985 resultados para North Carolina Medical Care Commission.


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This paper explains the voting process including: voting at the polling place, voting absentee, provisional ballots, photo ID requirements, curbside voting, assistance with voting, lost voter registration card and voters without photo ID.

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The objective of this study was to identify disparities in colonoscopy utilization and access to care across urban-rural populations in the Carolinas. NC and SC are in the top 10% of states for the proportion of residents living in rural areas, making these states an ideal location to examine the effects of access to care. This report illustrates key findings from a study using ambulatory surgery discharge data from NC and SC from 2001-2010. Described is the geographic distribution of colonoscopy providers in the Carolinas, estimated colonoscopy utilization in urban and rural populations, and how patients seek their care based on the availability of providers in their county.

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Annually, the association publishes a journal, The Proceedings, which consists of papers presented at the annual meeting. Writing and Research in Southern History by Fletcher Melvin Green – University of North Carolina The South Carolina Constitution of 1865 as a Democratic Document by John Harold Wolfe – Appalachian State Teachers College William Porcher Miles, Progressive Mayor of Charleston, 1855-1857 by Clarence McKittrick Smith Jr. – Newberry College Salient Attributes of Bodin’s Theory of Sovereignty by Charles N. Sisson – Coker College Sources for South Carolina History in the Nation’s Capital by Maxcy Robson Dickson – The National Archives

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Annually, the association publishes a journal, The Proceedings, which consists of papers presented at the annual meeting. Writing and Research in Southern History by Fletcher Melvin Green – University of North Carolina The South Carolina Constitution of 1865 as a Democratic Document by John Harold Wolfe – Appalachian State Teachers College William Porcher Miles, Progressive Mayor of Charleston, 1855-1857 by Clarence McKittrick Smith Jr. – Newberry College Salient Attributes of Bodin’s Theory of Sovereignty by Charles N. Sission – Coker College Sources for South Carolina History in the Nation’s Capital by Maxcy Robson Dickson – The National Archives

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Annually, the association publishes a journal, The Proceedings, which consists of papers presented at the annual meeting. The Chinese Labor Issue in British Politics, 1904-1907 by E. B. Hannum – University of South Alabama A Statistical and Historical Analysis and Interpretation of British By-Elections, 1906-1909 by Michael C. Griffin Slavery and the Presence of Free Will by William F. Steirer Reconsideration: The University of South Carolina during Reconstruction by John Herbert Roper – University of North Carolina

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Esta investigación midió la percepción del personal asistencial sobre la cultura de seguridad de los pacientes en un hospital de primer nivel de complejidad por medio de un estudio descriptivo de corte transversal. Se utilizó como herramienta de medición la encuesta ‘Hospital Survey on Patient Safety Cultura’ (HSOPSC) de la Agency of Healthcare Research and Quality (AHRQ) versión en español, la cual evalúa doce dimensiones. Los resultados mostraron fortalezas como el aprendizaje organizacional, las mejoras continuas y el apoyo de los administradores para la seguridad del paciente. Las dimensiones clasificadas como oportunidades de mejora fueron la cultura no punitiva, el personal, las transferencias y transiciones y el grado en que la comunicación es abierta. Se concluyó que aunque el personal percibía como positivo el proceso de mejoramiento y apoyo de la administración también sentía que era juzgado si reportaba algún evento adverso.

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La atención hospitalaria en el costo global de la atención de los pacientes en diálisis es muy importante. Este estudio se realizó con el fin de evaluar resultados posteriores a la implementación de un modelo de gestión de la enfermedad y cuidado coordinado en una red de diálisis en Colombia, evaluando los cambios específicos en las tasas de hospitalización de una cohorte de pacientes renales con dos años de seguimiento. El modelo se enfoca básicamente en mejorar la atención de los pacientes en diálisis protocolizando en el manejo de comorbilidades (diabetes, riesgo cardiovascular, patologías infecciosas) y en el cuidado coordinado entre el tratamiento ambulatorio y hospitalario de los pacientes en diálisis asegurando la continuidad en el proceso de atención de los pacientes. El Estudio observacional analítico de cohortes compuesto por 2 fases una primera cohorte histórica retrospectiva y una segunda con dos cohortes prospectivas, incluyó pacientes mayores de 18 años, con más de 90 días en diálisis, con al menos tres meses de intervención con el modelo de gestión de enfermedad en la red Renal Therapy Services (RTS®). En conclusión, la realización de este estudio, se pudo asociar a la reducción en la atención hospitalaria de pacientes en diálisis y a una menor mortalidad, modelos como este y otras soluciones para mejorar los desenlaces en salud en los pacientes en diálisis deben seguir siendo implementados para aliviar la carga de la enfermedad y reducir los costos de la atención en salud de esta población.

