Optimising mobility through the sit-to-stand activity for older people living in residential care facilities: A qualitative interview study of healthcare aide experiences.

PubMed

Kagwa, Sharon A; Boström, Anne-Marie; Ickert, Carla; Slaughter, Susan E

2018-03-01

To explore the experience of HCAs encouraging residents living in residential care to complete the sit-to-stand activity and to identify the strategies HCAs used to integrate the activity into their daily work routines. Decreased mobility in advanced ageing is further reduced when entering a residential care facility. Interventions such as the sit-to-stand activity have been shown to have a positive effect on the mobility of older people. There is evidence to suggest that healthcare aides are able to support residents to complete the sit-to-stand activity as part of their daily work routines; however, little is known about how healthcare aides actually do this with residents living in residential care. A qualitative interview study included seven purposively sampled HCAs working in residential care facilities. Semistructured interviews were analysed using inductive qualitative content analysis. The HCAs' experience with the sit-to-stand activity was represented by the following four categories: Resident participation, Feeling misunderstood and disrespected, Time and workload, and Management involvement. HCAs identified three strategies to help them support residents to complete the sit-to-stand activity: Motivating residents, Completing activity in a group and Using time management skills. HCAs reported some encouragement from managers and cooperation from residents to complete the sit-to-stand activity with residents; however, they also felt constrained by time limitations and workload demands and they felt misunderstood and disrespected. HCAs were able to identify several strategies that helped them to integrate the sit-to-stand activity into their daily routines. This study highlights the challenges and supportive factors of implementing the sit-to-stand activity into the daily work routine of HCAs. The study also identifies the strategic role of nurse managers when implementing interventions in residential care facilities. © 2017 John Wiley & Sons Ltd.

Risk Management Plan (RMP) Rule Overview

EPA Pesticide Factsheets

As required by Section 112(r) of the Clean Air Act Amendments, this rule contains regulations and guidance for chemical accident prevention at facilities that use extremely hazardous substances, and aids in emergency preparedness and response.

Awareness, attitudes and practices of first aid among school teachers in Mangalore, south India.

PubMed

Joseph, Nitin; Narayanan, Thanneermalai; Bin Zakaria, Saifuddin; Nair, Abhishek Venugopal; Belayutham, Lavina; Subramanian, Aathiya Mihiraa; Gopakumar, K G

2015-12-01

Circumstances requiring medical attention are common at schools. Teachers are often the first individuals to witness and handle situations requiring first aid and medical emergencies. To determine awareness, attitudes and practices of school teachers and the facilities available at schools with respect to administration of first aid. Data were obtained from 146 teachers in nine schools in Mangalore, India, using a self-administered questionnaire. The schools were also inspected for first aid equipment and facilities. Only 69 (47%) teachers had received first aid training previously. Poor and moderate knowledge of first aid was observed among 19 (13%) and 127 (87%) teachers, respectively. Only eight teachers knew the correct procedure for cardiopulmonary resuscitation. Most teachers 96 (66%) were willing to administer first aid if provided with the required training. A total of 74 teachers reported having practised first aid in response to a situation arising at their school. Wounds (36%) and syncopal attack (23%) were among the commonly encountered situations requiring first aid management at schools. Teachers' confidence level in administering first aid was significantly associated with prior training in first aid (p=0.001). First aid kits were available in only five of the nine schools surveyed. The current competency level among teachers in Mangalore to administer first aid is inadequate. Measures need to be taken at schools to ensure initiation of first aid training followed by periodic training for teachers in first aid.

Enhancing the quality of supportive supervisory behavior in long-term care facilities.

PubMed

McGillis Hall, Linda; McGilton, Katherine S; Krejci, Janet; Pringle, Dorothy; Johnston, Erin; Fairley, Laura; Brown, Maryanne

2005-04-01

The practices of managers and registered nurses (RNs) in long-term care facilities are frequently ineffective in assisting the licensed practical nurses (LPNs) and healthcare aides (HCAs) whom they supervise. Little research exists that examines the area of supportive relationships between nursing staff and supervisors in these settings. The purpose of this study was to gather data that could improve management practices in long-term care residential facilities and enhance the quality of the supervisory relationships between supervisors (nurse managers and RNs) and care providers (HCAs and LPNs) in these settings. The study also identified factors that influence the supervisors' ability to establish supportive relationships with care providers. The challenges and barriers to nurse managers and leaders related to enacting supportive behaviors are discussed as well as their implications for long-term care settings.

[The role of supply-side characteristics of services in AIDS mortality in Mexico].

PubMed

Bautista-Arredondo, Sergio; Serván-Mori, Edson; Silverman-Retana, Omar; Contreras-Loya, David; Romero-Martínez, Martín; Magis-Rodríguez, Carlos; Uribe-Zúñiga, Patricia; Lozano, Rafael

2015-01-01

To document the association between supply-side determinants and AIDS mortality in Mexico between 2008 and 2013. We analyzed the SALVAR database (system for antiretroviral management, logistics and surveillance) as well as data collected through a nationally representative survey in health facilities. We used multivariate logit regression models to estimate the association between supply-side characteristics, namely management, training and experience of health care providers, and AIDS mortality, distinguishing early and non-early mortality and controlling for clinical indicators of the patients. Clinic status of the patients (initial CD4 and viral load) explain 44.4% of the variability of early mortality across clinics and 13.8% of the variability in non-early mortality. Supply-side characteristics increase explanatory power of the models by 16% in the case of early mortality, and 96% in the case of non-early mortality. Aspects of management and implementation of services contribute significantly to explain AIDS mortality in Mexico. Improving these aspects of the national program, can similarly improve its results.

Life Cycle Costing as an Aid in Decision Making

ERIC Educational Resources Information Center

Blake, Robert

1973-01-01

Within an accepted process and measures framework, total program cost over the life of the program, including the life of facility(ies) that house the program, provides a rational decisionmaking environment for the accountable managers. (Author)

HIV/AIDS related commodities supply chain management in public health facilities of Addis Ababa, Ethiopia: a cross-sectional survey.

PubMed

Berhanemeskel, Eyerusalem; Beedemariam, Gebremedhin; Fenta, Teferi Gedif

2016-01-01

A wide range of pharmaceutical products are needed for diagnosis, treatment, and prevention of HIV/AIDS. However, interrupted supplies and stock-outs are the major challenges in the supply chain of ARV medicines and related commodities. The aim of this study was to assess the supply chain management of HIV/AIDS related commodities in public health facilities of Addis Ababa, Ethiopia. A descriptive cross-sectional survey complemented by qualitative method was conducted in 24 public health facilities (4 hospitals and 20 health centers). A semi-structured questionnaire and observation check list were used to collect data on HIV/AIDS related service, reporting and ordering; receiving, transportation and storage condition of ARV medicines and test kits; and supportive supervision and logistics management information system. In addition, in-depth interview with flexible probing techniques was used to complement the quantitative data with emphasis to the storage condition of ARV medicines and test kits. Quantitative data was analyzed using SPSS version-20. Analysis of qualitative data involved rigorous reading of transcripts in order to identify key themes and data was analyzed using thematic approach. The study revealed that 16 health centers and one hospital had recorded and reported patient medication record. Six months prior to the study, 14 health centers and 2 hospitals had stopped VCT services for one time or more. Three hospitals and 18 health centers claimed to have been able to submit the requisition and report concerning ARV medicines to Pharmaceutical Fund and Supply Agency according to the specific reporting period. More than three-fourth of the health centers had one or more emergency order of ARV medicines on the day of visit, while all of hospitals had emergency order more than 3 times within 6 months prior to the study. All of the hospitals and nearly half of the health centers had an emergency order of test kits more than 3 times in the past 6 months. Overall, nearly 3/4th of the health facilities faced stock-out of one or more ARV medicines and test kits on the day of visit. There was no adequate data on patient medication record and stock status of HIV/AIDS related commodities. Moreover there were frequent stock-outs of ARV medicines and HIV test kits, which was an indicator of the weak supply chain management. Hospitals and health centers, therefore, should devise a system to capture and make use of patient medication record and stock status information so as to ensure continuous supply of the commodities.

SCOPEOUT: sustainability and spread of quality improvement activities in long-term care- a mixed methods approach.

