Revolving funds and business enterprises of the Government,

On cover: Task force report on revolving funds and business enterprises of the Government, Appendix J. An appendix to a report by the Commission on Organization of the Executive Branch of the Government with title: Reorganization of Federal business enterprises; a report to the Congress, March 1949.

Selected problems of hazardous waste management in California; report.

Most of the pages of the photocopy, which is in double columns, represent approximately 2 pages of the original.

Annual session ...

Vols. for 1870-1873 include 2d-5th annual meetings of the Illinois Baptist Sunday School Association; 1881 includes 1st annual meeting of Illinois Baptist State S.S. Convention.

Report to the secretary and the Congress on immunosuppressive therapies /

"October 1985."

Public Land for Affordable Housing: An Evaluation of a HALA Proposal in Seattle

Thesis (Master's)--University of Washington, 2016-06

A proposed new classification system for whiplash associated disorders - implications for assessment and management

The development of chronic symptoms following whiplash injury is common and contributes substantially to costs associated with this condition. The currently used Quebec Task Force classification system of whiplash associated disorders is primarily based on the severity of signs and symptoms following injury and its usefulness has been questioned. Recent evidence is emerging that demonstrates differences in physical and psychological impairments between individuals who recover from the injury and those who develop persistent pain and disability. Motor dysfunction, local cervical mechanical hyperalgesia and psychological distress are present soon after injury in all whiplash injured persons irrespective of recovery. In contrast those individuals who develop persistent moderate/severe pain and disability show a more complex picture, characterized by additional impairments of widespread sensory hypersensitivity indicative of underlying disturbances in central pain processing as well as acute posttraumatic stress reaction, with these changes present from soon after injury. Based on this heterogeneity a new classification system is proposed that takes into account measurable disturbances in motor, sensory and psychological dysfunction. The implications for the management of this condition are discussed. (C) 2004 Elsevier Ltd. All rights reserved.

Clinical decision-making and myocardial viability: current perspectives

Not all myocardium involved in a myocardial infarction is dead or irreversibly damaged. The balance between the amount of scar and live tissue, and the nature of the live tissue, determine the likelihood that contractile function will improve after revascularisation. This improvement (which defines viability) may be predicted with about 80% accuracy using several techniques. This review examines the determinants of functional recovery and how they may be integrated in making decisions regarding revascularisation. (Intern Med J 2005; 35: 118–125)

Impact of gender on risk stratification by exercise and dobutamine stress echocardiography: long-term mortality in 4234 women and 6898 men

Aims Prior research is limited with regard to the diagnostic and prognostic accuracy of commonplace cardiac imaging modalities in women. The aim of this study was to examine 5-year mortality in 4234 women and 6898 men undergoing exercise or dobutamine stress echocardiography at three hospitals. Methods and results Univariable and multivariable Cox proportional hazards models were used to estimate time to cardiac death in this multi-centre, observational registry. Of the 11 132 patients, women had a greater frequency of cardiac risk factors (P < 0.0001). However, men more often had a history of coronary disease including a greater frequency of echocardiographic wall motion abnormalities (P < 0.0001). During 5 years of follow-up, 103 women and 226 men died from ischaernic heart disease (P < 0.0001). Echocardiographic estimates of left ventricular function (P < 0.0001) and the extent of ischaernic watt motion abnormalities (P < 0.0001) were highly predictive of cardiac death. Risk-adjusted 5-year survival was 99.4, 97.6, and 95% for exercising women with no, single, and multi-vessel ischaemia (P < 0.0001). For women undergoing dobutamine stress, 5-year survival was 95, 89, and 86.6% for those with 0, 1, and 2-3 vessel ischaemia (P < 0.0001). Exercising men had a 2.0-fold higher risk at every level of worsening ischaemia (P < 0.0001). Significantly worsening cardiac survival was noted for the 1568 men undergoing dobutamine stress echocardiography (P < 0.0001); no ischaemia was associated with 92% 5-year survival as compared with death rates of &GE; 16% for men with ischaemia on dobutamine stress echocardiography (P < 0.0001). Conclusion Echocardiographic measures of inducible wall motion abnormalities and global and regional left ventricutar function are highly predictive of long-term outcome for women and men alike.

Rotary atomizer drop size distribution database

Wind tunnel measurements of drop Size distributions from Micronair A U4000 and A U5000 rotary atomizers were collected to develop a database for model use. The measurements varied tank mix, flow rate, air speed, and blade angle conditions, which were correlated by multiple regressions (average R-2 = 0.995 for A U4000 and 0.988 for AU5000). This database replaces an outdated set of rotary atomizer data measured in the 1980s by the USDA Forest Service and fills in a gap in data measured in the 1990s by the Spray Drift Task Force. Since current USDA Forest Service spray projects rely on rotary atomizers, the creation of the database (and its multiple regression interpolation) satisfies a need seen for ten years.

Validity of BMI as a measure of obesity in Australian white Caucasian and Australian Sri lankan children

