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Sample records for pages health facilities

  1. Health Facilities

    MedlinePLUS

    Health facilities are places that provide health care. They include hospitals, clinics, outpatient care centers, and specialized care centers, such as birthing centers and psychiatric care centers. When you choose ...

  2. National Institute of Environmental Health Sciences Kids' Pages

    MedlinePLUS

    Skip Navigation National Institute of Environmental Health Sciences Kids Pages skip navigation Home Discover & Explore What's That Word Scientific Kids Fun & Games Parents & Teachers About Contact Oil Spills No one really ...

  3. Insights into Facebook Pages: an early adolescent health research study page targeted at parents.

    PubMed

    Amon, Krestina L; Paxton, Karen; Klineberg, Emily; Riley, Lisa; Hawke, Catherine; Steinbeck, Katharine

    2016-02-01

    Facebook has been used in health research, but there is a lack of literature regarding how Facebook may be used to recruit younger adolescents. A Facebook Page was created for an adolescent cohort study on the effects of puberty hormones on well-being and behaviour in early adolescence. Used as a communication tool with existing participants, it also aimed to alert potential participants to the study. The purpose of this paper is to provide a detailed description of the development of the study Facebook Page and present the fan response to the types of posts made on the Page using the Facebook-generated Insights data. Two types of posts were made on the study Facebook Page. The first type was study-related update posts and events. The second was relevant adolescent and family research and current news posts. Observations on the use of and response to the Page were made over 1 year across three phases (phase 1, very low Facebook use; phase 2, high Facebook use; phase 3, low Facebook use). Most Page fans were female (88.6%), with the largest group of fans aged between 35 and 44 years. Study-related update posts with photographs were the most popular. This paper provides a model on which other researchers could base Facebook communication and potential recruitment in the absence of established guidelines. PMID:25781667

  4. Code JEF Facilities Engineering Home Page for the Internet

    NASA Technical Reports Server (NTRS)

    Mahaffey, Valerie A.; Harrison, Marla J. (Technical Monitor)

    1995-01-01

    There are always many activities going on in JEF. We work on and manage the Construction of Facilities (C of F) projects at NASA-Ames. We are constantly designing or analyzing a new facility or project, or a modification to an existing facility. Every day we answer numerous questions about engineering policy, codes and standards, we attend design reviews, we count dollars and we make sure that everything at the Center is designed and built according to good engineering judgment. In addition, we study literature and attend conferences to make sure that we keep current on new legislation and standards.

  5. Using Facebook Page Insights Data to Determine Posting Best Practices in an Academic Health Sciences Library

    ERIC Educational Resources Information Center

    Houk, Kathryn M.; Thornhill, Kate

    2013-01-01

    Tufts University Hirsh Health Sciences Library created a Facebook page and a corresponding managing committee in March 2010. Facebook Page Insights data collected from the library's Facebook page were statistically analyzed to investigate patterns of user engagement. The committee hoped to improve posting practices and increase user


  6. Using Facebook Page Insights Data to Determine Posting Best Practices in an Academic Health Sciences Library

    ERIC Educational Resources Information Center

    Houk, Kathryn M.; Thornhill, Kate

    2013-01-01

    Tufts University Hirsh Health Sciences Library created a Facebook page and a corresponding managing committee in March 2010. Facebook Page Insights data collected from the library's Facebook page were statistically analyzed to investigate patterns of user engagement. The committee hoped to improve posting practices and increase user…

  7. Health Resources Statistics; Health Manpower and Health Facilities, 1969.

    ERIC Educational Resources Information Center

    National Center for Health Statistics (DHEW/PHS), Hyattsville, MD.

    Intended to provide current statistics on health manpower and inpatient health facilities for the evaluation, planning, and administration of health programs, data were gathered from college and university records, state licensing records, association membership records, and agencies and establishments that provide health services. About 3.7…

  8. Industrial Sanitation and Personal Facilities. Module SH-13. Safety and Health.

    ERIC Educational Resources Information Center

    Center for Occupational Research and Development, Inc., Waco, TX.

    This student module on industrial sanitation and personal facilities is one of 50 modules concerned with job safety and health. This module deals wth many facets of industrial sanitation and the facilities industries should provide so that proper health procedures may be followed. Following the introduction, 14 objectives (each keyed to a page in…

  9. VA Health Care Facilities Locator

    MedlinePLUS

    ... to start search site map [a-z] Health Health Care Information A-Z Health Topic Finder My Health ... General QUICK LIST Apply for Benefits Apply for Health Care Prescriptions My Health e Vet eBenefits Life Insurance ...

  10. Safety in Elevators and Grain Handling Facilities. Module SH-27. Safety and Health.

    ERIC Educational Resources Information Center

    Center for Occupational Research and Development, Inc., Waco, TX.

    This student module on safety in elevators and grain handling facilities is one of 50 modules concerned with job safety and health. Following the introduction, 15 objectives (each keyed to a page in the text) the student is expected to accomplish are listed (e.g., Explain how explosion suppression works). Then each objective is taught in detail,…

  11. Cost effective operations through informed risk taking at the DuPage County wastewater facility Knollwood WWTP phase III

    SciTech Connect

    Rafter, J.C.; Palmer, R.A.; Bowles, B.

    1998-07-01

    Using a proactive approach to responsible wastewater collection and treatment, DuPage County, Illinois in conjunction with CTE identified and presented adverse compliance challenges to the IEPA regarding the capabilities of the Region IX-East collection and treatment facilities. This approach contained an element of risk on the County's part, knowing that the IEPA's non-compliance penalties regarding these issues were severe and that a resolution within a court ordered time schedule. A careful plan was developed to involve all the parties, the County, the regulatory agencies, the engineer and the contractor to solve the potential challenges facing the County based on anticipated increases in wastewater flow due to population growth in the Region. Regional IX-Easts' customers are served by the Knollwood Wastewater Treatment Plant (Knollwood). The Knollwood site is located just north of forest preserve property along the Des Plaines River in Burr Ridge, Illinois. The surrounding area to the west consists of a commercial industrial park. A residential development is located to the north of the plant approximately 1000 feet from the nearest treatment plant processing unit. The Knollwood Plant was rated to treat an average daily flow of 8.3 mgd prior to the construction of the new facilities. The new facilities allow the plant to treat an average daily flow of 10 mgd and peak flows up to 50 mgd.

  12. Challenges, alternatives, and paths to sustainability: better public health promotion using social networking pages as key tools.

    PubMed

    Zaidan, A A; Zaidan, B B; Kadhem, Z; Larbani, M; Lakulu, M B; Hashim, M

    2015-02-01

    This paper discusses the possibility of promoting public health and implementing educational health services using Facebook. We discuss the challenges and strengths of using such a platform as a tool for public health care systems from two different perspectives, namely, the view of IT developers and that of physicians. We present a new way of evaluating user interactivity in health care systems from tools provided by Facebook that measure statistical traffic in the Internet. Findings show that Facebook is a very promising tool in promoting e-health services in Web 2.0. Results from statistical traffic show that a Facebook page is more efficient than other pages in promoting public health. PMID:25631841

  13. The health risks of decommissioning nuclear facilities.

    PubMed

    Dodic-Fikfak, M; Clapp, R; Kriebel, D

    1999-01-01

    The health risks facing workers involved in decommissioning nuclear facilities are a critical concern as the nuclear weapons complex and nuclear power plants begin to be dismantled. In addition to risks from exposure to radioactive materials, there are risks from other common industrial materials like crystalline silica dust and asbestos. We discuss these issues in the context of recent research on the risk of low-level ionizing radiation, the classification of crystalline silica as a carcinogen, and early experience with decommissioning nuclear facilities in the United States. Health and safety advocates will need to be vigilant to prevent worker exposure. PMID:17208791

  14. 42 CFR 476.76 - Cooperation with health care facilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Cooperation with health care facilities. 476.76 Section 476.76 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... § 476.76 Cooperation with health care facilities. Before implementation of review, a QIO must make...

  15. 42 CFR 476.76 - Cooperation with health care facilities.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Cooperation with health care facilities. 476.76 Section 476.76 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... § 476.76 Cooperation with health care facilities. Before implementation of review, a QIO must make...

  16. 42 CFR 476.76 - Cooperation with health care facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Cooperation with health care facilities. 476.76 Section 476.76 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... § 476.76 Cooperation with health care facilities. Before implementation of review, a QIO must make...

  17. 42 CFR 476.76 - Cooperation with health care facilities.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Cooperation with health care facilities. 476.76 Section 476.76 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... § 476.76 Cooperation with health care facilities. Before implementation of review, a QIO must make...

  18. Manned Mars mission health maintenance facility

    NASA Technical Reports Server (NTRS)

    Degioanni, Joseph C.

    1986-01-01

    The Health Maintenance Facility (HMF) requirements which enable/enhance manned Mars missions (MMMs) are addressed. It does not attempt to resolve any issues that may affect the feasibility of any given element in the HMF. Reference is made to current work being conducted in the design of the space station HMF. The HMF requirements are discussed within the context of two distinctly different scenarios: HMF as part of the Mars surface infrastructure, and HMF as part of the nine months translation from low Earth orbit to Mars orbit. Requirements for an HMF are provided, and a concept of HMF is shown.

  19. Health maintenance facility: Dental equipment requirements

    NASA Technical Reports Server (NTRS)

    Young, John; Gosbee, John; Billica, Roger

    1991-01-01

    The objectives were to test the effectiveness of the Health Maintenance Facility (HMF) dental suction/particle containment system, which controls fluids and debris generated during simulated dental treatment, in microgravity; to test the effectiveness of fiber optic intraoral lighting systems in microgravity, while simulating dental treatment; and to evaluate the operation and function of off-the-shelf dental handheld instruments, namely a portable dental hand drill and temporary filling material, in microgravity. A description of test procedures, including test set-up, flight equipment, and the data acquisition system, is given.

  20. 42 CFR 476.78 - Responsibilities of health care facilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Responsibilities of health care facilities. 476.78... § 476.78 Responsibilities of health care facilities. (a) Every hospital seeking payment for services.... (b) Cooperation with QIOs. Health care providers that submit Medicare claims must cooperate in...

  1. A health maintenance facility for space station freedom

    NASA Technical Reports Server (NTRS)

    Billica, R. D.; Doarn, C. R.

    1991-01-01

    We describe a health care facility to be built and used on an orbiting space station in low Earth orbit. This facility, called the health maintenance facility, is based on and modeled after isolated terrestrial medical facilities. It will provide a phased approach to health care for the crews of Space Station Freedom. This paper presents the capabilities of the health maintenance facility. As Freedom is constructed over the next decade there will be an increase in activities, both construction and scientific. The health maintenance facility will evolve with this process until it is a mature, complete, stand-alone health care facility that establishes a foundation to support interplanetary travel. As our experience in space continues to grow so will the commitment to providing health care.

  2. A health maintenance facility for space station freedom.

    PubMed

    Billica, R D; Doarn, C R

    1991-10-01

    We describe a health care facility to be built and used on an orbiting space station in low Earth orbit. This facility, called the health maintenance facility, is based on and modeled after isolated terrestrial medical facilities. It will provide a phased approach to health care for the crews of Space Station Freedom. This paper presents the capabilities of the health maintenance facility. As Freedom is constructed over the next decade there will be an increase in activities, both construction and scientific. The health maintenance facility will evolve with this process until it is a mature, complete, stand-alone health care facility that establishes a foundation to support interplanetary travel. As our experience in space continues to grow so will the commitment to providing health care. PMID:1743067

  3. Establishing and training health care facility decontamination teams.

    TOXLINE Toxicology Bibliographic Information

    Hick JL; Penn P; Hanfling D; Lappe MA; O'laughlin D; Burstein JL

    2003-09-01

    Recent terrorist events, changes in Joint Commission on Accreditation of Healthcare Organizations requirements, and availability of grant funding have focused health care facility attention on emergency preparedness. Health care facilities have historically been underprepared for contaminated patients presenting to their facilities. These incidents must be properly managed to reduce the health risks to the victims, providers, and facility. A properly equipped and well-trained health care facility team is a prerequisite for rapid and effective decontamination response. This article reviews Occupational Safety and Health Administration (OSHA) training requirements for personnel involved with decontamination responses, as well as issues of team selection and training. Sample OSHA operations-level training curricula tailored to the health care environment are outlined. Initial and ongoing didactic and practical training can be implemented by the health care facility to ensure effective response when contaminated patients arrive seeking emergency medical care.

  4. TB in Correctional Facilities Is a Public Health Concern

    MedlinePLUS

    ... Past Emails CDC Features TB in Correctional Facilities is a Public Health Concern Recommend on Facebook Tweet ... time of diagnosis. Figure 2 (larger view). TB is Diagnosed in all Types of Correctional Facilities Persons ...

  5. Psychiatric and Medical Health Care Policies in Juvenile Detention Facilities

    ERIC Educational Resources Information Center

    Pajer, Kathleen A.; Kelleher, Kelly; Gupta, Ravindra A.; Rolls, Jennifer; Gardner, William

    2007-01-01

    A study aims to examine the existing health care policies in U.S. juvenile detention centres. The results conclude that juvenile detention facilities have many shortfalls in providing care for adolescents, particularly mental health care.

  6. Health maintenance facility system effectiveness testing

    NASA Technical Reports Server (NTRS)

    Lloyd, Charles W.; Gosbee, John; Bueker, Richard; Kupra, Debra; Ruta, Mary

    1993-01-01

    The Medical Simulations Working Group conducted a series of medical simulations to evaluate the proposed Health Maintenance Facility (HMF) Preliminary Design Review (PDR) configuration. The goal of these simulations was to test the system effectiveness of the HMF PDR configurations. The objectives of the medical simulations are to (1) ensure fulfillment of requirements with this HMF design, (2) demonstrate the conformance of the system to human engineering design criteria, and (3) determine whether undesirable design or procedural features were introduced into the design. The simulations consisted of performing 6 different medical scenarios with the HMF mockup in the KRUG laboratory. The scenarios included representative medical procedures and used a broad spectrum of HMF equipment and supplies. Scripts were written and simulations performed by medical simulations working group members under observation from others. Data were collected by means of questionnaires, debriefings, and videotapes. Results were extracted and listed in the individual reports. Specific issues and recommendations from each simulation were compiled into the individual reports. General issues regarding the PDR design of the HMF are outlined in the summary report.

  7. 42 CFR 476.76 - Cooperation with health care facilities.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Cooperation with health care facilities. 476.76 Section 476.76 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Responsibilities of Quality Improvement Organizations (QIOs) General Provisions § 476.76 Cooperation with...

  8. Health Research Facilities: A survey of Doctorate-Granting Institutions.

    ERIC Educational Resources Information Center

    Atelsek, Frank J.; Gomberg, Irene L.

    The survey data cover three broad categories: (1) the status of existing health research facilities at doctorate-granting institutions (including their current value, adequacy, and condition); (2) the volume of new construction in progress; and (3) the additions to health research facilities anticipated during the next 5 years


  9. Machine learning approach for automatic quality criteria detection of health web pages.

    PubMed

    Gaudinat, Arnaud; Grabar, Natalia; Boyer, Célia

    2007-01-01

    The number of medical websites is constantly growing [1]. Owing to the open nature of the Web, the reliability of information available on the Web is uneven. Internet users are overwhelmed by the quantity of information available on the Web. The situation is even more critical in the medical area, as the content proposed by health websites can have a direct impact on the users' well being. One way to control the reliability of health websites is to assess their quality and to make this assessment available to users. The HON Foundation has defined a set of eight ethical principles. HON's experts are working in order to manually define whether a given website complies with s the required principles. As the number of medical websites is constantly growing, manual expertise becomes insufficient and automatic systems should be used in order to help medical experts. In this paper we present the design and the evaluation of an automatic system conceived for the categorisation of medical and health documents according to he HONcode ethical principles. A first evaluation shows promising results. Currently the system shows 0.78 micro precision and 0.73 F-measure, with 0.06 errors. PMID:17911808

  10. 7 CFR 15b.38 - Health care facilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Health care facilities. 15b.38 Section 15b.38... ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Other Aid, Benefits, or Services § 15b.38 Health care... impaired. A recipient hospital that provides health services or benefits shall establish a procedure...

  11. 7 CFR 15b.38 - Health care facilities.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 1 2014-01-01 2014-01-01 false Health care facilities. 15b.38 Section 15b.38... ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Other Aid, Benefits, or Services § 15b.38 Health care... impaired. A recipient hospital that provides health services or benefits shall establish a procedure...

  12. 7 CFR 15b.38 - Health care facilities.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 1 2012-01-01 2012-01-01 false Health care facilities. 15b.38 Section 15b.38... ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Other Aid, Benefits, or Services § 15b.38 Health care... impaired. A recipient hospital that provides health services or benefits shall establish a procedure...

  13. 7 CFR 15b.38 - Health care facilities.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 1 2011-01-01 2011-01-01 false Health care facilities. 15b.38 Section 15b.38... ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Other Aid, Benefits, or Services § 15b.38 Health care... impaired. A recipient hospital that provides health services or benefits shall establish a procedure...

  14. 7 CFR 15b.38 - Health care facilities.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 1 2013-01-01 2013-01-01 false Health care facilities. 15b.38 Section 15b.38... ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Other Aid, Benefits, or Services § 15b.38 Health care... impaired. A recipient hospital that provides health services or benefits shall establish a procedure...

  15. Health Care Facilities Resilient to Climate Change Impacts

    PubMed Central

    Paterson, Jaclyn; Berry, Peter; Ebi, Kristie; Varangu, Linda

    2014-01-01

    Climate change will increase the frequency and magnitude of extreme weather events and create risks that will impact health care facilities. Health care facilities will need to assess climate change risks and adopt adaptive management strategies to be resilient, but guidance tools are lacking. In this study, a toolkit was developed for health care facility officials to assess the resiliency of their facility to climate change impacts. A mixed methods approach was used to develop climate change resiliency indicators to inform the development of the toolkit. The toolkit consists of a checklist for officials who work in areas of emergency management, facilities management and health care services and supply chain management, a facilitator’s guide for administering the checklist, and a resource guidebook to inform adaptation. Six health care facilities representing three provinces in Canada piloted the checklist. Senior level officials with expertise in the aforementioned areas were invited to review the checklist, provide feedback during qualitative interviews and review the final toolkit at a stakeholder workshop. The toolkit helps health care facility officials identify gaps in climate change preparedness, direct allocation of adaptation resources and inform strategic planning to increase resiliency to climate change. PMID:25522050

  16. Health care facilities resilient to climate change impacts.

    PubMed

    Paterson, Jaclyn; Berry, Peter; Ebi, Kristie; Varangu, Linda

    2014-12-01

    Climate change will increase the frequency and magnitude of extreme weather events and create risks that will impact health care facilities. Health care facilities will need to assess climate change risks and adopt adaptive management strategies to be resilient, but guidance tools are lacking. In this study, a toolkit was developed for health care facility officials to assess the resiliency of their facility to climate change impacts. A mixed methods approach was used to develop climate change resiliency indicators to inform the development of the toolkit. The toolkit consists of a checklist for officials who work in areas of emergency management, facilities management and health care services and supply chain management, a facilitator's guide for administering the checklist, and a resource guidebook to inform adaptation. Six health care facilities representing three provinces in Canada piloted the checklist. Senior level officials with expertise in the aforementioned are as were invited to review the checklist, provide feedback during qualitative interviews and review the final toolkit at a stakeholder workshop. The toolkit helps health care facility officials identify gaps in climate change preparedness, direct allocation of adaptation resources and inform strategic planning to increase resiliency to climate change. PMID:25590098

  17. Health care facilities resilient to climate change impacts.

    PubMed

    Paterson, Jaclyn; Berry, Peter; Ebi, Kristie; Varangu, Linda

    2014-01-01

    Climate change will increase the frequency and magnitude of extreme weather events and create risks that will impact health care facilities. Health care facilities will need to assess climate change risks and adopt adaptive management strategies to be resilient, but guidance tools are lacking. In this study, a toolkit was developed for health care facility officials to assess the resiliency of their facility to climate change impacts. A mixed methods approach was used to develop climate change resiliency indicators to inform the development of the toolkit. The toolkit consists of a checklist for officials who work in areas of emergency management, facilities management and health care services and supply chain management, a facilitator's guide for administering the checklist, and a resource guidebook to inform adaptation. Six health care facilities representing three provinces in Canada piloted the checklist. Senior level officials with expertise in the aforementioned areas were invited to review the checklist, provide feedback during qualitative interviews and review the final toolkit at a stakeholder workshop. The toolkit helps health care facility officials identify gaps in climate change preparedness, direct allocation of adaptation resources and inform strategic planning to increase resiliency to climate change. PMID:25522050

  18. Development of a Master Health Facility List in Nigeria

    PubMed Central

    Azeez, Aderemi; Bamidele, Samson; Oyemakinde, Akin; Oyediran, Kolawole Azeez; Adebayo, Wura; Fapohunda, Bolaji; Abioye, Abimbola; Mullen, Stephanie

    2014-01-01

    Abstract Introduction Routine Health Information Systems (RHIS) are increasingly transitioning to electronic platforms in several developing countries. Establishment of a Master Facility List (MFL) to standardize the allocation of unique identifiers for health facilities can overcome identification issues and support health facility management. The Nigerian Federal Ministry of Health (FMOH) recently developed a MFL, and we present the process and outcome. Methods The MFL was developed from the ground up, and includes a state code, a local government area (LGA) code, health facility ownership (public or private), the level of care, and an exclusive LGA level health facility serial number, as part of the unique identifier system in Nigeria. To develop the MFL, the LGAs sent the list of all health facilities in their jurisdiction to the state, which in turn collated for all LGAs under them before sending to the FMOH. At the FMOH, a group of RHIS experts verified the list and identifiers for each state. Results The national MFL consists of 34,423 health facilities uniquely identified. The list has been published and is available for worldwide access; it is currently used for planning and management of health services in Nigeria. Discussion Unique identifiers are a basic component of any information system. However, poor planning and execution of implementing this key standard can diminish the success of the RHIS. Conclusion Development and adherence to standards is the hallmark for a national health information infrastructure. Explicit processes and multi-level stakeholder engagement is necessary to ensuring the success of the effort. PMID:25422720

  19. 42 CFR 476.78 - Responsibilities of health care facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) General Provisions § 476.78 Responsibilities of health care facilities. (a) Every hospital seeking payment for...

  20. 75 FR 54627 - Best Management Practices for Unused Pharmaceuticals at Health Care Facilities

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-08

    ... AGENCY Best Management Practices for Unused Pharmaceuticals at Health Care Facilities AGENCY... guidance document entitled, Best Management Practices for Unused Pharmaceuticals at Health Care Facilities... been studying unused pharmaceutical disposal practices at health care facilities, prompted by...

  1. Human health risk characterization of petroleum coke calcining facility emissions.

    PubMed

    Singh, Davinderjit; Johnson, Giffe T; Harbison, Raymond D

    2015-12-01

    Calcining processes including handling and storage of raw petroleum coke may result in Particulate Matter (PM) and gaseous emissions. Concerns have been raised over the potential association between particulate and aerosol pollution and adverse respiratory health effects including decrements in lung function. This risk characterization evaluated the exposure concentrations of ambient air pollutants including PM10 and gaseous pollutants from a petroleum coke calciner facility. The ambient air pollutant levels were collected through monitors installed at multiple locations in the vicinity of the facility. The measured and modeled particulate levels in ambient air from the calciner facility were compared to standards protective of public health. The results indicated that exposure levels were, on occasions at sites farther from the facility, higher than the public health limit of 150 Όg/m(3) 24-h average for PM10. However, the carbon fraction demonstrated that the contribution from the calciner facility was de minimis. Exposure levels of the modeled SO2, CO, NOx and PM10 concentrations were also below public health air quality standards. These results demonstrate that emissions from calcining processes involving petroleum coke, at facilities that are well controlled, are below regulatory standards and are not expected to produce a public health risk. PMID:26520182

  2. Housekeeper in Health Care Facilities. Student Manual [and] Instructor Key.

    ERIC Educational Resources Information Center

    Scott, Jane

    This packet contains a student manual and instructor key for a course in housekeeping for health care facilities in secondary health occupations programs. The student manual is divided into six units: (1) introduction to housekeeping; (2) interpersonal relations; (3) infection control and safety; (4) general cleaning procedures; (5) cleaning areas…

  3. ACSM's Health/Fitness Facility Standards and Guidelines. Second Edition.

    ERIC Educational Resources Information Center

    Peterson, James A., Ed; Tharrett, Stephen J., Ed.

    The American College of Sports Medicine (ACSM) sets the industry standard for certifying professionals involved in health and fitness and their clinical applications. This 5-part publication provides a revised edition of six standards representing the industry's consensus on design and operation of a safe and high-quality health/fitness facility

  4. Video Surveillance in Mental Health Facilities: Is it Ethical?

    PubMed

    Stolovy, Tali; Melamed, Yuval; Afek, Arnon

    2015-05-01

    Video surveillance is a tool for managing safety and security within public spaces. In mental health facilities, the major benefit of video surveillance is that it enables 24 hour monitoring of patients, which has the potential to reduce violent and aggressive behavior. The major disadvantage is that such observation is by nature intrusive. It diminishes privacy, a factor of huge importance for psychiatric inpatients. Thus, an ongoing debate has developed following the increasing use of cameras in this setting. This article presents the experience of a medium-large academic state hospital that uses video surveillance, and explores the various ethical and administrative aspects of video surveillance in mental health facilities. PMID:26137651

  5. Imbalances in the health labour force: an assessment using data from three national health facility surveys.

    PubMed

    Barden-O'Fallon, Janine; Angeles, Gustavo; Tsui, Amy

    2006-03-01

    Accurate knowledge of the characteristics of the health labour force that can affect health care production is of critical importance to health planners and policymakers. This study uses health facility survey data to examine characteristics of the primary health care labour force in Nicaragua, Tanzania and Bangladesh. The characteristics examined are those that are likely to affect service provision, including urban/rural distribution, demographic characteristics, and experience and in-service training, for three types of providers (physicians, nurses and auxiliary nurses). The profiles suggest a pattern of urban/rural imbalances in Nicaragua and Tanzania. The Bangladesh facility survey did not include hospitals, thereby making concrete conclusions on the supply and distribution of providers difficult to make. Multivariate logistic regressions are used to assess the relationship between the urban/rural placement of providers by health need, population demand and facility characteristics. Health need, as measured by child mortality rates, does not have a significant association with the placement of providers in either country, unlike population size and annual growth rates. The mean number of years providers have worked at a facility is significantly associated with a decreased likelihood of rural placement for the three types of providers in Nicaragua. The mean age and percentage of female providers at each facility has a negative association with the placement of rural providers in Tanzania. The use of health facility data to profile the health care labour force is also discussed. PMID:16434424

  6. Offsite intravenous admixture center shared by health-system facilities.

    PubMed

    Fauber, W S; Cosnotti, S J; Mady, R L

    1995-11-15

    The creation of an offsite i.v. admixture center shared by four affiliated health care facilities is described. The i.v. admixture center was developed to consolidate the admixture services of four Carilion Health System (Roanoke, Virginia)-affiliated facilities: Roanoke Memorial Hospital (RMH), RMH's Cancer and Rehabilitation Center, Community Hospital of Roanoke Valley (CHRV), and the Roanoke Memorial Home Health Parenteral Therapy Program. The proposed advantages of a shared i.v. admixture service included providing full i.v. services for CHRV, increasing the ability to prepare home i.v. admixtures on a daily basis, increasing space for preparing i.v. admixtures, avoiding adding admixture staff members at any of the facilities, reducing supply duplication and admixture waste, and standardizing and improving quality. The Carilion Admixture Center was built in Carilion's materials management building at a total cost for construction and new equipment of $80,000; it opened in April 1992. The facility is responsible for providing piggyback admixtures, premixed piggyback solutions, injectable antineoplastic agents, total parenteral nutrient solutions, prefilled syringes for pediatric patients, large-volume solutions containing additives, and all admixtures required for the home health care patients. The facility was certified as a Class 20,000 environment. Start-up problems included computer glitches and a heavier-than-anticipated workload during the first year of operation. Nearly 700,000 i.v. admixtures were compounded at the center between October 1992 and September 1994. There were 95 reports of missing doses during the day shift at RMH between November 1992 and January 1993; only 6% were due to errors at the admixture center. The estimated total cost avoidance for salaries, benefits, and nonbillable supplies for October 1992 through September 1994 was $437,000. Intravenous admixture services provided by three hospital facilities and one home health agency were successfully consolidated into one shared offsite center. PMID:8590238

  7. 42 CFR 475.105 - Prohibition against contracting with health care facilities, affiliates, and payor organizations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Prohibition against contracting with health care... contracting with health care facilities, affiliates, and payor organizations. (a) Basic rule. Except as... health care facility in the QIO area. (2) A health care facility affiliate; that is, an organization...

  8. Identifying health facilities outside the enterprise: challenges and strategies for supporting health reform and meaningful use.

    PubMed

    Dixon, Brian E; Colvard, Cyril; Tierney, William M

    2014-06-24

    Objective: To support collation of data for disability determination, we sought to accurately identify facilities where care was delivered across multiple, independent hospitals and clinics. Methods: Data from various institutions' electronic health records were merged and delivered as continuity of care documents to the United States Social Security Administration (SSA). Results: Electronic records for nearly 8000 disability claimants were exchanged with SSA. Due to the lack of standard nomenclature for identifying the facilities in which patients received the care documented in the electronic records, SSA could not match the information received with information provided by disability claimants. Facility identifiers were generated arbitrarily by health care systems and therefore could not be mapped to the existing international standards. Discussion: We propose strategies for improving facility identification in electronic health records to support improved tracking of a patient's care between providers to better serve clinical care delivery, disability determination, health reform and meaningful use. Conclusion: Accurately identifying the facilities where health care is delivered to patients is important to a number of major health reform and improvement efforts underway in many nations. A standardized nomenclature for identifying health care facilities is needed to improve tracking of care and linking of electronic health records. PMID:24960540

  9. Financial Health of Child Care Facilities Affects Quality of Care.

    ERIC Educational Resources Information Center

    Brower, Mary R.; Sull, Theresa M.

    2003-01-01

    Contends that child care facility owners, boards of directors, staff, and parents need to focus on financial management, as poor financial health compromises the quality of care for children. Specifically addresses the issues of: (1) concern for providing high quality child care; (2) the connection between quality and money; and (3) strengthening


  10. Managing facility risk: external threats and health care organizations.

    PubMed

    Reid, Daniel J; Reid, William H

    2014-01-01

    Clinicians and clinical administrators should have a basic understanding of physical and financial risk to mental health facilities related to external physical threat, including actions usually viewed as "terrorism" and much more common sources of violence. This article refers to threats from mentally ill persons and those acting out of bizarre or misguided "revenge," extortionists and other outright criminals, and perpetrators usually identified as domestic or international terrorists. The principles apply both to relatively small and contained acts (such as a patient or ex-patient attacking a staff member) and to much larger events (such as bombings and armed attack), and are relevant to facilities both within and outside the U.S. Patient care and accessibility to mental health services rest not only on clinical skills, but also on a place to practice them and an organized system supported by staff, physical facilities, and funding. Clinicians who have some familiarity with the non-clinical requirements for care are in a position to support non-clinical staff in preventing care from being interrupted by external threats or events such as terrorist activity, and/or to serve at the interface of facility operations and direct clinical care. Readers should note that this article is an introduction to the topic and cannot address all local, state and national standards for hospital safety, or insurance providers' individual facility requirements. PMID:24733720

  11. 42 CFR 476.90 - Lack of cooperation by a health care facility or practitioner.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Lack of cooperation by a health care facility or...) Qio Review Functions § 476.90 Lack of cooperation by a health care facility or practitioner. (a) If a health care facility or practitioner refuses to allow a QIO to enter and perform the duties and...

  12. 42 CFR 476.90 - Lack of cooperation by a health care facility or practitioner.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Lack of cooperation by a health care facility or...) Qio Review Functions § 476.90 Lack of cooperation by a health care facility or practitioner. (a) If a health care facility or practitioner refuses to allow a QIO to enter and perform the duties and...

  13. Community health facility preparedness for a cholera surge in Haiti.

    PubMed

    Mobula, Linda Meta; Jacquet, Gabrielle A; Weinhauer, Kristin; Alcidas, Gladys; Thomas, Hans-Muller; Burnham, Gilbert

    2013-01-01

    With increasing population displacement and worsening water insecurity after the 2010 earthquake, Haiti experienced a large cholera outbreak. Our goal was to evaluate the strengths and weaknesses of seven community health facilities' ability to respond to a surge in cholera cases. Since 2010, Catholic Relief Services (CRS) with a number of public and private donors has been working with seven health facilities in an effort to reduce morbidity and mortality from cholera infection. In November 2012, CRS through the Centers for Disease Control and Prevention (CDC)'s support, asked the Johns Hopkins Center for Refugee and Disaster Response to conduct a cholera surge simulation tabletop exercise at these health facilities to improve each facility's response in the event of a cholera surge. Using simulation development guidelines from the Pan American Health Organization and others, a simulation scenario script was produced that included situations of differing severity, supply chain, as well as a surge of patients. A total of 119 hospital staff from seven sites participated in the simulation exercise including community health workers, clinicians, managers, pharmacists, cleaners, and security guards. Clinics that had challenges during the simulated clinical care of patients were those that did not appropriately treat all cholera patients according to protocol, particularly those that were vulnerable, those that would need additional staff to properly treat patients during a surge of cholera, and those that required a better inventory of supplies. Simulation-based activities have the potential to identify healthcare delivery system vulnerabilities that are amenable to intervention prior to a cholera surge. PMID:24481887

  14. Trends in antenatal care attendance and health facility delivery following community and health facility systems strengthening interventions in Northern Uganda

    PubMed Central

    2013-01-01

    Background Maternal morbidity and mortality remains high in Uganda; largely due to inadequate antenatal care (ANC), low skilled deliveries and poor quality of other maternal health services. In order to address both the demand and quality of ANC and skilled deliveries, we introduced community mobilization and health facility capacity strengthening interventions. Methods Interventions were introduced between January 2010 and September 2011. These included: training health workers, provision of medical supplies, community mobilization using village health teams, music dance and drama groups and male partner access clubs. These activities were implemented at Kitgum Matidi health center III and its catchment area. Routinely collected health facility data on selected outcomes in the year preceding the interventions and after 21 months of implementation of the interventions was reviewed. Trend analysis was performed using excel and statistical significance testing was performed using EPINFO StatCal option. Results The number of pregnant women attending the first ANC visit significantly increased from 114 to 150 in the first and fourth quarter of 2010 (OR 1.72; 95% CI 1.39–2.12) and to 202 in the third quarter of 2011(OR 11.41; 95% CI 7.97–16.34). The number of pregnant women counselled, tested and given results for HIV during the first ANC attendance significantly rose from 92 (80.7%) to 146 (97.3%) in the first and fourth quarter of 2010 and then to 201 (99.5%) in the third quarter of 2011. The number of male partners counseled, tested and given results together with their wives at first ANC visit rose from 13 (16.7%) in the fourth quarter of 2009 to 130 (89%) in the fourth quarter of 2010 and to 180 (89.6%) in the third quarter of 2011. There was a significant rise in the number of pregnant women delivering in the health facility with provision of mama-kits (delivery kits), from 74 (55.2%) to 149 (99.3%) in the second and fourth quarter of 2010. Conclusions Combined community and facility systems strengthening interventions led to increased first ANC visits by women and their partners, and health facility deliveries. Interventions aimed at increasing uptake of maternal health services should address both the demand and availability of quality services. PMID:24134717

  15. Health Resources Statistics; Health Manpower and Health Facilities, 1968. Public Health Service Publication No. 1509.

    ERIC Educational Resources Information Center

    National Center for Health Statistics (DHEW/PHS), Hyattsville, MD.

    This report is a part of the program of the National Center for Health Statistics to provide current statistics as baseline data for the evaluation, planning, and administration of health programs. Part I presents data concerning the occupational fields: (1) administration, (2) anthropology and sociology, (3) data processing, (4) basic sciences,


  16. Web Page Design.

    ERIC Educational Resources Information Center

    Lindsay, Lorin

    Designing a web home page involves many decisions that affect how the page will look, the kind of technology required to use the page, the links the page will provide, and kinds of patrons who can use the page. The theme of information literacy needs to be built into every web page; users need to be taught the skills of sorting and applying


  17. A spatial national health facility database for public health sector planning in Kenya in 2008

    PubMed Central

    Noor, Abdisalan M; Alegana, Victor A; Gething, Peter W; Snow, Robert W

    2009-01-01

    Background Efforts to tackle the enormous burden of ill-health in low-income countries are hampered by weak health information infrastructures that do not support appropriate planning and resource allocation. For health information systems to function well, a reliable inventory of health service providers is critical. The spatial referencing of service providers to allow their representation in a geographic information system is vital if the full planning potential of such data is to be realized. Methods A disparate series of contemporary lists of health service providers were used to update a public health facility database of Kenya last compiled in 2003. These new lists were derived primarily through the national distribution of antimalarial and antiretroviral commodities since 2006. A combination of methods, including global positioning systems, was used to map service providers. These spatially-referenced data were combined with high-resolution population maps to analyze disparity in geographic access to public health care. Findings The updated 2008 database contained 5,334 public health facilities (67% ministry of health; 28% mission and nongovernmental organizations; 2% local authorities; and 3% employers and other ministries). This represented an overall increase of 1,862 facilities compared to 2003. Most of the additional facilities belonged to the ministry of health (79%) and the majority were dispensaries (91%). 93% of the health facilities were spatially referenced, 38% using global positioning systems compared to 21% in 2003. 89% of the population was within 5 km Euclidean distance to a public health facility in 2008 compared to 71% in 2003. Over 80% of the population outside 5 km of public health service providers was in the sparsely settled pastoralist areas of the country. Conclusion We have shown that, with concerted effort, a relatively complete inventory of mapped health services is possible with enormous potential for improving planning. Expansion in public health care in Kenya has resulted in significant increases in geographic access although several areas of the country need further improvements. This information is key to future planning and with this paper we have released the digital spatial database in the public domain to assist the Kenyan Government and its partners in the health sector. PMID:19267903

  18. Staff Report to the Senior Department Official on Recognition Compliance Issues. Recommendation Page: Council on Education for Public Health

    ERIC Educational Resources Information Center

    US Department of Education, 2010

    2010-01-01

    Between 1945-1973, the American Public Health Association (APHA), a membership organization for public professionals, accredited graduate programs in public health. In 1974, the APHA and the Association of Schools of Public Health (ASPH), a national association representing deans, faculty, and students of accredited schools of public health,


  19. Airborne infection control in India: Baseline assessment of health facilities

    PubMed Central

    Parmar, Malik M.; Sachdeva, K.S.; Rade, Kiran; Ghedia, Mayank; Bansal, Avi; Nagaraja, Sharath Burugina; Willis, Matthew D.; Misquitta, Dyson P.; Nair, Sreenivas A.; Moonan, Patrick K.; Dewan, Puneet K.

    2016-01-01

    Background Tuberculosis transmission in health care settings represents a major public health problem. In 2010, national airborne infection control (AIC) guidelines were adopted in India. These guidelines included specific policies for TB prevention and control in health care settings. However, the feasibility and effectiveness of these guidelines have not been assessed in routine practice. This study aimed to conduct baseline assessments of AIC policies and practices within a convenience sample of 35 health care settings across 3 states in India and to assess the level of implementation at each facility after one year. Method A multi-agency, multidisciplinary panel of experts performed site visits using a standardized risk assessment tool to document current practices and review resource capacity. At the conclusion of each assessment, facility-specific recommendations were provided to improve AIC performance to align with national guidelines. Result Upon initial assessment, AIC systems were found to be poorly developed and implemented. Administrative controls were not commonly practiced and many departments needed renovation to achieve minimum environmental standards. One year after the baseline assessments, there were substantial improvements in both policy and practice. Conclusion A package of capacity building and systems development that followed national guidelines substantially improved implementation of AIC policies and practice. PMID:26970461

  20. 77 FR 21580 - Changes in Certain Multifamily Housing and Health Care Facility Mortgage Insurance Premiums for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-10

    ... URBAN DEVELOPMENT Changes in Certain Multifamily Housing and Health Care Facility Mortgage Insurance...) Multifamily Housing, Health Care Facilities, and Hospital Mortgage Insurance programs for commitments to be... multifamily housing, health care facility, and hospital loans. The increases will not apply to Low...

  1. Health facility committees and facility management - exploring the nature and depth of their roles in Coast Province, Kenya

    PubMed Central

    2011-01-01

    Background Community participation has been emphasized internationally as a way of enhancing accountability, as well as a means to enhance health goals in terms of coverage, access and effective utilization. In rural health facilities in Kenya, initiatives to increase community accountability have focused on Health Facility Committees (HFCs). In Coast Province the role of HFCs has been expanded with the introduction of direct funding of rural facilities. We explored the nature and depth of managerial engagement of HFCs at the facility level in two rural districts in this Coastal setting, and how this has contributed to community accountability Methods We conducted structured interviews with the health worker in-charge and with patients in 30 health centres and dispensaries. These data were supplemented with in-depth interviews with district managers, and with health workers and HFC members in 12 health centres and dispensaries. In-depth interviews with health workers and HFC members included a participatory exercise to stimulate discussion of the nature and depth of their roles in facility management. Results HFCs were generally functioning well and played an important role in facility operations. The breadth and depth of engagement had reportedly increased after the introduction of direct funding of health facilities which allowed HFCs to manage their own budgets. Although relations with facility staff were generally good, some mistrust was expressed between HFC members and health workers, and between HFC members and the broader community, partially reflecting a lack of clarity in HFC roles. Moreover, over half of exit interviewees were not aware of the HFC's existence. Women and less well-educated respondents were particularly unlikely to know about the HFC. Conclusions There is potential for HFCs to play an active and important role in health facility management, particularly where they have control over some facility level resources. However, to optimise their contribution, efforts are needed to improve their training, clarify their roles, and improve engagement with the wider community. PMID:21936958

  2. Health promotion and education in youth correctional facilities.

    PubMed

    Greene, E; Lucarelli, P; Shocksnider, J

    1999-01-01

    In 1997 a comprehensive perinatal/pediatric needs assessment was conducted in the two counties comprising the region. As a result, the Regional Perinatal Consortium of Monmouth and Ocean Counties, Inc. submitted both a perinatal and a pediatric plan that addressed the strengths and the needs of the region to the New Jersey Department of Health and Senior Services. One of thirteen pediatric action plans, Pediatric Health Care and Educational Services in Correctional Facilities, set the stage for the start of ongoing and wide-ranging health programs for the youth in one of the county youth detention centers. Beginning with "Alternatives to Violence," Consortium staff have met monthly with the incarcerated youth to plan and provide these much needed sessions. As expected, these sessions have produced many responses from the youth, some anticipated and many pleasantly surprising, as they have begun to recognize the helpful intent and nature of our programs. The youth are encouraged to participate in planning for upcoming programs and their input is appreciated and respected. As many of these teens are parents themselves, this program has also been able to incorporate parenting skills in some of the sessions, with a major focus on child abuse prevention. Health-education services for incarcerated youth open the door to an exciting frontier for pediatric nurses to deliver prevention in this much-needed setting. This program is a model for planning, implementing, and evaluating public health programs in the pediatric arena. PMID:12024350

  3. Does the Health Maintenance Facility Provide Speciality Capabilities?

    NASA Technical Reports Server (NTRS)

    Boyce, Joey; Wurgler, James; Broadwell, Kim; Martin, William; Stiernberg, Charles M.; Bove, Alfred; Fromm, Rob; O'Neill, Daniel

    1991-01-01

    The Health Maintenance Facility (HMF) is capable of handling all minor illnesses, most moderate illnesses, and some major illnesses on board a space station. Its primary purpose should be to treat problems that are mission threatening, not life threatening. The HMF will have greater medical capabilities than those currently on Navy submarines. Much of the discussion in this document focuses on the possibilities of treating specific medical conditions on board a space station. The HMF will be limited to caring for critically ill patients for a few days, so a crew return vehicle will be important.

  4. 42 CFR 475.105 - Prohibition against contracting with health care facilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Prohibition against contracting with health care... with health care facilities. (a) Basic rule. Except as permitted under paragraph (b) of this section, the following are not eligible for QIO contracts: (1) A health care facility in the QIO area. (2)...

  5. 42 CFR 475.105 - Prohibition against contracting with health care facilities.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Prohibition against contracting with health care... with health care facilities. (a) Basic rule. Except as permitted under paragraph (b) of this section, the following are not eligible for QIO contracts: (1) A health care facility in the QIO area. (2)...

  6. 42 CFR 475.105 - Prohibition against contracting with health care facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Prohibition against contracting with health care... with health care facilities. (a) Basic rule. Except as permitted under paragraph (b) of this section, the following are not eligible for QIO contracts: (1) A health care facility in the QIO area. (2)...

  7. 7 CFR 1956.143 - Debt restructuring-hospitals and health care facilities.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 14 2013-01-01 2013-01-01 false Debt restructuring-hospitals and health care... Settlement-Community and Business Programs § 1956.143 Debt restructuring—hospitals and health care facilities. This section pertains exclusively to delinquent Community Facility hospital and health care...

  8. 7 CFR 1956.143 - Debt restructuring-hospitals and health care facilities.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 14 2011-01-01 2011-01-01 false Debt restructuring-hospitals and health care... Settlement-Community and Business Programs § 1956.143 Debt restructuring—hospitals and health care facilities. This section pertains exclusively to delinquent Community Facility hospital and health care...

  9. 7 CFR 1956.143 - Debt restructuring-hospitals and health care facilities.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 14 2014-01-01 2014-01-01 false Debt restructuring-hospitals and health care... Settlement-Community and Business Programs § 1956.143 Debt restructuring—hospitals and health care facilities. This section pertains exclusively to delinquent Community Facility hospital and health care...

  10. 7 CFR 1956.143 - Debt restructuring-hospitals and health care facilities.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 14 2012-01-01 2012-01-01 false Debt restructuring-hospitals and health care... Settlement-Community and Business Programs § 1956.143 Debt restructuring—hospitals and health care facilities. This section pertains exclusively to delinquent Community Facility hospital and health care...

  11. Tricine-SDS-PAGE.

    PubMed

    SchÀgger, Hermann

    2006-01-01

    Tricine-SDS-PAGE is commonly used to separate proteins in the mass range 1-100 kDa. It is the preferred electrophoretic system for the resolution of proteins smaller than 30 kDa. The concentrations of acrylamide used in the gels are lower than in other electrophoretic systems. These lower concentrations facilitate electroblotting, which is particularly crucial for hydrophobic proteins. Tricine-SDS-PAGE is also used preferentially for doubled SDS-PAGE (dSDS-PAGE), a proteomic tool used to isolate extremely hydrophobic proteins for mass spectrometric identification, and it offers advantages for resolution of the second dimension after blue-native PAGE (BN-PAGE) and clear-native PAGE (CN-PAGE). Here I describe a protocol for Tricine-SDS-PAGE, which includes efficient methods for Coomassie blue or silver staining and electroblotting, thereby increasing the versatility of the approach. This protocol can be completed in 1-2 d. PMID:17406207

  12. School Health Services: A Facility Planning and Design Guide for School Systems.

    ERIC Educational Resources Information Center

    Maryland State Dept. of Education, Baltimore.

    This guide for Maryland schools outlines the role of school health services and proper facility design for these services. Chapter 1 provides an overview, describing coordinated school health programs, school health services programs, school health services programs in Maryland, how school health services are delivered, trends, the number of…

  13. 42 CFR 431.110 - Participation by Indian Health Service facilities.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Participation by Indian Health Service facilities. 431.110 Section 431.110 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH... ADMINISTRATION Administrative Requirements: Provider Relations § 431.110 Participation by Indian Health...

  14. The Health Literacy Environment of Hospitals and Health Centers. Partners for Action: Making Your Healthcare Facility Literacy-Friendly

    ERIC Educational Resources Information Center

    Rudd, Rima E.; Anderson, Jennie E.

    2006-01-01

    The "health literacy environment" of a healthcare facility represents the expectations, preferences, and skills of those providing health information and services. Some of these demands are in the form of physical aspects of the hospital or health center, such as signs and postings. At the same time, access to and navigation of health services


  15. New Architecture for Mental Health; New York State Health and Mental Hygiene Facilities Improvement Corporation - Report to the Governor, 1969.

    ERIC Educational Resources Information Center

    New York State Health and Mental Hygiene Facilities Improvement Corp., Albany.

    The accomplishments of The Health and Mental Hygiene Facilities Improvement Corporation during the past years in creating needed hospitals and health centers for the mentally disabled is documented. The new facilities show awareness of architectural trends and new objectives in design in order to better serve the needs of the patient. Pictures and


  16. Parent and Health Care Professional Perspectives on Family-Centered Care for Children with Special Health Care Needs: Are We on the Same Page?

    ERIC Educational Resources Information Center

    Bellin, Melissa H.; Osteen, Philip; Heffernan, Caitlin; Levy, Judy M.; Snyder-Vogel, Mary E.

    2011-01-01

    A family-centered approach to health care for children with special health care needs (CSHCN) is widely acknowledged as the ideal model of service delivery, but less is known about the actual practice of family-centered care (FCC), especially from the viewpoints of parents and health care professionals. This cross-sectional research compared…

  17. Parent and Health Care Professional Perspectives on Family-Centered Care for Children with Special Health Care Needs: Are We on the Same Page?

    ERIC Educational Resources Information Center

    Bellin, Melissa H.; Osteen, Philip; Heffernan, Caitlin; Levy, Judy M.; Snyder-Vogel, Mary E.

    2011-01-01

    A family-centered approach to health care for children with special health care needs (CSHCN) is widely acknowledged as the ideal model of service delivery, but less is known about the actual practice of family-centered care (FCC), especially from the viewpoints of parents and health care professionals. This cross-sectional research compared


  18. A Method for the Design and Development of Medical or Health Care Information Websites to Optimize Search Engine Results Page Rankings on Google

    PubMed Central

    Cummins, Niamh Maria; Hannigan, Ailish; Shannon, Bill; Dunne, Colum; Cullen, Walter

    2013-01-01

    Background The Internet is a widely used source of information for patients searching for medical/health care information. While many studies have assessed existing medical/health care information on the Internet, relatively few have examined methods for design and delivery of such websites, particularly those aimed at the general public. Objective This study describes a method of evaluating material for new medical/health care websites, or for assessing those already in existence, which is correlated with higher rankings on Google's Search Engine Results Pages (SERPs). Methods A website quality assessment (WQA) tool was developed using criteria related to the quality of the information to be contained in the website in addition to an assessment of the readability of the text. This was retrospectively applied to assess existing websites that provide information about generic medicines. The reproducibility of the WQA tool and its predictive validity were assessed in this study. Results The WQA tool demonstrated very high reproducibility (intraclass correlation coefficient=0.95) between 2 independent users. A moderate to strong correlation was found between WQA scores and rankings on Google SERPs. Analogous correlations were seen between rankings and readability of websites as determined by Flesch Reading Ease and Flesch-Kincaid Grade Level scores. Conclusions The use of the WQA tool developed in this study is recommended as part of the design phase of a medical or health care information provision website, along with assessment of readability of the material to be used. This may ensure that the website performs better on Google searches. The tool can also be used retrospectively to make improvements to existing websites, thus, potentially enabling better Google search result positions without incurring the costs associated with Search Engine Optimization (SEO) professionals or paid promotion. PMID:23981848

  19. Uses of inorganic hypochlorite (bleach) in health-care facilities.

    PubMed Central

    Rutala, W A; Weber, D J

    1997-01-01

    Hypochlorite has been used as a disinfectant for more than 100 years. It has many of the properties of an ideal disinfectant, including a broad antimicrobial activity, rapid bactericidal action, reasonable persistence in treated potable water, ease of use, solubility in water, relative stability, relative nontoxicity at use concentrations, no poisonous residuals, no color, no staining, and low cost. The active species is undissociated hypochlorous acid (HOCl). Hypochlorites are lethal to most microbes, although viruses and vegetative bacteria are more susceptible than endospore-forming bacteria, fungi, and protozoa. Activity is reduced by the presence of heavy metal ions, a biofilm, organic material, low temperature, low pH, or UV radiation. Clinical uses in health-care facilities include hyperchlorination of potable water to prevent Legionella colonization, chlorination of water distribution systems used in hemodialysis centers, cleaning of environmental surfaces, disinfection of laundry, local use to decontaminate blood spills, disinfection of equipment, decontamination of medical waste prior to disposal, and dental therapy. Despite the increasing availability of other disinfectants, hypochlorites continue to find wide use in hospitals. PMID:9336664

  20. 42 CFR 475.105 - Prohibition against contracting with health care facilities.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Prohibition against contracting with health care facilities. 475.105 Section 475.105 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS QUALITY IMPROVEMENT ORGANIZATIONS Utilization and Quality Control...

  1. Provision of Mental Health Services in South African Substance Abuse Treatment Facilities

    ERIC Educational Resources Information Center

    Myers, Bronwyn; Fakier, Nuraan

    2009-01-01

    To date, South African research has not examined mental health service provision in substance abuse treatment facilities, even though these services improve client retention and treatment outcomes. To describe the extent to which substance abuse treatment facilities in Gauteng and KwaZulu-Natal provinces provide clients with mental health services…

  2. Provision of Mental Health Services in South African Substance Abuse Treatment Facilities

    ERIC Educational Resources Information Center

    Myers, Bronwyn; Fakier, Nuraan

    2009-01-01

    To date, South African research has not examined mental health service provision in substance abuse treatment facilities, even though these services improve client retention and treatment outcomes. To describe the extent to which substance abuse treatment facilities in Gauteng and KwaZulu-Natal provinces provide clients with mental health services


  3. Assessing Organizational Readiness for a Participatory Occupational Health/Health Promotion Intervention in Skilled Nursing Facilities.

    PubMed

    Zhang, Yuan; Flum, Marian; West, Cheryl; Punnett, Laura

    2015-09-01

    The long-term care sector is characterized by high morbidity and employee turnover, along with associated costs. Effective health protection and health promotion are important to improve physical and psychosocial well-being of caregivers. Assessment of organizational readiness for change is an essential precursor to the successful implementation of workplace programs addressing work climate, structure of tasks and relationships, and other issues that may be perceived as challenging by some within the institution. This study qualitatively assessed readiness of five skilled nursing facilities for a participatory occupational health/health promotion intervention. Selection criteria were developed to screen for program feasibility and ability to conduct prospective evaluations, and information was collected from managers and employees (interviews and focus groups). Three centers were selected for the program, and the first year of formative evaluation and intervention experience was then reviewed to evaluate and modify our selection criteria after the fact. Lessons learned include adding assessment of communication and the structure of problem solving to our selection criteria, improving methods to assess management support in a concrete (potentially nonverbal) form, and obtaining a stated financial commitment and resources to enable the team to function. Assessment of organizational readiness for change is challenging, although necessary to implement effective and sustainable health promotion programs in specific organizations. PMID:25715335

  4. Health Intervention Research: Understanding Research Design & Methods Sidani Souraya Health Intervention Research: Understanding Research Design & Methods 264 pages Ł26.99 Sage 9781446256176 1446256170 [Formula: see text].

    PubMed

    2015-11-25

    This book describes the rationale of different research designs and methods clearly and simply, and then examines their effectiveness in the context of health intervention. The practical descriptions for implementing different research methods are also helpful. PMID:26602665

  5. Development and use of a master health facility list: Haiti's experience during the 2010 earthquake response.

    PubMed

    Rose-Wood, Alyson; Heard, Nathan; Thermidor, Roody; Chan, Jessica; Joseph, Fanor; Lerebours, Gerald; Zugaldia, Antonio; Konkel, Kimberly; Edwards, Michael; Lang, Bill; Torres, Carmen-Rosa

    2014-08-01

    Master health facility lists (MHFLs) are gaining attention as a standards-based means to uniquely identify health facilities and to link facility-level data. The ability to reliably communicate information about specific health facilities can support an array of health system functions, such as routine reporting and emergency response operations. MHFLs support the alignment of donor-supported health information systems with county-owned systems. Recent World Health Organization draft guidance promotes the utility of MHFLs and outlines a process for list development and governance. Although the potential benefits of MHFLs are numerous and may seem obvious, there are few documented cases of MHFL construction and use. The international response to the 2010 Haiti earthquake provides an example of how governments, nongovernmental organizations, and others can collaborate within a framework of standards to build a more complete and accurate list of health facilities. Prior to the earthquake, the Haitian Ministry of Health (Ministère de la Santé Publique et de la Population [MSPP]) maintained a list of public-sector health facilities but lacked information on privately managed facilities. Following the earthquake, the MSPP worked with a multinational group to expand the completeness and accuracy of the list of health facilities, including information on post-quake operational status. This list later proved useful in the response to the cholera epidemic and is now incorporated into the MSPP's routine health information system. Haiti's experience demonstrates the utility of MHFL formation and use in crisis as well as in the routine function of the health information system. PMID:25276595

  6. Development and use of a master health facility list: Haiti's experience during the 2010 earthquake response

    PubMed Central

    Rose-Wood, Alyson; Heard, Nathan; Thermidor, Roody; Chan, Jessica; Joseph, Fanor; Lerebours, Gerald; Zugaldia, Antonio; Konkel, Kimberly; Edwards, Michael; Lang, Bill; Torres, Carmen-Rosa

    2014-01-01

    ABSTRACT Master health facility lists (MHFLs) are gaining attention as a standards-based means to uniquely identify health facilities and to link facility-level data. The ability to reliably communicate information about specific health facilities can support an array of health system functions, such as routine reporting and emergency response operations. MHFLs support the alignment of donor-supported health information systems with county-owned systems. Recent World Health Organization draft guidance promotes the utility of MHFLs and outlines a process for list development and governance. Although the potential benefits of MHFLs are numerous and may seem obvious, there are few documented cases of MHFL construction and use. The international response to the 2010 Haiti earthquake provides an example of how governments, nongovernmental organizations, and others can collaborate within a framework of standards to build a more complete and accurate list of health facilities. Prior to the earthquake, the Haitian Ministry of Health (MinistÚre de la Santé Publique et de la Population [MSPP]) maintained a list of public-sector health facilities but lacked information on privately managed facilities. Following the earthquake, the MSPP worked with a multinational group to expand the completeness and accuracy of the list of health facilities, including information on post-quake operational status. This list later proved useful in the response to the cholera epidemic and is now incorporated into the MSPP's routine health information system. Haiti's experience demonstrates the utility of MHFL formation and use in crisis as well as in the routine function of the health information system. PMID:25276595

  7. Health Insurance Portability and Accountability Act (HIPAA) legislation and its implication on speech privacy design in health care facilities

    NASA Astrophysics Data System (ADS)

    Tocci, Gregory C.; Storch, Christopher A.

    2005-09-01

    The Health Insurance Portability and Accountability Act (HIPAA) of 1996 (104th Congress, H.R. 3103, January 3, 1986), among many things, individual patient records and information be protected from unnecessary issue. This responsibility is assigned to the U.S. Department of Health and Human Services (HHS) which has issued a Privacy Rule most recently dated August 2002 with a revision being proposed in 2005 to strengthen penalties for inappropriate breaches of patient privacy. Despite this, speech privacy, in many instances in health care facilities need not be guaranteed by the facility. Nevertheless, the regulation implies that due regard be given to speech privacy in both facility design and operation. This presentation will explore the practical aspects of implementing speech privacy in health care facilities and make recommendations for certain specific speech privacy situations.

  8. Health status and socio-economic factors associated with health facility utilization in rural and urban areas in Zambia

    PubMed Central

    2012-01-01

    Abstracts Background With regards to equity, the objective for health care systems is “equal access for equal needs”. We examined associations of predisposing, enabling and need factors with health facility utilization in areas with high HIV prevalence and few people being aware of their HIV status. Methods The data is from a population-based survey among adults aged 15years or older conducted in 2003. The current study is based on a subset of this data of adults 15–49 years with a valid HIV test result. A modified Health behaviour model guided our analytical approach. We report unadjusted and adjusted odds ratios and their 95% confidence intervals from logistic regression analyses. Results Totals of 1042 males and 1547 females in urban areas, and 822 males and 1055 females in rural areas were included in the study. Overall, 53.1% of urban and 56.8% of rural respondents utilized health facilities past 12 months. In urban areas, significantly more females than males utilized health facilities (OR=1.4 (95% CI [1.1, 1.6]). Higher educational attainment (10+ years of schooling) was associated with utilization of health facilities in both urban (OR=1.7, 95% CI [1.3, 2.1]) and rural (OR=1.4, 95% CI [1.0, 2.0]) areas compared to respondents who attained up to 7 years of schooling. Respondents who self-rated their health status as very poor/ poor/fair were twice more likely to utilize health facilities compared to those who rated their health as good/excellent. Respondents who reported illnesses were about three times more likely to utilize health facilities compared to those who did not report the illnesses. In urban areas, respondents who had mental distress were 1.7 times more likely to utilize health facilities compare to those who had no mental distress. Compared to respondents who were HIV negative, respondents who were HIV positive were 1.3 times more likely to utilize health facilities. Conclusion The health care needs were the factors most strongly associated with health care seeking. After accounting for need differentials, health care seeking differed modestly by urban and rural residence, was somewhat skewed towards women, and increased substantially with socioeconomic position. PMID:23145945

  9. NCI Division of Extramural Activities - Home Page

    Cancer.gov

    National Institutes of Health, National Cancer Institute, Division of Extramural Activities - Home Page Skip to Main Content Home Funding Advisory Consumer Guides FAQs & Glossary Awarded Research Division of Extramural Activities About DEA Main Staff

  10. Construction Grants for Educational Facilities, Fiscal Years 1965-77. Health Manpower References.

    ERIC Educational Resources Information Center

    Berman, Bella U.; Rosenthal, Samuel

    This publication provides information on construction assistance awarded to schools of medicine, osteopathic medicine, dentistry, optometry, pharmacy, podiatric medicine, veterinary medicine, public health, and nursing. In addition it provides data on grants awarded to schools of allied health, medical libraries, and health research facilities

  11. Construction Grants for Educational Facilities, Fiscal Years 1965-77. Health Manpower References.

    ERIC Educational Resources Information Center

    Berman, Bella U.; Rosenthal, Samuel

    This publication provides information on construction assistance awarded to schools of medicine, osteopathic medicine, dentistry, optometry, pharmacy, podiatric medicine, veterinary medicine, public health, and nursing. In addition it provides data on grants awarded to schools of allied health, medical libraries, and health research facilities.