PubMed

Cranley, Lisa A; Hoben, Matthias; Yeung, Jasper; Estabrooks, Carole A; Norton, Peter G; Wagg, Adrian

2018-03-12

Interventions to improve quality of care for residents of long-term care facilities, and to examine the sustainability and spread of such initiatives, remain a top research priority. The purpose of this exploratory study was to assess the extent to which activities initiated in a quality improvement (QI) collaborative study using care aide led teams were sustained or spread following cessation of the initial project and to identify factors that led to its success. This study used an exploratory mixed methods study design and was conducted in seven residential long-term care facilities in two Canadian provinces. Sustainability and spread of QI activities were assessed by a questionnaire over five time points for 18 months following the collaborative study with staff from both intervention with non-intervention units. Semi-structured interviews were conducted with care managers at six and 12 months. QI team success in applying the QI model was ranked as high, medium, or low using criteria developed by the research team. Descriptive statistics, bivariate analyses, and General Estimating Equations were used to analyze the data. Interview data were analyzed using thematic analysis. In total, 683 surveys were received over the five time periods from 476 unique individuals on a facility unit. Seven managers were interviewed. A total of 533 surveys were analyzed. While both intervention and non-intervention units experienced a decline over time in all outcome measures, this decline was significantly less pronounced on intervention units. Facilities with medium and high success ranking had significantly higher scores in all four outcomes than facilities with a low success ranking. Care aides reported significantly less involvement of others in QI activities, less empowerment and less satisfaction with the quality of their work life than regulated care providers. Manager interviews provided evidence of sustainability of QI activities on the intervention units in four of the seven facilities up to 18 months following the intervention and demonstrated the need for continued staff and leadership engagement. Sustainability of a QI project which empowers and engages care aides is possible and achievable, but requires ongoing staff and leadership engagement.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Smith, K.L.

This document has been developed to provide guidance in the interchange of electronic CAD data with Martin Marietta Energy Systems, Inc., Oak Ridge, Tennessee. It is not meant to be as comprehensive as the existing standards and specifications, but to provide a minimum set of practices that will enhance the success of the CAD data exchange. It is now a Department of Energy (DOE) Oak Ridge Field Office requirement that Architect-Engineering (A-E) firms prepare all new drawings using a Computer Aided Design (CAD) system that is compatible with the Facility Manager`s (FM) CAD system. For Oak Ridge facilities, the CADmore » system used for facility design by the FM, Martin Marietta Energy Systems, Inc., is Intregraph. The format for interchange of CAD data for Oak Ridge facilities will be the Intergraph MicroStation/IGDS format.« less

Improving certified nurse aide retention. A long-term care management challenge.

PubMed

Mesirow, K M; Klopp, A; Olson, L L

1998-03-01

In the long-term care industry, the turnover rate among nurse aides is extremely high. This adversely affects resident satisfaction, resident care, morale, and finances. It presents a challenge to long-term care administration. Refusing to accept high turnover as an impossible situation allows changes to be made. The authors describe how the staff at one intermediate care facility identified its problems, assessed the causes, and implemented corrective action.

The "Total Immersion" Meeting Environment.

ERIC Educational Resources Information Center

Finkel, Coleman

1980-01-01

The designing of intelligently planned meeting facilities can aid management communication and learning. The author examines the psychology of meeting attendance; architectural considerations (lighting, windows, color, etc.); design elements and learning modes (furniture, walls, audiovisuals, materials); and the idea of "total immersion meeting…

Does a voucher program improve reproductive health service delivery and access in Kenya?

PubMed

Njuki, Rebecca; Abuya, Timothy; Kimani, James; Kanya, Lucy; Korongo, Allan; Mukanya, Collins; Bracke, Piet; Bellows, Ben; Warren, Charlotte E

2015-05-23

Current assessments on Output-Based Aid (OBA) programs have paid limited attention to the experiences and perceptions of the healthcare providers and facility managers. This study examines the knowledge, attitudes, and experiences of healthcare providers and facility managers in the Kenya reproductive health output-based approach voucher program. A total of 69 in-depth interviews with healthcare providers and facility managers in 30 voucher accredited facilities were conducted. The study hypothesized that a voucher program would be associated with improvements in reproductive health service provision. Data were transcribed and analyzed by adopting a thematic framework analysis approach. A combination of inductive and deductive analysis was conducted based on previous research and project documents. Facility managers and providers viewed the RH-OBA program as a feasible system for increasing service utilization and improving quality of care. Perceived benefits of the program included stimulation of competition between facilities and capital investment in most facilities. Awareness of family planning (FP) and gender-based violence (GBV) recovery services voucher, however, remained lower than the maternal health voucher service. Relations between the voucher management agency and accredited facilities as well as existing health systems challenges affect program functions. Public and private sector healthcare providers and facility managers perceive value in the voucher program as a healthcare financing model. They recognize that it has the potential to significantly increase demand for reproductive health services, improve quality of care and reduce inequities in the use of reproductive health services. To improve program functioning going forward, there is need to ensure the benefit package and criteria for beneficiary identification are well understood and that the public facilities are permitted greater autonomy to utilize revenue generated from the voucher program.

An Assessment of the Uniform Funding Policy of DoD Directive 3200.11.

DTIC Science & Technology

1980-09-01

34 Unpublished master’s thesis. GSM/SM/73-10, AFIT/EN, Wright-Patterson AFB OH 45433, 7 January 1974. Horngren , Charles T. Cost Accounting : A Management...reverse side if noceeeary aid identify by block number) Uniform Funding Policy Test Facilities Test and Evaluation Cost Accounting Accounting 20...segregated from overhead as a cost accounting device in both Government and industry. Historically, this distinc- tion has merely aided distribution of total

What is the cost of providing outpatient HIV counseling and testing and antiretroviral therapy services in selected public health facilities in Nigeria?

PubMed

Aliyu, Husaina Bello; Chuku, Nkata Nwani; Kola-Jebutu, Abimbola; Abubakar, Zubaida; Torpey, Kwasi; Chabikuli, Otto Nzapfurundi

2012-10-01

Limited data on actual cost of providing HIV/AIDS services in Nigeria makes planning difficult. A study was conducted in 9 public health facilities supported by the Global HIV/AIDS Initiative Nigeria. The objective was to determine the cost of outpatient HIV Testing and Counseling (HTC) and antiretroviral therapy (ART) services per patient. Two tertiary and 7 secondary facilities were purposively selected across the six geopolitical regions. Facilities were distributed in urban and rural settings. Utilization and cost data for a 12-month period (January to December 2010) were analyzed. Cost elements included consumables, human resources, infrastructure, trainings, facility management, and Global HIV/AIDS Initiative Nigeria technical support. Total costs were apportioned based on percentage utilization by services, and unit costs were derived by dividing resource inputs by service outputs. Data were analyzed using Microsoft Excel 2003. A sensitivity analysis was also conducted for key assumptions. Mean costs for HTC and ART were US $7.4 and US $209.0, respectively. Costs were higher in Northern facilities (US $6.9, US $250.8), compared with Southern ones (US $6.7, US $194.7); and in tertiary facilities ($18.5, $338.4), compared with secondary ones ($6.3, $204.9). Major cost drivers for HTC and ART were human resources--ranging from 62% to 50%, and ARV drugs--ranging from 54% to 31%, respectively. Governments' ability to negotiate lower priced antiretroviral drugs will be central to reducing the cost of ART. Additionally, use of lower cadre staff to provide HTC will reduce costs and improves efficiency.

Programming Language CAMIL II: Implementation and Evaluation.