Background: Body mass index ( BMI) is used to diagnose obesity. However, its ability to predict the percentage fat mass (% FM) reliably is doubtful. Therefore validity of BMI as a diagnostic tool of obesity is questioned. Aim: This study is focused on determining the ability of BMI- based cut- off values in diagnosing obesity among Australian children of white Caucasian and Sri Lankan origin. Subjects and methods: Height and weight was measured and BMI ( W/H-2) calculated. Total body water was determined by deuterium dilution technique and fat free mass and hence fat mass derived using age- and gender- specific constants. A % FM of 30% for girls and 20% for boys was considered as the criterion cut- off level for obesity. BMI- based obesity cut- offs described by the International Obesity Task Force ( IOTF), CDC/ NCHS centile charts and BMI- Z were validated against the criterion method. Results: There were 96 white Caucasian and 42 Sri Lankan children. Of the white Caucasians, 19 ( 36%) girls and 29 ( 66%) boys, and of the Sri Lankans 7 ( 46%) girls and 16 ( 63%) boys, were obese based on % FM. The FM and BMI were closely associated in both Caucasians ( r = 0.81, P < 0.001) and Sri Lankans ( r = 0.92, P< 0.001). Percentage FM and BMI also had a lower but significant association. Obesity cut- off values recommended by IOTF failed to detect a single case of obesity in either group. However, NCHS and BMI- Z cut- offs detected cases of obesity with low sensitivity. Conclusions: BMI is a poor indicator of percentage fat and the commonly used cut- off values were not sensitive enough to detect cases of childhood obesity in this study. In order to improve the diagnosis of obesity, either BMI cut- off values should be revised to increase the sensitivity or the possibility of using other indirect methods of estimating the % FM should be explored.

Incremental cost-effectiveness of exercise echocardiography vs. SPECT imaging for the evaluation of stable chest pain

Aims Technological advances in cardiac imaging have led to dramatic increases in test utilization and consumption of a growing proportion of cardiovascular healthcare costs. The opportunity costs of strategies favouring exercise echocardiography or SPECT imaging have been incompletely evaluated. Methods and results We examined prognosis and cost-effectiveness of exercise echocardiography (n=4884) vs. SPECT (n=4637) imaging in stable, intermediate risk, chest pain patients. Ischaemia extent was defined as the number of vascular territories with echocardiographic wall motion or SPECT perfusion abnormalities. Cox proportional hazard models were employed to assess time to cardiac death or myocardial infarction (MI). Total cardiovascular costs were summed (discounted and inflation-corrected) throughout follow-up. A cost-effectiveness ratio = 2% annual event risk), SPECT ischaemia was associated with earlier and greater utilization of coronary revascularization (P < 0.0001) resulting in an incremental cost-effectiveness ratio of $32 381/LYS. Conclusion Health care policies aimed at allocating limited resources can be effectively guided by applying clinical and economic outcomes evidence. A strategy aimed at cost-effective testing would support using echocardiography in low-risk patients with suspected coronary disease, whereas those higher risk patients benefit from referral to SPECT imaging.

Building Community Coalitions for the Promotion of Physical Activity: 10,000 Steps Rockhampton

The 10,000 Steps Rockhampton project is a multi-strategy community-wide, physical activity intervention based on the simultaneous implementation of five strategies, each identified as 'best practice' for the promotion of physical activity. Several community partners were engaged to develop and implement the strategies during the first eighteen months of the project. These included: the local media (TV, newspaper and radio); the local Division of General Practice and other health professional groups; the Heart Foundation and ‘Just Walk It’; the local council; and several large worksites. A local physical activity task force was also formed to administer a 'micro-grants' scheme, and to guide the development of community based strategies. The presentation will focus on the critical elements involved in developing and maintaining relationships with community partners. These include identification and ‘courting’ of potential partners, strategies for keeping them engaged, and the challenges of maintaining the balance between ‘top-down’ (evidence-based) and ‘bottom-up’ (community-driven) strategies. Data on implementation and uptake of the key strategies will also be presented. These include: 1) process data on the number of health

Inspiring lecturers: sharing e-learning practice through european case studies

What motivates a university lecturer to consider introducing a new e-learning approach to their educational practice? Accounts of e-learning practice can invite discussion and reflection on the approaches taken, reinforcement of a particular model, connection with the experience of others, vicarious learning opportunities and glimpses into tacit knowledge. If these examples provoke thinking, could they have the ‘sticky qualities’, the memorable inspiration and ideas that move us to action, when we observe the practice of others? (Szulanski, 2003) “Case studies have the capacity to inspire but also to provoke and to challenge.” (JISC, 2004) This paper will discuss a process followed for sharing best practices of e-learning. It will explain how good practices were identified and gathered by the EUNIS E-Learning Task Force collaboration, using a database and a weblog (EUNIC, 2008). It will examine the methods used for the developing and compiling of the practices and the communication of these. Actual examples of some of the case studies gathered will be included in an appendix. Suggestions of ways to develop this process further and the tangible benefits identified will be examined to ask if effective practice can also become embedded practice.

Presumed consent in organ donation: the devil is in the detail

This article follows the recent publication of the Organs for Donation Task Force report, "Organs for Transplants", and considers the debate surrounding a change in the law in favour of presumed consent in organ donation.

Responding to crisis through strategic knowledge management

Purpose - Many managers would like to take a strategic approach to preparing the organisation to avoid impending crisis but instead find themselves fire-fighting to mitigate its impact. This paper seeks to examine an organisation which made major strategic changes in order to respond to the full effect of a crisis which would be realised over a two to three year period. At the root of these changes was a strategic approach to managing knowledge. The paper's purpose is to reflect on managers' views of the impact this strategy had on preparing for the crisis and explore what happened in the organisation during and after the crisis. Design/methodology/approach - The paper examines a case-study of a financial services organisation which faced the crisis of its impending dissolution. The paper draws upon observations of change management workshops, as well as interviews with organisational members of a change management task force. Findings - The response to the crisis was to recognise the importance of the people and their knowledge to the organisation, and to build a strategy which improved business processes and communication flow across the divisions, as well as managing the departure of knowledge workers from an organisation in the process of being dissolved. Practical implications - The paper demonstrates the importance of building a knowledge management strategy during times of crisis, and draws out important lessons for organisations facing organisational change. Originality/value - The paper represents a unique opportunity to learn from an organisation adopting a strategic approach to managing its knowledge during a time of crisis. © Emerald Group Publishing Limited.