) MRSA colonization averted; (2) MRSA infection averted; (3) incremental cost per colonization averted; (4) incremental cost per infection averted. RESULTS A total of 1989 cases of colonization and 544 MRSA invasive infections occurred under standard precautions per 10,000 patients. Universal decolonization was the least expensive strategy and was more effective compared with all strategies except UCP+decolonization and UCP+chlorhexidine gluconate. UCP+decolonization was more effective than universal decolonization but would cost $2469 per colonization averted and $9007 per infection averted. If MRSA colonization prevalence decreases from 12% to 5%, active surveillance cultures plus selective decolonization becomes the least expensive strategy. CONCLUSIONS Universal decolonization is cost-saving, preventing 44% of cases of MRSA colonization and 45% of cases of MRSA infection. Our model provides useful guidance for decision makers choosing between multiple available hospital-based strategies to prevent MRSA transmission.

  19. SANS studies of polymers

    International Nuclear Information System (INIS)

    Wignall, G.D.

    1984-10-01

    Before small-angle neutron scattering (SANS), chain conformation studies were limited to light and small angle x-ray scattering techniques, usually in dilute solution. SANS from blends of normal and labeled molecules could give direct information on chain conformation in bulk polymers. Water-soluble polymers may be examined in H 2 O/D 2 O mixtures using contrast variation methods to provide further information on polymer structure. This paper reviews some of the information provided by this technique using examples of experiments performed at the National Center for Small-Angle Scattering Research (NCSASR)

  20. Wu-Ling-San formula prophylaxis against recurrent calcium oxalate ...

    African Journals Online (AJOL)

    Wu-Ling-San (WLS) formula has been proved to prevent calcium oxalate nephrolithiasis both in vitro and in vivo. This is the first prospective, randomized and placebo-controlled clinical trial of WLS in calcium oxalate nephrolithiasis prevention. All patients who enrolled were asked to drink enough fluid to urinate at least 2 L ...

  1. Implementation of central line-associated bloodstream infection prevention bundles in a surgical intensive care unit using peer tutoring

    Directory of Open Access Journals (Sweden)

    Sang-Won Park

    2017-10-01

    Full Text Available Abstract Background Central line-associated bloodstream infections (CLABSIs can be prevented through well-coordinated, multifaceted programs. However, implementation of CLABSI prevention programs requires individualized strategies for different institutional situations, and the best strategy in resource-limited settings is uncertain. Peer tutoring may be an efficient and effective method that is applicable in such settings. Methods A prospective intervention was performed to reduce CLABSIs in a surgical intensive care unit (SICU at a tertiary hospital. The core interventions consisted of implementation of insertion and maintenance bundles for CLABSI prevention. The overall interventions were guided and coordinated by active educational programs using peer tutoring. The CLABSI rates were compared for 9 months pre-intervention, 6 months during the intervention and 9 months post-intervention. The CLABSI rate was further observed for three years after the intervention. Results The rate of CLABSIs per 1000 catheter-days decreased from 6.9 infections in the pre-intervention period to 2.4 and 1.8 in the intervention (6 m; P = 0.102 and post-intervention (9 m; P = 0.036 periods, respectively. A regression model showed a significantly decreasing trend in the infection rate from the pre-intervention period (P < 0.001, with incidence-rate ratios of 0.348 (95% confidence interval [CI], 0.98–1.23 in the intervention period and 0.257 (95% CI, 0.07–0.91 in the post-intervention period. However, after the 9-month post-intervention period, the yearly CLABSI rates reverted to 3.0–5.4 infections per 1000 catheter-days over 3 years. Conclusions Implementation of CLABSI prevention bundles using peer tutoring in a resource-limited setting was useful and effectively reduced CLABSIs. However, maintaining the reduced CLABSI rate will require further strategies.

  2. Remembering San Diego

    International Nuclear Information System (INIS)

    Chuyanov, V.

    1999-01-01

    After 6 years of existence the ITER EDA project in San Diego, USA, was terminated by desition of the US Congress. This article describes how nice it was for everybody as long as it lasted and how sad it is now

  3. Cost assessment of a new oral care program in the intensive care unit to prevent ventilator-associated pneumonia.

    Science.gov (United States)

    Ory, Jérôme; Mourgues, Charline; Raybaud, Evelyne; Chabanne, Russell; Jourdy, Jean Christophe; Belard, Fabien; Guérin, Renaud; Cosserant, Bernard; Faure, Jean Sébastien; Calvet, Laure; Pereira, Bruno; Guelon, Dominique; Traore, Ousmane; Gerbaud, Laurent

    2018-06-01

    Ventilator-associated pneumonia (VAP) is the most frequent hospital-acquired infections in intensive care units (ICU). In the bundle of care to prevent the VAP, the oral care is very important strategies, to decrease the oropharyngeal bacterial colonization and presence of causative bacteria of VAP. In view of the paucity of medical economics studies, our objective was to determine the cost of implementing this oral care program for preventing VAP. In five ICUs, during period 1, caregivers used a foam stick for oral care and, during period 2, a stick and tooth brushing with aspiration. Budgetary effect of the new program from the hospital's point of view was analyzed for both periods. The costs avoided were calculated from the incidence density of VAP (cases per 1000 days of intubation). The cost study included device cost, benefit lost, and ICU cost (medication, employer and employee contributions, blood sample analysis…). A total of 2030 intubated patients admitted to the ICUs benefited from oral care. The cost of implementing the study protocol was estimated to be €11,500 per year. VAP rates decreased significantly between the two periods (p1 = 12.8% and p2 = 8.5%, p = 0.002). The VAP revenue was ranged from €28,000 to €45,000 and the average cost from €39,906 to €42,332. The total cost assessment calculated was thus around €1.9 million in favor of the new oral care program. Our study showed that the implementation of a simple strategy improved the quality of patient care is economically viable. NCT02400294.

  4. Preventable health and cost burden of adverse birth outcomes associated with pregestational diabetes in the United States.

    Science.gov (United States)

    Peterson, Cora; Grosse, Scott D; Li, Rui; Sharma, Andrea J; Razzaghi, Hilda; Herman, William H; Gilboa, Suzanne M

    2015-01-01

    Preconception care for women with diabetes can reduce the occurrence of adverse birth outcomes. We aimed to estimate the preconception care (PCC)-preventable health and cost burden of adverse birth outcomes associated with diagnosed and undiagnosed pregestational diabetes mellitus (PGDM) in the United States. Among women of reproductive age (15-44 years), we estimated age- and race/ethnicity-specific prevalence of diagnosed and undiagnosed diabetes. We applied age and race/ethnicity-specific pregnancy rates, estimates of the risk reduction from PCC for 3 adverse birth outcomes (preterm birth, major birth defects, and perinatal mortality), and lifetime medical and lost productivity costs for children with those outcomes. Using a probabilistic model, we estimated the reduction in adverse birth outcomes and costs associated with universal PCC compared with no PCC among women with PGDM. We did not assess maternal outcomes and associated costs. We estimated 2.2% of US births are to women with PGDM. Among women with diagnosed diabetes, universal PCC might avert 8397 (90% prediction interval [PI], 5252-11,449) preterm deliveries, 3725 (90% PI, 3259-4126) birth defects, and 1872 (90% PI, 1239-2415) perinatal deaths annually. Associated discounted lifetime costs averted for the affected cohort of children could be as high as $4.3 billion (90% PI, 3.4-5.1 billion) (2012 US dollars). PCC among women with undiagnosed diabetes could yield an additional $1.2 billion (90% PI, 951 million-1.4 billion) in averted cost. Results suggest a substantial health and cost burden associated with PGDM that could be prevented by universal PCC, which might offset the cost of providing such care. Published by Elsevier Inc.

  5. "I Always Feel Like I Have to Rush…" Pet Owner and Small Animal Veterinary Surgeons' Reflections on Time during Preventative Healthcare Consultations in the United Kingdom.

    Science.gov (United States)

    Belshaw, Zoe; Robinson, Natalie J; Dean, Rachel S; Brennan, Marnie L

    2018-02-08

    Canine and feline preventative healthcare consultations can be more complex than other consultation types, but they are typically not allocated additional time in the United Kingdom (UK). Impacts of the perceived length of UK preventative healthcare consultations have not previously been described. The aim of this novel study was to provide the first qualitative description of owner and veterinary surgeon reflections on time during preventative healthcare consultations. Semi-structured telephone interviews were conducted with 14 veterinary surgeons and 15 owners about all aspects of canine and feline preventative healthcare consultations. These qualitative data were thematically analysed, and four key themes identified. This paper describes the theme relating to time and consultation length. Patient, owner, veterinary surgeon and practice variables were recalled to impact the actual, versus allocated, length of a preventative healthcare consultation. Preventative healthcare consultations involving young, old and multi-morbid animals and new veterinary surgeon-owner partnerships appear particularly susceptible to time pressures. Owners and veterinary surgeons recalled rushing and minimizing discussions to keep consultations within their allocated time. The impact of the pace, content and duration of a preventative healthcare consultation may be influential factors in consultation satisfaction. These interviews provide an important insight into the complex nature of preventative healthcare consultations and the behaviour of participants under different perceived time pressures. These data may be of interest and relevance to all stakeholders in dog and cat preventative healthcare.

  6. A community-based delivery system of intermittent preventive treatment of malaria in pregnancy and its effect on use of essential maternity care at health units in Uganda

    DEFF Research Database (Denmark)

    Mbonye, Anthony K; Bygbjerg, I C; Magnussen, Pascal

    2007-01-01

    Community delivery of intermittent preventive treatment of malaria in pregnancy (IPTp) is one potential option that could mitigate malaria in pregnancy. However, there is concern that this approach may lead to complacency among women with low access to essential care at health units. A non-random...

  7. Preventive nebulization of mucolytic agents and bronchodilating drugs in invasively ventilated intensive care unit patients (NEBULAE): study protocol for a randomized controlled trial.

    Science.gov (United States)

    van der Hoeven, Sophia M; Binnekade, Jan M; de Borgie, Corianne A J M; Bosch, Frank H; Endeman, Henrik; Horn, Janneke; Juffermans, Nicole P; van der Meer, Nardo J M; Merkus, Maruschka P; Moeniralam, Hazra S; van Silfhout, Bart; Slabbekoorn, Mathilde; Stilma, Willemke; Wijnhoven, Jan Willem; Schultz, Marcus J; Paulus, Frederique

    2015-09-02

    Preventive nebulization of mucolytic agents and bronchodilating drugs is a strategy aimed at the prevention of sputum plugging, and therefore atelectasis and pneumonia, in intubated and ventilated intensive care unit (ICU) patients. The present trial aims to compare a strategy using the preventive nebulization of acetylcysteine and salbutamol with nebulization on indication in intubated and ventilated ICU patients. The preventive nebulization of mucolytic agents and bronchodilating drugs in invasively ventilated intensive care unit patients (NEBULAE) trial is a national multicenter open-label, two-armed, randomized controlled non-inferiority trial in the Netherlands. Nine hundred and fifty intubated and ventilated ICU patients with an anticipated duration of invasive ventilation of more than 24 hours will be randomly assigned to receive either a strategy consisting of preventive nebulization of acetylcysteine and salbutamol or a strategy consisting of nebulization of acetylcysteine and/or salbutamol on indication. The primary endpoint is the number of ventilator-free days and surviving on day 28. Secondary endpoints include ICU and hospital length of stay, ICU and hospital mortality, the occurrence of predefined pulmonary complications (acute respiratory distress syndrome, pneumonia, large atelectasis and pneumothorax), and the occurrence of predefined side effects of the intervention. Related healthcare costs will be estimated in a cost-benefit and budget-impact analysis. The NEBULAE trial is the first randomized controlled trial powered to investigate whether preventive nebulization of acetylcysteine and salbutamol shortens the duration of ventilation in critically ill patients. NCT02159196, registered on 6 June 2014.

  8. Estimated Human and Economic Burden of Four Major Adult Vaccine-Preventable Diseases in the United States, 2013.

    Science.gov (United States)

    McLaughlin, John M; McGinnis, Justin J; Tan, Litjen; Mercatante, Annette; Fortuna, Joseph

    2015-08-01

    Low uptake of routinely recommended adult immunizations is a public health concern. Using data from the peer-reviewed literature, government disease-surveillance programs, and the US Census, we developed a customizable model to estimate human and economic burden caused by four major adult vaccine-preventable diseases (VPD) in 2013 in the United States, and for each US state individually. To estimate the number of cases for each adult VPD for a given population, we multiplied age-specific incidence rates obtained from the literature by age-specific 2013 Census population data. We then multiplied the estimated number of cases for a given population by age-specific, estimated medical and indirect (non-medical) costs per case. Adult VPDs examined were: (1) influenza, (2) pneumococcal disease (both invasive disease and pneumonia), (3) herpes zoster (shingles), and (4) pertussis (whooping cough). Sensitivity analyses simulated the impact of various epidemiological scenarios on the total estimated economic burden. Estimated US annual cost for the four adult VPDs was $26.5 billion (B) among adults aged 50 years and older, $15.3B (58 %) of which was attributable to those 65 and older. Among adults 50 and older, influenza, pneumococcal disease, herpes zoster, and pertussis made up $16.0B (60 %), $5.1B (19 %), $5.0B (19 %), and $0.4B (2 %) of the cost, respectively. Among those 65 and older, they made up $8.3B (54 %), $3.8B (25 %), $3.0B (20 %), and 0.2B (1 %) of the cost, respectively. Most (80-85 %) pneumococcal costs stemmed from nonbacteremic pneumococcal pneumonia (NPP). Cost attributable to adult VPD in the United States is substantial. Broadening adult immunization efforts beyond influenza only may help reduce the economic burden of adult VPD, and a pneumococcal vaccination effort, primarily focused on reducing NPP, may constitute a logical starting place. Sensitivity analyses revealed that a pandemic influenza season or change in size of the US elderly population

  9. Educational Contributions Of The Nurse In The Prevention Of Sepsis In The Unit Of Intensive Therapy: Integrative Review

    Directory of Open Access Journals (Sweden)

    Alana Morais Venancio

    2017-02-01

    Full Text Available Sepsis is defined as a syndrome of inflammatory response, motivated by an aggressive agent, associated with systemic infection, the early approach of the infectious agent, both in the direction of diagnosis and in the control of infectious focus, are fundamental for the good evolution of the patient. This pathology has been considered a global health problem, affecting a large number of people and causing high rates of morbidity and mortality. OBJECTIVE: The study aimed to investigate how nurses contribute in an educational way in the prevention of complications caused by sepsis in an intensive care unit. METHOD: The research was carried out through an electronic search of scientific papers published in the databases LILACS, SCIELO and PUBMED, portal of the virtual library in health. Other materials were located in scientific journals available on university websites and articles related to the subject. The initial evaluation of the material occurred through the reading of the abstracts, in order to select those that met the objectives of the study, with this, 37 articles were selected. In carrying out the research it was possible to verify that the recognition of sepsis by nursing professionals is mainly identified through the changes in the signs and symptoms that are observed through the provision of care to these critical patients. RESULTS: It has been shown that even with all the advances in the production of knowledge about the pathophysiology and the treatment of sepsis, it is still possible to find several difficulties for the proper handling in the diagnosis and in the ideal treatment for each particular case. CONCLUSION: The professional nurse should always be updating and seeking new knowledge for a fast, safe and effective action, in conjunction with the entire health team to promote quality and resolutive care for the patient, especially those affected by sepsis.

  10. 75 FR 38412 - Safety Zone; San Diego POPS Fireworks, San Diego, CA

    Science.gov (United States)

    2010-07-02

    ...-AA00 Safety Zone; San Diego POPS Fireworks, San Diego, CA AGENCY: Coast Guard, DHS. ACTION: Temporary... waters of San Diego Bay in support of the San Diego POPS Fireworks. This safety zone is necessary to... San Diego POPS Fireworks, which will include fireworks presentations conducted from a barge in San...

  11. Geologic Map of the San Luis Quadrangle, Costilla County, Colorado

    Science.gov (United States)

    Machette, Michael N.; Thompson, Ren A.; Drenth, Benjamin J.

    2008-01-01

    The map area includes San Luis and the primarily rural surrounding area. San Luis, the county seat of Costilla County, is the oldest surviving settlement in Colorado (1851). West of the town are San Pedro and San Luis mesas (basalt-covered tablelands), which are horsts with the San Luis fault zone to the east and the southern Sangre de Cristo fault zone to the west. The map also includes the Sanchez graben (part of the larger Culebra graben), a deep structural basin that lies between the San Luis fault zone (on the west) and the central Sangre de Cristo fault zone (on the east). The oldest rocks exposed in the map area are the Pliocene to upper Oligocene basin-fill sediments of the Santa Fe Group, and Pliocene Servilleta Basalt, a regional series of 3.7?4.8 Ma old flood basalts. Landslide deposits and colluvium that rest on sediments of the Santa Fe Group cover the steep margins of the mesas. Rare exposures of the sediment are comprised of siltstones, sandstones, and minor fluvial conglomerates. Most of the low ground surrounding the mesas and in the graben is covered by surficial deposits of Quaternary age. The alluvial deposits are subdivided into three Pleistocene-age units and three Holocene-age units. The oldest Pleistocene gravel (unit Qao) forms extensive coalesced alluvial fan and piedmont surfaces, the largest of which is known as the Costilla Plain. This surface extends west from San Pedro Mesa to the Rio Grande. The primary geologic hazards in the map area are from earthquakes, landslides, and localized flooding. There are three major fault zones in the area (as discussed above), and they all show evidence for late Pleistocene to possible Holocene movement. The landslides may have seismogenic origins; that is, they may be stimulated by strong ground shaking during large earthquakes. Machette and Thompson based this geologic map entirely on new mapping, whereas Drenth supplied geophysical data and interpretations.

  12. Structural interventions to prevent HIV/sexually transmitted disease: are they cost-effective for women in the southern United States?

    Science.gov (United States)

    Cohen, Deborah A; Wu, Shin-Yi; Farley, Thomas A

    2006-07-01

    Structural interventions are theoretically promising for populations with a low prevalence of HIV, because they can reach large numbers of people to influence their social norms and collective risky behaviors for a relatively low cost per person. Because HIV transmission is continuing to increase among women in the southern United States, interventions to stem this epidemic are particularly warranted. This study explores whether structural interventions may be a cost-effective way to prevent HIV in this population. We used the cost-effectiveness estimator, "Maximizing the Benefit" to determine the relative cost-effectiveness of 6 structural HIV prevention interventions. "Maximizing the Benefit" is a spreadsheet tool using mathematical models to estimate the cost per HIV infection prevented taking into account the epidemiologic contexts, behavioral change as a result of an intervention, and the costs of intervention. We applied estimates of HIV prevalence related to blacks in the southern United States. All the structural interventions were cost-effective compared with average lifetime treatment costs of HIV, but mass media, condom availability, and alcohol taxes theoretically prevented the largest numbers of HIV infections. Although the assumptions used in cost-effectiveness estimates have many limitations, they do allow for a relative comparison of different interventions and help to inform policy decisions related to the allocation of HIV prevention resources. Structural interventions hold the greatest promise in reducing HIV transmission among low-prevalence populations.

  13. An overview of San Francisco Bay PORTS

    Science.gov (United States)

    Cheng, Ralph T.; McKinnie, David; English, Chad; Smith, Richard E.

    1998-01-01

    The Physical Oceanographic Real-Time System (PORTS) provides observations of tides, tidal currents, and meteorological conditions in real-time. The San Francisco Bay PORTS (SFPORTS) is a decision support system to facilitate safe and efficient maritime commerce. In addition to real-time observations, SFPORTS includes a nowcast numerical model forming a San Francisco Bay marine nowcast system. SFPORTS data and nowcast numerical model results are made available to users through the World Wide Web (WWW). A brief overview of SFPORTS is presented, from the data flow originated at instrument sensors to final results delivered to end users on the WWW. A user-friendly interface for SFPORTS has been designed and implemented. Appropriate field data analysis, nowcast procedures, design and generation of graphics for WWW display of field data and nowcast results are presented and discussed. Furthermore, SFPORTS is designed to support hazardous materials spill prevention and response, and to serve as resources to scientists studying the health of San Francisco Bay ecosystem. The success (or failure) of the SFPORTS to serve the intended user community is determined by the effectiveness of the user interface.

  14. Methodology and measures for preventing unacceptable flow-accelerated corrosion thinning of pipelines and equipment of NPP power generating units

    Science.gov (United States)

    Tomarov, G. V.; Shipkov, A. A.; Lovchev, V. N.; Gutsev, D. F.

    2016-10-01

    Problems of metal flow-accelerated corrosion (FAC) in the pipelines and equipment of the condensate- feeding and wet-steam paths of NPP power-generating units (PGU) are examined. Goals, objectives, and main principles of the methodology for the implementation of an integrated program of AO Concern Rosenergoatom for the prevention of unacceptable FAC thinning and for increasing operational flow-accelerated corrosion resistance of NPP EaP are worded (further the Program). A role is determined and potentialities are shown for the use of Russian software packages in the evaluation and prediction of FAC rate upon solving practical problems for the timely detection of unacceptable FAC thinning in the elements of pipelines and equipment (EaP) of the secondary circuit of NPP PGU. Information is given concerning the structure, properties, and functions of the software systems for plant personnel support in the monitoring and planning of the inservice inspection of FAC thinning elements of pipelines and equipment of the secondary circuit of NPP PGUs, which are created and implemented at some Russian NPPs equipped with VVER-1000, VVER-440, and BN-600 reactors. It is noted that one of the most important practical results of software packages for supporting NPP personnel concerning the issue of flow-accelerated corrosion consists in revealing elements under a hazard of intense local FAC thinning. Examples are given for successful practice at some Russian NPP concerning the use of software systems for supporting the personnel in early detection of secondary-circuit pipeline elements with FAC thinning close to an unacceptable level. Intermediate results of working on the Program are presented and new tasks set in 2012 as a part of the updated program are denoted. The prospects of the developed methods and tools in the scope of the Program measures at the stages of design and construction of NPP PGU are discussed. The main directions of the work on solving the problems of flow

  15. Prevalence and Correlates of Heroin–Methamphetamine Co-Injection Among Persons Who Inject Drugs in San Diego, California, and Tijuana, Baja California, Mexico

    Science.gov (United States)

    Meacham, Meredith C.; Strathdee, Steffanie A.; Rangel, Gudelia; Armenta, Richard F.; Gaines, Tommi L.; Garfein, Richard S.

    2016-01-01

    Objective: Although persons who inject drugs (PWID) in the western United States–Mexico border region are known to inject both heroin and methamphetamine, little is known about the prevalence and risks associated with co-injection of this depressant–stimulant combination (also known as “goofball” and “Mexican speedball”). Method: Baseline data from parallel cohort studies of PWID conducted concurrently in San Diego, CA, and Tijuana, Mexico, were used to estimate the prevalence and identify correlates of heroin–methamphetamine co-injection. PWID older than 18 years of age who reported injecting illicit drugs in the past month (N = 1,311; 32.7% female) were recruited in San Diego (n = 576) and Tijuana (n = 735) and completed interviewer-administered questionnaires. Bivariate and multivariable logistic regression analyses were used to identify correlates of heroin–methamphetamine co-injection. Results: The prevalence of co-injection in the past 6 months was 39.9% overall and was higher in Tijuana (55.8%) than in San Diego (19.8%). In multivariable analyses adjusting for study cohort, distributive syringe sharing, purchasing syringes prefilled with drugs, finding it hard to get new syringes, reporting great or urgent need for treatment, and younger age were independently associated with co-injection. Past-6-month overdose was significantly associated with higher odds of co-injection in San Diego than in Tijuana. Conclusions: These findings indicate that heroin–methamphetamine co-injection is more common in Tijuana than in San Diego, yet this practice was only associated with overdose in San Diego. Heroin–methamphetamine co-injection was also independently associated with HIV-associated injection risk behaviors. Overdose-prevention interventions should address co-injection of depressants and stimulants. PMID:27588536

  16. Prevalence and Correlates of Heroin-Methamphetamine Co-Injection Among Persons Who Inject Drugs in San Diego, California, and Tijuana, Baja California, Mexico.

    Science.gov (United States)

    Meacham, Meredith C; Strathdee, Steffanie A; Rangel, Gudelia; Armenta, Richard F; Gaines, Tommi L; Garfein, Richard S

    2016-09-01

    Although persons who inject drugs (PWID) in the western United States-Mexico border region are known to inject both heroin and methamphetamine, little is known about the prevalence and risks associated with co-injection of this depressant-stimulant combination (also known as "goofball" and "Mexican speedball"). Baseline data from parallel cohort studies of PWID conducted concurrently in San Diego, CA, and Tijuana, Mexico, were used to estimate the prevalence and identify correlates of heroin-methamphetamine co-injection. PWID older than 18 years of age who reported injecting illicit drugs in the past month (N = 1,311; 32.7% female) were recruited in San Diego (n = 576) and Tijuana (n = 735) and completed interviewer-administered questionnaires. Bivariate and multivariable logistic regression analyses were used to identify correlates of heroin-meth-amphetamine co-injection. The prevalence of co-injection in the past 6 months was 39.9% overall and was higher in Tijuana (55.8%) than in San Diego (19.8%). In multivariable analyses adjusting for study cohort, distributive syringe sharing, purchasing syringes prefilled with drugs, finding it hard to get new syringes, reporting great or urgent need for treatment, and younger age were independently associated with co-injection. Past-6-month overdose was significantly associated with higher odds of co-injection in San Diego than in Tijuana. These findings indicate that heroin-methamphetamine co-injection is more common in Tijuana than in San Diego, yet this practice was only associated with overdose in San Diego. Heroin-methamphetamine coinjection was also independently associated with HIV-associated injection risk behaviors. Overdose-prevention interventions should address co-injection of depressants and stimulants.

  17. The legislatio policy and practice concerning the prevention of stress atwork in the Netherlands, United Kingdom, Germany and France

    NARCIS (Netherlands)

    Gier, E. de; Kompier, M.; Draaisma, D.; Smulders, P.G.W.

    1994-01-01

    Last year, at the request of the Directorate-General of Labour of the Dutch Ministry of Social Affairs and Employment, TNO Institute of Preventive Health Care (NIPG) carried out an investigative, qualitative survey of the legislation, policy and practices concerning prevention of stress at work in

  18. Evaluation of a Statewide Initiative in the United States to Prevent/Reduce Sexual Harassment in Schools

    Science.gov (United States)

    Weist, Mark D.; Bryant, Yaphet U.; Dantzler, Joyce; Martin, Saran; D'Amico, Marie; Griffith, Brian; Gallun, Betsy

    2009-01-01

    Purpose: The purpose of this paper is to identify best practices in the implementation of school-based sexual violence prevention education. Design/methodology/approach: A three-phase plan was implemented to evaluate the Sexual Harassment/Assault Prevention Project (SHAPP) in one state in the USA. First, a structured review of the prevention…

  19. 77 FR 32716 - Price for the 2012 American Eagle San Francisco Two-Coin Silver Proof Set

    Science.gov (United States)

    2012-06-01

    ... DEPARTMENT OF THE TREASURY United States Mint Price for the 2012 American Eagle San Francisco Two...: The United States Mint is announcing the price of the 2012 American Eagle San Francisco Two-Coin Silver Proof Set. The coin set will be offered for sale at a price of $149.95. FOR FURTHER INFORMATION...

  20. Implications of design on infection prevention and control practice in a novel hospital unit: the Medical Ward of the 21st Century.

    Science.gov (United States)

    VanSteelandt, Amanda; Conly, John; Ghali, William; Mather, Charles

    2015-01-01

    The physical design of hospital wards is associated with transmission of pathogenic organisms and hospital-acquired infections. A novel hospital unit, the Medical Ward of the 21st Century (W21C), optimizes features for infection prevention and control practices. Ethnographic research on the W21C versus conventional hospital wards examined the experiential and behavioural elements of the different designs. Three recurring themes emerged regarding the design features on the W21C and included visual cues, 'having a place for things', and less sharing of spaces and materials. Observational data of healthcare worker practices demonstrated significantly higher compliance with hand hygiene opportunities on the W21C compared with older hospital units. These findings suggest how the physical design of a hospital ward may enhance infection prevention and control practices.

  1. San Onofre - the evolution of outage management

    International Nuclear Information System (INIS)

    Slagle, K.A.

    1993-01-01

    With the addition of units 2 and 3 to San Onofre nuclear station in 1983 and 1984, it became evident that a separate group was needed to manage outages. Despite early establishment of a division to handle outages, it was a difficult journey to make the changes to achieve short outages. Early organizational emphasis was on developing an error-free operating environment and work culture. This is difficult for a relatively large organization at a three-unit site. The work processes and decision styles were designed to be very deliberate with many checks and balances. The organization leadership and accountability were focused in the traditional operations, maintenance, and engineering divisions. Later, our organization emphasis shifted to achieving engineering excellence. With a sound foundation of operating and engineering excellence, our organizational focus has turned to achieving quality outages. This means accomplishing the right work in a shorter duration and having the units run until the next refueling

  2. Género, etnia y generación en la prevención e interrupción de embarazos en jóvenes estudiantes hablantes de lenguas mayas migrantes a San Cristóbal de las Casas, Chiapas (México Gênero, etnia e geração na prevenção e interrupção da gravidez em jovens estudantes de língua maia migrantes para San Cristobal de las Casas, Chiapas (México Gender, ethnicity and generation in pregnancy prevention and interruption among young Mayan speaking migrant students in San Cristobal de las Casas, Chiapas (Mexico

    Directory of Open Access Journals (Sweden)

    Diana L. Reartes

    2011-07-01

    education, place of residence, language spoken, among other factors. The article looks into ways of pregnancy prevention and interruption among Mayan speaking students (both men and women, who have migrated from indigenous communities to the city of San Cristobal de las Casas, in Chiapas.

  3. Unmet healthcare need among women who use methamphetamine in San Francisco.

    Science.gov (United States)

    Powelson, Elisabeth; Lorvick, Jennifer; Lutnick, Alexandra; Wenger, Lynn; Klausner, Jeffery; Kral, Alex H

    2014-02-01

    Methamphetamine use has increased substantially in the United States since the 1990s. Few studies have examined the healthcare service needs of women who use methamphetamine. This study describes unmet medical needs in a community-based sample of women who use methamphetamine in San Francisco, CA. Women who use methamphetamine were recruited in San Francisco and participated in a computer-assisted survey (N = 298 HIV-negative women). Multivariate analysis was performed to explore associations among sociodemographic variables, drug use, use of health and social services, and unmet healthcare need across three domains: chronic health problems, dermatologic problems, and women's preventive healthcare. Sixty-nine percent of participants reported a need for care for a chronic health condition, and 31% of them had an unmet need for care, in the last six months. Thirty-five percent of participants reported a need for dermatologic healthcare, and 66% had an unmet need for care in the last 6 months. Ninety-two percent of participants reported a need for women's preventive healthcare and 46% had an unmet need for care in the last year. Women who reported having a healthcare provider had lower odds of reporting an unmet need for a chronic health condition or women's preventive healthcare. Women who used a case manager had lower odds of having an unmet need for dermatologic care. A significant proportion of women who use methamphetamine in this sample had an unmet need for women's preventive healthcare, and overall these women had a significant unmet need for healthcare. These findings suggest that contact with a healthcare provider or a caseworker could help to expand access to healthcare for this vulnerable population.

  4. Perspective View, San Andreas Fault

    Science.gov (United States)

    2000-01-01

    The prominent linear feature straight down the center of this perspective view is California's famous San Andreas Fault. The image, created with data from NASA's Shuttle Radar Topography Mission (SRTM), will be used by geologists studying fault dynamics and landforms resulting from active tectonics. This segment of the fault lies west of the city of Palmdale, Calif., about 100 kilometers (about 60 miles) northwest of Los Angeles. The fault is the active tectonic boundary between the North American plate on the right, and the Pacific plate on the left. Relative to each other, the Pacific plate is moving away from the viewer and the North American plate is moving toward the viewer along what geologists call a right lateral strike-slip fault. Two large mountain ranges are visible, the San Gabriel Mountains on the left and the Tehachapi Mountains in the upper right. Another fault, the Garlock Fault lies at the base of the Tehachapis; the San Andreas and the Garlock Faults meet in the center distance near the town of Gorman. In the distance, over the Tehachapi Mountains is California's Central Valley. Along the foothills in the right hand part of the image is the Antelope Valley, including the Antelope Valley California Poppy Reserve. The data used to create this image were acquired by SRTM aboard the Space Shuttle Endeavour, launched on February 11, 2000.This type of display adds the important dimension of elevation to the study of land use and environmental processes as observed in satellite images. The perspective view was created by draping a Landsat satellite image over an SRTM elevation model. Topography is exaggerated 1.5 times vertically. The Landsat image was provided by the United States Geological Survey's Earth Resources Observations Systems (EROS) Data Center, Sioux Falls, South Dakota.SRTM uses the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR) that flew twice on the Space Shuttle Endeavour

  5. 75 FR 71106 - San Jose Water Company; Notice of Application Accepted for Filing and Soliciting Comments...

    Science.gov (United States)

    2010-11-22

    ... consumptive domestic use. The hydraulic capacity of each turbine will be 9.5 cubic feet per second and the...-kilowatt turbine/ generator units in parallel with a pressure reduction valve at the San Jose Water Company...

  6. Integrated corridor management initiative : demonstration phase evaluation, San Diego air quality test plan.

    Science.gov (United States)

    2012-08-01

    This report presents the test plan for conducting the Air Quality Analysis for the United States Department of Transportation (U.S. DOT) evaluation of the San Diego Integrated Corridor Management (ICM) Initiative Demonstration. The ICM projects being...

  7. Integrated corridor management initiative : demonstration phase evaluation, San Diego technical capability analysis test plan.

    Science.gov (United States)

    2012-08-01

    This report presents the test plan for conducting the Technical Capability Analysis for the United States Department of Transportation (U.S. DOT) evaluation of the San Diego Integrated Corridor Management (ICM) Initiative Demonstration. The ICM proje...

  8. Factors that encourage and discourage policy-making to prevent childhood obesity: Experience in the United States.

    Science.gov (United States)

    Rutkow, Lainie; Jones-Smith, Jesse; Walters, Hannah J; O'Hara, Marguerite; Bleich, Sara N

    2016-12-01

    Policy-makers throughout the world seek to address childhood obesity prevention, yet little is known about factors that influence policy-makers' decisions on this topic. From September 2014 to April 2015, we conducted 43 semi-structured interviews about factors that encourage and discourage policy-makers' support for childhood obesity prevention policies. We interviewed policy-makers (n = 12) and two other groups engaged with childhood obesity prevention policies: representatives of non-governmental organizations (n = 24) and academics (n = 7). Factors that encourage policy-makers' support for childhood obesity prevention policies included: positive impact on government finances, an existing evidence base, partnerships with community-based collaborators, and consistency with policy-makers' priorities. Factors that discourage policy-makers' support included the following: perceptions about government's role, food and beverage industry opposition, and policy-makers' beliefs about personal responsibility. As public health practitioners, advocates, and others seek to advance childhood obesity prevention in the U.S. and elsewhere, the factors we identified offer insights into ways to frame proposed policies and strategies to influence policy-makers.

  9. Compliance with Prevention Practices and their Association with Central Line-Associated Blood Stream Infections in Neonatal Intensive Care Units

    Science.gov (United States)

    Zachariah, Philip; Furuya, E. Yoko; Edwards, Jeffrey; Dick, Andrew; Liu, Hangsheng; Herzig, Carolyn; Pogorzelska-Maziarz, Monika; Stone, Patricia W.; Saiman, Lisa

    2014-01-01

    Background Bundles and checklists have been shown to decrease CLABSIs, but implementation of these practices and association with CLABSI rates have not been described nationally. We describe implementation and levels of compliance with prevention practices in a sample of US Neonatal ICUs and assess their association with CLABSI rates. Methods An online survey assessing infection prevention practices was sent to hospitals participating in National Healthcare Safety Network CLABSI surveillance in October 2011. Participating hospitals permitted access to their NICU CLABSI rates. Multivariable regressions were used to test the association between compliance with NICU specific CLABSI prevention practices and corresponding CLABSI rates. Results Overall, 190 Level II/III and Level III NICUs participated. The majority of NICUs had written policies (84%-93%) and monitored compliance with bundles and checklists (88% - 91%). Reporting ≥ 95% compliance for any of the practices ranged from 50%- 63%. Reporting ≥ 95% compliance with insertion checklist and assessment of daily line necessity were significantly associated with lower CLABSI rates (pprevention policies and monitor compliance, although reporting compliance ≥ 95% was suboptimal. Reporting ≥ 95% compliance with select CLABSI prevention practices was associated with lower CLABSI rates. Further studies should focus on identifying and improving compliance with effective CLABSI prevention practices in neonates. PMID:25087136

  10. A Comparison of Willingness to Pay to Prevent Child Maltreatment Deaths in Ecuador and the United States

    Science.gov (United States)

    Corso, Phaedra S.; Ingels, Justin B.; Roldos, M. Isabel

    2013-01-01

    Estimating the benefits of preventing child maltreatment (CM) is essential for policy makers to determine whether there are significant returns on investment from interventions to prevent CM. The aim of this study was to estimate the benefits of preventing CM deaths in an Ecuadorian population, and to compare the results to a similar study in a US population. The study used the contingent valuation method to elicit respondents’ willingness to pay (WTP) for a 1 in 100,000 reduction in the risk of CM mortality. After adjusting for differences in purchasing power, the WTP to prevent the CM mortality risk reduction in the Ecuador population was $237 and the WTP for the same risk reduction in the US population was $175. In the pooled analysis, WTP for a reduction in CM mortality was significantly impacted by country (p = 0.03), history of CM (p = 0.007), payment mechanism (p Ecuador, may be better served by developing their own benefits estimates for use in future benefit-cost analyses of interventions designed to prevent CM. PMID:23538730

  11. 76 FR 1386 - Safety Zone; Centennial of Naval Aviation Kickoff, San Diego Bay, San Diego, CA

    Science.gov (United States)

    2011-01-10

    ...-AA00 Safety Zone; Centennial of Naval Aviation Kickoff, San Diego Bay, San Diego, CA AGENCY: Coast... zone on the navigable waters of San Diego Bay in San Diego, CA in support of the Centennial of Naval... February 12, 2010, the Centennial of Naval Aviation Kickoff will take place in San Diego Bay. In support of...

  12. Riparian Habitat - San Joaquin River

    Data.gov (United States)

    California Natural Resource Agency — The immediate focus of this study is to identify, describe and map the extent and diversity of riparian habitats found along the main stem of the San Joaquin River,...

  13. Assessing HIV Stigma on Prevention Strategies for Black Men Who Have Sex with Men in the United States.

    Science.gov (United States)

    Sang, Jordan M; Matthews, Derrick D; Meanley, Steven P; Eaton, Lisa A; Stall, Ron D

    2018-06-02

    The deleterious effects of HIV stigma on HIV+ Black MSM care continuum outcomes have been well-documented. How HIV stigma shapes HIV prevention for HIV- persons in this community is poorly understood. We sought to test the relationship of HIV stigma with HIV- Black MSM on HIV testing, pre-exposure prophylaxis (PrEP) awareness, and PrEP use. We recruited 772 participants at Black Pride events across five US cities in 2016. Multivariable logistic regression models assessed the association of external HIV stigma on prevention outcomes adjusting for sociodemographic variables. Stigma was positively associated with PrEP awareness (AOR = 1.34; 95% CI = 1.09, 1.66; p value = 0.005), and not associated with PrEP use or HIV testing in our sample. These findings highlight the complex nature of HIV stigma among BMSM and include results for PrEP, which can affect uptake other prevention methods. We support anti-HIV stigma efforts and advise further exploration on HIV stigma among BMSM and prevention outcomes.

  14. POLLUTION PREVENTION OPPORTUNITY ASSESSMENT OF THE UNITED STATES ARMY CORPS OF ENGINEERS GARRISON DAM HYDRO- ELECTRIC POWERPLANT - RIVERDALE, NORTH DAKOTA

    Science.gov (United States)

    The report describes the results of pollution prevention opportunity assessments conducted at a representative U.S. Army Corps of Engineers civil works dam and hydroelectric power plant. ecommended methods for reducing pollution resulting primarily from the operation of these fac...

  15. Federal travel restrictions to prevent disease transmission in the United States: An analysis of requested travel restrictions.

