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Islamabad Stock Exchange

The Islamabad Stock Exchange ( or PSX-ISE) was a stock exchange located in Islamabad, Capital Territory, Pakistan. In 2016, it merged with the Pakistan Stock Exchange.

History
Islamabad Stock Exchange was incorporated as a guarantee-limited company on 25 October 1989 in Islamabad. In 1989, a Pakistani high court judge investigated the authorization of a new stock exchange in Islamabad. The judge's findings revealed that the Ehsan-ul-Haq Piracha, then Minister of State for Finance, had helped approve the deal, which exclusively favored a company with which he had previously served as a director. Additionally, a member of his family held a directorship at the same company at the time of the deal's approval. The judge presiding over the case issued a strongly worded opinion, alleging that the finance minister had engaged in improper dealings related to the authorization of the new stock exchange.

It was licensed as a stock exchange on 7 January 1992. It started trading in July 1992. ISE has been corporatized and demutualized on August 26, 2015 in terms of Stock Exchanges (Corporatization, Demutualization and Integration) Act, 2012. As a consequence thereof, its name has been changed as Islamabad Stock Exchange Limited. With effect from January 11, 2016 the Islamabad Stock Exchange was integrated with the Karachi Stock Exchange Limited under the Stock Exchanges (Corporatisation, Demutualization and Integration) Act, 2012 to form the Pakistan Stock Exchange.

Trading system
Initially, an outcry method of trading (a method of trading that uses verbal bids and offers in the trading pits) in shares was adopted which was replaced with the automated trading system (a computerized system for matching orders in securities) commonly called “ISE-CTS” in 1997. In the year 2002, ISECTS gave way to “ULTRA TRADE” trading system which is not only very efficient but also has extended trading capacity, internet trading functionality. The computerized trading system has brought about much needed transparency in the securities trading. It has been designed in such a way to provide automatic matching of bids and offers for execution purpose. All orders are treated in strict price and time priority, thus ensuring a pure auction market where no order is overlooked or traded through. In this manner, the best trade is executed and passed on to the participants without human interference. Printed confirmation and status messages are immediately received by a member for each of his order. Remote Trading or Internet Trading has been implemented in ISE on 23 June 2003. Now Brokers can trade from anywhere in the world using remote trading software of ISE with the same robustness as working on the LAN.

Unified trading system
Islamabad Stock Exchange joined hands with Lahore Stock Exchange on 30 April 2007 to establish a Unified Trading Platform to help in bringing increased liquidity in the market, improving price discovery, maximizing transparency, increasing turnover, broadening investor base, curtailing risks and distortions in trade, providing cost effective service to the investing public and enhancing the image of both the Exchanges.

Indexes
On 1 January 2004, ISE launched its own capital weighted index which is ISE-10 index with a base date of December 31, 2002 and a value of 1000. Before its launch ISE was using index of KSE-100. ISE also has a price weighted index called ISE Network Index which was launched in November 1996.

ISE Tower

ISE tower is a 22-storey building, which makes it the second highest building of Islamabad after the Telecom Tower. Area covered by the building is 562629 sqft, it consists of three levels of basements and ground plus 18 floors above. Basements have capacity to accommodate three hundred cars at a time. The building also accommodates a plant room for latest HVAC system requirements. Ground floor is allocated for meeting the requirements of banks. Each floor is covered by 6 passenger lifts and one cargo lift along with three stairwells. A central cooling and heating system is provided in the building. It was inaugurated by Prime Minister Syed Yousuf Raza Gilani on 31 July 2009.

title: Islamabad Stock Exchange


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William Spong Jr.

William Belser Spong Jr. (September 29, 1920 – October 8, 1997) was an American Democratic Party politician and a United States Senator who represented the state of Virginia from 1966 to 1973.

Early life and education
Spong was born in Portsmouth, Virginia, and attended public schools, Hampden–Sydney College in Hampden Sydney, the University of Virginia in Charlottesville, and the University of Edinburgh in Scotland. He studied law, and was admitted to the bar in 1947, commencing practice in Portsmouth soon thereafter. During World War II, Spong served in the Army Air Corps, Eighth Air Force from 1942 to 1945. After the war, Spong was a lecturer in law and government at the College of William and Mary from 1948 to 1949.

State politics
Spong entered Virginia politics as a member of the Virginia House of Delegates from 1954 to 1955, and afterwards as a member of the Virginia State Senate from 1956 to 1966. While in the Senate, Spong was chairman of the Virginia Commission on Public Education from 1958 to 1962.

National politics
In 1966, Spong was personally recruited by President Lyndon Johnson to mount a primary challenge against 20-year incumbent Senator A. Willis Robertson. Johnson was angered at Robertson's opposition to the Civil Rights and Voting Rights Acts. Spong defeated Robertson in one of the biggest upsets in Virginia political history and breezed to victory in November. Robertson resigned on December 31, 1966; Governor Mills Godwin appointed Spong to the seat, giving Spong higher seniority than other senators elected that November. Spong's primary victory marked the beginning of the end of the Byrd Organization's long dominance of Virginia politics. Spong's Senate career was short-lived; in 1972, he was narrowly defeated for reelection by 8th District Representative William L. Scott.

Spong would be the last Democrat elected to the Senate from Virginia until Chuck Robb's victory in 1988. Spong's Senate colleague, Harry F. Byrd Jr., became an independent in 1970.

Later life and death
After his Senate career, Spong returned to the practice of law, and also served as a law professor and the dean of the Marshall-Wythe School of Law at the College of William and Mary from 1976 to 1985. In 1976, Spong was president of the Virginia Bar Association. He was appointed interim president of Old Dominion University in 1988, and was a resident of Portsmouth until his death. He is interred at the University of Virginia Cemetery in Charlottesville, Virginia.