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Introducción El material particulado son partículas sólidas y líquidas emitidas al aire, las cuales pueden generar diferentes alteraciones en la salud, variando desde cuadros respiratorios alérgicos, a episodios asmáticos, dermatitis o inclusive llegar a facilitar la génesis de enfermedades de tipo neoplásico. Estos pueden tener origen natural e industrial, encontrandose en diferentes actividades económicas. Objetivo Evaluar la exposición laboral a material particulado en empresas pertenecientes a diferentes sectores económicos afiliadas a una ARL en Colombia, en el periodo comprendido entre 2011 al 2014 Metodología Es un estudio de corte transversal, analizando una base de datos de 257 empresas con 1108 mediciones de material particulado, recolectados entre 2011 – 2014. Las variables usadas fueron: región, actividad económica, área, oficio, tiempo de exposición y concentración de material particulado. Se realizó distribuciones de frecuencia, medidas de tendencia central y de dispersión. Se evaluaron las diferencias de las distribuciones de los tiempos de exposición y el porcentaje de exposición entre los grupos con y sin riesgo (los que sobrepasaban o no los límites permisibles), con la prueba asintótica no paramétrica de Mann Whitney. Resultados Las principales mediciones ambientales en las empresas fueron en la industria química con un 31%, siendo 2 de cada 3 datos pertenecientes a la región andina, las cuales tienen como principales contaminantes químicos las partículas no fraccionadas con el 70,9%. Respecto a las concentraciones ambientales de material particulado en las empresas participantes, se encontró un promedio de 1,72 mg/m3 ± 3,613, con una mediana de 0,480 mg/m3 y un coeficiente de variación de 210,05%. El 2,9% sobrepasaron los valores límites establecidos por la ACGIH (American Conference of Governmental Industrial Hygienists) y el 92,5% según los límites de la EPA (Agencia de Protección del Ambiente), presentando mayor riesgo en el personal operativo con 93,3% (p= 0,002). Conclusión El riesgo según los límites establecidos por la ACGIH para las mediciones realizadas en Colombia fue bajo, aunque al utilizar los parámetros de la EPA, el riesgo fue alto, por lo cual se requiere hacer un seguimiento específico a estas empresas y fomentar la implementación del sistema de gestión en seguridad y salud en el trabajo.

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Chronic myeloid leukemia (CML) requires strict daily compliance with oral medication and regular blood and bone marrow control tests. The objective was to evaluate CML patients' perceptions about the disease, their access to information regarding the diagnosis, monitoring and treatment, adverse effects and associations of these variables with patients' demographics, region and healthcare access. Prospective cross-sectional study among CML patients registered with the Brazilian Lymphoma and Leukemia Association (ABRALE). CML patients receiving treatment through the public healthcare system were interviewed by telephone. Among 1,102 patients interviewed, the symptoms most frequently leading them to seek medical care were weakness or fatigue. One third were diagnosed by means of routine tests. The time that elapsed between first symptoms and seeking medical care was 42.28 ± 154.21 days. Most patients had been tested at least once for Philadelphia chromosome, but 43.2% did not know the results. 64.8% had had polymerase chain reaction testing for the BCR/ABL gene every three months. 47% believed that CML could be controlled, but 33.1% believed that there was no treatment. About 24% reported occasionally stopping their medication. Imatinib was associated with nausea, cramps and muscle pain. Self-reported treatment adherence was significantly associated with normalized blood count, and positively associated with imatinib. There is a lack of information or understanding about disease monitoring tools among Brazilian CML patients; they are diagnosed quickly and have good access to treatment. Correct comprehension of CML control tools is impaired in Brazilian patients.