    Science.gov (United States)

    Jungerman, M Robynne; Vonnahme, Laura A; Washburn, Faith; Alvarado-Ramy, Francisco

    Individuals with certain communicable diseases may pose risks to the health of the traveling public; there has been documented transmission on commercial aircraft of tuberculosis (TB), measles, and severe acute respiratory syndrome (SARS). Federal public health travel restrictions (PHTR) prevent commercial air or international travel of persons with communicable diseases that pose a public health threat. We described demographics and clinical characteristics of all cases considered for PHTR because of suspected or confirmed communicable disease from May 22, 2007, to December 31, 2015. We reviewed 682 requests for PHTR; 414 (61%) actions were completed to place 396 individuals on PHTR. The majority (>99%) had suspected (n = 27) or confirmed (n = 367) infectious pulmonary TB; 58 (16%) had multidrug-resistant-TB. There were 128 (85%) interceptions that prevented the initiation or continuation of travel. PHTR were removed for 310 (78%) individuals after attaining noninfectious status and 86 (22%) remained on PHTR at the end of the analysis period. PHTR effectively prevent exposure during commercial air travel to persons with potentially infectious diseases. In addition, they are effective tools available to public health agencies to prevent commercial travel of individuals with certain communicable diseases and possibly reconnect them with public health authorities. Published by Elsevier Ltd.

  16. Assessment of Critical Care Provider's Application of Preventive Measures for Ventilator-Associated Pneumonia in Intensive Care Units.

    Science.gov (United States)

    Bagheri-Nesami, Masoumeh; Amiri-Abchuyeh, Maryam; Gholipour-Baradari, Afshin; Yazdani-Cherati, Jamshid; Nikkhah, Attieh

    2015-08-01

    The implementation of guidelines for the prevention of Ventilator-associated pneumonia has been shown to have a significant effect in reducing the incidence of VAP. The aim of the present study was to evaluate the implementation of the preventive strategies for VAP in ICUs of university hospitals of Sari, Iran. This cross-sectional study was carried out in 600 beds/day in the ICUs of university hospitals of Sari from April to June 2012. Sampling was done by availability technique in patients receiving mechanical ventilation in the ICU. The implementation of the preventive measures was assessed by a standard checklist with previously approved validity and reliability. The percentage of implementing each of the measures was as follows: sterile suction, 88.44%; semi-recumbent position, 76.8%; oral hygiene, 58.45%; using heat and moisture exchanges (HMEs), 58%; controlling cuff pressure, 46.8%; hand hygiene, 32.8%; using anti-coagulants, 26.8% and physiotherapy, 25.5%. Closed suction system, continuous drainage of subglottic secretions and kinetic beds were not used at all. The overall mean percentage of implementing preventive measures was low and required designing integrated guidelines by considering the conditions of the ICUs in each country, as well as educating and encouraging the staffs to use the recommended guidelines.

  17. Comparative effectiveness of quality improvement interventions for pressure ulcer prevention in academic medical centers in the United States.

    Science.gov (United States)

    Padula, William V; Makic, Mary Beth F; Mishra, Manish K; Campbell, Jonathan D; Nair, Kavita V; Wald, Heidi L; Valuck, Robert J

    2015-06-01

    Prevention of pressure ulcers, one of the hospital-acquired conditions (HACs) targeted by the 2008 nonpayment policy of the Centers for Medicare & Medicaid Services (CMS), is a critical issue. This study was conducted to determine the comparative effectiveness of quality improvement (QI) interventions associated with reduced hospital-acquired pressure ulcer (HAPU) rates. In an quasi-experimental design, interrupted time series analyses were conducted to determine the correlation between HAPU incidence rates and adoption of QI interventions. Among University HealthSystem Consortium hospitals, 55 academic medical centers were surveyed from September 2007 through February 2012 for adoption patterns of QI interventions for pressure ulcer prevention, and hospital-level data for 5,208 pressure ulcer cases were analyzed. Between- and within-hospital reduction significance was tested with t-tests post-CMS policy intervention. Fifty-three (96%) of the 55 hospitals used QI interventions for pressure ulcer prevention. The effect size analysis identified five effective interventions that each reduced pressure ulcer rates by greater than 1 case per 1,000 patient discharges per quarter: leadership initiatives, visual tools, pressure ulcer staging, skin care, and patient nutrition. The greatest reductions in rates occurred earlier in the adoption process (pprevention protocol for pressure ulcers. Hospitals can not only use these findings from this study as part of a QI bundle for preventing HAPUs.

  18. United States family planning providers' knowledge of and attitudes towards preexposure prophylaxis for HIV prevention: a national survey.

    Science.gov (United States)

    Seidman, Dominika; Carlson, Kimberly; Weber, Shannon; Witt, Jacki; Kelly, Patricia J

    2016-05-01

    The Centers for Disease Control and Prevention defines HIV prevention as a core family planning service. The HIV community identified family planning visits as key encounters for women to access preexposure prophylaxis (PrEP) for HIV prevention. No studies explore US family planning providers' knowledge of and attitudes towards PrEP. We conducted a national survey of clinicians to understand barriers and facilitators to PrEP implementation in family planning. Family planning providers recruited via website postings, national meetings, and email completed an anonymous survey in 2015. Descriptive statistics were performed. Among 604 respondents, 495 were eligible for analysis and 342 were potential PrEP prescribers (physicians, nurse practitioners, midwives or physicians assistants). Among potential prescribers, 38% correctly defined PrEP [95% confidence interval (CI): 32.5-42.8], 37% correctly stated the efficacy of PrEP (95% CI: 32.0-42.4), and 36% chose the correct HIV test after a recent exposure (95% CI: 30.6-40.8). Characteristics of those who answered knowledge questions correctly included age less than 35 years, practicing in the Northeast or West, routinely offering HIV testing, providing rectal sexually transmitted infection screening or having seen any PrEP guidelines. Even among providers in the Northeast and West, the proportion of respondents answering questions correctly was less than 50%. Thirty-six percent of respondents had seen any PrEP guidelines. Providers identified lack of training as the main barrier to PrEP implementation; 87% wanted PrEP education. To offer comprehensive HIV prevention services, family planning providers urgently need training on PrEP and HIV testing. US family planning providers have limited knowledge about HIV PrEP and HIV testing, and report lack of provider training as the main barrier to PrEP provision. Provider education is needed to ensure that family planning clients access comprehensive HIV prevention methods

  19. The use of mycobacterial interspersed repetitive unit typing and whole genome sequencing to inform tuberculosis prevention and control activities.

    Science.gov (United States)

    Gilbert, Gwendolyn L; Sintchenko, Vitali

    2013-07-01

    Molecular strain typing of Mycobacterium tuberculosis has been possible for only about 20 years; it has significantly improved our understanding of the evolution and epidemiology of Mycobacterium tuberculosis and tuberculosis disease. Mycobacterial interspersed repetitive unit typing, based on 24 variable number tandem repeat unit loci, is highly discriminatory, relatively easy to perform and interpret and is currently the most widely used molecular typing system for tuberculosis surveillance. Nevertheless, clusters identified by mycobacterial interspersed repetitive unit typing sometimes cannot be confirmed or adequately defined by contact tracing and additional methods are needed. Recently, whole genome sequencing has been used to identify single nucleotide polymorphisms and other mutations, between genotypically indistinguishable isolates from the same cluster, to more accurately trace transmission pathways. Rapidly increasing speed and quality and reduced costs will soon make large scale whole genome sequencing feasible, combined with the use of sophisticated bioinformatics tools, for epidemiological surveillance of tuberculosis.

  20. Trends and disparities in coronary heart disease, stroke, and other cardiovascular diseases in the United States: findings of the national conference on cardiovascular disease prevention.

    Science.gov (United States)

    Cooper, R; Cutler, J; Desvigne-Nickens, P; Fortmann, S P; Friedman, L; Havlik, R; Hogelin, G; Marler, J; McGovern, P; Morosco, G; Mosca, L; Pearson, T; Stamler, J; Stryer, D; Thom, T

    2000-12-19

    A workshop was held September 27 through 29, 1999, to address issues relating to national trends in mortality and morbidity from cardiovascular diseases; the apparent slowing of declines in mortality from cardiovascular diseases; levels and trends in risk factors for cardiovascular diseases; disparities in cardiovascular diseases by race/ethnicity, socioeconomic status, and geography; trends in cardiovascular disease preventive and treatment services; and strategies for efforts to reduce cardiovascular diseases overall and to reduce disparities among subpopulations. The conference concluded that coronary heart disease mortality is still declining in the United States as a whole, although perhaps at a slower rate than in the 1980s; that stroke mortality rates have declined little, if at all, since 1990; and that there are striking differences in cardiovascular death rates by race/ethnicity, socioeconomic status, and geography. Trends in risk factors are consistent with a slowing of the decline in mortality; there has been little recent progress in risk factors such as smoking, physical inactivity, and hypertension control. There are increasing levels of obesity and type 2 diabetes, with major differences among subpopulations. There is considerable activity in population-wide prevention, primary prevention for higher risk people, and secondary prevention, but wide disparities exist among groups on the basis of socioeconomic status and geography, pointing to major gaps in efforts to use available, proven approaches to control cardiovascular diseases. Recommendations for strategies to attain the year 2010 health objectives were made.

  1. An Assessment of Household and Individual-Level Mosquito Prevention Methods during the Chikungunya Virus Outbreak in the United States Virgin Islands, 2014-2015.

    Science.gov (United States)

    Feldstein, Leora R; Rowhani-Rahbar, Ali; Staples, J Erin; Halloran, M Elizabeth; Ellis, Esther M

    2018-03-01

    Recent large-scale chikungunya virus (CHIKV) and Zika virus epidemics in the Americas pose a growing public health threat. Given that mosquito bite prevention and vector control are the main prevention methods available to reduce transmission of these viruses, we assessed adherence to these methods in the United States Virgin Islands (USVI). We interviewed 334 USVI residents between December 2014 and February 2015 to measure differences in mosquito prevention practices by gender, income, presence of CHIKV symptoms, and age. Only 27% (91/334) of participants reported having an air conditioner, and of the 91 with air-conditioners, 18 (20%) reported never using it. Annual household income > $50,000 was associated with owning and using an air conditioner (41%; 95% confidence interval [CI]: 28-53% compared with annual household income ≤ $50,000: 17%; 95% CI: 12-22%). The majority of participants reported the presence of vegetation in their yard or near their home (79%; 265) and a cistern on their property (78%; 259). Only 52 (16%) participants reported wearing mosquito repellent more than once per week. Although the majority (80%; 268) of participants reported having screens on all of their windows and doors, most (82%; 273) of those interviewed still reported seeing mosquitoes in their homes. Given the uniformly low adherence to individual- and household-level mosquito bite prevention measures in the USVI, these findings emphasize the need for improved public health messaging and investment in therapeutic and vaccine research to mitigate vector-borne disease outbreaks.

  2. Effectiveness of EarthTec(®) for killing invasive quagga mussels (Dreissena rostriformis bugensis) and preventing their colonization in the Western United States.

    Science.gov (United States)

    Watters, Ashlie; Gerstenberger, Shawn L; Wong, Wai Hing

    2013-01-01

    Quagga mussels (Dreissena rostriformis bugensis) have created economic and ecological impacts in the western United States since their discovery in 2007. This study focuses on chemical control for preventing the spread of these mussels. The effectiveness of EarthTec(®) in killing quagga mussels (adults, juveniles, and veligers) in Lake Mead, Nevada-Arizona, was evaluated over time across six concentrations: 0, 1, 5, 10, 17, and 83 ppm. One hundred percent mortality of adult and juvenile mussels was achieved after 96 h with 17 ppm and 5 ppm (respectively), and 100% veliger mortality occurred within 30 min at 3 ppm. From December 2010 to February 2011, the effectiveness of EarthTec(®) in preventing veliger colonization was also evaluated and the results showed that 2.8 ppm was effective in preventing veliger colonization on fiberglass panels. This study indicates that EarthTec(®) has the potential to be an effective control agent against the invasive quagga mussel, and more specifically, in preventing the colonization of veligers.

  3. Translating sexual assault prevention from a college campus to a United States military installation: piloting the know-your-power bystander social marketing campaign.

    Science.gov (United States)

    Potter, Sharyn J; Stapleton, Jane G

    2012-05-01

    One population that shares both similar and different characteristics with traditional college-age students is the U.S. Military. Similarities include a high concentration of 18- to 26-year-olds dealing with new found independence, peer pressure, and the presence of social norms that support violence and hypermasculinity. Sexual violence is a major public health problem in the United States, and because of the similarities in the age group of college and military populations, the problems regarding sexual violence in both constituencies have been well-documented. In the current pilot study we seek to add to both current knowledge about and promising practices of translating prevention strategies from one target audience to another. We describe how we translated, administered, and evaluated a bystander intervention social marketing campaign focused on sexual assault prevention that had been found to significantly affect attitude change on a college campus for a U.S. Army installation in Europe. In addition to demonstrating the process of translating prevention strategies across target audiences, findings from this pilot study contribute to the evaluation data on the effectiveness of sexual violence prevention strategies implemented with members of the U.S. Military. From our analysis, we see that research participants indicate that the degree to which the images resonate with them and the familiarity of the context (i.e., social self-identification) significantly effect the participants' personal responsibility for reducing sexual assault, confidence in acting as a bystander, and reported engagement as a bystander.

  4. Oral Pre-Exposure Prophylaxis (PrEP) for Prevention of HIV in Serodiscordant Heterosexual Couples in the United States: Opportunities and Challenges

    Science.gov (United States)

    Myers, Julie E.; Kurth, Ann E.; Cohen, Stephanie E.; Mannheimer, Sharon B.; Simmons, Janie; Pouget, Enrique R.; Trabold, Nicole; Haberer, Jessica E.

    2014-01-01

    Abstract Oral HIV pre-exposure prophylaxis (PrEP) is a promising new biomedical prevention approach in which HIV-negative individuals are provided with daily oral antiretroviral medication for the primary prevention of HIV-1. Several clinical trials have demonstrated efficacy of oral PrEP for HIV prevention among groups at high risk for HIV, with adherence closely associated with level of risk reduction. In the United States (US), three groups have been prioritized for initial implementation of PrEP—injection drug users, men who have sex with men at substantial risk for HIV, and HIV-negative partners within serodiscordant heterosexual couples. Numerous demonstration projects involving PrEP implementation among MSM are underway, but relatively little research has been devoted to study PrEP implementation in HIV-serodiscordant heterosexual couples in the US. Such couples face a unique set of challenges to PrEP implementation at the individual, couple, and provider level with regard to PrEP uptake and maintenance, adherence, safety and toxicity, clinical monitoring, and sexual risk behavior. Oral PrEP also provides new opportunities for serodiscordant couples and healthcare providers for primary prevention and reproductive health. This article provides a review of the critical issues, challenges, and opportunities involved in the implementation of oral PrEP among HIV-serodiscordant heterosexual couples in the US. PMID:25045996

  5. 8 CFR 1215.4 - Procedure in case of alien prevented from departing from the United States.

    Science.gov (United States)

    2010-01-01

    ... IMMIGRATION REVIEW, DEPARTMENT OF JUSTICE IMMIGRATION REGULATIONS CONTROLS OF ALIENS DEPARTING FROM THE UNITED... represented by counsel of his own choice, (3) to have the opportunity to be heard and to present evidence, (4... the time and opportunity to produce evidence and witnesses on his own behalf, and (7) to reasonable...

  6. 78 FR 53243 - Safety Zone; TriRock San Diego, San Diego Bay, San Diego, CA

    Science.gov (United States)

    2013-08-29

    ... this rule because the logistical details of the San Diego Bay triathlon swim were not finalized nor... September 22, 2013. (c) Definitions. The following definition applies to this section: Designated...

  7. The promise of prevention: the effects of four preventable risk factors on national life expectancy and life expectancy disparities by race and county in the United States.

    Directory of Open Access Journals (Sweden)

    Goodarz Danaei

    2010-03-01

    Full Text Available There has been substantial research on psychosocial and health care determinants of health disparities in the United States (US but less on the role of modifiable risk factors. We estimated the effects of smoking, high blood pressure, elevated blood glucose, and adiposity on national life expectancy and on disparities in life expectancy and disease-specific mortality among eight subgroups of the US population (the "Eight Americas" defined on the basis of race and the location and socioeconomic characteristics of county of residence, in 2005.We combined data from the National Health and Nutrition Examination Survey and the Behavioral Risk Factor Surveillance System to estimate unbiased risk factor levels for the Eight Americas. We used data from the National Center for Health Statistics to estimate age-sex-disease-specific number of deaths in 2005. We used systematic reviews and meta-analyses of epidemiologic studies to obtain risk factor effect sizes for disease-specific mortality. We used epidemiologic methods for multiple risk factors to estimate the effects of current exposure to these risk factors on death rates, and life table methods to estimate effects on life expectancy. Asians had the lowest mean body mass index, fasting plasma glucose, and smoking; whites had the lowest systolic blood pressure (SBP. SBP was highest in blacks, especially in the rural South--5-7 mmHg higher than whites. The other three risk factors were highest in Western Native Americans, Southern low-income rural blacks, and/or low-income whites in Appalachia and the Mississippi Valley. Nationally, these four risk factors reduced life expectancy at birth in 2005 by an estimated 4.9 y in men and 4.1 y in women. Life expectancy effects were smallest in Asians (M, 4.1 y; F, 3.6 y and largest in Southern rural blacks (M, 6.7 y; F, 5.7 y. Standard deviation of life expectancies in the Eight Americas would decline by 0.50 y (18% in men and 0.45 y (21% in women if these risks

  8. Ephemeral-stream channel and basin-floor infiltration and recharge in the Sierra Vista subwatershed of the Upper San Pedro Basin, Southeastern Arizona: Chapter J in Ground-water recharge in the arid and semiarid southwestern United States (Professional Paper 1703)

    Science.gov (United States)

    Coes, A.L.; Pool, D.R.; Stonestrom, David A.; Constantz, Jim; Ferré, Ty P.A.; Leake, Stanley A.

    2007-01-01

    The timing and location of streamflow in the San Pedro River are partially dependent on the aerial distribution of recharge in the Sierra Vista subwatershed. Previous investigators have assumed that recharge in the subwatershed occurs only along the mountain fronts by way of stream-channel infiltration near the contact between low-permeability rocks of the mountains and the basin fill. Recent studies in other alluvial basins of the Southwestern United States, however, have shown that significant recharge can occur through the sediments of ephemeral stream channels at locations several kilometers distant from the mountains. The purpose of this study was to characterize the spatial distribution of infiltration and subsequent recharge through the ephemeral channels in the Sierra Vista subwatershed.Infiltration fluxes in ephemeral channels and through the basin floor of the subwatershed were estimated by using several methods. Data collected during the drilling and coring of 16 boreholes included physical, thermal, and hydraulic properties of sediments; chloride concentrations of sediments; and pore-water stable-isotope values and tritium activity. Surface and subsurface sediment temperatures were continuously measured at each borehole.Twelve boreholes were drilled in five ephemeral stream channels to estimate infiltration within ephemeral channels. Active infiltration was verified to at least 20 meters at 11 of the 12 borehole sites on the basis of low sediment-chloride concentrations, high soil-water contents, and pore-water tritium activity similar to present-day precipitation. Consolidated sediments at the twelfth site prevented core recovery and estimation of infiltration. Analytical and numerical methods were applied to determine the surface infiltration flux required to produce the observed sediment-temperature fluctuations at six sites. Infiltration fluxes were determined for summer ephemeral flow events only because no winter flows were recorded at the sites

  9. Healthcare workers and prevention of hepatitis C virus transmission: exploring knowledge, attitudes and evidence-based practices in hemodialysis units in Italy

    Directory of Open Access Journals (Sweden)

    Bianco Aida

    2013-02-01

    Full Text Available Abstract Background Evidence exists regarding the full prevention of HCV transmission to hemodialysis patients by implementing universal precaution. However, little information is available regarding the frequency with which hospitals have adopted evidence-based practices for preventing HCV infection among hemodialysis patients. A cross-sectional survey has been conducted among nurses in Calabria region (Italy in order to acquire information about the level of knowledge, the attitudes and the frequencies of evidence-based practices that prevent hospital transmission of HCV. Methods All 37 hemodialysis units (HDU of Calabria were included in the study and all nurses were invited to participate in the study and to fill in a self-administered questionnaire. Results 90% of the nurses working in HDU participated in the study. Correct answers about HCV pattern of transmission ranged from 73.7% to 99.3% and were significantly higher in respondents who knew that isolation of HCV-infected patients is not recommended and among those who knew that previous bloodstream infections should be included in medical record and among nurses with fewer years of practice. Most correctly thought that evidence-based infection control measures provide adequate protection against transmission of bloodborne pathogens among healthcare workers. Positive attitude was significantly higher among more knowledgeable nurses. Self-reporting of appropriate handwashing procedures were significantly more likely in nurses who were aware that transmission of bloodborne pathogens among healthcare workers may be prevented through adoption of evidence-based practices and with a correct knowledge about HCV transmission patterns. Conclusions Behavior changes should be aimed at abandoning outdated practices and adopting and maintaining evidence-based practices. Initiatives focused at enabling and reinforcing adherence to effective prevention practices among nurses in HDU are strongly needed.

  10. Application of the Life Change Unit model for the prevention of accident proneness among small to medium sized industries in Korea.

    Science.gov (United States)

    Kang, Youngsig; Hahm, Hyojoon; Yang, Sunghwan; Kim, Taegu

    2008-10-01

    Behavior models have provided an accident proneness concept based on life change unit (LCU) factors. This paper describes the development of a Korean Life Change Unit (KLCU) model for workers and managers in fatal accident areas, as well as an evaluation of its application. Results suggest that death of parents is the highest stress-giving factor for employees of small and medium sized industries a rational finding the viewpoint of Korean culture. The next stress-giving factors were shown to be the death of a spouse or loved ones, followed by the death of close family members, the death of close friends, changes of family members' health, unemployment, and jail terms. It turned out that these factors have a serious effect on industrial accidents and work-related diseases. The death of parents and close friends are ranked higher in the KLCU model than that of Western society. Crucial information for industrial accident prevention in real fields will be provided and the provided information will be useful for safety management programs related to accident prevention.

  11. Brigadier General James Stevens Simmons (1890-1954), Medical Corps, United States Army: a career in preventive medicine.

    Science.gov (United States)

    Marble, Sanders

    2012-02-01

    James Simmons began his career in the US Army as a laboratory officer and his assignments progressed into tropical medicine research. His interests and work evolved into preventive medicine (PM, as the Army termed public health), and he took both a PhD and a Doctorate in Public Health. As the Army's leading PM officer he was appointed head of PM in 1940 and guided the Army's PM effort through World War II. His responsibility ran from gas masks through healthy nutrition and occupational health to an enormous variety of diseases; by the war's end, the breadth and importance of PM was reflected in the Preventive Medicine Division, having fully one-sixth of all military personnel at the Surgeon General's Office. Simmons used his strong professional credentials to tap into civilian medicine for expertise the Army lacked and he established organizations that survive to this day. After retirement, he sought to expand the field of public health and raise another generation of public health physicians.

  12. Statin cost effectiveness in primary prevention: A systematic review of the recent cost-effectiveness literature in the United States

    Directory of Open Access Journals (Sweden)

    Mitchell Aaron P

    2012-07-01

    Full Text Available Abstract Background The literature on the cost-effectiveness of statin drugs in primary prevention of coronary heart disease is complex. The objective of this study is to compare the disparate results of recent cost-effectiveness analyses of statins. Findings We conducted a systematic review of the literature on statin cost-effectiveness. The four studies that met inclusion criteria reported varying conclusions about the cost-effectiveness of statin treatment, without a clear consensus as to whether statins are cost-effective for primary prevention. However, after accounting for each study’s assumptions about statin costs, we found substantial agreement among the studies. Studies that assumed statins to be more expensive found them to be less cost-effective, and vice-versa. Furthermore, treatment of low-risk groups became cost-effective as statins became less expensive. Conclusions Drug price is the primary determinant of statin cost-effectiveness within a given risk group. As more statin drugs become generic, patients at low risk for coronary disease may be treated cost-effectively. Though many factors must be weighed in any medical decision, from a cost-effectiveness perspective, statins may now be considered an appropriate therapy for many patients at low risk for heart disease.

  13. Prevention and control of rabies in an age of global travel: a review of travel- and trade-associated rabies events--United States, 1986-2012.

    Science.gov (United States)

    Lankau, E W; Cohen, N J; Jentes, E S; Adams, L E; Bell, T R; Blanton, J D; Buttke, D; Galland, G G; Maxted, A M; Tack, D M; Waterman, S H; Rupprecht, C E; Marano, N

    2014-08-01

    Rabies prevention and control efforts have been successful in reducing or eliminating virus circulation regionally through vaccination of specific reservoir populations. A notable example of this success is the elimination of canine rabies virus variant from the United States and many other countries. However, increased international travel and trade can pose risks for rapid, long-distance movements of ill or infected persons or animals. Such travel and trade can result in human exposures to rabies virus during travel or transit and could contribute to the re-introduction of canine rabies variant or transmission of other viral variants among animal host populations. We present a review of travel- and trade-associated rabies events that highlight international public health obligations and collaborative opportunities for rabies prevention and control in an age of global travel. Rabies is a fatal disease that warrants proactive coordination among international public health and travel industry partners (such as travel agents, tour companies and airlines) to protect human lives and to prevent the movement of viral variants among host populations. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

  14. Report on the International Workshop on Drug Prevention and Treatment in Rural Settings Organized by United Nation Office on Drugs and Crime (UNODC) and World Health Organization (WHO).

    Science.gov (United States)

    Milano, Giulia; Saenz, Elizabeth; Clark, Nicolas; Busse, Anja; Gale, John; Campello, Giovanna; Mattfeld, Elizabeth; Maalouf, Wadih; Heikkila, Hanna; Martelli, Antonietta; Morales, Brian; Gerra, Gilberto

    2017-11-10

    Very little evidence has been reported in literature regarding the misuse of substances in rural areas. Despite the common perception of rural communities as a protective and risk-mitigating environment, the scientific literature demonstrated the existence of many risk factors in rural communities. The Drug Prevention and Health Branch (DHB) of the United Nations Office on Drugs and Crime (UNODC), and the World Health Organization (WHO), in June 2016, organized a meeting of experts in treatment and prevention of SUDs in rural settings. The content presented during the meeting and the related discussion have provided materials for the preparation of an outline document, which is the basis to create a technical tool on SUDs prevention and treatment in rural settings. The UNODC framework for interventions in rural settings is a technical tool aimed to assist policy makers and managers at the national level. This paper is a report on UNODC/WHO efforts to improve the clinical conditions of people affected by SUDs and living in rural areas. The purpose of this article is to draw attention on a severe clinical and social problem in a reality forgotten by everyone.

  15. Regulatory approaches to obesity prevention: A systematic overview of current laws addressing diet-related risk factors in the European Union and the United States.

    Science.gov (United States)

    Sisnowski, Jana; Handsley, Elizabeth; Street, Jackie M

    2015-06-01

    High prevalence of overweight and obesity remains a significant international public health problem. Law has been identified as a tool for obesity prevention and selected high-profile measures have been reported. However, the nature and extent of enacted legislation internationally are unclear. This research provides an overview of regulatory approaches enacted in the United States, the European Union, and EU Member States since 2004. To this end, relevant databases of primary and secondary legislation were systematically searched to identify and explore laws addressing dietary risk factors for obesity. Across jurisdictions, current regulatory approaches to obesity prevention are limited in reach and scope. Target groups are rarely the general population, but instead sub-populations in government-supported settings. Consumer information provision is preferred over taxation and marketing restrictions other than the regulation of health and nutrition claims. In the EU in particular, product reformulation with industry consent has also emerged as a popular small-scale measure. While consistent and widespread use of law is lacking, governments have employed a range of regulatory measures in the name of obesity prevention, indicating that there is, in principle, political will. Results from this study may serve as a starting point for future research and policy development. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  16. The impact of occupational health and safety regulations on prevention through design in construction projects: Perspectives from Spain and the United Kingdom.

    Science.gov (United States)

    Martínez-Aires, María Dolores; Rubio Gámez, María Carmen; Gibb, Alistair

    2015-01-01

    Since the mid-1990 s, Prevention through Design (PtD) has become increasingly prevalent in the built environment. The acceptance of PtD has largely been due to the removal or reduction of risks during the execution phase of construction projects. European States have had the added impetus of national legislation. This paper analyzes the influence of European Union Directive 92/57/EEC on occupational safety and health injury prevention in the project design phase. Qualitative methods comprised individual semi-structured interviews and focus groups with a panel of experts. Sixty individuals from construction and related professions (architects, engineers, constructors, developers, and other construction experts) answered 17 key questions to establish national perceptions of the effectiveness of Directive 92/57/EEC in Spain and the United Kingdom (UK). The implementation of PtD in the project design phase in the UK is clearer since the regulations explicitly state the obligations of project designers as well as those of the coordinator. Interviews with Spanish experts show that, in Spain, the prevention culture is less frequently realized. The most significant differences between the European Directive and national regulations which influence PtD are linked to the Health and Safety Coordinator, and Health and Safety documents.

  17. Your blues ain't like mine: considering integrative antiracism in HIV prevention research with black men who have sex with men in Canada and the United States.

    Science.gov (United States)

    Nelson, LaRon E; Walker, Ja'Nina J; DuBois, Steve N; Giwa, Sulaimon

    2014-12-01

    Evidence-based interventions have been developed and used to prevent HIV infections among black men who have sex with men (MSM) in Canada and the United States; however, the degree to which interventions address racism and other interlocking oppressions that influence HIV vulnerability is not well known. We utilize integrative antiracism to guide a review of HIV prevention intervention studies with black MSM and to determine how racism and religious oppression are addressed in the current intervention evidence base. We searched CINAHL, PsychInfo, MEDLINE and the CDC compendium of evidence-based HIV prevention interventions and identified seventeen interventions. Three interventions targeted black MSM, yet only one intervention addressed racism, religious oppression, cultural assets and religious assets. Most interventions' samples included low numbers of black MSM. More research is needed on interventions that address racism and religious oppression on HIV vulnerability among black MSM. Future research should focus on explicating mechanisms by which multiple oppressions impact HIV vulnerability. We recommend the development and integration of social justice tools for nursing practice that aid in addressing the impacts of racism and other oppressions on HIV vulnerability of black MSM. © 2014 John Wiley & Sons Ltd.

  18. A Welfare Reform--Homelessness--Foster Care Connection? The Story of "Lag Families" and "Limbo Children" in San Diego.

    Science.gov (United States)

    Institute for Children and Poverty, New York, NY.

    An analysis of data from a survey of more than 100 parents residing in emergency shelter in San Diego, California, reveals a portrait of poverty that is prevalent among women and children in the United States today. Homeless families in San Diego, as in the rest of the country, are most often headed by women in their early thirties whose prospects…

  19. A Brief Review of Intimate Partner Violence in the United States: Nature, Correlates, and Proposed Preventative Measures

    Directory of Open Access Journals (Sweden)

    Pamela C. Regan

    2015-12-01

    Full Text Available Aggression and violence are themes which characterize a significant proportion of many close romantic relationships. Both women and men may find themselves caught in a web of intimate terror – controlled, manipulated, and hurt by a coercive and violent partner. In this brief review article, we summarize existing literature on the form of intimate partner violence known as coercive controlling violence (CCV, domestic abuse, or intimate terrorism. We begin by discussing the nature and consequences of CCV relationships. Personal or individual (e.g., biological sex, age, immigrant status, socioeconomic status, attitudes and beliefs, mental health and psychopathology, relational or interpersonal (e.g., relationship type, relationship satisfaction, and environmental (e.g., economic strain, social isolation risk factors associated with the occurrence of domestic abuse are identified. Finally, potential preventative measures at the individual, interpersonal, and sociocultural level that may serve to reduce the likelihood of this pernicious interpersonal phenomenon are considered.

  20. Marketing San Juan Basin gas

    International Nuclear Information System (INIS)

    Posner, D.M.

    1988-01-01

    Marketing natural gas produced in the San Juan Basin of New Mexico and Colorado principally involves four gas pipeline companies with significant facilities in the basin. The system capacity, transportation rates, regulatory status, and market access of each of these companies is evaluated. Because of excess gas supplies available to these pipeline companies, producers can expect improved take levels and prices by selling gas directly to end users and utilities as opposed to selling gas to the pipelines for system supply. The complexities of transporting gas today suggest that the services of an independent gas marketing company may be beneficial to smaller producers with gas supplies in the San Juan Basin

  1. Update: San Andreas Fault experiment

    Science.gov (United States)

    Christodoulidis, D. C.; Smith, D. E.

    1984-01-01

    Satellite laser ranging techniques are used to monitor the broad motion of the tectonic plates comprising the San Andreas Fault System. The San Andreas Fault Experiment, (SAFE), has progressed through the upgrades made to laser system hardware and an improvement in the modeling capabilities of the spaceborne laser targets. Of special note is the launch of the Laser Geodynamic Satellite, LAGEOS spacecraft, NASA's only completely dedicated laser satellite in 1976. The results of plate motion projected into this 896 km measured line over the past eleven years are summarized and intercompared.

  2. Antiretroviral Drug Use in a Cohort of HIV-Uninfected Women in the United States: HIV Prevention Trials Network 064.

    Directory of Open Access Journals (Sweden)

    Iris Chen

    Full Text Available Antiretroviral (ARV drug use was analyzed in HIV-uninfected women in an observational cohort study conducted in 10 urban and periurban communities in the United States with high rates of poverty and HIV infection. Plasma samples collected in 2009-2010 were tested for the presence of 16 ARV drugs. ARV drugs were detected in samples from 39 (2% of 1,806 participants: 27/181 (15% in Baltimore, MD and 12/179 (7% in Bronx, NY. The ARV drugs detected included different combinations of non-nucleoside reverse transcriptase inhibitors and protease inhibitors (1-4 drugs/sample. These data were analyzed in the context of self-reported data on ARV drug use. None of the 39 women who had ARV drugs detected reported ARV drug use at any study visit. Further research is needed to evaluate ARV drug use by HIV-uninfected individuals.

  3. Knowledge and periconceptional use of folic acid for the prevention of neural tube defects in ethnic communities in the United Kingdom: systematic review and meta-analysis.

    Science.gov (United States)

    Peake, Jordana N; Copp, Andrew J; Shawe, Jill

    2013-07-01

    It is widely accepted that periconceptional supplementation with folic acid can prevent a significant proportion of neural tube defects (NTDs). The present study evaluated how folic acid knowledge and periconceptional use for NTD prevention varies by ethnicity in the United Kingdom (U.K.). A literature search was conducted to identify studies that included assessment of folic acid knowledge or use in U.K. women of different ethnicities. Only research and referenced sources published after 1991, the year of the landmark Medical Research Council's Vitamin Study, were included. A meta-analysis was performed of studies that assessed preconceptional folic acid use in Caucasians and non-Caucasians. Five studies met the inclusion criteria for assessment of knowledge and/or use of folic acid supplements in U.K. women including non-Caucasians. The available evidence indicates that South Asians specifically have less knowledge and lower periconceptional use of folic acid than Caucasians; one study found that West Indian and African women also had lower folic acid uptake. A synthesis of results from three of the studies, in a meta-analysis, shows that Caucasians are almost three times more likely to take folic acid before conception than non-Caucasians. From the limited evidence available, U.K. women of non-Caucasian ethnicity appear to have less knowledge and a lower uptake of folic acid supplementation than Caucasians during the periconceptional period. Implementing targeted, innovative education campaigns together with a mandatory fortification policy, including the fortification of ethnic minority foods, will be required for maximum prevention of folic acid-preventable NTDs across different ethnic groups. Copyright © 2013 Wiley Periodicals, Inc.

  4. Defibrillator implantations for primary prevention in the United States: Inappropriate care or inadequate documentation: Insights from the National Cardiovascular Data ICD Registry.

    Science.gov (United States)

    Kaiser, Daniel W; Tsai, Vivian; Heidenreich, Paul A; Goldstein, Mary K; Wang, Yongfei; Curtis, Jeptha; Turakhia, Mintu P

    2015-10-01

    Prior studies have reported that more than 20% of implantable cardioverter-defibrillator (ICD) implantations in the United States do not adhere to trial-based criteria. We sought to investigate the patient characteristics associated with not meeting the inclusion criteria of the clinical trials that have demonstrated the efficacy of primary prevention ICDs. Using data from the National Cardiovascular Data Registry's ICD Registry, we identified patients who received ICDs for primary prevention from January 2006 to December 2008. We determined whether patients met the inclusion criteria of at least 1 of the 4 ICD primary prevention trials: Multicenter Automatic Defibrillator Implantation Trial (MADIT), MADIT-II, Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT), and the Multicenter Unsustained Tachycardia Trial (MUSTT). Among 150,264 patients, 86% met criteria for an ICD implantation based on trial data. The proportion of patients who did not meet trial-based criteria increased as age decreased. In multivariate analysis, the significant predictors for not meeting trial criteria included prior cardiac transplantation (odds ratio [OR] 2.1), pediatric electrophysiology operator (OR 2.0), and high-grade atrioventricular conduction disease (OR 1.4). Among National Cardiovascular Data Registry registrants receiving first-time ICDs for primary prevention, the majority met trial-based criteria. Multivariate analyses suggested that many patients who did not meet the trial-based criteria may have had clinical circumstances that warranted ICD implantation. These findings caution against the use of trial-based indications to determine site quality metrics that could penalize sites that care for younger patients. The planned incorporation of appropriate use criteria into the ICD registry may better characterize patient- and site-level quality and performance. Published by Elsevier Inc.

  5. Vegetation - San Felipe Valley [ds172

    Data.gov (United States)

    California Natural Resource Agency — This Vegetation Map of the San Felipe Valley Wildlife Area in San Diego County, California is based on vegetation samples collected in the field in 2002 and 2005 and...

  6. San Francisco Bay Water Quality Improvement Fund

    Science.gov (United States)

    EPAs grant program to protect and restore San Francisco Bay. The San Francisco Bay Water Quality Improvement Fund (SFBWQIF) has invested in 58 projects along with 70 partners contributing to restore wetlands, water quality, and reduce polluted runoff.,

  7. Prevention of ventilator-associated pneumonia, mortality and all intensive care unit acquired infections by topically applied antimicrobial or antiseptic agents: a meta-analysis of randomized controlled trials in intensive care units.

    Science.gov (United States)

    Pileggi, Claudia; Bianco, Aida; Flotta, Domenico; Nobile, Carmelo G A; Pavia, Maria

    2011-06-24

    Given the high morbidity and mortality attributable to ventilator-associated pneumonia (VAP) in intensive care unit (ICU) patients, prevention plays a key role in the management of patients undergoing mechanical ventilation. One of the candidate preventive interventions is the selective decontamination of the digestive or respiratory tract (SDRD) by topical antiseptic or antimicrobial agents. We performed a meta-analysis to investigate the effect of topical digestive or respiratory tract decontamination with antiseptics or antibiotics in the prevention of VAP, of mortality and of all ICU-acquired infections in mechanically ventilated ICU patients. A meta-analysis of randomised controlled trials was performed. The U.S. National Library of Medicine's MEDLINE database, Embase, and Cochrane Library computerized bibliographic databases, and reference lists of selected studies were used. Selection criteria for inclusion were: randomised controlled trials (RCTs); primary studies; examining the reduction of VAP and/or mortality and/or all ICU-acquired infections in ICU patients by prophylactic use of one or more of following topical treatments: 1) oropharyngeal decontamination using antiseptics or antibiotics, 2) gastrointestinal tract decontamination using antibiotics, 3) oropharyngeal plus gastrointestinal tract decontamination using antibiotics and 4) respiratory tract decontamination using antibiotics; reported enough data to estimate the odds ratio (OR) or risk ratio (RR) and their variance; English language; published through June 2010. A total of 28 articles met all inclusion criteria and were included in the meta-analysis. The overall estimate of efficacy of topical SDRD in the prevention of VAP was 27% (95% CI of efficacy = 16% to 37%) for antiseptics and 36% (95% CI of efficacy = 18% to 50%) for antibiotics, whereas in none of the meta-analyses conducted on mortality was a significant effect found. The effect of topical SDRD in the prevention of all ICU

  8. The San Bernabe power substation; La subestacion San Bernabe

    Energy Technology Data Exchange (ETDEWEB)

    Chavez Sanudo, Andres D. [Luz y Fuerza del Centro, Mexico, D. F. (Mexico)

    1997-12-31

    The first planning studies that gave rise to the San Bernabe substation go back to year 1985. The main circumstance that supports this decision is the gradual restriction for electric power generation that has been suffering the Miguel Aleman Hydro System, until its complete disappearance, to give priority to the potable water supply through the Cutzamala pumping system, that feeds in an important way Mexico City and the State of Mexico. In this document the author describes the construction project of the San Bernabe Substation; mention is made of the technological experiences obtained during the construction and its geographical location is shown, as well as the one line diagram of the same [Espanol] Los primeros estudios de planeacion que dieron origen a la subestacion San Bernabe se remontan al ano de 1985. La circunstancia principal que soporta esta decision es la restriccion paulatina para generar energia que ha venido experimentando el Sistema Hidroelectrico Miguel Aleman, hasta su desaparicion total, para dar prioridad al suministro de agua potable por medio del sistema de bombeo Cutzamala, que alimenta en forma importante a la Ciudad de Mexico y al Estado de Mexico. En este documento el autor describe el proyecto de construccion de la subestacion San Bernabe; se mencionan las experiencias tecnologicas obtenidas durante su construccion y se ilustra su ubicacion geografica, asi como un diagrama unifilar de la misma

  9. 33 CFR 165.754 - Safety Zone: San Juan Harbor, San Juan, PR.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Safety Zone: San Juan Harbor, San Juan, PR. 165.754 Section 165.754 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND... Zone: San Juan Harbor, San Juan, PR. (a) Regulated area. A moving safety zone is established in the...