ERIC Educational Resources Information Center

Gardner, Edward

A reimplementation of Computer assisted/managed instruction language (CAMIL) for qualitative and quantitative improvements in the software is presented. The reformatted language is described narratively, and major components of the system software are indicated and discussed. Authoring aids and imbedded support facilities are also described, and…

Organizational Characteristics Associated with Staff Turnover in Nursing Homes

ERIC Educational Resources Information Center

Castle, Nicholas G.; Engberg, John

2006-01-01

Purpose: The association between certified nurse aide, licensed practical nurse, and registered nurse turnover and the organizational characteristics of nursing homes are examined. Design and Methods: Hypotheses for eight organizational characteristics are examined (staffing levels, top management turnover, resident case mix, facility quality,…

On the periphery of HIV and AIDS: Reflections on stress as experienced by caregivers in a child residential care facility in South Africa

PubMed Central

Mohangi, Kesh; Pretorius, Chereen

2017-01-01

Abstract Few researchers have investigated how female caregivers of institutionalised children, especially those affected by HIV and AIDS, experience stress. The role played by caregivers cannot be overemphasised; yet caregivers who work in institutions caring for orphaned and/or abandoned children affected by HIV and AIDS, are often marginalised and on the periphery of the HIV and AIDS pandemic. The implication is that insufficient attention or consideration is given to the importance of the role they play in these children’s lives. The objective of the study was to explore how female caregivers of institutionalised children affected by HIV and AIDS experience stress. A qualitative research project with a case study design was conducted. The purposively selected participants from a previously identified care facility were seven females in the age ranges of 35–59. Data was gathered during individual interviews and focus group discussions. Thematic content analysis of the data yielded the following themes: (1) contextualising caregiving as ‘work’; (2) stresses linked to caregiving; and (3) coping with stress. Findings from this study indicated that participants experienced caregiving in an institution as stressful, demotivating, and emotionally burdensome. Moreover, caregivers working in an environment of HIV and AIDS experienced additional stress related to organisational and management impediments, lack of emotional and practical support, inadequate training, discipline difficulties, and lack of respect and appreciation from the children in their care. It is recommended that training and management support as well as personal support and counselling for caregivers in the institutional context could help them to cope better, feel empowered and to potentially elevate their status as valued members of society. PMID:29065771

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gibbs, P. W.

Secure Transport Management Course (STMC) course provides managers with information related to procedures and equipment used to successfully transport special nuclear material. This workshop outlines these procedures and reinforces the information presented with the aid of numerous practical examples. The course focuses on understanding the regulatory framework for secure transportation of special nuclear materials, identifying the insider and outsider threat(s) to secure transportation, organization of a secure transportation unit, management and supervision of secure transportation units, equipment and facilities required, training and qualification needed.

29 CFR 1918.97 - First aid and lifesaving facilities. (See appendix V of this part).

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 7 2010-07-01 2010-07-01 false First aid and lifesaving facilities. (See appendix V of... LONGSHORING General Working Conditions. § 1918.97 First aid and lifesaving facilities. (See appendix V of this... injury, regardless of severity, to the employer. (b) First aid. A first aid kit shall be available at or...

Epidemiological Criminology: Contextualization of HIV/AIDS Health Care for Female Inmates.

PubMed

Lanier, Mark M; Zaitzow, Barbara H; Farrell, C Thomas

2015-04-01

Worldwide, women are increasingly being incarcerated. One unintended consequence is the increase in unhealthy female offenders. Among the more serious health concerns are HIV and AIDS. Challenges associated with caring for women with HIV/AIDS impacts not only disease management and infection control within correctional facilities but also the prisoners' home communities where they will need health care, drug and alcohol rehabilitation, housing assistance, and employment opportunities. No bridging theory has been presented that links prison and community health concerns with criminal justice policy. This article not only presents recommendations for effective HIV/AIDS policy but also suggests epidemiological criminology as a means of explicit merging of health with justice issues and consequently provides a bridging framework. © The Author(s) 2015.

The Effectiveness and Need for Facility Based Nurse Aide Training Competency Evaluation Programs.

PubMed

Mileski, Michael; McIlwain, Amber S; Kruse, Clemens Scott; Lieneck, Cristian; Sokan, Amanda

2016-01-01

It has become crucial for nursing facilities to rapidly train future nurse aides and remove any barriers to their matriculation into the field of care. Facilities feel the organizational burden of insufficient staffing and need to lever all effective programs to train future employees. The facility-based, Nurse Aide Training Competency Evaluation Programs (NATCEP) serve as a viable option to help fill shortages in the professional medical workforce. Data were analyzed from the National Nursing Assistant Survey to provide an overview of the benefits of using facility-trained nurse aides, versus those trained elsewhere, including their own perceptions of training and abilities. These findings also show the importance of facility based training programs for nurse aides on a global level. Providing training on site increases the efficiency and proficiency of nurse aides, making the transition to caregivers an easier for students, employers and residents.

Advisory on Relocatable and Renovated Classrooms. IAQ Info Sheet.

ERIC Educational Resources Information Center

California State Dept. of Health Services, Berkeley.

Many California school districts, in complying with the Class Size Reduction Program, will obtain relocatable classrooms directly from manufacturers who are under no specific guidelines or codes relative to indoor air quality (IAQ). This document, designed to aid school facility managers in minimizing potential IAQ problems, summarizes the indoor…

Developing Mobile BIM/2D Barcode-Based Automated Facility Management System

PubMed Central

Chen, Yen-Pei

2014-01-01

Facility management (FM) has become an important topic in research on the operation and maintenance phase. Managing the work of FM effectively is extremely difficult owing to the variety of environments. One of the difficulties is the performance of two-dimensional (2D) graphics when depicting facilities. Building information modeling (BIM) uses precise geometry and relevant data to support the facilities depicted in three-dimensional (3D) object-oriented computer-aided design (CAD). This paper proposes a new and practical methodology with application to FM that uses an integrated 2D barcode and the BIM approach. Using 2D barcode and BIM technologies, this study proposes a mobile automated BIM-based facility management (BIMFM) system for FM staff in the operation and maintenance phase. The mobile automated BIMFM system is then applied in a selected case study of a commercial building project in Taiwan to verify the proposed methodology and demonstrate its effectiveness in FM practice. The combined results demonstrate that a BIMFM-like system can be an effective mobile automated FM tool. The advantage of the mobile automated BIMFM system lies not only in improving FM work efficiency for the FM staff but also in facilitating FM updates and transfers in the BIM environment. PMID:25250373

Developing mobile BIM/2D barcode-based automated facility management system.

PubMed

Lin, Yu-Cheng; Su, Yu-Chih; Chen, Yen-Pei

2014-01-01

Facility management (FM) has become an important topic in research on the operation and maintenance phase. Managing the work of FM effectively is extremely difficult owing to the variety of environments. One of the difficulties is the performance of two-dimensional (2D) graphics when depicting facilities. Building information modeling (BIM) uses precise geometry and relevant data to support the facilities depicted in three-dimensional (3D) object-oriented computer-aided design (CAD). This paper proposes a new and practical methodology with application to FM that uses an integrated 2D barcode and the BIM approach. Using 2D barcode and BIM technologies, this study proposes a mobile automated BIM-based facility management (BIMFM) system for FM staff in the operation and maintenance phase. The mobile automated BIMFM system is then applied in a selected case study of a commercial building project in Taiwan to verify the proposed methodology and demonstrate its effectiveness in FM practice. The combined results demonstrate that a BIMFM-like system can be an effective mobile automated FM tool. The advantage of the mobile automated BIMFM system lies not only in improving FM work efficiency for the FM staff but also in facilitating FM updates and transfers in the BIM environment.

[Comprehensive study on the prevention of food poisoning through the investigation of an affected hospital food service facility].

PubMed

Kubota, Satoshi; Kawai, Hiromi

2015-01-01

In Japan, more than 20,000 people suffer from various types of food poisoning annually. In this paper, we discuss the prevention of food poisoning in hospital food service facilities from the perspective of hygiene management and organizational behavior. We inspected the kitchen environment and the meal preparation process in a hospital food service facility in Japan that had been the site of a food poisoning incident. To clarify the present state of hygiene management, interviews were conducted with both the head of the nutrition and food service section and the administrative manager. In addition, questionnaires were distributed to the food service staff to assess their level of satisfaction with the working environment. The facility had been built about 10 years previously and was well maintained. Meal preparations were performed according to the operation manual, and education and training for the food service staff were carried out daily. No problems were evident regarding hygiene management. However, concerning organizational behavior, the satisfaction level of the staff was found to be relatively low, which may have led to a reduction in their organizational commitment and a decrease in their performance. To aid in the prevention of food poisoning incidents in hospital food service facilities, it is essential not only to conduct standard hygiene management and training, but also to consider the organizational behavior of the food service staff.

Factors associated with the use of cognitive aids in operating room crises: a cross-sectional study of US hospitals and ambulatory surgical centers.

