WorldWideScience

Sample records for united states emerging

  1. The crisis in United States hospital emergency services.

    Science.gov (United States)

    Harrison, Jeffrey P; Ferguson, Emily D

    2011-01-01

    Emergency services are critical for high-quality healthcare service provision to support acute illness, trauma and disaster response. The greater availability of emergency services decreases waiting time, improves clinical outcomes and enhances local community well being. This study aims to assess United States (U.S.) acute care hospital staffs ability to provide emergency medical services by evaluating the number of emergency departments and trauma centers. Data were obtained from the 2003 and 2007 American Hospital Association (AHA) annual surveys, which included over 5000 US hospitals and provided extensive information on their infrastructure and healthcare capabilities. U.S. acute care hospital numbers decreased by 59 or 1.1 percent from 2003 to 2007. Similarly, U.S. emergency rooms and trauma centers declined by 125, or 3 percent. The results indicate that US hospital staffs ability to respond to traumatic injury and disasters has declined. Therefore, US hospital managers need to increase their investment in emergency department beds as well as provide state-of-the-art clinical technology to improve emergency service quality. These investments, when linked to other clinical information systems and the electronic medical record, support further healthcare quality improvement. This research uses the AHA annual surveys,which represent self-reported data by individual hospital staff. However, the AHA expendssignificant resources to validate reported information and the annual survey data are widely used for hospital research. The declining US emergency rooms and trauma centers have negative implications for patients needing emergency services. More importantly, this research has significant policy implications because it documents a decline in the US emergency healthcare service infrastructure. This article has important information on US emergency service availability in the hospital industry.

  2. Ten major trends now emerging in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Naisbitt, J.

    1978-01-01

    Using a special analytical procedure for tracking and assessing events reported in the nation's newspapers, the Center for Policy Process has identified ten emerging trends in the United States that are having a major impact on all our lives and on all businesses and industries--and especially on the electric utility industry. Although the trends may move in contradictory directions and have different degrees of significance, all have been carefully monitored for a considerable length of time. All are firmly established--and are not to be viewed as the momentary interests of certain radical elements of the population. The ten trends are: the fast-emerging clash between nuclear fuel and coal as an environmental health issue; displacement of racism and sexism by ''ageism'' as society's most prominent anti-discrimination preoccupation, and the complete elimination soon of mandatory retirement; in government and technology, the phenomenon of ''appropriate scale'' replacing economies of scale, emergence of single-issue political organizations; coming-of-age of the recycling ethic; emergence of ''access to capital'' as the new equity issue--the new rights issue; continuing shift from centralization to decentralization; movement of society in the dual directions of high technology/high touch; business' increasing involvement with the well-established accountability trend; and shift from a representative democracy to a participatory democracy--this profound change in American democracy actually began about a decade or so ago.

  3. Monthly variation of United States pediatric headache emergency department visits.

    Science.gov (United States)

    Kedia, Sita; Ginde, Adit A; Grubenhoff, Joseph A; Kempe, Allison; Hershey, Andrew D; Powers, Scott W

    2014-05-01

    The objective of this article is to determine the monthly variation of emergency department (ED) visits for pediatric headache. We hypothesized youth have increased headache-related ED visits in the months associated with school attendance. Using a United States representative sample of ED visits in the National Hospital Ambulatory Medical Care Survey from 1997 to 2009, we estimated number of visits associated with ICD-9 codes related to headache, migraine, status migrainosus, or tension-type headache in 5- to 18-year-olds. Age-stratified multivariate models are presented for month of visit (July as reference). There was a national estimate of 250,000 ED visits annually related to headache (2.1% of total visits) in 5- to 18-year-olds. In 5- to 11-year-olds, the adjusted rate of headache-related visits was lower in April (OR 0.42, 95% CI 0.20, 0.88). In 12- to 18-year-olds, there were higher rates in January (OR 1.92, 95% CI 1.16, 3.14) and September (OR 1.64, 95% CI 1.06, 2.55). In adolescents we found higher ED utilization in January and September, the same months associated with school return from vacation for a majority of children nationally. No significant reduction in the summer suggests that school itself is not the issue, but rather changes in daily lifestyle and transitions.

  4. United States Department of Energy radiological emergency response programme - a national capability

    International Nuclear Information System (INIS)

    Gordon-Hagerty, L.E.

    1993-01-01

    In order to respond to a radiological emergency, the United States Department of Energy (USDOE) maintains seven emergency response assets and capabilities in support of a radiological emergency of any proportion within the continental United States and abroad. The seven emergency response assets and capabilities include: Accident Response Group; Aerial Measuring Systems; Atmospheric Release Advisory Capability; Federal Radiological Monitoring and Assessment Center; Nuclear Emergency Search Team; Radiation Emergency Assistance Center/Training Site; and Radiological Assistance Program. Presently, USDOE maintains the most comprehensive national radiological emergency response assets in the United States, capable of dealing with any type of emergency involving nuclear materials. In all, the Department's assets are available to support any type of accident/incident involving radioactive materials in coordination with other United States Federal agencies, as well as state and local governments, as required. (author)

  5. Emergency response planning in hospitals, United States: 2003-2004.

    Science.gov (United States)

    Niska, Richard W; Burt, Catharine W

    2007-08-20

    This study presents baseline data to determine which hospital characteristics are associated with preparedness for terrorism and natural disaster in the areas of emergency response planning and availability of equipment and specialized care units. Information from the Bioterrorism and Mass Casualty Preparedness Supplements to the 2003 and 2004 National Hospital Ambulatory Medical Care Surveys was used to provide national estimates of variations in hospital emergency response plans and resources by residency and medical school affiliation, hospital size, ownership, metropolitan statistical area status, and Joint Commission accreditation. Of 874 sampled hospitals with emergency or outpatient departments, 739 responded for an 84.6 percent response rate. Estimates are presented with 95 percent confidence intervals. About 92 percent of hospitals had revised their emergency response plans since September 11, 2001, but only about 63 percent had addressed natural disasters and biological, chemical, radiological, and explosive terrorism in those plans. Only about 9 percent of hospitals had provided for all 10 of the response plan components studied. Hospitals had a mean of about 14 personal protective suits, 21 critical care beds, 12 mechanical ventilators, 7 negative pressure isolation rooms, and 2 decontamination showers each. Hospital bed capacity was the factor most consistently associated with emergency response planning and availability of resources.

  6. Search for an Emergency Contraception Provider in the United States

    Science.gov (United States)

    ... emergency contraception provider. Concerned about cost? Click here . ---------- Emergency contraceptive pills are stocked by all major pharmacy chains, ... daily birth control pills you can use as emergency contraceptive pills. You can search for a provider in ...

  7. Contraceptive availability during an emergency response in the United States.

    Science.gov (United States)

    Ellington, Sascha R; Kourtis, Athena P; Curtis, Kathryn M; Tepper, Naomi; Gorman, Susan; Jamieson, Denise J; Zotti, Marianne; Barfield, Wanda

    2013-03-01

    This article provides the evidence for contraceptive need to prevent unintended pregnancy during an emergency response, discusses the most appropriate types of contraceptives for disaster situations, and details the current provisions in place to provide contraceptives during an emergency response.

  8. United States and Israeli Homeland Security: A Comparative Analysis of Emergency Preparedness Efforts

    National Research Council Canada - National Science Library

    Pockett, Consuella B

    2005-01-01

    This paper will provide a comparative analysis of the United States (U.S.) Department of Homeland Security's Emergency Preparedness and Response directorate and the Israel Defense Forces Home Front Command...

  9. Disparities in access to emergency general surgery care in the United States.

    Science.gov (United States)

    Khubchandani, Jasmine A; Shen, Connie; Ayturk, Didem; Kiefe, Catarina I; Santry, Heena P

    2018-02-01

    As fewer surgeons take emergency general surgery call and hospitals decrease emergency services, a crisis in access looms in the United States. We examined national emergency general surgery capacity and county-level determinants of access to emergency general surgery care with special attention to disparities. To identify potential emergency general surgery hospitals, we queried the database of the American Hospital Association for "acute care general hospital," with "surgical services," and "emergency department," and ≥1 "operating room." Internet search and direct contact confirmed emergency general surgery services that covered the emergency room 7 days a week, 24 hours a day. Geographic and population-level emergency general surgery access was derived from Geographic Information Systems and US Census. Of the 6,356 hospitals in the 2013 American Hospital Association database, only 2,811 were emergency general surgery hospitals. Counties with greater percentages of black, Hispanic, uninsured, and low-education individuals and rural counties disproportionately lacked access to emergency general surgery care. For example, counties above the 75th percentile of African American population (10.2%) had >80% odds of not having an emergency general surgery hospital compared with counties below the 25th percentile of African American population (0.6%). Gaps in access to emergency general surgery services exist across the United States, disproportionately affecting underserved, rural communities. Policy initiatives need to increase emergency general surgery capacity nationwide. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Golf-related injuries treated in United States emergency departments.

    Science.gov (United States)

    Walsh, Brittany A; Chounthirath, Thiphalak; Friedenberg, Laura; Smith, Gary A

    2017-11-01

    This study investigates unintentional non-fatal golf-related injuries in the US using a nationally representative database. This study analyzed golf-related injuries treated in US hospital emergency departments from 1990 through 2011 using the National Electronic Injury Surveillance System database. Injury rates were calculated using golf participation data. During 1990 through 2011, an estimated 663,471 (95% CI: 496,370-830,573) individuals ≥7years old were treated in US emergency departments for golf-related injuries, averaging 30,158 annually or 12.3 individuals per 10,000 golf participants. Patients 18-54years old accounted for 42.2% of injuries, but injury rates per 10,000 golf participants were highest among individuals 7-17years old (22.1) and ≥55years old (21.8) compared with 18-54years old (7.6). Patients ≥55years old had a hospital admission rate that was 5.01 (95% CI: 4.12-6.09) times higher than that of younger patients. Injured by a golf club (23.4%) or struck by a golf ball (16.0%) were the most common specified mechanisms of injury. The head/neck was the most frequently injured body region (36.2%), and sprain/strain (30.6%) was the most common type of injury. Most patients were treated and released (93.7%) and 5.9% required hospitalization. Although golf is a source of injury among all age groups, the frequency and rate of injury were higher at the two ends of the age spectrum. Given the higher injury and hospital admission rates of patients ≥55years, this age group merits the special attention of additional research and injury prevention efforts. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Emergency contraception use and counseling after changes in United States prescription status.

    Science.gov (United States)

    Kavanaugh, Megan L; Williams, Sanithia L; Schwarz, E Bimla

    2011-06-30

    Analysis of data from the 2006-2008 National Survey of Family Growth indicates that use of emergency contraception in the United States has increased after changes in its prescription status in 2006. However, clinicians continue to play a pivotal role in ensuring that women have accurate information about emergency contraception. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  12. Terrorism and emergency preparedness in state and territorial public health departments--United States, 2004.

    Science.gov (United States)

    2005-05-13

    After the events of September 11, 2001, federal funding for state public health preparedness programs increased from $67 million in fiscal year (FY) 2001 to approximately $1 billion in FY 2002. These funds were intended to support preparedness for and response to terrorism, infectious disease outbreaks, and other public health threats and emergencies. The Council of State and Territorial Epidemiologists (CSTE) assessed the impact of funding on epidemiologic capacity, including terrorism preparedness and response, in state health departments in November 2001 and again in May 2004, after distribution of an additional $1 billion in FY 2003. This report describes the results of those assessments, which indicated that increased funding for terrorism preparedness and emergency response has rapidly increased the number of epidemiologists and increased capacity for preparedness at the state level. However, despite the increase in epidemiologists, state public health officials estimate that 192 additional epidemiologists, an increase of 45.3%, are needed nationwide to fully staff terrorism preparedness programs.

  13. Independent Emergence of Yersinia ruckeri Biotype 2 in the United States and Europe

    DEFF Research Database (Denmark)

    Welch, Timothy J.; Verner-Jeffreys, David W.; Dalsgaard, Inger

    2011-01-01

    with an increased frequency of enteric redmouth disease (ERM) outbreaks in previously vaccinated salmonid fish. In this study, four independent specific natural mutations that cause the loss of both motility and secreted lipase activity were identified in BT2 strains from the United States, United Kingdom...... emerged separately at least four times. In addition, BT2 strains from the United Kingdom were shown to have the same mutant allele found in U.S. BT2 strains, suggesting a common origin of this BT2 lineage. This differentiation of distinct BT2 lineages is of critical importance for the development...

  14. The World Health Organization Global Health Emergency Workforce: What Role Will the United States Play?

    Science.gov (United States)

    Burkle, Frederick M

    2016-08-01

    During the May 2016 World Health Assembly of 194 member states, the World Health Organization (WHO) announced the process of developing and launching emergency medical teams as a critical component of the global health workforce concept. Over 64 countries have either launched or are in the development stages of vetting accredited teams, both international and national, to provide surge support to national health systems through WHO Regional Organizations and the delivery of emergency clinical care to sudden-onset disasters and outbreak-affected populations. To date, the United States has not yet committed to adopting the emergency medical team concept in funding and registering an international field hospital level team. This article discusses future options available for health-related nongovernmental organizations and the required educational and training requirements for health care provider accreditation. (Disaster Med Public Health Preparedness. 2016;10:531-535).

  15. The Epidemiology of Emergency Department Trauma Discharges in the United States.

    Science.gov (United States)

    DiMaggio, Charles J; Avraham, Jacob B; Lee, David C; Frangos, Spiros G; Wall, Stephen P

    2017-10-01

    Injury-related morbidity and mortality is an important emergency medicine and public health challenge in the United States. Here we describe the epidemiology of traumatic injury presenting to U.S. emergency departments (EDs), define changes in types and causes of injury among the elderly and the young, characterize the role of trauma centers and teaching hospitals in providing emergency trauma care, and estimate the overall economic burden of treating such injuries. We conducted a secondary retrospective, repeated cross-sectional study of the Nationwide Emergency Department Data Sample (NEDS), the largest all-payer ED survey database in the United States. Main outcomes and measures were survey-adjusted counts, proportions, means, and rates with associated standard errors (SEs) and 95% confidence intervals. We plotted annual age-stratified ED discharge rates for traumatic injury and present tables of proportions of common injuries and external causes. We modeled the association of Level I or II trauma center care with injury fatality using a multivariable survey-adjusted logistic regression analysis that controlled for age, sex, injury severity, comorbid diagnoses, and teaching hospital status. There were 181,194,431 (SE = 4,234) traumatic injury discharges from U.S. EDs between 2006 and 2012. There was a mean year-to-year decrease of 143 (95% CI = -184.3 to -68.5) visits per 100,000 U.S. population during the study period. The all-age, all-cause case-fatality rate for traumatic injuries across U.S. EDs during the study period was 0.17% (SE = 0.001%). The case-fatality rate for the most severely injured averaged 4.8% (SE = 0.001%), and severely injured patients were nearly four times as likely to be seen in Level I or II trauma centers (relative risk = 3.9 [95% CI = 3.7 to 4.1]). The unadjusted risk ratio, based on group counts, for the association of Level I or II trauma centers with mortality was risk ratio = 4.9 (95% CI = 4.5 to 5.3); however, after sex, age

  16. China, the United States, and competition for resources that enable emerging technologies

    Science.gov (United States)

    Gulley, Andrew L.; Nassar, Nedal T.; Xun, Sean

    2018-01-01

    Historically, resource conflicts have often centered on fuel minerals (particularly oil). Future resource conflicts may, however, focus more on competition for nonfuel minerals that enable emerging technologies. Whether it is rhenium in jet engines, indium in flat panel displays, or gallium in smart phones, obscure elements empower smarter, smaller, and faster technologies, and nations seek stable supplies of these and other nonfuel minerals for their industries. No nation has all of the resources it needs domestically. International trade may lead to international competition for these resources if supplies are deemed at risk or insufficient to satisfy growing demand, especially for minerals used in technologies important to economic development and national security. Here, we compare the net import reliance of China and the United States to inform mineral resource competition and foreign supply risk. Our analysis indicates that China relies on imports for over half of its consumption for 19 of 42 nonfuel minerals, compared with 24 for the United States—11 of which are common to both. It is for these 11 nonfuel minerals that competition between the United States and China may become the most contentious, especially for those with highly concentrated production that prove irreplaceable in pivotal emerging technologies.

  17. Malaria Treatment (United States)

    Science.gov (United States)

    ... Providers, Emergency Consultations, and General Public. Contact Us Malaria Treatment (United States) Recommend on Facebook Tweet Share Compartir Treatment of Malaria: Guidelines For Clinicians (United States) Download PDF version ...

  18. Analysis of inland crude oil spill threats, vulnerabilities, and emergency response in the midwest United States.

    Science.gov (United States)

    Brody, Thomas M; Di Bianca, Paisly; Krysa, Jan

    2012-10-01

    Although coastal oil spills tend to be highly publicized, crude oil spills in the United States affect inland areas relatively often. Spills to inland areas often affect sensitive environments and can have greater impacts to health and welfare than spills to coastal areas. For these reasons, the authors investigated inland crude oil spill threats, vulnerabilities, and emergency response in the midwestern U.S. states of Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin. These states work with the Region 5 Offices of the U.S. Environmental Protection Agency. Region 5's geospatial data in the Inland Sensitivity Atlas were turned into metrics indicating inland crude oil spill threats and vulnerabilities among the Region's sub-watersheds. These threats and vulnerabilities were weighted using data from the National Response Center and the Department of Energy's Environmental Restoration Priority System. The locations of the Region's emergency responders were geocoded in GIS. The GIS calculated the emergency response times to the Region's sub-watersheds. The resulting scatter plots are connected to the sub-watersheds in the map so stakeholders can (1) see the outlying sub-watersheds of concern and (2) better understand how reducing threats and better response time can reduce the risk of inland crude oil spills. Published 2012. This article is a U.S. Government work and is in the public domain in the U.S.A.

  19. Vintage, the First 40 Years: The Emergence and Persistence of Vintage Style in the United States

    Directory of Open Access Journals (Sweden)

    Nancy L. Fischer

    2015-03-01

    Full Text Available This paper historicizes when wearing vintage clothing first became fashionable in the United States. I trace when the trend emerges in the U.S. and explore various ways the press framed secondhand/vintage clothes and anachronistic dressing. I contend that the emergence of vintage occurs as a form of alternative consumption alongside changes that occurred in the U.S. garment industry such as outsourcing and product licensing. These changes led many consumers to seek more authentic consumption experiences. Consumers with cultural capital found in vintage an alternative market for sourcing fashionable street style. Consumers attribute characteristics to vintage clothing that are typically part of authenticity discourse such as it being of exceptional quality, original, handcrafted, made from natural fibers, and providing continuity with the past. The authenticity of vintage is symbolically deployed in opposition to contemporary mass-produced clothing and standardized retail shopping experiences.

  20. Early emergence of anthropogenically forced heat waves in the western United States and Great Lakes

    Science.gov (United States)

    Lopez, Hosmay; West, Robert; Dong, Shenfu; Goni, Gustavo; Kirtman, Ben; Lee, Sang-Ki; Atlas, Robert

    2018-05-01

    Climate projections for the twenty-first century suggest an increase in the occurrence of heat waves. However, the time at which externally forced signals of anthropogenic climate change (ACC) emerge against background natural variability (time of emergence (ToE)) has been challenging to quantify, which makes future heat-wave projections uncertain. Here we combine observations and model simulations under present and future forcing to assess how internal variability and ACC modulate US heat waves. We show that ACC dominates heat-wave occurrence over the western United States and Great Lakes regions, with ToE that occurred as early as the 2020s and 2030s, respectively. In contrast, internal variability governs heat waves in the northern and southern Great Plains, where ToE occurs in the 2050s and 2070s; this later ToE is believed to be a result of a projected increase in circulation variability, namely the Great Plain low-level jet. Thus, greater mitigation and adaptation efforts are needed in the Great Lakes and western United States regions.

  1. 77 FR 31026 - Use of Computer Simulation of the United States Blood Supply in Support of Planning for Emergency...

    Science.gov (United States)

    2012-05-24

    ...] Use of Computer Simulation of the United States Blood Supply in Support of Planning for Emergency... entitled: ``Use of Computer Simulation of the United States Blood Supply in Support of Planning for... and panel discussions with experts from academia, regulated industry, government, and other...

  2. Emergency planning requirements and short-term countermeasures for commercial nuclear power plants in the United States

    International Nuclear Information System (INIS)

    Kantor, F.; Hogan, R.; Mohseni, A.

    1995-01-01

    Since the accident at the Three Mile Island Unit, the United States Nuclear Regulatory's Commission (NRC's) emergency planning regulations are now considered and an important part of the regulatory framework for protecting the public health and safety. Many aspects of the countermeasures are presented: Emergency Planning Zones (EPZ), off-Site emergency planning and preparedness, responsibilities of nuclear power plants operators and states and local government. Finally, protective action recommendations are given as well as the federal response to an emergency. The authors noted that the use of potassium iodide is not considered as an effective countermeasure for the public protection in the US. (TEC). 1 fig

  3. Emergency response capabilities developed in the United States to deal with nuclear materials transportation accidents

    International Nuclear Information System (INIS)

    Vandevender, S.G.; Reese, R.T.; Schilling, A.H.

    1980-01-01

    The non-existence of emergency response programs is frequently stated as a reason for restricting the movement of radioactive materials through states or local jurisdictions. Yet, studies discussed here indicate that emergency response capability, while not in the best condition, is getting more money, interest and attention, and in most states response networks exist which could be effective in responding to radiological emergencies. Awareness of such capabilities by the public is an important feature in increasing the public's confidence in the ability of federal, state and local officials in controlling hazards. One aspect of this awareness program could be in broader availability of radioactive emergency techniques for possible first responders to emergencies. This training, public awareness and more emphasis on workable emergency plans will help to assure reliable and workable emergency response plans

  4. Emergency radiological monitoring and analysis United States Federal Radiological Monitoring and Assessment Center

    International Nuclear Information System (INIS)

    Thome, D.J.

    1994-01-01

    The United States Federal Radiological Emergency Response Plan (FRERP) provides the framework for integrating the various Federal agencies responding to a major radiological emergency. Following a major radiological incident the FRERP authorizes the creation of the Federal Radiological Monitoring and Assessment Center (FRMAC). The FRMAC is established to coordinate all Federal agencies involved in the monitoring and assessment of the off-site radiological conditions in support of the impacted states and the Lead Federal Agency (LFA). Within the FRMAC, the Monitoring and Analysis Division is responsible for coordinating all FRMAC assets involved in conducting a comprehensive program of environmental monitoring, sampling, radioanalysis and quality assurance. This program includes: (1) Aerial Radiological Monitoring - Fixed Wing and Helicopter, (2) Field Monitoring and Sampling, (3) Radioanalysis - Mobile and Fixed Laboratories, (4) Radiation Detection Instrumentation - Calibration and Maintenance, (5) Environmental Dosimetry, and (6) An integrated program of Quality Assurance. To assure consistency, completeness and the quality of the data produced, a methodology and procedures handbook is being developed. This paper discusses the structure, assets and operations of FRMAC monitoring and analysis and the content and preparation of this handbook

  5. Model describing the effect of employment of the United States military in a complex emergency.

    Science.gov (United States)

    MacMillan, Donald S

    2005-01-01

    The end of the Cold War vastly altered the worldwide political landscape. With the loss of a main competitor, the United States (US) military has had to adapt its strategic, operational, and tactical doctrines to an ever-increasing variety of non-traditional missions, including humanitarian operations. Complex emergencies (CEs) are defined in this paper from a political and military perspective, various factors that contribute to their development are described, and issues resulting from the employment of US military forces are discussed. A model was developed to illustrate the course of a humanitarian emergency and the potential impact of a military response. The US intervention in Haiti, Northern Iraq, Kosovo, Somalia, Bosnia, and Rwanda serve as examples. A CE develops when there is civil conflict, loss of national governmental authority, a mass population movement, and massive economic failure, each leading to a general decline in food security. The military can alleviate a CE in four ways: (1) provide security for relief efforts; (2) enforce negotiated settlements; (3) provide security for non-combatants; and/or (4) employ logistical capabilities. The model incorporates Norton and Miskel's taxonomy of identifying failing states and helps illustrate the factors that lead to a CE. The model can be used to determine if and when military intervention will have the greatest impact. The model demonstrates that early military intervention and mission assignment within the core competencies of the forces can reverse the course of a CE. Further study will be needed to verify the model.

  6. National Characteristics of Emergency Medical Services Responses for Older Adults in the United States.

    Science.gov (United States)

    Duong, Hieu V; Herrera, Lauren Nicholas; Moore, Justin Xavier; Donnelly, John; Jacobson, Karen E; Carlson, Jestin N; Mann, N Clay; Wang, Henry E

    2018-01-01

    Older adults, those aged 65 and older, frequently require emergency care. However, only limited national data describe the Emergency Medical Services (EMS) care provided to older adults. We sought to determine the characteristics of EMS care provided to older adults in the United States. We used data from the 2014 National Emergency Medical Services Information System (NEMSIS), encompassing EMS response data from 46 States and territories. We excluded EMS responses for children older adults as age ≥65 years. We compared patient demographics (age, sex, race, primary payer), response characteristics (dispatch time, location type, time intervals), and clinical course (clinical impression, injury, procedures, medications) between older and younger adult EMS emergency 9-1-1 responses. During the study period there were 20,212,245 EMS emergency responses. Among the 16,116,219 adult EMS responses, there were 6,569,064 (40.76%) older and 9,547,155 (59.24%) younger adults. Older EMS patients were more likely to be white and the EMS incident to be located in healthcare facilities (clinic, hospital, nursing home). Compared with younger patients, older EMS patients were more likely to present with syncope (5.68% vs. 3.40%; OR 1.71; CI: 1.71-1.72), cardiac arrest/rhythm disturbance (3.27% vs. 1.69%; OR 1.97; CI: 1.96-1.98), stroke (2.18% vs. 0.74%; OR 2.99; CI: 2.96-3.02) and shock (0.77% vs. 0.38%; OR 2.02; CI: 2.00-2.04). Common EMS interventions performed on older persons included intravenous access (32.02%), 12-lead ECG (14.37%), CPR (0.87%), and intubation (2.00%). The most common EMS drugs administered to older persons included epinephrine, atropine, furosemide, amiodarone, and albuterol or ipratropium. One of every three U.S. EMS emergency responses involves older adults. EMS personnel must be prepared to care for the older patient.

  7. The Military Emergency Unit

    International Nuclear Information System (INIS)

    Gonzalez Requena, J. M.

    2007-01-01

    One of the most justified and pressing demands that society makes of the State, requiring a fast, forceful and effective response, is that it guarantees the safety of people and their assets when a disaster seriously endangers them. At the proposal of the President of the Government, the Cabinet of Ministers, in its meeting held on October 7, 2005, agreed to create the Military Emergency Unit, known since the as the UME. Its mission is to intervene anywhere in the national territory when the President of the Government, or the Minister to whom he delegates, so decides in order to assure the safety and welfare of citizens in cases of serious risk, disaster, catastrophe or any other public need. The UME is organically incorporated into the Ministry of Defense and its actions may be supported with all the available human and material needs of the Armed Forces. Availability and effectiveness, with calmness and humility, have characterized the early actions of the Military Emergency Unit and are the guidelines for future action. The first steps of this military unit have focused on a clear goal: collaboration and participation in situations whose seriousness requires the coordination of different forces in order to immediately respond to them. The UME is the States tool to join forces and, with other administration and institutions, help to rapidly and effectively deal with emergencies. It has taken its first step and achieved the capacity specified in the UME Operations Order for 2007. The 150 men and women per battalion, plus the 80 in the Gando detachment, are on active duty and have sufficient material means to deploy, if necessary and when requested by the regions, town councils an other administrative bodies, to help in the extinction of forest fires. (Author)

  8. Self Inflicted Injuries among Children in United States - estimates from a nationwide emergency department sample.

    Directory of Open Access Journals (Sweden)

    Naseem Sulyman

    Full Text Available OBJECTIVE: The objectives of the current study are to provide nationally representative estimates of hospital based emergency department visits (ED attributed to self inflicted injuries and attempted suicides among children in United States; and to identify potential methods of such intentional self inflicted injuries and attempted suicides. METHODS: The Nationwide Emergency Department Sample (year 2007 was used. All ED visits occurring among children (aged ≤18 years with an External Cause of Injury for any of self inflicted injuries were selected. Outcomes examined include hospital ED charges and hospitalization charges. All estimates were projected to national levels. RESULTS: 77,420 visits to hospital based emergency departments were attributed to self inflicted injuries among children (26,045 males and 51,370 females. The average age of the ED visits was 15.7 years. 134 patients died in ED's (106 males and 28 females and 93 died in hospitals following in-patient admission (75 males and 18 females. A greater proportion of male ED visits were discharged routinely as opposed to female ED visits (51.1% versus 44%. A greater proportion of male ED visits also died in the emergency departments compared to female visits (0.4% versus 0.05%. 17,965 ED visits necessitated admission into same hospital. The mean charge for each ED visit was $1,874. Self inflicted injuries by poisoning were the most frequently reported sources accounting for close to 70% of all ED visits. CONCLUSIONS: Females comprise a greater proportion of ED visits attributed to self inflicted injuries. 227 children died either in the ED's or in hospitals. The current study results highlight the burden associated with such injuries among children.

  9. Incidence and Cost of Ankle Sprains in United States Emergency Departments

    Science.gov (United States)

    Shah, Shweta; Thomas, Abbey C.; Noone, Joshua M.; Blanchette, Christopher M.; Wikstrom, Erik A.

    2016-01-01

    Background: Ankle sprains represent a common injury in emergency departments, but little is known about common complications, procedures, and charges associated with ankle sprains in emergency departments. Hypothesis: There will be a higher incidence of ankle sprains among younger populations (≤25 years old) and in female patients. Complications and procedures will differ between ankle sprain types. Lateral ankle sprains will have lower health care charges relative to medial and high ankle sprains. Study Design: Descriptive epidemiological study. Level of Evidence: Level 3. Methods: A cross-sectional study of the 2010 Nationwide Emergency Department Sample was conducted. Outcomes such as charges, complications, and procedures were compared using propensity score matching between lateral and medial as well as lateral and high ankle sprains. Results: The sample contained 225,114 ankle sprains. Female patients sustained more lateral ankle sprains (57%). After propensity score adjustment, lateral sprains incurred greater charges than medial ankle sprains (median [interquartile range], $1008 [$702-$1408] vs $914 [$741-$1108]; P sprain of the foot (2.96% vs 0.70%, P ankle sprain events. Among procedures, medial ankle sprains were more likely to include diagnostic radiology (97.91% vs 83.62%, P ankle sprains (0.87% vs 2.79%, P ankle sprains than lateral ankle sprains (24 [6.06%] vs 1 [0.25%], P Ankle sprain emergency department visits account for significant health care charges in the United States. Age- and sex-related differences persist among the types of ankle sprains. Clinical Relevance: The health care charges associated with ankle sprains indicate the need for additional preventive measures. There are age- and sex-related differences in the prevalence of ankle sprains that suggest these demographics may be risk factors for ankle sprains. PMID:27474161

  10. Variation in Emergency Department vs Internal Medicine Excess Charges in the United States.

    Science.gov (United States)

    Xu, Tim; Park, Angela; Bai, Ge; Joo, Sarah; Hutfless, Susan M; Mehta, Ambar; Anderson, Gerard F; Makary, Martin A

    2017-08-01

    Uninsured and insured but out-of-network emergency department (ED) patients are often billed hospital chargemaster prices, which exceed amounts typically paid by insurers. To examine the variation in excess charges for services provided by emergency medicine and internal medicine physicians. Retrospective analysis was conducted of professional fee payment claims made by the Centers for Medicare & Medicaid Services for all services provided to Medicare Part B fee-for-service beneficiaries in calendar year 2013. Data analysis was conducted from January 1 to July 31, 2016. Markup ratios for ED and internal medicine professional services, defined as the charges submitted by the hospital divided by the Medicare allowable amount. Our analysis included 12 337 emergency medicine physicians from 2707 hospitals and 57 607 internal medicine physicians from 3669 hospitals in all 50 states. Services provided by emergency medicine physicians had an overall markup ratio of 4.4 (340% excess charges), which was greater than the markup ratio of 2.1 (110% excess charges) for all services performed by internal medicine physicians. Markup ratios for all ED services ranged by hospital from 1.0 to 12.6 (median, 4.2; interquartile range [IQR], 3.3-5.8); markup ratios for all internal medicine services ranged by hospital from 1.0 to 14.1 (median, 2.0; IQR, 1.7-2.5). The median markup ratio by hospital for ED evaluation and management procedure codes varied between 4.0 and 5.0. Among the most common ED services, laceration repair had the highest median markup ratio (7.0); emergency medicine physician review of a head computed tomographic scan had the greatest interhospital variation (range, 1.6-27.7). Across hospitals, markups in the ED were often substantially higher than those in the internal medicine department for the same services. Higher ED markup ratios were associated with hospital for-profit ownership (median, 5.7; IQR, 4.0-7.1), a greater percentage of uninsured patients seen

  11. Mountain biking-related injuries treated in emergency departments in the United States, 1994-2007.

    Science.gov (United States)

    Nelson, Nicolas G; McKenzie, Lara B

    2011-02-01

    Injury research on mountain biking has been mostly limited to examining professional riders and off-road biking. Mountain bikes represent the largest segment of bike sales in the United States. Recreational mountain bike use is popular and understudied. To describe the scope, distribution, and trends of mountain bike-related injuries treated in US emergency departments. Descriptive epidemiologic study. A retrospective analysis was conducted with data from the National Electronic Injury Surveillance System of the US Consumer Product Safety Commission for patients aged ≥ 8 years from 1994 through 2007. Sample weights provided by the system were used to calculate national estimates of mountain bike-related injuries based on 4624 cases. Bivariate comparisons between categorical variables were assessed with injury proportion ratios and 95% confidence intervals. Nationwide, an estimated 217 433 patients were treated for mountain bike-related injuries in US emergency departments from 1994 to 2007, an average of 15 531 injuries per year. The annual number of injuries decreased 56%, from a high of 23 177 in 1995 to 10 267 in 2007 (P bike-related injuries decreased from 1994 to 2007. Upper extremity fractures were the most common injury. Girls and women may be more likely than boys and men to sustain more severe injuries requiring hospitalization. Despite the decline over the past decade, more can be done to improve safety and reduce injuries in this popular recreational activity.

  12. Pharmaceuticals and other contaminants of emerging concern in landfill leachate of the United States

    Science.gov (United States)

    Kolpin, Dana W.; Masoner, Jason R.; Furlong, Edward T.; Cozzarelli, Isabelle M.; Gray, James L.; Schwab, Eric A.

    2015-01-01

    Landfills are commonly the final respository for a heterogeneous mixture of waste from residential, commercial, and industrial sources. The use of landfills as a means of waste disposal will likely increase as the global population increases and nations develop. Thus, landfills receiving such waste have the potential to produce leachate containing numerous organic chemicals including contaminants of emerging concern (CECs) such as pharmaceuticals, personal care products, and hormones. This leachate is often discharged to pathways that lead directly (e.g. groundwater, streams) or indirectly (e.g. wastewater treament plants) to the environment. Limited research, however, has been conducted regarding the characterisation of landfill leachate for CECs.To provide the first national-scale assessment of CECs in landfill leachate across the United States, fresh leachate samples (i.e. prior to onsite treatment) from 19 landfills in 16 states were collected in 2011 and analysed for 202 CECs [1]. The targeted CECs were selected for analysis because they were expected to be persistent in the environment; are used, excreted, or disposed of in substantial quantities; may have human or environmental health effects; or are potential indicators of environmentally relevant classes of chemicals or source materials.

  13. Factors associated with closures of emergency departments in the United States.

    Science.gov (United States)

    Hsia, Renee Y; Kellermann, Arthur L; Shen, Yu-Chu

    2011-05-18

    Between 1998 and 2008, the number of hospital-based emergency departments (EDs) in the United States declined, while the number of ED visits increased, particularly visits by patients who were publicly insured and uninsured. Little is known about the hospital, community, and market factors associated with ED closures. Federal law requiring EDs to treat all in need regardless of a patient's ability to pay may make EDs more vulnerable to the market forces that govern US health care. To determine hospital, community, and market factors associated with ED closures. Emergency department and hospital organizational information from 1990 through 2009 was acquired from the American Hospital Association (AHA) Annual Surveys (annual response rates ranging from 84%-92%) and merged with hospital financial and payer mix information available through 2007 from Medicare hospital cost reports. We evaluated 3 sets of risk factors: hospital characteristics (safety net [as defined by hospitals caring for more than double their Medicaid share of discharges compared with other hospitals within a 15-mile radius], ownership, teaching status, system membership, ED size, case mix), county population demographics (race, poverty, uninsurance, elderly), and market factors (ownership mix, profit margin, location in a competitive market, presence of other EDs). All general, acute, nonrural, short-stay hospitals in the United States with an operating ED anytime from 1990-2009. Closure of an ED during the study period. From 1990 to 2009, the number of hospitals with EDs in nonrural areas declined from 2446 to 1779, with 1041 EDs closing and 374 hospitals opening EDs. Based on analysis of 2814 urban acute-care hospitals, constituting 36,335 hospital-year observations over an 18-year study interval (1990-2007), for-profit hospitals and those with low profit margins were more likely to close than their counterparts (cumulative hazard rate based on bivariate model, 26% vs 16%; hazard ratio [HR], 1

  14. Important historical efforts at emergency department categorization in the United States and implications for regionalization.

    Science.gov (United States)

    Mehrotra, Abhishek; Sklar, David P; Tayal, Vivek S; Kocher, Keith E; Handel, Daniel A; Myles Riner, R

    2010-12-01

    This article is drawn from a report created for the American College of Emergency Physicians (ACEP) Emergency Department (ED) Categorization Task Force and also reflects the proceedings of a breakout session, "Beyond ED Categorization-Matching Networks to Patient Needs," at the 2010 Academic Emergency Medicine consensus conference, "Beyond Regionalization: Integrated Networks of Emergency Care." The authors describe a brief history of the significant national and state efforts at categorization and suggest reasons why many of these efforts failed to persevere or gain wider implementation. The history of efforts to categorize hospital (and ED) emergency services demonstrates recognition of the potential benefits of categorization, but reflects repeated failures to implement full categorization systems or limited excursions into categorization through licensing of EDs or designation of receiving and referral facilities. An understanding of the history of hospital and ED categorization could better inform current efforts to develop categorization schemes and processes. 2010 by the Society for Academic Emergency Medicine.

  15. Major alternatives for government policies, organizational structures, and actions in civilian nuclear reactor emergency management in the United States

    International Nuclear Information System (INIS)

    1980-01-01

    The purpose of this report is to identify and assess major alternatives for governmental policies, organizational structures, and actions in civilian nuclear reactor emergency management in the United States. The National Academy of Public Administration agreed to identify and evaluate alternatives for governmental policies, organizational structures, and actions in civilian nuclear reactor emergency management. It agreed to review present policies and practices in civilian nuclear reactor emergency management, to review selected experiences and practices of governmental agencies other than the Nuclear Regulatory Commission, and industries other than the nuclear power industry, and to identify alternatives to the present nuclear emergency system

  16. Vaccine escape recombinants emerge after pneumococcal vaccination in the United States.

    Science.gov (United States)

    Brueggemann, Angela B; Pai, Rekha; Crook, Derrick W; Beall, Bernard

    2007-11-01

    The heptavalent pneumococcal conjugate vaccine (PCV7) was introduced in the United States (US) in 2000 and has significantly reduced invasive pneumococcal disease; however, the incidence of nonvaccine serotype invasive disease, particularly due to serotype 19A, has increased. The serotype 19A increase can be explained in part by expansion of a genotype that has been circulating in the US prior to vaccine implementation (and other countries since at least 1990), but also by the emergence of a novel "vaccine escape recombinant" pneumococcal strain. This strain has a genotype that previously was only associated with vaccine serotype 4, but now expresses a nonvaccine serotype 19A capsule. Based on prior evidence for capsular switching by recombination at the capsular locus, the genetic event that resulted in this novel serotype/genotype combination might be identifiable from the DNA sequence of individual pneumococcal strains. Therefore, the aim of this study was to characterise the putative recombinational event(s) at the capsular locus that resulted in the change from a vaccine to a nonvaccine capsular type. Sequencing the capsular locus flanking regions of 51 vaccine escape (progeny), recipient, and putative donor pneumococci revealed a 39 kb recombinational fragment, which included the capsular locus, flanking regions, and two adjacent penicillin-binding proteins, and thus resulted in a capsular switch and penicillin nonsusceptibility in a single genetic event. Since 2003, 37 such vaccine escape strains have been detected, some of which had evolved further. Furthermore, two new types of serotype 19A vaccine escape strains emerged in 2005. To our knowledge, this is the first time a single recombinational event has been documented in vivo that resulted in both a change of serotype and penicillin nonsusceptibility. Vaccine escape by genetic recombination at the capsular locus has the potential to reduce PCV7 effectiveness in the longer term.

  17. Emergency department burden of constipation in the United States from 2006 to 2011.

    Science.gov (United States)

    Sommers, Thomas; Corban, Caroline; Sengupta, Neil; Jones, Michael; Cheng, Vivian; Bollom, Andrea; Nurko, Samuel; Kelley, John; Lembo, Anthony

    2015-04-01

    Although constipation is typically managed in an outpatient setting, there is an increasing trend in the frequency of constipation-related hospital visits. The aim of this study was to analyze trends related to chronic constipation (CC) in the United States with respect to emergency department (ED) visits, patient and hospital characteristics, and associated costs. Data from 2006 to 2011, in which constipation (The International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) diagnosis codes 564.00-564.09) was the primary discharge diagnosis, were obtained from the National Emergency Department Sample (NEDS). Between 2006 and 2011, the frequency of constipation-related ED visits increased by 41.5%, from 497,034 visits to 703,391 visits, whereas the mean cost per patient rose by 56.4%, from $1,474 in 2006 to $2,306 in 2011. The aggregate national cost of constipation-related ED visits increased by 121.4%, from $732,886,977 in 2006 to $1,622,624,341 in 2011. All cost data were adjusted for inflation and reported in 2014 dollars. Infants (constipation-related ED visits in both 2006 and 2011. The late elders (85+ years) had the second highest constipation-related ED visit rate in 2006; however, the 1- to 17-year-old age group experienced a 50.7% increase in constipation-related ED visit rate from 2006 to 2011 and had the second highest constipation-related ED visit rate in 2011. The frequency of and the associated costs of ED visits for constipation are significant and have increased notably from 2006 to 2011.

  18. Psychiatric boarding incidence, duration, and associated factors in United States emergency departments.

    Science.gov (United States)

    Nolan, Jason M; Fee, Christopher; Cooper, Bruce A; Rankin, Sally H; Blegen, Mary A

    2015-01-01

    Boarding, especially among psychiatric patients, has been characterized as a significant cause of ED crowding, but no quantitative analysis has described boarding nationally. This study determines the incidence, duration, and factors associated with ED boarding in the United States. 2008 National Hospital Ambulatory Medical Care Survey ED data were stratified by visit type (psychiatric vs. non-psychiatric), boarding status, and patient and hospital characteristics. Boarding was defined as a visit with an ED length of stay >6 hours, and boarding time as ED length of stay minus 6 hours. Pearson's chi-square tests describe hospital and patient characteristics stratified by boarding status. Multilevel multivariable logistic and linear regressions determine associations with boarding and boarding time. While 11% of all ED patients boarded, 21.5% of all psychiatric ED patients boarded. Boarding was also more prolonged for psychiatric ED patients. Controlling for confounders, odds of boarding for psychiatric patients were 4.78 (2.63-8.66) times higher than non-psychiatric, and psychiatric patients boarded 2.78 (1.91-3.64) hours longer than non-psychiatric. US EDs experienced high proportions and durations of boarding with psychiatric patients disproportionately affected. Additional research concerning mental health care services and legislation may be required to address ED psychiatric patient boarding. Copyright © 2015 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  19. Telehealth in older adults with cancer in the United States: The emerging use of wearable sensors.

    Science.gov (United States)

    Shen, John; Naeim, Arash

    2017-11-01

    As the aging and cancer populations in the world continue to increase, the need for complements to traditional geriatric assessments and the logical incorporation of fast and reliable telehealth tools have become interlinked. In the United States, studies examining the use of telehealth for chronic disease management have shown promising results in small groups. The implementation of health technology on a broader scale requires older adults to both accept and adapt such innovation into routine medical care. Though the commercial and recreational use of new technology has increased in older individuals, the transition into creating a smart and connected home that can interface with both patients and healthcare professionals is in its early phases. Current limitations include an inherent digital divide, as well as concerns regarding privacy, data volume, rapid change, cost and reimbursement. The emergence of low-cost, high-fidelity wearable sensors with a spectrum of clinical utility may be the key to increased use and adaptation by older adults. An opportunity to utilize wearable sensors for objective and real-time assessment of older patients with cancer for baseline functional status and treatment toxicity may be on the horizon. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. 21ST Century United States Military Strategy for East Asia: Countering an Emerging China

    National Research Council Canada - National Science Library

    LeBlanc, Lee

    2004-01-01

    .... The United States National Security Strategy (NSS) suggests that the U.S. has relied on a U.S. forward military presence in the East Asian region for over 50 years enabling it to achieve its NSS objectives...

  1. Patient characteristics and trends in nontraumatic dental condition visits to emergency departments in the United States

    Directory of Open Access Journals (Sweden)

    Xiang Q

    2012-01-01

    Full Text Available Christopher Okunseri1, Elaye Okunseri1, Joshua M Thorpe2, Qun Xiang3, Aniko Szabo31Department of Clinical Services, Marquette University School of Dentistry, Milwaukee, WI, 2Division of Social and Administrative Sciences, University of Wisconsin, Madison School of Pharmacy, Madison WI, 3Division of Biostatistics, Department of Population Health, Medical College of Wisconsin, Milwaukee, WI, USAObjective: We examined trends and patient characteristics for non-traumatic dental condition (NTDC visits to emergency departments (EDs, and compared them to other ED visit types, specifically non-dental ambulatory care sensitive conditions (non-dental ACSCs and non-ambulatory care sensitive conditions (non-ACSCs in the United States.Methods: We analyzed data from the National Hospital Ambulatory Medical Care survey (NHAMCS for 1997 to 2007. We performed descriptive statistics and used a multivariate multinomial logistic regression to examine the odds of one of the three visit types occurring at an ED. All analyses were adjusted for the survey design.Results: NTDC visits accounted for 1.4% of all ED visits with a 4% annual rate of increase (from 1.0% in 1997 to 1.7% in 2007. Self-pay patients (32% and Medicaid enrollees (27% were over-represented among NTDC visits compared to non-dental ACSC and non-ACSC visits (P < 0.0001. Females consistently accounted for over 50% of all types of ED visits examined. Compared to whites, Hispanics had significantly lower odds of an NDTC visit versus other visit types (P < 0.0001. Blacks had significantly lower odds of making NDTC visits when compared to non-dental ACSC visits only (P < 0.0001. Compared to private insurance enrollees, Medicaid and self-pay patients had 2–3 times the odds of making NTDC visits compared to other visit types.Conclusion: Nationally, NTDC visits to emergency departments increased over time. Medicaid and self-pay patients had significantly higher odds of making NDTC visits.Keywords: emergency

  2. Youth Versus Adult “Weightlifting” Injuries Presenting to United States Emergency Rooms: Accidental Versus Nonaccidental Injury Mechanisms

    OpenAIRE

    Myer, Gregory D.; Quatman, Carmen E.; Khoury, Jane; Wall, Eric J.; Hewett, Timothy E.

    2009-01-01

    Myer, GD, Quatman, CE, Khoury, J, Wall, EJ, and Hewett, TE. Youth versus adult “weightlifting” injuries presenting to united states emergency rooms: accidental versus nonaccidental injury mechanisms. J Strength Cond Res 23(7): 2054–2060, 2009—Resistance training has previously been purported to be unsafe and ineffective in children. The purpose of this investigation was to evaluate resistance training-related injuries presenting to U.S. emergency rooms by age, type, and mechanism of injury. W...

  3. Emergency medicine and internal medicine trainees’ smartphone use in clinical settings in the United States

    Directory of Open Access Journals (Sweden)

    Sonja E. Raaum

    2015-10-01

    Full Text Available Purpose: Smartphone technology offers a multitude of applications (apps that provide a wide range of functions for healthcare professionals. Medical trainees are early adopters of this technology, but how they use smartphones in clinical care remains unclear. Our objective was to further characterize smartphone use by medical trainees at two United States academic institutions, as well as their prior training in the clinical use of smartphones. Methods: In 2014, we surveyed 347 internal medicine and emergency medicine resident physicians at the University of Utah and Brigham and Women’s Hospital about their smartphone use and prior training experiences. Scores (0%–100% were calculated to assess the frequency of their use of general features (email, text and patient-specific apps, and the results were compared according to resident level and program using the Mann-Whitney U-test. Results: A total of 184 residents responded (response rate, 53.0%. The average score for using general features, 14.4/20 (72.2% was significantly higher than the average score for using patient-specific features and apps, 14.1/44 (33.0%, P<0.001. The average scores for the use of general features, were significantly higher for year 3–4 residents, 15.0/20 (75.1% than year 1–2 residents, 14.1/20 (70.5%, P=0.035, and for internal medicine residents, 14.9/20 (74.6% in comparison to emergency medicine residents, 12.9/20 (64.3%, P= 0.001. The average score reflecting the use of patient-specific apps was significantly higher for year 3–4 residents, 16.1/44 (36.5% than for year 1–2 residents, 13.7/44 (31.1%; P=0.044. Only 21.7% of respondents had received prior training in clinical smartphone use. Conclusion: Residents used smartphones for general features more frequently than for patient-specific features, but patient-specific use increased with training. Few residents have received prior training in the clinical use of smartphones.

  4. External causes of pediatric injury-related emergency department visits in the United States.

    Science.gov (United States)

    Simon, Tamara D; Bublitz, Caroline; Hambidge, Simon J

    2004-10-01

    To characterize the types and external causes of pediatric injury-related visits (IRVs) to emergency departments (EDs), in particular, sports-related injuries. To compare the characteristics of children with IRVs with those with non-IRVs, specifically, differences in IRV rates by race and ethnicity and by health insurance. This was a stratified random-sample survey of EDs in the National Hospital Ambulatory Medical Care Survey (NHAMCS), including all IRVs for patients less than 19 years of age in 1998 (n = 2,656). National estimates of pediatric IRVs were obtained using the assigned patient visit weights in the NHAMCS databases and SUDAAN analyses. Measures of association between predictor variables (patient and health insurance characteristics) and whether a child had an IRV were calculated using multivariate logistic regression analyses to determine adjusted odds ratios with 95% confidence intervals. Pediatric IRVs accounted for more than 11 million ED visits annually. The most common diagnoses for IRVs were open wounds, contusions, sprains and strains, and fractures and dislocations. The leading external causes of IRVs were sports-related injuries, accidental falls, being struck by objects, and motor vehicle collisions. Children with IRVs differed from those who presented for non-IRVs in many characteristics: they were more likely to be male, to be older, to be of white race, and to have private insurance, and less likely to be of Asian or Hispanic ethnicity. Sports and recreation are the leading external causes of pediatric IRVs to EDs in the United States. There are different patterns of IRVs according to gender, age, race, ethnicity, and insurance. Identification of specific patterns of injury is necessary for the design of effective prevention strategies.

