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Sample records for prevention unit san

  1. 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.

  2. 75 FR 15611 - Safety Zone; United Portuguese SES Centennial Festa, San Diego Bay, San Diego, CA

    Science.gov (United States)

    2010-03-30

    ... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA00 Safety Zone; United Portuguese SES Centennial Festa, San... United Portuguese SES Centennial Festa. This temporary safety zone is necessary to provide for the safety... Spectaculars is sponsoring the United Portuguese SES Centennial Festa, which will include a fireworks...

  3. 78 FR 6740 - Revisions to the California State Implementation Plan, San Joaquin Valley United Air Pollution...

    Science.gov (United States)

    2013-01-31

    ... the California State Implementation Plan, San Joaquin Valley United Air Pollution Control District... revisions to the San Joaquin Valley United Air Pollution Control District (SJVUAPCD) portion of the... CFR Part 52 Environmental protection, Air pollution control, Incorporation by reference...

  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... for the Otay River floodplain. Prior to implementation of the restoration project, the California...

  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... restoration project represents step-down restoration planning for the western portion of the Otay River... potential additional benefits of restoration or partial restoration of salt ponds as part of the Otay River...

  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. Status of groundwater quality in the San Fernando--San Gabriel study unit, 2005--California GAMA Priority Basin Project

    Science.gov (United States)

    Land, Michael; Kulongoski, Justin T.; Belitz, Kenneth

    2012-01-01

    Groundwater quality in the approximately 460-square-mile San Fernando--San Gabriel (FG) study unit was investigated as part of the Priority Basin Project of the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The study area is in Los Angeles County and includes Tertiary-Quaternary sedimentary basins situated within the Transverse Ranges of southern California. The GAMA Priority Basin Project is being conducted by the California State Water Resources Control Board in collaboration with the U.S. Geological Survey (USGS) and the Lawrence Livermore National Laboratory. The GAMA FG study was designed to provide a spatially unbiased assessment of the quality of untreated (raw) groundwater in the primary aquifer systems (hereinafter referred to as primary aquifers) throughout California. The assessment is based on water-quality and ancillary data collected in 2005 by the USGS from 35 wells and on water-quality data from the California Department of Public Health (CDPH) database. The primary aquifers were defined by the depth interval of the wells listed in the CDPH database for the FG study unit. The quality of groundwater in primary aquifers may be different from that in the shallower or deeper water-bearing zones; shallow groundwater may be more vulnerable to surficial contamination. This study assesses the status of the current quality of the groundwater resource by using data from samples analyzed for volatile organic compounds (VOCs), pesticides, and naturally occurring inorganic constituents, such as major ions and trace elements. This status assessment is intended to characterize the quality of groundwater resources in the primary aquifers of the FG study unit, not the treated drinking water delivered to consumers by water purveyors.

  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. 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.

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

    African Journals Online (AJOL)

    African Journal on Conflict Resolution ... The United Nations Organisation (UN) is best endowed to conduct preventive diplomacy (PD) by preventing disputes and conflicts arising from interstate and ... The UN has the means to prevent such conflicts and disputes from emerging and escalating into armed confrontation.

  15. Association between diabetes mellitus and tuberculosis in United States-born and foreign-born populations in San Francisco.

    Directory of Open Access Journals (Sweden)

    Gompol Suwanpimolkul

    Full Text Available The impact of diabetes on tuberculosis in United States and foreign-born populations in San Francisco has not been studied.To determine the characteristics, prevalence and temporal trends of diabetes in US and foreign-born persons attending the San Francisco Tuberculosis Clinic.We analyzed data from individuals seeking medical attention at the San Francisco Tuberculosis Clinic. We included patients with diagnosis of tuberculosis, latent infection, or not infected with Mycobacterium tuberculosis. We assessed the temporal trend and the characteristics of individuals with and without diabetes.Between 2005 and 2012, there were 4371 (19.0% individuals without evidence of tuberculosis infection, 17,856 (77.6% with latent tuberculosis, and 791 (3.4% with tuberculosis. 66% were born in the United States, China, Mexico, and the Philippines. The prevalence of diabetes was the highest among individuals with tuberculosis and increased during the study period. Patients with tuberculosis and diabetes were more likely to be male, older than 45 years and born in the Philippines. There was a disproportionate association of TB and DM relative to LTBI and DM among Filipinos in individuals older than 45 years old.Our data suggest that Filipinos older than 45 years old are more likely to have tuberculosis probably due to a higher prevalence of diabetes. In San Francisco, tuberculosis-screening programs in individuals with diabetes and latent tuberculosis may be beneficial in patients older than 45 years old especially from the Philippines.

  16. Association between diabetes mellitus and tuberculosis in United States-born and foreign-born populations in San Francisco.

    Science.gov (United States)

    Suwanpimolkul, Gompol; Grinsdale, Jennifer A; Jarlsberg, Leah G; Higashi, Julie; Osmond, Dennis H; Hopewell, Philip C; Kato-Maeda, Midori

    2014-01-01

    The impact of diabetes on tuberculosis in United States and foreign-born populations in San Francisco has not been studied. To determine the characteristics, prevalence and temporal trends of diabetes in US and foreign-born persons attending the San Francisco Tuberculosis Clinic. We analyzed data from individuals seeking medical attention at the San Francisco Tuberculosis Clinic. We included patients with diagnosis of tuberculosis, latent infection, or not infected with Mycobacterium tuberculosis. We assessed the temporal trend and the characteristics of individuals with and without diabetes. Between 2005 and 2012, there were 4371 (19.0%) individuals without evidence of tuberculosis infection, 17,856 (77.6%) with latent tuberculosis, and 791 (3.4%) with tuberculosis. 66% were born in the United States, China, Mexico, and the Philippines. The prevalence of diabetes was the highest among individuals with tuberculosis and increased during the study period. Patients with tuberculosis and diabetes were more likely to be male, older than 45 years and born in the Philippines. There was a disproportionate association of TB and DM relative to LTBI and DM among Filipinos in individuals older than 45 years old. Our data suggest that Filipinos older than 45 years old are more likely to have tuberculosis probably due to a higher prevalence of diabetes. In San Francisco, tuberculosis-screening programs in individuals with diabetes and latent tuberculosis may be beneficial in patients older than 45 years old especially from the Philippines.

  17. 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.

  18. 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 (...

  19. Operational Research to Improve HIV Prevention in the United States

    Science.gov (United States)

    Herbst, Jeffrey H.; Glassman, Marlene; Carey, James W.; Painter, Thomas M.; Gelaude, Deborah J.; Fasula, Amy M.; Raiford, Jerris L.; Freeman, Arin E.; Harshbarger, Camilla; Viall, Abigail H.; Purcell, David W.

    2015-01-01

    The HIV/AIDS epidemic in the United States continues despite several recent noteworthy advances in HIV prevention. Contemporary approaches to HIV prevention involve implementing combinations of biomedical, behavioral, and structural interventions in novel ways to achieve high levels of impact on the epidemic. Methods are needed to develop optimal combinations of approaches for improving efficiency, effectiveness, and scalability. This article argues that operational research offers promise as a valuable tool for addressing these issues. We define operational research relative to domestic HIV prevention, identify and illustrate how operational research can improve HIV prevention, and pose a series of questions to guide future operational research. Operational research can help achieve national HIV prevention goals of reducing new infections, improving access to care and optimization of health outcomes of people living with HIV, and reducing HIV-related health disparities. PMID:22217681

  20. 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.

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

    African Journals Online (AJOL)

    IGAD. Inter-Governmental Authority on Development. MSOEWC Mediation Support Office and Early Warning Capacity. NGOs. Non-Governmental Organisations. ONUB. United Nations Operations in Burundi. PD. Preventive diplomacy. POLISARIO Popular Front for the Liberation of Saguia el-Hamra and Río de Oro. RUF.

  2. 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

  3. [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.

  4. 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.

  5. 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

  6. 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

  7. Gang exposure and pregnancy incidence among female adolescents in San Francisco: evidence for the need to integrate reproductive health with violence prevention efforts.

    Science.gov (United States)

    Minnis, A M; Moore, J G; Doherty, I A; Rodas, C; Auerswald, C; Shiboski, S; Padian, N S

    2008-05-01

    Among a cohort of 237 sexually active females aged 14-19 years recruited from community venues in a predominantly Latino neighborhood in San Francisco, California, the authors examined the relation between gang exposure and pregnancy incidence over 2 years of follow-up between 2001 and 2004. Using discrete-time survival analysis, they investigated whether gang membership by individuals and partners was associated with pregnancy incidence and determined whether partnership characteristics, contraceptive behaviors, and pregnancy intentions mediated the relation between gang membership and pregnancy. Pregnancy incidence was determined by urine-based testing and self-report. Latinas represented 77% of participants, with one in five born outside the United States. One quarter (27.4%) became pregnant over follow-up. Participants' gang membership had no significant effect on pregnancy incidence (hazard ratio = 1.25, 95% confidence interval: 0.54, 3.45); however, having partners who were in gangs was associated with pregnancy (hazard ratio = 1.90, 95% confidence interval: 1.09, 3.32). The male partner's perceived pregnancy intentions and having a partner in detention each mediated the effect of partner's gang membership on pregnancy risk. Increased pregnancy incidence among young women with gang-involved partners highlights the importance of integrating reproductive health prevention into programs for gang-involved youth. In addition, high pregnancy rates indicate a heightened risk for sexually transmitted infections.

  8. 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... workers of International Business Machines (IBM), Software Group Business Unit, Optim Data Studio Tools QA... workers of International Business Machines (IBM), Software Group Business Unit, Quality Assurance Group...

  9. 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......-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....... Pretreatment of earrings with artificial sweat was not performed and the DMG may lead to both false-positive and false-negative results. Conclusions: Nickel exposure from inexpensive earrings is frequent in the United States. A regulatory governmental intervention may be warranted Udgivelsesdato: 2008/6...

  10. 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

    -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...

  11. Prevention of nosocomial infections in neonatal intensive care units.

    Science.gov (United States)

    Manzoni, Paolo; De Luca, Daniele; Stronati, Mauro; Jacqz-Aigrain, Evelyne; Ruffinazzi, Giulia; Luparia, Martina; Tavella, Elena; Boano, Elena; Castagnola, Elio; Mostert, Michael; Farina, Daniele

    2013-02-01

    Neonatal sepsis causes a huge burden of morbidity and mortality and includes bloodstream, urine, cerebrospinal, peritoneal, and lung infections as well as infections starting from burns and wounds, or from any other usually sterile sites. It is associated with cytokine - and biomediator-induced disorders of respiratory, hemodynamic, and metabolic processes. Neonates in the neonatal intensive care unit feature many specific risk factors for bacterial and fungal sepsis. Loss of gut commensals such as Bifidobacteria and Lactobacilli spp., as occurs with prolonged antibiotic treatments, delayed enteral feeding, or nursing in incubators, translates into proliferation of pathogenic microflora and abnormal gut colonization. Prompt diagnosis and effective treatment do not protect septic neonates form the risk of late neurodevelopmental impairment in the survivors. Thus prevention of bacterial and fungal infection is crucial in these settings of unique patients. In this view, improving neonatal management is a key step, and this includes promotion of breast-feeding and hygiene measures, adoption of a cautious central venous catheter policy, enhancement of the enteric microbiota composition with the supplementation of probiotics, and medical stewardship concerning H2 blockers with restriction of their use. Additional measures may include the use of lactoferrin, fluconazole, and nystatin and specific measures to prevent ventilator associated pneumonia. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  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. 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

  14. 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

  15. Age, distribution, and stratigraphic relationship of rock units in the San Joaquin Basin Province, California: Chapter 5 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

    relationships between hydrocarbon source and reservoir rocks, we compiled a database consisting of more than 13,000 well picks and of one-mile resolution seismic grids. Both the well picks and the seismic grids characterize the depths to the top of key stratigraphic units. This database formed the basis of subsequent numerical modeling efforts, including the construction of a three- dimensional geologic model (Hosford Scheirer, this volume, chapter 7) and simulation of the petroleum systems in space and time (Peters, Magoon, Lampe, and others, this volume, chapter 12). To accomplish this modeling, we synthesized the age, geographic distribution, lithology, and petroleum characteristics of hydrocarbon source and reservoir rocks in the basin. The results of that synthesis are presented in this paper in the form of new stratigraphic correlation columns for the northern, central, and southern San Joaquin Valley (fig. 5.1; note that all figures are at the back of this report, following the References Cited). The stratigraphic relationships and ages published here draw heavily on published and unpublished studies of the San Joaquin Basin. The stratigraphy presented in each of the columns necessarily idealizes the subsurface geology over a relatively large area, instead of representing the specific geology at an individual well, oil and gas field, or outcrop. In this paper we present the background rationale for defining the geographic divisions of the basin (inset map, fig. 5.1), the paleontological time scales used for assigning absolute ages to rock units (figs. 5.2 and 5.3), and the supporting maps illustrating the geographic distribution of each rock type included in the stratigraphic column (figs. 5.4 through 5.64).

  16. 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.

  17. The Architecture and Performance Evaluation of iSCSI-Based United Storage Network Merging NAS and SAN

    OpenAIRE

    Xianglin Fu; Changsheng Xie; Ruifang Liu; Shenggang Pan

    2012-01-01

    With the ever increasing volume of data in networks, the traditional storage architecture is greatly challenged; more and more people pay attention to network storage. Currently, the main technology of network storage is represented by NAS (Network Attached Storage) and SAN (Storage Area Network). They are different, but mutually complementary and used under different circumstances; however, both NAS and SAN may be needed in the same company. To reduce the TOC (total of cost), for easier impl...

  18. 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.

  19. 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...

  20. 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…

  1. Geology, ground-water hydrology, geochemistry, and ground-water simulation of the Beaumont and Banning Storage Units, San Gorgonio Pass area, Riverside County, California

    Science.gov (United States)

    Rewis, Diane L.; Christensen, Allen H.; Matti, Jonathan; Hevesi, Joseph A.; Nishikawa, Tracy; Martin, Peter

    2006-01-01

    Ground water has been the only source of potable water supply for residential, industrial, and agricultural users in the Beaumont and Banning storage units of the San Gorgonio Pass area, Riverside County, California. Ground-water levels in the Beaumont area have declined as much as 100 feet between the early 1920s and early 2000s, and numerous natural springs have stopped flowing. In 1961, the San Gorgonio Pass Water Agency (SGPWA) entered into a contract with the California State Department of Water Resources to receive 17,300 acre-feet per year of water to be delivered by the California State Water Project (SWP) to supplement natural recharge. Currently (2005), a pipeline is delivering SWP water into the area, and the SGPWA is artificially recharging the ground-water system using recharge ponds located along Little San Gorgonio Creek in Cherry Valley with the SWP water. In addition to artificial recharge, SGPWA is considering the direct delivery of SWP water for the irrigation of local golf courses and for agricultural supply in lieu of ground-water pumpage. To better understand the potential hydrologic effects of different water-management alternatives on ground-water levels and movement in the Beaumont and Banning storage units, existing geohydrologic and geochemical data were compiled, new data from a basin-wide ground-water level and water-quality monitoring network were collected, monitoring wells were installed near the Little San Gorgonio Creek recharge ponds, geohydrologic and geochemical analyses were completed, and a ground-water flow simulation model was developed. The San Gorgonio Pass area was divided into several storage units on the basis of mapped or inferred faults. This study addresses primarily the Beaumont and Banning storage units. The geologic units in the study area were generalized into crystalline basement rocks and sedimentary deposits. The younger sedimentary deposits and the surficial deposits are the main water-bearing deposits in 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. 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.

  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. 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.

  6. 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)

  7. 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

    DEPARTMENT OF THE AIR FORCE 59TH MEDICAL WING (AETC) LACKLAND AIR FORCE BASE TEXAS MEMORANDUMFORSGVT ATTN: DEBRA M NIEMEYER FROM: 59 MDW/SGVU... Dato of Mooting) 181 PLATFORM PRESENTATION (At c ivilian lnstitulionsfNamo of Meeting, State, Dato of Mooting) University of Texas at San Antonio...SAMHS & Universities Research Forum {SURF2016). TX, 05-20-2016 D OTHER (Describe: Name of Mooting, City, State, and Dato of Meeting) 6. WHAT IS THE

  8. 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)

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

    2015-01-01

    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 (MSM) 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. PMID:25835463

  9. Prevention of acute kidney injury and protection of renal function in the intensive care unit

    NARCIS (Netherlands)

    Joannidis, Michael; Druml, Wilfred; Forni, Lui G.; Groeneveld, A. B. Johan; Honore, Patrick; Oudemans-van Straaten, Heleen M.; Ronco, Claudio; Schetz, Marie R. C.; Woittiez, Arend Jan

    Acute renal failure on the intensive care unit is associated with significant mortality and morbidity. To determine recommendations for the prevention of acute kidney injury (AKI), focusing on the role of potential preventative maneuvers including volume expansion, diuretics, use of inotropes,

  10. Insights from a national survey into why substance abuse treatment units add prevention and outreach services

    Directory of Open Access Journals (Sweden)

    Lemak Christy

    2006-08-01

    Full Text Available Abstract Background Previous studies have found that even limited prevention-related interventions can affect health behaviors such as substance use and risky sex. Substance abuse treatment providers are ideal candidates to provide these services, but typically have little or no financial incentive to do so. The purpose of this study was therefore to explore why some substance abuse treatment units have added new prevention and outreach services. Based on an ecological framework of organizational strategy, three categories of predictors were tested: (1 environmental, (2 unit-level, and (3 unit leadership. Results A lagged cross-sectional logistic model of 450 outpatient substance abuse treatment units revealed that local per capita income, mental health center affiliation, and clinical supervisors' graduate degrees were positively associated with likelihood of adding prevention-related education and outreach services. Managed care contracts and methadone treatment were negatively associated with addition of these services. No hospital-affiliated agencies added prevention and outreach services during the study period. Conclusion Findings supported the study's ecological perspective on organizational strategy, with factors at environmental, unit, and unit leadership levels associated with additions of prevention and outreach services. Among the significant predictors, ties to managed care payers and unit leadership graduate education emerge as potential leverage points for public policy. In the current sample, units with managed care contracts were less likely to add prevention and outreach services. This is not surprising, given managed care's emphasis on cost control. However, the association with this payment source suggests that public managed care programs might affects prevention and outreach differently through revised incentives. Specifically, government payers could explicitly compensate substance abuse treatment units in managed care

  11. 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…

  12. 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

  13. Communication and Community in a City Under Siege: The AIDS Epidemic in San Francisco.

    Science.gov (United States)

    Rogers, Everett M.; And Others

    1995-01-01

    Discusses communication and social construction, AIDS and San Francisco, San Francisco's gay community, and the social construction of AIDS in San Francisco. Describes three eras of HIV-AIDS prevention in San Francisco, a particular HIV prevention program, and the impact of the epidemic in San Francisco. (SR)

  14. Community Mitigation Guidelines to Prevent Pandemic Influenza - United States, 2017.

    Science.gov (United States)

    Qualls, Noreen; Levitt, Alexandra; Kanade, Neha; Wright-Jegede, Narue; Dopson, Stephanie; Biggerstaff, Matthew; Reed, Carrie; Uzicanin, Amra

    2017-04-21

    When a novel influenza A virus with pandemic potential emerges, nonpharmaceutical interventions (NPIs) often are the most readily available interventions to help slow transmission of the virus in communities, which is especially important before a pandemic vaccine becomes widely available. NPIs, also known as community mitigation measures, are actions that persons and communities can take to help slow the spread of respiratory virus infections, including seasonal and pandemic influenza viruses.These guidelines replace the 2007 Interim Pre-pandemic Planning Guidance: Community Strategy for Pandemic Influenza Mitigation in the United States - Early, Targeted, Layered Use of Nonpharmaceutical Interventions (https://stacks.cdc.gov/view/cdc/11425). Several elements remain unchanged from the 2007 guidance, which described recommended NPIs and the supporting rationale and key concepts for the use of these interventions during influenza pandemics. NPIs can be phased in, or layered, on the basis of pandemic severity and local transmission patterns over time. Categories of NPIs include personal protective measures for everyday use (e.g., voluntary home isolation of ill persons, respiratory etiquette, and hand hygiene); personal protective measures reserved for influenza pandemics (e.g., voluntary home quarantine of exposed household members and use of face masks in community settings when ill); community measures aimed at increasing social distancing (e.g., school closures and dismissals, social distancing in workplaces, and postponing or cancelling mass gatherings); and environmental measures (e.g., routine cleaning of frequently touched surfaces).Several new elements have been incorporated into the 2017 guidelines. First, to support updated recommendations on the use of NPIs, the latest scientific evidence available since the influenza A (H1N1)pdm09 pandemic has been added. Second, a summary of lessons learned from the 2009 H1N1 pandemic response is presented to underscore

  15. Infection Prevention Practices in Japan, Thailand, and the United States: Results From National Surveys.

    Science.gov (United States)

    Krein, Sarah L; Greene, M Todd; Apisarnthanarak, Anucha; Sakamoto, Fumie; Tokuda, Yasuharu; Sakihama, Tomoko; Fowler, Karen E; Ratz, David; Saint, Sanjay

    2017-05-15

    Numerous evidence-based practices for preventing device-associated infections are available, yet the extent to which these practices are regularly used in acute care hospitals across different countries has not been compared, to our knowledge. Data from hospital surveys conducted in Japan, the United States, and Thailand in 2012, 2013, and 2014, respectively, were evaluated to determine the use of recommended practices to prevent central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP), and catheter-associated urinary tract infection (CAUTI). The outcomes were the percentage of hospitals reporting regular use (a score of 4 or 5 on a scale from 1 [never use] to 5 [always use]) of each practice across countries and identified hospital characteristics associated with the use of selected practices in each country. Survey response rates were 71% in Japan and the United States and 87% in Thailand. A majority of hospitals in Japan (76.6%), Thailand (63.2%), and the United States (97.8%) used maximum barrier precautions for preventing CLABSI and semirecumbent positioning to prevent VAP (66.2% for Japan, 86.7% for Thailand, and 98.7% for the United States). Nearly all hospitals (>90%) in Thailand and the United States reported monitoring CLABSI, VAP, and CAUTI rates, whereas in Japan only CLABSI rates were monitored by a majority of hospitals. Regular use of CAUTI prevention practices was variable across the 3 countries, with only a few practices adopted by >50% of hospitals. A majority of hospitals in Japan, Thailand, and the United States have adopted certain practices to prevent CLABSI and VAP. Opportunities for targeting prevention activities and reducing device-associated infection risk in hospitals exist across all 3 countries. Published by Oxford University Press for the Infectious Diseases Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  16. 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.

  17. 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.

  18. 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

  19. Petrographic report on samples from units 4 and 5 salt, lower San Andres formation, J. Friemel No. 1 well, Deaf Smith County, Palo Duro Basin, Texas

    International Nuclear Information System (INIS)

    Fukui, L.M.; Hopping, R.B.

    1985-01-01

    This report presents the results of mineralogic and petrographic analyses performed on samples of salt-bearing rock from a potential repository site in the Palo Duro Basin, Texas. The samples are from Permian Units 4 and 5 salt, Lower San Andres Formation, J. Friemel No. 1 well, Deaf Smith County, Texas. The mineralogic and petrographic data were obtained from polished thin sections cut parallel to the axis of the core for each sample. The polished thin sections were examined in order to determine the abundances of soluble (halite) and insoluble components (anhydrite, clay, carbonate, quartz, gypsum, etc.). The information reported here includes mineral associations (detrital, authigenic, cement, alteration, etc.), texture, grain size, and sedimentary fabrics. The report also includes representative photomicrographs with superimposed bar scales. Photomicrographs of polished thin sections have the up-core direction designated. X-ray diffraction was also used for identification of soluble and insoluble minerals. 7 refs., 2 tabs

  20. 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.

  1. 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.

  2. 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.

  3. 8 CFR 1215.2 - Authority of departure-control officer to prevent alien's departure from the United States.

    Science.gov (United States)

    2010-01-01

    ... comes within the provisions of § 1215.3 shall temporarily prevent the departure of such alien from the... prevent alien's departure from the United States. 1215.2 Section 1215.2 Aliens and Nationality EXECUTIVE... FROM THE UNITED STATES § 1215.2 Authority of departure-control officer to prevent alien's departure...

  4. 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.

  5. 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...

  6. Recommendations for using fluoride to prevent and control dental caries in the United States. Centers for Disease Control and Prevention.

    Science.gov (United States)

    2001-08-17

    Widespread use of fluoride has been a major factor in the decline in the prevalence and severity of dental caries (i.e., tooth decay) in the United States and other economically developed countries. When used appropriately, fluoride is both safe and effective in preventing and controlling dental caries. All U.S. residents are likely exposed to some degree to fluoride, which is available from multiple sources. Both health-care professionals and the public have sought guidance on selecting the best way to provide and receive fluoride. During the late 1990s, CDC convened a work group to develop recommendations for using fluoride to prevent and control dental caries in the United States. This report includes these recommendations, as well as a) critical analysis of the scientific evidence regarding the efficacy and effectiveness of fluoride modalities in preventing and controlling dental caries, b) ordinal grading of the quality of the evidence, and c) assessment of the strength of each recommendation. Because frequent exposure to small amounts of fluoride each day will best reduce the risk for dental caries in all age groups, the work group recommends that all persons drink water with an optimal fluoride concentration and brush their teeth twice daily with fluoride toothpaste. For persons at high risk for dental caries, additional fluoride measures might be needed. Measured use of fluoride modalities is particularly appropriate during the time of anterior tooth enamel development (i.e., age <6 years). The recommendations in this report guide dental and other health-care providers, public health officials, policy makers, and the public in the use of fluoride to achieve maximum protection against dental caries while using resources efficiently and reducing the likelihood of enamel fluorosis. The recommendations address public health and professional practice, self-care, consumer product industries and health agencies, and further research. Adoption of these

  7. 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...

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. The generative nature of the measurement unit in the medieval creative process. The design of San Francesco convent in Arezzo

    Directory of Open Access Journals (Sweden)

    Stefano Giannetti

    2015-07-01

    Full Text Available Comparing a 13th century parchment and a survey of the corresponding finished building offers a rare chance to investigate medieval construction and creative processes, as well as the way the design is translated into a building. A journey was taken back in time from the object to the design, and from the design to the project aims, based on an analysis of the unit of measurement. This reverse process revealed that the unit of measurement takes on two different values during the creative process: an absolute value when translating the drawing into a building, and a proportional value in the formation of geometric relationships within the drawing. Since, on the basis of this analysis, it can be concluded that two different units of measurement produce two different buildings, it is clear that measurement, as well as guaranteeing coherence within the creative process of architecture, is also one of the main sources of the rules that forge architecture.

  13. 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.

  14. Prevention of pressure ulcers: a descriptive study in 3 intensive care units in Turkey.

    Science.gov (United States)

    Ozdemir, Hafize; Karadag, Ayise

    2008-01-01

    The aim of this descriptive study was to describe the level of preventive care provided to intensive care unit (ICU) patients at risk for development of pressure ulcers (PU). Our study population comprised 126 nurses working at coronary ICU, cardiovascular surgery ICU, or a gastroenterology ICU of State Hospital in the Republic of Turkey. The study sample consisted of 30 nurses selected from these units using a layered sampling method. Data were collected using the following 4 forms: (1) ICU evaluation form, (2) demographic questionnaire form, (3) Braden Scale, and (4) observation form. The observation form was developed by the investigator to record PU prevention interventions made by the study nurses. Nurses were observed while giving care to patients at risk according to Braden Scale scores and each action of the nurses to prevent PU was recorded. Data were collected until 90 observations (3 observations with each of 30 nurses) were completed. Nurses did not consistently engage in interventions recommended for prevention of PU. Subjects did not consistently use the risk-evaluation scale, document position changes on the appropriate form, and train auxiliary personnel about PU prevention. The most frequently fulfilled behaviors for PU prevention were avoiding hot water when cleansing the skin, helping the patient eat, avoiding placing the patient directly on a trochanter, refraining from using improper support material, and use of pressure-redistribution surfaces. The least fulfilled behaviors were (1) application of a skin barrier or protectant on moist skin and (2) application of a moisturizer to dry or compromised skin, protecting the skin during patient transfer, repositioning, and documenting prevention interventions. This study demonstrates that critical care nurses do not consistently provide preventive care for PU.

  15. 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

  16. 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.

  17. 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)

  18. 22 CFR 46.4 - Procedure in case of alien prevented from departing from the United States.

    Science.gov (United States)

    2010-04-01

    ... ALIENS DEPARTING FROM THE UNITED STATES § 46.4 Procedure in case of alien prevented from departing from the United States. (a) Any alien, other than an enemy alien, whose departure has been temporarily prevented under the provisions of § 46.2 may, within 15 days of the service upon him of the written order...

  19. 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

  20. Nursing interventions to prevent pressure ulcers in intensive care units : systematic review

    OpenAIRE

    Lage, Isabel; Novais, Rui Manuel Freitas; Magalhães, Maria Manuela Almendra; Vilaça, Simão; Araújo, Odete

    2014-01-01

    Publicada na "Revista Saúde Pública", vol. 48, nr. spec. (May 2014) ; ISSN 0034-8910 , ISSN 1518-8787 (online) Introduction: It is estimated that Pressure Ulcer (PU) ranges from 0.4% to 38% in acute care worldwide, causing high costs in treatments, delaying functional recovery and deferring discharge hospital. Objective: To identify and synthesize primary studies which comprehend interventions focused on prevention of PU in critical care units. Methods: A systematic review follow...

