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AEI currently utilizes a RIEGL VZ400 Terrestrial Laser Scanner on various job sites.  This proecss utilizes a high accuracy 3D terrestrial LiDAR unit.  The data collected will be brought into a feature extraction software, TopoDOT.  TopoDOT utilizes a variety of tools to identify adn quickly extrapolate features within pointcloud data.  All features can then be imported into an AutoCAD drawing file.  AEI can provide an accurate 3D pointcloud of terrain plus any existing building or structures.  The pointcloud can also be converted for Building Information Models.

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Allen Engineering is involved with the civil design and surveying for the new park in Palm Bay, Flordia.  This Regional Park will feature 150 full service campsite hookups and is scheduled to break ground in 2018.  We are extremely proud to be involved in this project.

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Allen Engineering is beginning its 21st year associated with the Space Coast Post of the Society of American Military Engineers (SAME).  During our 21 years, we have helped raise over $350,000 in scholarships and endowments.  We are extremely proud to be associated with SAME and its continued commitment to offer opportunities for students pursuing careers in the engineering field.


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Community-based care may improve breastfeeding practices and increase referrals to arthritis pain relief youtube discount etodolac 200 mg with visa health facilities for pregnancy-related complications and other health care services during pregnancy arthritis diet generic etodolac 300mg on-line, such as iron and folic acid supplementation (Lassi and others 2013) arthritis pain.org purchase 400 mg etodolac overnight delivery. Results from a systematic review suggest that implementation of community-based intervention care packages led to arthritis in the knees natural remedies order 200 mg etodolac fast delivery a 25 percent reduction in neonatal mortality; referrals to health facilities for pregnancy-related complication increased by 40 percent; rates of early breastfeeding increased by 94 percent; and health care seeking for neonatal illnesses increased by 45 percent, leading to decreases in neonatal and maternal morbidity (tables 14. Bhutta and others (2013) show that intermittent preventive treatment with sulfadoxine-pyrimethamine in pregnancy, delivered through community-based approaches, is associated with a higher mean birth weight compared with case management (weighted mean difference 108. Salam, Maredia, and others (2014) also find that interventions such as preventive chemotherapy, health education to promote general hygiene and sanitation, iron and beta-carotene supplementation, construction of latrines, removal of cattle from residential areas, staff training, and community mobilization can have significant impacts on the prevention and management of worm infestations in children. Evidence suggests that school-based delivery of antihelminths can significantly reduce soil-transmitted helminths prevalence by 55 percent, schistosomiasis prevalence (risk ratio 0. It also improves the mean hemoglobin levels significantly (standard mean difference 0. Community delivery of highly active antiretroviral therapy during pregnancy and lactation also led to a 66 percent decrease in stillbirths (risk ratio 0. Community-Based Care to Improve Maternal, Newborn, and Child Health 269 Tuberculosis. Tuberculosis can be managed and prevented through community-based intervention packages, including through variants of the directly observed treatment short course, community outreach, training sessions, and increased awareness to boost the detection rate and decrease relapse rates. Findings from 41 studies on the effectiveness of community-based interventions for tuberculosis show that these interventions were associated with a significant increase in cure and the success and completion of treatment (risk ratio 1. Evidence suggests that community-based nutrition programs can have a positive impact on health outcomes. In the program, monthly community sessions are held to monitor and promote the growth of children ages two years and younger (Getachew 2011; World Bank 2012). The program empowers communities to assess the nutritional status of their children and take action, using their own resources, to prevent malnutrition. Monthly tracking of all children in the community enables the timely identification of severely underweight children and their referral for further examination and treatment. The government of Ethiopia introduced this initiative in 2008 in drought-prone and foodinsecure districts. The study also finds that the program positively influenced infant and young child feeding, including greater adherence to exclusive breastfeeding for babies younger than age six months, complementary feeding between ages 6 and 23 months, and dietary diversity for older children, thereby reducing morbidity and mortality related to malnutrition (Getachew 2011; World Bank 2012). A