  5. Contaminants of Emerging Concern in Bats from the Northeastern United States.

    Science.gov (United States)

    Secord, Anne L; Patnode, Kathleen A; Carter, Charles; Redman, Eric; Gefell, Daniel J; Major, Andrew R; Sparks, Daniel W

    2015-11-01

    We analyzed bat carcasses (Myotis lucifugus, M. sodalis, M. septentrionalis, and Eptesicus fuscus) from the northeastern United States for contaminants of emerging concern (CECs) such as polybrominated diphenyl ethers (PBDEs), and pharmaceuticals and personal care products. The CECs detected most frequently in samples were PBDEs (100 %), salicylic acid (81 %), thiabendazole (50 %), and caffeine (23 %). Other compounds detected in at least 15 % of bat samples were digoxigenin, ibuprofen, warfarin, penicillin V, testosterone, and N,N-diethyl-meta-toluamide (DEET). The CECs present at the highest geometric mean wet weight concentrations in bat carcasses were bisphenol A (397 ng/g), ΣPDBE congeners 28, 47, 99, 100, 153, and 154 (83.5 ng/g), triclosan (71.3 n/g), caffeine (68.3 ng/g), salicylic acid (66.4 ng/g), warfarin (57.6 ng/g), sulfathiazole (55.8 ng/g), tris(1-chloro-2-propyl) phosphate (53.8 ng/g), and DEET (37.2 ng/g). Bats frequently forage in aquatic and terrestrial habitats that may be subjected to discharges from wastewater-treatment plants, agricultural operations, and other point and nonpoint sources of contaminants. This study shows that some CECs are accumulating in the tissue of bats. We propose that CECs detected in bats have the potential to affect a number of physiological systems in bats including hibernation, immune function, and response to white-nose syndrome, a fungal disease causing population-level impacts to bats.

  6. Pediatric martial arts injuries presenting to Emergency Departments, United States 1990-2003.

    Science.gov (United States)

    Yard, Ellen E; Knox, Christy L; Smith, Gary A; Comstock, R Dawn

    2007-08-01

    Although an estimated 6.5 million United States (US) children aged 6-17 practiced a martial art in 2004, there have been no nationally representative studies comparing pediatric injuries among the three most popular disciplines, karate, taekwondo, and judo. Describe pediatric martial arts injuries presenting to a representative sample of US Emergency Departments (EDs) from 1990 to 2003. We reviewed all martial arts injuries captured by the US Consumer Product Safety Commission's (CPSC), National Electronic Injury Surveillance System (NEISS). An estimated 128,400 children injuries from 1990 to 2003. Injured tended to be male (73.0%) and had a mean age of 12.1 years. Most injuries were attributed to karate (79.5%). The most common mechanism of injury was being kicked (25.6%), followed by falling (20.6%) and kicking (18.0%). The majority of injuries occurred to the lower leg/foot/ankle (30.1%) and hand/wrist (24.5%). The most common injury diagnoses were sprains/strains (29.3%), contusions/abrasions (27.8%), and fractures (24.6%). Participants in judo sustained significantly higher proportions of shoulder/upper arm injuries than karate (IPR=4.31, 95% CI: 2.84-6.55) or taekwondo (IPR=9.75, 95% CI: 3.53-26.91) participants. There were also higher proportions of neck injuries sustained by judo participants compared to karate (IPR=4.73, 95% CI: 1.91-11.70) or taekwondo (IPR=4.17, 95% CI: 1.02-17.06) participants. Pediatric martial arts injuries differ by discipline. Understanding these injury patterns can assist with the development of discipline-specific preventive interventions.

  7. Utilization of head CT during injury visits to United States emergency departments: 2012-2015.

    Science.gov (United States)

    Yun, Brian J; Borczuk, Pierre; Zachrison, Kori S; Goldstein, Joshua N; Berlyand, Yosef; Raja, Ali S

    2018-05-18

    Studies have shown increasing utilization of head computed tomography (CT) imaging of emergency department (ED) patients presenting with an injury-related visit. Multiple initiatives, including the Choosing Wisely™ campaign and evidence-based clinical decision support based on validated decision rules, have targeted head CT use in patients with injuries. Therefore, we investigated national trends in the use of head CT during injury-related ED visits from 2012 to 2015. This was a secondary analysis of data from the annual United States (U.S.) National Hospital Ambulatory Medical Care Survey from 2012 to 2015. The study population was defined as injury-related ED visits, and we sought to determine the percentage in which a head CT was ordered and, secondarily, to determine both the diagnostic yield of clinically significant intracranial findings and hospital characteristics associated with increased head CT utilization. Between 2012 and 2015, 12.25% (95% confidence interval [CI] 11.48-13.02%) of injury-related visits received at least one head CT. Overall head CT utilization showed an increased trend during the study period (2012: 11.7%, 2015: 13.23%, p = 0.09), but the results were not statistically significant. The diagnostic yield of head CT for a significant intracranial injury over the period of four years was 7.4% (9.68% in 2012 vs. 7.67% in 2015, p = 0.23). Head CT use along with diagnostic yield has remained stable from 2012 to 2015 among patients presenting to the ED for an injury-related visit. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. United States Local Government Reform: The Emergence of the City Manager

    Directory of Open Access Journals (Sweden)

    Robert McEVOY

    2002-06-01

    Full Text Available City Managers came into being in the early 1900.s because of the corruption, waste, and lack of responsiveness of local governments in the United States. Business leaders in large cities had begun to recognise that major changes in their local governments were desperately needed for their businesses to grow and prosper. Andrew Carnegie, a founder of United States Steel, had indicated that business needed a stable society to prosper. Local government had to become responsive to the changing needs of the poor, abused and neglected children, the mentally ill and the elderly, to cite a few examples.

  9. An emerging paradigm for managing protected areas with examples from Europe and the United States

    Science.gov (United States)

    James Absher; Carsten Mann

    2010-01-01

    Parks and Protected Areas (PPA) have become increasingly important for societal well-being in Europe and the United States. Urbanization, detachment from nature, and demographic changes are fostering discussions about strengthening the social and cultural dimensions of management. The complexities and subtleties of incorporating PPAs into existing government and...

  10. Private Catholic Elementary Schools Established by Religious Congregations in the United States: Emerging Governance Models

    Science.gov (United States)

    Walsh, Mary Grace

    2010-01-01

    Private Catholic elementary schools in the United States often trace their origins to religious congregations of women and men. The rapid decline of religious vocations and the choice of many religious to serve in diverse ministries since the Second Vatican Council, has had an effect on all Catholic schools. Schools founded by religious…

  11. Utilization of Health Care Coalitions and Resiliency Forums in the United States and United Kingdom: Different Approaches to Strengthen Emergency Preparedness.

    Science.gov (United States)

    Walsh, John; Swan, Allan Graeme

    2016-02-01

    The process for developing national emergency management strategies for both the United States and the United Kingdom has led to the formulation of differing approaches to meet similar desired outcomes. Historically, the pathways for each are the result of the enactment of legislation in response to a significant event or a series of events. The resulting laws attempt to revise practices and policies leading to more effective and efficient management in preparing, responding, and mitigating all types of natural, manmade, and technological hazards. Following the turn of the 21st century, each country has experienced significant advancements in emergency management including the formation and utilization of 2 distinct models: health care coalitions in the United States and resiliency forums in the United Kingdom. Both models have evolved from circumstances and governance unique to each country. Further in-depth study of both approaches will identify strengths, weaknesses, and existing gaps to meet continued and future challenges of our respective disaster health care systems.

  12. Emergency Medical Services Public Health Implications and Interim Guidance for the Ebola Virus in the United States

    Directory of Open Access Journals (Sweden)

    Christopher E. McCoy

    2014-11-01

    Full Text Available The 25th known outbreak of the Ebola Virus Disease (EVD is now a global public health emergency and the World Health Organization (WHO has declared the epidemic to be a Public Health Emergency of International Concern (PHEIC. Since the first cases of the West African epidemic were reported in March 2014, there has been an increase in infection rates of over 13,000% over a 6-month period. The Ebola virus has now arrived in the United States and public health professionals, doctors, hospitals, Emergency Medial Services Administrators, Medical Directors, and policy makers have been working with haste to develop strategies to prevent the disease from reaching epidemic proportions. Prehospital care providers (emergency medical technicians and paramedics and medical first responders (including but not limited to firefighters and law enforcement are the healthcare systems front lines when it comes to first medical contact with patients outside of the hospital setting. Risk of contracting Ebola can be particularly high in this population of first responders if the appropriate precautions are not implemented. This article provides a brief clinical overview of the Ebola Virus Disease and provides a comprehensive summary of the Center for Disease Control and Prevention’s Interim Guidance for Emergency Medical Services (EMS Systems and 9-1-1 Public Safety Answering Points (PSAPS for Management of Patients with Known of Suspected Ebola Virus Disease in the United States. [West J Emerg Med. 2014;15(7:-0.

  13. Ambulatory cell phone injuries in the United States: an emerging national concern.

    Science.gov (United States)

    Smith, Daniel C; Schreiber, Kristin M; Saltos, Andreas; Lichenstein, Sarah B; Lichenstein, Richard

    2013-12-01

    Over the past 15 years, the use of cell phones has increased 8-fold in the United States. Cell phone use has been shown to increase crash risks for drivers, but no systematic analyses have described injuries related to ambulatory cell phone use. The purpose of this study is to describe and quantitate injuries and deaths among persons using cell phones while walking. We searched the National Electronic Injury Surveillance System (NEISS) for emergency department (ED) reports of injuries related to phone use. The cases that returned were screened initially using words that would eliminate cases unlikely to be related to cell phone use and walking, possibly linked to distraction. The resulting cases were randomized and evaluated for consistency with predetermined case definitions by two authors blinded to the dates of the incidents. Cases that were disagreed upon were evaluated in a second screening by both authors for final case determination. National ED visit rates were estimated based on NEISS sampling methods. Annual variations were analyzed using linear regression with a restricted maximum likelihood approach. Our screening process identified 5,754 possible cases that occurred between 2000 and 2011, and 310 were agreed on as cases of cell-phone-induced distraction. The majority of the patients were female (68%) and 40 years of age or younger (54%). The primary mechanism of injury was a fall (72%), and most patients were treated and released from the ED (85%). No patients died from their injuries while they were in the ED. Linear modeling by year revealed a statistically significant increase in distraction injury rates over the years of study (pcell phone use has been increasing. More research is needed to determine the risks associated with walking and talking on a cell phone and to develop strategies for intervention. Cell phone use continues to increase both at home and outdoor environments. The use of smart phones, with their more enticing features, increases

  14. Microbial Threats to Health. Emerging Infections: Microbial Threats to Health in the United States.

    Science.gov (United States)

    1992-10-01

    and HIV in- fection. Although in the United States, HIV infection occurs predominately in male homosexuals and intravenous substance abusers, the rate...Davis. W. A., J. G. Kane, and V. G. Garagusi. 1978. Human Aerononas infections : a review of the literature and a case report of endocarditis ...AD-A257 841 AD____ GRANT NO: DAMD17-90-Z-0047 TITLE: MICROBIAL THREATS TO HEALTH SUBTITLE: REmerging Infections - Microbial Threats to Health in the

  15. The state of emergency medicine in the United Republic of Tanzania

    Directory of Open Access Journals (Sweden)

    B.A. Nicks

    2012-09-01

    Currently at most hospitals, emergency patients are cared for in Emergency Centres (ECs staffed with rotating personnel who are neither trained nor equipped to provide complete resuscitative care, but dedicated emergency care training projects are emerging. The first Emergency Medicine residency in the country was initiated in 2010 and will produce its first graduates in 2013. In 2011, a dedicated Emergency Nursing curriculum was introduced, and the Emergency Medical Association of Tanzania (EMAT, the first Emergency Medicine professional society in the country, was formed and ratified by the Ministry of Health. EMAT has been given a mandate to develop feasible initiatives for the dissemination of emergency care training to district and sub-district facilities. However, significant gaps exist in the capacity for emergency medical care including deficits in human resources, essential equipment and infrastructure – concurrent issues that EMAT must address within its development strategy.

  16. Environmental risk of mesothelioma in the United States: An emerging concern-epidemiological issues.

    Science.gov (United States)

    Baumann, Francine; Carbone, Michele

    2016-01-01

    Despite predictions of decline in mesothelioma following the ban of asbestos in most industrial countries, the incidence is still increasing globally, particularly in women. Because occupational exposure to asbestos is the main cause of mesothelioma, it occurs four- to eightfold more frequently in men than women, at a median age of 74 years. When mesothelioma is due to an environmental exposure, the M:F sex ratio is 1:1 and the median age at diagnosis is ~60 years. Studying environmental risk of mesothelioma is challenging because of the long latency period and small numbers, and because this type of exposure is involuntary and unknown. Individual-based methods cannot be used, and new approaches need to be found. To better understand the most recent trends of mesothelioma in the United States, all mesothelioma deaths reported to the Centers for Disease Control and Prevention (CDC) during 1999-2010 were analyzed. Among all mesothelioma deaths in the United States, the 1920s birth cohort significantly predominated, and the proportion of younger cohorts constantly decreased with time, suggesting a decline in occupational exposure in these cohorts. The M:F mesothelioma sex ratio fell with time, suggesting an increased proportion of environmental cases. Environmental exposures occur in specific geographic areas. At the large scale of a state, mesotheliomas related to environmental exposure are diluted among occupational cases. The spatial analysis at a smaller scale, such as county, enables detection of areas with higher proportions of female and young mesothelioma cases, thus indicating possible environmental exposure, where geological and environmental investigations need to be carried out.

  17. Amphibian responses to wildfire in the western united states: Emerging patterns from short-term studies

    Science.gov (United States)

    Hossack, B.R.; Pilliod, D.S.

    2011-01-01

    The increased frequency and severity of large wildfires in the western United States is an important ecological and management issue with direct relevance to amphibian conservation. Although the knowledge of fire effects on amphibians in the region is still limited relative to most other vertebrate species, we reviewed the current literature to determine if there are evident patterns that might be informative for conservation or management strategies. Of the seven studies that compared pre- and post-wildfire data on a variety of metrics, ranging from amphibian occupancy to body condition, two reported positive responses and five detected negative responses by at least one species. Another seven studies used a retrospective approach to compare effects of wildfire on populations: two studies reported positive effects, three reported negative effects from wildfire, and two reported no effects. All four studies that included plethodontid salamanders reported negative effects on populations or individuals; these effects were greater in forests where fire had been suppressed and in areas that burned with high severity. Species that breed in streams are also vulnerable to post-wildfire changes in habitat, especially in the Southwest. Wildfire is also important for maintaining suitable habitat for diverse amphibian communities, although those results may not be evident immediately after an area burns. We expect that wildfire will extirpate few healthy amphibian populations, but it is still unclear how populations will respond to wildfire in the context of land management (including pre- and post-fire timber harvest) and fragmentation. Wildfire may also increase the risk of decline or extirpation for small, isolated, or stressed (e.g., from drought or disease) populations. Improved understanding of how these effects vary according to changes in fire frequency and severity are critical to form more effective conservation strategies for amphibians in the western United States.

  18. Progress in Public Health Emergency Preparedness-United States, 2001-2016.

    Science.gov (United States)

    Murthy, Bhavini Patel; Molinari, Noelle-Angelique M; LeBlanc, Tanya T; Vagi, Sara J; Avchen, Rachel N

    2017-09-01

    To evaluate the Public Health Emergency Preparedness (PHEP) program's progress toward meeting public health preparedness capability standards in state, local, and territorial health departments. All 62 PHEP awardees completed the Centers for Disease Control and Prevention's self-administered PHEP Impact Assessment as part of program review measuring public health preparedness capability before September 11, 2001 (9/11), and in 2014. We collected additional self-reported capability self-assessments from 2016. We analyzed trends in congressional funding for public health preparedness from 2001 to 2016. Before 9/11, most PHEP awardees reported limited preparedness capabilities, but considerable progress was reported by 2016. The number of jurisdictions reporting established capability functions within the countermeasures and mitigation domain had the largest increase, almost 200%, by 2014. However, more than 20% of jurisdictions still reported underdeveloped coordination between the health system and public health agencies in 2016. Challenges and barriers to building PHEP capabilities included lack of trained personnel, plans, and sustained resources. Considerable progress in public health preparedness capability was observed from before 9/11 to 2016. Support, sustainment, and advancement of public health preparedness capability is critical to ensure a strong public health infrastructure.

  19. Pediatric Firework-Related Injuries Presenting to United States Emergency Departments, 1990-2014.

    Science.gov (United States)

    Billock, Rachael M; Chounthirath, Thiphalak; Smith, Gary A

    2017-06-01

    This study characterizes the epidemiology of nonfatal pediatric firework-related injuries in the United States among children and adolescents by analyzing data from the National Electronic Injury Surveillance System from 1990 through 2014. During this 25-year period, an estimated 136 991 (95% CI = 113 574-160 408) children firework-related injuries. The annual injury rate decreased significantly by 30.4% during this period. Most of those injured were male (75.7%), mean patient age was 10.6 years, and 7.6% required hospital admission. The hands (30.0%) were the most commonly injured body region, followed by head and neck (22.2%), and eyes (21.5%). Sixty percent of injuries were burns. Injuries were most commonly associated with firecrackers (26.2%), aerial devices (16.3%), and sparklers (14.3%). Consumer fireworks pose a serious injury risk to pediatric users and bystanders, and families should be encouraged to attend public firework displays rather than use consumer fireworks.

  20. 78 FR 64889 - Fisheries of the Northeastern United States; Northeast Multispecies Fishery; Emergency Rule...

    Science.gov (United States)

    2013-10-30

    ... Catch (ABC) and Annual Catch Limit (ACL) for GB yellowtail flounder and white hake, and the 1.85-percent....noaa.gov/sfd/sfdmulti.html . FOR FURTHER INFORMATION CONTACT: Melissa Hooper, Fishery Policy Analyst... these emergency measures. 1. FY 2013 GB Yellowtail Flounder ABC The emergency specifications extended...

  1. Assessment of emerging contaminants including organophosphate esters and pyrethroids during DISCOVER-AQ in Houston, Texas, United States.

    Science.gov (United States)

    Usenko, Sascha; Clark, Addie; Sheesley, Rebecca

    2015-04-01

    DISCOVER-AQ (Deriving Information on Surface conditions from Column and Vertically Resolved Observations Relevant to Air Quality) is a NASA-funded air quality research program that focused on Houston, Texas, United States in September 2013. In conjunction with DISCOVER-AQ, particulate matter was collected for the month of September from four ground-based sampling sites across the Houston metropolitan area. The Houston metropolitan area is one of the most populous cities in the United States. Sampling sites included an upwind and downwind site as well as an urban (i.e. downtown) and industrial/port areas (i.e. Houston Ship Channel). Particulate matter samples were collected to examine both spatial and temporal trends (including day versus night). Particulate matter was collected on quartz fiber filters, which were analyzed for emerging classes of concern including organophosphate esters (OPEs; including flame retardants) and pyrethroids. OPEs have in recent years increased in both use and production as they replaced polybrominated diphenyl ethers flame retardants. Permethrin is one of the most commonly used mosquito adulticides in the United States.

  2. The Pediatric Emergency Care Applied Research Network: a history of multicenter collaboration in the United States.

    Science.gov (United States)

    Tzimenatos, Leah; Kim, Emily; Kuppermann, Nathan

    2015-01-01

    In this article, we review the history and progress of a large multicenter research network pertaining to emergency medical services for children. We describe the history, organization, infrastructure, and research agenda of the Pediatric Emergency Care Applied Research Network and highlight some of the important accomplishments since its inception. We also describe the network's strategy to grow its research portfolio, train new investigators, and study how to translate new evidence into practice. This strategy ensures not only the sustainability of the network in the future but the growth of research in emergency medical services for children in general.

  3. Neck injuries presenting to emergency departments in the United States from 1990 to 1999 for ice hockey, soccer, and American football

    OpenAIRE

    Delaney, J; Al-Kashmiri, A

    2005-01-01

    Objective: To examine the number and rate of neck injuries in the community as a whole for ice hockey, soccer, and American football by analysing data from patients presenting to emergency departments in the United States from 1990 to 1999.

  4. Rates of TBI-related Emergency Department Visits, Hospitalizations, and Deaths - United States, 2001 – 2010

    Data.gov (United States)

    U.S. Department of Health & Human Services — In general, total combined rates for traumatic brain injury (TBI)-related emergency department (ED) visits, hospitalizations and deaths have increased over the past...

  5. Maintenance Practices for Emergency Diesel Generator Engines Onboard United States Navy Los Angeles Class Nuclear Submarines

    National Research Council Canada - National Science Library

    Hawks, Matthew A

    2006-01-01

    .... All underway Navy nuclear reactors are operated with diesel generators as a backup power system, able to provide emergency electric power for reactor decay heat removal as well as enough electric...

  6. Disaster Education: A Survey Study to Analyze Disaster Medicine Training in Emergency Medicine Residency Programs in the United States.

    Science.gov (United States)

    Sarin, Ritu R; Cattamanchi, Srihari; Alqahtani, Abdulrahman; Aljohani, Majed; Keim, Mark; Ciottone, Gregory R

    2017-08-01

    The increase in natural and man-made disasters occurring worldwide places Emergency Medicine (EM) physicians at the forefront of responding to these crises. Despite the growing interest in Disaster Medicine, it is unclear if resident training has been able to include these educational goals. Hypothesis This study surveys EM residencies in the United States to assess the level of education in Disaster Medicine, to identify competencies least and most addressed, and to highlight effective educational models already in place. The authors distributed an online survey of multiple-choice and free-response questions to EM residency Program Directors in the United States between February 7 and September 24, 2014. Questions assessed residency background and details on specific Disaster Medicine competencies addressed during training. Out of 183 programs, 75 (41%) responded to the survey and completed all required questions. Almost all programs reported having some level of Disaster Medicine training in their residency. The most common Disaster Medicine educational competencies taught were patient triage and decontamination. The least commonly taught competencies were volunteer management, working with response teams, and special needs populations. The most commonly identified methods to teach Disaster Medicine were drills and lectures/seminars. There are a variety of educational tools used to teach Disaster Medicine in EM residencies today, with a larger focus on the use of lectures and hospital drills. There is no indication of a uniform educational approach across all residencies. The results of this survey demonstrate an opportunity for the creation of a standardized model for resident education in Disaster Medicine. Sarin RR , Cattamanchi S , Alqahtani A , Aljohani M , Keim M , Ciottone GR . Disaster education: a survey study to analyze disaster medicine training in emergency medicine residency programs in the United States. Prehosp Disaster Med. 2017;32(4):368-373.

  7. CAEP 2015 Academic Symposium: Current State and Recommendations to Achieve Adequate and Sustainable Funding for Emergency Medicine Academic Units.

    Science.gov (United States)

    Lang, Eddy S; Artz, Jennifer D; Wilkie, Ryan D; Stiell, Ian G; Topping, Claude; Belanger, François P; Afilalo, Marc; Renouf, Tia; Crocco, Anthony; Wyatt, Kelly; Christenson, Jim

    2016-05-01

    To describe the current state of academic emergency medicine (EM) funding in Canada and develop recommendations to grow and establish sustainable funding. A panel of eight leaders from different EM academic units was assembled. Using mixed methods (including a literature review, sharing of professional experiences, a survey of current EM academic heads, and data previously collected from an environmental scan), 10 recommendations were drafted and presented at an academic symposium. Attendee feedback was incorporated, and the second set of draft recommendations was further distributed to the Canadian Association Emergency Physicians (CAEP) Academic Section for additional comments before being finalized. Recommendations were developed around the funding challenges identified and solutions developed by academic EM university-based units across Canada. A strategic plan was seen as integral to achieving strong funding of an EM unit, especially when it aligned with departmental and institutional priorities. A business plan, although occasionally overlooked, was deemed an important component for planning and sustaining the academic mission. A number of recommendations surrounding philanthropy consisted of creating partnerships with existing foundations and engaging multiple stakeholders and communities. Synergy between academic and clinical EM departments was also viewed as an opportunity to ensure integration of common missions. Education and networking for current and future leaders were also viewed as invaluable to ensure that opportunities are optimized through strong leadership development and shared experiences to further the EM academic missions across the country. These recommendations were designed to improve the financial circumstances for many Canadian EM units. There is a considerable wealth of resources that can contribute to financial stability for an academic unit, and an annual networking meeting and continuing education on these issues will facilitate

  8. Geologic occurrences of erionite in the United States: an emerging national public health concern for respiratory disease

    Science.gov (United States)

    Van Gosen, Bradley S.; Blitz, Thomas A.; Plumlee, Geoffrey S.; Meeker, Gregory P.; Pierson, M. Patrick

    2013-01-01

    Erionite, a mineral series within the zeolite group, is classified as a Group 1 known respiratory carcinogen. This designation resulted from extremely high incidences of mesothelioma discovered in three small villages from the Cappadocia region of Turkey, where the disease was linked to environmental exposures to fibrous forms of erionite. Natural deposits of erionite, including fibrous forms, have been identified in the past in the western United States. Until recently, these occurrences have generally been overlooked as a potential hazard. In the last several years, concerns have emerged regarding the potential for environmental and occupational exposures to erionite in the United States, such as erionite-bearing gravels in western North Dakota mined and used to surface unpaved roads. As a result, there has been much interest in identifying locations and geologic environments across the United States where erionite occurs naturally. A 1996 U.S. Geological Survey report describing erionite occurrences in the United States has been widely cited as a compilation of all US erionite deposits; however, this compilation only focused on one of several geologic environments in which erionite can form. Also, new occurrences of erionite have been identified in recent years. Using a detailed literature survey, this paper updates and expands the erionite occurrences database, provided in a supplemental file (US_erionite.xls). Epidemiology, public health, and natural hazard studies can incorporate this information on known erionite occurrences and their characteristics. By recognizing that only specific geologic settings and formations are hosts to erionite, this knowledge can be used in developing management plans designed to protect the public.

  9. 75 FR 17618 - Fisheries of the Northeastern United States; Black Sea Bass Recreational Fishery; Emergency Rule...

    Science.gov (United States)

    2010-04-07

    ... Analyst, (978) 281-9104. SUPPLEMENTARY INFORMATION: Correction Rule NMFS published an emergency rule to... reconsider their previous recommendations regarding the Acceptable Biological Catch (ABC) for black sea bass for the 2010 fishing year. The SSC concluded that the ABC for black sea bass could be increased from 2...

  10. Influencing Tomorrow: A Study of Emerging Influence Techniques and Their Relevance to United States Information Operations

    Science.gov (United States)

    2015-06-12

    offers insights into an international network that has preserved a holistic identity, while simultaneously franchising globally . The Islamic State...preserved a holistic identity, while simultaneously franchising globally . The Islamic State of Iraq and the Levant is the second study and an...identity, while simultaneously franchising globally . The ISIL is an outstanding example of a regional non-state actor who rapidly claimed market share

  11. A national survey of emergency pharmacy practice in the United States.

    Science.gov (United States)

    Thomas, Michael C; Acquisto, Nicole M; Shirk, Mary Beth; Patanwala, Asad E

    2016-03-15

    The results of a survey to characterize pharmacy practice in emergency department (ED) settings are reported. An electronic survey was sent to all members of the American Society of Health-System Pharmacists' Emergency Medicine Connect group and the American College of Clinical Pharmacy's Emergency Medicine Practice and Research Network. Approximately 400 nontrainee pharmacy practitioners were invited to participate in the survey, which was open for 30 days. Descriptive statistics were used for all analyses. Two hundred thirty-three responses to the survey that were at least partially completed were received. After the removal of duplicate responses and null records, 187 survey responses were retained. The majority of respondents were from community hospitals (59.6%) or academic medical centers (36.1%). A pharmacist's presence in the ED of more than eight hours per day on weekdays and weekends was commonly reported (68.7% of respondents); 49.4% of institutions provided more than eight hours of coverage daily. Nearly one in three institutions (34.8%) provided no weekend ED staffing. The most frequently reported hours of coverage were during the 1 p.m.-midnight time frame. The distribution of ED pharmacist activities, by category, was as follows (data are median reported time commitments): clinical, 25% (interquartile range [IQR], 15-40%); emergency response, 15% (IQR, 10-20%); order processing, 15% (IQR, 5-25%); medication reconciliation/history-taking, 10% (IQR, 5-25%); teaching, 10% (IQR, 5-15%); administrative, 5% (IQR, 3-10%); and scholarly endeavors, 0% (IQR, 0-5%). Pharmacists from academic and community EDs perform a variety of clinical, educational, and administrative activities. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  12. Host and Potential Vector Susceptibility to an Emerging Orbivirus in the United States: Epizootic Hemorrhagic Disease Virus Serotype 6.

    Science.gov (United States)

    Ruder, M G; Stallknecht, D E; Allison, A B; Mead, D G; Carter, D L; Howerth, E W

    2016-05-01

    Epizootic hemorrhagic disease viruses (EHDVs) are orbiviruses transmitted by Culicoides biting midges to domestic and wild ruminants. EHDV-1 and EHDV-2 are endemic in the United States, where epizootic hemorrhagic disease is the most significant viral disease of white-tailed deer (WTD;Odocoileus virginianus) and reports of epizootic hemorrhagic disease in cattle are increasing. In 2006, a reassortant EHDV-6 was isolated from dead WTD in Indiana and has been detected each subsequent year over a wide geographic region. Since EHDV-6 is not a historically endemic serotype in the United States, it is important to understand infection outcome in potential hosts. Specifically, we aimed to evaluate the pathogenicity of the virus in 2 primary US ruminant hosts (WTD and cattle) and the susceptibility of a confirmed US vector (Culicoides sonorensis). Five WTD and 4 cattle were inoculated with >10(6)TCID50EHDV-6 by intradermal and subcutaneous injection. All 5 WTD exhibited moderate to severe disease, and 3 died. Viremia was first detected 3 to 5 days postinfection (dpi) with surviving animals seroconverting by 10 dpi. Two of 4 inoculated cattle had detectable viremia, 5 to 10 dpi and 7 to 24 dpi, respectively. No clinical, hematologic, or pathologic abnormalities were observed. Antibodies were detected by 10 dpi in 3 of 4 cows.C. sonorensis were fed on WTD blood spiked with EHDV-6 and held for 4 to 14 days postfeeding at 25°C. From 4 to 14 days postfeeding, 19 of 171 midges were virus isolation positive and 6 of 171 had ≥10(2.7)TCID50EHDV-6. Although outcomes varied, these studies demonstrate the susceptibility of ruminant and vector hosts in the United States for this recently emerged EHDV serotype. © The Author(s) 2015.

  13. Text messaging versus email for emergency medicine residents’ knowledge retention: a pilot comparison in the United States

    Directory of Open Access Journals (Sweden)

    Wirachin Hoonpongsimanont

    2016-10-01

    Full Text Available We evaluated the effectiveness of text messaging versus email, as a delivery method to enhance knowledge retention of emergency medicine (EM content in EM residents. We performed a multi-centered, prospective, randomized study consisting of postgraduate year (PGY 1 to PGY 3 & 4 residents in three United States EM residency programs in 2014. Fifty eight residents were randomized into one delivery group: text message or email. Participants completed a 40 question pre- and post-intervention exam. Primary outcomes were the means of pre- and post-intervention exam score differences. Data were analyzed using descriptive statistics, paired t-test, and multiple linear regressions. No significant difference was found between the primary outcomes of the two groups (P=0.51. PGY 2 status had a significant negative effect (P=0.01 on predicted exam score difference. Neither delivery method enhanced resident knowledge retention. Further research on implementation of mobile technology in residency education is required.

  14. Text messaging versus email for emergency medicine residents' knowledge retention: a pilot comparison in the United States.

    Science.gov (United States)

    Hoonpongsimanont, Wirachin; Kulkarni, Miriam; Tomas-Domingo, Pedro; Anderson, Craig; McCormack, Denise; Tu, Khoa; Chakravarthy, Bharath; Lotfipour, Shahram

    2016-01-01

    We evaluated the effectiveness of text messaging versus email, as a delivery method to enhance knowledge retention of emergency medicine (EM) content in EM residents. We performed a multi-centered, prospective, randomized study consisting of postgraduate year (PGY) 1 to PGY 3 & 4 residents in three United States EM residency programs in 2014. Fifty eight residents were randomized into one delivery group: text message or email. Participants completed a 40 question pre- and post-intervention exam. Primary outcomes were the means of pre- and post-intervention exam score differences. Data were analyzed using descriptive statistics, paired t-test, and multiple linear regressions. No significant difference was found between the primary outcomes of the two groups (P=0.51). PGY 2 status had a significant negative effect (P=0.01) on predicted exam score difference. Neither delivery method enhanced resident knowledge retention. Further research on implementation of mobile technology in residency education is required.

  15. The emergence of sociology from political economy in the United States: 1890 to 1940.

    Science.gov (United States)

    Young, Cristobal

    2009-01-01

    Professional sociology in the U.S. began as a field area within economics, but gradually emerged as a separate discipline. Using new data on joint meetings and the separation of departments, I track interdisciplinary relations through three phases: sponsorship (1890-1905), collaboration (1905-1940), and disengagement (post-1940). In the early years, sociology was mostly a branch of economics departments. With the formation of the American Sociological Society, relations with economics began to be more characterized by professionally autonomous collaboration. The 1920s saw a large wave of sociology departments separating from economics. Still, joint annual meetings (including joint presidential addresses) remained the norm until 1940. Paradigmatic conflict between institutional and neoclassical economists was the major force that sustained the economics-sociology collaboration. As institutionalism faded from the scene in the late 1930s, so went interdisciplinary contact.

  16. Public Health System Research in Public Health Emergency Preparedness in the United States (2009-2015): Actionable Knowledge Base.

    Science.gov (United States)

    Savoia, Elena; Lin, Leesa; Bernard, Dottie; Klein, Noah; James, Lyndon P; Guicciardi, Stefano

    2017-09-01

    In 2008, the Institute of Medicine released a letter report identifying 4 research priority areas for public health emergency preparedness in public health system research: (1) enhancing the usefulness of training, (2) improving timely emergency communications, (3) creating and maintaining sustainable response systems, and (4) generating effectiveness criteria and metrics. To (1) identify and characterize public health system research in public health emergency preparedness produced in the United States from 2009 to 2015, (2) synthesize research findings and assess the level of confidence in these findings, and (3) describe the evolution of knowledge production in public health emergency preparedness system research. Search Methods and Selection Criteria. We reviewed and included the titles and abstracts of 1584 articles derived from MEDLINE, EMBASE, and gray literature databases that focused on the organizational or financial aspects of public health emergency preparedness activities and were grounded on empirical studies. We included 156 articles. We appraised the quality of the studies according to the study design. We identified themes during article analysis and summarized overall findings by theme. We determined level of confidence in the findings with the GRADE-CERQual tool. Thirty-one studies provided evidence on how to enhance the usefulness of training. Results demonstrated the utility of drills and exercises to enhance decision-making capabilities and coordination across organizations, the benefit of cross-sector partnerships for successfully implementing training activities, and the value of integrating evaluation methods to support training improvement efforts. Thirty-six studies provided evidence on how to improve timely communications. Results supported the use of communication strategies that address differences in access to information, knowledge, attitudes, and practices across segments of the population as well as evidence on specific

  17. Epidemiology of humerus fractures in the United States: nationwide emergency department sample, 2008.

    Science.gov (United States)

    Kim, Sunny H; Szabo, Robert M; Marder, Richard A

    2012-03-01

    To evaluate the occurrence of emergency department (ED) visits due to humerus fractures in the US. We analyzed the 2008 Nationwide Emergency Department Sample, which contained approximately 28 million ED records. We identified the cases of interest using diagnostic codes for proximal, shaft, and distal humerus fractures. In 2008, approximately 370,000 ED visits in the US resulted from humerus fractures. Proximal humerus fractures were the most common, accounting for 50% of humerus fractures. The incidence rate of proximal humerus fractures followed the shape of an exponential function in the age groups 40-84 years for women (R(2) = 97.9%) and 60-89 years for men (R(2) = 98.2%). After the exponential increase in these age intervals, the growth rate of proximal humerus fracture slowed and eventually decreased. The peak occurrence of distal humerus fractures was in children ages 5-9 years; however, elderly women had an increased risk. As the baby boomer generation ages, unless fracture prevention programs improve, more than 490,000 ED visits due to humerus fractures are expected in 2030 when the youngest of the baby boomers turn age 65 years. Compared to epidemiologic studies in Japan and European countries, the incidence rates of humerus fractures are substantially higher in the US. The high incidence rate of humerus fractures in the expanding elderly population may contribute to the recent trend of rapid increase in shoulder arthroplasty in the US. Rigorous safety measures to reduce falls and improved preventive treatments of osteoporosis are needed. Copyright © 2012 by the American College of Rheumatology.

  18. The distribution of the h-index among academic emergency physicians in the United States.

    Science.gov (United States)

    DeLuca, Lawrence A; St John, Alex; Stolz, Uwe; Matheson, Lincoln; Simpson, Allan; Denninghoff, Kurt R

    2013-10-01

    Hirsch's h-index (h) attempts to measure the combined academic impact and productivity of a scientist by counting the number of publications by an author, ranked in descending order by number of citations, until the paper number equals the number of citations. This approach provides a natural number or index of the number of publications and the number of citations per publication. H was first described in physics and was demonstrated to be highly predictive of continued academic activity, including recognized measures of scientific excellence such as membership in the National Academy of Sciences and being a Nobel laureate. Citation rates, research environments, and years of experience all affect h, making any comparisons appropriate only for scientists working in the same field for a similar time period. The authors are unaware of any report describing the distribution of h among academic emergency physicians (AEPs). The objective was to describe the distribution of h for AEPs and to determine whether Hirsch's demonstration of the h-index as a predictor of continued scholarly activity among physicists would also apply to AEPs. Academic EPs were identified from lists provided on allopathic U.S. emergency medicine (EM) residency program websites. "Harzing's Publish or Perish," a free program available on the Web that queries Google Scholar, was used to calculate h for each AEP. Agreement between raters was analyzed on a subset of 100 EPs. An analysis of the 20 EPs with the top h-indices was performed to characterize the entire body of their scholarly work, and their h-indices were calculated at 12 and 24 years into their careers. A total of 4,744 AEPs from 136 programs were evaluated. Nine programs did not publicly list the faculty at their institutions and were excluded. A linear weighted kappa was used to measure rater concordance, with agreement of 98.3% and κ = 0.92 (95% confidence interval [CI] = 0.861 to 0.957). The majority of AEPs had h-indices of zero or

  19. A cross-sectional study of emergency department boarding practices in the United States.

    Science.gov (United States)

    Pitts, Stephen R; Vaughns, Frances L; Gautreau, Marc A; Cogdell, Matthew W; Meisel, Zachary

    2014-05-01

    The median emergency department (ED) boarding time for admitted patients has been a nationally reportable core measure that now also affects ED accreditation and reimbursement. However, no direct national probability samples of ED boarding data have been available to guide this policy until now. The authors studied new National Hospital Ambulatory Medical Care Survey (NHAMCS) survey items to establish baseline values, to generate hypotheses for future research, and to help improve survey quality in the future. This was a cross-sectional, multistage, stratified annual analysis of EDs and ED visits from the National Hospital Ambulatory Medical Care Survey public use files from 2007 to 2010, a total of 139,502 visit records. These data represent the only national measure of ED boarding. The main outcome of interest was boarding duration for individual patient visits. Data analyses accounted for complex sampling design. The national median boarding time was 79 minutes, with an interquartile range of 36 to 145 minutes. The prevalence of boarding for more than 2 hours among admitted patients was 32% (95% confidence interval [CI] = 30% to 35%). Average ED volume, occupancy, acuity, and hospital admission rates increased abruptly from the second to the third quartile of median boarding duration. The half of hospitals with the longest median boarding times accounted for 73% of ED visits and 79% of ED hospitalizations nationally. Thirty-nine percent of EDs (95% CI = 32% to 46%) reported never holding patients for more than 2 hours, but visit-level analysis at these EDs found that 21% of admissions did in fact stay in the ED over 2 hours. Only 19% of EDs (95% CI = 16% to 22%) used a strategy of moving admitted patients to alternative sites in the hospital during crowded times. In this national survey, ED boarding of admitted patients disproportionately affects hospitals with higher ED volumes, which also see sicker patients who wait longer to be seen, but not hospitals with

  20. Characteristics of Emergency Department Visits by Older Versus Younger Homeless Adults in the United States

    Science.gov (United States)

    Steinman, Michael A.

    2013-01-01

    Objectives. We compared the characteristics of emergency department (ED) visits of older versus younger homeless adults. Methods. We analyzed 2005–2009 data from the National Hospital Ambulatory Medical Care Survey, a nationally representative survey of visits to hospitals and EDs, and used sampling weights, strata, and clustering variables to obtain nationally representative estimates. Results. The ED visits of homeless adults aged 50 years and older accounted for 36% of annual visits by homeless patients. Although demographic characteristics of ED visits were similar in older and younger homeless adults, clinical and health services characteristics differed. Older homeless adults had fewer discharge diagnoses related to psychiatric conditions (10% vs 20%; P = .002) and drug abuse (7% vs 15%; P = .003) but more diagnoses related to alcohol abuse (31% vs 23%; P = .03) and were more likely to arrive by ambulance (48% vs 36%; P = .02) and to be admitted to the hospital (20% vs 11%; P = .003). Conclusions. Older homeless adults’ patterns of ED care differ from those of younger homeless adults. Health care systems need to account for these differences to meet the needs of the aging homeless population. PMID:23597348

  1. Nursery Product-Related Injuries Treated in United States Emergency Departments.

    Science.gov (United States)

    Gaw, Christopher E; Chounthirath, Thiphalak; Smith, Gary A

    2017-04-01

    The goal of this study was to determine the epidemiology of injuries associated with nursery products among young children treated in US emergency departments. Data from the National Electronic Injury Surveillance System were retrospectively analyzed for patients aged nursery product from 1991 through 2011. An estimated 1 391 844 (95% confidence interval, 1 169 489-1 614 199) nursery product-related injuries among children aged Nursery product-related injuries were most commonly associated with baby carriers (19.5%), cribs/mattresses (18.6%), strollers/carriages (16.5%), or baby walkers/jumpers/exercisers (16.2%). The most common mechanism of injury was a self-precipitated fall (80.0%), and the most frequently injured body region was the head or neck (47.1%). Although successful injury prevention efforts with baby walkers led to a decline in nursery product-related injuries from 1991 to 2003, the number and rate of these injuries have been increasing since 2003. Greater efforts are warranted to prevent injuries associated with other nursery products, especially baby carriers, cribs, and strollers. Prevention of falls and concussions/closed head injuries associated with nursery products also deserves special attention. Copyright © 2017 by the American Academy of Pediatrics.

  2. Youth versus adult "weightlifting" injuries presenting to United States emergency rooms: accidental versus nonaccidental injury mechanisms.

    Science.gov (United States)

    Myer, Gregory D; Quatman, Carmen E; Khoury, Jane; Wall, Eric J; Hewett, Timothy E

    2009-10-01

    Resistance training has previously been purported to be unsafe and ineffective in children. The purpose of this investigation was to evaluate resistance training-related injuries presenting to U.S. emergency rooms by age, type, and mechanism of injury. We hypothesized that older athletes would sustain greater percentages of joint sprains and muscle strains, whereas younger athletes would sustain a greater percentage of accidental injuries that would result in an increased percentage of fractures in youths. The U.S. Consumer Product Safety Commission (CPSC) National Electronic Injury Surveillance System was queried from 2002 to 2005 using the CPSC code for "Weightlifting." Subjects between the ages of 8 and 30 were grouped by age categories 8 to 13 (elementary/middle school age), 14 to 18 (high school), 19 to 22 (college), and 23 to 30 (adult). Injuries were classified as "accidental" if caused by dropped weight or improper equipment use. Multiple logistic regression was used to compare accidental injuries between age groups. The sample consisted of 4,111 patients. Accidental injuries decreased (p 14 to 18 > 19 to 22 years = 23 to 30 years. Conversely, sprain/strain injuries increased in each successive age group (p injuries (n = 2,565) showed that the oldest categories (19-22 and 23-30 yr) demonstrated a greater percentage of sprains and strains relative to younger age categories (p injuries sustained in the 8 to 13 group were to the hand and foot and were most often related to "dropping" and "pinching" in the injury descriptions, and there was an increased percentage of fractures in the 8 to 13 group relative to all other groups (p injuries are the result of accidents that are potentially preventable with increased supervision and stricter safety guidelines.

  3. Sports-related genitourinary injuries presenting to United States emergency departments.

    Science.gov (United States)

    Bagga, Herman S; Fisher, Patrick B; Tasian, Gregory E; Blaschko, Sarah D; McCulloch, Charles E; McAninch, Jack W; Breyer, Benjamin N

    2015-01-01

    To describe epidemiologic features of sports-related genitourinary (GU) injuries and determine patient cohorts and particular sporting activities associated with increased GU injury risk. The National Electronic Injury Surveillance System, a data set validated to provide a probability sample of injury-related US emergency department (ED) presentations, was analyzed to characterize GU injuries between 2002 and 2010. A total of 13,851 observations were analyzed to derive national estimates. Between 2002 and 2010, an estimated 137,525 individuals (95% confidence interval, 104,490-170,620) presented to US EDs with GU injuries sustained during sporting activities. Nearly three-quarters of injuries occurred in the pediatric population. The most common product involved was a bicycle, representing approximately one-third of injuries in both adult and pediatric populations. Injuries related to team sports such as football, baseball or softball, basketball, and soccer were also common, particularly among boys where they represented a combined third of all injuries. Eighty-nine percent of all patients were evaluated and treated in the ED without inpatient admission. The large majority of injuries involved the external genitalia (60%), and significant injuries of paired GU organs (kidneys and testicles) requiring inpatient admission were rare (8.5%). Sports-related GU injuries are most commonly sustained during the use of a bicycle. However, there are other associated activities with identifiable high-risk cohorts, products, and situations. Consumers, practitioners, and injury-prevention experts can use our epidemiologic data to prioritize and develop strategies aimed at the prevention and limitation of such injuries, particularly when counseling at-risk cohorts, such as those with solitary kidneys or testicles. Copyright © 2015. Published by Elsevier Inc.

  4. Critical Care Medicine and Infectious Diseases: An Emerging Combined Subspecialty in the United States.

    Science.gov (United States)

    Kadri, Sameer S; Rhee, Chanu; Fortna, Gregory S; O'Grady, Naomi P

    2015-08-15

    The recent rise in unfilled training positions among infectious diseases (ID) fellowship programs nationwide indicates that ID is declining as a career choice among internal medicine residency graduates. Supplementing ID training with training in critical care medicine (CCM) might be a way to regenerate interest in the specialty. Hands-on patient care and higher salaries are obvious attractions. High infection prevalence and antibiotic resistance in intensive care units, expanding immunosuppressed host populations, and public health crises such as the recent Ebola outbreak underscore the potential synergy of CCM-ID training. Most intensivists receive training in pulmonary medicine and only 1% of current board-certified intensivists are trained in ID. While still small, this cohort of CCM-ID certified physicians has continued to rise over the last 2 decades. ID and CCM program leadership nationwide must recognize these trends and the merits of the CCM-ID combination to facilitate creation of formal dual-training opportunities. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  5. Product related adult genitourinary injuries treated at emergency departments in the United States from 2002 to 2010.

    Science.gov (United States)

    Bagga, Herman S; Tasian, Gregory E; Fisher, Patrick B; McCulloch, Charles E; McAninch, Jack W; Breyer, Benjamin N

    2013-04-01

    We describe the epidemiological features of adult genitourinary injuries related to consumer products and determined the patient cohorts, products and situations associated with increased genitourinary injury risk. The National Electronic Injury Surveillance System, a data set validated to provide a probability sample of injury related emergency department presentations in the United States, was analyzed to characterize genitourinary injuries from 2002 to 2010. We analyzed 3,545 observations to derive national estimates. An estimated 142,144 adults (95% CI 115,324-168,964) presented to American emergency departments with genitourinary injuries from 2002 to 2010. Of the injuries 69% occurred in men. A large majority of injuries involved the external genitalia. The most common categories of products involved were sporting items in 30.2% of cases, clothing articles in 9.4% and furniture in 9.2%. The highest prevalence of injury was at ages 18 to 28 years (37.5%), which was most often related to sports equipment, such as bicycles. Older cohorts (age greater than 65 years) more commonly sustained injuries during falls and often in the bathroom during use of a shower or tub. Of all patients 88% were evaluated and treated in the emergency department without inpatient admission, although the admission rate increased with increasing patient age. Acute genitourinary injury is often associated with common consumer items and with identifiable high risk cohorts, products and situations. Consumers, practitioners and safety champions can use our epidemiological data to prioritize and develop strategies aimed at the prevention, limitation and informed treatment of such injuries. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  6. Mobile emergency response unit

    International Nuclear Information System (INIS)

    Kadi, W.J.; Trolan, R.T.; Becker, J.F.

    1979-01-01

    The Hotspot quick-response unit was the solution to a requirement to find, identify, and control areas of radioactive contamination at the scene of a nuclear weapons accident. The unit consists of two trucks and two trailers, and is designed to be transported by one U.S. Air Force C-141. One truck (generator truck) carries a 40 kW generator-heater-air conditioner combination, spare tires, and accessories. The other (water truck) carries supplies and a 250-gal water tank. One trailer (counting trailer) contains detecting, counting, and recording equipment. The other (decontaminating trailer) contains a shower, sink, 30-gal hot water tank, and supplies

  7. Head injuries presenting to emergency departments in the United States from 1990 to 1999 for ice hockey, soccer, and football.

    Science.gov (United States)

    Delaney, J Scott

    2004-03-01

    To examine the number and rates of head injuries occurring in the community as a whole for the team sports of ice hockey, soccer, and football by analyzing data from patients presenting to US emergency departments (EDs) from 1990 to 1999. Retrospective analysis. Data compiled for the US Consumer Product Safety Commission using the National Electronic Injury Surveillance System were used to generate estimates for the total number of head injuries, concussions, internal head injuries, and skull fractures occurring on a national level from the years 1990 to 1999. These data were combined with yearly participation figures to generate rates of injuries presenting to the ED for each sport. There were an estimated 17,008 head injuries from ice hockey, 86,697 from soccer, and 204,802 from football that presented to US EDs from 1990 to 1999. The total number of concussions presenting to EDs in the United States over the same period was estimated to be 4820 from ice hockey, 21,715 from soccer, and 68,861 from football. While the rates of head injuries, concussions, and combined concussions/internal head injuries/skull fractures presenting to EDs per 10,000 players were not always statistically similar for all 3 sports in each year data were available, they were usually comparable. While the total numbers of head injuries, concussions, and combined concussions/skull fractures/internal head injuries presenting to EDs in the United States are different for ice hockey, soccer, and football for the years studied, the yearly rates for these injuries are comparable among all 3 sports.

  8. Risk management of emergency service vehicle crashes in the United States fire service: process, outputs, and recommendations.

    Science.gov (United States)

    Bui, David P; Pollack Porter, Keshia; Griffin, Stephanie; French, Dustin D; Jung, Alesia M; Crothers, Stephen; Burgess, Jefferey L

    2017-11-17

    Emergency service vehicle crashes (ESVCs) are a leading cause of death in the United States fire service. Risk management (RM) is a proactive process for identifying occupational risks and reducing hazards and unwanted events through an iterative process of scoping hazards, risk assessment, and implementing controls. We describe the process, outputs, and lessons learned from the application of a proactive RM process to reduce ESVCs in US fire departments. Three fire departments representative of urban, suburban, and rural geographies, participated in a facilitated RM process delivered through focus groups and stakeholder discussion. Crash reports from department databases were reviewed to characterize the context, circumstances, hazards and risks of ESVCs. Identified risks were ranked using a risk matrix that considered risk likelihood and severity. Department-specific control measures were selected based on group consensus. Interviews, and focus groups were used to assess acceptability and utility of the RM process and perceived facilitators and barriers of implementation. Three to six RM meetings were conducted at each fire department. There were 7.4 crashes per 100 personnel in the urban department and 10.5 per 100 personnel in the suburban department; the rural department experienced zero crashes. All departments identified emergency response, backing, on scene struck by, driver distraction, vehicle/road visibility, and driver training as high or medium concerns. Additional high priority risks varied by department; the urban department prioritized turning and rear ending crashes; the suburban firefighters prioritized inclement weather/road environment and low visibility related crashes; and the rural volunteer fire department prioritized exiting station, vehicle failure, and inclement weather/road environment related incidents. Selected controls included new policies and standard operating procedures to reduce emergency response, cameras to enhance driver

  9. Emergency Contraceptive Pills: A 10-Year Follow-up Survey of Use and Experiences at College Health Centers in the Mid-Atlantic United States

    Science.gov (United States)

    Miller, Laura McKeller; Sawyer, Robin G.