  1. [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.

  2. 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.

  3. 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.

  4. 22 CFR 46.2 - Authority of departure-control officer to prevent alien's departure from the United States.

    Science.gov (United States)

    2010-04-01

    ... the case of an alien in the United States comes within the provisions of § 46.3 shall temporarily... prevent alien's departure from the United States. 46.2 Section 46.2 Foreign Relations DEPARTMENT OF STATE VISAS CONTROL OF ALIENS DEPARTING FROM THE UNITED STATES § 46.2 Authority of departure-control officer...

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

    Science.gov (United States)

    2010-01-01

    ... departing from the United States. 1215.4 Section 1215.4 Aliens and Nationality EXECUTIVE OFFICE FOR IMMIGRATION REVIEW, DEPARTMENT OF JUSTICE IMMIGRATION REGULATIONS CONTROLS OF ALIENS DEPARTING FROM THE UNITED STATES § 1215.4 Procedure in case of alien prevented from departing from the United States. (a) Any alien...

  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. History of Meningococcal Outbreaks in the United States: Implications for Vaccination and Disease Prevention.

    Science.gov (United States)

    Atkinson, Bruce; Gandhi, Ashesh; Balmer, Paul

    2016-08-01

    Invasive meningococcal disease caused by Neisseria meningitidis presents a significant public health concern. Meningococcal disease is rare but potentially fatal within 24 hours of onset of illness, and survivors may experience permanent sequelae. This review presents the epidemiology, incidence, and outbreak data for invasive meningococcal disease in the United States since 1970, and it highlights recent changes in vaccine recommendations to prevent meningococcal disease. Relevant publications were obtained by database searches for articles published between January 1970 and July 2015. The incidence of meningococcal disease has decreased in the United States since 1970, but serogroup B meningococcal disease is responsible for an increasing proportion of disease burden in young adults. Recent serogroup B outbreaks on college campuses warrant broader age-based recommendations for meningococcal group B vaccines, similar to the currently recommended quadrivalent vaccine that protects against serogroups A, C, W, and Y. After the recent approval of two serogroup B vaccines, the Advisory Committee on Immunization Practices first updated its recommendations for routine meningococcal vaccination to cover at-risk populations, including those at risk during serogroup B outbreaks, and later it issued a recommendation for those aged 16-23 years. Meningococcal disease outbreaks remain challenging to predict, making the optimal disease management strategy one of prevention through vaccination rather than containment. How the epidemiology of serogroup B disease and prevention of outbreaks will be affected by the new category B recommendation for serogroup B vaccines remains to be seen. © 2016 Pharmacotherapy Publications, Inc.

  8. 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.

  9. Pressure ulcer prevention in the intensive care unit: a case study.

    Science.gov (United States)

    Flike, Kimberlee

    2013-01-01

    Pressure ulcers are a growing problem in health care, particularly in the intensive care unit where patients are often unstable and skin care can be overshadowed by airway, breathing, and circulation. In an effort to acknowledge this growing problem, a pressure ulcer protocol based on the subscales of the Braden Scale was developed for the intensive care population. The tool highlights specific interventions for each of its 6 subscales and provides criteria for the application of a preventive sacral dressing. A case study of a suspected deep tissue injury that resulted in a stage III pressure ulcer is used as an example of how this new tool can be applied to assist in the prevention of pressure ulcers.

  10. Will routine annual influenza prevention and control systems serve the United States well in a pandemic?

    Science.gov (United States)

    Ringel, Jeanne S; Moore, Melinda; Zambrano, John; Lurie, Nicole

    2009-12-01

    To assess the extent to which the systems in place for prevention and control of routine annual influenza could provide the information and experience needed to manage a pandemic. The authors conducted a qualitative assessment based on key informant interviews and the review of relevant documents. Although there are a number of systems in place that would likely serve the United States well in a pandemic, much of the information and experience needed to manage a pandemic optimally is not available. Systems in place for routine annual influenza prevention and control are necessary but not sufficient for managing a pandemic, nor are they used to their full potential for pandemic preparedness. Pandemic preparedness can be strengthened by building more explicitly upon routine influenza activities and the public health system's response to the unique challenges that arise each influenza season (eg, vaccine supply issues, higher than normal rates of influenza-related deaths).

  11. Resurgence of Vaccine-Preventable Diseases in the United States: Anesthetic and Critical Care Implications.

    Science.gov (United States)

    Porteous, Grete H; Hanson, Neil A; Sueda, Lila Ann A; Hoaglan, Carli D; Dahl, Aaron B; Ohlson, Brooks B; Schmidt, Brian E; Wang, Chia C; Fagley, R Eliot

    2016-05-01

    Vaccine-preventable diseases (VPDs) such as measles and pertussis are becoming more common in the United States. This disturbing trend is driven by several factors, including the antivaccination movement, waning efficacy of certain vaccines, pathogen adaptation, and travel of individuals to and from areas where disease is endemic. The anesthesia-related manifestations of many VPDs involve airway complications, cardiovascular and respiratory compromise, and unusual neurologic and neuromuscular symptoms. In this article, we will review the presentation and management of 9 VPDs most relevant to anesthesiologists, intensivists, and other hospital-based clinicians: measles, mumps, rubella, pertussis, diphtheria, influenza, meningococcal disease, varicella, and poliomyelitis. Because many of the pathogens causing these diseases are spread by respiratory droplets and aerosols, appropriate transmission precautions, personal protective equipment, and immunizations necessary to protect clinicians and prevent nosocomial outbreaks are described.

  12. 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

  13. Prevention of Firearm Suicide in the United States: What Works and What Is Possible.

    Science.gov (United States)

    Mann, J John; Michel, Christina A

    2016-10-01

    About 21,000 suicides in the United States in 2014 involved a firearm. The authors reviewed evidence from around the world regarding the relationship between firearm ownership rates and firearm suicide rates and the potential effectiveness of policy-based strategies for preventing firearm suicides in the United States. Relevant publications were identified by searches of PubMed, PsycINFO, MEDLINE, and Google Scholar from 1980 to September 2015, using the search terms suicide AND firearms OR guns. Excluding duplicates, 1,687 results were found, 60 of which were selected for inclusion; these sources yielded an additional 10 studies, for a total of 70 studies. Case-control and ecological studies investigating geographic and temporal variations in firearm ownership and firearm suicide rates indicate that greater firearm availability is associated with higher firearm suicide rates. Time-series analyses, mostly from other countries, show that legislation reducing firearm ownership lowers firearm suicide rates. Because the Second Amendment curtails legislation broadly restricting firearm access in the United States, the emphasis is shifted to restricting access for those at risk of harming themselves or others. Most suicides involve guns purchased years earlier. Targeted initiatives like gun violence restraining orders, smart gun technology, and gun safety education campaigns potentially reduce access to already purchased firearms by suicidal individuals. Such measures are too new to have evidence of effectiveness. Broadly reducing availability and access to firearms has lowered firearm suicide rates in other countries but does not appear feasible in the United States. Approaches restricting access of at-risk individuals to already purchased firearms by engaging the public and major stakeholders require urgent implementation and outcome evaluation for firearm suicide prevention.

  14. Evaluating Infection Prevention Strategies in Out-Patient Dialysis Units Using Agent-Based Modeling.

    Directory of Open Access Journals (Sweden)

    Joanna R Wares

    Full Text Available Patients receiving chronic hemodialysis (CHD are among the most vulnerable to infections caused by multidrug-resistant organisms (MDRO, which are associated with high rates of morbidity and mortality. Current guidelines to reduce transmission of MDRO in the out-patient dialysis unit are targeted at patients considered to be high-risk for transmitting these organisms: those with infected skin wounds not contained by a dressing, or those with fecal incontinence or uncontrolled diarrhea. Here, we hypothesize that targeting patients receiving antimicrobial treatment would more effectively reduce transmission and acquisition of MDRO. We also hypothesize that environmental contamination plays a role in the dissemination of MDRO in the dialysis unit. To address our hypotheses, we built an agent-based model to simulate different treatment strategies in a dialysis unit. Our results suggest that reducing antimicrobial treatment, either by reducing the number of patients receiving treatment or by reducing the duration of the treatment, markedly reduces overall colonization rates and also the levels of environmental contamination in the dialysis unit. Our results also suggest that improving the environmental decontamination efficacy between patient dialysis treatments is an effective method for reducing colonization and contamination rates. These findings have important implications for the development and implementation of future infection prevention strategies.

  15. 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.

  16. High Rates of Tuberculosis and Opportunities for Prevention among International Students in the United States.

    Science.gov (United States)

    Collins, Jeffrey M; Reves, Randall R; Belknap, Robert W

    2016-04-01

    Foreign-born persons traveling on a student visa are not currently screened for tuberculosis on entry into the United States, despite residing in the United States for up to several years. To characterize the risk of tuberculosis in international students entering the United States and to identify strategies for early diagnosis and prevention in this population. Data were collected in 18 tuberculosis control jurisdictions in the United States. A cohort of 1,268 foreign-born patients of known visa status, diagnosed with active tuberculosis between 2004 and 2007, was used for analysis. Incidence rates were estimated on the basis of immigration data from study jurisdictions. Tuberculosis was diagnosed in 46 student residents, providing an annual estimate of 308 cases nationally. The estimated tuberculosis case rate in student residents was 48.1 cases per 100,000 person-years (95% confidence interval, 35.6-64.8), more than twice that of the general foreign-born population. Students identified by tuberculosis screening programs were more likely to be diagnosed within 6 months of U.S. arrival (75 vs. 6%; P < 0.001), and those with pulmonary disease were less likely to have a positive sputum smear for acid-fast bacilli compared with those not screened (18 vs. 63%; P = 0.05). In unscreened students, 71% were diagnosed more than 1 year after U.S. arrival and only 6% were previously treated for latent tuberculosis infection. The tuberculosis case rate in foreign-born students is significantly higher than in other foreign-born individuals. Screening this group after arrival to the United States is an effective strategy for earlier diagnosis of active tuberculosis.

  17. 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......, half of the studies were successful and had an effect on either overweight or obesity. Much more research is needed in order to effectively prevent paediatric obesity....

  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. Early Identification and Prevention of the Spread of Ebola - United States.

    Science.gov (United States)

    Van Beneden, Chris A; Pietz, Harald; Kirkcaldy, Robert D; Koonin, Lisa M; Uyeki, Timothy M; Oster, Alexandra M; Levy, Deborah A; Glover, Maleeka; Arduino, Matthew J; Merlin, Toby L; Kuhar, David T; Kosmos, Christine; Bell, Beth P

    2016-07-08

    In response to the 2014-2016 Ebola virus disease (Ebola) epidemic in West Africa, CDC prepared for the potential introduction of Ebola into the United States. The immediate goals were to rapidly identify and isolate any cases of Ebola, prevent transmission, and promote timely treatment of affected patients. CDC's technical expertise and the collaboration of multiple partners in state, local, and municipal public health departments; health care facilities; emergency medical services; and U.S. government agencies were essential to the domestic preparedness and response to the Ebola epidemic and relied on longstanding partnerships. CDC established a comprehensive response that included two new strategies: 1) active monitoring of travelers arriving from countries affected by Ebola and other persons at risk for Ebola and 2) a tiered system of hospital facility preparedness that enabled prioritization of training. CDC rapidly deployed a diagnostic assay for Ebola virus (EBOV) to public health laboratories. Guidance was developed to assist in evaluation of patients possibly infected with EBOV, for appropriate infection control, to support emergency responders, and for handling of infectious waste. CDC rapid response teams were formed to provide assistance within 24 hours to a health care facility managing a patient with Ebola. As a result of the collaborations to rapidly identify, isolate, and manage Ebola patients and the extensive preparations to prevent spread of EBOV, the United States is now better prepared to address the next global infectious disease threat.The activities summarized in this report would not have been possible without collaboration with many U.S. and international partners (http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/partners.html).

  20. 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

  1. Awareness among adults of vaccine-preventable diseases and recommended vaccinations, United States, 2015.

    Science.gov (United States)

    Lu, Peng-Jun; O'Halloran, Alissa; Kennedy, Erin D; Williams, Walter W; Kim, David; Fiebelkorn, Amy Parker; Donahue, Sara; Bridges, Carolyn B

    2017-05-25

    Adults are recommended to receive select vaccinations based on their age, underlying medical conditions, lifestyle, and other considerations. Factors associated with awareness of vaccine-preventable diseases and recommended vaccines among adults in the United States have not been explored. Data from a 2015 internet panel survey of a nationally representative sample of U.S. adults aged ≥19years were analyzed to assess awareness of selected vaccine-preventable diseases and recommended vaccines for adults. A multivariable logistic regression model with a predictive marginal approach was used to identify factors independently associated with awareness of selected vaccine-preventable infections/diseases and corresponding vaccines. Among the surveyed population, from 24.6 to 72.1% reported vaccination for recommended vaccines. Awareness of vaccine-preventable diseases among adults aged ≥19years ranged from 63.4% to 94.0% (63.4% reported awareness of HPV, 71.5% reported awareness of tetanus, 72.0% reported awareness of pertussis, 75.4% reported awareness of HZ, 75.8% reported awareness of hepatitis B, 83.1% reported awareness of pneumonia, and 94.0% reported awareness of influenza). Awareness of the corresponding vaccines among adults aged ≥19years ranged from 59.3% to 94.1% (59.3% HZ vaccine, 59.6% HPV vaccine, 64.3% hepatitis B vaccine, 66.2% pneumococcal vaccine, 86.3% tetanus vaccines, and 94.1% influenza vaccine). In multivariable analysis, being female and being a college graduate were significantly associated with a higher level of awareness for majority of vaccine-preventable diseases, and being female, being a college graduate, and working as a health care provider were significantly associated with a higher level of awareness for majority of corresponding vaccines. Although adults in this survey reported high levels of awareness for most vaccines recommended for adults, self-reported vaccination coverage was not optimal. Combining interventions known to

  2. 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

  3. Prevention of child camel jockey injuries: a success story from the United Arab Emirates.

    Science.gov (United States)

    Abu-Zidan, Fikri M; Hefny, Ashraf F; Branicki, Frank

    2012-11-01

    To study the effects of a law banning children from taking part in camel racing on child camel jockey injuries in Al-Ain City, United Arab Emirates. Prospective study. University Teaching Hospital. All patients who were admitted to Al-Ain Hospital and were injured while riding camels were prospectively studied between January 1, 2002, and December 31, 2009. Two periods, before the law and after its introduction, were compared. Pediatric injuries, their anatomical distribution, and severity of injury. Fifty-four patients were studied, and all were males. There were 13 children and 41 adults. All children were camel jockeys except 1 child who was riding a camel for fun. None of the adult camel riders was a camel jockey. The median (range) age of patients admitted before the law was 12.5 (5-45) years, which was significantly less compared with 27.2 (20-40) years after its introduction (P = 0.001, Mann-Whitney test). All 13 children sustained their injuries before the law was implemented, whereas 12 of 41 adults sustained their injuries before the legislation was in place (P law enforcement (P law enforcement in injury prevention, illustrated by the replacement of children by robot substitutes. This is possibly one of the few examples where child injury has been completely prevented by legislation.

  4. 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.

  5. 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.

  6. Healthcare Laundry and Textiles in the United States: Review and Commentary on Contemporary Infection Prevention Issues.

    Science.gov (United States)

    Sehulster, Lynne M

    2015-09-01

    Healthcare professionals have questions about the infection prevention effectiveness of contemporary laundry processes for healthcare textiles (HCTs). Current industrial laundry processes achieve microbial reductions via physical, chemical, and thermal actions, all of which result in producing hygienically clean HCTs. European researchers have demonstrated that oxidative laundry additives have sufficient potency to meet US Environmental Protection Agency benchmarks for sanitizers and disinfectants. Outbreaks of infectious diseases associated with laundered HCTs are extremely rare; only 12 such outbreaks have been reported worldwide in the past 43 years. Root cause analyses have identified inadvertent exposure of clean HCTs to environmental contamination (including but not limited to exposure to dust in storage areas) or a process failure during laundering. To date, patient-to-patient transmission of infection has not been associated with hygienically clean HCTs laundered in accordance with industry process standards. Occupationally acquired infection involved mishandling of soiled HCTs and failure to use personal protective equipment properly. Laboratory studies of antimicrobial treatments for HCTs demonstrate a wide range of activity from 1 to 7 log10 reduction of pathogens under various experimental conditions. Clinical studies are needed to evaluate potential use of these treatments for infection prevention. Microbiological testing of clean HCTs for certification purposes is now available in the United States. Key features (eg, microbial sampling strategy, numbers of textiles sampled) and justification of the testing are discussed.

  7. 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.

  8. 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.

  9. 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.

  10. Invasive pneumococcal disease and the potential for prevention by vaccination in the United Kingdom.

    Science.gov (United States)

    Parsons, H K; Metcalf, S C; Tomlin, K; Read, R C; Dockrell, D H

    2007-05-01

    Invasive pneumococcal disease (IPD) is associated with a high mortality despite antimicrobial therapy, but may be preventable by pneumococcal vaccination. The extent of previous exposure to pneumococcal capsular polysaccharide vaccination prior to an episode of IPD in hospitalised adults in the United Kingdom is unclear. We conducted a retrospective cohort study in adults with IPD admitted to either of two teaching hospitals in Sheffield, United Kingdom during 1992-2000. Receipt of pneumococcal vaccination, risk factors for IPD, death and disability were determined. The number of cases of IPD was 552 and 187/230 patient records from one site were reviewed. According to UK pneumococcal vaccination guidelines 59% of patients should have received the vaccine and 76% of patients if updated guidelines, which include age>65 years as an indication, are applied. In patients with known risk factors, excluding age, only 8% had been vaccinated. The mortality from IPD was 21% and an additional 6% suffered major complications. In patients hospitalised with IPD there is a high rate of pre-existing risk factors and a low rate of administration of pneumococcal vaccination. IPD incurs significant mortality, morbidity and economic cost and there is potential for reducing this by improved uptake of pneumococcal vaccination.

  11. Prevention of unplanned intensive care unit admissions and hospital mortality by early warning systems.

    Science.gov (United States)

    Mapp, Ila D; Davis, Leslie L; Krowchuk, Heidi

    2013-01-01

    Researchers have found that patients exhibit physiological changes up to 8 hours prior to an arrest event. Deaths have been attributed to a lack of observation, lack of documentation of observations, inability of a caregiver to recognize early signs of deterioration, and lack of communication between healthcare providers. This integrative review examines early warning scoring systems and their effectiveness in predicting a patient's potential for deterioration and considers whether these scoring systems prevent unplanned intensive care unit admissions and/or death. Three databases (MEDLINE, CINAHL [Cumulative Index to Nursing and Allied Health Literature], and the Cochrane Collaboration) were searched to identify the instruments and clinical support systems available to assist healthcare personnel in recognizing early clinical deterioration. Key search words included modified early warning score, early warning score, early warning systems, deteriorating patient, patients at risk, shock index, track and trigger systems, and failure to rescue. Two prior literature reviews examined early warning scoring systems and their effects on patient outcomes; however, the most recent one reviewed only articles published before 2007. This review examined studies of early warning systems and the incorporation of clinical support published from 2007 to 2012. Nine studies fitting the search criteria were included in this review. Early warning scoring systems that interface with electronic medical records and are supplemented with decision aides (algorithms) and clinical support systems produce an effective screening system for early identification of deteriorating patients. This multifaceted approach decreases unplanned intensive care unit admissions and hospital mortality.

  12. 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

  13. 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

  14. Prevention

    Science.gov (United States)

    ... Error processing SSI file About Heart Disease & Stroke Prevention Heart disease and stroke are an epidemic in ... secondhand smoke. Barriers to Effective Heart Disease & Stroke Prevention Many people with key risk factors for heart ...

  15. 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.

  16. Effectiveness of pressure ulcer prevention strategies for adult patients in intensive care units: a systematic review protocol.

    Science.gov (United States)

    Tayyib, Nahla; Coyer, Fiona

    2016-03-01

    The objective of this review is to identify the effectiveness of pressure ulcer (PU) prevention strategies on the incidence of hospital-acquired PUs in the intensive care unit (ICU).More specifically, the objectives are to identify the effectiveness of utilizing PU prevention strategies such as risk assessment, skin assessment, skin care, nutrition, position and repositioning, education and training, medical devices care or other strategies designed to manage the risk factors for PU development and reduce the incidence of PUs in ICUs.

  17. 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.

  18. 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.

  19. Association Between Vaccine Refusal and Vaccine-Preventable Diseases in the United States

    Science.gov (United States)

    Phadke, Varun K.; Bednarczyk, Robert A.; Salmon, Daniel A.; Omer, Saad B.

    2016-01-01

    IMPORTANCE Parents hesitant to vaccinate their children may delay routine immunizations or seek exemptions from state vaccine mandates. Recent outbreaks of vaccine-preventable diseases in the United States have drawn attention to this phenomenon. Improved understanding of the association between vaccine refusal and the epidemiology of these diseases is needed. OBJECTIVE To review the published literature to evaluate the association between vaccine delay, refusal, or exemption and the epidemiology of measles and pertussis, 2 vaccine-preventable diseases with recent US outbreaks. EVIDENCE REVIEW Search of PubMed through November 30, 2015, for reports of US measles outbreaks that have occurred since measles was declared eliminated in the United States (after January 1, 2000), endemic and epidemic pertussis since the lowest point in US pertussis incidence (after January 1, 1977), and for studies that assessed disease risk in the context of vaccine delay or exemption. FINDINGS We identified 18 published measles studies (9 annual summaries and 9 outbreak reports), which described 1416 measles cases (individual age range, 2 weeks-84 years; 178 cases younger than 12 months) and more than half (56.8%) had no history of measles vaccination. Of the 970 measles cases with detailed vaccination data, 574 cases were unvaccinated despite being vaccine eligible and 405 (70.6%) of these had nonmedical exemptions (eg, exemptions for religious or philosophical reasons, as opposed to medical contraindications; 41.8%of total). Among 32 reports of pertussis outbreaks, which included 10 609 individuals for whom vaccination status was reported (age range, 10 days-87 years), the 5 largest statewide epidemics had substantial proportions (range, 24%–45%) of unvaccinated or undervaccinated individuals. However, several pertussis outbreaks also occurred in highly vaccinated populations, indicating waning immunity. Nine reports (describing 12 outbreaks) provided detailed vaccination data on

  20. 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.

  1. The effect of topical olive oil on prevention of bedsore in intensive care units patients

    OpenAIRE

    Zahra Abbas Ali Madadi; Reza Zeighami; Jalil Azimian; Amir Javadi

    2015-01-01

    Background: Bedsores are injuries to skin and underlying tissues caused by prolonged pressure. Although, some methods like frequently changing position and using particular tools are used for preventing and caring of pressure ulcers, their prevention would still be as a vital urgency. Olive oil is an herbal product with potential preventive effects to prevent bedsores because of its numerous medical properties. The major aim of this study was to determine whether topical olive oil can prevent...

  2. San Mateo Creek Basin

    Science.gov (United States)

    The San Mateo Creek Basin comprises approximately 321 square miles within the Rio San Jose drainage basin in McKinley and Cibola counties, New Mexico. This basin is located within the Grants Mining District (GMD).

  3. Preventive behaviors adults report using to avoid catching or spreading influenza, United States, 2015-16 influenza season.

    Science.gov (United States)

    Srivastav, Anup; Santibanez, Tammy A; Lu, Peng-Jun; Stringer, M Christopher; Dever, Jill A; Bostwick, Michael; Kurtz, Marshica Stanley; Qualls, Noreen L; Williams, Walter W

    2018-01-01

    Influenza vaccination can prevent influenza and potentially serious influenza-related complications. Although the single best way to prevent influenza is annual vaccination, everyday preventive actions, including good hygiene, health, dietary, and social habits, might help, too. Several preventive measures are recommended, including: avoiding close contact with people who are sick; staying home when sick; covering your mouth and nose when coughing or sneezing; washing your hands often; avoiding touching your eyes, nose, and mouth; and practicing other good health habits like cleaning and disinfecting frequently touched surfaces, getting plenty of sleep, and drinking plenty of fluids. Understanding public acceptance and current usage of these preventive behaviors can be useful for planning both seasonal and pandemic influenza prevention campaigns. This study estimated the percentage of adults in the United States who reported practicing preventive behaviors to avoid catching or spreading influenza, and explored associations of reported behaviors with sociodemographic factors. We analyzed data from 2015 National Internet Flu Survey, a nationally representative probability-based Internet panel survey of the non-institutionalized U.S. population ≥18 years. The self-reported behaviors used to avoid catching or spreading influenza were grouped into four and three non-mutually exclusive subgroups, respectively. Weighted proportions were calculated. Multivariable logistic regression models were used to calculate adjusted prevalence differences and to determine independent associations between sociodemographic characteristics and preventive behavior subgroups. Common preventive behaviors reported were: 83.2% wash hands often, 80.0% cover coughs and sneezes, 78.2% stay home if sick with a respiratory illness, 64.4% avoid people sick with a respiratory illness, 51.7% use hand sanitizers, 50.2% get treatment as soon as possible, and 49.8% report getting the influenza

  4. Towards an integrated primary and secondary HIV prevention continuum for the United States: a cyclical process model.

    Science.gov (United States)

    Horn, Tim; Sherwood, Jennifer; Remien, Robert H; Nash, Denis; Auerbach, Judith D

    2016-01-01

    Every new HIV infection is preventable and every HIV-related death is avoidable. As many jurisdictions around the world endeavour to end HIV as an epidemic, missed HIV prevention and treatment opportunities must be regarded as public health emergencies, and efforts to quickly fill gaps in service provision for all people living with and vulnerable to HIV infection must be prioritized. We present a novel, comprehensive, primary and secondary HIV prevention continuum model for the United States as a conceptual framework to identify key steps in reducing HIV incidence and improving health outcomes among those vulnerable to, as well as those living with, HIV infection. We further discuss potential approaches to address gaps in data required for programme planning, implementation and evaluation across the elements of the HIV prevention continuum. Our model conceptualizes opportunities to monitor and quantify primary HIV prevention efforts and, importantly, illustrates the interplay between an outcomes-oriented primary HIV prevention process and the HIV care continuum to move aggressively forward in reaching ambitious reductions in HIV incidence. To optimize the utility of this outcomes-oriented HIV prevention continuum, a key gap to be addressed includes the creation and increased coordination of data relevant to HIV prevention across sectors.

  5. 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.

  6. 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.

  7. 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

  8. Prevention

    Science.gov (United States)

    ... Contact Aging & Health A to Z Find a Geriatrics Healthcare Professional Medications & Older Adults Making Your Wishes ... Prevention Hearing Loss Heart Attack High Blood Pressure Nutrition Osteoporosis Shingles Skin Cancer Related News Quitting Smoking, ...

  9. 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.

  10. Delirium prevention program in the surgical intensive care unit improved the outcomes of older adults.

    Science.gov (United States)

    Bryczkowski, Sarah B; Lopreiato, Maeve C; Yonclas, Peter P; Sacca, James J; Mosenthal, Anne C

    2014-07-01

    Hospital-acquired delirium is a known risk factor for negative outcomes in patients admitted to the surgical intensive care unit (SICU). Outcomes worsen as the duration of delirium increases. The purpose of this study was to evaluate the efficacy of a delirium prevention program and determine whether it decreased the incidence and duration of hospital-acquired delirium in older adults (age>50 y) admitted to the SICU. A prospective pre- or post-intervention cohort study was done at an academic level I trauma center. Older adults admitted to the SICU were enrolled in a delirium prevention program. Those with traumatic brain injury, dementia, or 0 d of obtainable delirium status were excluded from analysis. The intervention consisted of multidisciplinary education, a pharmacologic protocol to limit medications associated with delirium, and a nonpharmacologic sleep enhancement protocol. Primary outcomes were incidence of delirium and delirium-free days/30. Secondary outcomes were ventilator-free days/30, SICU length of stay (LOS), daily and cumulative doses of opioids (milligram, morphine equivalents) and benzodiazepines (milligram, lorazepam equivalents), and time spent in severe pain (greater than or equal to 6 on a scale of 1-10). Delirium was measured using the Confusion Assessment Method for the ICU. Data were analyzed using Chi-squared and Wilcoxon rank sum analysis. Of 624 patients admitted to the SICU, 123 met inclusion criteria: 57 preintervention (3/12-6/12) and 66 postintervention (7/12-3/13). Cohorts were similar in age, gender, ratio of trauma patients, and Injury Severity Score. Postintervention, older adults experienced delirium at the same incidence (pre 47% versus 58%, P=0.26), but for a significantly decreased duration as indicated by an increase in delirium-free days/30 (pre 24 versus 27, P=0.002). After intervention, older adults with delirium had more vent-free days (pre 21 versus 25, P=0.03), shorter SICU LOS (pre 13 [median 12] versus 7 [median 6

  11. 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

  12. San Francisco urban partnership agreement, national evaluation : transit system data test plan.

    Science.gov (United States)

    2011-06-01

    This report presents the test plan for collecting and analyzing the transit system 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 pro...

  13. San Francisco urban partnership agreement, national evaluation : cost benefit analysis test plan.

    Science.gov (United States)

    2011-06-01

    This report presents the test plan for collecting and analyzing cost and benefit 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 proje...

