966 resultados para Illinois. Military and Naval Department.
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Mode of access: Internet.
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Sponsored jointly by the Welding Research Council and the Department of the Navy.
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Objective: To assess the value of cusum analysis in hospital bed management. Design: Comparative analysis of medical patient flows, bed occupancy, and emergency department admission rates and access block over 2 years. Setting: Internal Medicine Services and Emergency Department in a teaching hospital. Interventions: Improvements in bed use and changes in the level of available beds. Main outcome measures: Average length of stay; percentage occupancy of available beds; number of patients waiting more than 8 hours for admission (access block); number of medical patients occupying beds in non-medical wards; and number of elective surgical admissions. Results: Cusum analysis provided a simple means of revealing important trends in patient flows that were not obvious in conventional time-series data. This prompted improvements in bed use that resulted in a decrease of 9500 occupied bed-days over a year. Unfortunately and unexpectedly, after some initial improvement, the levels of access block, medical ward congestion and elective surgical admissions all then deteriorated significantly. This was probably caused by excessive bed closures in response to the initial improvement in bed use. Conclusion: Cusum analysis is a useful technique for the early detection of significant changes in patient flows and bed use, and in determining the appropriate number of beds required for a given rate of patient flow.
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Background: In early 2001 Australia experienced a sudden and unexpected disruption to heroin availability, know as the 'heroin shortage'. This 'shortage has been linked to a decrease in needle and syringe output and therefore possibly a reduction in injecting drug use. We aimed to examine changes, if any, in blood-borne viral infections and presentations for injecting related problems related to injecting drug use following the reduction heroin availability in Australia, in the context of widespread harm reduction measures. Methods: Time series analysis of State level databases on HIV, hepatitis B, hepatitis C notifications and hospital and emergency department data. Examination of changes in HIV, hepatitis B, hepatitis C notifications and hospital and emergency department admissions for injection-related problems following the onset of the heroin shortage; non-parametric curve-fitting of number of hepatitis C notifications among those aged 15 - 19 years. Results: There were no changes observed in hospital visits for injection-related problems. There was no change related to the onset heroin shortage in the number of hepatitis C notifications among persons aged 15 - 19 years, but HCV notifications have subsequently decreased in this group. No change occurred in HIV and hepatitis B notifications. Conclusion: A marked reduction in heroin supply resulted in no increase in injection-related harm at the community level. However, a delayed decrease in HCV notifications among young people may be related. These changes occurred in a setting with widespread, publicly funded harm reduction initiatives.
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Objective: To examine the impact of a sudden and dramatic decrease in heroin availability, concomitant with increases in price and decreases in purity, on fatal and non-fatal drug overdoses in New South Wales, Australia. Design and setting: Time-series analysis was conducted where possible on data on overdoses collected from NSW hospital emergency departments, the NSW Ambulance Service, and all suspected drug-related deaths referred to the NSW Coroner's court. Main outcome measures: The number of suspected drug-related deaths where heroin and other drugs were mentioned; ambulance calls to suspected opioid overdoses; and emergency department admissions for overdoses on heroin and other drugs. Results: Both fatal and non-fatal heroin overdoses decreased significantly after heroin supply reduced; the reductions were greater among younger age groups than older age groups. There were no clear increases in non-fatal overdoses with cocaine, methamphetamines or benzodiazepines recorded at hospital emergency departments after the reduction in heroin supply. Data on drug-related deaths suggested that heroin use was the predominant driver of drug-related deaths in NSW, and that when heroin supply was reduced overdose deaths were more likely to involve a wider combination of drugs. Conclusion: A reduction in heroin supply reduced heroin-related deaths, and did not result in a concomitant increase, to the same degree, in deaths relating to other drugs. Younger people were more affected by the reduction in supply.