Humor
A popular Internet joke claims that William B. Spong of Virginia and Hiram Fong of Hawaii sponsored a bill recommending the mass ringing of church bells to welcome the arrival in Hong Kong of the U.S. Table Tennis Team after its tour of Communist China. The bill failed to pass, cheating the Senate out of passing the Spong-Fong Hong Kong Ping Pong Ding Dong Bell Bill.

In fact, Senator Spong never sponsored such a bill, but he did have some fun with the press soon after arriving in Washington, D.C. As described in an article by his cousin, the Rt. Rev. John Shelby Spong, Senator Spong:

"was invited with the other freshman senators to address the National Press Club. Fearful that someone on radio or television would call him Senator Sponge, he used his brief five-minute introductory speech to that body to secure proper name identification. His first act as a senator, he announced in his southern drawl, would be to introduce a bill to protect the rights of songwriters in Hong Kong. He would be joined in this effort by the senior senator of Louisiana, Russell Long, and the senior senator from Hawaii, Hiram Fong, and together they would present the Long Fong Spong Hong Kong Song Bill. His name was never mispronounced by members of the media."

Other sources crediting Spong with the humorous bill name suggest different contexts.

Family
Spong married the former Virginia Wise Galliford. They had two children, Martha and Tom.

license: Creative Commons - Attribution Share-Alike - https://creativecommons.org/licenses/by-sa/4.0/

title: William Spong Jr.


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Neonatal intensive care unit

A neonatal intensive care unit (NICU), also known as an intensive care nursery (ICN), is an intensive care unit (ICU) specializing in the care of ill or premature newborn infants. The NICU is divided into several areas, including a critical care area for babies who require close monitoring and intervention, an intermediate care area for infants who are stable but still require specialized care, and a step down unit where babies who are ready to leave the hospital can receive additional care before being discharged.

Neonatal refers to the first 28 days of life. Neonatal care, as known as specialized nurseries or intensive care, has been around since the 1960s.

The first American newborn intensive care unit, designed by Louis Gluck, was opened in October 1960 at Yale New Haven Hospital.

An NICU is typically directed by one or more neonatologists and staffed by resident physicians, nurses, nurse practitioners, pharmacists, physician assistants, respiratory therapists, and dietitians. Many other ancillary disciplines and specialists are available at larger units.

The term neonatal comes from neo, "new", and natal, "pertaining to birth or origin".

Nursing and neonatal populations
Healthcare institutions have varying entry-level requirements for neonatal nurses. Neonatal nurses are registered nurses (RNs), and therefore must have an Associate of Science in Nursing (ASN) or Bachelor of Science in Nursing (BSN) degree. Some countries or institutions may also require a midwifery qualification. Some institutions may accept newly graduated RNs having passed the NCLEX exam; others may require additional experience working in adult-health or medical/surgical nursing.

Some countries offer postgraduate degrees in neonatal nursing, such as the Master of Science in Nursing (MSN) and various doctorates. A nurse practitioner may be required to hold a postgraduate degree. The National Association of Neonatal Nurses recommends two years' experience working in a NICU before taking graduate classes.

As with any registered nurse, local licensing or certifying bodies, as well as employers, may set requirements for continuing education.

There are no mandated requirements to becoming an RN in an NICU, although neonatal nurses must have certification as a neonatal resuscitation provider. Some units prefer new graduates who do not have experience in other units, so they may be trained in the specialty exclusively, while others prefer nurses with more experience.

Intensive-care nurses undergo intensive didactic and clinical orientation in addition to their general nursing knowledge in order to provide highly specialized care for critical patients. Their competencies include the administration of high-risk medications, management of high-acuity patients requiring ventilator support, surgical care, resuscitation, advanced interventions such as extracorporeal membrane oxygenation or hypothermia therapy for neonatal encephalopathy procedures, as well as chronic-care management or lower acuity cares associated with premature infants such as feeding intolerance, phototherapy, or administering antibiotics. NICU RNs undergo annual skills tests and are subject to additional training to maintain contemporary practice.

History
The problem of premature and congenitally ill infants is not a new one. As early as the 17th and 18th centuries, there were scholarly papers published that attempted to share knowledge of interventions. It was not until 1922, however, that hospitals started grouping the newborn infants into one area, now called the neonatal intensive care unit (NICU). Before the industrial revolution, premature and ill infants were born and cared for at home and either lived or died without medical intervention. In the mid-nineteenth century, the infant incubator was first developed, based on the incubators used for chicken eggs. Stephane Tarnier is generally considered to be the father of the incubator (or isolette as it is now known), having developed it in 1880 to attempt to keep premature infants in a Paris maternity ward warm. Other methods had been used before, but this was the first closed model; in addition, he helped convince other physicians that the treatment helped premature infants. France became a forerunner in assisting premature infants, in part due to its concerns about a falling birth rate.

After Tarnier retired, Pierre Budin, followed in his footsteps, noting the limitations of infants in incubators and the importance of breastmilk and the mother's attachment to the child. Budin is known as the father of modern perinatology, and his seminal work The Nursling (Le Nourisson in French) became the first major publication to deal with the care of the neonate. The incubator was improved in 1890 in Marseilles by Alexandre Lion, who founded in 1891 the Œuvre Maternelle des Couveuses d'Enfants in Nice and in January 1896 in Paris.