  14. 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...

  15. San Francisco urban partnership agreement, national evaluation : environmental data test plan.

    Science.gov (United States)

    2011-06-01

    This report presents the test plan for collecting and analyzing environmental 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 projects...

  16. San Francisco urban partnership agreement, national evaluation : telecommuting/TDM data test plan.

    Science.gov (United States)

    2011-06-01

    This report presents the test plan for collecting and analyzing telecommuting/TDM 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 projects...

  17. San Francisco urban partnership agreement, national evaluation : traffic system data test plan.

    Science.gov (United States)

    2011-06-01

    This report presents the test plan for collecting and analyzing traffic system 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 project...

  18. San Francisco urban partnership agreement, national evaluation : traveler information data test plan.

    Science.gov (United States)

    2011-06-01

    This report presents the test plan for collecting and analyzing traveler information 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 p...

  19. 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....

  20. 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…

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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...

  6. 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.

  7. 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.

  8. Preventing HIV among adolescents with oral PrEP: observations and challenges in the United States and South Africa

    Science.gov (United States)

    Hosek, Sybil; Celum, Connie; Wilson, Craig M; Kapogiannis, Bill; Delany-Moretlwe, Sinead; Bekker, Linda-Gail

    2016-01-01

    Introduction Adolescents and young adults aged <25 are a key population in the HIV epidemic, with very high HIV incidence rates in many geographic settings and a large number who have limited access to prevention services. Thus, any biomedical HIV prevention approach should prepare licensure and implementation strategies for young populations. Oral pre-exposure prophylaxis (PrEP) is the first antiretroviral-based prevention intervention with proven efficacy across many settings and populations, and regulatory and policy approvals at global and national levels are occurring rapidly. We discuss available data from studies in the United States and South Africa on the use of oral PrEP for HIV prevention in adolescent minors, along with some of the implementation challenges. Discussion Ongoing studies in the United States and South Africa among youth under the age of 18 should provide the safety data needed by the end of 2016 to contribute to licensure of Truvada as daily PrEP in adolescents. The challenges of completing these studies as well as foreseeable broader challenges highlighted by this work are presented. Adherence to daily PrEP is a greater challenge for younger populations, and poor adherence was associated with decreased efficacy in all PrEP trials. Individual-level barriers include limited familiarity with antiretroviral-based prevention, stigma, product storage, and social support. Structural challenges include healthcare financing for PrEP, clinician acceptability and comfort with PrEP delivery, and the limited youth-friendly health services available. These challenges are discussed in the context of the work done to date in the United States and South Africa, but will likely be magnified in the setting of limited resources in many other countries that are heavily impacted by HIV. Conclusions Adolescent populations are particularly vulnerable to HIV, and oral PrEP in these populations is likely to have an impact on population-level HIV incidence. The

  9. 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.

  10. 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

  11. The potential impact of reducing indoor tanning on melanoma prevention and treatment costs in the United States: An economic analysis.

    Science.gov (United States)

    Guy, Gery P; Zhang, Yuanhui; Ekwueme, Donatus U; Rim, Sun Hee; Watson, Meg

    2017-02-01

    Indoor tanning is associated with an increased risk of melanoma. The US Food and Drug Administration proposed prohibiting indoor tanning among minors younger than 18 years. We sought to estimate the health and economic benefits of reducing indoor tanning in the United States. We used a Markov model to estimate the expected number of melanoma cases and deaths averted, life-years saved, and melanoma treatment costs saved by reducing indoor tanning. We examined 5 scenarios: restricting indoor tanning among minors younger than 18 years, and reducing the prevalence by 20%, 50%, 80%, and 100%. Restricting indoor tanning among minors younger than 18 years was estimated to prevent 61,839 melanoma cases, prevent 6735 melanoma deaths, and save $342.9 million in treatment costs over the lifetime of the 61.2 million youth age 14 years or younger in the United States. The estimated health and economic benefits increased as indoor tanning was further reduced. Limitations include the reliance on available data and not examining compliance to indoor tanning laws. Reducing indoor tanning has the potential to reduce melanoma incidence, mortality, and treatment costs. These findings help quantify and underscore the importance of continued efforts to reduce indoor tanning and prevent melanoma. Published by Elsevier Inc.

  12. 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.

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

    Science.gov (United States)

    2017-06-09

    of Other Actions Available to Commanders .............................55 Table 8. TARP Indicators of Potential International Terrorist-Associated...effectively prevent direct action attacks by insider threats? What actions are available to commanders who identify potential insider threats within... actions are available to commanders who identify potential insider threats within their organizations? As an initial research hypothesis the author

  14. Infusing Alcohol and Drug Prevention with Existing Classroom Study Units: Exceptional Education.

    Science.gov (United States)

    Valencia Community Coll., Orlando, FL.

    This curriculum module, one of seven developed by the "Infusion Project," offers information and lessons on drug use prevention for integration into an existing seventh-grade exceptional education middle school curriculum for social skills, mathematics, science and language arts. The module, based on a type of interactive learning called…

  15. Prevention and Punishment: Barriers to Accessing Health Services for Undocumented Immigrants in the United States

    Directory of Open Access Journals (Sweden)

    Parul Monga

    2014-01-01

    Full Text Available Undocumented immigrants face significant challenges in accessing health care. Throughout the United States, these challenges may relate to the structure of the public health system in which the undocumented find themselves. In addition, local, regional, and national practices aimed at targeting immigrants for deportation or other non-health reasons may serve to punish them for seeking health services or care. Spain and the United Kingdom serve as useful case studies in comparing the ability of the undocumented to seek health services in Europe and the United States. Overall, promoting access to comprehensive health services for the undocumented should be a national priority, along with analysis of any immigration-related laws or policies for potential harmful impact on health care access.

  16. 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

  17. 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

  18. 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.

  19. 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

    is evident between Denmark and Norway. RESULTS: Six MR preventive factors confounded [∆exp(B)> 10%] the difference in MR use between Denmark and Norway, including staff education (- 51%), substitute staff (- 17%), acceptable work environment (- 15%), separation of acutely disturbed patients (13%), patient-staff...... 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...... 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....

  20. 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

  1. Recommended Community Strategies and Measurements to Prevent Obesity in the United States: Implementation and Measurement Guide

    Science.gov (United States)

    Keener, Dana; Goodman, Kenneth; Lowry, Amy; Zaro, Susan; Khan, Laura Kettel

    2009-01-01

    America has a serious weight problem. Two-thirds of adults and nearly one-fifth of children in the United States are overweight, placing them at greater risk for heart disease, diabetes, and other chronic diseases including cancer and arthritis. Furthermore, obesity and its related health problems are placing a major strain on the U.S. health care…

  2. Road Accident Prevention Unit: An prototyping approach towards mitigating an omnipresent threat

    OpenAIRE

    Barua, Dibakar; Jain, Pranshu; Gupta, Jitesh; Gadre, Dhananjay V.

    2013-01-01

    An intelligent multisensor front end based on the ARM Cortex M3. It deduces a driver's configuration, ascertains his ability to drive safely and contacts near ones with location data for urgent disaster mitigation. Prevention measures are undertaken through external display modules and provision for being vehicle-powered through external voltage regulated supplies. The proof of concept for this paper is an ALL INDIA THIRD PRIZE WINNER at the Texas Instruments Analog Design Contest 2012-13 Nat...

  3. Risk assessment on the preventive maintenance of Ulchin units 3 and 4 during power operation

    International Nuclear Information System (INIS)

    Kang, Dae Il; Kim, See Darl; Jang, Seung Chul; Kim Kil Yoo; Ha, Jae Joo

    2000-01-01

    In this paper, the risk assessments on the change of AOTs and the PM during power operation of major safety systems for Ulchin Units 3 and 4 were performed to identify the possibility of on-line maintenance of them. From a point of vies of risk assessment, the results of this study show that the current AOTs of LPSIS, SCS, and CSS can be increased to 7 days and that of EDG to 10 days. Also, the results show that on-line maintenance of LPSIS< SCS, CSS, EDG, ECWS, ESWS, and CCWS for Ulchin Units 3 and 4 can be performed without increasing the risk greatly. It is expected that the PM at power for the systems mentioned in this study will decrease the shutdown period for refueling more than 2 days. (author)

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

    Science.gov (United States)

    2014-12-04

    power, China would able to produce military resources at a rate of 3.5 times that of the United States. Based on that figure, in the seven years it...threaten them while they recovered. To France’s advantage, the British taxed their own colonists to pay British debt from the war. The anger that...deployed Soviet aircraft were disguised as Chinese or North Korean aircraft, and Soviet aircraft would remain guarding rear areas. The hope for Stalin

  5. Preventing Cervical Cancer in the United States: Barriers and Resolutions for HPV Vaccination.

    Science.gov (United States)

    Beavis, Anna Louise; Levinson, Kimberly L

    2016-01-01

    Human papillomavirus (HPV) vaccination rates for preadolescent and adolescent girls in the United States are far behind those of other developed nations. These rates differ substantially by region and state, socioeconomic status, and insurance status. In parents and young women, a lack of awareness and a misperception of the risk of this vaccine drive low vaccination rates. In physicians, lack of comfort with discussion of sexuality and the perception that the vaccine should be delayed to a later age contribute to low vaccination rates. Patient- and physician-targeted educational campaigns, systems-based interventions, and school-based vaccine clinics offer a variety of ways to address the barriers to HPV vaccination. A diverse and culturally appropriate approach to promoting vaccine uptake has the potential to significantly improve vaccination rates in order to reach the Healthy People 2020 goal of over 80% vaccination in adolescent girls. This article reviews the disparities in HPV vaccination rates in girls in the United States, the influences of patients', physicians', and parents' attitudes on vaccine uptake, and the proposed interventions that may help the United States reach its goal for vaccine coverage.

  6. 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.

  7. 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.

  8. 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.

  9. [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.

  10. AIDS prevention research in Chile and implications for the United States.

    Science.gov (United States)

    Aiken, L H; Mullin, M

    1996-01-01

    Chile holds interest for researchers due to the relatively low but increasing prevalence of human immunodeficiency virus (HIV) and existence of an extensive infrastructure for implementing an affordable acquired immunodeficiency syndrome (AIDS) prevention strategy. To facilitate the development of a pragmatic, affordable AIDS intervention plan for Chile, the following data sources were reviewed: mandatory case reporting data collected by the Chilean Ministry of Health, findings of the Chilean version of the World Health Organization AIDS general population survey, studies of the validity of the official HIV transmission classification system used for national planning purposes, interviews with people with AIDS, and a study of HIV testing in Santiago's health care system. By June 1994, 1016 cases of AIDS had been reported and 1627 people had been identified as HIV-positive. 93% of those with AIDS were men; homosexual/bisexual transmission accounted for 66.2% of cases and heterosexual transmission another 19.4%. In-depth interviews with AIDS patients revealed they were a well-defined population subgroup with few linkages to other sectors. This finding calls into question the current government strategy of broad-based mass media campaigns. Preferable would be campaigns that target homosexual men. A strength of the Chilean primary health care system is its effective utilization of nurses. Nurses manage about 1/3 of clinic visits, with no input from physicians, and their involvement in AIDS prevention should be strengthened.

  11. 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.

  12. Epidemiology of burns in the United Arab Emirates: lessons for prevention.

    Science.gov (United States)

    Grivna, Michal; Eid, Hani O; Abu-Zidan, Fikri M

    2014-05-01

    To study mechanism, risk factors and outcome of hospitalized burns so as to give recommendations for prevention. Burn patients admitted to Al Ain hospital for more than 24h or who died after arrival were studied over 4 years. Demographics, burn type, location and time of injury, total body burned surface area (TBSA), body region, hospital and ICU stay and outcome were analyzed. 203 patients were studied, 69% were males and 25% were children under 5 years old. The most common location for burn was home. Women were burned more at home (pburns at work were from gas and flame. Burns caused by gas and flame had larger TBSA and longer ICU stay. Six (3%) patients died and nine (4%) were transferred to the specialized burn center. Safety education for caregivers and close supervision of young children is important to reduce pediatric burns. Occupational safety education of young men could prevent burns caused by gas and flame. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  13. An Assessment of Alcohol and Drug Education/Prevention Programs in the United States Army

    Science.gov (United States)

    1973-12-01

    paraphernalia such as exotic pipes, black lights, psychedelic posters, and the like. These elements of the drug culture must be considered when one...methods used were successf-il in curbing hard drug use, and that the benefits outweigh the costs, we recommend that the Army implemeni the program on a...Research ProbI~t • KI•773-3 ,’AN_ ASSESSMENIT OF ALCOHOL AND DRUG - EDUCATIONP/ EVENTIOON PROGRAMS IN THE UNITED STATES ARMY. 0t -.. -’. "--,’- D D

  14. 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  peer tutoring in a resource-limited setting was useful and effectively reduced CLABSIs. However, maintaining the reduced CLABSI rate will require further strategies.

  15. HIV prevention in action on the football field: the WhizzKids United program in South Africa.

    Science.gov (United States)

    Balfour, Louise; Farrar, Thomas; McGilvray, Marcus; Wilson, Douglas; Tasca, Giorgio A; Spaans, Johanna N; Mathews, Catherine; Maziya, Lungile; Khanyile, Siphosihle; Dalgleish, Tracy L; Cameron, William D

    2013-07-01

    The Africaid Trust is a grassroots South African non-profit organization that engages youth in HIV prevention by harnessing the popularity of football (i.e. soccer). WhizzKids United, the organization's primary program, operates a 12-week program in elementary schools in Pietermaritzburg, South Africa, which aims to impart knowledge and life skills critical to HIV prevention. The goal of this research was to compare elementary school youth who received the program to youth who only received traditional classroom-based HIV education on health behaviors and HIV-related knowledge and stigma. A secondary objective was to evaluate HIV knowledge, sexual behaviors, attitudes towards HIV and health care seeking behaviors among South African youth in grades 9-12. Elementary students who participated in the program reported greater HIV knowledge and lower HIV stigma (p < .001) than those who had not. The majority of youth in grades 9-12 report having sexual relations (55.6%), despite low levels of HIV testing (29.9%) in this high HIV prevalence region of South Africa. The results highlight the importance of supporting community-based HIV educational initiatives that engage high-risk youth in HIV prevention and the need for youth-friendly health services.

  16. Receipt of HIV/STD prevention counseling by HIV-infected adults receiving medical care in the United States.

    Science.gov (United States)

    Mizuno, Yuko; Zhu, Julia; Crepaz, Nicole; Beer, Linda; Purcell, David W; Johnson, Christopher H; Valverde, Eduardo E; Skarbinski, Jacek

    2014-01-28

    Guidelines recommend risk-reduction counseling by HIV providers to all HIV-infected persons. Among HIV-infected adults receiving medical care in the United States, we estimated prevalence of exposure to three types of HIV/sexually transmitted disease (STD) risk-reduction interventions and described the characteristics of persons who received these interventions. Data were from the Medical Monitoring Project (MMP), a supplemental HIV surveillance system designed to produce nationally representative estimates of behavioral and clinical characteristics of HIV-infected adults receiving medical care in the United States. Descriptive analyses were conducted to estimate the exposure to each type of HIV/STD risk-reduction intervention. Bivariate and multivariable analyses were conducted to assess associations between the selected correlates with each exposure variable. About 44% of participants reported a one-on-one conversation with a healthcare provider about HIV/STD prevention, 30% with a prevention program worker, 16% reported participation in a small group risk-reduction intervention, and 52% reported receiving at least one of the three interventions in the past 12 months. Minority race/ethnicity, low income, and risky sexual behavior consistently predicted greater intervention exposure. However, 39% of persons who reported risky sex did not receive any HIV/STD risk-reduction interventions. HIV-infected persons in care with fewer resources or those who engaged in risk behaviors were more likely to receive HIV/STD risk-reduction interventions. However, less than half of HIV-infected persons in care received HIV/STD prevention counseling from their provider, an intervention that has been shown to be effective and is supported by guidelines.

  17. Preventing cervical cancer in the United States: barriers and resolutions for HPV vaccination

    Directory of Open Access Journals (Sweden)

    Anna Louise Beavis

    2016-02-01

    Full Text Available HPV vaccination rates for preadolescent and adolescent girls in the United States are far behind those of other developed nations. These rates differ substantially by region and state, socioeconomic status, and insurance status. In parents and young women, a lack of awareness and a misperception of the risk of this vaccine drive low vaccination rates. In physicians, lack of comfort with discussion of sexuality, and the perception that the vaccine should be delayed to a later age contribute to low vaccination rates. Patient and physician-targeted educational campaigns, systems-based interventions, and school-based vaccine clinics offer a variety of ways to address the barriers to HPV vaccination. A diverse and culturally appropriate approach to promoting vaccine uptake has the potential to significantly improve vaccination rates in order to reach the Healthy People 2020 goal of over 80% vaccination in adolescent girls. This article reviews the disparities in HPV vaccination rates in girls in the United States, the influences of patients’, physicians’ and parents’ attitudes on vaccine uptake, and the proposed interventions that may help the US reach its goal for vaccine coverage.

  18. 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

  19. San Diego Collection

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — During the period 1987-2009 the Southwest Region (now West Coast Region) collected beach seine fish samples in the San Diego area in conjunction with eelgrass...

  20. 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

  1. 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)

    2014-01-01

    Background 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. Methods 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. Results Investigators and research staff shared preliminary findings across studies to provide feedback on instruments and insights regarding local

  2. 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)

  3. "Welfare queens" and "teen moms": how the social construction of fertile women impacts unintended pregnancy prevention policy in the United States.

    Science.gov (United States)

    James, E Angel; Rashid, Moira

    2013-01-01

    In the United States, unintended pregnancy is a serious health, social, and economic concern. However, the existing prevention policies have proven ineffective at decreasing the rate of unintended pregnancy at a national level. This lack of effective national prevention policy is better understood when viewed through the lens of a policy theory that incorporates an understanding of social construction and its effects on policy development. Through the application of one such policy theory, this article explores how the social construction of fertile women in the United States affects previous and recently enacted unintended pregnancy prevention policies.

  4. 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.

  5. 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

  6. Neonatal Pain And Preventive Strategies: An Experience In A Tertiary Care Unit.

    Science.gov (United States)

    Mahmud, Shahid; Shah, Sajid Ali; Khattak, Saeed Zaman

    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. This randomized control trial was carried out in NICU of MH, Rawalpindi from Jan 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. 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. Oral dextrose is a cheap and easily available solution and can be used in neonatal pain management during various painful procedures.

  7. 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)

  8. Prevention of postpartum smoking relapse in mothers of infants in the neonatal intensive care unit.

    Science.gov (United States)

    Phillips, R M; Merritt, T A; Goldstein, M R; Deming, D D; Slater, L E; Angeles, D M

    2012-05-01

    Approximately 40% of women who smoke tobacco quit smoking during pregnancy, yet up to 85% relapse after delivery. Those who resume smoking often do so by 2 to 8 weeks postpartum. Smoking mothers are more than twice as likely to quit breastfeeding by 10 weeks postpartum. The hospitalization of a newborn, while stressful, is an opportunity to emphasize the importance of a smoke-free environment for babies. Supporting maternal-infant bonding may reduce maternal stress and motivate mothers to remain smoke free and continue breastfeeding. The objective of this study was to reduce postpartum smoking relapse and prolong breastfeeding duration during the first 8 weeks postpartum in mothers who quit smoking just before or during pregnancy and have newborns admitted to the Neonatal Intensive Care Unit (NICU). This study was an Institutional Review Board-approved prospective randomized clinical trial. After informed consent, mothers of newborns admitted to the NICU were randomized to a control or intervention group. Both groups received weekly encouragement to remain smoke free and routine breastfeeding support. Mothers in the intervention group were also given enhanced support for maternal-infant bonding including information about newborn behaviors, and were encouraged to frequently hold their babies skin-to-skin. More mothers were smoke free (81 vs 46%, Pbreastfeeding (86 vs 21%, Pprolonged duration of breastfeeding during the first 8 weeks postpartum.

  9. 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

  10. Clinical outcomes from a foam wedge splinting program for axillary contracture prevention in the intensive care unit.

    Science.gov (United States)

    Godleski, Matthew; Holden, Mary Sullivan; Luby, Darcie; Weitzenkamp, David; Boimbo, Sandra; Lindberg, Gordon

    2014-01-01

    Preventing scar contracture after burn injury is a critical goal during recovery. Although the need for intervention is well-understood, data on specific techniques are limited. The study's objective is to provide data for the use of a foam abduction wedge in terms of safety, effectiveness, and patient and caregiver satisfaction through a prospective, single-arm trial. All patients presenting with a burn injury that required grafting in the axillary region and placed them at risk for shoulder joint contracture were offered inclusion. Patient outcomes were recorded for the duration of their burn intensive care unit admission. Ten subjects completed the protocol with a mean duration of wedge use of 41.5 ± 32.5 days. At discharge, the mean shoulder abduction was 132° ± 38° on the left and 118° ± 22° on the right. The mean shoulder flexion was 132° ± 31° on the left and 123° ± 29° on the right. As much as 90% of the subjects had greater than 90° of shoulder abduction and flexion at discharge. There were no observations of worsening burn injury wounds, graft failure, or new pressure-related wounds. One patient was found to have an upper-extremity peripheral nerve injury that was not clearly associated with the splint. Patient and nursing surveys indicated areas of satisfaction as well as areas for potential improvement. This study illustrates the anticipated clinical outcomes and care issues associated with the use of a specific contracture prevention method used in the burn intensive care unit setting as well as identifying areas for future research.

  11. Drug handling in a paediatric intensive care unit--can errors be prevented by a three-step intervention?

    Science.gov (United States)

    Niemann, D; Bertsche, A; Meyrath, D; Oelsner, S; Ewen, A L; Pickardt, B; Henhapl, T; Hoffmann, G; Meyburg, J; Bertsche, T

    2014-04-01

    Drug handling in paediatric intensive care units (PICU) is prone to medication errors. We aimed to identify type and prevalence of those errors and to assess preventative interventions. Prospective intervention study investigating a 3-step intervention for preventing errors in drug handling in a 10-bed PICU of a university hospital. Nurses' drug handling was monitored in daily routine to identify the number of patients affected by errors and overall prevalence and types of errors in drug handling. We implemented a comprehensive intervention consisting of an information handout, a training course, and a 76-page reference book tailored to reduce the prevalence. The prevalence of errors in drug handling decreased from 83 % (555 errors/668 processes)to 63 % (554/883; p drugs (1.33 errors/process) were more error-prone than intravenous (IV) drugs(0.64), despite being used less frequently (27 % vs.73 % of all processes, p drugs (p = 0.025). Errors in drug handling were alarmingly frequent. PO drugs were frequently subject to errors, even though being used less frequently. The implementation of a comprehensive intervention succeeded in reducing the prevalence of errors. Yet further refinements are necessary to decrease also the number of affected patients. © Georg Thieme Verlag KG Stuttgart · New York.

  12. Chlorhexidine-Impregnated Dressings and Prevention of Catheter-Associated Bloodstream Infections in a Pediatric Intensive Care Unit.

    Science.gov (United States)

    Düzkaya, Duygu Sönmez; Sahiner, Nejla Canbulat; Uysal, Gülzade; Yakut, Tülay; Çitak, Agop

    2016-12-01

    Bloodstream infections related to use of catheters are associated with increased morbidity and mortality rates, prolonged hospital lengths of stay, and increased medical costs. To compare the effectiveness of chlorhexidine-impregnated dressings with that of standard dressings in preventing catheter-related bloodstream infections. A total of 100 children were randomly divided into 2 groups of 50 each: a chlorhexidine group and a standard group. Patient care was provided in accordance with prevention bundles. Patients were followed up for development of catheter-related bloodstream infections. Catheter colonization occurred in 4 patients in the standard group (8%) and in 1 patient in the chlorhexidine group (2%). Catheter-related bloodstream infections occurred in 5 patients in the standard group (10%) and in 1 patient in the chlorhexidine group (2%). Although more patients in the standard group had catheter-related bloodstream infections, the difference in infection rates between the 2 groups was not significant (P = .07). Use of chlorhexidine-impregnated dressings reduced rates of catheter-related bloodstream infections, contamination, colonization, and local catheter infection in a pediatric intensive care unit but was not significantly better than use of standard dressings. ©2016 American Association of Critical-Care Nurses.

  13. Experiences with influenza-like illness and attitudes regarding influenza prevention--United States, 2003-04 influenza season.

    Science.gov (United States)

    2004-12-17

    Despite advances in medical treatment, influenza results in approximately 36,000 deaths each year in the United States. Vaccination has been a mainstay of influenza prevention, with annual vaccination recommended for adults and children at high risk; efforts to interrupt person-to-person transmission are also important. In October 2003, CDC recommended that health-care facilities implement a Universal Respiratory Hygiene Strategy, including providing masks or facial tissues in waiting rooms to persons with respiratory symptoms. To gather information on influenza-like illness (ILI) and attitudes regarding prevention of ILI (including use of vaccine and respiratory hygiene), CDC and 11 Emerging Infections Programs (EIPs) conducted a random-digit-dialed telephone survey of noninstitutionalized U.S. civilian adults in February 2004. This report summarizes the results of that survey, which determined that 43% of adults and 69% of children aged 6 months-17 years with ILI visited a health-care provider for the illness. Eight percent of adults with ILI reported having been asked by a health-care provider to wear a mask; 82% said they would wear a mask if requested. With the limited availability of influenza vaccine this season, the use of masks by persons with cough illnesses in health-care settings, a component of the Universal Respiratory Hygiene Strategy, might be a helpful and acceptable method for decreasing influenza transmission.

  14. Formulas for estimating the costs averted by sexually transmitted infection (STI prevention programs in the United States

    Directory of Open Access Journals (Sweden)

    Koski Kathryn

    2008-05-01

    Full Text Available Abstract Background Sexually transmitted infection (STI prevention programs can mitigate the health and economic burden of STIs. A tool to estimate the economic benefits of STI programs could prove useful to STI program personnel. Methods We developed formulas that can be applied to estimate the direct medical costs and indirect costs (lost productivity averted by STI programs in the United States. Costs and probabilities for these formulas were based primarily on published studies. Results We present a series of formulas that can be used to estimate the economic benefits of STI prevention (in 2006 US dollars, using data routinely collected by STI programs. For example, the averted sequelae costs associated with treating women for chlamydia is given as (Cw(0.16(0.925(0.70($1,995, where Cw is the number of infected women treated for chlamydia, 0.16 is the absolute reduction in the probability of pelvic inflammatory disease (PID as a result of treatment, 0.925 is an adjustment factor to prevent double-counting of PID averted in women with both chlamydia and gonorrhea, 0.70 is an adjustment factor to account for the possibility of re-infection, and $1,995 is the average cost per case of PID, based on published sources. Conclusion The formulas developed in this study can be a useful tool for STI program personnel to generate evidence-based estimates of the economic impact of their program and can facilitate the assessment of the cost-effectiveness of their activities.

  15. Prevention of pressure ulcers in the intensive care unit: a randomized trial of 2 viscoelastic foam support surfaces.

    Science.gov (United States)

    Ozyurek, Pakize; Yavuz, Meryem

    2015-01-01

    The aim of this study is to compare whether differences exist between 2 viscoelastic foam support surfaces in the development of new pressure ulcers. There is evidence to support the use of viscoelastic foam over standard hospital foam to reduce pressure. A comparative effectiveness study was done to compare 2 viscoelastic foam support surfaces. A randomized controlled trial was carried out. The study was performed in 2 intensive care units between October 1, 2008, and January 4, 2010. Patients (n = 105) admitted to intensive care unit were randomly assigned to viscoelastic foam 1 (n = 53) or viscoelastic foam 2 support surface (n = 52). In total, 42.8% of all patients developed a new pressure ulcer of stage 1 or worse. By stages, pressure ulcer incidence was 28.6%, 13.3%, and 1.0% for stages 1, 2, and 3, respectively. There was no significant difference in pressure ulcer incidence between the viscoelastic foam 1 and 2 groups (X2 = 0.07, df = 1, P > .05). No difference was found between 2 different viscoelastic foam surfaces in the prevention of pressure ulcers in patients treated in intensive care. Pressure ulcer incidence in critically ill patients remains high. Nurses must compare current products for effectiveness and develop innovative systems, processes, or devices to deliver best practices.

  16. Reducing ventilator-associated pneumonia in neonatal intensive care unit using "VAP prevention Bundle": a cohort study.