    2006-01-01

    The authors conducted a 10-year follow-up study using a telephone survey to investigate the availability of emergency contraceptive pills (ECPs) at college health centers in the mid-Atlantic region of the United States. They also examined related issues, such as distribution procedure, existence of a written protocol, personnel involved,…

  10. Youth Versus Adult “Weightlifting” Injuries Presenting to United States Emergency Rooms: Accidental Versus Nonaccidental Injury Mechanisms

    Science.gov (United States)

    Myer, Gregory D.; Quatman, Carmen E.; Khoury, Jane; Wall, Eric J.; Hewett, Timothy E.

    2014-01-01

    Myer, GD, Quatman, CE, Khoury, J, Wall, EJ, and Hewett, TE. Youth versus adult “weightlifting” injuries presenting to united states emergency rooms: accidental versus nonaccidental injury mechanisms. J Strength Cond Res 23(7): 2054–2060, 2009—Resistance training has previously been purported to be unsafe and ineffective in children. The purpose of this investigation was to evaluate resistance training-related injuries presenting to U.S. emergency rooms by age, type, and mechanism of injury. We hypothesized that older athletes would sustain greater percentages of joint sprains and muscle strains, whereas younger athletes would sustain a greater percentage of accidental injuries that would result in an increased percentage of fractures in youths. The U.S. Consumer Product Safety Commission (CPSC) National Electronic Injury Surveillance System was queried from 2002 to 2005 using the CPSC code for “Weightlifting.” Subjects between the ages of 8 and 30 were grouped by age categories 8 to 13 (elementary/middle school age), 14 to 18 (high school), 19 to 22 (college), and 23 to 30 (adult). Injuries were classified as “accidental” if caused by dropped weight or improper equipment use. Multiple logistic regression was used to compare accidental injuries between age groups. The sample consisted of 4, 111 patients. Accidental injuries decreased (p 14 to 18 > 19 to 22 years = 23 to 30 years. Conversely, sprain/strain injuries increased in each successive age group (p injuries (n = 2, 565) showed that the oldest categories (19–22 and 23–30 yr) demonstrated a greater percentage of sprains and strains relative to younger age categories (p injuries sustained in the 8 to 13 group were to the hand and foot and were most often related to “dropping” and “pinching” in the injury descriptions, and there was an increased percentage of fractures in the 8 to 13 group relative to all other groups (p injuries are the result of accidents that are potentially

  11. Point sources of emerging contaminants along the Colorado River Basin: Source water for the arid Southwestern United States

    Science.gov (United States)

    Jones-Lepp, Tammy L.; Sanchez, Charles; Alvarez, David A.; Wilson, Doyle C.; Taniguchi-Fu, Randi-Laurant

    2012-01-01

    Emerging contaminants (ECs) (e.g., pharmaceuticals, illicit drugs, personal care products) have been detected in waters across the United States. The objective of this study was to evaluate point sources of ECs along the Colorado River, from the headwaters in Colorado to the Gulf of California. At selected locations in the Colorado River Basin (sites in Colorado, Utah, Nevada, Arizona, and California), waste stream tributaries and receiving surface waters were sampled using either grab sampling or polar organic chemical integrative samplers (POCIS). The grab samples were extracted using solid-phase cartridge extraction (SPE), and the POCIS sorbents were transferred into empty SPEs and eluted with methanol. All extracts were prepared for, and analyzed by, liquid chromatography–electrospray-ion trap mass spectrometry (LC–ESI-ITMS). Log DOW values were calculated for all ECs in the study and compared to the empirical data collected. POCIS extracts were screened for the presence of estrogenic chemicals using the yeast estrogen screen (YES) assay. Extracts from the 2008 POCIS deployment in the Las Vegas Wash showed the second highest estrogenicity response. In the grab samples, azithromycin (an antibiotic) was detected in all but one urban waste stream, with concentrations ranging from 30 ng/L to 2800 ng/L. Concentration levels of azithromycin, methamphetamine and pseudoephedrine showed temporal variation from the Tucson WWTP. Those ECs that were detected in the main surface water channels (those that are diverted for urban use and irrigation along the Colorado River) were in the region of the limit-of-detection (e.g., 10 ng/L), but most were below detection limits.

  12. Population structure of the emerging plant pathogen Phytophthora ramorum on the west coast of the United States

    Science.gov (United States)

    S. Prospero; E.M. Hansen; N.J. Grünwald; J. Britt; L.M. Winton.

    2009-01-01

    Phytophthora ramorum is a devastating pathogen in native forests in California and southwestern Oregon and in nursery crops in California, Oregon and Washington. In this study we analyzed the population structure of P. ramorum in the west coast (CA, OR, and WA) of the United States by screening 579 isolates recovered...

  13. United States housing, 2012

    Science.gov (United States)

    Delton Alderman

    2013-01-01

    Provides current and historical information on housing market in the United States. Information includes trends for housing permits and starts, housing completions for single and multifamily units, and sales and construction. This report will be updated annually.

  14. Immigrants in the United States: “Illegal Aliens” On Their Way To Becoming Emergent “Possible Subjects”

    Directory of Open Access Journals (Sweden)

    Catherine Lejeune

    2009-12-01

    Full Text Available In the likely event that immigration reform will be discussed again in the U.S. Congress in the year 2010, the circumstances and events that have led to the current state of affairs will here be analysed: firstly, the immigration policies implemented from 9/11 until the failed attempt at reforming immigration legislation; secondly, the complex array of recent local and state initiatives which have increasingly served as a substitute for federal immigration control and management. As I examine this evolution and the conflict it has generated, I will devote special attention to undocumented immigrants: from the harsh treatment to which they were subjected during the Bush presidency to the conditions in which they have come to mobilize and have emerged as political actors, even to the point of transforming ideas of citizenship and related rights.   

  15. Epidemic Emergence in the United States of Escherichia coli Sequence Type 131-H30 (ST131-H30), 2000 to 2009.

    Science.gov (United States)

    Johnson, James R; Porter, Stephen; Thuras, Paul; Castanheira, Mariana

    2017-08-01

    The H 30 subclone of Escherichia coli sequence type 131 (ST131- H 30) has become the leading antimicrobial resistance E. coli lineage in the United States and often exhibits resistance to one or both of the two key antimicrobial classes for treating Gram-negative infections, extended-spectrum cephalosporins (ESCs) and fluoroquinolones (FQs). However, the timing of and reasons for its recent emergence are inadequately defined. Accordingly, from E. coli clinical isolates collected systematically across the United States by the SENTRY Antimicrobial Surveillance Program in 2000, 2003, 2006, and 2009, 234 isolates were selected randomly, stratified by year, within three resistance categories: (i) ESC-reduced susceptibility, regardless of FQ phenotype (ESC-RS); (ii) FQ resistance, ESC susceptible (FQ-R); and (iii) FQ susceptible, ESC susceptible (FQ-S). Susceptibility profiles, phylogroup, ST, ST131 subclone, and virulence genotypes were determined, and temporal trends and between-variable associations were assessed statistically. From 2000 to 2006, concurrently with the emergence of ESC-RS and FQ-R strains, the prevalence of (virulence-associated) phylogroup B2 among such strains also rose dramatically, due entirely to rapid emergence of ST131, especially H 30. By 2009, H 30 was the dominant E. coli lineage overall (22%), accounting for a median of 43% of all single-agent and multidrug resistance (68% for ciprofloxacin). H 30's emergence increased the net virulence gene content of resistant (especially FQ-R) isolates, giving stable overall virulence gene scores despite an approximately 4-fold expansion of the historically less virulent resistant population. These findings define more precisely the timing and tempo of H 30's emergence in the United States, identify possible reasons for it, and suggest potential consequences, including more frequent and/or aggressive antimicrobial-resistant infections. Copyright © 2017 American Society for Microbiology.

  16. National and Regional Representativeness of Hospital Emergency Department Visit Data in the National Syndromic Surveillance Program, United States, 2014

    Science.gov (United States)

    Coates, Ralph J.; Pérez, Alejandro; Baer, Atar; Zhou, Hong; English, Roseanne; Coletta, Michael; Dey, Achintya

    2016-01-01

    Objective We examined the representativeness of the nonfederal hospital emergency department (ED) visit data in the National Syndromic Surveillance Program (NSSP). Methods We used the 2012 American Hospital Association Annual Survey Database, other databases, and information from state and local health departments participating in the NSSP about which hospitals submitted data to the NSSP in October 2014. We compared ED visits for hospitals submitting 15 data with all ED visits in all 50 states and Washington, DC. Results Approximately 60.4 million of 134.6 million ED visits nationwide (~45%) were reported to have been submitted to the NSSP. ED visits in 5 of 10 regions and the majority of the states were substantially underrepresented in the NSSP. The NSSP ED visits were similar to national ED visits in terms of many of the characteristics of hospitals and their service areas. However, visits in hospitals with the fewest annual ED visits, in rural trauma centers, and in hospitals serving populations with high percentages of Hispanics and Asians were underrepresented. Conclusions NSSP nonfederal hospital ED visit data were representative for many hospital characteristics and in some geographic areas but were not very representative nationally and in many locations. Representativeness could be improved by increasing participation in more states and among specific types of hospitals. PMID:26883318

  17. Norovirus in the United States

    Centers for Disease Control (CDC) Podcasts

    2013-09-09

    Dr. Aron Hall, a CDC epidemiologist specializing in norovirus, discusses the impact of norovirus in the United States.  Created: 9/9/2013 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 9/17/2013.

  18. Cholera in the United States

    Centers for Disease Control (CDC) Podcasts

    2011-11-08

    Anna Newton, Surveillance Epidemiologist at CDC, discusses cholera that was brought to the United States during an outbreak in Haiti and the Dominican Republic (Hispaniola).  Created: 11/8/2011 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 11/8/2011.

  19. The Emergency Radiological Monitoring and Analysis Division of the United States Federal Radiological Monitoring and Assessment Center

    International Nuclear Information System (INIS)

    Thome, D.J.

    2000-01-01

    The U.S. Federal Radiological Emergency Response Plan (FRERP) provides the framework for integrating the various Federal agencies responding to a major radiological emergency. The FRERP authorises the creation of the Federal Radiological Monitoring and Assessment Center (FRMAC), which is established to co-ordinate all Federal agencies involved in the monitoring and assessment of the off-site radiological conditions in support of the impacted States and the Lead Federal Agency (LFA). Within the FRMAC, the Monitoring and Analysis Division is responsible for co-ordinating all FRMAC assets involved in conducting a comprehensive program of environmental monitoring, sampling, radioanalysis, and quality assurance. This program includes: 1. Aerial Radiological Monitoring - Fixed-Wing and Helicopter; 2. Field Monitoring and Sampling; 3. Radioanalysis - Mobile and Fixed Laboratories; 4. Radiation Detection Instrumentation - Calibration and Maintenance; 5. Environmental Dosimetry; 6. Integrated program of Quality Assurance. To assure consistency, completeness, and the quality of the data produced, a methodology and procedures manual is being developed. This paper discusses the structure, assets, and operations of the FRMAC Monitoring and Analysis Division and the content and preparation of the manual. (author)

  20. 31 CFR 515.321 - United States; continental United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States; continental United... General Definitions § 515.321 United States; continental United States. The term United States means the United States and all areas under the jurisdiction or authority thereof, including the Trust Territory of...

  1. 31 CFR 500.321 - United States; continental United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States; continental United... General Definitions § 500.321 United States; continental United States. The term United States means the United States and all areas under the jurisdiction or authority thereof, including U.S. trust territories...

  2. 31 CFR 535.321 - United States; continental United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States; continental United... General Definitions § 535.321 United States; continental United States. The term United States means the United States and all areas under the jurisdiction or authority thereof including the Trust Territory of...

  3. From the American Civil War to the War on Terror: Three Models of Emergency Law in the United States Supreme Court

    DEFF Research Database (Denmark)

    Hartz, Emily

    This book offers a systematic and comprehensive account of the key cases that have come to shape the jurisprudence on emergency law in the United States from the Civil War to the War on Terror. The legal questions raised in these cases concern fundamental constitutional issues such as the status...... of fundamental rights, the role of the court in times of war, and the question of how to interpret constitutional limitations to executive power. At stake in these difficult legal questions is the issue of how to conceive of the very status of law in liberal democratic states. The questions with which...... the Supreme Court justices have to grapple in these cases are therefore as philosophical as they are legal. In this book the Court's arguments are systematized according to categories informed by constitutional law as well as classic philosophical discussions of the problem of emergency. On this basis...

  4. Role of the community pharmacist in emergency contraception counseling and delivery in the United States: current trends and future prospects

    Directory of Open Access Journals (Sweden)

    Rafie S

    2017-03-01

    Full Text Available Sally Rafie,1 Rebecca H Stone,2 Tracey A Wilkinson,3 Laura M Borgelt,4,5 Shareen Y El-Ibiary,6 Denise Ragland7 1Department of Pharmacy, UC San Diego Health, San Diego, CA, 2Department of Clinical and Administrative Pharmacy, University of Georgia, College of Pharmacy, Athens, GA, 3Children’s Health Services Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, 4Department of Clinical Pharmacy, 5Department of Family Medicine, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO, 6Department of Pharmacy Practice, College of Pharmacy, Midwestern University, Glendale, AZ, 7Department of Pharmacy Practice, College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, AR, USA Abstract: Women and couples continue to experience unintended pregnancies at high rates. In the US, 45% of all pregnancies are either mistimed or unwanted. Mishaps with contraceptives, such as condom breakage, missed pills, incorrect timing of patch or vaginal ring application, contraceptive nonuse, forced intercourse, and other circumstances, place women at risk of unintended pregnancy. There is a critical role for emergency contraception (EC in preventing those pregnancies. There are currently three methods of EC available in the US. Levonorgestrel EC pills have been available with a prescription for over 15 years and over-the-counter since 2013. In 2010, ulipristal acetate EC pills became available with a prescription. Finally, the copper intrauterine device remains the most effective form of EC. Use of EC is increasing over time, due to wider availability and accessibility of EC methods. One strategy to expand access for both prescription and nonprescription EC products is to include pharmacies as a point of access and allow pharmacist prescribing. In eight states, pharmacists are able to prescribe and provide EC directly to women: levonorgestrel EC in eight states and ulipristal

  5. Epidemiology of Snow Skiing- Versus Snowboarding-Related Concussions Presenting to the Emergency Department in the United States from 2010 to 2014.

    Science.gov (United States)

    Gil, Joseph A; DeFroda, Steven F; Kriz, Peter; Owens, Brett D

    2017-09-01

    To examine the trend of concussions in skiers and snowboarders from 2010 to 2014; and to quantify and compare the incidence of concussions injuries in skiers and snowboarders who presented to emergency departments in the United States in 2014. Cross-sectional study of concussions in skiers and snowboarders who were evaluated in emergency departments in the United States. Incidence of concussions. The trend of the annual incidence of concussions for skiers and snowboarders remained stable from 2010 to 2014. An estimated total of 5388 skiing-related concussions and 5558 snowboarding-related concussions presented to emergency departments in the United States between January 1st, 2014, and December 31st, 2014. This represented an incidence of 16.9 concussions per 1 000 000 person-years for skiers and 17.4 concussions per 1 000 000 person-years for snowboarders. The incidence of concussions in the pediatric and young adult population of skiers was significantly higher than the incidence in the adult population. Similarly, the incidence of concussions in the pediatric and young adult population of snowboarders was significantly higher than the incidence in the adult population. The incidence of concussions was significantly higher in males compared with females in both skiing and snowboarding. The incidence of concussions from 2010 to 2014 plateaued in both skiers and snowboarders. Pediatric and young adult skiers and snowboarders had significantly higher incidences of concussion than the adult population. In contrast to the higher incidence of concussions in females in several sports including ice hockey, soccer, and basketball, the incidence of concussions was higher in males compared with females in both skiing and snowboarding.

  6. The war is a racket! The emergence of the libertarian discourse about world war I in the United States

    Directory of Open Access Journals (Sweden)

    Alexandre M. da Fonseca

    2014-11-01

    Full Text Available "It is not a coincidence that the century of war coincided with the century of central banking,” wrote Ron Paul, the libertarian candidate "sensation" for the presidential elections in 2008 and 2012, in the book End the Fed. This discussion explores in short, the powerful pamphlet by Major General Smedley Butler, "War is a Racket", demonstrating, specifically, who profited economically and who, in turn, bore the weight and violence of WW1, assuming that a war is never fought with the acquiescence of the population. However, this monograph goes further, looking for a reinterpretation of the official American history of the First World War through the lens of libertarian discourse. The aim is thus to understand, from another perspective, the fundamental cause of the paradigm shift from nonintervention to intervention taking place during this war, linking it to the project which led to the creation of the League of Nations and the growing importance of the US in the world. Finally, a fundamental connection will be established, exploring the theories argued in the book A Foreign Policy of Freedom, between the policies of Woodrow Wilson and the foreign policy of the United States throughout the 20th century and the beginning of the 21st.

  7. The process of implementation of emergency care units in Brazil.

    Science.gov (United States)

    O'Dwyer, Gisele; Konder, Mariana Teixeira; Reciputti, Luciano Pereira; Lopes, Mônica Guimarães Macau; Agostinho, Danielle Fernandes; Alves, Gabriel Farias

    2017-12-11

    To analyze the process of implementation of emergency care units in Brazil. We have carried out a documentary analysis, with interviews with twenty-four state urgency coordinators and a panel of experts. We have analyzed issues related to policy background and trajectory, players involved in the implementation, expansion process, advances, limits, and implementation difficulties, and state coordination capacity. We have used the theoretical framework of the analysis of the strategic conduct of the Giddens theory of structuration. Emergency care units have been implemented after 2007, initially in the Southeast region, and 446 emergency care units were present in all Brazilian regions in 2016. Currently, 620 emergency care units are under construction, which indicates expectation of expansion. Federal funding was a strong driver for the implementation. The states have planned their emergency care units, but the existence of direct negotiation between municipalities and the Union has contributed with the significant number of emergency care units that have been built but that do not work. In relation to the urgency network, there is tension with the hospital because of the lack of beds in the country, which generates hospitalizations in the emergency care unit. The management of emergency care units is predominantly municipal, and most of the emergency care units are located outside the capitals and classified as Size III. The main challenges identified were: under-funding and difficulty in recruiting physicians. The emergency care unit has the merit of having technological resources and being architecturally differentiated, but it will only succeed within an urgency network. Federal induction has generated contradictory responses, since not all states consider the emergency care unit a priority. The strengthening of the state management has been identified as a challenge for the implementation of the urgency network.

  8. The process of implementation of emergency care units in Brazil

    Directory of Open Access Journals (Sweden)

    Gisele O'Dwyer

    2017-12-01

    Full Text Available ABSTRACT OBJECTIVE To analyze the process of implementation of emergency care units in Brazil. METHODS We have carried out a documentary analysis, with interviews with twenty-four state urgency coordinators and a panel of experts. We have analyzed issues related to policy background and trajectory, players involved in the implementation, expansion process, advances, limits, and implementation difficulties, and state coordination capacity. We have used the theoretical framework of the analysis of the strategic conduct of the Giddens theory of structuration. RESULTS Emergency care units have been implemented after 2007, initially in the Southeast region, and 446 emergency care units were present in all Brazilian regions in 2016. Currently, 620 emergency care units are under construction, which indicates expectation of expansion. Federal funding was a strong driver for the implementation. The states have planned their emergency care units, but the existence of direct negotiation between municipalities and the Union has contributed with the significant number of emergency care units that have been built but that do not work. In relation to the urgency network, there is tension with the hospital because of the lack of beds in the country, which generates hospitalizations in the emergency care unit. The management of emergency care units is predominantly municipal, and most of the emergency care units are located outside the capitals and classified as Size III. The main challenges identified were: under-funding and difficulty in recruiting physicians. CONCLUSIONS The emergency care unit has the merit of having technological resources and being architecturally differentiated, but it will only succeed within an urgency network. Federal induction has generated contradictory responses, since not all states consider the emergency care unit a priority. The strengthening of the state management has been identified as a challenge for the implementation of the

  9. Rapanos v. United States & Carabell v. United States

    Science.gov (United States)

    Documents associated with guidance for implementing the definition of waters of the United States under the Clean Water Act following the Rapanos v. United States, and Carabell v. United States Supreme Court decision.

  10. A profile of acute care in an aging America: snowball sample identification and characterization of United States geriatric emergency departments in 2013.

    Science.gov (United States)

    Hogan, Teresita M; Olade, Tolulope Oyeyemi; Carpenter, Christopher R

    2014-03-01

    The aging of America poses a challenge to emergency departments (EDs). Studies show that elderly patients have poor outcomes despite increased testing, prolonged periods of observation, and higher admission rates. In response, emergency medicine (EM) leaders have implemented strategies for improved ED elder care, enhancing expertise, equipment, policies, and protocols. One example is the development of geriatric EDs gaining in popularity nationwide. To the authors' knowledge, this is the first research to systematically identify and qualitatively characterize the existence, locations, and features of geriatric EDs across the United States. The primary objective was to determine the number, distribution, and characteristics of geriatric EDs in the United States in 2013. This was a survey with potential respondents identified via a snowball sampling of known geriatric EDs, EM professional organizations' geriatric interest groups, and a structured search of the Internet using multiple search engines. Sites were contacted by telephone, and those confirming geriatric EDs presence received the survey via e-mail. Category questions included date of opening, location, volumes, staffing, physical plant changes, screening tools, policies, and protocols. Categories were reported based on general interest to those seeking to understand components of a geriatric ED. Thirty-six hospitals confirmed geriatric ED existence and received surveys. Thirty (83%) responded to the survey and confirmed presence or plans for geriatric EDs: 24 (80%) had existing geriatric EDs, and six (20%) were planning to open geriatric EDs by 2014. The majority of geriatric EDs are located in the Midwest (46%) and Northeast (30%) regions of the United States. Eighty percent serve from 5,000 to 20,000 elder patients annually. Seventy percent of geriatric EDs are attached to the main ED, and 66% have from one to 10 geriatric beds. Physical plant changes include modifications to beds (96%), lighting (90

  11. Neck injuries presenting to emergency departments in the United States from 1990 to 1999 for ice hockey, soccer, and American football.

    Science.gov (United States)

    Delaney, J S; Al-Kashmiri, A

    2005-04-01

    To examine the number and rate of neck injuries in the community as a whole for ice hockey, soccer, and American football by analysing data from patients presenting to emergency departments in the United States from 1990 to 1999. Data compiled for the US Consumer Product Safety Commission were used to generate estimates for the total number of neck injuries and the more specific diagnoses of neck fractures, dislocations, contusions, sprains, strains, and lacerations occurring nationally from 1990 to 1999. These data were combined with yearly participation figures to generate rates of injury presenting to emergency departments for each sport. There were an estimated 5038 neck injuries from ice hockey, 19,341 from soccer, and 114 706 from American football. These could be broken down as follows: 4964 contusions, sprains, or strains from ice hockey, 17,927 from soccer, and 104 483 from football; 105 neck fractures or dislocations from ice hockey, 214 from soccer, and 1588 from football; 199 neck lacerations for ice hockey, 0 for soccer, and 621 for football. The rates for total neck injuries and combined neck contusions, sprains, or strains were higher for football than for ice hockey or soccer in all years for which data were available. The rate of neck injury in the United States was higher in football than in ice hockey or soccer in the time period studied.

  12. Ethical issues in the response to Ebola virus disease in United States emergency departments: a position paper of the American College of Emergency Physicians, the Emergency Nurses Association, and the Society for Academic Emergency Medicine.

    Science.gov (United States)

    Venkat, Arvind; Asher, Shellie L; Wolf, Lisa; Geiderman, Joel M; Marco, Catherine A; McGreevy, Jolion; Derse, Arthur R; Otten, Edward J; Jesus, John E; Kreitzer, Natalie P; Escalante, Monica; Levine, Adam C

    2015-05-01

    The 2014 outbreak of Ebola virus disease (EVD) in West Africa has presented a significant public health crisis to the international health community and challenged U.S. emergency departments (EDs) to prepare for patients with a disease of exceeding rarity in developed nations. With the presentation of patients with Ebola to U.S. acute care facilities, ethical questions have been raised in both the press and medical literature as to how U.S. EDs, emergency physicians (EPs), emergency nurses, and other stakeholders in the health care system should approach the current epidemic and its potential for spread in the domestic environment. To address these concerns, the American College of Emergency Physicians, the Emergency Nurses Association, and the Society for Academic Emergency Medicine developed this joint position paper to provide guidance to U.S. EPs, emergency nurses, and other stakeholders in the health care system on how to approach the ethical dilemmas posed by the outbreak of EVD. This paper will address areas of immediate and potential ethical concern to U.S. EDs in how they approach preparation for and management of potential patients with EVD. © 2015 by the Society for Academic Emergency Medicine.

  13. A Very General Overview of the Development Pediatric Emergency Medicine as a Specialty in the United States and Advocacy for Pediatric Healthcare; the Charge to Other Countries

    Directory of Open Access Journals (Sweden)

    Ron D. Waldrop

    2017-12-01

    and publications. In addition, as trauma specialties and general emergency medicine grew under the auspices of the American College of Emergency Physicians (ACEP and the American Heart Association (AHA so did the need for sub-specialization for pediatric emergency medicine (PEM. In the early 1980s as an outgrowth of the ACEP and AAP, plans to cooperate and create the subspecialty of PEM began. The goal of the specialty was to train specialists, procure resources funding for research, and standardize training.  The first subspecialty board for PEM was administered in 1992 and has continues to this date. Another outgrowth was federally funded agency called Emergency Medicine Services for Children (EMSC whose goal was to find and fund resources, research, and training for PEM specialists, particularly prehospital providers. As late as 2001 the Institute of Medicine in their periodic report regarding United States healthcare noted that most emergency departments were still largely deficient regarding preparedness for pediatric emergencies. Since that time there has been intense emphasis on preparedness for pediatric emergencies and now the United States has innumerable academic and community hospitals with full pediatric preparedness. Similarly, with the modern explosion of medical information it is now virtually impossible for any physician to know all of one field.  Most certainly no general emergency physician can possibly know everything regarding PEM thus obviating the need for PEM specialists to provide optimum care beyond the basics.  Numerous studies in the United States have also demonstrated seriously ill or injured children care receive superior care with better outcomes when cared for in pediatric specific facilities.  This does not imply that general emergency medicine and pediatric emergency medicine cannot co-exist and have economy of resources.  It simply seems to be true that the best possible pediatric care is delivered by pediatric subspecialists

  14. United States Attorney Prosecutions

    Science.gov (United States)

    1993-10-01

    property of CocaCola Bottling Company, Fayetteville, North Carolina, of a value in excess of $100.00, in violation of Title 18 United States Code, Section...another, to-wit: a Cocacola soft drink machine, the amount of damage to said personal property being more than $200.00, in violation of North Carolina

  15. New source terms and the implications for emergency planning requirements at nuclear power plants in the United State

    International Nuclear Information System (INIS)

    Kaiser, G.D.; Cheok, M.C.

    1987-01-01

    This paper begins with a brief review of current approaches to source term driven changes to NRC emergency planning requirements and addresses significant differences between them. Approaches by IDCOR and EPRI, industry submittals to NRC and alternative risk-based evaluations have been considered. Important issues are discussed, such as the role of Protective Action Guides in determining the radius of the emergency planning zone (EPZ). The significance of current trends towards the prediction of longer warning times and longer durations of release in new source terms is assessed. These trends may help to relax the current notification time requirements. Finally, the implications of apparent support in the regulations for a threshold in warning time beyond which ad hoc protective measures are adequate is discussed

  16. Boxing, Wrestling, and Martial Arts Related Injuries Treated in Emergency Departments in the United States, 2002-2005

    OpenAIRE

    Pappas, Evangelos

    2007-01-01

    The incidence of injury in combat sports has not been adequately reported although it is important to identify the nature and frequency of injuries prior to the implementation of prevention programs. This study compared injury rates treated in Hospital Emergency Departments between different combat sports of boxing, wrestling, and martial arts. A secondary objective described anatomic region and diagnosis of these injuries. Data were obtained on all boxing, wrestling, and martial arts-related...

  17. The use of performance improvement methods to enhance emergency department patient satisfaction in the United States: a critical review of the literature and suggestions for future research.

    Science.gov (United States)

    Boudreaux, Edwin D; Cruz, Brian L; Baumann, Brigitte M

    2006-07-01

    The authors reviewed the evidence on performance improvement methods for increasing emergency department (ED) patient satisfaction to provide evidence-based suggestions for clinical practice. Data sources consisted of searches through MEDLINE, CINAHL, PSYCHINFO, Cochrane Library, and Emergency Medicine Abstracts and a manual search of references. Articles were included if they reported a performance improvement intervention targeting patient satisfaction in the ED setting. Articles on studies not conducted in the United States or that failed to provide enough details to allow critical evaluation of the study were excluded. Two authors used structured evaluation criteria to independently review each retained study. Nineteen articles met all selection criteria. Three studies found varying levels of support for multicomponent interventions, predominantly focused on implementation of clinical practice guidelines for specific presenting complaints and process redesign. Sixteen studies evaluated single-component interventions, with the following having at least one supportive study: using alternating patient assignment to provider teams rather than "zone"-based assignment, enhancing provider communication and customer service skills, incorporating information delivery interventions (e.g., pamphlets, video) that target patient expectations, using preformatted charts, and establishing ED-based observation units for specific conditions such as asthma and chest pain. There is modest evidence supporting a range of performance improvement interventions for improving ED patient satisfaction. Further work is needed before specific, evidence-based recommendations can be made regarding which process changes are most effective. Recommendations are made for improving the quality of performance improvement efforts in the ED setting.

  18. Boxing, Wrestling, and Martial Arts Related Injuries Treated in Emergency Departments in the United States, 2002-2005

    Science.gov (United States)

    Pappas, Evangelos

    2007-01-01

    The incidence of injury in combat sports has not been adequately reported although it is important to identify the nature and frequency of injuries prior to the implementation of prevention programs. This study compared injury rates treated in Hospital Emergency Departments between different combat sports of boxing, wrestling, and martial arts. A secondary objective described anatomic region and diagnosis of these injuries. Data were obtained on all boxing, wrestling, and martial arts-related injuries that were in the National Electronic Injury Surveillance System database and resulted in Emergency Department visits between 2002 and 2005. Pearson’s chi-square statistics were calculated to compare injury rates for each activity accounting for complex sample design. Martial arts had lower injury rates compared to boxing and wrestling for all diagnoses (pMartial arts have lower emergency department injury rates compared to boxing and wrestling. Wrestling has higher strains/sprains and dislocation injury rates compared to boxing. Combat sports do not appear to have higher injury rates compared to non-combat sports. PMID:24198705

  19. Rural Versus Urban Use of Traditional and Emerging Tobacco Products in the United States, 2013-2014.

    Science.gov (United States)

    Roberts, Megan E; Doogan, Nathan J; Stanton, Cassandra A; Quisenberry, Amanda J; Villanti, Andrea C; Gaalema, Diann E; Keith, Diana R; Kurti, Allison N; Lopez, Alexa A; Redner, Ryan; Cepeda-Benito, Antonio; Higgins, Stephen T

    2017-10-01

    To examine urban-rural differences in US prevalences of traditional and emerging tobacco product use as well as dual or polytobacco use of these products. Our data were derived from wave 1 (2013-2014) of the Population Assessment of Tobacco and Health (PATH) Study. We estimated weighted prevalences of adult tobacco use across urban-rural geographies and examined prevalences classified by gender, poverty level, and region of the country. Nationally, cigarette use and smokeless tobacco use, as well as dual or polytobacco use of traditional products, were more prevalent in rural than in urban areas. Conversely, cigarillo and hookah use and dual or polytobacco use of emerging products were higher in urban areas. There was no significant urban-rural difference in use of e-cigarettes. Gender, poverty, and region of the country did not seem to be driving most urban-rural differences, although differences related to cigarillo use and dual or polytobacco use of emerging products became nonsignificant after control for covariates. Our findings highlight important urban-rural differences in tobacco use. Whether the changing tobacco product landscape will contribute to a continuation of rural health disparities remains to be seen.

  20. BOXING, WRESTLING, AND MARTIAL ARTS RELATED INJURIES TREATED IN EMERGENCY DEPARTMENTS IN THE UNITED STATES, 2002-2005

    Directory of Open Access Journals (Sweden)

    Evangelos Pappas

    2007-10-01

    Full Text Available The incidence of injury in combat sports has not been adequately reported although it is important to identify the nature and frequency of injuries prior to the implementation of prevention programs. This study compared injury rates treated in Hospital Emergency Departments between different combat sports of boxing, wrestling, and martial arts. A secondary objective described anatomic region and diagnosis of these injuries. Data were obtained on all boxing, wrestling, and martial arts-related injuries that were in the National Electronic Injury Surveillance System database and resulted in Emergency Department visits between 2002 and 2005. Pearson's chi-square statistics were calculated to compare injury rates for each activity accounting for complex sample design. Martial arts had lower injury rates compared to boxing and wrestling for all diagnoses (p<0.001. Boxing had lower injury rates compared to wrestling for strains/sprains and dislocations. Boxing and wrestling had similar injury rates for concussions. Injury prevention efforts should consider the distribution of injuries and concentrate on preventing strains/sprains in wrestling, concussions in boxing and wrestling, and fractures for all three activities. The findings of the present study do not provide evidence that combat sports have alarmingly high rates of injuries resulting in emergency department visits

  1. CHARACTERIZING COSTS, SAVINGS AND BENEFITS OF A SELECTION OF ENERGY EFFICIENT EMERGING TECHNOLOGIES IN THE UNITED STATES

    Energy Technology Data Exchange (ETDEWEB)

    Xu, T.; Slaa, J.W.; Sathaye, J.

    2010-12-15

    Implementation and adoption of efficient end-use technologies have proven to be one of the key measures for reducing greenhouse gas (GHG) emissions throughout the industries. In many cases, implementing energy efficiency measures is among one of the most cost effective investments that the industry could make in improving efficiency and productivity while reducing CO2 emissions. Over the years, there have been incentives to use resources and energy in a cleaner and more efficient way to create industries that are sustainable and more productive. With the working of energy programs and policies on GHG inventory and regulation, understanding and managing the costs associated with mitigation measures for GHG reductions is very important for the industry and policy makers around the world. Successful implementation of emerging technologies not only can help advance productivities and competitiveness but also can play a significant role in mitigation efforts by saving energy. Providing evaluation and estimation of the costs and energy savings potential of emerging technologies is the focus of our work in this project. The overall goal of the project is to identify and select emerging and under-utilized energy-efficient technologies and practices as they are important to reduce energy consumption in industry while maintaining economic growth. This report contains the results from performing Task 2"Technology evaluation" for the project titled"Research Opportunities in Emerging and Under-Utilized Energy-Efficient Industrial Technologies," which was sponsored by California Energy Commission and managed by CIEE. The project purpose is to analyze market status, market potential, and economic viability of selected technologies applicable to the U.S. In this report, LBNL first performed re-assessments of all of the 33 emerging energy-efficient industrial technologies, including re-evaluation of the 26 technologies that were previously identified by Martin et al. (2000) and

  2. The burden of migraine in the United States: current and emerging perspectives on disease management and economic analysis.

    Science.gov (United States)

    Hazard, Elisabeth; Munakata, Julie; Bigal, Marcelo E; Rupnow, Marcia F T; Lipton, Richard B

    2009-01-01

    Migraine is often perceived as a low-impact condition that imposes a limited burden to society and the health-care system. This study reviews the current understanding of the burden of migraine in the U.S., the history of economic understanding of migraine treatment and identifies emergent trends for future studies evaluating clinical and economic outcomes of migraine treatment. This study traced the history of economic articles published on migraine by performing a literature search using PubMed MEDLINE database and ancestral searches of relevant articles. The intention was not to provide an exhaustive review of every article or adjudicate between studies with different findings. Migraine affects millions of individuals worldwide, generally during the most productive years of a person's life. Studies show that migraineurs are underdiagnosed, undertreated, and experience substantial decreases in functioning and productivity, which in turn translates into diminished quality of life for individuals, and financial burdens to both health-care systems and employers. Economic evaluations of migraine therapies have evolved with new clinical developments beginning with cognitive-behavioral therapy, introduction of triptans, concern over medication overuse, and emergence of migraine prophylaxis. Now recent clinical studies suggest that migraine may be a progressive disease with cardiovascular, cerebrovascular, and long-term neurologic effects. Migraine imposes a substantial burden on patients, families, employers and societies. The economic standards by which migraine and treatment are evaluated have evolved in response to clinical developments. Emerging evidence suggests that migraine is a chronic and progressive disease. If confirmed, approaches to acute and prophylactic treatments and economic evaluations of migraine treatment may require major reconsideration.

  3. A cross-sectional study of emergency care utilization and associated costs of violent-related (assault) injuries in the United States.

    Science.gov (United States)

    Monuteaux, Michael C; Fleegler, Eric W; Lee, Lois K

    2017-11-01

    Violent-related (assault) injuries are a leading cause of death and disability in the United States. Many violent injury victims seek treatment in the emergency department (ED). Our objectives were to (1) estimate rates of violent-related injuries evaluated in United States EDs, (2) estimate linear trends in ED visits for violent-related injuries from 2000 to 2010, and (3) to determine the associated health care and work-loss costs. We examined adults 18 years and older from a nationally representative survey (the National Hospital Ambulatory Medical Care Survey) of ED visits, from 2000 to 2010. Violent injury was defined using International Classification of Diseases-9th Rev.-Clinical Modification, diagnosis and mechanism of injury codes. We calculated rates of ED visits for violent injuries. Medical and work-loss costs accrued by these injuries were calculated for 2005, inflation-adjusted to 2011 dollars using the WISQARS Cost of Injury Reports. An annual average of 1.4 million adults were treated for violent injuries in EDs from 2000 to 2010, comprising 1.6% (95% confidence interval, 1.5%-1.6%) of all US adult ED visits. Young adults (18-25 years), men, nonwhites, uninsured or publically insured patients, and those residing in high poverty urban areas were at increased risk for ED visits for violent injury. The 1-year, inflation-adjusted medical and work-loss cost of violent-inflicted injuries in adults in the United States was US $49.5 billion. Violent injuries account for over one million ED visits annually among adults, with no change in rates over the past decade. Young black men are at especially increased risk for ED visits for violent injuries. Overall, violent-related injuries resulted in substantial financial and societal costs. Epidemiological study, level III.

  4. United States rejoin ITER

    International Nuclear Information System (INIS)

    Roberts, M.

    2003-01-01

    Upon pressure from the United States Congress, the US Department of Energy had to withdraw from further American participation in the ITER Engineering Design Activities after the end of its commitment to the EDA in July 1998. In the years since that time, changes have taken place in both the ITER activity and the US fusion community's position on burning plasma physics. Reflecting the interest in the United States in pursuing burning plasma physics, the DOE's Office of Science commissioned three studies as part of its examination of the option of entering the Negotiations on the Agreement on the Establishment of the International Fusion Energy Organization for the Joint Implementation of the ITER Project. These were a National Academy Review Panel Report supporting the burning plasma mission; a Fusion Energy Sciences Advisory Committee (FESAC) report confirming the role of ITER in achieving fusion power production, and The Lehman Review of the ITER project costing and project management processes (for the latter one, see ITER CTA Newsletter, no. 15, December 2002). All three studies have endorsed the US return to the ITER activities. This historical decision was announced by DOE Secretary Abraham during his remarks to employees of the Department's Princeton Plasma Physics Laboratory. The United States will be working with the other Participants in the ITER Negotiations on the Agreement and is preparing to participate in the ITA

  5. United States advanced technologies

    International Nuclear Information System (INIS)

    Longenecker, J.R.

    1985-01-01

    In the United States, the advanced technologies have been applied to uranium enrichment as a means by which it can be assured that nuclear fuel cost will remain competitive in the future. The United States is strongly committed to the development of advanced enrichment technology, and has brought both advanced gas centrifuge (AGC) and atomic vapor laser isotope separation (AVLIS) programs to a point of significant technical refinement. The ability to deploy advanced technologies is the basis for the confidence in competitive future price. Unfortunately, the development of advanced technologies is capital intensive. The year 1985 is the key year for advanced technology development in the United States, since the decision on the primary enrichment technology for the future, AGC or AVLIS, will be made shortly. The background on the technology selection process, the highlights of AGC and AVLIS programs and the way to proceed after the process selection are described. The key objective is to maximize the sales volume and minimize the operating cost. This will help the utilities in other countries supply low cost energy on a reliable, long term basis. (Kako, I.)

  6. Dynamic Modeling of Learning in Emerging Energy Industries: The Example of Advanced Biofuels in the United States: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Vimmerstedt, Laura J.; Bush, Brian W.; Peterson, Steven O.

    2015-09-03

    This paper (and its supplemental model) presents novel approaches to modeling interactions and related policies among investment, production, and learning in an emerging competitive industry. New biomass-to-biofuels pathways are being developed and commercialized to support goals for U.S. advanced biofuel use, such as those in the Energy Independence and Security Act of 2007. We explore the impact of learning rates and techno-economics in a learning model excerpted from the Biomass Scenario Model (BSM), developed by the U.S. Department of Energy and the National Renewable Energy Laboratory to explore the impact of biofuel policy on the evolution of the biofuels industry. The BSM integrates investment, production, and learning among competing biofuel conversion options that are at different stages of industrial development. We explain the novel methods used to simulate the impact of differing assumptions about mature industry techno-economics and about learning rates while accounting for the different maturity levels of various conversion pathways. A sensitivity study shows that the parameters studied (fixed capital investment, process yield, progress ratios, and pre-commercial investment) exhibit highly interactive effects, and the system, as modeled, tends toward market dominance of a single pathway due to competition and learning dynamics.

  7. Cost-Effectiveness of Helicopter Versus Ground Emergency Medical Services for Trauma Scene Transport in the United States

    Science.gov (United States)

    Delgado, M. Kit; Staudenmayer, Kristan L.; Wang, N. Ewen; Spain, David A.; Weir, Sharada; Owens, Douglas K.; Goldhaber-Fiebert, Jeremy D.

    2014-01-01

    Objective We determined the minimum mortality reduction that helicopter emergency medical services (HEMS) should provide relative to ground EMS for the scene transport of trauma victims to offset higher costs, inherent transport risks, and inevitable overtriage of minor injury patients. Methods We developed a decision-analytic model to compare the costs and outcomes of helicopter versus ground EMS transport to a trauma center from a societal perspective over a patient's lifetime. We determined the mortality reduction needed to make helicopter transport cost less than $100,000 and $50,000 per quality adjusted life year (QALY) gained compared to ground EMS. Model inputs were derived from the National Study on the Costs and Outcomes of Trauma (NSCOT), National Trauma Data Bank, Medicare reimbursements, and literature. We assessed robustness with probabilistic sensitivity analyses. Results HEMS must provide a minimum of a 17% relative risk reduction in mortality (1.6 lives saved/100 patients with the mean characteristics of the NSCOT cohort) to cost less than $100,000 per QALY gained and a reduction of at least 33% (3.7 lives saved/100 patients) to cost less than $50,000 per QALY. HEMS becomes more cost-effective with significant reductions in minor injury patients triaged to air transport or if long-term disability outcomes are improved. Conclusions HEMS needs to provide at least a 17% mortality reduction or a measurable improvement in long-term disability to compare favorably to other interventions considered cost-effective. Given current evidence, it is not clear that HEMS achieves this mortality or disability reduction. Reducing overtriage of minor injury patients to HEMS would improve its cost-effectiveness. PMID:23582619

  8. Emergence Unites Ecology and Society

    Directory of Open Access Journals (Sweden)

    Ronald L. Trosper

    2005-06-01

    Full Text Available The effort to combine analysis of ecosystems and social systems requires a firm theoretical basis. When humans are present in an ecosystem, their actions affect emergent structures; this paper examines forms of emergence that account for the presence of humans. Humans monitor and regulate ecosystems based on their cultural systems. Cultural systems consist of concepts linked in complicated ways that can form consistent world views, can contain inconsistencies, and may or may not accurately model the properties of a social-ecological system. Consequently, human monitoring and regulating processes will differ, depending on cultural systems. Humans, as agents, change or maintain pre-existing material and cultural emergent structures. The presentation is illustrated with a case study of fire-prone forests. The paper shows that explicit attention to emergence serves very well in unifying the following requirements for social-ecological analysis: coherent and observable definitions of sustainability; ways to link ecological and social phenomena; ways to understand cultural reasons for stability and instability in dynamic social-ecological systems; and ways to include human self-evaluation and culture within dynamic models of social-ecological systems. Analysis of cultural emergent structures clarifies many differences in assumptions among the fields of economics, sociology, political science, ecology, and ecological economics. Because it can be readily applied to empirical questions, the framework provides a good way to organize policy analysis that is not dominated by one or another discipline.

  9. National Estimates of Emergency Department Visits for Antibiotic Adverse Events Among Adults-United States, 2011-2015.

    Science.gov (United States)

    Geller, Andrew I; Lovegrove, Maribeth C; Shehab, Nadine; Hicks, Lauri A; Sapiano, Mathew R P; Budnitz, Daniel S

    2018-04-20

    Detailed, nationally representative data describing high-risk populations and circumstances involved in antibiotic adverse events (AEs) can inform approaches to prevention. Describe US burden, rates, and characteristics of emergency department (ED) visits by adults for antibiotic AEs. Nationally representative, public health surveillance of adverse drug events (National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance [NEISS-CADES]) and a nationally projected database of dispensed prescriptions (QuintilesIMS), 2011-2015. Antibiotic-treated adults (≥ 20 years) seeking ED care. Estimated annual numbers and rates of ED visits for antibiotic AEs among outpatients treated with systemically administered antibiotics. Based on 10,225 cases, US adults aged ≥ 20 years made an estimated 145,490 (95% confidence interval, 115,279-175,701) ED visits for antibiotic AEs each year in 2011-2015. Antibiotics were implicated in 13.7% (12.3-15.2%) of all estimated adult ED visits for adverse drug events. Most (56.6%; 54.8-58.4%) antibiotic AE visits involved adults aged Accounting for prescriptions dispensed from retail and long-term care pharmacies, adults aged 20-34 years had twice the estimated rate of ED visits for oral antibiotic AEs compared with those aged ≥ 65 years (9.7 [7.6-11.8] versus 4.6 [3.6-5.7] visits per 10,000 dispensed prescriptions, respectively). Allergic reactions accounted for three quarters (74.3%; 70.0-78.6%) of estimated ED visits for antibiotic AEs. The three most frequently implicated antibiotic classes in ED visits for antibiotic AEs were oral sulfonamides (23.2%; 20.6-25.8%), penicillins (20.8%; 19.3-22.4%), and quinolones (15.7%; 14.2-17.1%). Per-prescription rates declined with increasing age group. Antibiotics are a common cause of ED visits by adults for adverse drug events and represent an important safety issue. Quantifying risks of AEs from specific antibiotics for specific patient populations, such

  10. Forest Disturbance Across the Conterminous United States from 1985-2012: The Emerging Dominance of Forest Decline

    Science.gov (United States)

    Cohen, Warren B.; Yang, Zhiqiang; Stehman, Stephen; Schroeder, Todd; Bell, David M.; Masek, Jeffrey; Huang, Chengquan; Meigs, Garrett W.

    2015-01-01

    Evidence of shifting dominance among major forest disturbance agent classes regionally to globally has been emerging in the literature. For example, climate-related stress and secondary stressors on forests (e.g., insect and disease, fire) have dramatically increased since the turn of the century globally, while harvest rates in the western US and elsewhere have declined. For shifts to be quantified, accurate historical forest disturbance estimates are required as a baseline for examining current trends. We report annual disturbance rates (with uncertainties) in the aggregate and by major change causal agent class for the conterminous US and five geographic subregions between 1985 and 2012. Results are based on human interpretations of Landsat time series from a probability sample of 7200 plots (30 m) distributed throughout the study area. Forest disturbance information was recorded with a Landsat time series visualization and data collection tool that incorporates ancillary high-resolution data. National rates of disturbance varied between 1.5% and 4.5% of forest area per year, with trends being strongly affected by shifting dominance among specific disturbance agent influences at the regional scale. Throughout the time series, national harvest disturbance rates varied between one and two percent, and were largely a function of harvest in the more heavily forested regions of the US (Mountain West, Northeast, and Southeast). During the first part of the time series, national disturbance rates largely reflected trends in harvest disturbance. Beginning in the mid-90s, forest decline-related disturbances associated with diminishing forest health (e.g., physiological stress leading to tree canopy cover loss, increases in tree mortality above background levels), especially in the Mountain West and Lowland West regions of the US, increased dramatically. Consequently, national disturbance rates greatly increased by 2000, and remained high for much of the decade. Decline

  11. Social networks and substance use among at-risk emerging adults living in disadvantaged urban areas in the southern United States: a cross-sectional naturalistic study.

    Science.gov (United States)

    Tucker, Jalie A; Cheong, JeeWon; Chandler, Susan D; Crawford, Scott M; Simpson, Cathy A

    2015-09-01

    Substance use and risk-taking are common during emerging adulthood, a transitional period when peer influences often increase and family influences decrease. Investigating relationships between social network features and substance use can inform community-based prevention programs. This study investigated whether substance use among emerging adults living in disadvantaged urban areas was influenced by peer and family social network messages that variously encouraged and discouraged substance use. Cross-sectional, naturalistic field study. Lower-income neighborhoods in Birmingham, Alabama, USA with 344 participants (110 males, 234 females, ages 15-25 years; mean = 18.86 years), recruited via respondent-driven sampling. During structured interviews conducted in community locations, the Alcohol, Smoking and Substance Involvement Screening Test assessed substance use and related problems. Predictor variables were network characteristics, including presence of substance-using peers, messages from friends and family members about substance use and network sources for health information. Higher substance involvement was associated with friend and family encouragement of use and having close peer network members who used substances (Ps Social networks appear to be important in both promoting and preventing substance use in disadvantaged young adults in the United States. © 2015 Society for the Study of Addiction.

  12. The United States

    International Nuclear Information System (INIS)

    Art, R.J.

    1991-01-01

    This paper reports that at least in the national security arena, the outcomes of bureaucratic infighting and domestic political struggles are not determined wholly by what goes on with the state. Rather struggles among contending groups are greatly affected by what is perceived to be happening outside the nation. Because external conditions give greater potency to some domestic forces over other, the external environment is never neutral in its domestic impact. The decisions of the period 1950-53 discussed above illustrate the point. But so too do the decisions of 1947, 1960-61 and 1969-72. In the 1947 case, Soviet intransigence provoked US nuclear rearmament. In the 1960-61 case, extended deterrent considerations pushed the United States to preserve its again newly discovered nuclear superiority. In the 1969-72 case, a Soviet determination to remain equal forced US acceptance of nuclear equality. And perhaps the best evidence of all, the perpetuation of parity ended the US inclination to resort to nuclear brinkmanship. In each instance, concerns about relative position heavily affected nuclear choice. Finally, the events of the past three years testify to the effects of international events on domestic choice. Under the terms of the 1987 INF Treaty, the two superpowers decided to dismantle and destroy an entire class of missiles of intermediate range (500-3000 kilometers) that both had deployed in Europe in the 1970s and 1980s, and in their June 1990 joint statement on strategic nuclear weapons, President Gorbachev and Brush agreed to cut the number of Soviet and US long range nuclear forces by 30 per cent. This agreement marks a watershed in US-Soviet strategic arm negotiations because for the first time the United States and the Soviet Union agreed in principals to reduce the number of weapons aimed at one another. Between 1985 and 1990 the cold war was brought to a close

  13. Sequencing of emerging canine distemper virus strain reveals new distinct genetic lineage in the United States associated with disease in wildlife and domestic canine populations.