PubMed

Alidina, Shehnaz; Goldhaber-Fiebert, Sara N; Hannenberg, Alexander A; Hepner, David L; Singer, Sara J; Neville, Bridget A; Sachetta, James R; Lipsitz, Stuart R; Berry, William R

2018-03-26

Operating room (OR) crises are high-acuity events requiring rapid, coordinated management. Medical judgment and decision-making can be compromised in stressful situations, and clinicians may not experience a crisis for many years. A cognitive aid (e.g., checklist) for the most common types of crises in the OR may improve management during unexpected and rare events. While implementation strategies for innovations such as cognitive aids for routine use are becoming better understood, cognitive aids that are rarely used are not yet well understood. We examined organizational context and implementation process factors influencing the use of cognitive aids for OR crises. We conducted a cross-sectional study using a Web-based survey of individuals who had downloaded OR cognitive aids from the websites of Ariadne Labs or Stanford University between January 2013 and January 2016. In this paper, we report on the experience of 368 respondents from US hospitals and ambulatory surgical centers. We analyzed the relationship of more successful implementation (measured as reported regular cognitive aid use during applicable clinical events) with organizational context and with participation in a multi-step implementation process. We used multivariable logistic regression to identify significant predictors of reported, regular OR cognitive aid use during OR crises. In the multivariable logistic regression, small facility size was associated with a fourfold increase in the odds of a facility reporting more successful implementation (p = 0.0092). Completing more implementation steps was also significantly associated with more successful implementation; each implementation step completed was associated with just over 50% higher odds of more successful implementation (p ≤ 0.0001). More successful implementation was associated with leadership support (p < 0.0001) and dedicated time to train staff (p = 0.0189). Less successful implementation was associated with resistance among clinical providers to using cognitive aids (p < 0.0001), absence of an implementation champion (p = 0.0126), and unsatisfactory content or design of the cognitive aid (p = 0.0112). Successful implementation of cognitive aids in ORs was associated with a supportive organizational context and following a multi-step implementation process. Building strong organizational support and following a well-planned multi-step implementation process will likely increase the use of OR cognitive aids during intraoperative crises, which may improve patient outcomes.

A national survey of clubs medical personnel, facilities and protocols in Irish Rugby Union.

PubMed

Coughlan, G F; Fullen, B M; McCarthy, C

2014-03-01

Rugby Union is one of the most popular sports in Ireland. Participation in all sports carries risk, and there is an onus on governing bodies and those involved in sport to minimise this risk using injury prevention and management programmes. The aim of this study was to evaluate the current status of medical personnel, facilities and equipment in Rugby Union clubs in Ireland. A nationwide cross sectional survey of affiliated clubs in Ireland was undertaken at the beginning of the 2011-2012. Clubs were surveyed on a range of variables including their medical personnel, facilities, equipment, policies and concussion. 47.7 % of those surveyed responded. The majority reported involvement of appropriate medically qualified personnel, having a dedicated medical area/room, a first aid kit and defibrillator, and a demand for first aid courses. This survey provided key information on the current medical status of clubs in Ireland to the governing body. Many clubs have adequate medical resources in place, however a large number do not have medical professionals working with them or own basic medical equipment. The results of this study have lead to the development and implementation of a rugby specific injury prevention and management programme for medical and non-medical personnel at all levels of the game in Ireland.

The willingness of private-sector doctors to manage public-sector HIV/AIDS patients in the eThekwini metropolitan region of KwaZulu-Natal

PubMed Central

Jinabhai, Champaklal C.; Taylor, Myra

2010-01-01

ABSTRACT Background South Africa is severely affected by the AIDS pandemic and this has resulted in an already under-resourced public sector being placed under further stress, while there remains a vibrant private sector. To address some of the resource and personnel shortages facing the public sector in South Africa, partnerships between the public and private sectors are slowly being forged. However, little is known about the willingness of private-sector doctors in the eThekwini Metropolitan (Metro) region of KwaZulu-Natal, South Africa to manage public-sector HIV and AIDS patients. Objectives To gauge the willingness of private-sector doctor to manage public-sector HIV and AIDS patients and to describe factors that may influence their responses. Method A descriptive cross-sectional study was undertaken among private-sector doctors, both general practitioners (GPs) and specialists, working in the eThekwini Metro, using an anonymous, structured questionnaire to investigate their willingness to manage public-sector HIV and AIDS patients and the factors associated with their responses. Chi-square and independent t-tests were used to evaluate associations. Odds ratios were determined using a binary logistic regression model. A p value < 0.05 was considered statistically significant. Results Most of the doctors were male GPs aged 30–50 years who had been in practice for more than 10 years. Of these, 133 (77.8%) were willing to manage public-sector HIV and AIDS patients, with 105 (78.9%) reporting adequate knowledge, 99 (74.4%) adequate time, and 83 (62.4%) adequate infrastructure. Of the 38 (22.2%) that were unwilling to manage these patients, more than 80% cited a lack of time, knowledge and infrastructure to manage them. Another reason cited by five doctors (3.8%) who were unwilling, was the distance from public-sector facilities. Of the 33 specialist doctors, 14 (42.4%) indicated that they would not be willing to manage public-sector HIV and AIDS patients, compared with only 24 (17.4%) of the 138 GPs (p < 0.01). Conclusion Many private-sector doctors are willing to manage public-sector HIV and AIDS patients in the eThekwini Metro, potentially removing some of the current burden on the public health sector.

[The effects of multimedia-assisted instruction on the skin care learning of nurse aides in long-term care facilities].

PubMed

Wu, Yu-Ling; Kao, Yu-Hsiu

2014-08-01

Skin care is an important responsibility of nurse aides in long-term care facilities, and the nursing knowledge, attitudes, and skills of these aides significantly affects quality of care. However, the work schedule of nurse aides often limits their ability to obtain further education and training. Therefore, developing appropriate and effective training programs for nurse aides is critical to maintaining and improving quality of care in long-term care facilities. This study investigates the effects of multimedia assisted instruction on the skin care learning of nurse aides working in long-term care facilities. A quasi-experimental design and convenient sampling were adopted in this study. Participants included 96 nurse aides recruited from 5 long-term care facilities in Taoyuan County, Taiwan. The experimental group received 3 weeks of multimedia assisted instruction. The control group did not receive this instruction. The Skin Care Questionnaire for Nurse Aides in Long-term Care Facilities and the Skin Care Behavior Checklist were used for assessment before and after the intervention. (1) Posttest scores for skin care knowledge, attitudes, behavior, and the skin care checklist were significantly higher than pretest scores for the intervention group. There was no significant difference between pretest and posttest scores for the control group. (2) A covariance analysis of pretest scores for the two groups showed that the experimental group earned significantly higher average scores than their control group peers for skin care knowledge, attitudes, behavior, and the skin care checklist. The multimedia assisted instruction demonstrated significant and positive effects on the skin care leaning of nurse aides in long-term care facilities. This finding supports the use of multimedia assisted instruction in the education and training of nurse aides in long-term care facilities in the future.

Task sharing in Zambia: HIV service scale-up compounds the human resource crisis.

PubMed

Walsh, Aisling; Ndubani, Phillimon; Simbaya, Joseph; Dicker, Patrick; Brugha, Ruairí

2010-09-17

Considerable attention has been given by policy makers and researchers to the human resources for health crisis in Africa. However, little attention has been paid to quantifying health facility-level trends in health worker numbers, distribution and workload, despite growing demands on health workers due to the availability of new funds for HIV/AIDS control scale-up. This study analyses and reports trends in HIV and non-HIV ambulatory service workloads on clinical staff in urban and rural district level facilities. Structured surveys of health facility managers, and health services covering 2005-07 were conducted in three districts of Zambia in 2008 (two urban and one rural), to fill this evidence gap. Intra-facility analyses were conducted, comparing trends in HIV and non-HIV service utilisation with staff trends. Clinical staff (doctors, nurses and nurse-midwives, and clinical officers) numbers and staff population densities fell slightly, with lower ratios of staff to population in the rural district. The ratios of antenatal care and family planning registrants to nurses/nurse-midwives were highest at baseline and increased further at the rural facilities over the three years, while daily outpatient department (OPD) workload in urban facilities fell below that in rural facilities. HIV workload, as measured by numbers of clients receiving antiretroviral treatment (ART) and prevention of mother to child transmission (PMTCT) per facility staff member, was highest in the capital city, but increased rapidly in all three districts. The analysis suggests evidence of task sharing, in that staff designated by managers as ART and PMTCT workers made up a higher proportion of frontline service providers by 2007. This analysis of workforce patterns across 30 facilities in three districts of Zambia illustrates that the remarkable achievements in scaling-up HIV/AIDS service delivery has been on the back of sustained non-HIV workload levels, increasing HIV workload and stagnant health worker numbers. The findings are based on an analysis of routine data that are available to district and national managers. Mixed methods research is needed, combining quantitative analyses of routine health information with follow-up qualitative interviews, to explore and explain workload changes, and to identify and measure where problems are most acute, so that decision makers can respond appropriately. This study provides quantitative evidence of a human resource crisis in health facilities in Zambia, which may be more acute in rural areas.