    Science.gov (United States)

    Azab, Seham F A; Sherbiny, Hanan S; Saleh, Safaa H; Elsaeed, Wafaa F; Elshafiey, Mona M; Siam, Ahmed G; Arafa, Mohamed A; Alghobashy, Ashgan A; Bendary, Eman A; Basset, Maha A A; Ismail, Sanaa M; Akeel, Nagwa E; Elsamad, Nahla A; Mokhtar, Wesam A; Gheith, Tarek

    2015-08-06

    Ventilator-associated pneumonia (VAP) is a serious health care-associated infection, resulting in high morbidity and mortality. It also prolongs hospital stay and drives up hospital costs. Measures employed in preventing ventilator-associated pneumonia in developing countries are rarely reported. In this study we tried to assess the efficacy of our designed "VAP prevention bundle" in reducing VAP rate in our neonatal intensive care unit (NICU). This prospective before-and-after study was conducted at university hospital NICU, all neonates who had mechanical ventilation for ≥ 48 h were eligible. VAP rates were evaluated before (phase-I) and after (phase-II) full implementation of comprehensive preventive measures specifically designed by our infection control team. Of 143 mechanically ventilated neonates, 73 patients developed VAP (51%) throughout the study period (2500 mechanical ventilation days). The rate of VAP was significantly reduced from 67.8% (42/62) corresponding to 36.4 VAP episodes/1000 mechanical ventilation days (MV days) in phase-I to 38.2% (31/81) corresponding to 23 VAP/1000 MV days (RR 0.565, 95% confidence interval 0.408-0.782, p = 0.0006) after VAP prevention bundle implementation (phase-II). Parallel significant reduction in MV days/case were documented in post-intervention period (21.50 ± 7.6 days in phase-I versus 10.36 ± 5.2 days in phase-II, p = 0.000). There were a trend toward reduction in NICU length of stay (23.9 ± 10.3 versus 22.8 ± 9.6 days, p = 0.56) and overall mortality (25% versus 17.3%, p = 0.215) between the two phases but didn't reach statistical significance. The commonest micro-organisms isolated throughout the study were gram-negative bacteria (63/66, 95.5%) particularly Klebsilla pneumonia (55/66, 83.4%). Implementation of multifaceted infection control bundle resulted in reduction of VAP rate, length of stay in our NICU.

  17. 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.

  18. 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)

  19. 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 ...

  20. 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

    2017-11-30

    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.

  1. The Comparison of Chlorhexidine Solution and Swab With Toothbrush and Toothpaste Effect on Preventing Oral Lesions in Hospitalized Patients in Intensive Care Unit

    OpenAIRE

    Estaji, Zahra; Alinejad, Mohammad; Rakhshani, Mohammad Hassan; Rad, Mojtaba

    2015-01-01

    Background: Maintaining of oral hygiene has been known as one of the basic tasks of nurses working at intensive care unit. This study aimed to compare the effectiveness of chlorhexidine solution with toothbrush in prevention of oral lesions or ulcers in the different parts of the mouth. Methods: In this clinical trial study, research Society included patients hospitalized with endotracheal tube since the arrival time in intensive care unit. In this study, 30 patients were selected with target...

  2. SANS. An introduction

    International Nuclear Information System (INIS)

    Teixeira, J.

    1999-01-01

    At the origin of the neutron scattering technique there is the interaction of thermal neutrons with the nuclei of atoms. In SANS experiments, as in other diffraction studies, one measures the scattered intensity, as a function of the direction of scattering. Density and concentration fluctuations, form factors, structure factors are presented. Data treatment and experimental aspects are also discussed. (K.A.)

  3. 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

  4. 77 FR 54811 - Safety Zone; TriRock San Diego, San Diego Bay, San Diego, CA

    Science.gov (United States)

    2012-09-06

    ... to do so with respect to this rule, as the logistical details of the San Diego Bay swim were not... zone will be navigable waters of the San Diego Bay behind the San Diego Convention Center bound by the... the States, on the relationship between the national government and the States, or on the distribution...

  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. Minority participation in a school-based randomized clinical trial of tooth decay prevention in the United States.

    Science.gov (United States)

    Nelson, Suchitra; Milgrom, Peter

    2012-01-01

    To describe the strategies-based on the social triad concept of a partnership of researchers, school personnel and community-employed to recruit low-income, minority parent/caregivers of kindergarten children into a school-based tooth decay prevention trial in the United States. The study site was an urban school district with five elementary schools. Recruitment was carried out once each year for three years. Recruitment involved strategies at the school district, school, classroom, and student-parent level. A coalition of researchers, school personnel and community individuals was established for communication and recruitment. Outreach workers from the community were hired to promote, recruit, and disseminate oral health information. Study promotion included both print materials (logos, flyers, pictorial story boards) and presentations at school and community events. The School District Superintendent and administrators approved the study, and all five school principals and kindergarten teachers participated. All children within the classrooms were eligible: the overall participation rate of was 86% (580/672). Community outreach workers actively facilitated the recruitment and participants were recruited at open house for parent-teacher meeting (37% of all participants), sending letters and consent forms home (31%), at a prearranged convenient time during drop off and pick up of the child at their respective schools (30%), curriculum nights and health fairs (2%). Utilizing the social triad concept led to success in planning and carrying out the recruitment of predominantly minority school children with high participation rates. Copyright © 2011 Elsevier Inc. All rights reserved.

  7. 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...

  8. 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.

  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 55975 - Safety Zone; San Diego Harbor Shark Fest Swim; San Diego Bay, San Diego, CA

    Science.gov (United States)

    2010-09-15

    ... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA00 Safety Zone; San Diego Harbor Shark Fest Swim; San Diego... Shark Fest Swim, consisting of 600 swimmers swimming a predetermined course. The sponsor will provide 26...; San Diego Harbor Shark Fest Swim; San Diego Bay, San Diego, CA. (a) Location. The following area is a...

  11. Safety Standards: Implementing Fall Prevention Interventions and Sustaining Lower Fall Rates by Promoting the Culture of Safety on an Inpatient Rehabilitation Unit.

    Science.gov (United States)

    Leone, Rita Marie; Adams, Rachel Joy

    2016-01-01

    The purpose of this article is to review a quality improvement project aimed to examine how nurse leaders in an inpatient rehabilitation (IPR) unit can reduce the number of patient falls by implementing multiple fall prevention interventions and sustain their results by promoting a strong culture of safety on the unit. A retrospective review of IPR fall rates was performed. Quarterly fall rates were then compared with implementation dates of fall prevention interventions (safety huddles, signage, and hourly rounding). Culture of safety scores were also examined to assess the effect of an enhanced culture of safety on the sustainability of lowered fall rates. The largest decrease in fall rate was noted after initial revitalization efforts of the IPR unit's culture of safety concurrently with hourly rounding. Fall rates rise and fall despite multiple fall prevention interventions and encouraging a positive shift in the culture of safety. Physical injuries following a fall can reduce mobility and increase morbidity. Costs associated with falls negatively impact costs and reimbursement. Employing evidence-based fall prevention strategies are then of critical importance to nurse leaders as falls remain an ongoing serious adverse event. © 2015 Association of Rehabilitation Nurses.

  12. 76 FR 37044 - Revisions to the California State Implementation Plan, San Joaquin Valley Unified Air Pollution...

    Science.gov (United States)

    2011-06-24

    ... the California State Implementation Plan, San Joaquin Valley Unified Air Pollution Control District... approve revisions to the San Joaquin Valley Unified Air Pollution Control District (SJVUAPCD) portion of... Glass Manufacturing'', US EPA, June 1994. 7. ``Integrated Pollution Prevention and Control (IPPC...

  13. 77 FR 66429 - Revisions to the California State Implementation Plan, San Joaquin Valley Unified Air Pollution...

    Science.gov (United States)

    2012-11-05

    ... the California State Implementation Plan, San Joaquin Valley Unified Air Pollution Control District... approve revisions to the San Joaquin Valley Unified Air Pollution Control District (SJVUAPCD) portion of... 1994. 11. ``Integrated Pollution Prevention and Control (IPPC) Reference Document on Best Available...

  14. A survey of preventive measures used and their impact on central line-associated bloodstream infections (CLABSI) in intensive care units (SPIN-BACC).

    Science.gov (United States)

    Gonzales, Milagros; Rocher, Isabelle; Fortin, Elise; Fontela, Patricia; Kaouache, Mohammed; Tremblay, Claude; Frenette, Charles; Quach, Caroline

    2013-12-01

    The Quebec central line-associated bloodstream infections (CLABSI) in intensive care units (ICUs) Surveillance Program saw a decrease in CLABSI rates in most ICUs. Given the surveillance trends observed in recent years, we aimed to determine what preventive measures have been implemented, if compliance to measures was monitored and its impact on CLABSI incidence rates. All hospitals participating in the Quebec healthcare-associated infections surveillance program (SPIN-BACC - n = 48) received a 77-question survey about preventive measures implemented and monitored in their ICU. The questionnaire was validated for construct, content, face validity, and reliability. We used Poisson regression to measure the association between compliance monitoring to preventive measures and CLABSI rates. Forty-two (88%) eligible hospitals completed the survey. Two components from the maximum barrier precautions were used less optimally: cap (88%) and full sterile body drape (71%). Preventive measures reported included daily review of catheter need (79%) and evaluation of insertion site for the presence of inflammation (90%). Two hospitals rewired lines even if an infection was suspected or documented.In adult ICUs, there was a statistically significant greater decrease in CLABSI rates in ICUs that monitored compliance to preventive insertion measures, after adjusting for teaching status and the number of hospital beds (p = 0.036). Hospitals participating to the SPIN-BACC program follow recommendations for CLABSI prevention, but only a minority locally monitor their application. Compliance monitoring of preventive measures for catheter insertion was associated with a decrease in CLABSI incidence rates.

  15. 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.

  16. 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

  17. 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…

  18. An approach for actions to prevent suicides on commuter and metro rail systems in the United States.

    Science.gov (United States)

    2014-11-01

    The primary goals of this report are to discuss measures to prevent suicides on commuter and metro rail systems, and to outline : an approach for suicide prevention on rail systems. Based on existing literature and analysis of data obtained from the ...

  19. 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

  20. Use of a sacral silicone border foam dressing as one component of a pressure ulcer prevention program in an intensive care unit setting.

    Science.gov (United States)

    Walsh, Nancy S; Blanck, Alyson W; Smith, Lisa; Cross, Maribeth; Andersson, Liane; Polito, Carol

    2012-01-01

    In 2008, patients in the intensive care unit (ICU) at Danbury Hospital, Danbury, Connecticut, experienced 79 pressure ulcers. As a result, pressure ulcer-prevention interventions were standardized in critical care and medical-surgical units and education was provided to all direct patient care staff about principles of skin care and prevention. Following these efforts, 53 ICU patients developed pressure ulcers in the sacral area in fiscal year 2009, representing a 12.5% incidence for the ICU as compared to a 3.4% overall pressure ulcer incidence for the total hospital. In order to achieve additional reduction in pressure ulcer incidence, we replicated an initiative that called for application of a silicone foam dressing every 3 days to determine its effect on sacral pressure ulcer incidence in the ICU. We found that the use of the dressing further diminished the incidence of sacral pressure ulcers in our patients.

  1. 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.

  2. Prevention--a cost-effective way to fight the non-communicable disease epidemic: an academic perspective of the United Nations High-level NCD Meeting.

    Science.gov (United States)

    Probst-Hensch, Nicole; Tanner, Marcel; Kessler, Claudia; Burri, Christian; Künzli, Nino

    2011-09-07

    The United Nations General Assembly has convened a Summit on non-communicable diseases (NCDs), an historic moment in the global combat of these disorders. Lifestyles in increasingly urban and globalised environments have led to a steep surge in NCD incidence in low and middle income countries, where two thirds of all NCD deaths occur (most importantly from cancer, cardiovascular and respiratory disease as well as diabetes). Treatment of NCDs is usually long term and expensive, thus threatening patients' and nations' budgets and putting them at high risk for poverty. The NCD Summit offers an opportunity for strengthening and shaping primary prevention, the most cost-effective instrument to fight major risk factors such as tobacco smoking, alcohol abuse, physical inactivity and unhealthy diet. From a Swiss perspective, we also emphasised the efforts for new laws on prevention and diagnosis registration, in accordance with the recommendations of the NCD summit in order to strengthen primary prevention and disease monitoring. In addition, the need for structural prevention across all policy sectors with leadership in environmental policy making to prevent NCDs as well as the need to adapt and strengthen primary health care are equally relevant for Switzerland. To compliment efforts in primary prevention, the field of NCDs requires special R&D platforms for affordable NCD drugs and diagnostics for neglected population segments in both Switzerland and low and middle income countries. Switzerland has a track record in research and development against diseases of poverty on a global scale that now needs to be applied to NCDs.

  3. 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.

  4. A survey of Preventive Measures Used and their Impact on Central Line-Associated Bloodstream Infections (CLABSI) in Intensive Care Units (SPIN-BACC)

    OpenAIRE

    Gonzales, Milagros; Rocher, Isabelle; Fortin, Élise; Fontela, Patricia; Kaouache, Mohammed; Tremblay, Claude; Frenette, Charles; Quach, Caroline

    2013-01-01

    Background The Quebec central line-associated bloodstream infections (CLABSI) in intensive care units (ICUs) Surveillance Program saw a decrease in CLABSI rates in most ICUs. Given the surveillance trends observed in recent years, we aimed to determine what preventive measures have been implemented, if compliance to measures was monitored and its impact on CLABSI incidence rates. Methods All hospitals participating in the Quebec healthcare-associated infections surveillance program (SPIN-BACC...

  5. Assessment of dog owner adherence to veterinarians' flea and tick prevention recommendations in the United States using a cross-sectional survey.

    Science.gov (United States)

    Lavan, Robert P; Tunceli, Kaan; Zhang, Dongmu; Normile, Dorothy; Armstrong, Rob

    2017-06-06

    Adherence to a prescribed therapeutic regimen is a critical factor for achieving medication effectiveness and therefore treatment success. In the case of companion animal ectoparasite control, suboptimal owner adherence to medication recommendations is thought to be a common cause of treatment failure, and previous reports have found pet owners applying an average of 4.0-4.6 monthly flea and tick treatments per year to their dogs. This study investigated: US veterinary hospital self-reported flea and tick prevention recommendations; dog owner recollection of these recommendations; dog owner opinion on flea/tick recommendations and estimated owner flea and tick medication adherence based on veterinary hospital purchase records. Veterinarians at 24 veterinary hospitals in 4 United States regions provided their flea and tick prevention recommendations. Five hundred fifty-nine dog owners, clients of the 24 hospitals, completed a survey evaluating their recollection of the hospitals' recommendations and their opinions regarding required treatment frequency. Almost all veterinary hospitals in this study recommended 12 months of flea and tick prevention but only 62% of participating dog owners recalled this recommendation. The average owner response was that their dogs require 10.5 months of flea and tick prevention annually. Owner opinions were significantly different among U.S. regions with pet owners in the northeast U.S. believing that they needed significantly less canine flea and tick protection than pet owners in other parts of the United States. The estimated actual flea and tick prevention coverage was 6.1 months based on owner medication purchases over a 12-month period. In the United States, dog owner opinions and actions show that their flea and tick treatment adherence falls short of veterinarians' recommendations.

  6. 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.

  7. 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...

  8. San Diego's Capital Planning Process

    Science.gov (United States)

    Lytton, Michael

    2009-01-01

    This article describes San Diego's capital planning process. As part of its capital planning process, the San Diego Unified School District has developed a systematic analysis of functional quality at each of its school sites. The advantage of this approach is that it seeks to develop and apply quantifiable metrics and standards for the more…

  9. 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

  10. APPLICATION OF WATER-JET HORIZONTAL DRILLING TECHNOLOGY TO DRILL AND ACIDIZE HORIZONTAL DRAIN HOLES, TEDBIT (SAN ANDRES) FIELD, GAINES COUNTY, TEXAS

    Energy Technology Data Exchange (ETDEWEB)

    Michael W. Rose

    2005-09-22

    The San Andres Formation is one of the major hydrocarbon-producing units in the Permian Basin, with multiple reservoirs contained within the dolomitized subtidal portions of upward shoaling carbonate shelf cycles. The test well is located in Tedbit (San Andres) Field in northeastern Gaines County, Texas, in an area of scattered San Andres production associated with local structural highs. Selected on the basis of geological and historical data, the Oil and Gas Properties Wood No. 1 well is considered to be typical of a large number of San Andres stripper wells in the Permian Basin. Thus, successful completion of horizontal drain holes in this well would demonstrate a widely applicable enhanced recovery technology. Water-jet horizontal drilling is an emerging technology with the potential to provide significant economic benefits in marginal wells. Forecast benefits include lower recompletion costs and improved hydrocarbon recoveries. The technology utilizes water under high pressure, conveyed through small-diameter coiled tubing, to jet horizontal drain holes into producing formations. Testing of this technology was conducted with inconclusive results. Paraffin sludge and mechanical problems were encountered in the wellbore, initially preventing the water-jet tool from reaching the kick-off point. After correcting these problems and attempting to cut a casing window with the water-jet milling assembly, lateral jetting was attempted without success.

  11. 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.

  12. Evaluating the United Nation’s Agenda for Atrocity Prevention: Prospects for the International Regulation of Internal Security

    Directory of Open Access Journals (Sweden)

    Cecilia Jacob

    2015-10-01

    Full Text Available In recent years the UN Secretary-General has promoted mass atrocity prevention as the priority agenda for the Responsibility to Protect (R2P at the UN, redirecting debates on R2P away from military interventionism towards improved state capacity to prevent atrocity crimes and protect populations. This focus has been illustrated in the UNSG’s annual reports on R2P since 2009, and the 2014 “Framework of Analysis for Atrocity Crimes”, that emphasise state institutional capacity and the identification of atrocity-risk indicators. Through a case-study of Pakistan, this article problematizes the relationship between internal security and the UN agenda on atrocity prevention to evaluate the viability of promoting atrocity prevention as currently conceived by the Office of the UNSG in high-risk contexts. It argues that an atrocity prevention agenda informed by a responsive regulation framework would be more effective in taking into account the relational dynamics of atrocity crimes. This includes accounting for the interaction between the micro-dynamics of political violence with macro-dynamics created by lengthy historical conflicts and strategic repertoires.

  13. 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

  14. 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.

  15. 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

  16. Integrated corridor management initiative : demonstration phase evaluation, San Diego decision support system analysis test plan.

    Science.gov (United States)

    2012-08-01

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

  17. 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...

  18. 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...

  19. Integrated corridor management initiative : demonstration phase evaluation - San Diego benefit-cost analysis test plan.

    Science.gov (United States)

    This report presents the test plan for conducting the Benefit-Cost Analysis (BCA) for the United States : Department of Transportation (U.S. DOT) evaluation of the San Diego Integrated Corridor Management : (ICM) Initiative Demonstration. The ICM pro...

  20. Continuity of the San Andreas Fault at San Gorgonio Pass

    Science.gov (United States)

    Carena, S.; Suppe, J.

    2002-12-01

    The San Andreas fault at San Gorgonio Pass does not have a clear surface trace and is considered aseismic. Our findings suggest in fact that the existence of a through-going vertical or near-vertical San Andreas fault between Yucaipa and North Palm Springs is highly unlikely. We mapped over 70 faults in the San Gorgonio Pass-San Bernardino Mountains region using the catalog of 43,500 relocated 1975-1998 earthquakes of Richards-Dinger and Shearer (2000). A clustering algorithm was applied to the relocated earthquakes in order to obtain tighter earthquake clouds and thus better-defined fault surfaces. The earthquakes were then imported into Gocad, a 3D modeling software that allowed us to separate earthquakes into coplanar clusters associated with different faults and fault strands and to fit optimized surfaces to them. We also used the catalog of 13,000 focal mechanisms of Hauksson (2000) to confirm the nature of the mapped faults. We were able to constrain the 3D geometry of the San Andreas fault near San Gorgonio Pass from the 3D geometry of the fault network surrounding it. None of these faults show any displacement due to an hypothetical sub-vertical San Andreas. The San Andreas fault must therefore rotate to much shallower dips, or lose its continuity at depths between 3 and 15 km The most likely configuration is the one where the San Andreas fault merges into the shallow-dipping San Gorgonio Pass thrust W of North Palm Springs. Strike-slip motion is taken up by both the thrust (the slip vector on the N. Palm Springs segment is reverse/right-lateral strike-slip) and by a series of NW striking faults in the footwall of the thrust. The W termination of the most active part of the San Gorgonio Pass thrust coincides with one of these footwall faults at depth, and with the south bend in the San Andreas fault strand N of Banning. This boundary also marks a change in the stress field, with a dominant strike-slip regime to the E (and localized thrusting between San

  1. [The experience of the EPM (Ergonomics of Posture and Movement) Research Unit in risk analysis and the prevention of work-related musculo-skeletal diseases (WMSDs)].

    Science.gov (United States)

    Occhipinti, E; Colombini, Daniela; Molteni, G

    2003-01-01

    The twenty-year experience of the "Ergonomics of Posture and Movement (epm)" Research Unit for prevention of work-related musculoskeletal disorders (WMSDs) is briefly summarized. The epm research unit is the outcome of an agreement between Milan University (Clinica del Lavoro Luigi Devoto), Milan Polytechnic, Don Gnocchi Foundation IRCCS (Bioengineering Centre) and the Regional Health Service (CEMOC of ICP Hospital). Early activities of epm (1985-1993) are first outlined: they are characterized by a wide range of laboratory studies allowing the development of original methods and criteria for on-site analysis of fixed postures and awkward movements and for ad hoc clinical examination of the musculoskeletal apparatus in working populations. Epm contributions are reviewed for the analysis of working activity involving manual load handling (adapted NIOSH method) and hospital patients (MAPO method) as well as for standardization of health surveillance protocols of spinal diseases. Updated contributions are reported on analysis and prevention of upper limb MSDs connected with upper limb repetitive movements (OCRA method). Finally epm's main collaborations with national and international Authorities are summarized as well as the major technical (health promotion) publications addressed to operators and workers, in different working situations, for prevention of musculoskeletal disorders due to biomechanical overload.

  2. A Meta-Analysis of Adolescent Psychosocial Smoking Prevention Programs Published between 1978 and 1997 in the United States

    Science.gov (United States)

    Hwang, Myunghee Song; Yeagley, Kathleen Lux; Petosa, Rick

    2004-01-01

    Psychosocial smoking prevention studies have shown inconsistent results and theory-driven programs have been related to program success. This meta-analysis was used as a judgment tool for resolving these issues by estimating average program effects and investigating the relative efficacy of program types. The present study examined 65 adolescent…

  3. The Culture of Peace and the Prevention of Terrorism from the Perspectives of Islamic Education and the United Nations

    Science.gov (United States)

    Mawajdeh, Baker S.; Talhouni, Mansour H.; Rashaydeh, Mohammad S.; Hussein, Izdihar J.

    2017-01-01

    Terrorism is an unfamiliar phenomenon to the Islamic religion and it is in opposition to its doctrine. It leads to the loss of innocent lives, destruction of properties, spreading rumors, terrorizing the innocents and destabilization. All this makes fighting and preventing the phenomenon of terrorism the duty of all human beings. This study aimed…

  4. 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.

  5. Increased Suicides in the United States Army: Improving the Effectiveness of the US Army’s Suicide Prevention Program

    Science.gov (United States)

    2013-06-14

    a major cause of suicide, as expressed by an individual who suffered from it to the extent that he made a compulsive decision that almost cost him...Has the US Army Suicide Prevention Program changed the rate (either increased or decreased) of suicide in terms of more “ buy in” from senior leadership

  6. 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...

  7. 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.

  8. 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

  9. 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 (pinterventions had clinically meaningful associations with reduced stage III and IV HAPU incidence rates in 55 academic medical centers. These QI interventions can be used in support of an evidence-based prevention protocol for pressure ulcers. Hospitals can not only use these findings from this study as part of a QI bundle for preventing HAPUs.

  10. 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.

  11. 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.

  12. Riparian Habitat - San Joaquin River

    Data.gov (United States)

    California Department of Resources — 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. 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

  14. The cost-saving effect and prevention of medication errors by clinical pharmacist intervention in a nephrology unit.

    Science.gov (United States)

    Chen, Chia-Chi; Hsiao, Fei-Yuan; Shen, Li-Jiuan; Wu, Chien-Chih

    2017-08-01

    Medication errors may lead to adverse drug events (ADEs), which endangers patient safety and increases healthcare-related costs. The on-ward deployment of clinical pharmacists has been shown to reduce preventable ADEs, and save costs. The purpose of this study was to evaluate the ADEs prevention and cost-saving effects by clinical pharmacist deployment in a nephrology ward.This was a retrospective study, which compared the number of pharmacist interventions 1 year before and after a clinical pharmacist was deployed in a nephrology ward. The clinical pharmacist attended ward rounds, reviewed and revised all medication orders, and gave active recommendations of medication use. For intervention analysis, the numbers and types of the pharmacist's interventions in medication orders and the active recommendations were compared. For cost analysis, both estimated cost saving and avoidance were calculated and compared.The total numbers of pharmacist interventions in medication orders were 824 in 2012 (preintervention), and 1977 in 2013 (postintervention). The numbers of active recommendation were 40 in 2012, and 253 in 2013. The estimated cost savings in 2012 and 2013 were NT$52,072 and NT$144,138, respectively. The estimated cost avoidances of preventable ADEs in 2012 and 2013 were NT$3,383,700 and NT$7,342,200, respectively. The benefit/cost ratio increased from 4.29 to 9.36, and average admission days decreased by 2 days after the on-ward deployment of a clinical pharmacist.The number of pharmacist's interventions increased dramatically after her on-ward deployment. This service could reduce medication errors, preventable ADEs, and costs of both medications and potential ADEs.

  15. Space flight-associated neuro-ocular syndrome (SANS).

    Science.gov (United States)

    Lee, Andrew G; Mader, Thomas H; Gibson, C Robert; Brunstetter, Tyson J; Tarver, William J

    2018-03-12

    Interesting novel and somewhat perplexing physiologic and pathologic neuro-ocular findings have been documented in astronauts during and after long duration space flight (LDSF). These findings collectively have been termed the "space flight-associated neuro-ocular syndrome" (SANS). The National Aeronautics and Space Administration (NASA) in the United States has meticulously and prospectively documented the clinical, ultrasound, optical coherence tomography imaging, and radiographic findings of SANS including unilateral and bilateral optic disc edema, globe flattening, choroidal and retinal folds, hyperopic refractive error shifts, and nerve fiber layer infarcts (i.e., cotton wool spots). NASA and collaborating researchers continue to study SANS in preparation for future manned missions to space, including continued trips to the ISS, a return to the moon, or perhaps new voyages to the asteroid belt, or the planet, Mars.

  16. Residencia San Pedro, California

    Directory of Open Access Journals (Sweden)

    Neutra, Richard J.

    1961-01-01

    Full Text Available Esta vivienda representa una aproximación más hacia la típica casa grande española, con techos de teca de 7 cm, que los señores Rados han edificado y en la que albergan a su gran familia de hijos, los cuales tienen ya sus propios vástagos. Ambos, el señor y la señora Rados, descienden de familias navieras italianas de Trieste, y el propio señor Rados tiene una compañía constructora de barcos en el puerto de San Pedro, que puede verse desde su propia casa. Los dos son verdaderamente unos abuelos muy sociables, cariñosos y atentos. Por añadidura, la señora Rados se entretiene frecuentemente y le agrada el cuidado de la casa. Por ello ha sido proyectada para facilitar sensiblemente toda esta serie de actividades.

  17. Coverage of the Ebola Virus Disease Epidemic in Three Widely Circulated United States Newspapers: Implications for Preparedness and Prevention

    Directory of Open Access Journals (Sweden)

    Corey H Basch

    2014-12-01

    Full Text Available Background:Widespread media attention about Ebola influences public aware-ness and interest, yet there is limited research on what aspects of Ebola have and have not been communicated through the media. Methods:We examined the nature and extent of coverage about Ebola in the three most widely circulated United States (U.S. daily newspapers. Between September 17, 2014 and October 17, 2014, 301 articles about Ebola in The New York Times, USA Today, and The Wall Street Journal were identified and cod-ed. Results:The most common topic was coverage of cases in the United States (39%, followed by the outbreak in Africa (33.6%. Conclusion:This is the first study to describe coverage of the Ebola epidemic in widely circulated U.S. newspapers. A substantial portion of the American public is concerned about being infected with Ebola virus disease (EVD. In this study, a large emphasis was placed on death tolls and the cases in the United States. Much more can be done to educate readers about relevant aspects of the Ebola epidemic, including how Ebola is and is not transmitted.

  18. Coverage of the ebola virus disease epidemic in three widely circulated United States newspapers: implications for preparedness and prevention.

    Science.gov (United States)

    Basch, Corey H; Basch, Charles E; Redlener, Irwin

    2014-01-01

    Widespread media attention about Ebola influences public awareness and interest, yet there is limited research on what aspects of Ebola have and have not been communicated through the media. We examined the nature and extent of coverage about Ebola in the three most widely circulated United States (U.S.) daily newspapers. Between September 17, 2014 and October 17, 2014, 301 articles about Ebola in The New York Times, USA Today, and The Wall Street Journal were identified and coded. The most common topic was coverage of cases in the United States (39%), followed by the outbreak in Africa (33.6%). This is the first study to describe coverage of the Ebola epidemic in widely circulated U.S. newspapers. A substantial portion of the American public is concerned about being infected with Ebola virus disease (EVD). In this study, a large emphasis was placed on death tolls and the cases in the United States. Much more can be done to educate readers about relevant aspects of the Ebola epidemic, including how Ebola is and is not transmitted.

  19. 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

  20. The Comparison of Chlorhexidine Solution and Swab With Toothbrush and Toothpaste Effect on Preventing Oral Lesions in Hospitalized Patients in Intensive Care Unit.