systemic review of community-based interventions to improve child nutrition status suggests that nutrition education in both food-secure and foodinsecure populations is associated with an increase in height-for-age Z scores of 0. The review also suggests that simple interventions, such as individual counseling and group counseling, increase the odds of exclusive breastfeeding practices (Bhutta and others 2013; Lassi and others 2013). A decrease in neonatal morbidity through benefits of domiciliary practices, such as early initiation of breastfeeding and health-seeking behaviors, was also observed (risk ratio 1. A total of 35 centers were developed; only 20 were functioning as nutrition centers. Entry and exit criteria for rehabilitation were ill defined, resulting in some nonmalnourished children being enrolled. Few staff were adequately trained; knowledge was weak, especially about case management; and mothers were not effectively instructed. The program improved knowledge by about 10­20 percentage points beyond that seen in nonproject areas regarding exclusive breastfeeding. The program began in 168 villages in the Iringa Region of Tanzania, covering an estimated population of 46,000 children under age five years. Also aims to enhance the capability of the mother to look after the normal health, nutritional, and developmental needs of the child through proper community education. A World Bank evaluation in 1999 suggested that the program had no significant impact on nutritional outcomes. Sources: Balachander 1993; do Monte and others 1998; Gupta, Gupta, and Baridalyne 2013; World Bank 2005; Yambi and Mlolwa 1992. Six randomized controlled trials that built community support and advocacy groups for mobilization on issues related to maternal, neonatal, and child health were analyzed. A study from Ethiopia showed promising results when a group of women from the community were empowered and mobilized to recognize and treat malaria (Rosato and others 2008). This process led to an overall 40 percent reduction in mortality in children under age five years (Kidane and Morrow 2000). Neonatal mortality rates were reduced by 45 percent in the intervention arm (Tripathy and others 2010). The Makwanpur trial was conducted in a rural mountainous community in Nepal, where 94 percent of babies are born at home (Pradhan and New 1997) and only 13 percent of births are attended by trained health workers (Central Bureau of Statistics 2001). With the implementation of facilitated monthly group meetings among pregnant women, a decrease in neonatal mortality was seen in the intervention arm, compared with the control arm, with an odds ratio of 0. Results show that of the 1,421 women in the intervention group who took misoprostol, 100 percent correctly took it after birth. In the intervention area where communitybased distribution of misoprostol was introduced, near-universal uterotonic coverage (92 percent) was achieved, compared with 25 percent coverage in the control areas (Sanghvi and others 2010). Usage is particularly seen more in the South Asia region, with uterotonic usage rates of up to 69 percent (Flandermeyer, Stanton, and Armbruster 2010). In this trial, women receiving oxytocin had a reduced risk of postpartum hemorrhage (risk ratio 0. Investigators should focus on this area of research as a promising approach in low-resource settings. Improving the Quality of Community-Based Care Ensuring that care provided in communities meets quality standards is a key concern, and training and supervision are crucial mechanisms for ensuring quality care. Effective supervision requires that supervisors be trained and that they be provided with resources for supervision (Mason and others 2006).

Not only is this unequivocally demonstrated in the data from prospective cohort studies best mattress for arthritis in back order 300mg etodolac overnight delivery, but the corroborating experimental evidence on this topic strongly reinforces this conclusion arthritis diet causes purchase etodolac 400mg amex. Additionally arthritis hip pain order 300mg etodolac visa, the evidence reviewed here demonstrates that the health benefits of smoking cessation after a heart disease diagnosis extend to arthritis back young order etodolac 200 mg online mortality specifically from cardiac causes and sudden death. Third, the evidence indicates that smoking cessation is associated with decreased risk of new or recurrent cardiac events. Based on the causal criterion of coherence, the known causal associations between smoking and these outcomes in the general population support the causal nature of the associations. Because all the currently available evidence is from prospective studies, the temporal nature of the association is not ambiguous. The evidence for each outcome showed a high degree of consistency across diverse study populations and measurement approaches. These characteristics of the evidence clearly indicate that in current smokers diagnosed with heart disease, smoking cessation is associated with reduced risk of all-cause mortality, cause-specific mortality, and new or recurrent cardiac events. In patients who are