  12. Influence of Distance to Health Facilities on the Use of Skilled Attendants at Birth in Kenya.

    PubMed

    Ettarh, Remare R; Kimani, James

    2016-02-01

    We sought to determine the spatial variation in the use of skilled providers during deliveries across Kenya and the relationship between distance to health facilities and the use of skilled delivery. We found that women who resided 5 km or less from the nearest health facility were more likely to use skilled care at delivery than women residing at greater distances, although the pattern of choice of health facility level for delivery differed at this distance. Outreach maternity services are urgently required in counties with remote communities in order to improve access to skilled attendants during deliveries in these areas. PMID:24730670

  13. Perception and prevalence of work-related health hazards among health care workers in public health facilities in southern India

    PubMed Central

    Senthil, Arasi; Anandh, Balasubramanian; Jayachandran, Palsamy; Thangavel, Gurusamy; Josephin, Diana; Yamini, Ravindran; Kalpana, Balakrishnan

    2015-01-01

    Background: Health care workers (HCWs) are exposed to occupational related health hazards. Measuring worker perception and the prevalence of these hazards can help facilitate better risk management for HCWs, as these workers are envisaged to be the first point of contact, especially in resource poor settings. Objective: To describe the perception of occupational health hazards and self-reported exposure prevalence among HCWs in Southern India. Methods: We used cross sectional design with stratified random sampling of HCWs from different levels of health facilities and categories in a randomly selected district in Southern India. Data on perception and exposure prevalence were collected using a structured interview schedule developed by occupational health experts and administered by trained investigators. Results: A total of 482 HCWs participated. Thirty nine percent did not recognize work-related health hazards, but reported exposure to at least one hazard upon further probing. Among the 81·5% who reported exposure to biological hazard, 93·9% had direct skin contact with infectious materials. Among HCWs reporting needle stick injury, 70·5% had at least one in the previous three months. Ergonomic hazards included lifting heavy objects (42%) and standing for long hours (37%). Psychological hazards included negative feelings (20·3%) and verbal or physical abuse during work (20·5%). Conclusion: More than a third of HCWs failed to recognize work-related health hazards. Despite training in handling infectious materials, HCWs reported direct skin contact with infectious materials and needle stick injuries. Results indicate the need for training oriented toward behavioral change and provision of occupational health services. PMID:25482656

  14. Health and Safety Management for Small-scale Methane Fermentation Facilities

    NASA Astrophysics Data System (ADS)

    Yamaoka, Masaru; Yuyama, Yoshito; Nakamura, Masato; Oritate, Fumiko

    In this study, we considered health and safety management for small-scale methane fermentation facilities that treat 2-5 ton of biomass daily based on several years operation experience with an approximate capacity of 5 t·d-1. We also took account of existing knowledge, related laws and regulations. There are no qualifications or licenses required for management and operation of small-scale methane fermentation facilities, even though rural sewerage facilities with a relative similar function are required to obtain a legitimate license. Therefore, there are wide variations in health and safety consciousness of the operators of small-scale methane fermentation facilities. The industrial safety and health laws are not applied to the operation of small-scale methane fermentation facilities. However, in order to safely operate a small-scale methane fermentation facility, the occupational safety and health management system that the law recommends should be applied. The aims of this paper are to clarify the risk factors in small-scale methane fermentation facilities and encourage planning, design and operation of facilities based on health and safety management.

  15. Does use of a government service depend on distance from the health facility?

    PubMed

    NoorAli, R; Luby, S; Rahbar, M H

    1999-06-01

    To reduce mortality from common childhood illnesses such as diarrhoea and upper respiratory infections, it is important that health services are available and used appropriately. Physical accessibility to a health facility may influence its use, particularly in rural areas. We assessed whether use of government services for treatment of the three most common acute childhood illnesses (fever, diarrhoea and upper respiratory infections) was influenced by the physical accessibility of the government primary health care centres. We analyzed data from a household survey which was collected between November 1992 and January 1993, from 139 randomly selected villages located around 14 government facilities in Thatta, a rural district of Pakistan. There were 691 children under 5 years of age who suffered from the three acute illnesses; 85% of these children used either a government or a private service. Children living at less than 4 km from a government facility made 22% less use of that facility than those living 4 km or more away. After controlling for the effects of distance from a private facility and treatment cost in a multiple logistic regression model, children living less than 4 km from a government facility were no more likely to use the facility than those living 4 km or more away (Adjusted Odds Ratio: 1.01, 95% Confidence Interval: 0.68-1.50). These results suggest that factors other than distance are the primary determinants of use of government services for treating children in the Thatta district. To increase the use of government health services, policymakers should assess carefully the factors determining the use of existing facilities, before they plan the building of more health facilities. Further studies are needed to examine the management of health facilities and the clients' perception of health-care providers. PMID:10538722

  16. Wetlands and Web Pages.

    ERIC Educational Resources Information Center

    Tisone-Bartels, Dede

    1998-01-01

    Argues that the preservation of areas like the Shoreline Park (California) wetlands depends on educating students about the value of natural resources. Describes the creation of a Web page on the wetlands for third-grade students by seventh-grade art and ecology students. Outlines the technical process of developing a Web page. (DSK)

  17. Physical access to health facilities and contraceptive use in Kenya: evidence from the 2008-2009 Kenya Demographic and Health Survey.

    PubMed

    Ettarh, Remare R; Kyobutungi, Catherine

    2012-09-01

    The objective of the study was to determine the spatial variation in modern contraceptive use and unmet need for family planning across the counties of Kenya and to examine whether the spatial patterns were associated with inequalities in physical access to health facilities. Data were obtained from the 2008-2009 Kenya Demographic and Health Survey and linked to the location of health facilities in the country. Multivariate logistic regression was used to examine the influence of distance to the nearest health facility and health facility density, in addition to other covariates, on modern contraceptive use and unmet need. Overall, the prevalence of modern contraceptive use and unmet need among women aged 15-49 in Kenya was 42.1% and 19.7% respectively. Among the respondents who lived more than 5 km from the nearest health facility modern contraceptive use was significantly less likely compared to women resident 5 km or less from the nearest health facility. Women from counties with higher health facility density were 53% more likely to use modern contraceptives compared to women in counties with low health facility density. Distance and health facility density in the county were not significantly associated with unmet need. Physical access to health facilities is an important determinant of modern contraceptive use and unmet need in Kenya. Strategies should be developed in underserved counties to mitigate the challenge of distance to health facilities, such as delivering services by outreach and mobile facilities. PMID:23437499

  18. Public Health Risks from Mismanagement of Healthcare Wastes in Shinyanga Municipality Health Facilities, Tanzania

    PubMed Central

    Kuchibanda, Kizito; Mayo, Aloyce W.

    2015-01-01

    The increase of healthcare facilities in Shinyanga municipality has resulted in an increase of healthcare wastes, which poses serious threats to the environment, health workers, and the general public. This research was conducted to investigate management practices of healthcare wastes in Shinyanga municipality with a view of assessing health risks to health workers and the general public. The study, which was carried out in three hospitals, involved the use of questionnaires, in-depth interview, and observation checklist. The results revealed that healthcare wastes are not quantified or segregated in all the three hospitals. Healthcare wastes at the Shinyanga Regional Referral Hospital are disposed of by on-site incineration and burning and some wastes are disposed off-site. At Kolandoto DDH only on-site burning and land disposal are practiced, while at Kambarage UHC healthcare solid wastes are incinerated, disposed of on land disposal, and burned. Waste management workers do not have formal training in waste management techniques and the hospital administrations pay very little attention to appropriate management of healthcare wastes. In light of this, it is evident that management of healthcare solid wastes is not practiced in accordance with the national and WHO's recommended standards. PMID:26779565

  19. Occupational health and safety in household hazardous waste management facilities.

    PubMed

    Betsinger, G; Brosseau, L M; Golden, J

    2000-01-01

    Employees in household hazardous waste management facilities encounter a variety of potentially hazardous exposures. The purpose of this study was to evaluate both chemical and physical hazards at a representative group of household hazardous waste management facilities in Minnesota. Sampling results suggest that chemical exposures are generally not a problem when chemical bulking is performed outside the facility. For facilities operating year-round, however, proper ventilation is necessary to ensure adequate control of chemical exposures when bulking is done inside the building. The most significant chemical exposures occurred when handling paint (benzene) and broken fluorescent light bulbs (mercury). Guidelines for appropriate personal protective equipment and handling of broken fluorescent light bulbs were developed as a result of this study. Materials handling was the most significant physical hazard, resulting in wrist, elbow, and back injuries. The suspected reasons for these injuries (awkward postures and repetitive motions) were noted throughout the management process and should be further investigated. PMID:10976689

  20. Protecting new health facilities from natural hazards: guidelines for the promotion of disaster mitigation.

    PubMed

    2004-01-01

    The health sector is particularly vulnerable to naturally occurring events. The vulnerability of the health infrastructure (hospitals and clinics) is of particular concern. Not only are such facilities vulnerable structurally, but their ability to continue to provide essential functions may be severely compromised, thus leaving the stricken population without essential services. This paper summarizes a more detailed document, Guidelines for Vulnerability Reduction in the Design of New Health Facilities published by the Pan-American Health Organization (PAHO)/ World Health Organization (WHO). The current document summarizes these Guidelines emphasizing how they may be used, by whom, and for what purpose. Potential users of the Guidelines include, but are not limited to: (1) initiators of health facility construction projects; (2) executors and supervisors of health facility construction projects; and (3) financing bodies in charge of funding health facility construction projects. The Guidelines include: (1) implications of natural phenomena upon the health infrastructure; (2) guidelines for vulnerability reduction for incorporation into development project cycles; (3) definitive phases and stages within the phases for development projects including: (I) Projects Assessment (needs assessment; assessment of options, the preliminary project); (II) Investment (project design, construction); and (III) Operational Activities (operations and maintenance). In addition, investment in damage reduction measures, policies and regulations, training and education, and the role of international organizations in the promotion and funding of mitigation strategies are addressed. PMID:15645629

  1. 42 CFR 476.88 - Examination of the operations and records of health care facilities and practitioners.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... care facilities and practitioners. 476.88 Section 476.88 Public Health CENTERS FOR MEDICARE & MEDICAID... health care facilities and practitioners. (a) Authorization to examine records. A facility claiming... information on charges) that are pertinent to health care services furnished to Medicare beneficiaries and...

  2. 42 CFR 476.88 - Examination of the operations and records of health care facilities and practitioners.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... care facilities and practitioners. 476.88 Section 476.88 Public Health CENTERS FOR MEDICARE & MEDICAID... health care facilities and practitioners. (a) Authorization to examine records. A facility claiming... information on charges) that are pertinent to health care services furnished to Medicare beneficiaries and...

  3. 42 CFR 476.88 - Examination of the operations and records of health care facilities and practitioners.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... care facilities and practitioners. 476.88 Section 476.88 Public Health CENTERS FOR MEDICARE & MEDICAID... health care facilities and practitioners. (a) Authorization to examine records. A facility claiming... information on charges) that are pertinent to health care services furnished to Medicare beneficiaries and...

  4. 7 CFR 353.9 - Standards for accreditation of non-government facilities to perform laboratory seed health...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... facilities to perform laboratory seed health testing and seed crop phytosanitary inspection. 353.9 Section...-government facilities to perform laboratory seed health testing and seed crop phytosanitary inspection. (a... facility may apply to be accredited to perform laboratory seed health testing or seed crop...

  5. 7 CFR 353.9 - Standards for accreditation of non-government facilities to perform laboratory seed health...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... facilities to perform laboratory seed health testing and seed crop phytosanitary inspection. 353.9 Section...-government facilities to perform laboratory seed health testing and seed crop phytosanitary inspection. (a... facility may apply to be accredited to perform laboratory seed health testing or seed crop...

  6. 7 CFR 353.9 - Standards for accreditation of non-government facilities to perform laboratory seed health...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... facilities to perform laboratory seed health testing and seed crop phytosanitary inspection. 353.9 Section...-government facilities to perform laboratory seed health testing and seed crop phytosanitary inspection. (a... facility may apply to be accredited to perform laboratory seed health testing or seed crop...

  7. 7 CFR 353.9 - Standards for accreditation of non-government facilities to perform laboratory seed health...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... facilities to perform laboratory seed health testing and seed crop phytosanitary inspection. 353.9 Section...-government facilities to perform laboratory seed health testing and seed crop phytosanitary inspection. (a... facility may apply to be accredited to perform laboratory seed health testing or seed crop...

  8. 7 CFR 353.9 - Standards for accreditation of non-government facilities to perform laboratory seed health...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... facilities to perform laboratory seed health testing and seed crop phytosanitary inspection. 353.9 Section...-government facilities to perform laboratory seed health testing and seed crop phytosanitary inspection. (a... facility may apply to be accredited to perform laboratory seed health testing or seed crop...

  9. Differences in essential newborn care at birth between private and public health facilities in eastern Uganda

    PubMed Central

    Waiswa, Peter; Akuze, Joseph; Peterson, Stefan; Kerber, Kate; Tetui, Moses; Forsberg, Birger C.; Hanson, Claudia

    2015-01-01

    Background In Uganda and elsewhere, the private sector provides an increasing and significant proportion of maternal and child health services. However, little is known whether private care results in better quality services and improved outcomes compared to the public sector, especially regarding care at the time of birth. Objective To describe the characteristics of care-seekers and assess newborn care practices and services received at public and private facilities in rural eastern Uganda. Design Within a community-based maternal and newborn care intervention with health systems strengthening, we collected data from mothers with infants at baseline and endline using a structured questionnaire. Descriptive, bivariate, and multivariate data analysis comparing nine newborn care practices and three composite newborn care indicators among private and public health facilities was conducted. Results The proportion of women giving birth at private facilities decreased from 25% at baseline to 17% at endline, whereas overall facility births increased. Private health facilities did not perform significantly better than public health facilities in terms of coverage of any essential newborn care interventions, and babies were more likely to receive thermal care practices in public facilities compared to private (68% compared to 60%, p=0.007). Babies born at public health facilities received an average of 7.0 essential newborn care interventions compared to 6.2 at private facilities (p<0.001). Women delivering in private facilities were more likely to have higher parity, lower socio-economic status, less education, to seek antenatal care later in pregnancy, and to have a normal delivery compared to women delivering in public facilities. Conclusions In this setting, private health facilities serve a vulnerable population and provide access to service for those who might not otherwise have it. However, provision of essential newborn care practices was slightly lower in private compared to public facilities, calling for quality improvement in both private and public sector facilities, and a greater emphasis on tracking access to and quality of care in private sector facilities. PMID:25843495

  10. Assessment of Obstetric and Neonatal Health Services in Developing Country Health Facilities

    PubMed Central

    Manasyan, Albert; Saleem, Sarah; Koso-Thomas, Marion; Althabe, Fernando; Pasha, Omrana; Chomba, Elwyn; Goudar, Shivaprasad S.; Patel, Archana; Esamai, Fabian; Garces, Ana; Kodkany, Bhala; Belizan, Jose; McClure, Elizabeth M.; Derman, Richard J.; Hibberd, Patricia; Liechty, Edward A.; Hambidge, K. Michael; Carlo, Waldemar A.; Buekens, Pierre; Moore, Janet; Wright, Linda L.; Goldenberg, Robert L.

    2013-01-01

    Objective To describe the staffing and availability of medical equipment and medications and the performance of procedures at health facilities providing maternal and neonatal care at African, Asian, and Latin American sites participating in a multicenter trial to improve emergency obstetric/neonatal care in communities with high maternal and perinatal mortality. Study Design In 2009, prior to intervention, we surveyed 136 hospitals and 228 clinics in 7 sites in Africa, Asia, and Latin America regarding staffing, availability of equipment/ medications, and procedures including cesarean section. Results The coverage of physicians and nurses/midwives was poor in Africa and Latin America. In Africa, only 20% of hospitals had full-time physicians. Only 70% of hospitals in Africa and Asia had performed cesarean sections in the last 6 months. Oxygen was unavailable in 40% of African hospitals and 17% of Asian hospitals. Blood was unavailable in 80% of African and Asian hospitals. Conclusions Assuming that adequate facility services are necessary to improve pregnancy outcomes, it is not surprising that maternal and perinatal mortality rates in the areas surveyed are high. The data presented emphasize that to reduce mortality in these areas, resources that result in improved staffing and sufficient equipment, supplies, and medication, along with training, are required. PMID:23329566

  11. Older Adult Participation in Health Promotion Programs: Perspectives of Facility Administrators

    ERIC Educational Resources Information Center

    Wright, Tim; Hyner, Gerald C.

    2011-01-01

    Administrators of older adult-centered facilities must identify barriers to the planning and implementation of health promotion programs. In this qualitative research those barriers were identified through in-depth interviews with administrators of older adult-centered facilities. As identified by administrators, the predominant barriers to the…

  12. Older Adult Participation in Health Promotion Programs: Perspectives of Facility Administrators

    ERIC Educational Resources Information Center

    Wright, Tim; Hyner, Gerald C.

    2011-01-01

    Administrators of older adult-centered facilities must identify barriers to the planning and implementation of health promotion programs. In this qualitative research those barriers were identified through in-depth interviews with administrators of older adult-centered facilities. As identified by administrators, the predominant barriers to the


  13. Health workers’ knowledge of and attitudes towards computer applications in rural African health facilities

    PubMed Central

    Sukums, Felix; Mensah, Nathan; Mpembeni, Rose; Kaltschmidt, Jens; Haefeli, Walter E.; Blank, Antje

    2014-01-01

    Background The QUALMAT (Quality of Maternal and Prenatal Care: Bridging the Know-do Gap) project has introduced an electronic clinical decision support system (CDSS) for pre-natal and maternal care services in rural primary health facilities in Burkina Faso, Ghana, and Tanzania. Objective To report an assessment of health providers’ computer knowledge, experience, and attitudes prior to the implementation of the QUALMAT electronic CDSS. Design A cross-sectional study was conducted with providers in 24 QUALMAT project sites. Information was collected using structured questionnaires. Chi-squared tests and one-way ANOVA describe the association between computer knowledge, attitudes, and other factors. Semi-structured interviews and focus groups were conducted to gain further insights. Results A total of 108 providers responded, 63% were from Tanzania and 37% from Ghana. The mean age was 37.6 years, and 79% were female. Only 40% had ever used computers, and 29% had prior computer training. About 80% were computer illiterate or beginners. Educational level, age, and years of work experience were significantly associated with computer knowledge (p<0.01). Most (95.3%) had positive attitudes towards computers – average score (±SD) of 37.2 (±4.9). Females had significantly lower scores than males. Interviews and group discussions showed that although most were lacking computer knowledge and experience, they were optimistic about overcoming challenges associated with the introduction of computers in their workplace. Conclusions Given the low levels of computer knowledge among rural health workers in Africa, it is important to provide adequate training and support to ensure the successful uptake of electronic CDSSs in these settings. The positive attitudes to computers found in this study underscore that also rural care providers are ready to use such technology. PMID:25361721

  14. Sleep Apnea Information Page

    MedlinePLUS

    ... Awards Enhancing Diversity Find People About NINDS NINDS Sleep Apnea Information Page Table of Contents (click to ... en Español Additional resources from MedlinePlus What is Sleep Apnea? Sleep apnea is a common sleep disorder ...

  15. Making Pages That Move.

    ERIC Educational Resources Information Center

    Gepner, Ivan

    2001-01-01

    Explains the mechanism of producing dynamic computer pages which is based on three technologies: (1) the document object model; (2) cascading stylesheets; and (3) javascript. Discusses the applications of these techniques in genetics and developmental biology. (YDS)

  16. Prevalence and predictors of giving birth in health facilities in Bugesera District, Rwanda

    PubMed Central

    2012-01-01

    Background The proportion of births attended by skilled health personnel is one of two indicators used to measure progress towards Millennium Development Goal 5, which aims for a 75% reduction in global maternal mortality ratios by 2015. Rwanda has one of the highest maternal mortality ratios in the world, estimated between 249–584 maternal deaths per 100,000 live births. The objectives of this study were to quantify secular trends in health facility delivery and to identify factors that affect the uptake of intrapartum healthcare services among women living in rural villages in Bugesera District, Eastern Province, Rwanda. Methods Using census data and probability proportional to size cluster sampling methodology, 30 villages were selected for community-based, cross-sectional surveys of women aged 18–50 who had given birth in the previous three years. Complete obstetric histories and detailed demographic data were elicited from respondents using iPad technology. Geospatial coordinates were used to calculate the path distances between each village and its designated health center and district hospital. Bivariate and multivariate logistic regressions were used to identify factors associated with delivery in health facilities. Results Analysis of 3106 lifetime deliveries from 859 respondents shows a sharp increase in the percentage of health facility deliveries in recent years. Delivering a penultimate baby at a health facility (OR = 4.681 [3.204 - 6.839]), possessing health insurance (OR = 3.812 [1.795 - 8.097]), managing household finances (OR = 1.897 [1.046 - 3.439]), attending more antenatal care visits (OR = 1.567 [1.163 - 2.112]), delivering more recently (OR = 1.438 [1.120 - 1.847] annually), and living closer to a health center (OR = 0.909 [0.846 - 0.976] per km) were independently associated with facility delivery. Conclusions The strongest correlates of facility-based delivery in Bugesera District include previous delivery at a health facility, possession of health insurance, greater financial autonomy, more recent interactions with the health system, and proximity to a health center. Recent structural interventions in Rwanda, including the rapid scale-up of community-financed health insurance, likely contributed to the dramatic improvement in the health facility delivery rate observed in our study. PMID:23217157

  17. The Molecule Pages database

    PubMed Central

    Saunders, Brian; Lyon, Stephen; Day, Matthew; Riley, Brenda; Chenette, Emily; Subramaniam, Shankar

    2008-01-01

    The UCSD-Nature Signaling Gateway Molecule Pages (http://www.signaling-gateway.org/molecule) provides essential information on more than 3800 mammalian proteins involved in cellular signaling. The Molecule Pages contain expert-authored and peer-reviewed information based on the published literature, complemented by regularly updated information derived from public data source references and sequence analysis. The expert-authored data includes both a full-text review about the molecule, with citations, and highly structured data for bioinformatics interrogation, including information on protein interactions and states, transitions between states and protein function. The expert-authored pages are anonymously peer reviewed by the Nature Publishing Group. The Molecule Pages data is present in an object-relational database format and is freely accessible to the authors, the reviewers and the public from a web browser that serves as a presentation layer. The Molecule Pages are supported by several applications that along with the database and the interfaces form a multi-tier architecture. The Molecule Pages and the Signaling Gateway are routinely accessed by a very large research community. PMID:17965093

  18. Page turning system

    NASA Technical Reports Server (NTRS)

    Kerley, James J. (Inventor); Eklund, Wayne D. (Inventor)

    1992-01-01

    A device for holding reading materials for use by readers without arm mobility is presented. The device is adapted to hold the reading materials in position for reading with the pages displayed to enable turning by use of a rubber tipped stick that is held in the mouth and has a pair of rectangular frames. The frames are for holding and positioning the reading materials opened in reading posture with the pages displayed at a substantially unobstructed sighting position for reading. The pair of rectangular frames are connected to one another by a hinge so the angle between the frames may be varied thereby varying the inclination of the reading material. A pair of bent spring mounted wires for holding opposing pages of the reading material open for reading without substantial visual interference of the pages is mounted to the base. The wires are also adjustable to the thickness of the reading material and have a variable friction adjustment. This enables the force of the wires against the pages to be varied and permits the reader to manipulate the pages with the stick.

  19. Health physics manual of good practices for tritium facilities

    SciTech Connect

    Blauvelt, R.K.; Deaton, M.R.; Gill, J.T.

    1991-12-01

    The purpose of this document is to provide written guidance defining the generally accepted good practices in use at Department of Energy (DOE) tritium facilities. A {open_quotes}good practice{close_quotes} is an action, policy, or procedure that enhances the radiation protection program at a DOE site. The information selected for inclusion in this document should help readers achieve an understanding of the key radiation protection issues at tritium facilities and provide guidance as to what characterizes excellence from a radiation protection point of view. The ALARA (As Low as Reasonable Achievable) program at DOE sites should be based, in part, on following the good practices that apply to their operations.

  20. Health Professions Education Facilities in the Non-Profit Sector. 1973.

    ERIC Educational Resources Information Center

    Health Resources Administration (DHEW/PHS), Bethesda, MD. Bureau of Health Manpower.

    In this study of the physical facilities of the nation's health professions schools, all schools of dentistry, medicine, optometry, osteopathy, pharmacy, podiatry, public health, and veterinary medicine, and all parent institutions of the schools, were surveyed in May of 1973. The major goals of this pioneering survey were to assess the nature and…

  1. Training the Auxiliary Health Workers; An Analysis of Functions, Training Content, Training Costs, and Facilities.

    ERIC Educational Resources Information Center

    Health Services and Mental Health Administration (DHEW), Bethesda, MD.

    The booklet describes what each type of worker is allowed to do and presents an overview of the substantive content of the training, length of training, training costs, and kinds of facilities and staff needed. The types of workers include community health aide, homemaker-home health aide, social worker aide, food service supervisor, physical…

  2. Race Differences in Mental Health Service Access in a Secure Male Juvenile Justice Facility

    ERIC Educational Resources Information Center

    Dalton, Richard F.; Evans, Lisa J.; Cruise, Keith R.; Feinstein, Ronald A.; Kendrick, Rhonda F.

    2009-01-01

    This study examined whether African American and Caucasian male youths had similar rates of referral to mental health services in a juvenile justice secure facility when controlling for differences obtained in the initial screening and assessment process. Data from the Massachusetts Youth Screening Instrument-2 (MAYSI-2), Initial Health Care…

  3. 34 CFR 75.683 - Health or safety standards for facilities.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 1 2012-07-01 2012-07-01 false Health or safety standards for facilities. 75.683 Section 75.683 Education Office of the Secretary, Department of Education DIRECT GRANT PROGRAMS What Conditions Must Be Met by a Grantee? Other Requirements for Certain Projects § 75.683 Health or...

  4. 34 CFR 75.683 - Health or safety standards for facilities.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 1 2014-07-01 2014-07-01 false Health or safety standards for facilities. 75.683 Section 75.683 Education Office of the Secretary, Department of Education DIRECT GRANT PROGRAMS What Conditions Must Be Met by a Grantee? Other Requirements for Certain Projects § 75.683 Health or...

  5. 34 CFR 75.683 - Health or safety standards for facilities.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 1 2011-07-01 2011-07-01 false Health or safety standards for facilities. 75.683 Section 75.683 Education Office of the Secretary, Department of Education DIRECT GRANT PROGRAMS What Conditions Must Be Met by a Grantee? Other Requirements for Certain Projects § 75.683 Health or...

  6. 34 CFR 75.683 - Health or safety standards for facilities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Health or safety standards for facilities. 75.683 Section 75.683 Education Office of the Secretary, Department of Education DIRECT GRANT PROGRAMS What Conditions Must Be Met by a Grantee? Other Requirements for Certain Projects § 75.683 Health or...

  7. 34 CFR 75.683 - Health or safety standards for facilities.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 1 2013-07-01 2013-07-01 false Health or safety standards for facilities. 75.683 Section 75.683 Education Office of the Secretary, Department of Education DIRECT GRANT PROGRAMS What Conditions Must Be Met by a Grantee? Other Requirements for Certain Projects § 75.683 Health or...

  8. Healthy Firms: Constraints to Growth among Private Health Sector Facilities in Ghana and Kenya

    PubMed Central

    Burger, Nicholas E.; Kopf, Daniel; Spreng, Connor P.; Yoong, Joanne; Sood, Neeraj

    2012-01-01

    Background Health outcomes in developing countries continue to lag the developed world, and many countries are not on target to meet the Millennium Development Goals. The private health sector provides much of the care in many developing countries (e.g., approximately 50 percent in Sub-Saharan Africa), but private providers are often poorly integrated into the health system. Efforts to improve health systems performance will need to include the private sector and increase its contributions to national health goals. However, the literature on constraints private health care providers face is limited. Methodology/Principal Findings We analyze data from a survey of private health facilities in Kenya and Ghana to evaluate growth constraints facing private providers. A significant portion of facilities (Ghana: 62 percent; Kenya: 40 percent) report limited access to finance as the most significant barrier they face; only a small minority of facilities report using formal credit institutions to finance day to day operations (Ghana: 6 percent; Kenya: 11 percent). Other important barriers include corruption, crime, limited demand for goods and services, and poor public infrastructure. Most facilities have paper-based rather than electronic systems for patient records (Ghana: 30 percent; Kenya: 22 percent), accounting (Ghana: 45 percent; Kenya: 27 percent), and inventory control (Ghana: 41 percent; Kenya: 24 percent). A majority of clinics in both countries report undertaking activities to improve provider skills and to monitor the level and quality of care they provide. However, only a minority of pharmacies report undertaking such activities. Conclusions/Significance The results suggest that improved access to finance and improving business processes especially among pharmacies would support improved contributions by private health facilities. These strategies might be complementary if providers are more able to take advantage of increased access to finance when they have the business processes in place for operating a successful business and health facility. PMID:22383944

  9. Why caretakers bypass Primary Health Care facilities for child care - a case from rural Tanzania

    PubMed Central

    2011-01-01

    Background Research on health care utilization in low income countries suggests that patients frequently bypass PHC facilities in favour of higher-level hospitals - despite substantial additional time and financial costs. There are limited number of studies focusing on user's experiences at such facilities and reasons for bypassing them. This study aimed to identify factors associated with bypassing PHC facilities among caretakers seeking care for their underfive children and to explore experiences at such facilities among those who utilize them. Methods The study employed a mixed-method approach consisting of an interviewer administered questionnaires and in-depth interviews among selected care-takers seeking care for their underfive children at Korogwe and Muheza district hospitals in north-eastern Tanzania. Results The questionnaire survey included 560 caretakers. Of these 30 in-depth interviews were conducted. Fifty nine percent (206/348) of caretakers had not utilized their nearer PHC facilities during the index child's sickness episode. The reasons given for bypassing PHC facilities were lack of possibilities for diagnostic facilities (42.2%), lack of drugs (15.5%), closed health facility (10.2%), poor services (9.7%) and lack of skilled health workers (3.4%). In a regression model, the frequency of bypassing a PHC facility for child care increased significantly with decreasing travel time to the district hospital, shorter duration of symptoms and low disease severity. Findings from the in-depth interviews revealed how the lack of quality services at PHC facilities caused delays in accessing appropriate care and how the experiences of inadequate care caused users to lose trust in them. Conclusion The observation that people are willing to travel long distances to get better quality services calls for health policies that prioritize quality of care before quantity. In a situation with limited resources, utilizing available resources to improve quality of care at available facilities could be more appropriate for improving access to health care than increasing the number of facilities. This would also improve equity in health care access since the poor who can not afford travelling costs will then get access to quality services at their nearer PHC facilities. PMID:22094076

  10. Impacts of Natural Hazards on Primary Health Care Facilities of Iran: A 10-Year Retrospective Survey

    PubMed Central

    Ardalan, Ali; Mowafi, Hani; Yousefi, Homa

    2013-01-01

    Public health facilities in Iran are exposed to a wide range of natural hazards. This article presents the first survey of the impacts of such natural hazards on primary health care (PHC) centers in Iran from 2001 to 2011. A retrospective survey was conducted in 25 out of 30 provinces of Iran. Archival reports at provincial public health departments were cross-referenced with key informant interviews. During a 10-year period, 119 natural hazard events were recorded that led to physical damage and/or functional failure in 1,401 health centers, 127 deaths and injury or illness in 644 health staff. Earthquakes accounted for the most physical damage and all health-worker deaths. However, there was an increasing trend of impacts due to hydro-meteorological hazards. Iran’s health system needs to establish a registry to track the impact of natural hazards on health facilities, conduct regular hazard and vulnerability assessments and increase mitigation and preparedness measures. Keywords: Disaster, primary health care, facility, Iran, natural hazard Corresponding author: Ali Ardalan MD, PhD. Iran’s National Institute of Health Research, Tehran University of Medical Sciences. Harvard Humanitarian Initiative. Email: aardalan@tums.ac.ir PMID:23863871

  11. Health sciences libraries in Kuwait: a study of their resources, facilities, and services

    PubMed Central

    Al-Ansari, Husain A.; Al-Enezi, Sana

    2001-01-01

    The purpose of this study was to examine the current status of health sciences libraries in Kuwait in terms of their staff, collections, facilities, use of information technology, information services, and cooperation. Seventeen libraries participated in the study. Results show that the majority of health sciences libraries were established during the 1980s. Their collections are relatively small. The majority of their staff is nonprofessional. The majority of libraries provide only basic information services. Cooperation among libraries is limited. Survey results also indicate that a significant number of health sciences libraries are not automated. Some recommendations for the improvement of existing resources, facilities, and services are made. PMID:11465688

  12. Bioaerosol in composting facilities: occupational health risk assessment.

    PubMed

    Schlosser, Olivier; Huyard, Alain; Cartnick, Keith; Yańez, Adela; Catalán, Vicente; Quang, Zdravka Do

    2009-01-01

    This research found evidence of an association between occupational exposure to bioaerosols in composting plants and health outcome occurrence in exposed workers. An occupational exposure assessment in six composting plants was performed to better characterize personal exposure levels and evaluate associated health risk in workers. Sampling results showed large ranges of concentrations of dust, bacteria, molds, and endotoxin in ambient air and in personal samples, both when driving a front-end loader and when cleaning, monitoring, and performing maintenance tasks. Mean personal exposure levels were high at 100 to more than 10,000 times higher than outdoor background levels and fully consistent with occurrence of inflammatory and allergic respiratory outcomes among workers. Engineering control, personal protection, and education and training programs for employees, health, and safety officials, and occupational physicians are being developed and implemented. PMID:19860143

  13. Dual indices for prioritizing investment in decentralized HIV services at Nigerian primary health care facilities

    PubMed Central

    Oyediran, Kola’ A; Mullen, Stephanie; Kolapo, Usman M

    2016-01-01

    Decentralizing health services, including those for HIV prevention and treatment, is one strategy for maximizing the use of limited resources and expanding treatment options; yet few methods exist for systematically identifying where investments for service expansion might be most effective, in terms of meeting needs and rapid availability of improved services. The Nigerian Government, the United States Government under the President's Emergency Plan for AIDS Relief (PEPFAR) program and other donors are expanding services for prevention of mother-to-child transmission (PMTCT) of HIV to primary health care facilities in Nigeria. Nigerian primary care facilities vary greatly in their readiness to deliver HIV/AIDS services. In 2012, MEASURE Evaluation assessed 268 PEPFAR-supported primary health care facilities in Nigeria and developed a systematic method for prioritizing these facilities for expansion of PMTCT services. Each assessed facility was scored based on two indices with multiple, weighted variables: one measured facility readiness to provide PMTCT services, the other measured local need for the services and feasibility of expansion. These two scores were compiled and the summary score used as the basis for prioritizing facilities for PMTCT service expansion. The rationale was that using need and readiness to identify where to expand PMTCT services would result in more efficient allocation of resources. A review of the results showed that the indices achieved the desired effect—that is prioritizing facilities with high need even when readiness was problematic and also prioritizing facilities where rapid scale-up was feasible. This article describes the development of the two-part index and discusses advantages of using this approach when planning service expansion. The authors' objective is to contribute to development of methodologies for prioritizing investments in HIV, as well as other public health arenas, that should improve cost-effectiveness and strengthen services and systems in resource-limited countries. PMID:26363172

  14. Dual indices for prioritizing investment in decentralized HIV services at Nigerian primary health care facilities.

    PubMed

    Fronczak, Nancy; Oyediran, Kola' A; Mullen, Stephanie; Kolapo, Usman M

    2016-04-01

    Decentralizing health services, including those for HIV prevention and treatment, is one strategy for maximizing the use of limited resources and expanding treatment options; yet few methods exist for systematically identifying where investments for service expansion might be most effective, in terms of meeting needs and rapid availability of improved services. The Nigerian Government, the United States Government under the President's Emergency Plan for AIDS Relief (PEPFAR) program and other donors are expanding services for prevention of mother-to-child transmission (PMTCT) of HIV to primary health care facilities in Nigeria. Nigerian primary care facilities vary greatly in their readiness to deliver HIV/AIDS services. In 2012, MEASURE Evaluation assessed 268 PEPFAR-supported primary health care facilities in Nigeria and developed a systematic method for prioritizing these facilities for expansion of PMTCT services. Each assessed facility was scored based on two indices with multiple, weighted variables: one measured facility readiness to provide PMTCT services, the other measured local need for the services and feasibility of expansion. These two scores were compiled and the summary score used as the basis for prioritizing facilities for PMTCT service expansion. The rationale was that using need and readiness to identify where to expand PMTCT services would result in more efficient allocation of resources. A review of the results showed that the indices achieved the desired effect-that is prioritizing facilities with high need even when readiness was problematic and also prioritizing facilities where rapid scale-up was feasible. This article describes the development of the two-part index and discusses advantages of using this approach when planning service expansion. The authors' objective is to contribute to development of methodologies for prioritizing investments in HIV, as well as other public health arenas, that should improve cost-effectiveness and strengthen services and systems in resource-limited countries. PMID:26363172

  15. Factors associated with delivery outside a health facility: cross-sectional study in rural Malawi

    PubMed Central

    Mazalale, Jacob; Kambala, Christabel; Brenner, Stephan; Chinkhumba, Jobiba; Lohmann, Julia; Mathanga, Don P; Robberstad, Bjarne; Muula, Adamson S; De Allegri, Manuela

    2015-01-01

    Objective To identify factors associated with delivery outside a health facility in rural Malawi. Method A cross-sectional survey was conducted in Balaka, Dedza, Mchinji and Ntcheu districts in Malawi in 2013 among women who had completed a pregnancy 12 months prior to the day of the survey. Multilevel logistic regression was used to assess factors associated with delivery outside a facility. Results Of the 1812 study respondents, 9% (n = 159) reported to have delivered outside a facility. Unmarried women were significantly more likely [OR = 1.88; 95% CI (1.086–3.173)] to deliver outside a facility, while women from households with higher socio-economic status [third-quartile OR = 0.51; 95% CI (0.28–0.95) and fourth-quartile OR = 0.48; 95% CI (0.29–0.79)] and in urban areas [OR = 0.39; 95%-CI (0.23–0.67)] were significantly less likely to deliver outside a facility. Women without formal education [OR 1.43; 95% CI (0.96–2.14)] and multigravidae [OR = 1.14; 95% CI (0.98–1.73)] were more likely to deliver outside a health facility at 10% level of significance. Conclusion About 9% of women deliver outside a facility. Policies to encourage facility delivery should not only focus on health systems but also be multisectoral to address women's vulnerability and inequality. Facility-based delivery can contribute to curbing the high maternal illness burden if authorities provide incentives to those not delivering at the facility without losing existing users. PMID:25656750

  16. Strengthening health facilities for maternal and newborn care: experiences from rural eastern Uganda

    PubMed Central

    Namazzi, Gertrude; Waiswa, Peter; Nakakeeto, Margaret; Nakibuuka, Victoria K.; Namutamba, Sarah; Najjemba, Maria; Namusaabi, Ruth; Tagoola, Abner; Nakate, Grace; Ajeani, Judith; Peterson, Stefan; Byaruhanga, Romano N.

    2015-01-01

    Background In Uganda maternal and neonatal mortality remains high due to a number of factors, including poor quality of care at health facilities. Objective This paper describes the experience of building capacity for maternal and newborn care at a district hospital and lower-level health facilities in eastern Uganda within the existing system parameters and a robust community outreach programme. Design This health system strengthening study, part of the Uganda Newborn Study (UNEST), aimed to increase frontline health worker capacity through district-led training, support supervision, and mentoring at one district hospital and 19 lower-level facilities. A once-off supply of essential medicines and equipment was provided to address immediate critical gaps. Health workers were empowered to requisition subsequent supplies through use of district resources. Minimal infrastructure adjustments were provided. Quantitative data collection was done within routine process monitoring and qualitative data were collected during support supervision visits. We use the World Health Organization Health System Building Blocks to describe the process of district-led health facility strengthening. Results Seventy two per cent of eligible health workers were trained. The mean post-training knowledge score was 68% compared to 32% in the pre-training test, and 80% 1 year later. Health worker skills and competencies in care of high-risk babies improved following support supervision and mentoring. Health facility deliveries increased from 3,151 to 4,115 (a 30% increase) in 2 years. Of 547 preterm babies admitted to the newly introduced kangaroo mother care (KMC) unit, 85% were discharged alive to continue KMC at home. There was a non-significant declining trend for in-hospital neonatal deaths across the 2-year study period. While equipment levels remained high after initial improvement efforts, maintaining supply of even the most basic medications was a challenge, with less than 40% of health facilities reporting no stock-outs. Conclusion Health system strengthening for care at birth and the newborn period is possible even in low-resource settings and can be associated with improved utilisation and outcomes. Through a participatory process with wide engagement, training, and improvements to support supervision and logistics, health workers were able to change behaviours and practices for maternal and newborn care. Local solutions are needed to ensure sustainability of medical commodities. PMID:25843496

  17. Food security practice in Kansas schools and health care facilities.

    PubMed

    Yoon, Eunju; Shanklin, Carol W

    2007-02-01

    This pilot study investigated perceived importance and frequency of specific preventive measures, and food and nutrition professionals' and foodservice directors' willingness to develop a food defense management plan. A mail questionnaire was developed based on the US Department of Agriculture document, Biosecurity Checklist for School Foodservice Programs--Developing a Biosecurity Management Plan. The survey was sent to food and nutrition professionals and foodservice operators in 151 acute care hospitals, 181 long-term-care facilities, and 450 school foodservice operations. Chemical use and storage was perceived as the most important practice to protect an operation and was the practice implemented most frequently. Results of the study indicate training programs on food security are needed to increase food and nutrition professionals' motivation to implement preventive measures. PMID:17258972

  18. Keeping health facilities safe: one way of strengthening the interaction between disease-specific programmes and health systems.

    PubMed

    Harries, Anthony D; Zachariah, Rony; Tayler-Smith, Katie; Schouten, Erik J; Chimbwandira, Frank; Van Damme, Wim; El-Sadr, Wafaa M

    2010-12-01

    The debate on the interaction between disease-specific programmes and health system strengthening in the last few years has intensified as experts seek to tease out common ground and find solutions and synergies to bridge the divide. Unfortunately, the debate continues to be largely academic and devoid of specificity, resulting in the issues being irrelevant to health care workers on the ground. Taking the theme 'What would entice HIV- and tuberculosis (TB)-programme managers to sit around the table on a Monday morning with health system experts', this viewpoint focuses on infection control and health facility safety as an important and highly relevant practical topic for both disease-specific programmes and health system strengthening. Our attentions, and the examples and lessons we draw on, are largely aimed at sub-Saharan Africa where the great burden of TB and HIV ? AIDS resides, although the principles we outline would apply to other parts of the world as well. Health care infections, caused for example by poor hand hygiene, inadequate testing of donated blood, unsafe disposal of needles and syringes, poorly sterilized medical and surgical equipment and lack of adequate airborne infection control procedures, are responsible for a considerable burden of illness amongst patients and health care personnel, especially in resource-poor countries. Effective infection control in a district hospital requires that all the components of a health system function well: governance and stewardship, financing,infrastructure, procurement and supply chain management, human resources, health information systems, service delivery and finally supervision. We argue in this article that proper attention to infection control and an emphasis on safe health facilities is a concrete first step towards strengthening the interaction between disease-specific programmes and health systems where it really matters – for patients who are sick and for the health care workforce who provide the care and treatment. PMID:21137105

  19. 42 CFR 476.88 - Examination of the operations and records of health care facilities and practitioners.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... care facilities and practitioners. 476.88 Section 476.88 Public Health CENTERS FOR MEDICARE & MEDICAID... Functions § 476.88 Examination of the operations and records of health care facilities and practitioners. (a... examine its operation and records (including information on charges) that are pertinent to health...

  20. Adoption and utilization of electronic health record systems by long-term care facilities in Texas.

    PubMed

    Wang, Tiankai; Biedermann, Sue

    2012-01-01

    Long-term care (LTC) is an important sector in the healthcare industry; however, the adoption of electronic health record (EHR) systems in LTC facilities lags behind that in other sectors of healthcare. This study examines the adoption and utilization of EHRs in LTC facilities in Texas and identifies the barriers preventing implementation of EHRs. A survey instrument was mailed to all Texas LTC facilities between October 2010 and March 2011. The survey found that in Texas, 39.5 percent of LTC facilities have fully or partially implemented EHR systems and 15 percent of LTC facilities have no plans to adopt EHRs yet. There is significant variation in the use of EHR functionalities across the LTC facilities in Texas. In the LTC facilities, the administrative functions of EHRs have been more widely adopted and are more widely utilized than the clinical functions of EHRs. Among the clinical functions adopted, the resident assessment, physician orders, care management plan, and census management are the leading functions used by the LTC facilities in Texas. Lack of capital resources is still the greatest barrier to EHR adoption and implementation. Policy makers, vendors, LTC administrators, educators, and researchers should make more effort to improve EHR adoption in LTC facilities. PMID:22737099

  1. Preventing Airborne Disease Transmission: Review of Methods for Ventilation Design in Health Care Facilities

    PubMed Central

    Aliabadi, Amir A.; Rogak, Steven N.; Bartlett, Karen H.; Green, Sheldon I.

    2011-01-01

    Health care facility ventilation design greatly affects disease transmission by aerosols. The desire to control infection in hospitals and at the same time to reduce their carbon footprint motivates the use of unconventional solutions for building design and associated control measures. This paper considers indoor sources and types of infectious aerosols, and pathogen viability and infectivity behaviors in response to environmental conditions. Aerosol dispersion, heat and mass transfer, deposition in the respiratory tract, and infection mechanisms are discussed, with an emphasis on experimental and modeling approaches. Key building design parameters are described that include types of ventilation systems (mixing, displacement, natural and hybrid), air exchange rate, temperature and relative humidity, air flow distribution structure, occupancy, engineered disinfection of air (filtration and UV radiation), and architectural programming (source and activity management) for health care facilities. The paper describes major findings and suggests future research needs in methods for ventilation design of health care facilities to prevent airborne infection risk. PMID:22162813

  2. Page 4 May 2009

    Cancer.gov

    Inside PMBMay 2009 Shoot for The STARS! Cyberspace Voyage: To Boldy go... CTEP launched a new web site (ctep.cancer.gov) into your space in autumn 2008, but it’s still moving at the speed of light! Visit often: We’ve changed the PMB landing page

  3. Photorefractive page composer

    NASA Technical Reports Server (NTRS)

    Verber, C. M.

    1976-01-01

    Optical information-storage device is small, easy to operate, and has low optical losses. Device utilizes optical system in which storage medium, a plate of photosensitive material, changes its refractive index upon exposure to light. Major design feature is that page-composer plate does not require complete erasure between scans.

  4. Handley Page metal construction

    NASA Technical Reports Server (NTRS)

    1929-01-01

    In this report Handley Page construction techniques are shown such as: solid-drawn tubular duralumin spars are used in the stabilizer; plain channel sections are used extensively for minor components; and the manner of assembling them into a stabilizer compression strut is shown.

  5. Organizational factors influencing health information technology adoption in long-term-care facilities.

    PubMed

    Wang, Tiankai; Wang, Yangmei; Moczygemba, Jackie

    2014-01-01

    Long-term care (LTC) is an important sector of the health care industry. However, the adoption of health information technology (HIT) systems in LTC facilities lags behind that in other sectors of health care. Previous literature has focused on the financial and technical barriers. This study examined the organizational factors associated with HIT adoption in LTC facilities. A survey of 500 LTC facilities in Texas enabled researchers to compile HIT indexes for further statistical analyses. A general linear model was used to study the associations between the clinical/administrative HIT indexes and organizational factors. The empirical outcomes show that the size of an LTC facility has a significant association with HIT adoption. Rural LTC facilities, especially freestanding ones, adopt less HIT than their urban counterparts, whereas freestanding LTC facilities have the lowest HIT adoption overall. There is not enough evidence to support ownership status as a significant factor in HIT adoption. Some implications are proposed, but further research is necessary. PMID:24463588

  6. Health care facility-based decontamination of victims exposed to chemical, biological, and radiological materials.

    PubMed

    Koenig, Kristi L; Boatright, Connie J; Hancock, John A; Denny, Frank J; Teeter, David S; Kahn, Christopher A; Schultz, Carl H

    2008-01-01

    Since the US terrorist attacks of September 11, 2001, concern regarding use of chemical, biological, or radiological weapons is heightened. Many victims of such an attack would present directly to health care facilities without first undergoing field decontamination. This article reviews basic tenets and recommendations for health care facility-based decontamination, including regulatory concerns, types of contaminants, comprehensive decontamination procedures (including crowd control, triage, removal of contaminated garments, cleaning of body contaminants, and management of contaminated materials and equipment), and a discussion of methods to achieve preparedness. PMID:18082785

  7. A 'mystery client' evaluation of adolescent sexual and reproductive health services in health facilities from two regions in Tanzania.

    PubMed

    Mchome, Zaina; Richards, Esther; Nnko, Soori; Dusabe, John; Mapella, Elizabeth; Obasi, Angela

    2015-01-01

    Unwelcoming behaviours and judgemental attitudes have long been recognised as a barrier to young people's access to reproductive health services. Over the last decade youth friendly reproductive health services have been promoted and implemented world-wide. However, long term evidence of the impact of these programmes is lacking. We report the results of a large mystery client evaluation of adolescent sexual and reproductive health services in Tanzania, a country that has had a long established youth friendly policy. Forty-eight visits made to thirty-three health facilities were conducted by twelve young people (six in each region) trained to perform three different scripted scenarios (i.e., condom request, information on sexually transmitted infections and family planning). The study revealed barriers in relation to poor signage and reception for services. In addition health workers demonstrated paternalistic attitudes as well as lack of knowledge about adolescent sexual and reproductive health services. In some cases, health workers discouraged young people from using services such as condoms and family planning methods. Lack of confidentiality and privacy were also noted to be common challenges for the young people involved. Intervention strategies that focus on changing health workers' mind-set in relation to adolescent sexual and reproductive health are crucial for ensuring quality provision of sexual and reproductive health services to young people. The study identified the importance of reception or signs at the health units, as this can facilitate young people's efforts in seeking sexual and reproductive health services. Likewise, improvement of health workers knowledge of existing policy and practice on sexual and reproductive health services and youth friendly services is much needed. PMID:25803689

  8. A ‘Mystery Client’ Evaluation of Adolescent Sexual and Reproductive Health services in Health Facilities from Two Regions in Tanzania

    PubMed Central

    Mchome, Zaina; Richards, Esther; Nnko, Soori; Dusabe, John; Mapella, Elizabeth; Obasi, Angela

    2015-01-01

    Unwelcoming behaviours and judgemental attitudes have long been recognised as a barrier to young people’s access to reproductive health services. Over the last decade youth friendly reproductive health services have been promoted and implemented world-wide. However, long term evidence of the impact of these programmes is lacking. We report the results of a large mystery client evaluation of adolescent sexual and reproductive health services in Tanzania, a country that has had a long established youth friendly policy. Forty-eight visits made to thirty-three health facilities were conducted by twelve young people (six in each region) trained to perform three different scripted scenarios (i.e., condom request, information on sexually transmitted infections and family planning). The study revealed barriers in relation to poor signage and reception for services. In addition health workers demonstrated paternalistic attitudes as well as lack of knowledge about adolescent sexual and reproductive health services. In some cases, health workers discouraged young people from using services such as condoms and family planning methods. Lack of confidentiality and privacy were also noted to be common challenges for the young people involved. Intervention strategies that focus on changing health workers’ mind-set in relation to adolescent sexual and reproductive health are crucial for ensuring quality provision of sexual and reproductive health services to young people. The study identified the importance of reception or signs at the health units, as this can facilitate young people’s efforts in seeking sexual and reproductive health services. Likewise, improvement of health workers knowledge of existing policy and practice on sexual and reproductive health services and youth friendly services is much needed. PMID:25803689

  9. Gender equality and childbirth in a health facility: Nigeria and MDG5.

    PubMed

    Singh, Kavita; Bloom, Shelah; Haney, Erica; Olorunsaiye, Comfort; Brodish, Paul

    2012-09-01

    This paper examined how addressing gender equality can lead to reductions in maternal mortality in Nigeria through an increased use of facility delivery. Because the majority of maternal complications cannot be predicted and often arise suddenly during labor, delivery and the immediate postpartum period, childbirth in a health facility is key to reducing maternal mortality. This paper used data from the 2008 Nigeria Demographic and Health Survey (DHS) to examine associations of gender measures on the utilization of facility delivery after controlling for socio-demographic factors. Four gender equality measures were studied: household decision-making, financial decision-making, attitudes towards wife beating, and attitudes regarding a wife's ability to refuse sex. Results found older, more educated, wealthier, urban, and working women were more likely to have a facility delivery than their counterparts. In addition ethnicity was a significant variable indicating the importance of cultural and regional diversity. Notably, after controlling for the socioeconomic variables, two of the gender equality variables were significant: household decision-making and attitudes regarding a wife's ability to refuse sex. In resource-poor settings such as Nigeria, women with more decision-making autonomy are likely better able to advocate for and access a health facility for childbirth. Thus programs and policies that focus on gender in addition to focusing on education and poverty have the potential to reduce maternal mortality even further. PMID:23437506

  10. Profit versus public health: the need to improve the food environment in recreational facilities.

    PubMed

    Olstad, Dana Lee; Raine, Kim D

    2013-01-01

    Despite their wellness mandate, many publicly funded recreational facilities offer primarily unhealthy foods. Governments have developed programs and resources to assist facilities to improve their food offerings, however the challenge to incent preferential sale of healthier foods remains substantial. In the Canadian province of Alberta, uptake of government-issued voluntary nutrition guidelines for recreational facilities has been limited, and offers of free assistance to implement them as part of a research study were not embraced. Financial constraints appear to be the most important barrier to offering healthier items in Alberta's recreational facilities, as facility and food service managers perceive that selling healthier foods is unprofitable and might jeopardize sponsorship agreements. Mandatory government regulation may therefore be required to overcome the barriers to offering healthier foods in this setting. The advantages of a regulatory approach appear to outweigh any disadvantages, with benefits for population health, more effective use of public funds, and greater equity for the public and industry. Adverse effects on corporate profitability and freedom of choice are expected to be limited. Regulation may offer an efficient, effective and equitable means of ensuring that recreational facilities support child health and do not undermine it by exposing children to unhealthy food environments. PMID:23618211

  11. “It’s Got to Be on This Page”: Age and Cognitive Style in a Study of Online Health Information Seeking

    PubMed Central

    King, Abby C; Castro, Cynthia M; Wiley, Adrienne; Borzekowski, Dina LG

    2015-01-01

    Background The extensive availability of online health information offers the public opportunities to become independently informed about their care, but what affects the successful retrieval and understanding of accurate and detailed information? We have limited knowledge about the ways individuals use the Internet and the personal characteristics that affect online health literacy. Objective This study examined the extent to which age and cognitive style predicted success in searching for online health information, controlling for differences in education, daily Internet use, and general health literacy. Methods The Online Health Study (OHS) was conducted at Johns Hopkins School of Public Health and Stanford University School of Medicine from April 2009 to June 2010. The OHS was designed to explore the factors associated with success in obtaining health information across different age groups. A total of 346 men and women aged 35 years and older of diverse racial and ethnic backgrounds participated in the study. Participants were evaluated for success in searching online for answers to health-related tasks/questions on nutrition, cancer, alternative medicine, vaccinations, medical equipment, and genetic testing. Results Cognitive style, in terms of context sensitivity, was associated with less success in obtaining online health information, with tasks involving visual judgment most affected. In addition, better health literacy was positively associated with overall success in online health seeking, specifically for tasks requiring prior health knowledge. The oldest searchers were disadvantaged even after controlling for education, Internet use, general health literacy, and cognitive style, especially when spatial tasks such as mapping were involved. Conclusions The increasing availability of online health information provides opportunities to improve patient education and knowledge, but effective use of these resources depends on online health literacy. Greater support for those who are in the oldest cohorts and for design of interfaces that support users with different cognitive styles may be required in an age of shared medical decision making. PMID:25831483

  12. Guiding Ebola patients to suitable health facilities: an SMS-based approach

    PubMed Central

    Trad, Mohamad-Ali; Jurdak, Raja; Rana, Rajib

    2015-01-01

    Access to appropriate health services is a fundamental problem in developing countries, where patients do not have access to information and to the nearest health service facility. We propose building a recommendation system based on simple SMS text messaging to help Ebola patients readily find the closest health service with available and appropriate resources. The system will map people’s reported symptoms to likely Ebola case definitions and suitable health service locations. In addition to providing a valuable individual service to people with curable diseases, the proposed system will also predict population-level disease spread risk for infectious diseases using crowd-sourced symptoms from the population. Health workers will be able to better plan and anticipate responses to the current Ebola outbreak in West Africa. Patients will have improved access to appropriate health care. This system could also be applied in other resource poor or rich settings. PMID:25789162

  13. Lessons Learned from the On-Site Distillation of Used Solvents Generated by Health Care Facilities.

    ERIC Educational Resources Information Center

    Huang, Ching-San; Ciesla, John

    1992-01-01

    Discusses the sources of contaminants found in used solvents generated by the histopathological laboratories at health care facilities and the technical problems, corrective measures, and economic analysis associated with the on-site recycling and reusing of these solvents. An appendix contains an economic analysis for a used-solvent recycling


  14. 7 CFR 1956.143 - Debt restructuring-hospitals and health care facilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE... Settlement-Community and Business Programs § 1956.143 Debt restructuring—hospitals and health care facilities... as the poverty line interest rate in effect on community and business programs loans. Loan...

  15. [3D printing in health care facilities: What legislation in France?].

    PubMed

    Montmartin, M; Meyer, C; Euvrard, E; Pazart, L; Weber, E; Benassarou, M

    2015-11-01

    Health care facilities more and more use 3D printing, including making their own medical devices (MDs). However, production and marketing of MDs are regulated. The goal of our work was to clarify what is the current French regulation that should be applied concerning the production of custom-made MDs produced by 3D printing in a health care facility. MDs consist of all devices used for diagnosis, prevention, or treatment of diseases in patients. Prototypes and anatomic models are not considered as MDs and no specific laws apply to them. Cutting guides, splints, osteosynthesis plates or prosthesis are MDs. In order to become a MD manufacturer in France, a health care facility has to follow the requirements of the 93/42/CEE directive. In addition, custom-made 3D-printed MDs must follow the annex VIII of the directive. This needs the writing of a declaration of conformity and the respect of the essential requirements (proving that a MD is secure and conform to what is expected), the procedure has to be qualified, a risk analysis and a control of the biocompatibility of the material have to be fulfilled. The documents proving that these rules have been respected have to be available. Becoming a regulatory manufacturer of MD in France is possible for a health care facility but the specifications have to be respected. PMID:26071022

  16. Adoption factors associated with electronic health record among long-term care facilities: a systematic review

    PubMed Central

    Kruse, Clemens Scott; Mileski, Michael; Alaytsev, Vyachelslav; Carol, Elizabeth; Williams, Ariana

    2015-01-01

    Objectives The Health Information Technology for Economic and Clinical Health (HITECH) Act created incentives for adopting electronic health records (EHRs) for some healthcare organisations, but long-term care (LTC) facilities are excluded from those incentives. There are realisable benefits of EHR adoption in LTC facilities; however, there is limited research about this topic. The purpose of this systematic literature review is to identify EHR adoption factors for LTC facilities that are ineligible for the HITECH Act incentives. Setting We conducted systematic searches of Cumulative Index of Nursing and Allied Health Literature (CINAHL) Complete via Ebson B. Stephens Company (EBSCO Host), Google Scholar and the university library search engine to collect data about EHR adoption factors in LTC facilities since 2009. Participants Search results were filtered by date range, full text, English language and academic journals (n=22). Interventions Multiple members of the research team read each article to confirm applicability and study conclusions. Primary and secondary outcome measures Researchers identified common themes across the literature: specifically facilitators and barriers to adoption of the EHR in LTC. Results Results identify facilitators and barriers associated with EHR adoption in LTC facilities. The most common facilitators include access to information and error reduction. The most prevalent barriers include initial costs, user perceptions and implementation problems. Conclusions Similarities span the system selection phases and implementation process; of those, cost was the most common mentioned. These commonalities should help leaders in LTC facilities align strategic decisions to EHR adoption. This review may be useful for decision-makers attempting successful EHR adoption, policymakers trying to increase adoption rates without expanding incentives and vendors that produce EHRs. PMID:25631311

  17. Genomic Analysis of Blastocystis hominis Strains Isolated from Two Long-Term Health Care Facilities

    PubMed Central

    Yoshikawa, Hisao; Abe, Niichiro; Iwasawa, Mizue; Kitano, Syoko; Nagano, Isao; Wu, Zhiliang; Takahashi, Yuzo

    2000-01-01

    The genotype Blastocystis hominis is highly polymorphic. Therefore, a genetic marker would be a powerful tool for the identification or classification of B. hominis subtypes and could be used as a means to resolve the transmission route or origin of the parasite. To this end, 32 B. hominis isolates were collected from patients and/or staff members of two long-term health care facilities (facilities A and B), and these organisms were subjected to genotype analysis based on diagnostic PCR primers and restriction fragment length polymorphism (RFLP) of small subunit rRNA gene (rDNA). Based on PCR amplification using diagnostic primers which were developed from randomly amplified polymorphic DNA analysis of known strains of B. hominis, the 32 isolates of B. hominis were classified into three different subtypes. Thirty isolates, including twenty-four that were isolated from patients and a staff member, from facility A and all isolates isolated from six patients from facility B showed the same genotype. Two of six patients of facility B had been transferred from facility A, and these two patients also had the same-genotype B. hominis that corresponded to 24 isolates from facility A. This genotype strain may have been transmitted by these two patients from facility A to facility B, suggesting human-to-human transmission. In contrast, 2 of 26 isolates from facility A showed distinct genotypes, suggesting that the colonization by these two isolates is attributable to another infectious route. These different subtypes were subjected to RFLP analysis, and the RFLP profiles were correlated with the results obtained by diagnostic PCR primers. This study presents the first molecular evidence of possible human-to-human B. hominis infection between and/or among two small communities. PMID:10747102

  18. Environmental Assessment for the Health Protection Instrument Calibration Facility at the Savannah River Site

    SciTech Connect

    Not Available

    1993-08-01

    The purpose of this Environmental Assessment (EA) is to review the possible environmental consequences associated with the construction and operation of a Health Protection Instrument Calibration Facility on the Savannah River Site (SRS). The proposed replacement calibration facility would be located in B Area of SRS and would replace an inadequate existing facility currently located within A Area of SRS (Building 736-A). The new facility would provide laboratories, offices, test equipment and the support space necessary for the SRS Radiation Monitoring Instrument Calibration Program to comply with DOE Orders 5480.4 (Environmental Protection, Safety and Health Protection Standards) and 5480.11 (Radiation Protection for Occupational Workers). The proposed facility would serve as the central site source for the evaluation, selection, inspection, testing, calibration, and maintenance of all SRS radiation monitoring instrumentation. The proposed facility would be constructed on a currently undeveloped portion in B Area of SRS. The exact plot associated with the proposed action is a 1.2 hectare (3 acre) tract of land located on the west side of SRS Road No. 2. The proposed facility would lie approximately 4.4 km (2.75 mi) from the nearest SRS site boundary. The proposed facility would also lie within the confines of the existing B Area, and SRS safeguards and security systems. Archaeological, ecological, and land use reviews have been conducted in connection with the use of this proposed plot of land, and a detailed discussion of these reviews is contained herein. Socioeconomic, operational, and accident analyses were also examined in relation to the proposed project and the findings from these reviews are also contained in this EA.