    Science.gov (United States)

    Estaji, Zahra; Alinejad, Mohammad; Hassan Rakhshani, Mohammad; Rad, Mojtaba

    2015-10-20

    Maintaining of oral hygiene has been known as one of the basic tasks of nurses working at intensive care unit. This study aimed to compare the effectiveness of chlorhexidine solution with toothbrush in prevention of oral lesions or ulcers in the different parts of the mouth. In this clinical trial study, research Society included patients hospitalized with endotracheal tube since the arrival time in intensive care unit. In this study, 30 patients were selected with target-based approach and equally divided into two groups through the permutation blocking method for oral care toothbrush and toothpaste and using chlorhexidine and swab. The modified form of Beck Oral Assessment Scale (BOAS) and MPS were used to obtain needed information. Data were analyzed by means of R software (version 3.0.2) and also multiple logistic regressions in the confidence level of 95%. This study indicated an association between using toothbrush and the oral health level (OR: 1.52). In different parts of the mouth, there was no difference between two groups in prevention of lesions in gums, lips and tongue while, this was significant in relation to plaque, mucus and teeth with an odd ratio of 3.94 for teeth and 2.75 for mucus . In comparison, there was an association between implying chlorhexidine and saliva health level. (OR: 2.046). This survey showed that using toothbrush has a noticeable impact on declining oral lesions in varied parts of the mouth.

  1. 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.

  2. Abstinence and teenagers: prevention counseling practices of health care providers serving high-risk patients in the United States.

    Science.gov (United States)

    Harper, Cynthia C; Henderson, Jillian T; Schalet, Amy; Becker, Davida; Stratton, Laura; Raine, Tina R

    2010-06-01

    Abstinence-only education has had little demonstrable impact on teenagers' sexual behaviors, despite significant policy and funding efforts. Given the struggle over resources to improve teenagers' reproductive health outcomes, the views of clinicians serving teenagers at high risk for unintended pregnancy and STDs merit particular attention. In 2005, a qualitative study with 31 clinicians serving low-income, at-risk patients was conducted. A semistructured interview guide was used to ask clinicians about adolescent pregnancy, HIV and STD prevention counseling, and when they include abstinence. Thematic content analysis was used to examine the content of the counseling and the techniques used in different situations. Providers reported offering comprehensive counseling, presenting abstinence as a choice for teenagers, along with information about contraceptives and condoms. Several providers mentioned that with young, sexually inexperienced teenagers, they discuss delaying sexual activity and suggest other ways to be affectionate, while giving information on condoms. Providers explained how they assess whether teenagers feel ready to be sexually active and try to impart skills for healthy relationships. Some described abstinence as giving teenagers a way to opt out of unwanted sexual activity. Many support abstinence if that is the patient's desire, but routinely dispense condoms and contraceptives. Overall, providers did not give abstinence counseling as a rigid categorical concept in their preventive practices, but as a health tool to give agency to teenagers within a harm reduction framework. Their approach may be informative for adolescent policies and programs in the future.

  3. Substance Use Prevention Programs for Indigenous Adolescents in the United States of America, Canada, Australia and New Zealand: Protocol for a Systematic Review.

    Science.gov (United States)

    Snijder, Mieke; Stapinski, Lexine; Lees, Briana; Newton, Nicola; Champion, Katrina; Chapman, Catherine; Ward, James; Teesson, Maree

    2018-02-01

    Indigenous adolescents are at a higher risk of experiencing harms related to substance use compared with their non-Indigenous counterparts as a consequence of earlier onset and higher rates of substance use. Early onset of substance use has been identified as a risk factor for future substance use problems and other health, social, and family outcomes. Therefore, prevention of substance use among adolescents has been identified as a key area to improve health of Indigenous Peoples. Evidence exists for the effectiveness of prevention approaches for adolescents in mainstream populations and, most recently, for the use of computer- and Internet-delivered interventions to overcome barriers to implementation. However, there is currently no conclusive evidence about the effectiveness of these approaches for Indigenous adolescents. The purpose of this review is to synthesize the international evidence regarding the effectiveness of substance use prevention programs for Indigenous adolescents in the United States, Canada, Australia, and New Zealand. A total of 8 peer-reviewed databases and 20 gray literature databases will be searched, using search terms in line with the aims of this review and based on previous relevant reviews of substance use prevention. Studies will be included if they evaluate a substance use prevention program with Indigenous adolescents (aged 10 to 19 years) as the primary participant group and are published between January 1, 1990 and August 31, 2017. A narrative synthesis will be provided about the effectiveness of the programs, the type of program (whether culture-based, adapted, or unadapted), delivery of the program (computer- and Internet-delivered or traditional), and the setting in which the programs are delivered (community, school, family, clinical, or a combination). The study will identify core elements of effective substance use prevention programs among Indigenous adolescents and appraise the methodological quality of the studies. This

  4. 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.

  5. 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.

  6. Exploring diaphragm use as a potential HIV prevention strategy among women in the United States at risk.

    Science.gov (United States)

    Harvey, S Marie; Branch, Meredith R; Thorburn, Sheryl; Warren, Jocelyn; Casillas, America

    2008-04-01

    Given the immediate need for physical cervical barrier methods like the diaphragm to protect against HIV/STIs, understanding what factors influence the acceptability of these products and how to overcome obstacles to their use is important. We explored perceptions of the diaphragm and factors that might enhance its acceptability in 25 focus groups with racially/ethnically diverse young women in the U.S. at risk for HIV/STIs (N = 140). Women believed the diaphragm has positive attributes, and most indicated they would be more likely to use the diaphragm if they were confident they could use it correctly and it protected against HIV. They also considered it messy to use and difficult to insert or remove. Findings suggest that the diaphragm could be a desirable option for pregnancy and disease prevention for some women at risk for HIV/STIs. Although disadvantages to diaphragm use were identified, many could be eliminated through changes in product design and provider intervention.

  7. 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.

  8. Public health strategies for prevention and control of HSV-2 in persons who use drugs in the United States.

    Science.gov (United States)

    Semaan, Salaam; Leinhos, Mary; Neumann, Mary Spink

    2013-08-01

    Herpes simplex virus type 2 (HSV-2) affects HIV acquisition, transmission, and disease progression. Effective medications for genital herpes and for HIV/AIDS exist. Parenteral transmission of HIV among persons who inject drugs is decreasing. Reducing sexual transmission of HIV and HSV-2 among persons who use drugs (PWUD; i.e., heroin, cocaine, "speedball", crack, methamphetamine through injection or non-injection) necessitates relevant services. We reviewed HSV-2 sero-epidemiology and HSV-2/HIV associations in U.S.-based studies with PWUD and the general literature on HSV-2 prevention and treatment published between 1995 and 2012. We used the 6-factor Kass framework to assess relevant HSV-2 public health strategies and services in terms of their goals and effectiveness; identification of, and minimization of burdens and concerns; fair implementation; and fair balancing of benefits, burdens, and concerns. Eleven studies provided HSV-2 serologic test results. High HSV-2 sero-prevalence (range across studies 38-75%) and higher sero-prevalence in HIV-infected PWUD (97-100% in females; 61-74% in males) were reported. Public health strategies for HSV-2 prevention and control in PWUD can include screening or testing; knowledge of HSV-2 status and partner disclosure; education, counseling, and psychosocial risk-reduction interventions; treatment for genital herpes; and HIV antiretroviral medications for HSV-2/HIV co-infected PWUD. HSV-2 sero-prevalence is high among PWUD, necessitating research on development and implementation of science-based public health interventions for HSV-2 infection and HSV-2/HIV co-infections, including research on effectiveness and cost-effectiveness of such interventions, to inform development and implementation of services for PWUD. Published by Elsevier Ireland Ltd.

  9. Safety in the Heat: a comprehensive program for prevention of heat illness among workers in Abu Dhabi, United Arab Emirates.

    Science.gov (United States)

    Joubert, Darren; Thomsen, Jens; Harrison, Oliver

    2011-03-01

    The Safety in the Heat program was developed in response to the extreme heat stress conditions experienced by workers in the United Arab Emirates and other Middle Eastern countries each summer, where ambient air temperatures often reach 45°C (135°F) and higher with 90% humidity. A comprehensive, multimedia, economical education and awareness program targeting companies in the region was developed; 465 companies employing 814 996 heat-exposed workers across 6254 work and labor residence sites were reached. Feedback from program participants indicated a high level of support and satisfaction. Results indicated a marked reduction in heat related illness over a period of 2 years (2008-2009) at 2 companies, one of which reported a combined 79.5% decrease in cases (15.3 vs 1.16 cases per 1000 workers) while the other experienced a 50% reduction in serious cases (0.08-0.04 cases per 100,000 work hours).

  10. 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.

  11. 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…

  12. 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

  13. 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

  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. 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.

  16. 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

  17. Las sibilas de San Telmo

    OpenAIRE

    Buisel, María Delia

    2010-01-01

    Las Sibilas de San Telmo son doce telas ubicadas en la sacristía de la Iglesia de San Telmo (Buenos Aires, Argentina) que representan a las sibilas Cumea, Helespóntica, Líbica, Cumana, Pérsica, Tiburtina, Frigia, Délfica, Rodia, Eritrea, Sambetea y Samia. Son telas anónimas del siglo XVIII, cuyo origen es desconocido y discutido: pueden ser españolas o cuzqueñas. Cada cuadro consta de tres partes: 1. la imagen de la sibila de frente ricamente vestida; 2. un medallón o tondo, ornado de flores...

  18. 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.

  19. 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.

  20. Use of nitroglycerin by bolus prevents intensive care unit admission in patients with acute hypertensive heart failure.

    Science.gov (United States)

    Wilson, Suprat Saely; Kwiatkowski, Gregory M; Millis, Scott R; Purakal, John D; Mahajan, Arushi P; Levy, Phillip D

    2017-01-01

    The purpose of this study was to compare health care resource utilization among patients who were given intravenous nitroglycerin for acute heart failure (AHF) in the emergency department (ED) by intermittent bolus, continuous infusion, or a combination of both. We retrospectively identified 395 patients that received nitroglycerin therapy in the ED for the treatment of AHF over a 5-year period. Patients that received intermittent bolus (n=124) were compared with continuous infusion therapy (n=182) and combination therapy of bolus and infusion (n=89). The primary outcomes were the frequency of intensive care unit (ICU) admission and hospital length of stay (LOS). On unadjusted analysis, rates of ICU admission were significantly lower in the bolus vs infusion and combination groups (48.4% vs 68.7% vs 83%, respectively; PICU admission rate remained, and hospital LOS was 1.9 days shorter compared with infusion therapy alone. Use of intubation (bolus [8.9%] vs infusion [8.8%] vs combination [16.9%]; P=.096) and bilevel positive airway pressure (bolus [26.6%] vs infusion [20.3%] vs combination [29.2%]; P=.21) were similar as was the incidence of hypotension, myocardial injury, and worsening renal function. In ED patients with AHF, intravenous nitroglycerin by intermittent bolus was associated with a lower ICU admission rate and a shorter hospital LOS compared with continuous infusion. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. 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.

  2. 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.,

  3. Program Updates - San Antonio River Basin

    Science.gov (United States)

    This page will house updates for this urban waters partnership location. As projects progress, status updates can be posted here to reflect the ongoing work by partners in San Antonio working on the San Antonio River Basin.

  4. 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

  5. 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.

  6. 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...

  7. 78 FR 35593 - Special Local Regulation; Christmas Boat Parade, San Juan Harbor; San Juan, PR

    Science.gov (United States)

    2013-06-13

    ... DEPARTMENT OF HOMELAND SECURITY Coast Guard 33 CFR Part 100 [Docket Number USCG-2013-0295] RIN 1625-AA08 Special Local Regulation; Christmas Boat Parade, San Juan Harbor; San Juan, PR AGENCY: Coast... Regulation; Christmas Boat Parade, San Juan Harbor; San Juan, PR (a) Regulated Area. The following regulated...

  8. 78 FR 29289 - Safety Zone; Big Bay Boom, San Diego Bay, San Diego, CA

    Science.gov (United States)

    2013-05-20

    ... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA00 Safety Zone; Big Bay Boom, San Diego Bay, San Diego, CA... establish four temporary safety zones upon the navigable waters of San Diego ] Bay for the Port of San Diego... docket number using any one of the following methods: (1) Federal eRulemaking Portal: http://www...

  9. Measles outbreak in a pediatric oncology unit and the role of ribavirin in prevention of complications and containment of the outbreak.

    Science.gov (United States)

    Roy Moulik, Nirmalya; Kumar, Archana; Jain, Amita; Jain, Parul

    2013-10-01

    The role of oral ribavirin in treatment and containment of a measles outbreak in 15 children in an oncology unit is presented. Measles was diagnosed on clinical features and history of contact. Measles specific IgM ELISA and RNA were positive in 7 of 15 and 2 of 7 tested children, respectively. Duration of illness was longer in unimmunized as compared to immunized children (P = 0.02). Complications were higher in hematological malignancies (P = 0.025). Delay in starting ribavirin was associated with fatal complications (2 of 2 vs. 0 of 13, P = 0.009). Ribavirin prevented measles in all (21 of 21) patients exposed to the cases. Copyright © 2013 Wiley Periodicals, Inc.

  10. 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

    Background: The impact of intermittent preventive treatment (IPTp) on malaria in pregnancy is well known. However, in countries where this policy is implemented, poor access and low compliance have been widely reported. Novel approaches are needed to deliver this intervention. Objective: To assess...... 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......: An intervention study compared the delivery of IPTp in the community with routine delivery of IPTp at health units. The primary outcome measures were the proportion of adolescents and primigravidae accessed, and the proportion of women who received two doses of SP. The study also assessed the effect...

  11. Exposure to School and Community Based Prevention Programs and Reductions in Cigarette Smoking among Adolescents in the United States, 2000–08

    Science.gov (United States)

    Chen, Xinguang; Ren, Yuanjing; Lin, Feng; MacDonell, Karen; Jiang, Yifan

    2011-01-01

    Smoking remains prevalent among U.S. youth despite decades of antismoking efforts. Effects from exposure to prevention programs at national level may provide informative and compelling data supporting better planning and strategy for tobacco control. A national representative sample of youth 12–17 years of age from the National Survey on Drug Use and Health was analyzed. A 3-stage model was devised to estimate smoking behavior transitions using cross-sectional data and the Probabilistic Discrete Event System method. Cigarette smoking measures (prevalence rates and odds ratios) were compared between exposed and non-exposed youth. More than 95% of the sample was exposed to prevention programs. Exposure was negatively associated with lifetime smoking and past 30-day smoking with a dose-response relation. Reduction in smoking was related to increased quitting in 2000–02, to increased quitting and declined initiation in 2003–05, and to initiation, quitting and relapse in 2005–08. Findings of this analysis suggest that intervention programs in the United States can reduce cigarette smoking among youth. Quitting smoking was most responsive to program exposure and relapse was most sensitive to funding cuts since 2003. Health policy and decision makers should consider these factors in planning and revising tobacco control strategies. PMID:22410164

  12. Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States: implications for HIV prevention programs.

    Science.gov (United States)

    Marks, Gary; Crepaz, Nicole; Senterfitt, J Walton; Janssen, Robert S

    2005-08-01

    To compare the prevalence of high-risk sexual behaviors in HIV persons aware of their serostatus with that in HIV persons unaware of their status in the United States and to discuss implications for HIV prevention programs. A meta-analysis was conducted on 11 independent findings. Six findings compared HIV(+) aware persons with independent groups of HIV(+) unaware persons (between-group comparisons), and 5 findings compared seroconverting individuals before and after being notified of their HIV status (within-subject comparisons). Outcomes were self-reported unprotected anal or vaginal intercourse (UAV) during specified recall periods. The analysis integrating all 11 findings indicated that the prevalence of UAV with any partner was an average of 53% (95% confidence interval [CI]: 45%-60%) lower in HIV persons aware of their status relative to HIV(+) persons unaware of their status. There was a 68% reduction (95% CI: 59%-76%) after adjusting the data of the primary studies to focus on UAV with partners who were not already HIV(+). The reductions were larger in between-group comparisons than in within-subject comparisons. Findings for men and women were highly similar. The prevalence of high-risk sexual behavior is reduced substantially after people become aware they are HIV(+). Increased emphasis on HIV testing and counseling is needed to reduce exposure to HIV(+) from persons unaware they are infected. Ongoing prevention services are needed for persons who know they are HIV(+) and continue to engage in high-risk behavior.

  13. 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

  14. 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

  15. 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. 

  16. Aspirin for Evidence-Based Preeclampsia Prevention trial: effect of aspirin on length of stay in the neonatal intensive care unit.

    Science.gov (United States)

    Wright, David; Rolnik, Daniel L; Syngelaki, Argyro; de Paco Matallana, Catalina; Machuca, Mirian; de Alvarado, Mercedes; Mastrodima, Sofia; Yi Tan, Min; Shearing, Siobhan; Persico, Nicola; Jani, Jacques C; Plasencia, Walter; Papaioannou, George; Molina, Francisca S; Poon, Liona C; Nicolaides, Kypros H

    2018-03-02

    Preeclampsia is a major pregnancy complication with adverse short- and long-term implications for both the mother and baby. Screening for preeclampsia at 11-13 weeks' gestation by a combination of maternal demographic characteristics and medical history with measurements of biomarkers can identify about 75% of women that develop preterm-preeclampsia with delivery at intensive care unit, which was one of the secondary outcomes, was not significantly affected (odds ratio 0.93, 95% confidence interval, 0.62-1.40). To examine the effect of prophylactic use of aspirin during pregnancy in women at high-risk of preeclampsia on length of stay in the neonatal intensive care unit. This was a secondary analysis of data from the Aspirin for Evidence-Based Preeclampsia Prevention trial to assess evidence of differences in the effect of aspirin on length of stay in neonatal intensive care. Bootstrapping was used for the comparison of mean length of stay between the aspirin and placebo groups. Logistic-regression was used to assess treatment effects on stay in the neonatal intensive care unit. In the trial there were 1620 participants and 1571 neonates were liveborn. The total length of stay in neonatal intensive care was substantially longer in the placebo than aspirin group (1696 vs. 531 days). This is a reflection of significantly shorter mean lengths of stay in babies admitted to the neonatal intensive care unit from the aspirin than the placebo group (11.1 vs. 31.4 days; a reduction of 20.3 days (95% confidence interval, 7.0-38.6; p=0.008). Neonatal intensive care of babies born at intensive care across both treatment arms. These occurred in 9 (1.2%) of the 777 livebirths in the aspirin group and in 23 (2.9%) of 794 in the placebo group (odds ratio 0.42; 95% confidence interval, 0.19-0.93; p=0.033). Overall, in the whole population, including zero lengths of stay for those that were not admitted to the neonatal intensive care unit, the mean length of stay was longer in the

  17. 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

  18. 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

  19. 78 FR 58878 - Safety Zone; San Diego Shark Fest Swim; San Diego Bay, San Diego, CA

    Science.gov (United States)

    2013-09-25

    ... this rule because the logistical details of the San Diego Shark Fest Swim were not finalized nor... Operations Center will issue Broadcast Notice to Mariners on the location and enforcement of the safety zone... and the States, or on the distribution of power and responsibilities among the various levels of...

  20. Fragmented Landscapes in the San Gorgonio Pass Region: Insights into Quaternary Strain History of the Southern San Andreas Fault System

    Science.gov (United States)

    Kendrick, K. J.; Matti, J. C.; Landis, G. P.; Alvarez, R. M.

    2006-12-01

    The San Gorgonio Pass (SGP) region is a zone of structural complexity within the southern San Andreas Fault system that is characterized by (1) multiple strands of the San Andreas Fault (SAF), (2) intense and diverse microseismicity, (3) contraction within the SGP fault zone (SGPfz), and (4) complex and diverse landforms - all a consequence of structural complications in the vicinity of the southeastern San Bernardino Mountains (SBM). Multiple strands of the SAF zone in the SGP region partition the landscape into discrete geomorphic/geologic domains, including: San Gorgonio Mountain (SGM), Yucaipa Ridge (YR), Kitching Peak (KP), Pisgah Peak (PP), and Coachella Valley (CV) domains. The morphology of each domain reflects the tectonic history unique to that region. Development of the SGP knot in the Mission Creek strand of the SAF (SAFmi) led to westward deflection of the SAFmi, juxtaposition of the KP, PP, and SGM domains, initiation of uplift of YR domain along thrust faults in headwaters of San Gorgonio River, and development of the San Jacinto Fault. Slip on the SAF diminished as a result, thereby allowing integrated drainage systems to develop in the greater SGP region. San Gorgonio River, Whitewater River, and Mission Creek are discrete drainages that transport sediment across the SGM, YR, PP, KP, and CV domains into alluvial systems peripheral to the SGP region. There, depositional units (San Timoteo Formation, upper member, deformed gravels of Whitewater River) all contain clasts of SBM-type and San Gabriel Mountain-type basement, thus constraining slip on the SAF in the SGP region. Middle and late Pleistocene slip on the Mill Creek strand of the SAF (SAFm) in the SGP region has attempted to bypass the SGP knot, and has disrupted landscapes established during SAFmi quiescence. Restoration of right-slip on the SAFm is key to deciphering landscape history. Matti and others (1985, 1992) proposed that a bi-lobed alluvial deposit in the Raywood Flats area has been

  1. 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.

  2. 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

    2014-11-25

    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 surveyed

  3. The effect of a silicone border foam dressing for prevention of pressure ulcers and incontinence-associated dermatitis in intensive care unit patients.

    Science.gov (United States)

    Park, Kyung Hee

    2014-01-01

    We measured the effect of a silicone border foam dressing on the development of pressure ulcers (PUs) and incontinence-associated dermatitis in intensive care unit (ICU) patients. Nonrandomized comparison cohort (quasi-experimental) study. One hundred and two patients (>40 years of age) with a Braden Scale score of 16 or less who were admitted to 2 ICUs at the Samsung Medical Center in Seoul, South Korea, participated in the study. Pressure ulcer development was determined based on 2009 Guidelines from the National Pressure Ulcer Advisory Panel and European Pressure Ulcer Advisory Panel. Incontinence-associated dermatitis was measured using the Incontinence Associated Dermatitis and its Severity (IADS) instrument. Fifty-two subjects were assigned to the experimental group (standard PU preventive care routine plus application of the silicone border foam dressing), and 50 subjects were assigned to the control group (standard PU preventive care alone). The number of patients who developed PU in the experimental group was compared with that from the control group using the chi-square test (χ). The IADS score of the experimental group was measured and compared with those of the control group, using an independent t test. Logistic regression was carried out to analyze the relationship between the IADS score and PU development. Both the incidence of PU development and IADS scores were significantly lower (χ = 21.722, P border foam dressing decreased PU development and reduced the IADS score. Pressure ulcer development was found to be related to IADS score; the incidence of PU development significantly increased as IADS score increased.

  4. 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.

  5. Prevention and Control of Multidrug-Resistant Gram-Negative Bacteria in Adult Intensive Care Units: A Systematic Review and Network Meta-analysis.

    Science.gov (United States)

    Teerawattanapong, Nattawat; Kengkla, Kirati; Dilokthornsakul, Piyameth; Saokaew, Surasak; Apisarnthanarak, Anucha; Chaiyakunapruk, Nathorn

    2017-05-15

    This study evaluated the relative efficacy of strategies for the prevention of multidrug-resistant gram-negative bacteria (MDR-GNB) in adult intensive care units (ICUs). A systematic review and network meta-analysis was performed; searches of the Cochrane Library, PubMed, Embase, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) included all randomized controlled trials and observational studies conducted in adult patients hospitalized in ICUs and evaluating standard care (STD), antimicrobial stewardship program (ASP), environmental cleaning (ENV), decolonization methods (DCL), or source control (SCT), simultaneously. The primary outcomes were MDR-GNB acquisition, colonization, and infection; secondary outcome was ICU mortality. Of 3805 publications retrieved, 42 met inclusion criteria (5 randomized controlled trials and 37 observational studies), involving 62068 patients (median age, 58.8 years; median APACHE [Acute Physiology and Chronic Health Evaluation] II score, 18.9). The majority of studies reported extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae and MDR Acinetobacter baumannii. Compared with STD, a 4-component strategy composed of STD, ASP, ENV, and SCT was the most effective intervention (rate ratio [RR], 0.05 [95% confidence interval {CI}, .01-.38]). When ENV was added to STD+ASP or SCT was added to STD+ENV, there was a significant reduction in the acquisition of MDR A. baumannii (RR, 0.28 [95% CI, .18-.43] and 0.48 [95% CI, .35-.66], respectively). Strategies with ASP as a core component showed a statistically significant reduction the acquisition of ESBL-producing Enterobacteriaceae (RR, 0.28 [95% CI, .11-.69] for STD+ASP+ENV and 0.23 [95% CI, .07-.80] for STD+ASP+DCL). A 4-component strategy was the most effective intervention to prevent MDR-GNB acquisition. As some strategies were differential for certain bacteria, our study highlighted the need for further evaluation of the most effective prevention strategies

  6. 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.

  7. 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

  8. Factores de riesgo de accidentes en niños que consultaron al Policlínico Infantil de Medellín Diciembre 1 de 1998-marzo 6 de 1999 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

    Directory of Open Access Journals (Sweden)

    María Beatriz Mesa Restrepo

    2001-02-01

    Full Text Available 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 duración. Se trabajó con 1.185 pacientes. La distribución por sexo fue: 771 niños (65% y 414 niñas (35%; el 76,9% (912 pacientes procedían de Medellín y su área metropolitana. El lugar del accidente fue como sigue: en la calle 582 niños (49%; en el hogar 496 niños (41,9%, en la escuela 32 niños (2,7% y en otros sitios 75 niños (6,3%. Se encontraban solos en el momento del accidente 199 niños (16,8%, con otros niños 512 (43,2% y con adultos 474 (40%. El principal tipo de accidente fue el mecánico en 1.077 casos (90,9%; 740 niños sufrieron caídas lo que representó el 62,5% de todos los accidentes. El accidente por vehículos de motor representó el 10,3% (123 casos. El trauma fue leve en 1.128 niños (95,2%. La letalidad fue del 0,7% (8 niños, especialmente por trauma craneoencefálico debido a accidentes de tránsito y heridas por arma de fuego. El trauma fue más grave en los menores de 2 años. Se encontró diferencia estadísticamente significativa en la frecuencia de traumas entre el período de vacaciones y el académico, con más accidentes durante las vacaciones. Se recomienda iniciar programas de prevención de accidentes especialmente en el hogar, dirigidos a los padres y cuidadores de los menores, con énfasis en las etapas de desarrollo de los niños y los riesgos para los diferentes tipos de accidentes. 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

  9. “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

    Directory of Open Access Journals (Sweden)

    Zoe Belshaw

    2018-02-01

    Full Text Available 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.

  10. 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.

  11. 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.

  12. 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.

  13. Behavioral lifestyle interventions for the primary prevention of type 2 diabetes and translation to Hispanic/Latino communities in the United States and Mexico.

    Science.gov (United States)

    Venditti, Elizabeth M

    2017-01-01

    Lifestyle behaviors in overweight and obese individuals are closely linked to the development, course, and outcomes of type 2 diabetes and multiple comorbid health conditions. Behavior change theory and many randomized controlled studies offer strong support for screening and identifying adults at increased cardiometabolic risk and for providing early intervention to mitigate risk factors to prevent or delay the onset of disease. The current article reviews key lifestyle intervention efficacy and dissemination trials conducted with individuals deemed to be at increased risk for diabetes and describes the rationale for training teams of professionals and community health workers (e.g., promotores [in Spanish]) to implement comprehensive programs, with fidelity, in a variety of medical care and community settings. This evidence-based road map may be used to facilitate the design and implementation of strategies for structured behavioral diabetes risk reduction programs in the public and private healthcare sectors and other relevant community-based platforms serving individuals of Hispanic/Latino origin in the United States and Mexico. © The Author(s) 2016. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  14. Sensory Reduction on the General Milieu of a High-Acuity Inpatient Psychiatric Unit to Prevent Use of Physical Restraints: A Successful Open Quality Improvement Trial.

    Science.gov (United States)

    Yakov, Svetlana; Birur, Badari; Bearden, Melissa F; Aguilar, Barbara; Ghelani, Kinjal J; Fargason, Rachel E

    Impaired sensory gating in patients with acute mental illness predisposes to overstimulation and behavioral dyscontrol. Explore use of sensory reduction interventions on a high-acuity inpatient milieu to reduce high assault/restraint rates. A multidisciplinary team using failure mode and effect analysis to explore high restraint use between 4:00 p.m. and 7:00 p.m. observed patient/staff overstimulation contributed to behavioral escalations. The team implemented sensory reduction/integration improvements over a 5-month period to prevent excessive restraint use. Restraint rates dropped immediately following light and sound reduction interventions and by 72% at 11 months postimplementation. Mann-Whitney statistics for unpaired 6-month comparisons, 1-year pre- and postintervention showed significant reductions: Assault rates (median pre = 1.37, post = 0.18, U = 4, p = .02); Restraint rates (median pre = 0.50, post = 0.06, U = 0, p = .002). Sensory reduction during a high-stress time period on a high-acuity psychiatric unit was associated with a reduction in assaults and restraints.

  15. State-by-state Variation in Prostate-specific Antigen Screening Trends Following the 2011 United States Preventive Services Task Force Panel Update.