1400879

NASA Image and Video Library

2014-08-13

AIDING IN THE OFFICIAL BUILDING 4220 RIBBON-CUTTING ARE, FROM LEFT, JOHN HONEYCUTT, DEPUTY MANAGER OF THE SPACE LAUNCH SYSTEM PROGRAM OFFICE; LT. COL. TOM NELSON, DEPUTY COMMANDER OF THE U.S. ARMY CORPS OF ENGINEERS-MOBILE DISTRICT; U.S. SEN. JEFF SESSIONS OF ALABAMA; MARSHALL CENTER DIRECTOR PATRICK SCHEUERMANN; U.S. REP. MO BROOKS OF ALABAMA'S 5TH DISTRICT; MARSHALL DEPUTY DIRECTOR TERESA VANHOOSER; AND MARSHALL ENGINEER DAVID SKRIDULIS, TEAM LEAD FOR THE FACILITIES MANAGEMENT OFFICE'S CIVIL STRUCTURAL GROUP.

Are healthcare aides underused in long-term care? A cross-sectional study on continuing care facilities in Canada.

PubMed

Arain, Mubashir A; Deutschlander, Siegrid; Charland, Paola

2017-05-17

Over the last 10 years, appropriate workforce utilisation has been an important discussion among healthcare practitioners and policy-makers. The role of healthcare aides (HCAs) has also expanded to improve their utilisation. This evolving role of HCAs in Canada has prompted calls for standardised training, education and scope of practice for HCAs. The purpose of this research was to examine the differences in HCAs training and utilisation in continuing care facilities. From June 2014 to July 2015, we conducted a mixed-method study on HCA utilisation in continuing care. This paper presents findings gathered solely from the prospective cross-sectional survey of continuing care facilities (long-term care (LTC) and supportive living (SL)) on HCA utilisation. We conducted this study in a Western Canadian province. The managers of the continuing care facilities (SL and LTC) were eligible to participate in the survey. The pattern of HCAs involvement in medication assistance and other care activities in SL and LTC facilities. We received 130 completed surveys (LTC=64 and SL=52). Our findings showed that approximately 81% of HCAs were fully certified. We found variations in how HCAs were used in SL and LTC facilities. Overall, HCAs in SL were more likely to be involved in medication management such as assisting with inhaled medication and oral medication delivery. A significantly larger proportion of survey respondents from SL facilities reported that medication assistance training was mandatory for their HCAs (86%) compared with the LTC facilities (50%) (p value <0.01). The utilisation of HCAs varies widely between SL and LTC facilities. HCAs in SL facilities may be considered better used according to their required educational training and competencies. Expanding the role of HCAs in LTC facilities may lead to a cost-effective and more efficient utilisation of workforce in continuing care facilities. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Performance evaluation of the NASA/KSC CAD/CAE and office automation LAN's

NASA Technical Reports Server (NTRS)

Zobrist, George W.

1994-01-01

This study's objective is the performance evaluation of the existing CAD/CAE (Computer Aided Design/Computer Aided Engineering) network at NASA/KSC. This evaluation also includes a similar study of the Office Automation network, since it is being planned to integrate this network into the CAD/CAE network. The Microsoft mail facility which is presently on the CAD/CAE network was monitored to determine its present usage. This performance evaluation of the various networks will aid the NASA/KSC network managers in planning for the integration of future workload requirements into the CAD/CAE network and determining the effectiveness of the planned FDDI (Fiber Distributed Data Interface) migration.

Improving NAVFAC's total quality management of construction drawings with CLIPS

NASA Technical Reports Server (NTRS)

Antelman, Albert

1991-01-01

A diagnostic expert system to improve the quality of Naval Facilities Engineering Command (NAVFAC) construction drawings and specification is described. C Language Integrated Production System (CLIPS) and computer aided design layering standards are used in an expert system to check and coordinate construction drawings and specifications to eliminate errors and omissions.

The Impact of Quality Assurance Initiatives and Workplace Policies and Procedures on HIV/AIDS-Related Stigma Experienced by Patients and Nurses in Regions with High Prevalence of HIV/AIDS.

PubMed

Hewko, Sarah J; Cummings, Greta G; Pietrosanu, Matthew; Edwards, Nancy

2018-02-23

Stigma is commonly experienced by people living with HIV/AIDS and by those providing care to HIV/AIDS patients. Few intervention studies have explored the impact of workplace policies and/or quality improvement on stigma. We examine the contribution of health care workplace policies, procedures and quality assurance initiatives, and self- and peer-assessed individual nurse practices, to nurse-reported HIV/AIDS-stigma practices toward patients living with HIV/AIDS and nurses in health care settings. Our sample of survey respondents (n = 1157) included managers (n = 392) and registered/enrolled nurses (n = 765) from 29 facilities in 4 countries (South Africa, Uganda, Jamaica, Kenya). This is one of the first studies in LMIC countries to use hierarchical linear modeling to examine the contributions of organizational and individual factors to HIV/AIDS stigma. Based on our results, we argue that organizational interventions explicitly targeting HIV/AIDS stigma are required to reduce the incidence, prevalence and morbidity of HIV/AIDS.

The private sector role in HIV/AIDS in the context of an expanded global response: expenditure trends in five sub-Saharan African countries.

PubMed

Sulzbach, Sara; De, Susna; Wang, Wenjuan

2011-07-01

Global financing for the HIV response has reached unprecedented levels in recent years. Over US$10 billion were mobilized in 2007, an effort credited with saving the lives of millions of people living with HIV (PLHIV). A relatively unexamined aspect of the global HIV response is the role of the private sector in financing HIV/AIDS services. As the nature of the response evolves from emergency relief to long-term sustainability, understanding current and potential contributions from the private sector is critical. This paper examines trends in private sector financing, management and resource consumption related to HIV/AIDS in five sub-Saharan African countries, with a particular emphasis on the effects of recently scaled-up donor funding on private sector contributions. We analysed National Health Accounts HIV/AIDS subaccount data for Kenya, Malawi, Rwanda, Tanzania and Zambia between 2002 and 2006. HIV subaccounts provide comparable data on the flow of HIV/AIDS funding from source to use. Findings indicate that private sector contributions decreased in all countries except Tanzania. With regards to managing HIV/AIDS funds, non-governmental organizations are increasingly controlling the largest share of resources relative to other stakeholders, whereas private for-profit entities are managing fewer HIV/AIDS resources since the donor influx. The majority of HIV/AIDS funds were spent in the public sector, although a considerable amount was spent at private facilities, largely fuelled by out-of-pocket (OOP) payments. On the whole, OOP spending by PLHIV decreased over the 4-year period, with the exception of Malawi, demonstrating that PLHIV have increased access to free or subsidized HIV/AIDS services. Our findings suggest that the influx of donor funding has led to decreased private contributions for HIV/AIDS. The reduction in private sector investment and engagement raises concerns about the sustainability of HIV/AIDS programmes over the long term, particularly in light of current global economic crisis and emerging competing priorities.

Challenges encountered in providing integrated HIV, antenatal and postnatal care services: a case study of Katakwi and Mubende districts in Uganda.

PubMed

Ahumuza, Sharon Eva; Rujumba, Joseph; Nkoyooyo, Abdallah; Byaruhanga, Raymond; Wanyenze, Rhoda K

2016-04-18

Integration of sexual and reproductive health (SRH), HIV/AIDS and maternal health (MH) services is a critical strategy to confront the HIV/AIDS epidemic, high maternal mortality and the unmet need for contraception. In 2011 the AIDS Information Centre (AIC) in partnership with the Ministry of Health implemented SRH, HIV/AIDS and MH integration services in the districts of Katakwi and Mubende in Uganda. This paper documents challenges encountered in providing these integrated services in the two districts. This was a cross-sectional qualitative study conducted in Mubende and Katakwi districts in Uganda. Data were collected using 10 focus group discussions with 89 women attending ANC and postnatal care and 21 key informant interviews with district managers and health workers who were involved in the integrated service delivery. Content thematic approach was used for data analysis. The study findings indicate that various challenges were encountered in integrating HIV, ANC and PNC services. Major challenges included inadequate staff, gaps in knowledge of service providers especially with regard to provision of long-term family planning, limited space, shortage of critical supplies such as HIV test kits, drugs and gloves. These findings indicate that the delivery of integrated HIV, SRH and MH services is hampered greatly by health system challenges and depict the need for additional staffing in health facilities, capacity building of health workers and health managers as well as ensuring sufficient supplies to health facilities for smooth implementation of integrated SRH, HIV and MH services.