  19. Effects of health and safety problem recognition on small business facility investment

    PubMed Central

    2013-01-01

    Objectives This study involved a survey of the facility investment experiences, which was designed to recognize the importance of health and safety problems, and industrial accident prevention. Ultimately, we hope that small scale industries will create effective industrial accident prevention programs and facility investments. Methods An individual survey of businesses’ present physical conditions, recognition of the importance of the health and safety problems, and facility investment experiences for preventing industrial accidents was conducted. The survey involved 1,145 business operators or management workers in small business places with fewer than 50 workers in six industrial complexes. Results Regarding the importance of occupational health and safety problems (OHS), 54.1% said it was “very important”. Received technical and financial support, and industrial accidents that occurred during the past three years were recognized as highly important for OHS. In an investigation regarding facility investment experiences for industrial accident prevention, the largest factors were business size, greater numbers of industrial accidents, greater technical and financial support received, and greater recognition of the importance of the OHS. The related variables that decided facility investment for industry accident prevention in a logistic regression analysis were the experiences of business facilities where industrial accidents occurred during the past three years, received technical and financial support, and recognition of the OHS. Those considered very important were shown to be highly significant. Conclusions Recognition of health and safety issues was higher when small businesses had experienced industrial accidents or received financial support. The investment in industrial accidents was greater when health and safety issues were recognized as important. Therefore, the goal of small business health and safety projects is to prioritize health and safety issues in terms of business management and recognition of importance. Therefore, currently various support projects are being conducted. However, there are issues regarding the limitations of the target businesses and inadequacies in maintenance and follow-up. Overall, it is necessary to provide various incentives for onsite participation that can lead to increased recognition of health and safety issues and practical investments, while perfecting maintenance and follow up measures by thoroughly revising existing operating systems. PMID:24472180

  20. PAGES OF HISTORY.

    PubMed

    Navarro, Vicente

    2015-01-01

    The International Journal of Health Services is glad to publish a brief note about the origins of what is now known as the International Association of Health Policy, a worldwide association of professionals working on how to improve the health and well-being of the populations. The International Journal of Health Services was part of that history as well. PMID:26460457

  1. Health facilities safety in natural disasters: experiences and challenges from South East Europe.

    PubMed

    Radovic, Vesela; Vitale, Ksenija; Tchounwou, Paul B

    2012-05-01

    The United Nations named 2010 as a year of natural disasters, and launched a worldwide campaign to improve the safety of schools and hospitals from natural disasters. In the region of South East Europe, Croatia and Serbia have suffered the greatest impacts of natural disasters on their communities and health facilities. In this paper the disaster management approaches of the two countries are compared, with a special emphasis on the existing technological and legislative systems for safety and protection of health facilities and people. Strategic measures that should be taken in future to provide better safety for health facilities and populations, based on the best practices and positive experiences in other countries are recommended. Due to the expected consequences of global climate change in the region and the increased different environmental risks both countries need to refine their disaster preparedness strategies. Also, in the South East Europe, the effects of a natural disaster are amplified in the health sector due to its critical medical infrastructure. Therefore, the principles of environmental security should be implemented in public health policies in the described region, along with principles of disaster management through regional collaborations. PMID:22754465

  2. Behind bars: the compelling case for academic health centers partnering with correctional facilities.

    PubMed

    Trestman, Robert L; Ferguson, Warren; Dickert, Jeff

    2015-01-01

    Academic health centers (AHCs), particularly those that are publicly funded institutions, have as their mission the treatment of disadvantaged populations, the training of the next generation of clinicians, and the development and dissemination of new knowledge to reduce the burden of disease and improve the health of individuals and populations. Incarcerated populations have the most prevalent and acute disease burden and health disparities in the United States, even in comparison with inner-city populations. Yet, only a small proportion of AHCs have reached out to incarcerated populations to fulfill their mission. Those AHCs that have partnered with correctional facilities have overcome concerns about the value and popularity of "training behind bars"; the cost, liability, and pragmatics of caring for a medically complicated population; and the viability of correctional health research and extramural research funding. They have done so to great benefit to patients, students, and faculty. Partnering with correctional facilities to provide health care offers opportunities for AHCs to fulfill their core missions of clinical service, education, and research, while also enhancing their financial stability, to the benefit of all. In this Commentary, the authors discuss, based on their experiences, these concerns, how existing partnerships have overcome them, and the benefits of such relationships to both AHCs and correctional facilities. PMID:25054416

  3. Health Facilities Safety in Natural Disasters: Experiences and Challenges from South East Europe

    PubMed Central

    Radovic, Vesela; Vitale, Ksenija; Tchounwou, Paul B.

    2012-01-01

    The United Nations named 2010 as a year of natural disasters, and launched a worldwide campaign to improve the safety of schools and hospitals from natural disasters. In the region of South East Europe, Croatia and Serbia have suffered the greatest impacts of natural disasters on their communities and health facilities. In this paper the disaster management approaches of the two countries are compared, with a special emphasis on the existing technological and legislative systems for safety and protection of health facilities and people. Strategic measures that should be taken in future to provide better safety for health facilities and populations, based on the best practices and positive experiences in other countries are recommended. Due to the expected consequences of global climate change in the region and the increased different environmental risks both countries need to refine their disaster preparedness strategies. Also, in the South East Europe, the effects of a natural disaster are amplified in the health sector due to its critical medical infrastructure. Therefore, the principles of environmental security should be implemented in public health policies in the described region, along with principles of disaster management through regional collaborations. PMID:22754465

  4. 42 CFR 476.88 - Examination of the operations and records of health care facilities and practitioners.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Examination of the operations and records of health care facilities and practitioners. 476.88 Section 476.88 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW...

  5. The Mistreatment of Women during Childbirth in Health Facilities Globally: A Mixed-Methods Systematic Review

    PubMed Central

    Bohren, Meghan A.; Vogel, Joshua P.; Hunter, Erin C.; Lutsiv, Olha; Makh, Suprita K.; Souza, JoĂŁo Paulo; Aguiar, Carolina; Saraiva Coneglian, Fernando; Diniz, Alex LuĂ­z AraĂșjo; Tunçalp, Özge; Javadi, Dena; Oladapo, Olufemi T.; Khosla, Rajat; Hindin, Michelle J.; GĂŒlmezoglu, A. Metin

    2015-01-01

    Background Despite growing recognition of neglectful, abusive, and disrespectful treatment of women during childbirth in health facilities, there is no consensus at a global level on how these occurrences are defined and measured. This mixed-methods systematic review aims to synthesize qualitative and quantitative evidence on the mistreatment of women during childbirth in health facilities to inform the development of an evidence-based typology of the phenomenon. Methods and Findings We searched PubMed, CINAHL, and Embase databases and grey literature using a predetermined search strategy to identify qualitative, quantitative, and mixed-methods studies on the mistreatment of women during childbirth across all geographical and income-level settings. We used a thematic synthesis approach to synthesize the qualitative evidence and assessed the confidence in the qualitative review findings using the CERQual approach. In total, 65 studies were included from 34 countries. Qualitative findings were organized under seven domains: (1) physical abuse, (2) sexual abuse, (3) verbal abuse, (4) stigma and discrimination, (5) failure to meet professional standards of care, (6) poor rapport between women and providers, and (7) health system conditions and constraints. Due to high heterogeneity of the quantitative data, we were unable to conduct a meta-analysis; instead, we present descriptions of study characteristics, outcome measures, and results. Additional themes identified in the quantitative studies are integrated into the typology. Conclusions This systematic review presents a comprehensive, evidence-based typology of the mistreatment of women during childbirth in health facilities, and demonstrates that mistreatment can occur at the level of interaction between the woman and provider, as well as through systemic failures at the health facility and health system levels. We propose this typology be adopted to describe the phenomenon and be used to develop measurement tools and inform future research, programs, and interventions. PMID:26126110

  6. Measuring health workers’ motivation in rural health facilities: baseline results from three study districts in Zambia

    PubMed Central

    2013-01-01

    Introduction Health worker motivation can potentially affect the provision of health services. Low morale among the workforce can undermine the quality of service provision and drive workers away from the profession. While the presence of high-quality, motivated staff is a key aspect of health system performance, it is also one of the most difficult factors to measure. Methods We assessed health worker motivation as part of the baseline assessment for a health system strengthening intervention in three rural districts in Zambia. The intervention (Better Health Outcomes Through Mentoring and Assessment (BHOMA)) aims to increase health worker motivation through training, mentoring and support. We assessed motivation by examining underlying issues grouped around relevant outcome constructs such as job satisfaction, general motivation, burnout, organization commitment, conscientiousness and timeliness that collectively measure overall levels of motivation. The tools and the concepts have been used in high-income countries and they were recently applied in African settings to measure health worker motivation. Results Female participants had the highest motivation scores (female: mean 78.5 (SD 7.8) vs male: mean (SD 7.0)). By type of worker, nurses had the highest scores while environmental health technicians had the lowest score (77.4 (SD 7.8 vs 73.2 (SD 9.3)). Health workers who had been in post longer also had higher scores (>7 months). Health workers who had received some form of training in the preceding 12 months were more likely to have a higher score; this was also true for those older than 40 years when compared to those less than 40 years of age. The highest score values were noted in conscientiousness and timeliness, with all districts scoring above 80. Conclusions This study evaluated motivation among rural health workers using a simple adapted tool to measure the concept of motivation. Results showed variation in motivation score by sex, type of health worker, training and time in post. Further research is needed to establish why these health worker attributes were associated with motivation and whether health system interventions targeting health workers, such as the current intervention, could influence health worker motivation. PMID:23433226

  7. The food and beverage vending environment in health care facilities participating in the healthy eating, active communities program. — Measures of the Food Environment

    Cancer.gov

    Skip to Main Content at the National Institutes of Health | www.cancer.gov Print Page E-mail Page Search: Please wait while this form is being loaded.... Home Browse by Resource Type Browse by Area of Research Research Networks Funding Information About

  8. Preparedness of County Referral Health Facilities in Implementing Adolescent Friendly Health Services: A Case Study of Mama Lucy Kibaki Hospital.

    PubMed

    Owuondo, Pacific Akinyi; Mwaura-Tenembergen, Wanja; Adoyo, Maureen; Kiilu, Elizabeth M

    2015-11-01

    Health service delivery is a key pillar of the health system management. The World Health Organization recently emphasized the need to develop adolescent -friendly health services to improve the care provided to young people throughout the world. However, there is limited peer reviewed literature on this subject therefore necessitating assessment of whether the existing health facilities are prepared to implement the adolescent friendly health services. Adolescent friendly health services remains a relatively new and sensitive area mainly due to restrictive norms and policies guiding the services. After International Conference on Population and Development in 1994, countries started implementing adolescent friendly health services. The Government of Kenya together with partners in an attempt to address the health challenges came up with the Adolescent package of care (APOC) in 2013 whose guidelines were finalized in November 2014 and released for use by service providers . Despite this package of care, there is still ineffective staff capacity in relation to skills and knowledge gap of health professionals, training needs, health resources as well as health system factors that can affect implementation of AFHS. The study explored ways of mitigating or addressing the barriers to implementation of these services. The study used both quantitative and qualitative approaches to collect data. The study utilized survey research adapting descriptive cross sectional design and semi-structured questionnaire to interview 348 health care providers and 472 adolescents in Mam Lucy Kibaki Hospital from 3rd May 2014 to 16 June 2014. The key informants were mainly nurses, clinical officers and Medical doctors who were working at the health service delivery area at the time of study and were interviewed using an interview guide. The managers at the hospital were interviewed using an in-depth interview guide while the adolescents were interviewed through interview guide and focused group discussion. Quantitative data was analyzed using Statistical Package for Social Sciences (SPSS) Version 18.0. Descriptive statistics and chi-square tests were performed to determine significant associations. The study established that sex, age, level of education and adolescent awareness about existence of friendly health services offered were significantly associated with utilization at p<0.05. Long queues, unfavorable working hours and lack of money negatively affected consumption of AFHS. The study concluded that the utilization of health services among the adolescents was low largely due to unfriendliness of the health care providers at health facilities and lack of awareness of AFHS services. In view of the findings, this study recommends need for the Government through the Ministry of Health and partners in health service provision to increase the number of AFHS and ensure that the recommendations of Adolescent Package of care is implemented fully with good evaluation strategies in place. Laborious awareness drives to sensitize the adolescents about the available services through rigorous health education and increased involvement of both parents/guardians and teachers to scale up implementation are also recommended. PMID:26153176

  9. Historical analysis of the development of health care facilities in Kerala State, India.

    PubMed

    Kutty, V R

    2000-03-01

    Kerala's development experience has been distinguished by the primacy of the social sectors. Traditionally, education and health accounted for the greatest shares of the state government's expenditure. Health sector spending continued to grow even after 1980 when generally the fiscal deficit in the state budget was growing and government was looking for ways to control expenditure. But growth in the number of beds and institutions in the public sector had slowed down by the mid-1980s. From 1986-1996, growth in the private sector surpassed that in the public sector by a wide margin. Public sector spending reveals that in recent years, expansion has been limited to revenue expenditure rather than capital, and salaries at the cost of supplies. Many developments outside health, such as growing literacy, increasing household incomes and population ageing (leading to increased numbers of people with chronic afflictions), probably fueled the demand for health care already created by the increased access to health facilities. Since the government institutions could not grow in number and quality at a rate that would have satisfied this demand, health sector development in Kerala after the mid-1980s has been dominated by the private sector. Expansion in private facilities in health has been closely linked to developments in the government health sector. Public institutions play by far the dominant role in training personnel. They have also sensitized people to the need for timely health interventions and thus helped to create demand. At this point in time, the government must take the lead in quality maintenance and setting of standards. Current legislation, which has brought government health institutions under local government control, can perhaps facilitate this change by helping to improve standards in public institutions. PMID:10731241

  10. Annotated References on: Engineering Maintenance, Sanitation Public Health, Sanitation Health Care Facility, Housekeeping, and Purchasing.

    ERIC Educational Resources Information Center

    California Univ., Los Angeles. Div. of Vocational Education.

    Developed as part of the Allied Health Professions Projects, these five annotated bibliographies contain resource materials from the following areas: (1) Engineering Maintenance, 13 entries, (2) Sanitation and Public Health, 15 entries, (3) Hospital and Nursing Home Administration, 12 entries, (4) Hospital Housekeeping, 43 entries, and (5)…

  11. ACSM Fit Society Page

    MedlinePLUS

    ... is a quarterly e-newsletter written for the general public on a variety of popular health and fitness topics. Expert commentary and features on exercise, nutrition, sports and health offer tips and techniques for ...

  12. Public perception of health-risks from a MSW resource recovery facility

    SciTech Connect

    Rao, R.K.; Balmer, A.G.

    1996-12-31

    Within the last decade, the siting of a Municipal Solid Waste (MSW) Resource Recovery Facility (RRF) has become a very difficult, complex and controversial process. As in many communities across the nation, opposition to the siting of MSW RRFs has been largely due to public perception that organics, primarily dioxins, that are released in minute quantities from the stacks of the RRFs, create the risk of potential health effects including cancer. This has been underscored by the degree of dissension within the scientific community on this matter. In response to citizen concerns, Montgomery County, maryland conducted several health risk studies prior to applying for a Prevention of Significant Deterioration (PSD) of air quality permit for the facility. Although the results of these studies indicated that the health risks from stack emissions of the RRF are within acceptable levels as defined by regulatory agencies, County`s citizen advisory committees and people living in the townships near the site suggested that the County conduct an ambient monitoring program to collect baseline data on dioxins and other chemicals before making a decision to build the facility. This paper discusses public participation activities in the conduct of the health risk studies and the baseline environmental monitoring program, and presents some baseline data collected in the air and non-air media.

  13. Baseline results of the first malaria indicator survey in Iran at the health facility level

    PubMed Central

    2011-01-01

    Background Malaria continues to be a global public health challenge, particularly in developing countries. Delivery of prompt and effective diagnosis and treatment of malaria cases, detection of malaria epidemics within one week of onset and control them in less than a month, regular disease monitoring and operational classification of malaria are among the major responsibilities of the national malaria programme. The study was conducted to determine these indicators at the different level of primary health care facilities in malaria-affected provinces of Iran Methods In this survey, data was collected from 223 health facilities including health centres, malaria posts, health houses and hospitals as well as the profile of all 5, 836 recorded malaria cases in these facilities during the year preceding the survey. Descriptive statistics (i.e. frequencies, percentages) were used to summarize the results and Chi square test was used to analyse data. Results All but one percent of uncomplicated cases took appropriate and correctly-dosed of anti-malarial drugs in accordance to the national treatment guideline. A larger proportion of patients [85.8%; 95% CI: 84.8 - 86.8] were also given complete treatment including anti-relapse course, in line with national guidelines. About one third [35.0%; 95% CI: 33.6 - 36.4] of uncomplicated malaria cases were treated more than 48 hours after first symptoms onset. Correspondingly, half of severe malaria cases took recommended anti-malarial drugs for severe or complicated disease more than 48 hours of onset of first symptoms. The latter cases had given regular anti-malarial drugs promptly. The majority of malaria epidemics [97%; 95% CI: 90.6 - 100] in study areas were detected within one week of onset, but only half of epidemics were controlled within four weeks of detection. Just half of target districts had at least one health facility/emergency site with adequate supply and equipment stocks. Nevertheless, only one-third of them [33% (95% CI: 0.00 - 67.8)] had updated inventory of malaria foci on quarterly basis. Conclusion To sum up, malaria case management still constitutes a public health problem in Iran. Additionally, data suggest scarcity in management and evaluation of malaria foci, detection and control of malaria epidemics as well as assignment of emergency sites across different regions of the country. Consequently, massive and substantial investments need to be made at the Ministry of Health to coordinate national malaria control programmes towards achieving determined goals and targets. PMID:22029447

  14. The legal regulation of seclusion and restraint in mental health facilities.

    PubMed

    McSherry, Bernadette

    2013-12-01

    A recent report submitted to the United Nations Human Rights Council by the United Nations Special Rapporteur on Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, has called for "an absolute ban" on the use of seclusion and restraint in mental health facilities. In Australia, seclusion and some, but not all, forms of restraint are regulated either by legislation or guidelines. This column explores some of the issues raised by the lack of national reporting requirements for these practices and moves by the National Mental Health Commission towards their reduction or elimination. PMID:24597370

  15. Psychiatric components of a Health Maintenance Facility (HMF) on Space Station

    NASA Technical Reports Server (NTRS)

    Santy, Patricia A.

    1987-01-01

    The operational psychiatric requirements for a comprehensive Health Maintenance Facility (HMF) on a permanently manned Space Station are examined. Consideration is given to the psychological health maintenance program designed for the diagnosis of mental distress in astronauts during flight and for prevention of mental breakdown. The types of mental disorders that can possibly affect the astronauts in flight are discussed, including various organic, psychotic, and affective mental disorders, as well as anxiety, adjustment, and somatoform/dissociative disorders. Special attention is given to therapeutic considerations for psychiatric operations on Space Station, such as restraints, psychopharmacology, psychotherapy, and psychosocial support.

  16. Collaboration with behavioral health care facilities to implement systemwide tobacco control policies--California, 2012.

    PubMed

    Gordon, Lauren; Modayil, Mary V; Pavlik, Jim; Morris, Chad D

    2015-01-01

    The California Tobacco Control Program (CTCP) administered 4 regional trainings in 2012 to staffers at CTCP-funded projects, tobacco control coalitions, several county departments of mental health and alcohol and drug, and administrators and providers from behavioral health care facilities. These trainings focused on the special tobacco use cessation needs and opportunities for cessation among persons with mental illness or substance abuse disorders, and they provided information about cessation and smoke-free policies. CTCP surveyed county and private behavioral health care programs to assess their readiness for adopting tobacco control strategies at treatment facilities. Between baseline and follow-up we found a decrease in the proportion of organizations at the precontemplation or contemplation stages of change and twice as many organizations at the action and maintenance stages of change. Significant obstacles remain to implementing policy: many agencies have concerns about going tobacco-free. But significant progress has been made, as evidenced by new policies and a growing number of tobacco-free coalitions consisting of public health agencies, behavioral health care agencies, and local hospitals. PMID:25654218

  17. Collaboration With Behavioral Health Care Facilities to Implement Systemwide Tobacco Control Policies — California, 2012

    PubMed Central

    Gordon, Lauren; Modayil, Mary V.; Pavlik, Jim

    2015-01-01

    The California Tobacco Control Program (CTCP) administered 4 regional trainings in 2012 to staffers at CTCP-funded projects, tobacco control coalitions, several county departments of mental health and alcohol and drug, and administrators and providers from behavioral health care facilities. These trainings focused on the special tobacco use cessation needs and opportunities for cessation among persons with mental illness or substance abuse disorders, and they provided information about cessation and smoke-free policies. CTCP surveyed county and private behavioral health care programs to assess their readiness for adopting tobacco control strategies at treatment facilities. Between baseline and follow-up we found a decrease in the proportion of organizations at the precontemplation or contemplation stages of change and twice as many organizations at the action and maintenance stages of change. Significant obstacles remain to implementing policy: many agencies have concerns about going tobacco-free. But significant progress has been made, as evidenced by new policies and a growing number of tobacco-free coalitions consisting of public health agencies, behavioral health care agencies, and local hospitals. PMID:25654218

  18. Facilities

    NASA Technical Reports Server (NTRS)

    1999-01-01

    An expansion of medical data collection facilities was necessary to implement the Extended Duration Orbiter Medical Project (EDOMP). The primary objective of the EDOMP was to ensure the capability of crew members to reenter the Earth's atmosphere, land, and egress safely following a 16-day flight. Therefore, access to crew members as soon as possible after landing was crucial for most data collection activities. Also, with the advent of EDOMP, the quantity of investigations increased such that the landing day maximum data collection time increased accordingly from two hours to four hours. The preflight and postflight testing facilities at the Johnson Space Center (JSC) required only some additional testing equipment and minor modifications to the existing laboratories in order to fulfill EDOMP requirements. Necessary modifications at the landing sites were much more extensive.

  19. Patient satisfaction in government health facilities in the state of Qatar.

    PubMed

    Abdal Kareem, A; Aday, L A; Walker, G M

    1996-10-01

    There is an increasing interest in assessing patients' satisfaction with medical care in the United States and other countries. Patient satisfaction studies have, however, received comparatively little attention in public or government-sponsored settings, and in developing countries in particular. The research reported upon here is based on a mail, self-administered survey of patients receiving care in two major government outpatient health care facilities-Hamad General Hospital and the Khalifa Town Health Center-in the State of Qatar, for the purpose of providing data to improve service delivery and the quality of primary care provided in that country. Analysis was performed on data from 444 patients on seven dimensions of patient satisfaction with medical care: general satisfaction, availability of services, convenience of services, facilities (physical environment), humaneness of doctors, quality of care, and continuity of care. The study pointed to a number of deficiencies in the availability and delivery of services in government health facilities in the State of Qatar. It also surfaced methodological issues that should be addressed in comparable studies of culturally diverse populations. PMID:8894961

  20. Compliance with infection prevention and control in oral health-care facilities: a global perspective.

    PubMed

    Oosthuysen, Jeanné; Potgieter, Elsa; Fossey, Annabel

    2014-12-01

    Many publications are available on the topic of compliance with infection prevention and control in oral health-care facilities all over the world. The approaches of developing and developed countries show wide variation, but the principles of infection prevention and control are the same globally. This study is a systematic review and global perspective of the available literature on infection prevention and control in oral health-care facilities. Nine focus areas on compliance with infection-control measures were investigated: knowledge of infectious occupational hazards; personal hygiene and care of hands; correct application of personal protective equipment; use of environmental barriers and disposable items; sterilisation (recirculation) of instruments and handpieces; disinfection (surfaces) and housekeeping; management of waste disposal; quality control of dental unit waterlines, biofilms and water; and some special considerations. Various international studies from developed countries have reported highly scientific evidence-based information. In developed countries, the resources for infection prevention and control are freely available, which is not the case in developing countries. The studies in developing countries also indicate serious shortcomings with regard to infection prevention and control knowledge and education in oral health-care facilities. This review highlights the fact that availability of resources will always be a challenge, but more so in developing countries. This presents unique challenges and the opportunity for innovative thinking to promote infection prevention and control. PMID:25244364

  1. Have computers, will travel: providing on-site library instruction in rural health facilities using a portable computer lab.

    PubMed

    Neilson, Christine J

    2010-01-01

    The Saskatchewan Health Information Resources Partnership (SHIRP) provides library instruction to Saskatchewan's health care practitioners and students on placement in health care facilities as part of its mission to provide province-wide access to evidence-based health library resources. A portable computer lab was assembled in 2007 to provide hands-on training in rural health facilities that do not have computer labs of their own. Aside from some minor inconveniences, the introduction and operation of the portable lab has gone smoothly. The lab has been well received by SHIRP patrons and continues to be an essential part of SHIRP outreach. PMID:20391160

  2. 8. Photocopy of printed page (original Page 30 of the ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    8. Photocopy of printed page (original Page 30 of the Souvenir Program 1867-1967 Ridgely Centennial) Photographer unknown. Circa 1967. VIEW NORTHEAST, SOUTHWEST FRONT Ridgely's centennial was celebrated in 1967 and included in the souvenir brochure was page 30. This view shows the subject building with the 1950 modifications to provide for automotive traffic. It was a print of a current photograph. - 510 Central Avenue (Commercial Building), Ridgely, Caroline County, MD

  3. Physical Exposure to Seismic Hazards of Health Facilities in Mexico City, Mexico

    NASA Astrophysics Data System (ADS)

    Rodriguez, S. M.; Novelo Casanova, D.

    2010-12-01

    Although health facilities are essential infrastructure during disasters and emergencies, they are also usually highly vulnerable installations in the case of the occurrence of large and major earthquakes. Hospitals are one of the most complex critical facilities in modern cities and they are used as first response in emergency situations. The operability of a hospital must be maintained after the occurrence of a local strong earthquake in order to satisfy the need for medical care of the affected population. If a health facility is seriously damaged, it cannot fulfill its function when most is needed. In this case, hospitals become a casualty of the disaster. To identify the level of physical exposure of hospitals to seismic hazards in Mexico City, we analyzed their geographic location with respect to the seismic response of the different type of soils of the city from past earthquakes, mainly from the events that occurred on September 1985 (Ms= 8.0) and April 1989 (Ms= 6.9). Seismic wave amplification in this city is the result of the interaction of the incoming seismic waves with the soft and water saturated clay soils, on which a large part of Mexico City is built. The clay soils are remnants of the lake that existed in the Valley of Mexico and which has been drained gradually to accommodate the growing urban sprawl. Hospital facilities were converted from a simple database of names and locations into a map layer of resources. This resource layer was combined with other map layers showing areas of seismic microzonation in Mexico City. This overlay was then used to identify those hospitals that may be threatened by the occurrence of a large or major seismic event. We analyzed the public and private hospitals considered as main health facilities. Our results indicate that more than 50% of the hospitals are highly exposed to seismic hazards. Besides, in most of these health facilities we identified the lack of preventive measures and preparedness to reduce their vulnerability. For proper interpretation, our results are also presented in a Geographical Information System (GIS) that provides elements to support government plans to mitigate the impact of future earthquakes.

  4. A Healthy Investment: Building the Facilities to Train the Next Generation of Nursing and Allied Health Professionals

    ERIC Educational Resources Information Center

    Woods, Bob

    2013-01-01

    A growing number of community colleges are investing in new facilities and programs to train health care workers in a variety of professions, including nursing, radiology, health information technology, physical therapy, dentistry, and surgical technology. Community colleges have historically offered job training programs in health care, but with…

  5. A Healthy Investment: Building the Facilities to Train the Next Generation of Nursing and Allied Health Professionals

    ERIC Educational Resources Information Center

    Woods, Bob

    2013-01-01

    A growing number of community colleges are investing in new facilities and programs to train health care workers in a variety of professions, including nursing, radiology, health information technology, physical therapy, dentistry, and surgical technology. Community colleges have historically offered job training programs in health care, but with


  6. Social and cultural dimensions of hygiene in Cambodian health care facilities

    PubMed Central

    2011-01-01

    Background The frequency of bloodborne pathogen healthcare-associated infections is thought to be high in developing Southeast Asian Countries. The underlying social-cultural logics contributing to the risks of transmission are rarely studied. This report provides some insights on the social and cultural factors that shape hygiene practices in Cambodian health care settings. Methods We conducted qualitative surveys in various public and private health facilities in Phnom Penh, the capital city and in provinces. We observed and interviewed 319 participants, health care workers and patients, regarding hygiene practices and social relationships amongst the health care staff and with patients. We also examined the local perceptions of hygiene, their impact on the relationships between the health care staff and patients, and perceptions of transmission risks. Data collection stem from face to face semi-structured and open-ended interviews and focus group discussions with various health care staffs (i.e. cleaners, nurses, midwives and medical doctors) and with patients who attended the study health facilities. Results Overall responses and observations indicated that hygiene practices were burdened by the lack of adequate materials and equipements. In addition, many other factors were identified to influence and distort hygiene practices which include (1) informal and formal social rapports in hospitals, (2) major infection control roles played by the cleaners in absence of professional acknowledgment. Moreover, hygiene practices are commonly seen as an unessential matter to be devoted to low-ranking staff. Conclusion Our anthropological findings illustrate the importance of comprehensive understanding of hygiene practices; they need to be considered when designing interventions to improve infection control practices in a Cambodian medical setting. PMID:21294927

  7. FACTORS INFLUENCING THE CHOICE OF HEALTH CARE PROVIDING FACILITY AMONG WORKERS IN A LOCAL GOVERNMENT SECRETARIAT IN SOUTH WESTERN NIGERIA

    PubMed Central

    Uchendu, O.C.; Ilesanmi, O.S.; Olumide, A.E.

    2013-01-01

    Background: There is increasing interest in the choice of health care providing facility in Nigeria. Objectives: This study aimed to assess the factors influencing choice and satisfaction with health service providers among local government staff. Methods: A cross sectional survey of all 312 workers in a Local Government Secretariat in South West Nigeria was done. Chi Square and logistic regression analysis was done. Results: The mean age was 38.6 ± 7.5 years, 55% were females and 71.7% had tertiary education. The median monthly family income of the respondents was N 28, 000 (N3,000 – N500,000), with 24.4% earning a monthly income of N21, 000 to N30, 000. Many (72.3%) utilized public health facilities attributing the choice to the low cost of services. Respondents who are satisfied with their usual care providing facilities are 12.2 times more likely to have used public facilities than private facilities (95%, CI 3.431 – 43.114). Respondents who described the quality with ease of getting care/short waiting times as being good are 3.9 times more likely to have private facilities as their chosen health care providing facility (95%, CI 1.755 – 8.742). Cost/payment for service is 2.9 times more likely to predict the use of public health facility as the usual health care provider. Conclusion: Private facilities though costlier do not appear to be providing better services than public facilities. To increase access to health care the cost of services and the waiting time are important factors to address. PMID:25161426

  8. Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care facilities, 1994--CDC. Notice of final revisions to the "Guidelines for Preventing the Transmission of Mycobacterium Tuberculosis in health-care facilities, 1994".

    PubMed

    1994-10-28

    The purpose of this notice is to print the final "Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Facilities, 1994," and a summary of comments and responses to those comments. PMID:10137654

  9. A retrospective audit of antibiotic prescriptions in primary health-care facilities in Eastern Region, Ghana

    PubMed Central

    Ahiabu, Mary-Anne; TersbĂžl, Britt P; Biritwum, Richard; Bygbjerg, Ib C; Magnussen, Pascal

    2016-01-01

    Resistance to antibiotics is increasing globally and is a threat to public health. Research has demonstrated a correlation between antibiotic use and resistance development. Developing countries are the most affected by resistance because of high infectious disease burden, limited access to quality assured antibiotics and more optimal drugs and poor antibiotic use practices. The appropriate use of antibiotics to slow the pace of resistance development is crucial. The study retrospectively assessed antibiotic prescription practices in four public and private primary health-care facilities in Eastern Region, Ghana using the WHO/International Network for the Rational Use of Drugs rational drug use indicators. Using a systematic sampling procedure, 400 prescriptions were selected per facility for the period April 2010 to March 2011. Rational drug use indicators were assessed in the descriptive analysis and logistic regression was used to explore for predictors of antibiotic prescription. Average number of medicines prescribed per encounter was 4.01, and 59.9% of prescriptions had antibiotics whilst 24.2% had injections. In total, 79.2% and 88.1% of prescribed medicines were generics and from the national essential medicine list, respectively. In the multivariate analysis, health facility type (odds ratio [OR] = 2.05; 95% confidence interval [CI]: 1.42, 2.95), patient age (OR = 0.97; 95% CI: 0.97, 0.98), number of medicines on a prescription (OR = 1.85; 95% CI: 1.63, 2.10) and ‘no malaria drug’ on prescription (OR = 5.05; 95% CI: 2.08, 12.25) were associated with an antibiotic prescription. A diagnosis of upper respiratory tract infection was positively associated with antibiotic use. The level of antibiotic use varied depending on the health facility type and was generally high compared with the national average estimated in 2008. Interventions that reduce diagnostic uncertainty in illness management should be considered. The National Health Insurance Scheme, as the main purchaser of health services in Ghana, offers an opportunity that should be exploited to introduce policies in support of rational drug use. PMID:26045328

  10. A retrospective audit of antibiotic prescriptions in primary health-care facilities in Eastern Region, Ghana.

    PubMed

    Ahiabu, Mary-Anne; TersbĂžl, Britt P; Biritwum, Richard; Bygbjerg, Ib C; Magnussen, Pascal

    2016-03-01

    Resistance to antibiotics is increasing globally and is a threat to public health. Research has demonstrated a correlation between antibiotic use and resistance development. Developing countries are the most affected by resistance because of high infectious disease burden, limited access to quality assured antibiotics and more optimal drugs and poor antibiotic use practices. The appropriate use of antibiotics to slow the pace of resistance development is crucial. The study retrospectively assessed antibiotic prescription practices in four public and private primary health-care facilities in Eastern Region, Ghana using the WHO/International Network for the Rational Use of Drugs rational drug use indicators. Using a systematic sampling procedure, 400 prescriptions were selected per facility for the period April 2010 to March 2011. Rational drug use indicators were assessed in the descriptive analysis and logistic regression was used to explore for predictors of antibiotic prescription. Average number of medicines prescribed per encounter was 4.01, and 59.9% of prescriptions had antibiotics whilst 24.2% had injections. In total, 79.2% and 88.1% of prescribed medicines were generics and from the national essential medicine list, respectively. In the multivariate analysis, health facility type (odds ratio [OR] = 2.05; 95% confidence interval [CI]: 1.42, 2.95), patient age (OR = 0.97; 95% CI: 0.97, 0.98), number of medicines on a prescription (OR = 1.85; 95% CI: 1.63, 2.10) and 'no malaria drug' on prescription (OR = 5.05; 95% CI: 2.08, 12.25) were associated with an antibiotic prescription. A diagnosis of upper respiratory tract infection was positively associated with antibiotic use. The level of antibiotic use varied depending on the health facility type and was generally high compared with the national average estimated in 2008. Interventions that reduce diagnostic uncertainty in illness management should be considered. The National Health Insurance Scheme, as the main purchaser of health services in Ghana, offers an opportunity that should be exploited to introduce policies in support of rational drug use. PMID:26045328

  11. Competence of health care providers on care of newborns at birth in a level-1 health facility in Yaoundé, Cameroon

    PubMed Central

    Monebenimp, Francisca; Tenefopa, Makudjou; Mve Koh, Valere; Kago, Innocent

    2012-01-01

    Introduction This is an observational study which was carried out at a level one health facility in Yaoundé from June to July 2009. The aim was to evaluate the competence of health care providers towards newborns’ care at birth Methods Ten health care providers took care of three hundred and thirty-five pregnant women who were enrolled for the study after informed verbal consent in the delivery room. Results Out of 340 offspring delivered and taken care of, 179 (52.6%) were male and 161 (47.4%) were female. Only two out of ten health workers had a WHO Essential Newborn Care (ENC) training. None of them had received any refresher course for the past two years. The mean gestational age of women was 39.5±3.5 weeks. Resuscitation was carried out on 21 (6.2%) of the newborns including 7 (33.3%) who had birth asphyxia. Health care providers scored 100% in performing the following tasks: warming up the baby, applying eye drops, injecting vitamin K, identifying the neonate, searching for any apparent life threatening congenital malformations, preventing for infection after procedures and initiating breastfeeding. The score was 24% at neonatal resuscitation tasks. Low level of education was associated with poor competence on applying ENC tasks (p<0.001). Lack of WHO ENC training was associated with poor competence on ENC tasks (p<0.001) and poor skills on resuscitation (p=0.03). Conclusion There is a need to reinforce the capacity of health care providers by training in WHO ENC course with emphasis on providing skills on resuscitation in order to reduce the burden of neonatal intrapartum-related deaths. PMID:22593781

  12. DOE standard: Integration of environment, safety, and health into facility disposition activities. Volume 2: Appendices

    SciTech Connect

    1998-05-01

    This volume contains the appendices that provide additional environment, safety, and health (ES and H) information to complement Volume 1 of this Standard. Appendix A provides a set of candidate DOE ES and H directives and external regulations, organized by hazard types that may be used to identify potentially applicable directives to a specific facility disposition activity. Appendix B offers examples and lessons learned that illustrate implementation of ES and H approaches discussed in Section 3 of Volume 1. Appendix C contains ISMS performance expectations to guide a project team in developing and implementing an effective ISMS and in developing specific performance criteria for use in facility disposition. Appendix D provides guidance for identifying potential Applicable or Relevant and Appropriate Requirements (ARARs) when decommissioning facilities fall under the Comprehensive Environmental Response, Compensation, Liability Act (CERCLA) process. Appendix E discusses ES and H considerations for dispositioning facilities by privatization. Appendix F is an overview of the WSS process. Appendix G provides a copy of two DOE Office of Nuclear Safety Policy and Standards memoranda that form the bases for some of the guidance discussed within the Standard. Appendix H gives information on available hazard analysis techniques and references. Appendix I provides a supplemental discussion to Sections 3.3.4, Hazard Baseline Documentation, and 3.3.6, Environmental Permits. Appendix J presents a sample readiness evaluation checklist.

  13. Electronic health records use and barriers and benefits to use in skilled nursing facilities.

    PubMed

    Filipova, Anna A

    2013-07-01

    The purpose of this study was to determine the levels of automation for 21 clinical functions and the benefits and barriers to electronic health records use in skilled nursing facilities in one of the Midwestern states in the US. A cross-sectional design was implemented. Data were collected from nursing home administrators using a mail and online survey approach. A total of 156 usable questionnaires of 397 distributed were returned, for a 39.30% response rate. While many facilities reported fully automated Minimum Data Set assessments, licensed nurse clinical notes, and care plans, there remained a predominant reliance on paper for functions, such as diagnostic tests and consults. Although many facilities had advanced toward using automation to produce quality reports, they were lagging behind in the use of automated clinical decision support and summary reports. The top two barriers included the amount of capital needed and the cost for hardware and infrastructure. Facilities with paper records were more likely to identify those barriers for functions, such as clinical notes and assessments. The top three benefits were quality patient care monitoring, management control of performance, and anywhere/anytime easier access to clinical data. The study concludes with recommendations to nursing home leaders and other stakeholders. PMID:23774447

  14. Newborn care practices at home and in health facilities in 4 regions of Ethiopia

    PubMed Central

    2013-01-01

    Background Ethiopia is one of the ten countries with the highest number of neonatal deaths globally, and only 1 in 10 women deliver with a skilled attendant. Promotion of essential newborn care practices is one strategy for improving newborn health outcomes that can be delivered in communities as well as facilities. This article describes newborn care practices reported by recently-delivered women (RDWs) in four regions of Ethiopia. Methods We conducted a household survey with two-stage cluster sampling to assess newborn care practices among women who delivered a live baby in the period 1 to 7 months prior to data collection. Results The majority of women made one antenatal care (ANC) visit to a health facility, although less than half made four or more visits and women were most likely to deliver their babies at home. About one-fifth of RDWs in this survey had contact with Health Extension Workers (HEWS) during ANC, but nurse/midwives were the most common providers, and few women had postnatal contact with any health provider. Common beneficial newborn care practices included exclusive breastfeeding (87.6%), wrapping the baby before delivery of the placenta (82.3%), and dry cord care (65.2%). Practices contrary to WHO recommendations that were reported in this population of recent mothers include bathing during the first 24 hours of life (74.7%), application of butter and other substances to the cord (19.9%), and discarding of colostrum milk (44.5%). The results suggest that there are not large differences for most essential newborn care indicators between facility and home deliveries, with the exception of delayed bathing and skin-to-skin care. Conclusions Improving newborn care and newborn health outcomes in Ethiopia will likely require a multifaceted approach. Given low facility delivery rates, community-based promotion of preventive newborn care practices, which has been effective in other settings, is an important strategy. For this strategy to be successful, the coverage of counseling delivered by HEWs and other community volunteers should be increased. PMID:24289501

  15. RADIOFREQUENCY RADIATION EXPOSURE FACILITIES FOR BIO-EFFECTS RESEARCH AT THE HEALTH EFFECTS RESEARCH LABORATORY, RESEARCH TRIANGLE PARK, NORTH CAROLINA

    EPA Science Inventory

    The report describes the multi-user radiofrequency radiation exposure facilities for bio-effects research in use at the Health Effects Research Laboratory, Research Triangle Park, NC. Four facilities are described: (1) a 100 MHz CW exposure system, (2) a 2450 MHz CW exposure syst...

  16. Drug utilization in selected health facilities of South West Shoa Zone, Oromia Region, Ethiopia

    PubMed Central

    Kebede, Mengistu; Kebebe Borga, Dereje; Mulisa Bobasa, Eshetu

    2015-01-01

    Background Sustaining the availability and rational use of safe and effective drugs is a major problem in developing countries. Irrational drug use affects quality of health care more than accessibility of drugs. Objective To assess drug utilization in selected health facilities of South West Shoa Zone, Oromia Region, Ethiopia. Methods A cross-sectional study was conducted in selected health facilities of South West Shoa Zone from January 21–28, 2012 by using structured questionnaires. Results Of 50 prescribers and 30 dispensers, 58% and 83.3% were males, respectively. The result showed that majority of prescribers agreed on availability of essential drugs (72%) and had access to up-to-date drug information (76%). However, 43.3% of dispensers didn’t get access to up-to-date drug information. 86% and 88% of prescribers note cost of drugs and stick to standard treatment guidelines of Ethiopia during prescription, respectively. All drug dispensers check the name of the drug (100%), age of the patient (90%), the dosage form of drug (96.7%), the route of administration (90%), the duration of therapy (86.7%), and frequency of administration (86.7%) for prescription papers. Conclusion In general, drug utilization at the study sites was found to be good, although there are major deviations from the concept of rational drug use. PMID:26229506

  17. Parents' Yellow Pages.

    ERIC Educational Resources Information Center

    Caplan, Frank, Ed.

    This directory, compiled by the Princeton Center for Infancy, inventories a wide variety of organizations and services which parents can utilize in child rearing. More than 130 topics are discussed, including problems relating to health, daily routines, illness, family life, discipline, socialization, environment planning, education, family…

  18. Using geographical information systems for defining the accessibility to health care facilities in Jeddah City, Saudi Arabia.

    PubMed

    Murad, Abdulkader A

    2014-01-01

    Spatial data play an important role in the planning of health care facilities and their allocation. Today, geographical information systems (GIS) provide useful techniques for capturing, maintaining and analysing health care spatial data; indeed health geoinformatics is an emerging discipline that uses innovative geospatial technology to investigate health issues. The purpose of this paper is to define how GIS can be used for assessing the level of accessibility to health care. The paper identifies the advantages of using GIS in health care planning and covers GIS-based international accessibility with a focus on GIS applications for health care facilities in Jeddah city, Saudi Arabia. A geodatabase that includes location of health services, road networks, health care demand and population districts was created using ArcGIS software. The geodatabase produced is based on collected data and covers issues, such as defining the spatial distribution of health care facilities, evaluating health demand types and modelling health service areas based on analysis of driving-time and straight-line distances. PMID:25599637

  19. Reese Sorenson's Individual Professional Page

    NASA Technical Reports Server (NTRS)

    Sorenson, Reese; Nixon, David (Technical Monitor)

    1998-01-01

    The subject document is a World Wide Web (WWW) page entitled, "Reese Sorenson's Individual Professional Page." Its can be accessed at "http://george.arc.nasa.gov/sorenson/personal/index.html". The purpose of this page is to make the reader aware of me, who I am, and what I do. It lists my work assignments, my computer experience, my place in the NASA hierarchy, publications by me, awards received by me, my education, and how to contact me. Writing this page was a learning experience, pursuant to an element in my Job Description which calls for me to be able to use the latest computers. This web page contains very little technical information, none of which is classified or sensitive.

  20. Factors determining intention to quit tobacco: exploring patient responses visiting public health facilities in India

    PubMed Central

    2014-01-01

    Introduction Intention to quit and setting a quit date are key steps in the process towards improving quit rates and are thus an integral part of tobacco cessation efforts. The present study examined various motivating factors of “intention to quit” and “setting a quit date” in patients visiting public health facilities in two states of India. Methods A total of 1569 tobacco-users visiting public health facilities in 12 districts of the states of Andhra Pradesh and Gujarat were assessed through an interviewer-administered questionnaire. Bivariate and multivariable logistic regression was performed to assess the effect of socio-demographic characteristics, nicotine dependence, previous quit attempts and motivational factors on “intention to quit within 30 days” and “setting a quit date”. Results Only 12% of patients intended to quit tobacco within 30 days and about 11% of them were ready to set a quit date. Respondents aged above 25 years were 53% less likely to quit tobacco within 30 days when compared to those below 25 years (95% Confidence Intervals [CI]: 0.22 to 0.99). Smokeless tobacco users were associated with an odds ratio (OR) of 2.05 (95% CI: 1.15 to 3.65) for “setting a quit date” when compared to smokers. Those with 1 to 5 previous quit attempts (in the past twelve months) were associated with an OR of 2.2 (95% CI: 1.38 to 3.51) for “intention to quit” and 2.46 (95% CI: 1.52 to 3.96) for “setting a quit date”. “Concern for personal health” and “setting an example for children” were associated with ORs of 3.42 (95% CI: 1.35 to 8.65) and 2.5 (95% CI: 1.03 to 6.03) respectively for “setting a quit date”. Conclusions This study is amongst the first in India to explore factors associated with the “intention to quit” and “setting a quit date” among patients visiting public health facilities. Our findings suggest that socio-economic and individual-level factors are important factors depicting intention to quit and setting a quit date. We recommend the need for well-defined studies to understand the long term effects of factors influencing tobacco cessation for patients visiting public health facilities in India. PMID:24444137

  1. An assessment of clinical chemical sensing technology for potential use in space station health maintenance facility

    NASA Technical Reports Server (NTRS)

    1987-01-01

    A Health Maintenance Facility is currently under development for space station application which will provide capabilities equivalent to those found on Earth. This final report addresses the study of alternate means of diagnosis and evaluation of impaired tissue perfusion in a microgravity environment. Chemical data variables related to the dysfunction and the sensors required to measure these variables are reviewed. A technology survey outlines the ability of existing systems to meet these requirements. How the candidate sensing system was subjected to rigorous testing is explored to determine its suitability. Recommendations for follow-on activities are included that would make the commercial system more appropriate for space station applications.

  2. Why give birth in health facility? Users’ and providers’ accounts of poor quality of birth care in Tanzania

    PubMed Central

    2013-01-01

    Background In Tanzania, half of all pregnant women access a health facility for delivery. The proportion receiving skilled care at birth is even lower. In order to reduce maternal mortality and morbidity, the government has set out to increase health facility deliveries by skilled care. The aim of this study was to describe the weaknesses in the provision of acceptable and adequate quality care through the accounts of women who have suffered obstetric fistula, nurse-midwives at both BEmOC and CEmOC health facilities and local community members. Methods Semi-structured interviews involving 16 women affected by obstetric fistula and five nurse-midwives at maternity wards at both BEmOC and CEmOC health facilities, and Focus Group Discussions with husbands and community members were conducted between October 2008 and February 2010 at Comprehensive Community Based Rehabilitation in Tanzania and Temeke hospitals in Dar es Salaam, and Mpwapwa district in Dodoma region. Results Health care users and health providers experienced poor quality caring and working environments in the health facilities. Women in labour lacked support, experienced neglect, as well as physical and verbal abuse. Nurse-midwives lacked supportive supervision, supplies and also seemed to lack motivation. Conclusions There was a consensus among women who have suffered serious birth injuries and nurse midwives staffing both BEmOC and CEmOC maternity wards that the quality of care offered to women in birth was inadequate. While the birth accounts of women pointed to failure of care, the nurses described a situation of disempowerment. The bad birth care experiences of women undermine the reputation of the health care system, lower community expectations of facility birth, and sustain high rates of home deliveries. The only way to increase the rate of skilled attendance at birth in the current Tanzanian context is to make facility birth a safer alternative than home birth. The findings from this study indicate that there is a long way to go. PMID:23663299

  3. The effect of distance to formal health facility on childhood mortality in rural Tanzania, 2005–2007

    PubMed Central

    Kadobera, Daniel; Sartorius, Benn; Masanja, Honorati; Mathew, Alexander; Waiswa, Peter

    2012-01-01

    Background Major improvements are required in the coverage and quality of essential childhood interventions to achieve Millennium Development Goal Four (MDG 4). Long distance to health facilities is one of the known barriers to access. We investigated the effect of networked and Euclidean distances from home to formal health facilities on childhood mortality in rural Tanzania between 2005 and 2007. Methods A secondary analysis of data from a cohort of 28,823 children younger than age 5 between 2005 and 2007 from Ifakara Health and Demographic Surveillance System was carried out. Both Euclidean and networked distances from the household to the nearest health facility were calculated using geographical information system methods. Cox proportional hazard regression models were used to investigate the effect of distance from home to the nearest health facility on child mortality. Results Children who lived in homes with networked distance >5 km experienced approximately 17% increased mortality risk (HR=1.17; 95% CI 1.02–1.38) compared to those who lived <5 km networked distance to the nearest health facility. Death of a mother (HR=5.87; 95% CI 4.11–8.40), death of preceding sibling (HR=1.9; 95% CI 1.37–2.65), and twin birth (HR=2.9; 95% CI 2.27–3.74) were the strongest independent predictors of child mortality. Conclusions Physical access to health facilities is a determinant of child mortality in rural Tanzania. Innovations to improve access to health facilities coupled with birth spacing and care at birth are needed to reduce child deaths in rural Tanzania. PMID:23151364

  4. 77 FR 1495 - Criteria for Determining Priorities Among Correctional Facility Health Professional Shortage Areas

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-10

    ... shortages. This notice sets forth revised criteria for determining correctional facility HPSA scores. DATES... relative shortage. Correctional Facility HPSA Scores Correctional facility HPSA scores are currently... relative geographic HPSA score. The table below defines the points correctional facilities will...

  5. Capacity of Health Facilities to Manage Hypertension in Mukono and Buikwe Districts in Uganda: Challenges and Recommendations

    PubMed Central

    Musinguzi, Geofrey; Bastiaens, Hilde; Wanyenze, Rhoda K.; Mukose, Aggrey; Van geertruyden, Jean-Pierre; Nuwaha, Fred

    2015-01-01

    Background The burden of chronic diseases is increasing in both low- and middle-income countries. However, healthcare systems in low-income countries are inadequately equipped to deal with the growing disease burden, which requires chronic care for patients. The aim of this study was to assess the capacity of health facilities to manage hypertension in two districts in Uganda. Methods In a cross-sectional study conducted between June and October 2012, we surveyed 126 health facilities (6 hospitals, 4 Health Center IV (HCIV), 23 Health Center III (HCIII), 41 Health Center II (HCII) and 52 private clinics/dispensaries) in Mukono and Buikwe districts in Uganda. We assessed records, conducted structured interviews with heads of facilities, and administered questionnaires to 271 health workers. The study assessed service provision for hypertension, availability of supplies such as medicines, guidelines and equipment, in-service training for hypertension, knowledge of hypertension management, challenges and recommendations. Results Of the 126 health facilities, 92.9% reported managing (diagnosing/treating) patients with hypertension, and most (80.2%) were run by non-medical doctors or non-physician health workers (NPHW). Less than half (46%) of the facilities had guidelines for managing hypertension. A 10th of the facilities lacked functioning blood pressure devices and 28% did not have stethoscopes. No facilities ever calibrated their BP devices except one. About a half of the facilities had anti-hypertensive medicines in stock; mainly thiazide diuretics (46%), beta blockers (56%) and calcium channel blockers (48.4%). Alpha blockers, mixed alpha & beta blockers and angiotensin II receptor antagonists were only stocked by private clinics/dispensaries. Most HCIIs lacked anti-hypertensive medicines, including the first line thiazide diuretics. Significant knowledge gaps in classification of patients as hypertensive were noted among respondents. All health workers (except 5, 1.9%) indicated that they needed additional training in hypertension management. Several provider and patient related challenges were also observed in this study. Conclusions Health facilities in this setting are inadequately equipped to provide services for management of hypertension. Diagnostic equipment, anti-hypertensive drugs and personnel present great challenges. To address the increasing burden of hypertension and other chronic diseases, measures are needed to substantially strengthen the healthcare facilities, including training of personnel in management of hypertension and other chronic diseases, and improving diagnostic and treatment supplies. PMID:26560131

  6. Mapping the capacities of fixed health facilities to cover people at risk of gambiense human African trypanosomiasis

    PubMed Central

    2014-01-01

    Background The emphasis placed on the activities of mobile teams in the detection of gambiense human African trypanosomiasis (HAT) can at times obscure the major role played by fixed health facilities in HAT control and surveillance. The lack of consistent and detailed data on the coverage of passive case-finding and treatment further constrains our ability to appreciate the full contribution of the health system to the control of HAT. Methods A survey was made of all fixed health facilities that are active in the control and surveillance of gambiense HAT. Information on their diagnostic and treatment capabilities was collected, reviewed and harmonized. Health facilities were geo-referenced. Time-cost distance analysis was conducted to estimate physical accessibility and the potential coverage of the population at-risk of gambiense HAT. Results Information provided by the National Sleeping Sickness Control Programmes revealed the existence of 632 fixed health facilities that are active in the control and surveillance of gambiense HAT in endemic countries having reported cases or having conducted active screening activities during the period 2000-2012. Different types of diagnosis (clinical, serological, parasitological and disease staging) are available from 622 facilities. Treatment with pentamidine for first-stage disease is provided by 495 health facilities, while for second-stage disease various types of treatment are available in 206 health facilities only. Over 80% of the population at-risk for gambiense HAT lives within 5-hour travel of a fixed health facility offering diagnosis and treatment for the disease. Conclusions Fixed health facilities have played a crucial role in the diagnosis, treatment and coverage of at-risk-population for gambiense HAT. As the number of reported cases continues to dwindle, their role will become increasingly important for the prospects of disease elimination. Future updates of the database here presented will regularly provide evidence to inform and monitor a rational deployment of control and surveillance efforts. Support to the development and, if successful, the implementation of new control tools (e.g. new diagnostics and new drugs) is crucial, both for strengthening and expanding the existing network of fixed health facilities by improving access to diagnosis and treatment and for securing a sustainable control and surveillance of gambiense HAT. PMID:24517513

  7. Tracking implementation and (un)intended consequences: a process evaluation of an innovative peripheral health facility financing mechanism in Kenya.

    PubMed

    Waweru, Evelyn; Goodman, Catherine; Kedenge, Sarah; Tsofa, Benjamin; Molyneux, Sassy

    2016-03-01

    In many African countries, user fees have failed to achieve intended access and quality of care improvements. Subsequent user fee reduction or elimination policies have often been poorly planned, without alternative sources of income for facilities. We describe early implementation of an innovative national health financing intervention in Kenya; the health sector services fund (HSSF). In HSSF, central funds are credited directly into a facility's bank account quarterly, and facility funds are managed by health facility management committees (HFMCs) including community representatives. HSSF is therefore a finance mechanism with potential to increase access to funds for peripheral facilities, support user fee reduction and improve equity in access. We conducted a process evaluation of HSSF implementation based on a theory of change underpinning the intervention. Methods included interviews at national, district and facility levels, facility record reviews, a structured exit survey and a document review. We found impressive achievements: HSSF funds were reaching facilities; funds were being overseen and used in a way that strengthened transparency and community involvement; and health workers' motivation and patient satisfaction improved. Challenges or unintended outcomes included: complex and centralized accounting requirements undermining efficiency; interactions between HSSF and user fees leading to difficulties in accessing crucial user fee funds; and some relationship problems between key players. Although user fees charged had not increased, national reduction policies were still not being adhered to. Finance mechanisms can have a strong positive impact on peripheral facilities, and HFMCs can play a valuable role in managing facilities. Although fiduciary oversight is essential, mechanisms should allow for local decision-making and ensure that unmanageable paperwork is avoided. There are also limits to what can be achieved with relatively small funds in contexts of enormous need. Process evaluations tracking (un)intended consequences of interventions can contribute to regional financing and decentralization debates. PMID:25920355

  8. Trident Web page

    SciTech Connect

    Johnson, Randall P.; Fernandez, Juan C.

    2012-06-25

    An Extensive Diagnostic Suite Enables Cutting-edge Research at Trident The Trident Laser Facility at Los Alamos National Laboratory is an extremely versatile Nd:glass laser system dedicated to high energy density physics research and fundamental laser-matter interactions. Trident's Unique Laser Capabilities Provide an Ideal Platform for Many Experiments. The laser system consists of three high energy beams which can be delivered into two independent target experimental areas. The target areas are equipped with an extensive suite of diagnostics for research in ultra-intense laser matter interactions, dynamic material properties, and laser-plasma instabilities. Several important discoveries and first observations have been made at Trident including laser-accelerated MeV mono-energetic ions, nonlinear kinetic plasma waves, transition between kinetic and fluid nonlinear behavior, as well as other fundamental laser-matter interaction processes. Trident's unique long-pulse capabilities have enabled state-of-the-art innovations in laser-launched flyer-plates, and other unique loading techniques for material dynamics research.

  9. Utilisation of health services and geography: deconstructing regional differences in barriers to facility-based delivery in Nepal.

    PubMed

    Hodge, Andrew; Byrne, Abbey; Morgan, Alison; Jimenez-Soto, Eliana

    2015-03-01

    While established that geographical inaccessibility is a key barrier to the utilisation of health services, it remains unknown whether disparities are driven only by limited access to these services, or are also attributable to health behaviour. Significant disparities exist in health outcomes and the coverage of many critical health services between the mountains region of Nepal and the rest of the country, yet the principal factors driving these regional disparities are not well understood. Using national representative data from the 2011 Nepal Demographic and Health Survey, we examine the extent to which observable factors explain the overall differences in the utilisation of maternal health services. We apply nonlinear Blinder-Oaxaca-type decomposition methods to quantify the effect that differences in measurable characteristics have on the regional coverage gap in facility-based delivery. The mean coverage of facility-based deliveries was 18.6 and 36.3 % in the mountains region and the rest of Nepal, respectively. Between 54.8 and 74.1 % of the regional coverage gap was explained by differences in observed characteristics. Factors influencing health behaviours (proxied by mothers' education, TV viewership and tobacco use, and household wealth) and subjective distance to the health facility were the major factors, contributing between 52.9 and 62.5 % of the disparity. Mothers' birth history was also noteworthy. Policies simultaneously addressing access and health behaviours appear necessary to achieve greater coverage and better health outcomes for women and children in isolated areas. PMID:24927787

  10. Quality of newborn care: a health facility assessment in rural Ghana using survey, vignette and surveillance data

    PubMed Central

    Vesel, Linda; Manu, Alexander; Lohela, Terhi J; Gabrysch, Sabine; Okyere, Eunice; ten Asbroek, Augustinus H A; Hill, Zelee; Agyemang, Charlotte Tawiah; Owusu-Agyei, Seth; Kirkwood, Betty R

    2013-01-01

    Objective To assess the structural capacity for, and quality of, immediate and essential newborn care (ENC) in health facilities in rural Ghana, and to link this with demand for facility deliveries and admissions. Design Health facility assessment survey and population-based surveillance data. Setting Seven districts in Brong Ahafo Region, Ghana. Participants Heads of maternal/neonatal wards in all 64 facilities performing deliveries. Main outcome measures Indicators include: the availability of essential infrastructure, newborn equipment and drugs, and personnel; vignette scores and adequacy of reasons given for delayed discharge of newborn babies; and prevalence of key immediate ENC practices that facilities should promote. These are matched to the percentage of babies delivered in and admitted to each type of facility. Results 70% of babies were delivered in health facilities; 56% of these and 87% of neonatal admissions were in four referral level hospitals. These had adequate infrastructure, but all lacked staff trained in ENC and some essential equipment (including incubators and bag and masks) and/or drugs. Vignette scores for care of very low-birth-weight babies were generally moderate-to-high, but only three hospitals achieved high overall scores for quality of ENC. We estimate that only 33% of babies were born in facilities capable of providing high quality, basic resuscitation as assessed by a vignette plus the presence of a bag and mask. Promotion of immediate ENC practices in facilities was also inadequate, with coverage of early initiation of breastfeeding and delayed bathing both below 50% for babies born in facilities; this represents a lost opportunity. Conclusions Unless major gaps in ENC equipment, drugs, staff, practices and skills are addressed, strategies to increase facility utilisation will not achieve their potential to save newborn lives. Trial registration http://clinicaltrials.gov NCT00623337. PMID:23667161

  11. The impact of reducing financial barriers on utilisation of a primary health care facility in Rwanda.

    PubMed

    Dhillon, Ranu S; Bonds, Matthew H; Fraden, Max; Ndahiro, Donald; Ruxin, Josh

    2012-01-01

    This study investigates the impact of subsidising community-based health insurance (mutuelle) enrolment, removing point-of-service co-payments, and improving service delivery on health facility utilisation rates in Mayange, a sector of rural Rwanda of approximately 25,000 people divided among five 'imidugudu' or small villages. While comprehensive service upgrades were introduced in the Mayange Health Centre between April 2006 and February 2007, utilisation rates remained similar to comparison sites. Between February 2007 and April 2007, subsidies for mutuelle enrolment established virtually 100% coverage. Immediately after co-payments were eliminated in February 2007, patient visits levelled at a rate triple the previous value. Regression analyses using data from Mayange and two comparison sites indicate that removing financial barriers resulted in about 0.6 additional annual visits for curative care per capita. Although based on a single local pilot, these findings suggest that in order to achieve improved health outcomes, key short-term objectives include improved service delivery and reduced financial barriers. Based on this pilot, higher utilisation rates may be affected if broader swaths of the population are enrolled in mutuelle and co-payments are eliminated. Health leaders in Rwanda should consider further studies to determine if the impact of eliminating co-payments and increasing subsidies for mutuelle enrolment as seen in Mayange holds at greater levels of scale. Broader studies to better elucidate the impact of enrolment subsidies and co-payment subsidies on utilisation, health outcomes, and costs would also provide policy insights. PMID:21732708

  12. Reproductive rights denied: the Hyde Amendment and access to abortion for Native American women using Indian health service facilities.

    PubMed

    Arnold, Shaye Beverly

    2014-10-01

    Restrictions on the use of federal funds to provide abortions have limited the access to abortion services for Native American women receiving care at Indian Health Service facilities. Current data suggest that the vast majority of Indian Health Service facilities are unequipped to provide abortions under any circumstances. Native American women experience disproportionately high rates of sexual assault and unintended pregnancy. Hyde Amendment restrictions systematically infringe on the reproductive rights of Native American women and present a pressing public health policy concern. PMID:25122025

  13. PageRank of integers

    NASA Astrophysics Data System (ADS)

    Frahm, K. M.; Chepelianskii, A. D.; Shepelyansky, D. L.

    2012-10-01

    We up a directed network tracing links from a given integer to its divisors and analyze the properties of the Google matrix of this network. The PageRank vector of this matrix is computed numerically and it is shown that its probability is approximately inversely proportional to the PageRank index thus being similar to the Zipf law and the dependence established for the World Wide Web. The spectrum of the Google matrix of integers is characterized by a large gap and a relatively small number of nonzero eigenvalues. A simple semi-analytical expression for the PageRank of integers is derived that allows us to find this vector for matrices of billion size. This network provides a new PageRank order of integers.

  14. Code AI Personal Web Pages

    NASA Technical Reports Server (NTRS)

    Garcia, Joseph A.; Smith, Charles A. (Technical Monitor)

    1998-01-01

    The document consists of a publicly available web site (george.arc.nasa.gov) for Joseph A. Garcia's personal web pages in the AI division. Only general information will be posted and no technical material. All the information is unclassified.