Another factor that contributed to the development of modern neonatology was Martin Couney and his permanent installment of premature babies in incubators at Coney Island. A more controversial figure, he studied under Budin and brought attention to premature babies and their plight through his display of infants as sideshow attractions at Coney Island and the World's Fair in New York and Chicago in 1933 and 1939, respectively. Infants had also previously been displayed in incubators at the 1897, 1898, 1901, and 1904 World Fairs.

Early years
Doctors took an increasing role in childbirth from the eighteenth century onward. However, the care of newborn babies, sick or well, remained largely in the hands of mothers and midwives. Some baby incubators, similar to those used for hatching chicks, were devised in the late nineteenth century. In the United States, these were shown at commercial exhibitions, complete with babies inside, until 1931. A. Robert Bauer, at Henry Ford Hospital in Detroit, Michigan, successfully combined oxygen, heat, humidity, ease of accessibility, and ease of nursing care in 1931. It was not until after the Second World War that special-care baby units (SCBUs, pronounced 'scaboos') were established in many hospitals. In Britain, early SCBUs opened in Birmingham and Bristol, the latter set up with only £100. At Southmead Hospital, Bristol, initial opposition from obstetricians lessened after quadruplets born there in 1948 were successfully cared for in the new unit.

Incubators were expensive, so the whole room was often kept warm instead. Cross-infection between babies was greatly feared. Strict nursing routines involved staff wearing gowns and masks, constant hand-washing and minimal handling of babies. Parents were sometimes allowed to watch through the windows of the unit. Much was learned about feeding—frequent, tiny feeds seemed best—and breathing. Oxygen was given freely until the end of the 1950s, when it was shown that the high concentrations reached inside incubators caused some babies to go blind. Monitoring conditions in the incubator, and the baby itself, was to become a major area of research.

The 1960s were a time of rapid medical advances, particularly in respiratory support, that were at last making the survival of premature newborn babies a reality. Very few babies born before thirty two weeks survived and those who did often had neurological impairments. Herbert Barrie in London pioneered advances in resuscitation of the newborn. Barrie published his seminal paper on the subject in The Lancet in 1963. One of the concerns at this time was the worry that using high pressures of oxygen could be damaging to newborn lungs. Barrie developed an underwater safety valve in the oxygen circuit. The tubes were originally made of rubber, but these had the potential to cause irritation to sensitive newborn tracheas: Barrie switched to plastic. This new endotracheal tube, based on Barrie's design, was known as the "St Thomas's tube".

Most early units had little equipment, providing only oxygen and warmth, and relied on careful nursing and observation. In later years, further research allowed technology to play a larger role in the decline of infant mortality. The development of pulmonary surfactant, which facilitates the oxygenation and ventilation of underdeveloped lungs, has been the most important development in neonatology to date.

Increasing technology
By the 1970s, NICUs were an established part of hospitals in the developed world. In Britain, some early units ran community programmes, sending experienced nurses to help care for premature babies at home. But increasingly technological monitoring and therapy meant special care for babies became hospital-based. By the 1980s, over 90% of births took place in hospitals. The emergency dash from home to the NICU with baby in a transport incubator had become a thing of the past, though transport incubators were still needed. Specialist equipment and expertise were not available at every hospital, and strong arguments were made for large, centralised NICUs. On the downside was the long travelling time for frail babies and for parents. A 1979 study showed that 20% of babies in NICUs for up to a week were never visited by either parent. Centralised or not, by the 1980s few questioned the role of NICUs in saving babies. Around 80% of babies born weighing less than 1.5 kg now survived, compared to around 40% in the 1960s. From 1982, pediatricians in Britain could train and qualify in the sub-specialty of neonatal medicine.

Not only careful nursing but also new techniques and instruments now played a major role. As in adult intensive-care units, the use of monitoring and life-support systems became routine. These needed special modification for small babies, whose bodies were tiny and often immature. Adult ventilators, for example, could damage babies' lungs and gentler techniques with smaller pressure changes were devised. The many tubes and sensors used for monitoring the baby's condition, blood sampling and artificial feeding made some babies scarcely visible beneath the technology. Furthermore, by 1975, over 18% of newborn babies in Britain were being admitted to NICUs. Some hospitals admitted all babies delivered by Caesarian section or under 2500 g in weight. The fact that these babies missed early close contact with their mothers was a growing concern. The 1980s saw questions being raised about the human and economic costs of too much technology, and admission policies gradually became more conservative.

Changing priorities

NICUs now concentrate on treating very small, premature, or congenitally ill babies. Some of these babies are from higher-order multiple births, but most are still single babies born too early. Premature labour, and how to prevent it, remains a perplexing problem for doctors. Even though medical advancements allow doctors to save low-birth-weight babies, it is almost invariably better to delay such births. Over the last 10 years or so, SCBUs have become much more "parent-friendly", encouraging maximum involvement with the babies. Routine gowns and masks are gone and parents are encouraged to help with care as much as possible. Cuddling and skin-to-skin contact, also known as "kangaroo care", are seen as beneficial for all but the frailest (very tiny babies are exhausted by the stimulus of being handled; or larger critically ill infants). Less stressful ways of delivering high-technology medicine to tiny patients have been devised: sensors to measure blood oxygen levels through the skin, for example; and ways of reducing the amount of blood taken for tests.

Some major problems of the NICU have almost disappeared. Exchange transfusions, in which all the blood is removed and replaced, are rare now. Rhesus incompatibility (a difference in blood groups) between mother and baby is largely preventable, and was the most common cause for exchange transfusion in the past. However, breathing difficulties, intraventricular hemorrhage, necrotizing enterocolitis and infections still claim many infant lives and are the focus of many new and current research projects.