International aid and natural disasters: a pre- and post-earthquake longitudinal study of the healthcare infrastructure in Leogane, Haiti.

PubMed

Kligerman, Maxwell; Barry, Michele; Walmer, David; Bendavid, Eran

2015-02-01

The reconstruction of healthcare systems in developing countries after natural disasters is poorly understood. Using data collected before and after the 2010 Haiti earthquake, we detail the response of aid agencies and their interaction with local healthcare providers in Leogane, the city closest to the epicenter. We find that the period after the earthquake was associated with an increase in the total number of healthcare facilities, inpatient beds, and surgical facilities and that international aid has been a driving force behind this recovery. Aid has funded 12 of 13 new healthcare facilities that have opened since the earthquake as well as the reconstruction of 7 of 8 healthcare facilities that have been rebuilt. Despite increases in free, aid-financed healthcare, private Haitian healthcare facilities have remained at a constant number. The planned phase-out of several aid-financed facilities, however, will leave Leogane with fewer inpatient beds and healthcare services compared with the pre-earthquake period. © The American Society of Tropical Medicine and Hygiene.

The role of organic complexants and microparticulates in the facilitated transport of radionuclides

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schilk, A.J.; Robertson, D.E.; Abel, K.H.

1996-12-01

This progress report describes the results of ongoing radiological and geochemical investigations of the mechanisms of radionuclide transport in groundwater at two low-level waste (LLW) disposal sites within the waste management area of the Chalk River Laboratories (CRL), Ontario, Canada. These sites, the Chemical Pit liquid disposal facility and the Waste Management Area C solid LLW disposal site, have provided valuable 30- to 40-year-old field locations for characterizing the migration of radionuclides and evaluating a number of recent site performance objectives for LLW disposal facilities. This information will aid the NRC and other federal, state, and local regulators, as wellmore » as LLW disposal site developers and waste generators, in maximizing the effectiveness of existing or projected LLW disposal facilities for isolating radionuclides from the general public and thereby improving the health and safety aspects of LLW disposal.« less

Child Care Options: A Workplace Initiative for the 21st Century.

ERIC Educational Resources Information Center

Sher, Margery Leveen; Fried, Madeline

This book examines the business community's responsibility to aid employees and their families with child care. It provides information on why businesses should provide child care and how to plan and manage a work-place child care facility. The 11 chapters cover: (1) program design; (2) architecture; (3) playground design; (4) security; (5)…

Diving accident management, with special emphasis on the situation in the Red Sea.

PubMed

Taher, A

1999-01-01

Accident management is a concept commonly misunderstood, frequently confused with accident treatment. The situation in the Sinai and the Red Sea makes a broad definition of the term "management" necessary. Management encompasses the whole spectrum: from recognition of the need for a hyperbaric facility, establishing one, education of dive center management, instructors, boat skippers and deck hands, to actual contingency plans set according to the different geographical sites. The essential elements of communication, oxygen first aid, transportation, and actual recompression therapy or other treatments and follow-up must be included. Furthermore, a link to the international organisations involved with diving accident management is an essential and desired backup.

Maintenance of Airport Visual Aid Facilities

DOT National Transportation Integrated Search

1982-08-26

This advisory circular provides recommended guidelines for maintenance of : airport visual aid facilities. Since the function of such facilities is to : assist in the safe and efficient movement of aircraft during landing, takeoff, : and taxiing mane...

Use of personal digital assistants for data collection in a multi-site AIDS stigma study in rural south Nyanza, Kenya.

PubMed

Onono, M A; Carraher, N; Cohen, R C; Bukusi, E A; Turan, J M

2011-09-01

To describe the development, cost effectiveness and implementation of a PDA based electronic system to collect, verify and manage data from a multi-site study on HIV/AIDS stigma and pregnancy in a rural, resource-poor area. We worked within a large prevention of mother-to-child-transmission (PMTCT) program in nine rural health facilities to implement a PDA-based data collection system and to study the feasibility of its use in a multisite HIV research study in rural Kenya. The PDAs were programmed for collecting screening and eligibility data, and responses to structured interviews on HIV/AIDS stigma and violence in three local languages. Between November 2007 and December 2008, nine PDAs were used by Clinic and Community Health Assistants to enrol 1,270 participants on to the PMTCT program. Successes included: capacity-building of interviewers, low cost of implementation, quick turnaround time of data entry with good data quality, and convenience. Our study demonstrated the feasibility of utilizing PDAs for data collection in a multi-site observational study on HIV/AIDS stigma conducted in remote rural health facilities in Kenya. However, appropriate and frequent data backup protocols need to be established and paper forms are still needed as backup tools in resource-poor settings.

29 CFR 1917.26 - First aid and lifesaving facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 7 2010-07-01 2010-07-01 false First aid and lifesaving facilities. 1917.26 Section 1917..., DEPARTMENT OF LABOR (CONTINUED) MARINE TERMINALS Marine Terminal Operations § 1917.26 First aid and..., to the employer. (b) A first aid kit shall be available at the terminal, and at least one person...

Evaluation of location and number of aid post for sustainable humanitarian relief using agent based modeling (ABM) and geographic information system (GIS)

NASA Astrophysics Data System (ADS)

Khair, Fauzi; Sopha, Bertha Maya

2017-12-01

One of the crucial phases in disaster management is the response phase or the emergency response phase. It requires a sustainable system and a well-integrated management system. Any errors in the system on this phase will impact on significant increase of the victims number as well as material damage caused. Policies related to the location of aid posts are important decisions. The facts show that there are many failures in the process of providing assistance to the refugees due to lack of preparation and determination of facilities and aid post location. Therefore, this study aims to evaluate the number and location of aid posts on Merapi eruption in 2010. This study uses an integration between Agent Based Modeling (ABM) and Geographic Information System (GIS) about evaluation of the number and location of the aid post using some scenarios. The ABM approach aims to describe the agents behaviour (refugees and volunteers) in the event of a disaster with their respective characteristics. While the spatial data, GIS useful to describe real condition of the Sleman regency road. Based on the simulation result, it shows alternative scenarios that combine DERU UGM post, Maguwoharjo Stadium, Tagana Post and Pakem Main Post has better result in handling and distributing aid to evacuation barrack compared to initial scenario. Alternative scenarios indicates the unmet demands are less than the initial scenario.

State Capacity and Resistance in Afghanistan

DTIC Science & Technology

2009-03-01

PRGF )222 of the International Monetary Fund (IMF).223 Facing these self-imposed (internal) and international (external) constraints, budget and...Budget_Policy_Coord_Reporting/Fact _Sheet/Fact_sheet_final_1386.pdf (accessed 19 November 2008). 222 The PRGF provides aid and structural guidance in the...management. See: A Factsheet: The Poverty Reduction and Growth Facility ( PRGF ). (International Monetary Fund, October 2008). On the web: http

National AIDS Hotline: HIV and AIDS information service through a toll-free telephone system.

PubMed Central

Waller, R R; Lisella, L W

1991-01-01

The National AIDS Hotline (NAH), a service of the Centers for Disease Control (CDC), is an information resource for the population of the United States, its Territories, and Puerto Rico concerning the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). Since its inception in 1983, NAH has grown to be the world's largest health-related hotline service. NAH has received an average of more than 1.4 million calls per year since October 1987. Services of NAH include responding to the public's questions about HIV and AIDS and providing referrals to State and local resources. All services, including HIV and AIDS publications, are provided free of charge. The public contacts NAH 24 hours a day, 7 days a week, through a toll-free telephone system. Services are available to English-speaking, Spanish-speaking, and deaf populations. Each service has its own telephone number--English-speaking, 1-800-342-2437; Spanish-speaking, 1-800-344-7432; TTY service for the deaf, 1-800-243-7889. NAH employs approximately 170 information specialists to answer calls. The facility uses modern telecommunications technology to effectively manage and direct calls to 43 work stations. Each work station is supported by a personal computer that allows access to CDC's National AIDS Clearinghouse data bases for referrals and publication ordering. NAH ensures that information provided to the public is current, accurate, and consistent with approved government policy. Quality assurance reviews address call management, delivery of information, and content of calls. PMID:1659708

Difficulties facing healthcare workers in the era of AIDS treatment in Lesotho.