  15. Tracking implementation and (un)intended consequences: a process evaluation of an innovative peripheral health facility financing mechanism in Kenya

    PubMed Central

    Waweru, Evelyn; Goodman, Catherine; Kedenge, Sarah; Tsofa, Benjamin; Molyneux, Sassy

    2016-01-01

    In many African countries, user fees have failed to achieve intended access and quality of care improvements. Subsequent user fee reduction or elimination policies have often been poorly planned, without alternative sources of income for facilities. We describe early implementation of an innovative national health financing intervention in Kenya; the health sector services fund (HSSF). In HSSF, central funds are credited directly into a facility’s bank account quarterly, and facility funds are managed by health facility management committees (HFMCs) including community representatives. HSSF is therefore a finance mechanism with potential to increase access to funds for peripheral facilities, support user fee reduction and improve equity in access. We conducted a process evaluation of HSSF implementation based on a theory of change underpinning the intervention. Methods included interviews at national, district and facility levels, facility record reviews, a structured exit survey and a document review. We found impressive achievements: HSSF funds were reaching facilities; funds were being overseen and used in a way that strengthened transparency and community involvement; and health workers’ motivation and patient satisfaction improved. Challenges or unintended outcomes included: complex and centralized accounting requirements undermining efficiency; interactions between HSSF and user fees leading to difficulties in accessing crucial user fee funds; and some relationship problems between key players. Although user fees charged had not increased, national reduction policies were still not being adhered to. Finance mechanisms can have a strong positive impact on peripheral facilities, and HFMCs can play a valuable role in managing facilities. Although fiduciary oversight is essential, mechanisms should allow for local decision-making and ensure that unmanageable paperwork is avoided. There are also limits to what can be achieved with relatively small funds in contexts of enormous need. Process evaluations tracking (un)intended consequences of interventions can contribute to regional financing and decentralization debates. PMID:25920355

  16. Comparison of Perceived and Technical Healthcare Quality in Primary Health Facilities: Implications for a Sustainable National Health Insurance Scheme in Ghana

    PubMed Central

    Alhassan, Robert Kaba; Duku, Stephen Opoku; Janssens, Wendy; Nketiah-Amponsah, Edward; Spieker, Nicole; van Ostenberg, Paul; Arhinful, Daniel Kojo; Pradhan, Menno; Rinke de Wit, Tobias F.

    2015-01-01

    Background Quality care in health facilities is critical for a sustainable health insurance system because of its influence on clients’ decisions to participate in health insurance and utilize health services. Exploration of the different dimensions of healthcare quality and their associations will help determine more effective quality improvement interventions and health insurance sustainability strategies, especially in resource constrained countries in Africa where universal access to good quality care remains a challenge. Purpose To examine the differences in perceptions of clients and health staff on quality healthcare and determine if these perceptions are associated with technical quality proxies in health facilities. Implications of the findings for a sustainable National Health Insurance Scheme (NHIS) in Ghana are also discussed. Methods This is a cross-sectional study in two southern regions in Ghana involving 64 primary health facilities: 1,903 households and 324 health staff. Data collection lasted from March to June, 2012. A Wilcoxon-Mann-Whitney test was performed to determine differences in client and health staff perceptions of quality healthcare. Spearman’s rank correlation test was used to ascertain associations between perceived and technical quality care proxies in health facilities, and ordered logistic regression employed to predict the determinants of client and staff-perceived quality healthcare. Results Negative association was found between technical quality and client-perceived quality care (coef. = -0.0991, p<0.0001). Significant staff-client perception differences were found in all healthcare quality proxies, suggesting some level of unbalanced commitment to quality improvement and potential information asymmetry between clients and service providers. Overall, the findings suggest that increased efforts towards technical quality care alone will not necessarily translate into better client-perceived quality care and willingness to utilize health services in NHIS-accredited health facilities. Conclusion There is the need to intensify client education and balanced commitment to technical and perceived quality improvement efforts. This will help enhance client confidence in Ghana’s healthcare system, stimulate active participation in the national health insurance, increase healthcare utilization and ultimately improve public health outcomes. PMID:26465935

  17. Building capacity in health facility management: guiding principles for skills transfer in Liberia

    PubMed Central

    2010-01-01

    Background Management training is fundamental to developing human resources for health. Particularly as Liberia revives its health delivery system, facility and county health team managers are central to progress. Nevertheless, such management skills are rarely prioritized in health training, and sustained capacity building in this area is limited. We describe a health management delivery program in which a north and south institution collaborated to integrate classroom and field-based training in health management and to transfer the capacity for sustained management development in Liberia. Methods We developed and implemented a 6-month training program in health management skills (i.e. strategic problem solving, financial management, human resource management and leadership) delivered by Yale University and Mother Patern College from Liberia, with support from the Clinton HIV/AIDS Initiative. Over three 6-month cycles, responsibility for course instruction was transferred from the north institution to the south institution. A self-administered survey was conducted of all participants completing the course to measure changes in self-rated management skills, the degree to which the course was helpful and met its stated objectives, and faculty members' responsiveness to participant needs as the transfer process occurred. Results Respondents (n = 93, response rate 95.9%) reported substantial improvement in self-reported management skills, and rated the helpfulness of the course and the degree to which the course met its objectives highly. Levels of improvement and course ratings were similar over the three cohorts as the course was transferred to the south institution. We suggest a framework of five elements for implementing successful management training programs that can be transferred and sustained in resource-limited settings, including: 1) use a short-course format focusing on four key skill areas with practical tools; 2) include didactic training, on-site projects, and on-site mentoring; 3) collaborate with an in-country academic institution, willing and able to scale-up and maintain the training; 4) provide training for the in-country academic faculty; and 5) secure Ministry-level support to ensure participation. Conclusion Our findings demonstrate key elements for scaling up and replicating educational initiatives that address management skills essential for long-term health systems strengthening in resource-poor settings. PMID:20298565

  18. Work-related health symptoms among compost facility workers: a cross-sectional study

    PubMed Central

    2012-01-01

    Background Industrial composting is a relatively new and expanding activity. Several studies indicate that compost workers are at risk to develop health symptoms. The aim of this study was to assess the prevalence of work-related health symptoms among compost workers compared with control subjects. Methods A questionnaire was distributed among 62 workers (31 exposed and 31 non-exposed workers). Data were analyzed using simple and multiple logistic regression analyses. Results Workers exposed to organic dust reported significantly more often respiratory, irritation (e.g., eyes, nose and throat), gastrointestinal, and skin symptoms than the non-exposed group. Moreover, all work-related symptoms were significantly more often reported by exposed than non-exposed workers. After adjustment for smoking status and age, the associations between exposure and respiratory, gastrointestinal, and skin symptoms remained statistically significant, in particular if these symptoms were work-related. Conclusions This study confirms that workers at compost facilities are at risk to develop occupational health problems, most likely related to organic dust exposure. PMID:22958275

  19. Applications of ultraviolet germicidal irradiation disinfection in health care facilities: effective adjunct, but not stand-alone technology.

    PubMed

    Memarzadeh, Farhad; Olmsted, Russell N; Bartley, Judene M

    2010-06-01

    This review evaluates the applicability and relative contribution of ultraviolet germicidal irradiation (UVGI) to disinfection of air in health care facilities. A section addressing the use of UVGI for environmental surfaces is also included. The germicidal susceptibility of biologic agents is addressed, but with emphasis on application in health care facilities. The balance of scientific evidence indicates that UVGI should be considered as a disinfection application in a health care setting only in conjunction with other well-established elements, such as appropriate heating, ventilating, and air-conditioning (HVAC) systems; dynamic removal of contaminants from the air; and preventive maintenance in combination with through cleaning of the care environment. We conclude that although UVGI is microbiocidal, it is not "ready for prime time" as a primary intervention to kill or inactivate infectious microorganisms; rather, it should be considered an adjunct. Other factors, such as careful design of the built environment, installation and effective operation of the HVAC system, and a high level of attention to traditional cleaning and disinfection, must be assessed before a health care facility can decide to rely solely on UVGI to meet indoor air quality requirements for health care facilities. More targeted and multiparameter studies are needed to evaluate the efficacy, safety, and incremental benefit of UVGI for mitigating reservoirs of microorganisms and ultimately preventing cross-transmission of pathogens that lead to health care-associated infections. PMID:20569852

  20. Environmental Management Waste Management Facility (EMWMF) Site-Specific Health and Safety Plan, Oak Ridge, Tennessee

    SciTech Connect

    Flynn, N.C. Bechtel Jacobs

    2008-04-21

    The Bechtel Jacobs Company LLC (BJC) policy is to provide a safe and healthy workplace for all employees and subcontractors. The implementation of this policy requires that operations of the Environmental Management Waste Management Facility (EMWMF), located one-half mile west of the U.S. Department of Energy (DOE) Y-12 National Security Complex, be guided by an overall plan and consistent proactive approach to environment, safety and health (ES&H) issues. The BJC governing document for worker safety and health, BJC/OR-1745, 'Worker Safety and Health Program', describes the key elements of the BJC Safety and Industrial Hygiene (IH) programs, which includes the requirement for development and implementation of a site-specific Health and Safety Plan (HASP) where required by regulation (refer also to BJC-EH-1012, 'Development and Approval of Safety and Health Plans'). BJC/OR-1745, 'Worker Safety and Health Program', implements the requirements for worker protection contained in Title 10 Code of Federal Regulations (CFR) Part 851. The EMWMF site-specific HASP requirements identifies safe operating procedures, work controls, personal protective equipment, roles and responsibilities, potential site hazards and control measures, site access requirements, frequency and types of monitoring, site work areas, decontamination procedures, and outlines emergency response actions. This HASP will be available on site for use by all workers, management and supervisors, oversight personnel and visitors. All EMWMF assigned personnel will be briefed on the contents of this HASP and will be required to follow the procedures and protocols as specified. The policies and procedures referenced in this HASP apply to all EMWMF operations activities. In addition the HASP establishes ES&H criteria for the day-to-day activities to prevent or minimize any adverse effect on the environment and personnel safety and health and to meet standards that define acceptable waste management practices. The HASP is written to make use of past experience and best management practices to eliminate or minimize hazards to workers or the environment from events such as fires, falls, mechanical hazards, or any unplanned release to the environment.

  1. Perceived barriers to utilizing maternal and neonatal health services in contracted-out versus government-managed health facilities in the rural districts of Pakistan

    PubMed Central

    Riaz, Atif; Zaidi, Shehla; Khowaja, Asif Raza

    2015-01-01

    Background: A number of developing countries have contracted out public health facilities to the Non-Government Organizations (NGOs) in order to improve service utilization. However, there is a paucity of in-depth qualitative information on barriers to access services as a result of contracting from service users’ perspective. The objective of this study was to explore perceived barriers to utilizing Maternal and Neonatal Health (MNH) services, in health facilities contracted out by government to NGO for service provision versus in those which are managed by government (non-contracted). Methods: A community-based qualitative exploratory study was conducted between April to September 2012 at two contracted-out and four matched non-contracted primary healthcare facilities in Thatta and Chitral, rural districts of Pakistan. Using semi-structured guide, the data were collected through thirty-six Focus Group Discussions (FGDs) conducted with mothers and their spouses in the catchment areas of selected facilities. Thematic analysis was performed using NVivo version 10.0 in which themes and sub-themes emerged. Results: Key barriers reported in contracted sites included physical distance, user charges and familial influences. Whereas, poor functionality of health centres was the main barrier for non-contracted sites with other issues being comparatively less salient. Decision-making patterns for participants of both catchments were largely similar. Spouses and mother-in-laws particularly influenced the decision to utilize health facilities. Conclusion: Contracting out of health facility reduces supply side barriers to MNH services for the community served but distance, user charges and low awareness remain significant barriers. Contracting needs to be accompanied by measures for transportation in remote settings, oversight on user fee charges by contractor, and strong community-based behavior change strategies. PMID:25905478

  2. Correlates of change in health care worker seasonal influenza vaccination rates among dialysis facilities.

    PubMed

    Lynch, Janet R; Armistead, Nancy; Vinson, Brandy B; Howard, Andrew D

    2015-04-01

    We conducted a campaign to increase seasonal influenza vaccination of dialysis health care workers (HCWs) in the District of Columbia, Maryland, Virginia, and West Virginia. Between the 2010-2011 and 2011-2012 influenza seasons we examined the correlates of change. HCW vaccination rates improved significantly (P < .01) from a mean ± standard deviation of 64.5 ± 27.4 to 72.7 ± 23.1. Evidence-based practices were in wide use and although we did not find an association between these and improvement, we did find that lower-performing facilities tended to improve more (P < .01) and there was a positive relationship between patient influenza vaccination rates and improvement in HCW rates (P < .01), with the mean ± standard deviation patient rate of 88.3 ± 7.9 exceeding the HCW rate during the 2011-2012 season (P < .01). PMID:25681300

  3. Evaluation of prototype air/fluid separator for Space Station Freedom Health Maintenance Facility

    NASA Technical Reports Server (NTRS)

    Billica, Roger; Smith, Maureen; Murphy, Linda; Kizzee, Victor D.

    1991-01-01

    A prototype air/fluid separator suction apparatus proposed as a possible design for use with the Health Maintenance Facility aboard Space Station Freedom (SSF) was evaluated. A KC-135 parabolic flight test was performed for this purpose. The flights followed the standard 40 parabola profile with 20 to 25 seconds of near-zero gravity in each parabola. A protocol was prepared to evaluate the prototype device in several regulator modes (or suction force), using three fluids of varying viscosity, and using either continuous or intermittent suction. It was felt that a matrixed approach would best approximate the range of utilization anticipated for medical suction on SSF. The protocols were performed in one-gravity in a lab setting to familiarize the team with procedures and techniques. Identical steps were performed aboard the KC-135 during parabolic flight.

  4. Delivering at home or in a health facility? health-seeking behaviour of women and the role of traditional birth attendants in Tanzania

    PubMed Central

    2013-01-01

    Background Traditional birth attendants retain an important role in reproductive and maternal health in Tanzania. The Tanzanian Government promotes TBAs in order to provide maternal and neonatal health counselling and initiating timely referral, however, their role officially does not include delivery attendance. Yet, experience illustrates that most TBAs still often handle complicated deliveries. Therefore, the objectives of this research were to describe (1) women’s health-seeking behaviour and experiences regarding their use of antenatal (ANC) and postnatal care (PNC); (2) their rationale behind the choice of place and delivery; and to learn (3) about the use of traditional practices and resources applied by traditional birth attendants (TBAs) and how they can be linked to the bio-medical health system. Methods Qualitative and quantitative interviews were conducted with over 270 individuals in Masasi District, Mtwara Region and Ilala Municipality, Dar es Salaam, Tanzania. Results The results from the urban site show that significant achievements have been made in terms of promoting pregnancy- and delivery-related services through skilled health workers. Pregnant women have a high level of awareness and clearly prefer to deliver at a health facility. The scenario is different in the rural site (Masasi District), where an adequately trained health workforce and well-equipped health facilities are not yet a reality, resulting in home deliveries with the assistance of either a TBA or a relative. Conclusions Instead of focusing on the traditional sector, it is argued that more attention should be paid towards (1) improving access to as well as strengthening the health system to guarantee delivery by skilled health personnel; and (2) bridging the gaps between communities and the formal health sector through community-based counselling and health education, which is provided by well-trained and supervised village health workers who inform villagers about promotive and preventive health services, including maternal and neonatal health. PMID:23448583

  5. Direct facility funding as a response to user fee reduction: implementation and perceived impact among Kenyan health centres and dispensaries.

    PubMed

    Opwora, Antony; Kabare, Margaret; Molyneux, Sassy; Goodman, Catherine

    2010-09-01

    There is increasing pressure for reduction of user fees, but this can have adverse effects by decreasing facility-level funds. To address this, direct facility funding (DFF) was piloted in Coast Province, Kenya, with health facility committees (HFCs) responsible for managing the funds. We evaluated the implementation and perceived impact 2.5 years after DFF introduction. Quantitative data collection at 30 public health centres and dispensaries included a structured interview with the in-charge, record reviews and exit interviews. In addition, in-depth interviews were conducted with the in-charge and HFC members at 12 facilities, and with district staff and other stakeholders. DFF procedures were well established: HFCs met regularly and accounting procedures were broadly followed. DFF made an important contribution to facility cash income, accounting for 47% in health centres and 62% in dispensaries. The main items of expenditure were wages for support staff (32%), travel (21%), and construction and maintenance (18%). DFF was perceived to have a highly positive impact through funding support staff such as cleaners and patient attendants, outreach activities, renovations, patient referrals and increasing HFC activity. This was perceived to have improved health worker motivation, utilization and quality of care. A number of problems were identified. HFC training was reportedly inadequate, and no DFF documentation was available at facility level, leading to confusion. Charging user fees above those specified in the national policy remained common, and understanding of DFF among the broader community was very limited. Finally, relationships between HFCs and health workers were sometimes characterized by mistrust and resentment. Relatively small increases in funding may significantly affect facility performance when the funds are managed at the periphery. Kenya plans to scale up DFF nationwide. Our findings indicate this is warranted, but should include improved training and documentation, greater emphasis on community engagement, and insistence on user fee adherence. PMID:20211967

  6. Direct facility funding as a response to user fee reduction: implementation and perceived impact among Kenyan health centres and dispensaries

    PubMed Central

    Opwora, Antony; Kabare, Margaret; Molyneux, Sassy; Goodman, Catherine

    2010-01-01

    There is increasing pressure for reduction of user fees, but this can have adverse effects by decreasing facility-level funds. To address this, direct facility funding (DFF) was piloted in Coast Province, Kenya, with health facility committees (HFCs) responsible for managing the funds. We evaluated the implementation and perceived impact 2.5 years after DFF introduction. Quantitative data collection at 30 public health centres and dispensaries included a structured interview with the in-charge, record reviews and exit interviews. In addition, in-depth interviews were conducted with the in-charge and HFC members at 12 facilities, and with district staff and other stakeholders. DFF procedures were well established: HFCs met regularly and accounting procedures were broadly followed. DFF made an important contribution to facility cash income, accounting for 47% in health centres and 62% in dispensaries. The main items of expenditure were wages for support staff (32%), travel (21%), and construction and maintenance (18%). DFF was perceived to have a highly positive impact through funding support staff such as cleaners and patient attendants, outreach activities, renovations, patient referrals and increasing HFC activity. This was perceived to have improved health worker motivation, utilization and quality of care. A number of problems were identified. HFC training was reportedly inadequate, and no DFF documentation was available at facility level, leading to confusion. Charging user fees above those specified in the national policy remained common, and understanding of DFF among the broader community was very limited. Finally, relationships between HFCs and health workers were sometimes characterized by mistrust and resentment. Relatively small increases in funding may significantly affect facility performance when the funds are managed at the periphery. Kenya plans to scale up DFF nationwide. Our findings indicate this is warranted, but should include improved training and documentation, greater emphasis on community engagement, and insistence on user fee adherence. PMID:20211967

  7. Status of the implementation of the World Health Organization multimodal hand hygiene strategy in United States of America health care facilities

    PubMed Central

    Allegranzi, Benedetta; Conway, Laurie; Larson, Elaine; Pittet, Didier

    2014-01-01

    Background The World Health Organization (WHO) launched a multimodal strategy and campaign in 2009 to improve hand hygiene practices worldwide. Our objective was to evaluate the implementation of the strategy in United States health care facilities. Methods From July through December 2011, US facilities participating in the WHO global campaign were invited to complete the Hand Hygiene Self-Assessment Framework online, a validated tool based on the WHO multimodal strategy. Results Of 2,238 invited facilities, 168 participated in the survey (7.5%). A detailed analysis of 129, mainly nonteaching public facilities (80.6%), showed that most had an advanced or intermediate level of hand hygiene implementation progress (48.9% and 45.0%, respectively). The total Hand Hygiene Self-Assessment Framework score was 36 points higher for facilities with staffing levels of infection preventionists > 0.75/100 beds than for those with lower ratios (P = .01) and 41 points higher for facilities participating in hand hygiene campaigns (P = .002). Conclusion Despite the low response rate, the survey results are unique and allow interesting reflections. Whereas the level of progress of most participating facilities was encouraging, this may reflect reporting bias, ie, better hospitals more likely to report. However, even in respondents, further improvement can be achieved, in particular by embedding hand hygiene in a stronger institutional safety climate and optimizing staffing levels dedicated to infection prevention. These results should encourage the launch of a coordinated national campaign and higher participation in the WHO global campaign. PMID:24581011

  8. Health hazard evaluation report HETA 98-0041-2741, San Francisco Municipal Railway, Flynn Facility, San Francisco, California

    SciTech Connect

    Blade, L.M.; Mortimer, V.D.

    1999-06-01

    The Director of Public Transportation for the City and County of San Francisco, California, requested that the National Institute of Occupational Safety and Health (NIOSHS) conduct a health hazard evaluation (HHE) at the San Francisco Municipal Railway's Flynn Facility. This facility serves as a base of operations for approximately 123 diesel-powered buses, leading to employee exposures to diesel-engine exhaust emissions in the workplace air. The requester, concerned about the potential adverse effects of these exposures on workers' health and about the apparent ineffectiveness of the facility's ventilation systems and other exposure-control measures, asked that NIOSH evaluate workplace exposures along with the ventilation system and other control measure and recommend appropriate improvements.

  9. Paediatric liver transplantation for children treated at public health facilities in South Africa: time for change.

    PubMed

    Lala, S G; Britz, R; Botha, J; Loveland, J

    2014-11-01

    Paediatric liver transplantation (PLT) is the only therapeutic option for many children with end-stage chronic liver disease or irreversible fulminant hepatic failure, and is routinely considered as a therapy by paediatric gastroenterologists and surgeons working in developed countries. In South Africa (SA), a PLT programme has been available at Red Cross War Memorial Children's Hospital in Cape Town since November 1991, and another has rapidly developed at the Wits Donald Gordon Medical Centre in Johannesburg over the past decade. However, for most children with progressive chronic liver disease who are reliant on the services provided at state facilities in SA, PLT is not an option because of a lack of resources in a mismanaged public health system. This article briefly outlines the services offered at Chris Hani Baragwanath Academic Hospital--which is typical of state facilities in SA--and proposes that resources be allocated to establish an innovative, nationally funded centre that would enable greater numbers of children access to a PLT programme. PMID:26038799

  10. Differential utilisation of health facilities and services for childbirth in Peninsula Malaysia--the ethnic factor.

    PubMed

    Arhsat, H; Tan Boon Ann; Tey Nai Peng

    1985-12-01

    The ethnic factor in the differential utilization of the health facilities in Peninsular Malaysia is examined. Data from the Malaysian Population and Family Survey 1984/85 show that about 45% of the births were delivered in the government hospitals, 15% in the private hospitals/clinics and the remaining 40% were delivered at home. Utilisation of these facilities varies greatly by ethnicity. The Malays have the greatest tendency to choose home delivery (60%), as opposed to institutional delivery (40%). Although urbanization and better socioeconomic conditions have led to an increase in institutional delivery, social customs continue to exert an influence on their behavior in favor of home delivery. Almost all Chinese babies are delivered in hospitals or clinics, with those from the higher social class showing a tendency to resort to the use of private hospitals/clinics for delivery. Indians were the most frequent users of government hospital across nearly all the social strata. While institutional deliveries were all attended by trained personnel, about 71% of the home deliveries were attended by government midwives and 24% by village midwives or other untrained persons, and only 5% were delivered by a doctor or a nurse. PMID:12314737

  11. DOE standard: Integration of environment, safety, and health into facility disposition activities. Volume 1: Technical standard

    SciTech Connect

    1998-05-01

    This Department of Energy (DOE) technical standard (referred to as the Standard) provides guidance for integrating and enhancing worker, public, and environmental protection during facility disposition activities. It provides environment, safety, and health (ES and H) guidance to supplement the project management requirements and associated guidelines contained within DOE O 430.1A, Life-Cycle Asset Management (LCAM), and amplified within the corresponding implementation guides. In addition, the Standard is designed to support an Integrated Safety Management System (ISMS), consistent with the guiding principles and core functions contained in DOE P 450.4, Safety Management System Policy, and discussed in DOE G 450.4-1, Integrated Safety Management System Guide. The ISMS guiding principles represent the fundamental policies that guide the safe accomplishment of work and include: (1) line management responsibility for safety; (2) clear roles and responsibilities; (3) competence commensurate with responsibilities; (4) balanced priorities; (5) identification of safety standards and requirements; (6) hazard controls tailored to work being performed; and (7) operations authorization. This Standard specifically addresses the implementation of the above ISMS principles four through seven, as applied to facility disposition activities.

  12. Evaluation of Spatial Relationships between Health and the Environment: The Rapid Inquiry Facility

    PubMed Central

    Beale, Linda; Hodgson, Susan; Abellan, Juan Jose; LeFevre, Sam; Jarup, Lars

    2010-01-01

    Background The initiation of environmental public health tracking systems in the United States and the United Kingdom provided an opportunity to advance techniques and tools available for spatial epidemiological analysis integrating both health and environmental data. Objective The Rapid Inquiry Facility (RIF) allows users to calculate adjusted and unadjusted standardized rates and risks. The RIF is embedded in ArcGIS so that further geographical information system (GIS) spatial functionality can be exploited or results can be exported to statistical packages for further tailored analyses where required. The RIF also links directly to several statistical packages and displays the results in the GIS. Methods The value of the RIF is illustrated here with two case studies: risk of leukemia in areas surrounding oil refineries in the State of Utah (USA) and an analysis of the geographical variation of risk of esophageal cancer in relation to zinc cadmium sulfide exposure in Norwich (United Kingdom). Results The risk analysis study in Utah did not suggest any evidence of increased relative risk of leukemia, multiple myeloma, or Hodgkin’s lymphoma in the populations around the five oil-refining facilities but did reveal an excess risk of non-Hodgkin’s lymphoma that might warrant further investigation. The disease-mapping study in Norwich did not reveal any areas with higher relative risks of esophageal cancer common to both males and females, suggesting that a common geographically determined exposure was unlikely to be influencing cancer risk in the area. Conclusion The RIF offers a tool that allows epidemiologists to quickly carry out ecological environmental epidemiological analysis such as risk assessment or disease mapping. PMID:20457552

  13. Piloting Laboratory Quality System Management in Six Health Facilities in Nigeria

    PubMed Central

    Mbah, Henry; Ojo, Emmanuel; Ameh, James; Musuluma, Humphrey; Negedu-Momoh, Olubunmi Ruth; Jegede, Feyisayo; Ojo, Olufunmilayo; Uwakwe, Nkem; Ochei, Kingsley; Dada, Michael; Udah, Donald; Chiegil, Robert; Torpey, Kwasi

    2014-01-01

    Background Achieving accreditation in laboratories is a challenge in Nigeria like in most African countries. Nigeria adopted the World Health Organization Regional Office for Africa Stepwise Laboratory (Quality) Improvement Process Towards Accreditation (WHO/AFRO– SLIPTA) in 2010. We report on FHI360 effort and progress in piloting WHO-AFRO recognition and accreditation preparedness in six health facility laboratories in five different states of Nigeria. Method Laboratory assessments were conducted at baseline, follow up and exit using the WHO/AFRO– SLIPTA checklist. From the total percentage score obtained, the quality status of laboratories were classified using a zero to five star rating, based on the WHO/AFRO quality improvement stepwise approach. Major interventions include advocacy, capacity building, mentorship and quality improvement projects. Results At baseline audit, two of the laboratories attained 1- star while the remaining four were at 0- star. At follow up audit one lab was at 1- star, two at 3-star and three at 4-star. At exit audit, four labs were at 4- star, one at 3-star and one at 2-star rating. One laboratory dropped a ‘star’ at exit audit, while others consistently improved. The two weakest elements at baseline; internal audit (4%) and occurrence/incidence management (15%) improved significantly, with an exit score of 76% and 81% respectively. The elements facility and safety was the major strength across board throughout the audit exercise. Conclusion This effort resulted in measurable and positive impact on the laboratories. We recommend further improvement towards a formal international accreditation status and scale up of WHO/AFRO– SLIPTA implementation in Nigeria. PMID:25542022

  14. Quality of care for under-fives in first-level health facilities in one district of Bangladesh.

    PubMed Central

    Arifeen, S. E.; Bryce, J.; Gouws, E.; Baqui, A. H.; Black, R. E.; Hoque, D. M. E.; Chowdhury, E. K.; Yunus, M.; Begum, N.; Akter, T.; Siddique, A.

    2005-01-01

    OBJECTIVE: The multi-country evaluation of Integrated Management of Childhood Illness (IMCI) effectiveness, cost and impact (MCE) is a global evaluation to determine the impact of IMCI on health outcomes and its cost-effectiveness. MCE studies are under way in Bangladesh, Brazil, Peru, Uganda and the United Republic of Tanzania. The objective of this analysis from the Bangladesh MCE study was to describe the quality of care delivered to sick children under 5 years old in first-level government health facilities, to inform government planning of child health programmes. METHODS: Generic MCE Health Facility Survey tools were adapted, translated and pre-tested. Medical doctors trained in IMCI and these tools conducted the survey in all 19 health facilities in the study areas. The data were collected using observations, exit interviews, inventories and interviews with facility providers. FINDINGS: Few of the sick children seeking care at these facilities were fully assessed or correctly treated, and almost none of their caregivers were advised on how to continue the care of the child at home. Over one-third of the sick children whose care was observed were managed by lower-level workers who were significantly more likely than higher-level workers to classify the sick child correctly and to provide correct information on home care to the caregiver. CONCLUSION: These results demonstrate an urgent need for interventions to improve the quality of care provided for sick children in first-level facilities in Bangladesh, and suggest that including lower-level workers as targets for IMCI case-management training may be beneficial. The findings suggest that the IMCI strategy offers a promising set of interventions to address the child health service problems in Bangladesh. PMID:15868016

  15. Observation of the extent of smoking in a mental health inpatient facility with a smoke-free policy

    PubMed Central

    2014-01-01

    Background People with a mental illness experience a higher burden of smoking-related disease. Smoke-free policies in mental health facilities provide an opportunity to reduce smoking-related harms for patients and staff alike. Limited evidence regarding the effect of such policies on preventing smoking in mental health facilities has been reported. The aims of this study are to describe the extent of smoking and the provision of nicotine replacement therapy (NRT) to patients in a mental health facility with a smoke-free policy. Methods Cross-sectional studies of smoking (cigarette butt count and observed smoking) and nicotine dependence treatment (patient record audit) were undertaken over 9 consecutive weekdays in one mental health facility in Australia. A smoke-free policy incorporating a total smoking ban and guidelines for treating nicotine dependence among patients was implemented in the facility 4 years prior to the study. Results Two thousand one hundred and thirty seven cigarette butts were collected and 152 occasions of people smoking were observed. Staff members were observed to enforce the policy on 66% of occasions. Use of NRT was recorded for 53% of patients who were smokers. Conclusion Implementation of the smoke-free policy was less than optimal and as a consequence ineffective in eliminating smoking and in optimising the provision of NRT. Additional strategies to improve the provision of nicotine dependence treatment to patients and the monitoring of adherence are needed to ensure the intended benefits of smoke-free policies are realised. PMID:24679109

  16. Health Service Areas used in SEER*Stat

    Cancer.gov

    Health Service AreaPage ofHealth Service Area (SEER 17)Page ofHealth Service Area (SEER 17 excl AK)Page ofHealth Service Area (SEER 13)Page ofHealth Service Area (SEER 9)Page ofHSA # (NCI Modified) Health Service Area (NCI Modified) Description State-county FIPS Butler,

  17. The Faculty Web Page: Contrivance or Continuation?

    ERIC Educational Resources Information Center

    Lennex, Lesia

    2007-01-01

    In an age of Internet education, what does it mean for a tenure/tenure-track faculty to have a web page? How many professors have web pages? If they have a page, what does it look like? Do they really need a web page at all? Many universities have faculty web pages. What do those collective pages look like? In what way do they represent the…

  18. Hepatitis B outbreak associated with a home health care agency serving multiple assisted living facilities in Texas, 2008-2010.

    PubMed

    Zheteyeva, Yenlik A; Tosh, Pritish; Patel, Priti R; Martinez, Diana; Kilborn, Cindy; Awosika-Olumo, Debo; Khuwaja, Salma; Ibrahim, Syed; Ryder, Anthony; Tohme, Rania A; Khudyakov, Yury; Thai, Hong; Drobeniuc, Jan; Heseltine, Gary; Guh, Alice Y

    2014-01-01

    We investigated a multifacility outbreak of acute hepatitis B virus infection involving 21 residents across 10 assisted living facilities in Texas during the period January 2008 through July 2010. Epidemiologic and laboratory data suggested that these infections belonged to a single outbreak. The only common exposure was receipt of assisted monitoring of blood glucose from the same home health care agency. Improved infection control oversight and training of assisted living facility and home health care agency personnel providing assisted monitoring of blood glucose is needed. PMID:24176604

  19. Expansion of health facilities in Iraq a decade after the US-led invasion, 2003–2012

    PubMed Central

    2014-01-01

    Background In the last few decades, Iraq’s health care capacity has been severely undermined by the effects of different wars, international sanctions, sectarian violence and political instability. In the aftermath of the 2003 US-led invasion, the Ministry of Health has set plans to expand health service delivery, by reorienting the public sector towards primary health care and attributing a larger role to the private sector for hospital care. Quantitative assessments of the post-2003 health policy outcomes have remained scant. This paper addresses this gap focusing on a key outcome indicator that is the expansion of health facilities. Methods The analysis is based on data on health facilities provided by the World Health Organisation and Iraq’s Ministry of Health. For each governorate, we calculated the change in the absolute number of facilities by type from early 2003 to the end of 2012. To account for population growth, we computed the change in the number of facilities per 100,000 population. We compared trends in the autonomous northern Kurdistan region, which has been relatively stable from 2003 onwards, and in the rest of Iraq (centre/south), where fragile institutions and persistent sectarian strife have posed major challenges to health system recovery. Results The countrywide number of primary health care centres per 100,000 population rose from 5.5 in 2003 to 7.4 in 2012. The extent of improvement varied significantly within the country, with an average increase of 4.3 primary health care centres per 100,000 population in the Kurdistan region versus an average increase of only 1.4 in central/southern Iraq. The average number of public hospitals per 100,000 population rose from 1.3 to 1.5 in Kurdistan, whereas it remained at 0.6 in centre/south. The average number of private hospitals per 100,000 population rose from 0.2 to 0.6 in Kurdistan, whereas it declined from 0.3 to 0.2 in centre/south. Conclusions The expansion of both public and private health facilities in the Kurdistan region appears encouraging, but still much should be done to reach the standards of neighbouring countries. The slow pace of improvement in the rest of Iraq is largely attributable to the dire security situation and should be a cause for major concern. PMID:25221620

  20. Health Facility Graduation from Donor-Supported Intensive Technical Assistance and Associated Factors in Zambia

    PubMed Central

    Koni, Phillip; Chishinga, Nathaniel; Nyirenda, Lameck; Kasonde, Prisca; Nsakanya, Richard; Welsh, Michael

    2015-01-01

    Introduction The FHI360-led Zambia Prevention Care and Treatment partnership II (ZPCT II) with funding from United States Agency for International Development, supports the Zambian Ministry of Health in scaling up HIV/AIDS services. To improve the quality of HIV/AIDS services, ZPCT II provides technical assistance until desired standards are met and districts are weaned-off intensive technical support, a process referred to as district graduation. This study describes the graduation process and determines performance domains associated with district graduation. Methods Data were collected from 275 health facilities in 39 districts in 5 provinces of Zambia between 2008 and 2012. Performance in technical capacity, commodity management, data management and human resources domains were assessed in the following services areas: HIV counselling and testing and prevention of mother to child transmission, antiretroviral therapy/clinical care, pharmacy and laboratory. The overall mean percentage score was calculated by obtaining the mean of mean percentage scores for the four domains. Logistic regression models were used to obtain odds ratios (OR) and 95% confidence intervals (CI) for the domain mean percentage scores in graduated versus non-graduated districts; according to rural-urban, and province strata. Results 24 districts out of 39 graduated from intensive donor supported technical assistance while 15 districts did not graduate. The overall mean percentage score for all four domains was statistically significantly higher in graduated than non-graduated districts (93.2% versus 91.2%, OR = 1.34, 95%CI:1.20–1.49); including rural settings (92.4% versus 89.4%, OR = 1.43,95%CI:1.24–1.65). The mean percentage score in human resource domain was statistically significantly higher in graduated than non-graduated districts (93.6% versus 71.6%, OR = 5.81, 95%CI: 4.29–7.86) and in both rural and urban settings. Conclusions QA/QI tools can be used to assess performance at health facilities and determine readiness for district graduation. Human resources management domain was found to be an important factor associated with district graduation. PMID:26098555

  1. Improving district facility readiness: a 12-month evaluation of a data-driven health systems strengthening intervention in rural Rwanda

    PubMed Central

    Iyer, Hari S.; Kamanzi, Emmanuel; Mugunga, Jean Claude; Finnegan, Karen; Uwingabiye, Alice; Shyaka, Edward; Niyonzima, Saleh; Hirschhorn, Lisa R.; Drobac, Peter C.

    2015-01-01

    Background While health systems strengthening (HSS) interventions are recommended by global health policy experts to improve population health in resource-limited settings, few examples exist of evaluations of HSS interventions conducted at the district level. In 2009, a partnership between Partners In Health (PIH), a non-governmental organization, and the Rwandan Ministry of Health (RMOH) was provided funds to implement and evaluate a district-level HSS intervention in two rural districts of Rwanda. Design The partnership provided limited funds to 14 health centers for targeted systems support in 2010; six others received support prior to the intervention (reference). RMOH health systems norms were mapped across the WHO HSS framework, scored from 0 to 10 and incorporated into a rapid survey assessing 11 domains of facility readiness. Stakeholder meetings allowed partnership leaders to review results, set priorities, and allocate resources. Investments included salary support, infrastructure improvements, medical equipment, and social support for patients. We compared facility domain scores from the start of the intervention to 12 months and tested for correlation between change in score and change in funding allocation to assess equity in our approach. Results We found significant improvements among intervention facilities from baseline to 12 months across several domains [infrastructure (+4, p=0.0001), clinical services (+1.2, p=0.03), infection and sanitation control (+0.6, p=0.03), medical equipment (+1.0, p=0.02), information use (+2, p=0.002)]. Composite score across domains improved from 6.2 at baseline to 7.4 at 12 months (p=0.002). Across facilities, 50% had composite scores greater than the average score among reference facilities (7.4) at 12 months compared to none at baseline. Conclusions Rapid facility surveys, stakeholder engagement, and information feedback can be used for gap analysis and resource allocation. This approach can achieve effective use of limited resources, improve facility readiness, and ensure consistency of facility capacity to provide quality care at the district level. PMID:26140729

  2. Developing a Performance Measurement Framework and Indicators for Community Health Service Facilities in Urban China

    PubMed Central

    2010-01-01

    Background China has had no effective and systematic information system to provide guidance for strengthening PHC (Primary Health Care) or account to citizens on progress. We report on the development of the China results-based Logic Model for Community Health Facilities and Stations (CHS) and a set of relevant PHC indicators intended to measure CHS priorities. Methods We adapted the PHC Results Based Logic Model developed in Canada and current work conducted in the community health system in China to create the China CHS Logic Model framework. We used a staged approach by first constructing the framework and indicators and then validating their content through an interactive process involving policy analysis, critical review of relevant literature and multiple stakeholder consultation. Results The China CHS Logic Model includes inputs, activities, outputs and outcomes with a total of 287 detailed performance indicators. In these indicators, 31 indicators measure inputs, 64 measure activities, 105 measure outputs, and 87 measure immediate (n = 65), intermediate (n = 15), or final (n = 7) outcomes. Conclusion A Logic Model framework can be useful in planning, implementation, analysis and evaluation of PHC at a system and service level. The development and content validation of the China CHS Logic Model and subsequent indicators provides a means for stronger accountability and a clearer sense of overall direction and purpose needed to renew and strengthen the PHC system in China. Moreover, this work will be useful in moving towards developing a PHC information system and performance measurement across districts in urban China, and guiding the pursuit of quality in PHC. PMID:21087516

  3. Maternal mortality in health institutions with emergency obstetric care facilities in Enugu State, Nigeria.

    PubMed

    Onah, H E; Okaro, J M; Umeh, U; Chigbu, C O

    2005-08-01

    In order to assess the current level of maternal mortality in health institutions with comprehensive emergency obstetric care in Enugu State, South Eastern Nigeria, a retrospective analysis of maternal deaths for the years 1999-2003 was carried out to establish the maternal mortality ratios in the eligible health institutions. Each maternal death was studied in detail to establish the socio-demographic characteristics of the women who died; their referral sources, type of delay (if any), medical causes of death and their preventability. In-depth interviews of the service providers were carried out to throw more light on the maternal mortality situation in the state. Five out of seven eligible health institutions were studied. Within the 5-year period (1999-2003), there were 141 maternal deaths and 18,257 live births giving a maternal mortality ratio of 772 maternal deaths per 100,000. The folders of 89 out of the 141 women who died were retrieved. Of these 89 maternal deaths, 51.7% of them were unemployed, 52.4% were referred from private hospitals; type 3 delay was the commonest type of delay encountered in the care of the women. Referral delay was the main cause of delay accounting for 46.4% of all cases of type 3 delay. The leading causes of maternal deaths among the women were obstetric haemorrhage (19.1%), sepsis (18.0%), prolonged obstructed labour/ruptured uterus (16.9%) and pre-eclampsia/eclampsia (16.9%). The in-depth interviews corroborated the high maternal mortality ratio recorded and the type 3 delays in tackling obstetric emergencies. It also showed some discrepancies between reality and the health providers' perception of the magnitude of maternal mortality situation in the state. It was concluded that in health institutions in Enugu State with comprehensive emergency obstetric care facilities, the maternal mortality ratio remains high due to type 3 delays. Most of the referrals come from private hospitals, hence the need to retrain the private practitioners in emergency obstetric care. PMID:16234142

  4. [A guide to good practice for information security in the handling of personal health data by health personnel in ambulatory care facilities].

    PubMed

    Sånchez-Henarejos, Ana; Fernåndez-Alemån, José Luis; Toval, Ambrosio; Hernåndez-Hernåndez, Isabel; Sånchez-García, Ana Belén; Carrillo de Gea, Juan Manuel

    2014-04-01

    The appearance of electronic health records has led to the need to strengthen the security of personal health data in order to ensure privacy. Despite the large number of technical security measures and recommendations that exist to protect the security of health data, there is an increase in violations of the privacy of patients' personal data in healthcare organizations, which is in many cases caused by the mistakes or oversights of healthcare professionals. In this paper, we present a guide to good practice for information security in the handling of personal health data by health personnel, drawn from recommendations, regulations and national and international standards. The material presented in this paper can be used in the security audit of health professionals, or as a part of continuing education programs in ambulatory care facilities. PMID:24582808

  5. Learning through Web Page Design.

    ERIC Educational Resources Information Center

    Peel, Deborah

    2001-01-01

    Describes and evaluates the use of Web page design in an undergraduate course in the United Kingdom on town planning. Highlights include incorporating information and communication technologies into higher education; and a theoretical framework for the use of educational technology. (LRW)

  6. Web Page Design (Part One).

    ERIC Educational Resources Information Center

    Descy, Don E.

    1997-01-01

    Discusses rules for Web page design: consider audiences' Internet skills and equipment; know your content; outline the material; map or sketch the site; be consistent; regulate size of graphics to control download time; place eye catching material in the first 300 pixels; moderate use of color to control file size and bandwidth; include a…

  7. A retrospective evaluation of the quality of malaria case management at twelve health facilities in four districts in Zambia

    PubMed Central

    Chanda-Kapata, Pascalina; Chanda, Emmanuel; Masaninga, Freddie; Habluetzel, Annette; Masiye, Felix; Fall, Ibrahima Soce

    2014-01-01

    Objective To establish the appropriateness of malaria case management at health facility level in four districts in Zambia. Methods This study was a retrospective evaluation of the quality of malaria case management at health facilities in four districts conveniently sampled to represent both urban and rural settings in different epidemiological zones and health facility coverage. The review period was from January to December 2008. The sample included twelve lower level health facilities from four districts. The Pearson Chi-square test was used to identify characteristics which affected the quality of case management. Results Out of 4?891 suspected malaria cases recorded at the 12 health facilities, more than 80% of the patients had a temperature taken to establish their fever status. About 67% (CI95 66.1-68.7) were tested for parasitemia by either rapid diagnostic test or microscopy, whereas the remaining 22.5% (CI95 21.3.1-23.7) were not subjected to any malaria test. Of the 2?247 malaria cases reported (complicated and uncomplicated), 71% were parasitologically confirmed while 29% were clinically diagnosed (unconfirmed). About 56% (CI95 53.9-58.1) of the malaria cases reported were treated with artemether-lumefantrine (AL), 35% (CI95 33.1-37.0) with sulphadoxine-pyrimethamine, 8% (CI95 6.9-9.2) with quinine and 1% did not receive any anti-malarial. Approximately 30% of patients WHO were found negative for malaria parasites were still prescribed an anti-malarial, contrary to the guidelines. There were marked inter-district variations in the proportion of patients in WHOm a diagnostic tool was used, and in the choice of anti-malarials for the treatment of malaria confirmed cases. Association between health worker characteristics and quality of case malaria management showed that nurses performed better than environmental health technicians and clinical officers on the decision whether to use the rapid diagnostic test or not. Gender, in service training on malaria, years of residence in the district and length of service of the health worker at the facility were not associated with diagnostic and treatment choices. Conclusions Malaria case management was characterised by poor adherence to treatment guidelines. The non-adherence was mainly in terms of: inconsistent use of confirmatory tests (rapid diagnostic test or microscopy) for malaria; prescribing anti-malarials which are not recommended (e.g. sulphadoxine-pyrimethamine) and prescribing anti-malarials to cases testing negative. Innovative approaches are required to improve health worker adherence to diagnosis and treatment guidelines. PMID:25182953

  8. Use of facility assessment data to improve reproductive health service delivery in the Democratic Republic of the Congo

    PubMed Central

    2009-01-01

    Background Prolonged exposure to war has severely impacted the provision of health services in the Democratic Republic of the Congo (DRC). Health infrastructure has been destroyed, health workers have fled and government support to health care services has been made difficult by ongoing conflict. Poor reproductive health (RH) indicators illustrate the effect that the prolonged crisis in DRC has had on the on the reproductive health (RH) of Congolese women. In 2007, with support from the RAISE Initiative, the International Rescue Committee (IRC) and CARE conducted baseline assessments of public hospitals to evaluate their capacities to meet the RH needs of the local populations and to determine availability, utilization and quality of RH services including emergency obstetric care (EmOC) and family planning (FP). Methods Data were collected from facility assessments at nine general referral hospitals in five provinces in the DRC during March, April and November 2007. Interviews, observation and clinical record review were used to assess the general infrastructure, EmOC and FP services provided, and the infection prevention environment in each of the facilities. Results None of the nine hospitals met the criteria for classification as an EmOC facility (either basic or comprehensive). Most facilities lacked any FP services. Shortage of trained staff, essential supplies and medicines and poor infection prevention practices were consistently documented. All facilities had poor systems for routine monitoring of RH services, especially with regard to EmOC. Conclusions Women's lives can be saved and their well-being improved with functioning RH services. As the DRC stabilizes, IRC and CARE in partnership with the local Ministry of Health and other service provision partners are improving RH services by: 1) providing necessary equipment and renovations to health facilities; 2) improving supply management systems; 3) providing comprehensive competency-based training for health providers in RH and infection prevention; 4) improving referral systems to the hospitals; 5) advocating for changes in national RH policies and protocols; and 6) providing technical assistance for monitoring and evaluation of key RH indicators. Together, these initiatives will improve the quality and accessibility of RH services in the DRC - services which are urgently needed and to which Congolese women are entitled by international human rights law. PMID:20025757

  9. European network for promoting the physical health of residents in psychiatric and social care facilities (HELPS): background, aims and methods

    PubMed Central

    Weiser, Prisca; Becker, Thomas; Losert, Carolin; Alptekin, Köksal; Berti, Loretta; Burti, Lorenzo; Burton, Alexandra; Dernovsek, Mojca; Dragomirecka, Eva; Freidl, Marion; Friedrich, Fabian; Genova, Aneta; Germanavicius, Arunas; Halis, UlaƟ; Henderson, John; Hjorth, Peter; Lai, Taavi; Larsen, Jens Ivar; Lech, Katarzyna; Lucas, Ramona; Marginean, Roxana; McDaid, David; Mladenova, Maya; Munk-JĂžrgensen, Povl; Paziuc, Alexandru; Paziuc, Petronela; Priebe, Stefan; Prot-Klinger, Katarzyna; Wancata, Johannes; Kilian, Reinhold

    2009-01-01

    Background People with mental disorders have a higher prevalence of physical illnesses and reduced life expectancy as compared with the general population. However, there is a lack of knowledge across Europe concerning interventions that aim at reducing somatic morbidity and excess mortality by promoting behaviour-based and/or environment-based interventions. Methods and design HELPS is an interdisciplinary European network that aims at (i) gathering relevant knowledge on physical illness in people with mental illness, (ii) identifying health promotion initiatives in European countries that meet country-specific needs, and (iii) at identifying best practice across Europe. Criteria for best practice will include evidence on the efficacy of physical health interventions and of their effectiveness in routine care, cost implications and feasibility for adaptation and implementation of interventions across different settings in Europe. HELPS will develop and implement a "physical health promotion toolkit". The toolkit will provide information to empower residents and staff to identify the most relevant risk factors in their specific context and to select the most appropriate action out of a range of defined health promoting interventions. The key methods are (a) stakeholder analysis, (b) international literature reviews, (c) Delphi rounds with experts from participating centres, and (d) focus groups with staff and residents of mental health care facilities. Meanwhile a multi-disciplinary network consisting of 15 European countries has been established and took up the work. As one main result of the project they expect that a widespread use of the HELPS toolkit could have a significant positive effect on the physical health status of residents of mental health and social care facilities, as well as to hold resonance for community dwelling people with mental health problems. Discussion A general strategy on health promotion for people with mental disorders must take into account behavioural, environmental and iatrogenic health risks. A European health promotion toolkit needs to consider heterogeneity of mental disorders, the multitude of physical health problems, health-relevant behaviour, health-related attitudes, health-relevant living conditions, and resource levels in mental health and social care facilities. PMID:19715560

  10. Linkage strategies of rural hospitals--independent hospital, local health system, and/or externally linked facility.

    PubMed

    Gamm, L D; Kassab, C D; Brannon, S D; Fennell, M L

    1996-01-01

    Strategies associated with ownership or management of a range of health service facilities, service sharing, and other coordination activities are important to the viability of many rural hospitals. This article articulates a set of linkage strategies employed by rural hospitals. Such strategies and their environmental and organizational correlates are assessed in a sample of 46 rural Pennsylvania hospitals. PMID:10157965

  11. Draft Genome Sequences of Four NDM-1-Producing Klebsiella pneumoniae Strains from a Health Care Facility in Northern California

    PubMed Central

    Greninger, Alexander L.; Chorny, Ilya; Knowles, Susan; Ng, Valerie L.

    2015-01-01

    We report the draft genome sequences of Klebsiella pneumoniae strains from four patients at a northern California health care facility. All strains contained the New Delhi metallo-?-lactamase (NDM1) carbapenemase with extended antibiotic resistance, including resistance to expanded-spectrum cephalosporins, imipenem, ertapenem, and meropenem. NDM gene alignments revealed that the resistance was plasmid encoded. PMID:25977423

  12. Factors associated with health facility childbirth in districts of Kenya, Tanzania and Zambia: a population based survey

    PubMed Central

    2014-01-01

    Background Maternal mortality continues to be a heavy burden in low and middle income countries where half of all deliveries take place in homes without skilled attendance. The study aimed to investigate the underlying and proximate determinants of health facility childbirth in rural and urban areas of three districts in Kenya, Tanzania and Zambia. Methods A population-based survey was conducted in 2007 as part of the ‘REsponse to ACcountable priority setting for Trust in health systems’ (REACT) project. Stratified random cluster sampling was used and the data included information on place of delivery and factors that might influence health care seeking behaviour. A total of 1800 women who had childbirth in the previous five years were analysed. The distal and proximate conceptual framework for analysing determinants of maternal mortality was modified for studying factors associated with place of delivery. Socioeconomic position was measured by employing a construct of educational attainment and wealth index. All analyses were stratified by district and urban–rural residence. Results There were substantial inter-district differences in proportion of health facility childbirth. Facility childbirth was 15, 70 and 37% in the rural areas of Malindi, Mbarali and Kapiri Mposhi respectively, and 57, 75 and 77% in the urban areas of the districts respectively. However, striking socio-economic inequities were revealed regardless of district. Furthermore, there were indications that repeated exposure to ANC services and HIV related counselling and testing were positively associated with health facility deliveries. Perceived distance was negatively associated with facility childbirth in rural areas of Malindi and urban areas of Kapiri Mposhi. Conclusion Strong socio-economic inequities in the likelihood of facility childbirths were revealed in all the districts added to geographic inequities in two of the three districts. This strongly suggests an urgent need to strengthen services targeting disadvantaged and remote populations. The finding of a positive association between HIV counselling/testing and odds in favor of giving birth at a health facility suggests potential positive effects can be achieved by strengthening integrated approaches in maternal health service delivery. PMID:24996456

  13. 24 CFR 1710.105 - Cover page.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 5 2011-04-01 2011-04-01 false Cover page. 1710.105 Section 1710... Cover page. The cover page of the Property Report shall be prepared in accordance with the following...: READ THIS PROPERTY REPORT BEFORE SIGNING ANYTHING (c) The remainder of the page shall contain...

  14. Tuberculosis Laboratory Diagnosis Quality Assurance among Public Health Facilities in West Amhara Region, Ethiopia

    PubMed Central

    Shiferaw, Melashu Balew; Hailu, Hiwot Amare; Fola, Abebe Alemu; Derebe, Mulatu Melese; Kebede, Aimro Tadese; Kebede, Abayneh Admas; Emiru, Manamnot Agegne; Gelaw, Zelalem Dessie

    2015-01-01

    Introduction Reliable smear microscopy is an important component of Directly Observed Treatment Scheme (DOTS) strategy for TB control program in countries with limited resources. Despite external quality assessment is established in Ethiopia, there is lower TB detection rate (48%) in Amhara region compared to the World Health Organization (WHO) estimate (70%). This highlights the quality of smear microscopy needs to be evaluated. Therefore, the aim of this study was to assess the quality of sputum smear microscopy performance among health center laboratories in West Amhara region, Ethiopia. Materials and Methods A cross sectional study was conducted from July 08, 2013 to July 07, 2014. Data were collected from 201 public health center laboratories using a structured questionnaire. Slides were collected based on Lot Quality Assurance Sampling (LQAS) method and rechecked blindly by trained laboratory technologists. The data were entered into EPI info V.7 and smear quality indicators and AFB results were analyzed by SPSS version 20. Results Among 201 laboratories enrolled in this study, 47 (23.4%) laboratories had major errors. Forty one (20.4%) laboratories had a total of 67 false negative and 29 (14.4%) laboratories had a total of 68 false positive results. Specimen quality, smear thickness and evenness were found poor in 134 (66.7%), 133 (66.2%) and 126 (62.7%) laboratories, respectively. Unavailability of microscope lens cleaning solution (AOR: 2.90; 95% CI: 1.25–6.75; P: 0.013) and dirty smears (AOR: 2.65; 95% CI: 1.14–6.18; P: 0.024) were correlated with false negative results whereas no previous EQA participation (AOR: 3.43; 95% CI: 1. 39-8.45; P: 0.007) was associated with false positive results. Conclusion The performance of health facilities for sputum smear microscopy was relatively poor in West Amhara region. Hence, strengthening the EQA program and technical support on sputum smear microscopy are recommended to ensure quality tuberculosis diagnostic service. PMID:26376438

  15. Monitoring System for Storm Readiness and Recovery of Test Facilities: Integrated System Health Management (ISHM) Approach

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando; Morris, Jon; Turowski, Mark; Franzl, Richard; Walker, Mark; Kapadia, Ravi; Venkatesh, Meera; Schmalzel, John

    2010-01-01

    Severe weather events are likely occurrences on the Mississippi Gulf Coast. It is important to rapidly diagnose and mitigate the effects of storms on Stennis Space Center's rocket engine test complex to avoid delays to critical test article programs, reduce costs, and maintain safety. An Integrated Systems Health Management (ISHM) approach and technologies are employed to integrate environmental (weather) monitoring, structural modeling, and the suite of available facility instrumentation to provide information for readiness before storms, rapid initial damage assessment to guide mitigation planning, and then support on-going assurance as repairs are effected and finally support recertification. The system is denominated Katrina Storm Monitoring System (KStorMS). Integrated Systems Health Management (ISHM) describes a comprehensive set of capabilities that provide insight into the behavior the health of a system. Knowing the status of a system allows decision makers to effectively plan and execute their mission. For example, early insight into component degradation and impending failures provides more time to develop work around strategies and more effectively plan for maintenance. Failures of system elements generally occur over time. Information extracted from sensor data, combined with system-wide knowledge bases and methods for information extraction and fusion, inference, and decision making, can be used to detect incipient failures. If failures do occur, it is critical to detect and isolate them, and suggest an appropriate course of action. ISHM enables determining the condition (health) of every element in a complex system-of-systems or SoS (detect anomalies, diagnose causes, predict future anomalies), and provide data, information, and knowledge (DIaK) to control systems for safe and effective operation. ISHM capability is achieved by using a wide range of technologies that enable anomaly detection, diagnostics, prognostics, and advise for control: (1) anomaly detection algorithms and strategies, (2) fusion of DIaK for anomaly detection (model-based, numerical, statistical, empirical, expert-based, qualitative, etc.), (3) diagnostics/prognostics strategies and methods, (4) user interface, (5) advanced control strategies, (6) integration architectures/frameworks, (7) embedding of intelligence. Many of these technologies are mature, and they are being used in the KStorMS. The paper will describe the design, implementation, and operation of the KStorMS; and discuss further evolution to support other needs such as condition-based maintenance (CBM).

  16. Hazardous medical waste generation rates of different categories of health-care facilities

    SciTech Connect

    Komilis, Dimitrios; Fouki, Anastassia; Papadopoulos, Dimitrios

    2012-07-15

    Highlights: Black-Right-Pointing-Pointer We calculated hazardous medical waste generation rates (HMWGR) from 132 hospitals. Black-Right-Pointing-Pointer Based on a 22-month study period, HMWGR were highly skewed to the right. Black-Right-Pointing-Pointer The HMWGR varied from 0.00124 to 0.718 kg bed{sup -1} d{sup -1}. Black-Right-Pointing-Pointer A positive correlation existed between the HMWGR and the number of hospital beds. Black-Right-Pointing-Pointer We used non-parametric statistics to compare rates among hospital categories. - Abstract: Goal of this work was to calculate the hazardous medical waste unit generation rates (HMWUGR), in kg bed{sup -1} d{sup -1}, using data from 132 health-care facilities in Greece. The calculations were based on the weights of the hazardous medical wastes that were regularly transferred to the sole medical waste incinerator in Athens over a 22-month period during years 2009 and 2010. The 132 health-care facilities were grouped into public and private ones, and, also, into seven sub-categories, namely: birth, cancer treatment, general, military, pediatric, psychiatric and university hospitals. Results showed that there is a large variability in the HMWUGR, even among hospitals of the same category. Average total HMWUGR varied from 0.012 kg bed{sup -1} d{sup -1}, for the public psychiatric hospitals, to up to 0.72 kg bed{sup -1} d{sup -1}, for the public university hospitals. Within the private hospitals, average HMWUGR ranged from 0.0012 kg bed{sup -1} d{sup -1}, for the psychiatric clinics, to up to 0.49 kg bed{sup -1} d{sup -1}, for the birth clinics. Based on non-parametric statistics, HMWUGR were statistically similar for the birth and general hospitals, in both the public and private sector. The private birth and general hospitals generated statistically more wastes compared to the corresponding public hospitals. The infectious/toxic and toxic medical wastes appear to be 10% and 50% of the total hazardous medical wastes generated by the public cancer treatment and university hospitals, respectively.

  17. Programme level implementation of malaria rapid diagnostic tests (RDTs) use: outcomes and cost of training health workers at lower level health care facilities in Uganda

    PubMed Central

    2012-01-01

    Background The training of health workers in the use of malaria rapid diagnostic tests (RDTs) is an important component of a wider strategy to improve parasite-based malaria diagnosis at lower level health care facilities (LLHFs) where microscopy is not readily available for all patients with suspected malaria. This study describes the process and cost of training to attain competence of lower level health workers to perform malaria RDTs in a public health system setting in eastern Uganda. Methods Health workers from 21 health facilities in Uganda were given a one-day central training on the use of RDTs in malaria case management, including practical skills on how to perform read and interpret the test results. Successful trainees subsequently integrated the use of RDTs into their routine care for febrile patients at their LLHFs and transferred their acquired skills to colleagues (cascade training model). A cross-sectional evaluation of the health workers’ competence in performing RDTs was conducted six weeks following the training, incorporating observation, in-depth interviews with health workers and the review of health facility records relating to tests offered and antimalarial drug (AMD) prescriptions pre and post training. The direct costs relating to the training processes were also documented. Results Overall, 135 health workers were trained including 63 (47%) nursing assistants, a group of care providers without formal medical training. All trainees passed the post-training concordance test with???80% except 12 that required re-training. Six weeks after the one-day training, 51/64 (80%) of the health workers accurately performed the critical steps in performing the RDT. The performance was similar among the 10 (16%) participants who were peer-trained by their trained colleagues. Only 9 (14%) did not draw the appropriate amount of blood using pipette. The average cost of the one-day training was US$ 101 (range $92-$112), with the main cost drivers being trainee travel and per-diems. Health workers offered RDTs to 76% of febrile patients and AMD prescriptions reduced by 37% six weeks post-training. Conclusion One-day training on the use of RDTs successfully provided adequate skill and competency among health workers to perform RDTs in fever case management at LLHF in a Uganda setting. The cost averaged at US$101 per health worker trained, with the main cost drivers being trainee travel and per diems. Given the good peer training noted in this study, there is need to explore the cost-effectiveness of a cascade training model for large scale implementation of RDTs. PMID:22519958

  18. Integration of Chiropractic Services in Military and Veteran Health Care Facilities: A Systematic Review of the Literature.