The long-term outlook for premature babies saved by NICUs has always been a concern. From the early years, it was reported that a higher proportion than normal grew up with disabilities, including cerebral palsy and learning difficulties. Now that treatments are available for many of the problems faced by tiny or immature babies in the first weeks of life, long-term follow-up, and minimising long-term disability, are major research areas.

Besides prematurity and extreme low birth-weight, common diseases cared for in a NICU include perinatal asphyxia, major birth defects, sepsis, neonatal jaundice, and infant respiratory distress syndrome due to immaturity of the lungs. In general, the leading cause of death in NICUs is necrotizing enterocolitis. Complications of extreme prematurity may include intracranial hemorrhage, chronic bronchopulmonary dysplasia (see Infant respiratory distress syndrome), or retinopathy of prematurity. An infant may spend a day of observation in a NICU or may spend many months there. Neonatology and NICUs have greatly increased the survival of very low birth-weight and extremely premature infants. In the era before NICUs, infants of birth weight less than 1400 g, usually about 30 weeks gestation, rarely survived. Today, infants of 500 g at 26 weeks have a fair chance of survival. As of 2022, the world record for the lowest gestational age newborn to survive is held by Curtis Zy-Keith Means, who was born on July 5, 2020 in the United States, at 21 weeks and 1 day gestational age, weighing 420 g.

The NICU environment provides challenges as well as benefits. Stressors for the infants can include continual light, a high level of noise, separation from their mothers, reduced physical contact, painful procedures, and interference with the opportunity to breastfeed. To date there have been very few studies investigating noise reduction interventions in the NICU and it remains uncertain what their effects could be on babies' growth and development. An NICU can be stressful for the staff as well. A special aspect of NICU stress for both parents and staff is that infants may survive, but with damage to the brain, lungs, or eyes. When parents arrive at the NICU, they will have the availability to tour the unit and orientation to the various areas and equipment. This tour includes information on the different types of equipment used in the NICU, such as incubators, monitors, and ventilators, and how they help to support the health and well-being of the babies. Parental orientation to the NICU is essential in reducing parental anxiety and improving satisfaction with care.

Effective communication is critical in the NICU. Parents will be given information on who their primary point of contact is and how they can communicate with the medical staff caring for their baby. Parents should ask questions when given tour of the NICU just in case anything was misunderstood. The gynecologic and neonatal nursing found that effective communication between health care providers and parents in the NICU is critical for promoting parental involvement and reducing stress

NICU rotations are essential aspects of pediatric and obstetric residency programs, but NICU experience is encouraged by other specialty residencies, such as family practice, surgery, pharmacy, and emergency medicine.

Incubator
An incubator (or isolette or humidicrib) is an apparatus used to maintain environmental conditions suitable for a neonate (newborn baby). It is used in preterm births or for some ill full-term babies.

Additional items of equipment used to evaluate and treat sick neonates include:

Blood pressure monitor: The blood pressure monitor is a machine that's connected to a small cuff which is wrapped around the arm or leg of the patient. This cuff automatically takes the blood pressure and displays the data for review by care providers. Oxygen hood: This is a clear box that fits over the baby's head and supplies oxygen. This is used for babies who can still breathe but need some respiratory support.

Ventilator: This is a breathing machine that delivers air to the lungs. Babies who are severely ill will receive this intervention. Typically, the ventilator takes the role of the lungs while treatment is administered to improve lung and circulatory function.

Possible functions of a neonatal incubator are:
 * Oxygenation, through oxygen supplementation by head hood or nasal cannula, or even continuous positive airway pressure (CPAP) or mechanical ventilation. Infant respiratory distress syndrome is the leading cause of death in preterm infants, and the main treatments are CPAP, in addition to administering pulmonary surfactant and stabilizing the blood sugar, blood salts, and blood pressure.
 * Observation: Modern neonatal intensive care involves sophisticated measurement of temperature, respiration, cardiac function, oxygenation, and brain activity.
 * Protection from cold temperature, infection, noise, drafts and excess handling: Incubators may be described as bassinets enclosed in plastic, with climate control equipment designed to keep them warm and limit their exposure to germs.
 * Maintaining fluid balance by providing fluid and keeping a high air humidity to prevent too great a loss from skin and respiratory evaporation.

A transport incubator is an incubator in a transportable form, and is used when a sick or premature baby is moved, e.g., from one hospital to another, as from a community hospital to a larger medical facility with a proper neonatal intensive-care unit. It usually has a miniature ventilator, cardio-respiratory monitor, IV pump, pulse oximeter, and oxygen supply built into its frame.

Pain management
Many parents with newborns in the NICU have expressed that they would like to learn more about what types of pain their infants are feeling and how they can help relieve that pain. Parents want to know more about things such as; what caused their child's pain, if the pain that we feel is different than what they feel, how to possibly prevent and notice the pain, and how they could help their child through the pain they were struggling with. Another main worry that was mentioned was the long-term effects of their pain, and whether it mentally affect the child in the future, or even affect the relationship they have with their parents.

Relieving pain
There are multiple ways to manage pain for infants. If the mother is able to help, holding the infant in kangaroo position or breastfeeding can help calm the baby before a procedure is done. Other simple things that can help ease pain include: allowing the infant to suck on a gloved finger, gently binding the limbs in a flexed position, and creating a quiet and comfortable environment.