  10. 76 FR 45693 - Safety Zone; San Diego POPS Fireworks, San Diego, CA

    Science.gov (United States)

    2011-08-01

    ...-AA00 Safety Zone; San Diego POPS Fireworks, San Diego, CA AGENCY: Coast Guard, DHS. ACTION: Temporary... San Diego Bay in support of the San Diego POPS Fireworks. This safety zone is necessary to provide for... of the waterway during scheduled fireworks events. Persons and vessels will be prohibited from...

  11. International travelers with infectious diseases determined by pathology results, Centers for Disease Control and Prevention - United States, 1995-2015.

    Science.gov (United States)

    Angelo, Kristina M; Barbre, Kira; Shieh, Wun-Ju; Kozarsky, Phyllis E; Blau, Dianna M; Sotir, Mark J; Zaki, Sherif R

    2017-09-01

    The failure to consider travel-related diagnoses, the lack of diagnostic capacity for specialized laboratory testing, and the declining number of autopsies may affect the diagnosis and management of travel-related infections. Pre- and post-mortem pathology can help determine causes of illness and death in international travelers. We conducted a retrospective review of biopsy and autopsy specimens sent to the Infectious Diseases Pathology Branch laboratory (IDPBL) at the Centers for Disease Control and Prevention (CDC) for diagnostic testing from 1995 through 2015. Cases were included if the specimen submitted for diagnosis was from a traveler with prior international travel during the disease incubation period and the cause of illness or death was unknown at the time of specimen submission. Twenty-one travelers, six (29%) with biopsy specimens and 15 (71%) with autopsy specimens, met the inclusion criteria. Among the 15 travelers who underwent autopsies, the most common diagnoses were protozoal infections (7 travelers; 47%), including five malaria cases, followed by viral infections (6 travelers; 40%). Biopsy or autopsy specimens can assist in diagnosing infectious diseases in travelers, especially from pathogens not endemic in the U.S. CDC's IDPBL provides a useful resource for clinicians considering infectious diseases in returned travelers. Published by Elsevier Ltd.

  12. [Prevention of an outbreak of Acinetobacter baumannii in intensive care units: study of the efficacy of different mathematical methods].

    Science.gov (United States)

    Fresnadillo-Martínez, María José; García-Merino, Enrique; García-Sánchez, Enrique; Martín-del Rey, Ángel; Rodríguez-Encinas, Ángel; Rodríguez-Sánchez, Gerardo; García-Sánchez, José Elías

    2015-02-01

    Although in past decades, Acinetobacter baumanni infections have been sporadically identified in hospitals, nowadays the nosocomial infections due to this pathogen have notably increased. Its importance is due to its multidrug- resistance, morbidity and mortatility in healthcare settings. Consequently, it is important to predict the evolution of these outbreaks in order to stablish the most efficient control measures. There are several experimental studies shown that the compliance with hand and environmental hygiene and the efficient management of the healthcare work help to control the evolution of these outbreaks. The goal of this work is to formally proof these experimental results by means of the analysis of the results provided by the model. A stochastic mathematical model based on cellular automata was developed. The variables and parameters involved in it have been identified from the knowledge of the epidemiology and main characteristics of Acinetobacter infections. The model provides several simulations from different initial conditions. The analysis of these results proofs in a formal way that the compliance with hand and environmental hygiene and an efficient plannification of the work of healtcare workers yield a decrease in the colonized patients. Moreover, this is the unique model proposed studying the dynamics of an outbreak of A. baumanni. The computational implementation of the model provides us an efficient tool in the management of outbreaks due to A. baumanni. The analysis of the simulations obtained allows us to obtain a formal proof of the behaviour of the measures for control and prevention.

  13. Crustal structure of the coastal and marine San Francisco Bay region, California

    Science.gov (United States)

    Parsons, Tom

    2002-01-01

    As of the time of this writing, the San Francisco Bay region is home to about 6.8 million people, ranking fifth among population centers in the United States. Most of these people live on the coastal lands along San Francisco Bay, the Sacramento River delta, and the Pacific coast. The region straddles the tectonic boundary between the Pacific and North American Plates and is crossed by several strands of the San Andreas Fault system. These faults, which are stressed by about 4 cm of relative plate motion each year, pose an obvious seismic hazard.

  14. A simplified prevention bundle with dual hand hygiene audit reduces early-onset ventilator-associated pneumonia in cardiovascular surgery units: An interrupted time-series analysis.

    Directory of Open Access Journals (Sweden)

    Kang-Cheng Su

    Full Text Available To investigate the effect of a simplified prevention bundle with alcohol-based, dual hand hygiene (HH audit on the incidence of early-onset ventilation-associated pneumonia (VAP.This 3-year, quasi-experimental study with interrupted time-series analysis was conducted in two cardiovascular surgery intensive care units in a medical center. Unaware external HH audit (eHH performed by non-unit-based observers was a routine task before and after bundle implementation. Based on the realistic ICU settings, we implemented a 3-component bundle, which included: a compulsory education program, a knowing internal HH audit (iHH performed by unit-based observers, and a standardized oral care (OC protocol with 0.1% chlorhexidine gluconate. The study periods comprised 4 phases: 12-month pre-implementation phase 1 (eHH+/education-/iHH-/OC-, 3-month run-in phase 2 (eHH+/education+/iHH+/OC+, 15-month implementation phase 3 (eHH+/education+/iHH+/OC+, and 6-month post-implementation phase 4 (eHH+/education-/iHH+/OC-.A total of 2553 ventilator-days were observed. VAP incidences (events/1000 ventilator days in phase 1-4 were 39.1, 40.5, 15.9, and 20.4, respectively. VAP was significantly reduced by 59% in phase 3 (vs. phase 1, incidence rate ratio [IRR] 0.41, P = 0.002, but rebounded in phase 4. Moreover, VAP incidence was inversely correlated to compliance of OC (r2 = 0.531, P = 0.001 and eHH (r2 = 0.878, P < 0.001, but not applied for iHH, despite iHH compliance was higher than eHH compliance during phase 2 to 4. Compared to eHH, iHH provided more efficient and faster improvements for standard HH practice. The minimal compliances required for significant VAP reduction were 85% and 75% for OC and eHH (both P < 0.05, IRR 0.28 and 0.42, respectively.This simplified prevention bundle effectively reduces early-onset VAP incidence. An unaware HH compliance correlates with VAP incidence. A knowing HH audit provides better improvement in HH practice. Accordingly, we suggest

  15. Strengthening government management capacity to scale up HIV prevention programs through the use of Technical Support Units: lessons from Karnataka state, India

    Science.gov (United States)

    Sgaier, Sema K; Anthony, John; Bhattacharjee, Parinita; Baer, James; Malve, Vidyacharan; Bhalla, Aparajita; Hugar, Vijaykumar S

    2014-01-01

    ABSTRACT Scaling up HIV prevention programming among key populations (female sex workers and men who have sex with men) has been a central strategy of the Government of India. However, state governments have lacked the technical and managerial capacity to oversee and scale up interventions or to absorb donor-funded programs. In response, the national government contracted Technical Support Units (TSUs), teams with expertise from the private and nongovernmental sectors, to collaborate with and assist state governments. In 2008, a TSU was established in Karnataka, one of 6 Indian states with the highest HIV prevalence in the country and where monitoring showed that its prevention programs were reaching only 5% of key populations. The TSU provided support to the state in 5 key areas: assisting in strategic planning, rolling out a comprehensive monitoring and evaluation system, providing supportive supervision to intervention units, facilitating training, and assisting with information, education, and communication activities. This collaborative management model helped to increase capacity of the state, enabling it to take over funding and oversight of HIV prevention programs previously funded through donors. With the combined efforts of the TSU and the state government, the number of intervention units statewide increased from 40 to 126 between 2009 and 2013. Monthly contacts with female sex workers increased from 5% in 2008 to 88% in 2012, and with men who have sex with men, from 36% in 2009 to 81% in 2012. There were also increases in the proportion of both populations who visited HIV testing and counseling centers (from 3% to 47% among female sex workers and from 6% to 33% among men who have sex with men) and sexually transmitted infection clinics (from 4% to 75% among female sex workers and from 7% to 67% among men who have sex with men). Changes in sexual behaviors among key populations were also documented. For example, between 2008 and 2010, the proportion of

  16. Use of Transnational Services to Prevent Treatment Interruption in Tuberculosis-Infected Persons Who Leave the United States.

    Science.gov (United States)

    Tschampl, Cynthia A; Garnick, Deborah W; Zuroweste, Edward; Razavi, Moaven; Shepard, Donald S

    2016-03-01

    A major problem resulting from interrupted tuberculosis (TB) treatment is the development of drug-resistant TB, including multidrug-resistant TB (MDR TB), a more deadly and costly-to-treat form of the disease. Global health systems are not equipped to diagnose and treat the current burden of MDR TB. TB-infected foreign visitors and temporary US residents who leave the country during treatment can experience treatment interruption and, thus, are at greater risk for drug-resistant TB. Using epidemiologic and demographic data, we estimated TB incidence among this group, as well as the proportion of patients referred to transnational care-continuity and management services during relocation; each year, ≈2,827 visitors and temporary residents are at risk for TB treatment interruption, 222 (8%) of whom are referred for transnational services. Scale up of transnational services for persons at high risk for treatment interruption is possible and encouraged because of potential health gains and reductions in healthcare costs for the United States and receiving countries.

  17. Vancomycin-resistant enterococcus outbreak in a pediatric intensive care unit: report of successful interventions for control and prevention

    Directory of Open Access Journals (Sweden)

    F. Carmona

    2012-02-01

    Full Text Available The objective of this study is to retrospectively report the results of interventions for controlling a vancomycin-resistant enterococcus (VRE outbreak in a tertiary-care pediatric intensive care unit (PICU of a University Hospital. After identification of the outbreak, interventions were made at the following levels: patient care, microbiological surveillance, and medical and nursing staff training. Data were collected from computer-based databases and from the electronic prescription system. Vancomycin use progressively increased after March 2008, peaking in August 2009. Five cases of VRE infection were identified, with 3 deaths. After the interventions, we noted a significant reduction in vancomycin prescription and use (75% reduction, and the last case of VRE infection was identified 4 months later. The survivors remained colonized until hospital discharge. After interventions there was a transient increase in PICU length-of-stay and mortality. Since then, the use of vancomycin has remained relatively constant and strict, no other cases of VRE infection or colonization have been identified and length-of-stay and mortality returned to baseline. In conclusion, we showed that a bundle intervention aiming at a strict control of vancomycin use and full compliance with the Hospital Infection Control Practices Advisory Committee guidelines, along with contact precautions and hand-hygiene promotion, can be effective in reducing vancomycin use and the emergence and spread of vancomycin-resistant bacteria in a tertiary-care PICU.

  18. Parental weight perceptions: a cause for concern in the prevention and management of childhood obesity in the United Arab Emirates.

    Directory of Open Access Journals (Sweden)

    Abdulla Aljunaibi

    Full Text Available Parental participation is a key factor in the prevention and management of childhood obesity, thus parental recognition of weight problems is essential. We estimated parental perceptions and their determinants in the Emirati population. We invited 1541 students (grade 1-12; 50% boys and their parents, but only 1440 (6-19 years and their parents consented. Of these, 945 Emirati nationals provided data for analysis. Anthropometric and demographic variables were measured by standard methods. CDC BMI percentile charts for age and sex were used to classify children's weight. Parental perception of their children's weight status (underweight, normal, and overweight/obese was recorded. Logistic regression analyses were used to identify independent predictors of parental perceptions of children's weight status. Of all parents, 33.8% misclassified their children's' weight status; underestimating (27.4% or overestimating (6.3%. Misclassification was highest among parents of overweight/obese children (63.5% and underweight (55.1% children. More importantly, parental perceptions of their children being overweight or obese, among truly overweight/obese children, i.e. correct identification of an overweight/obese child as such, were associated with the true child's BMI percentile (CDC with an OR of 1.313 (95% CI: 1.209-1.425; p<0.001 per percentile point, but not age, parental education, household income, and child's sex. We conclude that the majority of parents of overweight/obese children either overestimated or, more commonly, underestimated children's weight status. Predictors of accurate parental perception, in this population, include the true children's BMI, but not age, household income, and sex. Thus, parents having an incorrect perception of their child's weight status may ignore otherwise appropriate health messages.

  19. Groundwater quality in the western San Joaquin Valley, California

    Science.gov (United States)

    Fram, Miranda S.

    2017-06-09

    Groundwater provides more than 40 percent of California’s drinking water. To protect this vital resource, the State of California created the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The Priority Basin Project of the GAMA Program provides a comprehensive assessment of the State’s groundwater quality and increases public access to groundwater-quality information. The Western San Joaquin Valley is one of the study units being evaluated. 

  20. Radiation accident Hospital San Juan de Dios August - September 1996

    International Nuclear Information System (INIS)

    Chin Cheng, R.

    2000-01-01

    In Costa Rica, a radiation accident occurred in 1996. It took place at the Radiotherapy Service of the San Juan de Dios Hospital, which affected 115 patients. The Unit of Radiotherapy made a mistake in the calibration of the new bundle because of the change of external faeces of cobalt 60 (Alycon II). The work is a retrospective study that describes what happened in this accident, and the medical consequences that derived from it [es

  1. ASTER Flyby of San Francisco

    Science.gov (United States)

    2002-01-01

    The Advanced Spaceborne Thermal Emission and Reflection radiometer, ASTER, is an international project: the instrument was supplied by Japan's Ministry of International Trade and Industry. A joint US/Japan science team developed algorithms for science data products, and is validating instrument performance. With its 14 spectral bands, extremely high spatial resolution, and 15 meter along-track stereo capability, ASTER is the zoom lens of the Terra satellite. The primary mission goals are to characterize the Earth's surface; and to monitor dynamic events and processes that influence habitability at human scales. ASTER's monitoring and mapping capabilities are illustrated by this series of images of the San Francisco area. The visible and near infrared image reveals suspended sediment in the bays, vegetation health, and details of the urban environment. Flying over San Francisco (3.2MB) (high-res (18.3MB)), we see the downtown, and shadows of the large buildings. Past the Golden Gate Bridge and Alcatraz Island, we cross San Pablo Bay and enter Suisun Bay. Turning south, we fly over the Berkeley and Oakland Hills. Large salt evaporation ponds come into view at the south end of San Francisco Bay. We turn northward, and approach San Francisco Airport. Rather than landing and ending our flight, we see this is as only the beginning of a 6 year mission to better understand the habitability of the world on which we live. For more information: ASTER images through Visible Earth ASTER Web Site Image courtesy of MITI, ERSDAC, JAROS, and the U.S./Japan ASTER Science Team

  2. The preventable causes of death in the United States: comparative risk assessment of dietary, lifestyle, and metabolic risk factors.

    Directory of Open Access Journals (Sweden)

    Goodarz Danaei

    2009-04-01

    Full Text Available Knowledge of the number of deaths caused by risk factors is needed for health policy and priority setting. Our aim was to estimate the mortality effects of the following 12 modifiable dietary, lifestyle, and metabolic risk factors in the United States (US using consistent and comparable methods: high blood glucose, low-density lipoprotein (LDL cholesterol, and blood pressure; overweight-obesity; high dietary trans fatty acids and salt; low dietary polyunsaturated fatty acids, omega-3 fatty acids (seafood, and fruits and vegetables; physical inactivity; alcohol use; and tobacco smoking.We used data on risk factor exposures in the US population from nationally representative health surveys and disease-specific mortality statistics from the National Center for Health Statistics. We obtained the etiological effects of risk factors on disease-specific mortality, by age, from systematic reviews and meta-analyses of epidemiological studies that had adjusted (i for major potential confounders, and (ii where possible for regression dilution bias. We estimated the number of disease-specific deaths attributable to all non-optimal levels of each risk factor exposure, by age and sex. In 2005, tobacco smoking and high blood pressure were responsible for an estimated 467,000 (95% confidence interval [CI] 436,000-500,000 and 395,000 (372,000-414,000 deaths, accounting for about one in five or six deaths in US adults. Overweight-obesity (216,000; 188,000-237,000 and physical inactivity (191,000; 164,000-222,000 were each responsible for nearly 1 in 10 deaths. High dietary salt (102,000; 97,000-107,000, low dietary omega-3 fatty acids (84,000; 72,000-96,000, and high dietary trans fatty acids (82,000; 63,000-97,000 were the dietary risks with the largest mortality effects. Although 26,000 (23,000-40,000 deaths from ischemic heart disease, ischemic stroke, and diabetes were averted by current alcohol use, they were outweighed by 90,000 (88,000-94,000 deaths from

  3. Pediatric Cardiopulmonary Arrest in the Postanesthesia Care Unit, Rare but Preventable: Analysis of Data From Wake Up Safe, The Pediatric Anesthesia Quality Improvement Initiative.

    Science.gov (United States)

    Christensen, Robert E; Haydar, Bishr; Voepel-Lewis, Terri D

    2017-04-01

    Nearly 20% of anesthesia-related pediatric cardiac arrests (CAs) occur during emergence or recovery. The aims of this case series were to use the Wake Up Safe database to describe the following: (1) the nature of pediatric postanesthesia care unit (PACU) CA and subsequent outcomes and (2) factors associated with harm after pediatric PACU CA. Pediatric CAs in the PACU were identified from the Wake Up Safe Pediatric Anesthesia Quality Improvement Initiative, a multicenter registry of adverse events in pediatric anesthesia. Demographics, underlying conditions, cause of CA, and outcomes were extracted. Descriptive statistics were used to characterize data and to assess risk of harm in those suffering CA. A total of 26 CA events were included: 67% in children anesthesia care providers until emergence from anesthesia may further reduce the preventable arrest rate. The root cause analyses conducted by individual institutions reporting these data to the Wake Up Safe provided only limited insight, so multicenter collaborative approaches may allow for greater insight into effective CA-prevention strategies.

  4. Intermittent pneumatic compression to prevent venous thromboembolism in patients with high risk of bleeding hospitalized in intensive care units: the CIREA1 randomized trial.

    Science.gov (United States)

    Vignon, Philippe; Dequin, Pierre-François; Renault, Anne; Mathonnet, Armelle; Paleiron, Nicolas; Imbert, Audrey; Chatellier, Delphine; Gissot, Valérie; Lhéritier, Gwenaelle; Aboyans, Victor; Prat, Gwenael; Garot, Denis; Boulain, Thierry; Diehl, Jean-Luc; Bressollette, Luc; Delluc, Aurélien; Lacut, Karine

    2013-05-01

    Venous thromboembolism (VTE) is a frequent and serious problem in intensive care units (ICU). Anticoagulant treatments have demonstrated their efficacy in preventing VTE. However, when the bleeding risk is high, they are contraindicated, and mechanical devices are recommended. To date, mechanical prophylaxis has not been rigorously evaluated in any trials in ICU patients. In this multicenter, open-label, randomized trial with blinded evaluation of endpoints, we randomly assigned 407 patients with a high risk of bleeding to receive intermittent pneumatic compression (IPC) associated with graduated compression stockings (GCS) or GCS alone for 6 days during their ICU stay. The primary endpoint was the occurrence of a VTE between days 1 and 6, including nonfatal symptomatic documented VTE, or death due to a pulmonary embolism, or asymptomatic deep vein thrombosis detected by ultrasonography systematically performed on day 6. The primary outcome was assessed in 363 patients (89.2%). By day 6, the incidence of the primary outcome was 5.6% (10 of 179 patients) in the IPC + GCS group and 9.2% (17 of 184 patients) in the GCS group (relative risk 0.60; 95% confidence interval 0.28-1.28; p = 0.19). Tolerance of IPC was poor in only 12 patients (6.0%). No intergroup difference in mortality rate was observed. With the limitation of a low statistical power, our results do not support the superiority of the combination of IPC + GCS compared to GCS alone to prevent VTE in ICU patients at high risk of bleeding.

  5. 78 FR 19103 - Safety Zone; Spanish Navy School Ship San Sebastian El Cano Escort; Bahia de San Juan; San Juan, PR

    Science.gov (United States)

    2013-03-29

    ...-AA00 Safety Zone; Spanish Navy School Ship San Sebastian El Cano Escort; Bahia de San Juan; San Juan... temporary moving safety zone on the waters of Bahia de San Juan during the transit of the Spanish Navy... Channel entrance, and to protect the high ranking officials on board the Spanish Navy School Ship San...

  6. San Pedro River Aquifer Binational Report

    Science.gov (United States)

    Callegary, James B.; Minjárez Sosa, Ismael; Tapia Villaseñor, Elia María; dos Santos, Placido; Monreal Saavedra, Rogelio; Grijalva Noriega, Franciso Javier; Huth, A. K.; Gray, Floyd; Scott, C. A.; Megdal, Sharon; Oroz Ramos, L. A.; Rangel Medina, Miguel; Leenhouts, James M.

    2016-01-01

    The United States and Mexico share waters in a number of hydrological basins and aquifers that cross the international boundary. Both countries recognize that, in a region of scarce water resources and expanding populations, a greater scientific understanding of these aquifer systems would be beneficial. In light of this, the Mexican and U.S. Principal Engineers of the International Boundary and Water Commission (IBWC) signed the “Joint Report of the Principal Engineers Regarding the Joint Cooperative Process United States-Mexico for the Transboundary Aquifer Assessment Program" on August 19, 2009 (IBWC-CILA, 2009). This IBWC “Joint Report” serves as the framework for U.S.-Mexico coordination and dialogue to implement transboundary aquifer studies. The document clarifies several details about the program such as background, roles, responsibilities, funding, relevance of the international water treaties, and the use of information collected or compiled as part of the program. In the document, it was agreed by the parties involved, which included the IBWC, the Mexican National Water Commission (CONAGUA), the U.S. Geological Survey (USGS), and the Universities of Arizona and Sonora, to study two priority binational aquifers, one in the San Pedro River basin and the other in the Santa Cruz River basin. This report focuses on the Binational San Pedro Basin (BSPB). Reasons for the focus on and interest in this aquifer include the fact that it is shared by the two countries, that the San Pedro River has an elevated ecological value because of the riparian ecosystem that it sustains, and that water resources are needed to sustain the river, existing communities, and continued development. This study describes the aquifer’s characteristics in its binational context; however, most of the scientific work has been undertaken for many years by each country without full knowledge of the conditions on the other side of the border. The general objective of this study is to

  7. Cataclastic rocks of the San Gabriel fault—an expression of deformation at deeper crustal levels in the San Andreas fault zone

    Science.gov (United States)

    Anderson, J. Lawford; Osborne, Robert H.; Palmer, Donald F.

    1983-10-01

    moderate to high stress regime for the San Andreas, which is consistent with experimental rock failure studies. Moreover, these results suggest that the previously observed lack of heat flow coaxial with the fault zone may be the result of dissipation rather than low stress. Much of the mineralogy of the cataclastic rocks is still relict from the earlier igneous or metamorphic history of the protolith; porphyroclasts, even in the most deformed rocks, consist of relict plagioclase (oligoclase to andesine), alkali feldspar, quartz, biotite, amphibole, epidote, allanite, and Fe-Ti oxides (ilmenite and magnetite). We have found no significant development of any clay minerals (illite, kaolinite, or montmorillonite). For many sites, the compositions of these minerals directly correspond to the mineral compositions in rock types on one or both sides of the fault. Whole rock major and trace element chemistry coupled with mineral compositions show that mixing within the zone of cataclasis is not uniform, and that originally micaceous foliated, or physically more heterogeneous rock units may contribute a disproportionally large amount to the resultant intrafault material. As previously found for the gouge along the San Andreas, chemical mobility is not a major factor in the formation of cataclastic rocks of the San Gabriel fault. We see only minor changes for Si and alkalies; however, there is a marked mobility of Li, which is a probable result of the alteration and formation of new mica minerals. The gouge of the San Andreas and San Gabriel faults probably formed by cataclastic flow. There is some indication, presently not well constrained, that the fine-grained matrix of the cataclasite of from the San Gabriel fault formed in response to superplastic flow.

  8. Resistance patterns and outcomes in intensive care unit (ICU)-acquired pneumonia. Validation of European Centre for Disease Prevention and Control (ECDC) and the Centers for Disease Control and Prevention (CDC) classification of multidrug resistant organisms.

    Science.gov (United States)

    Martin-Loeches, Ignacio; Torres, Antonio; Rinaudo, Mariano; Terraneo, Silvia; de Rosa, Francesca; Ramirez, Paula; Diaz, Emili; Fernández-Barat, Laia; Li Bassi, Gian Luigi; Ferrer, Miquel

    2015-03-01

    Bacterial resistance has become a major public health problem. To validate the definition of multidrug-resistant organisms (MDRO) based on the European Centre for Disease Prevention and Control (ECDC) and the Centers for Disease Control and Prevention (CDC) classification. Prospective, observational study in six medical and surgical Intensive-Care-Units (ICU) of a University hospital. Three-hundred-and-forty-three patients with ICU-acquired pneumonia (ICUAP) were prospectively enrolled, 140 patients had no microbiological confirmation (41%), 82 patients (24%) developed ICUAP for non-MDRO, whereas 121 (35%) were MDROs. Non-MDRO, MDRO and no microbiological confirmation patients did not present either a significant different previous antibiotic use (p 0.18) or previous hospital admission (p 0.17). Appropriate antibiotic therapy was associated with better ICU survival (105 [92.9%] vs. 74 [82.2%]; p = 0.03). An adjusted multivariate regression logistic analysis identified that only MDRO had a higher ICU-mortality than non-MDRO and no microbiological confirmation patients (OR 2.89; p < 0.05; 95% CI for Exp [β]. 1.02-8.21); Patients with MDRO ICUAP remained in ICU for a longer period than MDRO and no microbiological confirmation respectively (p < 0.01) however no microbiological confirmation patients had more often antibiotic consumption than culture positive ones. Patients who developed ICUAP due to MDRO showed a higher ICU-mortality than non-MDRO ones and use of ICU resources. No microbiological confirmation patients had more often antibiotic consumption than culture positive patients. Risk factors for MDRO may be important for the selection of initial antimicrobial therapy, in addition to local epidemiology. Copyright © 2014 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  9. Puente Coronado - San Diego (EE. UU.

    Directory of Open Access Journals (Sweden)

    Editorial, Equipo

    1971-12-01

    Full Text Available This 3,5 km long bridge, joining the cities of San Diego and Coronado is one of the longest in the world of this type, and one of the three most important straight line bridges in the United States. Its supporting structure consists of reinforced concrete columns resting on footings or piles, according to whether they are under the sea water or on dry land. The superstructure is partly of metal plates and partly of box girders. The surfacing of the deck consists of asphalt epoxy concrete, of 5 cm depth. Special paint was applied to the bridge, including layers of vinyl, iron oxide and blue vinyl on a zinc base.Este puente, de unos 3 km y medio, que une las ciudades de San Diego y Coronado es uno de los de mayor longitud del mundo, de este tipo, y uno de los tres principales ortótropos de los Estados Unidos de América. Su infraestructura está constituida por pilas de hormigón armado apoyadas sobre pilotes o sobre zapatas, según estén en el mar o en tierra firme. La superestructura está formada, en parte, por chapas metálicas y, en parte, por vigas cajón. El acabado del tablero metálico se realizó a base de hormigón asfáltico de epoxi con un espesor de 5 cm. La pintura es especial y se compone de capas de vinilo, de óxido de hierro y de vinilo azul sobre una capa de cinc.

  10. The green areas of San Juan, Puerto Rico

    Directory of Open Access Journals (Sweden)

    Olga M. Ramos-González

    2014-09-01

    Full Text Available Green areas, also known as green infrastructure or urban vegetation, are vital to urbanites for their critical roles in mitigating urban heat island effects and climate change and for their provision of multiple ecosystem services and aesthetics. Here, I provide a high spatial resolution snapshot of the green cover distribution of the city of San Juan, Puerto Rico, by incorporating the use of morphological spatial pattern analysis (MSPA as a tool to describe the spatial pattern and connectivity of the city's urban green areas. Analysis of a previously developed IKONOS 4-m spatial resolution classification of the city of San Juan from 2002 revealed a larger area of vegetation (green areas or green infrastructure than previously estimated by moderate spatial resolution imagery. The city as a whole had approximately 42% green cover and 55% impervious surfaces. Although the city appeared greener in its southern upland sector compared to the northern coastal section, where most built-up urban areas occurred (66% impervious surfaces, northern San Juan had 677 ha more green area cover dispersed across the city than the southern component. MSPA revealed that most forest cover occurred as edges and cores, and green areas were most commonly forest cores, with larger predominance in the southern sector of the municipality. In dense, built-up, urban land, most of the green areas occurred in private yards as islets. When compared to other cities across the United States, San Juan was most similar in green cover features to Boston, Massachusetts, and Miami, Florida. Per capita green space for San Juan (122.2 m²/inhabitant was also comparable to these two U.S. cities. This study explores the intra-urban vegetation variation in the city of San Juan, which is generally overlooked by moderate spatial resolution classifications in Puerto Rico. It serves as a starting point for green infrastructure mapping and landscape pattern analysis of the urban green spaces

  11. Methicillin-resistant Staphylococcus aureus transmission and infections in a neonatal intensive care unit despite active surveillance cultures and decolonization: challenges for infection prevention.

    Science.gov (United States)

    Popoola, Victor O; Budd, Alicia; Wittig, Sara M; Ross, Tracy; Aucott, Susan W; Perl, Trish M; Carroll, Karen C; Milstone, Aaron M

    2014-04-01

    To characterize the epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) transmission and infections in a level IIIC neonatal intensive care unit (NICU) and identify barriers to MRSA control. Retrospective cohort study in a university-affiliated NICU with an MRSA control program including weekly nares cultures of all neonates and admission nares cultures for neonates transferred from other hospitals or admitted from home. Medical records were reviewed to identify neonates with NICU-acquired MRSA colonization or infection between April 2007 and December 2011. Compliance with hand hygiene and an MRSA decolonization protocol were monitored. Relatedness of MRSA strains were assessed using pulsed-field gel electrophoresis (PFGE). Of 3,536 neonates, 74 (2.0%) had a culture grow MRSA, including 62 neonates with NICU-acquired MRSA. Nineteen of 74 neonates (26%) had an MRSA infection, including 8 who became infected before they were identified as MRSA colonized, and 11 of 66 colonized neonates (17%) developed a subsequent infection. Of the 37 neonates that underwent decolonization, 6 (16%) developed a subsequent infection, and 7 of 14 (50%) that remained in the NICU for 21 days or more became recolonized with MRSA. Using PFGE, there were 14 different strain types identified, with USA300 being the most common (31%). Current strategies to prevent infections-including active identification and decolonization of MRSA-colonized neonates-are inadequate because infants develop infections before being identified as colonized or after attempted decolonization. Future prevention efforts would benefit from improving detection of MRSA colonization, optimizing decolonization regimens, and identifying and interrupting reservoirs of transmission.

  12. Coastal processes study at Ocean Beach, San Francisco, CA: summary of data collection 2004-2006

    Science.gov (United States)

    Barnard, Patrick L.; Eshleman, Jodi; Erikson, Li H.; Hanes, Daniel M.

    2007-01-01

    Ocean Beach in San Francisco, California, contains a persistent erosional section in the shadow of the San Francisco ebb tidal delta and south of Sloat Boulevard that threatens valuable public infrastructure as well as the safe recreational use of the beach. Coastal managers have been discussing potential mediation measures for over a decade, with little scientific research available to aid in decision making. The United States Geological Survey (USGS) initiated the Ocean Beach Coastal Processes Study in April 2004 to provide the scientific knowledge necessary for coastal managers to make informed management decisions. This study integrates a wide range of field data collection and numerical modeling techniques to document nearshore sediment transport processes at the mouth of San Francisco Bay, with emphasis on how these processes relate to erosion at Ocean Beach. The Ocean Beach Coastal Processes Study is the first comprehensive study of coastal processes at the mouth of San Francisco Bay.

  13. Efficacy of a program of prevention and control for methicillin-resistant Staphylococcus aureus infections in an intensive-care unit

    Directory of Open Access Journals (Sweden)

    Marina Moreira

    Full Text Available Methicillin-resistant Staphylococcus aureus (MRSA is endemic in most Brazilian Hospitals, and there are few studies which show the efficacy of control measures in such situations. This study evaluated intensive care unit (ICU patients, in two years divided in control, intervention and post-intervention group. Intervention measures: hands-on educational programs for healthcare workers; early identification of MRSA infected or colonized patients, labeled with a bed-identification tag for contact isolation; nasal carriers, patients, and healthcare professionals treated with topical mupirocin for five days. The hospital infection rates in the control period were compared to the ones in the post-intervention period. Hospital infection rates were found by means of the NNISS methodology The incidence coefficients of MRSA hospital infection (monthly average of 1,000 pts/day in the control, intervention and post-intervention groups were respectively: 10.2, 5.1 and 2.5/1,000 pts/day (p<0.001 and MRSA-originated bloodstream infections were 3.6, 0.9 and 1.8/1,000 central venous catheter/day (p=0.281. Nasal colonization in both intervention and post-intervention periods was of 30.9% and 22.1% among the hospitalized patients, respectively 54.4% and 46.1% of whom were already MRSA-positive when admitted to the unit. In the intervention period, most of those MRSA infected patients (76.2% were nasal carrier. Mortality rates were, respectively 26.6%; 27.3% and 21.0% (p<0.001. Nasal carriers, both patients (93.7% and healthcare professionals (88.2%, were successfully treated with topical mupirocin. Intervention measures for the prevention and control of MRSA infections in ICUs, have been efficient in the reduction of the bloodstream and MRSA-originated hospital infections incidence, and reduced the overall mortality rate significantly.

  14. Six-year mortality in a street-recruited cohort of homeless youth in San Francisco, California.

    Science.gov (United States)

    Auerswald, Colette L; Lin, Jessica S; Parriott, Andrea

    2016-01-01

    Objectives. The mortality rate of a street-recruited homeless youth cohort in the United States has not yet been reported. We examined the six-year mortality rate for a cohort of street youth recruited from San Francisco street venues in 2004. Methods. Using data collected from a longitudinal, venue-based sample of street youth 15-24 years of age, we calculated age, race, and gender-adjusted mortality rates. Results. Of a sample of 218 participants, 11 died from enrollment in 2004 to December 31, 2010. The majority of deaths were due to suicide and/or substance abuse. The death rate was 9.6 deaths per hundred thousand person-years. The age, race and gender-adjusted standardized mortality ratio was 10.6 (95% CI [5.3-18.9]). Gender specific SMRs were 16.1 (95% CI [3.3-47.1]) for females and 9.4 (95% CI [4.0-18.4]) for males. Conclusions. Street-recruited homeless youth in San Francisco experience a mortality rate in excess of ten times that of the state's general youth population. Services and programs, particularly housing, mental health and substance abuse interventions, are urgently needed to prevent premature mortality in this vulnerable population.

  15. Six-year mortality in a street-recruited cohort of homeless youth in San Francisco, California

    Directory of Open Access Journals (Sweden)

    Colette L. Auerswald

    2016-04-01

    Full Text Available Objectives. The mortality rate of a street-recruited homeless youth cohort in the United States has not yet been reported. We examined the six-year mortality rate for a cohort of street youth recruited from San Francisco street venues in 2004. Methods. Using data collected from a longitudinal, venue-based sample of street youth 15–24 years of age, we calculated age, race, and gender-adjusted mortality rates. Results. Of a sample of 218 participants, 11 died from enrollment in 2004 to December 31, 2010. The majority of deaths were due to suicide and/or substance abuse. The death rate was 9.6 deaths per hundred thousand person-years. The age, race and gender-adjusted standardized mortality ratio was 10.6 (95% CI [5.3–18.9]. Gender specific SMRs were 16.1 (95% CI [3.3–47.1] for females and 9.4 (95% CI [4.0–18.4] for males. Conclusions. Street-recruited homeless youth in San Francisco experience a mortality rate in excess of ten times that of the state’s general youth population. Services and programs, particularly housing, mental health and substance abuse interventions, are urgently needed to prevent premature mortality in this vulnerable population.

  16. Risk factors for accidents in children that consulted to the emergency unit of San Vicente de Púl Children's Hospital of Medellín, Colombia. December 1, 1998 - March 6, 1999 Factores de riesgo de accidentes en niños que consultaron al Policlínico Infantil de Medellín Diciembre 1 de 1998-marzo 6 de 1999

    Directory of Open Access Journals (Sweden)

    Julio César Correa Escobar

    2001-02-01

    Full Text Available A prospective descriptive study was made to identify the factors of risk for accidents in children smaller than 12 years that consulted for this cause to the Emergency Unit of San Vicente de Paul Children´s Hospital of Medellin, from December 1 of 1998 until March 6 of 1999. These factors were compared during a period of school vacations and one of academic activity of same duration. We included 1.185 patients. The distribution for sex was: 771 children (65% and 414 girls (35%; 912 patients (76,9% came from Medellin and their metropolitan area. The place of the accident was like it continues: in the street 582 children (49%; in the home 496 children (41,9%, in the school 32 children (2,7% and in other places 75 children (6,3%. 199 children (16,8% were alone in the moment of the accident, 512 (43,2% were with other children and 474 (40% were with adults. The main accident type was the mechanic in 1.077 cases (90,9%; 740 children (62,5% suffered falls. Trauma was light in 1.128 children (95,2%. Lethally was of 0,7% (8 children, especially for craneoencephalic trauma due to traffic accidents and hurt by firearm. The trauma was more serious in those smaller than 2 years. There was difference statistically significant in the frequency of traumas between the period of vacations and the academic, with more accidents during the vacations. It is recommended to begin programs of prevention of accidents especially in the home, directed to the parents and the minor caretakers, with emphasis in the stages of the children’s development and the risks for the different types of accidents. Se hizo un estudio descriptivo prospectivo para identificar los factores de riesgo para accidentes en los niños menores de 12 años que consultaron por esta causa al Policlínico Infantil de Medellín, desde diciembre 1 de 1998 hasta marzo 6 de 1999. Se compararon dichos factores durante un período de vacaciones escolares y uno de actividad académica de igual duraci

  17. 77 FR 34988 - Notice of Inventory Completion: San Diego State University, San Diego, CA

    Science.gov (United States)

    2012-06-12

    .... ACTION: Notice. SUMMARY: San Diego State University Archeology Collections Management Program has... that believes itself to be culturally affiliated with the human remains and associated funerary objects may contact San Diego State University Archeology Collections Management Program. Repatriation of the...

  18. “I Always Feel Like I Have to Rush…” Pet Owner and Small Animal Veterinary Surgeons’ Reflections on Time during Preventative Healthcare Consultations in the United Kingdom

    Science.gov (United States)

    Robinson, Natalie J.; Dean, Rachel S.