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A pilot accident and emergency. teleconsulting service was established in Scotland. It was based at the accident and emergency department of the main hospital in Aberdeen. There were three peripheral sites in rural Grampian (Peterhead, Turriff and Huntly) and one in the Shetland Isles. The videoconferencing equipment used was connected by ISDN at 384 kbit/s. During the 15 months of the study, 1998 videoconference calls were made, of which 402 (20%) calls were made to the accident and emergency department for clinical consultations. The majority of the clinical calls (95%) were made between 09:00 and 17:00, and more than 90% were completed within 20 min. During the majority of calls (87%) one or more X-ray images were transmitted. The majority of patients (89%) received treatment without transportation to the main centre in Aberdeen. The present study demonstrated that accident and emergency teleconsultations can be technically reliable, effective in reducing the number of patient transfers and acceptable to the referring clinicians. As a result, approximately pound1.5 million has been made available by the government to develop a national system for Scotland.
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This paper considers the staging of violence, atrocities, and sexuality in the conduct of the war on terror. The piece discusses the manner in which the terms of the war on terror appear to shut down possible debate and examines the rhetorical and representational strategies that cause this. The paper argues that the war on terror includes a cultural project that seeks to create a consenting global audience. This cultural project appears more diffuse and less immediately instrumental than the military and diplomatic activities of this global battle. The piece argues that it is through the circulation of open secrets and accounts of torture and abuse that a global audience is constructed as both witness and participant in the practices and objectives of the war and that this positioning is designed to corral audience understanding into the suggested narratives of the proponents of the war. Este documento considera el escenario de la violencia, las atrocidades y la sexualidad en la conducta de la guerra contra el terror. El artículo plantea la manera en que los términos de la guerra contra el terror parecen suspender un posible debate y examina las estrategias retóricas y representativas que causaron esto. El documento plantea que la guerra contra el terror incluye un proyecto cultural que busca crear una audiencia global de común acuerdo. Este proyecto cultural parece más difuso y menos útil en el momento, que las actividades militares y diplomáticas de esta batalla global. El artículo sostiene que es mediante la circulación de secretos abiertos y de informes sobre la tortura y el abuso, que se forma una audiencia global tanto testigos como participantes de las prácticas y los objetivos de la guerra y que esa posición está designada a encerrar el conocimiento de la audiencia dentro de los relatos sugeridos por los proponentes de guerra.
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This paper analyzes a case study of wireless network implementation in a politically sensitive environment and seeks to gain practical insights for IT managers in today’s networked economy. The case evolved around an urgent decision to implement wireless networks that were a radical replacement for the existing wired network infrastructure. Although the wireless network infrastructure was well calculated as being considerably cost-efficient, inexperienced administrators and IT department failed to consult various involved stakeholders. Consequently, unintended results of wireless network implementation entangled with the cost efficiency of technology outcome and in turn undermined the objectives and achievement of the initial project plan. Drawing from social perspectives, this case study challenges traditionally dominant perspectives of technology efficiency and summarizes several lessons that could help IT managers and policy makers to better strategize ICT in general, and wireless networks in particular.
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The development of the distributed information measurement and control system for optical spectral research of particle beam and plasma objects and the execution of laboratory works on Physics and Engineering Department of Petrozavodsk State University are described. At the hardware level the system is represented by a complex of the automated workplaces joined into computer network. The key element of the system is the communication server, which supports the multi-user mode and distributes resources among clients, monitors the system and provides secure access. Other system components are formed by equipment servers (CАМАC and GPIB servers, a server for the access to microcontrollers MCS-196 and others) and the client programs that carry out data acquisition, accumulation and processing and management of the course of the experiment as well. In this work the designed by the authors network interface is discussed. The interface provides the connection of measuring and executive devices to the distributed information measurement and control system via Ethernet. This interface allows controlling of experimental parameters by use of digital devices, monitoring of experiment parameters by polling of analog and digital sensors. The device firmware is written in assembler language and includes libraries for Ethernet-, IP-, TCP- и UDP-packets forming.
