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The Surgical Care Improvement Project (SCIP) was designed to reduce perioperative complications. We describe our institutional experience in 6 major areas: surgical site infection, venous thromboembolism prevention, use of perioperative β-blockade, serum glucose level greater than 200 mg/dL, normothermia, and the use of electric razors for hair removal. This was a retrospective review of surgical cases. Evidence-based training and standardization of system and process were undertaken. Compliance with SCIP guidelines was determined. Overall SCIP compliance improved from 80% to 94% over a 2-year period. Standardized antibiotic dosing times improved compliance to more than 90%. Appropriate preoperative antibiotic choice improved to 100%. Cessation of antibiotics postoperatively within 24 hours remains a difficult task. Venous thromboembolism prophylaxis has been difficult to achieve because of postoperative bleeding concerns. Administration of β-blockers has remained one of the most difficult problems to correct because of the multiplicity of avenues by which a patient may arrive to the operating suite. Achievement of the SCIP goals is a formidable, but achievable, process requiring individual, cultural, systems, and institutional changes to achieve success.

Although pertussis is a vaccine-preventable disease, outbreaks can occur despite high levels of immunization in a community. This report summarizes an outbreak of pertussis that occurred predominantly among adolescents in a US military community in Kaiserslautern, Germany, during the period April-June 2005. All patients were determined to have had complete age-appropriate immunization with pertussis-containing vaccine, although newer vaccines have since been introduced for adolescents that could have greatly decreased the magnitude and impact of the outbreak.

Influenza and other respiratory infections, the most common cause of acute infectious disease in U.S adults, are also the leading cause of outpatient illness and a major cause of infectious disease hospitalization in U.S. military personnel. Although respiratory disease control is improved, epidemics continue to occur, and respiratory disease in military trainees continues to exceed that in U.S. civilian adults. Overall, Department of Defense utilization of the trivalent inactivated vaccine was much lower than anticipated during the 2004-2005 season. The slow start to the 2004-2005 influenza season resulted in a low demand for influenza immunization by the medically high-risk beneficiary population of the Department of Defense. Surveillance for influenza during the 2004-2005 season in U.S. Army Europe reached unprecedented heights, testing and confirming more cases than in any previous year.

Schizophrenia is a mental disorder that affects approximately 1% of the population. In addition to the well-known psychological symptoms of schizophrenia (SZ), patients also experience several cognitive deficits, many of which appear early in the course of the disease. These cognitive deficits have a significant impact on daily functioning, yet they are not adequately treated by many of the drugs available for schizophrenia (SZ). Two main cognitive deficits in schizophrenia (SZ) are found in visual processing and working memory. To investigate these deficits, a protocol was designed to probe the visual processing streams (both form and motion streams independently) and working memory networks. These tasks were designed using difficulty-matching to correct for differences between the SZ patients and healthy controls in effort, attention, and ability. Ten patients with SZ and ten healthy age- and gender-matched controls were imaged using functional magnetic resonance imaging (fMRI) while performing visual and working memory tasks to elucidate brain activation patterns. Compared with healthy controls, SZ patients had decreased brain activation in the left frontal eye field (L FEF) and anterior cingulate cortex (ACC), and increased activation in the left lingual gyrus during Form tasks. In Working Memory tasks, SZ patients had decreased activity in several frontal areas, including the ACC, L FEF, and L inferior frontal gyrus, as well as in bilateral inferior parietal lobes. Behavioral task performance in SZ patients was directly correlated with brain activation levels in the ACC—as patients performed better on the tasks, brain activation in the ACC increased toward activation levels seen in healthy controls. Further, patients with schizophrenia showed global decreased homogeneity in brain activation patterns for all tasks. This protocol has potential be used to study prodromal phases of SZ to identify risk of development of the disorder in at-risk individuals. In addition, research using this protocol may be useful to evaluate new and existing therapies for their effects on the cognitive aspects of SZ. By using this protocol to research medications to treat these cognitive impairments, we hope to impact the daily lives of patients with SZ.

This research extended the empirical literature on social cognitive career theory and added to the limited research on the 2005 version of the combined Strong Interest Inventory and the Skills Confidence Inventory, using high school age students as participants. One hundred twenty 11th- and 12th-grade students, ranging in age from 16 to 18, from a small, rural Midwestern town's high school participated in the study. The pattern of results in this study followed the pattern of results of previous studies, as self-efficacy was related positively to vocational interests for each of the six Holland interest themes. In addition, it was found that males had higher Realistic vocational interests than females, while females had higher Artistic and Social vocational interests than males. It was concluded that males had higher Realistic vocational self-efficacy than females, while females had higher Social vocational self-efficacy than males. Although it was predicted that males would have higher Investigative, Enterprising, and Conventional vocational self-efficacy than females, none of these hypotheses concerning higher confidence for males was supported by this research. Interpretations for the unexpected findings were proposed. Recommendations for future research and implications for counseling psychology were also discussed.

Washington - Home Depot Inc., the world's largest home improvement chain, and discount retailer Target Corp. said fiscal first-quarter profit fell as U.S. shoppers curbed spending.

Discussion on the advantages brought by the initiative of the US Coast Guard Academy to update energy conservation and resilience measures which has helped it to meet dynamic needs of the future is featured. It offers brief overview of the history of the campus and the challenges it faced due to aging infrastructure that presented energy management difficulties to the school's mission to graduate young men and women. To achieve its target outcomes, the Coast Guard has awarded a comprehensive $72.6 million contract to provide the highest yields of energy reduction and cost savings to the campus. The benefits of the initiative are also mentioned.

While the US Coast Guard Academy may be one of the smallest of the nation’s five federal service academies, it recently awarded the largest Utility Energy Service Contract (UESC) within the entire Department of Homeland Security’s history. The 85-year-old campus is now undergoing unprecedented improvements that will usher in holistic energy efficiency and energy resilience measures, and allow the academy to compete with top institutional chemistry labs in the region. The Coast Guard Academy was founded in 1876 aboard the schooner Dobbin, and today offers holistic education that includes academics, physical fitness, character, and leadership, and provides multi-mission roles for future leaders. It is the first place for Coast Guard education for officers, an education that will now entail developing and executing a comprehensive energy master plan. For numerous years, the academy, located in New London, CT, has ranked as the third-largest energy consumer within the Coast Guard.