    Science.gov (United States)

    Vetterlein, Malte W; Dalela, Deepansh; Sammon, Jesse D; Karabon, Patrick; Sood, Akshay; Jindal, Tarun; Meyer, Christian P; Löppenberg, Björn; Sun, Maxine; Trinh, Quoc-Dien; Menon, Mani; Abdollah, Firas

    2018-02-01

    To evaluate state-by-state trends in prostate-specific antigen (PSA) screening prevalence after the 2011 United States Preventive Services Task Force (USPSTF) recommendation against this practice. We included 222,475 men who responded to the Behavioral Risk Factor Surveillance System 2012 and 2014 surveys, corresponding to early and late post-USPSTF populations. Logistic regression was used to identify predictors of PSA screening and to calculate the adjusted and weighted state-by-state PSA screening prevalence and respective relative percent changes between 2012 and 2014. To account for unmeasured factors, the correlation between changes in PSA screening over time and changes in screening for colorectal and breast cancer were assessed. All analyses were conducted in 2016. Overall, 38.9% (95% confidence interval [CI] = 38.6%-39.2%) reported receiving PSA screening in 2012 vs 35.8% (95% CI = 35.1%-36.2%) in 2014. State of residence, age, race, education, income, insurance, access to care, marital status, and smoking status were independent predictors of PSA screening in both years (all P trends following the 2011 USPSTF recommendation. Further research is needed to elucidate the reasons for this heterogeneity in screening behavior among the states. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Geomorphological expression of a complex structural region: San Andreas Fault through the San Gorgonio Pass, southern California

    Science.gov (United States)

    Kendrick, K. J.; Matti, J. C.

    2015-12-01

    The San Gorgonio Pass (SGP) region of southern California is a locus of extensive Quaternary deformation surrounding a complex section of the San Andreas Fault (SAF) zone. The geomorphology of the SGP region reflects the complicated history of geologic events in the formation of this structural 'knot'. Critical questions remain in assessing earthquake hazard for this region: What is the likelihood that rupture will propagate through the SGP? If rupture is able to propagate, what pathway will connect the various fault strands? To address these questions, we focus on the geology and geomorphology of the SGP region. We have identified fault-bounded blocks, and focus on three that are developed within crystalline bedrock: the Yucaipa Ridge block (YRB) block, the Kitching Peak block (KPB), and the Pisgah Peak block (PPB). The latter two blocks are positioned south of the YRB, and partially separated from each other by the San Bernardino strand; this strand cannot be mapped at the surface as an active connection between fault strands. Both KPB and PPB are bounded to the south by the San Gorgonio Pass Fault Zone. Morphometric analyses consistently demonstrate distinctions between KPB and PPB, though the bedrock lithologies are the same. Geologic mapping of the region highlights the differences in Quaternary units within the blocks. These geomorphic and geologic distinctions lead to our interpretation that KPB and PPB have experienced markedly different uplift histories that constrain the history of dextral slip on the SAF through SGP. Specifically, although the latest Quaternary geologic setting of SGP raises questions about modern slip transfer through the Pass, the contrasting uplift histories of KPB and PPB strongly suggest that earlier in Quaternary time SGP was not a barrier to slip transfer between the Coachella Valley to the SE and the San Bernardino Basin to the NW.

  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. Treatment, Education, and Prevention: Adding to the Arsenal in the War on Drugs. Hearing before the Committee on the Judiciary, United States Senate, One Hundred Seventh Congress, First Session.

    Science.gov (United States)

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

    A hearing was held on the role of prevention in the comprehensive drug control policy of the United States. The hearing demonstrated a strengthening of the commitment to reduce the demand for drugs. It also showed bi-partisan support to remain vigilant in defense of the borders and in punishing those who sell or manufacture drugs. It states that…

  19. Child Abuse Prevention Act, 1973. Hearings Before the Subcommittee on Children and Youth of the Committee on Labor and Public Welfare, United States Senate, Ninety-third Congress, First Session on S.1191.

    Science.gov (United States)

    Congress of the U.S., Washington, DC. Senate Committee on Labor and Public Welfare.

    A record of the Senate hearings on The Child Abuse Prevention Act of 1973 is presented. A copy of Senator Mondale's bill to establish a national center on child abuse is included. The objectives of the hearings were to investigate the magnitude of the child abuse problem in the United States and to clarify a definition of the problem. Different…

  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. 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

  2. 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...

  3. 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...

  4. 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...

  5. 76 FR 55796 - Safety Zone; TriRock Triathlon, San Diego Bay, San Diego, CA

    Science.gov (United States)

    2011-09-09

    ... logistical details of the San Diego Bay swim were not finalized or presented to the Coast Guard in enough... navigable waters of the San Diego Bay behind the San Diego Convention Center bound by the following... Government and Indian tribes, or on the distribution of power and responsibilities between the Federal...

  6. 76 FR 1386 - Safety Zone; Centennial of Naval Aviation Kickoff, San Diego Bay, San Diego, CA

    Science.gov (United States)

    2011-01-10

    ... Diego Bay, San Diego, CA AGENCY: Coast Guard, DHS. ACTION: Notice of proposed rulemaking. SUMMARY: The Coast Guard proposes a temporary safety zone on the navigable waters of San Diego Bay in San Diego, CA... using any one of the following methods: (1) Federal eRulemaking Portal: http://www.regulations.gov . (2...

  7. 78 FR 77597 - Safety Zone; Allied PRA-Solid Works, San Diego Bay; San Diego, CA

    Science.gov (United States)

    2013-12-24

    ... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA00 Safety Zone; Allied PRA-Solid Works, San Diego Bay; San... the Allied PRA--Solid Works fireworks display, which will be conducted from a barge located southwest....T11-612 Safety zone; Allied PRA-Solid Works; San Diego, CA. (a) Location. The limits of the safety...

  8. 75 FR 27432 - Security Zone; Golden Guardian 2010 Regional Exercise; San Francisco Bay, San Francisco, CA

    Science.gov (United States)

    2010-05-17

    ...-AA87 Security Zone; Golden Guardian 2010 Regional Exercise; San Francisco Bay, San Francisco, CA AGENCY... security zones on the navigable waters of the San Francisco Bay in support of Golden Guardian 2010 Regional... the Coast Guard enforce temporary security zones for operations on May 18, 2010 at the Golden Guardian...

  9. 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.

  10. 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

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

    Science.gov (United States)

    Owens, Douglas K.; Goldhaber-Fiebert, Jeremy D.; Brandeau, Margaret L.

    2017-01-01

    Background 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). Methods and findings 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

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

    Science.gov (United States)

    Bernard, Cora L; Owens, Douglas K; Goldhaber-Fiebert, Jeremy D; Brandeau, Margaret L

    2017-05-01

    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$7

  13. 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.

  14. The impact of the United States Preventive Services Task Force (USPTSTF) recommendations against prostate-specific antigen (PSA) testing on PSA testing in Australia.

    Science.gov (United States)

    Zargar, Homayoun; van den Bergh, Roderick; Moon, Daniel; Lawrentschuk, Nathan; Costello, Anthony; Murphy, Declan

    2017-01-01

    To assess the impact of the United States Preventive Services Task Force (USPTSTF) recommendations on prostate-specific antigen (PSA) testing, prostate biopsy, and prostatectomy in Australian men based on the available Medicare data. Events were identified using Medicare item numbers for PSA testing (66655, 66659), prostate biopsy (37219), prostatectomy (37210), and prostatectomy with lymph node dissection (37211). The occurrences of each procedure was queried per 100 000 capita for consecutive financial years over the period 2000-2015. For each item number, reports were also generated for all Australian States. For PSA testing the data was stratified into three age groups of 45-54, 55-64, and 65-74 years. For assessing the rate of prostatectomy the capita rate values for two item numbers of prostatectomy (37210) and prostatectomy with lymph node dissection (37211) were combined. Steady declines in per capita incidences of all five item numbers assessed were seen for the three consecutive financial years (2013-2015) since the publication of the USPTSTF recommendation statement. These declines were seen across all Australian States. When examining the rate of PSA testing for the three age brackets 45-54, 55-64, and 65-74 years, similar trends were identified. Since the introduction of the USPTSTF recommendation statement there has been a steady nationwide decline in per capita incidences of PSA testing, prostate biopsy, and prostatectomy based on the Australian Medicare data. Whether these declines are in the right direction toward reduction in over-diagnosis and overtreatment of clinically insignificant prostate cancer or stage migration toward more locally advanced disease due to lost opportunity in diagnosing and treating early clinically significant prostate cancer will remain to be seen. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.

  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. Child and youth traffic-related injuries: use of a trauma registry to identify priorities for prevention in the United Arab Emirates.

    Science.gov (United States)

    Grivna, Michal; Barss, Peter; Stanculescu, Cristina; Eid, Hani O; Abu-Zidan, Fikri M

    2013-01-01

    Traffic-related injuries are the main cause of death during childhood and youth in the United Arab Emirates (UAE), use of safety restraints by citizens is uncommon, rollovers are frequent, and current legislation does not protect rear-seat occupants. Because little was known about the circumstances of hospitalizations for traffic injuries to guide prevention, a trauma registry was used to assess causes and determinants for traffic-related injuries during childhood and youth (children and youth with traffic injuries were admitted for more than 24 h at surgical wards of the main trauma hospital in the Al-Ain region during a 36-month period (2003-2006). Injuries were analyzed by age, nationality, road user and vehicle types, severity, anatomical region, and the presence of head injury using Injury Severity Scores (ISS) and the Abbreviated Injury Scale (AIS). Traffic injuries represented 40 percent (n = 193) of injuries to 0- to 19-year-olds, followed by falls (39 percent). Among 15- to 19-year-olds, who accounted for 46 percent of child and youth victims, the incidence was 150/100,000 person years, compared to an incidence of 15 to 51 for younger age groups. Overall, 53 percent were vehicle occupants, 23 percent were pedestrians, 14 percent were bicyclists, 6 percent were motorcyclists, with 4 percent other. The ratio of male-to-female victims was 6.7:1; for drivers it was 33:0; and for pedestrians, bicyclists, and motorcyclists it was between 10:1 and 12:1; injured females were mainly rear-seat passengers and the male: female ratio was 1.4:1. Seventy-one percent of pedestrians were ≤9 years old. Although the ratio of UAE children to foreign children was estimated at 0.7:1 in the community, 58 percent of the injured were UAE citizens. The ratio of injured UAE: non-UAE citizens was 1.4:1 overall but 5.6:1 for drivers and 4.5:1 for motorcyclists. Forty-one percent of citizens were injured in 4-wheel drive sport utility vehicles compared to 13 percent of non

  17. 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

  18. 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…

  19. SANS-1: Small angle neutron scattering

    Directory of Open Access Journals (Sweden)

    André Heinemann

    2015-08-01

    Full Text Available The new small angle scattering instrument SANS-1, jointly operated by the Technische Universität München and GEMS, Helmholtz-Zentrum Geesthacht, has completed commissioning and is in regular user service (Gilles et al., 2006. SANS-1 is located at the end of neutron guide NL4a in the Neutron Guide Hall West.

  20. SANS-1: Small angle neutron scattering

    OpenAIRE

    Heinemann, André; Mühlbauer, Sebastian

    2015-01-01

    The new small angle scattering instrument SANS-1, jointly operated by the Technische Universität München and GEMS, Helmholtz-Zentrum Geesthacht, has completed commissioning and is in regular user service (Gilles et al., 2006). SANS-1 is located at the end of neutron guide NL4a in the Neutron Guide Hall West.

  1. Jack London and the San Francisco earthquake

    Science.gov (United States)

    Sachs, J.S.

    1982-01-01

    After it was over, it seemed to many, and especially to eyewitnesses like Jack London, that the earthquake and fire had devastated San Francisco. However people were confident that, like the phoeniz, San Francisco would rise from the ashes and regain her palce as the "Imperial City of the West." 

  2. 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.

  3. Characterization of the grafting copolymer EPDM-SAN

    International Nuclear Information System (INIS)

    Turchette, Renato; Felisberti, Maria Isabel

    2001-01-01

    This work aims the characterization of the grafting copolymer EPDM-SAN. This copolymer presents a fraction of free SAN chains, which was extracted by solubilization in chloroform followed of precipitation of the grafting copolymer EPDM-g-SAN in acetone. The EPDM-SAN and EPDM-g-SAN were characterized by 13 C NMR, DSC, TGA and SEM. EPDM-SAN contain 23 wt% of free SAN and 77 wt% of EPDM-g-SAN. Both materials are heterogeneous and the thermal and thermo-oxidative degradation are independent of the composition. (author)

  4. PV Validation and Bankability Workshop: San Jose, California

    Energy Technology Data Exchange (ETDEWEB)

    Granata, J.; Howard, J.

    2011-12-01

    This report is a collaboration between Sandia National Laboratories, the National Renewable Energy Laboratory, and the Florida Solar Energy Center (FSEC). The report provides feedback from the U.S. Department of Energy's (DOE) Solar Program PV Validation and Bankability Workshop in San Jose, California on August 31, 2011. It focuses on the current state of PV in the United States, private funding to fund U.S. PV industry growth, roles and functions of the regional test center program, and ways to improve the current validation and bankability practices.

  5. 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....

  6. Healthcare Access and PrEP Continuation in San Francisco and Miami After the US PrEP Demo Project.

    Science.gov (United States)

    Doblecki-Lewis, Susanne; Liu, Albert; Feaster, Daniel; Cohen, Stephanie E; Cardenas, Gabriel; Bacon, Oliver; Andrew, Erin; Kolber, Michael A

    2017-04-15

    Pre-exposure prophylaxis (PrEP) for prevention of HIV infection has demonstrated efficacy in randomized controlled trials and in demonstration projects. For PrEP implementation to result in significant reductions in HIV incidence for men who have sex with men in the United States, sufficient access to PrEP care and continued engagement outside of demonstration projects is required. We report the results of a follow-up survey of 173 former participants from the Miami and San Francisco sites of the US PrEP Demo Project, administered 4-6 months after study completion. Survey respondents continued to frequently access medical care and had a high incidence of sexually transmitted infections after completion of the Demo Project, indicating ongoing sexual risk behavior. Interest in continuing PrEP was high with 70.8% indicating that they were "very interested" in continuing PrEP. Among respondents, 39.9% reported continuation of PrEP after completion of the Demo Project, largely through their primary care providers and frequently at low or no cost. Variability in access and engagement was seen, with participants from the San Francisco site, those with medical insurance, and those with a primary care provider at the end of the Demo Project more likely to successfully obtain PrEP medication. Two respondents reported HIV seroconversion in the period between study completion and the follow-up survey. Additional effort to increase equitable access to PrEP outside of demonstration projects is needed to realize the potential impact of this evidence-based prevention intervention.

  7. Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices - United States, 2017-18 Influenza Season.

    Science.gov (United States)

    Grohskopf, Lisa A; Sokolow, Leslie Z; Broder, Karen R; Walter, Emmanuel B; Bresee, Joseph S; Fry, Alicia M; Jernigan, Daniel B

    2017-08-25

    , Connecticut); and expansion of the age indication for FluLaval Quadrivalent (IIV4; ID Biomedical Corporation of Quebec, Quebec City, Quebec, Canada), previously licensed for ≥3 years, to ≥6 months.• Pregnant women may receive any licensed, recommended, age-appropriate influenza vaccine.• Afluria (IIV3; Seqirus, Parkville, Victoria, Australia) may be used for persons aged ≥5 years, consistent with Food and Drug Administration-approved labeling.• FluMist Quadrivalent (LAIV4; MedImmune, Gaithersburg, Maryland) should not be used during the 2017-18 season due to concerns about its effectiveness against influenza A(H1N1)pdm09 viruses in the United States during the 2013-14 and 2015-16 influenza seasons.This report focuses on the recommendations for use of vaccines for the prevention and control of influenza during the 2017-18 season in the United States. A Background Document containing further information and a summary of these recommendations are available at https://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/flu.html. These recommendations apply to licensed influenza vaccines used within Food and Drug Administration-licensed indications, including those licensed after the publication date of this report. Updates and other information are available at CDC's influenza website (https://www.cdc.gov/flu). Vaccination and health care providers should check CDC's influenza website periodically for additional information.

  8. Kokes Awards for the 21st NAM Meeting (San Francisco, CA, 2009)

    Energy Technology Data Exchange (ETDEWEB)

    Katz, Alex [Univ. of California, Berkeley, CA (United States)

    2009-08-31

    The PI in this project Alexander Katz, UC Berkeley (askatz@berkeley.edu), in conjunction with the Kokes Awards subcommittee and conference organizing committee, used DOE grant DE-FG-02-08ER15993 to partially offset costs of attending the 21st North American Catalysis Society in San Francisco, California, for 30 graduate students from the United States.

  9. 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

  10. The San Francisco Peace Treaty: The Cold War and the Peace Process.

    Science.gov (United States)

    Brunette, Rachel

    International treaties have played a central role in diplomatic history since the rise of the modern nation state. Since the end of World War II, more treaties have been formed than in the preceding four centuries. The year 2001 marks the 50th anniversary of the San Francisco Peace Treaty. This unit provides students with historical knowledge of…

  11. 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

  12. Associations of the type of childcare with reported preventive medical and dental care utilization for 1- to 5-year-old children in the United States.

    Science.gov (United States)

    Kim, Juhee; Kaste, Linda M

    2013-10-01

    Despite that the majority of US children use nonparental childcare (NPC), research examining its effects on children's preventive healthcare utilization is lacking. Our aim was to contrast NPC against parental childcare in terms of preventive medical and dental care utilization. Associations of childcare and healthcare utilization were evaluated using the 2007 National Survey of Children's Health, a telephone interview of parent-reported children's health (22,773 children ages 1- to 5-year old). The type of childcare was categorized as parental care, center-based care (CBC), nonrelative home care (NRHC), relative care (RCC), and mixed care (MCC). The outcome measures were preventive medical care (≥ 1 physical examination/well child check-up visit) and preventive dental care (≥ 1 check-ups/dental cleanings visit) during the past 12 months. Overall, 94.7% of 1- to 5-year-old children received preventive medical care, while only 53.6% received preventive dental care. The highest odds for preventive medical care was for 1- to 2-year-old children utilizing CBC [Odds Ratio (OR) = 2.85, 95% CI = 1.11-7.30] and for 3- to 5-year-old children utilizing MCC (OR = 2.00, 95% CI = 1.23-3.26) followed by CBC (OR = 1.66, 95% CI = 1.13-2.42). Considering preventive dental care, a statistically significant increase occurred for 1- to 2-year-old children with CBC (OR = 1.93, 95% CI = 1.62-2.30), and none occurred for any NPC above the parental childcare rates for 3- to 5-year-old children. Childcare use, particularly center-based care, may provide a means to raise preventive healthcare utilization for young children. Future regulations, as well as policy and program development, should consider promoting childcare settings as a means to improve preventive health care utilization. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. 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...

  14. 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)

  15. 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; 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.

  16. Sediment conditions in the San Antonio River Basin downstream from San Antonio, Texas, 2000-13

    Science.gov (United States)

    Ockerman, Darwin J.; Banta, J. Ryan; Crow, Cassi L.; Opsahl, Stephen P.

    2015-01-01

    Sediment plays an important role in the ecological health of rivers and estuaries and consequently is an important issue for water-resource managers. To better understand sediment characteristics in the San Antonio River Basin, the U.S. Geological Survey, in cooperation with the San Antonio River Authority, completed a two-part study in the San Antonio River Basin downstream from San Antonio, Texas, to (1) collect and analyze sediment data to characterize sediment conditions and (2) develop and calibrate a watershed model to simulate hydrologic conditions and suspended-sediment loads during 2000–12.

  17. 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)

  18. 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...

  19. San Pablo Avenue Green Stormwater Spine

    Science.gov (United States)

    Information about the SFBWQP San Pablo Avenue Green Stormwater Spine Project project, part of an EPA competitive grant program to improve SF Bay water quality focused on restoring impaired waters and enhancing aquatic resources.

  20. 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)

  1. 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...

  2. 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...

  3. 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...

  4. 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...

  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. 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....

  7. 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...

  8. Earliest record of the invasive Foraminifera Trochammina hadai in San Francisco Bay, California, USA

    Science.gov (United States)

    McGann, Mary

    2014-01-01

    In 1995, Trochammina hadai, a benthic Foraminifera prevalent in Japanese estuaries, was found in San Francisco Bay, California, USA. Subsequent field investigations determined that the species was also present in nearly all of the major ports and estuaries along the western United States. Because of its widespread colonization, it is of interest to determine when T. hadai first appeared as an invasive in the coastal regions of the North Pacific. In San Francisco Bay, the species was not found in 404 surface samples collected between 1930 and 1981. In 1983, however, a grab sediment sample from one of four sites in the southern portion of the bay contained T. hadai. This site was the most northern of the four and contained 12 specimens of the invasive, comprising 1.5% of the assemblage. This is the earliest appearance on record of T. hadai in San Francisco Bay.

  9. 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

    ..., PR AGENCY: Coast Guard, DHS. ACTION: Temporary final rule. SUMMARY: The Coast Guard is establishing a... Sebastian El Cano escort, Bahia de San Juan; San Juan, PR. (a) Regulated Areas. The following regulated area...

  10. Malaria control in the municipality of San Esteban, Honduras Control de la malaria en el municipio de San Esteban, Honduras

    Directory of Open Access Journals (Sweden)

    Christine Elizabeth Bell

    2009-03-01

    Full Text Available OBJECTIVES: To assess the burden of malaria in San Esteban, Department of Olancho, Honduras, and provide recommendations for control. METHODS: Malaria causes appreciable morbidity in San Esteban. In 2006, health workers reported an increase in malaria cases and requested recommendations for control. In 2005, 385 cases (Plasmodium vivax, 316; P. falciparum, 69 were detected from 4 007 blood smears in the San Esteban laboratory (slide positivity rate = 9.6%. During May-July 2006, we assessed the burden of malaria and made recommendations. We reviewed epidemiologic data from slide-confirmed malaria cases in 2005 and 2006 and conducted a knowledge, attitudes, and practices survey in households to assess malaria diagnostic, treatment, and prevention practices. RESULTS: During May-July 2006, 143 laboratory-confirmed malaria cases were detected (P. vivax, 134; P. falciparum, 9 in San Esteban, compared with 104 (P. vivax, 79; P. falciparum, 25 in May-July 2005. From January 2005 to July 2006, 538 cases were detected in San Esteban, with increased frequency in May-October and the highest incidence in children 0-14 years old. We administered 112 surveys in 19 communities. Seventy percent of respondents reported a history of malaria in a household member, with the highest frequency reported in mothers (45% and children under 14 years old (37%. Most households did not have mosquito protection such as bed nets, screens, or indoor residual insecticide. CONCLUSIONS: Malaria is ongoing in San Esteban, with increased incidence in children. We recommend increased availability and promotion of insecticide-treated bed nets, improved timing and coverage of indoor residual spraying, and improved community malaria practices through education sessions.OBJETIVOS: Evaluar la carga de malaria en San Esteban, departamento de Olancho, Honduras, y ofrecer recomendaciones para su control. MÉTODOS: La malaria es causa de una considerable morbilidad en San Esteban. En 2006

  11. Psychiatric disorders and substance use in homeless youth: a preliminary comparison of san francisco and chicago.

    Science.gov (United States)

    Quimby, Ernika G; Edidin, Jennifer P; Ganim, Zoe; Gustafson, Erika; Hunter, Scott J; Karnik, Niranjan S

    2012-09-01

    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.

  12. 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.

  13. 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.)

  14. The San Andreas Fault 'Supersite' (Invited)

    Science.gov (United States)

    Hudnut, K. W.

    2013-12-01

    An expanded and permanent Supersite has been proposed to the Committee on Earth Observation Satellites (CEOS) for the San Andreas Fault system, based upon the successful initial Group on Earth Observations (GEO) Geohazard Supersite for the Los Angeles region from 2009-2013. As justification for the comprehensive San Andreas Supersite, consider the earthquake history of California, in particular the devastating M 7.8 San Francisco earthquake of 1906, which occurred along the San Andreas Fault, as did an earthquake of similar magnitude in 1857 in southern California. Los Angeles was only a small town then, but now the risk exposure has increased for both of California's megacities. Between the San Francisco and Los Angeles urban areas lies a section of the San Andreas Fault known to creep continually, so it has relatively less earthquake hazard. It used to be thought of as capable of stopping earthquakes entering it from either direction. Transitional behavior at either end of the creeping section is known to display a full range of seismic to aseismic slip events and accompanying seismicity and strain transient events. Because the occurrence of creep events is well documented by instrumental networks such as CISN and PBO, the San Andreas Supersite can be expected to be especially effective. A good baseline level of geodetic data regarding past events and strain accumulation and release exists. Many prior publications regarding the occurrence of geophysical phenomena along the San Andreas Fault system mean that in order to make novel contributions, state-of-the-art science will be required within this Supersite region. In more recent years, the 1989 Loma Prieta earthquake struck adjacent to the San Andreas Fault and caused the most damage along the western side of the San Francisco Bay Area. More recently, the concern has focused on the potential for future events along the Hayward Fault along the eastern side of San Francisco Bay. In Southern California, earthquakes

  15. 77 FR 57494 - Safety Zone; Fleet Week Fireworks, San Francisco Bay, San Francisco, CA

    Science.gov (United States)

    2012-09-18

    ... Zone; Fleet Week Fireworks, San Francisco Bay, San Francisco, CA AGENCY: Coast Guard, DHS. ACTION: Notice of enforcement of regulation. SUMMARY: The Coast Guard will enforce the safety zone for the Fleet...[deg]23'27'' W (NAD83) for the Fleet Week Fireworks in 33 CFR 165.1191, Table 1, item number 25. This...

  16. Una Visita al Viejo San Juan (A Visit to Old San Juan).

    Science.gov (United States)

    Cabello, Victor; And Others

    Written in Spanish, this black and white illustrated booklet provides a tour of Old San Juan, Puerto Rico's oldest and most historic city. Brief historical information is provided on the Perro de San Jeronimo, a statue of a barking dog found in front of the Castillo; Plaza de Colon, a small plaza dedicated to Christopher Columbus; the Catedral de…

  17. 77 FR 70891 - Safety Zone; Bay Bridge Construction, San Francisco Bay, San Francisco, CA

    Science.gov (United States)

    2012-11-28

    ...-AA00 Safety Zone; Bay Bridge Construction, San Francisco Bay, San Francisco, CA AGENCY: Coast Guard... construction of the Bay Bridge, the safety zone is necessary to provide for the safety of mariners transiting... zones (33 U.S.C. 1221 et seq.). CALTRANS will sponsor the Bay Bridge Construction Safety Zone on...

  18. Synthesis of SAN-PB-SAN triblock copolymers via a ''living'' copolymerization with macro-photoiniferters

    NARCIS (Netherlands)

    Kroeze, E; de Boer, B.; ten Brinke, G.; Hadziioannou, G

    1996-01-01

    A technique is described for the synthesis of poly((styrene-co-acrylonitrile)-block-butadiene-block-(styrene-co-acrylonitrile)) (SAN-PB-SAN) triblock copolymers through polybutadiene-based photo-iniferters. Dihydroxy- and dicarboxy-terminated polybutadienes were transformed into the

  19. 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...

  20. 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…

  1. Exposure to School and Community Based Prevention Programs and Reductions in Cigarette Smoking among Adolescents in the United States, 2000-08

    Science.gov (United States)

    Chen, Xinguang; Ren, Yuanjing; Lin, Feng; MacDonell, Karen; Jiang, Yifan

    2012-01-01

    Smoking remains prevalent among US youth despite decades of antismoking efforts. Effects from exposure to prevention programs at national level may provide informative and compelling data supporting better planning and strategy for tobacco control. A national representative sample of youth 12-17 years of age from the National Survey on Drug Use…

  2. HIV Risk Behaviors and Utilization of Prevention Services, Urban and Rural Men Who Have Sex with Men in the United States: Results from a National Online Survey.

    Science.gov (United States)

    McKenney, Jennie; Sullivan, Patrick S; Bowles, Kristina E; Oraka, Emeka; Sanchez, Travis H; DiNenno, Elizabeth

    2017-10-06

    Rural men who have sex with men (MSM) are heavily affected by HIV, and many lack culturally competent HIV prevention resources. Rural MSM may find sexual partners on the internet, which may also be a way to deliver prevention services to them. To understand the differences between rural and urban MSM with respect to HIV risk factors and behaviors and the utilization of online HIV prevention services, we used data from the 2012 Web-Based HIV Behavioral Survey (WHBS). Using WHBS data collected between June and August 2012, we compared the characteristics of MSM with positive or unknown HIV infection status who had sex with a male in the past 12 months, from rural vs urban areas using Chi square tests and median tests. We used logistic regression and calculated adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) to compare self-reported HIV risk behaviors, HIV/STI testing behaviors, use of prevention services, and perceived discrimination. Of the 8166 MSM included in our analysis, 3583 (44%) were from rural areas, and 4583 (56%) were from urban areas. Compared to urban MSM, rural MSM were less likely to ever test for HIV (aPR = 0.94, CI 0.92-0.95), to be tested for HIV in the last year (aPR = 0.83, CI 0.79-0.87), or to receive free condoms (aPR = 0.83, CI 0.79-0.86) or individual prevention counseling in the past year (aPR = 0.86, CI 0.78-0.95). Rural MSM were less likely to have been tested in the last year for syphilis, gonorrhea, or chlamydia (aPR = 0.70, CI 0.62-0.78; aPR = 0.72, CI 0.64-0.81; aPR = 0.75, CI 0.67-0.85, respectively). Rural MSM also reported perceiving less tolerance of gays and bisexuals within their community (aPR = 0.80, CI 0.77-0.84). HIV prevalence is lower among MSM in rural areas compared to MSM in urban areas, but rural MSM report that they are more likely to face intolerance and are less likely to use basic HIV prevention services compared to urban MSM. Therefore, this hard-to-reach population could benefit

  3. Implications for San Andreas Fault Ruptures Based on New Evidence from the Cabazon, CA Paleoseismic Site, San Gorgonio Pass Fault Zone

    Science.gov (United States)

    Scharer, K. M.; Yule, D.; Humbert, L. R.; Witkowsky, R.