current smokers when diagnosed with coronary heart disease, the evidence is sufficient to infer a causal relationship between 304 Chapter 4 Smoking Cessation smoking cessation and a reduction in all-cause mortality. In patients who are current smokers when diagnosed with coronary heart disease, the evidence is sufficient to infer a causal relationship between smoking cessation and reductions in deaths due to cardiac causes and sudden death. The reductions in risk are substantial for total mortality and cardiovascular disease-specific outcomes. Estimates across studies indicate that smoking cessation reduces relative risks for these outcomes by 30­40%. A Cochrane review found evidence for efficacy of smoking cessation interventions in patients hospitalized for cardiovascular disease (Rigotti et al. The critical role of smoking cessation in cardiac rehabilitation is already recognized in evidence-based medicine guidelines (King et al. In particular, cardiologists who provide care to patients who have experienced cardiovascular events should (a) clearly communicate to these patients that quitting smoking is the most important action they can take to improve their prognosis and (b) offer patients evidence-based cessation treatments, including counseling, medications, and referral to more intensive assistance, including state quitlines (Fiore et al. Chronic Respiratory Disease Tobacco smoke contains thousands of chemical components that are inhaled and then deposited throughout the large and small airways and alveoli of the lungs (U. Two independent reviewers identified 45 articles through consensus after reviewing the titles and abstracts. With sustained abstinence from smoking, the rate of decline in pulmonary function among former smokers returns to that of never smokers. The residual excess risk of death for the ex-smoker is directly proportional to the overall lifetime exposure to cigarette smoke and to the total number of years since one quit smoking. Cessation reduces the chance of premature death from chronic bronchitis and emphysema. There is debate, however, on using the lower limit of normal for selected reference populations as the best approach to standardizing the interpretation of spirometry results by accounting for age, sex, height, and race (Mannino et al. The Health Benefits of Smoking Cessation 307 A Report of the Surgeon General with measures of health-related quality of life and mortality (Wise 2006). Additionally, however, there is evidence to support the presence of considerable smoking-related respiratory disease among persons with normal lung function. For example, in a study by Woodruff and colleagues (2016), half of current or former smokers with preserved pulmonary function exhibited respiratory symptoms, and former smokers with preserved lung function had higher rates of exacerbation events than lifelong nonsmokers. Sensitive imaging approaches are now used to quantify changes in the lungs, including emphysema, that have health implications. However, the analysis did not find differences in the risk of having such changes by smoking status. Despite this narrowing of the difference between men and women, mortality rates in men continue to exceed those in women (Ford 2015). Since the 1990 report, both clinical and population studies have examined the association between cessation of tobacco smoking and the decline of lung function. In a separate analysis of data from the Lung Health Study, a decrease in the number of cigarettes smoked by continued smokers did not reduce the rate of decline of lung function compared with complete cessation, unless the number of cigarettes smoked was reduced by at least 85% (Simmons et al. The American Journal of Respiratory and Critical Care Medicine is an official journal of the American Thoracic Society. Several studies have examined how quickly benefits of smoking cessation are observed. This last finding suggests that the effects of smoking cessation on decline in lung function are not immediate and may take up to 2 years to be manifested. Studies and trials have continued to demonstrate immediate improvement in self-reported respiratory symptoms at 1 to 3 months after cessation (Louhelainen et al. Smoking cessation has a beneficial effect at any age, although the benefit was found to be more pronounced among persons who quit before 30 years of age compared with those who quit after 40 years of age (Kohansal et al. Although smoking cessation results in less severe respiratory symptoms, the inflammatory burden may persist. In a prospective cohort, Louhelainen and colleagues (2009) found oxidant and protease burden in airways (using sputum as a proxy to measure airway inflammation) that persisted for months after smoking cessation. The Health Benefits of Smoking Cessation 309 A Report of the Surgeon General Table 4. Former smokers were only included if they had quit smoking after the age of 50 years and less than 10 years before inclusion. Furthermore, novel therapeutic options-such as epigenetic regulation-can be reprogrammed, potentially modifying risk and supporting treatment of disease states (Sakao and Tatsumi 2011).