    PubMed

    Green, Bart N; Johnson, Claire D; Daniels, Clinton J; Napuli, Jason G; Gliedt, Jordan A; Paris, David J

    2016-04-01

    This literature review examined studies that described practice, utilization, and policy of chiropractic services within military and veteran health care environments. A systematic search of Medline, CINAHL, and Index to Chiropractic Literature was performed from inception through April 2015. Thirty articles met inclusion criteria. Studies reporting utilization and policy show that chiropractic services are successfully implemented in various military and veteran health care settings and that integration varies by facility. Doctors of chiropractic that are integrated within military and veteran health care facilities manage common neurological, musculoskeletal, and other conditions; severe injuries obtained in combat; complex cases; and cases that include psychosocial factors. Chiropractors collaboratively manage patients with other providers and focus on reducing morbidity for veterans and rehabilitating military service members to full duty status. Patient satisfaction with chiropractic services is high. Preliminary findings show that chiropractic management of common conditions shows significant improvement. PMID:26677851

  19. Non-professional health practitioners and referrals to facilities: lessons from maternal care in Bangladesh.

    PubMed

    Parkhurst, Justin O; Rahman, Syed Azizur

    2007-05-01

    Over half a million women in the developing world die of pregnancy and childbirth related causes each year, despite well-known interventions to manage most maternal complications. One problem facing policy makers is that women in low-income settings often seek care from a range of non-professional sources when they have trouble with pregnancy and childbirth. Questions remain as to the best way to engage with such providers to encourage use of professional care, in part because little policy-oriented research has attempted to study the roles of non-professional practitioners, and the specific situations which can encourage or discourage referral behaviour. This paper investigates the roles played by alternative health practitioners in referral to facilities for maternal care in Bangladesh. In-depth case studies were used to investigate labour experiences, decision-making processes and the roles played by key individuals in deciding to use professional services. Findings show that the commonly used heading of 'traditional birth attendant' is often too broad for programmatic use, as it encompasses a range of individuals with different reasons to work with, or oppose, professional services. It was found that women seek care from multiple non-professional cadres who each have differing services, scopes and linkages to professional care. Policy makers need to understand the roles of different providers and potential links to professional care which can be built upon to encourage the use of professional emergency care for maternal complications in low-income settings. PMID:17400575

  20. Pregnancy outcomes associated with Cesarean deliveries in Peruvian public health facilities.

    PubMed

    Gonzales, Gustavo F; Tapia, Vilma L; Fort, Alfredo L; Betran, Ana Pilar

    2013-01-01

    A continuous rise in the rate of cesarean deliveries has been reported in many countries over recent decades. This trend has prompted the emergence of a debate on the risks and benefits associated with cesarean section. The present study was designed to estimate cesarean section rates over time during the period between 2000 and 2010 in Peru and to present outcomes for each mode of delivery. This is a secondary analysis of a large database obtained from the Perinatal Information System, which includes 570,997 pregnant women and their babies from 43 Peruvian public health facilities in three geographical regions: coast, highlands, and jungle. Over 10 years, 558,901 women delivered 563,668 infants weighing at least 500 g. The cesarean section rate increased from 25.5% in 2000 to 29.9% in 2010 (26.9% average; P < 0.01). The rate of stillbirths was lower with cesarean than vaginal deliveries (P < 0.01). On the other hand, and as expected, the rates for preterm births, twin pregnancies, and preeclampsia were higher in women who delivered by cesarean section (P < 0.01). More importantly, the rate of maternal mortality was 5.5 times higher in the cesarean section group than in the vaginal delivery group. Data suggest that cesarean sections are associated with adverse pregnancy outcomes. PMID:24124393

  1. Assessment of Screening Practices for Gestational Hyperglycaemia in Public Health Facilities: A Descriptive Study in Bangalore, India

    PubMed Central

    Babu, Giridhara R.; Tejaswi, B.; Kalavathi, M.; Vatsala, G.M.; Murthy, G.V.S.; Kinra, Sanjay; Neelon, Sara E. Benjamin

    2015-01-01

    Background Screening and timely treatment of gestational hyperglycaemia (GH) is proved to be beneficial and improves maternal and foetal health outcomes. To understand screening practices, we explored the knowledge and perceptions of doctors working in public health facilities in Bangalore, India. We also studied participation factors by examining whether undergoing glucose estimation tests affects morning sickness in pregnant women. Design and methods We aimed to understand the screening practices and knowledge of doctors. A semi-structured questionnaire was self-administered by the 50 participant doctors, selected from the sampling frame comprising of all the doctors working in public health facilities. We included 105 pregnant women for baseline assessment, in whom a well-structured questionnaire was used. Results We reported that gestational diabetes mellitus (GDM) screening was done in nearly all the health centres (96%). However, only 12% of the doctors could provide all components of GDM diagnosis and management correctly and 46% would diagnose by using a random blood glucose test. A majority (92%) of the doctors had poor knowledge (68%) about the cut-off values of glucose tests. More than 80% of pregnant women experienced some discomfort mostly due to rapid ingestion glucose in short span of time. Conclusions Our study established that screening for GH is done in most public health facilities. Nonetheless, knowledge of doctors on the glucose tests and their interpretation needs improvement. Re-orientation trainings of the doctors can improve their knowledge and thereby can efficiently screen for GH. Further, adequate planning prior to the tests can aid successful completion of them. Significance for public health Rising burden of hyperglycaemia in pregnancy is a cause for concern and is associated with short and long term deleterious consequences for mother and offspring. Hence, there is an urgent need to explore the screening practices for gestational hyperglycaemia (GH). The current study considers patient and doctors’ perspectives regarding GH screening. The results from our study indicate several issues during screening of gestational hyperglycaemia in public health facilities in Bangalore, India. These included low awareness levels among doctors, lack of standard operating procedures and lack of adequate care and attention provided to pregnant women. Re-orientation trainings of the doctors within public health facilities can improve their knowledge and thereby can efficiently screen for GH. Further, adequate planning and preparation of the patient prior to the tests can help ensure successful completion of the tests. The findings of the study are comparable with the practices of public health hospitals in India. PMID:25918698

  2. Cerumen impaction: Challenges and management profile in a rural health facility

    PubMed Central

    Gabriel, Olajide Toye

    2015-01-01

    Background: Cerumen impaction is a worldwide problem. It constitutes a significant proportion of health problems in many settings and its prevalence varies. Very few studies were done in this region with none from our center. The aim of this study is to review the challenges and management profile of cerumen impaction in a rural health facility in Nigeria. Materials and Methods: This was a 3-year retrospective study of all patients that were managed for cerumen impaction from June 2008 to May 2011, in the Department of Otorhinolaryngology, Federal Medical Centre, Ido-Ekiti, Nigeria. Results: A total of 239 patients, aged 3–98 years were managed for cerumen impaction. The male: female ratio was 1.6:1. The age group 1–20 years was mostly affected in 29.3%. Major complaints were hearing impairment in 120 cases. Both ears were mostly affected in 48.5% of the patients. Olive oil was a major ceruminolytic agent used in 95.4%. Ear syringing was carried out in 91.2% of cases. Major complications were bruises of external auditory canal and otalgia in 7.3% of cases each. Forty-two (17.8%) of our patients were asymptomatic, and they did not complained of ear problem. Out of those patients that were symptomatic, 44.3% had visited general medical practitioners and non-otolaryngologist, while 27.6% had self-medication or visited chemist for their ear complaints. Only 3.7% of them had been seen by ear, nose, and throat (ENT) specialist in the past. Conclusion: Cerumen impaction is a common otolaryngological problem that presents to ENT surgeon, children, and elderly are more affected. Hearing impairment is the major complaint which may increase the burden of disability on society. Syringing is the most common mode of treatment of our patients. Continuing medical education, proper otological examination by the non-otolaryngologist and public health education to improve the low level of awareness on danger of self-medication is essential. PMID:26903695

  3. Market study: Tactile paging system

    NASA Technical Reports Server (NTRS)

    1977-01-01

    A market survey was conducted regarding the commercialization potential and key market factors relevant to a tactile paging system for deaf-blind people. The purpose of the tactile paging system is to communicate to the deaf-blind people in an institutional environment. The system consists of a main console and individual satellite wrist units. The console emits three signals by telemetry to the wrist com (receiving unit) which will measure approximately 2 x 4 x 3/4 inches and will be fastened to the wrist by a strap. The three vibration signals are fire alarm, time period indication, and a third signal which will alert the wearer of the wrist com to the fact that the pin on the top of the wrist is emitting a morse coded message. The Morse code message can be felt and recognized with the finger.

  4. Planetary Photojournal Home Page Graphic

    NASA Technical Reports Server (NTRS)

    2004-01-01

    This image is an unannotated version of the Planetary Photojournal Home Page graphic. This digital collage contains a highly stylized rendition of our solar system and points beyond. As this graphic was intended to be used as a navigation aid in searching for data within the Photojournal, certain artistic embellishments have been added (color, location, etc.). Several data sets from various planetary and astronomy missions were combined to create this image.

  5. Photojournal Home Page Graphic 2007

    NASA Technical Reports Server (NTRS)

    2008-01-01

    This image is an unannotated version of the Photojournal Home Page graphic released in October 2007. This digital collage contains a highly stylized rendition of our solar system and points beyond. As this graphic was intended to be used as a navigation aid in searching for data within the Photojournal, certain artistic embellishments have been added (color, location, etc.). Several data sets from various planetary and astronomy missions were combined to create this image.

  6. Use of a Balanced Scorecard in strengthening health systems in developing countries: an analysis based on nationally representative Bangladesh Health Facility Survey.

    PubMed

    Khan, M Mahmud; Hotchkiss, David R; Dmytraczenko, Tania; Zunaid Ahsan, Karar

    2013-01-01

    This paper illustrates the importance of collecting facility-based data through regular surveys to supplement the administrative data, especially for developing countries of the world. In Bangladesh, measures based on facility survey indicate that only 70% of very basic medical instruments and 35% of essential drugs were available in health facilities. Less than 2% of officially designated obstetric care facilities actually had required drugs, injections and personnel on-site. Majority of (80%) referral hospitals at the district level were not ready to provide comprehensive emergency obstetric care. Even though the Management Information System reports availability of diagnostic machines in all district-level and sub-district-level facilities, it fails to indicate that 50% of these machines are not functional. In terms of human resources, both physicians and nurses are in short supply at all levels of the healthcare system. The physician-nurse ratio also remains lower than the desirable level of 3.0. Overall job satisfaction index was less than 50 for physicians and 66 for nurses. Patient satisfaction score, however, was high (86) despite the fact that process indicators of service quality were poor. Facility surveys can help strengthen not only the management decision-making process but also the quality of administrative data. PMID:22887590

  7. MOVE: weight management program across the veterans health administration: patient- and facility-level predictors of utilization

    PubMed Central

    2013-01-01

    Background Health care systems initiating major behavioral health programs often face challenges with variable implementation and uneven patient engagement. One large health care system, Veterans Health Administration (VHA), recently initiated the MOVE!ź Weight Management Program, but it is unclear if veterans most in need of MOVE!ź services are accessing them. The purpose of this study was to examine patient and facility factors associated with MOVE!ź utilization (defined as 1 or more visits) across all VHA facilities. Methods Using national administrative data in a retrospective cohort study of eligible overweight (25??=30) VHA outpatients, we examined variation in and predictors of MOVE!ź utilization in fiscal year (FY) 2010 using generalized linear mixed models. Results 4.39% (n?=?90,230) of all eligible overweight and obese patients using VHA services utilized MOVE!ź services at least once in FY 2010. Facility-level MOVE! Utilization rates ranged from 0.05% to 16%. Veterans were more likely to have at least one MOVE!ź visit if they had a higher BMI, were female, unmarried, younger, a minority, or had a psychiatric or obesity-related comorbidity. Conclusions Although substantial variation exists across VHA facilities in MOVE!ź utilization rates, Veterans most in need of obesity management services were more likely to access MOVE!ź, although at a low level. However, there may still be many Veterans who might benefit but are not accessing these services. More research is needed to examine the barriers and facilitators of MOVE!ź utilization, particularly in facilities with unusually high and low reach. PMID:24325730

  8. Evidence from facility level inputs to improve quality of care for maternal and newborn health: interventions and findings

    PubMed Central

    2014-01-01

    Most of the maternal and newborn deaths occur at birth or within 24 hours of birth. Therefore, essential lifesaving interventions need to be delivered at basic or comprehensive emergency obstetric care facilities. Facilities provide complex interventions including advice on referrals, post discharge care, long-term management of chronic conditions along with staff training, managerial and administrative support to other facilities. This paper reviews the effectiveness of facility level inputs for improving maternal and newborn health outcomes. We considered all available systematic reviews published before May 2013 on the pre-defined facility level interventions and included 32 systematic reviews. Findings suggest that additional social support during pregnancy and labour significantly decreased the risk of antenatal hospital admission, intrapartum analgesia, dissatisfaction, labour duration, cesarean delivery and instrumental vaginal birth. However, it did not have any impact on pregnancy outcomes. Continued midwifery care from early pregnancy to postpartum period was associated with reduced medical procedures during labour and shorter length of stay. Facility based stress training and management interventions to maintain well performing and motivated workforce, significantly reduced job stress and improved job satisfaction while the interventions tailored to address identified barriers to change improved the desired practice. We found limited and inconclusive evidence for the impacts of physical environment, exit interviews and organizational culture modifications. At the facility level, specialized midwifery teams and social support during pregnancy and labour have demonstrated conclusive benefits in improving maternal newborn health outcomes. However, the generalizability of these findings is limited to high income countries. Future programs in resource limited settings should utilize these findings to implement relevant interventions tailored to their needs. PMID:25208539

  9. Promoting universal financial protection: contracting faith-based health facilities to expand access – lessons learned from Malawi

    PubMed Central

    2013-01-01

    Background Public-private collaborations are increasingly being utilized to universalize health care. In Malawi, the Ministry of Health contracts selected health facilities owned by the main faith-based provider, the Christian Health Association of Malawi (CHAM), to deliver care at no fee to the most vulnerable and underserved populations in the country through Service Level Agreements (SLAs). This study examined the features of SLAs and their effectiveness in expanding universal coverage. The study involved a policy analysis focusing on key stakeholders around SLAs as well as a case study approach to analyse how design and implementation of SLAs affect efficiency, equity and sustainability of services delivered by SLAs. Methods The study employed both qualitative and quantitative research methods to address the research questions and was conducted in five CHAM health facilities: Mulanje Mission, Holy Family, and Mtengowanthenga Hospitals, and Mabiri and Nkope Health Centres. National and district level decision makers were interviewed while providers and clients associated with the health facilities were surveyed on their experiences. A total of 155 clients from an expected 175 were recruited in the study. Results The study findings revealed key aspects of how SLAs were operating, the extent to which their objectives were being attained and why. In general, the findings demonstrated that SLAs had the potential to improve health and universal health care coverage, particularly for the vulnerable and underserved populations. However, the findings show that the performance of SLAs in Malawi were affected by various factors including lack of clear guidelines, non-revised prices, late payment of bills, lack of transparency, poor communication, inadequate human and material resources, and lack of systems to monitor performance of SLAs, amongst others. Conclusions There was strong consensus and shared interest between the government and CHAM regarding SLAs. It was clear that free services provided by SLAs had a great impact on the impoverished locals that used the facilities. However, lack of supporting systems, inadequate infrastructure and shortage of health care providers affected SLA performance. The paper provides recommendations to policy makers for the replication and strengthening of SLA implementation in the roll-out of universalization policy. PMID:23958156

  10. Environmental Assessment for the construction and operation of the Health Physics Site Support Facility on the Savannah River Site

    SciTech Connect

    1995-07-01

    DOE has prepared an environmental assessment for the proposed construction and operation of the Health Physics Site Support Facility on the Savannah River Site. This (new) facility would meet requirements of the site radiological protection program and would ensure site compliance with regulations. It was determined that the proposed action is not a major Federal action significantly affecting the quality of the environment within the meaning of NEPA. Therefore, a finding of no significant impact is made, and no environmental impact statement is needed.

  11. Rotordynamic Analysis and Feasibility Study of a Disk Spin Test Facility for Rotor Health Monitoring

    NASA Technical Reports Server (NTRS)

    Sawicki, Jerzy T.

    2005-01-01

    Recently, National Aeronautics and Space Administration (NASA) initiated a program to achieve the significant improvement in aviation safety. One of the technical challenges is the design and development of accelerated experiments that mimic critical damage cases encountered in engine components. The Nondestructive Evaluation (NDE) Group at the NASA Glenn Research Center (GRC) is currently addressing the goal concerning propulsion health management and the development of propulsion system specific technologies intended to detect potential failures prior to catastrophe. For this goal the unique disk spin simulation system was assembled at NASA GRC, which allows testing of rotors with the spinning speeds up to 10K RPM, and at the elevated temperature environment reaching 540 C (1000 F). It is anticipated that the facility can be employed for detection of Low Cycle Fatigue disk cracking and further High Cycle Fatigue blade vibration. The controlled crack growth studies at room and elevated temperatures can be conducted on the turbine wheels, and various NDE techniques can be integrated and assessed as in-situ damage monitoring tools. Critical rotating parts in advanced gas turbine engines such as turbine disks frequently operate at high temperature and stress for long periods of time. The integrity of these parts must be proven by non-destructive evaluation (NDE) during various machining steps ranging from forging blank to finished shape, and also during the systematic overhaul inspections. Conventional NDE methods, however, have unacceptable limits. Some of these techniques are time-consuming and inconvenient for service aircraft testing. Almost all of these techniques require that the vicinity of the damage is known in advance. These experimental techniques can provide only local information and no indication of the structural strength at a component and/or system level. The shortcomings of currently available NDE methods lead to the requirement of new damage detection techniques that can provide global information on the rotating components/system, and, in addition, they do not require direct human access to the operating system. During this period of research considerable effort was directed towards the further development of experimental facility and development of the vibration-based crack detection methodology for rotating disks and shafts. A collection of papers and reports were written to describe the results of this work. The attached captures that effort and represents the research output during the grant period.

  12. The Tanzania Connect Project: a cluster-randomized trial of the child survival impact of adding paid community health workers to an existing facility-focused health system

    PubMed Central

    2013-01-01

    Background Tanzania has been a pioneer in establishing community-level services, yet challenges remain in sustaining these systems and ensuring adequate human resource strategies. In particular, the added value of a cadre of professional community health workers is under debate. While Tanzania has the highest density of primary health care facilities in Africa, equitable access and quality of care remain a challenge. Utilization for many services proven to reduce child and maternal mortality is unacceptably low. Tanzanian policy initiatives have sought to address these problems by proposing expansion of community-based providers, but the Ministry of Health and Social Welfare (MoHSW ) lacks evidence that this merits national implementation. The Tanzania Connect Project is a randomized cluster trial located in three rural districts with a population of roughly 360,000 ( Kilombero, Rufiji, and Ulanga). Description of intervention Connect aims to test whether introducing a community health worker into a general program of health systems strengthening and referral improvement will reduce child mortality, improve access to services, expand utilization, and alter reproductive, maternal, newborn and child health seeking behavior; thereby accelerating progress towards Millennium Development Goals 4 and 5. Connect has introduced a new cadre — Community Health Agents (CHA) — who were recruited from and work in their communities. To support the CHA, Connect developed supervisory systems, launched information and monitoring operations, and implemented logistics support for integration with existing district and village operations. In addition, Connect’s district-wide emergency referral strengthening intervention includes clinical and operational improvements. Evaluation design Designed as a community-based cluster-randomized trial, CHA were randomly assigned to 50 of the 101 villages within the Health and Demographic Surveillance System (HDSS) in the three study districts. To garner detailed information on household characteristics, behaviors, and service exposure, a random sub-sample survey of 3,300 women of reproductive age will be conducted at the baseline and endline. The referral system intervention will use baseline, midline, and endline facility-based data to assess systemic changes. Implementation and impact research of Connect will assess whether and how the presence of the CHA at village level provides added life-saving value to the health system. Discussion Global commitment to launching community-based primary health care has accelerated in recent years, with much of the implementation focused on Africa. Despite extensive investment, no program has been guided by a truly experimental study. Connect will not only address Tanzania’s need for policy and operational research, it will bridge a critical international knowledge gap concerning the added value of salaried professional community health workers in the context of a high density of fixed facilities. Trial registration: ISRCTN96819844 PMID:23819587

  13. Monitoring the ability to deliver care in low- and middle-income countries: a systematic review of health facility assessment tools

    PubMed Central

    Nickerson, Jason W; Adams, Orvill; Attaran, Amir; Hatcher-Roberts, Janet; Tugwell, Peter

    2015-01-01

    Introduction Health facilities assessments are an essential instrument for health system strengthening in low- and middle-income countries. These assessments are used to conduct health facility censuses to assess the capacity of the health system to deliver health care and to identify gaps in the coverage of health services. Despite the valuable role of these assessments, there are currently no minimum standards or frameworks for these tools. Methods We used a structured keyword search of the MEDLINE, EMBASE and HealthStar databases and searched the websites of the World Health Organization, the World Bank and the International Health Facilities Assessment Network to locate all available health facilities assessment tools intended for use in low- and middle-income countries. We parsed the various assessment tools to identify similarities between them, which we catalogued into a framework comprising 41 assessment domains. Results We identified 10 health facility assessment tools meeting our inclusion criteria, all of which were included in our analysis. We found substantial variation in the comprehensiveness of the included tools, with the assessments containing indicators in 13 to 33 (median: 25.5) of the 41 assessment domains included in our framework. None of the tools collected data on all 41 of the assessment domains we identified. Conclusions Not only do a large number of health facility assessment tools exist, but the data they collect and methods they employ are very different. This certainly limits the comparability of the data between different countries’ health systems and probably creates blind spots that impede efforts to strengthen those systems. Agreement is needed on the essential elements of health facility assessments to guide the development of specific indicators and for refining existing instruments. PMID:24895350

  14. Reproductive health and access to healthcare facilities: risk factors for depression and anxiety in women with an earthquake experience

    PubMed Central

    2011-01-01

    Background The reproductive and mental health of women contributes significantly to their overall well-being. Three of the eight Millennium Development Goals are directly related to reproductive and sexual health while mental disorders make up three of the ten leading causes of disease burden in low and middle-income countries. Among mental disorders, depression and anxiety are two of the most prevalent. In the context of slower progress in achieving Millennium Development Goals in developing countries and the ever-increasing man-made and natural disasters in these areas, it is important to understand the association between reproductive health and mental health among women with post-disaster experiences. Methods This was a cross-sectional study with a sample of 387 women of reproductive age (15-49 years) randomly selected from the October 2005 earthquake affected areas of Pakistan. Data on reproductive health was collected using the Centers for Disease Control reproductive health assessment toolkit. Depression and anxiety were measured using the Hopkins Symptom Checklist-25, while earthquake experiences were captured using the Harvard Trauma Questionnaire. The association of either depression or anxiety with socio-demographic variables, earthquake experiences, reproductive health and access to health facilities was estimated using multivariate logistic regression. Results Post-earthquake reproductive health events together with economic deprivation, lower family support and poorer access to health care facilities explained a significant proportion of differences in the experiencing of clinical levels of depression and anxiety. For instance, women losing resources for subsistence, separation from family and experiencing reproductive health events such as having a stillbirth, having had an abortion, having had abnormal vaginal discharge or having had genital ulcers, were at significant risk of depression and anxiety. Conclusion The relationship between women's post-earthquake mental health and reproductive health, socio-economic status, and health care access is complex and explained largely by the socio-cultural role of women. It is suggested that interventions that consider gender differences and that are culturally appropriate are likely to reduce the incidence. PMID:21718519

  15. Effect of Community Engagement Interventions on Patient Safety and Risk Reduction Efforts in Primary Health Facilities: Evidence from Ghana

    PubMed Central

    Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Spieker, Nicole; Arhinful, Daniel Kojo; Ogink, Alice; van Ostenberg, Paul; Rinke de Wit, Tobias F.

    2015-01-01

    Background Patient safety and quality care remain major challenges to Ghana’s healthcare system. Like many health systems in Africa, this is largely because demand for healthcare is outstripping available human and material resource capacity of healthcare facilities and new investment is insufficient. In the light of these demand and supply constraints, systematic community engagement (SCE) in healthcare quality assessment can be a feasible and cost effective option to augment existing quality improvement interventions. SCE entails structured use of existing community groups to assess healthcare quality in health facilities. Identified quality gaps are discussed with healthcare providers, improvements identified and rewards provided if the quality gaps are closed. Purpose This paper evaluates whether or not SCE, through the assessment of health service quality, improves patient safety and risk reduction efforts by staff in healthcare facilities. Methods A randomized control trail was conducted in 64 primary healthcare facilities in the Greater Accra and Western regions of Ghana. Patient risk assessments were conducted in 32 randomly assigned intervention and control facilities. Multivariate multiple regression test was used to determine effect of the SCE interventions on staff efforts towards reducing patient risk. Spearman correlation test was used to ascertain associations between types of community groups engaged and risk assessment scores of healthcare facilities. Findings Clinic staff efforts towards increasing patient safety and reducing risk improved significantly in intervention facilities especially in the areas of leadership/accountability (Coef. = 10.4, p<0.05) and staff competencies (Coef. = 7.1, p<0.05). Improvement in service utilization and health resources could not be attributed to the interventions because these were outside the control of the study and might have been influenced by institutional or national level developments between the baseline and follow-up period. Community groups that were gender balanced, religious/faith-based, and had structured leadership appeared to be better options for effective SCE in healthcare quality assessment. Conclusion Community engagement in healthcare quality assessment is a feasible client-centered quality improvement option that should be discussed for possible scale-up in Ghana and other resource poor countries in Africa. PMID:26619143

  16. A Multidisciplinary Paradigm and Approach to Protecting Human Health and the Environment, Society, and Stakeholders at Nuclear Facilities - 12244

    SciTech Connect

    Burger, Joanna; Gochfeld, Michael; Clarke, James; Powers, Charles W.; Kosson, David

    2012-07-01

    As the Department of Energy (DOE) continues to remediate its lands, and to consider moving toward long-term stewardship and the development of energy parks on its industrial, remediated land, it is essential to adequately characterize the environment around such facilities to protect society, human health, and the environment. While DOE sites re considering several different land-use scenarios, all of them require adequate protection of the environment. Even if DOE lands are developed for energy parks that are mainly for industrializes sections of DOE lands that will not be remediated to residential standards, there is still the need to consider the protection of human health and the environment. We present an approach to characterization and establishment of teams that will gather the information, and integrate that information for a full range of stakeholders from technical personnel, to public policy makers, and that public. Such information is needed to establish baselines, site new energy facilities in energy parks, protect existing nuclear facilities and nuclear wastes, improve the basis for emergency planning, devise suitable monitoring schemes to ensure continued protection, provide data to track local and regional response changes, and for mitigation, remediation and decommissioning planning. We suggest that there are five categories of information or data needs, including 1) geophysical, sources, fate and transport, 2) biological systems, 3) human health, 4) stakeholder and environmental justice, and 5) societal, economic, and political. These informational needs are more expansive than the traditional site characterization, but encompass a suite of physical, biological, and societal needs to protect all aspects of human health and the environment, not just physical health. We suggest a Site Committee be established that oversees technical teams for each of the major informational categories, with appropriate representation among teams and with a broad involvement of a range of governmental personnel, natural and social scientists, Native Americans, environmental justice communities, and other stakeholders. Such informational teams (and Oversight Committee) would report to a DOE-designated authority or Citizen's Advisory Board. Although designed for nuclear facilities and energy parks on DOE lands, the templates and information teams can be adapted for other hazardous facilities, such as a mercury storage facility at Oak Ridge. (authors)

  17. Limited electricity access in health facilities of sub-Saharan Africa: a systematic review of data on electricity access, sources, and reliability

    PubMed Central

    Adair-Rohani, Heather; Zukor, Karen; Bonjour, Sophie; Wilburn, Susan; Kuesel, Annette C; Hebert, Ryan; Fletcher, Elaine R

    2013-01-01

    ABSTRACT Background: Access to electricity is critical to health care delivery and to the overarching goal of universal health coverage. Data on electricity access in health care facilities are rarely collected and have never been reported systematically in a multi-country study. We conducted a systematic review of available national data on electricity access in health care facilities in sub-Saharan Africa. Methods: We identified publicly-available data from nationally representative facility surveys through a systematic review of articles in PubMed, as well as through websites of development agencies, ministries of health, and national statistics bureaus. To be included in our analysis, data sets had to be collected in or after 2000, be nationally representative of a sub-Saharan African country, cover both public and private health facilities, and include a clear definition of electricity access. Results: We identified 13 health facility surveys from 11 sub-Saharan African countries that met our inclusion criteria. On average, 26% of health facilities in the surveyed countries reported no access to electricity. Only 28% of health care facilities, on average, had reliable electricity among the 8 countries reporting data. Among 9 countries, an average of 7% of facilities relied solely on a generator. Electricity access in health care facilities increased by 1.5% annually in Kenya between 2004 and 2010, and by 4% annually in Rwanda between 2001 and 2007. Conclusions: Energy access for health care facilities in sub-Saharan African countries varies considerably. An urgent need exists to improve the geographic coverage, quality, and frequency of data collection on energy access in health care facilities. Standardized tools should be used to collect data on all sources of power and supply reliability. The United Nations Secretary-General's “Sustainable Energy for All” initiative provides an opportunity to comprehensively monitor energy access in health care facilities. Such evidence about electricity needs and gaps would optimize use of limited resources, which can help to strengthen health systems. PMID:25276537

  18. Interstellar Initiative Web Page Design

    NASA Technical Reports Server (NTRS)

    Mehta, Alkesh

    1999-01-01

    This summer at NASA/MSFC, I have contributed to two projects: Interstellar Initiative Web Page Design and Lenz's Law Relative Motion Demonstration. In the Web Design Project, I worked on an Outline. The Web Design Outline was developed to provide a foundation for a Hierarchy Tree Structure. The Outline would help design a Website information base for future and near-term missions. The Website would give in-depth information on Propulsion Systems and Interstellar Travel. The Lenz's Law Relative Motion Demonstrator is discussed in this volume by Russell Lee.

  19. Exposures and Health Outcomes in Relation to Bioaerosol Emissions From Composting Facilities: A Systematic Review of Occupational and Community Studies

    PubMed Central

    Pearson, Clare; Littlewood, Emma; Douglas, Philippa; Robertson, Sarah; Gant, Timothy W.; Hansell, Anna L.

    2015-01-01

    The number of composting sites in Europe is rapidly increasing, due to efforts to reduce the fraction of waste destined for landfill, but evidence on possible health impacts is limited. This article systematically reviews studies related to bioaerosol exposures within and near composting facilities and associated health effects in both community and occupational health settings. Six electronic databases and bibliographies from January 1960 to July 2014 were searched for studies reporting on health outcomes and/or bioaerosol emissions related to composting sites. Risk of bias was assessed using a customized score. Five hundred and thirty-six papers were identified and reviewed, and 66 articles met the inclusion criteria (48 exposure studies, 9 health studies, 9 health and exposure studies). Exposure information was limited, with most measurements taken in occupational settings and for limited time periods. Bioaerosol concentrations were highest on-site during agitation activities (turning, shredding, and screening). Six studies detected concentrations of either Aspergillus fumigatus or total bacteria above the English Environment Agency’s recommended threshold levels beyond 250 m from the site. Occupational studies of compost workers suggested elevated risks of respiratory illnesses with higher bioaerosol exposures. Elevated airway irritation was reported in residents near composting sites, but this may have been affected by reporting bias. The evidence base on health effects of bioaerosol emissions from composting facilities is still limited, although there is sufficient evidence to support a precautionary approach for regulatory purposes. While data to date are suggestive of possible respiratory effects, further study is needed to confirm this and to explore other health outcomes. PMID:25825807

  20. Exposures and health outcomes in relation to bioaerosol emissions from composting facilities: a systematic review of occupational and community studies.

    PubMed

    Pearson, Clare; Littlewood, Emma; Douglas, Philippa; Robertson, Sarah; Gant, Timothy W; Hansell, Anna L

    2015-01-01

    The number of composting sites in Europe is rapidly increasing, due to efforts to reduce the fraction of waste destined for landfill, but evidence on possible health impacts is limited. This article systematically reviews studies related to bioaerosol exposures within and near composting facilities and associated health effects in both community and occupational health settings. Six electronic databases and bibliographies from January 1960 to July 2014 were searched for studies reporting on health outcomes and/or bioaerosol emissions related to composting sites. Risk of bias was assessed using a customized score. Five hundred and thirty-six papers were identified and reviewed, and 66 articles met the inclusion criteria (48 exposure studies, 9 health studies, 9 health and exposure studies). Exposure information was limited, with most measurements taken in occupational settings and for limited time periods. Bioaerosol concentrations were highest on-site during agitation activities (turning, shredding, and screening). Six studies detected concentrations of either Aspergillus fumigatus or total bacteria above the English Environment Agency's recommended threshold levels beyond 250 m from the site. Occupational studies of compost workers suggested elevated risks of respiratory illnesses with higher bioaerosol exposures. Elevated airway irritation was reported in residents near composting sites, but this may have been affected by reporting bias. The evidence base on health effects of bioaerosol emissions from composting facilities is still limited, although there is sufficient evidence to support a precautionary approach for regulatory purposes. While data to date are suggestive of possible respiratory effects, further study is needed to confirm this and to explore other health outcomes. PMID:25825807

  1. Management of severely ill children at first-level health facilities in sub-Saharan Africa when referral is difficult.

    PubMed Central

    Simoes, Eric A. F.; Peterson, Stefan; Gamatie, Youssouf; Kisanga, Felix S.; Mukasa, Gelasius; Nsungwa-Sabiiti, Jesca; Were, M. Wilson; Weber, Martin W.

    2003-01-01

    OBJECTIVES: To quantify the main reasons for referral of infants and children from first-level health facilities to referral hospitals in sub-Saharan Africa and to determine what further supplies, equipment, and legal empowerment might be needed to manage such children when referral is difficult. METHODS: In an observational study at first-level health facilities in Uganda, the United Republic of Tanzania, and Niger, over 3-5 months, we prospectively documented the diagnoses and severity of diseases in children using the standardized Integrated Management of Childhood Illness (IMCI) guidelines. We reviewed the facilities for supplies and equipment and examined the legal constraints of health personnel working at these facilities. FINDINGS: We studied 7195 children aged 2-59 months, of whom 691 (9.6%) were classified under a severe IMCI classification that required urgent referral to a hospital. Overall, 226 children had general danger signs, 292 had severe pneumonia or very severe disease, 104 were severely dehydrated, 31 had severe persistent diarrhoea, 207 were severely malnourished, and 98 had severe anaemia. Considerably more ill were 415 young infants aged one week to two months: nearly three-quarters of these required referral. Legal constraints and a lack of simple equipment (suction pumps, nebulizers, and oxygen concentrators) and supplies (nasogastric tubes and 50% glucose) could prevent health workers from dealing more appropriately with sick children when referral was not possible. CONCLUSION: When referral is difficult or impossible, some additional supplies and equipment, as well as provision of simple guidelines, may improve management of seriously ill infants and children. PMID:12973645

  2. 42 CFR 415.204 - Services of residents in skilled nursing facilities and home health agencies.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... agencies. (a) Medicare Part A payment. Payment is made under Medicare Part A for interns' and residents... facility. Payment to a participating skilled nursing facility may include the cost of services of an intern... cost of the services of an intern or resident who is under an approved GME program of a hospital...

  3. 42 CFR 415.204 - Services of residents in skilled nursing facilities and home health agencies.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... agencies. (a) Medicare Part A payment. Payment is made under Medicare Part A for interns' and residents... facility. Payment to a participating skilled nursing facility may include the cost of services of an intern... cost of the services of an intern or resident who is under an approved GME program of a hospital...

  4. Gender-based distributional skewness of the United Republic of Tanzania’s health workforce cadres: a cross-sectional health facility survey

    PubMed Central

    2013-01-01

    Background While severe shortages, inadequate skills and a geographical imbalance of health personnel have been consistently documented over the years as long term critical challenges in the health sector of the United Republic of Tanzania, there is limited evidence on the gender-based distribution of the health workforce and its likely implications. Extant evidence shows that some people may not seek healthcare unless they have access to a provider of their gender. This paper, therefore, assesses the gender-based distribution of the United Republic of Tanzania’s health workforce cadres. Methods This is a secondary analysis of data collected in a cross-sectional health facility survey on health system strengthening in the United Republic of Tanzania in 2008. During the survey, 88 health facilities, selected randomly from 8 regions, yielded 815 health workers (HWs) eligible for the current analysis. While Chi-square was used for testing associations in the bivariate analysis, multivariate analysis was conducted using logistic regression to assess the relationship between gender and each of the cadres involved in the analysis. Results The mean age of the HWs was 39.7, ranging from 15 to 63 years. Overall, 75% of the HWs were women. The proportion of women among maternal and child health aides or medical attendants (MCHA/MA), nurses and midwives was 86%, 86% and 91%, respectively, while their proportion among clinical officers (COs) and medical doctors (MDs) was 28% and 21%, respectively. Multivariate analysis revealed that the odds ratio (OR) and 95% confidence interval (CI) that a HW was a female (baseline category is “male”) for each cadre was: MCHA/MA, OR?=?3.70, 95% CI 2.16-6.33; nurse, OR?=?5.61, 95% CI 3.22-9.78; midwife, OR?=?2.74, 95% CI 1.44-5.20; CO, OR?=?0.08, 95% CI 0.04-0.17 and MD, OR?=?0.04, 95% CI 0.02-0.09. Conclusion The distribution of the United Republic of Tanzania’s health cadres is dramatically gender-skewed, a reflection of gender inequality in health career choices. MCHA/MA, nursing and midwifery cadres are large and female-dominant, whereas COs and MDs are fewer in absolute numbers and male-dominant. While a need for more staff is necessary for an effective delivery of quality health services, adequate representation of women in highly trained cadres is imperative to enhance responses to some gender-specific roles and needs. PMID:23800028

  5. Health Habits of Employees in a Large Medical Center: Time Trends and Impact of a Worksite Wellness Facility

    PubMed Central

    Abu Dabrh, Abd Moain; Gorty, Archana; Jenkins, Sarah M.; Murad, Mohammad Hassan; Hensrud, Donald D.

    2016-01-01

    Worksite health interventions are not novel but their effect remains subject of debate. We examined employer-based wellness program to determine health habits trends, and compare prevalence estimates to national data. We conducted serial surveys (1996 and 2007–10) to employees of a large medical center that included questions measuring outcomes, including obesity, regular exercise, cardiovascular activity, and smoking status. Logistic regression models were estimated to compare data by membership across years, considering p-values ≀ 0.01 as statistically significant. 3,206 employees responded (Response rates 59–68%). Obesity prevalence increased over time in members and nonmembers of the wellness facility, consistent with national trends. Members had a lower prevalence of cigarette smoking compared to nonmembers (overall year-adjusted odds ratio 0.66, P < 0.001). Further, employees had a lower prevalence of cigarette smoking (9.7 vs. 17.3% in 2010, P < 0.001) compared with national data. Wellness facility membership was associated with increased regular exercise and cardiovascular exercise (P < 0.001) compared to nonmembers. In summary, working in a medical center was associated with a decreased prevalence of cigarette smoking, but not with lower prevalence of obesity. Worksite wellness facility membership was associated with increased exercise and decreased cigarette smoking. Employer-based interventions may be effective in improving some health behaviors. PMID:26864205

  6. Health Habits of Employees in a Large Medical Center: Time Trends and Impact of a Worksite Wellness Facility.

    PubMed

    Abu Dabrh, Abd Moain; Gorty, Archana; Jenkins, Sarah M; Murad, Mohammad Hassan; Hensrud, Donald D

    2016-01-01

    Worksite health interventions are not novel but their effect remains subject of debate. We examined employer-based wellness program to determine health habits trends, and compare prevalence estimates to national data. We conducted serial surveys (1996 and 2007-10) to employees of a large medical center that included questions measuring outcomes, including obesity, regular exercise, cardiovascular activity, and smoking status. Logistic regression models were estimated to compare data by membership across years, considering p-values???0.01 as statistically significant. 3,206 employees responded (Response rates 59-68%). Obesity prevalence increased over time in members and nonmembers of the wellness facility, consistent with national trends. Members had a lower prevalence of cigarette smoking compared to nonmembers (overall year-adjusted odds ratio 0.66, P?facility membership was associated with increased regular exercise and cardiovascular exercise (P?facility membership was associated with increased exercise and decreased cigarette smoking. Employer-based interventions may be effective in improving some health behaviors. PMID:26864205

  7. 16 CFR 436.3 - Cover page.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 16 Commercial Practices 1 2013-01-01 2013-01-01 false Cover page. 436.3 Section 436.3 Commercial... CONCERNING FRANCHISING Contents of a Disclosure Document § 436.3 Cover page. Begin the disclosure document with a cover page, in the order and form as follows: (a) The title “FRANCHISE DISCLOSURE DOCUMENT”...

  8. 43 CFR 10010.24 - Page limits.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false Page limits. 10010.24 Section 10010.24... Environmental Impact Statements § 10010.24 Page limits. An EIS should be as brief as possible and still convey the required information. Normally this should be accomplished in less than 150 pages,...

  9. 43 CFR 10010.24 - Page limits.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Page limits. 10010.24 Section 10010.24... Environmental Impact Statements § 10010.24 Page limits. An EIS should be as brief as possible and still convey the required information. Normally this should be accomplished in less than 150 pages,...

  10. 12 CFR 1010.105 - Cover page.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 8 2012-01-01 2012-01-01 false Cover page. 1010.105 Section 1010.105 Banks and... § 1010.105 Cover page. The cover page of the Property Report shall be prepared in accordance with the... reads as follows: “READ THIS PROPERTY REPORT BEFORE SIGNING ANYTHING”. (c) The remainder of the...

  11. 16 CFR 436.3 - Cover page.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 16 Commercial Practices 1 2014-01-01 2014-01-01 false Cover page. 436.3 Section 436.3 Commercial... CONCERNING FRANCHISING Contents of a Disclosure Document § 436.3 Cover page. Begin the disclosure document with a cover page, in the order and form as follows: (a) The title “FRANCHISE DISCLOSURE DOCUMENT”...

  12. 43 CFR 10010.24 - Page limits.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Page limits. 10010.24 Section 10010.24... Environmental Impact Statements § 10010.24 Page limits. An EIS should be as brief as possible and still convey the required information. Normally this should be accomplished in less than 150 pages,...

  13. 16 CFR 436.3 - Cover page.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Cover page. 436.3 Section 436.3 Commercial... CONCERNING FRANCHISING Contents of a Disclosure Document § 436.3 Cover page. Begin the disclosure document with a cover page, in the order and form as follows: (a) The title “FRANCHISE DISCLOSURE DOCUMENT”...

  14. 16 CFR 436.3 - Cover page.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Cover page. 436.3 Section 436.3 Commercial... CONCERNING FRANCHISING Contents of a Disclosure Document § 436.3 Cover page. Begin the disclosure document with a cover page, in the order and form as follows: (a) The title “FRANCHISE DISCLOSURE DOCUMENT”...

  15. 12 CFR 1010.105 - Cover page.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 8 2014-01-01 2014-01-01 false Cover page. 1010.105 Section 1010.105 Banks and... § 1010.105 Cover page. The cover page of the Property Report shall be prepared in accordance with the... reads as follows: “READ THIS PROPERTY REPORT BEFORE SIGNING ANYTHING”. (c) The remainder of the...

  16. 12 CFR 1010.105 - Cover page.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 8 2013-01-01 2013-01-01 false Cover page. 1010.105 Section 1010.105 Banks and... § 1010.105 Cover page. The cover page of the Property Report shall be prepared in accordance with the... reads as follows: “READ THIS PROPERTY REPORT BEFORE SIGNING ANYTHING”. (c) The remainder of the...

  17. 43 CFR 10010.24 - Page limits.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false Page limits. 10010.24 Section 10010.24... Environmental Impact Statements § 10010.24 Page limits. An EIS should be as brief as possible and still convey the required information. Normally this should be accomplished in less than 150 pages,...

  18. 16 CFR 436.3 - Cover page.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 1 2012-01-01 2012-01-01 false Cover page. 436.3 Section 436.3 Commercial... CONCERNING FRANCHISING Contents of a Disclosure Document § 436.3 Cover page. Begin the disclosure document with a cover page, in the order and form as follows: (a) The title “FRANCHISE DISCLOSURE DOCUMENT”...

  19. Making the Editorial Page More Dynamic.

    ERIC Educational Resources Information Center

    Jungblut, Joseph A.

    1991-01-01

    Asserts that editorial pages need a distinctive look so that the reader knows the difference between the editorial page and any other page in the paper. Offers ideas for creating the design, the masthead, the editorial itself, editorial artwork, personal columns, letters to the editor, and photo polls. Discusses eight types of editorial styles.


  20. Spatial Analysis of the Level of Exposure to Seismic Hazards of Health Facilities in Mexico City, Mexico

    NASA Astrophysics Data System (ADS)

    Moran, S.; Novelo-Casanova, D. A.

    2011-12-01

    Although health facilities are essential infrastructure during disasters and emergencies, they are also usually highly vulnerable installations in the case of the occurrence of large and major earthquakes. Hospitals are one of the most complex critical facilities in modern cities and they are used as first response in emergency situations. The operability of a hospital must be maintained after the occurrence of a local strong earthquake in order to satisfy the need for medical care of the affected population. If a health facility is seriously damaged, it cannot fulfill its function when most is needed. In this case, hospitals become a casualty of the disaster. To identify the level of physical exposure of hospitals to seismic hazards in Mexico City, we analyzed their geographic location with respect to the seismic response of the different type of soils of the city from past earthquakes, mainly from the events that occurred on September 1985 (Ms= 8.0) and April 1989 (Ms= 6.9). Seismic wave amplification in this city is the result of the interaction of the incoming seismic waves with the soft and water saturated clay soils, on which a large part of Mexico City is built. The clay soils are remnants of the lake that existed in the Valley of Mexico and which has been drained gradually to accommodate the growing urban sprawl. Hospital facilities were converted from a simple database of names and locations into a map layer of resources. This resource layer was combined with other map layers showing areas of seismic microzonation in Mexico City. This overlay was then used to identify those hospitals that may be threatened by the occurrence of a large or major seismic event. We analyzed the public and private hospitals considered as main health facilities. Our results indicate that more than 50% of the hospitals are highly exposed to seismic hazards. Besides, in most of these health facilities we identified the lack of preventive measures and preparedness to reduce their vulnerability. For proper interpretation, our results are also presented in a Geographical Information System (GIS) that provides elements to support government plans to mitigate the impact of future earthquakes.

  1. Chronic Diseases and Health Promotion

    MedlinePLUS

    ... of blindness among adults. 6 Top of Page Health Risk Behaviors that Cause Chronic Diseases Health risk behaviors ... of Page The Cost of Chronic Diseases and Health Risk Behaviors In the United States, chronic diseases and ...

  2. Do Physical Proximity and Availability of Adequate Infrastructure at Public Health Facility Increase Institutional Delivery? A Three Level Hierarchical Model Approach

    PubMed Central

    Patel, Rachana; Ladusingh, Laishram

    2015-01-01

    This study aims to examine the inter-district and inter-village variation of utilization of health services for institutional births in EAG states in presence of rural health program and availability of infrastructures. District Level Household Survey-III (2007–08) data on delivery care and facility information was used for the purpose. Bivariate results examined the utilization pattern by states in presence of correlates of women related while a three-level hierarchical multilevel model illustrates the effect of accessibility, availability of health facility and community health program variables on the utilization of health services for institutional births. The study found a satisfactory improvement in state Rajasthan, Madhya Pradesh and Orissa, importantly, in Bihar and Uttaranchal. The study showed that increasing distance from health facility discouraged institutional births and there was a rapid decline of more than 50% for institutional delivery as the distance to public health facility exceeded 10 km. Additionally, skilled female health worker (ANM) and observed improved public health facility led to significantly increase the probability of utilization as compared to non-skilled ANM and not-improved health centers. Adequacy of essential equipment/laboratory services required for maternal care significantly encouraged deliveries at public health facility. District/village variables neighborhood poverty was negatively related to institutional delivery while higher education levels in the village and women’s residing in more urbanized districts increased the utilization. “Inter-district” variation was 14 percent whereas “between-villages” variation for the utilization was 11 percent variation once controlled for all the three-level variables in the model. This study suggests that the mere availability of health facilities is necessary but not sufficient condition to promote utilization until the quality of service is inadequate and inaccessible considering the inter-districts variation for the program implementation. PMID:26689199

  3. Health physics manual of good practices for plutonium facilities. [Contains glossary

    SciTech Connect

    Brackenbush, L.W.; Heid, K.R.; Herrington, W.N.; Kenoyer, J.L.; Munson, L.F.; Munson, L.H.; Selby, J.M.; Soldat, K.L.; Stoetzel, G.A.; Traub, R.J.

    1988-05-01

    This manual consists of six sections: Properties of Plutonium, Siting of Plutonium Facilities, Facility Design, Radiation Protection, Emergency Preparedness, and Decontamination and Decommissioning. While not the final authority, the manual is an assemblage of information, rules of thumb, regulations, and good practices to assist those who are intimately involved in plutonium operations. An in-depth understanding of the nuclear, physical, chemical, and biological properties of plutonium is important in establishing a viable radiation protection and control program at a plutonium facility. These properties of plutonium provide the basis and perspective necessary for appreciating the quality of control needed in handling and processing the material. Guidance in selecting the location of a new plutonium facility may not be directly useful to most readers. However, it provides a perspective for the development and implementation of the environmental surveillance program and the in-plant controls required to ensure that the facility is and remains a good neighbor. The criteria, guidance, and good practices for the design of a plutonium facility are also applicable to the operation and modification of existing facilities. The design activity provides many opportunities for implementation of features to promote more effective protection and control. The application of ''as low as reasonably achievable'' (ALARA) principles and optimization analyses are generally most cost-effective during the design phase. 335 refs., 8 figs., 20 tabs.

  4. Utilisation of a community-based health facility in a low-income urban community in Ibadan, Nigeria

    PubMed Central

    Asuzu, Michael C.

    2015-01-01

    Background Primary healthcare is established to ensure that people have access to health services through facilities located in their community. However, utilisation of health facilities in Nigeria remains low in many communities. Aim To assess the utilisation of community-based health facility (CBHF) amongst adults in Ibadan, Nigeria Settings A low-income community in Ibadan North West Local Government Area of Oyo State. Methods A cross-sectional survey was conducted using a simple random sampling technique to select one adult per household in all 586 houses in the community. A semi-structured interviewer-administered questionnaire was used to collect information on respondents' sociodemographic characteristics, knowledge and utilisation of the CBHF. Data analysis included descriptive statistics and association testing using the Chi-square test at p = 0.05. Results The mean age of the respondents was 46.5 ± 16.0 years; 46.0% were men and 81.0% married; 26% had no formal education and 38.0% had secondary-level education and above; traders constituted 52.0% of the sample; and 85.2% were of low socioeconomic standing; 90% had patronised the CBHF. The main reasons for non-utilisation were preference for general hospitals (13.8%) and self-medication (12.1%). Respondents who had secondary education and above, were in a higher socioeconomic class, who had good knowledge of the facility and were satisfied with care, utilised the CBHF three months significantly more than their counterparts prior to the study (p < 0.05). However, only satisfaction with care was found to be a significant predictor of utilisation of the CBHF. Conclusion The utilisation of the CBHF amongst adults in the study setting is high, driven mostly by satisfaction with the care received previously. Self-medication, promoted by uncontrolled access to drugs through pharmacies and patent medicine stores, threatens this high utilisation. PMID:26245600

  5. Less Than One-Third of Caretakers Sought Formal Health Care Facilities for Common Childhood Illnesses in Ethiopia: Evidence from the 2011 Ethiopian Demographic Health Survey

    PubMed Central

    Gebretsadik, Achamyelesh; Worku, Alemayehu; Berhane, Yemane

    2015-01-01

    Background. Most of the childhood illnesses can be proven with effective interventions. However, countless children die needlessly in developing countries due to the failure of their guardians to seek care timely. The aim of this study was to assess health care seeking behavior of caretakers of children under the age of five years for treatment of common childhood illnesses. Methods. Further analysis of the Ethiopian 2011 demographic and health survey was done. All children under the age of five reported to have been ill from the three common childhood illnesses and their caretakers were included in the analysis. A complex sample logistic regression model was employed to determine factors associated with the health care seeking behavior of caretakers. Result. A total of 2,842 caregivers who reported that their index child had at least one of the three common childhood illnesses in the two weeks preceding the survey were captured, of which 849 (29.87%; 95% CI: 28, 32%) sought formal health care facilities. Conclusion and Recommendation. In Ethiopia health care seeking behavior of caretakers for common childhood illnesses is low. Increasing mass media exposure can possibly improve the health seeking behavior of caretakers. PMID:26273479

  6. Evaluation of the impact of a simple hand-washing and water-treatment intervention in rural health facilities on hygiene knowledge and reported behaviours of health workers and their clients, Nyanza Province, Kenya, 2008.

    PubMed

    Sreenivasan, N; Gotestrand, S A; Ombeki, S; Oluoch, G; Fischer, T K; Quick, R

    2015-03-01

    Many clinics in rural western Kenya lack access to safe water and hand-washing facilities. To address this problem, in 2005 a programme was initiated to install water stations for hand washing and drinking water in 109 health facilities, train health workers on water treatment and hygiene, and motivate clients to adopt these practices. In 2008, we evaluated this intervention's impact by conducting observations at facilities, and interviewing staff and clients about water treatment and hygiene. Of 30 randomly selected facilities, 97% had water stations in use. Chlorine residuals were detectable in at least one container at 59% of facilities. Of 164 interviewed staff, 79% knew the recommended water-treatment procedure. Of 298 clients, 45% had received training on water treatment at a facility; of these, 68% knew the recommended water-treatment procedure. Use of water stations, water treatment, and client training were sustained in some facilities for up to 3 years. PMID:24865584

  7. [Medicine on mission: The international health reform of Seventh-Day Adventists and their health care facilities in Sweden].

    PubMed

    Eklöf, Motzi

    2008-01-01

    The international non-conformist denomination, Seventh-day Adventists, have since their foundation in 1863, had a distinctive health care model for their members. The life-style has included vegetarian diet, abstinence from alcohol, tobacco and other drugs and the observance of a day of rest once a week. The health policy has striven to care for God's creation in the hope of resurrection at the Day of Judgment and to reform the conventional medical practice. The Adventists have pursued an extensive international health care system--from the start based on dietary and physical treatment methods, such as hydrotherapy, massage and physiotherapy--in line with the Christian mission. Health care establishments have been inaugurated around the world as a vehicle for enabling the Christian health care message to reach the upper classes. With Adventist and Doctor, John Harvey Kellogg's Battle Creek Sanatorium in Michigan as both inspirational source and educational institution, the health care mission--including a vegetarian health food industry, following in the footsteps of cornflakes--spread to the Nordic countries by the turn of the century, 1900. Skodsborgs Badesanatorium near Copenhagen became the model institution for several health care establishments in Sweden during the 1900's, such as Hultafors Sanatorium. The American-Nordic link has manifested itself through co-publication of papers, exchange of health care personnel and reporting to the central Adventist church. The American non-conformist domain as well as a private sphere of activity, aiming mainly from the outset at society's upper classes, has encountered certain difficulties in maintaining this distinction in Sweden's officially increasing secularised society, and in relation to a state health insurance and a publicly financed health care system. With the passing of time, the socioeconomic composition of patients at Hultafors became more heterogeneous, and conventional medical procedures were increasingly incorporated into the array of treatment resources. The successful enterprises--as they had been for a considerable time--could not, at the end of the 20th century, continue to be self financing or fulfil the missionary objectives among the upper classes. The institutionalised health care apparatus came to an end around the turn of the century, which also included the sale of health associated food product companies. The Seventh-day Adventist's combination of medicine and religion with Christian missionary aims have indeed, not only steered health care models and institutions worldwide, but also which target groups to mainly turn to, the specific treatment philosophy, desirable working environment and which medical technologies to use. Furthermore, the Adventist's health reform and care of the sick provide an example for how different medical cultures influence each other and develop in relation to one another in a pluralistic medical market. The developments are not merely a reflection of the medical, scientific and technical advancements, but also of the medical market's structure, financing and (inter)national connections, of religion, culture and not least of all, patients' options and their choices. PMID:19848037

  8. Diversion of Drugs Within Health Care Facilities, a Multiple-Victim Crime: Patterns of Diversion, Scope, Consequences, Detection, and Prevention

    PubMed Central

    Berge, Keith H.; Dillon, Kevin R.; Sikkink, Karen M.; Taylor, Timothy K.; Lanier, William L.

    2012-01-01

    Mayo Clinic has been involved in an ongoing effort to prevent the diversion of controlled substances from the workplace and to rapidly identify and respond when such diversion is detected. These efforts have found that diversion of controlled substances is not uncommon and can result in substantial risk not only to the individual who is diverting the drugs but also to patients, co-workers, and employers. We believe that all health care facilities should have systems in place to deter controlled substance diversion and to promptly identify diversion and intervene when it is occurring. Such systems are multifaceted and require close cooperation between multiple stakeholders including, but not limited to, departments of pharmacy, safety and security, anesthesiology, nursing, legal counsel, and human resources. Ideally, there should be a broad-based appreciation of the dangers that diversion creates not only for patients but also for all employees of health care facilities, because diversion can occur at any point along a long supply chain. All health care workers must be vigilant for signs of possible diversion and must be aware of how to engage a preexisting group with expertise in investigating possible diversions. In addition, clear policies and procedures should be in place for dealing with such investigations and for managing the many possible outcomes of a confirmed diversion. This article provides an overview of the multiple types of risk that result from drug diversion from health care facilities. Further, we describe a system developed at Mayo Clinic for evaluating episodes of potential drug diversion and for taking action once diversion is confirmed. PMID:22766087

  9. Diversion of drugs within health care facilities, a multiple-victim crime: patterns of diversion, scope, consequences, detection, and prevention.

    PubMed

    Berge, Keith H; Dillon, Kevin R; Sikkink, Karen M; Taylor, Timothy K; Lanier, William L

    2012-07-01

    Mayo Clinic has been involved in an ongoing effort to prevent the diversion of controlled substances from the workplace and to rapidly identify and respond when such diversion is detected. These efforts have found that diversion of controlled substances is not uncommon and can result in substantial risk not only to the individual who is diverting the drugs but also to patients, co-workers, and employers. We believe that all health care facilities should have systems in place to deter controlled substance diversion and to promptly identify diversion and intervene when it is occurring. Such systems are multifaceted and require close cooperation between multiple stakeholders including, but not limited to, departments of pharmacy, safety and security, anesthesiology, nursing, legal counsel, and human resources. Ideally, there should be a broad-based appreciation of the dangers that diversion creates not only for patients but also for all employees of health care facilities, because diversion can occur at any point along a long supply chain. All health care workers must be vigilant for signs of possible diversion and must be aware of how to engage a preexisting group with expertise in investigating possible diversions. In addition, clear policies and procedures should be in place for dealing with such investigations and for managing the many possible outcomes of a confirmed diversion. This article provides an overview of the multiple types of risk that result from drug diversion from health care facilities. Further, we describe a system developed at Mayo Clinic for evaluating episodes of potential drug diversion and for taking action once diversion is confirmed. PMID:22766087

  10. Why are babies born before arrival at health facilities in King Sabata Dalindyebo Local Municipality, Eastern Cape, South Africa? A qualitative study

    PubMed Central

    Alabi, Adeyinka A.; Wright, Graham; Ntsaba, Mohlomi J.

    2015-01-01

    Introduction Babies born before arrival at a health facility have a higher risk of neonatal death and their mothers a higher risk of maternal death compared with those born in-facility. The study explored the reasons for mothers giving birth before arrival (BBA) at health facilities and their experiences of BBA. Methods A qualitative research design was used. Individual and focus group interviews of BBA mothers and of nurses were undertaken at a community health centre and a district hospital in King Sabata Dalindyebo Local Municipality. Results Reasons for BBA included a lack of transport, a lack of security at night that deterred mothers from travelling, precipitate labour, failure to identify true labour, and a lack of waiting areas at health facilities. Traditional and cultural beliefs favouring childbirth at home and nurses’ negative attitudes during antenatal care and labour influenced mothers to go to health facilities when in advanced labour. Mothers were aware of possible complications associated with BBA. Conclusion Socio-economic, individual, cultural and health system factors influence the occurrence of BBA. Relevant parties need to address these factors to ensure that all babies in the King Sabata Dalindyebo Local Municipality are delivered within designated health facilities. PMID:26842514

  11. Clostridium difficile Infections in Veterans Health Administration Long-Term Care Facilities.

    PubMed

    Reeves, Jeffrey S; Evans, Martin E; Simbartl, Loretta A; Kralovic, Stephen M; Kelly, Allison A; Jain, Rajiv; Roselle, Gary A

    2016-03-01

    OBJECTIVE A nationwide initiative was implemented in February 2014 to decrease Clostridium difficile infections (CDI) in Veterans Affairs (VA) long-term care facilities. We report a baseline of national CDI data collected during the 2 years before the Initiative. METHODS Personnel at each of 122 reporting sites entered monthly retrospective CDI case data from February 2012 through January 2014 into a national database using case definitions similar to those used in the National Healthcare Safety Network Multidrug-Resistant Organism/CDI module. The data were evaluated using Poisson regression models to examine infection occurrences over time while accounting for admission prevalence and type of diagnostic test. RESULTS During the 24-month analysis period, there were 100,800 admissions, 6,976,121 resident days, and 1,558 CDI cases. The pooled CDI admission prevalence rate (including recurrent cases) was 0.38 per 100 admissions, and the pooled nonduplicate/nonrecurrent community-onset rate was 0.17 per 100 admissions. The pooled long-term care facility-onset rate and the clinically confirmed (ie, diarrhea or evidence of pseudomembranous colitis) long-term care facility-onset rate were 1.98 and 1.78 per 10,000 resident days, respectively. Accounting for diagnostic test type, the long-term care facility-onset rate declined significantly (P=.05), but the clinically confirmed long-term care facility-onset rate did not. CONCLUSIONS VA long-term care facility CDI rates were comparable to those in recent reports from other long-term care facilities. The significant decline in the long-term care facility-onset rate but not in the clinically confirmed long-term care facility-onset rate may have been due to less testing of asymptomatic patients. Efforts to decrease CDI rates in long-term care facilities are necessary as part of a coordinated approach to decrease healthcare-associated infections. Infect. Control Hosp. Epidemiol. 2016;37(3):295-300. PMID:26686361

  12. Registration of food facilities under the Public Health Security and Bioterrorism Preparedness and Response Act of 2002. Final rule.

    PubMed

    2005-10-01

    The Food and Drug Administration (FDA) is issuing a final regulation that confirms the interim final rule entitled "Registration of Food Facilities Under the Public Health Security and Bioterrorism Preparedness and Response Act of 2002" (68 FR 58894, October 10, 2003 (interim final rule) as corrected by a technical amendment (69 FR 29428, May 24, 2004), and responds to comments submitted in response to the request for comments in the interim final rule. This final rule affirms the interim final rule's requirement that domestic and foreign facilities that manufacture/process, pack, or hold food for human or animal consumption in the United States be registered with FDA by December 12, 2003. The interim final rule implemented the Public Health Security and Bioterrorism Preparedness and Response Act of 2002 (the Bioterrorism Act), which requires domestic and foreign facilities to be registered with FDA by December 12, 2003. This final rule does not make any changes to the regulatory requirements established by the interim final rule. PMID:16200686

  13. Assessment of athletic health care facility surfaces for MRSA in the secondary school setting.

    PubMed

    Montgomery, Kyle; Ryan, Timothy J; Krause, Andrew; Starkey, Chad

    2010-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) was once largely a hospital-acquired infection, but increasingly, community-associated MRSA (CA-MRSA) is causing outbreaks among otherwise healthy people in athletic settings. Secondary school athletic trainers, student athletes, and the general student population may be at elevated risk of MRSA infection. To identify the prevalence of MRSA on surfaces in high school athletic training settings, 10 rural high school athletic training facilities and locker rooms were sampled for MRSA. Results showed 90% of facilities had two or more positive MRSA surfaces, while one school had no recoverable MRSA colonies. Of all surfaces tested (N=90), 46.7% produced a positive result. From this limited sample, it is evident that significant exposure opportunities to MRSA exist in athletic training clinics and adjacent facilities for both the patient and the clinician. Furthermore, the findings point to the need for community hygiene education about skin and soft tissue infections like MRSA. PMID:20104827

  14. Health and safety plan for characterization sampling of ETR and MTR facilities

    SciTech Connect

    Baxter, D.E.

    1994-10-01

    This health and safety plan establishes the procedures and requirements that will be used to minimize health and safety risks to persons performing Engineering Test Reactor and Materials Test Reactor characterization sampling activities, as required by the Occupational Safety and Health Administration standard, 29 CFR 1910.120. It contains information about the hazards involved in performing the tasks, and the specific actions and equipment that will be used to protect persons working at the site.