    Science.gov (United States)

    Riley, Matthew C; Wilkes, Rebecca P

    2015-12-18

    Recent outbreaks of canine distemper have prompted examination of strains from clinical samples submitted to the University of Tennessee College of Veterinary Medicine (UTCVM) Clinical Virology Lab. We previously described a new strain of CDV that significantly diverged from all genotypes reported to date including America 2, the genotype proposed to be the main lineage currently circulating in the US. The aim of this study was to determine when this new strain appeared and how widespread it is in animal populations, given that it has also been detected in fully vaccinated adult dogs. Additionally, we sequenced complete viral genomes to characterize the strain and determine if variation is confined to known variable regions of the genome or if the changes are also present in more conserved regions. Archived clinical samples were genotyped using real-time RT-PCR amplification and sequencing. The genomes of two unrelated viruses from a dog and fox each from a different state were sequenced and aligned with previously published genomes. Phylogenetic analysis was performed using coding, non-coding and genome-length sequences. Virus neutralization assays were used to evaluate potential antigenic differences between this strain and a vaccine strain and mixed ANOVA test was used to compare the titers. Genotyping revealed this strain first appeared in 2011 and was detected in dogs from multiple states in the Southeast region of the United States. It was the main strain detected among the clinical samples that were typed from 2011-2013, including wildlife submissions. Genome sequencing demonstrated that it is highly conserved within a new lineage and preliminary serologic testing showed significant differences in neutralizing antibody titers between this strain and the strain commonly used in vaccines. This new strain represents an emerging CDV in domestic dogs in the US, may be associated with a stable reservoir in the wildlife population, and could facilitate vaccine

  14. EMERGENCY STATES IN ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    M. A. Gurevich

    2014-01-01

    Full Text Available The article describes in detail potential emergency states in patients with different stages of arterial hypertension with special attention to diagnosis and rational management of hypertensive crisis. Differentiated approach to management of different forms of hypertensive crisis is specified.

  15. Radionuclide diagnosis of emergency states

    International Nuclear Information System (INIS)

    Ishmukhametov, A.I.

    1985-01-01

    Solution of emergency state radionuclide diagnostics from the technical point of view is provided by the application of the mobile quick-operating equipment in combination with computers, by the use of radionuclides with acceptable for emergency medicine characteristics and by development of radionuclide investigation data propcessing express-method. Medical developments include the study of acute disease and injury radioisotope semiotics, different indication diagnostic value determining, comparison of the results, obtained during radionuclide investigation, with clinicolaboratory and instrumental data, separation of methodical complex series

  16. A Guide to Directors of Homeland Security, Emergency Management, and Military Departments in the States and Territories of the United States

    Science.gov (United States)

    2007-12-01

    www3.state.id.us/idstat/ TOC /46010KTOC.html (Title 46—Militia and Military Affairs, chapter 10—State Disaster Preparedness Act). Adjutant General...officer in the national guard of Idaho and has attained the rank of colonel or above. Source: http://www3.state.id.us/idstat/ TOC /46001KTOC.html (Title 46...http://www.fortaleza.gobierno.pr/admin_fortaleza/ sistema /ordens/0028.pdf. Adjutant General Director: Colonel David Carrion Baralt Functions

  17. 7 CFR 1160.104 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true United States. 1160.104 Section 1160.104 Agriculture... Definitions § 1160.104 United States. United States means the 48 contiguous states in the continental United States and the District of Columbia, except that United States means the 50 states of the United States...

  18. United States mineral resources

    Science.gov (United States)

    Brobst, Donald A.; Pratt, Walden P.

    1973-01-01

    650 of the U.S. Bureau of Mines) ; indeed, we regard that book and the present volume as being complementary. In the examination of the geologic possibilities for finding new deposits-in many respects the principal innovative contributions of this volume-we asked the authors to frankly apply the limits of their ingenuity and not only to summarize current theories but also to express their own intuitive ideas, however speculative and unconventional they may seem, that have come from years of study devoted to the origin of mineral deposits. Readers will see that some authors have speculated more courageously than others. In any case, we believe readers will find all the chapters interesting, and many stimulating; and a few we believe can be frankly characterized as intellectually exciting. Most chapters include a section on prospecting techniques, and a summary of geologic or related problems on which the authors believe research might be most fruitful in the continuing efforts to find new resources. An integral part of the book is the bibliographic material cited at the conclusion of each chapter, in lieu of repetition of detailed descriptions already in print. Index and "spot" maps are not included in most chapters because they are available elsewhere, and in many cases with more detail than could possibly be included here. Maps showing the distribution of known deposits of many commodities in the United States are available in the Mineral Resource (MR) map series of the U.S. Geological Survey and in the National Atlas of the United States. The first three chapters deal not with resources of specific commodities but with general information that is pertinent to the study of mineral resources. In the introductory chapter we discuss the purposes of the book, the distinctions between reserves and various categories of resources, and some general conclusions drawn from our view of the book in its entirety. In the second chapter V. E. McKelvey discusses the problems of

  19. The Ability of the United States Federal Radiological Monitoring and Assessment Center to Collect and Disseminate Environmental Measurements during Radiological Emergencies

    International Nuclear Information System (INIS)

    Marianno, Craig; Essex, James

    2007-01-01

    The Federal Radiological Monitoring and Assessment Center (FRMAC) is the United States response organization for radiological emergencies. The FRMAC is structured as an operations center and employs the combined resources of several federal agencies to respond to any disaster resulting in the release of radioactivity. The mission of the FRMAC is to support state and local authorities in the gathering of environmental data using an array of survey equipment ranging from alpha probes, beta/gamma probes, and high-purity germanium (HPGe) spectroscopy to the gathering of physical samples. Once collected, the data are projected on maps to assist public officials make protective action decisions. In addition to the accumulation of data, it is the legal obligation of the FRMAC to keep archival records of all data points and their actions. During an event, it is conceivable that hundreds to thousands of sample points will be recorded over a relatively short time. It is in the interest of the federal government and public that the information collected be put to the best use as fast as possible. Toward this end, the Remote Sensing Laboratory, working under the direction of the United States Department of Energy's National Nuclear Security Administration, is investigating the use of several technologies that will accelerate data flow from field teams to the FRMAC and, finally, distribution of data to decision makers and the public. Not only can finished data products be viewed through the internet, but the actual collection of data via 'real-time' telemetry can be viewed using this same method. Data from the field will be transferred directly to the FRMAC using the MCPD (multi-path communication device). This base station receives the survey information from the field teams via Bluetooth and instantly investigates the best communication pathway to transfer data to the FRMAC. Possible paths include standalone radio, commercial cellular networks (GPRS and CDMA) and satellite

  20. Dengue Fever in the United States

    Centers for Disease Control (CDC) Podcasts

    2012-04-09

    Dr. Amesh Adalja, an associate at the Center for Biosecurity and clinical assistant professor at the University of Pittsburgh School, of Medicine, discusses dengue fever outbreaks in the United States.  Created: 4/9/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 4/16/2012.

  1. United States panel presentations

    International Nuclear Information System (INIS)

    Beyea, J.

    1990-01-01

    Before I begin I have to make a disclaimer. That is that I am going to be talking about public perception because I think that is very important. But I do not want to give the impression that I think the public is wrong. I happen to agree with the public's perception of nuclear power, and I want to make that clear. I do not like the current generation of nuclear plants as I have made clear in many statements that I have made. On the other hand, in the long term, I feel that we have only two choices on the supply side, and that is nuclear power and solar electricity. And although I think solar electricity has the best chance, I am realistic enough to know that technologies do not always work the way I want. And so I think it is necessary to have at least some kind of nuclear option available. On the other hand, I do not think just any kind of nuclear technology will do. I want to talk to you about the conditions that I think you have to take into account when you try to design reactors that are publicly acceptable. I look at this as an insurance policy. Again, I do not want to be misquoted: I think nuclear power should be considered as an insurance policy, not as our first line of defense. Having made those disclaimers, what we need to do is set out a problem statement. The problem statement I set out is, 'How could one design and demonstrate a nuclear reactor that would regain public confidence in the United States, if one chose to do that?' By regaining confidence, I mean regaining sufficient confidence to site reactors at a number of locations. It is a pretty heavy task because the public cannot judge the technical issues. They have to judge the players by their characters and their histories, just as the way we calibrate anyone that knows things that we do not. I have three theses that I think are crucial. The first is that people do not believe in the claims of advocates, of any point of view, not just nuclear power, once the advocates have been proved wrong on

  2. State of pine decline in the southeastern United States

    Science.gov (United States)

    Lori Eckhardt; Mary Anne Sword Sayer; Don Imm

    2010-01-01

    Pine decline is an emerging forest health issue in the southeastern United States. Observations suggest pine decline is caused by environmental stress arising from competition, weather, insects and fungi, anthropogenic disturbances, and previous management. The problem is most severe for loblolly pine on sites that historically supported longleaf pine, are highly...

  3. Legislative update: United States

    International Nuclear Information System (INIS)

    Anon.

    2007-01-01

    The US Senate consented to the ratification of the Convention on Supplementary Compensation for Nuclear Damage (CSC) on 4 August 2006. The entry into force of the Convention on Supplementary Compensation will substantially change the face of the international nuclear liability regime. The CSC is a free-standing instrument, open to all states. This means that countries can become party to a new global regime providing for liability and compensation for victims of a nuclear incident, without also having to become a contracting party to the Paris Convention or the Vienna Convention. This is certainly a major step forward given that at the present time, over half of the world's reactors in operation or under construction are not covered by any of the international nuclear third party liability conventions. The CSC creates an instrument by which states can ensure that more money will be made available to compensate more victims for a broader range of damage than ever before. The CSC provides for two tiers of compensation. The first tier, fixed at 300 million Special Drawing Rights, is to be provided by the liable operator. This tier is to be distributed on a non-discriminatory basis to victims both inside and outside of the Installation State. If 300 million SDRs are insufficient to compensate all damage, then contracting parties will be required to contribute to the second tier (the international fund). The amount of this second tier is not fixed, but rather will depend on the number of operating nuclear power plants in contracting parties, and is designed to increase as the number of such plants increases

  4. State of emergency medicine in Azerbaijan

    OpenAIRE

    Sule, Harsh; Kazimov, Shirin; Shahmaliyev, Oktay; Sirois, Adam

    2008-01-01

    Background There has been no previous study into the state of emergency medicine in Azerbaijan. As a legacy of the Soviet Semashko system, the ?specialty? model of emergency medicine and integrated emergency departments do not exist here. Instead, pre-hospital emergency care is delivered by ambulance physicians and in-hospital care by individual departments, often in specialty hospitals. Emergency care is therefore fragmented, highly specialized and inefficient. Aims The Emergency Medicine De...

  5. NCHS - Injury Mortality: United States

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset describes injury mortality in the United States beginning in 1999. Two concepts are included in the circumstances of an injury death: intent of injury...

  6. 77 FR 48542 - United States

    Science.gov (United States)

    2012-08-14

    ... litigation.'' United States v. Armour and Co., 402 U.S. 673, 681 (1971). Section 5 of the Clayton Act... relief in consent judgment that contained recitals in which defendants asserted their innocence); Armour...

  7. United States Strategy for Mexico

    National Research Council Canada - National Science Library

    Centner, Robert C

    2005-01-01

    The security and stability of Mexico is of national interest to the United States, and a strong, effective alliance between the two countries is pivotal to our national defense strategy and economic prosperity...

  8. United States panel presentations

    International Nuclear Information System (INIS)

    Young, H.

    1990-01-01

    The Department of Energy is supporting a number of programs directed at improving nuclear power's ability to compete by the mid 1990s in providing some of what will be urgently needed new baseload capacity, and at meeting both utility requirements and public goals. More specifically, we are co-funding demonstration by 1993 of the process for life extension of current nuclear plants. We are supporting the development of new ALWR designs which rely more on methods such as natural circulation, gravity, reduced power density, or the characteristics of materials, rather than engineered systems to provide safety. These designs will meet the criteria set forth in EPRI's Utility Requirements Documents. We have established a cost-sharing program to demonstrate the success of the nuclear plant standardization and licensing process by obtaining NRC certification by 1992 or 1993 of two evolutionary 1300MWe ALWR designs. We are also cost-sharing a program to certify by 1995 passively safe 600MWe ALWRs employing more natural safety features and modular construction. These programs will involve a rule-making hearing process. We are supporting the development and possible certification early in the next century of modular high temperature gas reactor and advanced liquid metal reactor plant designs. We are planning to demonstrate the early site approval licensing process through a cost-sharing arrangement with the private sector by 1995. In developing the National Energy Strategy, we are examining the issue of a fully satisfactory regulatory process, including the possibility of legislation codifying 10 CFR Part 52, limiting the possible delays associated with a potential second hearing and dealing with emergency planning issues before start of construction. We recently announced a restructured plan to develop a permanent waste repository by 2010. By 1995 we expect to have made significant progress in evaluating the suitability of Yucca Mountain. We expect to have selected a

  9. 31 CFR 800.225 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 800.225 Section 800... TAKEOVERS BY FOREIGN PERSONS Definitions § 800.225 United States. The term United States or U.S. means the United States of America, the States of the United States, the District of Columbia, and any commonwealth...

  10. 7 CFR 1220.615 - State and United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false State and United States. 1220.615 Section 1220.615... CONSUMER INFORMATION Procedures To Request a Referendum Definitions § 1220.615 State and United States. State and United States include the 50 States of the United States of America, the District of Columbia...

  11. 7 CFR 1220.129 - State and United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false State and United States. 1220.129 Section 1220.129... CONSUMER INFORMATION Soybean Promotion and Research Order Definitions § 1220.129 State and United States. The terms State and United States include the 50 States of the United States of America, the District...

  12. State nuclear initiatives in the United States

    International Nuclear Information System (INIS)

    Strauss, P.L.; Stoiber, C.R.

    1977-01-01

    The paper deals with State nuclear initiatives regarding the role of nuclear power in the energy future of the United States. The question of whether and under what circumstances nuclear facilities should be used to generate electricity was put to the popular vote in several States in 1976. Some general principles of Federal-State relations are discussed with specific reference to nuclear regulations. The initiative mechanism itself is described as well as its legal form and background. The parallel developments in the State and Federal legislative consideration of nuclear issues is reviewed and the suggested reasons for the defeat of the proposals in the seven States concerned are discussed. Finally, the author draws some conclusions on the effects of the 1976 initiatives on future decision-making in the US on energy policy in general and nuclear power in particular. (NEA) [fr

  13. THE UNITED STATES EDUCATIONAL SYSTEM

    OpenAIRE

    David Suriñach Fernández

    2017-01-01

    The United States educational system is very complex. Due to the fact a big number of agents take play of its regulation, the differences between the education from one State compared to the education from another, or even between school districts, might be considerable. The last two largest federal education initiatives, No Child Left Behind and Race to the Top, have had a huge impact on the American education system. The escalation of the standardized test throughout the whole country as a ...

  14. United States Navy DL Perspective

    Science.gov (United States)

    2010-08-10

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

  15. 7 CFR 1250.308 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1250.308 Section 1250.308 Agriculture... Research and Promotion Order Definitions § 1250.308 United States. United States means the 48 contiguous States of the United States of America and the District of Columbia. ...

  16. 31 CFR 592.311 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 592.311 Section 592... § 592.311 United States. The term United States, when used in the geographic sense, means the several States, the District of Columbia, and any commonwealth, territory, or possession of the United States. ...

  17. 7 CFR 1205.23 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1205.23 Section 1205.23 Agriculture... Procedures for Conduct of Sign-up Period Definitions § 1205.23 United States. The term United States means the 50 states of the United States of America. Procedures ...

  18. 31 CFR 597.318 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 597.318 Section 597... General Definitions § 597.318 United States. The term United States means the United States, its territories, states, commonwealths, districts, and possessions, and all areas under the jurisdiction or...

  19. 7 CFR 1150.106 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true United States. 1150.106 Section 1150.106 Agriculture... Order Definitions § 1150.106 United States. United States means the 48 contiguous States in the continental United States. ...

  20. 7 CFR 1219.26 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1219.26 Section 1219.26 Agriculture..., AND INFORMATION Hass Avocado Promotion, Research, and Information Order Definitions § 1219.26 United States. United States means collectively the several 50 States of the United States, the District of...

  1. 22 CFR 120.13 - United States.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false United States. 120.13 Section 120.13 Foreign... United States. United States, when used in the geographical sense, includes the several states, the Commonwealth of Puerto Rico, the insular possessions of the United States, the District of Columbia, the...

  2. 7 CFR 1205.313 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1205.313 Section 1205.313 Agriculture... Research and Promotion Order Definitions § 1205.313 United States. United States means the 50 States of the United States of America. [31 FR 16758, Dec. 31, 1966. Redesignated at 56 FR 64472, Dec. 10, 1991] ...

  3. 7 CFR 1209.21 - State and United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false State and United States. 1209.21 Section 1209.21... Definitions § 1209.21 State and United States. (a) State means any of the several States, the District of Columbia, and the Commonwealth of Puerto Rico. (b) United States means collectively the several States of...

  4. Emergence of serine carbapenemases (KPC and SME) among clinical strains of Enterobacteriaceae isolated in the United States Medical Centers: report from the MYSTIC Program (1999-2005).

    Science.gov (United States)

    Deshpande, Lalitagauri M; Rhomberg, Paul R; Sader, Helio S; Jones, Ronald N

    2006-12-01

    Among 8885 Enterobacteriaceae tested in the 1999 to 2005 period as part of the USA Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Program, 51 strains with increased imipenem and meropenem MIC values (> or =2 microg/mL) were detected. bla(KPC) was identified from 28 Klebsiella pneumoniae from 3 medical centers in the New York City area (8 ribotypes), 2 Klebsiella oxytoca from Arkansas (same ribotype), 7 Citrobacter freundii (6 from New York [5 ribotypes] and 1 from Delaware), 4 Enterobacter spp. from New York (2 species, different ribotypes), 3 Escherichia coli (2 from New York and 1 from Ohio, same ribotype), and 1 Serratia marcescens (New York). Sequencing confirmed KPC-2 or -3 in all of the strains. S. marcescens strains harboring SME-1 (2 isolates, same ribotype) and SME-2 (1 isolate) were identified from medical centers in Illinois and Washington state, respectively. Our results indicate that bla(KPC-2/3) has emerged widely (New York City area, Arkansas, Delaware, and Ohio) among Enterobacteriaceae isolated in the MYSTIC Program participant sites (2000-2005) and continues to be isolated from multiple species, as a result of clonal expansion and horizontal gene transfer. The escalating occurrence (0.35%) of serine carbapenemases could compromise the role of carbapenems and other beta-lactams in USA clinical practice although observed in only a few locations to date.

  5. A Chronosequence Feasibility Assessment of Emergency Fire Rehabilitation Records within the Intermountain Western United States - Final Report to the Joint Fire Science Program - Project 08-S-08

    Science.gov (United States)

    Knutson, Kevin C.; Pyke, David A.; Wirth, Troy A.; Pilliod, David S.; Brooks, Matthew L.; Chambers, Jeanne C.

    2009-01-01

    Department of the Interior (DOI) bureaus have invested heavily (for example, the U.S. Bureau of Land Management (BLM) spent more than $60 million in fiscal year 2007) in seeding vegetation for emergency stabilization and burned area rehabilitation of non-forested arid lands over the past 10 years. The primary objectives of these seedings commonly are to (1) reduce the post-fire dominance of non-native annual grasses, such as cheatgrass (Bromus tectorum) and red brome (Bromus rubens); (2) minimize the probability of recurrent fire; and (3) ultimately produce desirable vegetation characteristics (for example, ability to recover following disturbance [resilience], resistance to invasive species, and a capacity to support a diverse flora and fauna). Although these projects historically have been monitored to varying extents, land managers currently lack scientific evidence to verify whether seeding arid and semiarid lands achieves desired objectives. Given the amount of resources dedicated to post-fire seeding projects, a synthesis of information determining the factors that result in successful treatments is critically needed. Although results of recently established experiments and monitoring projects eventually will provide useful insights for the future direction of emergency stabilization and burned area rehabilitation programs, a chronosequence approach evaluating emergency stabilization and burned area rehabilitation treatments (both referenced hereafter as ESR treatments) over the past 30 years could provide a comprehensive assessment of treatment success across a range of regional environmental gradients. By randomly selecting a statistically robust sample from the population of historic ESR treatments in the Intermountain West, this chronosequence approach would have inference for most ecological sites in this region. The goal of this feasibility study was to compile and examine historic ESR records from BLM field offices across the Intermountain West to

  6. State of emergency and emergency: Comparative terminological and semantic aspects

    OpenAIRE

    Avramović, Dragutin; Mlađan, Dragan

    2014-01-01

    The issue of theoretical definition and distinction between a state of emergency and an emergency is made current in recent national and international literature, as well as in different comparative law normative solutions. Considering the usage inconsistencies of the two terms, this paper attempts to highlight the differences between them, as they essentially carry distinctive legal meanings despite their implied lexical and logical similarity. The paper stresses the necessity of their clear...

  7. Landfill leachate as a mirror of today's disposable society: Pharmaceuticals and other contaminants of emerging concern in final leachate from landfills in the conterminous United States

    Science.gov (United States)

    Masoner, Jason R.; Kolpin, Dana W.; Furlong, Edward T.; Cozzarelli, Isabelle M.; Gray, James L.

    2015-01-01

    Final leachates (leachate after storage or treatment processes) from 22 landfills in 12 states were analyzed for 190 pharmaceuticals and other contaminants of emerging concern (CECs), which were detected in every sample, with the number of CECs ranging from 1 to 58 (median = 22). In total, 101 different CECs were detected in leachate samples, including 43 prescription pharmaceuticals, 22 industrial chemicals, 15 household chemicals, 12 nonprescription pharmaceuticals, 5 steroid hormones, and 4 animal/plant sterols. The most frequently detected CECs were lidocaine (91%, local anesthetic), cotinine (86%, nicotine degradate), carisoprodol (82%, muscle relaxant), bisphenol A (77%, component of plastics and thermal paper), carbamazepine (77%, anticonvulsant), and N,N-diethyltoluamide (68%, insect repellent). Concentrations of CECs spanned 7 orders of magnitude, ranging from 2.0 ng/L (estrone) to 17 200 000 ng/L (bisphenol A). Concentrations of household and industrial chemicals were the greatest (∼1000-1 000 000 ng/L), followed by plant/animal sterols (∼1000-100 000 ng/L), nonprescription pharmaceuticals (∼100-10 000 ng/L), prescription pharmaceuticals (∼10-10 000 ng/L), and steroid hormones (∼10-100 ng/L). The CEC concentrations in leachate from active landfills were significantly greater than those in leachate from closed, unlined landfills (p = 0.05). The CEC concentrations were significantly greater (p landfills than in leachate released to groundwater from closed, unlined landfills (p = 0.04). The CEC concentrations were significantly greater (p = 0.06) in the fresh leachate (leachate before storage or treatment) reported in a previous study compared with the final leachate sampled for the present study.

  8. 31 CFR 598.317 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 598.317 Section 598.317 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Definitions § 598.317 United States. The term United States means the United States, its territories and...

  9. 31 CFR 596.312 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 596.312 Section 596.312 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... General Definitions § 596.312 United States. The term United States means the United States, including its...

  10. 31 CFR 538.314 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 538.314 Section 538.314 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... § 538.314 United States. The term United States means the United States, its territories and possessions...

  11. 31 CFR 543.310 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 543.310 Section 543.310 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Definitions § 543.310 United States. The term United States means the United States, its territories and...

  12. 31 CFR 542.310 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 542.310 Section 542.310 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF....310 United States. The term United States means the United States, its territories and possessions...

  13. 31 CFR 548.310 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 548.310 Section 548.310 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF....310 United States. The term United States means the United States, its territories and possessions...

  14. 7 CFR 65.255 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false United States. 65.255 Section 65.255 Agriculture..., PEANUTS, AND GINSENG General Provisions Definitions § 65.255 United States. United States means the 50... United States. ...

  15. 31 CFR 546.310 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 546.310 Section 546.310 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF....310 United States. The term United States means the United States, its territories and possessions...

  16. 31 CFR 594.313 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 594.313 Section 594.313 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Definitions § 594.313 United States. The term United States means the United States, its territories and...

  17. 31 CFR 588.310 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 588.310 Section 588.310 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Definitions § 588.310 United States. The term United States means the United States, its territories and...

  18. 31 CFR 536.315 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 536.315 Section 536.315 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Definitions § 536.315 United States. The term United States means the United States, its territories and...

  19. 31 CFR 544.310 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 544.310 Section 544.310 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... REGULATIONS General Definitions § 544.310 United States. The term United States means the United States, its...

  20. 31 CFR 545.313 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 545.313 Section 545.313 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Definitions § 545.313 United States. The term United States means the United States, its territories and...

  1. 31 CFR 595.314 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 595.314 Section 595.314 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... § 595.314 United States. The term United States means the United States, its territories and possessions...

  2. 31 CFR 586.318 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 586.318 Section 586...) KOSOVO SANCTIONS REGULATIONS General Definitions § 586.318 United States. The term United States means the United States, its territories and possessions, and all areas under the jurisdiction or authority...

  3. 31 CFR 537.318 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 537.318 Section 537.318 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF....318 United States. The term United States means the United States, its territories and possessions...

  4. 31 CFR 560.307 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 560.307 Section 560.307 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... § 560.307 United States. The term United States means the United States, including its territories and...

  5. 31 CFR 593.311 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 593.311 Section 593.311 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... REGULATIONS General Definitions § 593.311 United States. The term United States means the United States, its...

  6. 31 CFR 585.316 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 585.316 Section 585.316 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... General Definitions § 585.316 United States. The term United States means the United States, its...

  7. 31 CFR 575.319 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 575.319 Section 575.319 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF....319 United States. The term United States means the United States, its territories and possessions...

  8. 7 CFR 1212.31 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1212.31 Section 1212.31 Agriculture..., Consumer Education, and Industry Information Order Definitions § 1212.31 United States. “United States... territories and possessions of the United States. ...

  9. 31 CFR 539.312 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 539.312 Section 539.312 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... General Definitions § 539.312 United States. The term United States means the United States, its...

  10. 31 CFR 551.309 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 551.309 Section 551.309 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF....309 United States. The term United States means the United States, its territories and possessions...

  11. 31 CFR 587.310 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 587.310 Section 587...) MILOSEVIC SANCTIONS REGULATIONS General Definitions § 587.310 United States. The term United States means the United States, its territories and possessions, and all areas under the jurisdiction or authority...

  12. 31 CFR 541.310 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 541.310 Section 541.310 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... § 541.310 United States. The term United States means the United States, its territories and possessions...

  13. 31 CFR 540.313 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 540.313 Section 540.313 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... REGULATIONS General Definitions § 540.313 United States. The term United States means the United States, its...

  14. 31 CFR 547.310 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 547.310 Section 547.310 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... General Definitions § 547.310 United States. The term United States means the United States, its...

  15. Masturbation in the United States.

    Science.gov (United States)

    Das, Aniruddha

    2007-01-01

    Using data from the nationally representative National Health and Social Life Survey, this study queried the correlates of masturbation in the United States in 1992. Among those aged 18-60, 38% (CI, 35-41) of women and 61% (CI, 57-65) of men reported any masturbation over the preceding year. The system of factors underlying masturbation was similar for both genders, consistent with a convergence in gender patterns of sexual expression in the United States. Among both women and men, masturbation responded to a stable sexualized personality pattern, catalyzed by early-life factors and manifested in current sexual traits. Strikingly, the masturbation-partnered sex linkage, often conceptualized either as compensating for unsatisfying sex or complementing a satisfactory sex life, appeared to be bimodal for both genders. For some, masturbation complemented an active and pleasurable sex life, while among others, it compensated for a lack of partnered sex or satisfaction in sex.

  16. Environmental performance reviews: United States

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-01-15

    This book presents OECD assessments and recommendations regarding the United States' effort to manage its environment including air, water nature, and biodiversity to do this in a sustainable manner; and to do this in co-operation with its global neighbours. In particular, it assesses progress made since 1996, when OECD's previous review on the US was done. 40 figs., 21 tabs.

  17. United States National Seismographic Network

    International Nuclear Information System (INIS)

    Buland, R.

    1993-09-01

    The concept of a United States National Seismograph Network (USNSN) dates back nearly 30 years. The idea was revived several times over the decades. but never funded. For, example, a national network was proposed and discussed at great length in the so called Bolt Report (U. S. Earthquake Observatories: Recommendations for a New National Network, National Academy Press, Washington, D.C., 1980, 122 pp). From the beginning, a national network was viewed as augmenting and complementing the relatively dense, predominantly short-period vertical coverage of selected areas provided by the Regional Seismograph Networks (RSN's) with a sparse, well-distributed network of three-component, observatory quality, permanent stations. The opportunity finally to begin developing a national network arose in 1986 with discussions between the US Geological Survey (USGS) and the Nuclear Regulatory Commission (NRC). Under the agreement signed in 1987, the NRC has provided $5 M in new funding for capital equipment (over the period 1987-1992) and the USGS has provided personnel and facilities to develop. deploy, and operate the network. Because the NRC funding was earmarked for the eastern United States, new USNSN station deployments are mostly east of 105 degree W longitude while the network in the western United States is mostly made up of cooperating stations (stations meeting USNSN design goals, but deployed and operated by other institutions which provide a logical extension to the USNSN)

  18. An introduction to joint research by the USEPA and USGS on contaminants of emerging concern in source and treated drinking waters of the United States

    Science.gov (United States)

    Improvements in analytical methodology have allowed low-level detection of an ever increasing number of pharmaceuticals, personal care products, hormones, pathogens and other contaminants of emerging concern (CECs). The use of these improved analytical tools has allowed researche...

  19. Improving Emergency Attendance and Mortality – The Case for Unit ...

    African Journals Online (AJOL)

    BACKGROUND: Emergency attendance and mortality which are reliable indicators of quality of care, have been of concern to many health institutions. Different models are being proposed to improve emergency outcomes in different parts of the world. A model to separate a single emergency Unit into multiple emergency ...

  20. Inadequate emergence after anesthesia: emergence delirium and hypoactive emergence in the Postanesthesia Care Unit.

    Science.gov (United States)

    Xará, Daniela; Silva, Acácio; Mendonça, Júlia; Abelha, Fernando

    2013-09-01

    To evaluate the frequency, determinants, and outcome of inadequate emergence after elective surgery in the Postanesthesia Care Unit (PACU). Prospective observational study. 12-bed PACU of a tertiary-care hospital in a major metropolitan area. 266 adult patients admitted to the PACU. To evaluate inadequate emergence, the Richmond Agitation and Sedation Scale (RASS) was administered to patients 10 minutes after their admission to the PACU. Demographic data, perioperative variables, and postoperative length of stay (LOS) in the PACU and the hospital were recorded. 40 (15%) patients showed symptoms of inadequate emergence: 17 patients (6.4%) screened positive for emergence delirium and 23 patients (8.6%) showed hypoactive emergence. Determinants of emergence delirium were longer duration of preoperative fasting (P = 0.001), higher visual analog scale (VAS) scores for pain (P = 0.002), and major surgical risk (P = 0.001); these patients had a higher frequency of postoperative delirium (P = 0.017) and had higher nausea VAS score 6 hours after surgery (P = 0.001). Determinants of hypoactive emergence were duration of surgery (P = 0.003), amount of crystalloids administered during surgery (P = 0.002), residual neuromuscular block (P < 0.001), high-risk surgery (P = 0.002), and lower core temperature on PACU admission (P = 0.028); these patients also had more frequent residual neuromuscular block (P < 0.001) postoperative delirium (P < 0.001), and more frequent adverse respiratory events (P = 0.02). Patients with hypoactive emergence had longer PACU and hospital LOS. Preventable determinants for emergence delirium were higher postoperative pain scores and longer fasting times. Hypoactive emergence was associated with longer postoperative PACU and hospital LOSs. © 2013 Elsevier Inc. All rights reserved.

  1. Depression Among Non-Daily Smokers Compared to Daily Smokers and Never-Smokers in the United States: An Emerging Problem.

    Science.gov (United States)

    Weinberger, Andrea H; Gbedemah, Misato; Wall, Melanie M; Hasin, Deborah S; Zvolensky, Michael J; Chaiton, Michael; Goodwin, Renee D

    2017-09-01

    Depression is strongly associated with daily smoking. Yet, little is known about the association between depression and non-daily smoking. The aim of this study was to investigate the prevalence of past-year depression and changes in past-year depression over time among non-daily smokers, compared to daily smokers and never-smokers, overall and stratified by age, gender, income, nicotine dependence, and cigarettes per day. Data were drawn from the National Household Survey on Drug Use (NSDUH), an annual cross-sectional study of persons aged 12 and over (total study population N = 496 805). The prevalence of past-year depression was examined annually among non-daily smokers, daily smokers, and never-smokers from 2005 to 2013 using linear trend analyses. Past-year depression was common among 10.10% of non-daily smokers, common among 10.78% of daily smokers, and 5.51% of never-smokers in 2013. The prevalence of depression increased from 2005 to 2013 among non-daily smokers (9.06% vs. 10.10%; p = .034) while there was no significant change in depression over time among daily smokers. Increases in depression among non-daily smokers occurred for both men and women and appear most pronounced youth, those smoking fewer cigarettes, and those without nicotine dependence. The prevalence of depression among non-daily smokers was equivalent to daily smokers and nearly twice that among nonsmokers. Depression appears to be increasing over time in non-daily smokers especially among youth, those who smoke less, and those without nicotine dependence. More work on the mental health of non-daily smokers is needed as this is an increasing and understudied group. This is the first study to investigate changes in the prevalence of depression among non-daily smokers compared to daily smokers and never-smokers over the past decade in a nationally representative sample of the United States. The results suggest an increase in depression among non-daily smokers over time that did not

  2. Violence in the United States

    Science.gov (United States)

    Sumner, Steven A.; Mercy, James A.; Dahlberg, Linda L.; Hillis, Susan D.; Klevens, Joanne; Houry, Debra

    2015-01-01

    IMPORTANCE Interpersonal violence, which includes child abuse and neglect, youth violence, intimate partner violence, sexual violence, and elder abuse, affects millions of US residents each year. However, surveillance systems, programs, and policies to address violence often lack broad, cross-sector collaboration, and there is limited awareness of effective strategies to prevent violence. OBJECTIVES To describe the burden of interpersonal violence in the United States, explore challenges to violence prevention efforts and to identify prevention opportunities. DATA SOURCES We reviewed data from health and law enforcement surveillance systems including the National Vital Statistics System, the Federal Bureau of Investigation’s Uniform Crime Reports, the US Justice Department’s National Crime Victimization Survey, the National Survey of Children’s Exposure to Violence, the National Child Abuse and Neglect Data System, the National Intimate Partner and Sexual Violence Survey, the Youth Risk Behavior Surveillance System, and the National Electronic Injury Surveillance System—All Injury Program. RESULTS Homicide rates have decreased from a peak of 10.7 per 100 000 persons in 1980 to 5.1 per 100 000 in 2013. Aggravated assault rates have decreased from a peak of 442 per 100 000 in 1992 to 242 per 100 000 in 2012. Nevertheless, annually, there are more than 16 000 homicides and 1.6 million nonfatal assault injuries requiring treatment in emergency departments. More than 12 million adults experience intimate partner violence annually and more than 10 million children younger than 18 years experience some form of maltreatment from a caregiver, ranging from neglect to sexual abuse, but only a small percentage of these violent incidents are reported to law enforcement, health care clinicians, or child protective agencies. Moreover, exposure to violence increases vulnerability to a broad range of mental and physical health problems over the life course; for example

  3. 7 CFR 1206.23 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1206.23 Section 1206.23 Agriculture... INFORMATION Mango Promotion, Research, and Information Order Definitions § 1206.23 United States. United... Rico, and the territories and possessions of the United States. ...

  4. Selecting Communication Channels for Substance Misuse Prevention with At-Risk African-American Emerging Adults Living in the Southern United States

    Science.gov (United States)

    Tucker, Jalie A.; Cheong, JeeWon; Chandler, Susan D.

    2016-01-01

    Natural health information sources used by African-American emerging adults were investigated to identify sources associated with high and low substance-related risk. Participants (110 males, 234 females; M age = 18.9 years) were recruited using respondent-driven sampling, and structured interviews assessed substance use, sources of health…

  5. Emergency Contraceptive Pill (ECP) Use and Experiences at College Health Centers in the Mid-Atlantic United States: Changes since ECP Went Over-the-Counter

    Science.gov (United States)

    Miller, Laura M.

    2011-01-01

    Objective: To investigate the availability of emergency contraceptive pills (ECPs) at college health centers since ECP went over-the-counter (OTC) in 2006. Related issues, such as distribution procedure, existence of a written protocol, personnel involved, contraindications, follow-up procedures, methods of advertising, and staff attitudes, were…

  6. Emergency and Disaster Preparedness of School Transportation Staff and School Buses in the United States: Compliance With Recommendations for School Transportation Safety.

    Science.gov (United States)

    Olympia, Robert P; Weber, Christopher; Brady, Jodi; Ho, Susana

    2017-11-01

    The aim of the study was to determine the compliance of school transportation staff and school buses with recommendations for the safe transportation of children to and from school and school-related activities. An electronic questionnaire was distributed to school transportation staff represented by the International Brotherhood of Teamsters during the 2013-2014 academic year. Analysis was performed on 558 completed questionnaires (13% usable response rate). Responders had previous training in first aid (89%), basic life support (28%), and cardiopulmonary resuscitation (52%). Seventy-eight percent of school buses in our sample had restraint devices and 87% had seat belt cutters. Responders reported the immediate availability of the following on their bus: communication devices (81%), first aid kits (97%), fire extinguishers (89%), automated external defibrillators (1%), and epinephrine autoinjectors (2%). Thirty percent of responders have had no previous training in the management of emergencies such as trouble breathing, severe allergic reaction, seizures, cardiac arrest or unresponsiveness, and head, neck, or extremity trauma. Thirteen percent of responders are unfamiliar with or have had no previous training on protocols regarding emergency shelters and community evacuation plans in the event of a disaster. Variability exists in the compliance of school transportation staff and school buses with recommendations for the safe transportation of children. Areas for improvement were identified, such as educating school transportation staff in the recognition and initial management of pediatric emergencies, ensuring the presence of restraint devices, increasing the immediate availability of certain emergency medications and equipment, and familiarizing school transportation staff with designated emergency shelters and community evacuation plans.

  7. 7 CFR 1215.20 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1215.20 Section 1215.20 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... United States. United States means all of the States. Popcorn Board ...

  8. 7 CFR 1260.108 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1260.108 Section 1260.108 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... Promotion and Research Order Definitions § 1260.108 United States. United States means the 50 States and the...

  9. 7 CFR 1280.127 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1280.127 Section 1280.127 Agriculture... INFORMATION ORDER Lamb Promotion, Research, and Information Order Definitions § 1280.127 United States. United States means collectively the 50 States and the District of Columbia. ...

  10. 7 CFR 1210.315 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1210.315 Section 1210.315 Agriculture... PLAN Watermelon Research and Promotion Plan Definitions § 1210.315 United States. United States means each of the several States and the District of Columbia. [60 FR 10797, Feb. 28, 1995] National...

  11. 7 CFR 1221.32 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1221.32 Section 1221.32 Agriculture... INFORMATION ORDER Sorghum Promotion, Research, and Information Order Definitions § 1221.32 United States. United States or U.S. means collectively the 50 States, the District of Columbia, the Commonwealth of...

  12. 7 CFR 1216.30 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1216.30 Section 1216.30 Agriculture... INFORMATION ORDER Peanut Promotion, Research, and Information Order Definitions § 1216.30 United States. United States means collectively the 50 states, the District of Columbia, the Commonwealth of Puerto Rico...

  13. 7 CFR 1218.22 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1218.22 Section 1218.22 Agriculture... INFORMATION ORDER Blueberry Promotion, Research, and Information Order Definitions § 1218.22 United States. United States means collectively the 50 states, the District of Columbia, the Commonwealth of Puerto Rico...

  14. Malaria Surveillance - United States, 2015.

    Science.gov (United States)

    Mace, Kimberly E; Arguin, Paul M; Tan, Kathrine R

    2018-05-04

    Malaria in humans is caused by intraerythrocytic protozoa of the genus Plasmodium. These parasites are transmitted by the bite of an infective female Anopheles species mosquito. The majority of malaria infections in the United States occur among persons who have traveled to regions with ongoing malaria transmission. However, malaria is occasionally acquired by persons who have not traveled out of the country through exposure to infected blood products, congenital transmission, laboratory exposure, or local mosquitoborne transmission. Malaria surveillance in the United States is conducted to provide information on its occurrence (e.g., temporal, geographic, and demographic), guide prevention and treatment recommendations for travelers and patients, and facilitate transmission control measures if locally acquired cases are identified. This report summarizes confirmed malaria cases in persons with onset of illness in 2015 and summarizes trends in previous years. Malaria cases diagnosed by blood film microscopy, polymerase chain reaction, or rapid diagnostic tests are reported to local and state health departments by health care providers or laboratory staff members. Case investigations are conducted by local and state health departments, and reports are transmitted to CDC through the National Malaria Surveillance System (NMSS), the National Notifiable Diseases Surveillance System (NNDSS), or direct CDC consultations. CDC reference laboratories provide diagnostic assistance and conduct antimalarial drug resistance marker testing on blood samples submitted by health care providers or local or state health departments. This report summarizes data from the integration of all NMSS and NNDSS cases, CDC reference laboratory reports, and CDC clinical consultations. CDC received reports of 1,517 confirmed malaria cases, including one congenital case, with an onset of symptoms in 2015 among persons who received their diagnoses in the United States. Although the number of

  15. Discharge from an emergency department observation unit and a surgical assessment unit

    DEFF Research Database (Denmark)

    Schultz, Helen; Qvist, Niels; Backer Mogensen, Christian

    2014-01-01

    To investigate the experiences of patients with acute abdominal pain at discharge from an emergency department observation unit compared with discharge from a surgical assessment unit.......To investigate the experiences of patients with acute abdominal pain at discharge from an emergency department observation unit compared with discharge from a surgical assessment unit....

  16. United States of America National Report

    International Nuclear Information System (INIS)

    1992-01-01

    The United States has produced this report as part of the preparations for the United Nations Conference on Environment and Development (UNCED) to be held in Brazil in June 1992. It summarizes this nation's efforts to protect and enhance the quality of the human environment in concert with its efforts to provide economic well-being during the two decades since the United Nations Conference on the Human Environment was held in Stockholm. The information presented in this report is primarily and deliberately retrospective. It is an attempt to portray the many human, economic and natural resources of the United States, to describe resource use and the principal national laws and programs established to protect these resources, and to analyze key issues on the agenda of UNCED. This analysis is presented in terms of past and present conditions and trends, measures of progress made in responding to the key issues, and a summary of government activities, underway or pending, to address ongoing or newly emerging national environmental and resource management problems

  17. Incidence of Patients With Knee Strain and Sprain Occurring at Sports or Recreation Venues and Presenting to United States Emergency Departments.

    Science.gov (United States)

    Gray, Aaron M; Buford, William L

    2015-11-01

    Knee injuries account for a substantial percentage of all athletic injuries. The relative rates of knee injury for a variety of sports by sex and age need to be understood so we can better allocate resources, such as athletic trainers, to properly assess and treat injuries and reduce injury risk. To describe the epidemiology of patients with sport-related knee strain and sprain presenting to US emergency departments from 2002 to 2011. Cross-sectional study. Using the Consumer Products Safety Commission's National Electronic Injury Surveillance System and the US Census Bureau, we extracted raw data to estimate national rates of patients with knee strain and sprain presenting to emergency departments. Participants were individuals sustaining a knee strain or sprain at sports or recreation venues and presenting to local emergency departments for treatment. We included 12 popular sports for males and 11 for females. Ages were categorized in six 5-year increments for ages 5 to 34 years and one 10-year increment for ages 35 to 44 years. Incidence rates were calculated using weights provided by the National Electronic Injury Surveillance System and reported with their 95% confidence intervals for sport, sex, and age. Strain and sprain injury rates varied greatly by sport, sex, and age group. The highest injury rates occurred in football and basketball for males and in soccer and basketball for females. The most at-risk population was 15 to 19 years for both sexes. Athletes experience different rates of knee strain and sprain according to sport, sex, and age. Increased employment of athletic trainers to care for the highest-risk populations, aged 10 to 19 years, is recommended to reduce emergency department use and implement injury-prevention practices.

  18. The Military Emergency Unit; La Unidad Militar de Emergencias (UME)

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez Requena, J. M.

    2007-07-01

    One of the most justified and pressing demands that society makes of the State, requiring a fast, forceful and effective response, is that it guarantees the safety of people and their assets when a disaster seriously endangers them. At the proposal of the President of the Government, the Cabinet of Ministers, in its meeting held on October 7, 2005, agreed to create the Military Emergency Unit, known since the as the UME. Its mission is to intervene anywhere in the national territory when the President of the Government, or the Minister to whom he delegates, so decides in order to assure the safety and welfare of citizens in cases of serious risk, disaster, catastrophe or any other public need. The UME is organically incorporated into the Ministry of Defense and its actions may be supported with all the available human and material needs of the Armed Forces. Availability and effectiveness, with calmness and humility, have characterized the early actions of the Military Emergency Unit and are the guidelines for future action. The first steps of this military unit have focused on a clear goal: collaboration and participation in situations whose seriousness requires the coordination of different forces in order to immediately respond to them. The UME is the States tool to join forces and, with other administration and institutions, help to rapidly and effectively deal with emergencies. It has taken its first step and achieved the capacity specified in the UME Operations Order for 2007. The 150 men and women per battalion, plus the 80 in the Gando detachment, are on active duty and have sufficient material means to deploy, if necessary and when requested by the regions, town councils an other administrative bodies, to help in the extinction of forest fires. (Author)

  19. United States position on severe accidents

    International Nuclear Information System (INIS)

    Ross, D.F.

    1988-01-01

    The United States policy on severe accidents was published in 1985 for both new plant applications and for existing plants. Implementation of this policy is in progress. This policy, aided by a related safety goal policy and by analysis capabilities emerging from improved understanding of accident phenomenology, is viewed as a logical development from the pioneering work in the WASH-1400 Reactor Safety Study published by the United States Nuclear Regulatory Commission (NRC) in 1975. This work provided an estimate of the probability and consequences of severe accidents which, prior to that time, had been mostly evaluated by somewhat arbitrary assumptions dating back 30 years. The early history of severe accident evaluation is briefly summarized for the period 1957-1979. Then, the galvanizing action of Three Mile Island Unit 2 (TMI-2) on severe accident analysis, experimentation and regulation is reviewed. Expressions of US policy in the form of rulemaking, severe accident policy, safety research, safety goal policy and court decisions (on adequacy of safety) are discussed. Finally, the NRC policy as of March 1988 is stated, along with a prospective look at the next few years. (author). 19 refs

  20. Fluid therapy in the emergency unit

    African Journals Online (AJOL)

    Senior Specialist Paediatrician, Department of Ambulatory and Emergency Paediatrics, Red Cross War Memorial Children's Hospital, Cape. Town. Dr Diedericks is currently head of the Paediatric Emergency Service at Red Cross Hospital. He has previous experience ... intravenous fluid administration. Choosing the correct ...

  1. State of emergency medicine in Azerbaijan.

    Science.gov (United States)

    Sule, Harsh; Kazimov, Shirin; Shahmaliyev, Oktay; Sirois, Adam

    2008-04-01

    There has been no previous study into the state of emergency medicine in Azerbaijan. As a legacy of the Soviet Semashko system, the "specialty" model of emergency medicine and integrated emergency departments do not exist here. Instead, pre-hospital emergency care is delivered by ambulance physicians and in-hospital care by individual departments, often in specialty hospitals. Emergency care is therefore fragmented, highly specialized and inefficient. The Emergency Medicine Development Initiative (EMDI) of the International Medical Corps (IMC) was designed to improve the quality of emergency care in four pilot regional centers in Azerbaijan. The objective of this study was to assess the baseline emergency medical capacity of these four centers. EMDI staff conducted a four-part baseline survey in April 2006 to assess emergency care in Ganja (the second largest city in Azerbaijan), Kurdamir, Shamkir and Yevlakh. Data collection involved interviews with relevant personnel and a retrospective records review in each city. Pre-hospital: The number of ambulance teams per 10,000 inhabitants is below the number required by local regulations. On average, 45% of 27 medications and 37% of 17 pieces of critical equipment were available. Of the emergency procedures, 21% could be performed in the pre-hospital setting. In-hospital: Admission rates were near 100% for the admissions department-an area that is supposed to function as an emergency department would. On average 57% of 40 medications and 42% of 22 pieces of critical equipment were available. Of the emergency procedures, 62% could be performed in the in-hospital setting. The emergency medical system surveyed in Azerbaijan is inefficiently organized, under-financed, poorly equipped and lacks adequately trained staff. Reforms need to be directed towards achieving international standards, while adapting new models for service delivery into the existing framework and improving system capacity as highlighted by this baseline

  2. Teen Pregnancy in the United States

    Science.gov (United States)

    ... United States: the contribution of abstinence and improved contraceptive use. Am J Public Health. 2007;97(1):150-6. Lindberg LD, Santelli JS, Desai, S. Understanding the Decline in Adolescent Fertility in the United States, 2007–2012. J ...

  3. Care management in nursing within emergency care units

    OpenAIRE

    Roberta Juliane Tono de Oliveira; Patrícia Madalena Vieira Hermida; Fernanda Hannah da Silva Copelli; José Luís Guedes dos Santos; Alacoque Lorenzini Erdmann; Selma Regina de Andrade

    2015-01-01

    Objective.Understand the conditions involved in the management of nursing care in emergency care units. Methodology. Qualitative research using the methodological framework of the Grounded Theory. Data collection occurred from September 2011 to June 2012 through semi-structured interviews with 20 participants of the two emergency care units in the city of Florianopolis, Brazil. Results. Hindering factors to care management are: lack of experience and knowledge of professionals in emergency se...

  4. Nurse management skills required at an emergency care unit

    OpenAIRE

    Montezeli, Juliana Helena; Peres, Aida Maris; Bernardino, Elizabeth

    2013-01-01

    Objective: To identify the management skills needed for this professional at an emergency care unit. Method: An exploratory descriptive qualitative study conducted with eight nurses in which semi-structured interviews with nonparticipating systematic observation were conducted; the data was processed by content analysis. Results: The categories which emerged from the content analysis served as a list of management skills necessary to their work at the emergency care unit: leadership, decision...

  5. Characteristics and Outcomes of Pediatric Heart Failure-Related Emergency Department Visits in the United States: A Population-Based Study.

    Science.gov (United States)

    Mejia, Erika J; O'Connor, Matthew J; Lin, Kimberly Y; Song, Lihai; Griffis, Heather; Mascio, Christopher E; Shamszad, Pirouz; Donoghue, Aaron; Ravishankar, Chitra; Shaddy, Robert E; Rossano, Joseph W

    2018-02-01

    To describe the frequency, characteristics, and outcomes of heart failure-related emergency department (ED) visits in pediatric patients. We aimed to test the hypothesis that these visits are associated with higher admission rates, mortality, and resource utilization. A retrospective analysis of the Nationwide Emergency Department Sample for 2010 of patients ≤18 years of age was performed to describe ED visits with and without heart failure. Cases were identified using International Classification of Disease, Ninth Revision, Clinical Modification codes and assessed for factors associated with admission, mortality, and resource utilization. Among 28.6 million pediatric visits to the ED, there were 5971 (0.02%) heart failure-related cases. Heart failure-related ED patients were significantly more likely to be admitted (59.8% vs 4.01%; OR 35.3, 95% CI 31.5-39.7). Among heart failure-related visits, admission was more common in patients with congenital heart disease (OR 5.0, 95% CI 3.3-7.4) and in those with comorbidities including respiratory failure (OR 78.3, 95% CI 10.4-591) and renal failure (OR 7.9, 95% CI 1.7-36.3). Heart failure-related cases admitted to the hospital had a higher likelihood of death than nonheart failure-related cases (5.9% vs 0.32%, P failure (OR 4.5, 95% CI 2.2-9.2) and renal failure (OR 7.8, 95% CI 2.9-20.7). Heart failure-related ED visits were more expensive than nonheart failure-related ED visits ($1460 [IQR $861-2038] vs $778 [IQR $442-1375] [P failure-related visits represent a minority of pediatric ED visits but are associated with increased hospital admission and resource utilization. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Fracking in the United States

    International Nuclear Information System (INIS)

    Cho, Renee

    2015-01-01

    Over the last decade, advances in technology have made it profitable to extract natural gas from shale, leading to a boom in shale gas development in the United States. Hydraulic fracturing, or fracking, the controversial method for extracting natural gas, offers numerous benefits: relatively cheap energy, enhanced energy security, job creation, tax revenues and decreased dependence on dirty coal. Fracking, however, can also increase greenhouse gas emissions, pollute the air and result in health effects, consume huge quantities of water, and cause earthquakes. While some areas welcome fracking for the economic benefits it brings, other communities are attempting to ban fracking altogether. This article examines the benefits and risks of fracking in the U.S

  7. United States uranium enrichment policies

    International Nuclear Information System (INIS)

    Roberts, R.W.