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São apresentadas novas informações sobre a distribuição geográfica de algumas espécies de peixes teleósteos que ocorrem na costa brasileira, incluindo duas espécies que nunca haviam sido registradas em nossas águas. Os serranídeos Pseudogramma gregoryi (assinalado da Flórida à Venezuela) e Plectranthias garrupellus (registrado da Carolina do Norte ao Caribe) foram encontrados, respectivamente, na costa do Ceará e na costa sudeste-sul do Brasil. São aqui mencionados e discutidos os dois primeiros registros do gênero Caristius (Caristiidae) no Brasil, bem como os primeiros registros na costa sudeste-sul do Brasil das espécies Enchelycore carychroa (Muraenidae), e Chilomycterus antillarum (Diodontidae), e da espécie Neobythites brasiliensis(Bythitidae) no nordeste do Brasil. É também assinalada a ocorrência mais setentrional do pargo Calamus mu (Sparidae), uma espécie até então circunscrita à região entre o Espírito Santo e São Paulo, e são discutidos os registros adicionais de Bascanichthys paulensis (Ophichthidae), Nezumia aequalis (Macrouridae), Antigonia combatia (Caproidae) e Notolycodes schmidti (Zoarcidae) na costa brasileira.

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OBJETIVO: Conhecer a qualidade dos dados de internação por causas externas em São José dos Campos, São Paulo. MÉTODO: Foram estudadas as internações pelo Sistema Único de Saúde por lesões decorrentes de causas externas no primeiro semestre de 2003, no Hospital Municipal, referência para o atendimento ao trauma no Município, por meio da comparação dos dados registrados no Sistema de Informações Hospitalares com os prontuários de 990 internações. A concordância das variáveis relativas à vítima, à internação e ao agravo foi avaliada pela taxa bruta de concordância e pelo coeficiente Kappa. As lesões e as causas externas foram codificadas segundo a 10ª revisão da Classificação Internacional de Doenças, respectivamente, capítulos XIX e XX. RESULTADOS: A taxa de concordância bruta foi de boa qualidade para as variáveis relativas à vítima e à internação, variando de 89,0% a 99,2%. As lesões tiveram concordância ótima, exceto os traumatismos do pescoço (k=0,73), traumatismos múltiplos (k=0,67) e fraturas do tórax (k=0,49). As causas externas tiveram concordância ótima para acidentes de transporte (k=0,90) e quedas (k=0,83). A confiabilidade foi menor para agressões (k=0,50), causas indeterminadas (k=0,37), e complicações da assistência médica (k=0,03). Houve concordância ótima nos acidentes de transporte em pedestres, ciclistas e motociclistas. CONCLUSÃO: A maioria das variáveis de estudo teve boa qualidade no nível de agregação analisado. Algumas variáveis relativas à vítima e alguns tipos de causas externas necessitam de aperfeiçoamento da qualidade dos dados. O perfil da morbidade hospitalar encontrado confirmou os acidentes de transporte como importante causa externa de internação hospitalar no Município.

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Medium density fiberboard (MDF) is an engineered wood product formed by breaking down selected lignin-cellulosic material residuals into fibers, combining it with wax and a resin binder, and then forming panels by applying high temperature and pressure. Because the raw material in the industrial process is ever-changing, the panel industry requires methods for monitoring the composition of their products. The aim of this study was to estimate the ratio of sugarcane (SC) bagasse to Eucalyptus wood in MDF panels using near infrared (NIR) spectroscopy. Principal component analysis (PCA) and partial least square (PLS) regressions were performed. MDF panels having different bagasse contents were easily distinguished from each other by the PCA of their NIR spectra with clearly different patterns of response. The PLS-R models for SC content of these MDF samples presented a strong coefficient of determination (0.96) between the NIR-predicted and Lab-determined values and a low standard error of prediction (similar to 1.5%) in the cross-validations. A key role of resins (adhesives), cellulose, and lignin for such PLS-R calibrations was shown. PLS-DA model correctly classified ninety-four percent of MDF samples by cross-validations and ninety-eight percent of the panels by independent test set. These NIR-based models can be useful to quickly estimate sugarcane bagasse vs. Eucalyptus wood content ratio in unknown MDF samples and to verify the quality of these engineered wood products in an online process.