Patient populations

Common diagnoses and pathologies in the NICU include:
 * Esophageal atresia
 * Apnea
 * Bradycardia
 * Bronchopulmonary dysplasia (BPD)
 * Hydrocephalus
 * Intraventricular hemorrhage (IVH)
 * Jaundice
 * Necrotizing enterocolitis (NEC)
 * Patent ductus arteriosus (PDA)
 * Periventricular leukomalacia (PVL)
 * Infant respiratory distress syndrome (RDS)
 * Retinopathy of prematurity (ROP)
 * Neonatal sepsis
 * Transient tachypnea of the newborn (TTN)

Levels of care
The concept of designations for hospital facilities that care for newborn infants according to the level of complexity of care provided was first proposed in the United States in 1976. Levels in the United States are designated by the guidelines published by the American Academy of Pediatrics In Britain, the guidelines are issued by The British Association of Perinatal Medicine (BAPM), and in Canada, they are maintained by The Canadian Paediatric Society.

Neonatal care is split into categories or "levels of care". these levels apply to the type of care needed and is determined by the governing body of the area.

India
India has 3-tier system based on weight and gestational age of neonate.

Level I care
Neonates weighing more than 1800 grams or having gestational maturity of 34 weeks or more are categorized under level I care. The care consists of basic care at birth, provision of warmth, maintaining asepsis and promotion of breastfeeding. This type of care can be given at home, subcenter and primary health centre.

Level II care
Neonates weighing 1200-1800 grams or having gestational maturity of 30–34 weeks are categorized under level II care and are looked after by trained nurses and pediatricians. The equipment and facilities used for this level of care include equipment for resuscitation, maintenance of thermoneutral environment, intravenous infusion, gavage feeding, phototherapy and exchange blood transfusion. This type of care can be given at first referral units, district hospitals, teaching institutions and nursing homes.

Level III care
Neonates weighing less than 1200 grams or having gestational maturity of less than 30 weeks are categorized under level III care. The care is provided at apex institutions and regional perinatal centers equipped with centralized oxygen and suction facilities, servo-controlled incubators, vital signs monitors, transcutaneous monitors, ventilators, infusion pumps etc. This type of care is provided by skilled nurses and neonatologists.

United Kingdom
The terminology used in the United Kingdom can be confusing because different criteria are used to designate 'special' and 'intensive' neonatal care locally and nationally.

Level 1 Neonatal Units
Also known as 'Special Care Baby Units' (SCBU). These look after babies who need more care than healthy newborns but are relatively stable and mature. SCBU might provide tube-feeding, oxygen therapy, antibiotics to treat infection and phototherapy for jaundice. In a SCBU, a nurse can be assigned up to four babies to care for.

Level 2 Neonatal Units
Also known as 'Local Neonatal Units', these can look after babies who need more advanced support such as parenteral nutrition and continuous positive airway pressure (CPAP). Confusingly, they may also look after babies who need short-term intensive care such as mechanical ventilation. Babies who will need longer-term or more elaborate intensive care, for example extremely preterm infants, are usually transferred to a Level 3 unit. Babies in a Level 2 unit may be classified for nursing purposes as 'Special Care', 'High Dependency' (HDU) (in which a nurse will be assigned up to two babies) or 'Intensive care' (where nursing is one-to-one, or sometimes even two-to-one).

Level 3 Neonatal Units
Also known as 'Neonatal Intensive Care Units' (NICU) - although Level 2 units may also have their own NICU. These look after the smallest, most premature and most unwell babies and often serve a large geographical region. Therapies such as prolonged mechanical ventilation, therapeutic hypothermia, neonatal surgery and inhaled nitric oxide are usually provided in Level 3 Units, although not every unit has access to all therapies. Some babies being cared for in Level 3 units will require less intensive treatment and will be looked after in HDU or SCBU nurseries on the same site. NHS England recommended in December 2019 that these units should care for at least 100 babies weighing less than 1.5 kg, and usually perform more than 2,000 intensive care days per year.

United States
The definition of a neonatal intensive-care unit (NICU) according to the National Center for Statistics is a "hospital facility or unit staffed and equipped to provide continuous mechanical ventilatory support for a newborn infant". In 2012, the American Academy of Pediatric updated their policy statement delineating the different levels of neonatal care. One major difference in the 2012 updated policy statement from the AAP compared to the 2004 policy statement is the removal of subspeciality nurseries for levels II and III with the addition of a level IV NICU. The four distinct levels of neonatal care defined in the most recent policy statement from the AAP are:
 * 1) Level I, Well newborn nursery
 * 2) Level II, Special care nursery
 * 3) Level III, Neonatal intensive-care unit (NICU)
 * 4) Level IV, Regional neonatal intensive-care unit (Regional NICU)

Level I (well newborn nursery)
Level I units are typically referred to as the well baby nursery. Well newborn nurseries have the capability to provide neonatal resuscitation at every delivery; evaluate and provide postnatal care to healthy newborn infants; stabilize and provide care for infants born at 35 to 37 weeks' gestation who remain physiologically stable; and stabilize newborn infants who are ill and those born less than 35 weeks' gestation until transfer to a facility that can provide the appropriate level of neonatal care. Required provider types for well newborn nurseries include pediatricians, family physicians, nurse practitioners, and other advanced practice registered nurses.

Level II (special care nursery)
Previously, Level II units were subdivided into 2 categories (level IIA & level IIB) on the basis of their ability to provide assisted ventilation including continuous positive airway pressure. Level II units are also known as special care nurseries and have all of the capabilities of a level I nursery. In addition to providing level I neonatal care, Level II units are able to:
 * Provide care for infants born ≥32-week gestation and weighing ≥1500 g who have physiologic immaturity or who are moderately ill with problems that are expected to resolve rapidly and are not anticipated to need subspecialty services on an urgent basis
 * Provide care for infants who are feeding and growing stronger or convalescing after intensive care
 * Provide mechanical ventilation for a brief duration (<24 h) or continuous positive airway pressure
 * Stabilize infants born before 32-week gestation and weighing less than 1500 g until transfer to a neonatal intensive-care facility
 * Level II nurseries are required to be managed and staffed by a pediatrician, however many Level II special care nurseries are staffed by neonatologists and neonatal nurse practitioners.