    1977-01-01

    ERDA's uranium enrichment program policies governing the manner in which ERDA's enrichment complex is being operated and expanded to meet customer requirements for separative work, research and development activities directed at providing technology alternatives for future enrichment capacity, and establishing the framework for additional domestic uranium enrichment capacity to meet the domestic and foreign nuclear industry's growing demand for enrichment services are considered. The ERDA enrichment complex consists of three gaseous diffusion plants located in Oak Ridge, Tennessee; Paducah, Kentucky; and Portsmouth, Ohio. Today, these plants provide uranium enrichment services for commercial nuclear power generation. These enrichment services are provided under contracts between the Government and the utility customers. ERDA's program involves a major pilot plant cascade, and pursues an advanced isotope separation technique for the late 1980's. That the United States must develop additional domestic uranium enrichment capacity is discussed

  8. Oil Vulnerabilities and United States Strategy

    Science.gov (United States)

    2007-02-08

    Mazda, Mercedes - Benz , Ford, Mercury, and Nissan offer flexible fuel vehicles in the United States. Ethanol is currently produced in the United States...USAWC STRATEGY RESEARCH PROJECT OIL VULNERABILITIES AND UNITED STATES STRATEGY by Colonel Shawn P. Walsh...Colleges and Schools, 3624 Market Street, Philadelphia, PA 19104, (215) 662-5606. The Commission on Higher Education is an institutional accrediting

  9. Malaria Surveillance - United States, 2014.

    Science.gov (United States)

    Mace, Kimberly E; Arguin, Paul M

    2017-05-26

    Malaria in humans is caused by intraerythrocytic protozoa of the genus Plasmodium. These parasites are transmitted by the bite of an infective female Anopheles mosquito. The majority of malaria infections in the United States occur among persons who have traveled to regions with ongoing malaria transmission. However, malaria is occasionally acquired by persons who have not traveled out of the country through exposure to infected blood products, congenital transmission, laboratory exposure, or local mosquitoborne transmission. Malaria surveillance in the United States is conducted to identify episodes of local transmission and to guide prevention recommendations for travelers. This report summarizes cases in persons with onset of illness in 2014 and trends during previous years. Malaria cases diagnosed by blood film, polymerase chain reaction, or rapid diagnostic tests are reported to local and state health departments by health care providers or laboratory staff. Case investigations are conducted by local and state health departments, and reports are transmitted to CDC through the National Malaria Surveillance System, National Notifiable Diseases Surveillance System, or direct CDC consultations. CDC conducts antimalarial drug resistance marker testing on blood samples submitted by health care providers or local or state health departments. Data from these reporting systems serve as the basis for this report. CDC received reports of 1,724 confirmed malaria cases, including one congenital case and two cryptic cases, with onset of symptoms in 2014 among persons in the United States. The number of confirmed cases in 2014 is consistent with the number of confirmed cases reported in 2013 (n = 1,741; this number has been updated from a previous publication to account for delayed reporting for persons with symptom onset occurring in late 2013). Plasmodium falciparum, P. vivax, P. ovale, and P. malariae were identified in 66.1%, 13.3%, 5.2%, and 2.7% of cases, respectively

  10. Preparedness for the Evaluation and Management of Mass Casualty Incidents Involving Anticholinesterase Compounds: A Survey of Emergency Department Directors in the 12 Largest Cities in the United States

    Science.gov (United States)

    2010-11-01

    and the resulting survey was piloted among a group of 24 physicians, nurses , and governmental officials. It was submitted to an institu- tional...appropriate antidotes. ch emical attack with nerve agents could be devastat- g. As physicians, nurses , and allied health profession- , it is our professional...state and local medical countermeasure stockpile investments through the Shelf-Life Extension Program. Biosecur Bioterror. 2009; 7(1): 101-107. 86

  11. Analysis of the United States Computer Emergency Readiness Team’s (U.S. CERT) EINSTEIN III Intrusion Detection System, and Its Impact on Privacy

    Science.gov (United States)

    2013-03-01

    61 3. FISA and CyberSpace as a Foreign Domain ...................................62 4. Freedom of Speech and...amendment’s primary intent is to protect the freedom of speech . It states: Congress shall make no law respecting an establishment of religion, or...prohibiting the free exercise thereof; or abridging the freedom of speech , or of the press; or the right of the people peaceably to assemble, and to

  12. Prevalence and direct costs of emergency department visits and hospitalizations for selected diseases that can be transmitted by water, United States.

    Science.gov (United States)

    Adam, E A; Collier, S A; Fullerton, K E; Gargano, J W; Beach, M J

    2017-10-01

    National emergency department (ED) visit prevalence and costs for selected diseases that can be transmitted by water were estimated using large healthcare databases (acute otitis externa, campylobacteriosis, cryptosporidiosis, Escherichia coli infection, free-living ameba infection, giardiasis, hepatitis A virus (HAV) infection, Legionnaires' disease, nontuberculous mycobacterial (NTM) infection, Pseudomonas-related pneumonia or septicemia, salmonellosis, shigellosis, and vibriosis or cholera). An estimated 477,000 annual ED visits (95% CI: 459,000-494,000) were documented, with 21% (n = 101,000, 95% CI: 97,000-105,000) resulting in immediate hospital admission. The remaining 376,000 annual treat-and-release ED visits (95% CI: 361,000-390,000) resulted in $194 million in annual direct costs. Most treat-and-release ED visits (97%) and costs ($178 million/year) were associated with acute otitis externa. HAV ($5.5 million), NTM ($2.3 million), and salmonellosis ($2.2 million) were associated with next highest total costs. Cryptosporidiosis ($2,035), campylobacteriosis ($1,783), and NTM ($1,709) had the highest mean costs per treat-and-release ED visit. Overall, the annual hospitalization and treat-and-release ED visit costs associated with the selected diseases totaled $3.8 billion. As most of these diseases are not solely transmitted by water, an attribution process is needed as a next step to determine the proportion of these visits and costs attributable to waterborne transmission.

  13. Assessing the Burden of Diabetes Mellitus in Emergency Departments in the United States: The National Hospital Ambulatory Medical Care Survey (NHAMCS)

    Science.gov (United States)

    Asao, Keiko; Kaminski, James; McEwen, Laura N.; Wu, Xiejian; Lee, Joyce M.; Herman, William H.

    2014-01-01

    Objective To evaluate the performance of three alternative methods to identify diabetes in patients visiting Emergency Departments (EDs), and to describe the characteristics of patients with diabetes who are not identified when the alternative methods are used. Research Design and Methods We used data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) 2009 and 2010. We assessed the sensitivity and specificity of using providers’ diagnoses and diabetes medications (both excluding and including biguanides) to identify diabetes compared to using the checkbox for diabetes as the gold standard. We examined the characteristics of patients whose diabetes was missed using multivariate Poisson regression models. Results The checkbox identified 5,567 ED visits by adult patients with diabetes. Compared to the checkbox, the sensitivity was 12.5% for providers’ diagnoses alone, 20.5% for providers’ diagnoses and diabetes medications excluding biguanides, and 21.5% for providers’ diagnoses and diabetes medications including biguanides. The specificity of all three of the alternative methods was >99%. Older patients were more likely to have diabetes not identified. Patients with self-payment, those who had glucose measured or received IV fluids in the ED, and those with more diagnosis codes and medications, were more likely to have diabetes identified. Conclusions NHAMCS's providers’ diagnosis codes and medication lists do not identify the majority of patients with diabetes visiting EDs. The newly introduced checkbox is helpful in measuring ED resource utilization by patients with diabetes. PMID:24680472

  14. 44 CFR 351.26 - The United States Department of Agriculture.

    Science.gov (United States)

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false The United States Department of Agriculture. 351.26 Section 351.26 Emergency Management and Assistance FEDERAL EMERGENCY... PREPAREDNESS Interagency Assignments § 351.26 The United States Department of Agriculture. (a) Assist FEMA in...

  15. Care management in nursing within emergency care units

    Directory of Open Access Journals (Sweden)

    Roberta Juliane Tono de Oliveira

    2015-12-01

    Full Text Available Objective.Understand the conditions involved in the management of nursing care in emergency care units. Methodology. Qualitative research using the methodological framework of the Grounded Theory. Data collection occurred from September 2011 to June 2012 through semi-structured interviews with 20 participants of the two emergency care units in the city of Florianopolis, Brazil. Results. Hindering factors to care management are: lack of experience and knowledge of professionals in emergency services; inadequate number of professionals; work overload of emergency care units in the urgent care network; difficulty in implementing nursing care systematization, and need for team meetings. Facilitating factors are: teamwork; importance of professionals; and confidence of the nursing technicians in the presence of the nurse. Conclusion. Whereas the hindering factors in care management are related to the organizational aspects of the emergency care units in the urgency care network, the facilitating ones include specific aspects of teamwork.

  16. Care management in nursing within emergency care units.

    Science.gov (United States)

    Tono de Oliveira, Roberta Juliane; Vieira Hermida, Patrícia Madalena; da Silva Copelli, Fernanda Hannah; Guedes Dos Santos, José Luís; Lorenzini Erdmann, Alacoque; Regina de Andrade, Selma

    2015-12-01

    Understand the conditions involved in the management of nursing care in emergency care units. Qualitative research using the methodological framework of the Grounded Theory. Data collection occurred from September 2011 to June 2012 through semi-structured interviews with 20 participants of the two emergency care units in the city of Florianopolis, Brazil. Hindering factors to care management are: lack of experience and knowledge of professionals in emergency services; inadequate number of professionals; work overload of emergency care units in the urgent care network; difficulty in implementing nursing care systematization, and need for team meetings. Facilitating factors are: teamwork; importance of professionals; and confidence of the nursing technicians in the presence of the nurse. Whereas the hindering factors in care management are related to the organizational aspects of the emergency care units in the urgency care network, the facilitating ones include specific aspects of teamwork.

  17. TRAINING OF THE STATE PRESIDENT'S UNIT

    African Journals Online (AJOL)

    The primary function of the State President's Unit is to protect the head of state - not his person as is generally believed, but his authority over the state. Ironically, the ceremonial performances of the State President's Unit lead people to believe that they are only capable of doing drill exer- cises. However, upon investigating.

  18. Status of the breeder fuel cycle in the United States

    International Nuclear Information System (INIS)

    Burch, W.D.

    1985-01-01

    This paper reviews the status and plans for the fast reactor fuel cycle in the United States. The United States is undertaking a complete reexamination of its entire breeder program strategy, and the direction of the new program is not yet clear. Studies in progress to examine the associated fuel cycle strategies as they relate to the overall emerging breeder strategy are described. The present status of and recent developments in the fuel cycle R and D programs are summarized

  19. Human prion diseases in the United States.

    Directory of Open Access Journals (Sweden)

    Robert C Holman

    Full Text Available BACKGROUND: Prion diseases are a family of rare, progressive, neurodegenerative disorders that affect humans and animals. The most common form of human prion disease, Creutzfeldt-Jakob disease (CJD, occurs worldwide. Variant CJD (vCJD, a recently emerged human prion disease, is a zoonotic foodborne disorder that occurs almost exclusively in countries with outbreaks of bovine spongiform encephalopathy. This study describes the occurrence and epidemiology of CJD and vCJD in the United States. METHODOLOGY/PRINCIPAL FINDINGS: Analysis of CJD and vCJD deaths using death certificates of US residents for 1979-2006, and those identified through other surveillance mechanisms during 1996-2008. Since CJD is invariably fatal and illness duration is usually less than one year, the CJD incidence is estimated as the death rate. During 1979 through 2006, an estimated 6,917 deaths with CJD as a cause of death were reported in the United States, an annual average of approximately 247 deaths (range 172-304 deaths. The average annual age-adjusted incidence for CJD was 0.97 per 1,000,000 persons. Most (61.8% of the CJD deaths occurred among persons >or=65 years of age for an average annual incidence of 4.8 per 1,000,000 persons in this population. Most deaths were among whites (94.6%; the age-adjusted incidence for whites was 2.7 times higher than that for blacks (1.04 and 0.40, respectively. Three patients who died since 2004 were reported with vCJD; epidemiologic evidence indicated that their infection was acquired outside of the United States. CONCLUSION/SIGNIFICANCE: Surveillance continues to show an annual CJD incidence rate of about 1 case per 1,000,000 persons and marked differences in CJD rates by age and race in the United States. Ongoing surveillance remains important for monitoring the stability of the CJD incidence rates, and detecting occurrences of vCJD and possibly other novel prion diseases in the United States.

  20. Emerging Energy Alternatives for the Southeastern States

    Science.gov (United States)

    Stefanakos, E. K. (Editor)

    1978-01-01

    The proceedings of the first symposium on emerging energy alternatives for the Southeastern States are presented. Some topics discussed are: (1) solar energy, (2) wood energy, (3) novel energy sources, (4) agricultural and industrial process heat, (5) waste utilization, (6) energy conservation and (7) ocean thermal energy conversion.

  1. State of emergency declared for Gran Sasso

    CERN Multimedia

    2003-01-01

    "On June 27th the Council of Ministers has declared the state of socioeconomic and environmental emergency in the territory of L'Aquila and Teramo, the provinces involved in the safety of the Gran Sasso system. The measure includes the INFN Gran Sasso National Laboratories, the high-way tunnels, the environment in general and water in particular" (1 page).

  2. AREVA in the United States

    International Nuclear Information System (INIS)

    2007-01-01

    In 2005, the United States had 297 million inhabitants (the 3. most populous country in the world) and a land area of 9.4 million km 2 (17 times larger than France). With a GDP of 10,996 billion dollars (under the economic conditions of the year 2000), the U.S. is the largest economic power in the world. It is also the largest consumer of energy, with primary energy consumption of 2,329 million metric tons, meaning that 25% of the world's energy is consumed by just 4% of its population. Although it has large domestic energy supplies, the U.S. is very far from achieving energy self-sufficiency. A decline of nearly 50% in oil production over a period of more than 30 years and the simultaneous stagnation of gas production have further weakened the U.S. energy balance. On a more general level, the increasing depletion of hydrocarbon resources (gas and oil), the concentration of the world's main resources in geo-politically unstable areas and the forecasted increase in the consumption and price of hydrocarbons, especially since 2005, mean that energy independence and supply security have become 2 of the top priorities of U.S. commercial and international policy. In 2007, the U.S. accounted for 22% of global CO 2 emissions, equaling those of China. In relation to population, the U.S. emits 8 metric tons/inhabitant compared to a world average of 4.2 metric tons/inhabitant. Although global warming is seen as a reality by the American public, it has only recently become a major argument in favor of a nuclear energy revival in the U.S. The context is, however, changing significantly. This is evidenced by America's adoption, in recent years, of measures to reduce greenhouse gases, particularly through the development of new, more environmentally friendly technologies. Since 2001, nearly 23 billion dollars in public funds have been devoted to climate research and the development of clean energy sources, notably renewable energies such as wind and solar, but also hydrogen and

  3. AREVA in the United States

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2007-07-01

    In 2005, the United States had 297 million inhabitants (the 3. most populous country in the world) and a land area of 9.4 million km{sup 2} (17 times larger than France). With a GDP of 10,996 billion dollars (under the economic conditions of the year 2000), the U.S. is the largest economic power in the world. It is also the largest consumer of energy, with primary energy consumption of 2,329 million metric tons, meaning that 25% of the world's energy is consumed by just 4% of its population. Although it has large domestic energy supplies, the U.S. is very far from achieving energy self-sufficiency. A decline of nearly 50% in oil production over a period of more than 30 years and the simultaneous stagnation of gas production have further weakened the U.S. energy balance. On a more general level, the increasing depletion of hydrocarbon resources (gas and oil), the concentration of the world's main resources in geo-politically unstable areas and the forecasted increase in the consumption and price of hydrocarbons, especially since 2005, mean that energy independence and supply security have become 2 of the top priorities of U.S. commercial and international policy. In 2007, the U.S. accounted for 22% of global CO{sub 2} emissions, equaling those of China. In relation to population, the U.S. emits 8 metric tons/inhabitant compared to a world average of 4.2 metric tons/inhabitant. Although global warming is seen as a reality by the American public, it has only recently become a major argument in favor of a nuclear energy revival in the U.S. The context is, however, changing significantly. This is evidenced by America's adoption, in recent years, of measures to reduce greenhouse gases, particularly through the development of new, more environmentally friendly technologies. Since 2001, nearly 23 billion dollars in public funds have been devoted to climate research and the development of clean energy sources, notably renewable energies such as wind and solar

  4. United States Stateplane Zones - NAD27

    Data.gov (United States)

    Earth Data Analysis Center, University of New Mexico — U.S. State Plane Zones (NAD 1927) represents the State Plane Coordinate System (SPCS) Zones for the 1927 North American Datum within United States.

  5. United States Stateplane Zones - NAD83

    Data.gov (United States)

    Earth Data Analysis Center, University of New Mexico — U.S. State Plane Zones (NAD 1983) represents the State Plane Coordinate System (SPCS) Zones for the 1983 North American Datum within United States.

  6. Death in the United States, 2011

    Science.gov (United States)

    ... Order from the National Technical Information Service NCHS Death in the United States, 2011 Recommend on Facebook ... 2011 SOURCE: National Vital Statistics System, Mortality. Do death rates vary by state? States experience different mortality ...

  7. Data report: western United States

    International Nuclear Information System (INIS)

    Cook, J.R.; Fay, W.M.

    1982-04-01

    This abbreviated summary data report, presents results of ground water and stream surface sediment reconnaissance in the western United States. Surface sediment samples were collected at 67,741 sites, at a target sampling density of one site per 13 square kilometers. Ground water samples were collected at 13,979 sites, and surface water samples were collected at 2,958 sites. Neutron activaton analysis results are given for uranium and 16 other elements in sediments, and for uranium and 9 other elements in waters. Mass spectrometry results are given for helium in ground waters. Supplemental analyses of the sediments for extractable uranium and 22 other elements are given where they are available. Supplemental analyses of water samples for 33 additional elements are also reported where they are available. Analytical data and field measurements are presented in tables on microfiche. Data from ground water sites (on microfiche in pocket) include (1) water chemistry measurements (pH, conductivity, and alkalinity), (2) physical measurements where applicable (water temperature, well description, and scintillometer reading), and (3) elemental analyses (U, Al, Br Cl, Dy, F, Mg, Mn, Na, and V by neutron activation and Ag, Al, As, B, Ba, Be, Ca, Ce, Co, Cr, Cu, Fe, K, Li, Mg, Mn, Mo, Na, Nb, Ni, P, Sc, Se, Si, Sr, Th, Ti, V, Y, Zn, and Zr by spectrophotometry). Helium analyses are given for ground water

  8. State Emergency Department Opioid Guidelines: Current Status.

    Science.gov (United States)

    Broida, Robert I; Gronowski, Tanner; Kalnow, Andrew F; Little, Andrew G; Lloyd, Christopher M

    2017-04-01

    The purpose of this study was to evaluate and categorize current state-sponsored opioid guidelines for the practice of emergency medicine (EM). We conducted a comprehensive search of EM-specific opioid prescribing guidelines and/or policies in each state to determine current state involvement in EM opioid prescribing, as well as to evaluate some of the specifics of each guideline or policy. The search was conducted using an online query and a follow-up email request to each state chapter of ACEP. We found that 17 states had emergency department-specific guidelines. We further organized the guidelines into four categories: limiting prescriptions for opioids with 67 total recommendations; preventing/diverting abuse with 56 total recommendations; addiction-related guidelines with 29 total recommendations; and a community resources section with 24 total recommendations. Our results showed that current state guidelines focus on providers limiting opioid pain prescriptions and vetting patients for possible abuse/diversion. This study highlights the 17 states that have addressed opioid prescribing guidelines and categorizes their efforts to date. It is hoped that this study will provide the basis for similar efforts in other states.

  9. Overcrowding of accident & emergency units: is it a growing concern ...

    African Journals Online (AJOL)

    Overcrowding of accident & emergency units: is it a growing concern in Nigeria? ... of the Nigeria's Accident and Emergency Departments (AED) to meet current ... The data supporting perceptions of insufficient capacity are limited. ... better organized and diligent discharge planning, and reducing access block should be a ...

  10. Emergency War Surgery: Third United States Revision

    Science.gov (United States)

    2004-01-01

    hospitals in the rear. Though one can hope that major strides in these and other areas of trauma resuscitation will be reflected in a future edition, our...more fervent hope is for mankind’s dream of peace and the exercise of his better Angels, … whereby this Handbook becomes altogether unnecessary. Dave... Ostomy Patients: Vent collection bags to avoid excess gas dislodging the bag from the stoma wafer. Use a straight pin to put two holes in the bag

  11. Contemporary United States Foreign Policy Towards Indonesia

    National Research Council Canada - National Science Library

    McAslan, Hugh

    2004-01-01

    United States national interests in Indonesia have traditionally being based on strategic security requirements given Indonesia's geographic location between the Indian and Pacific Oceans, and strong...

  12. Drug Poisoning Mortality by State: United States

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset describes drug poisoning deaths at the U.S. and state level by selected demographic characteristics, and includes age-adjusted death rates for drug...

  13. Financial Viability of Emergency Department Observation Unit Billing Models.

    Science.gov (United States)

    Baugh, Christopher W; Suri, Pawan; Caspers, Christopher G; Granovsky, Michael A; Neal, Keith; Ross, Michael A

    2018-05-16

    Outpatients receive observation services to determine the need for inpatient admission. These services are usually provided without the use of condition-specific protocols and in an unstructured manner, scattered throughout a hospital in areas typically designated for inpatient care. Emergency department observation units (EDOUs) use protocolized care to offer an efficient alternative with shorter lengths of stay, lower costs and higher patient satisfaction. EDOU growth is limited by existing policy barriers that prevent a "two-service" model of separate professional billing for both emergency and observation services. The majority of EDOUs use the "one-service" model, where a single composite professional fee is billed for both emergency and observation services. The financial implications of these models are not well understood. We created a Monte Carlo simulation by building a model that reflects current clinical practice in the United States and uses inputs gathered from the most recently available peer-reviewed literature, national survey and payer data. Using this simulation, we modeled annual staffing costs and payments for professional services under two common models of care in an EDOU. We also modeled cash flows over a continuous range of daily EDOU patient encounters to illustrate the dynamic relationship between costs and revenue over various staffing levels. We estimate the mean (±SD) annual net cash flow to be a net loss of $315,382 ±$89,635 in the one-service model and a net profit of $37,569 ±$359,583 in the two-service model. The two-service model is financially sustainable at daily billable encounters above 20 while in the one-service model, costs exceed revenue regardless of encounter count. Physician cost per hour and daily patient encounters had the most significant impact on model estimates. In the one-service model, EDOU staffing costs exceed payments at all levels of patient encounters, making a hospital subsidy necessary to create a

  14. Toll Facilities in the United States

    Data.gov (United States)

    Department of Transportation — Biennial report containing selected information on toll facilities in the United States that has been provided to FHWA by the States and/or various toll authorities...

  15. UNITED STATES DURING THE COLD WAR 1945-1990

    Directory of Open Access Journals (Sweden)

    Novita Mujiyati

    2016-02-01

    Full Text Available United States and the Soviet Union is a country on the part of allies who emerged as the winner during World War II. However, after reaching the Allied victory in the situation soon changed, man has become an opponent. United States and the Soviet Union are competing to expand the influence and power. To compete the United States strive continuously strengthen itself both in the economic and military by establishing a defense pact and aid agencies in the field of economy. During the Cold War the two are not fighting directly in one of the countries of the former Soviet Union and the United States. However, if understood, teradinya the Korean War and the Vietnam War is a result of tensions between the two countries and is a direct warfare conducted by the United States and the Soviet Union. Cold War ended in conflict with the collapse of the Soviet Union and the United States emerged as the winner of the country.

  16. The United Kingdom: Issues for the United States

    National Research Council Canada - National Science Library

    Archick, Kristin

    2007-01-01

    ...; and more recently, from the UK's strong support in countering terrorism and confronting Iraq. The United States and Britain also share a mutually beneficial trade and economic relationship, and are each other's biggest foreign direct investors...

  17. An environmental assessment of United States drinking water watersheds

    Science.gov (United States)

    James Wickham; Timothy Wade; Kurt Riitters

    2011-01-01

    Abstract There is an emerging recognition that natural lands and their conservation are important elements of a sustainable drinking water infrastructure. We conducted a national, watershed-level environmental assessment of 5,265 drinking water watersheds using data on land cover, hydrography and conservation status. Approximately 78% of the conterminous United States...

  18. Global Entrepreneurship and the United States

    Science.gov (United States)

    2010-09-01

    Global Entrepreneurship and the United States by Zoltan J. Acs Laszlo Szerb Ruxton, MD 21204 for under contract number SBAHQ-09...SUBTITLE Global Entrepreneurship and the United States 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT...3 2.1. Assessing Entrepreneurship ..................................................................................4 2.2. Stages of Development

  19. Immigration Enforcement Within the United States

    Science.gov (United States)

    2006-04-06

    Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Policy Issues...Remained in the United States, (Washington: Center for Immigration Studies, May 2002). Immigration Enforcement Within the United States Introduction ...interior enforcement lack a border component. For example, fugitive taskforces, investigations of alien slavery and sweatshops , and employer sanctions do

  20. 75 FR 25925 - United States Mint

    Science.gov (United States)

    2010-05-10

    ... Committee May 25, 2010 Public Meeting. SUMMARY: Pursuant to United States Code, Title 31, section 5135(b)(8... scheduled for May 25, 2010. Date: May 25, 2010. Time: 9 a.m. to 12 p.m. Location: 8th Floor Board Room, United States Mint, 801 9th Street, NW., Washington, DC 20220. Subject: Review and discuss obverse and...

  1. Latino College Completion: United States

    Science.gov (United States)

    Excelencia in Education (NJ1), 2012

    2012-01-01

    In 2009, Excelencia in Education launched the Ensuring America's Future initiative to inform, organize, and engage leaders in a tactical plan to increase Latino college completion. An executive summary of Latino College Completion in 50 states synthesizes information on 50 state factsheets and builds on the national benchmarking guide. Each…

  2. Climatography of the United States

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Numbered series of NOAA publications that contain environmental information climate summaries and station normals. Each series contains a volume for each state,...

  3. The United States of America

    International Nuclear Information System (INIS)

    Taylor, J.J.

    1987-01-01

    The development of nuclear power in the USA is recounted. Starting with the making of the nuclear bomb during the Second World War, the next phase (1947-1954) was the development of the peaceful atom. The commercial origins of the nuclear electric power demonstration programme during 1954-1961 are recalled. The years 1961-1968 saw the building of Westinghouse pressurized water reactors both in the USA and overseas. 1968-1975 saw the construction and operation of more nuclear power plants and the development of a regulatory framework. However, problems also began to emerge in this period; licensing changes and delays, construction delays, equipment modifications, escalating costs, public hearing and legal delays and reliability issues. These led in 1975-1979 to a cessation of growth and increased public opposition. The accidents at the Three Mile Island nuclear power plant in 1979 and Chernobyl in 1986 and their impacts are discussed. (U.K.)

  4. Nuclear development in the United States

    International Nuclear Information System (INIS)

    Brewer, S.

    1983-01-01

    The history of the nuclear development in the United States has been one of international cooperation relations so far. The United States is to offer the technical information on atomic energy utilization to foreign countries in exchange for the guarantee that they never attempt to have or develop nuclear weapons. Actually, the United States has supplied the technologies on nuclear fuel cycle and other related fields to enable other countries to achieve economical and social progress. The Department of Energy clarified the public promise of the United States regarding the idea of international energy community. The ratio of nuclear power generation to total electric power supply in the United States exceeded 12%, and will exceed 20% by 1990. Since 1978, new nuclear power station has not been ordered, and some of the contracted power stations were canceled. The atomic energy industry in the United States prospered at the beginning of 1970s, but lost the spirit now, mainly due to the institutional problems rather than the technical ones. As the policy of the government to eliminate the obstacles, the improvement of the procedure for the permission and approval, the establishment of waste disposal capability, the verification of fast breeder reactor technology and the promotion of commercial fuel reprocessing were proposed. The re-establishment of the United States as the reliable supplier of atomic energy service is the final aim. (Kako, I.)

  5. Household pesticide usage in the United States.

    Science.gov (United States)

    Savage, E P; Keefe, T J; Wheeler, H W; Mounce, L; Helwic, L; Applehans, F; Goes, E; Goes, T; Mihlan, G; Rench, J; Taylor, D K

    1981-01-01

    A total of 10,000 U.S. households in 25 standard metropolitan statistical areas and 25 counties were included in the United States. More than 8,200 households granted an interview. Nine of every ten households in the United States used some types of pesticide in their house, garden, or yard. Households in the southeastern United States used the most pesticides. Although more than 500 different pesticide formulations were used by the sampled households, 15 pesticides accounted for 65.5% of all pesticides reported in this study. Thirteen of these 15 pesticides were insecticides, one was a herbicide, and one was a rodenticide.

  6. HCUP State Emergency Department Databases (SEDD) - Restricted Access File

    Data.gov (United States)

    U.S. Department of Health & Human Services — The State Emergency Department Databases (SEDD) contain the universe of emergency department visits in participating States. Restricted access data files are...

  7. Substance misuse in youth admitted to a psychiatric emergency unit ...

    African Journals Online (AJOL)

    , A J Flisher, R Allin, J A Laubscher. Abstract. Objectives. To investigate the pattern of substance misuse in youth admitted to a psychiatric emergency unit of a 'major hospital, and to compare regular users of cannabis,methaqualone and ...

  8. [The nurse within emergency medical-psychological units].

    Science.gov (United States)

    Darbon, Rémy; Dalphin, Catherine; Prieto, Nathalie; Cheucle, Éric

    2017-04-01

    The growing recognition of post-traumatic stress disorders and the need to intervene early justifies the creation of emergency medical-psychological units. The nurse has a major role to play within these teams. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  9. Electric trade in the United States, 1996

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-12-01

    Wholesale trade in electricity plays an important role for the US electric utility industry. Wholesale, or bulk power, transactions allow electric utilities to reduce power costs, increase power supply options, and improve reliability. In 1996, the wholesale trade market totaled 2.3 trillion kilowatthours, over 73% of total sales to ultimate consumers. This publication, Electric Trade in the United States 1996 (ELECTRA), is the sixth in a series of reports on wholesale power transactions prepared by the Office of Coal, Nuclear, Electric and Alternate Fuels, Energy Information Administration (EIA). The electric trade data are published biennially. The first report presented 1986 data, and this report provides information on the electric power industry during 1996. The electric trade data collected and presented in this report furnish important information on the wholesale structure found within the US electric power industry. The patterns of interutility trade in the report support analyses of wholesale power transactions and provide input for a broader understanding of bulk power market issues that define the emerging national electric energy policies. The report includes information on the quantity of power purchased, sold, exchanged, and wheeled; the geographical locations of transactions and ownership classes involved; and the revenues and costs. 1 fig., 43 tabs.

  10. 2011 floods of the central United States

    Science.gov (United States)

    ,

    2013-01-01

    The Central United States experienced record-setting flooding during 2011, with floods that extended from headwater streams in the Rocky Mountains, to transboundary rivers in the upper Midwest and Northern Plains, to the deep and wide sand-bedded lower Mississippi River. The U.S. Geological Survey (USGS), as part of its mission, collected extensive information during and in the aftermath of the 2011 floods to support scientific analysis of the origins and consequences of extreme floods. The information collected for the 2011 floods, combined with decades of past data, enables scientists and engineers from the USGS to provide syntheses and scientific analyses to inform emergency managers, planners, and policy makers about life-safety, economic, and environmental-health issues surrounding flood hazards for the 2011 floods and future floods like it. USGS data, information, and scientific analyses provide context and understanding of the effect of floods on complex societal issues such as ecosystem and human health, flood-plain management, climate-change adaptation, economic security, and the associated policies enacted for mitigation. Among the largest societal questions is "How do we balance agricultural, economic, life-safety, and environmental needs in and along our rivers?" To address this issue, many scientific questions have to be answered including the following: * How do the 2011 weather and flood conditions compare to the past weather and flood conditions and what can we reasonably expect in the future for flood magnitudes?

  11. Inching toward incrementalism: federalism, devolution, and health policy in the United States and the United Kingdom.

    Science.gov (United States)

    Sparer, Michael S; France, George; Clinton, Chelsea

    2011-02-01

    In the United States, the recently enacted Patient Protection and Affordable Care Act of 2010 envisions a significant increase in federal oversight over the nation's health care system. At the same time, however, the legislation requires the states to play key roles in every aspect of the reform agenda (such as expanding Medicaid programs, creating insurance exchanges, and working with providers on delivery system reforms). The complicated intergovernmental partnerships that govern the nation's fragmented and decentralized system are likely to continue, albeit with greater federal oversight and control. But what about intergovernmental relations in the United Kingdom? What impact did the formal devolution of power in 1999 to Scotland, Wales, and Northern Ireland have on health policy in those nations, and in the United Kingdom more generally? Has devolution begun a political process in which health policy in the United Kingdom will, over time, become increasingly decentralized and fragmented, or will this "state of unions" retain its long-standing reputation as perhaps the most centralized of the European nations? In this article, we explore the federalist and intergovernmental implications of recent reforms in the United States and the United Kingdom, and we put forward the argument that political fragmentation (long-standing in the United States and just emerging in the United Kingdom) produces new intergovernmental partnerships that, in turn, produce incremental growth in overall government involvement in the health care arena. This is the impact of what can be called catalytic federalism.

  12. A functional intranet for the United States Coast Guard Unit

    OpenAIRE

    Hannah, Robert Todd.

    1998-01-01

    Approved for public release; distribution in unlimited. This thesis describes the complete development process of a friendly functional Intranet for an operational United States Coast Guard (USCG) electronic Support Unit (ESU) in Alameda, California. The final product is suitable for immediate use. It may also be used as a prototype for future Intranet development efforts. The methodology used to develop a finished, working product provides the core subject matter for this thesis. The disc...

  13. Analysis of United States' Broadband Policy

    National Research Council Canada - National Science Library

    Uzarski, Joel S

    2007-01-01

    .... With every month that passes, the United States fails to close the gap in the digital divide both inside its borders as well as among the other countries that lead the world in broadband penetration...

  14. 2012 United States Automatic Identification System Database

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The 2012 United States Automatic Identification System Database contains vessel traffic data for planning purposes within the U.S. coastal waters. The database is...

  15. 2014 United States Automatic Identification System Database

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The 2014 United States Automatic Identification System Database contains vessel traffic data for planning purposes within the U.S. coastal waters. The database is...

  16. Health, United States, 2012: Men's Health

    Science.gov (United States)

    ... Mailing List Previous Reports Suggested Citation Related Sites Purchase Health, United States Behavioral Health Report Children’s ... with Internet Explorer may experience difficulties in directly accessing links to Excel files ...

  17. Improving the United States' Strategic Communication Strategy

    National Research Council Canada - National Science Library

    Risberg, Robert H

    2008-01-01

    ...? Much of the answer to this question is the failure of the United States Government to effectively use strategic communication to inform and influence populations to recognize the value of American...

  18. United States Interagency Elevation Inventory (USIEI)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The U.S. Interagency Elevation Inventory displays high-accuracy topographic and bathymetric data for the United States and its territories. The project is a...

  19. 2009 United States Automatic Identification System Database

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The 2009 United States Automatic Identification System Database contains vessel traffic data for planning purposes within the U.S. coastal waters. The database is...

  20. NCHS - Leading Causes of Death: United States

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset presents the age-adjusted death rates for the 10 leading causes of death in the United States beginning in 1999. Data are based on information from all...

  1. The United States and Europe: Current Issues

    National Research Council Canada - National Science Library

    Archick, Kristin; Morelli, Vince L

    2006-01-01

    The United States and Europe share a long and intertwined history. Both sides of the Atlantic face a common set of international concerns, have few other comparable partners, and share a deep economic relationship...

  2. Dengue Fever in the United States

    Centers for Disease Control (CDC) Podcasts

    Dr. Amesh Adalja, an associate at the Center for Biosecurity and clinical assistant professor at the University of Pittsburgh School, of Medicine, discusses dengue fever outbreaks in the United States.

  3. Climate change indicators in the United States

    Science.gov (United States)

    2010-04-01

    The U.S. Environmental Protection Agency (EPA) has published this report, Climate Change Indicators in the United States, to help readers interpret a set of important indicators to better understand climate change. The report presents 24 indicators, ...

  4. Surveillance for Viral Hepatitis - United States, 2014

    Science.gov (United States)

    ... Resource Center Anonymous Feedback Viral Hepatitis Surveillance for Viral Hepatitis – United States, 2014 Recommend on Facebook Tweet Share ... Cases Hepatitis A Hepatitis B Hepatitis C Discussion Hepatitis A virus Index PAGE DESCRIPTION Table 2.1 Reported ...

  5. 2010 United States Automatic Identification System Database

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The 2010 United States Automatic Identification System Database contains vessel traffic data for planning purposes within the U.S. coastal waters. The database is...

  6. 2011 United States Automatic Identification System Database

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The 2011 United States Automatic Identification System Database contains vessel traffic data for planning purposes within the U.S. coastal waters. The database is...

  7. United States housing, first quarter 2013

    Science.gov (United States)

    Delton Alderman

    2014-01-01

    Provides current and historical information on housing market in the United States. Information includes trends for housing permits and starts, housing under construction, and housing completions for single and multifamily units, and sales and construction. This report will be updated regularly.

  8. Regulatory practices - United States example

    International Nuclear Information System (INIS)

    Shapar, M.

    1976-01-01

    In 1954, the Atomic Energy Act of 1946 was revised to do away with the federal state monopoly in this field and to enable private industry to develop nuclear power. This evolution led the federal authorities to give the Atomic Energy Commission the powers to control the design, licensing and operation of nuclear reactors. These powers were constantly strengthened and are now exercised by the Nuclear Regulatory Commission (NRC). Since its creation in 1975, the Commission has amended the regulations on licensing of nuclear reactors in the light of experience acquired so as to shorten the duration of this procedure. These amendments concern the standardization of nuclear power plants, limited work authorizations, the methods for issuing licenses. The objective of the Commission aim to make the licensing procedure for nuclear power plants simpler and more efficient and hence, less costly, while ensuring that a very high level for safety standards and environmental protection is maintained. (NEA) [fr

  9. Energy problems of the United States

    International Nuclear Information System (INIS)

    Pertuzio, A.

    2006-01-01

    The united states are the third world producer of oil which accounts for 440% of world production and 20 million barrels/day of which 60% are imported. That dependence on imports is likely to increase in the next decades. Such supplies and their security are therefore a fundamental factor of the United States foreign policy in combination with their political, economic and strategic objectives in a world both unsure and dangerous

  10. Trial by jury in the United States

    Directory of Open Access Journals (Sweden)

    Lochhead Robert

    2015-10-01

    Full Text Available Th e Republic of Moldova is considering the adoption of trial by jury in select criminal cases. Th e following article is intended to contribute to the discussion of that proposal. Th e article will briefl y describe the history of juries under the English common law and as adopted by the United States. It will then outline some of the basic procedures in trials by jury as currently practiced in the United States federal court system.

  11. Oil and Gas Emergency Policy: United Kingdom 2010 update

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    This publication provides a detailed look at the specific systems in the United Kingdom for responding to an oil supply crisis. In 2007, the IEA published ''Oil Supply Security: Emergency Response of IEA Countries''. Rather than waiting for the completion of the current review cycle to renew this full publication, the IEA will provide updates to the country chapters as these become available following the specific country's review. The aim of series of publications is to provide an overview of the IEA oil emergency response system and a detailed look at the specific systems in each IEA country for responding to an oil supply crisis. The 2007 publication represented the findings of a five year review cycle of the emergency response mechanisms in IEA member countries. Since the 2007 publication, the IEA has started a new cycle of reviews which now includes reviewing gas emergency policies.

  12. Southern states radiological emergency response laws and regulations

    International Nuclear Information System (INIS)

    1990-06-01

    The purpose of this report is to provide a summary of the emergency response laws and regulations in place in the various states within the southern region for use by legislators, emergency response planners, the general public and all persons concerned about the existing legal framework for emergency response. SSEB expects to periodically update the report as necessary. Radiation protection regulations without emergency response provisions are not included in the summary. The radiological emergency response laws and regulations of the Southern States Energy Compact member states are in some cases disparate. Several states have very specific laws on radiological emergency response while in others, the statutory law mentions only emergency response to ''natural disasters.'' Some states have adopted extensive regulations on the topic, others have none. For this reason, any general overview must necessarily discuss laws and regulations in general terms. State-by-state breakdowns are given for specific states

  13. Estimated United States Transportation Energy Use 2005

    Energy Technology Data Exchange (ETDEWEB)

    Smith, C A; Simon, A J; Belles, R D

    2011-11-09

    A flow chart depicting energy flow in the transportation sector of the United States economy in 2005 has been constructed from publicly available data and estimates of national energy use patterns. Approximately 31,000 trillion British Thermal Units (trBTUs) of energy were used throughout the United States in transportation activities. Vehicles used in these activities include automobiles, motorcycles, trucks, buses, airplanes, rail, and ships. The transportation sector is powered primarily by petroleum-derived fuels (gasoline, diesel and jet fuel). Biomass-derived fuels, electricity and natural gas-derived fuels are also used. The flow patterns represent a comprehensive systems view of energy used within the transportation sector.

  14. Universality of emergent states in diverse physical systems

    Science.gov (United States)

    Guidry, Mike

    2017-12-01

    Our physics textbooks are dominated by examples of simple weakly-interacting microscopic states, but most of the real world around us is most effectively described in terms of emergent states that have no clear connection to simple textbook states. Emergent states are strongly-correlated and dominated by properties that emerge as a consequence of interactions and are not part of the description of the corresponding weakly-interacting system. This paper proposes a connection of weakly-interacting textbook states and realistic emergent states through fermion dynamical symmetries having fully-microscopic generators of the emergent states. These imply unique truncation of the Hilbert space for the weakly-interacting system to a collective subspace where the emergent states live. Universality arises because the possible symmetries under commutation of generators, which transcend the microscopic structure of the generators, are highly restricted in character and determine the basic structure of the emergent state, with the microscopic structure of the generators influencing emergent state only parametrically. In support of this idea we show explicit evidence that high-temperature superconductors, collective states in heavy atomic nuclei, and graphene quantum Hall states in strong magnetic fields exhibit a near-universal emergent behavior in their microscopically-computed total energy surfaces, even though these systems share essentially nothing in common at the microscopic level and their emergent states are characterized by fundamentally different order parameters.

  15. 76 FR 38700 - United States, et al.

    Science.gov (United States)

    2011-07-01

    ... prices in advertisements, in-store displays, and online. Consumer World believes these rules should be... has ruled on that motion. I. Procedural History The United States and seven Plaintiff States filed the... Restraints result in higher merchant costs, and merchants generally pass costs on to consumers, retail prices...

  16. Noise exposure during prehospital emergency physicians work on Mobile Emergency Care Units and Helicopter Emergency Medical Services

    DEFF Research Database (Denmark)

    Hansen, Mads Christian Tofte; Schmidt, Jesper Hvass; Brøchner, Anne C

    2017-01-01

    BACKGROUND: Prehospital personnel are at risk of occupational hearing loss due to high noise exposure. The aim of the study was to establish an overview of noise exposure during emergency responses in Mobile Emergency Care Units (MECU), ambulances and Helicopter Emergency Medical Services (HEMS)....... initiatives. Although no hearing loss was demonstrated in the personnel of the ground-based units, a reduced function of the outer sensory hair cells was found in the HEMS group following missions.......BACKGROUND: Prehospital personnel are at risk of occupational hearing loss due to high noise exposure. The aim of the study was to establish an overview of noise exposure during emergency responses in Mobile Emergency Care Units (MECU), ambulances and Helicopter Emergency Medical Services (HEMS......). A second objective was to identify any occupational hearing loss amongst prehospital personnel. METHODS: Noise exposure during work in the MECU and HEMS was measured using miniature microphones worn laterally to the auditory canals or within the earmuffs of the helmet. All recorded sounds were analysed...

  17. Exporting Rambutan to United States: One Reality?

    International Nuclear Information System (INIS)

    Ahmad Zainuri Mohd Dzomir; Zainon Othman; Mohd Sidek Othman

    2011-01-01

    Rambutan is a one of commodity that are passed by United States of America authority to be market in that states. The main condition for the approval is the exporter must use irradiation technology as quarantine treatment to monitor the insects in there. United States of America's Agriculture Department (USDA-APHIS) has make early survey to the facilities involved in exporting process chain to overview Malaysia preparedness for this purpose. This paper work will discussed the possibility of this exporting implemented based on conditions rule by the USDA. (author)

  18. Assessing subject privacy and data confidentiality in an emerging region for clinical trials: United Arab Emirates.

    Science.gov (United States)

    Nair, Satish Chandrasekhar; Ibrahim, Halah

    2015-01-01

    Pharmaceutical sponsored clinical trials, formerly conducted predominantly in the United States and Europe, have expanded to emerging regions, including the Middle East. Our study explores factors influencing clinical trial privacy and confidentiality in the United Arab Emirates. Factors including concept familiarity, informed consent compliance, data access, and preservation, were analyzed to assess current practices in the Arab world. As the UAE is an emerging region for clinical trials, there is a growing need for regulations related to data confidentiality and subject privacy. Informational and decisional privacy should be viewed within the realms of Arab culture and religious background.

  19. Radiation therapy facilities in the United States

    International Nuclear Information System (INIS)

    Ballas, Leslie K.; Elkin, Elena B.; Schrag, Deborah; Minsky, Bruce D.; Bach, Peter B.

    2006-01-01

    Purpose: About half of all cancer patients in the United States receive radiation therapy as a part of their cancer treatment. Little is known, however, about the facilities that currently deliver external beam radiation. Our goal was to construct a comprehensive database of all radiation therapy facilities in the United States that can be used for future health services research in radiation oncology. Methods and Materials: From each state's health department we obtained a list of all facilities that have a linear accelerator or provide radiation therapy. We merged these state lists with information from the American Hospital Association (AHA), as well as 2 organizations that audit the accuracy of radiation machines: the Radiologic Physics Center (RPC) and Radiation Dosimetry Services (RDS). The comprehensive database included all unique facilities listed in 1 or more of the 4 sources. Results: We identified 2,246 radiation therapy facilities operating in the United States as of 2004-2005. Of these, 448 (20%) facilities were identified through state health department records alone and were not listed in any other data source. Conclusions: Determining the location of the 2,246 radiation facilities in the United States is a first step in providing important information to radiation oncologists and policymakers concerned with access to radiation therapy services, the distribution of health care resources, and the quality of cancer care

  20. Commercial landscape of noninvasive prenatal testing in the United States.

    Science.gov (United States)

    Agarwal, Ashwin; Sayres, Lauren C; Cho, Mildred K; Cook-Deegan, Robert; Chandrasekharan, Subhashini

    2013-06-01

    Cell-free fetal DNA-based noninvasive prenatal testing (NIPT) could significantly change the paradigm of prenatal testing and screening. Intellectual property (IP) and commercialization promise to be important components of the emerging debate about clinical implementation of these technologies. We have assembled information about types of testing, prices, turnaround times, and reimbursement of recently launched commercial tests in the United States from the trade press, news articles, and scientific, legal, and business publications. We also describe the patenting and licensing landscape of technologies underlying these tests and ongoing patent litigation in the United States. Finally, we discuss how IP issues may affect clinical translation of NIPT and their potential implications for stakeholders. Fetal medicine professionals (clinicians and researchers), genetic counselors, insurers, regulators, test developers, and patients may be able to use this information to make informed decisions about clinical implementation of current and emerging noninvasive prenatal tests. © 2013 John Wiley & Sons, Ltd.

  1. Nuclear power in the United States

    International Nuclear Information System (INIS)

    Johnston, J.B.

    1985-01-01

    All over the world except in the United States, nuclear energy is a low cost, secure, environmentally acceptable form of energy. In the United States, civilian nuclear power is dead. 112 nuclear power plants have been abandoned or cancelled in the last decade, and there has been no new order for nuclear plants since 1978. It will be fortunate to have 125 operating nuclear plants in the United States in the year 2000. There are almost 90 completed nuclear power plants and about 45 under construction in the United States, but several of those under construction will eventually be abandoned. About 20 % of the electricity in the United States will be generated by nuclear plants in 2000 as compared with 13 % supplied in the last year. Under the present regulatory and institutional arrangement, American electric utilities would not consider to order a new nuclear power plant. Post-TMI nuclear plants became very expensive, and there is also ideological opposition to nuclear power. Coal-firing plants are also in the similar situation. The uncertainty about electric power demand, the cost of money, the inflation of construction cost and regulation caused the situation. (Kako, I.)

  2. Application of Prognostic Mesoscale Modeling in the Southeast United States

    International Nuclear Information System (INIS)

    Buckley, R.L.

    1999-01-01

    A prognostic model is being used to provide regional forecasts for a variety of applications at the Savannah River Site (SRS). Emergency response dispersion models available at SRS use the space and time-dependent meteorological data provided by this model to supplement local and regional observations. Output from the model is also used locally to aid in forecasting at SRS, and regionally in providing forecasts of the potential time and location of hurricane landfall within the southeast United States

  3. Child Labor Trafficking in the United States: A Hidden Crime

    OpenAIRE

    Kaufka Walts, Katherine

    2017-01-01

    Emerging research brings more attention to labor trafficking in the United States. However, very few efforts have been made to better understand or respond to labor trafficking of minors. Cases of children forced to work as domestic servants, in factories, restaurants, peddling candy or other goods, or on farms may not automatically elicit suspicion from an outside observer as compared to a child providing sexual services for money. In contrast to sex trafficking, labor trafficking is often t...

  4. Monitoring water for radioactive releases in the United States

    International Nuclear Information System (INIS)

    Porter, C.R.; Broadway, J.A.; Kahn, B.

    1990-01-01

    The major radiological environmental monitoring programs for water in the United States are described. The applications of these programs for monitoring radioactive fallout, routine discharges from nuclear facilities, and releases due to accidents at such facilities are discussed, and some examples of measurements are presented. The programs monitor rainfall, surface water, and water supplies. Samples are usually collected and analyzed on a monthly or quarterly schedule, but the frequency is increased in response to emergencies. (author)

  5. Geothermal power generation in the United States 1985 through 1989

    International Nuclear Information System (INIS)

    Rannels, J.E.; McLarty, L.

    1990-01-01

    The United States has used geothermal energy for the production of electricity since 1960 and has the largest installed capacity of any country in the world. During the 1980s, expansion at The Geysers and emergence of the hot water segment of the industry fueled explosive growth in generating capacity. In this paper geothermal development in the U.S. during the second half of the decade is reviewed, and development over the next five years is forecast

  6. United states technical and social programs for Chornobyl and Slavutych

    International Nuclear Information System (INIS)

    Terner, D.