  15. Community accountability at peripheral health facilities: a review of the empirical literature and development of a conceptual framework

    PubMed Central

    Molyneux, Sassy; Atela, Martin; Angwenyi, Vibian; Goodman, Catherine

    2012-01-01

    Public accountability has re-emerged as a top priority for health systems all over the world, and particularly in developing countries where governments have often failed to provide adequate public sector services for their citizens. One approach to strengthening public accountability is through direct involvement of clients, users or the general public in health delivery, here termed ‘community accountability’. The potential benefits of community accountability, both as an end in itself and as a means of improving health services, have led to significant resources being invested by governments and non-governmental organizations. Data are now needed on the implementation and impact of these initiatives on the ground. A search of PubMed using a systematic approach, supplemented by a hand search of key websites, identified 21 papers from low- or middle-income countries describing at least one measure to enhance community accountability that was linked with peripheral facilities. Mechanisms covered included committees and groups (n = 19), public report cards (n = 1) and patients’ rights charters (n = 1). In this paper we summarize the data presented in these papers, including impact, and factors influencing impact, and conclude by commenting on the methods used, and the issues they raise. We highlight that the international interest in community accountability mechanisms linked to peripheral facilities has not been matched by empirical data, and present a conceptual framework and a set of ideas that might contribute to future studies. PMID:22279082

  16. Reasons and circumstances for the late notification of Acute Flaccid Paralysis (AFP) cases in health facilities in Luanda

    PubMed Central

    Macama, Arciolanda; Okeibunor, Joseph; Grando, Silvia; Djibaoui, Karim; Yameogo, Robert Koudounoaga; Morais, Alda; Gasasira, Alex Ntale; Mbaye, Salla; Mihigo, Richard; Nshimirimana, Deo

    2014-01-01

    Introduction As the polio eradication effort enters the end game stage, surveillance for Acute Flaccid Paralysis in children becomes a pivotal tool. Thus given the gaps in AFP surveillance as identified in the cases of late notification, this study was designed to explore the reasons and circumstances responsible for late notification of AFP and collection of inadequate stools (more than 14 days of onset of paralysis until collection of the 2nd stool specimen) of AFP cases in health facilities equipped to manage AFP cases. Methods Eleven AFP cases with inadequate stools were reported from January 2 to July 8, 2012 - Epidemiological Weeks 1-27. The families of these cases were interviewed with an in-depth interview guide. The staff of the seven health units, where they later reported, was also enlisted for the study which used in-depth interview guide in eliciting information from them. Results Ignorance and wrong perception of the etiology of the cases as well as dissatisfaction with the health units as the major reasons for late reporting of AFP cases. The first port of call is usually alternative health care system such as traditional healers and spiritualists because the people hold the belief that the problem is spiritually induced. The few, who make it to health units, are faced with ill equipped rural health workers who wait for the arrival of more qualified staff, who may take days to do so. Conclusion An understanding of the health seeking behavior of the population is germane to effective AFP surveillance. There is thus a need to tailor AFP surveillance to the health seeking behavior of the populations and expand it to community structures. PMID:25426197

  17. A systematic review of the literature for evidence on health facility committees in low- and middle-income countries.

    PubMed

    McCoy, David C; Hall, Jennifer A; Ridge, Melanie

    2012-09-01

    Community participation in health (CPH) has been advocated as a health-improving strategy for many decades. However, CPH comes in many different forms, one of which is the use of health facility committees (HFCs) on which there is community representation. This paper presents the findings of a systematic literature review of: (a) the evidence of HFCs' effectiveness, and (b) the factors that influence the performance and effectiveness of HFCs. Four electronic databases and the websites of eight key organizations were searched. Out of 341 potentially relevant publications, only four provided reasonable evidence of the effectiveness of HFCs. A further 37 papers were selected and used to draw out data on the factors that influence the functioning of HFCs. A conceptual model was developed to describe the key factors. It consists of, firstly, the features of the HFC, community and facility, and their interactions; secondly, process factors relating to the way HFCs are established and supported; and finally, a set of contextual factors. The review found some evidence that HFCs can be effective in terms of improving the quality and coverage of health care, as well as impacting on health outcomes. However, the external validity of these studies is inevitably limited. Given the different potential roles/functions of HFCs and the complex and multiple set of factors influencing their functioning, there is no 'one size fits all' approach to CPH via HFCs, nor to the evaluation of HFCs. However, there are plenty of experiences and lessons in the literature which decision makers and managers can use to optimize HFCs. PMID:22155589

  18. Achieving the HIV and AIDS National Strategic Plan: A practical calculator for local target setting in district health facilities.

    PubMed

    Leydon, Nicholas G; Venter, Francois; Webster, Patricia D; Moleko, Winnie; Osih, Regina; Barker, Pierre M

    2010-07-01

    The South African HIV National Strategic Plan (NSP) aims to provide access to appropriate treatment, care and support to 80% of the HIV-infected population by 2011. By mid-2008, highly active antiretroviral treatment (HAART) was being dispensed to about half the HIV-infected population in need. Reaching the NSP targets will require full mobilisation of all of South Africa's health facilities. While the NSP has broad political and programmatic support from the Department of Health and civil society, and managers are able to recite the national targets, it has been difficult for these managers to relate the targets to their own geographical areas of responsibility. National, regional and district targets for HIV care have been set from South Africa's relatively good census, modelling and epidemiological data. However, few practical tools are available to help clinicians and managers understand their facility's actual contribution to the district regional and national NSP targets for each step of the HIV care pathway (HIV testing, CD4 testing, HAART referral and initiation). The calculation of HAART initiation targets is complicated by the anticipated additional demand for treatment that will be generated by a change in the recommended CD4-count threshold for initiation of treatment.4 Accordingly, we provide a data-based tool that is readily available, and that district and facility managers can use to calculate their annual steady-state HIV testing, CD4 testing and HAART initiation requirements. These calculated values can be used for local and regional planning and to assess and improve current performance at facility level. PMID:20822598

  19. New York State School Facilities and Student Health, Achievement, and Attendance: A Data Analysis Report

    ERIC Educational Resources Information Center

    Boese, Stephen; Shaw, John

    2005-01-01

    Students who attend schools with environmental hazards that impact indoor air quality are more likely to miss class, and therefore lose learning opportunities. Yet school environmental health and safety remains largely unregulated and there is no state or federal agency in charge of protecting children's environmental health in schools. This…

  20. Master Facilities Inventory: A Study of Health Manpower Training Resources. Jackson and Clay Counties, Missouri--1967.

    ERIC Educational Resources Information Center

    Zimmerman, T. F.; Crnic, Carol A.

    The objective of this inventory was to provide basic data concerning the effectiveness of new health manpower training programs for comparison with future studies and documented information, for planning purposes. It was necessary to define the components of the health manpower training network and to identify individuals responsible for its


  1. Critical Factors in Mental Health Programming for Juveniles in Corrections Facilities

    ERIC Educational Resources Information Center

    Underwood, Lee A.; Phillips, Annie; von Dresner, Kara; Knight, Pamela D.

    2006-01-01

    Juveniles with mental health and other specialized needs are overrepresented in the juvenile justice system, and while juvenile corrections have not historically provided standardized and evidence-based mental health services for its incarcerated youth, the demand is evident. The reality is that juveniles with serious mental illness are committed


  2. Construction Grants for Educational Facilities. Fiscal Years 1965-76. Health Manpower References.

    ERIC Educational Resources Information Center

    Health Resources Administration (DHEW/PHS), Bethesda, MD. Bureau of Health Manpower.

    This publication provides information on construction assistance awarded during fiscal years 1965 through 1976 by the Bureau of Health Manpower (BHM) and its predecessors to schools of medicine, osteopathic medicine, dentistry, optometry, pharmacy, podiatric medicine, veterinary medicine, public health, and nursing. In addition, it provides data


  3. JAMA Patient Page: Abdominal Hernia

    MedlinePLUS

    ... shown to be better than traditional open operations. Sources: National Library of Medicine at the National Institutes of Health FOR MORE INFORMATION National Library of Medicine http://www.nlm.nih. ...

  4. SUSTAINABLE TECHNOLOGY DIVISION - HOME PAGE

    EPA Science Inventory

    The mission of the Sustainable Technology Division is to advance the scientific understanding, development and application of technologies and methods for prevention, removal and control of environmental risks to human health and ecology. The Division is organized into four bra...

  5. Realistic page-turning of electronic books

    NASA Astrophysics Data System (ADS)

    Fan, Chaoran; Li, Haisheng; Bai, Yannan

    2014-01-01

    The booming electronic books (e-books), as an extension to the paper book, are popular with readers. Recently, many efforts are put into the realistic page-turning simulation o f e-book to improve its reading experience. This paper presents a new 3D page-turning simulation approach, which employs piecewise time-dependent cylindrical surfaces to describe the turning page and constructs smooth transition method between time-dependent cylinders. The page-turning animation is produced by sequentially mapping the turning page into the cylinders with different radii and positions. Compared to the previous approaches, our method is able to imitate various effects efficiently and obtains more natural animation of turning page.

  6. The "Pathological Gambling and Epidemiology" (PAGE) study program: design and fieldwork.

    PubMed

    Meyer, Christian; Bischof, Anja; Westram, Anja; Jeske, Christine; de Brito, Susanna; Glorius, Sonja; Schön, Daniela; Porz, Sarah; GĂŒrtler, Diana; Kastirke, Nadin; Hayer, Tobias; Jacobi, Frank; Lucht, Michael; Premper, Volker; Gilberg, Reiner; Hess, Doris; Bischof, Gallus; John, Ulrich; Rumpf, Hans-JĂŒrgen

    2015-03-01

    The German federal states initiated the "Pathological Gambling and Epidemiology" (PAGE) program to evaluate the public health relevance of pathological gambling. The aim of PAGE was to estimate the prevalence of pathological gambling and cover the heterogenic presentation in the population with respect to comorbid substance use and mental disorders, risk and protective factors, course aspects, treatment utilization, triggering and maintenance factors of remission, and biological markers. This paper describes the methodological details of the study and reports basic prevalence data. Two sampling frames (landline and mobile telephone numbers) were used to generate a random sample from the general population consisting of 15,023 individuals (ages 14 to 64) completing a telephone interview. Additionally, high-risk populations have been approached in gambling locations, via media announcements, outpatient addiction services, debt counselors, probation assistants, self-help groups and specialized inpatient treatment facilities. The assessment included two steps: (1) a diagnostic interview comprising the gambling section of the Composite International Diagnostic Interview (CIDI) for case finding; (2) an in-depth clinical interview with participants reporting gambling problems. The in-depth clinical interview was completed by 594 participants, who were recruited from the general or high-risk populations. The program provides a rich epidemiological database which is available as a scientific use file. PMID:25583586

  7. Releases of Contaminants from Oak Ridge Facilities and Risks to Public Health; Final Report of the Oak Ridge Health Agreement Steering Panel

    SciTech Connect

    Alexander, James; Brooks, Barbara; Erwin, Paul; Hamilton, Joseph; Holloway, Jacqueline; Lipford, Patrick; Morin, Norma; Peelle, Robert; Smith, James; Voilleque, Paul; Zawia, Nasser; Williams, Leo

    1999-12-01

    In the early 1990s, concern about the Oak Ridge Reservation's past releases of contaminants to the environment prompted Tennessee's public health officials to pursue an in-depth study of potential off-site health effects at Oak Ridge. This study, the Oak Ridge dose reconstruction, was supported by an agreement between the U.S. Department of Energy (DOE) and the State of Tennessee, and was overseen by a 12-member panel appointed by Tennessee's Commissioner of Health. The following report, "Releases of Contaminants from Oak Ridge Facilities and Risks to Public Health," was written by the Oak Ridge Health Agreement Steering Panel (ORHASP) for the following purposes: (1) to explain the components and process of the lengthy, complex study; (2) to summarize important study results in less technical language; and (3) to provide the State with the Panel's recommendations for future actions concerning the Oak Ridge communities.The dose reconstruction process involved the examination of thousands of historical records to obtain information relating to past operations at each facility. It resulted in hundreds of documents being declassified and provided an avenue for a complete public accounting of past practices and releases. Researchers used this information to identify released contaminants of concern, to estimate the quantity and timing of these releases, to evaluate the routes taken by contaminants through the environment to nearby populations, and to estimate the doses and health risks to exposed groups.The results suggest it is likely that some people's risks of developing various types of cancers or other health effects were increased because of the releases. Two groups were most likely to have been harmed: local children drinking milk, in the early 1950's, from a "backyard" cow or goat that had grazed on pastures contaminated with iodine-131, and fetuses carried in the 1950's and early 1960's by women who routinely ate fish taken from nearby creeks and rivers contaminated with mercury and PCBs. More detailed dose and risk estimates, and associated uncertainties, are presented in seven technical reports. One way to easily locate them in OSTI's Information Bridge is by searching the "author field" for the name "Widner," since Mr. T.E. Widner was the principal investigator on this project.

  8. Four Single-Page Learning Models.

    ERIC Educational Resources Information Center

    Hlynka, Denis

    1979-01-01

    Identifies four models of single-page learning systems that can streamline lengthy, complex prose: Information Mapping, Focal Press Model, Behavioral Objectives Model, and School Mathematics Model. (CMV)

  9. Mental Health Disorders and Treatment Seeking Among Veterans in Non-VA Facilities: Results and Implications from the Veterans’ Health Study

    PubMed Central

    Boscarino, Joseph A.; Hoffman, Stuart N.; Pitcavage, James M.; Urosevich, Thomas G.

    2015-01-01

    We surveyed 700 veterans who were outpatients in a non–Veterans Affairs (VA) multihospital system. Our objective was to assess the prevalence of mental disorders and service use among these veterans. The majority were Vietnam veterans (72.0%), and male (95.9%), and 40.4% reported recently using the VA for care. The prevalence of lifetime post-traumatic stress disorder (PTSD) was 9.6%, lifetime depression 18.4%, and lifetime mental health service use 50.1%. In multivariate analyses, significant factors associated with PTSD, depression, and mental health service use were low self-esteem, use of alcohol/drugs to cope, history of childhood adversity, high combat exposure, and low psychological resilience. VA service use was associated with greater mental health service use and combat exposure. With the exception of alcohol misuse, the mental health status of veterans seen in non-VA facilities appeared to be better than reported in past studies. Because most veterans have access to both VA and non-VA services, these findings have implications for veterans and outcomes research. PMID:26640743

  10. Effects of Linear Texts in Page Scrolling and Page-by-Page Reading Forms on Reading Comprehension Introduction

    ERIC Educational Resources Information Center

    Sahin, Ayfer

    2011-01-01

    This research aims to analyse the Effect of Scrolling and page by page moving Static Texts on Comprehension of Screen Reading of 4th grade students. The sample was composed of 46 students of 4th grade students of a elementary school in Kirsehir Central Province. The classrooms of the participants were selected by random sampling method and…

  11. 47 CFR 22.531 - Channels for paging operation.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 22.531 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Paging and Radiotelephone Service Paging Operation § 22.531 Channels for paging operation. The following channels are allocated for assignment to base transmitters that provide paging...

  12. 47 CFR 22.531 - Channels for paging operation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 22.531 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Paging and Radiotelephone Service Paging Operation § 22.531 Channels for paging operation. The following channels are allocated for assignment to base transmitters that provide paging...

  13. 47 CFR 22.531 - Channels for paging operation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 22.531 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Paging and Radiotelephone Service Paging Operation § 22.531 Channels for paging operation. The following channels are allocated for assignment to base transmitters that provide paging...

  14. 47 CFR 22.531 - Channels for paging operation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 22.531 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Paging and Radiotelephone Service Paging Operation § 22.531 Channels for paging operation. The following channels are allocated for assignment to base transmitters that provide paging...

  15. Current issues in the design of academic health sciences libraries: findings from three recent facility projects*

    PubMed Central

    Nelson, Patricia P.

    2003-01-01

    Planning a new health sciences library at the beginning of the twenty-first century is a tremendous challenge. Technology has radically changed the way libraries function in an academic environment and the services they provide. Some individuals question whether the library as place will continue to exist as information becomes increasingly available electronically. To understand how libraries resolve programming and building design issues, visits were made to three academic health sciences libraries that have had significant renovation or completed new construction. The information gathered will be valuable for planning a new library for the University of Colorado Health Sciences Center and may assist other health sciences librarians as they plan future library buildings. PMID:12883559

  16. Current issues in the design of academic health sciences libraries: findings from three recent facility projects.

    PubMed

    Nelson, Patricia P

    2003-07-01

    Planning a new health sciences library at the beginning of the twenty-first century is a tremendous challenge. Technology has radically changed the way libraries function in an academic environment and the services they provide. Some individuals question whether the library as place will continue to exist as information becomes increasingly available electronically. To understand how libraries resolve programming and building design issues, visits were made to three academic health sciences libraries that have had significant renovation or completed new construction. The information gathered will be valuable for planning a new library for the University of Colorado Health Sciences Center and may assist other health sciences librarians as they plan future library buildings. PMID:12883559

  17. Health risk assessment of exposure to chlorpyrifos and dichlorvos in children at childcare facilities.

    PubMed

    Kim, Ho-Hyun; Lim, Young-Wook; Yang, Ji-Yeon; Shin, Dong-Chun; Ham, Hyun-Sook; Choi, Byung-Soon; Lee, Jae-Young

    2013-02-01

    The present study evaluated 168 childcare facilities from 6 cities in South Korea to assess exposure to organophosphorus pesticides (OPs) in children through 4 major pathways (indoor air, indoor dust, surface wipe of indoor objects, and hand wash water of children). The Excess Cancer Risk (ECR) was calculated based on the Cancer Potency Factor (CPF) and Age Dependent Adjustment Factor (ADAF) in adults. Dichlorvos residues were detected in the indoor air, indoor dust, surface wipes of indoor objects, and the hand wash water of children at frequencies of 47.4, 90, 100, and 100%, respectively. After revision based on the ADAF, total cancer risk in the 50th percentile was 3.99×10(-3) for inhalation, oral intake, and dermal contact in children ages 3 to 4 and 4.63×10(-4) in kindergarteners ages 5 to 6. Inhalation was the primary pathway of pesticide exposure in children in childcare facilities. Children ages 3 to 4 in daycare centers had a Hazard Quotient (HQ) of 0.5 for dichlorvos, which was 50% lower than the risk criterion level of 1 but was higher than the 95% percentile with a HQ of 1.9. This study postulates that children in childcare facilities may be exposed to specific OPs. PMID:23291477

  18. Information needs for siting new, and evaluating current, nuclear facilities: ecology, fate and transport, and human health.

    PubMed

    Burger, Joanna; Clarke, James; Gochfeld, Michael

    2011-01-01

    The USA is entering an era of energy diversity, and increasing nuclear capacity and concerns focus on accidents, security, waste, and pollution. Physical buffers that separate outsiders from nuclear facilities often support important natural ecosystems but may contain contaminants. The US Nuclear Regulatory Commission (NRC) licenses nuclear reactors; the applicant provides environmental assessments that serve as the basis for Environmental Impact Statements developed by NRC. We provide a template for the types of information needed for safe siting of nuclear facilities with buffers in three categories: ecological, fate and transport, and human health information that can be used for risk evaluations. Each item on the lists is an indicator for evaluation, and individual indicators can be selected for specific region. Ecological information needs include biodiversity (species, populations, communities) and structure and functioning of ecosystems, habitats, and landscapes, in addition to common, abundant, and unique species and endangered and rare ones. The key variables of fate and transport are sources of release for radionuclides and other chemicals, nature of releases (atmospheric vapors, subsurface liquids), features, and properties of environmental media (wind speed, direction and atmospheric stability, hydraulic gradient, hydraulic conductivity, groundwater chemistry). Human health aspects include receptor populations (demography, density, dispersion, and distance), potential pathways (drinking water sources, gardening, fishing), and exposure opportunities (lifestyle activities). For each of the three types of information needs, we expect that only a few of the indicators will be applicable to a particular site and that stakeholders should agree on a site-specific suite. PMID:20140506

  19. Improved Malaria Case Management through the Implementation of a Health Facility-Based Sentinel Site Surveillance System in Uganda

    PubMed Central

    Sserwanga, Asadu; Harris, Jamal C.; Kigozi, Ruth; Menon, Manoj; Bukirwa, Hasifa; Gasasira, Anne; Kakeeto, Stella; Kizito, Fred; Quinto, Ebony; Rubahika, Denis; Nasr, Sussann; Filler, Scott; Kamya, Moses R.; Dorsey, Grant

    2011-01-01

    Background Heath facility-based sentinel site surveillance has been proposed as a means of monitoring trends in malaria morbidity but may also provide an opportunity to improve malaria case management. Here we described the impact of a sentinel site malaria surveillance system on promoting laboratory testing and rational antimalarial drug use. Methodology/Principal Findings Sentinel site malaria surveillance was established at six health facilities in Uganda between September 2006 and January 2007. Data were collected from all patients presenting to the outpatient departments including demographics, laboratory results, diagnoses, and treatments prescribed. Between the start of surveillance and March 2010, a total 424,701 patients were seen of which 229,375 (54%) were suspected of having malaria. Comparing the first three months with the last three months of surveillance, the proportion of patients with suspected malaria who underwent diagnostic testing increased from 39% to 97% (p<0.001). The proportion of patients with an appropriate decision to prescribe antimalarial therapy (positive test result prescribed, negative test result not prescribed) increased from 64% to 95% (p<0.001). The proportion of patients appropriately prescribed antimalarial therapy who were prescribed the recommended first-line regimen artemether-lumefantrine increased from 48% to 69% (p<0.001). Conclusions/Significance The establishment of a sentinel site malaria surveillance system in Uganda achieved almost universal utilization of diagnostic testing in patients with suspected malaria and appropriate decisions to prescribed antimalarial based on test results. Less success was achieved in promoting prescribing practice for the recommended first-line therapy. This system could provide a model for improving malaria case management in other health facilities in Africa. PMID:21283815

  20. An Evaluation of the Clinical Assessments of Under-Five Febrile Children Presenting to Primary Health Facilities in Rural Ghana

    PubMed Central

    Baiden, Frank; Owusu-Agyei, Seth; Bawah, Justina; Bruce, Jane; Tivura, Mathilda; Delmini, Rupert; Gyaase, Stephaney; Amenga-Etego, Seeba; Chandramohan, Daniel; Webster, Jayne

    2011-01-01

    Background The shift to test-based management of malaria represents an important departure from established practice under the Integrated Management of Childhood Illnesses (IMCI). The possibility of false results of tests for malaria and co-morbidity, however, make it important that guidelines in IMCI case assessment are still followed. Methods and Findings We conducted a cross-sectional observational study to evaluate current practices in IMCI-based assessment of febrile children in 10 health centres and 5 district hospitals, with follow up of a subset of children to determine day 7–10 post-treatment clinical outcome. Clinical consultation, examination and prescribing practices were recorded using a checklist by trained non-medical observers. The facility case management of 1,983 under-five years old febrile children was observed and 593 followed up at home on days 5–10. The mean number of tasks performed from the 11 tasks expected to be done by the IMCI guidelines was 6 (SD 1.6). More than 6 tasks were performed in only 35% of children and this varied substantially between health facilities (range 3–85%). All 11 tasks were performed in only 1% of children. The most commonly performed tasks were temperature measurement (91%) and weighing (88%). Respiratory rate was checked in only 4% of children presenting with cough or difficulty in breathing. The likelihood of performing “better than average number of tasks” (>6) was higher when the consultation was done by medical assistants than doctors (O.R.?=?3.16, 1.02–9.20). The number of tasks performed during assessment did not, however, influence clinical outcome (O.R.?=?1.02, 0.83–1.24). Conclusion Facility-tailored interventions are needed to improve adherence to IMCI guidelines incorporating test-based management of malaria. Studies are needed to re-evaluate the continued validity of tasks defined in IMCI case assessment guidelines. PMID:22174932

  1. Quality of Antimalarial Drugs and Antibiotics in Papua New Guinea: A Survey of the Health Facility Supply Chain

    PubMed Central

    Hetzel, Manuel W.; Page-Sharp, Madhu; Bala, Nancy; Pulford, Justin; Betuela, Inoni; Davis, Timothy M. E.; Lavu, Evelyn K.

    2014-01-01

    Background Poor-quality life-saving medicines are a major public health threat, particularly in settings with a weak regulatory environment. Insufficient amounts of active pharmaceutical ingredients (API) endanger patient safety and may contribute to the development of drug resistance. In the case of malaria, concerns relate to implications for the efficacy of artemisinin-based combination therapies (ACT). In Papua New Guinea (PNG), Plasmodium falciparum and P. vivax are both endemic and health facilities are the main source of treatment. ACT has been introduced as first-line treatment but other drugs, such as primaquine for the treatment of P. vivax hypnozoites, are widely available. This study investigated the quality of antimalarial drugs and selected antibiotics at all levels of the health facility supply chain in PNG. Methods and Findings Medicines were obtained from randomly sampled health facilities and selected warehouses and hospitals across PNG and analysed for API content using validated high performance liquid chromatography (HPLC). Of 360 tablet/capsule samples from 60 providers, 9.7% (95% CI 6.9, 13.3) contained less, and 0.6% more, API than pharmacopoeial reference ranges, including 29/37 (78.4%) primaquine, 3/70 (4.3%) amodiaquine, and one sample each of quinine, artemether, sulphadoxine-pyrimethamine and amoxicillin. According to the package label, 86.5% of poor-quality samples originated from India. Poor-quality medicines were found in 48.3% of providers at all levels of the supply chain. Drug quality was unrelated to storage conditions. Conclusions This study documents the presence of poor-quality medicines, particularly primaquine, throughout PNG. Primaquine is the only available transmission-blocking antimalarial, likely to become important to prevent the spread of artemisinin-resistant P. falciparum and eliminating P. vivax hypnozoites. The availability of poor-quality medicines reflects the lack of adequate quality control and regulatory mechanisms. Measures to stop the availability of poor-quality medicines should include limiting procurement to WHO prequalified products and implementing routine quality testing. PMID:24828338

  2. Automated Title Page Cataloging: A Feasibility Study.

    ERIC Educational Resources Information Center

    Weibel, Stuart; And Others

    1989-01-01

    Describes the design of a prototype rule-based system for the automation of descriptive cataloging from title pages. The discussion covers the results of tests of the prototype, major impediments to automatic cataloging from title pages, and prospects for further progress. The rules implemented in the prototype are appended. (16 references)…

  3. Unit Pages: Differentiation for 200 Students

    ERIC Educational Resources Information Center

    Carver, Andrea; Bailey, Janelle M.

    2010-01-01

    Based upon the models of differentiated instruction (Tomlinson and Edison 2003) and Layered Curriculum (Nunley 2004), the author created the Unit Pages strategy. Just like Layered Curriculum, the pages can be handed directly to students, allowing them to take charge of their own learning rather than requiring the teacher to individually monitor…

  4. Adding Sound and Video to Web Pages.

    ERIC Educational Resources Information Center

    Duval, Beverly K.; Main, Linda

    1997-01-01

    Explains how to incorporate sound and video into Web pages with special software and HTML tags. Topics include creating sound files; sound formats; video technology; video formats; referencing sound and video files in HTML pages; embedding sounds and videos; players, plug-ins, and viewers; sound and video files from the Web; and streaming. (LRW)

  5. 40 CFR 1502.7 - Page limits.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 33 2011-07-01 2011-07-01 false Page limits. 1502.7 Section 1502.7 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY ENVIRONMENTAL IMPACT STATEMENT § 1502.7 Page limits. The text of final environmental impact statements (e.g., paragraphs (d) through (g) of §...

  6. 40 CFR 1502.7 - Page limits.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 34 2013-07-01 2013-07-01 false Page limits. 1502.7 Section 1502.7 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY ENVIRONMENTAL IMPACT STATEMENT § 1502.7 Page limits. The text of final environmental impact statements (e.g., paragraphs (d) through (g) of §...

  7. 40 CFR 1502.7 - Page limits.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 34 2012-07-01 2012-07-01 false Page limits. 1502.7 Section 1502.7 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY ENVIRONMENTAL IMPACT STATEMENT § 1502.7 Page limits. The text of final environmental impact statements (e.g., paragraphs (d) through (g) of §...

  8. 40 CFR 1502.7 - Page limits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Page limits. 1502.7 Section 1502.7 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY ENVIRONMENTAL IMPACT STATEMENT § 1502.7 Page limits. The text of final environmental impact statements (e.g., paragraphs (d) through (g) of §...

  9. 40 CFR 1502.7 - Page limits.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 33 2014-07-01 2014-07-01 false Page limits. 1502.7 Section 1502.7 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY ENVIRONMENTAL IMPACT STATEMENT § 1502.7 Page limits. The text of final environmental impact statements (e.g., paragraphs (d) through (g) of §...

  10. Web Page Authoring Tools: Comparison and Trends.

    ERIC Educational Resources Information Center

    Craney, Linda

    Initially available from universities and individual enthusiasts, software tools to author World Wide Web pages are maturing into very feature-rich applications and are now offered by large corporations. These applications are enabling more companies to create and maintain pages themselves on the Web or on corporate Intranets. The market continues


  11. Awareness and knowledge of disease surveillance and notification by health-care workers and availability of facility records in Anambra state, Nigeria

    PubMed Central

    Nnebue, Chinomnso C.; Onwasigwe, Chika N.; Adogu, Prosper O. U; Onyeonoro, Ugochukwu U.

    2012-01-01

    Background: Disease surveillance and notification (DSN) is part of the Health Management Information System (HMIS) which comprises databases, personnel, and materials that are organized to collect data which are utilized for informed decision making. The knowledge about DSN is very important for the reporting of notifiable diseases. Objective: The aim of this study is to examine the awareness and knowledge of health-care workers about DSN, and availability of facility records in Anambra State, Nigeria. Materials and Methods: The study was a descriptive cross-sectional one in which relevant data were collected from health-care workers selected by a multistage sampling technique. Qualitative information was also elicited by key informant interviews, whereas an observational checklist, preceded by a desk review was used to examine the availability of facility records. Results: Although 89.8% of the health-care workers were aware of the DSN system, only 33.3, 31.1, and 33.7% of them knew the specific uses of forms IDSR 001, IDSR 002, and IDSR 003 (IDSR: Integrated Diseases Surveillance and Response), respectively. Knowledge of use of the various forms at the facility and local government area (LGA) levels were generally low, although the observational checklist revealed that IDSR 001 and IDSR 002 forms were predominantly found in primary health-care facilities. HMIS forms were less likely to be available in secondary health-care facilities (?2=7.67, P=0.005). Conclusions: Regular training and retraining of concerned health-care workers on DSN at the LGA level is recommended. This should run concurrently with adequate and regular provision of IDSR forms, copies of the standard case definitions, and other necessary logistics to the health-care facilities by the local and state governments. PMID:23661882

  12. [Youth and health: discourse analysis on supply and access to public facilities].

    PubMed

    Souza, Cinoélia Leal; Souzas, Raquel

    2012-01-01

    From the standpoint of sociodemographic, teens today represent an important portion of the Brazilian population. In 2005 the Brazilian government published the National Youth Policy. Despite of this, many teens still find difficulties in accessing public services, especially the ones involving health. This study aimed to analyze young students' speeches about the conditions of access to public services and health through qualitative research. The students inquired live in rural and urban areas of the city of Vitória da Conquista - Bahia. The method used was the content analysis proposed by Bardin (1979) and Minayo (2006), and the technique of discussion groups for youth proposed by Weller (2006). PMID:23559169

  13. Recent changes in human resources for health and health facilities at the district level in Indonesia: evidence from 3 districts in Java

    PubMed Central

    2011-01-01

    Background There is continuing discussion in Indonesia about the need for improved information on human resources for health at the district level where programs are actually delivered. This is particularly the case after a central government decision to offer doctors, nurses and midwives on contract the chance to convert to permanent civil service status. Our objective here is to report changes between 2006 and 2008 in numbers and employment status of health staff in three districts following the central government decision. Methods Information was derived from records at the district health office and, where necessary for clarification, discussions with district officials. Results Across the three districts and all public sector provider categories there was an increase of almost 680 providers between 2006 and 2008 - more than 300 nurses, more than 300 midwives and 25 doctors. The increases for permanent public servants were proportionately much greater (43%) than the total (16%). The increase in those who are permanent civil servants was greatest for nurses (51%) and midwives (35%) with corresponding decreases in the proportion of staff on contract. There was considerable variation between the three districts. Conclusions There has been a significant increase in the number of healthcare providers in the 3 districts surveyed and the proportion now permanent public servants has increased even more than the increase in total numbers. The changes have the effect of increasing the proportion of total public expenditure allocated to salaries and reducing the flexibility of the districts in managing their own budgets. Because public servants are allowed private practice outside office hours there has also been an increase in the number of private practice facilities offering health care. These changes illustrate the need for a much improved human resources information system and a coherent policy to guide actions on human resources for health at the national, provincial and district levels. PMID:21314986

  14. Health Systems Readiness to Manage the Hypertension Epidemic in Primary Health Care Facilities in the Western Cape, South Africa: A Study Protocol

    PubMed Central

    Yaya, Sanni; Labonté, Ronald

    2016-01-01

    Background Developing countries are undergoing a process of epidemiological transition from infectious to noncommunicable diseases, described by the United Nations Secretary General Ban Ki-Moon as ‘‘a public health emergency in slow motion.” One of the most prevalent in sub-Saharan Africa is hypertension, which is a complex chronic condition often referred to as a “silent killer” and key contributor to the development of cardiovascular and cerebrovascular diseases. Hypertensive patients in this setting are estimated to increase from 74.7 million in 2008 to 125.5 million in 2025, a 68% increase. However, there is an important gap between emerging high-level policies and recommendations, and the near-absence of practical guidance and experience delivering long-term medical care for noncommunicable diseases within resource-limited health systems. Objective To address this gap, our study will consist of field investigations to determine the minimum health systems requirements to ensure successful delivery of antihypertensive medications when scaling-up interventions to control the hypertension epidemic. Methods A cross-sectional analytic study will be conducted in the Western Cape using a mixed-method approach with two semistructured interview guides. The first will be for health professionals involved in the care of hypertensive patients within at least 6 community health centers (3 urban and 3 rural) to understand the challenges associated with their care. The second will be to map and assess the current supply chain management system of antihypertensive medications by interviewing key informants at different levels of the processes. Finally, modeling and simulation tools will be used to understand how to estimate minimum numbers of health workers required at each supply chain interval to ensure successful delivery of medications when scaling-up interventions. Results Funding for the study was secured through a Doctoral Research Award in October 2014 from the International Development Research Centre (IDRC). The study is currently in the data analysis phase and results are expected during the first half of 2016. Conclusions This investigation will highlight the detailed processes in place for the care of hypertensive patients in primary health care facilities, and thus also identify the challenges. It will also describe the drug supply chain management systems in place and identify their strengths and weaknesses. The findings, along with the estimates from modeling and simulation, will inform the health system minimum requirements to scale-up interventions to manage and control the hypertension epidemic in the Western Cape province of South Africa. PMID:26925539

  15. The value of purpose built mental health facilities: Use of the Ward Atmosphere Scale to gauge the link between milieu and physical environment.

    PubMed

    Nicholls, Daniel; Kidd, Kevin; Threader, Jennifer; Hungerford, Catherine

    2015-08-01

    This study investigated changes in the 'atmosphere' of an acute adult mental health setting following relocation to a new purpose-built facility. The Ward Atmosphere Scale (WAS) was designed and validated for specific use in hospital-based psychiatric facilities, and measures several dimensions of an environment. In this study, the WAS was administered to consumers and staff at periods before and also after their relocation to a new purpose-built acute adult mental health facility. There were significant improvements in the physical atmosphere of the new facility, when compared with the old facility. In terms of ward atmosphere, however, improvements were seen to occur in only a small number of measures and there were minor differences between consumers' and staff perspectives on some indicators. Interestingly, it was found that consumers noted less 'staff control' in the new setting, raising the question of the differences in understanding of control. For staff only, there was a perception of greater levels of consumer 'involvement' in the new facility. Despite the minor differences in perception, the study does confirm that architecture is an important influence on the 'atmosphere' of a health facility, for both staff and consumers. PMID:25975388

  16. 42 CFR 415.204 - Services of residents in skilled nursing facilities and home health agencies.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... health agencies. (a) Medicare Part A payment. Payment is made under Medicare Part A for interns' and... an intern or resident who is in an approved GME program in a hospital with which the skilled nursing... for the cost of the services of an intern or resident who is under an approved GME program of...

  17. 42 CFR 415.204 - Services of residents in skilled nursing facilities and home health agencies.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... health agencies. (a) Medicare Part A payment. Payment is made under Medicare Part A for interns' and... an intern or resident who is in an approved GME program in a hospital with which the skilled nursing... for the cost of the services of an intern or resident who is under an approved GME program of...

  18. 42 CFR 415.204 - Services of residents in skilled nursing facilities and home health agencies.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... health agencies. (a) Medicare Part A payment. Payment is made under Medicare Part A for interns' and... an intern or resident who is in an approved GME program in a hospital with which the skilled nursing... for the cost of the services of an intern or resident who is under an approved GME program of...

  19. Occupational Analysis of Social Service in Medical Care Facilities. The UCLA Allied Health Professions Project.

    ERIC Educational Resources Information Center

    Ainsworth, T. David; Goldsmith, Katherine L.

    This report is a summary of the functional analysis of the activities of those engaged in social service occupations in medical settings, which was conducted as part of the UCLA Allied Health Professions Project. A task inventory composed of 192 tasks relating to intake, information and referral, treatment, supportive, community and administrative…

  20. Barriers and solutions in implementing occupational health and safety services at a large nuclear weapons facility.

    PubMed

    Takaro, T K; Ertell, K; Salazar, M K; Beaudet, N; Stover, B; Hagopian, A; Omenn, G; Barnhart, S

    2000-01-01

    The Hanford Nuclear Reservation is one of the U.S. Department of Energy's largest nuclear weapons sites. The enormous changes experienced by Hanford over the last several years, as its mission has shifted from weapons production to cleanup, has profoundly affected its occupational health and safety services. Innovative programs and new initiatives hold promise for a safer workplace for the thousands of workers at Hanford and other DOE sites. However, occupational health and safety professionals continue to face multiple organizational, economic, and cultural challenges. A major problem identified during this review was the lack of coordination of onsite services. Because each health and safety program operates independently (albeit with the guidance of the Richland field operations office), many services are duplicative and the health and safety system is fragmented. The fragmentation is compounded by the lack of centralized data repositories for demographic and exposure data. Innovative measures such as a questionnaire-driven Employee Job Task Analysis linked to medical examinations has allowed the site to move from the inefficient and potentially dangerous administrative medical monitoring assignment to defensible risk-based assignments and could serve as a framework for improving centralized data management and service delivery. PMID:11186038

  1. Benefits of community-based education to the community in South African health science facilities

    PubMed Central

    Flack, Penny

    2013-01-01

    Abstract Background Community-based education (CBE) is utilised by health science faculties worldwide to provide a relevant primary care experience for students and a service to underserved communities and, hopefully, to affect student career choices. The benefits to training institutions and students are well documented, but it may well be that communities, too, will be able to benefit from a more balanced partnership, where they are consulted in the planning of such training programmes. Method An exploratory qualitative study was undertaken by three South African universities in the provinces of Limpopo, KwaZulu-Natal and the Western Cape. Focus group interviews were conducted in their local languages with groups of community leaders, patients and supervisors at community sites involved in CBE training. A thematic analysis of their views was undertaken with the aid of NVivo (version 9). Ethics approval was obtained from the respective universities and health care training sites. Results Benefits to the community could be categorised into short-term and long-term benefits. Short-term benefits included improved service delivery, reduction in hospital referrals, home visits and community orientated primary health care, improved communication with patients and enhanced professionalism of the health care practitioner. Long-term benefits included improved teaching through a relationship with an academic institution and student familiarity with the health care system. Students also became involved in community upliftment projects, thereby acting as agents of change in these communities. Conclusion Communities can certainly benefit from well-planned CBE programmes involving a training site - community site partnership.

  2. A Comparative Analysis of the Functional Disability Levels of Adult Day Care, Adult Day Health and ICF-Level Nursing Home Elderly in Hawaii.

    ERIC Educational Resources Information Center

    Hayashida, Cullen T.

    This study compared the functional disability levels of participants in adult day centers with patients in intermediate care facilities (ICFs). A three-page questionnaire measuring demographics, social resources, physical health, mental health, and activities of daily living as assessed by the Activities of Daily Living scale and the Instrumental


  3. Economic Activities, Illness Pattern and Utilisation of Health Care Facilities in the Rural Population of Kwazulu-Natal, South Africa

    PubMed Central

    2009-01-01

    ABSTRACT Background The study was undertaken among the rural and black communities of the Uthungulu health district of the KwaZulu-Natal province, South Africa. Method A cross-sectional community-based descriptive study was conducted. A multi-stage sampling strategy was adopted to obtain a representative sample of the communities. Results The mean age of the population was 27 years and majority was female (54%). Among the adult population only 30% were educated, 19% were engaged in some form of economic activities while 9% were in the formal employment sector. The average monthly income per household was R1 301 (95% CI, R1 283; R1 308). The illnesses were reported by 27% of the total population over a period of one month. Notably higher rates of female individuals (29%) were sick compared to males (24%, p < 0.001). The rates of illnesses among adult females (39%) were also significantly higher than among males (31%, p < 0.009). Most of them (69%) attended primary health care (PHC) clinics for medical services, while 67% reported chronic conditions. Age (OR = 1.4), gender (OR = 0.711), education (OR = 0.64) and economic activities (OR = 1.9) were found to be associated with being ill or not. Conclusion The rural black communities are underdeveloped and deprived, which results in higher prevalence of illnesses; however, the utilisation of PHC facilities is comparatively higher than in the rest of the province and other parts of the country. Interventions to improve community health care services among the deprived population should be focused through public health strategies such as all-encompassing PHC that includes health promotion, education and basic essential amenities.

  4. Meditation and Health

    MedlinePLUS

    ... Health Features Media Sign up for Features Get Email Updates To receive email updates about this page, ... topic . Features Media Sign up for Features Get Email Updates To receive email updates about this page, ...

  5. Health Effects of Exposure to Asbestos

    MedlinePLUS

    ... Asbestos Exposure, and your Health . Top of Page Health Risks of Asbestos Exposure Chronic exposure to asbestos may ... action that you can take to improve your health and decrease your risk of cancer. Top of Page Conditions Associated with ...

  6. Perceived health status and environmental quality in the assessment of external costs of waste disposal facilities. An empirical investigation.

    PubMed

    Giaccaria, Sergio; Frontuto, Vito

    2012-08-01

    Taxation for urban waste management has been reformed in Italy by the introduction of an environmental law in 2006. In the planning phase of waste management, externalities generated by new facilities remain widely unaccounted, with a consequent distortion for prices, often raising local conflicts. The paper presents a survey based on the choice modelling methodology, aimed to evaluate on a monetary scale the disamenity effect perceived by incinerator and landfills in an Italian urban context: the city of Turin. In a random utility framework the behaviour of respondents, whose choices are found to be driven by the endowment of information about technological options, socio-economic characteristics as income, education, family composition, and also by their health status was modelled. Furthermore, empirical evidence that the behaviour in residential location choices is affected by different aspects of the respondent life and in particular by the health status was found. Distinct estimates of willingness to accept compensation for disamenity effects of incinerator (Euro 2670) and landfill (Euro 3816) are elicited. The effect of health status of the respondents, their level of information about the waste disposal infrastructure, the presence of a subjective strong aversion (NIMBY) and the actual endowment and concentration of infrastructures are demonstrated to be significant factors determining the choice behaviour, but differentiated and specific for incinerators and landfills. PMID:22588111

  7. Routine delivery of artemisinin-based combination treatment at fixed health facilities reduces malaria prevalence in Tanzania: an observational study

    PubMed Central

    2012-01-01

    Background Artemisinin-based combination therapy (ACT) has been promoted as a means to reduce malaria transmission due to their ability to kill both asexual blood stages of malaria parasites, which sustain infections over long periods and the immature derived sexual stages responsible for infecting mosquitoes and onward transmission. Early studies reported a temporal association between ACT introduction and reduced malaria transmission in a number of ecological settings. However, these reports have come from areas with low to moderate malaria transmission, been confounded by the presence of other interventions or environmental changes that may have reduced malaria transmission, and have not included a comparison group without ACT. This report presents results from the first large-scale observational study to assess the impact of case management with ACT on population-level measures of malaria endemicity in an area with intense transmission where the benefits of effective infection clearance might be compromised by frequent and repeated re-infection. Methods A pre-post observational study with a non-randomized comparison group was conducted at two sites in Tanzania. Both sites used sulphadoxine-pyrimethamine (SP) monotherapy as a first-line anti-malarial from mid-2001 through 2002. In 2003, the ACT, artesunate (AS) co-administered with SP (AS?+?SP), was introduced in all fixed health facilities in the intervention site, including both public and registered non-governmental facilities. Population-level prevalence of Plasmodium falciparum asexual parasitaemia and gametocytaemia were assessed using light microscopy from samples collected during representative household surveys in 2001, 2002, 2004, 2005 and 2006. Findings Among 37,309 observations included in the analysis, annual asexual parasitaemia prevalence in persons of all ages ranged from 11% to 28% and gametocytaemia prevalence ranged from <1% to 2% between the two sites and across the five survey years. A multivariable logistic regression model was fitted to adjust for age, socioeconomic status, bed net use and rainfall. In the presence of consistently high coverage and efficacy of SP monotherapy and AS?+?SP in the comparison and intervention areas, the introduction of ACT in the intervention site was associated with a modest reduction in the adjusted asexual parasitaemia prevalence of 5 percentage-points or 23% (p?health facilities only modestly reduced asexual parasitaemia prevalence. ACT is effective for treatment of uncomplicated malaria and should have substantial public health impact on morbidity and mortality, but is unlikely to reduce malaria transmission substantially in much of sub-Saharan Africa where individuals are rapidly re-infected. PMID:22545573

  8. Poverty and mental health: a qualitative study of residential care facility tenants.

    PubMed

    Wilton, Robert D

    2003-04-01

    The impact of poverty on daily living was assessed for twenty-two mental health consumers using qualitative in-depth interviews. Consumers reported considerable difficulty meeting basic needs, such as clothing, shoes and personal care items. A majority reported running out of money before the end of each month. Respondents used strategies including careful budgeting, borrowing and employment to cope with poverty. Analysis indicated that the poverty experienced by respondents worked directly against participation in meaningful activities and their ability to build and sustain social relationships. Moreover, poverty directly contributed to stigma experienced by respondents. Findings suggest that a failure to recognize poverty as a key mental health policy issue will continue to constrain efforts to facilitate consumer empowerment and social integration. PMID:12723848

  9. Integrating security in multiple, remote, and diverse facilities: how major health systems are meeting today's and tomorrow's technological and organizational challenges.

    PubMed

    1996-11-01

    As the trend to mergers and diversification of healthcare facilities grows, so too does the challenge to security directors to effectively and efficiently protect not only acute care, emergency, and outpatient facilities, but physician office buildings, parking garages, long-term-care units, medical schools, technical service units, and even health clubs. Besides the different security and communications problems posed by each type of facility, the problem of distance between facilities and their geographic location must also be met. In this report, we'll update you on the approaches being taken by security and planning executives at three leading health systems and how they are dealing with current and future problems. PMID:10162834

  10. Antiretroviral Therapy Program Expansion in Zambézia Province, Mozambique: Geospatial Mapping of Community-Based and Health Facility Data for Integrated Health Planning

    PubMed Central

    Moon, Troy D.; Ossemane, Ezequiel B.; Green, Ann F.; Ndatimana, Elisée; José, Eurico; Buehler, Charlotte P.; Wester, C. William; Vermund, Sten H.; Olupona, Omo

    2014-01-01

    Objective To generate maps reflecting the intersection of community-based Voluntary Counseling and Testing (VCT) delivery points with facility-based HIV program demographic information collected at the district level in three districts (Ile, Maganja da Costa and Chinde) of Zambézia Province, Mozambique; in order to guide planning decisions about antiretroviral therapy (ART) program expansion. Methods Program information was harvested from two separate open source databases maintained for community-based VCT and facility-based HIV care and treatment monitoring from October 2011 to September 2012. Maps were created using ArcGIS 10.1. Travel distance by foot within a 10 km radius is generally considered a tolerable distance in Mozambique for purposes of adherence and retention planning. Results Community-based VCT activities in each of three districts were clustered within geographic proximity to clinics providing ART, within communities with easier transportation access, and/or near the homes of VCT volunteers. Community HIV testing results yielded HIV seropositivity rates in some regions that were incongruent with the Ministry of Health’s estimates for the entire district (2–13% vs. 2% in Ile, 2–54% vs. 11.5% in Maganja da Costa, and 23–43% vs. 14.4% in Chinde). All 3 districts revealed gaps in regional disbursement of community-based VCT activities as well as access to clinics offering ART. Conclusions Use of geospatial mapping in the context of program planning and monitoring allowed for characterizing the location and size of each district’s HIV population. In extremely resource limited and logistically challenging settings, maps are valuable tools for informing evidence-based decisions in planning program expansion, including ART. PMID:25329169

  11. Health impact assessment of waste management facilities in three European countries

    PubMed Central

    2011-01-01

    Background Policies on waste disposal in Europe are heterogeneous and rapidly changing, with potential health implications that are largely unknown. We conducted a health impact assessment of landfilling and incineration in three European countries: Italy, Slovakia and England. Methods A total of 49 (Italy), 2 (Slovakia), and 11 (England) incinerators were operating in 2001 while for landfills the figures were 619, 121 and 232, respectively. The study population consisted of residents living within 3 km of an incinerator and 2 km of a landfill. Excess risk estimates from epidemiological studies were used, combined with air pollution dispersion modelling for particulate matter (PM10) and nitrogen dioxide (NO2). For incinerators, we estimated attributable cancer incidence and years of life lost (YoLL), while for landfills we estimated attributable cases of congenital anomalies and low birth weight infants. Results About 1,000,000, 16,000, and 1,200,000 subjects lived close to incinerators in Italy, Slovakia and England, respectively. The additional contribution to NO2 levels within a 3 km radius was 0.23, 0.15, and 0.14 ?g/m3, respectively. Lower values were found for PM10. Assuming that the incinerators continue to operate until 2020, we are moderately confident that the annual number of cancer cases due to exposure in 2001-2020 will reach 11, 0, and 7 in 2020 and then decline to 0 in the three countries in 2050. We are moderately confident that by 2050, the attributable impact on the 2001 cohort of residents will be 3,621 (Italy), 37 (Slovakia) and 3,966 (England) YoLL. The total exposed population to landfills was 1,350,000, 329,000, and 1,425,000 subjects, respectively. We are moderately confident that the annual additional cases of congenital anomalies up to 2030 will be approximately 2, 2, and 3 whereas there will be 42, 13, and 59 additional low-birth weight newborns, respectively. Conclusions The current health impacts of landfilling and incineration can be characterized as moderate when compared to other sources of environmental pollution, e.g. traffic or industrial emissions, that have an impact on public health. There are several uncertainties and critical assumptions in the assessment model, but it provides insight into the relative health impact attributable to waste management. PMID:21635784

  12. Expanding Access to the Intrauterine Device in Public Health Facilities in Ethiopia: A Mixed-Methods Study.

    PubMed

    Tilahun, Yewondwossen; Mehta, Sarah; Zerihun, Habtamu; Lew, Candace; Brooks, Mohamad I; Nigatu, Tariku; Hagos, Kidest Lulu; Asnake, Mengistu; Tasissa, Adeba; Ali, Seid; Desalegn, Ketsela; Adane, Girmay

    2016-03-01

    In Ethiopia, modern contraceptive prevalence among currently married women nearly tripled over the last decade, but the method mix remains skewed toward short-acting methods. Since 2011, the Integrated Family Health Program (IFHP+), jointly implemented by Pathfinder International and John Snow Inc., has supported the Federal Ministry of Health to introduce intrauterine devices (IUDs) in more than 800 health centers across 4 regions to improve access to a wider range of methods. Between March and August 2014, Pathfinder conducted a mixed-methods study in 40 purposively selected health centers to assess shifts in the contraceptive method mix following introduction of IUDs using data from family planning registers; determine the characteristics of IUD users through a cross-sectional survey of 2,943 family planning clients who accepted the IUD; explore reasons for method discontinuation among 165 clients seeking IUD removal services; and identify facilitators and barriers to IUD use through focus group discussions (N = 115 clients) and key informant interviews (N = 36 providers, facility heads, and health office heads). Introduction of IUDs into the 40 health centers participating in the study was correlated with a statistically significant increase in the contribution of all long-acting reversible contraceptives (LARCs)-both IUDs and implants-to the method mix, from 6.9% in 2011 to 20.5% in 2014 (P<.001). Our study found that latent demand for the IUD was more prevalent than anticipated and that the method was acceptable to a broad cross-section of women. Of the 2,943 women who sought IUDs during the 6-month study period, 18.0% were new contraceptive users (i.e., those using a contraceptive method for the first time ever), 44.7% reported no educational attainment, 62.5% were from rural areas, and 59.3% were younger than 30 years old, with almost 3 in 10 (27.7%) under the age of 25. The most commonly cited reason for seeking IUD removal services was a desire to become pregnant (43% of women). Qualitative data indicated that while acceptability of the method is growing, limited community awareness, myths and misconceptions about the IUD, and infrastructure deficits at health centers must be addressed to further expand access to a broad range of contraceptive methods. PMID:27016541

  13. Vital Signs: Estimated Effects of a Coordinated Approach for Action to Reduce Antibiotic-Resistant Infections in Health Care Facilities — United States

    PubMed Central

    Slayton, Rachel B.; Toth, Damon; Lee, Bruce Y.; Tanner, Windy; Bartsch, Sarah M.; Khader, Karim; Wong, Kim; Brown, Kevin; McKinnell, James A.; Ray, William; Miller, Loren G.; Rubin, Michael; Kim, Diane S.; Adler, Fred; Cao, Chenghua; Avery, Lacey; Stone, Nathan T.B.; Kallen, Alexander; Samore, Matthew; Huang, Susan S.; Fridkin, Scott; Jernigan, John A.

    2015-01-01

    Background Treatments for health care–associated infections (HAIs) caused by antibiotic-resistant bacteria and Clostridium difficile are limited, and some patients have developed untreatable infections. Evidence-supported interventions are available, but coordinated approaches to interrupt the spread of HAIs could have a greater impact on reversing the increasing incidence of these infections than independent facility-based program efforts. Methods Data from CDC’s National Healthcare Safety Network and Emerging Infections Program were analyzed to project the number of health care–associated infections from antibiotic-resistant bacteria or C. difficile both with and without a large scale national intervention that would include interrupting transmission and improved antibiotic stewardship. As an example, the impact of reducing transmission of one antibiotic-resistant infection (carbapenem-resistant Enterobacteriaceae [CRE]) on cumulative prevalence and number of HAI transmission events within interconnected groups of health care facilities was modeled using two distinct approaches, a large scale and a smaller scale health care network. Results Immediate nationwide infection control and antibiotic stewardship interventions, over 5 years, could avert an estimated 619,000 HAIs resulting from CRE, multidrug-resistant Pseudomonas aeruginosa, invasive methicillin-resistant Staphylococcus aureus (MRSA), or C. difficile. Compared with independent efforts, a coordinated response to prevent CRE spread across a group of inter-connected health care facilities resulted in a cumulative 74% reduction in acquisitions over 5 years in a 10-facility network model, and 55% reduction over 15 years in a 102-facility network model. Conclusions With effective action now, more than half a million antibiotic-resistant health care–associated infections could be prevented over 5 years. Models representing both large and small groups of interconnected health care facilities illustrate that a coordinated approach to interrupting transmission is more effective than historical independent facility-based efforts. Implications for Public Health Public health–led coordinated prevention approaches have the potential to more completely address the emergence and dissemination of these antibiotic-resistant organisms and C. difficile than independent facility–based efforts. PMID:26247436

  14. Environmental health-risk assessment for tritium releases from the National Tritium Labeling Facility (NTLF) at Lawrence Berkeley Laboratory

    SciTech Connect

    McKone, T.E.; Brand, K.P.

    1994-12-01

    This report is a health risk assessment that addresses continuous releases of tritium to the environment from the National Tritium Labeling Facility (NTLF) at the Lawrence Berkeley Laboratory (LBL). The NTLF contributes approximately 95% of all tritium releases from LBL. Transport and transformation models were used to determine the movement of tritium releases from the NRLF to the air, surface water, soils, and plants and to determine the subsequent doses to humans. These models were calibrated against environmental measurements of tritium levels in the vicinity of the NTLF and in the surrounding community. Risk levels were determined for human populations in each of these zones. Risk levels to both individuals and populations were calculated. In this report population risks and individual risks were calculated for three types of diseases--cancer, heritable genetic effects, and developmental and reproductive effects.

  15. An overview of the space medicine program and development of the Health Maintenance Facility for Space Station

    NASA Technical Reports Server (NTRS)

    Pool, Sam Lee

    1988-01-01

    Because the prolonged stay on board the Space Station will increase the risk of possible inflight medical problems from that on Skylab missions, the Health Maintenance Facility (HMF) planned for the Space Station is much more sophisticated than the small clinics of the Skylab missions. The development of the HMF is directed by the consideration of three primary factors: prevention, diagnosis, and treatment of injuries and illnesses that may occur in flight. The major components of the HMF include the clinical laboratory, pharmacy, imaging system, critical-care system, patient-restraint system, data-management system, exercise system, surgical system, electrophysiologic-monitoring system, introvenous-fluid system, dental system, and hyperbaric-treatment-support system.

  16. Use of international classification of diseases coding to identify fetal alcohol syndrome--Indian Health Service facilities, 1981-1992.

    PubMed

    1995-04-01

    Fetal alcohol syndrome (FAS) is one of the leading causes of preventable birth defects and developmental disabilities in the United States (1). Since 1979, surveillance systems for estimating and tracking FAS have categorized cases using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), code 760.71 (2). This code comprises noxious influences affecting the fetus or newborn through placenta or breast milk, specifically alcohol, and includes FAS. Because the code is not specific for FAS and may reflect maternal alcohol consumption during pregnancy or other adverse effects of alcohol on the fetus, CDC assessed the usefulness of this code in ascertaining FAS cases by reviewing medical records for 1981-1993 from the Aberdeen Area Indian Health Service (IHS) and IHS contract facilities in eight of the 19 tribal or American Indian communities in the area. This report summarizes the findings of the analysis. PMID:7898421

  17. South Carolina Department of Health and Environmental Control federal facility agreement. Annual progress report, fiscal year 1995

    SciTech Connect

    Hucks, R.L.

    1996-01-30

    South Carolina Department of Health and Environmental Control (SCDHEC) reviewed 105 primary documents during fiscal year 1995 (October 1, 1994 through September 30, 1995). The primary documents reviewed consisted of 27 RCRA Facility Investigation/Remedial Investigation (RFI/RI) workplans, 13 RFI/RI Reports, 12 Baseline Risk Assessments (BRA`s), 27 Site Evaluation (SE) Reports, 8 Proposed Plans, 5 Record of Decisions (ROD`s), 6 Remedial Design Workplans, 6 Remedial Action Workplans and 10 miscellaneous primary documents. Numerous other administrative duties were conducted during the reporting period that are not accounted for above. These included, but were not limited to, extension requests, monitoring well approvals, and Treatability Studies. The list of outgoing correspondence from SCDHEC to the Department of Energy (DOE) and Westinghouse Savannah River Company (WSRC) is attached.

  18. Use of T12 lighting systems in retrofit applications within New York Office of Mental Health Facilities - A case history

    SciTech Connect

    Henry, C.P.; Marsh, E.J.

    1997-06-01

    In 1990, the Governor of New York State issued Executive Order No. 132, directing all state agencies to reduce energy consumption by 20% from the base year of 1988/89 by the year 2000. To assist in meeting this goal, the New York State Office of Mental Health (OMH) established the Lighting Revitalization Program in 1992. State facilities are divided into five regions, each served by existing Environmental Revitalization Teams. OMH supplemented these teams with lighting technicians in this new program. The program`s goal was to rehabilitate outdated, inefficient lighting systems throughout 28 OMH facilities, totaling 28 million square feet in area. OMH requested the former Facility Development Corporation (FDC), now the Dormitory Authority of the State of New York (DASNY), to contract with Novus Engineering to evaluate the relative efficiency of T8 and T12 ballasts. Novus contracted an independent laboratory, Eastern Testing Laboratories (ETL), for performance testing. ETL tested four ballast/lamp configurations for light Output and input power, and Novus analyzed the results for relative efficiency and also calculated 25-year life cycle costs. The test results indicated that the efficiencies of the T12/34W and T8/32W ballast/lamp technologies were nearly identical. The input power and light output of these systems were similar. The lumens per Watt ratings for the two systems were nearly equal, with the T8 technology being only about two percent more efficient, generating more light with similar input power. The life cycle costs for the two systems were nearly identical, with the T12 system providing a slightly lower life cycle cost. Given the above considerations, the agency has been installing T12 electronic ballasts and 34W lamps in buildings where fluorescent fixtures warranted upgrading. This type of retrofit goes against current trends, but the use of T8 system could not be justified in buildings undergoing minor retrofitting.

  19. Prevalence and associated factors of malaria among febrile children in Ethiopia: A cross-sectional health facility-based study.

    PubMed

    Haji, Yusuf; Fogarty, Andrew W; Deressa, Wakgari

    2016-03-01

    Malaria is one of the most important public health problems in Ethiopia. The objective of this study was to identify the prevalence and associated factors of malaria among children who presented for investigation. A cross-sectional health facility-based study was conducted between October and November 2012 in East Shewa Zone of Oromia Regional Sate in Ethiopia. Blood samples by finger pricks were collected for microscopic diagnosis of malaria from children under the age of 16 years with symptoms suggestive of malaria attending five health centers. An interview was conducted with the parents/guardians of the children using a pre-tested structured questionnaire. Bivariate and multivariate logistic regression was employed to study associations between malaria infection and associated factors. Of 830 children who provided blood samples, 170/830 (20.5%) were microscopically confirmed for malaria parasites. The predominant Plasmodium species were Plasmodium vivax (11.7%) and Plasmodium falciparum (8.4%), whilst mixed infections of both species were identified in 0.4% of patients (relative proportion: 57.1%, 41.2%, and 1.8%, respectively). Household's ownership of insecticide treated nets (ITNs) was significantly associated with decreased odds of malaria infection (adjusted odds ratio [aOR]: 0.69, 95% confidence interval [CI]: 0.56-0.85). However, an increased odds of malaria infection was observed among children between 10 and 15 years old (aOR: 2.19, 95% CI: 1.25-3.83) compared to children under the age of 2 years. The strong association reported here between household's ownership of ITNs and malaria infection among children in this part of Ethiopia call for continued efforts of net distribution and use to control malaria, which in turn might improve children's health and development. PMID:26739654

  20. In-flight demonstration of the Space Station Freedom Health Maintenance Facility fluid therapy system (E300/E05)

    NASA Technical Reports Server (NTRS)

    Lloyd, Charles W.