    2013-12-01

    The 10-km section of the San Gorgonio Pass fault zone (SGPFZ) between the Banning and San Bernardino strands of the San Andreas fault is composed of roughly orthogonal, alternating strike slip and thrust fault sections. In order to investigate whether the complexity of the fault system is a barrier to thoroughgoing ruptures and consequently a limit on earthquake magnitude, we excavated a mega-trench across a compressional section of the SGPFZ approximately 2 km northeast of Cabazon, CA. The mega-trench was located at the base of the San Bernardino Mountains and exposed Pleistocene Cabazon Formation in the hanging wall block, thrust over Holocene alluvial units. Sediments in the 9-m-deep trench consisted of boulder to cobble debris flow deposits and silty sand fluvial sequences, which buried and were interbedded with incipient soil horizons. We present evidence for five earthquakes in the mega-trench, determined by several generations of fault scarps buried by progressively younger sediments. Vertical separation for each event was small, on the order of 30 to 60 cm at the paleo-ground surfaces. Preliminary radiocarbon dating of charcoal collected from the deformed sediments constrains the five observed events to the past ~6000 years and the most recent event to ca. 500-700 years ago; additional dates are pending that will enable us to determine the age of each earthquake. Based on the existing age control, the average earthquake recurrence interval for the SGPFZ is ~1400 years, seven times longer than the average interval for neighboring sections on the southern San Andreas fault. If the earthquakes recorded at the Cabazon site record great San Andreas fault ruptures like those modeled in the 2008 ShakeOut Scenario, much of the vertical slip must occur within the bedrock in the hanging wall or in blind faults in the alluvium below the site. Alternatively, these earthquakes may represent more local, M6-M7 events that rupture the San Gorgonio Pass and possibly

  4. 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.

    Science.gov (United States)

    Yazdani, Majid; Sabetian, Golnar; Ra'ofi, Shahin; Roudgari, Amir; Feizi, Monireh

    2015-04-01

    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. 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 self-report 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. 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. Training the nurses is highly effective in preventing VAP, particularly for appropriate cuff pressure, suctioning and disinfecting hands.

  5. 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…

  6. Rapid contrast matching by microfluidic SANS.

    Science.gov (United States)

    Adamo, Marco; Poulos, Andreas S; Miller, Ruhina M; Lopez, Carlos G; Martel, Anne; Porcar, Lionel; Cabral, João T

    2017-05-02

    We report a microfluidic approach to perform small angle neutron scattering (SANS) measurements of contrast variation and matching, extensively employed in soft and biological matter research. We integrate a low scattering background microfluidic mixer and serpentine channel in a SANS beamline to yield a single phase, continuous flow, reconfigurable liquid cell. By contrast with conventional, sequential measurements of discrete (typically 4-6) solutions of varying isotopic solvent composition, our approach continually varies solution composition during SANS acquisition. We experimentally and computationally determine the effects of flow dispersion and neutron beam overillumination of microchannels in terms of the composition resolution and precision. The approach is demonstrated with model systems: H 2 O/D 2 O mixtures, a surfactant (sodium dodecyl sulfate, SDS), a triblock copolymer (pluronic F127), and silica nanoparticles (Ludox) in isotopic aqueous mixtures. The system is able to zoom into a composition window to refine contrast matching conditions, and robustly resolve solute structure and form factors by simultaneous fitting of scattering data with continuously varying contrast. We conclude by benchmarking our microflow-SANS with the discrete approach, in terms of volume required, composition resolution and (preparation and measurement) time required, proposing a leap forward in equilibrium, liquid solution phase mapping and contrast variation by SANS.

  7. San Diego Science Alliance Education Outreach Activities

    Science.gov (United States)

    Blue, Anne P.

    1996-11-01

    The General Atomics Science Education Outreach Activities as well as those of several other San Diego area institutions led to the formation in 1994 of the San Diego Science Alliance. The Science Alliance is a consortium of science-related industries, institutions of research and higher education, museums, medical health networks, and science competitions in support of K-12 science education. Some Alliance accomplishments include printing over 4000 resource catalogs for teachers, workshops presented by over 20 of their business members at the San Diego Science Education Conference, and hosting of 3 eight-week courses for teachers. The Alliance provides an important forum for interaction between schools and teachers and local industries and institutions. The Science Alliance maintains a World Wide Web Home Page at elvbf http://www.cerf.net/sd_science/. General Atomics' role in the San Diego Science Alliance will be presented.(Presented by Patricia S. Winter for the General Atomics Science Education Groups and San Diego Science Alliance.)

  8. Evidence from precise earthquake hypocenters for segmentation of the San Andreas Fault in San Gorgonio Pass

    Science.gov (United States)

    Magistrale, Harold; Sanders, Christopher

    1996-02-01

    We use precise hypocenter patterns and focal mechanisms to investigate the presence or absence of a continuous strike-slip fault at depth connecting the San Bernardino strand of the San Andreas fault with the Coachella Valley segment of the Banning fault. We inverted 560,000 arrival times from 23,000 earthquakes (1981-1993) for high-quality hypocenters and three-dimensional P wave velocity structure in a 1° by 2° area centered on the San Gorgonio Pass. Cross-sectional plots of relocated earthquakes reveal an abrupt 5 to 7 km high step in the maximum depth of hypocenters. The step riser defines a near-vertical, locally curved surface that extends westerly more than 60 km from the Coachella Valley segment of the San Andreas fault to the San Jacinto fault. A hypothetical continuous vertical San Andreas fault through San Gorgonio Pass would cross the step at an oblique angle. We suggest that the step is the expression of the contact between different basement rock types juxtaposed by large-scale right-slip motion on the ancestral San Andreas fault. South of the step in Peninsular Ranges type basement (intrusives), brittle failure occurs down to about 20-km depth, while north of the step in San Bernardino type basement (Pelona schist), brittle failure occurs to only about 13-km depth. The step provides a piercing plane that should be offset about 3 km right laterally by an active, continuous, vertical San Andreas fault. Within the resolution of our mapping the step is not offset in this manner, implying either that there has not been a throughgoing vertical fault at depth, that a throughgoing fault has not experienced enough slip to offset the step, or that a throughgoing fault is not vertical and dips north over the top of the step. Hypocentral patterns and focal mechanisms indicate distributed deformation (thrust, normal, and strike-slip faulting) over a large volume in the San Gorgonio Pass region; there is no evidence of hypocenter or slip vector alignments that

  9. Choking Prevention

    Science.gov (United States)

    ... Healthy Living Healthy Living Healthy Living Nutrition Fitness Sports Oral Health Emotional Wellness Growing Healthy Sleep Safety & Prevention Safety & Prevention Safety and Prevention Immunizations At Home ...

  10. 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,…

  11. 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.

  12. San Sebastian, the challenges of a coastal city

    Energy Technology Data Exchange (ETDEWEB)

    Iglesias, V. [City Council of Donostia-San Sebastian (Spain)

    2008-07-01

    integrated strategy of energy saving, energy efficiency and use of renewable energies; and (3) To promote the responsible consumption in the city as the base for waste prevention and to strengthen the reutilization and recycling of that waste, ensuring it is correctly managed 4th strategic line: To protect the rural natural areas and to efficiently manage the water and carbon sinks of the municipality. By implementing this Plan, San Sebastian assumes the short-term objective of reducing greenhouse gas emissions regarding those of 2005 by 9% during the 2008--2013 period. Greenhouse gas emissions are aimed to be reduced by 90% by 2050 with ragard to the emissions in 2005.

  13. 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.

  14. 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

  15. 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

  16. Winning the Hearts and Minds: Improving U.S. Counter-Radicalization Efforts Through a Study of the United Kingdoms Prevent Strategy

    Science.gov (United States)

    2015-03-01

    require greater collaboration among the different U.S. government agencies. Hoffman aptly describes the dilemma that the United States finds itself...terrorism around the world. Part of this dilemma stems from what was stated at the beginning of this research where terrorism is evolving and subsequently... whistleblowing act, where he released an estimated 1.7 million classified documents, showed how the NSA carried out surveillance aimed at foreign governments

  17. A Model International Partnership for Community-based Research on Vaccine-preventable Diseases: the Kamphaeng Phet-AFRIMS Virology Research Unit (KAVRU)

    Science.gov (United States)

    2013-01-01

    Medical Units in Kuala Lumpur Malaya and the Armed Forces Research Institute of Medical Sciences (AFRIMS) in Bangkok; 2013. Thailand. 5 February 1987...particularly in the military populations , rates of hepatitis A disease have dropped with the use of hepatitis A vaccine. Studies of the...patients. Because the hospital is he principal focus for medical care in the province, it is well suited o serve as the headquarters for population -based

  18. 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.

  19. Education and stomatological care of child patients with renal failure in patients of soledad de graciano sanchez, san luis potosí

    OpenAIRE

    Orellana Centeno, José Eduardo; Delgado De Alba, Flor Angélica; Nava Calvillo, Jaime Francisco; Nava Zárate, Nadya; Orellana Centeno, Mauricio; Onofre Quilantán, María Guadalupe

    2014-01-01

    Introduction: Research article by the Instituto Mexicano del Seguro Social (imss), 2007, and the Universidad Autónoma de San Luis Potosí, Programas de Prevención para la Salud (prevenimss) (Mexican Social Security Institute and autonomous University of San Luis Potosi, Health Prevention Programs). Systemic diseases such as Renal Failure require comprehensive health care. That is why the oral cavity is also considered to be an important aspect of the health of patients and particularly in chil...

  20. 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...

  1. Nanostructural characterisation of catalysts by SANS

    International Nuclear Information System (INIS)

    De Stefanis, A.; Tomlinson, A.A.G.; Steriotis, Th.A.; Stefanopoulos, K.L.; Keiderling, U.

    2004-01-01

    A series of restructured clays used as catalysts in small- and large-scale chemical reactions, have been studied by small-angle neutron scattering (SANS). Analysis of the spectra provides detailed information both on the nanopore structure and the surface texture of these materials. Additionally, pillared inter-layered clays (PILCs) have a great potential for industrial utilisation in catalysis, sorption and separations. PILCs have been studied with contrast-matching SANS in order to independently resolve the structure of each phase since by matching the neutron scattering length density of the clay or the pillars, the scattering curve results only from the non-contrast matched phase

  2. Nanostructural characterisation of catalysts by SANS

    Science.gov (United States)

    Stefanis, A. De; Tomlinson, A. A. G.; Steriotis, Th. A.; Stefanopoulos, K. L.; Keiderling, U.

    2004-07-01

    A series of restructured clays used as catalysts in small- and large-scale chemical reactions, have been studied by small-angle neutron scattering (SANS). Analysis of the spectra provides detailed information both on the nanopore structure and the surface texture of these materials. Additionally, pillared inter-layered clays (PILCs) have a great potential for industrial utilisation in catalysis, sorption and separations. PILCs have been studied with contrast-matching SANS in order to independently resolve the structure of each phase since by matching the neutron scattering length density of the clay or the pillars, the scattering curve results only from the non-contrast matched phase.

  3. San Gorgonio Pass wind energy project, California

    Energy Technology Data Exchange (ETDEWEB)

    1982-06-01

    Construction and operation of large-scale wind-turbine fields on approximately 12,780 acres of public land in the San Gorgonio Pass of Palm Springs, California are proposed. The wind farm systems would be operated by Windfarms Limited, U.S. Windpower, Southern California Edison Company, PanAero Corporation, the city of Riverside, and San Gorgonio Farms, Inc. Implementation of the preferred scheme would allow development of wind turbines on public lands except in those areas that have been identified as having resources that are extremely sensitive to development. Positive and negative impacts of the project are discussed.

  4. Effect of color on recall in fire prevention signing

    Science.gov (United States)

    William S. Folkman

    1964-01-01

    An exploratory experiment, designed to determine the effect of color on recall in fire prevention signing, was conducted on the San Bernardino National Forest. Background color of usual black on light yellow fire prevention signing, was changed to bright, high intensity orange. The change may have affected impact, but did not improve recall. Frequency of exposure to...

  5. Mammal Track Counts - San Diego County [ds442

    Data.gov (United States)

    California Department of Resources — 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...

  6. 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...

  7. 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...

  8. 77 FR 66910 - Environmental Impact Statement, San Diego County, California

    Science.gov (United States)

    2012-11-07

    ... Transportation Engineer/Border Engineer, Federal Highway Administration--California Division, 401 B Street, Suite...[aacute]nchez, Senior Transportation Engineer/Border Engineer, Federal Highway Administration, San Diego... DEPARTMENT OF TRANSPORTATION Federal Highway Administration Environmental Impact Statement, San...

  9. Plasma SansEC Cosmic Radiation Shielding for Spacecraft

    Data.gov (United States)

    National Aeronautics and Space Administration — A dielectric barrier discharge SansEC sensor will be demonstrated and characterized. The highly conductive plasma which constitutes an operational SansEC trace will...

  10. Mammal Track Counts - San Diego County, 2010 [ds709

    Data.gov (United States)

    California Department of Resources — 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. Coastal Cactus Wren, San Diego Co. - 2009 [ds702

    Data.gov (United States)

    California Department of Resources — 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....

  12. Botswana's San communities and the challenge of accessing basic ...

    African Journals Online (AJOL)

    way schooling curriculum as an alternative strategy that would ensure the San retain not only interest but the necessary confidence in formal education system. KEYWORDS: San, Botswana, two-way model, curriculum, formal education, culture ...

  13. Coastal Cactus Wren, San Diego Co. - 2011 [ds708

    Data.gov (United States)

    California Department of Resources — 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....

  14. Pyrethroid insecticide concentrations and toxicity in streambed sediments and loads in surface waters of the San Joaquin Valley, California, USA

    Science.gov (United States)

    Domagalski, Joseph L.; Weston, Donald P.; Zhang, Minghua; Hladik, Michelle L.

    2010-01-01

    Pyrethroid insecticide use in California, USA, is growing, and there is a need to understand the fate of these compounds in the environment. Concentrations and toxicity were assessed in streambed sediment of the San Joaquin Valley of California, one of the most productive agricultural regions of the United States. Concentrations were also measured in the suspended sediment associated with irrigation or storm‐water runoff, and mass loads during storms were calculated. Western valley streambed sediments were frequently toxic to the amphipod, Hyalella azteca, with most of the toxicity attributable to bifenthrin and cyhalothrin. Up to 100% mortality was observed in some locations with concentrations of some pyrethroids up to 20 ng/g. The western San Joaquin Valley streams are mostly small watersheds with clay soils, and sediment‐laden irrigation runoff transports pyrethroid insecticides throughout the growing season. In contrast, eastern tributaries and the San Joaquin River had low bed sediment concentrations (pyrethroids in irrigation and storm water runoff. Esfenvalerate, fenpropathrin, and resmethrin were also detected. All sampled streams contributed to the insecticide load of the San Joaquin River during storms, but some compounds detected in the smaller creeks were not detected in the San Joaquin River. The two smallest streams, Ingram and Hospital Creeks, which had high sediment toxicity during the irrigation season, accounted for less than 5% of the total discharge of the San Joaquin River during storm conditions, and as a result their contribution to the pyrethroid mass load of the larger river was minimal. 

  15. 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.

  16. 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.

  17. 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

  18. Human aspects of air quality in the San Bernardino Mountains

    Science.gov (United States)

    P.L. Winter

    1999-01-01

    The preceding chapters of this book have provided infomation on the ecological characteristics of the San Bernardino Mountains, as well as the effects of ozone and other air pollutants on vegetation and soil in the San Bernardinos, and additional interactions with air pollution and forest health. This chapter focuses on the human aspects of air quality in the San...

  19. [Homework Policies of San Mateo County School Districts.

    Science.gov (United States)

    San Mateo County Office of Education, Redwood City, CA. SMERC Information Center.

    Homework policy statements from six elementary school districts in San Mateo County, California (Menlo Park City, Millbrae, San Bruno, Portola Valley, San Carlos, and Redwood City) covering kindergarten through grade 8 are presented. Responsibilities of the principal, the teachers, the students, and the parents are indicated; and time limits,…

  20. 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

  1. 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.

  2. Mobile Media at San Francisco Medical Center.

    Science.gov (United States)

    Banks, Thomas L.

    1968-01-01

    In 1966 the University of California Medical Center at San Francisco (including Schools of Dentistry, Medicine, Nursing, and Pharmacy) established a broadly based communications media center designed to serve the variety of teaching, research, and continuing education requirements of the faculty. This article dwells on the variety of applications…

  3. 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.)

  4. Computer-based PRA at San Onofre

    International Nuclear Information System (INIS)

    Anon.

    1996-01-01

    Personal computer software, called Safety Monitor, used to perform probabilistic risk assessments (PRAs) is described. Safety Monitor assesses core damage and containment failure risks in less than 60 seconds. The software was developed by San Onofre PRA analysts and NUS Corporation. Operational use and cost savings are described

  5. The Writing Process Goes to San Quentin.

    Science.gov (United States)

    Juska, Jane

    1999-01-01

    A writing instructor describes her experience teaching 15 San Quentin Prison inmates how to write fiction, revise their work, and submit it for publication. Inmates were polite, demanded advice on mechanics, and avoided writing about reasons for life sentences. Insights later emerged in stories. (MLH)

  6. 77 FR 20379 - San Diego Gas &

    Science.gov (United States)

    2012-04-04

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL00-95-000, et al.] San Diego Gas & Electric Company v. Sellers of Energy and Ancillary Services Into Markets Operated by the California Independent System Operator Corporation and the California Power Exchange; Notice of Designation...

  7. 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...

  8. San Jose, California: Solar in Action (Brochure)

    Energy Technology Data Exchange (ETDEWEB)

    2011-10-01

    This brochure provides an overview of the challenges and successes of San Jose, CA, a 2008 Solar America City awardee, on the path toward becoming a solar-powered community. Accomplishments, case studies, key lessons learned, and local resource information are given.

  9. San Diego, California: Solar in Action (Brochure)

    Energy Technology Data Exchange (ETDEWEB)

    2011-10-01

    This brochure provides an overview of the challenges and successes of San Diego, CA, a 2007 Solar America City awardee, on the path toward becoming a solar-powered community. Accomplishments, case studies, key lessons learned, and local resource information are given.

  10. San Antonio, Texas: Solar in Action (Brochure)

    Energy Technology Data Exchange (ETDEWEB)

    2011-10-01

    This brochure provides an overview of the challenges and successes of San Antonio, TX, a 2008 Solar America City awardee, on the path toward becoming a solar-powered community. Accomplishments, case studies, key lessons learned, and local resource information are given.

  11. San Francisco, California: Solar in Action (Brochure)

    Energy Technology Data Exchange (ETDEWEB)

    2011-10-01

    This brochure provides an overview of the challenges and successes of San Francisco, CA, a 2007 Solar America City awardee, on the path toward becoming a solar-powered community. Accomplishments, case studies, key lessons learned, and local resource information are given.

  12. Teen Peer Outreach-Street Work Project: HIV prevention education for runaway and homeless youth.

    Science.gov (United States)

    Podschun, G D

    1993-01-01

    Each year, there are approximately 2 million homeless and runaway youths in the United States. On any given night, there are 1,000 homeless youngsters living on the streets of San Diego, CA. Homeless young people are commonly involved in one or more of the following activities that place them at risk for HIV infection--unprotected sexual intercourse, needle-sharing in the use of injectable drugs, sex with someone who injects drugs. The Teen Peer Outreach-Street Work Project trains teen peer educators to work in three existing San Diego youth service programs with street outreach staff members to provide HIV prevention education and referral services to San Diego's homeless youth. Selected teens from the target population also participate in street-based case management that provides skill development to bring about behavioral and attitudinal changes. An HIV outreach program cannot stand alone and is most successful if it is integrated with services that meet the basic needs of its clients. In the three participating youth service programs of the Teen Peer Outreach-Street Work Project, food, clothes, and shelter information are provided. There are shelters in two of the three programs that become places where HIV educational messages, delivered on the street, can be reinforced. Immediate and concrete assistance can be offered to homeless youth. Low literacy among the target population presents a significant obstacle to adequate and appropriate HIV prevention education for homeless youth. Currently, education materials that specifically target homeless youth do not exit. The outreach street project is being expanded to develop materials for homeless youth with low literacy levels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8464971

  13. 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.

  14. 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

  15. 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.

  16. 78 FR 13890 - Notice of Intent To Repatriate Cultural Items: San Francisco State University NAGPRA Program, San...

    Science.gov (United States)

    2013-03-01

    ... Intent To Repatriate Cultural Items: San Francisco State University NAGPRA Program, San Francisco, CA... NAGPRA Program, in consultation with the appropriate Indian tribe, has determined that the cultural items... tribe that believes itself to be culturally affiliated with the cultural items may contact the San...

  17. 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.

  18. 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

  19. 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.

  20. Does the West Salton Detachment extend through San Gorgonio Pass, southern California?

    Science.gov (United States)

    Matti, J. C.; Langenheim, V. E.

    2008-12-01

    Rift-related extension and low-angle crustal detachment are key structural elements of the late Cenozoic southern San Andreas Fault system, as manifested by the West Salton Detachment (WSD). The most northwestern exposure of the WSD is in the Santa Rosa Mts (SRM), where the Zosel Fault bottoms a hangingwall sequence of upper Cenozoic marine and terrestrial sedimentary deposits that include stratigraphic units well known throughout the Salton Trough region. We have used geologic and geophysical data to investigate the distribution of the WSD system in the northern Salton Trough, including its possible extension into and beyond San Gorgonio Pass. Although the WSD is not exposed north of the SRM, late Miocene marine and terrigenous sedimentary rocks at Garnet Hill probably are hangingwall deposits squeezed up within the San Andreas Fault zone. West of Garnet Hill lie San Gorgonio Pass (SGP) and the 3 km-high northern escarpment of the San Jacinto Mountains (SJM). In SGP, upper Cenozoic sedimentary rocks south of the Banning strand of the San Gabriel Fault include the marine Imperial Formation and associated terrestrial deposits, a sequence similar to that in the WSD hangingwall throughout the greater Salton Trough region. We propose that the WSD originally extended from the NW head of Coachella Valley west into SGP, where the detachment may form the base of the Cenozoic marine and terrestrial sedimentary sequence. The WSD probably continues west beyond SGP, with extensional translation decreasing until the detachment intersects the Banning Fault near Calimesa. There, we propose that the WSD underlies a subsurface sedimentary package north of the San Timoteo badlands and south of the Banning Fault that a gravity low suggests is 2 km thick, and that reportedly contains marine sediment penetrated in boreholes. When ~44 km of right-slip is restored on the Banning Fault (Matti and Morton, 1993), the Calimesa low restores opposite a similar low in the northwestern Coachella

  1. 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

  2. Olmec civilization, veracruz, Mexico: dating of the san lorenzo phase.

    Science.gov (United States)

    Coe, M D; Diehl, R A; Stuiver, M

    1967-03-17

    Archeological excavations at San Lorenzo Tenochtitlan, Veracruz, show that the Olmec sculptures of this zone are associated with the San Lorenzo phase, which can be placed in the Early Formative period (1500-800 B.C.) on the basis of ceramic comparisons. Five of six radiocarbon dates for the San Lorenzo phase fall within the 1200-900 B.C. span. The San Lorenzo phase therefore marks the beginning of Olmec civilization, and the sites forming the San Lorenzo Tenochtitlan group represent the oldest civilized communities known in Mexico or Central America.

  3. Cost-effectiveness evaluation of quadrivalent influenza vaccines for seasonal influenza prevention: a dynamic modeling study of Canada and the United Kingdom.

    Science.gov (United States)

    Thommes, Edward W; Ismaila, Afisi; Chit, Ayman; Meier, Genevieve; Bauch, Christopher T

    2015-10-27

    The adoption of quadrivalent influenza vaccine (QIV) to replace trivalent influenza vaccine (TIV) in immunization programs is growing worldwide, thus helping to address the problem of influenza B lineage mismatch. However, the price per dose of QIV is higher than that of TIV. In such circumstances, cost-effectiveness analyses provide important and relevant information to inform national health recommendations and implementation decisions. This analysis assessed potential vaccine impacts and cost-effectiveness of a country-wide switch from TIV to QIV, in Canada and the UK, from a third-party payer perspective. An age-stratified, dynamic four-strain transmission model which incorporates strain interaction, transmission-rate seasonality and age-specific mixing in the population was used. Model input data were obtained from published literature and online databases. In Canada, we evaluated a switch from TIV to QIV in the entire population. For the UK, we considered two strategies: Children aged 2-17 years who receive the live-attenuated influenza vaccine (LAIV) switch to the quadrivalent formulation (QLAIV), while individuals aged > 18 years switch from TIV to QIV. Two different vaccination uptake scenarios in children (UK1 and UK2, which differ in the vaccine uptake level) were considered. Health and cost outcomes for both vaccination strategies, and the cost-effectiveness of switching from TIV/LAIV to QIV/QLAIV, were estimated from the payer perspective. For Canada and the UK, cost and outcomes were discounted using 5 % and 3.5 % per year, respectively. Overall, in an average influenza season, our model predicts that a nationwide switch from TIV to QIV would prevent 4.6 % influenza cases, 4.9 % general practitioner (GP) visits, 5.7 % each of emergency room (ER) visits and hospitalizations, and 6.8 % deaths in Canada. In the UK (UK1/UK2), implementing QIV would prevent 1.4 %/1.8 % of influenza cases, 1.6 %/2.0 % each of GP and ER visits, 1.5 %/1.9 % of

  4. [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.

  5. 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

  6. A Three-Dimensional Numerical Investigation of San Andreas Fault Configuration Through the San Gorgonio Pass

    Science.gov (United States)

    Dair, L.; Cooke, M.

    2007-12-01

    The partitioning of deformation among strands of the San Andreas Fault through the San Gorgonio pass depends on fault geometry. We investigate three alternative three-dimensional configurations of the San Andreas Fault to explore the influence of fault geometry on uplift patterns and slip rates. One model has the commonly used vertical geometry for the system. Another uses the Southern California Earthquake Center Community Fault Model to include two north-dipping, discontinuous, alternative stands. We developed a third model that smoothly connects the north-dipping faults to adjacent segments. Regional transform loading is applied as slip at the distal edges of a deep detachment as well as along the distal portions of the primary fault segments. The model with vertical faults fails to produce uplift in the San Bernardino Mountains. Both of the north-dipping models produce significant uplift that may correspond to observations of recent uplift in the San Bernardino Mountains (Spotila et al, 1998). The vertical model has faster strike-slip rates while the north-dipping, discontinuous system has the slowest strike-slip rates. While the vertical model has the greatest net slip and more efficiently transmits deformation through the pass, the north-dipping fault configurations better match uplift patterns. We altered the continuous and north-dipping model to explore the effects of slip partitioning among the San Andreas and San Jacinto faults and secondary faults to the model. Debate continues about the slip partitioning between the Coachella Valley segment of the SAF and the San Jacinto fault. Our study suggests that slip portioning between the two faults has less of an effect on the slip rates and off fault deformation than fault geometry. The addition of secondary faults to the model significantly increases uplift in the northern San Bernardino Mountains. The senses of slip along secondary faults in the model are consistent with geologic observations. Continuing

  7. 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.

  8. Rape prevention

    Science.gov (United States)

    Date rape - prevention; Sexual assault - prevention ... Centers for Disease Control and Prevention website. Sexual assault and abuse and STDs. In: 2015 sexually transmitted diseases treatment guidelines 2015. www.cdc.gov/std/tg2015/sexual- ...

  9. Dengue Prevention

    Science.gov (United States)

    ... Address What's this? Submit What's this? Submit Button Prevention Recommend on Facebook Tweet Share Compartir This photograph ... medications to treat a dengue infection. This makes prevention the most important step, and prevention means avoiding ...

  10. 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

  11. 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.

  12. Plague Prevention

    Science.gov (United States)

    ... Healthcare Professionals Clinicians Public Health Officials Veterinarians Prevention History of Plague Resources FAQ Prevention Recommend on Facebook Tweet Share Compartir Reduce rodent habitat around your ...

  13. Impact and cost-effectiveness of a second tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine dose to prevent pertussis in the United States.