    2002-01-01

    Major United States initiatives for Chornobyl and Slavutych: Slavutych division of the International Chornobyl Center; international radioecology laboratory; nuclear, fire and workers safety upgrade at Chornobyl nuclear power plant; Chornobyl closure; Ukraine off-site training and emergency center; Slavutych-Richland community partnership program; employment transition services and economic development; Slavutych energy efficiency program; Slavutych business incubator; Chornobyl management interactions with hanford site; humanitarian assistance for Slavutych

  7. Southern states radiological emergency response laws and regulations

    International Nuclear Information System (INIS)

    1989-02-01

    The radiological emergency response laws and regulations of the Southern States Energy Compact member states are in some cases disparate. Several states have very specific laws on radiological emergency response while in others, the statutory law mentions only emergency response to ''natural disasters.'' Some states have adopted extensive regulations on the topic; others have none. For this reason, any general overview must necessarily discuss laws and regulations in general terms

  8. Fragmentation of Continental United States Forests

    Science.gov (United States)

    Kurt H. Riitters; James D. Wickham; Robert V. O' Neill; K. Bruce Jones; Elizabeth R. Smith; John W. Coulston; Timothy G. Wade; Jonathan H. Smith

    2002-01-01

    We report a multiple-scale analysis of forest fragmentation based on 30-m (0.09 ha pixel-1) land- cover maps for the conterminous United States. Each 0.09-ha unit of forest was classified according to fragmentation indexes measured within the surrounding landscape, for five landscape sizes including 2.25, 7.29, 65.61, 590.49, and 5314.41 ha....

  9. Toll Facilities in the United States - Toll Facilities in the United States

    Data.gov (United States)

    Department of Transportation — Biennial report containing selected information on toll facilities in the United States that has been provided to FHWA by the States and/or various toll authorities...

  10. Understanding human trafficking in the United States.

    Science.gov (United States)

    Logan, T K; Walker, Robert; Hunt, Gretchen

    2009-01-01

    The topic of modern-day slavery or human trafficking has received increased media and national attention. However, to date there has been limited research on the nature and scope of human trafficking in the United States. This article describes and synthesizes nine reports that assess the U.S. service organizations' legal representative knowledge of, and experience with, human trafficking cases, as well as information from actual cases and media reports. This article has five main goals: (a) to define what human trafficking is, and is not; (b) to describe factors identified as contributing to vulnerability to being trafficked and keeping a person entrapped in the situation; (c) to examine how the crime of human trafficking differs from other kinds of crimes in the United States; (d) to explore how human trafficking victims are identified; and, (e) to provide recommendations to better address human trafficking in the United States.

  11. Emergency rescue in accidents with HDR afterloading units

    International Nuclear Information System (INIS)

    Kaulich, T.W.; Nuesslin, F.; Becker, G.; Lamprecht, U.; Bamberg, M.

    1999-01-01

    Problem: HDR brachyradiotherapy has minimized the exposure to radiation of the personnel working in this field. Nonetheless there are periodically reported troubles with afterloading units concerning the retraction of sources that require immediate action for the limitation of possible damage. Legal Principles according to the German Regulation Concerning Protection against Radiation (Strahlenschutzverordnung=StrlSchV): If in afterloading brachyradiotherapy the radiation source remains extended through malfunction we deal with an emergency according to the StrlSchV. The rescue personnel should be chosen in accordance with Paragraph 50 StrlSchV. Organization of the Rescue of the Patient: The quickest possible rescue of a patient in an emergency demands an unequivocal definition of responsibilities. Our recommendations in this instance: The physicist is responsible for the organization of the emergency rescue. The radiation oncologist in charge informs himself about the necessary emergency measures before starting the treatment and carries out the emergency rescue. If the physicist diagnoses a failure in the retraction of the source he tries to remove the failure. If he doesn't succeed in retracting the source the radiation oncologist carries out the rescue of the patient. The organizational structure of the clinic allowing, the emergency physician should invariably be the physician who placed the applicator. In the emergency rescue the radiation oncologist should be protected by a lead barrier and use manipulators. Dose Assessment in Personnel and Patient: The radiation exposure of the rescue personnel is calculated from the photon-equivalence dose H x with the help of the dose-rate constant of 192 Ir. According to the same procedure there can be evaluated the local radiation exposure of the patient concerned. Conclusions: Generally speaking, all considerations regarding the topic of emergency rescue should always start out from a worst-case scenario. Of all the

  12. Enrichment situation outside the United States

    International Nuclear Information System (INIS)

    Anon.

    1979-01-01

    Different enrichment technologies are briefly characterized which include gaseous diffusion, which is presently the production mainstay of the United States and France; the gaseous centrifuge which is the production plant for Urenco and the technology for future United States enrichment expansion; the aero-dynamic processes which include the jet nozzle (also known as the Becker process) and the fixed-wall centrifuge (also known as the Helikon process); chemical processes; laser isotope separation processes (also referred to in the literature as LIS); and plasma technology

  13. Solar energy in the United States

    International Nuclear Information System (INIS)

    Ochoa, D.; Slaoui, A.; Soler, R.; Bermudez, V.

    2009-01-01

    Written by a group of five French experts who visited several research centres, innovating companies and solar power stations in the United States, this report first proposes an overview of solar energy in the United States, indicating and commenting the respective shares of different renewable energies in the production, focusing on the photovoltaic energy production and its RD sector. The second part presents industrial and research activities in the solar sector, and more specifically photovoltaic technologies (silicon and thin layer technology) and solar concentrators (thermal solar concentrators, photovoltaic concentrators). The last chapter presents the academic research activities in different universities (California Tech Beckman Institute, Stanford, National Renewable Energy Laboratory, Colorado School of Mines)

  14. Food irradiation in the United States

    International Nuclear Information System (INIS)

    Pauli, G.H.

    1991-01-01

    Since 1963, some irradiated foods have been permitted for sale in the United States. Yet, at this time, commercial application has been limited to irradiation of a relatively small fraction of the spices and seasonings used as ingredients in other foods. The current situation regarding irradiated foods in the United States and how it developed is discussed. The author writes from experience gained as a Government regulator concerned primarily with ensuring safety of food and therefore this is stressed together with the crucial role played by consumers and industry. (author)

  15. Employers mexican migrants in the United States

    Directory of Open Access Journals (Sweden)

    Eduardo Fernández Guzmán

    2013-09-01

    Full Text Available You might think that by definition the migrant labor plays in less profitable niches and meager social mobility. However, a large group of migrants in different economically developed countries have successfully launched businesses of diverse nature and volume. This is why entrepreneurship of migrants is an issue that has received increasing attention in recent years. Compared to other immigrant groups in the United States, Mexicans show low levels of entrepreneurial activity. The aim of this paper is to, through a general literature review of official statistical data, a preliminary analysis of mexican migrant entrepreneurship in the United States, that is to say in recent years has been growing in importance.

  16. 31 CFR 596.313 - United States person.

    Science.gov (United States)

    2010-07-01

    ... FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY TERRORISM LIST GOVERNMENTS SANCTIONS REGULATIONS General Definitions § 596.313 United States person. The term United States person means any United States...

  17. Obesity: A United States Strategic Imperative

    Science.gov (United States)

    2013-04-01

    States Department of Veterans Affairs 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS(ES) Dr. Thomas ...Army Ms. Karen Malebranche United States Department of Veterans Affairs Project Adviser Dr. Thomas Williams U.S. Army War...per American has increased by 57 pounds per year ( poultry representing 46 pounds).86 Surprisingly however, the percentage of calories from meat

  18. THE UNITED STATES AND NIGERIAN RELATIONS:

    African Journals Online (AJOL)

    Mrs. I.D

    2009-12-25

    Dec 25, 2009 ... response from the Nigerian government. ... domestic crises that negatively impacts state stability, the US government ... Harrison C. Ajebon, Department of Political Science, University of Calabar, ..... Sweden. United Kingdom. Switzerland. Asia & far East. Japan ..... case Study of Nigeria, in Ikonnechidi and.

  19. Fragmentation of eastern United States forest types

    Science.gov (United States)

    Kurt H. Riitters; John W. Coulston

    2013-01-01

    Fragmentation is a continuing threat to the sustainability of forests in the Eastern United States, where land use changes supporting a growing human population are the primary driver of forest fragmentation (Stein and others 2009). While once mostly forested, approximately 40 percent of the original forest area has been converted to other land uses, and most of the...

  20. Nuclear accidents. Three mile Island (United States)

    International Nuclear Information System (INIS)

    Duco, J.

    2004-01-01

    This paper describes the accident of Three Miles Island power plant which occurred the 28 march 1979 in the United States. The accident scenario, the consequences and the reactor core and vessel, after the accident, are analyzed. (A.L.B.)

  1. Energy policy in the United States

    Energy Technology Data Exchange (ETDEWEB)

    McCormack, M

    1978-06-01

    Energy policy in the United States is examined with particular regard to the nuclear power industry. The advantages of nuclear power over conventional and other sources are presented and the vigorous expansion of research and development is advocated. Future energy supplies are discussed and the author stresses the necessity for continued research into breeder technology.

  2. Political initiative needed in the United States

    International Nuclear Information System (INIS)

    Hollister, K.

    1979-01-01

    The financing of nuclear power stations in the United States is in trouble mainly because of the long lead times caused by licensing. It will again become feasible when legislation reduces the construction time to eight years or less. The overriding need to protect the dollar by reducing oil imports, will lead the US Government to embrace nuclear power openly. (U.K.)

  3. Motorcycle trends in the United States

    Science.gov (United States)

    2009-05-01

    During the last decade there has been a significant increase in the number of motorcycle sales and registrations in the United States. At the same time there has been a shift in the demographics of motorcycle users and increased focus on motorcycle s...

  4. Social science findings in the United States

    Science.gov (United States)

    Sarah McCaffrey; Eric Toman; Melanie Stidham; Bruce. Shindler

    2015-01-01

    The rising number of acres burned annually and growing number of people living in or adjacent to fire-prone areas in the United States make wildfire management an increasingly complex and challenging problem. Given the prominence of social issues in shaping the current challenges and determining paths forward, it will be important to have an accurate understanding of...

  5. 76 FR 18783 - United States et al.

    Science.gov (United States)

    2011-04-05

    ... customers based on existing supplier-customer relationships. d. Neither Supply Responses Nor Entry Would... Final Judgment, Stipulation and Competitive Impact Statement Notice is hereby given pursuant to the... Competitive Impact Statement have been filed with the United States District Court for the Eastern District of...

  6. Overview of United States synchrotron radiation facilities

    International Nuclear Information System (INIS)

    Watson, R.E.

    1983-01-01

    There has been considerable activity within the past year involving the creation of new and the improvement of existing capabilities for research with synchrotron light. The purpose of this review is to summarize what has happened within the United States. Being a status report, some of the information necessarily has a date attached to it - the date, in this case, being early September 1983

  7. Veterinary Fusarioses within the United States

    Science.gov (United States)

    Multilocus DNA sequence data was used to retrospectively assess the genetic diversity and evolutionary relationships of 67 Fusarium strains from veterinary sources, most of which were from the United States. Molecular phylogenetic analyses revealed that the strains comprised 23 phylogenetically dist...

  8. Friendships of Indonesian and United States Youth

    Science.gov (United States)

    French, Doran C.; Pidada, Sri; Victor, Andrea

    2005-01-01

    Issues in the study of friendship across cultures were explored by reviewing a set of studies focusing on the friendships of Indonesian and United States youth. Four topics are considered: similarity of friendships across cultures, dimensions of friendships that vary across cultures, the utility of the individualism/collectivism dimension for…

  9. Woody encroachment in the Central United States

    Science.gov (United States)

    Greg C. Liknes; Dacia M. Meneguzzo; Kevin. Nimerfro

    2015-01-01

    The landscape of the central United States is dominated by cropland and rangeland mixed with remnants of short- and tall-grass prairies that were once prevalent. Since the last ice age, these areas had sparse tree cover due to cyclical severe droughts, intentional fires used by indigenous people as a land management tool, and natural fires caused by lightning. More...

  10. Radioactive waste management in the United States

    International Nuclear Information System (INIS)

    Smiley, J.L.

    1985-01-01

    In the United States, efforts to dispose of the nation's high- and low-level radioactive wastes are based on somewhat different approaches.The individual States are responsible for disposing of low-level wastes with the Federal Government providing technical and financial support to help the States in the early phases of their efforts. The Federal Government has responsibility for developing facilities for the disposal of high-level waste. However, both efforts show a common need to meet national objectives while satisfying the concerns of the public. (author)

  11. Both Europe's and the United States' electrification

    International Nuclear Information System (INIS)

    Matly, M.

    2006-01-01

    While the United States quickly had the largest electrical indus in the world, electrification in rural areas ended about thirty years after most European countries. Public intervention is a deciding factor in completing electrification, and the late involvement by the American authorities explains the gap. However it would be wrong to oppose in Europe and in the United States a motivated public sector and little involved private companies. In both continents indeed, major private and public urban distributors were almost not involved in rural electrification processes, where local players prevailed: local communities around Europe, small and medium size business in some European countries such as France, co-operative companies in the United States. Additionally, there is an essential difference between electrification in Europe and in the United States. The former does not provide much more than lighting and its success leaves few traces in popular memories; the latter includes many facilities and services, changes the lives of rural populations and is celebrated a such. Whereas the colonial venture keep European economies away from their domestic markets, while in the United States the urban market growth contents large companies, the American co-operative movement is right to believe in the existence of a large electrical equipment market among farmers then considered poor and behind. It even uses the market to complete a more profitable and less costly electrification. Electricity stories that offer food for the thoughts of Third World decision makers and power companies, when they entrust most rural electrification to their large urban companies and deny the existence of a real equipment market in their own rural world. (author)

  12. Emergency plans for civil nuclear installations in the United Kingdom

    International Nuclear Information System (INIS)

    Gronow, W.S.

    1984-01-01

    The operators of nuclear installations in the United Kingdom have plans to deal with accidents or emergencies at their nuclear sites. These plans provide for any necessary action, both on and off the nuclear site, to protect members of the public and are regularly exercised. The off-site actions involve the emergency services and other authorities which may be called upon to implement measures to protect the public in any civil emergency. In a recent review of these plans by Government Departments and agencies and the nuclear site operators, a number of possible improvements were identified. These improvements are concerned mainly with the provisions made for liaison with local and national authorities and for public information and have been incorporated into existing plans. An outline is given of the most likely consequences of an accidental release of radioactive material and the scope of emergency plans. Details are also provided on the responsibilities and functions of the operator and other organizations with duties under the plans and the arrangements made for public information. (author)

  13. Epidemiology of Human Plague in the United States, 1900–2012

    Centers for Disease Control (CDC) Podcasts

    2015-02-23

    Dr. Kiersten Kugeler discusses the Epidemiology of Human Plague in the United States.  Created: 2/23/2015 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 2/23/2015.

  14. Antiabortion violence in the United States.

    Science.gov (United States)

    Russo, Jennefer A; Schumacher, Kristin L; Creinin, Mitchell D

    2012-11-01

    This study was conducted to determine if an association exists between the amount of harassment and violence directed against abortion providers and the restrictiveness of state laws relating to family planning. We used responses from a July 2010 survey of 357 abortion providers in 50 states to determine their experience of antiabortion harassment and violence. Their responses were grouped and analyzed in relation to a published grading of state laws in the United States (A, B, C, D and F) as they relate to restrictions on family planning services. Group by group comparison of respondents illustrates that the difference in the number of reported incidents of minor vandalism by group is statistically significant (A vs. C, p=.07; A vs. D, p=.017; A vs. F, p=.0002). Incidents of harassment follow a similar pattern. There were no differences noted overall for violence or major vandalism. Major violence, including eight murders, is a new occurrence in the last two decades. Harassment of abortion providers in the United States has an association with the restrictiveness of state abortion laws. In the last two decades, murder of abortion providers has become an unfortunate part of the violence. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. From Agamben State of Emergency to Colombian State of Emergency: A Possibility of Understanding

    Directory of Open Access Journals (Sweden)

    Juan Carlos López

    2017-07-01

    Full Text Available The following article seeks to open the possibility of thinking the reality of the Colombian conflict from new conceptual categories, specifically those put forth by Giorgio Agamben, not necessarily to force the facts into the theory, but to open new possibilities of understanding the human tragedy that Colombia has lived (and continues to live in terms of human loss (death policies, of lack of conditions to live a dignified life and of an existence that is zoé (barely existence, stripped from dignity rather than bios (life in political community. The text further proposes the question of whether the Colombian State has become an everlasting State of Emergency that employs it as a normal mode of establishing social and political hegemony

  16. Southern states radiological emergency response laws and regulations

    International Nuclear Information System (INIS)

    1989-07-01

    The purpose of this report is to provide a summary of the emergency response laws and regulations in place in the various states within the southern region for use by legislators, emergency response planners, the general public and all persons concerned about the existing legal framework for emergency response. SSEB expects to periodically update the report as necessary. Radiation protection regulations without emergency response provisions are not included in the summary

  17. Clinical audit of emergency unit before and after establishment of the emergency medicine department.

    Science.gov (United States)

    Amini, Afshin; Dindoost, Payam; Moghimi, Mehrdad; Kariman, Hamid; Shahrami, Ali; Dolatabadi, Ali Arhami; Ali-Mohammadi, Hossein; Alavai-Moghaddam, Mostafa; Derakhshanfar, Hojjat; Hatamabadi, HamidReza; Heidari, Kamran; Alamdari, Shahram; Meibodi, Mohammad Kalantar; Shojaee, Majid; Foroozanfar, Mohammad Mehdi; Hashemi, Behrooz; Sabzeghaba, Anita; Kabir, Ali

    2012-02-01

    To assess the deficiencies and potential areas through a medical audit of the emergency departments, in six general hospitals affiliated to Shahid Beheshti University of Medical Sciences at Tehran, Iran, after preparing specific wards-based international standards. A checklist was completed for all hospitals which met our eligibility criteria mainly observation and interviews with head nurses and managers of the emergency medicine unit of the hospitals before (2003) and after (2008) the establishment of emergency departments there. Domains studied included staffing, education and continuing professional development (CPD), facility (design), equipment, ancillary services, medical records, manuals and references, research, administration, pre-hospital care, information systems, disaster planning, bench-marking and hospital accreditation. Education and CPD (p = 0.042), design and facility (p = 0.027), equipment (p = 0.028), and disaster (p = 0.026) had significantly improved after the establishment of emergency departments. Nearly all domains showed a positive change though it was non-significant in a few. In terms of observation, better improvement was seen in disaster, security, design, and research. According to the score for each domain compared to what it was in the earlier phase, better improvement was observed in hospital accreditation, information systems, security, disaster planning, and research. Security, disaster planning, research, design and facility had improved in hospitals that wave studied, while equipment, records, ancillary services, administration and bench-marking had the lowest improvement even after the establishment of emergency department, and, hence, needed specific attention.

  18. The State of Homeless Children in the United States

    Science.gov (United States)

    Kabler, Brenda; Weinstein, Elana

    2009-01-01

    Across America, the numbers of homeless children and families are growing as a result of many factors including the recent economic crisis, home foreclosures, and natural disasters. Because of an increase in the number of homeless children throughout the United States, this population has unmet needs that can be targeted in school settings under…

  19. Pakistan: Can the United States Secure an Insecure State?

    Science.gov (United States)

    2010-01-01

    do not have female staff; the male-to-female staff ratio in the health field is 7 to 1.130 More nurses and female staff are needed, especially to...exercise was rescheduled for 2009. 9 Interview with Ninth Air Force personnel, September 12, 2008. 200 Pakistan: Can the United States Secure an Insecure

  20. 45 CFR 212.7 - Repayment to the United States.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 2 2010-10-01 2010-10-01 false Repayment to the United States. 212.7 Section 212... UNITED STATES CITIZENS RETURNED FROM FOREIGN COUNTRIES § 212.7 Repayment to the United States. (a) An..., any or all of the cost of such assistance to the United States, except insofar as it is determined...

  1. 20 CFR 416.215 - You leave the United States.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false You leave the United States. 416.215 Section... Eligible § 416.215 You leave the United States. You lose your eligibility for SSI benefits for any month during all of which you are outside of the United States. If you are outside of the United States for 30...

  2. 31 CFR 515.330 - Person within the United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Person within the United States. 515... Definitions § 515.330 Person within the United States. (a) The term person within the United States, includes: (1) Any person, wheresoever located, who is a resident of the United States; (2) Any person actually...

  3. 39 CFR 221.1 - The United States Postal Service.

    Science.gov (United States)

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false The United States Postal Service. 221.1 Section 221.1 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION GENERAL ORGANIZATION § 221.1 The United States Postal Service. The United States Postal Service was established as an...

  4. 75 FR 13345 - Pricing for Certain United States Mint Products

    Science.gov (United States)

    2010-03-19

    ... DEPARTMENT OF THE TREASURY United States Mint Pricing for Certain United States Mint Products AGENCY: United States Mint, Department of the Treasury. ACTION: Notice. SUMMARY: The United States Mint is announcing the price of First Spouse Bronze Medals and 2010 First Spouse Bronze Medal Series: Four...

  5. 7 CFR 1212.32 - United States Customs Service.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States Customs Service. 1212.32 Section 1212... § 1212.32 United States Customs Service. “United States Customs Service” or “Customs” means the United States Customs and Border Protection, an agency of the Department of Homeland Security. Honey Packers and...

  6. 37 CFR 1.412 - The United States Receiving Office.

    Science.gov (United States)

    2010-07-01

    ... Information § 1.412 The United States Receiving Office. (a) The United States Patent and Trademark Office is a Receiving Office only for applicants who are residents or nationals of the United States of America. (b) The... “United States Receiving Office” or by the abbreviation “RO/US.” (c) The major functions of the Receiving...

  7. State laws on tobacco control--United States, 1998.

    Science.gov (United States)

    Fishman, J A; Allison, H; Knowles, S B; Fishburn, B A; Woollery, T A; Marx, W T; Shelton, D M; Husten, C G; Eriksen, M P

    1999-06-25

    State laws addressing tobacco use, the leading preventable cause of death in the United States, are summarized. Laws address smoke-free indoor air, minors' access to tobacco products, advertising of tobacco products, and excise taxes on tobacco products. Legislation effective through December 31, 1998. CDC identified laws addressing tobacco control by using an on-line legal research database. CDC's findings were verified with the National Cancer Institute's State Cancer Legislative Database. Since a previous surveillance summary on state tobacco-control laws published in November 1995 (covering legislation effective through June 30, 1995), several states have enacted new restrictions or strengthened existing legislation that addresses smoke-free indoor air, minors' access to tobacco, tobacco advertising, and tobacco taxes. Five states strengthened their smoke-free indoor air legislation. All states and Washington, D.C., continued to prohibit the sale and distribution of tobacco products to minors; however, 21 states expanded minors' access laws by designating enforcement authorities, adding license suspension or revocation for sale to minors, or requiring signage. Since the 1995 report, eight additional states (a total of 19 states and Washington, D.C.) now ban vending machines from areas accessible to minors. Thirteen states restrict advertising of tobacco products, an increase of four states since the 1995 report. Although the number of states that tax cigarettes and smokeless tobacco did not change, 13 states increased excise taxes on cigarettes, and five states increased excise taxes on smokeless tobacco products. The average state excise tax on cigarettes is 38.9 cents per pack, an increase of 7.4 cents compared with the average tax in the 1995 report. State laws addressing tobacco control vary in relation to restrictiveness, enforcement and penalties, preemptions, and exceptions. The data summarizing state tobacco-control laws are available through CDC

  8. The United States and world energy markets

    International Nuclear Information System (INIS)

    Ramsay, W.C.

    1992-01-01

    The United States, dominating the world's energy markets as a producer and consumer, is sensitive to changes in this market and intends to influence the development of global energy policy. Supply will be increased by nations such as Venezuela, Indonesia and perhaps in the future a United Yemen and the Commonwealth of Independent States, moving to freer market economies which will allow investment opportunities previously inaccessible to foreign companies. Although world energy demand will grow, little of this will be in the US where, under the National Energy Strategy, comprehensive measures are being introduced to improve energy efficiency. The US energy security will be further improved by such measures as diversification of supply, larger domestic production and increasing interdependence between suppliers, traders and consumers. (author)

  9. United States Holocaust Museums: Pathos, Possession, Patriotism

    OpenAIRE

    Baum, Rob

    2011-01-01

    This article examines the role of United States holocaust museums in directing (American) knowledge and memory of World War II, and demonstrates how signifiers of race, colour and Jewishness are played out and theatricalised. Erected in two principal U.S. cities of Los Angeles and Washington, D.C., the Holocaust Museum and Museum of Tolerance uphold very different mandates: the first dedicated to revealing European civilian tragedies during WWII; the latter dealing with Jewish persecution and...

  10. The United States toward Energy Independence?

    International Nuclear Information System (INIS)

    Nardon, Laurence

    2013-01-01

    The U.S.'s exploitation of 'unconventional' domestic oil reserves is reviving its economy. It will also have effects on the country's energy independence and thus its geopolitical position. While it is unlikely that the relationship between Washington and the Middle East region will be fundamentally altered, the U.S.'s relationships with China, Russia, and Europe could be affected. The United States will have to incorporate these changes into its global strategies

  11. Low birth weight in the United States.

    Science.gov (United States)

    Goldenberg, Robert L; Culhane, Jennifer F

    2007-02-01

    Pregnancy outcomes in the United States and other developed countries are considerably better than those in many developing countries. However, adverse pregnancy outcomes are generally more common in the United States than in other developed countries. Low-birth-weight infants, born after a preterm birth or secondary to intrauterine growth restriction, account for much of the increased morbidity, mortality, and cost. Wide disparities exist in both preterm birth and growth restriction among different population groups. Poor and black women, for example, have twice the preterm birth rate and higher rates of growth restriction than do most other women. Low birth weight in general is thought to place the infant at greater risk of later adult chronic medical conditions, such as diabetes, hypertension, and heart disease. Of interest, maternal thinness is a strong predictor of both preterm birth and fetal growth restriction. However, in the United States, several nutritional interventions, including high-protein diets, caloric supplementation, calcium and iron supplementation, and various other vitamin and mineral supplementations, have not generally reduced preterm birth or growth restriction. Bacterial intrauterine infections play an important role in the etiology of the earliest preterm births, but, at least to date, antibiotic treatment either before labor for risk factors such as bacterial vaginosis or during preterm labor have not consistently reduced the preterm birth rate. Most interventions have failed to reduce preterm birth or growth restriction. The substantial improvement in newborn survival in the United States over the past several decades is mostly due to better access to improved neonatal care for low-birth-weight infants.

  12. OECD environmental performance reviews: United States

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-01-15

    This book presents OECD assessments and recommendations regarding the United States' efforts to manage its environment including air, water, nature, and biodiversity; to do this in a sustainable manner; and to do this in co-operation with its global neighbours. In particular, it assesses progress made since 1996, when OECD's previous review on the US was done. 47 figs., 20 tabs.

  13. Diesel fuel in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Bensaid, B.; Saint-Antonin, V

    2003-07-01

    In the 1970's, Diesel technology had a poor image in the United States owing to the inadequate performance and reliability observed in certain models. The 1990's brought increased awareness of greenhouse effect issues. Greater Diesel penetration of the American automobile market could represent a short-term solution for reducing CO{sub 2} emissions, along with the use of hybrid vehicles, but the impact on American refining plant would be substantial. (author)

  14. Diesel fuel in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Bensaid, B; Saint-Antonin, V

    2003-07-01

    In the 1970's, Diesel technology had a poor image in the United States owing to the inadequate performance and reliability observed in certain models. The 1990's brought increased awareness of greenhouse effect issues. Greater Diesel penetration of the American automobile market could represent a short-term solution for reducing CO{sub 2} emissions, along with the use of hybrid vehicles, but the impact on American refining plant would be substantial. (author)

  15. Diesel fuel in the United States

    International Nuclear Information System (INIS)

    Bensaid, B.; Saint-Antonin, V.

    2003-01-01

    In the 1970's, Diesel technology had a poor image in the United States owing to the inadequate performance and reliability observed in certain models. The 1990's brought increased awareness of greenhouse effect issues. Greater Diesel penetration of the American automobile market could represent a short-term solution for reducing CO 2 emissions, along with the use of hybrid vehicles, but the impact on American refining plant would be substantial. (author)

  16. Electric trade in the United States 1990

    International Nuclear Information System (INIS)

    1992-01-01

    Electric Trade in the United States 1990 (ELECTRA) is the third in a series of reports on wholesale power transactions prepared by the Electric Data Systems Branch, Survey Management Division, Office of Coal, Nuclear, Electric and Alternate Fuels, Energy Information Administration (EIA). The electric trade data are published biennially. The first report presented 1986 data. The second report contained data for 1988. This report provides information on the industry during 1990

  17. The United States facing their petroleum dependence

    International Nuclear Information System (INIS)

    Noel, P.

    2002-06-01

    In the framework of ''the energy crisis of 2000-2001'', the Cheney report and the petroleum dependence, this study presents a critical examination of the United States petroleum situation, its perception in the american political milieu and the public policies implementing during the last ten years. The first section is devoted to the petroleum supply. In the second section, the american petroleum policy and the energy safety are studied. (A.L.B.)

  18. United States Energy Policy: Security Not Independence

    Science.gov (United States)

    2013-03-01

    on leased land, ensuring fracking is done responsibly, and getting more natural gas and hybrid systems into U.S. mass transit. Internationally, the...fewer environ disturbances -Can store underground -Environ impacts of fracking unknown -uses large amount of water -potential for saline...from shale continues to rise as the United States determines how to drill safely. However, the impact of fracking on the environment is still

  19. ISO developments in the United States

    International Nuclear Information System (INIS)

    Hogan, William W.

    1998-01-01

    An important feature of the restructuring process in the United States is the creation of independent system operators (ISOs) to coordinate dispatch and access to transmission grids. A number of ISOs have been proposed and are summarized here. Perhaps the greatest challenge is the pricing of transmission to give proper economic signals to market participants, and the locational pricing scheme now operating in the PJM system offers the best hope for efficient pricing. (author)

  20. Burnup credit activities in the United States

    International Nuclear Information System (INIS)

    Lake, W.H.; Thomas, D.A.; Doering, T.W.

    2001-01-01

    This report covers progress in burnup credit activities that have occurred in the United States of America (USA) since the International Atomic Energy Agency's (IAEA's) Advisory Group Meeting (AGM) on Burnup Credit was convened in October 1997. The Proceeding of the AGM were issued in April 1998 (IAEA-TECDOC-1013, April 1998). The three applications of the use of burnup credit that are discussed in this report are spent fuel storage, spent fuel transportation, and spent fuel disposal. (author)

  1. United States steps up waste isolation programme

    Energy Technology Data Exchange (ETDEWEB)

    Smedes, H W [Department of Energy, Germantown, MD (USA). Office of Waste Isolation; Carbiener, W A [Battelle Columbus Labs., OH (USA)

    1982-11-01

    A description is given of the United States' waste isolation programme which now involves tests of specific sites. The US Department of Energy plans to build a system of mined geological repositories for the disposal of commercially generated high-level and transuranic radioactive waste. It is hoped that the first repository will be available by 1998. Studies of the geology and hydrology of the proposed sites, the waste packaging and the repository design are reported.

  2. The United States and the Kurds: Case Studies in United States Engagement

    National Research Council Canada - National Science Library

    Lambert, Peter

    1997-01-01

    ..., between 1969- 1975, and 1990-1996. Both eras saw the United States able to influence events relating to the Kurds in support of a larger regional policy, only to find no easy solution to the Kurdish quest for autonomy...

  3. Estimating annualized earthquake losses for the conterminous United States

    Science.gov (United States)

    Jaiswal, Kishor S.; Bausch, Douglas; Chen, Rui; Bouabid, Jawhar; Seligson, Hope

    2015-01-01

    We make use of the most recent National Seismic Hazard Maps (the years 2008 and 2014 cycles), updated census data on population, and economic exposure estimates of general building stock to quantify annualized earthquake loss (AEL) for the conterminous United States. The AEL analyses were performed using the Federal Emergency Management Agency's (FEMA) Hazus software, which facilitated a systematic comparison of the influence of the 2014 National Seismic Hazard Maps in terms of annualized loss estimates in different parts of the country. The losses from an individual earthquake could easily exceed many tens of billions of dollars, and the long-term averaged value of losses from all earthquakes within the conterminous U.S. has been estimated to be a few billion dollars per year. This study estimated nationwide losses to be approximately $4.5 billion per year (in 2012$), roughly 80% of which can be attributed to the States of California, Oregon and Washington. We document the change in estimated AELs arising solely from the change in the assumed hazard map. The change from the 2008 map to the 2014 map results in a 10 to 20% reduction in AELs for the highly seismic States of the Western United States, whereas the reduction is even more significant for Central and Eastern United States.

  4. Phocine Distemper Virus in Seals, East Coast, United States, 2006

    Science.gov (United States)

    Earle, J.A. Philip; Melia, Mary M.; Doherty, Nadine V.; Nielsen, Ole

    2011-01-01

    In 2006 and 2007, elevated numbers of deaths among seals, constituting an unusual mortality event, occurred off the coasts of Maine and Massachusetts, United States. We isolated a virus from seal tissue and confirmed it as phocine distemper virus (PDV). We compared the viral hemagglutinin, phosphoprotein, and fusion (F) and matrix (M) protein gene sequences with those of viruses from the 1988 and 2002 PDV epizootics. The virus showed highest similarity with a PDV 1988 Netherlands virus, which raises the possibility that the 2006 isolate from the United States might have emerged independently from 2002 PDVs and that multiple lineages of PDV might be circulating among enzootically infected North American seals. Evidence from comparison of sequences derived from different tissues suggested that mutations in the F and M genes occur in brain tissue that are not present in lung, liver, or blood, which suggests virus persistence in the central nervous system. PMID:21291591

  5. Responding to rural health disparities in the United States

    Directory of Open Access Journals (Sweden)

    Ian Jones

    2013-04-01

    Full Text Available The paper focuses on the need to address territorial inequalities in American healthcare services. It shows how much the situation has become critical in the United States. It discusses to what extent telemedicine is a sustainable option to reduce the negative consequences of the economic, professional and physical barriers to care in rural areas. As far as healthcare is concerned, rural and urban environments in the United States do not have to face the same barriers and challenges. The article first details what specific health issues have to be dealt with in rural areas. The case of emergency care in Vermont is then developed to illustrate what could be the benefits of using ICTs to improve access to care.

  6. PERMITTING LEADERSHIP IN THE UNITED STATES

    International Nuclear Information System (INIS)

    Ken Nemeth

    2002-01-01

    In accordance with the Southern States Energy Board (SSEB) proposal, as incorporated into NETL/DE-FC26-97FT34199, the objective of this agreement is to streamline the environmental technology permitting process site-to-site, state-to-state, and industry-to-industry to achieve remediation and waste processing faster, better and cheaper. SSEB is working with member Governors, legislators and regulators to build consensus on streamlining the permitting process for new and innovative technologies for addressing the legacy of environmental problems from 50 years of weapons research, development and production. This report reviews mechanisms whereby industry consortiums and the Department of Energy (DOE) have been working with State regulators and other officials in technology deployment decisions within the DOE complex. The historic development of relationships with State regulators is reviewed and the current nature of the relationships examined. The report contains observations from internal DOE reviews as well as recommendations from the General Accounting Office (GAO) and other external organizations. The report discusses reorganization initiatives leading up to a DOE Top-to-Bottom review of the Environmental Management (EM) Program and highlights points of consideration for maintaining effective linkages with State regulators. It notes how the proposed changes will place new demands upon the National Energy Technology Laboratory (NETL) and how NETL can leverage its resources by refocusing existing EM efforts specifically to states that have DOE facilities within their borders (host-states). Finally, the report discusses how SSEB's Permitting Leadership in the United States (PLUS) program can provide the foundation for elements of NETL's technical assistance program that are delivered to regulators and other decision- makers in host-states. As a regional compact commission, SSEB provides important direct linkages to regulators and stakeholders who need technical

  7. Taxation of United States general aviation

    Science.gov (United States)

    Sobieralski, Joseph Bernard

    General aviation in the United States has been an important part of the economy and American life. General aviation is defined as all flying excluding military and scheduled airline operations, and is utilized in many areas of our society. The majority of aircraft operations and airports in the United States are categorized as general aviation, and general aviation contributes more than one percent to the United States gross domestic product each year. Despite the many benefits of general aviation, the lead emissions from aviation gasoline consumption are of great concern. General aviation emits over half the lead emissions in the United States or over 630 tons in 2005. The other significant negative externality attributed to general aviation usage is aircraft accidents. General aviation accidents have caused over 8000 fatalities over the period 1994-2006. A recent Federal Aviation Administration proposed increase in the aviation gasoline tax from 19.4 to 70.1 cents per gallon has renewed interest in better understanding the implications of such a tax increase as well as the possible optimal rate of taxation. Few studies have examined aviation fuel elasticities and all have failed to study general aviation fuel elasticities. Chapter one fills that gap and examines the elasticity of aviation gasoline consumption in United States general aviation. Utilizing aggregate time series and dynamic panel data, the price and income elasticities of demand are estimated. The price elasticity of demand for aviation gasoline is estimated to range from -0.093 to -0.185 in the short-run and from -0.132 to -0.303 in the long-run. These results prove to be similar in magnitude to automobile gasoline elasticities and therefore tax policies could more closely mirror those of automobile tax policies. The second chapter examines the costs associated with general aviation accidents. Given the large number of general aviation operations as well as the large number of fatalities and

  8. Case law: Canada, France, Switzerland, United States

    International Nuclear Information System (INIS)

    Anon.

    2012-01-01

    Canada: Appellate decision upholding nuclear regulatory licensing process and practices for consultation with aboriginal groups: Fond du Lac Denesuline First Nation v. Canada (Attorney General). France: Court of Appeal of Nimes regarding the SOCATRI incident in July 2008; Conseil d'Etat regarding the association Reseau 'Sortir du nucleaire'. Switzerland: Judgement of the Federal Administrative Court in the matter of Balmer-Schafroth a.o.v. BKW FMB Energy Ltd on the repeal of the time limitation with respect to the operating licence for the Muehleberg nuclear power plant. United States: Judgement of a US District Court granting a permanent injunction against the State of Vermont in order to prevent certain State laws from prohibiting Vermont Yankee nuclear power plant's continued operation

  9. Is there a shortage of neurosurgeons in the United States?

    Science.gov (United States)

    Rosman, Judy; Slane, Steve; Dery, Beth; Vogelbaum, Michael A; Cohen-Gadol, Aaron A; Couldwell, William T

    2013-08-01

    Neurosurgical workforce decision-making is typically driven by the 1 neurosurgeon per 100,000 population ratio proposed in 1977 in the Study on Surgical Services for the United States report. The actual ratio has always been higher than suggested. We evaluated whether the 1:100,000 ratio from the Study on Surgical Services for the United States report is still valid, whether there are enough neurosurgeons in the United States to meet patient needs, and whether demand is driven by patient need. For our analysis, the distribution of practicing US neurosurgeons was merged with census data to yield density indices of neurosurgeons by state; a survey assessing practice characteristics was e-mailed to practicing neurosurgeons; and a compilation of job advertisements for US neurosurgeons was evaluated. Multivariant statistical analyses yielded inconclusive results regarding patient demand because existing data sets are not designed to establish patient demand and many neurosurgeons are subspecialized. The data indicated that the ratio of neurosurgeons to total US population is 1:65,580. In the survey responses, neurosurgeon-to-patient ratios varied dramatically by state and were inconsistently correlated with whether neurosurgeons indicated they were overworked or underworked. The 305 job advertisements may indicate a shortage. Twenty-four percent of advertising practices indicated that they are recruiting only for emergency department coverage, and an additional 26% indicated that they might not be recruiting if not for the need for emergency coverage. Demand ratios should be reevaluated by region and subspecialty to consider changes in neurosurgery practice. A "shortage" in the employment market may reflect factors other than patient need.

  10. Surveillance for Lyme Disease - United States, 2008-2015.

    Science.gov (United States)

    Schwartz, Amy M; Hinckley, Alison F; Mead, Paul S; Hook, Sarah A; Kugeler, Kiersten J

    2017-11-10

    from states with low incidence, infection occurred more commonly among females and older adults. In addition, probable cases occurred more commonly among females and with a higher modal age than confirmed cases. Lyme disease continues to be the most commonly reported vectorborne disease in the United States. Although concentrated in historically high-incidence areas, the geographic distribution is expanding into neighboring states. The trend of stable to decreasing case counts in many states with high incidence could be a result of multiple factors, including actual stabilization of disease incidence or artifact due to modifications in reporting practices employed by some states to curtail the resource burden associated with Lyme disease surveillance. This report highlights the continuing public health challenge of Lyme disease in states with high incidence and demonstrates its emergence in neighboring states that previously experienced few cases. Educational efforts should be directed accordingly to facilitate prevention, early diagnosis, and appropriate treatment. As Lyme disease emerges in neighboring states, clinical suspicion of Lyme disease in a patient should be based on local experience rather than incidence cutoffs used for surveillance purposes. A diagnosis of Lyme disease should be considered in patients with compatible clinical signs and a history of potential exposure to infected ticks, not only in states with high incidence but also in areas where Lyme disease is known to be emerging. These findings underscore the ongoing need to implement personal prevention practices routinely (e.g., application of insect repellent and inspection for and removal of ticks) and to develop other effective interventions.

  11. Rabies Elimination in Dogs in the United States

    Centers for Disease Control (CDC) Podcasts

    2008-12-01

    Rabies has been eliminated from dogs in the United States through efforts to promote annual vaccination, but it's still a problem in wildlife in the U.S. and in wild and domesticated animals abroad. In this podcast, CDC's Dr. Charles Rupprecht discusses a study which provides proof of the elimination of rabies in dogs and what this means for the average American.  Created: 12/1/2008 by Emerging Infectious Diseases.   Date Released: 12/1/2008.

  12. State cigarette minimum price laws - United States, 2009.

    Science.gov (United States)

    2010-04-09

    Cigarette price increases reduce the demand for cigarettes and thereby reduce smoking prevalence, cigarette consumption, and youth initiation of smoking. Excise tax increases are the most effective government intervention to increase the price of cigarettes, but cigarette manufacturers use trade discounts, coupons, and other promotions to counteract the effects of these tax increases and appeal to price-sensitive smokers. State cigarette minimum price laws, initiated by states in the 1940s and 1950s to protect tobacco retailers from predatory business practices, typically require a minimum percentage markup to be added to the wholesale and/or retail price. If a statute prohibits trade discounts from the minimum price calculation, these laws have the potential to counteract discounting by cigarette manufacturers. To assess the status of cigarette minimum price laws in the United States, CDC surveyed state statutes and identified those states with minimum price laws in effect as of December 31, 2009. This report summarizes the results of that survey, which determined that 25 states had minimum price laws for cigarettes (median wholesale markup: 4.00%; median retail markup: 8.00%), and seven of those states also expressly prohibited the use of trade discounts in the minimum retail price calculation. Minimum price laws can help prevent trade discounting from eroding the positive effects of state excise tax increases and higher cigarette prices on public health.

  13. The state of amphibians in the United States

    Science.gov (United States)

    Muths, E.; Adams, M.J.; Grant, E.H.C.; Miller, D.; Corn, P.S.; Ball, L.C.

    2012-01-01

    More than 25 years ago, scientists began to identify unexplained declines in amphibian populations around the world. Much has been learned since then, but amphibian declines have not abated and the interactions among the various threats to amphibians are not clear. Amphibian decline is a problem of local, national, and international scope that can affect ecosystem function, biodiversity, and commerce. This fact sheet provides a snapshot of the state of the amphibians and introduces examples to illustrate the range of issues in the United States.

  14. 31 CFR 103.39 - Person outside the United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Person outside the United States. 103... Person outside the United States. For the purposes of this subpart, a remittance or transfer of funds, or... the United States, shall be deemed to be a remittance or transfer to a person outside the United...

  15. States of Confusion: Regulation of Surrogacy in the United States

    OpenAIRE

    Mohapatra, Seema

    2017-01-01

    Introduction Some countries, including Switzerland, Germany, Spain, France, Greece, and Norway, ban commercial surrogacy (Patton 2010, 523). Others, such as India and the Ukraine, have actively tried to be seen as commercial surrogacy destinations (Mohapatra 2012, 412, 432–437, 441–448). Unlike either of these approaches, the United States (US) has no national stance on surrogacy. In fact, there are no national laws or regulations related to surrogacy in the US (Margalit 2014). Instea...

  16. The politics of home birth in the United States.

    Science.gov (United States)

    Declercq, Eugene

    2012-12-01

    Home birth has emerged as a political issue in several states in the United States, and this essay examines two aspects of home births politics. First, legislative battles over home birth policy do not conform to our typical models of partisan (i.e., Democratic vs Republican) politics, and attempts at advocacy cannot rely on classical strategies of alignment with a dominant party in a state. Second, the debates over home birth have increasingly begun to parallel current partisan battles in their emotion and intensity with the related gridlock and reluctance to consider compromises that are often necessary to achieve policy goals. This essay calls for a greater willingness for all sides to approach home birth less as an ideological mission and more as a health policy challenge to support consumers interested in an integrated system of care. © 2012, Copyright the Authors Journal compilation © 2012, Wiley Periodicals, Inc.

  17. A State of Emergency in Alabama

    Directory of Open Access Journals (Sweden)

    Larry Edward Spencer

    2012-09-01

    Full Text Available This study examines the Alabama Department of Corrections August 2009 Monthly Statistical Report and Fiscal Year 2008 Annual Report, recent articles to explain the serious public safety issue of prison overcrowding within the state of Alabama, lack of funding and correctional staff, and increasing violence among inmates. It is imperative that the stakeholders take a restorative justice approach to offenders who commit nonviolent crimes or otherwise be prepared to release substantial numbers of violent inmates due to federal court intervention, expanding parole, and other types of early release programs. Violent offenders will pose a greater threat to the community. Correctional workers continue to be exposed daily to the risk of injury or death caused by severe prison overcrowding. The state could experience additional financial hardship to rebuild a destroyed correctional facility in an event of a riot. The excessive use of incarceration for nonviolent offenders is one of the most important issues facing the state of Alabama this decade.

  18. Advanced Reactor Development in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Giessing, D. F.; Griffith, J. D.; McGoff, D. J.; Rosen, Sol [U. S. Department of Energy, Texas (United States)

    1990-04-15

    In the United States, three technologies are employed for the new generation of advanced reactors. These technologies are Advanced Light Water Reactors (A LWRs) for the 1990s and beyond, the Modular High Temperature Gas Reactor (M HTGR) for commercial use after the turn of the century, and Liquid Metal Reactors (LWRs) to provide energy production and to convert reactor fission waste to a more manageable waste product. Each technology contributes to the energy solution. Light Water Reactors For The 1990s And Beyond--The U. S. Program The economic and national security of the United States requires a diversified energy supply base built primarily upon adequate, domestic resources that are relatively free from international pressures. Nuclear energy is a vital component of this supply and is essential to meet current and future national energy demands. It is a safe, economically continues to contribute to national energy stability, and strength. The Light Water Reactor (LWR) has been a major and successful contributor to the electrical generating needs of many nations throughout the world. It is being counted upon in the United States as a key to revitalizing nuclear energy option in the 1990s. In recent years, DOE joined with the industry to ensure the availability and future viability of the LWR option. This national program has the participation of the Nation's utility industry, the Electric Power Research Institute (EPRI), and several of the major reactor manufacturers and architect-engineers. Separate but coordinated parts of this program are managed by EPRI and DOE.

  19. Radiological emergency response in a medical waste treatment unit

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Fabio F.; Boni-Mitake, Malvina; Vianna, Estanislau B.; Nicolau, Jose R.A.; Rodrigues, Demerval L. [Instituto de Pesquisas Energeticas e Nucleares (IPEN), Sao Paulo, SP (Brazil)

    2000-07-01

    Radioactive materials are largely used in medicine, research and industry. The amount of radioactive material employed in each application varies from negligible to large and it can be in sealed or non-sealed form. A medical waste treatment unit that deals only with A-type medical waste (ABNT-NBR 12808), which does not include radioactive waste, detected abnormal radiation levels in a collecting truck and the IPEN-CNEN/SP Nuclear and Radiological Emergency Response Team was called. The presence of radioactive material inside the truck was confirmed; however, its origin and nature were not possible to be determined because the truck had collected medical waste in several facilities. So, an operation in order to segregate and identify that material was carried out. During the operation, a second collecting truck presenting abnormal radiation levels arrived to the unit and the same procedure was carried out on that truck. In both situations, the contaminated objects found were infantile diapers. The radioactive waste was transported to IPEN-CNEN/SP to be managed. Samples of the radioactive materials were submitted to gamma spectrometry and the radionuclide was identified as Iodine-131. Since that attendance, similar occurrences have been frequent. These events suggest that it is necessary a better control of the radioactive waste at the generating facilities and there should be basic radioprotection orientations to the discharging patients that were submitted to nuclear medicine procedures. (author)

  20. Radiological emergency response in a medical waste treatment unit

    International Nuclear Information System (INIS)

    Suzuki, Fabio F.; Boni-Mitake, Malvina; Vianna, Estanislau B.; Nicolau, Jose R.A.; Rodrigues, Demerval L.

    2000-01-01

    Radioactive materials are largely used in medicine, research and industry. The amount of radioactive material employed in each application varies from negligible to large and it can be in sealed or non-sealed form. A medical waste treatment unit that deals only with A-type medical waste (ABNT-NBR 12808), which does not include radioactive waste, detected abnormal radiation levels in a collecting truck and the IPEN-CNEN/SP Nuclear and Radiological Emergency Response Team was called. The presence of radioactive material inside the truck was confirmed; however, its origin and nature were not possible to be determined because the truck had collected medical waste in several facilities. So, an operation in order to segregate and identify that material was carried out. During the operation, a second collecting truck presenting abnormal radiation levels arrived to the unit and the same procedure was carried out on that truck. In both situations, the contaminated objects found were infantile diapers. The radioactive waste was transported to IPEN-CNEN/SP to be managed. Samples of the radioactive materials were submitted to gamma spectrometry and the radionuclide was identified as Iodine-131. Since that attendance, similar occurrences have been frequent. These events suggest that it is necessary a better control of the radioactive waste at the generating facilities and there should be basic radioprotection orientations to the discharging patients that were submitted to nuclear medicine procedures. (author)

  1. Hybrid Reactor designs in the United States

    International Nuclear Information System (INIS)

    Wolkenhauer, W.C.

    1978-01-01

    This paper reviews the current, active, interrelated Hybrid Reactor development programs in the United States, and offers a probable future course of action for the technology. The Department of Energy (DOE) program primarily emphasizes development of Hybrid Reactors that are optimized for proliferation resistance. The Electric Power Research Institute (EPRI) program concentrates on avenues for Hybrid Reactor commercialization. The history of electrical generation technology has been one of steady movement toward higher power densities and higher quality fuels. An apparent advantage of the Hybrid Reactor option is that it follows this trend

  2. United States Army Weapon Systems 2010

    Science.gov (United States)

    2009-09-18

    equipment, tractor, van, wrecker, 8.8-ton Load Handling System (LHS), 8.8-ton LHS trailer, and 10-ton dump truck models). Three truck variants and...NJ) hydraulic pump and motor: Vickers (Jackson, MS) 131 UnIteD StAteS Army ACqUISItIon phASe InveStment Component High Mobility Engineer Excavator...MEDEVAC and hoist configuration, the UH-72A is also being fielded in a VIP, National Guard Homeland Security (HLS) and a Combined Training Center

  3. Wind Lidar Activities in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Clifton, Andrew; Newman, Jennifer; St. Pe, Alexandra; Iungo, G. Valerio; Wharton, Sonia; Herges, Tommy; Filippelli, Matthew; Pontbriand, Philippe; Osler, Evan

    2017-06-28

    IEA Wind Task 32 seeks to identify and mitigate the barriers to the adoption of lidar for wind energy applications. This work is partly achieved by sharing experience across researchers and practitioners in the United States and worldwide. This presentation is a short summary of some wind lidar-related activities taking place in the country, and was presented by Andrew Clifton at the Task 32 meeting in December 2016 in his role as the U.S. Department of Energy-nominated country representative to the task.

  4. Nuclear engineering education in the United States

    International Nuclear Information System (INIS)

    Williamson, T.G.