    1993-01-01

    The Space Station Freedom (SSF) Health Maintenance Facility (HMF) will provide medical care for crew members for up to 10 days. An integral part of the required medical care consists of providing intravenous infusion of fluids, electrolyte solutions, and nutrients to sustain an ill or injured crew member. In terrestrial health care facilities, intravenous solutions are normally stored in large quantities. However, due to the station's weight and volume constraints, an adequate supply of the required solutions cannot be carried onboard SSF. By formulating medical fluids onboard from concentrates and station water as needed, the Fluid Therapy System (FTS) eliminates weight and volume concerns regarding intravenous fluids. The first full-system demonstration of FTS is continuous microgravity will be conducted in Spacelab-Japan (SL-J). The FTS evaluation consists of two functional objectives and an in-flight demonstration of intravenous administration of fluids. The first is to make and store sterile water and IV solutions onboard the spacecraft. If intravenous fluids are to be produced in SSF, successful sterilization of water and reconstituting of IV solutions must be achieved. The second objective is to repeat the verification of the FTS infusion pump, which had been performed in Spacelab Life Sciences - 1 (SLS-1). during SLS-1, the FTS IV pump was operated in continuous microgravity for the first time. The pump functioned successfully, and valuable knowledge on its performance in continuous microgravity was obtained. Finally, the technique of starting an IF in microgravity will be demonstrated. The IV technique requires modifications in microgravity, such as use of restraints for equipment and crew members involved.

  1. A hospital-based estimate of major causes of death among under-five children from a health facility in Lagos, Southwest Nigeria: possible indicators of health inequality

    PubMed Central

    2012-01-01

    Introduction Current evidence on the root-causes of deaths among children younger than 5years is critical to direct international efforts to improve child survival, focus on health promotion and achieve Millennium Development Goal 4. We report a hospital-based estimate for 2005-2007 of the major causes of death in children in this age-group in south-west Nigeria. Methods We used retrospective data from the intensive care unit of a second-tier health facility to extract the presenting complaints, clinical diagnosis, treatment courses, prognosis and outcome among children aged 6—59months. SPSS-19 was used for data analysis. Results Of the 301 children (58% males, 42% females) admitted into the ICU within the period of study, 173 (26%) presented with complaints related to the gastrointestinal system, 138 (21%) with respiratory symptoms and 196 (29%) with complaints of fever. Overall, 708 investigations were requested for among which were full blood count (215, 30%) and blood slides for malaria parasite (166, 23%). Infection ranked highest (181, 31%) in clinicians’ diagnosis, followed by haematological health problems (109, 19%) and respiratory illnesses (101, 17%). There were negative correlations between outcome of the illness and patient’s weight (r=-0.195, p=0.001) and a strong positive correlation between prognosis and outcome of admission (r=0.196, p=0.001). Of the 59 (20%) children that died, presentation of respiratory tract illnesses were significantly higher in females (75%) than in males (39%) (?Č=7.06; p=0.008) and diagnoses related to gastrointestinal pathology were significantly higher in males (18%) than in females (0%) (?Č=4.07; p=0.05). Majority of the deaths (21%) occurred among children aged 1.0 to 1.9years old and among weight group of 5.1-15.0kg. Conclusion The major causes of deaths among under-five years old originate from respiratory, gastrointestinal and infectious diseases – diseases that were recognized as major causes of childhood mortality about half a century earlier. Realization of MDG4 - to reduce child mortality by two-thirds – is only possible if the government and donor agencies look beyond the health sector to find hidden causative factors such as education and housing and within the health sector such as vibrant maternal, new-born, and child health interventions. PMID:22873746

  2. Environment, safety, and health at DOE facilities. Annual report, calendar year 1981

    SciTech Connect

    Not Available

    1982-10-01

    During 1981 the US Department of Energy's (DOE) safety and property protection performance remained excellent in all reported categories with loss rates generally less than one-third of comparable private-industry rates. The 1981 occupational-injury rates of 1.0 lost-workday cases and 13.5 lost workdays per 200,000 work hours were better than 1980 rates of 1.1 lost-workday cases and 17.5 lost workdays per 200,000 work hours. The recorded occupational illness rate, based on only 61 cases in 1981, was 0.04 cases per 200,000 work hours compared to 0.06 cases per 200,000 work hours for 1980. Property losses during 1981 totaled $4.7 million, with the largest loss of $1.25 million resulting from a fire at a Bonneville Power Administration lighting substation in Ellenberg, Washington. Fire losses during 1981 totaled $2.01 million, resulting in a fire loss rate of 0.38 cent per $100 property valuation - about one-eight the best class private-sector rate. Non-fire losses during 1981 totaled $2.65 million. The resulting non-fire loss rate of 0.48 cent per $100 property valuation was approx. one-third (36%) the 1980 loss rate of 1.34 cents per $100 property valuation. The 82,873 monitored Department of Energy federal and contractor employees received a total radiation dose of 6902 rem in 1981. The total amount of effluent radioactivity released from all DOE facilities in 1981 was 1.9 million curies, compared to 1.4 million curies in 1980. The largest probable whole-body radiation dose received by a maximally exposed public individual from any of these facilities was the same as in 1980: 15 millirem, or 3% of the DOE Radiation Protection Guide standard. A major accomplishemet during 1981 was the successful pilot testing of the Computerized Accident/Incident Reporting System (CAIRS), which will provide more-comprehensive safety information than the present data system.

  3. Knowledge and Practice of Clinicians regarding Syndromic Management of Sexually Transmitted Infections in Public Health Facilities of Gamo Gofa Zone, South Ethiopia

    PubMed Central

    Alemayehu, Addisu; Godana, Wanzahun

    2015-01-01

    Background. Sexually Transmitted Infections (STIs) are the leading causes of morbidity among young adults. This study assessed the knowledge and practice of clinicians regarding syndromic management of STIs in public health facilities of Gamo Gofa Zone, Southern Ethiopia. Methods. Facility based cross-sectional study with mixed methods of data collection was conducted in public health facilities of Gamo Gofa Zone. The study included 250 clinicians and 12 health facilities, 26 mystery clients were hired, and 120 STI patient cards were reviewed. Data was entered in EPI info version 7.0.1 and analyzed by SPSS version 20. Results. Of the participated clinicians, 32 (12.8%) were trained on syndromic management of STIs. Highest knowledge of clinicians was for urethral discharge (27.2%). Professional category of clinicians and type of health facility (AOR = 0.194; 95% CI = 0.092, 0.412) were determinants of urethral discharge knowledge. Of the cards reviewed, only in 8.3% of cards and 19.23% of mystery clients did the clinicians correctly follow the guideline. Conclusion. Knowledge and practice of clinicians regarding syndromic management of STIs in study area were poor. Efforts should be made to increase the knowledge of clinicians by providing training on syndromic management of STIs and supportive supervision should be regular. PMID:26605102

  4. ORNL necessary and sufficient standards for environment, safety, and health. Final report of the Identification Team for other industrial, radiological, and non-radiological hazard facilities

    SciTech Connect

    1998-07-01

    This Necessary and Sufficient (N and S) set of standards is for Other Industrial, Radiological, and Non-Radiological Hazard Facilities at Oak Ridge National Laboratory (ORNL). These facility classifications are based on a laboratory-wide approach to classify facilities by hazard category. An analysis of the hazards associated with the facilities at ORNL was conducted in 1993. To identify standards appropriate for these Other Industrial, Radiological, and Non-Radiological Hazard Facilities, the activities conducted in these facilities were assessed, and the hazards associated with the activities were identified. A preliminary hazards list was distributed to all ORNL organizations. The hazards identified in prior hazard analyses are contained in the list, and a category of other was provided in each general hazard area. A workshop to assist organizations in properly completing the list was held. Completed hazard screening lists were compiled for each ORNL division, and a master list was compiled for all Other Industrial, Radiological Hazard, and Non-Radiological facilities and activities. The master list was compared against the results of prior hazard analyses by research and development and environment, safety, and health personnel to ensure completeness. This list, which served as a basis for identifying applicable environment, safety, and health standards, appears in Appendix A.

  5. Health risks associated with ingesting venison from a uranium enrichment facility with multiple operable units

    SciTech Connect

    Duncan, J.; Welsh, C.

    1995-12-31

    Ingestion of game, including venison, may be a significant exposure pathway in human health risk assessments at hazardous waste sites. The difficulty associated with modeling contaminant tissue concentrations in a wide-ranging herbivorous mammal is compounded when the home range of the mammal extends over multiple operable units (OUs) of varying size and media contaminant concentration. Using biotransfer factors extracted from the literature and species-specific parameter information (e.g., home range size, diet, forage and water ingestion rates) the authors estimate contaminant concentrations in venison based on soil and surface water contaminant concentrations and determine the contribution of individual OUs to modeled venison tissue concentrations. Estimated tissue concentrations are calculated through the use of site foraging factors (SFFS) that adjust exposure contributions from individual OUs to account for the size of the OU in relation to the animals home range. The authors then use the venison tissue concentrations to estimate human health risk associated with ingesting venison under both a current and future exposure scenario.

  6. Universal emergence of PageRank

    NASA Astrophysics Data System (ADS)

    Frahm, K. M.; Georgeot, B.; Shepelyansky, D. L.

    2011-11-01

    The PageRank algorithm enables us to rank the nodes of a network through a specific eigenvector of the Google matrix, using a damping parameter ? ? ]0, 1[. Using extensive numerical simulations of large web networks, with a special accent on British University networks, we determine numerically and analytically the universal features of the PageRank vector at its emergence when ? ? 1. The whole network can be divided into a core part and a group of invariant subspaces. For ? ? 1, PageRank converges to a universal power-law distribution on the invariant subspaces whose size distribution also follows a universal power law. The convergence of PageRank at ? ? 1 is controlled by eigenvalues of the core part of the Google matrix, which are extremely close to unity, leading to large relaxation times as, for example, in spin glasses.

  7. Using Links to Classify Wikipedia Pages

    NASA Astrophysics Data System (ADS)

    Kaptein, Rianne; Kamps, Jaap

    This paper contains a description of experiments for the 2008 INEX XML-mining track. Our goal for the XML-mining track is to explore whether we can use link information to improve classification accuracy. Our approach is to propagate category probabilities over linked pages. We find that using link information leads to marginal improvements over a baseline that uses a Naive Bayes model. For the initially misclassified pages, link information is either not available or contains too much noise.

  8. Availability of drugs and medical supplies for emergency obstetric care: experience of health facility managers in a rural District of Tanzania

    PubMed Central

    2014-01-01

    Background Provision of quality emergency obstetric care relies upon the presence of skilled health attendants working in an environment where drugs and medical supplies are available when needed and in adequate quantity and of assured quality. This study aimed to describe the experience of rural health facility managers in ensuring the timely availability of drugs and medical supplies for emergency obstetric care (EmOC). Methods In-depth interviews were conducted with a total of 17 health facility managers: 14 from dispensaries and three from health centers. Two members of the Council Health Management Team and one member of the Council Health Service Board were also interviewed. A survey of health facilities was conducted to supplement the data. All the materials were analysed using a qualitative thematic analysis approach. Results Participants reported on the unreliability of obtaining drugs and medical supplies for EmOC; this was supported by the absence of essential items observed during the facility survey. The unreliability of obtaining drugs and medical supplies was reported to result in the provision of untimely and suboptimal EmOC services. An insufficient budget for drugs from central government, lack of accountability within the supply system and a bureaucratic process of accessing the locally mobilized drug fund were reported to contribute to the current situation. Conclusion The unreliability of obtaining drugs and medical supplies compromises the timely provision of quality EmOC. Multiple approaches should be used to address challenges within the health system that prevent access to essential drugs and supplies for maternal health. There should be a special focus on improving the governance of the drug delivery system so that it promotes the accountability of key players, transparency in the handling of information and drug funds, and the participation of key stakeholders in decision making over the allocation of locally collected drug funds. PMID:24646098

  9. [Health problems of the city of Split on the pages of the first newspaper written in Croatian language: "Il Regio Dalmata-Kraglski Dalmatin" (1806-1810): on the occasion of the 200th anniversary of termination of its publication].

    PubMed

    Brisky, Livia

    2010-01-01

    At the beginning of the 19th century, one of the most important cultural events in Dalmatia was the publication of a bilingual newspaper Il Regio Dalmata - Kraglski Dalmatin in Italian and Croatian, issued by the French government in Zadar between 12 July 1806 and 22 January 1808. Between 29 January 1808 and 1 April 1810 it changed name to Il Regio Dalmata. The journal paid much attention to the health problems of the city of Split, especially between 1806 and 1808. The aim of this study was to analyze the original articles published in this first newspaper in Croatian language and to understand the role of this publication as means of promoting health policies in Split. The journal published articles about health care for the poor and foundlings, about the need for charity institutions to refer them to the city hospital and to the foundling home, and encouraged citizens to help maintain these institutions. Great attention was also dedicated to vaccination against smallpox and demographic problems of Split. Thanks to Croatian, Il Regio Dalmata-Kraglski Dalmatin informed a wider audience about the existing health conditions in the city of Split and about the efforts of the French government for its improvement. PMID:21192116

  10. A Web Page Summarization for Mobile Phones

    NASA Astrophysics Data System (ADS)

    Hasegawa, Takaaki; Nishikawa, Hitoshi; Imamura, Kenji; Kikui, Gen'ichiro; Okumur, Manabu

    Recently, web pages for mobile devices are widely spread on the Internet and a lot of people can access web pages through search engines by mobile devices as well as personal computers. A summary of a retrieved web page is important because the people judge whether or not the page would be relevant to their information need according to the summary. In particular, the summary must be not only compact but also grammatical and meaningful when the users retrieve information using a mobile phone with a small screen. Most search engines seem to produce a snippet based on the keyword-in-context (KWIC) method. However, this simple method could not generate a refined summary suitable for mobile phones because of low grammaticality and content overlap with the page title. We propose a more suitable method to generate a snippet for mobile devices using sentence extraction and sentence compression methods. First, sentences are biased based on whether they include the query terms from the users or words that are relevant to the queries, as well as whether they do not overlap with the page title based on maximal marginal relevance (MMR). Second, the selected sentences are compressed based on their phrase coverage, which is measured by the scores of words, and their phrase connection probability measured based on the language model, according to the dependency structure converted from the sentence. The experimental results reveal the proposed method outperformed the KWIC method in terms of relevance judgment, grammaticality, non-redundancy and content coverage.

  11. Savings analysis of a 1 MW cogeneration system at a Texas mental health facility

    SciTech Connect

    Athar, A.; Turner, W.D.; Caton, J.A.; McClean, G.

    1995-12-31

    Cogeneration is defined as the generation of electric power and coincident recovery of useful thermal energy from a single prime mover using a single fuel. The 1 MW gas turbine cogeneration system at Texas Department of Mental Health and Mental Retardation (TDMHMR), Austin, came on line in March, 1992 and is a unique application of federal and state funds. This system has been analyzed for its present performance and loads using hourly measured data. The Energy Systems Laboratory (ESL) at Texas A and M University has been collecting hourly data for natural gas use and the electrical energy produced by the engine since August, 1992. Waste heat recovered by the Waste Heat Recovery Boiler (WHRB) is also monitored. This paper describes the present system, analyzes the system using hourly monitored data, calculates energy and dollar savings, compares the measured results with the estimated savings, and discusses some of the problems encountered during the first year of operation.

  12. The epidemiology and control of Acinetobacter baumannii in health care facilities.

    PubMed

    Fournier, Pierre Edouard; Richet, Hervé

    2006-03-01

    Acinetobacter baumannii is a ubiquitous pathogen capable of causing both community and health care-associated infections (HAIs), although HAIs are the most common form. This organism has emerged recently as a major cause of HAI because of the extent of its antimicrobial resistance and its propensity to cause large, often multifacility, nosocomial outbreaks. The occurrence of outbreak is facilitated by both tolerance to desiccation and multidrug resistance, contributing to the maintenance of these organisms in the hospital environment. In addition, the epidemiology of A. baumannii infection is often complex, with the coexistence of epidemic and endemic infections, the latter of which often is favored by the selection pressure of antimicrobials. The only good news is that potentially severe A. baumannii infection, such as bacteremia or pneumonia in patients in the intensive care unit who are undergoing intubation, do not seem to be associated with a higher attributable mortality rate or an increased length of hospital stay. PMID:16447117

  13. Using SERVQUAL for assessing and improving patient satisfaction at a rural health facility in Pakistan.

    PubMed

    Shaikh, B T; Mobeen, N; Azam, S I; Rabbani, F

    2008-01-01

    A cross-sectional study of patient satisfaction with care was conducted over a period of 1 year from March 2004 to March 2005 in a secondary-level hospital in a peri-urban area of Karachi, Pakistan. Using the SERVQUAL tool and exit interviews, data were collected quarterly from a total of 1533 patients. Results sharing and capacity-building workshops were arranged during the 4 phases of the survey to sensitize the staff of the hospital to work towards improving patient satisfaction. The level of satisfaction of the patients with the outpatient health services provided showed a gradual increase from 34.4% to 82.0% over the 1-year period. PMID:18561738

  14. Giving cell phones to pregnant women and improving services may increase primary health facility utilization: a case–control study of a Nigerian project

    PubMed Central

    2014-01-01

    Background Worldwide, about 287 000 women die each year from mostly preventable complications related to pregnancy and childbirth. A disproportionately high number of these deaths occur in sub-Saharan Africa. The Abiye (‘Safe Motherhood’) project in the Ifedore Local Government Area (LGA) of Ondo-State of Nigeria aimed at improving facility utilization and maternal health through the use of cell phones and generally improved health care services for pregnant women, including Health Rangers, renovated Health Centres, and improved means of transportation. Methods A one-year sample of retrospective data was collected from hospital records and patients’ case files from Ifedore (the project area) and Idanre (control area) and was analyzed to determine healthcare facility utilization rates in each location. Semi-structured questionnaires were used to generate supplemental data. Results The total facility utilization rate of pregnant women was significantly higher in Ifedore than in Idanre. The facility utilization rate of the primary health care centres was significantly higher in Ifedore than in Idanre. The number of recorded cases of the five major causes of maternal death in the two LGAs was not significantly different, possibly because the project was new. Conclusions Giving cell phones to pregnant women and generally improving services could increase their utilization of the primary healthcare system. PMID:24438150

  15. Evaluating the level of satisfaction of patients utilizing first-level health facilities as a function of health system performance rating in the province of Elazig, Turkey

    PubMed Central

    Bulut, Aliye; Oguzoncul, A Ferdane

    2014-01-01

    Purpose This study was conducted to determine the level of satisfaction of patients utilizing first-level health care facilities as a function of health system performance rating in Elazig province of Turkey. Methods The study was conducted between December 2013 and March 2014 at the family health centers in the Elazig province center. For collecting the data in the cross-sectional study conducted with 1,290 patients, personal data form for patients and the Turkish version of European Patients Evaluate General/Family Practice scale was used. Results Of the patients who participated in the study, 54.3% were female. According to the general average scores received by the patients from European Patients Evaluate General/Family Practice-TR Patient Satisfaction Survey questions, average scores of male patients were found to be higher than those of female patients. Scores of the divorced and widow patients were higher compared to other groups, but this was not statistically significant. Average scores of the patients whose educational status is secondary school were higher compared to other groups. Scores of the patients with children were higher compared to those without children. Scores of the patients whose occupation was farming were higher compared to the other groups of occupation. Scores of the patients whose income was TL 1,001–2,500 were found to be higher compared to other patients. Scores of the patients who stated that they never had difficulty in access were higher compared to others, but this was not statistically significant. Average scores of the patients who had chronic diseases and patients who stated to have physical handicap were higher compared to those who did not have chronic disease and physical handicap, but these differences were not found to be statistically significant, either. Conclusion There is a statistically significant difference between the patients’ demographic characteristics (sex, educational status, occupation, and income status) and their levels of satisfaction with the family medicine practice. PMID:25414572

  16. Barriers and Facilitators of Compliance with Universal Precautions at First Level Health Facilities in Northern Rural Pakistan

    PubMed Central

    Yousafzai, Mohammad Tahir; Janjua, Naveed Zafar; Siddiqui, Amna Rehana; Rozi, Shafquat

    2015-01-01

    Aim We assessed the compliance at first level care facilities (FLCF) with universal precautions (UP) and its behavioral predictors using Health Belief Model (HBM). Methods A sample of FLCF from public clinic (PC), privately owned licensed practitioners’ clinic (LPC) and non-licensed practitioners’ clinic (NLPC) was obtained. Health Care Workers (HCW) who diagnose and prescribe medication was termed as Prescriber and that carries out prescriber’s order was defined Assistant. Compliance to UP was measured on 11 items Likert scale. HCW responded “always” or “often” to all items of UP were added to compute a binary variable of overall compliance. We used linear regression to assess association between HBM and UP score. Results We interviewed 485 HCW (75% prescribers) from 365 clinics; mean age 38±10.4 years. Overall, compliance to UP was 6.6%; 11.6% LPC, 5.3% PC, and 4.4% NLPC. Prescribers were less compliant than Assistants. Compliance with not recapping contaminated needle was poor (PC=32%, LPC=33%, NLPC=15%). Compliance with wearing gloves during blood or body fluid exposure was lowest (30%) at PC. Modes of transmission knowledge, self-efficacy and perceived benefits of safe practice, and susceptibility to blood borne infections were positively associated with UP score. Conclusion Higher perception of barriers and severity of blood borne infection result in lower compliance. PMID:26715918

  17. Environmental health-risk assessment for tritium releases at the National Tritium Labeling Facility at Lawrence Berkeley National Laboratory

    SciTech Connect

    McKone, T.E.; Brand, K.P.; Shan, C.

    1997-04-01

    This risk assessment calculates the probability of experiencing health effects, including cancer incidence due to tritium exposure for three groups of people: (1) LBNL workers near the LBNL facility--Building 75--that uses tritium; (2) other workers at LBNL and nearby neighbors; and (3) people who use the UC Berkeley campus area, and some Berkeley residents. All of these groups share the same probability of health effects from the background radiation from natural sources in the Berkeley area environment, including an increased risk of developing a cancer of 11,000 chances per million. In calculating risk the authors assumed continuous operation in Building 75 for at least a human lifetime. Under this assumption, LBNL workers located near Building 75 have an additional risk of 60 chances out of one million to suffer a cancer; other workers at LBNL and people who live near LBNL have an additional risk of six chances out of one million over a lifetime of exposure; and users of the UC Berkeley campus area and other residents of Berkeley have an additional risk of less than once chance out of one million over a lifetime.

  18. Description Meta Tags in Public Home and Linked Pages.

    ERIC Educational Resources Information Center

    Craven, Timothy C.

    2001-01-01

    Random samples of 1,872 Web pages registered with Yahoo! And 1,638 pages reachable from Yahoo!-registered pages were analyzed for use of meta tags and specifically those containing descriptions. Results: 727 (38.8%) of the Yahoo!-registered pages and 442 (27%) of the other pages included descriptions in meta tages. Some descriptions greatly…

  19. Impact of Health Facility-Based Insecticide Treated Bednet Distribution in Malawi: Progress and Challenges towards Achieving Universal Coverage

    PubMed Central

    Skarbinski, Jacek; Mwandama, Dyson; Luka, Madalitso; Jafali, James; Wolkon, Adam; Townes, David; Campbell, Carl; Zoya, John; Ali, Doreen; Mathanga, Don P.

    2011-01-01

    Background High levels of insecticide treated bednet (ITN) use reduce malaria burden in countries with intense transmission such as Malawi. Since 2007 Malawi has implemented free health facility-based ITN distribution for pregnant women and children <5 years old (under-5s). We evaluated the progress of this targeted approach toward achieving universal ITN coverage. Methods We conducted a cross-sectional household survey in eight districts in April 2009. We assessed household ITN possession, ITN use by all household members, and P. falciparum asexual parasitemia and anemia (hemoglobin <11 grams/deciliter) in under-5s. Results We surveyed 7,407 households containing 29,806 persons. Fifty-nine percent of all households (95% confidence interval [95% CI]: 56–62), 67% (95% CI: 64–70) of eligible households (i.e., households with pregnant women or under-5s), and 40% (95% CI: 36–45) of ineligible households owned an ITN. In households with at least one ITN, 76% (95% CI: 74–78) of all household members, 88% (95% CI: 87–90) of under-5s and 90% (95% CI: 85–94) of pregnant women used an ITN the previous night. Of 6,677 ITNs, 92% (95% CI: 90–94) were used the previous night with a mean of 2.4 persons sleeping under each ITN. In multivariable models adjusting for district, socioeconomic status and indoor residual spraying use, ITN use by under-5s was associated with a significant reduction in asexual parasitemia (adjusted odds ratio (aOR) 0.79; 95% CI: 0.64–0.98; p-value 0.03) and anemia (aOR 0.79; 95% CI 0.62–0.99; p-value 0.04). Of potential targeted and non-targeted mass distribution strategies, a campaign distributing 1 ITN per household might increase coverage to 2.1 household members per ITN, and thus achieve near universal coverage often defined as 2 household members per ITN. Conclusions Malawi has substantially increased ITN coverage using health facility-based distribution targeting pregnant women and under-5s, but needs to supplement these activities with non-targeted mass distribution campaigns to achieve universal coverage and maximum public health impact. PMID:21811553

  20. Climate Impacts on Human Health

    MedlinePLUS

    ... Climate Change Impacts Human Health Impacts Human Health Climate Impacts on Human Health Climate Impacts on Alaska On This Page Impacts from ... in air pollution and the associated health effects Climate Change Affects Human Health and Welfare In 2008, ...

  1. Assessment of laboratory logistics management information system practice for HIV/AIDS and tuberculosis laboratory commodities in selected public health facilities in Addis Ababa, Ethiopia

    PubMed Central

    Desale, Adino; Taye, Bineyam; Belay, Getachew; Nigatu, Alemayehu

    2013-01-01

    Introduction Logistics management information system for health commodities remained poorly implemented in most of developing countries. To assess the status of laboratory logistics management information system for HIV/AIDS and tuberculosis laboratory commodities in public health facilities in Addis Ababa. Methods A cross-sectional descriptive study was conducted from September 2010-January 2011 at selected public health facilities. A stratified random sampling method was used to include a total of 43 facilities which, were investigated through quantitative methods using structured questionnaires interviews. Focus group discussion with the designated supply chain managers and key informant interviews were conducted for the qualitative method. Results There exists a well-designed logistics system for laboratory commodities with trained pharmacy personnel, distributed standard LMIS formats and established inventory control procedures. However, majority of laboratory professionals were not trained in LMIS. Majority of the facilities (60.5%) were stocked out for at least one ART monitoring and TB laboratory reagents and the highest stock out rate was for chemistry reagents. Expired ART monitoring laboratory commodities were found in 25 (73.5%) of facilities. Fifty percent (50%) of the assessed hospitals and 54% of health centers were currently using stock/bin cards for all HIV/AIDS and TB laboratory commodities in main pharmacy store, among these only 25% and 20.8% of them were updated with accurate information matching with the physical count done at the time of visit for hospitals and health centers respectively. Conclusion Even though there exists a well designed laboratory LMIS, keeping quality stock/bin cards and LMIS reports were very low. Key ART monitoring laboratory commodities were stock out at many facilities at the day of visit and during the past six months. Based on findings, training of laboratory personnel's managing laboratory commodities and keeping accurate inventory control procedures were recommended. PMID:24106574

  2. Utilization of outpatient services in refugee settlement health facilities: a comparison by age, gender, and refugee versus host national status

    PubMed Central

    2011-01-01

    Background Comparisons between refugees receiving health care in settlement-based facilities and persons living in host communities have found that refugees have better health outcomes. However, data that compares utilization of health services between refugees and the host population, and across refugee settlements, countries and regions is limited. The paper will address this information gap. The analysis in this paper uses data from the United Nations High Commissioner of Refugees (UNHCR) Health Information System (HIS). Methods Data about settlement populations and the use of outpatient health services were exported from the UNHCR health information system database. Tableau Desktop was used to explore the data. STATA was used for data cleaning and statistical analysis. Differences in various indicators of the use of health services by region, gender, age groups, and status (host national vs. refugee population) were analyzed for statistical significance using generalized estimating equation models that adjusted for correlated data within refugee settlements over time. Results Eighty-one refugee settlements were included in this study and an average population of 1.53 million refugees was receiving outpatient health services between 2008 and 2009. The crude utilization rate among refugees is 2.2 visits per person per year across all settlements. The refugee utilization rate in Asia (3.5) was higher than in Africa on average (1.8). Among refugees, females have a statistically significant higher utilization rate than males (2.4 visits per person per year vs. 2.1). The proportion of new outpatient attributable to refugees is higher than that attributable to host nationals. In the Asian settlements, only 2% outpatient visits, on average, were attributable to host community members. By contrast, in Africa, the proportion of new outpatient (OPD) visits by host nationals was 21% on average; in many Ugandan settlements, the proportion of outpatient visits attributable to host community members was higher than that for refugees. There was no statistically significant difference between the size of the male and female populations across refugee settlements. Across all settlements reporting to the UNHCR database, the percent of the refugee population that was less than five years of age is 16% on average. Conclusions The availability of a centralized database of health information across UNHCR-supported refugee settlements is a rich resource. The SPHERE standard for emergencies of 1-4 visits per person per year appears to be relevant for Asia in the post-emergency phase, but not for Africa. In Africa, a post-emergency standard of 1-2 visits per person per year should be considered. Although it is often assumed that the size of the female population in refugee settlements is higher than males, we found no statistically significant difference between the size of the male and female populations in refugee settlements overall. Another assumption---that the under-fives make up 20% of the settlement population during the emergency phase---does not appear to hold for the post-emergency phase; under-fives made up about 16% of refugee settlement populations. PMID:21936911

  3. Health risks for the population living in the vicinity of an Integrated Waste Management Facility: screening environmental pollutants.

    PubMed

    Domingo, José L; Rovira, Joaquim; Vilavert, Lolita; Nadal, Martí; Figueras, María J; Schuhmacher, Marta

    2015-06-15

    We performed a screening investigation to assess the human health risks of the Integrated Waste Management Facility (IWMF: mechanical-biological treatment (MBT) plant plus municipal solid waste incinerator (MSWI); Ecoparc-3) of Barcelona (Spain). Air concentrations of pollutants potentially released by the MBT plant (VOCs and bioaerosols) and the MSWI (trace elements, PCDD/Fs and PCBs) were determined. Trace elements, PCDD/Fs and PCBs were also analyzed in soil samples. The concentrations of trace elements and bioaerosols were similar to those previously reported in other areas of similar characteristics, while formaldehyde was the predominant VOC. Interestingly, PCDD/F concentrations in soil and air were the highest ever reported near a MSWI in Catalonia, being maximum concentrations 10.8 ng WHO-TEQ/kg and 41.3 fg WHO-TEQ/m(3), respectively. In addition, there has not been any reduction in soils, even after the closure of a power plant located adjacently. Human health risks of PCDD/F exposure in the closest urban nucleus located downwind the MSWI are up to 10-times higher than those nearby other MSWIs in Catalonia. Although results must be considered as very preliminary, they are a serious warning for local authorities. We strongly recommend to conduct additional studies to confirm these findings and, if necessary, to implement measures to urgently mitigate the impact of the MSWI on the surrounding environment. We must also state the tremendous importance of an individual evaluation of MSWIs, rather than generalizing their environmental and health risks. PMID:25770949

  4. Counting the cost of not costing HIV health facilities accurately: pay now, or pay more later.

    PubMed

    Beck, Eduard J; Avila, Carlos; Gerbase, Sofia; Harling, Guy; De Lay, Paul

    2012-10-01

    The HIV pandemic continues to be one of our greatest contemporary public health threats. Policy makers in many middle- and low-income countries are in the process of scaling up HIV prevention, treatment and care services in the context of a reduction in international HIV funding due to the global economic downturn. In order to scale up services that are sustainable in the long term, policy makers and implementers need to have access to robust and contemporary strategic information, including financial information on expenditure and cost, in order to be able to plan, implement, monitor and evaluate HIV services. A major problem in middle- and low-income countries continues to be a lack of basic information on the use of services, their cost, outcome and impact, while those few costing studies that have been performed were often not done in a standardized fashion. Some researchers handle this by transposing information from one country to another, developing mathematical or statistical models that rest on assumptions or information that may not be applicable, or using top-down costing methods that only provide global financial costs rather than using bottom-up ingredients-based costing. While these methods provide answers in the short term, countries should develop systematic data collection systems to store, transfer and produce robust and contemporary strategic financial information for stakeholders at local, sub-national and national levels. National aggregated information should act as the main source of financial data for international donors, agencies or other organizations involved with the global HIV response. This paper describes the financial information required by policy makers and other stakeholders to enable them to make evidence-informed decisions and reviews the quantity and quality of the financial information available, as indicated by cost studies published between 1981 and 2008. Among the lessons learned from reviewing these studies, a need was identified for providing countries with practical guidance to produce reliable and standardized costing data to monitor performance, as countries want to improve programmes and services, and have to demonstrate an efficient use of resources. Finally, the issues raised in this paper relate to the provision of all areas of healthcare in countries and it is going to be increasingly important to leverage the lessons learned from the HIV experience and use resources more effectively and efficiently to improve health systems in general. PMID:22830633

  5. Woodbridge research facility remedial investigation/feasibility study. Health and safety plan. Final report

    SciTech Connect

    Thompson, P.; McKown, G.; Waugh, J.; Houser, W.; Joy, G.

    1995-09-01

    The requirements set forth in 29 CFR 1910.120(f), shall be met for all employees performing or supervising hazardous waste operations. Medical exams shall be conducted as soon as possible upon notification by an employee that he/she has developed signs or symptoms indicating possible health hazards or overexposure to hazardous substances. Subcontractor personnel shall provide documentation of current status of participation in a medical surveillance program as required by 29 CFR 1910.120(f). Subcontractors unable to provide such documentation shall have successfully completed a medical examination as described in the above referenced OSHA standard prior to beginning work in a contaminated zone. Specific protocols for medical examinations are designed by an occupational physician. Common components include: (a) medical history and physical examination; (b) dipstick urinalysis, vision screen and vital signs; (c) spirometry ;(d) audiometry; (e) blood chemistry (complete blood count, liver function, kidney function, lipid metabolism, carbohydrate metabolism); (f) resting EkG (with approval); (g) chest radiograph (P/A). No project-specific medical examinations, or biological monitoring is required for this project.

  6. Transformation to room service food delivery in a pediatric health care facility.

    PubMed

    Kuperberg, Karen; Mager, Diana; Dello, Susan

    2009-01-01

    Patient food service is an important component in the nutritional management of hospitalized children. The previous meal delivery system at The Hospital for Sick Children in Toronto was a cold-plating re-thermalized system. Issues related to this model included order lead time, the reheating process, menu selection, and service style. Research into other systems led us toward room service, an innovative and flexible mode of meal delivery. Transformation to room service occurred over one year, and included implementation of a new computer system, kitchen renovation, redesign of menus and a new meal delivery system called Meal Train, and changes to human resource allocations. Throughout the transformation, consultations were held with key stakeholders, including the children's council, the family advisory, the nursing council, and a multidisciplinary committee involving nursing staff, dietitians, patient service aides, infection control personnel, occupational health employees, patient representatives, and food services staff. Now, Meal Train is running smoothly, and meal days and food costs have been reduced. Others considering a project like this must know their clients' needs and be willing to think outside the box. They should familiarize themselves with current information on systems and equipment, consult with key stakeholders within their organization, and then create the system that will work for them. PMID:19958577

  7. Improving antimicrobial use among health workers in first-level facilities: results from the multi-country evaluation of the Integrated Management of Childhood Illness strategy.

    PubMed Central

    Gouws, Eleanor; Bryce, Jennifer; Habicht, Jean-Pierre; Amaral, JoĂŁo; Pariyo, George; Schellenberg, Joanna Armstrong; Fontaine, Olivier

    2004-01-01

    OBJECTIVE: The objective of this study was to assess the effect of Integrated Management of Childhood Illness (IMCI) case management training on the use of antimicrobial drugs among health-care workers treating young children at first-level facilities. Antimicrobial drugs are an essential child-survival intervention. Ensuring that children younger than five who need these drugs receive them promptly and correctly can save their lives. Prescribing these drugs only when necessary and ensuring that those who receive them complete the full course can slow the development of antimicrobial resistance. METHODS: Data collected through observation-based surveys in randomly selected first-level health facilities in Brazil, Uganda and the United Republic of Tanzania were statistically analysed. The surveys were carried out as part of the multi-country evaluation of IMCI effectiveness, cost and impact (MCE). FINDINGS: Results from three MCE sites show that children receiving care from health workers trained in IMCI are significantly more likely to receive correct prescriptions for antimicrobial drugs than those receiving care from workers not trained in IMCI.They are also more likely to receive the first dose of the drug before leaving the health facility, to have their caregiver advised how to administer the drug, and to have caregivers who are able to describe correctly how to give the drug at home as they leave the health facility. CONCLUSIONS: IMCI case management training is an effective intervention to improve the rational use of antimicrobial drugs for sick children visiting first-level health facilities in low-income and middle-income countries. PMID:15508195

  8. Improving neonatal care in district and community health facilities in South Africa.

    PubMed

    Woods, David Lawrance

    2015-08-01

    A high standard of newborn care, especially at a primary level, is needed to address the neonatal mortality rate in South Africa. The current approach to continuing training of health-care workers uses traditional methods of centralised teaching by formal tutors away from the place of work. This is no longer affordable, achievable or desirable, particularly in rural areas. An innovative system of self-directed learning by groups of nurses caring for mothers and their newborn infants uses specially prepared course books without the need for trainers. Using self-study supported by peer discussion groups, nurses can take responsibility for their own professional growth. This builds competence, confidence and a sense of pride. Since 1993, the Perinatal Education Programme has provided continuing learning opportunities for thousands of nurses in Southern Africa. A number of prospective trials have demonstrated that study groups can significantly improve knowledge and understanding, attitudes, clinical skills and quality of care provided to mothers and infants. A recent review of 10,000 successful participants across a wide range of provinces, ages and home languages documented the success of the project. Using a question-and-answer format to promote problem-solving, case studies, simple skills workshops and multiple choice tests, each module addresses common conditions with appropriate care practices such as thorough drying at birth, delayed cord-clamping, skin-to-skin care, breast feeding, basic resuscitation, correct use of oxygen therapy, hand-washing, blood glucose monitoring and promotion of parental bonding. The training material is now also available free of charge on an on-line website as well as being presented as e-books which can be downloaded onto personal computers, tablet readers and smart phones. This is supplemented by regular SMS text messages providing nurses with relevant 'knowledge bites'. All nurses caring for newborn infants now have easy, affordable access to continuing education which promises nationwide improvements in newborn care. PMID:25948148

  9. Cost-Effectiveness Analysis of Health Care Waste Treatment Facilities in Iran Hospitals; a Provider Perspective

    PubMed Central

    RASHIDIAN, Arash; ALINIA, Cyrus; MAJDZADEH, Reza

    2015-01-01

    Background: Our aim was to make right and informative decision about choosing the most cost-effectiveness heterogeneous infectious waste treatment methods and devices. Methods: In this descriptive study, decision tree analysis, with 10-yr time horizon in bottom-up approach was used to estimate the costs and effectiveness criteria of the employed devices at provider perspective in Iranian hospitals. We used the one-way and scenario sensitivity analysis to measure the effects of variables with uncertainty. The resources of data were national Environmental and Occupational Health Center Survey (EOHCS) in 2012, field observation and completing questionnaire by relevant authorities in mentioned centers. Results: Devices called Saray 2, Autoclave based, and Newster 10, Hydroclave based, with 92032.4 (±12005) and 6786322.9 (±826453) Dollars had the lowest and highest costs respectively in studied time period and given the 5–10% discount rate. Depending on effectiveness factor type, Newster 10 with Ecodas products and Saray products respectively had the highest and lowest effectiveness. In most considered scenarios, Caspian-Alborz device was the most cost-effectiveness alternative, so for the treatment of each adjusted unit of volume and weight of infectious waste in a 10 year period and in different conditions, between 39.4 (±5.1) to 915 (±111.4) dollars must be spent. Conclusion: The findings indicate the inefficiency and waste of resources, so in order to efficient resource allocation and to encourage further cost containment in infectious waste management we introduce policy recommendation that be taken in three levels. PMID:25905078

  10. Environment, safety, health at DOE Facilities. Annual report, Fiscal Year 1980

    SciTech Connect

    Not Available

    1981-07-01

    The Department of Energy's occupational safety and property protection performance in fiscal year 1980 was excellent in all reported categories with loss rates generally less than one-third of comparable industry figures. The Department of Energy's fiscal year 1980 incidence rate per 200,000 work hours was 1.1 lost workday cases and 18.2 lost workdays compared to 1.1 lost workday cases and 17.2 lost workdays during fiscal year 1979. The recorded occupational illness rate, based on only 70 cases, was 0.05 cases per 200,000 work hours compared to 0.06 cases per 200,000 work hours for fiscal year 1979. Ten fatalities involving Federal or contractor employees occurred in fiscal year 1980 compared to nine for fiscal year 1979. Four of those in fiscal year 1980 resulted from two aircraft accidents. Total reported property loss during fiscal year 1980 was $7.1 million with $3.5 million attributable to earthquake damage sustained by the Lawrence Livermore and Sandia National Laboratories on January 24, 1980. A total of 131 million vehicle miles of official vehicular travel during fiscal year 1980 resulted in 768 accidents and $535,145 in property damages. The 104,986 monitored Department of Energy and Department of Energy contractor employees received a total dose of 9040 REM in calendar year 1979. Both the total dose and the 1748 employees receiving radiation exposures greater than 1 REM in 1979 represent a continuing downward trend from the calendar year 1978 total dose of 9380 REM and the 1826 employees who received radiation exposures greater than 1 REM. The fifty-nine appraisals conducted indicate that generally adequate plans have been developed and effective organizational structures have been established to carry out the Department of Energy's Environmental Protection, Safety, and Health Protection (ES and H) Program.

  11. Cost-effective facility disposition planning with safety and health lessons learned and good practices from the Oak Ridge Decontamination and Decommissioning Program

    SciTech Connect

    1998-05-01

    An emphasis on transition and safe disposition of DOE excess facilities has brought about significant challenges to managing worker, public, and environmental risks. The transition and disposition activities involve a diverse range of hazardous facilities that are old, poorly maintained, and contain radioactive and hazardous substances, the extent of which may be unknown. In addition, many excess facilities do not have historical facility documents such as operating records, plant and instrumentation diagrams, and incident records. The purpose of this report is to present an overview of the Oak Ridge Decontamination and Decommissioning (D and D) Program, its safety performance, and associated safety and health lessons learned and good practices. Illustrative examples of these lessons learned and good practices are also provided. The primary focus of this report is on the safety and health activities and implications associated with the planning phase of Oak Ridge facility disposition projects. Section 1.0 of this report provides the background and purpose of the report. Section 2.0 presents an overview of the facility disposition activities from which the lessons learned and good practices discussed in Section 3.0 were derived.

  12. Sporadic "transitional" community-associated methicillin-resistant Staphylococcus aureus strains from health care facilities in the United States.

    PubMed

    Brady, Jennifer M; Stemper, Mary E; Weigel, Ashley; Chyou, Po-Huang; Reed, Kurt D; Shukla, Sanjay K

    2007-08-01

    We describe phenotypic and genotypic traits of a group of methicillin-resistant Staphylococcus aureus (MRSA) clones that are either remnants of unsuccessful community-associated MRSA (CA-MRSA) clones or represent a transitional state with some yet-to-be-acquired characteristics of CA-MRSA. These rare strains (n = 20) were identified during a 10-year period (1990-1999) from 13 unrelated health care facilities in Wisconsin. The isolates were recovered from patients in nosocomial or long-term chronic care facilities (60%) and outpatient settings (40%). Sixty percent (n = 12) of the isolates were recovered from skin and soft tissue infections, whereas the remaining isolates (n = 8) were from invasive infections. Ninety percent of isolates were susceptible to all antibiotic classes tested or resistant to erythromycin and clindamycin. Pulsed-field gel electrophoresis, multilocus sequence typing, and spa typing clustered these isolates into 8, 8, and 14 clonal groups, respectively. Eight plasmid profiles were represented in these strains. All four agr types were represented, with type IV being predominant (40%). All strains harbored subtypes of type IV staphylococcal cassette chromosome mec but lacked genes for the virulence factor Panton-Valentine leukocidin (PVL). The strains harbored one or more of the following toxin genes: sea, seb, sec, sed, see, seh, sej, sek, sel, seg, sei, sem, sen, and seo. Individual clonal groups maintained the same set of enterotoxin genes even though they were isolated over extended time periods, suggesting significant genomic stability. The potential role of PVL-carrying phages and plasmids in the success of CA-MRSA clones has been discussed. PMID:17567793

  13. Adults with Intellectual Disabilities Living in Hong Kong's Residential Care Facilities: A Descriptive Analysis of Health and Disease Patterns by Sex, Age, and Presence of Down Syndrome

    ERIC Educational Resources Information Center

    Wong, Chi Wai

    2011-01-01

    The aim of this study was to describe the health status profile and identify the healthcare needs of adults with intellectual disability (ID) residing in 18 of Hong Kong's residential care facilities. The author employed a cross-sectional study using a structured questionnaire survey to collect data on 811 persons with ID (432 males, 53.3%, and


  14. Study--The Feasibility, Practicability and Cost of the Soundproofing of Schools, Hospitals, and Public Health Facilities Located Near Airports. Report to Congress.

    ERIC Educational Resources Information Center

    Federal Aviation Administration (DOT), Washington, DC.

    This report fulfills the requirement of Public Law 94-353 that requires the Secretary of Transportation to report to the Congress with respect to the feasibility, practicability, and cost of soundproofing noise-impacted schools, hospitals, and public health facilities, in order to reduce the possible adverse effects of aircraft noise. A survey of…

  15. Adults with Intellectual Disabilities Living in Hong Kong's Residential Care Facilities: A Descriptive Analysis of Health and Disease Patterns by Sex, Age, and Presence of Down Syndrome

    ERIC Educational Resources Information Center

    Wong, Chi Wai

    2011-01-01

    The aim of this study was to describe the health status profile and identify the healthcare needs of adults with intellectual disability (ID) residing in 18 of Hong Kong's residential care facilities. The author employed a cross-sectional study using a structured questionnaire survey to collect data on 811 persons with ID (432 males, 53.3%, and…

  16. The mediating role of facebook fan pages.

    PubMed

    Chih, Wen-Hai; Hsu, Li-Chun; Wang, Kai-Yu; Lin, Kuan-Yu

    2014-01-01

    Using the dual mediation hypothesis, this study investigates the role of interestingness (the power of attracting or holding one's attention) attitude towards the news, in the formation of Facebook Fan Page users' electronic word-of-mouth intentions. A total of 599 Facebook fan page users in Taiwan were recruited and structural equation modeling (SEM) was used to test the research hypotheses. The results show that both perceived news entertainment and informativeness positively influence interestingness attitude towards the news. Interestingness attitude towards the news subsequently influences hedonism and utilitarianism attitudes towards the Fan Page, which then influence eWOM intentions. Interestingness attitude towards the news plays a more important role than hedonism and utilitarianism attitudes in generating electronic word-of-mouth intentions. Based on the findings, the implications and future research suggestions are provided. PMID:24875695

  17. European user trial of paging by satellite

    NASA Technical Reports Server (NTRS)

    Fudge, R. E.; Fenton, C. J.

    1990-01-01

    British Telecom conceived the idea of adapting their existing paging service, together with the use of existing terrestrial pagers, to yield a one way data (i.e., paging) satellite service to mobiles. The user trial of paging by satellites was successful. It demonstrated that services could be provided over a wide geographical area to low priced terminals. Many lessons were learned in unexpected areas. These include the need for extensive liaison with all users involved, especially the drivers, to ensure they understood the potential benefits. There was a significant desire for a return acknowledgement channel or even a return data channel. Above all there is a need to ensure that the equipment can be taken across European borders and legitimately used in all European countries. The next step in a marketing assessment would be to consider the impact of two way data messaging such as INMARSAT-C.

  18. A rendering approach for stereoscopic web pages

    NASA Astrophysics Data System (ADS)

    Zhang, Jianlong; Wang, Wenmin; Wang, Ronggang; Chen, Qinshui

    2014-03-01

    Web technology provides a relatively easy way to generate contents for us to recognize the world, and with the development of stereoscopic display technology, the stereoscopic devices will become much more popular. The combination of web technology and stereoscopic display technology will bring revolutionary visual effect. The Stereoscopic 3D (S3D) web pages, in which text, image and video may have different depth, can be displayed on stereoscopic display devices. This paper presents the approach about how to render two viewing S3D web pages including text, images, widgets: first, an algorithm should be developed in order to display stereoscopic elements like text, widgets by using 2D graphic library; second, a method should be presented to render stereoscopic web page based on current framework of the browser; third, a rough solution is invented to fix the problem that comes out in the method.

  19. Home Health Care

    MedlinePLUS

    ... Page Resize Text Printer Friendly Online Chat Home Health Care Home health care helps older adults live independently for as long ... need for long-term nursing home care. Home health care may include occupational and physical therapy, speech therapy, ...

  20. Factors Influencing Job Satisfaction and Anticipated Turnover among Nurses in Sidama Zone Public Health Facilities, South Ethiopia

    PubMed Central

    Belachew, Tefera; Yimam, Ebrahim

    2014-01-01

    Background. Workplace turnover is destructive to nursing and patient outcomes as it leads to losing competent and qualified nurses. However, developments of coping strategies demand a clear understanding of workplace variables that either motivate nurses to remain employed or lead them to leave their current jobs. Objective. This study was designed toassess factors influencing job satisfaction and intention to turnover among nurses in Sidama zone public health facilities, in Southern Ethiopia. Method. Cross-sectional study design was carried out on 278 nurses using both qualitative and quantitative data collection methods from May 12 to June 05, 2010. Result. A total of 242 nurses were interviewed giving a response rate of 87%. Nearly two-third (68.6%) of the participants were female, and the mean age was 28 (±6.27) years for both sexes. All job satisfaction subscale except benefit and salary subscale were significant predictors of overall job satisfaction. Satisfactions with work environment and group cohesion (AOR: 0.25 [95% CI: 0.12, 0.51]), single cohesion (AOR: 2.56 [95% CI: 1.27, 5.13]), and working in hospital (AOR: 2.19 [95% CI: 1.12, 4.30]) were the final significant predictors of anticipated turnover of Sidama zone nurses. Conclusions. More than any factors managers should consider the modification of working environment and group cohesions rather than trying to modify nurses to retain and maintain more experienced nurses for the organizations. PMID:24707397

  1. Educational needs of health care providers working in long-term care facilities with regard to pain management

    PubMed Central

    Tousignant-Laflamme, Yannick; Tousignant, Michel; Lussier, David; Lebel, Paule; Savoie, Maryse; Lalonde, Lyne; Choinière, Manon

    2012-01-01

    BACKGROUND: The prevalence of chronic pain ranges from 40% to 80% in long-term care facilities (LTCF), with the highest proportion being found among older adults and residents with dementia. Unfortunately, pain in older adults is underdiagnosed, undertreated, inadequately treated or not treated at all. A solution to this problem would be to provide effective and innovative interdisciplinary continuing education to health care providers (HCPs). OBJECTIVE: To identify the educational needs of HCPs working in LTCF with regard to pain management. METHODS: A qualitative research design using the nominal group technique was undertaken. Seventy-two HCPs (21 physicians/pharmacists, 15 occupational/physical therapists, 24 nurses and 21 orderlies) were recruited from three LTCF in Quebec. Each participant was asked to provide and prioritize a list of the most important topics to be addressed within a continuing education program on chronic pain management in LTCF. RESULTS: Forty topics were generated across all groups, and six specific topics were common to at least three out of the four HCP groups. Educational need in pain assessment was ranked the highest by all groups. Other highly rated topics included pharmacological treatment of pain, pain neurophysiology, nonpharmacological treatments and how to distinguish pain expression from other behaviours. CONCLUSION: The present study showed that despite an average of more than 10 years of work experience in LTCF, HCPs have significant educational needs in pain management, especially pain assessment. These results will help in the development of a comprehensive pain management educational program for HCPs in LTCF. PMID:23061085

  2. Prescribing antibiotics in government health facilities in the Philippines within the context of the WHO-CARI programme.

    PubMed

    Vergeire-Dalmacion, G; Delino, R A

    1999-01-01

    ARI deaths at 10.23/1000 infants in the Philippines remain disturbingly 12 and 50 times higher than corresponding rates from the United States and Canada. A cross-sectional study of all government health facilities in two pre-selected areas where the WHO-CARI Program has been implemented was conducted to determine the pattern of prescribing antibiotics for ARI. The therapeutic and diagnostic guideline recommended by the WHO Program was used as a benchmark to identify irrational prescribing. Only 297 encounters out of 885 evaluable cases (35%) had their respiratory rates counted by the prescribers. There was a high proportion of undiagnosed cases at 25% and low agreement between diagnoses of prescribers and those based on the CARI guideline. Moreover, there was failure to treat cases perceived as pneumonia with antibiotics while cases perceived as simple acute respiratory infection were over-treated with the same. However, inter-observer reliability of counting respiratory rates between the research team and caregivers was fair at 0.71. PMID:15073946

  3. Recovery in the health of fish populations and communities following remedial activities at a bleached kraft mill facility

    SciTech Connect

    Greeley, M.S. Jr.; Adams, S.M.; Saylor, C.F.

    1995-12-31

    Fish populations and communities were studied over a seven year period in a river receiving bleached kraft mill effluent (BKME). The period of these investigations preceded and accompanied the extensive modernization of mill facilities and the implementation of design changes to reduce contaminant discharges and minimize impacts on the river ecology. Before modernization, reaches of the river downstream of the discharges were characterized by depauperate fish communities and severely skewed population distributions. The relative condition of both individual fish and fish populations in the river prior to remediation was consistent with effects frequently attributed to exposure to endocrine disrupting agents, including a sex ratio strongly skewed towards male fish, alterations in reproductive hormone levels, pronounced atresia of the developing oocytes in female fish, and a general absence of young fish suggesting near total reproductive failure in a sentinel fish population. Following modernization, sex ratios have trended towards normality, young fish have returned to the mainstream river, and fish communities have become more diverse coincident with corresponding decreases in body burdens of dioxin and other indirect indicators of contaminant exposure, including liver detoxification enzyme activity. The significance of these studies lie in the establishment of distinct links between both: (1) the exposure of individual wild fish to BKME and alterations in fish population and community structure, and (2) the implementation of process changes in a mill producing BKME and noticeable improvements in fish health from the individual to community levels of biological organization.

  4. Factors affecting acceptance of provider-initiated HIV testing and counseling services among outpatient clients in selected health facilities in Harar Town, Eastern Ethiopia

    PubMed Central

    Abdurahman, Sami; Seyoum, Berhanu; Oljira, Lemessa; Weldegebreal, Fitsum

    2015-01-01

    Purpose To improve the slow uptake of HIV counseling and testing, the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) have developed draft guidelines on provider-initiated testing and counseling (PITC). Both in low- and high-income countries, mainly from outpatient clinics and tuberculosis settings, indicates that the direct offer of HIV testing by health providers can result in significant improvements in test uptake. In Ethiopia, there were limited numbers of studies conducted regarding PITC in outpatient clinics. Therefore, in this study, we have assessed the factors affecting the acceptance of PITC among outpatient clients in selected health facilities in Harar, Harari Region State, Ethiopia. Materials and methods Institutional-based, cross-sectional quantitative and qualitative studies were conducted from February 12–30, 2011 in selected health facilities in Harar town, Harari Region State, Ethiopia. The study participants were recruited from the selected health facilities of Harar using a systematic random sampling technique. The collected data were double entered into a data entry file using Epi Info version 3.5.1. The data were transferred to SPSS software version 16 and analyzed according to the different variables. Results A total of 362 (70.6%) clients accepted PITC, and only 39.4% of clients had heard of PITC in the outpatient department service. Age, occupation, marital status, anyone who wanted to check their HIV status, and the importance of PITC were the variables that showed significant associations with the acceptance of PITC upon bivariate and multivariate analyses. The main reasons given for not accepting the tests were self-trust, not being at risk for HIV, not being ready, needing to consult their partners, a fear of the results, a shortage of staff, a busy work environment, a lack of private rooms, and a lack of refresher training, which were identified as the main barriers for PITC. Conclusion There is evidence of the relatively increased acceptability of PITC services by outpatient department clients. A program needs to be strengthened to enhance the use of PITC; the Ministry of Health, Regional Health Bureau, and other responsible bodies – including health facilities – should design and strengthen information education and communication/behavioral change and communication interventions and promote activities related to PITC and HIV counseling and testing in both health facilities and the community at large. PMID:26028979

  5. Efficiency of antenatal care and childbirth services in selected primary health care facilities in rural Tanzania: a cross-sectional study

    PubMed Central

    2014-01-01

    Background Cost studies are paramount for demonstrating how resources have been spent and identifying opportunities for more efficient use of resources. The main objective of this study was to assess the actual dimension and distribution of the costs of providing antenatal care (ANC) and childbirth services in selected rural primary health care facilities in Tanzania. In addition, the study analyzed determining factors of service provision efficiency in order to inform health policy and planning. Methods This was a retrospective quantitative cross-sectional study conducted in 11 health centers and dispensaries in Lindi and Mtwara rural districts. Cost analysis was carried out using step down cost accounting technique. Unit costs reflected efficiency of service provision. Multivariate regression analysis on the drivers of observed relative efficiency in service provision between the study facilities was conducted. Reported personnel workload was also described. Results The health facilities spent on average 7 USD per capita in 2009. As expected, fewer resources were spent for service provision at dispensaries than at health centers. Personnel costs contributed a high approximate 44% to total costs. ANC and childbirth consumed approximately 11% and 12% of total costs; and 8% and 10% of reported service provision time respectively. On average, unit costs were rather high, 16 USD per ANC visit and 79.4 USD per childbirth. The unit costs showed variation in relative efficiency in providing the services between the health facilities. The results showed that efficiency in ANC depended on the number of staff, structural quality of care, process quality of care and perceived quality of care. Population-staff ratio and structural quality of basic emergency obstetric care services highly influenced childbirth efficiency. Conclusions Differences in the efficiency of service provision present an opportunity for efficiency improvement. Taking into consideration client heterogeneity, quality improvements are possible and necessary. This will stimulate utilization of ANC and childbirth services in resource-constrained health facilities. Efficiency analyses through simple techniques such as measurement of unit costs should be made standard in health care provision, health managers can then use the performance results to gauge progress and reward efficiency through performance based incentives. PMID:24581003

  6. Systematic review of facility-based sexual and reproductive health services for female sex workers in Africa

    PubMed Central

    2014-01-01

    Background Several biological, behavioural, and structural risk factors place female sex workers (FSWs) at heightened risk of HIV, sexually transmitted infections (STIs), and other adverse sexual and reproductive health (SRH) outcomes. FSW projects in many settings have demonstrated effective ways of altering this risk, improving the health and wellbeing of these women. Yet the optimum delivery model of FSW projects in Africa is unclear. This systematic review describes intervention packages, service-delivery models, and extent of government involvement in these services in Africa. Methods On 22 November 2012, we searched Web of Science and MEDLINE, without date restrictions, for studies describing clinical and non-clinical facility-based SRH prevention and care services for FSWs in low- and middle-income countries in Africa. We also identified articles in key non-indexed journals and on websites of international organizations. A single reviewer screened titles and abstracts, and extracted data from articles using standardised tools. Results We located 149 articles, which described 54 projects. Most were localised and small-scale; focused on research activities (rather than on large-scale service delivery); operated with little coordination, either nationally or regionally; and had scanty government support (instead a range of international donors generally funded services). Almost all sites only addressed HIV prevention and STIs. Most services distributed male condoms, but only 10% provided female condoms. HIV services mainly encompassed HIV counselling and testing; few offered HIV care and treatment such as CD4 testing or antiretroviral therapy (ART). While STI services were more comprehensive, periodic presumptive treatment was only provided in 11 instances. Services often ignored broader SRH needs such as family planning, cervical cancer screening, and gender-based violence services. Conclusions Sex work programmes in Africa have limited coverage and a narrow scope of services and are poorly coordinated with broader HIV and SRH services. To improve FSWs’ health and reduce onward HIV transmission, access to ART needs to be addressed urgently. Nevertheless, HIV prevention should remain the mainstay of services. Service delivery models that integrate broader SRH services and address structural risk factors are much needed. Government-led FSW services of high quality and scale would markedly reduce SRH vulnerabilities of FSWs in Africa. PMID:24916010

  7. Women's Education Level, Maternal Health Facilities, Abortion Legislation and Maternal Deaths: A Natural Experiment in Chile from 1957 to 2007

    PubMed Central

    Koch, Elard; Thorp, John; Bravo, Miguel; Gatica, SebastiĂĄn; Romero, Camila X.; Aguilera, HernĂĄn; Ahlers, Ivonne

    2012-01-01

    Background The aim of this study was to assess the main factors related to maternal mortality reduction in large time series available in Chile in context of the United Nations' Millennium Development Goals (MDGs). Methods Time series of maternal mortality ratio (MMR) from official data (National Institute of Statistics, 1957–2007) along with parallel time series of education years, income per capita, fertility rate (TFR), birth order, clean water, sanitary sewer, and delivery by skilled attendants were analysed using autoregressive models (ARIMA). Historical changes on the mortality trend including the effect of different educational and maternal health policies implemented in 1965, and legislation that prohibited abortion in 1989 were assessed utilizing segmented regression techniques. Results During the 50-year study period, the MMR decreased from 293.7 to 18.2/100,000 live births, a decrease of 93.8%. Women's education level modulated the effects of TFR, birth order, delivery by skilled attendants, clean water, and sanitary sewer access. In the fully adjusted model, for every additional year of maternal education there was a corresponding decrease in the MMR of 29.3/100,000 live births. A rapid phase of decline between 1965 and 1981 (−13.29/100,000 live births each year) and a slow phase between 1981 and 2007 (−1.59/100,000 live births each year) were identified. After abortion was prohibited, the MMR decreased from 41.3 to 12.7 per 100,000 live births (−69.2%). The slope of the MMR did not appear to be altered by the change in abortion law. Conclusion Increasing education level appears to favourably impact the downward trend in the MMR, modulating other key factors such as access and utilization of maternal health facilities, changes in women's reproductive behaviour and improvements of the sanitary system. Consequently, different MDGs can act synergistically to improve maternal health. The reduction in the MMR is not related to the legal status of abortion. PMID:22574194

  8. High Levels of Asymptomatic and Subpatent Plasmodium falciparum Parasite Carriage at Health Facilities in an Area of Heterogeneous Malaria Transmission Intensity in the Kenyan Highlands

    PubMed Central

    Stresman, Gillian H.; Stevenson, Jennifer C.; Ngwu, Nnenna; Marube, Elizabeth; Owaga, Chrispin; Drakeley, Chris; Bousema, Teun; Cox, Jonathan

    2014-01-01

    In endemic settings, health facility surveys provide a convenient approach to estimating malaria transmission intensity. Typically, testing for malaria at facilities is performed on symptomatic attendees, but asymptomatic infections comprise a considerable proportion of the parasite reservoir. We sampled individuals attending five health facilities in the western Kenyan highlands. Malaria prevalence by rapid diagnostic test (RDT) was 8.6–32.9% in the health facilities. Of all polymerase chain reaction-positive participants, 46.4% (95% confidence interval [95% CI] = 42.6–50.2%) of participants had infections that were RDT-negative and asymptomatic, and 55.9% of those infections consisted of multiple parasite clones as assessed by merozoite surface protein-2 genotyping. Subpatent infections were more common in individuals reporting the use of non-artemisinin–based antimalarials in the 2 weeks preceding the survey (odds ratio = 2.49, 95% CI = 1.04–5.92) compared with individuals not reporting previous use of antimalarials. We observed a large and genetically complex pool of subpatent parasitemia in the Kenya highlands that must be considered in malaria interventions. PMID:25331807

  9. Facility safety study

    NASA Technical Reports Server (NTRS)

    1979-01-01

    The safety of NASA's in house microelectronics facility is addressed. Industrial health standards, facility emission control requirements, operation and safety checklists, and the disposal of epitaxial vent gas are considered.

