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BACKGROUND: Tracheal bronchus (TB) is defined as an abnormal bronchus that originates directly from the lateral wall of the trachea above the carina and goes towards the upper lobe territory of the lung. We analyzed rigid endoscopies of the trachea in children to determine the incidence and characteristics of TB. METHODS: In total, 1021 rigid endoscopies of the trachea recorded from children aged 0 to 6 years were analyzed. Endoscopic examination was performed from supraglottic region to carina using a 0-degree Hopkins rod-lens telescope. Patients with a TB were identified and the site of origin of the TB and its level above the carina was noted. Data of the identified patients was reviewed for the presence of preoperative airway findings such as stridor, upper lobe pneumonia and wheezing or atelectasis, other congenital anomalies, and intraoperative complications. RESULTS: TB was detected in 11 (1.06%) of 1021 upper airway endoscopic examinations. All originated from the right lateral wall of the trachea. Six children had retained secretions in the TB, and 3 children had perioperative airway problems unrelated to the TB. One child showed right main stem bronchus narrowing as seen at the true carina, in the presence of a TB. All the children with TB exhibited at least 1 additional congenital anomaly at birth besides TB. CONCLUSIONS: TB is a relatively common congenital endoscopic lower airway anomaly in childhood, which is itself rarely symptomatic, but almost always coexists with other congenital anomalies.

Background: Intensive diet and physical activity interventions have been found to reduce cardiovascular disease (CVD) risk, but are resource intensive. The American Heart Association recently recommended motivational interviewing (MI) as an effective approach for low-intensity interventions to promote health-related outcomes such as weight loss. However, there is limited research evaluating the long-term effectiveness of MI-based interventions on health-related outcomes associated with CVD risk. The current research evaluated the effectiveness of a six-month low-intensity MI intervention in a UK primary-care setting in maintaining reductions in CVD risk factors at12 months post-intervention. Methods: Primary-care patients were randomised to an intervention group that received standard exercise and nutrition information plus up to five face-to-face MI sessions, delivered by a physical activity specialist and registered dietician over a 6-month period, or to a minimal intervention comparison group that received the standard information only. Follow-up measures of behavioural (vigorous and moderate physical activity, walking, physical activity stage-of-change, fruit and vegetable intake, and dietary fat intake) and biomedical (weight, body mass index [BMI], blood pressure, cholesterol) outcomes were taken immediately post-intervention and at a 12-month follow-up occasion.Results: Intent-to-treat analyses revealed significant differences between groups for walking and cholesterol. Obese and hypercholesterolemic patients at baseline exhibited significant improvements in BMI and cholesterol respectively among those allocated to the intervention group compared to the comparison group. Post-intervention improvements in other health-related outcomes including blood pressure, weight, and BMI were not maintained. Conclusions: The present study suggests that a low-intensity MI counselling intervention is effective in bringing about long-term changes in some, but not all, health

This study describes the Defense Department's processes for planning, guidance, and decisionmaking and assesses how well they support the Secretary of Defense in developing effective, integrated military forces. First it describes the management practices advocated by the Packard Commission and earlier independent reviews of defense management, for designing and executing acquisition programs that are consistent with national military strategy and projected budgets. Next it reviews the long-standing concerns with DoD management that ultimately gave rise to the Goldwater-Nichols Act in 1986. The report then describes the resulting changes within DoD since 1986, including actions to implement Secretary Cheney's Defense Management Report. Finally, the report presents a prototype management system to illustrate one approach for establishing the advocated management practices within existing DoD organizations and processes, and offers an agenda for implementing this proposed system.

This report presents the results of the first phase of research on the Major Army Command (MACOM) Engineer Decision Support System (DSS) project designed to provide the MACOM Deputy Chief of Staff Engineer (DCSENG) a technical guide to office automation. The research was based on developing a generalized systems configuration and applications approach to be followed by all MACOM DSCENGs to standardize automation of microcomputer systems. The goals of this phase of research were to: (1) identify one MACOM to serve as a knowledge base from which a generalized DSS would be structured, (2) use this site to test the system configuration and software applications developed, and (3) compile the research information as a reference for the other MACOMs. The first year's research produced two software programs, analyzed the WANG mini and micro environments, and identified a shortcoming in the MACOM automation support for the micro environment. Recommendations on training, maintenance and repair, programming support, networks, user groups, and supplies are included.

The approach concentrates on limiting the main potential sources of inefficient loading. That is, rather than seek the most efficient loading of a given set of equipment on a given fleet of aircraft, the procedure set forth avoids gross inefficiencies and thus reasonably approximate the most efficient loading. The first step in such an approach is to review the loadings accomplished by other simulators and by loadmasters in order to identify systematic inefficiencies due to aircraft and equipment characteristics. The review suggests several specific ways in which loading might be improved and provides a set of factors to consider in selecting the order in which to load equipment.