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The intestines of poultry are easily colonized (the organism establishes itself without a detectable host immune response) with C does arthritis in dogs go away etodolac 200 mg generic. Once the organism is established within the flock arthritis relief home remedies buy cheap etodolac 300mg online, it can be very difficult to juvenile arthritis in dogs generic 200 mg etodolac eliminate (4 rheumatoid arthritis mortality proven 300mg etodolac,5). When an infected bird is slaughtered, Campylobacter organisms can be transferred from the intestines to the meat. It is estimated that over half of all commercial chicken and turkey flocks harbor C. Another study reported an isolation rate of 98% for retail chicken meat, with bacterial counts often exceeding 103 per 100 grams. When fecal samples from chicken carcasses chosen at random from butcher shops were tested for Campylobacter, 83% of the samples yielded more than 106 colony forming units per gram of feces (4,5). The reasons might be higher contamination levels or inadequate cooking procedures. One way humans infect themselves is by cutting raw poultry meat on a cutting board, then using the unwashed cutting board or utensil to prepare vegetables or other raw or lightly cooked foods. The infectious dose (number of organisms necessary to cause disease) is very small; fewer than 500 Campylobacter organisms can cause illness in humans (4,5). However, in contrast to other agents offoodborne gastroenteritis, including Salmonella spp. For humans, waterfowl are just as important a source of Campylobacter jejuni as chickens and turkeys. Wild birds, including migratory birds-cranes, ducks, geese, and seagulls-and domestic bird species can all harbor C. Often these organisms may survive for months in the water after the birds have migrated elsewhere. Young animals are more often colonized than older animals, and feedlot cattle are more likely than grazing animals to carry Campylobacter jejuni. This community was an insular religious group of about 150 consisting primarily of agricultural workers who practiced small-scale and traditional farming. During the fair, unpasteurized cheese was made at an activity station by adding rennet extract to unpasteurized milk donated by a local dairy, producing soft cheese in 5-6 hours with little additional processing. By October 29, seventeen additional members of the community had reported gastrointestinal illness and visited the clinic within a week. All ninteen persons reported consuming the fresh cheese that was made on October 20. Among the ill persons, 66 (97%) reported watery diarrhea, 18 (27%) reported bloody diarrhea, and 16 (24%) reported vomiting and diarrhea. One case of secondary transmission occurred in a person who did not consume the fresh cheese, but became ill on October 29, six days after her child became ill. As part of the investigation a questionnaire was distributed at a community meeting on Nov. Consuming fresh cheese produced from unpasteurized milk was significantly associated with illness. Cultures of stool specimens collected from three persons who met the case definition all yielded C. Unpasteurized (raw) milk can become contaminated if the cow has an infection with Campylobacter in her udder, or if the milk is contaminated with manure. As shown in the case study, raw milk may be made into cheese or other milk products that may contain C. One study showed 12% of raw milk samples from dairy farms in eastern Tennessee were contaminated with C. It is believed that improvements in the production of milk, such as control of Campylobacter contamination on the farm, strict animal hygiene, as well as many food safety measures have reduced campylobacteriosis outbreaks from milk. Large outbreaks of campylobacteriosis throughout the world have been associated with unchlorinated drinking water (4,5). Surface water and mountain streams, if used as drinking water, can be contaminated with infected feces from cows, wild birds, or other animals (4). The incidence of Campylobacter infections is usually sporadic-a single event following ingestion of improperly handled or cooked food, primarily poultry products. Campylobacteriosis can occur in large outbreaks, when a number of people become ill at one time, sometimes as many as >1,000 illnesses from the same source. The rise in the number of cases during the summer may be due to higher levels of poultry contamination during warmer weather, and/or to summer food-consumption patterns, including barbecuing and eating outdoors, which may result in food that is undercooked or cross-contaminated. Other sporadic infections have been associated with some person-to-person contact via the fecal-oral route. This has been noted from infected individuals who have very frequent episodes of diarrhea, and also from infected infants who are still in diapers. Because the infectious dose is small, campylobacteriosis can easily be spread from person to person, particularly if individuals do not properly wash their hands (4,5). Studies of other sporadic Campylobacter infections have found such risk factors as contact with domesticated animals and contact with farm animals (1,2). The incidence of sporadic infection follows primarily a bimodal (2-peak) age distribution, with the highest incidence in infants and young children, followed by a second peak in young adults 20 to 40 years old. In the United States, infants and young adults have the highest Campylobacter rate of infection (1,2,4). Infants and young children have a rate of infection of approximately 14 per 100,000 person years. As children get older, isolation rates decline to approximately 4 per 100,000 person years for young adolescents.