    1982-01-01

    In discussing nuclear engineering education in the United States it is shown that the most critical issue facing the nuclear engineering education community today is enrolment in a time of increasing demand for graduate engineers. Related to the issue of enrolment is support for graduate students, whether it be fellowships, traineeships, or research assistantships. Other issues are those of maintaining a vital faculty in the face of a competitive job market, of maintaining research facilities and developing new ones, and of determining the directions of educational efforts in the future. (U.K.)

  5. Early uranium mining in the United States

    International Nuclear Information System (INIS)

    Hahne, F.J.

    1990-01-01

    Uranium mining in the United States is closer to 100 years old than to the 200 years since the discovery of the element. Even then, for much of this time the rock was brought out of the ground for reasons other than its uranium content. The history of the US uranium industry is divided into five periods which follow roughly chronologically upon one another, although there is some overlap. The periods cover: uranium use in glass and ceramics; radium extraction; vanadium extraction; government uranium extraction and commercial extraction. (author)

  6. Uranium enrichment services in the United States

    International Nuclear Information System (INIS)

    Jelinek, P.; Lenders, M.

    1994-01-01

    The United States of America is the world's largest market for uranium enrichment services. After the disintegration of the Soviet Union, Russian uranium is entering the world market on an increasing scale. The U.S. tries to protect its market and, in this connection, also the European market from excessive price drops by taking anti-dumping measures. In order to become more competitive, American companies have adapted modern enrichment techniques from Europe. European - U.S. joint ventures are to help, also technically and economically, to integrate military uranium, accumulating as a consequence of worldwide disarmament, into the commercial fuel cycle for the peaceful use of nuclear power. (orig.) [de

  7. Outbreak-associated Salmonella enterica Serotypes and Food Commodities, United States, 1998- 2008

    Centers for Disease Control (CDC) Podcasts

    2013-09-09

    Dr. Mike Miller reads an abridged version of the Emerging Infectious Diseases’ study, Outbreak-associated Salmonella enterica Serotypes and Food Commodities, United States, 1998- 2008.  Created: 9/9/2013 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 9/9/2013.

  8. 75 FR 31465 - United States, State of Illinois, State of Colorado, and State of Indiana

    Science.gov (United States)

    2010-06-03

    ..., and often offer full-service restaurants or in-service dining. Premiere theatres also differ from... selection is deemed not to be a suitable alternative, the United States shall in its sole discretion select... suitable alternative pursuant to Section VI(A). If AMC's selection is deemed not to be a suitable...

  9. 22 CFR 22.3 - Remittances in the United States.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Remittances in the United States. 22.3 Section...-DEPARTMENT OF STATE AND FOREIGN SERVICE § 22.3 Remittances in the United States. (a) Type of remittance. Remittances shall be in the form of: (1) Check or bank draft drawn on a bank in the United States; (2) money...

  10. Assisted Reproductive Technology Surveillance - United States, 2015.

    Science.gov (United States)

    Sunderam, Saswati; Kissin, Dmitry M; Crawford, Sara B; Folger, Suzanne G; Boulet, Sheree L; Warner, Lee; Barfield, Wanda D

    2018-02-16

    Since the first U.S. infant conceived with assisted reproductive technology (ART) was born in 1981, both the use of ART and the number of fertility clinics providing ART services have increased steadily in the United States. ART includes fertility treatments in which eggs or embryos are handled in the laboratory (i.e., in vitro fertilization [IVF] and related procedures). Although the majority of infants conceived through ART are singletons, women who undergo ART procedures are more likely than women who conceive naturally to deliver multiple-birth infants. Multiple births pose substantial risks for both mothers and infants, including obstetric complications, preterm delivery (state-specific information for the United States (including the District of Columbia and Puerto Rico) on ART procedures performed in 2015 and compares birth outcomes that occurred in 2015 (resulting from ART procedures performed in 2014 and 2015) with outcomes for all infants born in the United States in 2015. 2015. In 1995, CDC began collecting data on ART procedures performed in fertility clinics in the United States as mandated by the Fertility Clinic Success Rate and Certification Act of 1992 (FCSRCA) (Public Law 102-493 [October 24, 1992]). Data are collected through the National ART Surveillance System, a web-based data collection system developed by CDC. This report includes data from 52 reporting areas (the 50 states, the District of Columbia, and Puerto Rico). In 2015, a total of 182,111 ART procedures (range: 135 in Alaska to 23,198 in California) with the intent to transfer at least one embryo were performed in 464 U.S. fertility clinics and reported to CDC. These procedures resulted in 59,334 live-birth deliveries (range: 55 in Wyoming to 7,802 in California) and 71,152 infants born (range: 68 in Wyoming to 9,176 in California). Nationally, the number of ART procedures performed per 1 million women of reproductive age (15-44 years), a proxy measure of the ART utilization rate, was

  11. Emergency distress call system for automobiles in Lagos state, Nigeria

    African Journals Online (AJOL)

    Emergency distress call system for automobiles in Lagos state, Nigeria. ... PROMOTING ACCESS TO AFRICAN RESEARCH ... and communications technology capabilities to transportation and the medical care system in order to save lives, ...

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

    International Nuclear Information System (INIS)

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

    1989-01-01

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

  13. License renewal in the United States

    International Nuclear Information System (INIS)

    Brons, Jack

    2002-01-01

    Full text: Nuclear plants in the United States are licensed for 40 years, a length specified in the Atomic Energy Act of 1954, which laid out much of the regulatory basis for the commercial nuclear industry. The Act, however, made provision for license renewal. The original 40-year license period was chosen arbitrarily by the U.S. Congress because it was the typical period over which utilities recovered their investment in electricity generating plants. Nuclear plants, however, are subject to a rigorous program of Nuclear Regulatory Commission oversight, maintenance and equipment replacement. In effect, they must be in the same operating condition on the last day of their licenses as they were on the first. As the industry matured, it became apparent that there was no physical limitation on the continued operation of nuclear plants past 40 years. The industry turned its attention toward license renewal. When the issue was first raised, the NRC considered stringent process equivalent to seeking a new operating license for each plant. The complexity, length and cost of the process made it unlikely that many nuclear plants would seek license renewal. The nuclear industry worked successfully with NRC on the application of generic principles to license renewal, however, and in 1995, the NRC issued an efficient, tightly-focused rule that made license renewal a safe, viable option. To extend the operating license for a reactor, a company must demonstrate to the NRC that aging effects will be adequately managed during the renewal terms, thus ensuring equipment functionality. The rule allows licensees to apply for extensions of up to 20 years. The first license renewal application was filed in 1998 by the owner of the two-unit Calvert Cliffs plant. Shortly thereafter, an application was filed for the three-unit Oconee Nuclear Station. The NRC renewed the licenses for all five units in 2000, and since then, five more licenses have been renewed. The NRC has received 37

  14. Renewable energy atlas of the United States.

    Energy Technology Data Exchange (ETDEWEB)

    Kuiper, J.A.; Hlava, K.Greenwood, H.; Carr, A. (Environmental Science Division)

    2012-05-01

    The Renewable Energy Atlas (Atlas) of the United States is a compilation of geospatial data focused on renewable energy resources, federal land ownership, and base map reference information. It is designed for the U.S. Department of Agriculture Forest Service (USFS) and other federal land management agencies to evaluate existing and proposed renewable energy projects. Much of the content of the Atlas was compiled at Argonne National Laboratory (Argonne) to support recent and current energy-related Environmental Impact Statements and studies, including the following projects: (1) West-wide Energy Corridor Programmatic Environmental Impact Statement (PEIS) (BLM 2008); (2) Draft PEIS for Solar Energy Development in Six Southwestern States (DOE/BLM 2010); (3) Supplement to the Draft PEIS for Solar Energy Development in Six Southwestern States (DOE/BLM 2011); (4) Upper Great Plains Wind Energy PEIS (WAPA/USFWS 2012, in progress); and (5) Energy Transport Corridors: The Potential Role of Federal Lands in States Identified by the Energy Policy Act of 2005, Section 368(b) (in progress). This report explains how to add the Atlas to your computer and install the associated software; describes each of the components of the Atlas; lists the Geographic Information System (GIS) database content and sources; and provides a brief introduction to the major renewable energy technologies.

  15. Child Labor Trafficking in the United States: A Hidden Crime

    Directory of Open Access Journals (Sweden)

    Katherine Kaufka Walts

    2017-06-01

    Full Text Available Emerging research brings more attention to labor trafficking in the United States. However, very few efforts have been made to better understand or respond to labor trafficking of minors. Cases of children forced to work as domestic servants, in factories, restaurants, peddling candy or other goods, or on farms may not automatically elicit suspicion from an outside observer as compared to a child providing sexual services for money. In contrast to sex trafficking, labor trafficking is often tied to formal economies and industries, which often makes it more difficult to distinguish from "legitimate" work, including among adolescents. This article seeks to provide examples of documented cases of child labor trafficking in the United States, and to provide an overview of systemic gaps in law, policy, data collection, research, and practice. These areas are currently overwhelmingly focused on sex trafficking, which undermines the policy intentions of the Trafficking Victims Protection Act (2000, the seminal statute criminalizing sex and labor trafficking in the United States, its subsequent reauthorizations, and international laws and protocols addressing human trafficking.

  16. Improving rapeseed production practices in the southeastern United States

    Energy Technology Data Exchange (ETDEWEB)

    Thomas, D.L.; Breve, M.A.; Raymer, P.L.; Minton, N.A.; Sumner, D.R. (Georgia Univ., Tifton, GA (USA). Georgia Coastal Plain Experiment Station)

    1990-04-01

    Oilseed rape or rapeseed is a crop which offers a potential for double-cropping in the southeastern United States. This final project report describes the results from a three year study aimed at evaluating the effect of different planting and harvesting practices on establishment and yield of three rape cultivars, and the double cropping potential of rapeseed in the southeastern United States. The project was conducted on two yield sites in Tifton, Georgia during 1986--87, 1987--88 and 1988--89. The general objective of this research is to improve the seed and biomass yield of winter rapeseed in the southeastern United States by developing appropriate agronomic practices for the region. The primary constraint is to grow rapeseed within the allowable period for double cropping with an economically desirable crop, such as peanut or soybean. Planting and harvesting are the most critical steps in this process. Therefore, the specific objectives of this research were: evaluate and improve the emergence of rapeseed by developing planting techniques that enhance the soil, water and seed regimes for winter rapeseed in the southeast, and evaluate and improve the yields of harvested rapeseed by developing techniques for determining the optimum timing of harvest and efficient methods for harvesting winter rapeseed in the southeast. 6 refs., 12 figs., 9 tabs.

  17. Step-grandparenthood in the United States.

    Science.gov (United States)

    Yahirun, Jenjira J; Park, Sung S; Seltzer, Judith A

    2018-01-18

    This study provides new information about the demography of step-grandparenthood in the United States. Specifically, we examine the prevalence of step-grandparenthood across birth cohorts and for socioeconomic and racial/ethnic groups. We also examine lifetime exposure to the step-grandparent role. Using data from the Panel Study of Income Dynamics and the Health and Retirement Study, we use percentages to provide first estimates of step-grandparenthood and to describe demographic and socioeconomic variation in who is a step-grandparent. We use life tables to estimate the exposure to step-grandparenthood. The share of step-grandparents is increasing across birth cohorts. However, individuals without a college education and non-Whites are more likely to become step-grandparents. Exposure to the step-grandparent role accounts for approximately 15% of total grandparent years at age 65 for women and men. A growing body of research finds that grandparents are increasingly instrumental in the lives of younger generations. However, the majority of this work assumes that these ties are biological, with little attention paid to the role of family complexity across three generations. Understanding the demographics of step-grandparenthood sheds light on the family experiences of an overlooked, but growing segment of the older adult population in the United States. © The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  18. Zoonotic Leprosy in the Southeastern United States

    Science.gov (United States)

    Sharma, Rahul; Singh, Pushpendra; Loughry, W.J.; Lockhart, J. Mitchell; Inman, W. Barry; Duthie, Malcolm S.; Pena, Maria T.; Marcos, Luis A.; Scollard, David M.; Cole, Stewart T.

    2015-01-01

    Nine-banded armadillos (Dasypus novemcinctus) are naturally infected with Mycobacterium leprae and have been implicated in zoonotic transmission of leprosy. Early studies found this disease mainly in Texas and Louisiana, but armadillos in the southeastern United States appeared to be free of infection. We screened 645 armadillos from 8 locations in the southeastern United States not known to harbor enzootic leprosy for M. leprae DNA and antibodies. We found M. leprae–infected armadillos at each location, and 106 (16.4%) animals had serologic/PCR evidence of infection. Using single-nucleotide polymorphism variable number tandem repeat genotyping/genome sequencing, we detected M. leprae genotype 3I-2-v1 among 35 armadillos. Seven armadillos harbored a newly identified genotype (3I-2-v15). In comparison, 52 human patients from the same region were infected with 31 M. leprae types. However, 42.3% (22/52) of patients were infected with 1 of the 2 M. leprae genotype strains associated with armadillos. The geographic range and complexity of zoonotic leprosy is expanding. PMID:26583204

  19. Regional geologic framework off northeastern United States

    Science.gov (United States)

    Schlee, J.; Behrendt, John C.; Grow, J.A.; Robb, James M.; Mattick, R.; Taylor, P.T.; Lawson, B.J.

    1976-01-01

    Six multichannel seismic-reflection profiles taken across the Atlantic continental margin Previous HitoffTop the northeastern United States show an excess of 14 km of presumed Mesozoic and younger sedimentary rocks in the Baltimore Canyon trough and 8 km in the Georges Bank basin. Beneath the continental rise, the sedimentary prism thickness exceeds 7 km south of New Jersey and Maryland, and it is 4.5 km thick south of Georges Bank. Stratigraphically, the continental slope--outer edge of the continental shelf is a transition zone of high-velocity sedimentary rock, probably carbonate, that covers deeply subsided basement. Acoustically, the sedimentary sequence beneath the shelf is divided into three units which are correlated speculatively with the Cenozoic, the Cretaceous, and the Jurassic-Triassic sections. These units thicken offshore, and some have increased seismic velocities farther offshore. The uppermost unit thickens from a fraction of a kilometer to slightly more than a kilometer in a seaward direction, and velocity values range from 1.7 to 2.2 km/sec. The middle unit thickens from a fraction of a kilometer to as much as 5 km (northern Baltimore Canyon trough), and seismic velocity ranges from 2.2 to 5.4 km/sec. The lowest unit thickens to a maximum of 9 km (northern Baltimore Canyon), and velocities span the 3.9 to 5.9-km/sec interval. The spatial separation of magnetic and gravity anomalies on line 2 (New Jersey) suggests that in the Baltimore Canyon region the magnetic-slope anomaly is due to edge effects and that the previously reported free-air and isostatic gravity anomalies over the outer shelf may be due in part to a lateral increase in sediment density (velocity) near the shelf edge. The East Coast magnetic anomaly and the free-air gravity high both coincide over the outer shelf edge on line 1 (Georges Bank) but are offset by 20 km from the ridge on the reflection profile. Because the magnetic-slope-anomaly wavelength is nearly 50 km across, a

  20. State-level emergency preparedness and response capabilities.

    Science.gov (United States)

    Watkins, Sharon M; Perrotta, Dennis M; Stanbury, Martha; Heumann, Michael; Anderson, Henry; Simms, Erin; Huang, Monica

    2011-03-01

    Prior assessments of public health readiness had identified gaps in radiation preparedness. In recent years, preparedness planning has involved an "all-hazards" approach. Current assessment of the national status related to radiation public health emergency preparedness capabilities at the state and local health department levels was needed. A survey of state health departments related to radiation readiness was undertaken in 2010 by the Council of State and Territorial Epidemiologists (CSTE). States with nuclear power plants were instructed to consider their responses exclusive of capabilities and resources related to the plants given that the emergency response plans for nuclear power plants are specific and unique. Thirty-eight (76%) state health departments responded to the survey, including 26 of the 31 states with nuclear power plants. Specific strengths noted at the state level included that the majority of states had a written radiation response plan and most plans include a detailed section for communications issues during a radiation emergency. In addition, more than half of the states indicated that their relationship with federal partners is sufficient to provide resources for radiation emergencies, indicating the importance states placed on federal resources and expertise. Specific weaknesses are discussed and include that most states had completed little to no planning for public health surveillance to assess potential human health impacts of a radiation event; less than half had written plans to address exposure assessment, environmental sampling, human specimen collection and analysis, and human health assessment. Few reported having sufficient resources to do public health surveillance, radiation exposure assessment, laboratory functions and other capabilities. Levels of planning, resources and partnerships varied among states, those with nuclear power plants were better prepared. Gaps were evident in all states; however and additional training and

  1. 31 CFR 500.520 - Payments from accounts of United States citizens in employ of United States in foreign countries...

    Science.gov (United States)

    2010-07-01

    ... States citizens in employ of United States in foreign countries and certain other persons. 500.520..., Authorizations and Statements of Licensing Policy § 500.520 Payments from accounts of United States citizens in employ of United States in foreign countries and certain other persons. (a) Banking institutions within...

  2. 31 CFR 515.520 - Payments from accounts of United States citizens in employ of United States in foreign countries...

    Science.gov (United States)

    2010-07-01

    ... States citizens in employ of United States in foreign countries and certain other persons. 515.520..., Authorizations, and Statements of Licensing Policy § 515.520 Payments from accounts of United States citizens in employ of United States in foreign countries and certain other persons. (a) Banking institutions within...

  3. Acinetobacter infections as an emerging threat in intensive care units

    International Nuclear Information System (INIS)

    Tahseen, U.; Talib, M.T.

    2015-01-01

    Nosocomial infections caused by Acinetobacter species (Spp.) is an emerging threat in health care setups especially intensive care units (ICU). The objective of this observational study was to determine the pattern of Acinetobacter infections and its association with length of stay in patients admitted to our medical ICU from January to August 2011. Methods: All patients above 16 years of age with stay of more than 48 hours were checked for any development of new infections not present or incubating at the time of admission. Nosocomial infections were documented in the light of clinical findings and lab results. Data was analysed using statistical software SPSS 15.0. Results: A total of 146 patients had a stay of at least 48 hours; frequency of nosocomial infection was 30.8% out of which 57.8% were Acinetobacter infections. Respiratory system was most commonly involved. Acinetobacter Spp showed high resistance (96.2%) to penicillins, cephalosporins and even extended spectrum antibiotics including carbepenems, quinolones and piperacillin plus tazobactam. Extended drug resistance was seen in 92.3% isolates; while we found high susceptibility to tigecycline (88.5%) and polymyxins (100%). Acinetobacter Spp. infected patients had mean length of stay (LOS) of 12.92 days when compared to patients with other nosocomial infections and no infection with mean LOS of 7.05 days (p=0.05) and 4.86 days (p=0.00) respectively. Conclusions: Acinetobacter Spp infections increase with longer duration of stay in ICU. Emergence of multi-drug and extended-drug resistant Acinetobacter Spp is alarming and overwhelming at this rate for already stretched out health system with its economic and health implications. (author)

  4. Ventilator-associated pneumonia in surgical emergency intensive care unit.

    Science.gov (United States)

    Ertugrul, Bulent M; Yildirim, Ayse; Ay, Pinar; Oncu, Serkan; Cagatay, Atahan; Cakar, Nahit; Ertekin, Cemalettin; Ozsut, Halit; Eraksoy, Haluk; Calangu, Semra

    2006-01-01

    To investigate the incidence, risk factors and the etiology of ventilator-associated pneumonia (VAP) in surgical emergency intensive care unit (ICU) patients. We conducted this prospective cohort study in the surgical emergency ICU of Istanbul Medical Faculty between December 1999 and May 2001. We included 100 mechanically ventilated patients in this study. We diagnosed VAP according to the current diagnostic criteria. We identified the etiology of VAP cases by both quantitative cultures of endotracheal aspiration and blood cultures. To analyze the predisposing factors for the development of VAP, we recorded the following variables: age, gender, acute physiology and chronic health evaluation (APACHE) II score, Glasgow coma scale (GCS), sequential organ failure assessment (SOFA) score, serum albumin level, duration of mechanical ventilation (MV) prior to the development of VAP, and underlying diseases. We determined the VAP incidence rate as 28%. We found the APACHE II score and the duration of MV to be statistically significant variables for the development of VAP. There were no significant differences regarding age, gender, GCS, SOFA score, albumin level, or underlying diseases for the development of VAP. The isolated bacteria among VAP cases were as follows: Staphylococcus aureus (n=12, 43%), Acinetobacter spp. (n=6, 21%), coagulase-negative Staphylococci (n=4, 15%), Pseudomonas aeruginosa (n=3, 10.7%) and Klebsiella pneumoniae (n=3, 10.7%). Ventilator-associated pneumonia is a common infection, and certain interventions might affect the incidence of VAP. The ICU clinicians should be aware of the risk factors for VAP, which could prove useful in identifying patients at high risk for VAP, and modifying patient care to minimize the risk of VAP.

  5. United States of America: health system review.

    Science.gov (United States)

    Rice, Thomas; Rosenau, Pauline; Unruh, Lynn Y; Barnes, Andrew J; Saltman, Richard B; van Ginneken, Ewout

    2013-01-01

    This analysis of the United States health system reviews the developments in organization and governance, health financing, health-care provision, health reforms and health system performance. The US health system has both considerable strengths and notable weaknesses. It has a large and well-trained health workforce, a wide range of high-quality medical specialists as well as secondary and tertiary institutions, a robust health sector research program and, for selected services, among the best medical outcomes in the world. But it also suffers from incomplete coverage of its citizenry, health expenditure levels per person far exceeding all other countries, poor measures on many objective and subjective measures of quality and outcomes, an unequal distribution of resources and outcomes across the country and among different population groups, and lagging efforts to introduce health information technology. It is difficult to determine the extent to which deficiencies are health-system related, though it seems that at least some of the problems are a result of poor access to care. Because of the adoption of the Affordable Care Act in 2010, the United States is facing a period of enormous potential change. Improving coverage is a central aim, envisaged through subsidies for the uninsured to purchase private insurance, expanded eligibility for Medicaid (in some states) and greater protection for insured persons. Furthermore, primary care and public health receive increased funding, and quality and expenditures are addressed through a range of measures. Whether the ACA will indeed be effective in addressing the challenges identified above can only be determined over time. World Health Organization 2013 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies).

  6. Radiological transportation emergency response training course funding and timing in the southern states

    International Nuclear Information System (INIS)

    1991-10-01

    The following is a review of the enabling statutes of 16 southern states regarding training for personnel preparing for or responding to a transportation-related emergency involving highway route-controlled quantities of spent fuel and high-level radioactive waste. This report outlines the funding sources and procedures for administering funds for programs attended by state and local officials. Additionally, the report outlines the views of emergency response officials in the southem states concerning the timing and administration of future federal assistance to be provided under section 180(c) of the Nuclear Waste Policy Amendments Act. Under section 180(c) of the Nuclear Waste Policy Amendments Act of 1987, the US Department of Energy (DOE) is required to provide technical assistance and funds to states for training public safety officials of appropriate units of local government and Indian tribes when spent nuclear fuel or high-level radioactive waste is transported through their jurisdictions. The Comprehensive Cooperative Agreement (CCA) is the primary funding mechanism for federal assistance to states for the development of their overall emergency management capabilities. FEMA supports 12 separate emergency management programs including the Emergency Management Training program (EMT). This program provides funds for emergency management training and technical assistance to states for unique state training needs. Funds may be used for instructors, students and other related costs

  7. Leading Causes of Death in Females United States

    Science.gov (United States)

    ... and Health Issues at Work Health Equity Leading Causes of Death in Females, United States Recommend on Facebook Tweet ... to current and previous listings for the leading causes of death in females in the United States. Please note ...

  8. Arsenic in Ground Water of the United States

    Science.gov (United States)

    ... Team More Information Arsenic in groundwater of the United States Arsenic in groundwater is largely the result of ... Gronberg (2011) for updated arsenic map. Featured publications United States Effects of human-induced alteration of groundwater flow ...

  9. Residency training in the United States: What foreign medical ...

    African Journals Online (AJOL)

    FMGs) planning to pursue post-graduate residency training in the United States of America (USA). While the number of residency training positions is shrinking, and the number of United States graduates has steadily declined over the past ...

  10. The United States and the Arab Gulf Monarchies

    International Nuclear Information System (INIS)

    Kechichian, J.A.

    1999-01-01

    The United States has enduring strategic interests in the Persian Gulf region. To understand these interests and the Usa policy towards the Arab Gulf Monarchies, the french institute of international relations (IFRI) proposes this document. The following chapters are detailed: the United States and the Arab Gulf Monarchies, overview, Chief Unites States Objective: Access to oil, re-evaluating United States Foreign Policy in the Gulf, the second term (Usa strategy). (A.L.B.)

  11. Air pollution problem in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Heimann, H

    1964-10-01

    Air pollution in the United States as a problem affecting health, as well as man's enjoyment of his property, was first noted in 1912 in the reports of the investigators at the Mellon Institute of the University of Pittsburgh. The Selby copper smelter incident in 1915 was among the first episodic air pollution events documented. The US Public Health Service studied carbon monoxide buildup in vehicular tunnels in 1928 and 1929. the Donora (Pennsylvania) pollution episode, where 17 people died, occurred in 1949. It and the onset of smog conditions in the Los Angeles area really initiated broad public awareness of air pollution as a public health hazard in the USA. The symptoms of air pollution-related injuries are discussed, the role of the US Public Health Service in dealing with air pollution, and the effect of the Clean Air Act of 1963 are discussed. 26 references.

  12. United States Transuranium and Uranium Registries

    International Nuclear Information System (INIS)

    Kathren, R.L.; Filipy, R.E.; Dietert, S.E.

    1991-06-01

    This report summarizes the primary scientific activities of the United States Transuranium and Uranium Registries for the period October 1, 1989 through September 30, 1990. The Registries are parallel human tissue research programs devoted to the study of the actinide elements in humans. To date there have been 261 autopsy or surgical specimen donations, which include 11 whole bodies. The emphasis of the Registry was directed towards quality improvement and the development of a fully computerized data base that would incorporate not only the results of postmortem radiochemical analysis, but also medical and monitoring information obtained during life. Human subjects reviews were also completed. A three compartment biokinetic model for plutonium distribution is proposed. 2 tabs

  13. Licensing of HTGRs in the United States

    International Nuclear Information System (INIS)

    Fisher, C.R.; Orvis, D.D.

    1981-01-01

    The licensing history of the high-temperature gas-cooled reactor (HTGR) in the United States is given historical perspective. The experience began with the licensing of the Peach Bottom Atomic Power Station and extends to the continuing experience at the Fort St. Vrain Nuclear Generating Station. Additional experience was obtained from the licensing reviews in the mid-1970s of the large HTGR plants that were to be built by Philadelphia Electric Company and Delmarva Power and Light. Also, information was provided by the licensing review of the General Atomic standard plant by the U.S. Nuclear Regulatory Commission (NRC) at about the same time. These experiences are summarized in terms of the principal design criteria that were required by the regulatory authority for each project. These criteria include specification of the design basis accidents that were postulated for the plant safety analysis. Several technical issues raised by the NRC during their review of the large HTGR are presented. (author)

  14. Licensing of HTGRs in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Fisher, C. R.; Orvis, D. D. [General Atomic Co., San Diego, CA (USA)

    1981-01-15

    The licensing history of the high-temperature gas-cooled reactor (HTGR) in the United States is given historical perspective. The experience began with the licensing of the Peach Bottom Atomic Power Station and extends to the continuing experience at the Fort St. Vrain Nuclear Generating Station. Additional experience was obtained from the licensing reviews in the mid-1970s of the large HTGR plants that were to be built by Philadelphia Electric Company and Delmarva Power and Light. Also, information was provided by the licensing review of the General Atomic standard plant by the U.S. Nuclear Regulatory Commission (NRC) at about the same time. These experiences are summarized in terms of the principal design criteria that were required by the regulatory authority for each project. These criteria include specification of the design basis accidents that were postulated for the plant safety analysis. Several technical issues raised by the NRC during their review of the large HTGR are presented.

  15. Electric trade in the United States 1994

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-08-01

    Wholesale trade in electricity plays an important role for the US electric utility industry. Wholesale, or bulk power, transactions allow electric utilities to reduce power costs, increase power supply options, and improve reliability. In 1994, the wholesale trade market totaled 1.9 trillion kilowatthours, about 66% of total sales to ultimate consumers. This publication, Electric Trade in the United States 1994 (ELECTRA), is the fifth in a series of reports on wholesale power transactions prepared by the Office of Coal, Nuclear, Electric and Alternate Fuels, Energy Information Administration (EIA). The electric trade data are published biennially. The first report presented 1986 data, and this report provides information on the electric power industry during 1994.

  16. Radiation protection standards in the United States

    International Nuclear Information System (INIS)

    Mills, W.A.; Arsenault, F.J.; Conti, E.F.

    1988-01-01

    Standards to protect workers and members of the general public against any harmful effects of ionizing radiation are numerous and complex in the United States. Many Federal agencies have protection responsibilities, our Congress limits the discretionary authority given to these agencies in providing for this protection, and our court system appears at times to render judgments that are illogical to our sense of the degree of radiological protection required. To many our standards appear to be overprotective in that they have, at best, marginal health benefits and without question are costly to implement. Government agencies, the Congress, industry, professional organizations, and others have expressed their concerns and interests regarding standards in a variety of ways

  17. Nuclear material control in the United States

    International Nuclear Information System (INIS)

    Jaeger, C.; Waddoups, I.

    1995-01-01

    The Department of Energy has defined a safeguards system to be an integrated system of physical protection, material accounting and material control subsystems designed to deter, prevent, detect, and respond to unauthorized possession, use, or sabotage of SNM. In practice, safeguards involve the development and application of techniques and procedures dealing with the establishment and continued maintenance of a system of activities. The system must also include administrative controls and surveillance to assure that the procedures and techniques of the system are effective and are being carried out. The control of nuclear material is critical to the safeguarding of nuclear materials within the United States. The U.S. Department of Energy includes as part of material control four functional performance areas. They include access controls, material surveillance, material containment and detection/assessment. This paper will address not only these areas but also the relationship between material control and other safeguards and security functions

  18. Uranium resources in the United States

    International Nuclear Information System (INIS)

    Grenon, Michel.

    1975-01-01

    The United States are certainly the country which is the most concerned by a better evaluation of uranium resources. This is so because of the importance of the American nuclear program and because of a certain number of doubts in their uranium supply. This is probably why studies concerning American uranium resources have been very frequent in recent months. Although, most of these studies are not yet finished it is perhaps possible to draw a few conclusions in order to better see the framework of this important uranium resources problem. This is what this article attempts, using among other studies, the one carried-out for the National Science Foundation which is among the most complete, especially concerning the complete range of resources [fr

  19. China, Southeast Asia, and the United States

    Directory of Open Access Journals (Sweden)

    Lowell Dittmer

    2016-04-01

    Full Text Available Southeast Asia has historically been a meeting point between East Asia and South Asia before Western colonialism opened the region to the West and to the winds of global modernization. Since Japan’s coercive decolonization during the Second World War, the dominant outside influences have come from the United States and from the People’s Republic of China. The post-Cold War era began with a withdrawal of both China’s and US power projection from Southeast Asia, facilitating the configuration of a triangular ménage à trios, with ASEAN expanding to include all of Southeast Asia and introducing a number of extended forums intended to socialize the rest of East Asia into the ASEAN way. The “rise of China” occurred within this friendly context, though beginning around 2010 its strategic implications began to appear more problematic with the mounting dispute over the issue of the South China Sea.

  20. The United States nuclear merchant ship program

    International Nuclear Information System (INIS)

    Maynard, E.V.

    1978-01-01

    The issues of financial protection contemplate appropriate financing to permit construction of the involved vessels. In addition, the licensing process will require a demonstrated ability for financial response in the event of injury to persons or damage to property. Since the thrust in the United States is to use the Price-Anderson framework for Insurance and Indemnity, much attention is devoted to this legislation. The pre-existing regime is related to the distinguishing requirements of the Maritime field with proposals being advanced to more nearly parallel the insurance coverage philosophy of Europe, i.e., to utilize insurance pools for the nuclear risks and utilize the conventional insurance market for non-nuclear risks. Public affairs issues impact heavily on legislation efforts and thusly become significant in developing a program for Financial Protection

  1. Renewable Energy Atlas of the United States

    Energy Technology Data Exchange (ETDEWEB)

    Kuiper, J. [Environmental Science Division; Hlava, K. [Environmental Science Division; Greenwood, H. [Environmentall Science Division; Carr, A. [Environmental Science Division

    2013-12-13

    The Renewable Energy Atlas (Atlas) of the United States is a compilation of geospatial data focused on renewable energy resources, federal land ownership, and base map reference information. This report explains how to add the Atlas to your computer and install the associated software. The report also includes: A description of each of the components of the Atlas; Lists of the Geographic Information System (GIS) database content and sources; and A brief introduction to the major renewable energy technologies. The Atlas includes the following: A GIS database organized as a set of Environmental Systems Research Institute (ESRI) ArcGIS Personal GeoDatabases, and ESRI ArcReader and ArcGIS project files providing an interactive map visualization and analysis interface.

  2. Hantavirus Pulmonary Syndrome in the United States.

    Science.gov (United States)

    Fabbri, Marilyn; Maslow, Melanie J.

    2001-06-01

    Since the first outbreak of hantavirus pulmonary syndrome (HPS) in 1993, understanding of the vast distribution and potential impact of hantaviruses has grown. At least 277 cases of HPS have been documented in the United States. The full clinical spectrum has yet to be elucidated, and one outbreak suggested the possibility of person-to-person transmission. New research has identified the b-3 integrins as cellular receptors for hantaviruses and has determined the pivotal role of the immune system in pathogenesis. Rapid diagnosis has been facilitated by a new immunoblot assay to detect Sin Nombre virus infection. Treatment remains primarily supportive; however, a placebo- controlled trial of ribavirin is ongoing. Extracorporeal membrane oxygenation may be a potential therapy in severe cases; inhaled nitric oxide needs further study. Vaccines developed against hantaviruses associated with hemorrhagic fever and renal syndrome might be effective against HPS-associated strains.

  3. Unplanned pregnancies in the United States.

    Science.gov (United States)

    Grimes, D A

    1986-03-01

    Unplanned pregnancies constitute an epidemic in the United States. Over 3 million unplanned pregnancies occur, and over 1.5 million induced abortions are performed each year. Women of minority races and those with less than 12 years of education are at high risk of having unwanted children. Fear of complications (not the complications themselves) is the most powerful deterrent to women's use of contraception. Much of this fear is due to bad press. Recent good news about contraception, such as protection against ovarian and endometrial cancer, protection against ectopic pregnancy, and absence of teratogenic effects, has not received appropriate media coverage. For healthy women younger than 35 years, failure to use fertility control is more dangerous than use of any method.

  4. Electric trade in the United States 1994

    International Nuclear Information System (INIS)

    1998-08-01

    Wholesale trade in electricity plays an important role for the US electric utility industry. Wholesale, or bulk power, transactions allow electric utilities to reduce power costs, increase power supply options, and improve reliability. In 1994, the wholesale trade market totaled 1.9 trillion kilowatthours, about 66% of total sales to ultimate consumers. This publication, Electric Trade in the United States 1994 (ELECTRA), is the fifth in a series of reports on wholesale power transactions prepared by the Office of Coal, Nuclear, Electric and Alternate Fuels, Energy Information Administration (EIA). The electric trade data are published biennially. The first report presented 1986 data, and this report provides information on the electric power industry during 1994

  5. Global context for the United States Forest Sector in 2030

    Science.gov (United States)

    James Turner; Joseph Buongiorno; Shushuai Zhu; Jeffrey P. Prestemon

    2005-01-01

    The purpose of this study was to identify markets for, and competitors to, the United States forest industries in the next 30 years. The Global Forest Products Model was used to make predictions of international demand, supply, trade, and prices, conditional on the last RPA Timber Assessment projections for the United States. It was found that the United States, Japan...

  6. 27 CFR 479.89 - Transfers to the United States.

    Science.gov (United States)

    2010-04-01

    ... Transfers to the United States. A firearm may be transferred to the United States or any department... 27 Alcohol, Tobacco Products and Firearms 3 2010-04-01 2010-04-01 false Transfers to the United States. 479.89 Section 479.89 Alcohol, Tobacco Products, and Firearms BUREAU OF ALCOHOL, TOBACCO...

  7. 32 CFR 516.54 - Witnesses for the United States.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Witnesses for the United States. 516.54 Section..., Travel, and Expenses of Witnesses § 516.54 Witnesses for the United States. (a) Status of witness. A military member authorized to appear as a witness for the United States, including those authorized to...

  8. 32 CFR 150.21 - Appeals by the United States.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false Appeals by the United States. 150.21 Section 150... the United States. (a) Restricted filing. Only a representative of the government designated by the Judge Advocate General of the respective service may file an appeal by the United States under Article...

  9. 78 FR 27857 - United States Standards for Wheat

    Science.gov (United States)

    2013-05-13

    ... RIN 0580-AB12 United States Standards for Wheat AGENCY: Grain Inspection, Packers and Stockyards... (GIPSA) is revising the United States Standards for Wheat under the United States Grain Standards Act (USGSA) to change the definition of Contrasting classes (CCL) in the class Hard White wheat. This change...

  10. 31 CFR 515.334 - United States national.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States national. 515.334 Section 515.334 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE... of the United States, and which has its principal place of business in the United States. [61 FR...

  11. A proposed United States resource classification system

    International Nuclear Information System (INIS)

    Masters, C.D.

    1980-01-01

    Energy is a world-wide problem calling for world-wide communication to resolve the many supply and distribution problems. Essential to a communication problem are a definition and comparability of elements being communicated. The US Geological Survey, with the co-operation of the US Bureau of Mines and the US Department of Energy, has devised a classification system for all mineral resources, the principles of which, it is felt, offer the possibility of world communication. At present several other systems, extant or under development (Potential Gas Committee of the USA, United Nations Resource Committee, and the American Society of Testing and Materials) are internally consistent and provide easy communication linkage. The system in use by the uranium community in the United States of America, however, ties resource quantities to forward-cost dollar values rendering them inconsistent with other classifications and therefore not comparable. This paper develops the rationale for the new USGS resource classification and notes its benefits relative to a forward-cost classification and its relationship specifically to other current classifications. (author)

  12. Latin America and the United States: What Do United States History Textbooks Tell Us?

    Science.gov (United States)

    Fleming, Dan B.

    1982-01-01

    Evaluates how U.S.-Latin American relations are presented in high school U.S. history textbooks. An examination of 10 textbooks published between 1977-81 revealed inadequate coverage of Latin American cultural diversity and United States foreign policy from the Latin American perspective. (AM)

  13. Short Rotation Crops in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Wright, L L

    1998-06-04

    The report is based primarily on the results of survey questions sent to approximately 60 woody and 20 herbaceous crop researchers in the United States and on information from the U.S. Department of Energy's Bioenergy Feedstock Development Program. Responses were received from 13 individuals involved in woody crops research or industrial commercialization (with 5 of the responses coming from industry). Responses were received from 11 individuals involved in herbaceous crop research. Opinions on market incentives, technical and non-technical barriers, and highest priority research and development areas are summarized in the text. Details on research activities of the survey responders are provided as appendices to the paper. Woody crops grown as single-stem systems (primarily Populus and Eucalyptus species) are perceived to have strong pulp fiber and oriented strand board markets, and the survey responders anticipated that energy will comprise 25% or less of the utilization of single-stem short-rotation woody crops between now and 2010. The only exception was a response from California where a substantial biomass energy market does currently exist. Willows (Salix species) are only being developed for energy and only in one part of the United States at present. Responses from herbaceous crop researchers suggested frustration that markets (including biomass energy markets) do not currently exist for the crop, and it was the perception of many that federal incentives will be needed to create such markets. In all crops, responses indicate that a wide variety of research and development activities are needed to enhance the yields and profitability of the crops. Ongoing research activities funded by the U.S. Department of Energy's Bioenergy Feedstock Development Program are described in an appendix to the paper.

  14. Fires Across the Western United States

    Science.gov (United States)

    2007-01-01

    Days of record heat made the western United States tinder dry in early July 2007. Numerous wildfires raced across the dry terrain during the weekend of July 7. From Washington to Arizona, firefighters were battling fast-moving wildfires that threatened residences, businesses, gas wells, coal mines, communications equipment, and municipal watersheds. This image of the West was captured by the Moderate Resolution Imaging Spectroradiometer (MODIS) on NASA's Terra satellite on Sunday, July 8. Places where MODIS detected actively burning fires are marked in red. Some of the largest blazes are labeled. Utah's Milford Flat was the largest; according to the July 9 morning report from the National Interagency Fire Center, the blaze was more than 280,000 acres, having grown more than 124,000 acres in the previous 24 hours. The fires have destroyed homes, forced evacuations, shut down trains and highways, and killed several people. Weather conditions were not expected to improve significantly across much of the area for several days, with hot temperatures and dry thunderstorms (lightning and winds, but little rain) likely in many places. Nearly the entire western United States was experiencing some level of drought as of July 3, according to the U.S. Drought Monitor. The drought had reached the 'extreme' category in southern California and western Arizona, and ranged from moderate to severe across most of the rest of the Southwest and Great Basin. The large image provided above has a spatial resolution (level of detail) of 500 meters per pixel. The MODIS Rapid Response Team provides twice-daily images of the region in additional resolutions and formats, including an infrared-enhanced version that makes burned terrain appear brick red. NASA image courtesy the MODIS Rapid Response Team, Goddard Space Flight Center

  15. The United States: breakthroughs and waste.

    Science.gov (United States)

    Reinhardt, U E

    1992-01-01

    The health system of the United States is in a paradoxical position. At its best, the system is a magnet for those seeking the latest technical breakthroughs. It can offer that excellence because there have never been effective financial constraints on the imagination; the system has become a major economic frontier, at which professional and other entrepreneurs successfully seek their fortune. At the same time, the system is leaving increasing numbers of Americans frustrated and disillusioned. It is beset by excess capacity in many areas, is needlessly expensive, and often bestows unnecessary health services. Yet only the experts are aware of these flaws; most Americans still express high satisfaction with the quality of the services they receive from their doctors and hospitals. The public's major misgivings arise over the awkward and inequitable way in which American health care is financed. The typical private health insurance policy, for example, is tied to a particular job. If the job is lost, so is the health insurance. Furthermore, these policies are priced on actuarially "fair" principles, so sick individuals are forced to pay higher insurance premiums than relatively healthy ones and chronically ill persons often cannot obtain health insurance coverage at any price. Although there are public programs to catch many persons not privately insured, the coverage tends to be insufficiently extensive and deep. Some 35 million Americans, mostly poor, have no health insurance whatsoever. Unfortunately, at this time there is no political force in the United States strong enough to reform the American health system toward greater social equity and economic efficiency, whereas there are numerous groups powerful enough to block whatever reform might harm their own narrow economic interests. Other nations can learn from America's clinical and organizational innovations in health care delivery. They can also learn what not to do by studying the unseemly way in which

  16. Eye on China and United States

    Directory of Open Access Journals (Sweden)

    Milad Mahyari

    2016-07-01

    Full Text Available United States strives to force the Chinese into agreement of increasing the value of their exchange rate to help the USA avoid inflation As China did not come into an agreement with the USA, Tariffs are being put on Chinese products entering USA. However China as began to add tariff on poultry received from the US as well. China was previously not named in the legislation permitting US to add tariff on their goods. But recently a bill was passed giving the commerce department the ability to place important tariffs on all countries to undervalue their currency. The bill passed in legislation had the support of 99 republicans. China has been managing their currency in a manner that makes their goods cheaper to sell and American goods more expensive. The Chinese manipulation of their currency has been quite expensive for the USA, as it has cost them $1.5 billion jobs increasing the percentage of unemployment greatly and significantly. This imposition of tariffs on Chinese goods could result in effecting $300 billion dollars worth of their products. It is obvious that the Americans are attempting to improve and acknowledge their growth and power. As predictions have developed over this conflict, arguing the fact that China will not negotiate with the USA at this point rather fight back and also approach in adding tariffs on USimports. However, this reaction by the Chinese will only worsen the scenario and result in the possible inflation of the US economy or worldwide trade war. This is a very sensitive time for the United States as their biggest hopes are dependent on the Chinese. But it doesn’t look like they will be too satisfied with the outcome.

  17. Expecting the unexpected [The IAEA's Incident and Emergency Centre helps prepare States to face radiological emergencies

    International Nuclear Information System (INIS)

    Stern, W.; Buglova, E.

    2007-01-01

    The IAEA works with its partners worldwide to promote safe, secure and peaceful nuclear technologies. The IAEA's Statute assigns functions to the Secretariat in relation to radiation emergencies, including fostering international cooperation in the area of emergency preparedness and response. The Convention on Early Notification of a Nuclear Accident and the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency (often called the 'Emergency Conventions') place specific legal obligations on the IAEA with regard to emergency preparedness and response. In 2005, the IAEA established a fully integrated Incident and Emergency Centre (IEC) which acts as the global focal point for international preparedness, communication and response to nuclear and radiological incidents or emergencies irrespective of their cause. In this role, the IEC stands at the centre of coordinating effective and efficient activities worldwide. While emergency response capabilities have existed within the IAEA since concluding the Emergency Conventions in the 1980s, the decision to create an integrated Centre within the IAEA became more pressing with the growing use of nuclear applications worldwide as well as increasing concern over malicious use of nuclear or radioactive materials. Today, the IEC provides around-the-clock assistance to States dealing with nuclear and radiological events. Under the Emergency Conventions, the IEC coordinates actions of global experts and efforts within the IAEA. It also helps coordinate the responses of States as well as other international organizations, such as the WHO (World Health Organization), FAO (Food and Agricultural Organization) or WMO (World Meteorological Organization) in case of a nuclear or radiological emergency. Response to incidents and emergencies can involve exchange of information, provision of advice and/or coordination of field response. The IEC ensures that the IAEA's incident and emergency arrangements are fully

  18. Energy market environments in Europe and the United States

    International Nuclear Information System (INIS)

    Puettgen, H.B.; Haubrich, H.J.; Stotz, J.; Winje, D.; Klappa, G.; Denton, D.H.

    1997-01-01

    On July 21, the technical program of the IEEE Power Engineering Society (PES) 1997 Summer Meeting began with a joint plenary, cosponsored by VDE-ETG. Simultaneous translation allowed the audience to listen to the presentations in either German or English. Emerging Energy Market Environments in Europe and the United states was chaired by H.J. Haubrich, RWTH, and H.B. Puettgen, Georgia Institute of Technology. Following welcome addresses and introductory remarks by E.F. Peschke, chair or the local organizing committee, K. Bechtold, BEWAG, Berlin, H. Wolters, VDE chair, L. Bochanky, ETG chair, Charles K. Alexander, IEEE president, and Robert A. Dent, PES president, the following presentations were given: The Process of Integration of the East and West European Networks, Juergen Stotz, VEAG, Germany; Electric Power Turns into a Commodity: A Change of Paradigm in the Power Industry, Dietmar Winje, BEWAG, Germany; The Brave New World of Customer Satisfaction, Gale Klappa, Southwest Utilities, United Kingdom; Deregulation Risks and Opportunities, Donald H. Denton, Jr., Duke Power Company, United States. Summaries of the four presentations are included

  19. Abortion surveillance--United States, 1991.

    Science.gov (United States)

    Koonin, L M; Smith, J C; Ramick, M

    1995-05-05

    From 1980 through 1991, the number of legal induced abortions reported to CDC remained stable, varying each year by 1969, CDC has compiled abortion data received from 52 reporting areas: 50 states, the District of Columbia, and New York City. In 1991, 1,388,937 abortions were reported--a 2.8% decrease from 1990. The abortion ratio was 339 legal induced abortions per 1,000 live births, and the abortion rate was 24 per 1,000 women 15-44 years of age. Women who were undergoing an abortion were more likely to be young, white, and unmarried; most had had no previous live births and had been obtaining an abortion for the first time. More than half (52%) of all abortions were performed at or before the 8th week of gestation, and 88% were before the 13th week. Younger women (i.e., women may partially account for this decline. An accurate assessment of the number and characteristics of women who obtain abortions in the United States is necessary both to monitor efforts to prevent unintended pregnancy and to identify and reduce preventable causes of morbidity and mortality associated with abortions.

  20. State of emergency preparedness for US health insurance plans.

    Science.gov (United States)

    Merchant, Raina M; Finne, Kristen; Lardy, Barbara; Veselovskiy, German; Korba, Caey; Margolis, Gregg S; Lurie, Nicole

    2015-01-01

    Health insurance plans serve a critical role in public health emergencies, yet little has been published about their collective emergency preparedness practices and policies. We evaluated, on a national scale, the state of health insurance plans' emergency preparedness and policies. A survey of health insurance plans. We queried members of America's Health Insurance Plans, the national trade association representing the health insurance industry, about issues related to emergency preparedness issues: infrastructure, adaptability, connectedness, and best practices. Of 137 health insurance plans queried, 63% responded, representing 190.6 million members and 81% of US plan enrollment. All respondents had emergency plans for business continuity, and most (85%) had infrastructure for emergency teams. Some health plans also have established benchmarks for preparedness (eg, response time). Regarding adaptability, 85% had protocols to extend claim filing time and 71% could temporarily suspend prior medical authorization rules. Regarding connectedness, many plans shared their contingency plans with health officials, but often cited challenges in identifying regulatory agency contacts. Some health insurance plans had specific policies for assisting individuals dependent on durable medical equipment or home healthcare. Many plans (60%) expressed interest in sharing best practices. Health insurance plans are prioritizing emergency preparedness. We identified 6 policy modifications that health insurance plans could undertake to potentially improve healthcare system preparedness: establishing metrics and benchmarks for emergency preparedness; identifying disaster-specific policy modifications, enhancing stakeholder connectedness, considering digital strategies to enhance communication, improving support and access for special-needs individuals, and developing regular forums for knowledge exchange about emergency preparedness.

  1. Brackish groundwater in the United States

    Science.gov (United States)

    Stanton, Jennifer S.; Anning, David W.; Brown, Craig J.; Moore, Richard B.; McGuire, Virginia L.; Qi, Sharon L.; Harris, Alta C.; Dennehy, Kevin F.; McMahon, Peter B.; Degnan, James R.; Böhlke, John Karl

    2017-04-05

    For some parts of the Nation, large-scale development of groundwater has caused decreases in the amount of groundwater that is present in aquifer storage and that discharges to surface-water bodies. Water supply in some areas, particularly in arid and semiarid regions, is not adequate to meet demand, and severe drought is affecting large parts of the United States. Future water demand is projected to heighten the current stress on groundwater resources. This combination of factors has led to concerns about the availability of freshwater to meet domestic, agricultural, industrial, mining, and environmental needs. To ensure the water security of the Nation, currently [2016] untapped water sources may need to be developed.Brackish groundwater is an unconventional water source that may offer a partial solution to current and future water demands. In support of the national census of water resources, the U.S. Geological Survey completed the national brackish groundwater assessment to better understand the occurrence and characteristics of brackish groundwater in the United States as a potential water resource. Analyses completed as part of this assessment relied on previously collected data from multiple sources; no new data were collected. Compiled data included readily available information about groundwater chemistry, horizontal and vertical extents and hydrogeologic characteristics of principal aquifers (regionally extensive aquifers or aquifer systems that have the potential to be used as a source of potable water), and groundwater use. Although these data were obtained from a wide variety of sources, the compiled data are biased toward shallow and fresh groundwater resources; data representing groundwater that is at great depths and is saline were not as readily available.One of the most important contributions of this assessment is the creation of a database containing chemical characteristics and aquifer information for the known areas with brackish groundwater

  2. United States electric industry : restructuring in review

    International Nuclear Information System (INIS)

    Slocum Hollis, S.