Level III (neonatal intensive-care unit)
The 2004 AAP guidelines subdivided Level III units into 3 categories (level IIIA, IIIB & IIIC). Level III units are required to have pediatric surgeons in addition to care providers required for level II (pediatric hospitalists, neonatologists, and neonatal nurse practitioners) and level I (pediatricians, family physicians, nurse practitioners, and other advanced practice registered nurses). Also, required provider types that must either be on site or at a closely related institution by prearranged consultative agreement include pediatric medical subspecialists, pediatric anesthesiologists, and pediatric ophthalmologists. In addition to providing the care and having the capabilities of level I and level II nurseries, level III neonatal intensive-care units are able to:
 * Provide sustained life support
 * Provide comprehensive care for infants born <32 wks gestation and weighing <1500 g
 * Provide comprehensive care for infants born at all gestational ages and birth weights with critical illness
 * Provide prompt and readily available access to a full range of pediatric medical subspecialists, pediatric surgical specialists, pediatric anesthesiologists, and pediatric ophthalmologists
 * Provide a full range of respiratory support that may include conventional and/or high-frequency ventilation and inhaled nitric oxide
 * Perform advanced imaging, with interpretation on an urgent basis, including computed tomography, MRI, and echocardiography

Level IV (regional NICU)
The highest level of neonatal care provided occurs at regional NICUs, or Level IV neonatal intensive-care units. Level IV units are required to have pediatric surgical subspecialists in addition to the care providers required for Level III units. Regional NICUs have all of the capabilities of Level I, II, and III units. In addition to providing the highest level of care, level IV NICUs:
 * Are located within an institution with the capability to provide surgical repair of complex congenital or acquired conditions
 * Maintain a full range of pediatric medical subspecialists, pediatric surgical subspecialists, and pediatric anesthesiologists at the site
 * Facilitate transport and provide outreach education.

title: Neonatal intensive care unit


text:
Thirty-eighth Amendment of the Constitution of India

The Thirty-eighth Amendment of the Constitution of India, officially known as The Constitution (Thirty-eighth Amendment) Act, 1975, made the declaration of "The Emergency" final and conclusive. In particular it codified and enlarged the State's power to remove fundamental rights from its citizens during states of emergency.

Introduced on 22 July 1975, the bill received presidential assent in ten days. The Amendment barred judicial review of proclamations of emergency whether made to meet external, internal, or financial threats (Article 360 for the latter). It also barred judicial review of overlapping emergency proclamations, or ordinances promulgated by the President or by governors, and of laws enacted during emergencies that contravened Fundamental Rights.

Ratification
The Act was passed when it was ratified by more than half of the State Legislatures. State Legislatures that ratified the amendment are listed below:

 * 1) Andhra Pradesh
 * 2) Assam
 * 3) Bihar
 * 4) Haryana
 * 5) Himachal Pradesh
 * 6) Karnataka
 * 7) Kerala
 * 8) Madhya Pradesh
 * 9) Maharashtra
 * 10) Meghalaya
 * 11) Orissa
 * 12) Punjab
 * 13) Rajasthan
 * 14) Sikkim
 * 15) Tripura
 * 16) Uttar Pradesh
 * 17) West Bengal

Did not ratify:
 * 1) Jammu and Kashmir
 * 2) Gujarat
 * 3) Manipur
 * 4) Nagaland
 * 5) Tamil Nadu


text:
Louis Eugene, Duke of Württemberg

Ludwig Eugen, Duke of Württemberg (6 January 1731 – 20 May 1795), was the reigning Duke of Württemberg from 1793 until his death in 1795.

Early life and ancestry
He was born as the third son of Duke Karl Alexander and his wife, Princess Maria Augusta of Thurn and Taxis (11 August 1706 – 1 February 1756).

His maternal grandparents were Anselm Franz, 2nd Prince of Thurn and Taxis (30 January 1681 – 8 November 1739) and Princess Maria Ludovika Anna von Lobkowicz (20 October 1683 – 20 January 1750). Maria Ludovika was daughter of Prince Ferdinand August Leopold von Lobkowicz-Sagan (1655–1715) and Princess Maria Anna Wilhelmine of Baden-Baden (1655-1702).

Maria Anna was a daughter of William, Margrave of Baden-Baden (1593–1677) and Countess Maria Magdalena of Oettingen-Baldern (1619-1688). Her paternal grandparents were Edward Fortunatus, Margrave of Baden-Rodemachern (1565–1600) and Baroness Maria of Eicken (1569-1636).

Edward was a son of Christopher II, Margrave of Baden-Rodemachern (1537–1575) and Princess Cecilia of Sweden (1540–1627). Cecilia was a daughter of Gustav I of Sweden (1496–1560) and Margaret Leijonhufvud (1516–1551).