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The objective of this manuscript is to discuss the existing barriers for the dissemination of medical guidelines, and to present strategies that facilitate the adaptation of the recommendations into clinical practice. The literature shows that it usually takes several years until new scientific evidence is adopted in current practice, even when there is obvious impact in patients' morbidity and mortality. There are some examples where more than thirty years have elapsed since the first case reports about the use of a effective therapy were published until its utilization became routine. That is the case of fibrinolysis for the treatment of acute myocardial infarction. Some of the main barriers for the implementation of new recommendations are: the lack of knowledge of a new guideline, personal resistance to changes, uncertainty about the efficacy of the proposed recommendation, fear of potential side-effects, difficulties in remembering the recommendations, inexistence of institutional policies reinforcing the recommendation and even economical restrains. In order to overcome these barriers a strategy that involves a program with multiple tools is always the best. That must include the implementation of easy-to-use algorithms, continuous medical education materials and lectures, electronic or paper alerts, tools to facilitate evaluation and prescription, and periodic audits to show results to the practitioners involved in the process. It is also fundamental that the medical societies involved with the specific medical issue support the program for its scientific and ethical soundness. The creation of multidisciplinary committees in each institution and the inclusion of opinion leaders that have pro-active and lasting attitudes are the key-points for the program's success. In this manuscript we use as an example the implementation of a guideline for venous thromboembolism prophylaxis, but the concepts described here can be easily applied to any other guideline. Therefore, these concepts could be very useful for institutions and services that aim at quality improvement of patient care. Changes in current medical practice recommended by guidelines may take some time. However, if there is a broader participation of opinion leaders and the use of several tools listed here, they surely have a greater probability of reaching the main objectives: improvement in provided medical care and patient safety.

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Organosolv lignins can replace petroleum chemicals such as phenol either partially or totally in various applications. Eight lignins, seven of which corresponded to the ethanol-water fractionation of bagasse and the other to a reference lignin (Alcell (R)) were analyzed with the aim to evaluate their chemical and physicochemical characteristics. The purity of the lignin fractions was determined by high pressure liquid chromatography (HPLC) and by ash content. Fourier Transform-Infrared Spectroscopy (FTIR) techniques and differential UV spectroscopy were applied to identify the chemical groups in the lignin samples. The molecular weight distribution was determined by size exclusion chromatography (HPSEC). Thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC) techniques were used to determine the mass loss due to the high temperature treatment. The lignins studied showed the presence of p-hydroxyphenyl (H unit) and a greater proportion of guaiacyl (G unit) moieties, lower purity, similar or greater amount of phenolic hydroxyl groups, and higher degradation temperatures, than the Alcell (R) lignin.

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Despite its importance to agriculture, the genetic basis of heterosis is still not well understood. The main competing hypotheses include dominance, overdominance, and epistasis. NC design III is an experimental design that. has been used for estimating the average degree of dominance of quantitative trait 106 (QTL) and also for studying heterosis. In this study, we first develop a multiple-interval mapping (MIM) model for design III that provides a platform to estimate the number, genomic positions, augmented additive and dominance effects, and epistatic interactions of QTL. The model can be used for parents with any generation of selling. We apply the method to two data sets, one for maize and one for rice. Our results show that heterosis in maize is mainly due to dominant gene action, although overdominance of individual QTL could not completely be ruled out due to the mapping resolution and limitations of NC design III. For rice, the estimated QTL dominant effects could not explain the observed heterosis. There is evidence that additive X additive epistatic effects of QTL could be the main cause for the heterosis in rice. The difference in the genetic basis of heterosis seems to be related to open or self pollination of the two species. The MIM model for NC design III is implemented in Windows QTL Cartographer, a freely distributed software.