Photograph of a man pitching hay from an Agricultural Extension Report, This photograph wase taken by Martin G. Bailey, who was initially hired as an Agriculture Agent for Southern Maryland counties, Mr. Bailey was promoted to the position of District Agent, supervising the state's "Negro" Agriculture Agents. Once the system in Maryland was desegregated in the late '60s, Bailey served as the state Supervisor of the Agriculture Agents until his retirement. This collection of photos (late 1930s -- early 1960s) of Black Marylanders consists of homemakers, 4-H youth displaying their crops, livestock, farm equipment, and farm and home improvement projects

Photograph of tow men loading a truck from an Agricultural Extension Report. This photograph wase taken by Martin G. Bailey, who was initially hired as an Agriculture Agent for Southern Maryland counties, Mr. Bailey was promoted to the position of District Agent, supervising the state's "Negro" Agriculture Agents. Once the system in Maryland was desegregated in the late '60s, Bailey served as the state Supervisor of the Agriculture Agents until his retirement. This collection of photos (late 1930s -- early 1960s) of Black Marylanders consists of homemakers, 4-H youth displaying their crops, livestock, farm equipment, and farm and home improvement projects

Photograph of a man and six women tying a matress from an Agricultural Extension Report. This photograph wase taken by Martin G. Bailey, who was initially hired as an Agriculture Agent for Southern Maryland counties, Mr. Bailey was promoted to the position of District Agent, supervising the state's "Negro" Agriculture Agents. Once the system in Maryland was desegregated in the late '60s, Bailey served as the state Supervisor of the Agriculture Agents until his retirement. This collection of photos (late 1930s -- early 1960s) of Black Marylanders consists of homemakers, 4-H youth displaying their crops, livestock, farm equipment, and farm and home improvement projects

Photograph of a man holding ears of corn and standing in front of hanging tobacco leaves from an Agricultural Extension Report. This photograph wase taken by Martin G. Bailey, who was initially hired as an Agriculture Agent for Southern Maryland counties, Mr. Bailey was promoted to the position of District Agent, supervising the state's "Negro" Agriculture Agents. Once the system in Maryland was desegregated in the late '60s, Bailey served as the state Supervisor of the Agriculture Agents until his retirement. This collection of photos (late 1930s -- early 1960s) of Black Marylanders consists of homemakers, 4-H youth displaying their crops, livestock, farm equipment, and farm and home improvement projects

Photograph of three women poising on a bench. This photograph wase taken by Martin G. Bailey, who was initially hired as an Agriculture Agent for Southern Maryland counties, Mr. Bailey was promoted to the position of District Agent, supervising the state's "Negro" Agriculture Agents. Once the system in Maryland was desegregated in the late '60s, Bailey served as the state Supervisor of the Agriculture Agents until his retirement. This collection of photos (late 1930s -- early 1960s) of Black Marylanders consists of homemakers, 4-H youth displaying their crops, livestock, farm equipment, and farm and home improvement projects

Photograph of a man and woman inspecting a matress from an Agricultural Extension Report. This photograph wase taken by Martin G. Bailey, who was initially hired as an Agriculture Agent for Southern Maryland counties, Mr. Bailey was promoted to the position of District Agent, supervising the state's "Negro" Agriculture Agents. Once the system in Maryland was desegregated in the late '60s, Bailey served as the state Supervisor of the Agriculture Agents until his retirement. This collection of photos (late 1930s -- early 1960s) of Black Marylanders consists of homemakers, 4-H youth displaying their crops, livestock, farm equipment, and farm and home improvement projects

Photograph of a man and driving a tractor in a corn field from an Agricultural Extension Report. This photograph wase taken by Martin G. Bailey, who was initially hired as an Agriculture Agent for Southern Maryland counties, Mr. Bailey was promoted to the position of District Agent, supervising the state's "Negro" Agriculture Agents. Once the system in Maryland was desegregated in the late '60s, Bailey served as the state Supervisor of the Agriculture Agents until his retirement. This collection of photos (late 1930s -- early 1960s) of Black Marylanders consists of homemakers, 4-H youth displaying their crops, livestock, farm equipment, and farm and home improvement projects

Photograph of a man and driving a tractor in a corn field from an Agricultural Extension Report. This photograph wase taken by Martin G. Bailey, who was initially hired as an Agriculture Agent for Southern Maryland counties, Mr. Bailey was promoted to the position of District Agent, supervising the state's "Negro" Agriculture Agents. Once the system in Maryland was desegregated in the late '60s, Bailey served as the state Supervisor of the Agriculture Agents until his retirement. This collection of photos (late 1930s -- early 1960s) of Black Marylanders consists of homemakers, 4-H youth displaying their crops, livestock, farm equipment, and farm and home improvement projects