Marriage
He married (initially morganatically) Countess Sophie Albertine von Beichlingen (15 December 1728 – 10 May 1807), a daughter of August Gottfried Dietrich, Count of Beichlingen (1703–1769) and his wife, Sophie Helene, Baroness of Stöcken (1710–1738). Louis and Sophie had three daughters:
 * Sophie Antoinette (29 June 1763 – 12 May 1775)
 * Wilhelmine Friederike Elisabeth (3 July 1764 – 9 August 1817), married Prince Kraft Ernst von Oettingen-Oettingen und Oettingen-Wallerstein (3 Aug 1748 – 6 Oct 1802)
 * Henriette Charlotte Friederike (11 March 1767 – 23 May 1817), married Prince Karl Joseph von Hohenlohe-Bartenstein-Jagstberg (12 Dec 1766 – 6 Jul 1838)

Reign
He succeeded his brother Karl Eugen as Duke of Württemberg in 1793, and reigned until his own death in 1795, when he was succeeded by his younger brother Frederick Eugen.

title: Louis Eugene, Duke of Württemberg


text:
Talk:Ontonagon, Michigan

About my typing of 'centres' — sorry, it was automatic, not deliberate. Mel Etitis ( Μελ Ετητης ) 20:22, 4 Feb 2005 (UTC)

big ass fire
any info about this?

http://thehistorycellar.blogspot.com/2009/03/in-fall-of-1896-town-of-ontonagon-in.html —Preceding unsigned comment added by 218.166.210.235 (talk) 03:59, 11 July 2009 (UTC)

Information removed
I removed this confusing paragraph from the geography section, because it fails to provide adequate citations, and the one reference listed does not actually mention anything relevant to Ontonagon. While it is interesting to note if Ontonagon is the westernmost incorporated community in the Eastern time zone, that tidbit might be superfluous and hard to adequately source. The information I removed is as followed:

Ontonagon is the westernmost incorporated community in the United States to be located in the legally designated Eastern Time Zone as determined by the United States Department of Transportation. In the summer, the sun sets over Lake Superior at 10 p.m. local time, with dusk lasting until almost 11 p.m. By contrast, in the winter, the sun does not rise until just before 9 a.m. and it is still pitch black at 8 a.m. Ontonagon is within one degree of longitude to the east of the 90th meridian west, which is actually the meridian for the Central Time Zone. Therefore, Ontonagon should theoretically be situated in the Central Time Zone, not the Eastern Time Zone. As a result of this idiosyncrasy, Ontonagon actually has its solar noon occur either at or near 1 p.m. during the winter when standard time (EST) is being observed and 2 p.m. when daylight saving time (EDT) is being observed. The same is true for solar midnight, which occurs at or near 1 a.m. while on standard time and 2 a.m. while on daylight saving time.

title: Talk:Ontonagon, Michigan


text:
Talk:Whitney Institute Middle School

This could use various cleanup, especially for tone. It could also use fact-checking, but I despair of being able to do it without a local Bermudan historian on hand. Isomorphic 20:22, 4 Feb 2005 (UTC)

I did some wikifying but the sentence at the end Taken from the Whitney Institute Archives as written by William Zuill Sr. 1946 makes me worry we aren't clear on copyright. RJFJR 03:32, 9 March 2006 (UTC)

title: Talk:Whitney Institute Middle School


text:
Army of the Gulf

The Army of the Gulf was a Union Army that served in the general area of the Gulf states controlled by Union forces. It mainly saw action in Louisiana and Alabama.

History
The Department of the Gulf was created following the capture of New Orleans by Admiral David G. Farragut in 1862. The commander of the Union occupation forces, Benjamin F. Butler, was placed in command of the department. In March, Butler assumed command of the department, and the Army of the Gulf was created from the troops now designated to the Department of the Gulf.

The army saw little action the rest of 1862 and Butler was replaced by Major General Nathaniel P. Banks on December 17. Banks assumed command of the Department of the Gulf and the Army of the Gulf. At the time the Army of the Gulf consisted of only one corps, the XIX Corps, which Banks was also appointed command of. Banks led the army in several engagements in lower Louisiana that eventually led to the Siege of Port Hudson, this army's first major engagement. The army endured the siege and the post was finally surrendered by Confederate forces on July 9, 1863. The next year the XIII Corps and two divisions of the XVI Corps were added to the department, increasing the army to over three corps. Banks retained command of the army and department while Gen. William H. Emory assumed command of the XIX Corps.

In March 1864, Banks began his disastrous Red River Campaign. After it failed, he resigned from the Army and was replaced by Maj. Gen. Stephen A. Hurlbut. The XIX Corps was sent to the Shenandoah Valley, and the forces that remained in the army participated in the land attack at the Battle of Mobile Bay.

Late in the war, Maj. Gen. Edward Canby's Military Division of West Mississippi was given the army's two remaining corps, the XIII and the XVI, for a planned offensive to capture the city of Mobile. During this operation, Canby renamed the force the Army of West Mississippi after the military division that he commanded. Although now under a different title, the force was virtually the same army and it took part in the Battle of Spanish Fort and the Battle of Fort Blakeley. Canby was appointed command of the Department of the Gulf at the closing of the war and the forces once again became the Army of the Gulf.

Battle orders

 * Port Hudson order of battle

title: Army of the Gulf


text:
Charles Eugene, Duke of Württemberg

Charles Eugene (German: Carl Eugen; 11 February 1728 – 24 October 1793) was the Duke of Württemberg, and the eldest son, and successor, of Charles Alexander; his mother was Princess Marie Auguste of Thurn and Taxis.

Life
Born in Brussels, he succeeded his father as ruler of Württemberg at the age of 9, but the real power was in the hands of Regents Carl Rudolf, Duke of Württemberg-Neuenstadt (1737–1738) and Carl Frederick von Württemberg-Oels (1738–1746).

He was educated at the court of Frederick II of Prussia. He also studied keyboard with Carl Philipp Emanuel Bach in the 1740s (Bach's "Württemberg" sonatas, published in 1744, were dedicated to Charles Eugene).