    2018-01-01

    Canine and feline preventative healthcare consultations can be more complex than other consultation types, but they are typically not allocated additional time in the United Kingdom (UK). Impacts of the perceived length of UK preventative healthcare consultations have not previously been described. The aim of this novel study was to provide the first qualitative description of owner and veterinary surgeon reflections on time during preventative healthcare consultations. Semi-structured telephone interviews were conducted with 14 veterinary surgeons and 15 owners about all aspects of canine and feline preventative healthcare consultations. These qualitative data were thematically analysed, and four key themes identified. This paper describes the theme relating to time and consultation length. Patient, owner, veterinary surgeon and practice variables were recalled to impact the actual, versus allocated, length of a preventative healthcare consultation. Preventative healthcare consultations involving young, old and multi-morbid animals and new veterinary surgeon-owner partnerships appear particularly susceptible to time pressures. Owners and veterinary surgeons recalled rushing and minimizing discussions to keep consultations within their allocated time. The impact of the pace, content and duration of a preventative healthcare consultation may be influential factors in consultation satisfaction. These interviews provide an important insight into the complex nature of preventative healthcare consultations and the behaviour of participants under different perceived time pressures. These data may be of interest and relevance to all stakeholders in dog and cat preventative healthcare. PMID:29419766

  19. Overcoming the Challenges in Implementing Type 2 Diabetes Mellitus Prevention Programs Can Decrease the Burden on Healthcare Costs in the United States

    Directory of Open Access Journals (Sweden)

    Kritika Subramanian

    2017-01-01

    Full Text Available Theoretically, identifying prediabetics would reduce the diabetic burden on the American healthcare system. As we expect the prevalence rate of prediabetes to continue increasing, we wonder if there is a better way of managing prediabetics and reducing the economic cost on the healthcare system. To do so, understanding the demographics and behavioral factors of known prediabetics was important. For this purpose, responses of prediabetic/borderline diabetes patients from the most recent publicly available 2015 Behavioral Risk Factor Surveillance System (BRFSS survey were analyzed. The findings showed that there was a correlation between household income, geographic residence in the US, and risk for developing diabetes mellitus type 2, aside from the accepted risk factors such as high BMI. In conclusion, implementation of the National Diabetes Prevention Program is a rational way of reducing the burden of DM on the healthcare system both economically and by prevalence. However, difficulties arise in ensuring patient compliance to the program and providing access to all regions and communities of the United States. Technology incorporation in the NDPP program would maintain a low-cost implementation by the healthcare system, be affordable and accessible for all participants, and decrease economic burden attributed to diabetes mellitus.

  20. Species - San Diego Co. [ds121

    Data.gov (United States)

    California Natural Resource Agency — This is the Biological Observation Database point layer representing baseline observations of sensitive species (as defined by the MSCP) throughout San Diego County....

  1. 78 FR 34123 - Notice of Inventory Completion: San Francisco State University NAGPRA Program, San Francisco, CA

    Science.gov (United States)

    2013-06-06

    ... completion of an inventory of human remains and associated funerary objects under the control of the San....R50000] Notice of Inventory Completion: San Francisco State University NAGPRA Program, San Francisco, CA... NAGPRA Program has completed an inventory of human remains and associated funerary objects, in...

  2. 78 FR 21403 - Notice of Inventory Completion: San Francisco State University NAGPRA Program, San Francisco, CA

    Science.gov (United States)

    2013-04-10

    ... completion of an inventory of human remains and associated funerary objects under the control of the San....R50000] Notice of Inventory Completion: San Francisco State University NAGPRA Program, San Francisco, CA... NAGPRA Program has completed an inventory of human remains and associated funerary objects, in...

  3. San Andreas Fault in the Carrizo Plain

    Science.gov (United States)

    2000-01-01

    The 1,200-kilometer (800-mile)San Andreas is the longest fault in California and one of the longest in North America. This perspective view of a portion of the fault was generated using data from the Shuttle Radar Topography Mission (SRTM), which flew on NASA's Space Shuttle last February, and an enhanced, true-color Landsat satellite image. The view shown looks southeast along the San Andreas where it cuts along the base of the mountains in the Temblor Range near Bakersfield. The fault is the distinctively linear feature to the right of the mountains. To the left of the range is a portion of the agriculturally rich San Joaquin Valley. In the background is the snow-capped peak of Mt. Pinos at an elevation of 2,692 meters (8,831 feet). The complex topography in the area is some of the most spectacular along the course of the fault. To the right of the fault is the famous Carrizo Plain. Dry conditions on the plain have helped preserve the surface trace of the fault, which is scrutinized by both amateur and professional geologists. In 1857, one of the largest earthquakes ever recorded in the United States occurred just north of the Carrizo Plain. With an estimated magnitude of 8.0, the quake severely shook buildings in Los Angeles, caused significant surface rupture along a 350-kilometer (220-mile) segment of the fault, and was felt as far away as Las Vegas, Nev. This portion of the San Andreas is an important area of study for seismologists. For visualization purposes, topographic heights displayed in this image are exaggerated two times.The elevation data used in this image was acquired by SRTM aboard the Space Shuttle Endeavour, launched on February 11, 2000. SRTM used the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR) that flew twice on Endeavour in 1994. SRTM was designed to collect three-dimensional measurements of Earth's land surface. To collect the 3-D SRTM data, engineers added a mast 60

  4. Organizing knowledge for tutoring fire loss prevention

    Science.gov (United States)

    Daniel L. Schmoldt

    1989-01-01

    The San Bernardino National Forest in southern California has recently developed a systematic approach to wildfire prevention planning. However, a comprehensive document or other mechanism for teaching this process to other prevention personnel does not exist. An intelligent tutorial expert system is being constructed to provide a means for learning the process and to...

  5. Cuartel San Carlos. Yacimiento veterano

    Directory of Open Access Journals (Sweden)

    Mariana Flores

    2007-01-01

    Full Text Available El Cuartel San Carlos es un monumento histórico nacional (1986 de finales del siglo XVIII (1785-1790, caracterizado por sufrir diversas adversidades en su construcción y soportar los terremotos de 1812 y 1900. En el año 2006, el organismo encargado de su custodia, el Instituto de Patrimonio Cultural del Ministerio de Cultura, ejecutó tres etapas de exploración arqueológica, que abarcaron las áreas Traspatio, Patio Central y las Naves Este y Oeste de la edificación. Este trabajo reseña el análisis de la documentación arqueológica obtenida en el sitio, a partir de la realización de dicho proyecto, denominado EACUSAC (Estudio Arqueológico del Cuartel San Carlos, que representa además, la tercera campaña realizada en el sitio. La importancia de este yacimiento histórico, radica en su participación en los acontecimientos que propiciaron conflictos de poder durante el surgimiento de la República y en los sucesos políticos del siglo XX. De igual manera, se encontró en el sitio una amplia muestra de materiales arqueológicos que reseñan un estilo de vida cotidiana militar, así como las dinámicas sociales internas ocurridas en el San Carlos, como lugar estratégico para la defensa de los diferentes regímenes que atravesó el país, desde la época del imperialismo español hasta nuestros días.

  6. SANS from interpenetrating polymer networks

    International Nuclear Information System (INIS)

    Markotsis, M.G.; Burford, R.P.; Knott, R.B.; Australian Nuclear Science and Technology Organisation, Menai, NSW; Hanley, T.L.; CRC for Polymers,; Australian Nuclear Science and Technology Organisation, Menai, NSW; Papamanuel, N.

    2003-01-01

    Full text: Interpenetrating polymer networks (IPNs) have been formed by combining two polymeric systems in order to gain enhanced material properties. IPNs are a combination of two or more polymers in network form with one network polymerised and/or crosslinked in the immediate presence of the other(s).1 IPNs allow better blending of two or more crosslinked networks. In this study two sets of IPNs were produced and their microstructure studied using a variety of techniques including small angle neutron scattering (SANS). The first system combined a glassy polymer (polystyrene) with an elastomeric polymer (SBS) with the glassy polymer predominating, to give a high impact plastic. The second set of IPNs contained epichlorohydrin (CO) and nitrile rubber (NBR), and was formed in order to produce novel materials with enhanced chemical and gas barrier properties. In both cases if the phase mixing is optimised the probability of controlled morphologies and synergistic behaviour is increased. The PS/SBS IPNs were prepared using sequential polymerisation. The primary SBS network was thermally crosslinked, then the polystyrene network was polymerised and crosslinked using gamma irradiation to avoid possible thermal degradation of the butadiene segment of the SBS. Tough transparent systems were produced with no apparent thermal degradation of the polybutadiene segments. The epichlorohydrin/nitrile rubber IPNs were formed by simultaneous thermal crosslinking reactions. The epichlorohydrin network was formed using lead based crosslinker, while the nitrile rubber was crosslinked by peroxide methods. The use of two different crosslinking systems was employed in order to achieve independent crosslinking thus resulting in an IPN with minimal grafting between the component networks. SANS, Transmission electron microscopy (TEM), and atomic force microscopy (AFM) were used to examine the size and shape of the phase domains and investigate any variation with crosslinking level and

  7. Morbimortalidad en la unidad de cuidados intensivos pediátricos del Hospital Universitario San Vicente de Paúl, Medellín, Colombia, 2001-2005 Morbidity and mortality at a pediatric intensive care unit in Medellín, Colombia, 2001-2005

    Directory of Open Access Journals (Sweden)

    Augusto Quevedo Vélez

    2008-01-01

    ="MsoNormal">Introduction: increase in the number and complexity of pediatric intensive care units (PICU, added to their high cost, have stimulated interest in evaluating their functioning, efficiency and quality by means of markers derived from descriptive studies of morbidity and mortality.

     

    Objective: to describe the causes of morbidity and mortality, as well as the social and demographic characteristics of patients admitted to the PICU of Hospital Universitario San Vicente de Paúl (HUSVP in Medellín, Colombia, between January 1, 2001 and December 31, 2005.

     

    Methodology: descriptive and retrospective cross section study. 328 patient charts were randomly selected and then reviewed. All information was tabulated and statistically analyzed.

     

    Results: 59.8% of the patients were males, 40.9% were under one year of age, and 43% came from the metropolitan area around Medellín. Average age at admission was 44 months. Only 47% of the patients had some type of health insurance. The main causes for admission to the PICU were: respiratory infection (23.8%, post surgical cases (23.5%, respiratory failure (18.6%, septic

  8. City College of San Francisco 1997 Sexual Harassment Student Opinion Survey.

    Science.gov (United States)

    City Coll. of San Francisco, CA. Office of Institutional Research, Planning and Grants.

    This document describes the findings of a 1997 sexual harassment student opinion survey conducted at City College of San Francisco. Survey questions were jointly developed by the Sexual Harassment Prevention Sub-Committee of the Diversity Advisory Committee and the Office of Research and Planning, approved by the College Advisory Council, and…

  9. Trouble Brewing in San Francisco. Policy Brief

    Science.gov (United States)

    Buck, Stuart

    2010-01-01

    The city of San Francisco will face enormous budgetary pressures from the growing deficits in public pensions, both at a state and local level. In this policy brief, the author estimates that San Francisco faces an aggregate $22.4 billion liability for pensions and retiree health benefits that are underfunded--including $14.1 billion for the city…

  10. San Diego's High School Dropout Crisis

    Science.gov (United States)

    Wilson, James C.

    2012-01-01

    This article highlights San Diego's dropout problem and how much it's costing the city and the state. Most San Diegans do not realize the enormous impact high school dropouts on their city. The California Dropout Research Project, located at the University of California at Santa Barbara, has estimated the lifetime cost of one class or cohort of…

  11. A new record for American Bullfrog (Lithobates catesbeianus in San Juan, Argentina Nuevo registro de rana toro americana (Lithobates catesbeianus en San Juan, Argentina

    Directory of Open Access Journals (Sweden)

    Eduardo Sanabria

    2011-03-01

    Full Text Available We report a new record of Lithobates catesbeianus (American bullfrog from Argentina. L. catesbeianus was first introduced to San Juan Province 11 years ago in Calingasta Department, where the habitat is pre-cordilleran. The new record is for Zonda Department, San Juan Province, in the Monte desert region. Here, L. catesbeianus uses artificial ponds for reproduction and tadpole development. These ponds receive water from an irrigation system that connects the whole agriculture land in the region. The tadpoles use the irrigation canals to move among ponds. We suggest that legislation should be established to prevent future invasions and to achieve sustainable management of the wild American bullfrog populations in San Juan. Prevention of future invasion and management of established populations of this species requires the cooperation of numerous stake holders.Se presenta un nuevo registro de Lithobates catesbeianus (rana toro americana en Argentina. L. catesbeianus fue introducida por primera vez a la provincia de San Juan hace 11 años en el Departamento Calingasta, donde el hábitat es pre-cordillerano. El nuevo registro es para el Departamento Zonda en la provincia de San Juan, en el desierto del Monte. En este sitio, L. catesbeianus usa estanques artificiales para la reproducción y desarrollo del renacuajo. Los estanques reciben agua de un sistema de riego que conecta todas las tierras de la agricultura en la región. Los renacuajos utilizan los canales de riego para moverse entre los estanques. Sugerimos que se establezcan leyes para prevenir invasiones futuras y para lograr un manejo integrado de las poblaciones silvestres de rana toro que se encuentran en San Juan. La prevención de futuras invasiones y el manejo de las poblaciones establecidas de esta especie requieren la cooperación de numerosas entidades tanto gubernamentales como privadas.

  12. Estimation of the cost-effectiveness of HIV prevention portfolios for people who inject drugs in the United States: A model-based analysis.

    Directory of Open Access Journals (Sweden)

    Cora L Bernard

    2017-05-01

    Full Text Available The risks of HIV transmission associated with the opioid epidemic make cost-effective programs for people who inject drugs (PWID a public health priority. Some of these programs have benefits beyond prevention of HIV-a critical consideration given that injection drug use is increasing across most United States demographic groups. To identify high-value HIV prevention program portfolios for US PWID, we consider combinations of four interventions with demonstrated efficacy: opioid agonist therapy (OAT, needle and syringe programs (NSPs, HIV testing and treatment (Test & Treat, and oral HIV pre-exposure prophylaxis (PrEP.We adapted an empirically calibrated dynamic compartmental model and used it to assess the discounted costs (in 2015 US dollars, health outcomes (HIV infections averted, change in HIV prevalence, and discounted quality-adjusted life years [QALYs], and incremental cost-effectiveness ratios (ICERs of the four prevention programs, considered singly and in combination over a 20-y time horizon. We obtained epidemiologic, economic, and health utility parameter estimates from the literature, previously published models, and expert opinion. We estimate that expansions of OAT, NSPs, and Test & Treat implemented singly up to 50% coverage levels can be cost-effective relative to the next highest coverage level (low, medium, and high at 40%, 45%, and 50%, respectively and that OAT, which we assume to have immediate and direct health benefits for the individual, has the potential to be the highest value investment, even under scenarios where it prevents fewer infections than other programs. Although a model-based analysis can provide only estimates of health outcomes, we project that, over 20 y, 50% coverage with OAT could avert up to 22,000 (95% CI: 5,200, 46,000 infections and cost US$18,000 (95% CI: US$14,000, US$24,000 per QALY gained, 50% NSP coverage could avert up to 35,000 (95% CI: 8,900, 43,000 infections and cost US$25,000 (95% CI: US

  13. Control of water infiltration into near surface LLW disposal units

    International Nuclear Information System (INIS)

    O'Donnell, E.; Ridky, R.W.; Schulz, R.K.

    1989-01-01

    Water infiltration to buried waste is the prime problem of concern in designing waste disposal units for the humid areas. Conventional compacted clay layers (resistance layer barriers) have been subject to failure by subsidence and by permeability increases brought about by plant roots. A clay barrier with a rock cover sans plants is being investigated. Also a combination of a resistive layer overlying a conductive layer is being investigated. Laboratory studies indicate that this approach can be very effective and field evaluations are underway. However, it must be noted that subsidence will negate the effectiveness of any buried layer barriers. A surface barrier (bioengineering management) has been valuated in the field and found to be very effective in preventing water entry into waste disposal units. This surface barrier is easily repairable if damaged by subsidence and could be the system of choice under active subsidence conditions

  14. Prevention of deaths from harmful drinking in the United States: the potential effects of tax increases and advertising bans on young drinkers.

    Science.gov (United States)

    Hollingworth, William; Ebel, Beth E; McCarty, Carolyn A; Garrison, Michelle M; Christakis, Dimitri A; Rivara, Frederick P

    2006-03-01

    Harmful alcohol consumption is a leading cause of death in the United States. The majority of people who die from alcohol use begin drinking in their youth. In this study, we estimate the impact of interventions to reduce the prevalence of drinking among youth on subsequent drinking patterns and alcohol-attributable mortality. We first estimated the effect of public health interventions to decrease harmful drinking among youth from literature reviews and used life table methods to estimate alcohol-attributable years of life lost by age 80 years among the cohort of approximately 4 million U.S. residents aged 20 in the year 2000. Then, from national survey data on transitions in drinking habits by age, we modeled the impact of interventions on alcohol-attributable mortality. A tax increase and an advertising ban were the most effective interventions identified. In the absence of intervention, there would be 55,259 alcohol-attributable deaths over the lifetime of the cohort. A tax-based 17% increase in the price of alcohol of dollar 1 per six pack of beer could reduce deaths from harmful drinking by 1,490, equivalent to 31,130 discounted years of potential life saved or 3.3% of current alcohol-attributable mortality. A complete ban on alcohol advertising would reduce deaths from harmful drinking by 7,609 and result in a 16.4% decrease in alcohol-related life-years lost. A partial advertising ban would result in a 4% reduction in alcohol-related life-years lost. Interventions to prevent harmful drinking by youth can result in reductions in adult mortality. Among interventions shown to be successful in reducing youthful drinking prevalence, advertising bans appear to have the greatest potential for premature mortality reduction.

  15. The State of Prescreening Discussions About Prostate-specific Antigen Testing Following Implementation of the 2012 United States Preventive Services Task Force Statement.

    Science.gov (United States)

    Turini, George A; Gjelsvik, Annie; Renzulli, Joseph F

    2017-06-01

    To determine if the quality of prescreening discussions has changed following release of the United States Preventive Services Task Force statement against prostate cancer screening. This cross-sectional study used the 2012 and 2014 Behavioral Risk Factor Surveillance System surveys. Respondents were categorized based on the year in which they responded to the Behavioral Risk Factor Surveillance System Survey. Quality of prescreening discussion was operationalized as having discussed only advantages, only disadvantages, both advantages and disadvantages, or neither. Race/ethnicity, education level, income, insurance status, and having a prostate-specific antigen (PSA) level actually drawn after prescreening counseling served as confounders in our multivariate analysis. Among 217,053 men in the analytic sample, 37% were told about only advantages of PSA screening compared to 30% of men who were advised about both advantages and disadvantages. Men who were told about neither advantages nor disadvantages were more likely to be Hispanic, not graduate high school, have low income, and not have insurance. Controlling for covariates, men in 2014 were significantly more likely to have undergone PSA testing without having discussed either advantages or disadvantages than men in 2012. Comprehensive prescreening discussions about advantages and disadvantages of PSA testing are critical to informed decision making about prostate cancer screening. Disparities not only exist with regard to the quality of prescreening discussions that patients receive from their providers prior to PSA testing across categories of race/ethnicity, education, income, and insurance status, but these disparities became more substantial between 2012 and 2014. Further investigation is warranted to elicit more specific reasons behind these variations. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Experiencia con pacientes hospitalizados en la unidad de capacitación para el tratamiento de la diarrea del Hospital Univertario San Vicente de Paúl de Medellín Experience with hospitalized children at a training unit for diarrhea treatment, in Medellín, Colombia

    Directory of Open Access Journals (Sweden)

    Carlos A. Bernal Parra

    1995-02-01

    Full Text Available

    Entre 1988 y 1994 se atendieron 1.755 niños en la sala de hospitalización de la Unidad de Capacitación para el Tratamiento de la Diarrea, del Hospital Universitario San Vicente de Paúl, de Medellín; 1.022 (58.2% fueron hombres y 733 (41.8% mujeres; mil setenta y ocho eran menores de un año (61.4% y 677 (38.6% tenían más de un año. Eran desnutridos 888 (50.6%. Presentaban diarrea persistente 418 (23.8%; 1.056 (82.2% diarrea acuosa, 213 (16.6% diarrea disentérica y 16 (1.2% solamente vómitos. Novecientos trece pacientes (52% consultaron o estuvieron en la sala de hidratación oral y 276 (15.7% habían estado hospitalizados por diarrea durante el último mes. Al ingreso 670 (38.2% se encontraban hidratados, 151 (8.6% tenían deshidratación grave y 934 (53.2% presentaban otros grados de deshidratación. La bacteria más frecuentemente identificada fue Salmonella enteritidis (258 casos; 23.9%. Setecientos ochenta y seis pacientes (44.8% recibieron los líquidos solamente por vía oral o por sonda nasogástrica y 969 (55.2% por vía intravenosa. Al egreso 1.088 (62% tuvieron el diagnóstico de diarrea aguda y 667 (38% el de diarrea persistente. La mortalidad fue de 1.5% (27 pacientes.

    We present the results of our experience in the in-patient treatment of children with diarrhea. Between 1988 and 1994,1.755 children were hospitalized for this purpose at the Training Unit for Diarrhea Treatment, Hospital San Vicente, in Medellín, Colombia; 1.022 (58.2% were males and 733 (41.8% females; 1.078 (61.4% were younger than one year and 677 (38.6% were above this age. Eight hundred and eighty eight (50.6% were undernourished. At admission, persistent diarrhea was found in 418 (23.8%; stools were watery in 1.056 (82.2% and dysenteric in 213 (16.6%; 16

  17. Evaluation of prenatal care at basic health units in the city of Sao Paulo Evaluación de la asistencia prenatal en unidades básicas del municipio de San Pablo Avaliação da assistência pré-natal em unidades básicas do município de São Paulo

    Directory of Open Access Journals (Sweden)

    Regina Célia de Menezes Succi

    2008-12-01

    Full Text Available The aim of this study was to evaluate the quality of prenatal care offered in 12 Basic Health Units (BHU in the city of Sao Paulo, Brazil, through a review of medical and nurse charts, before and after the municipalization of the public health system. The indicator used considered excellence in care as: starting prenatal care in the first quarter of pregnancy; at least six medical visits; at least two results of blood screening for syphilis and one for HIV; returning to BHU up to 42 days after delivery. This indicator was not present in any care delivered in 2000, and only 7.7% of the care delivered in 2004 obtained it (1.1% to 30% of the care per unit assessed. Although there was an evident improvement in care during the period, the low proportion of excellent prenatal care shows an urgent need to improve this care in the BHU of São Paulo city.El objetivo de este estudio fue evaluar la calidad de la asistencia prenatal ofrecida en doce Unidades Básicas de Salud (UBS del municipio de San Pablo a través de la revisión de los registros médicos y de enfermería antes y después de la municipalización del sistema de salud. Fue utilizado un indicador que consideraba como atención de excelencia aquella con: inicio del acompañamiento prenatal en el primer trimestre de la gestación; con un mínimo de seis consultas; registro de por lo menos dos resultados de exámenes serológicos para sífilis y una prueba para el VIH; retorno a la UBS hasta 42 días después del parto. Ese indicador no fue obtenido en ninguna atención realizada en el 2000 y apenas en 7,7% de las atenciones en el 2004 (1,1% a 30% de las atenciones por unidad evaluada. A pesar de que con evidente mejoría de la atención en el período, la baja proporción de atención prenatal de excelencia, revela una urgente necesidad de mejorar esa asistencia en las UBS en el Municipio de San Pablo.O objetivo deste estudo foi avaliar a qualidade da assistência pré-natal oferecida em doze

  18. Observations on the seasonal distribution of native fish in a 10-kilometer reach of San Bernardino Creek, Sonora, Mexico

    Science.gov (United States)

    C. O. Minckley

    2013-01-01

    San Bernardino Creek is a northern tributary of the Río Yaqui that originates in the United States and crosses the International Border just east of Douglas, Arizona/Agua Prieta, Sonora and immediately south of San Bernardino/Leslie Canyon National Wildlife Refuge. Six of eight Río Yaqui native fishes occur in this reach:four minnows, a sucker, and a poeciliid....

  19. Optimally Locating MARFORRES Units

    OpenAIRE

    Salmeron, Javier; Dell, Rob

    2015-01-01

    Javier Salmeron and Rob Dell The U.S. Marine Forces Reserve (USMCR, MARFORRES) is conducting realignment studies where discretionary changes may benefit from formal mathematical analysis. This study has developed an optimization tool to guide and/or support Commander, MARFORRES (CMFR) decisions. A prototype of the optimization tool has been tested with data from the units and Reserve Training Centers (RTCs) in the San Francisco, CA and Sacramento, CA areas. Prepared for: MARFORRES, POC:...

  20. Fire hazard analysis at the first unit of the Ignalina nuclear power plant: 1. Analysis of fire prevention and ventilation systems and secondary effects

    International Nuclear Information System (INIS)

    Poskas, P.; Simonis, V.; Zujus, R. and others

    2004-01-01

    Evaluation of the fire prevention and ventilation systems and the secondary effects on safety at the Ignalina NPP from the point of view of fire hazard using computerized system is presented. Simplified screening algorithms for fire prevention, ventilation and the evaluation of secondary effects are developed, which allow accelerating fire hazard analysis at the Ignalina NPP. The analysis indicated that the fire prevention systems practically meet the national requirements and international recommendations for fire prevention. But it is necessary to introduce in separate rooms the measures improving fire prevention to guarantee the effective functioning of the ventilation systems and the reduction of the influence of secondary effects on safety. Computerized system of fire prevention and ventilation systems and evaluation of secondary effects on safety can be easily applied for fire hazard analysis at different big plants. (author)

  1. Dos edificios administrativos, en San Francisco

    Directory of Open Access Journals (Sweden)

    Skidmore, Owings & Merrill, Arquitectos

    1964-07-01

    Full Text Available The Crown Zellerbach has been built on a large triangular plaza, at the outskirts of San Francisco. This is one of the most recent tall buildings in the city. The Wells Fargo Bank is also situated on this plaza. It is of special interest, both as regards its shape and functional organisation. It has a ground floor, where most of the mercantile activities take place, and a basement, containing a Council room; the strong rooms, with 2,500 private boxes as well as the bank's own safe; washing rooms; mechanical equipment rooms; a rest room; a bar for the employees and independent stairs. The building has a circular planform, 21.5 m in diameter and 354 m2 in area. The structure is metallic, the vertical supports are along the periphery, spaced every 1.626 m. The enclosing curtain walls are glass and anodized aluminium. The roof has radially distributed metal beams, interconnected by prefabricated concrete units, covered with copper sheeting. This bank, shaped like a hunting lodge, and finished with delicate care, contrasts sharply with the powerful volume of the Crown Zellerbach, and of other nearby buildings, and adds distinction to the plaza.Sobre una gran plaza triangular del extrarradio de San Francisco se alzan: el Crown Zellerbach, uno de sus más recientes rascacielos, y un bello pabellón independiente, el Wells Fargo Bank. El resto de la plaza es de dominio público. La originalidad, en forma y organización del segundo, ha hecho que le dediquemos la mayor atención: consta de una planta baja, en la que se desarrollan, prácticamente, todas las actividades mercantiles, y un piso inferior, en donde se distribuyen: un Salón de Consejos, el departamento de cajas de seguridad, con 2.500 unidades, y las cajas del Banco, los aseos, equipos mecánicos, etc., una sala de descanso y bar para los empleados, con escalera de acceso independiente. Tiene planta circular, de 21,5 m de diámetro y 354 m2 de superficie. La estructura es metálica, con

  2. Fronteras 1976. San Diego/Tijuana--The International Border in Community Relations: Gateway or Barrier?

    Science.gov (United States)

    Skagen, Kiki, Ed.

    Nine papers comprise the proceedings from the conference on cultural interdependence between the border regions of San Diego, California, and Tijuana, Mexico. The papers discuss the following: (1) insurgence of the Southwest's Spanish-speaking minority since 1960; (2) opportunities for cooperation between the United States and Mexican governments;…

  3. Phytolith analysis in fluvial quaternary sediment (San Salvador and Palmar formation) Uruguay river and Argentina eastern

    International Nuclear Information System (INIS)

    Patterer, N.; Passeggi, E.; Zucol, A.; Brea, M.; Krohling, D.

    2012-01-01

    This work is about two microfossils fluvial units deposited by the Uruguay river during the Quaternary. These are San Salvador and Palmar formation (Plio-Pleistocene - Upper Pleistocene).The Palmar formation is a band of 4-15 km along the right bank of the Uruguay river outcropping from the eastern provinces of Corrientes and Entre Rios, to Concepcion del Uruguay

  4. Isotope identification as a part of the decommissioning of San Diego State University's Texas Nuclear neutron generator

    International Nuclear Information System (INIS)

    Taylor, D.

    1997-07-01

    The Department of Physics at San Diego State University has maintained a Neutron Generator facility in room P-32C since the mid 1960's. This facility has provided students and faculty with a resource for the study of neutron interactions with matter, such as activation analysis, flux determinations, cross section determinations and shielding studies. The model 9500 was built by Texas Nuclear Research in the early 1960's, and could be used for either photon or neutron generation, depending on the source ions introduced into the accelerator's plasma bottle and the target material. In February of 1988, the Texas Nuclear Research neutron generator was replaced by a unit manufactured by Kaman Sciences Corporation. The Texas Nuclear unit was then removed and stored for later disassembly and disposal. In the summer of 1993, the neutron generator was disassembled into three large sections consisting of the titanium-tritide target, the oil diffusion pump and the corona shield/accelerator tube assembly. The target was packaged and stored in room P-33A and the other 2 assemblies were wrapped in plastic for storage. In June of 1995 the neutron generator was further disassembled to enable storage in 55 gallon drums and thoroughly surveyed for loose surface contamination. Openings on the disassembled hardware components were closed off using either duct tape or bolted stainless steel flanges to prevent the possible spread of contamination. Significant levels of removable surface contamination could be found on system internal and some external surfaces, up to five hundred thousand disintegrations per minute. Initial analysis of the removable contamination using aluminum absorbers and a Geiger-Meuller tube indicated beta particle or possibly photon emitters with an energy of approximately 180 keV. This apparent radiation energy conflicted with what one would be expected to find, given knowledge of the source material and the possible neutron activated products that would be

  5. Enhanced Preliminary Assessment Report: Presidio of San Francisco Military Reservation, San Francisco, California

    Science.gov (United States)

    1989-11-01

    CAD981415656 Filmore Steiner Bay San Francisco 24 PG&E Gas Plant SanFran 502-IG CAD981415714 Bay North Point Buchanan Laguna 25 PG&E Gas Plant SanFran 502-1H...76-ioV /5,JO /0.7 /,230 PSF Water PSF, Main U.N. Lagunda Honda Analvte Plant Clearwell Reservoir Plaza Reservoi- Chlordane inetab. ə.2 ə.2 (1.2 ə.2

  6. A case for historic joint rupture of the San Andreas and San Jacinto faults

    OpenAIRE

    Lozos, Julian C.

    2016-01-01

    The San Andreas fault is considered to be the primary plate boundary fault in southern California and the most likely fault to produce a major earthquake. I use dynamic rupture modeling to show that the San Jacinto fault is capable of rupturing along with the San Andreas in a single earthquake, and interpret these results along with existing paleoseismic data and historic damage reports to suggest that this has likely occurred in the historic past. In particular, I find that paleoseismic data...

  7. Environmental geologic analysis of Rio de las Taguas basin Departmento Iglesia San Juan Argentina

    International Nuclear Information System (INIS)

    Arroqui Langer, A.; Cardus, A.; Sindern, S.; Nozica, G.

    2007-01-01

    A mineral environmental research project results where it has been located in Rio de las Taguas basin, Departamento Iglesia, Provincia de San Juan, Argentina. It has been placed in frontal Andean mountain in San Juan. In this geographic framework has been developed Au and Ag mineral project in order the world scale. The aim of this article is has been related the mineral and geological units bet wen the basin chemistry as well as to carry out future measurements mines impacts in this area. (author)

  8. Description of gravity cores from San Pablo Bay and Carquinez Strait, San Francisco Bay, California

    Science.gov (United States)

    Woodrow, Donald L.; John L. Chin,; Wong, Florence L.; Fregoso, Theresa A.; Jaffe, Bruce E.

    2017-06-27

    Seventy-two gravity cores were collected by the U.S. Geological Survey in 1990, 1991, and 2000 from San Pablo Bay and Carquinez Strait, California. The gravity cores collected within San Pablo Bay contain bioturbated laminated silts and sandy clays, whole and broken bivalve shells (mostly mussels), fossil tube structures, and fine-grained plant or wood fragments. Gravity cores from the channel wall of Carquinez Strait east of San Pablo Bay consist of sand and clay layers, whole and broken bivalve shells (less than in San Pablo Bay), trace fossil tubes, and minute fragments of plant material.

  9. 76 FR 9709 - Water Quality Challenges in the San Francisco Bay/Sacramento-San Joaquin Delta Estuary

    Science.gov (United States)

    2011-02-22

    ... Water Quality Challenges in the San Francisco Bay/Sacramento-San Joaquin Delta Estuary AGENCY... the San Francisco Bay/ Sacramento-San Joaquin Delta Estuary (Bay Delta Estuary) in California. EPA is... programs to address recent significant declines in multiple aquatic species in the Bay Delta Estuary. EPA...

  10. 33 CFR 165.776 - Security Zone; Coast Guard Base San Juan, San Juan Harbor, Puerto Rico

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Security Zone; Coast Guard Base San Juan, San Juan Harbor, Puerto Rico 165.776 Section 165.776 Navigation and Navigable Waters COAST... Guard District § 165.776 Security Zone; Coast Guard Base San Juan, San Juan Harbor, Puerto Rico (a...

  11. 76 FR 22809 - Safety Zone; Bay Ferry II Maritime Security Exercise; San Francisco Bay, San Francisco, CA

    Science.gov (United States)

    2011-04-25

    ... DEPARTMENT OF HOMELAND SECURITY Coast Guard 33 CFR Part 165 [Docket No. USCG-2011-0196] RIN 1625-AA00 Safety Zone; Bay Ferry II Maritime Security Exercise; San Francisco Bay, San Francisco, CA AGENCY... Security Exercise; San Francisco Bay, San Francisco, CA. (a) Location. The limits of this safety zone...

  12. 76 FR 10945 - San Luis Trust Bank, FSB, San Luis Obispo, CA; Notice of Appointment of Receiver

    Science.gov (United States)

    2011-02-28

    ... DEPARTMENT OF THE TREASURY Office of Thrift Supervision San Luis Trust Bank, FSB, San Luis Obispo, CA; Notice of Appointment of Receiver Notice is hereby given that, pursuant to the authority... appointed the Federal Deposit Insurance Corporation as sole Receiver for San Luis Trust Bank, FSB, San Luis...

  13. Performance of BATAN-SANS instrument

    Energy Technology Data Exchange (ETDEWEB)

    Ikram, Abarrul; Insani, Andon [National Nuclear Energy Agency, P and D Centre for Materials Science and Technology, Serpong (Indonesia)

    2003-03-01

    SANS data from some standard samples have been obtained using BATAN-SANS instrument in Serpong. The experiments were performed for various experimental set-ups that involve different detector positions and collimator lengths. This paper describes the BATAN-SANS instrument briefly as well as the data taken from those experiments and followed with discussion of the results concerning the performance and calibration of the instrument. The standard samples utilized in these experiments include porous silica, polystyrene-poly isoprene, silver behenate, poly ball and polystyrene-poly (ethylene-alt-propylene). Even though the results show that BATAN-SANS instrument is in good shape, but rooms for improvements are still widely open especially for the velocity selector and its control system. (author)

  14. AMS San Diego Testbed - Calibration Data

    Data.gov (United States)

    Department of Transportation — The data in this repository were collected from the San Diego, California testbed, namely, I-15 from the interchange with SR-78 in the north to the interchange with...

  15. San Antonio Bay 1986-1989

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The effect of salinity on utilization of shallow-water nursery habitats by aquatic fauna was assessed in San Antonio Bay, Texas. Overall, 272 samples were collected...

  16. San Francisco Bay Interferometric Bathymetry: Area B

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — High resolution sonar data were collected over ultra-shallow areas of the San Francisco Bay estuary system. Bathymetric and acoustic backscatter data were collected...

  17. San Jacinto Tries Management by Objectives

    Science.gov (United States)

    Deegan, William

    1974-01-01

    San Jacinto, California, has adopted a measurable institutional objectives approach to management by objectives. Results reflect, not only improved cost effectiveness of community college education, but also more effective educational programs for students. (Author/WM)

  18. Radon emanation on San Andreas Fault

    International Nuclear Information System (INIS)

    King, C.-Y.

    1978-01-01

    It is stated that subsurface radon emanation monitored in shallow dry holes along an active segment of the San Andreas fault in central California shows spatially coherent large temporal variations that seem to be correlated with local seismicity. (author)

  19. Hydrogeologic reconnaissance of the San Miguel River basin, southwestern Colorado

    Science.gov (United States)

    Ackerman, D.J.; Rush, F.E.

    1984-01-01

    The San Miguel River Basin encompasses 4,130 square kilometers of which about two-thirds is in the southeastern part of the Paradox Basin. The Paradox Basin is a part of the Colorado Plateaus that is underlain by a thick sequence of evaporite beds of Pennsylvanian age. The rock units that underlie the area have been grouped into hydrogeologic units based on their water-transmitting ability. Evaporite beds of mostly salt are both overlain and underlain by confining beds. Aquifers are present above and below the confining-bed sequence. The principal element of ground-water outflow from the upper aquifer is flow to the San Miguel River and its tributaries; this averages about 90 million cubic meters per year. A water budget for the lower aquifer has only two equal, unestimated elements, subsurface outflow and recharge from precipitation. The aquifers are generally isolated from the evaporite beds by the bounding confining beds; as a result, most ground water has little if any contact with the evaporites. No brines have been sampled and no brine discharges have been identified in the basin. Salt water has been reported for petroleum-exploration wells, but no active salt solution has been identified. (USGS)

  20. SANS observations on weakly flocculated dispersions

    DEFF Research Database (Denmark)

    Mischenko, N.; Ourieva, G.; Mortensen, K.

    1997-01-01

    Structural changes occurring in colloidal dispersions of poly-(methyl metacrylate) (PMMA) particles, sterically stabilized with poly-(12-hydroxystearic acid) (PHSA), while varying the solvent quality, temperature and shear rate, are investigated by small-angle neutron scattering (SANS......). For a moderately concentrated dispersion in a marginal solvent the transition on cooling from the effective stability to a weak attraction is monitored, The degree of attraction is determined in the framework of the sticky spheres model (SSM), SANS and rheological results are correlated....

  1. Trouble Brewing in San Diego. Policy Brief

    Science.gov (United States)

    Buck, Stuart

    2010-01-01

    The city of San Diego will face enormous budgetary pressures from the growing deficits in public pensions, both at a state and local level. In this policy brief, the author estimates that San Diego faces total of $45.4 billion, including $7.95 billion for the county pension system, $5.4 billion for the city pension system, and an estimated $30.7…

  2. Toxic phytoplankton in San Francisco Bay

    Science.gov (United States)

    Rodgers, Kristine M.; Garrison, David L.; Cloern, James E.

    1996-01-01

    The Regional Monitoring Program (RMP) was conceived and designed to document the changing distribution and effects of trace substances in San Francisco Bay, with focus on toxic contaminants that have become enriched by human inputs. However, coastal ecosystems like San Francisco Bay also have potential sources of naturally-produced toxic substances that can disrupt food webs and, under extreme circumstances, become threats to public health. The most prevalent source of natural toxins is from blooms of algal species that can synthesize metabolites that are toxic to invertebrates or vertebrates. Although San Francisco Bay is nutrient-rich, it has so far apparently been immune from the epidemic of harmful algal blooms in the world’s nutrient-enriched coastal waters. This absence of acute harmful blooms does not imply that San Francisco Bay has unique features that preclude toxic blooms. No sampling program has been implemented to document the occurrence of toxin-producing algae in San Francisco Bay, so it is difficult to judge the likelihood of such events in the future. This issue is directly relevant to the goals of RMP because harmful species of phytoplankton have the potential to disrupt ecosystem processes that support animal populations, cause severe illness or death in humans, and confound the outcomes of toxicity bioassays such as those included in the RMP. Our purpose here is to utilize existing data on the phytoplankton community of San Francisco Bay to provide a provisional statement about the occurrence, distribution, and potential threats of harmful algae in this Estuary.