PubMed

Koto, Masebeo Veronica; Maharaj, Pranitha

2016-01-01

Sub-Saharan Africa is most affected by the AIDS pandemic and Lesotho is no exception. In many countries, healthcare workers are at the forefront of the fight against AIDS. This study explores the difficulties facing healthcare workers in Lesotho using a combination of qualitative methods--focus group discussions and in-depth interviews. The findings suggest that healthcare workers are afraid of contracting HIV from their patients and this affects their delivery of services. In addition, the results revealed that poor infrastructure and shortage of supplies at the facilities hinder healthcare workers from performing their duties effectively. The other concern was the heavy workload and severe time constraints which puts enormous stress on healthcare workers. Stigma and discrimination emerged as major problems for healthcare workers. Addressing the challenges facing healthcare workers is essential in effectively managing the AIDS pandemic facing the continent.

Orbital transfer vehicle launch operations study: Manpower summary and facility requirements, volume 5

NASA Technical Reports Server (NTRS)

1986-01-01

All manpower numbers, number of heads (by skill), serial time and manhours have been accumulated and compiled on a per subtask basis in spreadsheet format for both the ground based and the space based data flows. To aid in identifying the facility resources required to process the Ground Based Orbital Transfer Vehicle (GBOTV) and/or the space based orbital transfer vehicle (SBOTV) through the ground facilities at Kennedy Space Center (KSC), a software application package was developed using a general purpose data base management system known as Data Flex. The facility requirements are used as the basic input to this software application. The resources of the KSC facility that could be used by orbital transfer vehicle program were digitized in the same format used to identify facility requirements. The facility capabilities were digitized in this format for subsequent, automated comparative analyses. Composite facility requirements are compared to each of the baseline facility capabilities and the system generates a relative score that indicates how each facility weighs against the composite requirements in relation to the other facilities in the set.

Disaster Response and Preparedness Application: Emergency Environmental Response Tool (EERT)

NASA Technical Reports Server (NTRS)

Smoot, James; Carr, Hugh; Jester, Keith

2003-01-01

In 2000, the National Aeronautics and Space Administration (NASA) Environmental Office at the John C. Stennis Space Center (SSC) developed an Environmental Geographic Information Systems (EGIS) database. NASA had previously developed a GIS database at SSC to assist in the NASA Environmental Office's management of the Center. This GIS became the basis for the NASA-wide EGIS project, which was proposed after the applicability of the SSC database was demonstrated. Since its completion, the SSC EGIS has aided the Environmental Office with noise pollution modeling, land cover assessment, wetlands delineation, environmental hazards mapping, and critical habitat delineation for protected species. At SSC, facility management and safety officers are responsible for ensuring the physical security of the facilities, staff, and equipment as well as for responding to environmental emergencies, such as accidental releases of hazardous materials. All phases of emergency management (planning, mitigation, preparedness, and response) depend on data reliability and system interoperability from a variety of sources to determine the size and scope of the emergency operation. Because geospatial data are now available for all NASA facilities, it was suggested that this data could be incorporated into a computerized management information program to assist facility managers. The idea was that the information system could improve both the effectiveness and the efficiency of managing and controlling actions associated with disaster, homeland security, and other activities. It was decided to use SSC as a pilot site to demonstrate the efficacy of having a baseline, computerized management information system that ultimately was referred to as the Emergency Environmental Response Tool (EERT).

Food Insecurity, Nutritional Status, and Factors Associated with Malnutrition among People Living with HIV/AIDS Attending Antiretroviral Therapy at Public Health Facilities in West Shewa Zone, Central Ethiopia.

PubMed

Gebremichael, Delelegn Yilma; Hadush, Kokeb Tesfamariam; Kebede, Ermiyas Mulu; Zegeye, Robel Tezera

2018-01-01

In resource limited settings, HIV/AIDS patients lack access to sufficient nutritious foods, which poses challenges to the success of antiretroviral therapy. HIV/AIDS and malnutrition are still major public health problems in Ethiopia. Though measuring nutritional status is an essential part of ART program, little evidence exists on food insecurity and nutritional status of HIV/AIDS patients in Ethiopia. Hence, the study aimed to determine food insecurity and nutritional status and contextual determinants of malnutrition among HIV/AIDS patients in West Shewa Zone, Ethiopia. Institution-based cross-sectional study was conducted among HIV/ADIS patients who have been attending antiretroviral therapy at public health facilities in West Shewa Zone from April to May 2016, Ethiopia. The sample size was 512 and study participants were selected from each facilities using systematic random sampling method. Data were collected using pretested questionnaire by trained data collectors. Data were entered to Epi-Info 3.5.1 for Windows and analyzed using SPSS version 22. Logistic regression analyses were conducted to determine independent factors associated with malnutrition. Prevalence of malnutrition was 23.6% (95% CI: 19.7%-27.4%) and prevalence of household food insecurity was 35.2% (95% CI: 31.1%-39.0%). Factors significantly associated with malnutrition among HIV/AIDS patients were unemployment (AOR = 3.4; 95% CI: 1.8-5.3), WHO clinical stages III/IV (AOR = 3.3; 95% CI: 1.8-6.5), CD4 count less than 350 cells/ μ l (AOR = 2.0; 95% CI: 1.8-4.2), tuberculosis (AOR = 2.3; 95% CI: 1.3-4.9), duration on antiretroviral therapy (AOR = 1.8; 95% CI: 1.2-2.9), and household food insecurity (AOR = 5.3; 95% CI: 2.5-8.3). The findings revealed high prevalence of malnutrition and household food insecurity among HIV/AIDS patients attended ART. The negative interactive effects of undernutrition, inadequate food consumption, and HIV infection demand effective cross-sectorial integrated programs and effective management of opportunistic infections like tuberculosis.

A reassessment and review of the Bam earthquake five years onward: what was done wrong?

PubMed

Motamedi, Mohammad Hosein Kalantar; Saghafinia, Masound; Bararani, Azadeh Hassani; Panahi, Farzad

2009-01-01

An earthquake measuring 6.6 on the Richter scale on 23 December 2003 devastated the city of Bam in southeastern Iran. During the response and recovery phases, considerable shortcomings were discovered. The dire situation in the affected area, a variety of urgently required interventions, and the large number of aid organizations involved brought about difficulties in management, coordination, and communication among authorities and aid organizations. This article highlights flaws in management in the various aspects of this disaster in order to assess what was done, and what should be done to overcome these shortcomings in future disasters. A retrospective review of the various aspects of management related to the Bam disaster was done via the assessment of files, multi-center studies, governmental data, and available literature from 2003-2008. A review of the available data relevant to search and rescue operations and short-term aid provision revealed flaws in different aspects of disaster management including personnel, the transfer of the injured, availability medical supplies, treatment planning, problems concerning the composition of treatment forces dispatched to the region, distribution of tasks among treatment workers, transferring of equipment, availability of facilities, and lack of coordination among the organizations responsible for the management of the disaster. Most of the aforementioned issues have been addressed. A comprehensive disaster management plan must not be limited only to the response phase, but rather must include: preparedness, recovery with optimal legislation and budgeting, improvement of healthcare facilities, and organized communication channels between the different governmental departments. This important issue has been addressed, and a disaster management organization under the supervision of the President has been established, developing a national search and rescue strategy and protocol for unified managerial organization, an alert system, an international disaster command system (under which search and rescue and emergency medical service teams can be deployed, increasing the efficacy and coordination of the arrival of foreign teams and the construction field hospitals), and developing a flowchart to coordinate international agencies and the domestic authorities in charge. Continuous education, training of the general population, conducting periodic exercise drills, and provision for prepared task force mobilization in disaster management all are important aspects of the management of disasters due to natural hazards.

Variation in hematologic and serum biochemical values of belugas (Delphinapterus leucas) under managed care.