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This article presents the principal results of the Ph.D. thesis Intelligent systems in bioinformatics: mapping and merging anatomical ontologies by Peter Petrov, successfully defended at the St. Kliment Ohridski University of Sofia, Faculty of Mathematics and Informatics, Department of Information Technologies, on 26 April 2013.
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This article studies the determinants of pharmaceutical innovation diffusion among specialists. To this end, it investigates the influences of six categories of factors—social embeddedness, socio-demography, scientific orientation, prescribing patterns, practice characteristics, and patient panel composition—on the use of new drugs for the treatment of type 2 diabetes mellitus in Hungary. Here, in line with international trends, 11 brands were introduced between April 2008 and April 2010, outperforming all other therapeutic classes. The Cox proportional hazards model identifies three determinants—social contagion (in the social embeddedness category) and prescribing portfolio and insulin prescribing ratio (in the prescribing pattern category). First, social contagion has a positive effect among geographically close colleagues—the higher the adoption ratio, the higher the likelihood of early adoption—but no influence among former classmates and scientific collaborators. Second, the wider the prescribing portfolio, the earlier the new drug uptake. Third, the lower the insulin prescribing ratio, the earlier the new drug uptake—physicians’ therapeutic convictions and patients’ socioeconomic statuses act as underlying influencers. However, this finding does not extend to opinion-leading physicians such as scientific leaders and hospital department and outpatient center managers. This article concludes by arguing that healthcare policy strategists and pharmaceutical companies may rely exclusively on practice location and prescription data to perfect interventions and optimize budgets.
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Excerpt from EXECUTIVE SUMMARY This report examines the situation of the Haitians in Miami who were formerly incarcerated during 1981 and 1982 in the Immigration and Naturalization Service's Krome Detention Center or other Federal detention centers in the U.S. and Puerto Rico. For convenience, the report refers to all of them as Krome Haitians. This study is based upon a sociological survey of the Krome Haitians and intensive anthropological fieldwork conducted by Dr. Alex Stepick of the Sociology and Anthropology Department of Florida International University with support from the Catholic Services Bureau of Miami. It is the only scientific study of the Krome Haitians and the scientific procedures of the survey complemented by the anthropological fieldwork combine t o produce highly reliable results . To provide context to the conditions of the Krome Haitians, the report compares the characteristics of this population to that of the Haitian Entrants who arrived in 1980 or earlier and provides an update to earlier studies by this author (Stepick 1982) and another by the Behavioral Science Research Institute (1983). The report describes the conditions of the Krome Haitians, including their background in Haiti, experiences in the U.S., past and present employment status , experience with discrimination and social isolation , and adaptation to American society. The report concludes with some specific policy recommendations to state and local agencies and individuals that will assist the Haitians' integration into American society.
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Today's wireless networks rely mostly on infrastructural support for their operation. With the concept of ubiquitous computing growing more popular, research on infrastructureless networks have been rapidly growing. However, such types of networks face serious security challenges when deployed. This dissertation focuses on designing a secure routing solution and trust modeling for these infrastructureless networks. ^ The dissertation presents a trusted routing protocol that is capable of finding a secure end-to-end route in the presence of malicious nodes acting either independently or in collusion, The solution protects the network from active internal attacks, known to be the most severe types of attacks in an ad hoc application. Route discovery is based on trust levels of the nodes, which need to be dynamically computed to reflect the malicious behavior in the network. As such, we have developed a trust computational model in conjunction with the secure routing protocol that analyzes the different malicious behavior and quantifies them in the model itself. Our work is the first step towards protecting an ad hoc network from colluding internal attack. To demonstrate the feasibility of the approach, extensive simulation has been carried out to evaluate the protocol efficiency and scalability with both network size and mobility. ^ This research has laid the foundation for developing a variety of techniques that will permit people to justifiably trust the use of ad hoc networks to perform critical functions, as well as to process sensitive information without depending on any infrastructural support and hence will enhance the use of ad hoc applications in both military and civilian domains. ^