  3. [An analysis of appeals against the ruling of the occupational physician's lodged to the Department of Prevention and Safety in the Working Environment--Health Prevention and Occupational Epidemiology Operative Unit within the A.S.P. Palermo (Palermo Health Authority), years 2008-2010].

    Science.gov (United States)

    Marsala, M G L; Morici, M; Lacca, G; Curcurù, L; Eduardo, E Costagliola; Ilardo, S; Trapani, E; Caracausi, R; Firenze, A

    2012-01-01

    The purpose of this study is to analyze the appeals against a "suitability judgment for work" lodged to the U.O.S. "Health Prevention and Occupational Epidemiology Operative Unit" of Department of Prevention and Safety in the Working Environment within the ASP Palermo (U.O.S.), from 2008 to 2010. Studying the appeals gives an indirect view on the occupational physician activity and allows to monitor their actions, analysis aims at highlighting those issues around which any planning and implementation of coordination activities should be focused.

  4. Modelling SANS and SAXS data

    International Nuclear Information System (INIS)

    Reynolds, P.

    1999-01-01

    Full text: Small angle scattering data while on an absolute scale and relatively accurate over large ranges of observables (0.003 -1 ; 0.1 -1 ) is often relatively featureless. I will address some of the problems this causes, and some of the ways of minimising these, by reference to our recent SANS results. For the benefit of newer chums this will involve discussion of the strengths and weaknesses of data from ISIS (LOQ), Argonne (SAND) and the I.L.L. (D22), and the consequences these have for modelling. The use of simple portable or remote access systems for modelling will be discussed - in particular the IGOR based NIST system of Dr. S. Kline and the VAX based FISH system of Dr. R. Heenan, ISIS. I will illustrate that a wide variety of physically appealing and complete models are now available. If you have reason to believe in a particular microstructure, this belief can now be either falsified, or the microstructure quantified, by fitting to the entire set of scattering patterns over the entire Q-range. For example, only in cases of drastic ignorance need we use only Guinier and Porod analyses, although these may provide useful initial guidance in the modelling. We now rarely need to use oversimplified logically incomplete models - such as spherical micelles with neglect of intermicellar correlation- now that we possess fast desktop/experimental computers

  5. [Study of prevention and control of delirium in ventilated patients by simulating blockage of circadian rhythm with sedative in intensive care unit].

    Science.gov (United States)

    Li, Junyan; Dong, Chenming; Zhang, Hong; Zhang, Hongsong; Song, Ruixia; Yang, Zhaohui; Feng, Fang; Qi, Yan; Yang, Jing

    2016-01-01

    To explore the effect of giving sedatives according to the circadian rhythm in prevention of occurrence of delirium and the prognosis of patients undergoing mechanical ventilation in intensive care unit (ICU). A prospective double-blinded randomized controlled trial (RCT) was conducted. The patients admitted to Department of Critical Care Medicine of the Second Hospital of Lanzhou University from July 2014 to February 2015, undergoing invasive mechanical ventilation over 12 hours were enrolled. All the patients were given fentanyl for analgesia, and they were randomly divided into simulated circadian clock group (study group, n = 35) and non-simulated circadian clock group (control group, n = 35). The patients in each group were subdivided into three subgroups according to the kinds of sedative drugs, namely dexmedetomidine group (n = 8), propofol group (n = 14), and dexmedetomidine combined with propofol group (combination group, n = 13). Visual analogue scale (VAS) standard and Richmond agitation-sedation scale (RASS) were used to control the analgesic and to quantify the depth of sedation by titrating the dose of sedative drugs, the simulated circadian clock was set to control the RASS score at 0-1 during the day, and -1 to -2 at night in study group. The RASS score in the control group was set at -1 to -2 day and night. The urine 6-hydroxy acid melatonin (aMT6s) levels at different time points in the first diurnal rhythm (06:00, 12:00, 18:00, 24:00) were determined by enzyme linked immunosorbent assay (ELISA). The incidence of delirium, severe hypotension, severe bradycardia and other adverse reactions, duration of mechanical ventilation and the time of extubation, length of ICU stay, amount of sedative and analgesic drugs used were recorded. The correlation between delirium and other indexes was analyzed by using Spearman correlation analysis. (1) There were no significant differences in gender, age, acute physiology and chronic health evaluation II (APACHEII

  6. Psychiatric Disorders and Substance Use in Homeless Youth: A Preliminary Comparison of San Francisco and Chicago

    Directory of Open Access Journals (Sweden)

    Ernika G. Quimby

    2012-08-01

    Full Text Available Youth homelessness is a growing problem in the United States. The experience of homelessness appears to have numerous adverse consequences, including psychiatric and substance use disorders. This study compared the frequencies of psychiatric disorders, including substance use, between homeless youth (18–24 years-old in San Francisco (N = 31 and Chicago (N = 56. Subjects were administered the Mini International Neuropsychiatric Interview (M.I.N.I. to assess DSM-IV-TR diagnoses and substance use disorders. Eighty-seven percent of the San Francisco youth, and 81% of the Chicago youth met criteria for at least one M.I.N.I. psychiatric diagnosis. Nearly two-thirds of the youth in both samples met criteria for a mood disorder. Approximately one-third met criteria for an anxiety disorder. Thirty-two percent of the San Francisco sample and 18% of the Chicago met criteria for Antisocial Personality Disorder. Approximately 84% of the San Francisco youth and 48% of the Chicago youth met criteria for a substance-related disorder, and more substances were used by San Francisco youth. In conclusion, the high rate of psychiatric disorders in homeless youth provides clear evidence that the mental health needs of this population are significant. Implications are discussed.

  7. SANS studies of solutions and molecular composites prepared from cellulose tricarbanilate

    CERN Document Server

    Alava, C; Cameron, J D; Cowie, J M G; Vaqueiro, P; Möller, A; Triolo, A

    2002-01-01

    We report on SANS measurements carried out on the instrument SANS1 (V4) at the BENSC facility on solutions and composites of cellulose tricarbanilate (CTC). This cellulose derivative exhibits lyotropic behaviour in methylacrylate (MA). The SANS data indicate that in the isotropic liquid state (up to 25% wt CTC in MA) the CTC chains behave like rods of mass per unit length (M/L). In the liquid crystalline (LC) phase (at and above 35% wt CTC in MA), the Q dependence varies from Q sup - sup 1 to Q sup - sup 4 , probably as a result of self-assembling of the CTC chains. The general aim of our work is to prepare molecular composites, i.e. miscible blends of rigid-rod and flexible-coil polymers, from CTC solutions in polymerizable media. To establish the degree of homogeneity of the composites, we performed SANS measurements on UV-cured CTC/MA solutions. Here, we compare the SANS data of CTC/monomer solutions with those of the corresponding composites. (orig.)

  8. Isotopic investigation of ground water resources in the Ojo Alamo sandstone, Nacimiento, and San Jose Formations, San Juan Basin, New Mexico. Technical completion report

    International Nuclear Information System (INIS)

    Phillips, F.M.; Peeters, L.A.; Tansey, M.K.

    1984-06-01

    The San Juan Basin, in northwest New Mexico, has vast reserves of strippable, low-sulfur coal. Development of the resource will require large quantities of water, from an area where water resources are not abundant. Since surface-water supplies are fully allocated, increased future water demands will have to be met through ground-water development. The study concentrates on the Ojo Alamo, Nacimiento, and San Jose Formations, the aquifers directly above the principal coal unit. Carbon-14 and tritium methods were used to date the ground water in these units. Initial radiocarbon activities were calculated using the models of Vogel, Tamers, Pearson, Mook and Fontes. The observation lends support to the hypothesis of isotopically lighter Pleistocene precipitation. Such lighter recharge was most likely due to a colder mean annual temperature and perhaps increased winter precipitation. A similar change is obtained from noble-gas paleothermometry

  9. POLLUTION PREVENTION OPPORTUNITY ASSESSMENT UNITED STATES ARMY CORPS OF ENGINEERS PITTSBURGH ENGINEER WAREHOUSE AND REPAIR STATION AND EMSWORTH LOCKS AND DAMS PITTSBURGH, PENNSYLVANIA

    Science.gov (United States)

    This report summarizes work conducted at the United States Army Corps of Engineers (USACE) Pittsburgh Engineering Warehouse and Repair Station (PEWARS) and Emsworth Locks and Dams in Pittsburgh, Pennsylvania under the U.S. Environmental Protection Agency's (EPA's) Waste Reduction...

  10. 77 FR 59969 - Notice of Inventory Completion: San Francisco State University, Department of Anthropology, San...

    Science.gov (United States)

    2012-10-01

    ... Inventory Completion: San Francisco State University, Department of Anthropology, San Francisco, CA... Francisco State University, NAGPRA Program (formerly in the Department of Anthropology). The human remains... State University Department of Anthropology records. In the Federal Register (73 FR 30156-30158, May 23...

  11. 78 FR 57482 - Safety Zone; America's Cup Aerobatic Box, San Francisco Bay, San Francisco, CA

    Science.gov (United States)

    2013-09-19

    ...-AA00 Safety Zone; America's Cup Aerobatic Box, San Francisco Bay, San Francisco, CA AGENCY: Coast Guard... America's Cup air shows. These safety zones are established to provide a clear area on the water for... announced by America's Cup Race Management. ADDRESSES: Documents mentioned in this preamble are part of...

  12. 77 FR 42649 - Safety Zone: Sea World San Diego Fireworks, Mission Bay; San Diego, CA

    Science.gov (United States)

    2012-07-20

    ... 1625-AA00 Safety Zone: Sea World San Diego Fireworks, Mission Bay; San Diego, CA AGENCY: Coast Guard... authorized by the Captain of the Port, or his designated representative. DATES: This rule is effective from 8... to ensure the public's safety. B. Basis and Purpose The Ports and Waterways Safety Act gives the...

  13. 75 FR 27432 - Security Zone; Golden Guardian 2010 Regional Exercise; San Francisco Bay, San Francisco, CA

    Science.gov (United States)

    2010-05-17

    ... can better evaluate its effects on them and participate in the rulemaking process. Small businesses... DEPARTMENT OF HOMELAND SECURITY Coast Guard 33 CFR Part 165 [Docket No. USCG-2010-0221] RIN 1625-AA87 Security Zone; Golden Guardian 2010 Regional Exercise; San Francisco Bay, San Francisco, CA AGENCY...

  14. Social Integration of the San Society From the Viewpoint of Sexual Relationships (Natural History of Communication among the Central Kalahari San)

    OpenAIRE

    TANAKA, Jiro

    2016-01-01

    The Central Kalahari San, living in the central part of Botswana, practice divorce and remarriage frequently. Most people have experienced marriage more than twice in their lives. The rate of polygamous marriage is rather high, and moreover, a kind of love-relationship called zÄ ku, which is usually recognized openly, is widely seen in this society. Four examples of social clusters united by marriage and other sexual relationships are here examined and analyzed to see how those sexual relatio...

  15. Compact High Resolution SANS using very cold neutrons (VCN-SANS)

    International Nuclear Information System (INIS)

    Kennedy, S.; Yamada, M.; Iwashita, Y.; Geltenbort, P.; Bleuel, M.; Shimizu, H.

    2011-01-01

    SANS (Small Angle Neutron Scattering) is a popular method for elucidation of nano-scale structures. However science continually challenges SANS for higher performance, prompting exploration of ever-more exotic and expensive technologies. We propose a compact high resolution SANS, using very cold neutrons, magnetic focusing lens and a wide-angle spherical detector. This system will compete with modern 40 m pinhole SANS in one tenth of the length, matching minimum Q, Q-resolution and dynamic range. It will also probe dynamics using the MIEZE method. Our prototype lens (a rotating permanent-magnet sextupole), focuses a pulsed neutron beam over 3-5 nm wavelength and has measured SANS from micelles and polymer blends. (authors)

  16. Integration of Federal Bureau of Investigation and United States Secret Service/Department of Education Threat Assessment Models into a Conceptual Framework for Prevention of School Violence

    Science.gov (United States)

    Augustyniak, Kristine M.

    2005-01-01

    Professionals entered the 21st century with a heightened call to address school safety. Though notable contributions have been made to insure peaceful school communities through a wide range of primary and secondary prevention programs, research suggests that these programs are often an insufficient response to students who are at increased risk…

  17. Valued Youth Partnerships: Programs in Caring. Cross-Age Tutoring Dropout Prevention Strategies.

    Science.gov (United States)

    Intercultural Development Research Association, San Antonio, TX.

    This booklet provides information about the Valued Youth Partnership (VYP) program for dropout prevention. Begun in 1984 with the support of the Coca-Cola Company and the collaboration of the Intercultural Development Research Association, the VYP program is being implemented in the Edgewood and South San Antonio school districts in San Antonio,…

  18. Deep permeability of the San Andreas Fault from San Andreas Fault Observatory at Depth (SAFOD) core samples

    Science.gov (United States)

    Morrow, Carolyn A.; Lockner, David A.; Moore, Diane E.; Hickman, Stephen H.

    2014-01-01

    The San Andreas Fault Observatory at Depth (SAFOD) scientific borehole near Parkfield, California crosses two actively creeping shear zones at a depth of 2.7 km. Core samples retrieved from these active strands consist of a foliated, Mg-clay-rich gouge containing porphyroclasts of serpentinite and sedimentary rock. The adjacent damage zone and country rocks are comprised of variably deformed, fine-grained sandstones, siltstones, and mudstones. We conducted laboratory tests to measure the permeability of representative samples from each structural unit at effective confining pressures, Pe up to the maximum estimated in situ Pe of 120 MPa. Permeability values of intact samples adjacent to the creeping strands ranged from 10−18 to 10−21 m2 at Pe = 10 MPa and decreased with applied confining pressure to 10−20–10−22 m2 at 120 MPa. Values for intact foliated gouge samples (10−21–6 × 10−23 m2 over the same pressure range) were distinctly lower than those for the surrounding rocks due to their fine-grained, clay-rich character. Permeability of both intact and crushed-and-sieved foliated gouge measured during shearing at Pe ≥ 70 MPa ranged from 2 to 4 × 10−22 m2 in the direction perpendicular to shearing and was largely insensitive to shear displacement out to a maximum displacement of 10 mm. The weak, actively-deforming foliated gouge zones have ultra-low permeability, making the active strands of the San Andreas Fault effective barriers to cross-fault fluid flow. The low matrix permeability of the San Andreas Fault creeping zones and adjacent rock combined with observations of abundant fractures in the core over a range of scales suggests that fluid flow outside of the actively-deforming gouge zones is probably fracture dominated.

  19. The Performance of Nearshore Dredge Disposal at Ocean Beach, San Francisco, California, 2005-2007

    Science.gov (United States)

    Barnard, Patrick L.; Erikson, Li H.; Hansen, Jeff E.; Elias, Edwin

    2009-01-01

    Ocean Beach, California, contains an erosion hot spot in the shadow of the San Francisco ebb tidal delta that threatens valuable public infrastructure as well as the safe recreational use of the beach. In an effort to reduce the erosion at this location a new plan for the management of sediment dredged annually from the main shipping channel at the mouth of San Francisco Bay was implemented in May 2005 by the United States Army Corps of Engineers, San Francisco District (USACE). The USACE designated a temporary nearshore dredge disposal site for the annual disposal of about 230,000 m3 (300,000 yd3) of sand about 750 m offshore and slightly south of the erosion hot spot, in depths between approximately 9 and 14 m. The site has now been used three times for a total sediment disposal of about 690,000 m3 (about 900,000 yds3). The disposal site was chosen because it is in a location where strong tidal currents and open-ocean waves can potentially feed sediment toward the littoral zone in the reach of the beach that is experiencing critical erosion, as well as prevent further scour on an exposed outfall pipe. The onshore migration of sediment from the target disposal location might feed the primary longshore bar or the nearshore zone, and provide a buffer to erosion that peaks during winter months when large waves impact the region. The United States Geological Survey (USGS) has been monitoring and modeling the bathymetric evolution of the test dredge disposal site and the adjacent coastal region since inception in May 2005. This paper reports on the first 2.5 years of this monitoring program effort (May 2005 to December 2007) and assesses the short-term coastal response. Here are the key findings of this report: *Approximately half of the sediment that has been placed in the nearshore dredge-disposal site during the 2.5 years of this study remains within the dredge focus area. *In the winter of 2006-7, large waves transported the dredge-mound material onshore. *High

  20. Preventing and Addressing Homophobic and Transphobic Bullying in Education: A Human Rights-Based Approach Using the United Nations Convention on the Rights of the Child

    Science.gov (United States)

    Cornu, Christophe

    2016-01-01

    Homophobic and transphobic bullying in schools can have a serious effect on children and young people subjected to it at a crucial moment in their lives. It is an obstacle to the right to education, which is one of the basic universal human rights enshrined in the Universal Declaration of Human Rights and various United Nations Conventions. This…

  1. Saving Our Seniors: Preventing Elder Abuse, Neglect, and Exploitation. Hearing before the Special Committee on Aging, United States Senate, One Hundred Seventh Congress, First Session.

    Science.gov (United States)

    Congress of the U.S., Washington, DC. Senate Special Committee on Aging.

    In this report of a congressional hearing, testimony includes statements and prepared statements of these four senators: John Breaux, Larry Craig, Debbie Stabenow, and Herbert Kohl. Panel I is presented by the Acting Assistant Attorney General, United States (U.S.) Department of Justice. Panel II consists of individuals representing the National…

  2. Cacao use and the San Lorenzo Olmec

    Science.gov (United States)

    Powis, Terry G.; Cyphers, Ann; Gaikwad, Nilesh W.; Grivetti, Louis; Cheong, Kong

    2011-01-01

    Mesoamerican peoples had a long history of cacao use—spanning more than 34 centuries—as confirmed by previous identification of cacao residues on archaeological pottery from Paso de la Amada on the Pacific Coast and the Olmec site of El Manatí on the Gulf Coast. Until now, comparable evidence from San Lorenzo, the premier Olmec capital, was lacking. The present study of theobromine residues confirms the continuous presence and use of cacao products at San Lorenzo between 1800 and 1000 BCE, and documents assorted vessels forms used in its preparation and consumption. One elite context reveals cacao use as part of a mortuary ritual for sacrificial victims, an event that occurred during the height of San Lorenzo's power. PMID:21555564

  3. 77 FR 66499 - Environmental Impact Statement: San Bernardino and Los Angeles Counties, CA

    Science.gov (United States)

    2012-11-05

    ... San Bernardino, 285 East Hospitality Lane, San Bernardino, California 92408 (2) Sheraton Ontario..., November 13, 2012 from 5-7 p.m. at the Hilton San Bernardino, 285 East Hospitality Lane, San Bernardino...

  4. Carbetocin versus oxytocin for prevention of post-partum haemorrhage at caesarean section in the United Kingdom: An economic impact analysis.

    Science.gov (United States)

    van der Nelson, Helen A; Draycott, Tim; Siassakos, Dimitrios; Yau, Christopher W H; Hatswell, Anthony J

    2017-03-01

    To determine the economic impact of the introduction of carbetocin for the prevention of postpartum haemorrhage (PPH) at caesarean section, compared to oxytocin. The model is a decision tree conducted from a UK National Health Service perspective. 1500 caesarean sections (both elective and emergency) were modelled over a 12 month period. Efficacy data was taken from a published Cochrane meta-analysis, and costs from NHS Reference costs, the British National Formulary and the NHS electronic Medicines Information Tool. A combination of hospital audit data and expert input from an advisory board of clinicians was used to inform resource use estimates. The main outcome measures were the incidence of PPH and total cost over a one year time horizon, as a result of using carbetocin compared to oxytocin for prevention of PPH at caesarean section. The use of carbetocin compared to oxytocin for prevention of PPH at caesarean section was associated with a reduction of 30 (88 vs 58) PPH events (>500ml blood loss), and a cost saving of £27,518. In probabilistic sensitivity analysis, carbetocin had a 91.5% probability of producing better outcomes, and a 69.4% chance of being dominant (both cheaper and more effective) compared to oxytocin. At list price, the introduction of carbetocin appears to provide improved clinical outcomes along with cost savings, though this is subject to uncertainty regarding the underlying data in efficacy, resource use, and cost. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

  5. Paleomagnetic investigation of late Quaternary sediments of south San Francisco Bay, California

    Science.gov (United States)

    Hillhouse, John W.

    1977-01-01

    Paleomagnetic inclinations of the Late Quaternary sediments of South San Francisco Bay were determined from bore hole samples collected near Dumbarton Bridge. The sediments consist of estuarine muds and nonmarine sand deposits, floored by bedrock of the Mesozoic Franciscan Formation. - Beneath Dumbarton Bridge the entire sedimentary fill is normally polarized; therefore, the fill postdates the Brunhes-Matayama polarity reversal (700,000 y. B.P.). Magnetic time lines such as the Mono Lake excursion (24,000 y. B.P.) and the reversed Blake event (110,000 y B.P.) were not found in this bore hole. In addition to Holocene and modern deposits of San Francisco Bay, an older estuarine unit occurs in the stratigraphic section. The older unit was deposited during a period of high sea level, tentatively correlated with the Sangamon interglacial period. Because evidence of the Blake event is not present in the older estuarine unit, the proposed age of this unit could not be confirmed. Although the Holocene estuarine deposits of South San Francisco Bay carry stable remanent magnetization, a reliable record of geomagnetic secular variation could not be recovered because the water-saturated sdiment was deformed by drilling.

  6. Mammal Track Counts - San Diego County, 2010 [ds709

    Data.gov (United States)

    California Natural Resource Agency — The San Diego Tracking Team (SDTT) is a non-profit organization dedicated to promoting the preservation of wildlife habitat in San Diego County through citizen-based...

  7. Coastal Cactus Wren, San Diego Co. - 2009 [ds702

    Data.gov (United States)

    California Natural Resource Agency — The San Diego Multiple Species Conservation program (MSCP) was developed for the conservation of plants and animals in the southeast portion of San Diego County....

  8. Coastal Cactus Wren, San Diego Co. - 2011 [ds708

    Data.gov (United States)

    California Natural Resource Agency — The San Diego Multiple Species Conservation program (MSCP) was developed for the conservation of plants and animals in the southeast portion of San Diego County....

  9. Species Observations (poly) - San Diego County [ds648

    Data.gov (United States)

    California Natural Resource Agency — Created in 2009, the SanBIOS database serves as a single repository of species observations collected by various departments within the County of San Diego's Land...

  10. Mammal Track Counts - San Diego County [ds442

    Data.gov (United States)

    California Natural Resource Agency — The San Diego Tracking Team (SDTT) is a non-profit organization dedicated to promoting the preservation of wildlife habitat in San Diego County through citizen-based...

  11. Species Observations (poly) - San Diego County [ds648

    Data.gov (United States)

    California Department of Resources — Created in 2009, the SanBIOS database serves as a single repository of species observations collected by various departments within the County of San Diego's Land...

  12. Provencance of the late Proterozoic to early Cambrian metaclastic sediments ot the Sierra de San Luis (Eastern Sierras Pampeanas) and Cordillera Oriental, Argentina

    DEFF Research Database (Denmark)

    Drobe, M.; López de Luchi, M.; Steenken, A.

    2009-01-01

    Provenance studies have been performed utilising major and trace elements, Nd systematics, whole rock Pb-Pb isotopes and zircon U/Pb SHRIMP data on metasedimentary rocks of the Sierra de San Luis (Nogolí Metamorphic Complex, Pringles Metamorphic Complex, Conlara Metamorphic Complex and San Luis...... is depicted for all the complexes using major and trace elements. The Pringles Metamorphic Complex shows indications for crustal recycling, pointing to a bimodal provenance. Major volcanic input has to be rejected due to Th/Sc, Y/Ni and Cr/V ratios for all units. The eNd(540 Ma) data is lower for the San Luis...... Formation and higher for the Conlara Metamorphic Complex, as compared to the other units, in which a good consistency is given. This is similar to the TDM ages, where the metapsammitic samples of the San Luis Formation are slightly older. The spread of data is largest for the Pringles Metamorphic Complex...

  13. Removal of waterborne pathogens from liver transplant unit water taps in prevention of healthcare-associated infections: a proposal for a cost-effective, proactive infection control strategy.

    Science.gov (United States)

    Zhou, Z Y; Hu, B J; Qin, L; Lin, Y E; Watanabe, H; Zhou, Q; Gao, X D

    2014-04-01

    Hospital water supplies often contain waterborne pathogens, which can become a reservoir for healthcare-associated infections (HAIs). We surveyed the extent of waterborne pathogen contamination in the water supply of a Liver Transplant Unit. The efficacy of point-of-use (POU) water filters was evaluated by comparative analysis in routine clinical use. Our baseline environmental surveillance showed that Legionella spp. (28%, 38/136), Pseudomonas aeruginosa (8%, 11/136), Mycobacterium spp. (87%, 118/136) and filamentous fungi (50%, 68/136) were isolated from the tap water of the Liver Transplant Unit. 28.9% of Legionella spp.-positive water samples (n = 38) showed high-level Legionella contamination (≥10(3) CFU/L). After installation of the POU water filter, none of these pathogens were found in the POU filtered water samples. Furthermore, colonizations/infections with Gram-negative bacteria determined from patient specimens were reduced by 47% during this period, even if only 27% (3/11) of the distal sites were installed with POU water filters. In conclusion, the presence of waterborne pathogens was common in the water supply of our Liver Transplant Unit. POU water filters effectively eradicated these pathogens from the water supply. Concomitantly, healthcare-associated colonization/infections declined after the POU filters were installed, indicating their potential benefit in reducing waterborne HAIs. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

  14. San Francisco Bay Long Term Management Strategy for Dredging

    Science.gov (United States)

    The San Francisco Bay Long Term Management Strategy (LTMS) is a cooperative effort to develop a new approach to dredging and dredged material disposal in the San Francisco Bay area. The LTMS serves as the Regional Dredging Team for the San Francisco area.

  15. 33 CFR 110.120 - San Luis Obispo Bay, Calif.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false San Luis Obispo Bay, Calif. 110... ANCHORAGES ANCHORAGE REGULATIONS Special Anchorage Areas § 110.120 San Luis Obispo Bay, Calif. (a) Area A-1. Area A-1 is the water area bounded by the San Luis Obispo County wharf, the shoreline, a line drawn...

  16. Geology and petrography of the Socoscora Sierra . Province of San Luis. Republica Argentina

    International Nuclear Information System (INIS)

    Carugno Duran, A.

    1998-01-01

    The following paper include an study geological and petrographic of the Sierra de Socoscora. San Luis, Argentina. This mountainas is a block with less elevation that the Sierra de San Luis, and it located in the west center of it. It' s formed by an crystalline basement composed by metamorphic haigh grade rocks, with a penetrative foliation of strike N-S. in this context is possible to define petrographicly the following units, migmatitic that fill a big part of the mountain, amphibolites, marbles, skarns, milonites and pegmatites. This units have amphibolitic facies assemblanges mineral and in some them, we can observe retrograde metamorphism of the greesnschist facies. The metamorphic structure is complex and evidence at least three deformation event

  17. Rocks and geology in the San Francisco Bay region

    Science.gov (United States)

    Stoffer, Philip W.

    2002-01-01

    The landscape of the San Francisco Bay region is host to a greater variety of rocks than most other regions in the United States. This introductory guide provides illustrated descriptions of 46 common and important varieties of igneous, sedimentary, and metamorphic rock found in the region. Rock types are described in context of their identification qualities, how they form, and where they occur in the region. The guide also provides discussion about of regional geology, plate tectonics, the rock cycle, the significance of the selected rock types in relation to both earth history and the impact of mineral resources on the development in the region. Maps and text also provide information where rocks, fossils, and geologic features can be visited on public lands or in association with public displays in regional museums, park visitor centers, and other public facilities.

  18. Addendum Guidelines for the Prevention of Peanut Allergy in the United States: Report of the National Institute of Allergy and Infectious Diseases-Sponsored Expert Panel.

    Science.gov (United States)

    Togias, Alkis; Cooper, Susan F; Acebal, Maria L; Assa'ad, Amal; Baker, James R; Beck, Lisa A; Block, Julie; Byrd-Bredbenner, Carol; Chan, Edmond S; Eichenfield, Lawrence F; Fleischer, David M; Fuchs, George J; Furuta, Glenn T; Greenhawt, Matthew J; Gupta, Ruchi S; Habich, Michele; Jones, Stacie M; Keaton, Kari; Muraro, Antonella; Plaut, Marshall; Rosenwasser, Lanny J; Rotrosen, Daniel; Sampson, Hugh A; Schneider, Lynda C; Sicherer, Scott H; Sidbury, Robert; Spergel, Jonathan; Stukus, David R; Venter, Carina; Boyce, Joshua A

    Food allergy is an important public health problem because it affects children and adults, can be severe and even life-threatening, and may be increasing in prevalence. Beginning in 2008, the National Institute of Allergy and Infectious Diseases, working with other organizations and advocacy groups, led the development of the first clinical guidelines for the diagnosis and management of food allergy. A recent landmark clinical trial and other emerging data suggest that peanut allergy can be prevented through introduction of peanut-containing foods beginning in infancy. Prompted by these findings, along with 25 professional organizations, federal agencies, and patient advocacy groups, the National Institute of Allergy and Infectious Diseases facilitated development of addendum guidelines to specifically address the prevention of peanut allergy. The addendum provides 3 separate guidelines for infants at various risk levels for the development of peanut allergy and is intended for use by a wide variety of health care providers. Topics addressed include the definition of risk categories, appropriate use of testing (specific IgE measurement, skin prick tests, and oral food challenges), and the timing and approaches for introduction of peanut-containing foods in the health care provider's office or at home. The addendum guidelines provide the background, rationale, and strength of evidence for each recommendation. Guidelines have been developed for early introduction of peanut-containing foods into the diets of infants at various risk levels for peanut allergy. Published by Elsevier Inc.

  19. October 1986 San Salvador, El Salvador Images

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — At least 1,000 people killed, 10,000 injured, 200,000 homeless and severe damage in the San Salvador area. About 50 fatalities were the result of landslides in the...

  20. SANS analysis of aqueous ionic perfluoropolyether micelles

    CERN Document Server

    Gambi, C M C; Chittofrati, A; Pieri, R; Baglioni, P; Teixeira, J

    2002-01-01

    Preliminary SANS results of ionic chlorine terminated perfluoropolyether micelles in water are given. The experimental spectra have been analyzed by a two-shell ellipsoidal model for the micellar form factor and a screened Coulombic plus hard-sphere repulsion potential for the structure factor. (orig.)

  1. Groundwater quality in the San Diego Drainages Hydrogeologic Province, California

    Science.gov (United States)

    Wright, Michael T.; Belitz, Kenneth

    2011-01-01

    More than 40 percent of California's drinking water is from groundwater. To protect this vital resource, the State of California created the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The Priority Basin Project of the GAMA Program provides a comprehensive assessment of the State's groundwater quality and increases public access to groundwater-quality information. The San Diego Drainages Hydrogeologic Province (hereinafter referred to as San Diego) is one of the study units being evaluated. The San Diego study unit is approximately 3,900 square miles and consists of the Temecula Valley, Warner Valley, and 12 other alluvial basins (California Department of Water Resources, 2003). The study unit also consists of all areas outside defined groundwater basins that are within 3 kilometers of a public-supply well. The study unit was separated, based primarily on hydrogeologic settings, into four study areas: Temecula Valley, Warner Valley, Alluvial Basins, and Hard Rock (Wright and others, 2005). The sampling density for the Hard Rock study area, which consists of areas outside of groundwater basins, was much lower than for the other study areas. Consequently, aquifer proportions for the Hard Rock study area are not used to calculate the aquifer proportions shown by the pie charts. An assessment of groundwater quality for the Hard Rock study area can be found in Wright and Belitz, 2011. The temperatures in the coastal part of the study unit are mild with dry summers, moist winters, and an average annual rainfall of about 10 inches. The temperatures in the mountainous eastern part of the study unit are cooler than in the coastal part, with an annual precipitation of about 45 inches that occurs mostly in the winter. The primary aquifers consist of Quaternary-age alluvium and weathered bedrock in the Temecula Valley, Warner Valley, and Alluvial Basins study areas, whereas in the Hard Rock study area the primary aquifers consist mainly of fractured and

  2. 77 FR 46115 - Notice of Inventory Completion: San Diego Museum of Man, San Diego, CA

    Science.gov (United States)

    2012-08-02

    ...The San Diego Museum of Man has completed an inventory of human remains in consultation with the appropriate Indian tribe, and has determined that there is a cultural affiliation between the human remains and a present-day Indian tribe. Representatives of any Indian tribe that believes itself to be culturally affiliated with the human remains may contact the San Diego Museum of Man. Repatriation of the human remains to the Indian tribe stated below may occur if no additional claimants come forward.

  3. Origins of the Salado, Seven Rivers, and San Andres salt margins in Texas and New Mexico: Revision 1: Topical report

    International Nuclear Information System (INIS)

    Boyd, S.D.; Murphy, P.J.

    1987-02-01

    The present boundaries of the San Andres, Seven Rivers, and Salado salts generally lie along the periphery of the Palo Duro and Tucumcari Basins. Various geologic mechanisms occurring singularly or in combination determined the positions of the salt margins. These mechanisms include nondeposition of salt and syndepositional and postdepositional dissolution. In New Mexico, San Andres units pinch out against the Pedernal and Sierra Grande Uplifts, indicating that nondeposition established the original salt margins there. Syndepositional dissolution of exposed Upper San Andres salts occurred in response to Guadalupian upwarp of the basin margins. Triassic erosion differentially removed Permian salt-bearing formations along the uplifts. Late Tertiary dissolution is indicated by fill of north-south trending collapse valleys. In Texas, Guadalupian upwarp along the Amarillo Uplift caused pinchout of Units 2 and 3 in the Lower San Andres and influenced the deposition of subsequent salt-bearing strata. The discontinuity of Upper San Andres evaporites across the Amarillo Uplift suggests syndepositional dissolution. Along the eastern and northeastern basin margin, dissolution may have accompanied Triassic erosion of locally uplifted Upper Permian strata. Tertiary dissolution is recognized beneath anomalously thick Ogallala Formation sections that overlie collasped Permian strata. 49 refs., 31 figs., 2 tabs

  4. Interagency partnering for weed prevention--progress on development of a National Early Detection and Rapid Response System for Invasive Plants in the United States

    Science.gov (United States)

    Westbrooks, R.; Westbrooks, R.

    2011-01-01

    Over the past 50 years, experience has shown that interagency groups provide an effective forum for addressing various invasive species issues and challenges on multiple land units. However, more importantly, they can also provide a coordinated framework for early detection, reporting, identification and vouchering, rapid assessment, and rapid response to new and emerging invasive plants in the United States. Interagency collaboration maximizes the use of available expertise, resources, and authority for promoting early detection and rapid response (EDRR) as the preferred management option for addressing new and emerging invasive plants. Currently, an interagency effort is underway to develop a National EDRR System for Invasive Plants in the United States. The proposed system will include structural and informational elements. Structural elements of the system include a network of interagency partner groups to facilitate early detection and rapid response to new invasive plants, including the Federal Interagency Committee for the Management of Noxious and Exotic Weeds (FICMNEW), State Invasive Species Councils, State Early Detection and Rapid Response Coordinating Committees, State Volunteer Detection and Reporting Networks, Invasive Plant Task Forces, and Cooperative Weed Management Areas. Informational elements and products being developed include Regional Invasive Plant Atlases, and EDRR Guidelines for EDRR Volunteer Network Training, Rapid Assessment and Rapid Response, and Criteria for Selection of EDRR Species. System science and technical support elements which are provided by cooperating state and federal scientists, include EDRR guidelines, training curriculum for EDRR volunteers and agency field personnel, plant identification and vouchering, rapid assessments, as well as predictive modeling and ecological range studies for invasive plant species.

  5. Groundwater quality in the North San Francisco Bay shallow aquifer, California

    Science.gov (United States)

    Bennett, George L.; Fram, Miranda S.

    2018-02-23

    Groundwater provides more than 40 percent of California’s drinking water. To protect this vital resource, the State of California created the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The Priority Basin Project of the GAMA Program provides a comprehensive assessment of the State’s groundwater quality and increases public access to groundwater-quality information. The North San Francisco Bay Shallow Aquifer constitutes one of the study units being evaluated.

  6. [Visual communication in the prevention of cross infection: study performed at the intensive care unit of the Evangélic Hospital on Londrina].

    Science.gov (United States)

    Baldy, J L; Russo, S; Jabur, A; Fantinato, I C; Yamamura, M

    1990-01-01

    The influence of posters with illustrations, instructions, and appeals for hand-washing was evaluated in terms of their effect on the frequency of occurrence this procedure, before the contact with the patients, in the Intensive Therapy Unit of the Hospital Evangélico, Londrina, Paraná, Brazil. The influence of posters was statistically significant on the frequency of hand-washing by physicians, trained-nurses and laboratory technicians, but not in respect to physical-therapists, or blood-bank and X-ray technicians.

  7. A case for historic joint rupture of the San Andreas and San Jacinto faults

    Science.gov (United States)

    Lozos, Julian C.

    2016-01-01

    The San Andreas fault is considered to be the primary plate boundary fault in southern California and the most likely fault to produce a major earthquake. I use dynamic rupture modeling to show that the San Jacinto fault is capable of rupturing along with the San Andreas in a single earthquake, and interpret these results along with existing paleoseismic data and historic damage reports to suggest that this has likely occurred in the historic past. In particular, I find that paleoseismic data and historic observations for the ~M7.5 earthquake of 8 December 1812 are best explained by a rupture that begins on the San Jacinto fault and propagates onto the San Andreas fault. This precedent carries the implications that similar joint ruptures are possible in the future and that the San Jacinto fault plays a more significant role in seismic hazard in southern California than previously considered. My work also shows how physics-based modeling can be used for interpreting paleoseismic data sets and understanding prehistoric fault behavior. PMID:27034977

  8. A case for historic joint rupture of the San Andreas and San Jacinto faults.

    Science.gov (United States)

    Lozos, Julian C

    2016-03-01

    The San Andreas fault is considered to be the primary plate boundary fault in southern California and the most likely fault to produce a major earthquake. I use dynamic rupture modeling to show that the San Jacinto fault is capable of rupturing along with the San Andreas in a single earthquake, and interpret these results along with existing paleoseismic data and historic damage reports to suggest that this has likely occurred in the historic past. In particular, I find that paleoseismic data and historic observations for the ~M7.5 earthquake of 8 December 1812 are best explained by a rupture that begins on the San Jacinto fault and propagates onto the San Andreas fault. This precedent carries the implications that similar joint ruptures are possible in the future and that the San Jacinto fault plays a more significant role in seismic hazard in southern California than previously considered. My work also shows how physics-based modeling can be used for interpreting paleoseismic data sets and understanding prehistoric fault behavior.

  9. Preliminary Geologic Map of the San Fernando 7.5' Quadrangle, Southern California: A Digital Database

    Science.gov (United States)

    Yerkes, R.F.