Cages are autoclaved or thoroughly decontaminated before bedding is removed and before they are cleaned 72 10 arthritis medication dogs discount etodolac 200 mg. Vertebrate Animal Biosafety Level Criteria - Animal Biosafety Level 4 and was hed zoom for arthritis in dogs etodolac 400mg cheap. Equ ipm ent a nd w ork s urfa ces are ro utine ly decontaminated with an appropriate disinfectant after work with infectious materials diffuse arthritis definition buy discount etodolac 300 mg line, and especially after spills rheumatoid arthritis zinc 400 mg etodolac otc, splashe s, or other contam ination by infec tious m aterials. Equipment must be decontaminated according to any local, state, or federal regulations before removal from the facility for repair or maintenance. Based on the risk assessment (see Section V), use of squeeze cages, working only with anesthetized animals, or other appropriate procedures to reduce possible worker exposure must be instituted. Personnel enter and leave the facility only through the clothing change and shower room s. Personnel should not enter or leave the facility through the air lock s, exce pt in an em ergenc y. Complete laboratory clothing, including undergarments, pants and shirts or jump suits, shoes, and gloves, is provided and used by personnel entering the facility. When exiting, personnel remove laboratory clothing in the inner change room before entering the shower area. Sup plies a nd m ateria ls are introd uce d into the fa cility via a double-door autoclave or fumigation chamber. After the outer door is secure, personnel inside the facility open the inner door to retrieve the materials. The doors of the autoclave and fumigation chamber are interlocked in a manner that preven ts opening of the outer door unless the autoclave has been operated through a "sterilization cycle" or the fumigation chamber has been decontaminated. A system is established for the reporting of accidents, incidents, exposures, and employee absenteeism, and for the medical surveillance of potential laboratory-associated illnesses. An essential adjunct to such a reporting /surveillanc e system is the availab ility of a facility for the quarantine, isolation, and medical care of persons with potential or known laboratory-associated illnesses. Infected animals should be housed in a partial con tainm ent s ystem (suc h as o pen cage s plac ed in ventilated enclosures, solid wall and bottom cages covered with filter bonnets and opened in laminar flow hoods, or other eq uivalent prim ary contain men t system s). The use of dispos able material that does not require cleaning, including an imal ca ging, sho uld be co nsidere d. Disposable materials must be autoclaved on exit from the facility and then incinerate d. S um ma ry of R eco mm end ed B iosa fety Le vels f or Ac tivities in W hich Exp erim enta lly or Na turally In fecte d Ve rtebr ate A nim als Are Used. Mechanical cage washer used 1 Not known to consistently cause disease in healthy human adults. Standard animal care and management practices, including appropriate medical surveillance programs 2 Associated with human disease. Autoclave available in facility 4 Dangerous/exotic agents that pose high risk of life threatening disease; aerosol transmission, or related agents with unknown risk of transmission. Entrance through change room where personal clothing is removed and laboratory clothing is put on; shower on exiting! In the context of the microbiological and biomedical laboratories, the assessment of risk focuses primarily on the prevention of laboratory-associated infections. When addressing laboratory activities involving infectious or potentially infectious mate rial, risk ass essm ent is a critica l and prod uctive ex ercise. The int ent o f this section is to provide guidance and to establish a framework for selecting the appr opriate bios afety level. In the face of such com plexity, meaningful quantitative sampling methods are frequently unavailable. Therefore, the process of doing a risk assessment for work with biohazardous materials cannot depend on a prescribed algorithm. The labor atory d irecto r or pr incipa l inves tigato r is res pon sible for ass essing r isks in ord er to set the biosafe ty level for the wo rk. This should be done in close collaboration with the Institutional Biosafety Comm ittee (and/or other biosafety professionals as needed) to ensure compliance with established guidelines and regulation s. In performing a qualitative risk assessm ent, all the risk factors are first identified and explored. In some cases, one must rely on other sources of information such as field data from subject matte r experts. This infor mation is interprete d for its tend ency to raise or lower the risk of laboratory-acquired infection. A conservative approach is generally advisable when insufficient information forces subjective judgement. The factors of interest in a risk assessment include: · the pathog enicity of the infectious or suspected infectious agent, inc luding dise ase incid ence a nd seve rity. Agents that can be transmitted by the aeroso l route have cause d mo st laborato ry infections. It is wis e, wh en pla nning work with a relativ ely uncharacterized agent with an uncertain mode of transmission, to consider the potential for aerosol 78 · Risk Assessment transmission. Fac tors suc h as de siccation, expos ure to sunlight or ultraviolet light, or exposure to chemical disinfectants must be considered. The complex nature of the interaction of microorganisms and the host presents a significant challenge even to the healthiest immunized laboratory worker, and may pose a serious risk to those with lesser resistance. The concentration (number of infectious organisms per unit volum e) will be im portant in d eterm ining the risk. Such a determination will include consideration of the milieu containing the organism.


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