In his early years he ruled with an iron fist. In 1744 he ordered that the corpse of Joseph Süß Oppenheimer, his father's financial advisor executed by the Duke of Württemberg-Neuenstadt, whose decaying corpse had been suspended in an iron cage by Stuttgart's Prag gallows for six years, be taken down and given a decent burial. He was also well known for his extensive library, his extravagant interest in opera, and interest in large scale horticulture for the feeding of the masses.

Charles Eugene made the first of his five trips to Paris and the Palace of Versailles in 1748 with his first wife. He used these trips to sightsee and acquire Parisian goods for Ludwigsburg Palace while touring the workshops those goods were manufactured in. From 1776 Etienne Sollicoffre, a banker Charles Eugene had met in Paris, befriended the Duke and acted as the agent of his purchases in the city.

Between 1751 and 1759 Karl Eugen was involved in an increasingly bitter struggle with his adviser, the eminent Liberal jurist Johann Jakob Moser who strongly opposed the Duke's absolutist tendencies. In 1759 Charles Eugene had Moser charged with authoring "a subversive writing" and cast into prison for the next five years. However, in 1764 Moser was released, due in part to the intercession of Friedrich the Great of Prussia, and was rehabilitated and restored to his position, rank and titles.

Having accepted a subsidy from the French, in the Seven Years' War against Prussia, Charles Eugene advanced into Saxony.

In 1761, Charles Eugen founded an Académie des Arts in Stuttgart (now the State Academy of Fine Arts Stuttgart), in 1765 a public library in Ludwigsburg (now the Württembergische Landesbibliothek, Stuttgart), and he was responsible for the construction of a number of other key palaces and buildings in the area including the New Palace which still stands at the centre of the Schlossplatz, Solitude Palace, Einsiedel Palace and Castle Hohenheim.

Charles Eugene was known for his interest in agriculture and travel and is considered the inspiration behind today's Hohenheim university, part of which now occupies his former summer estate. His original botanical gardens form the basis for today's Landesarboretum Baden-Württemberg and Botanischer Garten der Universität Hohenheim, which still contain some of the specimens he planted. He was also involved in Aviculture. He built a large number of palaces and bankrupted his lands through courtly extravagance, accepting huge French government loans in exchange for maintaining large numbers of support troops in Württemberg.

He was an early patron of Friedrich Schiller. However, in 1780 he had him arrested for deserting his post as a regimental doctor in Stuttgart in order to attend the first performance of his play The Robbers in Mannheim. Schiller was sentenced to 14 days of imprisonment, and forbidden by Karl Eugen from publishing any further works.

Hermann Sacher, writing in the Catholic Encyclopedia called Charles Eugene "a despot, spendthrift, and profligate". Charles Eugene ruled until his death in 1793, when he was succeeded by his younger brother. He died in Hohenheim.

Marriages
Charles Eugene married twice, first in Bayreuth on 26 September 1748 to Margravine Elisabeth Fredericka Sophie of Brandenburg-Bayreuth with whom he had one daughter, Friederike Wilhelmine Augusta Luise Charlotte, who was born in Stuttgart on 19 February 1750 and died after 13 months in Stuttgart on 12 March 1751. Elisabetha left Charles Eugene in 1756 to return to her parents' court in Bayreuth although they never divorced.

In the meantime, Charles Eugene kept a string of mistresses and fathered eleven children by them. The last of these mistresses was Franziska von Hohenheim, whom he raised to the status of Countess and married in Stuttgart on 10 or 11 January 1785.

Mistresses and illegitimate issue
By an unknown mistress he had:
 * Karoline (31 December 1755 – 14 May 1839), unmarried and without issue

By Luisa Toscani he had:
 * Karl von Ostheim (1761 – Batavia, 24 February 1793), unmarried and without issue
 * Karl Alexander von Ostheim (31 December 1765 – after 1821), unmarried and without issue

By an unknown mistress he had:
 * Charlotte (9 February 1762 – 31 August 1811), married 30 June 1783 Julius Friedrich von Lützow (? – 4 July 1833), without issue

By Teresa Bonafoni he had:
 * Karl Bonafoni (2 July 1768 – 30 April 1769)
 * Karl genannt Borel (18 May 1770 – before 1821), who committed suicide, unmarried and without issue

By Anna Eleonora Franchi he had:
 * Eugen Franchi (5 October 1768 – c. 1794), unmarried and without issue
 * Eleonore Franchi, Freiin von Franquemont (17 January 1771 – 1833), married in 1792 Jean François Louis Marie, Comte d'Orsay (15 June 1772 – 26 December 1843), and had issue

By an unknown mistress he had:
 * Friedrich Wilhelm (? – 19 December 1790), unmarried and without issue

By Katharina Kurz he had:
 * Karl-David von Franquemont (13 March 1769 – 20 July 1830), married firstly in May 1795 to a Baroness Maria Barbara von Hügel (1778-1803), daughter of Baron Theobald von Hügel (1739-1800), by whom he had a daughter, and married secondly in May 1795 to Luise Sophie Henriette von Jett (September 1783 – 24 January 1852), by whom he had a daughter:
 * Charlotte Elisabeth Piron von Franquemont (1797–1868), who lived in Ceylon and married Matthias Johann August David von Franquemont (1795-1844)
 * Karoline Luise von Franquemont (Samarang, 20 July 1800 – Ludwigsburg, 3 April 1857), married on 21 October 1819 Johann von Raben (? – 18 November 1853), without issue

By Regina Monti he had:
 * Friedrich, Graf von Franquemont (Ludwigsburg, 5 March 1770 – 3 January 1842), unmarried and without issue, general and War minister.

title: Charles Eugene, Duke of Württemberg