    1997-01-01

    . The San Fernando area lies on the southern slopes of the San Gabriel Mountains. The basement rocks here include high-grade metamorphic rocks of Precambrian age. The mountains are largely composed of crystalline basement that includes the Pelona Scist of probable Mesozoic age that has been overthrust by Precambrian gneisses; the gneisses were subsequently intruded by Mesozoic plutons prior to overthrusting along the latest Cretaceous Vincent thrust. Gneisses of somewhat variable composition and possibly varying ages are found in four terranes, but not all are in contact with Pelona Schist. Large tracts of Precambrian (1.2 billion years old) andesine anorthosite are intrusive into 1.7 billion year-old Mendenhall gneiss, and are found in the western part of the San Gabriels. Mixed with these are younger marble, limestone, and schist of possible Paleozoic age found in association with plutons along the southern margin of the range. The older rocks are intruded by diorite, quartz diorite, and granodiorite of Jurassic age. Also present are siliceous sedimentary rocks of Jurassic age. A thick section of Tertiary sedimentary and volcanic rocks overlie these units. The sediments located south of the San Gabriel Fault are totally different in character from those on the northern range flank, and mostly resemble the western Transverse Ranges due to their deposition in the southeastern Ventura basin; approximately 3,000 m of these sediments are exposed north and west of the city of San Fernando in the Tujunga syncline. Some of the Tertiary rocks are Paleocene and Eocene in age, but the bulk of these rocks are Oligocene and Miocene in age. The Vasquez and Sespe Formations of basal basaltic volcanic and sandstone are Oligocene and lower Miocene in age. These are overlain by clastic rocks of Tick Canyon and Mint Canyon Formations of middle to late Miocene age. Above these rocks are the Castaic, Modelo, and Santa Margarita Formations of fossiliferous marine shale, sand

  10. San Juan Uchucuanicu: évolution historique

    Directory of Open Access Journals (Sweden)

    1975-01-01

    Full Text Available La communauté de San Juan est reconnue depuis 1939. Une première partie concerne l’organisation de la reducción de San Juan vers le milieu du XVIe siècle. Le poids fiscal s’exerce durement sur le village et la crise est générale dans toute la vallée du Chancay au XVIIe. siècle. La christianisation des habitants est définitive au milieu de ce même siècle. C’est vers la fin du XVIIe siècle et durant tout le XVIIIe que se multiplient les conflits entre San Juan et les villages voisins liés aux terrains de pâture et à la possession de l’eau. La deuxième partie du travail concerne les rapports de la communauté de San Juan avec le Pérou contemporain : contrainte fiscale toujours très lourde durant la fin de l’époque coloniale, exactions des militaires juste avant l’indépendance. La période républicaine voit toujours les conflits avec les villages voisins mais aussi la naissance de familles qui cherchent à retirer le maximum de la communauté. Les terres sont divisées et attribuées : la détérioration de l’organisation communale traditionnelle est manifeste. L4es conflits se multiplient entre petits propriétaires, mais aussi avec les haciendas voisines : c’est l’apparition d’une véritable lutte de classes. La situation actuelle est incertaine, le poids de l’économie marchande se développe avec l’exode des jeunes. Que sera la communauté San Juan à la fin de ce siècle? La comunidad de San Juan está reconocida desde 1939. La primera parte concierne a la organización de la 'reducción' de San Juan hacia mediados del siglo XVI. El peso fiscal se ejerce duramente sobre el pueblo y en el siglo XVII la crisis es general en todo el valle de Chancay. Hacia mediados del mismo siglo la cristianización de los habitantes es definitiva. Es hacia fines del siglo XVII y durante todo el siglo XVIII que se multiplican los conflictos entre San Juan y los pueblos vecinos, los que están relacionados con los terrenos de

  11. Benchmarking of Percutaneous Injuries at the Ministry of Health Hospitals of Saudi Arabia in Comparison with the United States Hospitals Participating in Exposure Prevention Information Network (EPINet™

    Directory of Open Access Journals (Sweden)

    ZA Memish

    2015-01-01

    Full Text Available Background: Exposure to blood-borne pathogens from needle-stick and sharp injuries continues to pose a significant risk to health care workers. These events are of concern because of the risk to transmit blood-borne diseases such as hepatitis B virus, hepatitis C virus, and the human immunodeficiency virus. Objective: To benchmark different risk factors associated with needle-stick incidents among health care workers in the Ministry of Health hospitals in the Kingdom of Saudi Arabia compared to the US hospitals participating in Exposure Prevention Information Network (EPINet ™. Methods: Prospective surveillance of needle-stick and sharp incidents carried out during the year 2012 using EPINet™ ver 1.5 that provides uniform needle stick and sharp injury report form. Results: The annual percutaneous incidents (PIs rate per 100 occupied beds was 3.2 at the studied MOH hospitals. Nurses were the most affected job category by PIs (59.4%. Most PIs happened in patients' wards in the Ministry of Health hospitals (34.6%. Disposable syringes were the most common cause of PIs (47.20%. Most PIs occurred during use of the syringes (36.4%. Conclusion: Among health care workers, nurses and physicians appear especially at risk of exposure to PIs. Important risk factors of injuries include working in patient room, using disposable syringes, devices without safety features. Preventive strategies such as continuous training of health care workers with special emphasis on nurses and physicians, encouragement of reporting of such incidents, observation of sharp handling, their use and implementation of safety devices are warranted.

  12. A novel cost-effectiveness model of prescription eicosapentaenoic acid extrapolated to secondary prevention of cardiovascular diseases in the United States.

    Science.gov (United States)

    Philip, Sephy; Chowdhury, Sumita; Nelson, John R; Benjamin Everett, P; Hulme-Lowe, Carolyn K; Schmier, Jordana K

    2016-10-01

    Given the substantial economic and health burden of cardiovascular disease and the residual cardiovascular risk that remains despite statin therapy, adjunctive therapies are needed. The purpose of this model was to estimate the cost-effectiveness of high-purity prescription eicosapentaenoic acid (EPA) omega-3 fatty acid intervention in secondary prevention of cardiovascular diseases in statin-treated patient populations extrapolated to the US. The deterministic model utilized inputs for cardiovascular events, costs, and utilities from published sources. Expert opinion was used when assumptions were required. The model takes the perspective of a US commercial, third-party payer with costs presented in 2014 US dollars. The model extends to 5 years and applies a 3% discount rate to costs and benefits. Sensitivity analyses were conducted to explore the influence of various input parameters on costs and outcomes. Using base case parameters, EPA-plus-statin therapy compared with statin monotherapy resulted in cost savings (total 5-year costs $29,393 vs $30,587 per person, respectively) and improved utilities (average 3.627 vs 3.575, respectively). The results were not sensitive to multiple variations in model inputs and consistently identified EPA-plus-statin therapy to be the economically dominant strategy, with both lower costs and better patient utilities over the modeled 5-year period. The model is only an approximation of reality and does not capture all complexities of a real-world scenario without further inputs from ongoing trials. The model may under-estimate the cost-effectiveness of EPA-plus-statin therapy because it allows only a single event per patient. This novel model suggests that combining EPA with statin therapy for secondary prevention of cardiovascular disease in the US may be a cost-saving and more compelling intervention than statin monotherapy.

  13. Effect of a community-based delivery of intermittent preventive treatment of malaria in pregnancy on treatment seeking for malaria at health units in Uganda

    DEFF Research Database (Denmark)

    Mbonye, A K; Schultz Hansen, K; Bygbjerg, I C

    2008-01-01

    whether traditional birth attendants, drug-shop vendors, community reproductive health workers and adolescent peer mobilizers can administer IPTp with sulphadoxine-pyrimethamine (SP) to pregnant women, reach those at greatest risk of malaria, and increase access and compliance with IPTp. STUDY DESIGN...... of the intervention on access to malaria treatment, antenatal care, other services and related costs. RESULTS: More women (67.5%) received two doses of SP through the community approach compared with health units (39.9%; P... in the community had sought malaria treatment (70.3%), suggesting the possibility that the novel approach had a positive impact on care seeking for malaria. Similarly, utilization of antenatal care, insecticide-treated nets and delivery care by women in the community was high. The total costs per woman receiving...

  14. Effect of a community-based delivery of intermittent preventive treatment of malaria in pregnancy on treatment seeking for malaria at health units in Uganda

    DEFF Research Database (Denmark)

    Mbonye, Anthony; Hansen, Kristian Schultz; Bygbjerg, Ib

    2008-01-01

    whether traditional birth attendants, drug-shop vendors, community reproductive health workers and adolescent peer mobilizers can administer IPTp with sulphadoxine-pyrimethamine (SP) to pregnant women, reach those at greatest risk of malaria, and increase access and compliance with IPTp. Study design...... of the intervention on access to malaria treatment, antenatal care, other services and related costs. Results: More women (67.5%) received two doses of SP through the community approach compared with health units (39.9%; P... in the community had sought malaria treatment (70.3%), suggesting the possibility that the novel approach had a positive impact on care seeking for malaria. Similarly, utilization of antenatal care, insecticide-treated nets and delivery care by women in the community was high. The total costs per woman receiving...

  15. Prevention of Medical Device-Related Pressure Injuries Associated With Respiratory Equipment Use in a Critical Care Unit: A Quality Improvement Project.

    Science.gov (United States)

    Padula, Cynthia A; Paradis, Heidi; Goodwin, Robert; Lynch, Judith; Hegerich-Bartula, Deborah

    Medical devices have been identified as an extrinsic risk factor for development of pressure injuries, with as many as 30% to 70% of medical device-related pressure injuries resulting from respiratory equipment. This article describes a quality improvement project undertaken to reduce the occurrence of respiratory device-related pressure injuries in a critically care unit. Multiple actions were implemented to achieve this goal. Respiratory therapists were trained to document occurrences on a daily basis, and apparent cause analyses were conducted on each occurrence. An interdisciplinary team conducted biweekly rounds on patients with respiratory devices and consulted other professionals as indicated. Nurses and respiratory therapists attended an evidence-based, collaborative, educational offering and completed a measure of team functioning before the program and at the end of the study period. The occurrence rates of respiratory device-related pressure injuries were reduced over the project period, and these changes were sustained over the subsequent 12 months.

  16. A comparative study of teaching clinical guideline for prevention of ventilator-associated pneumonia in two ways: face-to-face and workshop training on the knowledge and practice of nurses in the Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    MAJID YAZDANI

    2015-04-01

    Full Text Available Introduction: Ventilator-associated pneumonia (VAP is one of the most popular nosocomial infections in the intensive care units and the nurse’s role in preventing it is very important. The aim of this study was to compare the effect of two methods of face to face training and work- shop clinical guidelines in prevention of VAP. Methods: In this experimental randomized clinical trial, the knowledge and practice of nurses in ICUs were studied in two groups: face to face training (35 nurses and workshops (40 nurses by using clinical guidelines in prevention of VAP in one of the hospitals of Shiraz University of Medical Sciences. The level of knowledge and practice in each group was assessed by selfreport questionnaire, knowledge questionnaire and also direct observation of practice, before and after training. Data were analyzed with descriptive statistics, paired t-test, independent t-test, McNemar test, Fisher’s exact, sign and Chi-square test, using SPSS 14. Results: This study demonstrated that both methods of face to face training and workshop were very effective. The incidence of inappropriate pressure of cuff in the tracheal tubes and tracheostomy tubes was significantly reduced after training (p=0.001. But, by comparison of these two methods and the relationship between the variables revealed that no significant difference was found between the two groups of face to face training and workshop. Conclusion: Training the nurses is highly effective in preventing VAP, particularly for appropriate cuff pressure, suctioning and disinfecting hands.

  17. Data related uncertainty in near-surface vulnerability assessments for agrochemicals in the San Joaquin Valley.

    Science.gov (United States)

    Loague, Keith; Blanke, James S; Mills, Melissa B; Diaz-Diaz, Ricardo; Corwin, Dennis L

    2012-01-01

    Precious groundwater resources across the United States have been contaminated due to decades-long nonpoint-source applications of agricultural chemicals. Assessing the impact of past, ongoing, and future chemical applications for large-scale agriculture operations is timely for designing best-management practices to prevent subsurface pollution. Presented here are the results from a series of regional-scale vulnerability assessments for the San Joaquin Valley (SJV). Two relatively simple indices, the retardation and attenuation factors, are used to estimate near-surface vulnerabilities based on the chemical properties of 32 pesticides and the variability of both soil characteristics and recharge rates across the SJV. The uncertainties inherit to these assessments, derived from the uncertainties within the chemical and soil data bases, are estimated using first-order analyses. The results are used to screen and rank the chemicals based on mobility and leaching potential, without and with consideration of data-related uncertainties. Chemicals of historic high visibility in the SJV (e.g., atrazine, DBCP [dibromochloropropane], ethylene dibromide, and simazine) are ranked in the top half of those considered. Vulnerability maps generated for atrazine and DBCP, featured for their legacy status in the study area, clearly illustrate variations within and across the assessments. For example, the leaching potential is greater for DBCP than for atrazine, the leaching potential for DBCP is greater for the spatially variable recharge values than for the average recharge rate, and the leaching potentials for both DBCP and atrazine are greater for the annual recharge estimates than for the monthly recharge estimates. The data-related uncertainties identified in this study can be significant, targeting opportunities for improving future vulnerability assessments. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America

  18. The disappearing San of southeastern Africa and their genetic affinities.

    Science.gov (United States)

    Schlebusch, Carina M; Prins, Frans; Lombard, Marlize; Jakobsson, Mattias; Soodyall, Himla

    2016-12-01

    Southern Africa was likely exclusively inhabited by San hunter-gatherers before ~2000 years ago. Around that time, East African groups assimilated with local San groups and gave rise to the Khoekhoe herders. Subsequently, Bantu-speaking farmers, arriving from the north (~1800 years ago), assimilated and displaced San and Khoekhoe groups, a process that intensified with the arrival of European colonists ~350 years ago. In contrast to the western parts of southern Africa, where several Khoe-San groups still live today, the eastern parts are largely populated by Bantu speakers and individuals of non-African descent. Only a few scattered groups with oral traditions of Khoe-San ancestry remain. Advances in genetic research open up new ways to understand the population history of southeastern Africa. We investigate the genomic variation of the remaining individuals from two South African groups with oral histories connecting them to eastern San groups, i.e., the San from Lake Chrissie and the Duma San of the uKhahlamba-Drakensberg. Using ~2.2 million genetic markers, combined with comparative published data sets, we show that the Lake Chrissie San have genetic ancestry from both Khoe-San (likely the ||Xegwi San) and Bantu speakers. Specifically, we found that the Lake Chrissie San are closely related to the current southern San groups (i.e., the Karretjie people). Duma San individuals, on the other hand, were genetically similar to southeastern Bantu speakers from South Africa. This study illustrates how genetic tools can be used to assess hypotheses about the ancestry of people who seemingly lost their historic roots, only recalling a vague oral tradition of their origin.

  19. [Principles of prevention of pneumonia associated with the use of artificial ventilation of the lungs in resuscitation and intensive care units].

    Science.gov (United States)

    Eremenko, A A; Ziuliaeva, T P; Bozh'eva, L V; Bogomolova, N S; Oreshkina, T D; Bol'shakov, L V; Kuslieva, E V

    2001-01-01

    Pneumonia ranks among the most incident complications associated with forced ventilation of the lungs (FVL). Its incidence depends on FVL duration and according to published reports varies from 9 to 70%. Pneumonia deteriorates the prognosis and essentially increases the mortality in intensive care wards. Based on published reports and their own experience, the authors formulate the fundamentals of prevention of pneumonia in patients on FVL: use of intubation tubes with low-pressure cuffs; minimum duration or no procedures involving the intubation tube cuff blowing off; regular sanitization of the tracheobronchial tree and oropharynx; use of devices for removal of tracheobronchial secretion in the closed contour and of disposable catheters; inhalation of bronchomucolytics and antibiotics through a nebulizer; patient's position in bed with elevated head part; rigid approach to prescription of antacide drugs and H2-receptor blockers; decontamination and regulation of intestinal function; antibiotic therapy with consideration for the results of bacteriological studies; no or minimum exposure to procedures involving the respiratory contour seal opening; use of sterile gloves; use of disposable respiratory contours and hydrophobic bacterial filters instead of humidifiers.

  20. Origen de la surgencia del Balneario de San Andrés (Provincia de Jaén)

    OpenAIRE

    Hidalgo Estévez, Mari Carmen; Rey Arrans, Javier; Redondo, L.

    1997-01-01

    The hydrogeological context of the San Andrés spa (province of Jaén) is analysed in this work. Piezometric data, hydrochemical analysis and groundwater quality trends are discussed for groundwater samples obtained from the main aquifer units in the region (jurassic carbonatic aquifer and miocene detrital aquifer) in order to stablish the origin of the San Andrés spring. Considering altitude, discharge rate, temperature and hydrochemical features of the spring, it seems to be related to the mi...

  1. Late Quaternary evolution of the San Antonio Submarine Canyon in the central Chile forearc (∼33°S)

    Science.gov (United States)

    Laursen, Jane; Normark, William R.

    2002-01-01

    Hydrosweep swath-bathymetry and seismic-reflection data reveal the morphology, sedimentary processes, and structural controls on the submarine San Antonio Canyon. The canyon crosses the forearc slope of the central Chile margin for more than 150 km before it empties into the Chile Trench near 33°S latitude. In its upper reaches, the nearly orthogonal segments of the San Antonio Canyon incise ∼1 km into thick sediment following underlying margin-perpendicular basement faults and along the landward side of a prominent margin-parallel thrust ridge on the outer mid-slope. At a breach in the outer ridge, the canyon makes a sharp turn into the San Antonio Reentrant. Resistance to erosion of outcropping basement at the head of the reentrant has prevented the development of a uniformly sloping thalweg, leaving gentle gradients (6°) across the lower slope. Emergence of an obstruction across the head of the San Antonio Reentrant has trapped sediment in the mid-slope segments of the canyon. Presently, little sediment appears to reach the Chile Trench through the San Antonio Canyon. The development of the San Antonio Canyon was controlled by the impact of a subducted seamount, which formed the San Antonio Reentrant and warped the middle slope along its landward advancing path. Incision of the canyon landward of the outer mid-slope ridge may be ascribed to a combination of headward erosion and entrenchment by captured unconfined turbidity currents. Flushing of the canyon was likely enhanced during the lowered sea level of the last glaciation. Where the canyon occupies the triangular embayment of the reentrant at the base of the slope, sediment has ponded behind a small accretionary ridge. On the trench floor opposite the San Antonio Canyon mouth, a 200-m-thick levee–overbank complex formed on the left side of a distributary channel emanating from a breach in the accretionary ridge. Axial transfer of sediment was inhibited to the north of the San Antonio Canyon mouth

  2. Coastal Adaptation: The Case of Ocean Beach, San Francisco

    Science.gov (United States)

    Cheong, S.

    2012-12-01

    Coastal erosion, storms, sea-level rise, and tsunamis all lead to inundation that puts people and communities at risk. Adapting to these coastal hazards has gained increasing attention with climate change. Instead of promoting one particular strategy such as seawalls or defending against one type of hazard, scholars and practitioners encourage a combination of existing methods and strategies to promote synergistic effects. The recently published Intergovernmental Panel on Climate Change (IPCC) Special Report on climate extremes reflects this trend in the integration of disaster risk management and climate change adaptation. This paper focuses on the roles, compatibilities, and synergies of three coastal adaptation options - engineering, vegetation, and policy - in the case of Ocean Beach in San Francisco. Traditionally engineering approach and ecosystem conservation often have stood in opposition as hard shoreline structures destroy coastal habitats, worsen coastal erosion, divert ocean currents, and prevent the natural migration of shores. A natural migration of shores without structure translates into the abandonment of properties in the coastal zone, and is at odds with property rights and development. For example, policies of relocation, retreat, and insurance may not be popular given the concerns of infrastructure and coastal access. As such, engineering, natural defense, and policy can be more conflictual than complementary. Nonetheless, all these responses are used in combination in many locations. Complementarities and compatibilities, therefore, must be assessed when considering the necessity of engineering responses, natural defense capabilities, and policy options. In this light, the question is how to resolve the problem of mixed responses and short- and long-term interests and values, identify compatibilities, and generate synergies. In the case of Ocean Beach, recent erosions that endangered San Francisco's wastewater treatment system acted as major

  3. Efficacy of a program of prevention and control for methicillin-resistant Staphylococcus aureus infections in an intensive-care unit.

    Science.gov (United States)

    Moreira, Marina; Freitas, Marise R; Martins, Sinaida T; Castelo, Adauto; Medeiros, Eduardo Alexandrino Servolo

    2007-02-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is endemic in most Brazilian Hospitals, and there are few studies which show the efficacy of control measures in such situations. This study evaluated intensive care unit (ICU) patients, in two years divided in control, intervention and post-intervention group. Intervention measures: hands-on educational programs for healthcare workers; early identification of MRSA infected or colonized patients, labeled with a bed-identification tag for contact isolation; nasal carriers, patients, and healthcare professionals treated with topical mupirocin for five days. The hospital infection rates in the control period were compared to the ones in the post-intervention period. Hospital infection rates were found by means of the NNISS methodology The incidence coefficients of MRSA hospital infection (monthly average of 1,000 pts/day) in the control, intervention and post-intervention groups were respectively: 10.2, 5.1 and 2.5/1,000 pts/day (punit. In the intervention period, most of those MRSA infected patients (76.2%) were nasal carrier. Mortality rates were, respectively 26.6%; 27.3% and 21.0% (pcontrol of MRSA infections in ICUs, have been efficient in the reduction of the bloodstream and MRSA-originated hospital infections incidence, and reduced the overall mortality rate significantly.

  4. A case study using the United Republic of Tanzania: costing nationwide HPV vaccine delivery using the WHO Cervical Cancer Prevention and Control Costing Tool

    Directory of Open Access Journals (Sweden)

    Hutubessy Raymond

    2012-11-01

    Full Text Available Abstract Background The purpose, methods, data sources and assumptions behind the World Health Organization (WHO Cervical Cancer Prevention and Control Costing (C4P tool that was developed to assist low- and middle-income countries (LMICs with planning and costing their nationwide human papillomavirus (HPV vaccination program are presented. Tanzania is presented as a case study where the WHO C4P tool was used to cost and plan the roll-out of HPV vaccines nationwide as part of the national comprehensive cervical cancer prevention and control strategy. Methods The WHO C4P tool focuses on estimating the incremental costs to the health system of vaccinating adolescent girls through school-, health facility- and/or outreach-based strategies. No costs to the user (school girls, parents or caregivers are included. Both financial (or costs to the Ministry of Health and economic costs are estimated. The cost components for service delivery include training, vaccination (health personnel time and transport, stationery for tally sheets and vaccination cards, and so on, social mobilization/IEC (information, education and communication, supervision, and monitoring and evaluation (M&E. The costs of all the resources used for HPV vaccination are totaled and shown with and without the estimated cost of the vaccine. The total cost is also divided by the number of doses administered and number of fully immunized girls (FIGs to estimate the cost per dose and cost per FIG. Results Over five years (2011 to 2015, the cost of establishing an HPV vaccine program that delivers three doses of vaccine to girls at schools via phased national introduction (three regions in year 1, ten regions in year 2 and all 26 regions in years 3 to 5 in Tanzania is estimated to be US$9.2 million (excluding vaccine costs and US$31.5 million (with vaccine assuming a vaccine price of US$5 (GAVI 2011, formerly the Global Alliance for Vaccines and Immunizations. This is equivalent to a

  5. Development of measures to evaluate youth advocacy for obesity prevention

    OpenAIRE

    Millstein, Rachel A.; Woodruff, Susan I.; Linton, Leslie S.; Edwards, Christine C.; Sallis, James F.

    2016-01-01

    Background Youth advocacy has been successfully used in substance use prevention but is a novel strategy in obesity prevention. As a precondition for building an evidence base for youth advocacy for obesity prevention, the present study aimed to develop and evaluate measures of youth advocacy mediator, process, and outcome variables. Methods The Youth Engagement and Action for Health (YEAH!) program (San Diego County, CA) engaged youth and adult group leaders in advocacy for school and neighb...

  6. SANS-1 Experimental reports of 2000

    International Nuclear Information System (INIS)

    Willumeit, R.; Haramus, V.

    2001-01-01

    The instrument SANS-1 at the Geesthacht neutron facility GeNF was used for scattering experiments in 2000 at 196 of 200 days of reactor and cold source operation. The utilisation was shared between the in-house R and D program and user groups from different universities and research centers. These measurements were performed and analysed either by guest scientists or GKSS staff. The focus of the work in 2000 at the experiment SANS-1 was the structural investigation of hydrogen containing substances such as biological macromolecules (ribosomes, protein-RNA-complexes, protein solutions, glycolipids and membranes), molecules which are important in the fields of environmental research (refractoric organic substances) and technical chemistry (surfactants, micelles). (orig.) [de

  7. San Rafael mining and fabrication complex today

    International Nuclear Information System (INIS)

    Navarra, Pablo; Aldebert, Sergio R.

    2005-01-01

    In Mendoza province, 35 km West San Rafael city, is located a CNEA installation for uranium ore extraction and concentration: the San Rafael Mining and Fabrication Complex. By the middle of the nineties, as a consequence of the very low prices of uranium concentrate in the international market and of the high internal production costs, uranium extraction was stopped. To day, the international price of the concentrate had a very important increase and the Government has decided the completion of the Atucha II Nuclear Power Station construction. Moreover, studies have been started for new nuclear power plants. In such circumstances the reactivation of the Complex will make sure the uranium supply for our nuclear power stations, contributing to the improvement of the energy generation mix in our country. (author) [es

  8. San Telmo, backpackers y otras globalizaciones

    Directory of Open Access Journals (Sweden)

    Fernando Firmo

    2015-12-01

    Full Text Available Este artículo pretende contribuir al debate sobre otras formas de globalización  presentando una etnografía realizada en el barrio de San Telmo sobre mochileros que combinan en sus experiencias viaje y trabajo. Su objetivo es viajar al mismo tiempo que sacan provecho de esto para conseguir el capital necesario que les permita continuar en movimiento alrededor del globo. En este texto quiero hablar sobre estos auténticos actores de la globalización popular que ponen el foco en procesos y agentes alternativos no hegemónicos y que en este caso desarrollan su actividad en el contexto de la experiencia mochilera en San Telmo, siendo mi intención enriquecer las reflexiones sobre la globalización desde abajo.

  9. SAFOD Penetrates the San Andreas Fault

    Directory of Open Access Journals (Sweden)

    Mark D. Zoback

    2006-03-01

    Full Text Available SAFOD, the San Andreas Fault Observatory at Depth (Fig. 1, completed an important milestone in July 2005 by drilling through the San Andreas Fault at seismogenic depth. SAFOD is one of three major components of EarthScope, a U.S. National Science Foundation (NSF initiative being conducted in collaboration with the U.S. Geological Survey (USGS. The International Continental Scientific DrillingProgram (ICDP provides engineering and technical support for the project as well as online access to project data and information (http://www.icdp-online.de/sites/sanandreas/news/news1.html. In 2002, the ICDP, the NSF, and the USGS provided funding for a pilot hole project at the SAFOD site. Twenty scientifi c papers summarizing the results of the pilot hole project as well as pre-SAFOD site characterization studies were published in Geophysical Research Letters (Vol.31, Nos. 12 and 15, 2004.

  10. Hispanics of a San Diego Barrio.

    Science.gov (United States)

    1983-04-01

    electronic music of Black American discoteques, played loudly on automobile stereo systems or on the oversized "sound boxes" which have more...rider" automobiles , and intense partying are parts of an essentially anti-social image held by the larger San Diego community. Parallels might be drawn...Research Naval Academy, U.S. Annapolis, MD 21402 - .I . . . . I I II I I l i List 7 HRM Officer in Charge Commanding Officer Human Resource Management

  11. Pinturas Murales en San Marcos de Salamanca

    Directory of Open Access Journals (Sweden)

    Julián ÁLVAREZ VILLAR

    2009-10-01

    Full Text Available En los primeros días de setiembre se iniciaron unas obras de repaso en el tejado de la iglesia de San Marcos, aprovechando el tiempo del cierre obligado del templo para realizar algunas reparaciones que condujeron al párroco don José Marcos ayudado por el coadjutor don Leandro Lozano, a interesantes hallazgos que dan aún más valor artístico a esta interesante iglesia.

  12. San Bernardino National Wildlife Refuge Well 10

    Energy Technology Data Exchange (ETDEWEB)

    Ensminger, J.T.; Easterly, C.E.; Ketelle, R.H.; Quarles, H.; Wade, M.C.

    1999-12-01

    The U.S. Geological Survey (USGS), at the request of the U.S. Fish and Wildlife Service, evaluated the water production capacity of an artesian well in the San Bernardino National Wildlife Refuge, Arizona. Water from the well initially flows into a pond containing three federally threatened or endangered fish species, and water from this pond feeds an adjacent pond/wetland containing an endangered plant species.

  13. Bedrock aquifers of eastern San Juan County, Utah

    Science.gov (United States)

    Avery, Charles

    1986-01-01

    This study is one of a series of studies appraising the waterbearing properties of the Navajo Sandstone and associated formations in southern Utah.  The study area is about 4,600 square miles, extending from the Utah-Arizona State line northward to the San Juan-Grand County line and westward from the Utah-Colorado State line to the longitude of about 109°50'.Some of the water-yielding formations are grouped into aquifer systems. The C aquifer is comprised of the DeChelly Sandstone Member of the Cutler Formation.  The P aquifer is comprised of the Cedar Mesa Member of the Cutler Formation and the undifferentiated Cutler Formation. The N aquifer is comprised of the sedimentary section that includes the Wingate Sandstone, Kayenta Formation, Navajo Sandstone, Carmel Formation, and Entrada sandstone.  The M aquifer is comprised of the Bluff Sandstone Member and other sandstone units of the Morrison Formation.  The D aquifer is comprised of the Burro Canyon Formation and Dakota Sandstone.  Discharge from the ground-water reservoir to the San Juan River between gaging stations at Four Corners and Mexican Hat is about 66 cubic feet per second.The N aquifer is the main aquifer in the study area. Recharge by infiltration of precipitation is estimated to be 25,000 acre-feet per year.  A major ground-water divide exists under the broad area east of Monticello.  The thickness of the N aquifer, where the sedimentary section is fully preserved and saturated, generally is 750 to 1,250 feet.   Hydraulic conductivity values obtained from aquifer tests range from 0.02 to 0.34 foot per day.  The total volume of water in transient storage is about 11 million acre-feet. Well discharge somewhat exceeded 2,340 acre-feet during 1981.  Discharge to the San Juan River from the N aquifer is estimated to be 6.9 cubic feet per second. Water quality ranges from a calcium bicarbonate to sodium chloride type water

  14. Surveillance for previously unmonitored organic contaminants in the San Francisco Estuary.

    Science.gov (United States)

    Oros, Daniel R; Jarman, Walter M; Lowe, Theresa; David, Nicole; Lowe, Sarah; Davis, Jay A

    2003-09-01

    The San Francisco Estuary Regional Monitoring Program initiated surveillance monitoring to identify previously unmonitored synthetic organic contaminants in the San Francisco Estuary. Organic extracts of water samples were analyzed using gas chromatography-mass spectrometry in full scan mode. The major contaminant classes identified in the samples were fire retardants, pesticides, personal care product ingredients, and plasticizers. Evidence from the literature suggests that some of these contaminants can persist in the environment, induce toxicity, and accumulate in marine biota and in higher food chain consumers. The major sources of these contaminants into the marine environment are the discharge of municipal and industrial wastewater effluents, urban stormwater, and agricultural runoff. As a proactive effort, it is suggested that surveillance studies be used routinely in monitoring programs to identify and prevent potential problem contaminants from harming the marine environment.

  15. Ground motion modeling of the 1906 San Francisco earthquake II: Ground motion estimates for the 1906 earthquake and scenario events

    Energy Technology Data Exchange (ETDEWEB)

    Aagaard, B; Brocher, T; Dreger, D; Frankel, A; Graves, R; Harmsen, S; Hartzell, S; Larsen, S; McCandless, K; Nilsson, S; Petersson, N A; Rodgers, A; Sjogreen, B; Tkalcic, H; Zoback, M L

    2007-02-09

    We estimate the ground motions produced by the 1906 San Francisco earthquake making use of the recently developed Song et al. (2008) source model that combines the available geodetic and seismic observations and recently constructed 3D geologic and seismic velocity models. Our estimates of the ground motions for the 1906 earthquake are consistent across five ground-motion modeling groups employing different wave propagation codes and simulation domains. The simulations successfully reproduce the main features of the Boatwright and Bundock (2005) ShakeMap, but tend to over predict the intensity of shaking by 0.1-0.5 modified Mercalli intensity (MMI) units. Velocity waveforms at sites throughout the San Francisco Bay Area exhibit characteristics consistent with rupture directivity, local geologic conditions (e.g., sedimentary basins), and the large size of the event (e.g., durations of strong shaking lasting tens of seconds). We also compute ground motions for seven hypothetical scenarios rupturing the same extent of the northern San Andreas fault, considering three additional hypocenters and an additional, random distribution of slip. Rupture directivity exerts the strongest influence on the variations in shaking, although sedimentary basins do consistently contribute to the response in some locations, such as Santa Rosa, Livermore, and San Jose. These scenarios suggest that future large earthquakes on the northern San Andreas fault may subject the current San Francisco Bay urban area to stronger shaking than a repeat of the 1906 earthquake. Ruptures propagating southward towards San Francisco appear to expose more of the urban area to a given intensity level than do ruptures propagating northward.

  16. Conhecimentos sobre prevenção e tratamento de glaucoma entre pacientes de unidade hospitalar Knowledge on glaucoma prevention and treatment of patients in a hospital unit

    Directory of Open Access Journals (Sweden)

    Marcelo Jordão Lopes da Silva

    2004-10-01

    explanations. The level of knowledge about the disease was directly related to the educational level. This study confirms the need of maintenance of guide lines, continuous popularization of information on prevention, which would help to treat patients with this problem and improve visual prognosis.

  17. Cross-connected onsite emergency A.C. power supplies for multi-unit nuclear power plant sites

    International Nuclear Information System (INIS)

    Martore, J.A.; Voss, J.D.; Duncil, B.

    1987-01-01

    Recently, utility management, both at the corporate and plant operations levels, have reinforced their commitment to assuring increased plant reliability and availability. One means of achieving this objective involves an effective preventive maintenance program with technical specifications which allow implementation of certain preventive maintenance without plant shutdown. To accomplish this, Southern California Edison Company (SCE) has proposed a design change for San Onofre nuclear generating station (SONGS) units 2 and 3 to permit on emergency diesel generator for one unit to perform as an available AC power source for both units. Technical specifications for SCE's SONGS units 2 and 3, as at most nuclear power plants, currently require plant shutdown should one of the two dedicated onsite emergency AC power sources (diesel generators) become inoperable for more than 72 hours. This duration hinders root cause failure analysis, tends to limit the flexibility of preventive maintenance and precludes plant operation in the event of component failure. Therefore, this proposed diesel generator cross-connect design change offers an innovative means for averting plant shutdown should a single diesel generator become inoperable for longer than 72 hours. (orig./GL)

  18. Infection prevention practices in adult intensive care units in a large community hospital system after implementing strategies to reduce health care-associated, methicillin-resistant Staphylococcus aureus infections.

    Science.gov (United States)

    Moody, Julia; Septimus, Edward; Hickok, Jason; Huang, Susan S; Platt, Richard; Gombosev, Adrijana; Terpstra, Leah; Avery, Taliser; Lankiewicz, Julie; Perlin, Jonathan B

    2013-02-01

    A range of strategies and approaches have been developed for preventing health care-associated infections. Understanding the variation in practices among facilities is necessary to improve compliance with existing programs and aid the implementation of new interventions. In 2009, HCA Inc administered an electronic survey to measure compliance with evidence-based infection prevention practices as well as identify variation in products or methods, such as use of special approach technology for central vascular catheters and ventilator care. Responding adult intensive care units (ICUs) were those considering participation in a clinical trial to reduce health care-associated infections. Responses from 99 ICUs in 55 hospitals indicated that many evidenced-based practices were used consistently, including methicillin-resistant Staphylococcus aureus (MRSA) screening and use of contact precautions for MRSA-positive patients. Other practices exhibited wide variability including discontinuation of precautions and use of antimicrobial technology or chlorhexidine patches for central vascular catheters. MRSA decolonization was not a predominant practice in ICUs. In this large, community-based health care system, there was substantial variation in the products and methods to reduce health care-associated infections. Despite system-wide emphasis on basic practices as a precursor to adding special approach technologies, this survey showed that these technologies were commonplace, including in facilities where improvement in basic practices was needed. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  19. A decrease in the number of cases of necrotizing enterocolitis associated with the enhancement of infection prevention and control measures during a Staphylococcus aureus outbreak in a neonatal intensive care unit.

    Science.gov (United States)

    Lemyre, Brigitte; Xiu, Wenlong; Bouali, Nicole Rouvinez; Brintnell, Janet; Janigan, Jo-Anne; Suh, Kathryn N; Barrowman, Nicholas

    2012-01-01

    Most cases of necrotizing enterocolitis (NEC) are sporadic, but outbreaks in hospital settings suggest an infectious cause. Our neonatal intensive care unit (NICU) experienced an outbreak of methicillin-sensitive Staphylococcus aureus (MSSA). We aimed to assess whether the enhancement of infection prevention and control measures would be associated with a reduction in the number of cases of NEC. Retrospective chart review. A 24-bed, university-affiliated, inborn level 3 NICU. Infants of less than 30 weeks gestation or birth weight ≤ 1,500 g admitted to the NICU between January 2007 and December 2008 were considered at risk of NEC. All cases of NEC were reviewed. Infection prevention and control measures, including hand hygiene education, were enhanced during the outbreak. Avoidance of overcapacity in the NICU was reinforced, environmental services (ES) measures were enhanced, and ES hours were increased. Two hundred eighty-two at-risk infants were admitted during the study. Their gestational age and birth weight (mean ± SD) were 28.2 ± 2.7 weeks and 1,031 ± 290 g, respectively. The proportion of NEC was 18/110 (16.4%) before the outbreak, 1/54 (1.8%) during the outbreak, and 4/118 (3.4%) after the outbreak. After adjustment for gestational age, birth weight, gender, and singleton versus multiple births, the proportion was lower in the postoutbreak period than in the preoutbreak period (P control measures to manage an MSSA outbreak.

  20. Hydrogeologic framework of the middle San Pedro watershed, southeastern Arizona

    Science.gov (United States)

    Dickinson, Jesse; Kennedy, Jeffrey R.; Pool, D.R.; Cordova, Jeffrey T.; Parker, John T.; Macy, J.P.; Thomas, Blakemore

    2010-01-01

    Water managers in rural Arizona are under increasing pressure to provide sustainable supplies of water despite rapid population growth and demands for environmental protection. This report describes the results of a study of the hydrogeologic framework of the middle San Pedro watershed. The components of this report include: (1) a description of the geologic setting and depositional history of basin fill sediments that form the primary aquifer system, (2) updated bedrock altitudes underlying basin fill sediments calculated using a subsurface density model of gravity data, (3) delineation of hydrogeologic units in the basin fill using lithologic descriptions in driller's logs and models of airborne electrical resistivity data, (4) a digital three-dimensional (3D) hydrogeologic framework model (HFM) that represents spatial extents and thicknesses of the hydrogeologic units (HGUs), and (5) description of the hydrologic properties of the HGUs. The lithologic interpretations based on geophysical data and unit thickness and extent of the HGUs included in the HFM define potential configurations of hydraulic zones and parameters that can be incorporated in groundwater-flow models. The hydrogeologic framework comprises permeable and impermeable stratigraphic units: (1) bedrock, (2) sedimentary rocks predating basin-and-range deformation, (3) lower basin fill, (4) upper basin fill, and (5) stream alluvium. The bedrock unit includes Proterozoic to Cretaceous crystalline rocks, sedimentary rocks, and limestone that are relatively impermeable and poor aquifers, except for saturated portions of limestone. The pre-basin-and-range sediments underlie the lower basin fill but are relatively impermeable owing to cementation. However, they may be an important water-bearing unit where fractured. Alluvium of the lower basin fill, the main water-bearing unit, was deposited in the structural trough between the uplifted ridges of bedrock and (or) pre-basin-and-range sediments. Alluvium of

  1. San Marco C-2 (San Marco-4) Post Launch Report No. 1

    Science.gov (United States)

    1974-01-01

    The San Marco C-2 spacecraft, now designated San Marco-4, was successfully launched by a Scout vehicle from the San Marco Platform on 18 February 1974 at 6:05 a.m. EDT. The launch occurred 2 hours 50 minutes into the 3-hour window due co low cloud cover at the launch site. All spacecraft subsystems have been checked and are functioning normally. The protective caps for the two U.S. experiments were ejected and the Omegatron experiment activated on 19 February. The neutral mass spectrometer was activated as scheduled on 22 February after sufficient time to allow for spacecraft outgassing and to avoid the possibility of corona occurring. Both instruments are performing properly and worthwhile scientific data is being acquired.

  2. Preliminary study of the uranium potential of Tertiary rocks in the central San Juan Basin, New Mexico

    International Nuclear Information System (INIS)

    Vizcaino, H.P.; O'Neill, A.J.