    2004-01-01

    This paper provides a detailed review of the United States electric power industry. The aim of the review was to clarify and better define current industry procedures and practices in light of significant and recent restructuring. In addition, recent bankruptcies and the power blackout in 2003 have raised concerns over industry practices. Issues concerning Independent System Operators (ISO) and regional transmission organizations were evaluated, with reference to an evolution and implementation of Regional Transmission Organization (RTO) policy, including a cost-benefit analysis. A background of RTO formations was provided with reference to consolidation, selection process and transfer of assets. Standard market design, network access and pricing issues were reviewed, as well as market and reliability concerns. Issues concerning affiliate treatment, shortages and the effect of sale of securities were presented. Various approaches to congestion management were examined, with examples from California and New England. Market monitoring issues, investigations and hearings were also examined, with examples and orders, including details of refunds. Measures to improve reliability were reviewed, including: management systems, benefit margins, requirements, assurance agreements and reserve markets. Issues concerning information access were presented, including: Open Access Same-time Information System (OASIS) requirements; tagging; standard business practices and protocols; and quarterly report practices and protocols. Interconnection policies were reviewed with reference to applicability, service options and pricing. The issue of variations was examined, with case examples concerning cost allocation, contract rights and treatment of specific costs. Jurisdiction issues concerning corporate realignments and power exchanges were presented, as well as specific services and state-federal relations. Issues concerning mergers and merger policy were also discussed, with reference

  3. 78 FR 70274 - United States Travel and Tourism Advisory Board: Meeting of the United States Travel and Tourism...

    Science.gov (United States)

    2013-11-25

    ... DEPARTMENT OF COMMERCE International Trade Administration United States Travel and Tourism Advisory Board: Meeting of the United States Travel and Tourism Advisory Board AGENCY: International Trade... the schedule and agenda for an open meeting of the United States Travel and Tourism Advisory Board...

  4. 78 FR 3398 - United States Travel and Tourism Advisory Board: Meeting of the United States Travel and Tourism...

    Science.gov (United States)

    2013-01-16

    ... DEPARTMENT OF COMMERCE International Trade Administration United States Travel and Tourism Advisory Board: Meeting of the United States Travel and Tourism Advisory Board AGENCY: International Trade... the schedule and agenda for an open meeting of the United States Travel and Tourism Advisory Board...

  5. On Emergent Physics, "Unparticles" and Exotic "Unmatter" States

    Directory of Open Access Journals (Sweden)

    Smarandache F.

    2008-10-01

    Full Text Available Emergent physics refers to the formation and evolution of collective patterns in systems that are nonlinear and out-of-equilibrium. This type of large-scale behavior often develops as a result of simple interactions at the component level and involves a dynamic interplay between order and randomness. On account of its universality, there are credible hints that emergence may play a leading role in the Tera-ElectronVolt (TeV sector of particle physics. Following this path, we examine the possibility of hypothetical high-energy states that have fractional number of quanta per state and consist of arbitrary mixtures of particles and antiparticles. These states are similar to "un-particles", massless fields of non-integral scaling dimensions that were recently conjectured to emerge in the TeV sector of particle physics. They are also linked to "unmatter", exotic clusters of matter and antimatter introduced few years ago in the context of Neutrosophy.

  6. Strategies used by nursing technicians to face the occupational suffering in an emergency unit

    Directory of Open Access Journals (Sweden)

    Alessandra Bassalobre Garcia

    2016-05-01

    Full Text Available Objective: to understand the strategies used by nursing technicians in order to face the occupational suffering in an emergency room. Methods: qualitative study carried out in an emergency room of a high complexity hospital located in the north of Paraná state. Data were collected through semi-structured interviews with 12 nursing technicians. The analysis relied on content analysis procedures. Results: respondents revealed as individual strategies to face suffering: try not to get involved with the patient; separation between professional and personal life; and spirituality/religion as support for coping. The collective strategies described by respondents included: action planning for unexpected events in this unit; creating a supportive environment; and attempt to obtain recognition of headship. Conclusion: individual and collective strategies were used consciously by workers and should be encouraged by managers to face the occupational suffering.

  7. [Structure, organization and capacity problems in emergency medical services, emergency admission and intensive care units].

    Science.gov (United States)

    Dick, W

    1994-01-01

    Emergency medicine is subjected worldwide to financial stringencies and organizational evaluations of cost-effectiveness. The various links in the chain of survival are affected differently. Bystander assistance or bystander CPR is available in only 30% of the emergencies, response intervals--if at all required by legislation--are observed to only a limited degree or are too extended for survival in cardiac arrest. A single emergency telephone number is lacking. Too many different phone numbers for emergency reporting result in confusion and delays. Organizational realities are not fully overcome and impair efficiency. The position of the emergency physician in the EMS System is inadequately defined, the qualification of too many emergency physicians are unsatisfactory. In spite of this, emergency physicians are frequently forced to answer out-of-hospital emergency calls. Conflicts between emergency physicians and EMTs may be overcome by providing both groups with comparable qualifications as well as by providing an explicit definition of emergency competence. A further source of conflict occurs at the juncture of prehospital and inhospital emergency care in the emergency department. Deficiencies on either side play a decisive role. At least in principle there are solutions to the deficiencies in the EMSS and in intensive care medicine. They are among others: Adequate financial compensation of emergency personnel, availability of sufficient numbers of highly qualified personnel, availability of a central receiving area with an adjacent emergency ward, constant information flow to the dispatch center on the number of available emergency beds, maintaining 5% of all beds as emergency beds, establishing intermediate care facilities. Efficiency of emergency physician activities can be demonstrated in polytraumatized patients or in patients with ventricular fibrillation or acute myocardial infarction, in patients with acute myocardial insufficiency and other emergency

  8. A chronosequence feasibility assessment of emergency fire rehabilitation records within the intermountain western United States-final report to the Joint Fire Science Program-Project 08-S-08

    Science.gov (United States)

    Kevin C. Knutson; David A. Pyke; Troy A. Wirth; David S. Pilliod; Matthew L. Brooks; Jeanne C. Chambers

    2009-01-01

    Department of the Interior (DOI) bureaus have invested heavily (for example, the U.S. Bureau of Land Management (BLM) spent more than $60 million in fiscal year 2007) in seeding vegetation for emergency stabilization and burned area rehabilitation of non-forested arid lands over the past 10 years. The primary objectives of these seedings commonly are to (1) reduce the...

  9. S. 335, the Emerging Telecommunications Technologies Act of 1993. Hearing before the Subcommittee on Communications of the Committee on Commerce, Science, and Transportation. United States Senate, One Hundred Third Congress, First Session.

    Science.gov (United States)

    Congress of the U.S., Washington, DC. Senate Committee on Commerce, Science, and Transportation.

    A hearing was held on Senate Bill 335, the Emerging Telecommunications Technologies Act of 1993, a bill that requires the federal government to transfer 200 megahertz of spectrum to the Federal Communications Commission (FCC) for new technologies. Integral to this measure, a bipartisan effort, is a provision that will allow the FCC to use…

  10. Building the United States National Vegetation Classification

    Science.gov (United States)

    Franklin, S.B.; Faber-Langendoen, D.; Jennings, M.; Keeler-Wolf, T.; Loucks, O.; Peet, R.; Roberts, D.; McKerrow, A.

    2012-01-01

    The Federal Geographic Data Committee (FGDC) Vegetation Subcommittee, the Ecological Society of America Panel on Vegetation Classification, and NatureServe have worked together to develop the United States National Vegetation Classification (USNVC). The current standard was accepted in 2008 and fosters consistency across Federal agencies and non-federal partners for the description of each vegetation concept and its hierarchical classification. The USNVC is structured as a dynamic standard, where changes to types at any level may be proposed at any time as new information comes in. But, because much information already exists from previous work, the NVC partners first established methods for screening existing types to determine their acceptability with respect to the 2008 standard. Current efforts include a screening process to assign confidence to Association and Group level descriptions, and a review of the upper three levels of the classification. For the upper levels especially, the expectation is that the review process includes international scientists. Immediate future efforts include the review of remaining levels and the development of a proposal review process.

  11. Regional geologic framework off northeastern United States

    International Nuclear Information System (INIS)

    Schlee, J.; Behrendt, J.C.; Grow, J.A.; Robb, J.M.; Mattick, R.E.; Taylor, P.T.; Lawson, B.J.

    1976-01-01

    Six multichannel seismic-reflection profiles taken across the Atlantic continental margin off the northeastern United States show an excess of 14 km of presumed Mesozoic and younger sedimentary rocks in the Baltimore Canyon trough and 8 km in the Georges Bank basin. Beneath the continental rise, the sedimentary prism thickness exceeds 7 km south of New Jersey and Maryland, and it is 4.5 km thick south of Georges Bank Stratigraphically, the continental slope--outer edge of the continental shelf is a transition zone of high-velocity sedimentary rock, probably carbonate, that covers deeply subsidized basement. The spatial separation of magnetic and gravity anomalies on line 2 (New Jersey) suggests that in the Baltimore Canyon region the magnetic-slope anomaly is due to edge effects and that the previously reported free-air and isostatic gravity anomalies over the outer shelf may be due in part to a lateral increase in sediment density (velocity) near the shelf edge. The East Coast magnetic anomaly and the free-air gravity high both coincide over the outer shelf edge on line 1 (Georges Bank) but are offset by 20 km from the ridge on the reflection profile

  12. Monthly hydroclimatology of the continental United States

    Science.gov (United States)

    Petersen, Thomas; Devineni, Naresh; Sankarasubramanian, A.

    2018-04-01

    Physical/semi-empirical models that do not require any calibration are of paramount need for estimating hydrological fluxes for ungauged sites. We develop semi-empirical models for estimating the mean and variance of the monthly streamflow based on Taylor Series approximation of a lumped physically based water balance model. The proposed models require mean and variance of monthly precipitation and potential evapotranspiration, co-variability of precipitation and potential evapotranspiration and regionally calibrated catchment retention sensitivity, atmospheric moisture uptake sensitivity, groundwater-partitioning factor, and the maximum soil moisture holding capacity parameters. Estimates of mean and variance of monthly streamflow using the semi-empirical equations are compared with the observed estimates for 1373 catchments in the continental United States. Analyses show that the proposed models explain the spatial variability in monthly moments for basins in lower elevations. A regionalization of parameters for each water resources region show good agreement between observed moments and model estimated moments during January, February, March and April for mean and all months except May and June for variance. Thus, the proposed relationships could be employed for understanding and estimating the monthly hydroclimatology of ungauged basins using regional parameters.

  13. The United Mexican States: an update.

    Science.gov (United States)

    Hakkert, R; Aguirre, E J

    1988-09-01

    Although the popular North American opinion of Mexico is one that paints a picture of a poor, disadvantaged country, South America sees Mexico has a richer more prosperous nation. It is observed that only in the Latin American countries of Venezuela, Suriname and Trinidad and Tobago do consumers have higher incomes than Mexican consumers. Moreover, while millions of Mexicans migrate to the United States to seek a better standard of living, several thousand Central American refugees illegally migrate to Mexico in search of a better life. This better life includes an increased age of lie expectancy from 51 years in the 1950s to 64 years in the late 1970s. There have also been improvements in health care and school enrollments and in the low cost availability of education. Tourism and the prospect of the manufacturing of energy are significant, positive factors working in favor of an improved Mexican economy and a higher overall quality of life. However, Mexico faces serious problems such as a mounting foreign debt. Also rising is Mexico's population which has doubled since 1964 and which continues to grow at a rate of 1.9%. Economic programs and reforms and family development planning have been instituted in response to the countries' current recession and population growth and have begun to show positive results.

  14. Interfuel substitution in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Serletis, Apostolos; Vasetsky, Olexandr [Department of Economics, University of Calgary, Calgary, Alberta (Canada); Timilsina, Govinda R. [Development Research Group, The World Bank, 1818 H Street N.W., Washington, DC 20433 (United States)

    2010-05-15

    In this paper, we use the locally flexible translog functional form to investigate the demand for energy and interfuel substitution in the United States and to provide a comparison of our results with most of the existing empirical energy demand literature. Motivated by the widespread practice of ignoring theoretical regularity, we follow Barnett's (2002) suggestions and estimate the model subject to theoretical regularity, using methods developed by Diewert and Wales (1987) and Ryan and Wales (2000), in an attempt to produce inference consistent with neoclassical microeconomic theory. Moreover, we use the most recent data, published by the U.S. Energy Information Administration (EIA), and in addition to investigating interfuel substitution possibilities in total U.S. energy demand, we follow Serletis et al. (2009) and also examine interfuel substitution possibilities in energy demand by sector. Moreover, we test for weak separability, with the objective of discovering the structure of the functional form in total energy demand as well as energy demand by sector. (author)

  15. United States Holocaust Museums: Pathos, Possession, Patriotism

    Directory of Open Access Journals (Sweden)

    Rob Baum

    2011-12-01

    Full Text Available This article examines the role of United States holocaust museums in directing (American knowledge and memory of World War II, and demonstrates how signifiers of race, colour and Jewishness are played out and theatricalised. Erected in two principal U.S. cities of Los Angeles and Washington, D.C., the Holocaust Museum and Museum of Tolerance uphold very different mandates: the first dedicated to revealing European civilian tragedies during WWII; the latter dealing with Jewish persecution and the L.A. Riots of 1991, with references to other cultural catastrophes. While these projects are different, they are not opposed; both museums locate the American perspective of events and their meanings at the forefront. American holocaust museums seem to challenge spaces between memory and its direction, vision and revision. Within the gruesome context of holocaust portrayal, interrogate the valences of memory’s play and expose American holocaust museums as theatres of pornographic memory. The seduction of feeling does not invite change so much as purgation, what Aristotle identified as catharsis — an emotional and physical release, unfortunately replicating the seductive techniques used by Goebbels for the glorification of Hitler. Through manipulation of viewers as automatic audiences, these museums function as centres for pathos I question the policy and polity of presenting genocide as an entertainment leading to catharsis, recognizing that the final act of purgation is all too easily negation.

  16. Recurrent Kawasaki disease, United States and Japan

    Science.gov (United States)

    Maddox, Ryan A.; Holman, Robert C.; Uehara, Ritei; Callinan, Laura S.; Guest, Jodie L.; Schonberger, Lawrence B.; Nakamura, Yosikazu; Yashiro, Mayumi; Belay, Ermias D.

    2015-01-01

    Background Descriptive epidemiologic studies of recurrent and non-recurrent Kawasaki disease (KD) may identify other potentially important differences between these illnesses. Methods Data from the United States and Japan, the Centers for Disease Control and Prevention (CDC) national KD surveillance (1984–2008) and the 17th Japanese nationwide survey (2001–2002), respectively, were analyzed to examine recurrent KD patients <18 years of age meeting the CDC KD case or atypical KD case definition. These patients were compared to non-recurrent KD patients. Results Of the 5557 US KD patients <18 years of age during 1984–2008, 97 (1.7%) were identified as having had recurrent KD. Among the US Asian/Pacific Islander KD patients, 3.5% had recurrent KD, which was similar to the percentage identified among KD patients (3.5%) in the Japanese survey. Compared to non-recurrent KD patients, KD patients experiencing a recurrent KD episode were more likely to be older, fulfill the atypical KD case definition, and have coronary artery abnormalities (CAA) despite IVIG treatment. Conclusions Differences in the age, race, and frequency of CAA exist between recurrent and non-recurrent KD patients. The increased association of CAA with recurrent KD suggests that more aggressive treatment strategies in conjunction with IVIG may be indicated for the second episode of KD. PMID:26096590

  17. Derecho Hazards in the United States.

    Science.gov (United States)

    Ashley, Walker S.; Mote, Thomas L.

    2005-11-01

    Convectively generated wind-storms occur over broad temporal and spatial scales; however, the more widespread and longer lived of these windstorms have been given the name "derecho." Utilizing an integrated derecho database, including 377 events from 1986 to 2003, this investigation reveals the amount of insured property losses, fatalities, and injuries associated with these windstorms in the United States. Individual derechos have been responsible for up to 8 fatalities, 204 injuries, forest blow-downs affecting over 3,000 km2 of timber, and estimated insured losses of nearly a $500 million. Findings illustrate that derecho fatalities occur more frequently in vehicles or while boating, while injuries are more likely to happen in vehicles or mobile homes. Both fatalities and injuries are most common outside the region with the highest derecho frequency. An underlying synthesis of both physical and social vulnerabilities is suggested as the cause of the unexpected casualty distribution. In addition, casualty statistics and damage estimates from hurricanes and tornadoes are contrasted with those from derechos to emphasize that derechos can be as hazardous as many tornadoes and hurricanes.

  18. Seismic hazard in the eastern United States

    Science.gov (United States)

    Mueller, Charles; Boyd, Oliver; Petersen, Mark D.; Moschetti, Morgan P.; Rezaeian, Sanaz; Shumway, Allison

    2015-01-01

    The U.S. Geological Survey seismic hazard maps for the central and eastern United States were updated in 2014. We analyze results and changes for the eastern part of the region. Ratio maps are presented, along with tables of ground motions and deaggregations for selected cities. The Charleston fault model was revised, and a new fault source for Charlevoix was added. Background seismicity sources utilized an updated catalog, revised completeness and recurrence models, and a new adaptive smoothing procedure. Maximum-magnitude models and ground motion models were also updated. Broad, regional hazard reductions of 5%–20% are mostly attributed to new ground motion models with stronger near-source attenuation. The revised Charleston fault geometry redistributes local hazard, and the new Charlevoix source increases hazard in northern New England. Strong increases in mid- to high-frequency hazard at some locations—for example, southern New Hampshire, central Virginia, and eastern Tennessee—are attributed to updated catalogs and/or smoothing.

  19. Adherence barriers to chronic dialysis in the United States.

    Science.gov (United States)

    Chan, Kevin E; Thadhani, Ravi I; Maddux, Franklin W

    2014-11-01

    Hemodialysis patients often do not attend their scheduled treatment session. We investigated factors associated with missed appointments and whether such nonadherence poses significant harm to patients and increases overall health care utilization in an observational analysis of 44 million hemodialysis treatments for 182,536 patients with ESRD in the United States. We assessed the risk of hospitalization, emergency room visit, or intensive-coronary care unit (ICU-CCU) admission in the 2 days after a missed treatment relative to the risk for patients who received hemodialysis. Over the 5-year study period, the average missed treatment rate was 7.1 days per patient-year. In covariate adjusted logistic regression, the risk of hospitalization (odds ratio [OR], 3.98; 95% confidence interval [95% CI], 3.93 to 4.04), emergency room visit (OR, 2.00; 95% CI, 1.87 to 2.14), or ICU-CCU admission (OR, 3.89; 95% CI, 3.81 to 3.96) increased significantly after a missed treatment. Overall, 0.9 missed treatment days per year associated with suboptimal transportation to dialysis, inclement weather, holidays, psychiatric illness, pain, and gastrointestinal upset. These barriers also associated with excess hospitalization (5.6 more events per patient-year), emergency room visits (1.1 more visits), and ICU-CCU admissions (0.8 more admissions). In conclusion, poor adherence to hemodialysis treatments may be a substantial roadblock to achieving better patient outcomes. Addressing systemic and patient barriers that impede access to hemodialysis care may decrease missed appointments and reduce patient morbidity. Copyright © 2014 by the American Society of Nephrology.

  20. Adapting United States training practices to European utilities

    International Nuclear Information System (INIS)

    Walsh, T.E.

    1983-01-01

    The factors which must be considered in the process of adapting United States nuclear utility training programs to the needs of a European utility are discussed. Following a review of the present situation and drawing up of a new training program, the management commitments in terms of personnel and finance must be considered. Short term, medium and long term programs are outlined. The long term objectives should include the establishment of a total training centre. This facility should be capable of providing all the training necessary to operate a power plant safely. This would include specific simulator training, classroom training for operators, technician training, staff training, management training etc. In addition to a simulator, it should include an emergency response facility to train personnel. (U.K.)

  1. Evaluation of four tax reforms in the United States

    DEFF Research Database (Denmark)

    Eissa, Nada; Kleven, Henrik Jacobsen; Kreiner, Claus Thustrup

    2008-01-01

    approach accounts for the observed heterogeneity in the microdata, but is simple to implement because we do not need to specify utility functions and estimate utility parameters. We find that each of the four tax acts created substantial welfare gains, and that the gains were concentrated almost......An emerging consensus is that labor force participation is more responsive to taxes and transfers than hours worked. To understand the implications of participation responses for the welfare analysis of tax reform, this paper embeds this margin of labor supply in an explicit welfare theoretic...... framework. We apply the framework to examine the welfare effects on single mothers in the United States following four tax acts passed in 1986, 1990, 1993, and 2001. We propose a simulation method combining features of fully structural microsimulation studies and simple deadweight loss calculations. Our...

  2. Origins of a national seismic system in the United States

    Science.gov (United States)

    Filson, John R.; Arabasz, Walter J.

    2016-01-01

    This historical review traces the origins of the current national seismic system in the United States, a cooperative effort that unifies national, regional, and local‐scale seismic monitoring within the structure of the Advanced National Seismic System (ANSS). The review covers (1) the history and technological evolution of U.S. seismic networks leading up to the 1990s, (2) factors that made the 1960s and 1970s a watershed period for national attention to seismology, earthquake hazards, and seismic monitoring, (3) genesis of the vision of a national seismic system during 1980–1983, (4) obstacles and breakthroughs during 1984–1989, (5) consensus building and convergence during 1990–1992, and finally (6) the two‐step realization of a national system during 1993–2000. Particular importance is placed on developments during the period between 1980 and 1993 that culminated in the adoption of a charter for the Council of the National Seismic System (CNSS)—the foundation for the later ANSS. Central to this story is how many individuals worked together toward a common goal of a more rational and sustainable approach to national earthquake monitoring in the United States. The review ends with the emergence of ANSS during 1999 and 2000 and its statutory authorization by Congress in November 2000.

  3. The United States Federal Monitoring and Assessment Centre and radiological database management

    International Nuclear Information System (INIS)

    Mueller, P.G.

    1998-01-01

    In the spring of 1979, a series of events occurring at the Three Mile Island Nuclear Power plant near Harrisburg, Pennsylvania, resulted in severe core damage. Recognizing that state resources were insufficient to respond to the first major nuclear power plant emergency in the United States, the State of Pennsylvania asked the Federal Government for assistance. The United States Government undertook the preparation of a plan, which would co-ordinate all federal assets. The Federal Radiological Emergency Response Plan (FRERP) assigned unique responsibilities and authorities for responding to domestic radiological emergencies to each of 12 different federal agencies which form the FRERP. The overall data collection, analysis, and processing procedures within the FRMAC are overviewed. (author)

  4. "ZEMSTVO STATE AFFAIR": UNIT OF ZEMSTVO IN STATE CONTROL SYSTEM

    Directory of Open Access Journals (Sweden)

    Гульназ Булатовна Азаматова

    2014-12-01

    Full Text Available Local self-government in the Russian Empire (1864-1918 arose as a result of the bourgeois reforms and had a diversified character. This article reviews the role of zemstvo in the implementation of individual bourgeois reforms, local self-government relations with the justice of the peace, peasant authorities, the system of taxation and management of national education. The author concludes that district and executive councils complemented the administrative-bureaucratic system of local government through the district and provincial levels and human resources structure. At the same time, local authorities increased the scope of decentralization and democratization of local administration through election of magistrates, civil servants of peasant bodies as well as via representation in collegial bodies. The independent status of zemstvo promoted to emergence of a new level in the administrative and political management culture. The government used zemstvo to create a modernized system of taxation. Through district councils the Russian Empire established the valuation area of taxation and professional human resources. Thus, district councils helped to improve state administration and became the tool of implementation of the government reform programs in the late 19 th and early 20 th centuries.

  5. Consumer bankruptcy law for Ethiopia: Lessons from United States ...

    African Journals Online (AJOL)

    After deregulation of consumer credit and resultant availability, ... Germany, United States, United Kingdom and France are some of the countries ... social insurance, development policy and rehabilitative function of discharge and fresh start.

  6. Emerging Powers and Effective Governance in Fragile States | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    New and emerging development organizations are providing assistance to countries experiencing tensions and challenges after periods of conflict. This research will test whether their development assistance approaches are more effective at addressing the political and social realities of fragile states than those used by ...

  7. Veterinary Fusarioses within the United States.

    Science.gov (United States)

    O'Donnell, Kerry; Sutton, Deanna A; Wiederhold, Nathan; Robert, Vincent A R G; Crous, Pedro W; Geiser, David M

    2016-11-01

    Multilocus DNA sequence data were used to assess the genetic diversity and evolutionary relationships of 67 Fusarium strains from veterinary sources, most of which were from the United States. Molecular phylogenetic analyses revealed that the strains comprised 23 phylogenetically distinct species, all but two of which were previously known to infect humans, distributed among eight species complexes. The majority of the veterinary isolates (47/67 = 70.1%) were nested within the Fusarium solani species complex (FSSC), and these included 8 phylospecies and 33 unique 3-locus sequence types (STs). Three of the FSSC species (Fusarium falciforme, Fusarium keratoplasticum, and Fusarium sp. FSSC 12) accounted for four-fifths of the veterinary strains (38/47) and STs (27/33) within this clade. Most of the F. falciforme strains (12/15) were recovered from equine keratitis infections; however, strains of F. keratoplasticum and Fusarium sp. FSSC 12 were mostly (25/27) isolated from marine vertebrates and invertebrates. Our sampling suggests that the Fusarium incarnatum-equiseti species complex (FIESC), with eight mycoses-associated species, may represent the second most important clade of veterinary relevance within Fusarium Six of the multilocus STs within the FSSC (3+4-eee, 1-b, 12-a, 12-b, 12-f, and 12-h) and one each within the FIESC (1-a) and the Fusarium oxysporum species complex (ST-33) were widespread geographically, including three STs with transoceanic disjunctions. In conclusion, fusaria associated with veterinary mycoses are phylogenetically diverse and typically can only be identified to the species level using DNA sequence data from portions of one or more informative genes. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  8. Homicides - United States, 2007 and 2009.

    Science.gov (United States)

    Logan, Joseph E; Hall, Jeffrey; McDaniel, Dawn; Stevens, Mark R

    2013-11-22

    According to 1981-2009 data, homicide accounts for 16,000-26,000 deaths annually in the United States and ranks within the top four leading causes of death among U.S. residents aged 1-40 years. Homicide can have profound long-term emotional consequences on families and friends of victims and on witnesses to the violence, as well as cause excessive economic costs to residents of affected communities. For years, homicide rates have been substantially higher among certain populations. Previous reports have found that homicides are higher among males, adolescents and young adults, and certain racial/ethnic groups, such as non-Hispanic blacks, non-Hispanic American Indian/Alaska Natives (AI/ANs), and Hispanics. The 2011 CDC Health Disparities and Inequalities Report (CHDIR) described similar findings for the year 2007. For example, the 2011 report showed that the 2007 homicide rate was highest among non-Hispanic blacks (23.1 deaths per 100,000), followed by AI/ANs (7.8 deaths per 100,000), Hispanics (7.6 deaths per 100,000), non-Hispanic whites (2.7 deaths per 100,000), and Asian/Pacific Islanders (A/PIs) (2.4 deaths per 100,000). In addition, non-Hispanic black men aged 20-24 years were at greatest risk for homicide in 2007, with a rate that exceeded 100 deaths per 100,000 population. Other studies have reported that community factors such as poverty and economic inequality and individual factors such as unemployment and involvement in criminal activities can play a substantial role in these persistent disparities in homicide rates. Public health strategies are needed in communities at high risk for homicide to prevent violence and save lives.

  9. United States Military in Central Asia: Beyond Operation Enduring Freedom

    Science.gov (United States)

    2009-10-23

    Malinowski , advocacy director for Human Rights Watch, stated, “the United States is most effective in promoting liberty around the world when people...26 U.S. President, The National Security Strategy of the United States of America, page? 27 Thomas Malinowski , “Testimony

  10. Refugee Status Required for Resettlement in the United States

    Science.gov (United States)

    2017-06-09

    STATES REFUGEE ADMISSIONS PROGRAM FLOWCHART ...the American public’s concerns. 50 APPENDIX A UNITED STATES REFUGEE ADMISSIONS PROGRAM FLOWCHART Source: US Citizenship and Immigration...TITLE AND SUBTITLE Refugee Status Required for Resettlement in the United States 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT

  11. A Comparison of Mortality Following Emergency Laparotomy Between Populations From New York State and England.

    Science.gov (United States)

    Tan, Benjamin H L; Mytton, Jemma; Al-Khyatt, Waleed; Aquina, Christopher T; Evison, Felicity; Fleming, Fergal J; Griffiths, Ewen; Vohra, Ravinder S

    2017-08-01

    The aim of this study was to compare mortality following emergency laparotomy between populations from New York State and England. Mortality following emergency surgery is a key quality improvement metric in both the United States and UK. Comparison of the all-cause 30-day mortality following emergency laparotomy between populations from New York State and England might identify factors that could improve care. Patient demographics, in-hospital, and 30-day outcomes data were extracted from Hospital Episode Statistics (HES) in England and the New York Statewide Planning and Research Cooperative System (SPARCS) administrative databases for all patients older than 18 years undergoing laparotomy for emergency open bowel surgery between April 2009 and March 2014. The primary outcome measure was all-cause mortality within 30 days of the index laparotomy. Mixed-effects logistic regression was performed to model independent demographic variables against mortality. A one-to-one propensity score matched dataset was created to compare the odd ratios of mortality between the 2 populations. Overall, 137,869 patient records, 85,286 (61.9%) from England and 52,583 (38.1%) from New York State, were extracted. Crude 30-day mortality for patients was significantly higher in the England compared with New York State [11,604 (13.6%) vs 3633 (6.9%) patients, P New York State (odds ratio 2.35, confidence interval 2.24-2.46, P New York State despite similar patient groups.

  12. Differences and similarities of motivating and demotivating factors of emergency nursing care in rural and urban emergency units – A study of selected rural and urban emergency units in the Volta Region of Ghana

    Directory of Open Access Journals (Sweden)

    Confidence Alorse Atakro

    Full Text Available Objective: The objective of this study was to explore differences and similarities of motivating and demotivating factors of emergency nursing care in selected rural and urban emergency units in the Volta Region of Ghana. Materials and methods: This study was conducted at selected rural and urban emergency units in the Volta Region of Ghana. The study utilised qualitative exploratory descriptive design. Purposive sampling technique was employed in selecting emergency units and nurses. Data were collected through semi-structured interviews of 30 nurses. Data saturation was determined after interviewing 30 participants. Data analysis was done through qualitative content analysis. Results: Twenty-six (26 out of a total of thirty (30 participants were between the ages of twenty-five (25 and twenty-nine (29. Nurses working in the emergency units studied general nursing at the Nurses Training Colleges (NTCs. None of the respondents studied emergency nursing as a degree programme. Twenty four (24 out of thirty (30 participants had worked for about two years in emergency units. Four thematic categories that represented differences and similarities of motivating and demotivating factors for nurses in rural and urban emergency units were extracted from data. The thematic categories are: a Support from hospital management for provision of material resources; b Task shifting to nurses; c Stimulant for learning; d Interpersonal relations. Discussions: Evidence available in this study suggests that there are differences as well as similarities of motivating and demotivating factors within emergency units of rural and urban settings in the Volta Region of Ghana. Differences in resource allocation and task shifting was identified. Stimulating environments of emergency unit for learning and excellent interpersonal relations were found to be common motivations for both rural and urban emergency unit nurses. Keywords: Motivating, Demotivating, Emergency

  13. Unites States and the oil of the Middle-East

    International Nuclear Information System (INIS)

    Noel, P.

    2005-08-01

    The author discusses different aspects of the United States intervention and behavior in the Middle-East petroleum management. The Iraq and Iran potentials are largely under used. The Saudi Arabia defines its own oil policy, but benefits of the Unites States military help. The United States intervention is in the domain of the security of flux on the world market. (A.L.B.)

  14. [Organization of clinical emergency units. Mission and environmental factors determine the organizational concept].

    Science.gov (United States)

    Genewein, U; Jakob, M; Bingisser, R; Burla, S; Heberer, M

    2009-02-01

    Mission and organization of emergency units were analysed to understand the underlying principles and concepts. The recent literature (2000-2007) on organizational structures and functional concepts of clinical emergency units was reviewed. An organizational portfolio based on the criteria specialization (presence of medical specialists on the emergency unit) and integration (integration of the emergency unit into the hospital structure) was established. The resulting organizational archetypes were comparatively assessed based on established efficiency criteria (efficiency of resource utilization, process efficiency, market efficiency). Clinical emergency units differ with regard to autonomy (within the hospital structure), range of services and service depth (horizontal and vertical integration). The "specialization"-"integration"-portfolio enabled the definition of typical organizational patterns (so-called archetypes): profit centres primarily driven by economic objectives, service centres operating on the basis of agreements with the hospital board, functional clinical units integrated into medical specialty units (e.g., surgery, gynaecology) and modular organizations characterized by small emergency teams that would call specialists immediately after triage and initial diagnostic. There is no "one fits all" concept for the organization of clinical emergency units. Instead, a number of well characterized organizational concepts are available enabling a rational choice based on a hospital's mission and demand.

  15. Exploring a United States Maize Cellulose Biofuel Scenario Using an Integrated Energy and Agricultural Markets Solution Approach

    Science.gov (United States)

    Biofuel feedstock production in the United States (US) is an emergent environmental nutrient management issue, whose exploration can benefit from a multi-scale and multimedia systems modeling approach that explicitly addresses diverging stakeholder interests. In the present anal...

  16. The Rising Tiger (United States Policy Consideration towards Southeast Asia)

    National Research Council Canada - National Science Library

    Douglas, Carla; Pagliano, Gary; Rosner, Elliot J

    1997-01-01

    .... Southeast Asia, consisting of the countries of Thailand, Cambodia, Burma, Laos, Vietnam, Malaysia, Singapore, Indonesia, Brunei, and the Philippines, presents opportunities for the United States...

  17. Iran and the United States: Recreating a Strategic Partnership

    National Research Council Canada - National Science Library

    Weynand, Gordon W

    2009-01-01

    Iran's geographical location, regional influence, large and well-educated population, extensive petroleum resources, and functioning theocratic democracy make it critical for the United States to seek...

  18. Factors Affecting Productivity in the United States Naval Construction Force

    National Research Council Canada - National Science Library

    Morton, Darren

    1997-01-01

    By using a craftsman questionnaire, this thesis identifies and ranks the most important factors impairing Petty Officer productivity and morale in the United States Naval Construction Force (Seabees...

  19. Private forest-land owners of the United States, 1994

    Science.gov (United States)

    Thomas W. Birch; Thomas W. Birch

    1996-01-01

    A statistical analytical report on mail canvass of private forest-land owners in the United States. It discusses landowner characteristics, attitudes, harvesting experience, tenure, and management planning.

  20. Dengue in the United States of America: A Worsening Scenario?

    Directory of Open Access Journals (Sweden)

    Germán Añez

    2013-01-01

    Full Text Available Dengue is a febrile illness caused by any of the four dengue virus types (DENV-1 to -4, genus Flavivirus, family Flaviviridae mainly transmitted by the mosquito Aedes aegypti. DENV can be transmitted by blood transfusion. Dengue has been historically present in the continental United States (US, in the state of Hawaii, and in the US insular territories in the Caribbean and the Pacific. During the second half of the 20th century, most of the cases reported in the US were imported cases brought to the country by travelers. Since 2009, cases of autochthonous dengue have been recognized in the state of Florida after 75 years of absence, followed by intensification of transmission in endemic places including the US territories of US Virgin Islands and Puerto Rico, which experienced a large dengue epidemic in 2010. The widespread distribution of dengue mosquito vectors, deficient mosquito control measures and increased frequency of DENV-infected visitors to the US coming from dengue-endemic locations or places experiencing epidemics appear to be jointly responsible for the emergence and reemergence of dengue in the US and its territories.

  1. The United States of America Country Update

    Energy Technology Data Exchange (ETDEWEB)

    Lund, John W. (1); Bloomquist, R. Gordon (2); Boyd, Tonya L. (1); Renner, Joel (3); (1) Geo-Heat Center, Oregon Institute of Technology, Klamath Falls, OR; (2) Washington State University Energy Program, Olympia, WA; (3) Idaho National Engineering and Environmental Laboratory, Idaho Falls, ID

    0001-01-01

    Geothermal energy is used for electric power generation and direct utilization in the United States. The present installed capacity (gross) for electric power generation is 2,534 MWe with about 2,000 MWe net delivering power to the grid producing approximately 17,840 GWh per year for a 80.4% gross capacity factor. Geothermal electric power plants are located in California, Nevada, Utah and Hawaii. The two largest concentrations of plants are at The Geysers in northern California and the Imperial Valley in southern California. The latest development at The Geysers, starting in 1998, is injecting recycled wastewater from two communities into the reservoir, which presently has recovered about 100 MWe of power generation. The second pipeline from the Santa Rosa area has just come on line. The direct utilization of geothermal energy includes the heating of pools and spas, greenhouses and aquaculture facilities, space heating and district heating, snow melting, agricultural drying, industrial applications and groundsource heat pumps. The installed capacity is 7,817 MWt and the annual energy use is about 31,200 TJ or 8,680 GWh. The largest application is ground-source (geothermal) heat pumps (69% of the energy use), and the next largest direct-uses are in space heating and agricultural drying. Direct utilization (without heat pumps) is increasing at about 2.6% per year; whereas electric power plant development is almost static, with only about 70 MWe added since 2000 (there were errors in the WGC2000 tabulation). A new 185-MWe plant being proposed for the Imperial Valley and about 100 MWe for Glass Mountain in northern California could be online by 2007-2008. Several new plants are proposed for Nevada totaling about 100 MWe and projects have been proposed in Idaho, New Mexico, Oregon and Utah. The total planned in the next 10 years is 632 MWe. The energy savings from electric power generation, direct-uses and ground-source heat pumps amounts to almost nine million tonnes

  2. The United States of America Country Update

    Energy Technology Data Exchange (ETDEWEB)

    Lund, John W [1; Bloomquist, R Gordon [2; Boyd, Tonya L [1; Renner, Joel [3; (1) Geo-Heat Center, Oregon Institute of Technology, Klamath Falls, OR; (2) Washington State University Energy Program, Olympia, WA; (3) Idaho National Engineering and Environmental Laboratory, Idaho Falls, ID

    0000-12-30

    Geothermal energy is used for electric power generation and direct utilization in the United States. The present installed capacity (gross) for electric power generation is 2,534 MWe with about 2,000 MWe net delivering power to the grid producing approximately 17,840 GWh per year for a 80.4% gross capacity factor. Geothermal electric power plants are located in California, Nevada, Utah and Hawaii. The two largest concentrations of plants are at The Geysers in northern California and the Imperial Valley in southern California. The latest development at The Geysers, starting in 1998, is injecting recycled wastewater from two communities into the reservoir, which presently has recovered about 100 MWe of power generation. The second pipeline from the Santa Rosa area has just come on line. The direct utilization of geothermal energy includes the heating of pools and spas, greenhouses and aquaculture facilities, space heating and district heating, snow melting, agricultural drying, industrial applications and groundsource heat pumps. The installed capacity is 7,817 MWt and the annual energy use is about 31,200 TJ or 8,680 GWh. The largest application is ground-source (geothermal) heat pumps (69% of the energy use), and the next largest direct-uses are in space heating and agricultural drying. Direct utilization (without heat pumps) is increasing at about 2.6% per year; whereas electric power plant development is almost static, with only about 70 MWe added since 2000 (there were errors in the WGC2000 tabulation). A new 185-MWe plant being proposed for the Imperial Valley and about 100 MWe for Glass Mountain in northern California could be online by 2007-2008. Several new plants are proposed for Nevada totaling about 100 MWe and projects have been proposed in Idaho, New Mexico, Oregon and Utah. The total planned in the next 10 years is 632 MWe. The energy savings from electric power generation, direct-uses and ground-source heat pumps amounts to almost nine million tonnes

  3. The United States of America country update

    Energy Technology Data Exchange (ETDEWEB)

    Lund, John W.; Bloomquist, R. Gordon; Boyd, Tonya L.; Renner, Joel

    2005-01-01

    Geothermal energy is used for electric power generation and direct utilization in the United States. The present installed capacity (gross) for electric power generation is 2,534 MWe with about 2,000 MWe net delivering power to the grid producing approximately 17,840 GWh per year for a 80.4% gross capacity factor. Geothermal electric power plants are located in California, Nevada, Utah and Hawaii. The two largest concentrations of plants are at The Geysers in northern California and the Imperial Valley in southern California. The latest development at The Geysers, starting in 1998, is injecting recycled wastewater from two communities into the reservoir, which presently has recovered about 100 MWe of power generation. The second pipeline from the Santa Rosa area has just come on line. The direct utilization of geothermal energy includes the heating of pools and spas, greenhouses and aquaculture facilities, space heating and district heating, snow melting, agricultural drying, industrial applications and groundsource heat pumps. The installed capacity is 7,817 MWt and the annual energy use is about 31,200 TJ or 8,680 GWh. The largest application is ground-source (geothermal) heat pumps (69% of the energy use), and the next largest direct-uses are in space heating and agricultural drying. Direct utilization (without heat pumps) is increasing at about 2.6% per year; whereas electric power plant development is almost static, with only about 70 MWe added since 2000 (there were errors in the WGC2000 tabulation). A new 185-MWe plant being proposed for the Imperial Valley and about 100 MWe for Glass Mountain in northern California could be online by 2007-2008. Several new plants are proposed for Nevada totaling about 100 MWe and projects have been proposed in Idaho, New Mexico, Oregon and Utah. The total planned in the next 10 years is 632 MWe. The energy savings from electric power generation, direct-uses and ground-source heat pumps amounts to almost nine million tonnes

  4. Anti-Terrorism Authority Under the Laws of the United Kingdom and the United States

    National Research Council Canada - National Science Library

    Feikert, Clare; Doyle, Charles

    2006-01-01

    This is a comparison of the laws of the United Kingdom and of the United States that govern criminal and intelligence investigations of terrorist activities Both systems rely upon a series of statutory authorizations...

  5. ABC estimation of unit costs for emergency department services.

    Science.gov (United States)

    Holmes, R L; Schroeder, R E

    1996-04-01

    Rapid evolution of the health care industry forces managers to make cost-effective decisions. Typical hospital cost accounting systems do not provide emergency department managers with the information needed, but emergency department settings are so complex and dynamic as to make the more accurate activity-based costing (ABC) system prohibitively expensive. Through judicious use of the available traditional cost accounting information and simple computer spreadsheets. managers may approximate the decision-guiding information that would result from the much more costly and time-consuming implementation of ABC.

  6. Contemporary Romanian Art in the United States1

    Directory of Open Access Journals (Sweden)

    Altman Dana

    2014-08-01

    Full Text Available The article discusses the recent international interest in contemporary Romanian art and its growth in market share, with a focus on the United States. The theme is followed thorough in numerous museum exhibitions, increased collector following, art fair presence, gallery representation and auction activity initially in Europe and the United States. The phenomenon is discussed both in the context of the larger international movement conducive to the contemporary art price bubble, and in that of the local socio-economic changes. My chief interest lies in the factors leading up to the entry of post 1989 Romanian art in the global arena as a manifestation of market forces in the field. The analysis follows its grass roots local emergence through non-profit institutions, individual artists, small publications, low budget galleries, as well as the lack of contribution (with few notable exceptions of state institutions, while pointing out the national context of increasing deregulation of social support systems resulting in lack of focus on cultural manifestations. The conclusion is that the recent ascent of contemporary Romanian art (and coincidentally, the award winning contemporary Romanian cinematography is a fortuitous convergence of various factors, among which, increased international mobility and sharing. At the same time, it is also the result of the evolution of various individual artists that pursued a form of art rooted in Romanian artistic tradition but with a focus on the symbolic figurative. The result is a personal semiotics of raising the mundane to extraordinary levels that reconfigured the anxiety of entering a new system into an unmistakable and lasting visual language.

  7. NCHS - Births and General Fertility Rates: United States

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset includes crude birth rates and general fertility rates in the United States since 1909. The number of states in the reporting area differ historically....

  8. Southern state radiological emergency preparedness and response agencies

    International Nuclear Information System (INIS)

    1988-11-01

    This Report provides information on the state agencies assigned to radioactive materials transportation incidents in 16 Southern States Energy Board member states. For each, the report lists the agencies with primary authority for preparedness and response, their responsibilities and personnel within the agencies who can offer additional information on their radioactive materials transportation programs. The report also lists each state's emergency team members and its laboratory and analytical capabilities. Finally, the governor's designee for receiving advance notification of high-level radioactive materials and spent fuel shipments under 10 CFR Parts 71 and 73 of the US Nuclear Regulatory Commission's regulations is listed for each state. Part 71 requires prenotification for large quantity radioactive waste shipments. Part 73 addresses prenotification for spent nuclear reactor fuel shipments

  9. Summary of Notifiable Diseases, United States. Volume 45, Number 53.

    Science.gov (United States)

    1997-10-31

    Trichinosis Tuberculosis Typhoid fever Yellow fever NOTE: Although varicella is not a nationally notifiable disease, the Council of State and...plague among humans, two of which were fatal, were re- ported in the United States (two cases in Arizona, one in Colorado, and two in New Mexico ). Both...13 cases per year) were reported in the United States. Of these cases, 80% occurred in the southwestern states of New Mexico , Arizona, and

  10. Improving Emergency Attendance and Mortality – The Case for Unit ...

    African Journals Online (AJOL)

    METHODS: The study compared the outcomes (attendance and mortality) in a Single Emergency Model (SEM) with a USM, over a two-year period. Two groups of patients were studied - the SEM phase comprising 809 patients, and the USM phase comprising 3,505 patients. Data on patients' attendance and mortality in the ...

  11. Southern State Radiological Transportation Emergency Response Training Course Summary

    International Nuclear Information System (INIS)

    1990-09-01

    The Southern States Energy Board (SSEB) is an interstate compact organization that serves 16 states and the commonwealth of Puerto Rico with information and analysis in energy and environmental matters. Nuclear waste management is a topic that has garnered considerable attention in the SSEB region in the last several years. Since 1985, SSEB has received support from the US Department of Energy for the regional analysis of high-level radioactive waste transportation issues. In the performance of its work in this area, SSEB formed the Advisory Committee on High-Level Radioactive Materials Transportation, which comprises representatives from impacted states and tribes. SSEB meets with the committee semi-annually to provide issue updates to members and to solicit their views on activities impacting their respective states. Among the waste transportation issues considered by SSEB and the committee are shipment routing, the impacts of monitored retrievable storage, state liability in the event of an accident and emergency preparedness and response. This document addresses the latter by describing the radiological emergency response training courses and programs of the southern states, as well as federal courses available outside the southern region

  12. Manual hyperinflation and the role of physical therapy in intensive care and emergency units

    Directory of Open Access Journals (Sweden)

    Rafael Vinícius Santos Cruz

    Full Text Available Abstract Introduction: Although manual hyperinflation (MHI is a physical therapy technique commonly used in intensive care and emergency units, there is little consensus about its use. Objective: To investigate the knowledge of physical therapists working in intensive care and emergency units about manual hyperinflation. Methods: Data were collected through self-administered questionnaires on manual hyperinflation. Data collection took place between September 2014 and January 2015, in Itabuna and Ilhéus, Bahia, Brazil. Results: The study sample was composed of 32 physical therapists who had between 4 months and 10 years working experience. All respondents affirmed that they used the technique in their professional practice. However, only 34.4% reported it to be a routine practice. 90.6% stated that the most common patient position during manual hyperinflation is “supine”. Participants were almost unanimous (93.8% in citing secretion removal and cough stimulation as perceived benefits of MHI. High peak airway pressure was identified as being a precaution to treatment with MHI by 84.4% of participants, whilst 100% of the sample agreed that an undrained pneumothorax was a contraindication to MHI. Conclusion: The most common answers to the questionnaire were: supine position during MHI; secretion removal and cough stimulation as perceived benefits; high peak airway pressure as a precaution; and an undrained pneumothorax as a contraindication.

  13. Leadership Styles in United States Marine Corps Transport Helicopter Squadrons

    Science.gov (United States)

    1989-12-01

    This thesis examined leadership styles in United States Marine Corps transport helicopter squadrons. Analyses were conducted to determine how... leadership styles related to subordinate extra effort, leader effectiveness, satisfaction with leader, unit cohesion, and unit morale. The importance of...military history to the development of military leaders was also examined. Leadership styles of officers were evaluated by the leader himself as well as

  14. Identification of factors which affect the tendency towards and attitudes of emergency unit nurses to make medical errors.

    Science.gov (United States)

    Kiymaz, Dilek; Koç, Zeliha

    2018-03-01

    To determine individual and professional factors affecting the tendency of emergency unit nurses to make medical errors and their attitudes towards these errors in Turkey. Compared with other units, the emergency unit is an environment where there is an increased tendency for making medical errors due to its intensive and rapid pace, noise and complex and dynamic structure. A descriptive cross-sectional study. The study was carried out from 25 July 2014-16 September 2015 with the participation of 284 nurses who volunteered to take part in the study. Data were gathered using the data collection survey for nurses, the Medical Error Tendency Scale and the Medical Error Attitude Scale. It was determined that 40.1% of the nurses previously witnessed medical errors, 19.4% made a medical error in the last year, 17.6% of medical errors were caused by medication errors where the wrong medication was administered in the wrong dose, and none of the nurses filled out a case report form about the medical errors they made. Regarding the factors that caused medical errors in the emergency unit, 91.2% of the nurses stated excessive workload as a cause; 85.1% stated an insufficient number of nurses; and 75.4% stated fatigue, exhaustion and burnout. The study showed that nurses who loved their job were satisfied with their unit and who always worked during day shifts had a lower medical error tendency. It is suggested to consider the following actions: increase awareness about medical errors, organise training to reduce errors in medication administration, develop procedures and protocols specific to the emergency unit health care and create an environment which is not punitive wherein nurses can safely report medical errors. © 2017 John Wiley & Sons Ltd.

  15. Factors Influencing Chinese Students' Decisions to Study in the United States

    Science.gov (United States)

    Austin, Larry; Shen, Libi

    2016-01-01

    The central research question was: Why do Chinese students want to study in the United States? The participants were 20 Chinese students who studied in the U.S. Ten interview questions were used and data were processed in NVivo 10. Five major themes emerged from this study: (a) American culture benefits foreign perceptions of education in the…

  16. First report of dodder (Cuscuta pentagona) on chickpea (Cicer arietinum) in the United States

    Science.gov (United States)

    Chickpea (Cicer arietinum L.) is an important rotational and an emerging specialty crop in the Pacific Northwest of the United States, in California, and in the Northern Great Plains of the USA and Canada. Dodders (Cuscuta spp.) are widespread parasitic weeds on many crops worldwide. Several Cusc...

  17. Increase in Clostridium difficile-related Mortality Rates, United States, 1999-2004

    Centers for Disease Control (CDC) Podcasts

    2008-01-08

    Deaths related to Clostridium difficile are on the rise in the United States. Matthew Redelings from the Los Angeles County Department of Health discusses the increase and what can be done to prevent this infection.  Created: 1/8/2008 by Emerging Infectious Diseases.   Date Released: 1/8/2008.

  18. Encephalitis Caused by Pathogens Transmitted through Organ Transplants, United States, 2002–2013

    Centers for Disease Control (CDC) Podcasts

    2014-10-21

    Dr. Mike Miller reads an abridged version of the article, Encephalitis Caused by Pathogens Transmitted through Organ Transplants, United States, 2002–2013.  Created: 10/21/2014 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 10/23/2014.

  19. Blastomycosis Mortality Rates, United States, 1990–2010

    Centers for Disease Control (CDC) Podcasts

    2015-01-05

    Diana Khuu discusses Blastomycosis Mortality Rates, United States, 1990–2010.  Created: 1/5/2015 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 1/7/2015.

  20. The State of the World Environment, 1987. United Nations Environment Programme.

    Science.gov (United States)

    United Nations Environment Programme, Nairobi (Kenya).

    One of the main activities assigned to the Governing Council of the United Nations Environment Programme (UNEP) is to review the world environmental situation to insure that emerging environmental problems of wide international significance receive appropriate and adequate consideration by governments. Accordingly, UNEP has assessed the state of…