  10. Policy Analysis of the Greenhouse Effect (PAGE)

    EPA Science Inventory

    PAGE09 is a spreadsheet probabilistic model written in Microsoft Office Excel. The model calculates regional and global impacts of climate change, and social costs of different greenhouse gases. It also calculates the costs of abatement and adaptation. It is an Integrated Assessm...

  11. Thomas Jefferson, Page Design, and Desktop Publishing.

    ERIC Educational Resources Information Center

    Hartley, James

    1991-01-01

    Discussion of page design for desktop publishing focuses on the importance of functional issues as opposed to aesthetic issues, and criticizes a previous article that stressed aesthetic issues. Topics discussed include balance, consistency in text structure, and how differences in layout affect the clarity of "The Declaration of Independence."…

  12. 24 CFR 1710.105 - Cover page.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 5 2012-04-01 2012-04-01 false Cover page. 1710.105 Section 1710.105 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR HOUSING-FEDERAL HOUSING COMMISSIONER, DEPARTMENT OF HOUSING AND...

  13. 24 CFR 1710.105 - Cover page.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 5 2013-04-01 2013-04-01 false Cover page. 1710.105 Section 1710.105 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR HOUSING-FEDERAL HOUSING COMMISSIONER, DEPARTMENT OF HOUSING AND...

  14. 24 CFR 1710.105 - Cover page.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 5 2014-04-01 2014-04-01 false Cover page. 1710.105 Section 1710.105 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR HOUSING-FEDERAL HOUSING COMMISSIONER, DEPARTMENT OF HOUSING AND...

  15. 24 CFR 1710.105 - Cover page.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Cover page. 1710.105 Section 1710.105 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR HOUSING-FEDERAL HOUSING COMMISSIONER, DEPARTMENT OF HOUSING AND...

  16. What's Not Funny about the Funny Pages?

    ERIC Educational Resources Information Center

    Lum, Lydia

    2008-01-01

    As a kid, Darrin Bell devoured newspaper comic strips. So it was disappointing whenever editors refused years later to add his comic strip, "Candorville," to their funny pages as soon as they saw that his lead characters were minorities. The editors would say they already carried a so-called Black strip. It is difficult for cartoonists like Bell…

  17. Perspectives on the Consecutive Pages Problem

    ERIC Educational Resources Information Center

    Srinivasan, V. K.

    2011-01-01

    This article presents different approaches to a problem, dubbed by the author as "the consecutive pages problem". The aim of this teaching-oriented article is to promote the teaching of abstract concepts in mathematics, by selecting a challenging amusement problem and then presenting various solutions in such a way that it can engage the attention…

  18. Turning the Page with Preconference Workshops

    ERIC Educational Resources Information Center

    Knowledge Quest, 2011

    2011-01-01

    For those who are experiencing a lack of creative inspiration within their school library program but are ready to "turn a page" in their career or school library program, they may head to Minneapolis to attend one of the many great preconference workshops. This article presents and describes preconference workshops design to rid librarians of the…

  19. Reconfigurable Full-Page Braille Displays

    NASA Technical Reports Server (NTRS)

    Garner, H. Douglas

    1994-01-01

    Electrically actuated braille display cells of proposed type arrayed together to form full-page braille displays. Like other braille display cells, these provide changeable patterns of bumps driven by digitally recorded text stored on magnetic tapes or in solid-state electronic memories. Proposed cells contain electrorheological fluid. Viscosity of such fluid increases in strong electrostatic field.

  20. Accounting Programs' Home Pages: What's Happening.

    ERIC Educational Resources Information Center

    Peek, Lucia E.; Roxas, Maria L.

    2002-01-01

    Content analysis of 62 accounting programs' websites indicated the following: 53% include mission statements; 62.9% list accreditation; many faculty biographies and personal pages used inconsistent formats; provision of information on financial aid, student organizations, career services, and certified public accountant requirements varied. Many…

  1. Turning the Page with Preconference Workshops

    ERIC Educational Resources Information Center

    Knowledge Quest, 2011

    2011-01-01

    For those who are experiencing a lack of creative inspiration within their school library program but are ready to "turn a page" in their career or school library program, they may head to Minneapolis to attend one of the many great preconference workshops. This article presents and describes preconference workshops design to rid librarians of the


  2. What's Not Funny about the Funny Pages?

    ERIC Educational Resources Information Center

    Lum, Lydia

    2008-01-01

    As a kid, Darrin Bell devoured newspaper comic strips. So it was disappointing whenever editors refused years later to add his comic strip, "Candorville," to their funny pages as soon as they saw that his lead characters were minorities. The editors would say they already carried a so-called Black strip. It is difficult for cartoonists like Bell


  3. Pages from Part I.pdf

    Cancer.gov

    This section presents five charts containing a wide range of state laws and local ordinances designed to reduce tobacco use. There are also three summary tables that present the total number of various types of local ordi-nances by state. Clean Indoor Air Provisions Summary Table 1 (page 71) summarizes the local clean indoor air provisions that appear in Charts 1 through 3.

  4. Efficient Web Change Monitoring with Page Digest

    SciTech Connect

    Buttler, D J; Rocco, D; Liu, L

    2004-02-20

    The Internet and the World Wide Web have enabled a publishing explosion of useful online information, which has produced the unfortunate side effect of information overload: it is increasingly difficult for individuals to keep abreast of fresh information. In this paper we describe an approach for building a system for efficiently monitoring changes to Web documents. This paper has three main contributions. First, we present a coherent framework that captures different characteristics of Web documents. The system uses the Page Digest encoding to provide a comprehensive monitoring system for content, structure, and other interesting properties of Web documents. Second, the Page Digest encoding enables improved performance for individual page monitors through mechanisms such as short-circuit evaluation, linear time algorithms for document and structure similarity, and data size reduction. Finally, we develop a collection of sentinel grouping techniques based on the Page Digest encoding to reduce redundant processing in large-scale monitoring systems by grouping similar monitoring requests together. We examine how effective these techniques are over a wide range of parameters and have seen an order of magnitude speed up over existing Web-based information monitoring systems.

  5. Communicating health risks to the community from a state-of-the art waste-to-energy resource recovery facility through multimedia environmental monitoring program

    SciTech Connect

    Rao, R.K.

    1998-07-01

    Since 1986, when Montgomery County, Maryland decided to construct a municipal solid waste Resource Recovery Facility (RRF), the County has been seeking citizen input through citizen advisory committee meetings. Due to public concern that organics, primarily dioxins, that are released from municipal waste combustion create the risk of potential health-effects including cancer, the County conducted a multiple pathway health-risk study in 1989. In this study, organics and trace metals that are known to be released from municipal waste combustors and are generally considered to be of importance from a public health perspective were addressed. The County conducted several citizen meetings for communicating the results of the health risk studies. In these meetings, some citizens living in the neighborhood of the facility still expressed concern, and asked the County to conduct an ambient monitoring program prior to and during the operation of the facility. The County agreed to conduct a multimedia environmental monitoring program. The County Council endorsed this program. The major objective of the program was to determine the existing background levels of toxics prior to the operation of the facility and incremental increases, if any, resulting from the operation of the facility. In this program organics and trace metals discussed earlier, were periodically sampled. The media sampled were: air, soil, garden vegetables, surface water, fish and sediment from the farm ponds, dairy milk and hay. This paper discusses the original design of the program, citizen input to the design of the program, results of the program, and typical issues raised by the citizens in numerous public briefing conducted by the County, and the County's responses.

  6. Why some women fail to give birth at health facilities: a qualitative study of women’s perceptions of perinatal care from rural Southern Malawi

    PubMed Central

    2013-01-01

    Background Despite Malawi government’s policy to support women to deliver in health facilities with the assistance of skilled attendants, some women do not access this care. Objective The study explores the reasons why women delivered at home without skilled attendance despite receiving antenatal care at a health centre and their perceptions of perinatal care. Methods A descriptive study design with qualitative data collection and analysis methods. Data were collected through face-to-face in-depth interviews using a semi- structured interview guide that collected information on women’s perception on perinatal care. A total of 12 in- depth interviews were conducted with women that had delivered at home in the period December 2010 to March 2011. The women were asked how they perceived the care they received from health workers before, during, and after delivery. Data were manually analyzed using thematic analysis. Results Onset of labor at night, rainy season, rapid labor, socio-cultural factors and health workers’ attitudes were related to the women delivering at home. The participants were assisted in the delivery by traditional birth attendants, relatives or neighbors. Two women delivered alone. Most women went to the health facility the same day after delivery. Conclusions This study reveals beliefs about labor and delivery that need to be addressed through provision of appropriate perinatal information to raise community awareness. Even though, it is not easy to change cultural beliefs to convince women to use health facilities for deliveries. There is a need for further exploration of barriers that prevent women from accessing health care for better understanding and subsequently identification of optimal solutions with involvement of the communities themselves. PMID:23394229

  7. 48 CFR 1852.215-81 - Proposal page limitations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 6 2014-10-01 2014-10-01 false Proposal page limitations... 1852.215-81 Proposal page limitations. As prescribed in 1815.209-70(d), insert the following provision: Proposal Page Limitations (FEB 1998) (a) The following page limitations are established for each portion...

  8. 48 CFR 1852.215-81 - Proposal page limitations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Proposal page limitations... 1852.215-81 Proposal page limitations. As prescribed in 1815.209-70(d), insert the following provision: Proposal Page Limitations (FEB 1998) (a) The following page limitations are established for each portion...

  9. 48 CFR 1852.215-81 - Proposal page limitations.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 6 2012-10-01 2012-10-01 false Proposal page limitations... 1852.215-81 Proposal page limitations. As prescribed in 1815.209-70(d), insert the following provision: Proposal Page Limitations (FEB 1998) (a) The following page limitations are established for each portion...

  10. 48 CFR 1852.215-81 - Proposal page limitations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 6 2013-10-01 2013-10-01 false Proposal page limitations... 1852.215-81 Proposal page limitations. As prescribed in 1815.209-70(d), insert the following provision: Proposal Page Limitations (FEB 1998) (a) The following page limitations are established for each portion...

  11. Young Children's Interpretations of Page Breaks in Contemporary Picture Storybooks

    ERIC Educational Resources Information Center

    Sipe, Lawrence R.; Brightman, Anne E.

    2009-01-01

    This article reports on a study of the responses of a second-grade class to the page breaks in contemporary picturebooks. In a picturebook, the text and accompanying illustrations are divided into a series of facing pages called openings, and the divisions between the openings are called page breaks or turns. Unlike a novel, in which the page…

  12. 48 CFR 1852.215-81 - Proposal page limitations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 6 2011-10-01 2011-10-01 false Proposal page limitations... 1852.215-81 Proposal page limitations. As prescribed in 1815.209-70(d), insert the following provision: Proposal Page Limitations (FEB 1998) (a) The following page limitations are established for each portion...

  13. Crises and Resilience at the Frontline—Public Health Facility Managers under Devolution in a Sub-County on the Kenyan Coast

    PubMed Central

    Nyikuri, Mary; Tsofa, Benjamin; Barasa, Edwine; Okoth, Philip; Molyneux, Sassy

    2015-01-01

    Background Public primary health care (PHC) facilities are for many individuals the first point of contact with the formal health care system. These facilities are managed by professional nurses or clinical officers who are recognised to play a key role in implementing health sector reforms and facilitating initiatives aimed at strengthening community involvement. Little in-depth research exists about the dimensions and challenges of these managers’ jobs, or on the impact of decentralisation on their roles and responsibilities. In this paper, we describe the roles and responsibilities of PHC managers–or ‘in-charges’ in Kenya, and their challenges and coping strategies, under accelerated devolution. Methods The data presented in this paper is part of a wider set of activities aimed at understanding governance changes under devolution in Kenya, under the umbrella of a ‘learning site’. A learning site is a long term process of collaboration between health managers and researchers deciding together on key health system questions and interventions. Data were collected through seven formal in depth interviews and observations at four PHC facilities as well as eight in depth interviews and informal interactions with sub-county managers from June 2013 to July 2014. Drawing on the Aragon framework of organisation capacity we discuss the multiple accountabilities, daily routines, challenges and coping strategies among PHC facility managers. Results PHC in-charges perform complex and diverse roles in a difficult environment with relatively little formal preparation. Their key concerns are lack of job clarity and preparedness, the difficulty of balancing multidirectional accountability responsibilities amidst significant resource shortages, and remuneration anxieties. We show that day-to-day management in an environment of resource constraints and uncertainty requires PHC in-charges who are resilient, reflective, and continuously able to learn and adapt. We highlight the importance of leadership development including the building of critical soft skills such as relationship building. PMID:26696096

  14. Oral Health

    MedlinePLUS

    ... navigation ePublications Our ePublications For health professionals Federal report page Subscribe to ePublications email updates. Enter ... information in Spanish (en español) Print this fact sheet Oral health fact sheet (PDF, 856 KB) Related information Anxiety disorders fact sheet Body image Diabetes fact sheet Fitness and nutrition HIV/AIDS Pregnancy What is oral health? What ...

  15. Substance Abuse Treatment Facility Locator

    MedlinePLUS

    ... Health Services Locator Buprenorphine Physician Locator Find a Facility in Your State To locate the drug and ... Service . Privacy Policy . Home | About the Locator | Find Facilities Near You | Find Facilities by City, County, State ...

  16. Periodontal conditions, low birth weight and preterm birth among postpartum mothers in two tertiary health facilities in Uganda

    PubMed Central

    2014-01-01

    Background Literature reports have indicated an increase in research evidence suggesting association between periodontal disease and the risk of pre-term birth (PTB) and low birth weight (LBW). Periodontal diseases in Uganda have been documented as a public health problem, but their association to adverse pregnancy outcomes is unknown. This study was conducted to assess the association between periodontital diseases in postpartum mothers and PTB and LBW of babies in Mulago and Mbarara referral hospitals. Methods This was a cross sectional study using medical records, clinical examination and oral interview of mothers at the two tertiary health facilities. Mothers with singleton babies from Mulago (n = 300) and Mbarara Hospital (n = 100) were recruited for the study. The women were clinically examined for periodontal disease by 2 trained and calibrated dentists. Data on PTB and LBW were retrieved from medical records. The data were analyzed to determine the relationship between the four parameters for periodontal disease (bleeding gingiva, periodontal pockets, gingival recession and calculus with plaque deposits) and the adverse pregnancy outcomes. Frequency distribution was used to describe the data. Bivariate and multivariate analyses were used to study the association between the periodontal diseases and adverse pregnancy outcomes. Results Approximately 26% and 29% of the postpartum mothers examined had bleeding gingiva and periodontal pockets of 4 mm or more deep, respectively. Advanced periodontitis i.e. pocket depth ≄ 6 mm was recorded in 13 (3.6%) of the mothers. Calculus with plaque deposits were recorded in 86% (n = 343) of the mothers. Gingival recession was recorded in 9.0% of the mothers and significantly and directly related to birth weight (p < 0.05). Conclusion Periodontal conditions of postpartum mothers in this study were found to be better than previously reported amongst the Ugandan population. Bivariate analysis showed a significant association only between gingival recession and low birth weight. However, this finding should be interpreted with caution as it could have occurred by chance. PMID:24773772

  17. Individual and health facility factors and the risk for obstructed labour and its adverse outcomes in south-western Uganda

    PubMed Central

    2011-01-01

    Background Obstructed labour is still a major cause of maternal morbidity and mortality and of adverse outcome for newborns in low-income countries. The aim of this study was to investigate the role of individual and health facility factors and the risk for obstructed labour and its adverse outcomes in south-western Uganda. Methods A review was performed on 12,463 obstetric records for the year 2006 from six hospitals located in south-western Uganda and 11,180 women records were analysed. Multivariate logistic regression analyses were applied to control for probable confounders. Results Prevalence of obstructed labour for the six hospitals was 10.5% and the main causes were cephalopelvic disproportion (63.3%), malpresentation or malposition (36.4%) and hydrocephalus (0.3%). The risk of obstructed labour was statistically significantly associated with being resident of a particular district [Isingiro] (AOR 1.39, 95% CI: 1.04-1.86), with nulliparous status (AOR 1.47, 95% CI: 1.22-1.78), having delivered once before (AOR 1.57, 95% CI: 1.30-1.91) and age group 15-19 years (AOR 1.21, 95% CI: 1.02-1.45). The risk for perinatal death as an adverse outcome was statistically significantly associated with districts other than five comprising the study area (AOR 2.85, 95% CI: 1.60-5.08) and grand multiparous status (AOR 1.89, 95% CI: 1.11-3.22). Women who lacked paid employment were at increased risk of obstructed labour. Perinatal mortality rate was 142/1000 total births in women with obstructed labour compared to 65/1000 total births in women without the condition. The odds of having maternal complications in women with obstructed labour were 8 times those without the condition. The case fatality rate for obstructed labour was 1.2%. Conclusions Individual socio-demographic and health system factors are strongly associated with obstructed labour and its adverse outcome in south-western Uganda. Our study provides baseline information which may be used by policy makers and implementers to improve implementation of safe motherhood programmes. PMID:21995340

  18. What factors are important for deprescribing in Australian long-term care facilities? Perspectives of residents and health professionals

    PubMed Central

    Edwards, Susan; Stanners, Melinda; Shakib, Sepehr; Bell, J Simon

    2016-01-01

    Objectives Polypharmacy and multimorbidity are common in long-term care facilities (LTCFs). Reducing polypharmacy may reduce adverse events and maintain quality of life. Deprescribing refers to reducing medications after consideration of therapeutic goals, benefits and risks, and medical ethics. The objective was to use nominal group technique (NGT) to generate then rank factors that general medical practitioners (GPs), nurses, pharmacists and residents or their representatives perceive are most important when deciding whether or not to deprescribe medications. Design Qualitative research using NGT. Setting Participants were invited if they worked with, or resided in LTCFs across metropolitan and regional South Australia. Participants 11 residents/representatives, 19 GPs, 12 nurses and 14 pharmacists participated across six separate groups. Methods Individual groups of GPs, nurses, pharmacists and residents/representatives were convened. Using NGT each group ranked factors perceived to be most important when deciding whether or not to deprescribe. Then, using NGT, the prioritised factors from individual groups were discussed and prioritised by a multidisciplinary metropolitan and regional group comprised of resident representatives, GPs, nurses and pharmacists. Results No two groups had the same priorities. GPs ranked ‘evidence for deprescribing’ and ‘communication with family/resident’ as most important factors. Nurses ranked ‘GP receptivity to deprescribing’ and ‘nurses ability to advocate for residents’ as most important. Pharmacists ranked ‘clinical appropriateness of therapy’ and ‘identifying residents’ goals of care’ as most important. Residents ranked ‘wellbeing of the resident’ and ‘continuity of nursing staff’ as most important. The multidisciplinary groups ranked ‘adequacy of medical and medication history’ and ‘identifying residents’ goals of care’ as most important. Conclusions While each group prioritised different factors, common and contrasting factors emerged. Future deprescribing interventions need to consider the similarities and differences within the range of factors prioritised by residents and health professionals. PMID:26966056

  19. Respectful maternity care in three health facilities in Burkina Faso: the experience of the Society of Gynaecologists and Obstetricians of Burkina Faso.

    PubMed

    Ouédraogo, Ali; Kiemtoré, Sibraogo; Zamané, Hyacinthe; Bonané, Blandine T; Akotionga, Michel; Lankoande, Jean

    2014-10-01

    The Society of Gynaecologists and Obstetricians of Burkina Faso (SOGOB) conducted a project to reinforce skills in respectful maternity care among its members and health workers at three facilities. The participatory process allowed health workers to self-diagnose quality of care, recognize their own responsibility, propose solutions, and pledge respectful care commitments that were specific for each unit. Key commitments included good reception; humanistic clinical examination; attentive listening and responsiveness to patient needs; privacy, discretion, and confidentiality; availability; and comfort. These commitments can potentially be modified after each evaluation by SOGOB. Poor working conditions were found to negatively impact on quality of care. High staff turnover, frequent technical malfunctions, and inadequate infrastructure were identified as issues that require future focus to ensure improvements in quality of care are sustainable. Programs that aim to improve the maternity experience by linking good practice with humanistic care merit rollout to all healthcare facilities in Burkina Faso. PMID:25087176

  20. Achieving the 150-page environmental impact statement (and the 15-page environmental assessment)

    SciTech Connect

    Smillie, S.M.; Swartz, L.L.

    1997-08-01

    Regulations issued by the Council on Environmental Quality (CEQ) to implement the procedural provisions of the National Environmental Policy Act (NEPA) state that the text of environmental impact statements (EIS) shall normally be less than 150 pages and for proposals of unusual scope or complexity shall normally be less than 300 pages. 40 CFR {section} 1502.7. Guidance issued by CEQ suggests that environmental assessments (EA) be 10--15 pages in length. Forty Most Asked Questions Concerning CEQ`s National Environmental Policy Act Regulations, 46 Fed. Reg. 18026 (1981), Questions 36a and 36b. Rarely are these page limits met. This paper will suggest some reasons why EISs and EAs are so lengthy and what can be done to shorten them appropriately while still fully complying with NEPA.

  1. Comparing the knowledge, attitude and practices of health care workers in public and private primary care facilities in Lagos State on Ebola virus disease

    PubMed Central

    Idris, Bilqisu Jibril; Inem, Victor; Balogun, Mobolanle

    2015-01-01

    Introduction The West African sub-region is currently witnessing an outbreak of EVD that began in December 2013. The first case in Nigeria was diagnosed in Lagos, at a private medical facility in July 2014. Health care workers are known amplifiers of the disease. The study aimed to determine and compare EVD knowledge, attitude and practices among HCWs in public and private primary care facilities in Lagos, Nigeria. Methods This was a comparative cross-sectional study. Seventeen public and private primary care facilities were selected from the 3 senatorial districts that make up Lagos State. 388 respondents from these facilities were selected at random and interviewed using a structured questionnaire. Results Proportion of respondents with good knowledge and practice among public HCWs was 98.5% and 93.8%; and among private HCW, 95.9% and 89.7%. Proportion of respondents with positive attitude was 67% (public) and 72.7% (private). Overall, there were no statistically significant differences between the knowledge, attitude and preventive practices of public HCWs and that of private HCWs, (p≀0.05). Conclusion Timely and intense social mobilization and awareness campaigns are the best tools to educate all segments of the community about public health emergencies. There exists significant surmountable gaps in EVD knowledge, negative attitude and sub-standard preventive practices that can be eliminated through continued training of HCW and provision of adequate material resources. PMID:26740847

  2. Evolving dynamic web pages using web mining

    NASA Astrophysics Data System (ADS)

    Menon, Kartik; Dagli, Cihan H.

    2003-08-01

    The heterogeneity and the lack of structure that permeates much of the ever expanding information sources on the WWW makes it difficult for the user to properly and efficiently access different web pages. Different users have different needs from the same web page. It is necessary to train the system to understand the needs and demands of the users. In other words there is a need for efficient and proper web mining. In this paper issues and possible ways of training the system and providing high level of organization for semi structured data available on the web is discussed. Web pages can be evolved based on history of query searches, browsing, links traversed and observation of the user behavior like book marking and time spent on viewing. Fuzzy clustering techniques help in grouping natural users and groups, neural networks, association rules and web traversals patterns help in efficient sequential anaysis based on previous searches and queries by the user. In this paper we analyze web server logs using above mentioned techniques to know more about user interactions. Analyzing these web server logs help to closely understand the user behavior and his/her web access pattern.

  3. The Potential Trajectory of Carbapenem-Resistant Enterobacteriaceae, an Emerging Threat to Health-Care Facilities, and the Impact of the Centers for Disease Control and Prevention Toolkit.

    PubMed

    Lee, Bruce Y; Bartsch, Sarah M; Wong, Kim F; McKinnell, James A; Slayton, Rachel B; Miller, Loren G; Cao, Chenghua; Kim, Diane S; Kallen, Alexander J; Jernigan, John A; Huang, Susan S

    2016-03-01

    Carbapenem-resistant Enterobacteriaceae (CRE), a group of pathogens resistant to most antibiotics and associated with high mortality, are a rising emerging public health threat. Current approaches to infection control and prevention have not been adequate to prevent spread. An important but unproven approach is to have hospitals in a region coordinate surveillance and infection control measures. Using our Regional Healthcare Ecosystem Analyst (RHEA) simulation model and detailed Orange County, California, patient-level data on adult inpatient hospital and nursing home admissions (2011-2012), we simulated the spread of CRE throughout Orange County health-care facilities under 3 scenarios: no specific control measures, facility-level infection control efforts (uncoordinated control measures), and a coordinated regional effort. Aggressive uncoordinated and coordinated approaches were highly similar, averting 2,976 and 2,789 CRE transmission events, respectively (72.2% and 77.0% of transmission events), by year 5. With moderate control measures, coordinated regional control resulted in 21.3% more averted cases (n = 408) than did uncoordinated control at year 5. Our model suggests that without increased infection control approaches, CRE would become endemic in nearly all Orange County health-care facilities within 10 years. While implementing the interventions in the Centers for Disease Control and Prevention's CRE toolkit would not completely stop the spread of CRE, it would cut its spread substantially, by half. PMID:26861238

  4. The Potential Trajectory of Carbapenem-Resistant Enterobacteriaceae, an Emerging Threat to Health-Care Facilities, and the Impact of the Centers for Disease Control and Prevention Toolkit

    PubMed Central

    Lee, Bruce Y.; Bartsch, Sarah M.; Wong, Kim F.; McKinnell, James A.; Slayton, Rachel B.; Miller, Loren G.; Cao, Chenghua; Kim, Diane S.; Kallen, Alexander J.; Jernigan, John A.; Huang, Susan S.

    2016-01-01

    Carbapenem-resistant Enterobacteriaceae (CRE), a group of pathogens resistant to most antibiotics and associated with high mortality, are a rising emerging public health threat. Current approaches to infection control and prevention have not been adequate to prevent spread. An important but unproven approach is to have hospitals in a region coordinate surveillance and infection control measures. Using our Regional Healthcare Ecosystem Analyst (RHEA) simulation model and detailed Orange County, California, patient-level data on adult inpatient hospital and nursing home admissions (2011–2012), we simulated the spread of CRE throughout Orange County health-care facilities under 3 scenarios: no specific control measures, facility-level infection control efforts (uncoordinated control measures), and a coordinated regional effort. Aggressive uncoordinated and coordinated approaches were highly similar, averting 2,976 and 2,789 CRE transmission events, respectively (72.2% and 77.0% of transmission events), by year 5. With moderate control measures, coordinated regional control resulted in 21.3% more averted cases (n = 408) than did uncoordinated control at year 5. Our model suggests that without increased infection control approaches, CRE would become endemic in nearly all Orange County health-care facilities within 10 years. While implementing the interventions in the Centers for Disease Control and Prevention's CRE toolkit would not completely stop the spread of CRE, it would cut its spread substantially, by half. PMID:26861238

  5. Human Health and Ecological Risk Assessment for the Operation of the Explosives Waste Treatment Facility at Site 300 of the Lawrence Livermore National Laboratory

    SciTech Connect

    Gallegos, G; Daniels, J; Wegrecki, A

    2007-10-01

    This document contains the human health and ecological risk assessment for the Resource Recovery and Conservation Act (RCRA) permit renewal for the Explosives Waste Treatment Facility (EWTF). Volume 1 is the text of the risk assessment, and Volume 2 (provided on a compact disc) is the supporting modeling data. The EWTF is operated by the Lawrence Livermore National Laboratory (LLNL) at Site 300, which is located in the foothills between the cities of Livermore and Tracy, approximately 17 miles east of Livermore and 8 miles southwest of Tracy. Figure 1 is a map of the San Francisco Bay Area, showing the location of Site 300 and other points of reference. One of the principal activities of Site 300 is to test what are known as 'high explosives' for nuclear weapons. These are the highly energetic materials that provide the force to drive fissionable material to criticality. LLNL scientists develop and test the explosives and the integrated non-nuclear components in support of the United States nuclear stockpile stewardship program as well as in support of conventional weapons and the aircraft, mining, oil exploration, and construction industries. Many Site 300 facilities are used in support of high explosives research. Some facilities are used in the chemical formulation of explosives; others are locations where explosive charges are mechanically pressed; others are locations where the materials are inspected radiographically for such defects as cracks and voids. Finally, some facilities are locations where the machined charges are assembled before they are sent to the onsite test firing facilities, and additional facilities are locations where materials are stored. Wastes generated from high-explosives research are treated by open burning (OB) and open detonation (OD). OB and OD treatments are necessary because they are the safest methods for treating explosives wastes generated at these facilities, and they eliminate the requirement for further handling and transportation that would be required if the wastes were treated off site.

  6. Effect of the Ebola-virus-disease epidemic on malaria case management in Guinea, 2014: a cross-sectional survey of health facilities

    PubMed Central

    Plucinski, Mateusz M; Guilavogui, Timothée; Sidikiba, Sidibe; Diakité, Nouman; Diakité, Souleymane; Dioubaté, Mohamed; Bah, Ibrahima; Hennessee, Ian; Butts, Jessica K; Halsey, Eric S; McElroy, Peter D; Kachur, S Patrick; Aboulhab, Jamila; James, Richard; Keita, Moussa

    2015-01-01

    Summary Background The ongoing west Africa Ebola-virus-disease epidemic has disrupted the entire health-care system in affected countries. Because of the overlap of symptoms of Ebola virus disease and malaria, the care delivery of malaria is particularly sensitive to the indirect effects of the current Ebola-virus-disease epidemic. We therefore characterise malaria case management in the context of the Ebola-virus-disease epidemic and document the effect of the Ebola-virus-disease epidemic on malaria case management. Methods We did a cross-sectional survey of public health facilities in Guinea in December, 2014. We selected the four prefectures most affected by Ebola virus disease and selected four randomly from prefectures without any reported cases of the disease. 60 health facilities were sampled in Ebola-affected and 60 in Ebola-unaffected prefectures. Study teams abstracted malaria case management indicators from registers for January to November for 2013 and 2014 and interviewed health-care workers. Nationwide weekly surveillance data for suspect malaria cases reported between 2011 and 2014 were analysed independently. Data for malaria indicators in 2014 were compared with previous years. Findings We noted substantial reductions in all-cause outpatient visits (by 23 103 [11%] of 214 899), cases of fever (by 20249 [15%] of 131 330), and patients treated with oral (by 22 655 [24%] of 94 785) and injectable (by 5219 [30%] of 17 684) antimalarial drugs in surveyed health facilities. In Ebola-affected prefectures, 73 of 98 interviewed community health workers were operational (74%, 95% CI 65–83) and 35 of 73 were actively treating malaria cases (48%, 36–60) compared with 106 of 112 (95%, 89–98) and 102 of 106 (96%, 91–99), respectively, in Ebola-unaffected prefectures. Nationwide, the Ebola-virus-disease epidemic was estimated to have resulted in 74 000 (71 000–77 000) fewer malaria cases seen at health facilities in 2014. Interpretation The reduction in the delivery of malaria care because of the Ebola-virus-disease epidemic threatens malaria control in Guinea. Untreated and inappropriately treated malaria cases lead to excess malaria mortality and more fever cases in the community, impeding the Ebola-virus-disease response. Funding Global Fund to Fight AIDS, Tuberculosis and Malaria, and President’s Malaria Initiative. PMID:26116183

  7. Acute antimicrobial pesticide-related illnesses among workers in health-care facilities - California, Louisiana, Michigan, and Texas, 2002-2007.

    PubMed

    2010-05-14

    Antimicrobial pesticides (e.g., sterilizers, disinfectants, and sanitizers) are chemicals used to destroy or suppress the growth of harmful microorganisms on inanimate objects and surfaces. Health-care facilities use antimicrobial pesticides to prevent pathogen transmission from contaminated environmental surfaces. Occupational exposures to antimicrobial pesticides are known to cause adverse health effects. To assess the nature and frequency of such exposures in health-care settings, CDC analyzed data from pesticide poisoning surveillance programs in California, Louisiana, Michigan, and Texas (the only four states that regularly collect data on antimicrobial pesticide-related illness) for the period 2002-2007. This report summarizes the results of that analysis, which identified 401 cases of work-related illness associated with antimicrobial pesticide exposures in health-care facilities. Most cases were identified through workers compensation systems (61%) and occurred among females (82%) and persons aged 25-54 years (73%). The most frequent occupations reported were janitors/housekeepers (24%) and nursing/medical assistants (16%). The reported mechanism of injury usually was splashes/spills (51%). The eyes were the most common organ/system affected (55%); only 15% of the 265 persons who had exposures while handling antimicrobial pesticides reported using eye protection. Reported symptoms were mostly mild and temporary. One fatality due to acute asthma and subsequent cardiopulmonary collapse was identified. Health-care facilities should educate workers about antimicrobial pesticide hazards, promote the use of personal protective equipment (PPE) as appropriate, and implement effective risk communication strategies for antimicrobial pesticide use to prevent bystander exposure. Improved design of handling equipment might prevent handler and bystander exposure. PMID:20467413

  8. Road map to scaling-up: translating operations research study’s results into actions for expanding medical abortion services in rural health facilities in Nepal

    PubMed Central

    2014-01-01

    Background Identifying unsafe abortion among the major causes of maternal deaths and respecting the rights to health of women, in 2002, the Nepali parliament liberalized abortion up to 12 weeks of pregnancy on request. However, enhancing women’s awareness on and access to safe and legal abortion services, particularly in rural areas, remains a challenge in Nepal despite a decade of the initiation of safe abortion services. Methods Between January 2011 and December 2012, an operations research study was carried out using quasi-experimental design to determine the effectiveness of engaging female community health volunteers, auxiliary nurse midwives, and nurses to provide medical abortion services from outreach health facilities to increase the accessibility and acceptability of women to medical abortion. This paper describes key components of the operations research study, key research findings, and follow-up actions that contributed to create a conducive environment and evidence in scaling up medical abortion services in rural areas of Nepal. Results It was found that careful planning and implementation, continuous advocacy, and engagement of key stakeholders, including key government officials, from the planning stage of study is not only crucial for successful completion of the project but also instrumental for translating research results into action and policy change. While challenges remained at different levels, medical abortion services delivered by nurses and auxiliary nurse midwives working at rural outreach health facilities without oversight of physicians was perceived to be accessible, effective, and of good quality by the service providers and the women who received medical abortion services from these rural health facilities. Conclusions This research provided further evidence and a road-map for expanding medical abortion services to rural areas by mid-level service providers in minimum clinical settings without the oversight of physicians, thus reducing complications and deaths due to unsafe abortion. PMID:24886393

  9. Where Do the Rural Poor Deliver When High Coverage of Health Facility Delivery Is Achieved? Findings from a Community and Hospital Survey in Tanzania

    PubMed Central

    Straneo, Manuela; Fogliati, Piera; Azzimonti, Gaetano; Mangi, Sabina; Kisika, Firma

    2014-01-01

    Introduction As part of maternal mortality reducing strategies, coverage of delivery care among sub-Saharan African rural poor will improve, with a range of facilities providing services. Whether high coverage will benefit all socio-economic groups is unknown. Iringa rural District, Southern Tanzania, with high facility delivery coverage, offers a paradigm to address this question. Delivery services are available in first-line facilities (dispensaries, health centres) and one hospital. We assessed whether all socio-economic groups access the only comprehensive emergency obstetric care facility equally, and surveyed existing delivery services. Methods District population characteristics were obtained from a household community survey (n?=?463). A Hospital survey collected data on women who delivered in this facility (n?=?1072). Principal component analysis on household assets was used to assess socio-economic status. Hospital population socio-demographic characteristics were compared to District population using multivariable logistic regression. Deliveries' distribution in District facilities and staffing were analysed using routine data. Results Women from the hospital compared to the District population were more likely to be wealthier. Adjusted odds ratio of hospital delivery increased progressively across socio-economic groups, from 1.73 for the poorer (p?=?0.0031) to 4.53 (p<0.0001) for the richest. Remarkable dispersion of deliveries and poor staffing were found. In 2012, 5505/7645 (72%) institutional deliveries took place in 68 first-line facilities, the remaining in the hospital. 56/68 (67.6%) first-line facilities reported ?100 deliveries/year, attending 33% of deliveries. Insufficient numbers of skilled birth attendants were found in 42.9% of facilities. Discussion Poorer women remain disadvantaged in high coverage, as they access lower level facilities and are under-represented where life-saving transfusions and caesarean sections are available. Tackling the challenges posed by low caseloads and staffing on first-line rural care requires confronting a dilemma between coverage and quality. Reducing number of delivery sites is recommended to improve quality and equity of care. PMID:25460007

  10. Mixed and low-level waste treatment project: Appendix C, Health and safety criteria for the mixed and low-level waste treatment facility at the Idaho National Engineering Laboratory. Part 2, Chemical constituents

    SciTech Connect

    Neupauer, R.M.; Thurmond, S.M.

    1992-09-01

    This report contains health and safety information relating to the chemicals that have been identified in the mixed waste streams at the Waste Treatment Facility at the Idaho National Engineering Laboratory. Information is summarized in two summary sections--one for health considerations and one for safety considerations. Detailed health and safety information is presented in material safety data sheets (MSDSs) for each chemical.

  11. Mixed and low-level waste treatment project: Appendix C, Health and safety criteria for the mixed and low-level waste treatment facility at the Idaho National Engineering Laboratory

    SciTech Connect

    Neupauer, R.M.; Thurmond, S.M.

    1992-09-01

    This report contains health and safety information relating to the chemicals that have been identified in the mixed waste streams at the Waste Treatment Facility at the Idaho National Engineering Laboratory. Information is summarized in two summary sections--one for health considerations and one for safety considerations. Detailed health and safety information is presented in material safety data sheets (MSDSs) for each chemical.

  12. Child Mortality after Discharge from a Health Facility following Suspected Pneumonia, Meningitis or Septicaemia in Rural Gambia: A Cohort Study

    PubMed Central

    Chhibber, Aakash Varun; Hill, Philip C.; Jafali, James; Jasseh, Momodou; Hossain, Mohammad Ilias; Ndiaye, Malick; Pathirana, Jayani C.; Greenwood, Brian; Mackenzie, Grant A.

    2015-01-01

    Objective To measure mortality and its risk factors among children discharged from a health centre in rural Gambia. Methods We conducted a cohort study between 12 May 2008 and 11 May 2012. Children aged 2–59 months, admitted with suspected pneumonia, sepsis, or meningitis after presenting to primary and secondary care facilities, were followed for 180 days after discharge. We developed models associating post-discharge mortality with clinical syndrome on admission and clinical risk factors. Findings One hundred and five of 3755 (2.8%) children died, 80% within 3 months of discharge. Among children aged 2–11 and 12–59 months, there were 30 and 29 deaths per 1000 children per 180 days respectively, compared to 11 and 5 respectively in the resident population. Children with suspected pneumonia unaccompanied by clinically severe malnutrition (CSM) had the lowest risk of post-discharge mortality. Mortality increased in children with suspected meningitis or septicaemia without CSM (hazard ratio [HR] 2.6 and 2.2 respectively). The risk of mortality greatly increased with CSM on admission: CSM with suspected pneumonia (HR 8.1; 95% confidence interval (CI) 4.4 to 15), suspected sepsis (HR 18.4; 95% CI 11.3 to 30), or suspected meningitis (HR 13.7; 95% CI 4.2 to 45). Independent associations with mortality were: mid-upper arm circumference (MUAC) of 11.5–13.0 cm compared to >13.0 cm (HR 7.2; 95% CI 3.0 to 17.0), MUAC 10.5–11.4 cm (HR 24; 95% CI 9.4 to 62), and MUAC <10.5 cm (HR 44; 95% CI 18 to 108), neck stiffness (HR 10.4; 95% CI 3.1 to 34.8), non-medical discharge (HR 4.7; 95% CI 2.0 to 10.9), dry season discharge (HR 2.0; 95% CI 1.2 to 3.3), while greater haemoglobin (HR 0.82; 0.73 to 0.91), axillary temperature (HR 0.71; 95% CI 0.58 to 0.87), and oxygen saturation (HR 0.96; 95% CI 0.93 to 0.99) were associated with reduced mortality. Conclusion Gambian children experience increased mortality after discharge from primary and secondary care. Interventions should target both moderately and severely malnourished children. PMID:26353110

  13. Initiation of a ring approach to infection prevention and control at non-Ebola health care facilities - Liberia, January-February 2015.

    PubMed

    Nyenswah, Tolbert; Massaquoi, Moses; Gbanya, Miatta Zenabu; Fallah, Mosoka; Amegashie, Fred; Kenta, Adolphus; Johnson, Kumblytee L; Yahya, Disu; Badini, Mehboob; Soro, Lacina; Pessoa-Silva, Carmem L; Roger, Isabelle; Selvey, Linda; VanderEnde, Kristin; Murphy, Matthew; Cooley, Laura A; Olsen, Sonja J; Christie, Athalia; Vertefeuille, John; Navin, Thomas; McElroy, Peter; Park, Benjamin J; Esswein, Eric; Fagan, Ryan; Mahoney, Frank

    2015-05-15

    From mid-January to mid-February 2015, all confirmed Ebola virus disease (Ebola) cases that occurred in Liberia were epidemiologically linked to a single index patient from the St. Paul Bridge area of Montserrado County. Of the 22 confirmed patients in this cluster, eight (36%) sought and received care from at least one of 10 non-Ebola health care facilities (HCFs), including clinics and hospitals in Montserrado and Margibi counties, before admission to an Ebola treatment unit. After recognition that three patients in this emerging cluster had received care from a non-Ebola treatment unit, and in response to the risk for Ebola transmission in non-Ebola treatment unit health care settings, a focused infection prevention and control (IPC) rapid response effort for the immediate area was developed to target facilities at increased risk for exposure to a person with Ebola (Ring IPC). The Ring IPC approach, which provided rapid, intensive, and short-term IPC support to HCFs in areas of active Ebola transmission, was an addition to Liberia's proposed longer term national IPC strategy, which focused on providing a comprehensive package of IPC training and support to all HCFs in the country. This report describes possible health care worker exposures to the cluster's eight patients who sought care from an HCF and implementation of the Ring IPC approach. On May 9, 2015, the World Health Organization (WHO) declared the end of the Ebola outbreak in Liberia. PMID:25974636

  14. Communities, birth attendants and health facilities: a continuum of emergency maternal and newborn care (the global network's EmONC trial)

    PubMed Central

    2010-01-01

    Background Maternal and newborn mortality rates remain unacceptably high, especially where the majority of births occur in home settings or in facilities with inadequate resources. The introduction of emergency obstetric and newborn care services has been proposed by several organizations in order to improve pregnancy outcomes. However, the effectiveness of emergency obstetric and neonatal care services has never been proven. Also unproven is the effectiveness of community mobilization and community birth attendant training to improve pregnancy outcomes. Methods/Design We have developed a cluster-randomized controlled trial to evaluate the impact of a comprehensive intervention of community mobilization, birth attendant training and improvement of quality of care in health facilities on perinatal mortality in low and middle-income countries where the majority of births take place in homes or first level care facilities. This trial will take place in 106 clusters (300-500 deliveries per year each) across 7 sites of the Global Network for Women's and Children's Health Research in Argentina, Guatemala, India, Kenya, Pakistan and Zambia. The trial intervention has three key elements, community mobilization, home-based life saving skills for communities and birth attendants, and training of providers at obstetric facilities to improve quality of care. The primary outcome of the trial is perinatal mortality. Secondary outcomes include rates of stillbirth, 7-day neonatal mortality, maternal death or severe morbidity (including obstetric fistula, eclampsia and obstetrical sepsis) and 28-day neonatal mortality. Discussion In this trial, we are evaluating a combination of interventions including community mobilization and facility training in an attempt to improve pregnancy outcomes. If successful, the results of this trial will provide important information for policy makers and clinicians as they attempt to improve delivery services for pregnant women and newborns in low-income countries. Trial Registration ClinicalTrials.gov NCT01073488 PMID:21156060

  15. Situation analysis and issues in management of biomedical waste in select small health care facilities in a ward under Bruhat Bengaluru Mahanagara Palike, Bangalore, India.

    PubMed

    Chethana, Thirthahalli; Thapsey, Hemanth; Gautham, Melur Sukumar; Sreekantaiah, Pruthvish; Suryanarayana, Suradhenupura Puttajois

    2014-04-01

    Smaller health care facilities especially clinics though believed to generate lesser quantum/categories of medical waste, the number of clinics/small health care settings are considerable. The movement to manage biomedical waste in a safe and scientific manner has gathered momentum among the medium and large hospitals in Bangalore, but there has been a little understanding and focus on the smaller health care facilities/clinics in this aspect. It is important to gather evidence regarding the current situation of bio-medical waste (BMW) management and issues in smaller health care settings, so as to expand the safe management to all points of generation in Bangalore and will also help to plan relevant interventional strategies for the same. Hence an exploratory study was conducted to assess the current situation and issues in management of BMW among small health care facilities (sHCF). This cross sectional study was conducted in T. Dasarahalli (ward number 15) under Bruhat Bengaluru Mahanagar Palike (BBMP) of Bangalore. Data was collected from a convenient sample of 35 nursing homes (<50 beds) and clinics in December 2011. The results of this study indicate that 3 (20 %) of nursing homes had a Policy for Health Care Waste Management, though committees for Infection control and Hospital waste management were absent. Recording system like injury and waste management registers were non-existent. In our study the Common Bio-medical Waste Treatment Facility operator collected waste from 28 (80 %) of the sHCF. Segregation at the point of generation was present in 22 (62.9 %) of the sHCF. Segregation process was compliant as per BMW rules 1998 among 5 (16.1 %) of the sHCF. 18 sHCF workers were vaccinated with hepatitis B and tetanus. Deficiencies were observed in areas of containment, sharps management and disinfection. It was observed that though the quantum and category of waste generated was limited there exist deficiencies which warrant initiation of system development measures including capacity building. PMID:23982773

  16. Prevalence and determinants of caesarean section in private and public health facilities in underserved South Asian communities: cross-sectional analysis of data from Bangladesh, India and Nepal

    PubMed Central

    Neuman, Melissa; Alcock, Glyn; Azad, Kishwar; Kuddus, Abdul; Osrin, David; More, Neena Shah; Nair, Nirmala; Tripathy, Prasanta; Sikorski, Catherine; Saville, Naomi; Sen, Aman; Colbourn, Tim; Houweling, Tanja A J; Seward, Nadine; Manandhar, Dharma S; Shrestha, Bhim P; Costello, Anthony; Prost, Audrey

    2014-01-01

    Objectives To describe the prevalence and determinants of births by caesarean section in private and public health facilities in underserved communities in South Asia. Design Cross-sectional study. Setting 81 community-based geographical clusters in four locations in Bangladesh, India and Nepal (three rural, one urban). Participants 45?327 births occurring in the study areas between 2005 and 2012. Outcome measures Proportion of caesarean section deliveries by location and type of facility; determinants of caesarean section delivery by location. Results Institutional delivery rates varied widely between settings, from 21% in rural India to 90% in urban India. The proportion of private and charitable facility births delivered by caesarean section was 73% in Bangladesh, 30% in rural Nepal, 18% in urban India and 5% in rural India. The odds of caesarean section were greater in private and charitable health facilities than in public facilities in three of four study locations, even when adjusted for pregnancy and delivery characteristics, maternal characteristics and year of delivery (Bangladesh: adjusted OR (AOR) 5.91, 95% CI 5.15 to 6.78; Nepal: AOR 2.37, 95% CI 1.62 to 3.44; urban India: AOR 1.22, 95% CI 1.09 to 1.38). We found that highly educated women were particularly likely to deliver by caesarean in private facilities in urban India (AOR 2.10; 95% CI 1.61 to 2.75) and also in rural Bangladesh (AOR 11.09, 95% CI 6.28 to 19.57). Conclusions Our results lend support to the hypothesis that increased caesarean section rates in these South Asian countries may be driven in part by the private sector. They also suggest that preferences for caesarean delivery may be higher among highly educated women, and that individual-level and provider-level factors interact in driving caesarean rates higher. Rates of caesarean section in the private sector, and their maternal and neonatal health outcomes, require close monitoring. PMID:25550293

  17. Communicating about cancer through Facebook: a qualitative analysis of a breast cancer awareness page.

    PubMed

    Abramson, Karley; Keefe, Brian; Chou, Wen-Ying Sylvia

    2015-01-01

    Social media channels are increasingly being used for health communication and promotion. Social networking sites such as Facebook have become popular platforms for organizations to communicate health messages and encourage user participation around health topics. While the evaluation of social media's effectiveness in health promotion is beginning to emerge in the literature, few studies have examined actual interactions and user behaviors on Facebook Pages hosted by health organizations. The authors present a qualitative case study of a popular Facebook Page from a nonprofit organization devoted to raising awareness about breast cancer. With the goal of identifying the functions and uses of the Page, our study analyzes the content of Wall posts during Breast Cancer Awareness Month, October 2010. Common themes and characteristics are identified, including open mic communication, scarcity of health information, the commodification of breast cancer, unpredictable locations of conversation, and the use of gendered images and language. The findings have potential implications for health promotion efforts using social media platforms. PMID:25495200

  18. 45. Photograph of a published page. OPERATIONS IN 'H' OR ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    45. Photograph of a published page. OPERATIONS IN 'H' OR DEWATERING BUILDING: HOLSTON DEFENSE CORPORATION. 'HOLSTON ARMY AMMUNITION PLANT.' Page 16. (no date). - Holston Army Ammunition Plant, RDX-and-Composition-B Manufacturing Line 9, Kingsport, Sullivan County, TN

  19. 46. Photograph of a published page. 'OPERATIONS IN INCORPORATION BUILDINGS: ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    46. Photograph of a published page. 'OPERATIONS IN INCORPORATION BUILDINGS: HOLSTON DEFENSE CORPORATION. 'HOLSTON ARMY AMMUNITION PLANT.' Page 17. (no date). - Holston Army Ammunition Plant, RDX-and-Composition-B Manufacturing Line 9, Kingsport, Sullivan County, TN

  20. The Department of Energy`s Rocky Flats Plant: A guide to record series useful for health-related research. Volume III, facilities and equipment

    SciTech Connect

    1995-08-01

    This is the third in a series of seven volumes which constitute a guide to records of the Rocky Flats Plant useful for conducting health-related research. The primary purpose of Volume M is to describe record series pertaining to facilities and equipment at the Department of Energy`s (DOE) Rocky Flats Plant, now named the Rocky Flats Environmental Technology Site, near Denver, Colorado. History Associates Incorporated (HAI) prepared this guide as part of its work as the support services contractor for DOE`s Epidemiologic Records Inventory Project. This introduction briefly describes the Epidemiologic Records Inventory Project and HAI`s role in the project, provides a history of facilities and equipment practices at Rocky Flats, and identifies organizations contributing to facilities and equipment policies and activities. Other topics include the scope and arrangement of this volume and the organization to contact for access to these records. Comprehensive introductory and background information is available in Volume I. Other volumes in the guide pertain to administrative and general subjects, production and materials handling, workplace and environmental monitoring, employee health, and waste management. In addition, HAI has produced a subject-specific guide, titled The September 1957 Rocky Flats Fire: A Guide to Record Series of the Department of Energy and Its Contractors, which researchers should consult for further information about records related to this incident.

  1. African American Health

    MedlinePLUS

    ... racial or ethnic group has specific health concerns. Differences in the health of groups can result from Genetics Environmental factors Access to care Cultural factors On this page, you'll find links ...

  2. Hispanic American Health

    MedlinePLUS

    ... racial or ethnic group has specific health concerns. Differences in the health of groups can result from Genetics Environmental factors Access to care Cultural factors On this page, you'll find links ...

  3. Asian American Health

    MedlinePLUS

    ... racial or ethnic group has specific health concerns. Differences in the health of groups can result from Genetics Environmental factors Access to care Cultural factors On this page, you'll find links ...

  4. Native American Health

    MedlinePLUS

    ... racial or ethnic group has specific health concerns. Differences in the health of groups can result from: Genetics Environmental factors Access to care Cultural factors On this page, you'll find links ...

  5. Humidifiers and health

    MedlinePLUS

    Health and humidifiers; Using a humidifier for colds; Humidifiers and colds ... Commission. CPSC safety alert: dirty humidifiers may cause health problems. Available at: www.cpsc.gov/PageFiles/121804/ ...

  6. Urinary Tract Health

    MedlinePLUS

    ... Information Clinical Trials Resources and Publications Urinary Tract Health: Condition Information Skip sharing on social media links Share this: Page Content What is urinary tract health? The urinary (pronounced YOOR-uh-ner-ee ) tract― ...

  7. Facebook's personal page modelling and simulation

    NASA Astrophysics Data System (ADS)

    Sarlis, Apostolos S.; Sakas, Damianos P.; Vlachos, D. S.

    2015-02-01

    In this paper we will try to define the utility of Facebook's Personal Page marketing method. This tool that Facebook provides, is modelled and simulated using iThink in the context of a Facebook marketing agency. The paper has leveraged the system's dynamic paradigm to conduct Facebook marketing tools and methods modelling, using iThinkℱ system to implement them. It uses the design science research methodology for the proof of concept of the models and modelling processes. The following model has been developed for a social media marketing agent/company, Facebook platform oriented and tested in real circumstances. This model is finalized through a number of revisions and iterators of the design, development, simulation, testing and evaluation processes. The validity and usefulness of this Facebook marketing model for the day-to-day decision making are authenticated by the management of the company organization. Facebook's Personal Page method can be adjusted, depending on the situation, in order to maximize the total profit of the company which is to bring new customers, keep the interest of the old customers and deliver traffic to its website.

  8. Classroom Web Pages: A "How-To" Guide for Educators.

    ERIC Educational Resources Information Center

    Fehling, Eric E.

    This manual provides teachers, with very little or no technology experience, with a step-by-step guide for developing the necessary skills for creating a class Web Page. The first part of the manual is devoted to the thought processes preceding the actual creation of the Web Page. These include looking at other Web Pages, deciding what should be…

  9. Digital Ethnography: Library Web Page Redesign among Digital Natives

    ERIC Educational Resources Information Center

    Klare, Diane; Hobbs, Kendall

    2011-01-01

    Presented with an opportunity to improve Wesleyan University's dated library home page, a team of librarians employed ethnographic techniques to explore how its users interacted with Wesleyan's current library home page and web pages in general. Based on the data that emerged, a group of library staff and members of the campus' information


  10. 7 CFR 3402.11 - Proposal cover page.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 15 2013-01-01 2013-01-01 false Proposal cover page. 3402.11 Section 3402.11 Agriculture Regulations of the Department of Agriculture (Continued) NATIONAL INSTITUTE OF FOOD AND... Preparation of an Application § 3402.11 Proposal cover page. The Proposal Cover Page, Form NIFA-2002, must...

  11. 7 CFR 3402.11 - Proposal cover page.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 15 2014-01-01 2014-01-01 false Proposal cover page. 3402.11 Section 3402.11 Agriculture Regulations of the Department of Agriculture (Continued) NATIONAL INSTITUTE OF FOOD AND... Preparation of an Application § 3402.11 Proposal cover page. The Proposal Cover Page, Form NIFA-2002, must...

  12. 7 CFR 3402.11 - Proposal cover page.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 15 2011-01-01 2011-01-01 false Proposal cover page. 3402.11 Section 3402.11 Agriculture Regulations of the Department of Agriculture (Continued) NATIONAL INSTITUTE OF FOOD AND... Preparation of an Application § 3402.11 Proposal cover page. The Proposal Cover Page, Form CSREES-2002,...

  13. Digital Ethnography: Library Web Page Redesign among Digital Natives

    ERIC Educational Resources Information Center

    Klare, Diane; Hobbs, Kendall

    2011-01-01

    Presented with an opportunity to improve Wesleyan University's dated library home page, a team of librarians employed ethnographic techniques to explore how its users interacted with Wesleyan's current library home page and web pages in general. Based on the data that emerged, a group of library staff and members of the campus' information…

  14. Required Discussion Web Pages in Psychology Courses and Student Outcomes

    ERIC Educational Resources Information Center

    Pettijohn, Terry F., II; Pettijohn, Terry F.

    2007-01-01

    We conducted 2 studies that investigated student outcomes when using discussion Web pages in psychology classes. In Study 1, we assigned 213 students enrolled in Introduction to Psychology courses to either a mandatory or an optional Web page discussion condition. Students used the discussion Web page significantly more often and performed…

  15. 7 CFR 3402.11 - Proposal cover page.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 15 2012-01-01 2012-01-01 false Proposal cover page. 3402.11 Section 3402.11 Agriculture Regulations of the Department of Agriculture (Continued) NATIONAL INSTITUTE OF FOOD AND... Preparation of an Application § 3402.11 Proposal cover page. The Proposal Cover Page, Form NIFA-2002, must...

  16. Knowledge Representation of the Visual Image of a Title Page.

    ERIC Educational Resources Information Center

    Jeng, Ling Hwey

    1991-01-01

    Reports on a study of 203 title pages as the source of information for descriptive cataloging, and bibliographic data on title pages as written artifacts having their own visual characteristics. Frame structure representations at various levels of abstraction are suggested for a prototype title page, and expert systems for descriptive cataloging…

  17. Elementary Rehabilitation Nursing Care; a Manual for Nurses and Ancillary Workers in Nursing Homes, Hospitals, Convalescent Facilities, and Public Health Agencies. Public Health Service Publication No. 1436.

    ERIC Educational Resources Information Center

    Colorado State Dept. of Public Health, Denver. Public Health Nursing Section.

    This guide for teacher and student use presents a comprehensive program of physical rehabilitation for aged and physically disabled patients. Developed by the Public Health Nursing Section, the manual was tested by state health department personnel and persons doing inservice teaching in their respective nursing homes. The program is designed to


  18. Challenges facing effective implementation of co-trimoxazole prophylaxis in children born to HIV-infected mothers in the public health facilities

    PubMed Central

    Kamuhabwa, Appolinary AR; Manyanga, Vicky

    2015-01-01

    Background If children born to HIV-infected mothers are not identified early, approximately 30% of them will die within the first year of life due to opportunistic infections. In order to prevent morbidity and mortality due to opportunistic infections in children, the World Health Organization recommends the use of prophylaxis using co-trimoxazole. However, the challenges affecting effective implementation of this policy in Tanzania have not been documented. Aim In this study, we assessed the challenges facing the provision of co-trimoxazole prophylaxis among children born to HIV-infected mothers in the public hospitals of Dar es Salaam, Tanzania. Methodology Four hundred and ninety-eight infants’ PMTCT (Prevention of Mother-to-Child Transmission of HIV) register books for the past 2 years were reviewed to obtain information regarding the provision of co-trimoxazole prophylaxis. One hundred and twenty-six health care workers were interviewed to identify success stories and challenges in the provision of co-trimoxazole prophylaxis in children. In addition, 321 parents and guardians of children born to HIV-infected mothers were interviewed in the health facilities. Results Approximately 80% of children were initiated with co-trimoxazole prophylaxis within 2 months after birth. Two hundred and ninety-one (58.4%) children started using co-trimoxazole within 4 weeks after birth. Majority (n=458, 91.8%) of the children were prescribed 120 mg of co-trimoxazole per day, whereas 39 (7.8%) received 240 mg per day. Only a small proportion (n=1, 0.2%) of children received 480 mg/day. Dose determination was based on the child’s age rather than body weight. Parents and guardians reported that 42 (13.1%) children had missed one or more doses of co-trimoxazole during the course of prophylaxis. The majority of health care workers (89.7%) reported that co-trimoxazole is very effective for the prevention of opportunistic infections among children, but frequent shortage of co-trimoxazole in the health facilities was the main challenge. Conclusion Most children who were initiated with co-trimoxazole prophylaxis did not experience significant opportunistic infections, and the drug was well tolerated. The major barrier for co-trimoxazole prophylaxis was due to frequent out-of-stocks of pediatric co-trimoxazole formulations in the health facilities. Dose determination was based on the age rather than the weight of children, thus creating potential for under- or over-dosing of children. PMID:26604825

  19. Strengthening the delivery of asthma and chronic obstructive pulmonary disease care at primary health-care facilities: study design of a cluster randomized controlled trial in Pakistan

    PubMed Central

    Khan, Muhammad Amir; Ahmed, Maqsood; Anil, Shirin; Walley, John

    2015-01-01

    Background Respiratory diseases, namely asthma and chronic obstructive pulmonary disease (COPD), account for one-fourth of the patients at the primary health-care (PHC) facilities in Pakistan. Standard care practices to manage these diseases are necessary to reduce the morbidity and mortality rate associated with non-communicable diseases in developing countries. Objective To develop and measure the effectiveness of operational guidelines and implementation materials, with sound scientific evidence, for expanding lung health care, especially asthma and COPD through PHC facilities already strengthened for tuberculosis (TB) care in Pakistan. Design A cluster randomized controlled trial with two arms (intervention and control), with qualitative and costing study components, is being conducted in 34 clusters; 17 clusters per arm (428 asthma and 306 COPD patients), in three districts in Pakistan from October 2014 to December 2016. The intervention consists of enhanced case management of asthma and COPD patients through strengthening of PHC facilities. The main outcomes to be measured are asthma and COPD control among the registered cases at 6 months. Cluster- and individual-level analyses will be done according to intention to treat. Residual confounding will be addressed by multivariable logistic and linear regression models for asthma and COPD control, respectively. The trial is registered with ISRCTN registry (ISRCTN 17409338). Conclusions Currently, only about 20% of the estimated prevalent asthma and COPD cases are being identified and reported through the respective PHC network. Lung health care and prevention has not been effectively integrated into the core PHC package, although a very well-functioning TB program exists at the PHC level. Inclusion of these diseases in the already existent TB program is expected to increase detection rates and care for asthma and COPD. PMID:26578109

  20. The Uganda Newborn Study (UNEST): an effectiveness study on improving newborn health and survival in rural Uganda through a community-based intervention linked to health facilities - study protocol for a cluster randomized controlled trial

    PubMed Central

    2012-01-01

    Background Reducing neonatal-related deaths is one of the major bottlenecks to achieving Millennium Development Goal 4. Studies in Asia and South America have shown that neonatal mortality can be reduced through community-based interventions, but these have not been adapted to scalable intervention packages for sub-Saharan Africa where the culture, health system and policy environment is different. In Uganda, health outcomes are poor for both mothers and newborn babies. Policy opportunities for neonatal health include the new national Health Sector Strategic Plan, which now prioritizes newborn health including use of a community model through Village Health Teams (VHT). The aim of the present study is to adapt, develop and cost an integrated maternal-newborn care package that links community and facility care, and to evaluate its effect on maternal and neonatal practices in order to inform policy and scale-up in Uganda. Methods/Design Through formative research around evidence-based practices, and dialogue with policy and technical advisers, we constructed a home-based neonatal care package implemented by the responsible VHT member, effectively a Community Health Worker (CHW). This CHW was trained to identify pregnant women and make five home visits - two before and three just after birth - so that linkages will be made to facility care and targeted messages for home-care and care-seeking delivered. The project is improving care in health units to provide standardized care for the mother and the newborn in both intervention and comparison areas. The study is taking place in a new Demographic Surveillance Site in two rural districts, Iganga and Mayuge, in Uganda. It is a two-arm cluster randomized controlled design with 31 intervention and 32 control areas (villages). The comparison parishes receive the standard care already being provided by the district, but to the intervention villages are added a system for CHWs to visit the mother five times in her home during pregnancy and the neonatal period. Both areas benefit from a standardized strengthening of facility care for mothers and neonates. Discussion UNEST is designed to directly feed into the operationalization of maternal and newborn care in the national VHT strategy, thereby helping to inform scale-up in rural Uganda. The study is registered as a randomized controlled trial, number ISRCTN50321130. PMID:23153395