    1977-12-01

    Three formations in the Tertiary of the San Juan Basin were investigated for their uranium favorability. They are the Ojo Alamo Sandstone, the Nacimiento Formation, and the San Jose Formation. The study comprised a literature survey and a basin analysis, which consisted of subsurface lithofacies, stratigraphic, and radiometric mapping. Field work in preparation for the subsurface analysis consisted of examination of outcrop and measured sections, surface radiometric traverses, and checking of reported surface radioactive anomalies. Interpretation of subsurface mapping provided the primary basis for favorability assessment. The sandstone trends depicted in lithofacies maps, and stratigraphic cross sections reflect large channel complexes and major fluvial systems originating in favorable source areas. Although surface radioactivity anomalies were found to be few, weak, and widespread, the San Juan Basin has abundant favorable host rocks. The subsurface anomalies, although weak, are widespread and sometimes persist throughout thickness intervals greater than 50 ft. Subsurface anomalies were mapped on a wide-spaced grid and are generalized. On the basis of apparent source, lithology, differential permeability, contents of carbonaceous detritus, and geometry, the Nacimiento Formation and the basal facies of the San Jose Formation in the north-central basin have the greatest potential. The Ojo Alamo Sandstone is less favorable, and the Nacimiento Formation in the southern part of the basin and the upper San Jose Formation are the least favorable of the units studied

  3. Underground storage of imported water in the San Gorgonio Pass area, southern California

    Science.gov (United States)

    Bloyd, Richard M.

    1971-01-01

    The San Gorgonio Pass ground-water basin is divided into the Beaumont, Banning, Cabazon, San Timoteo, South Beaumont, Banning Bench, and Singleton storage units. The Beaumont storage unit, centrally located in the agency area, is the largest in volume of the storage units. Estimated long-term average annual precipitation in the San Gorgonio Pass Water Agency drainage area is 332,000 acre-feet, and estimated average annual recoverable water is 24,000 acre-feet, less than 10 percent of the total precipitation. Estimated average annual surface outflow is 1,700 acre-feet, and estimated average annual ground-water recharge is 22,000 acre-feet. Projecting tack to probable steady-state conditions, of the 22.000 acre-feet of recharge, 16,003 acre-feet per year became subsurface outflow into Coachella Valley, 6,000 acre-feet into the Redlands area, and 220 acre-feet into Potrero Canyon. After extensive development, estimated subsurface outflow from the area in 1967 was 6,000 acre-feet into the Redlands area, 220 acre-feet into Potrero Canyon, and 800 acre-feet into the fault systems south of the Banning storage unit, unwatered during construction of a tunnel. Subsurface outflow into Coachella Valley in 1967 is probably less than 50 percent of the steady-state flow. An anticipated 17,000 .acre-feet of water per year will be imported by 1980. Information developed in this study indicates it is technically feasible to store imported water in the eastern part of the Beaumont storage unit without causing waterlogging in the storage area and without losing any significant quantity of stored water.

  4. [The Chinese nuclear test and 'atoms for peace' as a measure for preventing nuclear armament of Japan: the nuclear non-proliferation policy of the United States and the introduction of light water reactors into Japan, 1964-1968].

    Science.gov (United States)

    Yamazaki, Masakatsu

    2014-07-01

    Japan and the United States signed in 1968 a new atomic energy agreement through which US light-water nuclear reactors, including those of the Fukushima Daiichi Nuclear Power Plant of Tokyo Electric Power Company, were to be introduced into Japan. This paper studies the history of negotiations for the 1968 agreement using documents declassified in the 1990s in the US and Japan. After the success of the Chinese nuclear test in October 1964, the United States became seriously concerned about nuclear armament of other countries in Asia including Japan. Expecting that Japan would not have its own nuclear weapons, the US offered to help the country to demonstrate its superiority in some fields of science including peaceful nuclear energy to counter the psychological effect of the Chinese nuclear armament. Driven by his own political agenda, the newly appointed Prime Minister Eisaku Sato responded to the US expectation favorably. When he met in January 1965 with President Johnson, Sato made it clear that Japan would not pursue nuclear weapons. Although the US continued its support after this visit, it nevertheless gave priority to the control of nuclear technology in Japan through the bilateral peaceful nuclear agreement. This paper argues that the 1968 agreement implicitly meant a strategic measure to prevent Japan from going nuclear and also a tactic to persuade Japan to join the Nuclear Non -Proliferation Treaty.

  5. Development of instruments and components for SANS and PNS

    Energy Technology Data Exchange (ETDEWEB)

    Park, Kook Nam; Lee, Chang Hee; Lee, C. H. and others

    2000-11-01

    The base floor of SANS was constructed by the 27 steel plates with horizontal flatness of {+-}0.5mm. That is for the two dimensional position sensitivity neutron detector(2D-PSD), which is operated in vacuum chamber, as moving smoothly. Concerned to the equipments, we designed and installed the inner-shielding of the PNS which will be used for research of magnetic structure and critical phenomena of the materials. In the development of experimental devices, we have designed and manufactured a beam-stop exchange unit and a detector carriage which are used for 2D-PSD. The detector carriage is to control the distance between sample and detector. The beam-stop exchange unit is to protect detector from exposure of direct neutron beam. Especially, many experimental devices or instruments such as high-resolution collimator, components for low temperature facility, multi-purpose vacuum chamber, etc. were made in domestic, it is worth meaningful in domestic availability and standardization for the neutron instrument component.

  6. Development of 40m SANS and Its Utilization Techniques

    International Nuclear Information System (INIS)

    Choi, Sung Min; Kim, Tae Hwan

    2010-06-01

    Small angle neutron scattering (SANS) has been a very powerful tool to study nanoscale (1-100 nm) bulk structures in various materials such as polymer, self assembled materials, nano-porous materials, nano-magnetic materials, metal and ceramics. Understanding the importance of the SANS instrument, the 8m SANS instrument was installed at the CN beam port of HANARO in 2001. However, without having a cold neutron source, the beam intensity is fairly low and the Q-range is rather limited due to short instrument length. In July 1, 2003, therefore, the HANARO cold neutron research facility project was launched and a state of the art 40m SANS instrument was selected as top-priority instrument. The development of the 40m SANS instrument was completed as a joint project between Korea Advanced Institute of Science and Technology and the HANARO in 2010. Here, we report the specification of a state of art 40m SANS instrument at HANARO

  7. Prevention of criticality accidents

    International Nuclear Information System (INIS)

    Canavese, S.I.

    1982-01-01

    These notes used in the postgraduate course on Radiological Protection and Nuclear Safety discuss macro-and microscopic nuclear constants for fissile materials systems. Critical systems: their definition; criteria to analyze the critical state; determination of the critical size; analysis of practical problems about prevention of criticality. Safety of isolated units and of sets of units. Application of standards. Conception of facilities from the criticality control view point. (author) [es

  8. Airborne electromagnetic and magnetic survey data of the Paradox and San Luis Valleys, Colorado

    Science.gov (United States)

    Ball, Lyndsay B.; Bloss, Benjamin R.; Bedrosian, Paul A.; Grauch, V.J.S.; Smith, Bruce D.

    2015-01-01

    In October 2011, the U.S. Geological Survey (USGS) contracted airborne magnetic and electromagnetic surveys of the Paradox and San Luis Valleys in southern Colorado, United States. These airborne geophysical surveys provide high-resolution and spatially comprehensive datasets characterizing the resistivity structure of the shallow subsurface of each survey region, accompanied by magnetic-field information over matching areas. These data were collected to provide insight into the distribution of groundwater brine in the Paradox Valley, the extent of clay aquitards in the San Luis Valley, and to improve our understanding of the geologic framework for both regions. This report describes these contracted surveys and releases digital data supplied under contract to the USGS.

  9. Offshore geology and geomorphology from Point Piedras Blancas to Pismo Beach, San Luis Obispo County, California

    Science.gov (United States)

    Watt, Janet Tilden; Johnson, Samuel Y.; Hartwell, Stephen R.; Roberts, Michelle

    2015-01-01

    Marine geology and geomorphology were mapped along the continental shelf and upper slope between Point Piedras Blancas and Pismo Beach, California. The map area is divided into the following three (smaller) map areas, listed from north to south: San Simeon, Morro Bay, and Point San Luis. Each smaller map area consists of a geologic map and the corresponding geophysical data that support the geologic mapping. Each geophysical data sheet includes shaded-relief multibeam bathymetry, seismic-reflection-survey tracklines, and residual magnetic anomalies, as well as a smaller version of the geologic map for reference. Offshore geologic units were delineated on the basis of integrated analysis of adjacent onshore geology, seafloor-sediment and rock samples, multibeam bathymetry and backscatter imagery, magnetic data, and high-resolution seismic-reflection profiles. Although the geologic maps are presented here at 1:35,000 scale, map interpretation was conducted at scales of between 1:6,000 and 1:12,000.

  10. 关于地质勘探单位管理风险防控之探讨%Probe into Risk Prevention and Control in Geological Exploration Unit Management

    Institute of Scientific and Technical Information of China (English)

    朱永飞; 马革非

    2012-01-01

    地质勘探单位随着勘查市场和生产规模的拓展,队伍点、线、面越来越分散,管理风险加大.从“三重一大”决策、工程施工关键环节和堵塞经营漏洞人手,加强决策、生产和经营过程的风险防控,十分必要.“三重一大”决策制度的落实,可有效防止权力的过度集中,保证决策程序合理、制度执行合法、审查监督到位;对于项目承揽、施工、结算等关键生产各环节,应以单位的最大利益为目标,树立质量第一、顾客至上、安全为天的经营理念,科学组织,保证资金安全;针对单位经营管理中的薄弱环节,应找准点位,有的放矢,抓好落实,做到政务公开.%Along with the expanding of exploration market and industrial scale, points, lines and planes of geological exploration units are more and more dispersed, and management risk increased. Proceed with the "three majors and one large" (major issues decision-making, major functionaries appointing and removing, major projects investment decision and large amount funds using) decisions, key links of engineering construction and management weak points stopping up, to strengthen risk prevention and control in decision, production and management courses are quite necessary. The "three majors and one large" decision system put into effect can prevent excessive concentration of power,ensure rational decision-making procedure, legal execution of institutions and well placed inspecting and monitoring. With regard to key production links of project contracting, construction and balance the books, should take the greatest advantage of units as the target, set up quality, customers and safety first operation philosophy, scientifically organizing, ensure financing safety. In allusion to weak links in unit operation and management, should capture exact position, have a definite object in view, grasp implement and accomplish administration in public.

  11. Measuring pollution prevention

    International Nuclear Information System (INIS)

    Stephan, D.G.; Bridges, J.S.

    1992-01-01

    To assess progress in pollution prevention, estimates or measurements of the amounts of pollution actually prevented have to be made. Such estimates or measurements tell us how far we have come and, possibly, how much farther there is to go in utilizing pollution prevention as a tool for improving environmental quality. They can, theoretically, be used to assess progress on a scale ranging from the individual facility or even the individual process or activity generation wastes to scale as large as a geographical area such as a county, a state or even the United States as a whole. 3 refs

  12. City of San Francisco, California street tree resource analysis

    Science.gov (United States)

    E.G. McPherson; J.R. Simpson; P.J. Peper; Q. Xiao

    2004-01-01

    Street trees in San Francisco are comprised of two distinct populations, those managed by the city’s Department of Public Works (DPW) and those managed by private property owners with or without the help of San Francisco’s urban forestry nonprofit, Friends of the Urban Forest (FUF). These two entities believe that the public’s investment in stewardship of San Francisco...

  13. Public Involvement and Response Plan (Community Relations Plan), Presidio of San Francisco, San Francisco, California

    Science.gov (United States)

    1992-03-01

    passenger ship destination, and tourist attraction. San Francisco’s location and cultural and recreational opportunities make it a prime tourism center...equestrians, she said. C-52 m% smm : - TUESDAY, JUNE 19,1990 * . COPYKIGHT 1*90/THE TIMES MlRkOX COMPANY /CC/1 JO PAGES P. A-l, 22, 23 Complex

  14. 78 FR 35593 - Special Local Regulation; Christmas Boat Parade, San Juan Harbor; San Juan, PR

    Science.gov (United States)

    2013-06-13

    ... individually or cumulatively have a significant effect on the human environment. This proposed rule involves.... Pearson, Captain, U.S. Coast Guard, Captain of the Port San Juan. [FR Doc. 2013-13994 Filed 6-12-13; 8:45...

  15. Dal "San Marco" al "Vega". (English Title: From "San Marco" to Vega)

    Science.gov (United States)

    Savi, E.

    2017-10-01

    Apart from the two superpowers, among the other countries Italy has had an important role in astronautics. The roots of Italian astronautics' history runs deep in the hottest years of the Cold War, and it had its first remarkable achievement in the San Marco project..after years of advanced technologies testing, they achieved European cooperation and built VEGA, the current Arianespace light launcher.

  16. 75 FR 39166 - Safety Zone; San Francisco Giants Baseball Game Promotion, San Francisco, CA

    Science.gov (United States)

    2010-07-08

    ... San Francisco, CA. The fireworks display is meant for entertainment purposes. This safety zone is... National Technology Transfer and Advancement Act (NTTAA) (15 U.S.C. 272 note) directs agencies to use...), of the Instruction. This rule involves establishing, disestablishing, or changing Regulated...

  17. SANS-II at SINQ: Installation of the former Risø-SANS facility

    DEFF Research Database (Denmark)

    Strunz, P.; Mortensen, K.; Janssen, S.

    2004-01-01

    SANS-II facility at SINQ (Paul Scherrer Institute)-the reinstalled former Riso small-angle neutron scattering instrument-is presented. Its operational characteristics are listed. Approaches for precise determination of wavelength, detector dead time and attenuation factors are described as well. (C...

  18. 78 FR 42027 - Safety Zone; San Diego Bayfair; Mission Bay, San Diego, CA

    Science.gov (United States)

    2013-07-15

    ... safety zones. Thunderboats Unlimited Inc. is sponsoring San Diego Bayfair, which is held on the navigable... distribution of power and responsibilities between the Federal Government and Indian tribes. 12. Energy Effects This proposed rule is not a ``significant energy action'' under Executive Order 13211, Actions...

  19. El San Juan y la Universidad Nacional

    Directory of Open Access Journals (Sweden)

    Victor Manuel Moncayo

    2000-04-01

    Full Text Available Encontrar una solución para la crisis de la Fundación San Juan de Dios no es un problema jurídico, ni tampoco de gestión ordinaria de una institución. La crisis es de tal magnitud que desborda las capacidades reales de la organización actual y, en especial, de su Junta Directiva o de quienes ejerzan su representación legal o de quienes colaboran como empleados o trabajadores de la institución.

  20. L’alimentation des sans-abri

    OpenAIRE

    Amistani, Carole; Terrolle, Daniel

    2012-01-01

    L’alimentation des sans-logis est analysable, à partir du terrain, selon deux versants, parfois utilisés conjointement, qui sont celui de leur autonomie et/ou celui de leur dépendance envers le don alimentaire. Dans ce dernier cas, les contenus comme les formes témoignent trop souvent d’une impossibilité d’assurer l’équilibre nutritionnel de ces mangeurs et le respect des multiples aspects socialisants compris dans l’acte alimentaire. Le choix d’un traitement social dans l’ « urgence » et par...

  1. Neuroimaging Features of San Luis Valley Syndrome

    Directory of Open Access Journals (Sweden)

    Matthew T. Whitehead

    2015-01-01

    Full Text Available A 14-month-old Hispanic female with a history of double-outlet right ventricle and developmental delay in the setting of recombinant chromosome 8 syndrome was referred for neurologic imaging. Brain MR revealed multiple abnormalities primarily affecting midline structures, including commissural dysgenesis, vermian and brainstem hypoplasia/dysplasia, an interhypothalamic adhesion, and an epidermoid between the frontal lobes that enlarged over time. Spine MR demonstrated hypoplastic C1 and C2 posterior elements, scoliosis, and a borderline low conus medullaris position. Presented herein is the first illustration of neuroimaging findings from a patient with San Luis Valley syndrome.

  2. Salmonella Prevention

    Science.gov (United States)

    ... and in vegetable and fruit harvesting and packing operations may help prevent salmonellosis caused by contaminated foods. Better education of food industry workers in basic food safety and restaurant inspection procedures may prevent cross-contamination and other ...

  3. Neonatal Pressure Ulcer Prevention.

    Science.gov (United States)

    Scheans, Patricia

    2015-01-01

    The incidence of pressure ulcers in acutely ill infants and children ranges up to 27 percent in intensive care units, with a range of 16-19 percent in NICUs. Anatomic, physiologic, and developmental factors place ill and preterm newborns at risk for skin breakdown. Two case studies illustrate these factors, and best practices for pressure ulcer prevention are described.

  4. Control of simultaneous outbreaks of carbapenemase-producing enterobacteriaceae and extensively drug-resistant Acinetobacter baumannii infection in an intensive care unit using interventions promoted in the Centers for Disease Control and Prevention 2012 carbapenemase-resistant Enterobacteriaceae Toolkit.

    Science.gov (United States)

    Enfield, Kyle B; Huq, Nujhat N; Gosseling, Megan F; Low, Darla J; Hazen, Kevin C; Toney, Denise M; Slitt, Gavin; Zapata, Heidi J; Cox, Heather L; Lewis, Jessica D; Kundzins, John R; Mathers, Amy J; Sifri, Costi D

    2014-07-01

    We describe the efficacy of enhanced infection control measures, including those recommended in the Centers for Disease Control and Prevention's 2012 carbapenem-resistant Enterobacteriaceae (CRE) toolkit, to control concurrent outbreaks of carbapenemase-producing Enterobacteriaceae (CPE) and extensively drug-resistant Acinetobacter baumannii (XDR-AB). Before-after intervention study. Fifteen-bed surgical trauma intensive care unit (ICU). We investigated the impact of enhanced infection control measures in response to clusters of CPE and XDR-AB infections in an ICU from April 2009 to March 2010. Polymerase chain reaction was used to detect the presence of blaKPC and resistance plasmids in CRE. Pulsed-field gel electrophoresis was performed to assess XDR-AB clonality. Enhanced infection-control measures were implemented in response to ongoing transmission of CPE and a new outbreak of XDR-AB. Efficacy was evaluated by comparing the incidence rate (IR) of CPE and XDR-AB before and after the implementation of these measures. The IR of CPE for the 12 months before the implementation of enhanced measures was 7.77 cases per 1,000 patient-days, whereas the IR of XDR-AB for the 3 months before implementation was 6.79 cases per 1,000 patient-days. All examined CPE shared endemic blaKPC resistance plasmids, and 6 of the 7 XDR-AB isolates were clonal. Following institution of enhanced infection control measures, the CPE IR decreased to 1.22 cases per 1,000 patient-days (P = .001), and no more cases of XDR-AB were identified. Use of infection control measures described in the Centers for Disease Control and Prevention's 2012 CRE toolkit was associated with a reduction in the IR of CPE and an interruption in XDR-AB transmission.

  5. The Justice of Preventive War

    National Research Council Canada - National Science Library

    Stephenson, Henry

    2004-01-01

    In response to the 9/11 attacks and continuing threats of mass-casualty terrorism, the United States has adopted a new security strategy that emphasizes anticipatory actions, including preventive war...

  6. Synthetic seismicity for the San Andreas fault

    Directory of Open Access Journals (Sweden)

    S. N. Ward

    1994-06-01

    Full Text Available Because historical catalogs generally span only a few repetition intervals of major earthquakes, they do not provide much constraint on how regularly earthquakes recur. In order to obtain better recurrence statistics and long-term probability estimates for events M ? 6 on the San Andreas fault, we apply a seismicity model to this fault. The model is based on the concept of fault segmentation and the physics of static dislocations which allow for stress transfer between segments. Constraints are provided by geological and seismological observations of segment lengths, characteristic magnitudes and long-term slip rates. Segment parameters slightly modified from the Working Group on California Earthquake Probabilities allow us to reproduce observed seismicity over four orders of magnitude. The model yields quite irregular earthquake recurrence patterns. Only the largest events (M ? 7.5 are quasi-periodic; small events cluster. Both the average recurrence time and the aperiodicity are also a function of position along the fault. The model results are consistent with paleoseismic data for the San Andreas fault as well as a global set of historical and paleoseismic recurrence data. Thus irregular earthquake recurrence resulting from segment interaction is consistent with a large range of observations.

  7. United front may help prevent crisis.

    Science.gov (United States)

    2003-03-01

    Warnings of looming crisis are all around us, including within services for older people. Recent reports warn that the care home sector is reaching a critical juncture and, without long-term planning and investment, crisis will turn to meltdown ( Burstow 2003 ). In the past five years something like 50,000 long-term care beds have been lost and now, according to the National Audit Office, tens of thousands of older people each year find themselves unable to leave hospital because there is insufficient post-hospital care (see page five ). Emergency hospital readmissions have increased by nearly 20 per cent over the past two years and the reality of intermediate care has yet to live up to the policy rhetoric.

  8. The San Diego Panasonic Partnership: A Case Study in Restructuring.

    Science.gov (United States)

    Holzman, Michael; Tewel, Kenneth J.

    1992-01-01

    The Panasonic Foundation provides resources for restructuring school districts. The article examines its partnership with the San Diego City School District, highlighting four schools that demonstrate promising practices and guiding principles. It describes recent partnership work on systemic issues, noting the next steps to be taken in San Diego.…

  9. Characterization of alumina using small angle neutron scattering (SANS)

    International Nuclear Information System (INIS)

    Megat Harun Al Rashidn Megat Ahmad; Abdul Aziz Mohamed; Azmi Ibrahim; Che Seman Mahmood; Edy Giri Rachman Putra; Muhammad Rawi Muhammad Zin; Razali Kassim; Rafhayudi Jamro

    2007-01-01

    Alumina powder was synthesized from an aluminium precursor and studied using small angle neutron scattering (SANS) technique and complemented with transmission electron microscope (TEM). XRD measurement confirmed that the alumina produced was high purity and highly crystalline αphase. SANS examination indicates the formation of mass fractals microstructures with fractal dimension of about 2.8 on the alumina powder. (Author)

  10. Voice and Valency in San Luis Potosi Huasteco

    Science.gov (United States)

    Munoz Ledo Yanez, Veronica

    2014-01-01

    This thesis presents an analysis of the system of transitivity, voice and valency alternations in Huasteco of San Luis Potosi (Mayan) within a functional-typological framework. The study is based on spoken discourse and elicited data collected in the municipalities of Aquismon and Tancanhuitz de Santos in the state of San Luis Potosi, Mexico. The…

  11. 33 CFR 80.1130 - San Luis Obispo Bay, CA.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false San Luis Obispo Bay, CA. 80.1130 Section 80.1130 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY INTERNATIONAL NAVIGATION RULES COLREGS DEMARCATION LINES Pacific Coast § 80.1130 San Luis Obispo Bay, CA. A line drawn from...

  12. NEW DATA ON THE LOWER PLEISTOCENE (GELASIAN LIGNITE BEDS OF CASTEL SAN PIETRO (RIETI, CENTRAL ITALY

    Directory of Open Access Journals (Sweden)

    LUCA PANDOLFI

    2017-04-01

    Full Text Available A multiproxy study of the lignite-bearing lacustrine sequence cropping out at Castel San Pietro (CSP (Rieti, central Italy provides new insights on the paleoenvironmental evolution of an extensional basin, located on the Tyrrhenian side of the Apennine range. The CSP fossiliferous levels reflect deposition in a stable lacustrine environment. Mammal remains collected from this locality during the past centuries include Stephanorhinus etruscus, Anancus arvernensis and the beaver Castor fiber. The co-existence of the Etruscan rhinoceros and the mastodont suggests a middle Villafranchian age (Montopoli or Coste San Giacomo Faunal Unit for the lignite beds of CSP. New paleoflora findings are in agreement with an attribution to the Piacenzian or Gelasian age for these deposits whilst the presence of the ostracod Qinghaicypris cf. Q. riojensis suggests a time interval from Zanclean to Gelasian (between ~4.5 and ~1.8 Ma. Accordingly, the lignite beds of CSP most likely were deposited during the Gelasian (from ca. 2.5 to 1.8 Ma; from Montopoli to Coste San Giacomo FUs or possibly to Olivola FU in forested area and warm and humid conditions.

  13. Water quality modelling in the San Antonio River Basin driven by radar rainfall data

    Directory of Open Access Journals (Sweden)

    Almoutaz Elhassan

    2016-05-01

    Full Text Available Continuous monitoring of stream water quality is needed as it has significant impacts on human and ecological health and well-being. Estimating water quality between sampling dates requires model simulation based on the available geospatial and water quality data for a given watershed. Models such as the Soil and Water Assessment Tool (SWAT can be used to estimate the missing water quality data. In this study, SWAT was used to estimate water quality at a monitoring station near the outlet of the San Antonio River. Precipitation data from both rain gauges and weather radar were used to force the SWAT simulations. Virtual rain gauges which were based on weather radar data were created in the approximate centres of the 163 sub-watersheds of the San Antonio River Basin for SWAT simulations. This method was first tested in a smaller watershed in the middle of the Guadalupe River Basin resulting in increased model efficiency in simulating surface run-off. The method was then applied to the San Antonio River watershed and yielded good simulations for surface run-off (R2 = 0.7, nitrate (R2 = 0.6 and phosphate (R2 = 0.5 at the watershed outlet (Goliad, TX – USGS (United States Geological Survey gauge as compared to observed data. The study showed that the proper use of weather radar precipitation in SWAT model simulations improves the estimation of missing water quality data.

  14. Executive Summary -- assessment of undiscovered oil and gas resources of the San Joaquin Basin Province of California, 2003: Chapter 1 in Petroleum systems and geologic assessment of oil and gas in the San Joaquin Basin Province, California

    Science.gov (United States)

    Gautier, Donald L.; Scheirer, Allegra Hosford; Tennyson, Marilyn E.; Peters, Kenneth E.; Magoon, Leslie B.; Lillis, Paul G.; Charpentier, Ronald R.; Cook, Troy A.; French, Christopher D.; Klett, Timothy R.; Pollastro, Richard M.; Schenk, Christopher J.

    2007-01-01

    In 2003, the U.S. Geological Survey (USGS) completed an assessment of the oil and gas resource potential of the San Joaquin Basin Province of California (fig. 1.1). The assessment is based on the geologic elements of each Total Petroleum System defined in the province, including hydrocarbon source rocks (source-rock type and maturation and hydrocarbon generation and migration), reservoir rocks (sequence stratigraphy and petrophysical properties), and hydrocarbon traps (trap formation and timing). Using this geologic framework, the USGS defined five total petroleum systems and ten assessment units within these systems. Undiscovered oil and gas resources were quantitatively estimated for the ten assessment units (table 1.1). In addition, the potential was estimated for further growth of reserves in existing oil fields of the San Joaquin Basin.

  15. Surveillance for Certain Health Behaviors, Chronic Diseases, and Conditions, Access to Health Care, and Use of Preventive Health Services Among States and Selected Local Areas
- Behavioral Risk Factor Surveillance System, United States, 2012.

    Science.gov (United States)

    Chowdhury, Pranesh P; Mawokomatanda, Tebitha; Xu, Fang; Gamble, Sonya; Flegel, David; Pierannunzi, Carol; Garvin, William; Town, Machell

    2016-04-29

    Chronic diseases (e.g., heart diseases, cancer, chronic lower respiratory disease, stroke, diabetes, and arthritis) and unintentional injuries are the leading causes of morbidity and mortality in the United States. Behavioral risk factors (e.g., tobacco use, poor diet, physical inactivity, excessive alcohol consumption, failure to use seat belts, and insufficient sleep) are linked to the leading causes of death. Modifying these behavioral risk factors and using preventive health services (e.g., cancer screenings and influenza and pneumococcal vaccination of adults aged ≥65 years) can substantially reduce morbidity and mortality in the U.S. Continuous monitoring of these health-risk behaviors, chronic conditions, and use of preventive services are essential to the development of health promotion strategies, intervention programs, and health policies at the state, city, and county level. January-December 2012. The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing, state-based, random-digit-dialed landline- and cellular-telephone survey of noninstitutionalized adults aged ≥18 years residing in the United States. BRFSS collects data on health-risk behaviors, chronic diseases and conditions, access to health care, and use of preventive health services related to the leading causes of death and disability. This report presents results for all 50 states, the District of Columbia, participating U.S. territories that include the Commonwealth of Puerto Rico (Puerto Rico) and Guam, 187 Metropolitan/Micropolitan Statistical Areas (MMSAs), and 210 counties (n = 475,687 survey respondents) for the year 2012. In 2012, the estimated prevalence of health-risk behaviors, chronic diseases or conditions, access to health care, and use of preventive health services substantially varied by state and territory, MMSA, and county. The following portion of the abstract lists a summary of results by selected BRFSS measures. Each set of proportions refers to the range of

  16. SAN MICHELE. ENTRE CIELO Y MAR / San Michele, between sky and sea

    Directory of Open Access Journals (Sweden)

    Pablo Blázquez Jesús

    2012-11-01

    Full Text Available RESUMEN El cementerio es uno de los tipos arquitectónicos más profundos y metafóricos. El concurso para la ampliación del cementerio de San Michele, convocado en 1998 por la administración Municipal de Venecia, se convierte en un excelente campo de pruebas sobre el que poder analizar el contexto histórico en torno a esta tipología, y su relación con la ciudad y el territorio. El estudio de este caso concreto nos permite descubrir personajes, relaciones casuales y hallazgos que se despliegan a lo largo del texto. La historia del cementerio de San Michele es también la crónica de la transformación de la ciudad de Venecia y su Laguna. Interpretando este concurso como un instrumento de investigación, el objetivo del artículo es el de comprender la realidad contemporánea de la arquitectura funeraria a través de la isla de San Michele, Venecia, y las propuestas finalistas de Carlos Ferrater, Enric Miralles y David Chipperfield. Una historia bajo la cual se vislumbran claves que nos sirven para reflexionar acerca del cementerio contemporáneo, la ciudad y el territorio. SUMMARY The cemetery is one of the most profound and metaphorical kinds of architecture. The competition for the extension of the San Michele Cemetery, called in 1998 by the Venice municipal administration, is an excellent testing ground on which to analyse the historical context surrounding this type of architecture, and its relationship with the city and the region. The study of this particular case allows us to uncover characters, casual relationships and findings that unfold throughout the text. The history of the San Michele cemetery is also the chronicle of the transformation of the city of Venice and its Lagoon. Interpreting this competition as a research tool, the aim of the paper is to understand the contemporary reality of funerary architecture through the island of San Michele, Venice, and the finalist proposals of Carlos Ferrater, Enric Miralles and David

  17. Correlation of data on strain accumulation adjacent to the San Andreas Fault with available models

    Science.gov (United States)

    Turcotte, Donald L.

    1986-01-01

    Theoretical and numerical studies of deformation on strike slip faults were performed and the results applied to geodetic observations performed in the vicinity of the San Andreas Fault in California. The initial efforts were devoted to an extensive series of finite element calculations of the deformation associated with cyclic displacements on a strike-slip fault. Measurements of strain accumulation adjacent to the San Andreas Fault indicate that the zone of strain accumulation extends only a few tens of kilometers away from the fault. There is a concern about the tendency to make geodetic observations along the line to the source. This technique has serious problems for strike slip faults since the vector velocity is also along the fault. Use of a series of stations lying perpendicular to the fault whose positions are measured relative to a reference station are suggested to correct the problem. The complexity of faulting adjacent to the San Andreas Fault indicated that the homogeneous elastic and viscoelastic approach to deformation had serious limitations. These limitation led to the proposal of an approach that assumes a fault is composed of a distribution of asperities and barriers on all scales. Thus, an earthquake on a fault is treated as a failure of a fractal tree. Work continued on the development of a fractal based model for deformation in the western United States. In order to better understand the distribution of seismicity on the San Andreas Fault system a fractal analog was developed. The fractal concept also provides a means of testing whether clustering in time or space is a scale-invariant process.

  18. Microbial biogeography of San Francisco Bay sediments

    Science.gov (United States)

    Lee, J. A.; Francis, C. A.

    2014-12-01

    The largest estuary on the west coast of North America, San Francisco Bay is an ecosystem of enormous biodiversity, and also enormous human impact. The benthos has experienced dredging, occupation by invasive species, and over a century of sediment input as a result of hydraulic mining. Although the Bay's great cultural and ecological importance has inspired numerous surveys of the benthic macrofauna, to date there has been almost no investigation of the microbial communities on the Bay floor. An understanding of those microbial communities would contribute significantly to our understanding of both the biogeochemical processes (which are driven by the microbiota) and the physical processes (which contribute to microbial distributions) in the Bay. Here, we present the first broad survey of bacterial and archaeal taxa in the sediments of the San Francisco Bay. We conducted 16S rRNA community sequencing of bacteria and archaea in sediment samples taken bimonthly for one year, from five sites spanning the salinity gradient between Suisun and Central Bay, in order to capture the effect of both spatial and temporal environmental variation on microbial diversity. From the same samples we also conducted deep sequencing of a nitrogen-cycling functional gene, nirS, allowing an assessment of evolutionary diversity at a much finer taxonomic scale within an important and widespread functional group of bacteria. We paired these sequencing projects with extensive geochemical metadata as well as information about macrofaunal distribution. Our data reveal a diversity of distinct biogeographical patterns among different taxa: clades ubiquitous across sites; clades that respond to measurable environmental drivers; and clades that show geographical site-specificity. These community datasets allow us to test the hypothesis that salinity is a major driver of both overall microbial community structure and community structure of the denitrifying bacteria specifically; and to assess

  19. The Massacres of Migrants in San Fernando and Cadereyta: Two Examples of Necropolitan Governmentality

    Directory of Open Access Journals (Sweden)

    Amarela Varela Huerta

    2017-05-01

    Full Text Available The text addresses two emblematic massacres of migrants from contemporary Mexico, the San Fernando, Tamaulipas massacre in 2010, and the Cadereyta, Nuevo Leon massacre in 2012 as examples of a "necropolitan governmentality" of migrations in Mesoamerica. It is hypothesized that these massacres are, in addition to disputes over territorial control, crimes that with their performativity seek to exemplify the punishment for those who dare to disobey the laws of access and permanence in the North American territory (Mexico or United States of America. It is an analytical exercise that emphasizes the violence against migrants, which are essential scenarios to be understood in contemporary migratory studies.

  20. Quality management for design engineering for San Onofre nuclear generating station

    International Nuclear Information System (INIS)

    Thompson, P.C.; Baker, R.L.

    1991-01-01

    Quality management, as applied to design engineering for the San Onofre nuclear generating station, provides a systematic process for data collection and analysis of performance indicators for quality, cost, and delivery of design modifications for the three operating units. Southern California Edison (SCE) and Bechtel Power Corporation (BPC) have collaborated to establish a performance baseline from nearly 2 years of data. This paper discusses how the baseline was developed and how it can be used to predict and assess future performance. It further discusses new insights to the engineering process and opportunities for improvements that have been identified

  1. Trabajadores agrícolas en el valle de San Joaquín

    Directory of Open Access Journals (Sweden)

    Florencio Posadas Segura

    2012-06-01

    Full Text Available Agricultural workers are the backbone of the rural economy in California and the United States. More than 95 percent are Mexicans, especially in Michoa- can. An extensive fieldwork in the San Joaquin Valley, economic and demo- graphic indicators reveal that confirm the formation of various segments of employees: men and women, children, youth, adults and seniors, indigenous and non-indigenous residents and migrants, documented and undocumen- ted. This vast contingent reinforces the paradoxical trend toward increased production of agricultural wealth and the increasing poverty of authentic food producers.

  2. Potential field studies of the central San Luis Basin and San Juan Mountains, Colorado and New Mexico, and southern and western Afghanistan

    Science.gov (United States)

    Drenth, Benjamin John

    This dissertation includes three separate chapters, each demonstrating the interpretive utility of potential field (gravity and magnetic) geophysical datasets at various scales and in various geologic environments. The locations of these studies are the central San Luis Basin of Colorado and New Mexico, the San Juan Mountains of southwestern Colorado, and southern and western Afghanistan. The San Luis Basin is the northernmost of the major basins that make up the Rio Grande rift, and interpretation of gravity and aeromagnetic data reveals patterns of rifting, rift-sediment thicknesses, distribution of pre-rift volcanic and sedimentary rocks, and distribution of syn-rift volcanic rocks. Syn-rift Santa Fe Group sediments have a maximum thickness of ˜2 km in the Sanchez graben near the eastern margin of the basin along the central Sangre de Cristo fault zone. Under the Costilla Plains, thickness of these sediments is estimated to reach ˜1.3 km. The Santa Fe Group sediments also reach a thickness of nearly 1 km within the Monte Vista graben near the western basin margin along the San Juan Mountains. A narrow, north-south-trending structural high beneath San Pedro Mesa separates the graben from the structural depression beneath the Costilla Plains. Aeromagnetic anomalies are interpreted to mainly reflect variations of remanent magnetic polarity and burial depth of the 5.3-3.7 Ma Servilleta basalt of the Taos Plateau volcanic field. Magnetic-source depth estimates indicate patterns of subsidence following eruption of the basalt and show that the Sanchez graben has been the site of maximum subsidence. One of the largest and most pronounced gravity lows in North America lies over the rugged San Juan Mountains in southwestern Colorado. A buried, low-density silicic batholith related to an Oligocene volcanic field coincident with the San Juan Mountains has been the accepted interpretation of the source of the gravity low since the 1970s. However, this interpretation was

  3. Fossil content and structural relationships of the San Luis zone and the Caborca zone of NW Sonora, Mexico, suppression of the precambrian Z of Caborca

    International Nuclear Information System (INIS)

    Radelli, Luigi; Solis Weiss, Vivianne; Dorame Navarro, Miguel; De La Cruz Ortega, Lissette del Carmen; Urrutia, Jose

    2008-01-01

    In the Caborca region of western Sonora a Precambrian Z does not cover a unique Precambrian socle as previously believed. Two tectonic zones occur there instead: the San Luis Zone and the Caborca Zone. The first is comprised of the Precambrian San Luis socle of gneiss and granite, crossed by 1.1 Ga old anorthosites, the San Luis sedimentary cover, and, above it, a Lower Jurassic volcano-sedimentary sequence. The Caborca Zone consists of the Precambrian Bamori socle of parametamorphic rocks crossed by 1.1 Ga old Aibo granite, and of the Gamuza sedimentary cover. 1.1 Ga ago the two zones were far away from each other. They have been brought together by the Nevadian orogeny. Both zones are allochthonous, and the Caborca Zone is a nappe upon the San Luis Zone. The lowermost units of the Gamuza cover furnished psammocorals and a possible Pterophyllum jageri (?). Accordingly, its geological age is either Palaeozoic or Triassic.The San Luis cover furnished Nematophites [Prototaxites (?) and Nematothallus] from its lower part; Calcispongiae, Cardaicarpus' seeds, and Artisia from its upper part Thus, it is a Devono-Carboniferous unit. The study area belongs in the Baja-Borderland block, which underwent, an Eocene northwards drifting of about 900 - 1000 km, and a 30 celsius degrade to 40 celsius degrade clockwise rotation relative to the main part of Sonora.

  4. Prevention: Exercise

    Medline Plus

    Full Text Available ... Steroid Injections Lumbar Zygapophysical (Facet) Joint Injections PREVENTION Lifestyle Choices 10 Tips for a Healthy Back Smoking Weight Patient Safety Exercise Strengthening Strengthen ...

  5. Lithofacies characterization related to the Raigon Formation located in the southern area of the San Jose Department

    International Nuclear Information System (INIS)

    Spoturno, J.; Morales, E.; Cazaux, S.; Aubet, N.; Loureiro, J.

    2004-01-01

    In this work the different lithofacies characterization related to the Raigon Formation, located in the southern area of the San Jose Department, is exposed supported by surface and subsurface data. Six stratigraphical sections were constructed considering lithological borehole descriptions to the aim of making a contribution on the spatial distribution, thickness, disposition, lithofaciological variations of this Formation and its stratigraphical relationships with other units [es

  6. San Andreas-sized Strike-slip Fault on Europa

    Science.gov (United States)

    1998-01-01

    subsequent tidal stress causes it to move lengthwise in one direction. Then tidal forces close the fault again, preventing the area from moving back to its original position. Daily tidal cycles produce a steady accumulation of lengthwise offset motions. Here on Earth, unlike Europa, large strike-slip faults like the San Andreas are set in motion by plate tectonic forces. North is to the top of the picture and the sun illuminates the surface from the top. The image, centered at 66 degrees south latitude and 195 degrees west longitude, covers an area approximately 300 by 203 kilometers(185 by 125 miles). The pictures were taken on September 26, 1998by Galileo's solid-state imaging system. This image and other images and data received from Galileo are posted on the World Wide Web, on the Galileo mission home page at URL http://galileo.jpl.nasa.gov. Background information and educational context for the images can be found at URL http://www.jpl.nasa.gov/galileo/sepo

  7. Aerial radiological survey of the San Onofre Nuclear Generating Station and surrounding area, San Clemente, California

    International Nuclear Information System (INIS)

    Hilton, L.K.