    Science.gov (United States)

    Kamiya, Hajime; Cho, Bo-Hyun; Messonnier, Mark L; Clark, Thomas A; Liang, Jennifer L

    2016-04-04

    The United States experienced a substantial increase in reported pertussis cases over the last decade. Since 2005, persons 11 years and older have been routinely recommended to receive a single dose of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccine. The objective of this analysis was to evaluate the potential impact and cost-effectiveness of recommending a second dose of Tdap. A static cohort model was used to calculate the epidemiologic and economic impact of adding a second dose of Tdap at age 16 or 21 years. Projected costs and outcomes were examined from a societal perspective over a 20-year period. Quality-adjusted Life Years (QALY) saved were calculated. Using baseline pertussis incidence from the National Notifiable Diseases Surveillance System, Tdap revaccination at either age 16 or 21 years would reduce outpatient visits by 433 (5%) and 285 (4%), and hospitalization cases by 7 (7%) and 5 (5%), respectively. The costs per QALY saved with a second dose of Tdap were approximately US $19.7 million (16 years) and $26.2 million (21 years). In sensitivity analyses, incidence most influenced the model; as incidence increased, the costs per QALY decreased. To a lesser degree, initial vaccine effectiveness and waning of effectiveness also affected cost outcomes. Multivariate sensitivity analyses showed that under a set of optimistic assumptions, the cost per QALY saved would be approximately $163,361 (16 years) and $204,556 (21 years). A second dose of Tdap resulted in a slight decrease in the number of cases and other outcomes, and that trend is more apparent when revaccinating at age 16 years than at age 21 years. Both revaccination strategies had high dollar per QALY saved even under optimistic assumptions in a multivariate sensitivity analysis. Published by Elsevier Ltd.

  14. Chlorhexidine bathing for the prevention of colonization and infection with multidrug-resistant microorganisms in a hematopoietic stem cell transplantation unit over a 9-year period

    Science.gov (United States)

    Mendes, Elisa Teixeira; Ranzani, Otavio T.; Marchi, Ana Paula; da Silva, Mariama Tomaz; Filho, José Ulysses Amigo; Alves, Tânia; Guimarães, Thais; Levin, Anna S.; Costa, Silvia Figueiredo

    2016-01-01

    Abstract Health care associated infections (HAIs) are currently among the major challenges to the care of hematopoietic stem cell transplantation (HSCT) patients. The objective of the present study was to evaluate the impact of 2% chlorhexidine (CHG) bathing on the incidence of colonization and infection with vancomycin-resistant Enterococcus (VRE), multidrug-resistant (MDR) gram-negative pathogens, and to evaluate their CHG minimum inhibitory concentration (MIC) after the intervention. A quasi-experimental study with duration of 9 years was conducted. VRE colonization and infection, HAI rates, and MDR gram-negative infection were evaluated by interrupted time series analysis. The antibacterial susceptibility profile and mechanism of resistance to CHG were analyzed in both periods by the agar dilution method in the presence or absence of the efflux pump inhibitor carbonyl cyanide-m-chlorophenyl hydrazone (CCCP) and presence of efflux pumps (qacA/E, qacA, qacE, cepA, AdeA, AdeB, and AdeC) by polymerase chain reaction (PCR). The VRE colonization and infection rates were significantly reduced in the postintervention period (P = 0.001). However, gram-negative MDR rates in the unit increased in the last years of the study. The CHG MICs for VRE increased during the period of exposure to the antiseptic. A higher MIC at baseline period was observed in MDR gram-negative strains. The emergence of a monoclonal Pseudomonas aeruginosa clone was observed in the second period. Concluding, CHG bathing was efficient regarding VRE colonization and infection, whereas no similar results were found with MDR gram-negative bacteria. PMID:27861350

  15. Panton-Valentine Leukocidin gene positive methicillin resistant Staphylococcus aureus, the community strains causing infections in intensive care unit - High risk of outbreak and preventing strategies

    Directory of Open Access Journals (Sweden)

    Mowna Karthik

    2016-07-01

    Full Text Available Methicillin resistant Staphylococcus aureus (MRSA is an important pathogen that causes hospital acquired infections recorded in the intensive care unit (ICU. Most of the MRSA isolates carry mecA gene which is a molecular marker for Methicilin resistance. There are two types of MRSA , community acquired (C and ndash;MRSA and hospital acquired (H-MRSA, both of these contain mecA gene. The Panton-Valentine Leukocidin (PVL gene is normally present in C-MRSA infections which are now found to be widespread in hospital setting. Our objective was to assess the presence of PVL gene in mecA gene positive MRSA isolates from ICUs. This was a cross sectional study in ICUs of a tertiary care hospital over a period of 8 months (June 2013 to January 2014. Total of two hundred patients admitted in the ICUs who were suspected to have acquired infection 48 hours after admission were included in the study. By routine bacteriological examination and disc diffusion sensitivity testing with 30 and #956;g cefoxitin discs, MRSA strains were isolated. Polymerized chain reaction (PCR was performed to detect mecA gene and PVL gene using specific primers. Cefoxitin disc diffusion screening showed 112 positive MRSA strains among which the mecA gene was detected in 104 strains and was absent in the remaining eight strains of total MRSA. Among the 104 mecA gene positive MRSA strains, 46 (44% strains contained PVL gene. Our results indicate a higher prevalence of PVL-positive MRSA strains in the ICUs compared to many earlier studies. These strains were susceptible only to very few antibiotics and the empirical treatment options should be planned accordingly. Awareness of intensive care physicians and proper training of health care workers in the ICU could lower the magnitude of this problem. [J Med Allied Sci 2016; 6(2.000: 56-60

  16. 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

  17. 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.

  18. 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...

  19. 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)

  20. BRCA Genetic Testing and Receipt of Preventive Interventions Among Women Aged 18-64 Years with Employer-Sponsored Health Insurance in Nonmetropolitan and Metropolitan Areas - United States, 2009-2014.

    Science.gov (United States)

    Kolor, Katherine; Chen, Zhuo; Grosse, Scott D; Rodriguez, Juan L; Green, Ridgely Fisk; Dotson, W David; Bowen, M Scott; Lynch, Julie A; Khoury, Muin J

    2017-09-08

    Genetic testing for breast cancer 1 (BRCA1) and breast cancer 2 (BRCA2) gene mutations can identify women at increased risk for breast and ovarian cancer. These testing results can be used to select preventive interventions and guide treatment. Differences between nonmetropolitan and metropolitan populations in rates of BRCA testing and receipt of preventive interventions after testing have not previously been examined. 2009-2014. Medical claims data from Truven Health Analytics MarketScan Commercial Claims and Encounters databases were used to estimate rates of BRCA testing and receipt of preventive interventions after BRCA testing among women aged 18-64 years with employer-sponsored health insurance in metropolitan and nonmetropolitan areas of the United States, both nationally and regionally. From 2009 to 2014, BRCA testing rates per 100,000 women aged 18-64 years with employer-sponsored health insurance increased 2.3 times (102.7 to 237.8) in metropolitan areas and 3.0 times (64.8 to 191.3) in nonmetropolitan areas. The relative difference in BRCA testing rates between metropolitan and nonmetropolitan areas decreased from 37% in 2009 (102.7 versus 64.8) to 20% in 2014 (237.8 versus 191.3). The relative difference in BRCA testing rates between metropolitan and nonmetropolitan areas decreased more over time in younger women than in older women and decreased in all regions except the West. Receipt of preventive services 90 days after BRCA testing in metropolitan versus nonmetropolitan areas throughout the period varied by service: the percentage of women who received a mastectomy was similar, the percentage of women who received magnetic resonance imaging of the breast was lower in nonmetropolitan areas (as low as 5.8% in 2014 to as high as 8.2% in 2011) than metropolitan areas (as low as 7.3% in 2014 to as high as 10.3% in 2011), and the percentage of women who received mammography was lower in nonmetropolitan areas in earlier years but was similar in later years

  1. Sediment Deposition, Erosion, and Bathymetric Change in Central San Francisco Bay: 1855-1979

    Science.gov (United States)

    Fregoso, Theresa A.; Foxgrover, Amy C.; Jaffe, Bruce E.

    2008-01-01

    Central San Francisco Bay is the hub of a dynamic estuarine system connecting the San Joaquin and Sacramento River Deltas, Suisun Bay, and San Pablo Bay to the Pacific Ocean and South San Francisco Bay. To understand the role that Central San Francisco Bay plays in sediment transport throughout the system, it is necessary to first determine historical changes in patterns of sediment deposition and erosion from both natural and anthropogenic forces. The first extensive hydrographic survey of Central San Francisco Bay was conducted in 1853 by the National Ocean Service (NOS) (formerly the United States Coast and Geodetic Survey (USCGS)). From 1894 to 1979, four additional surveys, composed of a total of approximately 700,000 bathymetric soundings, were collected within Central San Francisco Bay. Converting these soundings into accurate bathymetric models involved many steps. The soundings were either hand digitized directly from the original USCGS and NOS hydrographic sheets (H-sheets) or obtained digitally from the National Geophysical Data Center's (NGDC) Geophysical Data System (GEODAS) (National Geophysical Data Center, 1996). Soundings were supplemented with contours that were either taken directly from the H-sheets or added in by hand. Shorelines and marsh areas were obtained from topographic sheets. The digitized soundings, depth contours, shorelines, and marsh areas were entered into a geographic information system (GIS) and georeferenced to a common horizontal datum. Using surface modeling software, bathymetric grids with a horizontal resolution of 25 m were developed for each of the five hydrographic surveys. Before analyses of sediment deposition and erosion were conducted, interpolation bias was removed and all of the grids were converted to a common vertical datum. These bathymetric grids were then used to develop bathymetric change maps for subsequent survey periods and to determine long-term changes in deposition and erosion by calculating volumes and

  2. 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.

  3. San Cristobal Galapagos wind power project

    Energy Technology Data Exchange (ETDEWEB)

    Tolan, J. [Sgurr Energy, Glasgow (United Kingdom)

    2009-07-01

    The San Cristobal Galapagos wind power project was described. With its unique endemic flora and fauna, the Galapagos Islands were declared a world heritage site and marine reserve. The San Cristobal wind project was initiated in 1999 to reduce the environmental impacts of energy use on the island, and has been operational since 2007. Three 800 kW wind turbines have been installed in order to reduce 52 per cent of the island's diesel generation. The project's high penetration wind-diesel hybrid system included 300 kW diesel generators, a 13.2 kV utility distribution system, and six 300 kW wind turbines. The project is located outside of Galapagos Petrel flight paths and nesting areas. Turbines from a factory in Spain were used. The wind turbine foundation was constructed from concrete sand and stone mined on the island. Photographs of the installation process were included. tabs., figs.

  4. 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

  5. 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.

  6. 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

  7. 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.

  8. 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.

  9. The San Joaquin Valley Westside Perspective

    Energy Technology Data Exchange (ETDEWEB)

    Quinn, Nigel W.T.; Linneman, J. Christopher; Tanji, Kenneth K.

    2006-03-27

    Salt management has been a challenge to westside farmerssince the rapid expansion of irrigated agriculture in the 1900 s. Thesoils in this area are naturally salt-affected having formed from marinesedimentary rocks rich in sea salts rendering the shallow groundwater,and drainage return flows discharging into the lower reaches of the SanJoaquin River, saline. Salinity problems are affected by the importedwater supply from Delta where the Sacramento and San Joaquin Riverscombine. Water quality objectives on salinity and boron have been inplace for decades to protect beneficial uses of the river. However it wasthe selenium-induced avian toxicity that occurred in the evaporationponds of Kesterson Reservoir (the terminal reservoir of a planned but notcompleted San Joaquin Basin Master Drain) that changed public attitudesabout agricultural drainage and initiated a steady stream ofenvironmental legislation directed at reducing non-point source pollutionof the River. Annual and monthly selenium load restrictions and salinityand boron Total Maximum Daily Loads (TMDLs) are the most recent of thesepolicy initiatives. Failure by both State and Federal water agencies toconstruct a Master Drain facility serving mostly west-side irrigatedagriculture has constrained these agencies to consider only In-Valleysolutions to ongoing drainage problems. For the Westlands subarea, whichhas no surface irrigation drainage outlet to the San Joaquin River,innovative drainage reuse systems such as the Integrated Farm DrainageManagement (IFDM) offer short- to medium-term solutions while morepermanent remedies to salt disposal are being investigated. Real-timesalinity management, which requires improved coordination of east-sidereservoir releases and west-side drainage, offers some relief toGrasslands Basin farmers and wetland managers - allowing greater salinityloading to the River than under a strict TMDL. However, currentregulation drives a policy that results in a moratorium on all

  10. 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.

  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. Examination of spotted sand bass (Paralabrax maculatofasciatus pollutant bioaccumulation in San Diego Bay, San Diego, California

    Directory of Open Access Journals (Sweden)

    Chad L. Loflen

    2013-11-01

    Full Text Available The spotted sand bass (Paralabrax maculatofasciatus is an important recreational sport and subsistence food fish within San Diego Bay, a large industrialized harbor in San Diego, California. Despite this importance, few studies examining the species life history relative to pollutant tissue concentrations and the consumptive fishery exist. This study utilized data from three independent spotted sand bass studies from 1989 to 2002 to investigate PCB, DDT, and mercury tissue concentrations relative to spotted sand bass age and growth in San Diego Bay, with subsequent comparisons to published pollutant advisory levels and fishery regulations for recreational and subsistence consumption of the species. Subsequent analysis focused on examining temporal and spatial differences for different regions of San Diego Bay.Study results for growth confirmed previous work, finding the species to exhibit highly asymptotic growth, making tissue pollutant concentrations at initial take size difficult if not impossible to predict. This was corroborated by independent tissue concentration results for mercury, which found no relationship between fish size and pollutant bioaccumulation observed. However, a positive though highly variable relationship was observed between fish size and PCB tissue concentration.Despite these findings, a significant proportion of fish exhibited pollutant levels above recommended state recreational angler consumption advisory levels for PCBs and mercury, especially for fish above the minimum take size, making the necessity of at-size predictions less critical. Lastly, no difference in tissue concentration was found temporally or spatially within San Diego Bay.

  13. Guillain-Barré syndrome after vaccination in United States: data from the Centers for Disease Control and Prevention/Food and Drug Administration Vaccine Adverse Event Reporting System (1990-2005).

    Science.gov (United States)

    Souayah, Nizar; Nasar, Abu; Suri, M Fareed K; Qureshi, Adnan I

    2009-09-01

    There are isolated reports of Guillain-Barré syndrome (GBS) after receiving vaccination. To determine the rates and characteristics of GBS after administration of vaccination in United States We used data for 1990 to 2005 from the Vaccine Adverse Event Reporting System, which is a cooperative program of the Centers for Disease Control and Prevention and the US Food and Drug Administration. There were 1000 cases (mean age, 47 years) of GBS reported after vaccination in the United States between 1990 and 2005. The onset of GBS was within 6 weeks in 774 cases, >6 weeks in 101, and unknown in 125. Death and disability after the event occurred in 32 (3.2%) and 167 (16.7%) subjects, respectively. The highest number (n = 632) of GBS cases was observed in subjects receiving influenza vaccine followed by hepatitis B vaccine (n = 94). Other vaccines or combinations of vaccines were associated with 274 cases of GBS. The incidence of GBS after influenza vaccination was marginally higher in subjects or=65 years (P = 0.09); for hepatitis vaccine, the incidence was significantly higher (P Death was more frequent in subjects >or=65 years compared with those vaccines other than influenza vaccine can be associated with GBS. Vaccination-related GBS results in death or disability in one fifth of affected individuals, which is comparable to the reported rates in the general GBS population.

  14. [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.

  15. Bartonella quintana in body lice and head lice from homeless persons, San Francisco, California, USA.

    Science.gov (United States)

    Bonilla, Denise L; Kabeya, Hidenori; Henn, Jennifer; Kramer, Vicki L; Kosoy, Michael Y

    2009-06-01

    Bartonella quintana is a bacterium that causes trench fever in humans. Past reports have shown Bartonella spp. infections in homeless populations in San Francisco, California, USA. The California Department of Public Health in collaboration with San Francisco Project Homeless Connect initiated a program in 2007 to collect lice from the homeless to test for B. quintana and to educate the homeless and their caregivers on prevention and control of louse-borne disease. During 2007-2008, 33.3% of body lice-infested persons and 25% of head lice-infested persons had lice pools infected with B. quintana strain Fuller. Further work is needed to examine how homeless persons acquire lice and determine the risk for illness to persons infested with B. quintana-infected lice.

  16. Food insecurity among homeless and marginally housed individuals living with HIV/AIDS in San Francisco.

    Science.gov (United States)

    Weiser, Sheri D; Bangsberg, David R; Kegeles, Susan; Ragland, Kathleen; Kushel, Margot B; Frongillo, Edward A

    2009-10-01

    Food insecurity is a risk factor for both HIV transmission and worse HIV clinical outcomes. We examined the prevalence of and factors associated with food insecurity among homeless and marginally housed HIV-infected individuals in San Francisco recruited from the Research on Access to Care in the Homeless Cohort. We used multiple logistic regression to determine socio-demographic and behavioral factors associated with food insecurity, which was measured using the Household Food Insecurity Access Scale. Among 250 participants, over half (53.6%) were food insecure. Higher odds of food insecurity was associated with being white, low CD4 counts, recent crack use, lack of health insurance, and worse physical and mental health. Food insecurity is highly prevalent among HIV-infected marginally housed individuals in San Francisco, and is associated with poor physical and mental health and poor social functioning. Screening for and addressing food insecurity should be a critical component of HIV prevention and treatment programs.

  17. 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.

  18. Estudo da mobilidade molecular das blendas aPA/SAN/MMA-MA usando relaxação dielétrica Molecular mobility study of aPA/SAN/MMA-MA using dielectric relaxation

    Directory of Open Access Journals (Sweden)

    Daniela Becker

    2008-09-01

    Full Text Available Blendas de poliamida amorfa (aPA com copolímero de estireno-acrilonitrila (SAN utilizando uma série de copolímeros de metil metacrilato-anidrido maleico (MMA-MA como agente compatibilizante foram preparadas. Estes copolímeros acrílicos são miscíveis com a fase SAN, e o anidrido maleico (MA é capaz de reagir com os grupos terminais da poliamida, levando a formação de um copolímero na interfase da blenda durante o processamento. Este estudo foca o efeito da massa molar e a concentração de anidrido maleico do compatibilizante nas propriedades de relaxação dielétrica. Os resultados mostram que tanto a concentração de anidrido maleico e a massa molar do compatibilizante influenciam a mobilidade molecular. Blendas com compatibilizantes com 5 e 10% de anidrido maleico apresentaram menor energia de ativação devido à alta mobilidade da fase SAN.Blends of amorphous polyamide (aPA with acrylonitrile/styrene copolymer (SAN using a series of methyl methacrylate-maleic anhydride (MMA-MA copolymers as compatibilizing agents were prepared. These acrylic copolymers were miscible with SAN, whereas the maleic anhydride units in the copolymers are capable to react with the polyamide end groups; this could lead to the formation of grafted copolymers at the blend interface during melt processing. This study focuses on the effects of molecular weight and concentration of the reactive maleic anhydride units of the compatibilizer on the dielectric relaxation properties. The results show that both maleic anhydride quantity and molecular weight of MMA MA influenced the dielectric relaxation properties. Blends with 5 and 10% of MA in the compatibilizer present lower activation energy due to the high mobility of SAN phase.

  19. 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

  20. The San Juan Canyon, southeastern Utah: A geographic and hydrographic reconnaissance

    Science.gov (United States)

    Miser, Hugh D.

    1924-01-01

    This report, which describes the San Juan Canyon, San Juan River and the tributary streams and the geography and to some extent the geology of the region, presents information obtained by me during the descent of the river with the Trimble party in 1921. The exploration of the canyon, which was financed jointly by the United States Geological Survey and the Southern California Edison Co., had as its primary object the mapping and study of the San Juan in connection with proposed power and storage projects along this and Colorado rivers.1 The exploration party was headed by K. W. Thimble, topographic engineer of the United States Geological Survey. Other members of the party were Robert N. Allen, Los Angeles, Calif., recorder; H. E. Blake, jr., Monticello, Utah, and Hugh Hyde, Salt Lake City, Utah, rodmen; Bert Loper, Green River, Utah, boatman; Heber Christensen, Moab, Utah, cook; and H. D. Miser, geologist. Wesley Oliver, of Mexican Hat, Utah, served as packer for the party and brought mail and provisions by pack train twice a month to specified accessible places west of Goodridge.

  1. 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

  2. An Analysis of the Potential Impact of Climate Change on Dengue Transmission in the Southeastern United States.

    Science.gov (United States)

    Butterworth, Melinda K; Morin, Cory W; Comrie, Andrew C

    2017-04-01

    Dengue fever, caused by a mosquito-transmitted virus, is an increasing health concern in the Americas. Meteorological variables such as temperature and precipitation can affect disease distribution and abundance through biophysical impacts on the vector and on the virus. Such tightly coupled links may facilitate further spread of dengue fever under a changing climate. In the southeastern United States, the dengue vector is widely established and exists on the current fringe of dengue transmission. We assessed projected climate change-driven shifts in dengue transmission risk in this region. We used a dynamic mosquito population and virus transmission model driven by meteorological data to simulate Aedes aegypti populations and dengue cases in 23 locations in the southeastern United States under current climate conditions and future climate projections. We compared estimates for each location with simulations based on observed data from San Juan, Puerto Rico, where dengue is endemic. Our simulations based on current climate data suggest that dengue transmission at levels similar to those in San Juan is possible at several U.S. locations during the summer months, particularly in southern Florida and Texas. Simulations that include climate change projections suggest that conditions may become suitable for virus transmission in a larger number of locations and for a longer period of time during each year. However, in contrast with San Juan, U.S. locations would not sustain year-round dengue transmission according to our model. Our findings suggest that Dengue virus (DENV) transmission is limited by low winter temperatures in the mainland United States, which are likely to prevent its permanent establishment. Although future climate conditions may increase the length of the mosquito season in many locations, projected increases in dengue transmission are limited to the southernmost locations.

  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. 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

  5. Imaging Active Faults From Earthquakes in the San Gorgonio Pass - San Bernardino Mountains-San Jacinto Region, California and the Deep Continuity of the San Jacinto and San Andreas Faults

    Science.gov (United States)

    Yue, L.; Carena, S.; Suppe, J.; Kao, H.

    2001-12-01

    We imaged and mapped in 3-D over 50 active faults and fault segments using earthquake locations and focal mechanisms. The majority of these faults are previously unknown or unnamed. The 3-D fault maps better define the active structure of this complex region marked by profound uncertainties over the fundamental structural framework, including the subsurface continuity and geometry of the first-order San Andreas and San Jacinto faults, as well as the existence and role of major blind faults. We used the catalog of 43,500 relocated 1975-1998 earthquakes of Richards-Dinger and Shearer (2000), separating them into coplanar clusters associated with different faults and fault strands and fitting optimized surfaces to them. A clustering algorithm was applied to the relocated earthquakes in order to obtain tighter earthquake clouds and thus better-defined fault surfaces. We used the catalog of 13,000 focal mechanisms of Hauksson (2000) to confirm the nature of the mapped faults. Examples of our results are as follows: [1] The major San Jacinto strike-slip fault is offset by an east-dipping thrust fault near Anza at a depth of 11-15 km, and a similar fault geometry may exist near San Bernardino. [2] We do not see any seismic illumination of an active through-going San Andreas fault at depth in the San Gorgonio Pass area, but we can place several constraints on its possible location and geometry on the basis of the 3-D geometry and distribution of other faults. Between 5 and 20 km depth, this area is dominated by closely spaced faults trending SE-NW, which in map view occupy a triangle delimited by the Mission Creek fault to the N, the San Jacinto fault zone to the E, and the San Jacinto Mountains to the S. To the E, some of these faults terminate against an E-W trending fault. These faults do not show any sign of having been displaced by an intersecting fault. Some of the faults we imaged have a surface area comparable to the size of the rupture on the Northridge thrust

  6. 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.

  7. 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

  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. 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

  10. Ruptures of the San Andreas fault system in San Gorgonio Pass

    Science.gov (United States)

    Yule, D.; Sieh, K. E.

    2010-12-01

    Fault behavior models for the San Andreas fault system in San Gorgonio Pass hinge upon contrasting interpretations of the structural complexity and diffuse seismicity in the Pass region. One model maintains that the fault system can rupture through the Pass in ~ M 7.8 earthquakes that extend from the Salton Sea to the Mojave Desert. Another model argues that the structural complexity here arrests San Andreas ruptures as they approach from either side of the Pass and limits their size to ~ M 7.5. One way to test these models is to examine the paleoseismic record of active faults in the Pass. Work at the Burro Flats site, located where the San Bernardino strand feeds into San Gorgonio Pass from the north, reveals evidence for at least nine earthquakes in the last 2000 yrs. The average earthquake recurrence is about 200 yrs with the maximum and minimum intervals between earthquakes equal to about 550 and 80 yrs, respectively. The average recurrence is considered to be a maximum value because a hiatus in sedimentation during the Early Middle Ages may ‘hide’ one or more event during this time period. The maximum recurrence interval of 550 yrs is likely an overestimate owing to the large errors in the timing of one event ~1300 yrs ago. In general, the Burro Flats event record and average recurrence is very similar to those at sites in the San Bernardino and Coachella Valley regions. The most recent rupture at Burro Flats cuts strata that contain European-introduced pollen and is interpreted to record the southeastern extent of the 1812 Wrightwood earthquake, a possible example of a ‘Pass-as-a-barrier’, moderate-sized event. The timing of pre-1812 events at Burro Flats correlate with the timing of San Andreas events in the San Bernardino and Coachella Valley regions, possible examples of through going, larger-sized earthquakes. Work at the Cabezon site, located on a thrust segment of the San Gorgonio Pass fault zone, shows evidence for two ruptures since ~ AD 1300

  11. Characterization of the neutron detector upgrade to the GP-SANS and Bio-SANS instruments at HFIR

    Science.gov (United States)

    Berry, Kevin D.; Bailey, Katherine M.; Beal, Justin; Diawara, Yacouba; Funk, Loren; Steve Hicks, J.; Jones, A. B.; Littrell, Kenneth C.; Pingali, S. V.; Summers, P. R.; Urban, Volker S.; Vandergriff, David H.; Johnson, Nathan H.; Bradley, Brandon J.

    2012-11-01

    Over the past year, new 1 m×1 m neutron detectors have been installed at both the General Purpose SANS (GP-SANS) and the Bio-SANS instruments at HFIR, each intended as an upgrade to provide improved high rate capability. This paper presents the results of characterization studies performed in the detector test laboratory, including position resolution, linearity and background, as well as a preliminary look at high count rate performance.

  12. 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.

  13. 2007 San Diego wildfires and asthmatics.

    Science.gov (United States)

    Vora, Chirag; Renvall, Marian J; Chao, Peter; Ferguson, Paul; Ramsdell, Joe W

    2011-02-01

    This case series reports the changes in the respiratory health of eight asthmatic subjects and the relationship with air quality associated with the October 2007 firestorm in San Diego County of California. Participants were eight subjects with asthma enrolled in Asthma Clinical Research Network (ACRN) (NIH# U10-HL074218) studies at the University of California San Diego (UCSD), School of Medicine, who had study data collected immediately prior, during and 1 month after the 5-day firestorm in San Diego County. Air quality deteriorated to an extreme average of 71.5 mg/m(3) small particulate matter less than 2.5 μm (PM(2.5)) during the firestorm. Respiratory health data included morning and evening peak expiratory flow rates (PEFR), morning and evening Forced Expiratory Volume in one second (FEV(1)), rescue medication usage, and sputum eosinophils. Morning and evening PEFR and FEV(1) rates remained stable. The two subjects tested during the fires had elevated eosinophil counts and rescue medication usage was increased in five of the eight subjects. Pulmonary function test values were stable during the wildfires for all eight subjects but there was a statistically significant increase in rescue medication usage during the wildfires that correlated with PM(2.5) values. The two subjects tested during the fires showed increases in sputum eosinophil counts consistent with increased airways inflammation. These findings suggest that poor air quality associated with wildfires resulted in an increase in airways inflammation in these asthmatic subjects, but pulmonary function tests remained stable, possibly due to increased rescue medication usage. This is especially pertinent as there is an increase in incidence of wildfires this decade.

  14. 76 FR 46352 - Approval of Noise Compatibility Program for San Diego International, San Diego, CA

    Science.gov (United States)

    2011-08-02

    ... approved. No program elements relating to new or revised flight procedures for noise abatement were... actions for noise abatement, noise mitigation, land use planning and program management on and off the... environmental analysis. Any new procedures proposed for noise abatement at SAN may not be implemented prior to a...

  15. 77 FR 42649 - Safety Zone: Sea World San Diego Fireworks, Mission Bay; San Diego, CA

    Science.gov (United States)

    2012-07-20

    ... AVI Resort and Casino. This safety zone is necessary to provide for the safety of the participants... Docket Management Facility in Room W12-140 on the ground floor of the Department of Transportation West..., call or email Petty Officer David Varela, Waterways Management, U.S. Coast Guard Sector San Diego...

  16. 75 FR 28194 - Safety Zone; San Clemente 3 NM Safety Zone, San Clemente Island, CA

    Science.gov (United States)

    2010-05-20

    ... Regional Stakeholder Group. The Navy has a longstanding appreciation of the economic importance of San... rule elsewhere in this preamble. Taking of Private Property This rule will not cause a taking of private property or otherwise have taking implications under Executive Order 12630, Governmental Actions...

  17. 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.

  18. Otomi de San Andres Cuexcontitlan, Estado de Mexico (Otomi of San Andres Cuexcontitlan, State of Mexico).

    Science.gov (United States)

    Lastra, Yolanda

    This document is one of 17 volumes on indigenous Mexican languages and is the result of a project undertaken by the Archivo de Lenguas Indigenas de Mexico. This volume contains information on Otomi, an indigenous language of Mexico spoken in San Andres Cuexcontitlan, in the state of Mexico. The objective of collecting such a representative…

  19. 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...

  20. 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...