    1980-12-01

    An airborne radiological survey of an 11 km 2 area surrounding the San Onofre Nuclear Generating Station was made 9 to 17 January 1980. Count rates observed at 60 m altitude were converted to exposure rates at 1 m above the ground and are presented in the form of an isopleth map. Detected radioisotopes and their associated gamma ray exposure rates were consistent with that expected from normal background emitters, except directly over the plant

  8. How Do You Motivate Long-Term Behavior Change to Prevent Cancer?

    Science.gov (United States)

    John P. Pierce PhD, a professor in the Department of Family and Preventive Medicine at the University of California, San Diego and Director of Population Science at Moores Cancer Center, presented "How Do You Motivate Long-Term Behavior Change to Prevent Cancer?" 

  9. Paleomagnetism of San Cristobal Island, Galapagos

    Science.gov (United States)

    Cox, A.

    1971-01-01

    Isla San Cristobal, the most easterly of the Galapagos Islands, consists of two parts: a large volcano constitutes the southwest half of the island and an irregular apron of small cones and flows makes up the northeast half. As some of the younger flows on the flanks of the large volcano are reversely magnetized, the minimum age of the volcano is 0.7 my, which is the age of the Brunhes-Matuyama reversal boundary. The true age is probably several times greater. The cones and flows to the northeast are all normally magnetized. The between-site angular dispersion of virtual poles is 11.3?? - a value consistent with mathematical models for the latitude dependence of geomagnetic secular variation. ?? 1971.

  10. San Carlos Apache Tribe - Energy Organizational Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Rapp, James; Albert, Steve

    2012-04-01

    The San Carlos Apache Tribe (SCAT) was awarded $164,000 in late-2011 by the U.S. Department of Energy (U.S. DOE) Tribal Energy Program's "First Steps Toward Developing Renewable Energy and Energy Efficiency on Tribal Lands" Grant Program. This grant funded:  The analysis and selection of preferred form(s) of tribal energy organization (this Energy Organization Analysis, hereinafter referred to as "EOA").  Start-up staffing and other costs associated with the Phase 1 SCAT energy organization.  An intern program.  Staff training.  Tribal outreach and workshops regarding the new organization and SCAT energy programs and projects, including two annual tribal energy summits (2011 and 2012). This report documents the analysis and selection of preferred form(s) of a tribal energy organization.

  11. Carboniferous calcareous algae and their associations in the San Emiliano and Lois-Ciguera Formations (Prov. León, NW Spain)

    NARCIS (Netherlands)

    Rácz, L.

    1965-01-01

    This study of the calcareous algae in the limestone deposits of the two formations (San Emiliano and Lois-Ciguera) in NW Spain is based on field observations and microscopical study. It was possible in the field to divide almost all the limestone members into smaller units on the basis of physical,

  12. Paleohydrogeology of the San Joaquin basin, California

    Science.gov (United States)

    Wilson, A.M.; Garven, G.; Boles, J.R.

    1999-01-01

    Mass transport can have a significant effect on chemical diagenetic processes in sedimentary basins. This paper presents results from the first part of a study that was designed to explore the role of an evolving hydrodynamic system in driving mass transport and chemical diagenesis, using the San Joaquin basin of California as a field area. We use coupled hydrogeologic models to establish the paleohydrogeology, thermal history, and behavior of nonreactive solutes in the basin. These models rely on extensive geological information and account for variable-density fluid flow, heat transport, solute transport, tectonic uplift, sediment compaction, and clay dehydration. In our numerical simulations, tectonic uplift and ocean regression led to large-scale changes in fluid flow and composition by strengthening topography-driven fluid flow and allowing deep influx of fresh ground water in the San Joaquin basin. Sediment compaction due to rapid deposition created moderate overpressures, leading to upward flow from depth. The unusual distribution of salinity in the basin reflects influx of fresh ground water to depths of as much as 2 km and dilution of saline fluids by dehydration reactions at depths greater than ???2.5 km. Simulations projecting the future salinity of the basin show marine salinities persisting for more than 10 m.y. after ocean regression. Results also show a change from topography-to compaction-driven flow in the Stevens Sandstone at ca. 5 Ma that coincides with an observed change in the diagenetic sequence. Results of this investigation provide a framework for future hydrologic research exploring the link between fluid flow and diagenesis.

  13. Developing solar power programs : San Francisco's experience

    International Nuclear Information System (INIS)

    Schwartz, F.

    2006-01-01

    This keynote address discussed an array of solar programs initiated in government-owned buildings in San Francisco. The programs were strongly supported by the city's mayor,and the voting public. Known for its fog and varying microclimates, 11 monitoring stations were set up throughout the city to determine viable locations for the successful application of solar technologies. It was observed that 90 per cent of the available sunshine occurred in the central valley, whereas fog along the Pacific shore was problematic. Seven of the monitoring sites showed excellent results. Relationships with various city departments were described, as well as details of study loads, load profiles, electrical systems, roofs and the structural capabilities of the selected government buildings. There was a focus on developing good relations with the local utility. The Moscone Convention Center was selected for the program's flagship installation, a 675 kW solar project which eventually won the US EPA Green Power Award for 2004 and received high press coverage. Cost of the project was $4.2 million. 825,000 kWh solar electricity was generated, along with 4,500,000 kWh electricity saved annually from efficiency measures, resulting in a net reduction of 5,325,000 kWh. Savings on utilities bills for the center were an estimated $1,078,000. A pipeline of solar projects followed, with installations at a sewage treatment plant and a large recycling depot. A program of smaller sites included libraries, schools and health facilities. Details of plans to apply solar technology to a 500 acre redevelopment site in southeast San Francisco with an aging and inadequate electrical infrastructure were described. A model of efficient solar housing for the development was presented, with details of insulation, windows, heating ventilation and air-conditioning (HVAC), water heating, lighting, appliances and a 1.2 kilowatt solar system. Peak demand reductions were also presented. tabs., figs

  14. Knowledge, Indications and Willingness to Take Pre-Exposure Prophylaxis among Transwomen in San Francisco, 2013.

    Directory of Open Access Journals (Sweden)

    Erin C Wilson

    Full Text Available Safe and effective HIV prevention strategies are needed for transwomen. Transwomen in the US have a 34 times greater odds of being infected with HIV than all adults age 15-49, and in San Francisco, California 42.4% of transwomen are estimated to be infected with HIV. Pre-exposure prophylaxis (PrEP is the first biomedical intervention with promise for reducing HIV acquisition in transwomen. However, little is known about whether transwomen know about PrEP, are taking PrEP and would be good candidates for PrEP based on their risk profile and behaviors. A population-based dataset was analyzed to determine how many transwomen in San Francisco knew about PrEP by the end of 2013 - more than a year after iPrex results demonstrated efficacy of PrEP in preventing HIV. We found that of 233 transwomen, only 13.7% had heard of PrEP. Transwomen who were living with HIV compared to those who were HIV-negative, and those who recently injected drugs compared to non-injection drug users were more likely to have heard of PrEP. Based on CDC guidelines for PrEP among MSM and IDU, 45 (30.2% transwomen of the 149 HIV-negative transwomen in the sample were candidates for PrEP. This estimate based on CDC criteria is arguably low. Given that almost half of transwomen in San Francisco are living with HIV, this findings points to a need for further consideration of PrEP criteria that are specific and tailored to the risks for HIV faced by transwomen that are different from MSM and injection drug users. Research to scale up access and test the effectiveness of PrEP for transwomen is also urgently needed.

  15. Backwater Flooding in San Marcos, TX from the Blanco River

    Science.gov (United States)

    Earl, Richard; Gaenzle, Kyle G.; Hollier, Andi B.

    2016-01-01

    Large sections of San Marcos, TX were flooded in Oct. 1998, May 2015, and Oct. 2015. Much of the flooding in Oct. 1998 and Oct. 2015 was produced by overbank flooding of San Marcos River and its tributaries by spills from upstream dams. The May 2015 flooding was almost entirely produced by backwater flooding from the Blanco River whose confluence is approximately 2.2 miles southeast of downtown. We use the stage height of the Blanco River to generate maps of the areas of San Marcos that are lower than the flood peaks and compare those results with data for the observed extent of flooding in San Marcos. Our preliminary results suggest that the flooding occurred at locations more than 20 feet lower than the maximum stage height of the Blanco River at San Marcos gage (08171350). This suggest that the datum for either gage 08171350 or 08170500 (San Marcos River at San Marcos) or both are incorrect. There are plans for the U.S. Army Corps of Engineers to construct a Blanco River bypass that will divert Blanco River floodwaters approximately 2 miles farther downstream, but the $60 million price makes its implementation problematic.

  16. Achieving Health Equity Through Community Engagement in Translating Evidence to Policy: The San Francisco Health Improvement Partnership, 2010–2016

    Science.gov (United States)

    Vargas, Roberto A.; Fleisher, Paula; Aragón, Tomás J.; Chung, Lisa; Chawla, Colleen; Yant, Abbie; Garcia, Estela R.; Santiago, Amor; Lang, Perry L.; Jones, Paula; Liu, Wylie; Schmidt, Laura A.

    2017-01-01

    Background The San Francisco Health Improvement Partnership (SFHIP) promotes health equity by using a novel collective impact model that blends community engagement with evidence-to-policy translational science. The model involves diverse stakeholders, including ethnic-based community health equity coalitions, the local public health department, hospitals and health systems, a health sciences university, a school district, the faith community, and others sectors. Community Context We report on 3 SFHIP prevention initiatives: reducing consumption of sugar sweetened beverages (SSBs), regulating retail alcohol sales, and eliminating disparities in children’s oral health. Methods SFHIP is governed by a steering committee. Partnership working groups for each initiative collaborate to 1) develop and implement action plans emphasizing feasible, scalable, translational-science–informed interventions and 2) consider sustainability early in the planning process by including policy and structural interventions. Outcome Through SFHIP’s efforts, San Francisco enacted ordinances regulating sale and advertising of SSBs and a ballot measure establishing a soda tax. Most San Francisco hospitals implemented or committed to implementing healthy-beverage policies that prohibited serving or selling SSBs. SFHIP helped prevent Starbucks and Taco Bell from receiving alcohol licenses in San Francisco and helped prevent state authorization of sale of powdered alcohol. SFHIP increased the number of primary care clinics providing fluoride varnish at routine well-child visits from 3 to 14 and acquired a state waiver to allow dental clinics to be paid for dental services delivered in schools. Interpretation The SFHIP model of collective impact emphasizing community engagement and policy change accomplished many of its intermediate goals to create an environment promoting health and health equity. PMID:28333598

  17. Achieving Health Equity Through Community Engagement in Translating Evidence to Policy: The San Francisco Health Improvement Partnership, 2010-2016.

    Science.gov (United States)

    Grumbach, Kevin; Vargas, Roberto A; Fleisher, Paula; Aragón, Tomás J; Chung, Lisa; Chawla, Colleen; Yant, Abbie; Garcia, Estela R; Santiago, Amor; Lang, Perry L; Jones, Paula; Liu, Wylie; Schmidt, Laura A

    2017-03-23

    The San Francisco Health Improvement Partnership (SFHIP) promotes health equity by using a novel collective impact model that blends community engagement with evidence-to-policy translational science. The model involves diverse stakeholders, including ethnic-based community health equity coalitions, the local public health department, hospitals and health systems, a health sciences university, a school district, the faith community, and others sectors. We report on 3 SFHIP prevention initiatives: reducing consumption of sugar sweetened beverages (SSBs), regulating retail alcohol sales, and eliminating disparities in children's oral health. SFHIP is governed by a steering committee. Partnership working groups for each initiative collaborate to 1) develop and implement action plans emphasizing feasible, scalable, translational-science-informed interventions and 2) consider sustainability early in the planning process by including policy and structural interventions. Through SFHIP's efforts, San Francisco enacted ordinances regulating sale and advertising of SSBs and a ballot measure establishing a soda tax. Most San Francisco hospitals implemented or committed to implementing healthy-beverage policies that prohibited serving or selling SSBs. SFHIP helped prevent Starbucks and Taco Bell from receiving alcohol licenses in San Francisco and helped prevent state authorization of sale of powdered alcohol. SFHIP increased the number of primary care clinics providing fluoride varnish at routine well-child visits from 3 to 14 and acquired a state waiver to allow dental clinics to be paid for dental services delivered in schools. The SFHIP model of collective impact emphasizing community engagement and policy change accomplished many of its intermediate goals to create an environment promoting health and health equity.

  18. Preventative Maintenance.

    Science.gov (United States)

    Migliorino, James

    Boards of education must be convinced that spending money up front for preventive maintenance will, in the long run, save districts' tax dollars. A good program of preventive maintenance can minimize disruption of service; reduce repair costs, energy consumption, and overtime; improve labor productivity and system equipment reliability; handle…

  19. Design of the HPTN 065 (TLC-Plus) study: A study to evaluate the feasibility of an enhanced test, link-to-care, plus treat approach for HIV prevention in the United States.

    Science.gov (United States)

    Gamble, Theresa; Branson, Bernard; Donnell, Deborah; Hall, H Irene; King, Georgette; Cutler, Blayne; Hader, Shannon; Burns, David; Leider, Jason; Wood, Angela Fulwood; G Volpp, Kevin; Buchacz, Kate; El-Sadr, Wafaa M

    2017-08-01

    Background/Aims HIV continues to be a major public health threat in the United States, and mathematical modeling has demonstrated that the universal effective use of antiretroviral therapy among all HIV-positive individuals (i.e. the "test and treat" approach) has the potential to control HIV. However, to accomplish this, all the steps that define the HIV care continuum must be achieved at high levels, including HIV testing and diagnosis, linkage to and retention in clinical care, antiretroviral medication initiation, and adherence to achieve and maintain viral suppression. The HPTN 065 (Test, Link-to-Care Plus Treat [TLC-Plus]) study was designed to determine the feasibility of the "test and treat" approach in the United States. Methods HPTN 065 was conducted in two intervention communities, Bronx, NY, and Washington, DC, along with four non-intervention communities, Chicago, IL; Houston, TX; Miami, FL; and Philadelphia, PA. The study consisted of five components: (1) exploring the feasibility of expanded HIV testing via social mobilization and the universal offer of testing in hospital settings, (2) evaluating the effectiveness of financial incentives to increase linkage to care, (3) evaluating the effectiveness of financial incentives to increase viral suppression, (4) evaluating the effectiveness of a computer-delivered intervention to decrease risk behavior in HIV-positive patients in healthcare settings, and (5) administering provider and patient surveys to assess knowledge and attitudes regarding the use of antiretroviral therapy for prevention and the use of financial incentives to improve health outcomes. The study used observational cohorts, cluster and individual randomization, and made novel use of the existing national HIV surveillance data infrastructure. All components were developed with input from a community advisory board, and pragmatic methods were used to implement and assess the outcomes for each study component. Results A total of 76 sites in

  20. Fitting the datum of SANS with Pxy program

    International Nuclear Information System (INIS)

    Sun, Liangwei; Peng, Mei; Chen, Liang

    2009-04-01

    The thesis introduces the basic theory of Small-Angle neutron scattering, enumerates several approximate law. It simply describes the components of Small-Angle neutron spectrometer (SANS) and the parameters of SANS of Budapest Neutron Center (BNC) in Hungary. During the period of studying at Budapest Neutron Center in Hungary, the experiments of wavelength calibration was carried out with SIBE and the SANS experiments of sample Micelles. The experiments are briefly introduced. Pxy program is used to fit these datum, and the results of wavelength and sizes of sample Micelles are presented. (authors)

  1. The Effect of Bangpungtongsung-san Extracts on Adipocyte Metabolism

    Directory of Open Access Journals (Sweden)

    Sang Min, Lee

    2008-03-01

    Full Text Available Objective : The purpose of this study is to investigate the effects of Bangpungtongsung-san extracts on the preadipocytes proliferation, of 3T3-L1 cell line. lipolysis of adipocytes in rat's epididymis and localized fat accumulation of porcine by extraction methods(alcohol and water. Methods : Diminish 3T3-L1 proliferation and lipogenesis do primary role to reduce obesity. So, 3T3-L1 preadipocyte and adipocytes were performed on cell cultures, and using Sprague-Dawley rats for the lipogenesis, and treated with 0.01-1 ㎎/㎖ Bangpungtongsung-san Extracts depend on concentrations. Porcine skin including fat tissue after treated Bangpungtongsung-san Extracts by means of the dosage dependent variation are investigated the histologic changes after injection of these extracts. Results : Following results were obtained from the 3T3-L1 preadipocyte proliferation and lipolysis of adipocyte in rats and histologic investigation of fat tissue. 1. Bangpungtongsung-san extracts were showed the effect of decreased preadipocyte proliferation on the high dosage(1.0㎎/㎖. 2. Bangpungtongsung-san extracts were showed the effect of decreased the activity of glycerol-3-phosphate dehydrogenase(GPDH on the high dosage(1.0㎎/㎖ and Specially, alcohol extract of Bangpungtongsung -san was clear as time goes by high concentration. 3. Bangpungtongsung-san extracts were showed tries to compare the effect of lipolysis, alcohol extract of Bangpungtongsung-san on the high dosage(1.0㎎/㎖ was observed the effect is higher than water extract. 4. Investigated the histological changes in porcine fat tissue after treated Bangpungtongsung-san extracts, we knew that water extract of Bangpungtongsung-san was showed the effect of lipolysis on the high dosage(10.0㎎/㎖ and alcohol extract of Bangpungtongsung-san was showed significant activity to the lysis of cell membranes in all concentration. Conclusion : These results suggest that Bangpungtongsung-san extracts efficiently

  2. San Juanico Hybrid System Technical and Institutional Assessment: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Corbus, D.; Newcomb, C.; Yewdall, Z.

    2004-07-01

    San Juanico is a fishing village of approximately 120 homes in the Municipality of Comondu, Baja California. In April, 1999, a hybrid power system was installed in San Juanico to provide 24-hour power, which was not previously available. Before the installation of the hybrid power system, a field study was conducted to characterize the electrical usage and institutional and social framework of San Juanico. One year after the installation of the hybrid power system a''post-electrification'' study was performed to document the changes that had occurred after the installation. In December of 2003, NREL visited the site to conduct a technical assessment of the system.

  3. Aplicabilidade do protocolo de prevenção de úlcera de pressão em unidade de terapia intensiva Applicability of the prevention protocol of pressure ulcers in intensive care unit

    Directory of Open Access Journals (Sweden)

    Emanuelly Wedja do Nascimento Lima e Silva

    2010-06-01

    Full Text Available OBJETIVO: O não desenvolvimento da úlcera de pressão de pacientes graves em terapia intensiva é um grande desafio para a enfermagem. Portanto, é relevante a prevenção para que se garanta um cuidado de boa qualidade. O objetivo da pesquisa foi avaliar a aplicabilidade da escala de Braden em pacientes de terapia intensiva. MÉTODOS: Estudo prospectivo baseado na avaliação de todos os pacientes internados na unidade de terapia intensiva adulto, no período 14 de Julho a 10 de Agosto de 2009. A coleta de dados foi realizada através da aplicação da escala de Braden por três juízes, identificando os riscos para o desenvolvimento da úlcera de pressão. Para a análise dos dados foi utilizado o Software estatístico SAS Na avaliação do grau de coincidência entre os juízes utilizou-se valor kappa (IC=95%. RESULTADOS: Quanto aos fatores de risco relacionados: 36,4% apresentavam leve limitação à percepção sensorial, 50,9% pele ocasionalmente úmida; 97,3% restritos ao leito; 39,1% muito limitados à mobilidade, 45% nutrição provavelmente inadequada, 61,8% apresentaram problema quanto à fricção e cisalhamento. Quanto à concordância entre os juízes (38,1% a 100,0% foram registradas em nutrição e atividade física; a hipótese do Kappa populacional nulo foi rejeitada; análise entre pares de examinadores de coincidência (41,7% a 100,0% foi registrada no item umidade e atividade física, os valores de Kappa variaram de 0,13 a 1. CONCLUSÕES: Observou-se elevado risco para ulcera de pressão em pacientes de terapia intensiva. Esse instrumento parece ser adequado para auxiliar na implementação de medidas de prevenção.OBJECTIVE: The avoidance of pressure ulcers development in critically ill patients is a major nursing challenge. Prevention is thus relevant for assurance of high quality care. This study aimed to evaluate the applicability of the Braden scale in intensive care unit patients. METHODS: This was a prospective

  4. The challenge of defining standards of prevention in HIV prevention trials

    NARCIS (Netherlands)

    Philpott, Sean; Heise, Lori; McGrory, Elizabeth; Paxton, Lynn; Hankins, Catherine; Alexander, Lorraine; Apuuli, David Kihumuro; Baeten, Jared; Birx, Deborah; de Bruyn, Guy; Bukusi, Elizabeth; Burns, David; Calazans, Gabriela; Campbell, James; Caswell, Georgina; Coutinho, Alex; Dawson, Liza; Dhai, Amaboo; Dube, Samukeliso; Ecuru, Julius; Essack, Zaynab; Farley, Timothy; Gafos, Mitzy; Irungu, Pauline; Kaleebu, Pontiano; Kamali, Anatoli; Kestelyn, Evelyne; Kublin, James; Lohse, Nicolai; Lutalo, Tom; Macklin, Ruth; Mâsse, Benôıt; Mauney, Chris; McCormack, Sheena; Miller, Lori; Mfutso-Bengo, Joseph; Misra, Rajender; Muganwa, Margaret; Ndase, Patrick; Nel, Annalene; Nielsen, Leslie; Nkala, Busisiwe; O'Reilly, Kevin; Okware, Sam; Paicheler, Geneviève; Rees, Helen; Rerks-Ngarm, Supachai; Ridzon, Renee; Rosenberg, Zeda; Singh, Jerome

    2011-01-01

    As new HIV prevention tools are developed, researchers face a number of ethical and logistic questions about how and when to include novel HIV prevention strategies and tools in the standard prevention package of ongoing and future HIV prevention trials. Current Joint United Nations Programme on

  5. 77 FR 60897 - Safety Zone: America's Cup World Series Finish-Line, San Francisco, CA

    Science.gov (United States)

    2012-10-05

    ... navigable waters of the San Francisco Bay in vicinity of San Francisco West Yacht Harbor Light 2... vicinity of San Francisco West Yacht Harbor Light 2. Unauthorized persons or vessels are prohibited from... San Francisco West Yacht Harbor Light 2. This safety zone establishes a temporary restricted area on...

  6. 75 FR 65985 - Safety Zone: Epic Roasthouse Private Party Firework Display, San Francisco, CA

    Science.gov (United States)

    2010-10-27

    ... the navigable waters of San Francisco Bay 1,000 yards off Epic Roasthouse Restaurant, San Francisco.... Wright, Program Manager, Docket Operations, telephone 202-366-9826. SUPPLEMENTARY INFORMATION: Regulatory... waters of San Francisco Bay, 1,000 yards off Epic Roasthouse Restaurant, San Francisco, CA. The fireworks...

  7. Timber resource statistics for the San Joaquin and southern resource areas of California.

    Science.gov (United States)

    Karen L. Waddell; Patricia M. Bassett

    1997-01-01

    This report is a summary of timber resource statistics for the San Joaquin and Southern Resource Areas of California, which include Alpine, Amador, Calaveras, Fresno, Imperial, Inyo, Kern, Kings, Los Angeles, Madera, Mariposa, Merced, Mono, Orange, Riverside, San Bernardino, San Diego, San Joaquin, Stanislaus, Tulare, and Tuolumne Counties. Data were collected as part...

  8. Counterproliferation Strategy: The Role of Preventive War, Preventive Strikes, and Interdiction

    National Research Council Canada - National Science Library

    Rak, Claire

    2003-01-01

    This thesis analyzes the potential effectiveness of preventive war, preventive strikes, and interdiction as tools for the United States to counter the proliferation of weapons of mass destruction (WMD...

  9. Prevention and Treatment of Smoking and Tobacco Use During Pregnancy in Selected Indigenous Communities in High-Income Countries of the United States, Canada, Australia, and New Zealand: An Evidence-Based Review.

    Science.gov (United States)

    Gould, Gillian S; Lim, Ling Li; Mattes, Joerg

    2017-10-01

    Tobacco smoking during pregnancy is the most important modifiable risk factor for adverse pregnancy outcomes and long-term health complications for mother and baby. Tobacco use during pregnancy has decreased in high-income countries but not in Indigenous women in Australia, New Zealand, the United States, and Canada. This evidence-based review focuses on tobacco use among Indigenous pregnant women in high-income countries that share a history of European colonization. Indigenous women are more likely to use tobacco because of socioeconomic disadvantage, social norms, and poor access to culturally appropriate tobacco cessation support. Complications arising from tobacco smoking during pregnancy, such as low birth weight, prematurity, perinatal death, and sudden infant death syndrome, are much higher in Indigenous populations. Effective approaches to cessation in pregnant nonindigenous women involves behavioral counseling, with or without nicotine replacement therapy (NRT). Higher nicotine metabolism during pregnancy and poor adherence may affect therapeutic levels of NRT. Only two randomized trials were conducted among Indigenous women: neither found a statistically significant difference in cessation rates between the treatment and comparison arms. Considerations should be given to (1) whole life course approaches to reduce tobacco use in Indigenous women, (2) prohibiting tobacco promotion and reducing access to alcohol for minors to prevent smoking initiation in Indigenous youth, and (3) training health-care professionals in culturally appropriate smoking cessation care to improve access to services. It is critical to ensure acceptability and feasibility of study designs, consult with the relevant Indigenous communities, and preempt implementation challenges. Research is needed into the effect of reducing or stopping smoking during pregnancy when using NRT on subsequent maternal and infant outcomes. Copyright © 2017 The Authors. Published by Elsevier Inc. All

  10. Effectiveness of a multidimensional approach for the prevention of ventilator-associated pneumonia in an adult intensive care unit in Cuba: findings of the International Nosocomial Infection Control Consortium (INICC).

    Science.gov (United States)

    Guanche-Garcell, Humberto; Morales-Pérez, Clara; Rosenthal, Victor D

    2013-04-01

    This study sought to assess the effect of the multidimensional approach developed by the International Nosocomial Infection Control Consortium (INICC) on the reduction of ventilator-associated pneumonia (VAP) rates in patients hospitalized in an adult intensive care unit (AICU) in an INICC member hospital in Havana, Cuba. We conducted a prospective surveillance pre-post study in AICU patients. The study was divided into two periods:baseline and intervention. During the baseline period, we conducted active prospective surveillance of VAP using the Centers for Disease Control and Prevention (CDC) National Health Safety Network (NHSN) definition and INICC methods. During the intervention period, we implemented the INICC multidimensional approach for VAP, in addition to performing active surveillance. This multidimensional approach included the following measures: a bundle of infection control interventions, education, outcome surveillance, process surveillance, feedback of VAP rates and performance feedback of infection control practices. The baseline rates of VAP were compared to the rates obtained after intervention, and we analyzed the impact of our interventions by Poisson regression. During the baseline period, we recorded 114 mechanical ventilator (MV) days, whereas we recorded 2350MV days during the intervention period. The baseline rate of VAP was 52.63 per 1000MV days and 15.32 per 1000MV days during the intervention. At the end of the study period, we achieved a 70% reduction in the rate of VAP (RR, 0.3; 95% CI, 0.12-0.7; P value, 0.003.). The implementation the INICC multidimensional approach for VAP was associated with a significant reduction in the VAP rate in the participating AICU of Cuba. Copyright © 2013 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  11. Demographic and Travel Characteristics of Travel-Associated Zika Virus Infection Case-Patients in San Diego County, California (January 1, 2016-March 31, 2017).

    Science.gov (United States)

    Escutia, Gabriela; McDonald, Eric; Rodríguez-Lainz, Alfonso; Healy, Jessica

    2018-06-01

    Most Zika disease cases diagnosed in the continental US have been associated with travel to areas with risk of Zika transmission, mainly the Caribbean and Latin America. Limited information has been published about the demographic and travel characteristics of Zika case-patients in the United States, besides their age and gender. During 2016-2017 the County of San Diego Health and Human Services Agency, California, expanded the scope and completeness of demographic and travel information collected from Zika case-patients for public health surveillance purposes. The majority (53.8%) of travel-related Zika virus infection case-patients (n = 78) in the county were Hispanic, significantly higher (p ≤ 0.05) than the 33.0% of Hispanics in the county. Foreign-born residents, mainly from Mexico, were also overrepresented among cases compared to their share in the county population (33.3 vs. 23.0%; p ≤ 0.05). Seventeen (21.8%) patients reported a primary language other than English (14 Spanish). Most case-patients traveled for tourism (54%) or to visit friends and relatives (36%). This surveillance information helps identify higher-risk populations and implement culturally targeted interventions for Zika prevention and control.

  12. Preventive analgesia

    DEFF Research Database (Denmark)

    Dahl, Jørgen B; Kehlet, Henrik

    2011-01-01

    This paper will discuss the concepts of pre-emptive and preventive analgesia in acute and persistent postsurgical pain, based on the most recent experimental and clinical literature, with a special focus on injury-induced central sensitization and the development from acute to chronic pain. Recent...... of preventive analgesia for persistent postoperative pain are promising. However, clinicians must be aware of the demands for improved design of their clinical studies in order to get more conclusive answers regarding the different avenues for intervention. Summary: The concept of preventive analgesia is still...

  13. ASTER Images San Francisco Bay Area

    Science.gov (United States)

    2000-01-01

    These images of the San Francisco Bay region were acquired on March 3, 2000 by the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) on NASA's Terra satellite. Each covers an area 60 kilometers (37 miles) wide and 75 kilometers (47 miles) long. With its 14 spectral bands from the visible to the thermal infrared wavelength region, and its high spatial resolution of 15 to 90 meters (about 50 to 300 feet), ASTER will image the Earth for the next 6 years to map and monitor the changing surface of our planet.Upper Left: The color infrared composite uses bands in the visible and reflected infrared. Vegetation is red, urban areas are gray; sediment in the bays shows up as lighter shades of blue. Thanks to the 15 meter (50-foot) spatial resolution, shadows of the towers along the Bay Bridge can be seen.Upper right: A composite of bands in the short wave infrared displays differences in soils and rocks in the mountainous areas. Even though these regions appear entirely vegetated in the visible, enough surface shows through openings in the vegetation to allow the ground to be imaged.Lower left: This composite of multispectral thermal bands shows differences in urban materials in varying colors. Separation of materials is due to differences in thermal emission properties, analogous to colors in the visible.Lower right: This is a color coded temperature image of water temperature, derived from the thermal bands. Warm waters are in white and yellow, colder waters are blue. Suisun Bay in the upper right is fed directly from the cold Sacramento River. As the water flows through San Pablo and San Francisco Bays on the way to the Pacific, the waters warm up.Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) is one of five Earth-observing instruments launched December 18, 1999, on NASA's Terra satellite. The instrument was built by Japan's Ministry of International Trade and Industry. A joint U.S./Japan science team is responsible for

  14. San Francisco-Pacifica Coast Landslide Susceptibility 2011

    Data.gov (United States)

    California Natural Resource Agency — The San Francisco-Pacifica Coast grid map was extracted from the California Geological Survey Map Sheet 58 that covers the entire state of California and originally...

  15. San Diego, California 1/3 arc-second DEM

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The 1/3-second San Diego, California Elevation Grid provides bathymetric data in ASCII raster format of 1/3-second resolution in geographic coordinates. This grid is...

  16. San Diego Littoral Cell CRSMP Receiver Sites 2009

    Data.gov (United States)

    California Natural Resource Agency — A total of 27 possible placement sites (some with multiple placement footprints) are incorporated into this San Diego Coastal Regional Sediment Management Plan to...

  17. Geological literature on the San Joaquin Valley of California

    Science.gov (United States)

    Maher, J.C.; Trollman, W.M.; Denman, J.M.

    1973-01-01

    The following list of references includes most of the geological literature on the San Joaquin Valley and vicinity in central California (see figure 1) published prior to January 1, 1973. The San Joaquin Valley comprises all or parts of 11 counties -- Alameda, Calaveras, Contra Costa, Fresno, Kern, Kings, Madera, Merced, San Joaquin, Stanislaus, and Tulare (figure 2). As a matter of convenient geographical classification the boundaries of the report area have been drawn along county lines, and to include San Benito and Santa Clara Counties on the west and Mariposa and Tuolumne Counties on the east. Therefore, this list of geological literature includes some publications on the Diablo and Temblor Ranges on the west, the Tehachapi Mountains and Mojave Desert on the south, and the Sierra Nevada Foothills and Mountains on the east.

  18. San Francisco Bay Multi-beam Bathymetry: Area A

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — These multi-beam bathymetric data were collected over shallow subtidal areas in the San Francisco Bay estuary system. Bathymetric and acoustic backscatter data were...

  19. San Francisco Bay Interferometric Side Scan Imagery: Area A

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Backscatter imagery data were collected over shallow subtidal areas in the San Francisco Bay estuary system. Bathymetric and acoustic backscatter data were collected...

  20. San Joaquin Valley Aerosol Health Effects Research Center (SAHERC)

    Data.gov (United States)

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

  1. National Status and Trends: Bioeffects Program - San Francisco Bay Database

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This study was based on the sediment quality triad (SQT) approach. A stratified probabilistic sampling design was utilized to characterize the San Francisco Bay...

  2. San Diego Littoral Cell CRSMP Potential Offshore Borrow Areas 2009

    Data.gov (United States)

    California Natural Resource Agency — Offshore sediment sources along the entire reach of the San Diego Coastal RSM Plan region were previously identified by SANDAG and used for Regional Beach Sand...

  3. San Diego Littoral Cell CRSMP Receiver Sites 2009

    Data.gov (United States)

    California Department of Resources — A total of 27 possible placement sites (some with multiple placement footprints) are incorporated into this San Diego Coastal Regional Sediment Management Plan to...

  4. Vegetation Mapping - Tecolote Canyon, San Diego Co. [ds656

    Data.gov (United States)

    California Natural Resource Agency — Vegetation mapping has been conducted at various City of San Diego Park and Recreation Open Space lands in support of natural resource management objectives and the...

  5. San Juan, Puerto Rico Tsunami Forecast Grids for MOST Model

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The San Juan, Puerto Rico Forecast Model Grids provides bathymetric data strictly for tsunami inundation modeling with the Method of Splitting Tsunami (MOST) model....

  6. Port San Luis, California Tsunami Forecast Grids for MOST Model

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Port San Luis, California Forecast Model Grids provides bathymetric data strictly for tsunami inundation modeling with the Method of Splitting Tsunami (MOST)...

  7. BNSF San Bernardino case study : positive train control risk assessment.

    Science.gov (United States)

    2014-09-01

    The Federal Railroad Administration funded the BNSF San Bernardino Case Study to verify its Generalized Train Movement : Simulator (GTMS) risk assessment capabilities on a planned implementation of the I-ETMS PTC system. The analysis explicitly : sim...

  8. San Francisco Bay, California 1 arc-second DEM

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The 1-second San Francisco Bay, California Elevation Grid provides bathymetric data in ASCII raster format of 1-second resolution in geographic coordinates. This...

  9. Baseline Surveys - Tecolote Canyon, San Diego Co. [ds655

    Data.gov (United States)

    California Natural Resource Agency — Various resource projects have been conducted in the City of San Diego's Open Space Parks as part of the implementation of the City's Multiple Species Conservation...

  10. San Francisco, California Tsunami Forecast Grids for MOST Model

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The San Francisco, California Forecast Model Grids provides bathymetric data strictly for tsunami inundation modeling with the Method of Splitting Tsunami (MOST)...

  11. Rare Plants - City of San Diego [ds455

    Data.gov (United States)

    California Natural Resource Agency — The Biological Monitoring Plan (BMP; Ogden 1996) for the Multiple Species Conservation Program (MSCP) was developed in 1996 and is a component of the City of San...

  12. Groundwater quality in the Madera and Chowchilla subbasins of the San Joaquin Valley, California

    Science.gov (United States)

    Shelton, Jennifer L.; Fram, Miranda S.; Belitz, Kenneth

    2013-01-01

    Groundwater provides more than 40 percent of California’s drinking water. To protect this vital resource, the State of California created the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The Priority Basin Project of the GAMA Program provides a comprehensive assessment of the State’s untreated groundwater quality and increases public access to groundwater-quality information. The Madera and Chowchilla subbasins of the San Joaquin Valley constitute one of the study units being evaluated. The Madera-Chowchilla study unit is about 860 square miles and consists of the Madera and Chowchilla groundwater subbasins of the San Joaquin Valley Basin (California Department of Water Resources, 2003; Shelton and others, 2009). The study unit has hot, dry summers and cool, moist winters. Average annual rainfall ranges from 11 to 15 inches, most of which occurs between November and February. The main surface-water features in the study unit are the San Joaquin, Fresno, and Chowchilla Rivers, and the Madera and Chowchilla canals. Land use in the study unit is about 69 percent (%) agricultural, 28% natural (mainly grasslands), and 3% urban. The primary crops are orchards and vineyards. The largest urban area is the city of Madera. The primary aquifer system is defined as those parts of the aquifer corresponding to the perforated intervals of wells listed in the California Department of Public Health (CDPH) database. In the Madera-Chowchilla study unit, these wells typically are drilled to depths between 200 and 800 feet, consist of a solid casing from land surface to a depth of about 140 to 400 feet, and are perforated below the solid casing. Water quality in the primary aquifer system may differ from that in the shallower and deeper parts of the aquifer system. The primary aquifer system in the study unit consists of Quaternary-age alluvial-fan and fluvial deposits that were formed by the rivers draining the Sierra Nevada. Sediments consist of gravels, sands

  13. Effects of Choto-san and Chotoko on thiopental-induced sleeping time

    OpenAIRE

    JEENAPONGSA, Rattima; Tohda, Michihisa; Watanabe, Hiroshi

    2003-01-01

    Choto-san has been used for treatment of centrally regulated disorders such as dementia, hypertension, headache and vertigo. Our laboratory showed that Choto-san improved learning memory in ischemic mice. It is noticeable that Choto-san treated animals and animals that underwent conducting occlusion of common carotid arteries (2VO) operation slept longer than the normal animals. Therefore, this study aimed to clarify the effects of Choto-san and its related component; Chotoko and Choto-san wi...

  14. Clinical Epidemiology Unit - overview of research areas

    Science.gov (United States)

    Clinical Epidemiology Unit (CEU) conducts etiologic research with potential clinical and public health applications, and leads studies evaluating population-based early detection and cancer prevention strategies

  15. Prevention: Exercise

    Medline Plus

    Full Text Available ... Tips for a Healthy Back Smoking Weight Patient Safety Exercise Strengthening Strengthen Your Core! Stretching/Flexibility Aerobic ... Strength Training for the Elderly Other Back Pack Safety Pregnancy and Back Pain Preventing Osteoporosis Back Pain ...

  16. Preventing Rejection

    Science.gov (United States)

    ... After the transplant Preventing rejection Post-transplant medications Types of immunosuppressants Switching immunosuppressants Side effects Other medications Generic and brand name drugs Post-transplant tests Infections and immunity Lifestyle changes Health concerns Back to work or ...

  17. Prevent Cyberbullying

    Science.gov (United States)

    ... Tips for Teachers Report Cyberbullying Print Share Prevent Cyberbullying Be Aware of What Your Kids are Doing ... Signs a Child is Being Cyberbullied or is Cyberbullying Others Many of the warning signs that cyberbullying ...

  18. Preventing Suicide

    Science.gov (United States)

    ... protective factors listed below: Skills in problem solving, conflict resolution, and nonviolent ways of handling disputes Effective ... 2017 Page last updated: August 9, 2017 Content source: National Center for Injury Prevention and Control, Division ...

  19. Prevention: Exercise

    Medline Plus

    Full Text Available ... A SPECIALIST Prevention Strengthening Exercise Committee Exercise Committee Core Strengthening Many popular forms of exercise focus on ... acute pain, you should stop doing it. Transverse Core Strengthening This strengthens the muscles that cross from ...

  20. Prevention: Exercise

    Medline Plus

    Full Text Available ... Training for the Elderly Other Back Pack Safety Pregnancy and Back Pain Preventing Osteoporosis Back Pain Basics ... increases your back pain after five repetitions, or causes acute pain, you should stop doing it. Transverse ...