PubMed

Norman, Stephanie A; Beckett, Laurel A; Miller, Woutrina A; St Leger, Judy; Hobbs, Roderick C

2013-06-01

Blood analytes are critical for evaluating the general health of cetacean populations, so it is important to understand the intrinsic variability of hematology and serum chemistry values. Previous studies have reported data for follow-up periods of several years in managed and wild populations, but studies over long periods of time (> 20 yr) have not been reported. The study objective was to identify the influences of partitioning characteristics on hematology and serum chemistry analytes of apparently healthy managed beluga (Delphinapterus leucas). Blood values from 31 managed belugas, at three facilities, collected over 22 yr, were assessed for seasonal variation and aging trends, and evaluated for biologic variation among and within individuals. Linear mixed effects models assessed the relationship between the analytes and sex, age, season, facility location, ambient air temperature, and photoperiod. Sex differences in analytes and associations with increasing age were observed. Seasonal variation was observed for hemoglobin, hematocrit, mean corpuscular volume, monocytes, alkaline phosphatase, total bilirubin, cholesterol, and triglycerides. Facilities were associated with larger effects on analyte values compared to other covariates, whereas age, sex, and ambient temperature had smaller effects compared to facility and season. Present findings provide important baseline information for future health monitoring efforts. Interpretation of blood analytes and animal health in managed and wild populations over time is aided by having available typical levels for the species and reference intervals for the degree to which individual animals vary from the species average and from their own baseline levels during long-term monitoring.

Web-Based Software for Managing Research

NASA Technical Reports Server (NTRS)

Hoadley, Sherwood T.; Ingraldi, Anthony M.; Gough, Kerry M.; Fox, Charles; Cronin, Catherine K.; Hagemann, Andrew G.; Kemmerly, Guy T.; Goodman, Wesley L.

2007-01-01

aeroCOMPASS is a software system, originally designed to aid in the management of wind tunnels at Langley Research Center, that could be adapted to provide similar aid to other enterprises in which research is performed in common laboratory facilities by users who may be geographically dispersed. Included in aeroCOMPASS is Web-interface software that provides a single, convenient portal to a set of project- and test-related software tools and other application programs. The heart of aeroCOMPASS is a user-oriented document-management software subsystem that enables geographically dispersed users to easily share and manage a variety of documents. A principle of "write once, read many" is implemented throughout aeroCOMPASS to eliminate the need for multiple entry of the same information. The Web framework of aeroCOMPASS provides links to client-side application programs that are fully integrated with databases and server-side application programs. Other subsystems of aeroCOMPASS include ones for reserving hardware, tracking of requests and feedback from users, generating interactive notes, administration of a customer-satisfaction questionnaire, managing execution of tests, managing archives of metadata about tests, planning tests, and providing online help and instruction for users.

The Physical Learning Environment for Teaching: Child Care Services, Clothing Services, Food Services, Health Services, Home Furnishings Service, Housekeeping Services, and Management Services. Home Economics Occupational Education.

ERIC Educational Resources Information Center

New York State Education Dept., Albany. Bureau of Secondary Curriculum Development.

Suggestions are given to aid school administrators, area directors, teachers, advisory committees, and architects in planning for the home economics occupational education facility. Requirements are listed for space and equipment for instructional classrooms, laboratories, and laundry and storage areas, as well as space allocation in square feet…

Software solutions manage the definition, operation, maintenance and configuration control of the National Ignition Facility

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dobson, D; Churby, A; Krieger, E

2011-07-25

The National Ignition Facility (NIF) is the world's largest laser composed of millions of individual parts brought together to form one massive assembly. Maintaining control of the physical definition, status and configuration of this structure is a monumental undertaking yet critical to the validity of the shot experiment data and the safe operation of the facility. The NIF business application suite of software provides the means to effectively manage the definition, build, operation, maintenance and configuration control of all components of the National Ignition Facility. State of the art Computer Aided Design software applications are used to generate a virtualmore » model and assemblies. Engineering bills of material are controlled through the Enterprise Configuration Management System. This data structure is passed to the Enterprise Resource Planning system to create a manufacturing bill of material. Specific parts are serialized then tracked along their entire lifecycle providing visibility to the location and status of optical, target and diagnostic components that are key to assessing pre-shot machine readiness. Nearly forty thousand items requiring preventive, reactive and calibration maintenance are tracked through the System Maintenance & Reliability Tracking application to ensure proper operation. Radiological tracking applications ensure proper stewardship of radiological and hazardous materials and help provide a safe working environment for NIF personnel.« less

[The organization and management of First Aid in the workplace: critical issues and innovations to be introduced].

PubMed

Papaleo, Bruno; Cangiano, Giovanna; Calicchia, Sara; Marcellini, Laura; Colagiacomo, Chiara; Pera, Alessandra

2012-01-01

Develop an effective First Aid's system in workplaces is significantly important to the outcomes of accidents at work, thus contributing positively to create healthy and safe environments, improving responsible attitude and risk perception by workers. The italian regulation (D. Lgs. 81/08; DM 388/03) gives an important role to First Aid within the system for managing health and safety in workplaces and requires the employers to designate and train workers and organize facilities in the workplace. However, to ensure that First Aid's system actually contributes to increasing health and safety in workplaces, it's necessary to verify its effectiveness, beyond the law compliance. The article stands to evaluate the critical issues and related innovations to be introduced in this context, by analyzing data from literature and field experiences involving actors in the prevention system. The goal is to provide suggestions and action proposals to improve first aid's system in workplaces, paying particular attention to the aiders training (selection, motivation, teaching methods, retraining), as well as introduce to innovations to allow an immediate and timely emergency response (company equipments, other useful devices). On this last aspect, it has given particular emphasis to the introduction of semi-automatic defibrillator (AED), which is essential in case of sudden cardiac arrest with ventricular fibrillation, and special aiders training by means of BLSD (Basic Life Support and Defibrillation) courses based on international guidelines.

14 CFR 121.561 - Reporting potentially hazardous meteorological conditions and irregularities of ground facilities...

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Reporting potentially hazardous meteorological conditions and irregularities of ground facilities or navigation aids. 121.561 Section 121.561... meteorological conditions and irregularities of ground facilities or navigation aids. (a) Whenever he encounters...

14 CFR 121.561 - Reporting potentially hazardous meteorological conditions and irregularities of ground facilities...

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Reporting potentially hazardous meteorological conditions and irregularities of ground facilities or navigation aids. 121.561 Section 121.561... meteorological conditions and irregularities of ground facilities or navigation aids. (a) Whenever he encounters...

14 CFR 121.561 - Reporting potentially hazardous meteorological conditions and irregularities of ground facilities...

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Reporting potentially hazardous meteorological conditions and irregularities of ground facilities or navigation aids. 121.561 Section 121.561... meteorological conditions and irregularities of ground facilities or navigation aids. (a) Whenever he encounters...

Observations of sexually transmitted disease consultations in India.

PubMed

Mertens, T E; Smith, G D; Kantharaj, K; Mugrditchian, D; Radhakrishnan, K M

1998-03-01

To assess the quality of sexually transmitted disease (STD) case management provided in public and private health facilities in selected areas of Madras, Tamil Nadu, India, in order to make recommendations for improving the quality of care and promote the syndromic approach to STD treatment. Structured observations of consultations for STDs in health care facilities. Scoring of the observations according to standards for history taking, examination, treatment and provision of basic health promotion advice allows evaluation of STD case management. With STD treatment adequacy scored against Indian national guidelines (which recommend aetiologic treatment), history taking, examination and treatment were satisfactory in 76 out of 108 (70%) of observed consultations. However, if STD treatment adequacy is scored with respect to the syndrome approach towards selected STD (male urethritis and non herpetic genital ulcer for both sexes), only 8 out of 81 (10%) of the patients were satisfactory managed. During 32 out of 108 (30%) of the consultations, advice on the use of condoms in order to prevent STD or HIV/AIDS was given. Instructions regarding how to use condoms were offered to seven (6%) patients and condoms were only provided to one patient (1%). Patients were urged to refer their partner(s) for treatment during 29 (27%) of consultations. A criterion of adequate use of the STD consultation for health promotion, requiring both promotion of condoms and encouragement to refer partner(s) for treatment, was met during 13 (12%) of consultations. Monitoring and improving the standards of care at facilities at which STDs are treated have become key roles of STD/HIV/AIDS programmes. The present report suggests that in Madras the activities of medical practitioners who treat STD patients are far from ideal at present. Improvements would involve simplifying existing treatment guidelines by promoting the syndromic approach to STD management, continuing education programmes for health care providers in the public and private sectors and repeat assessments and feedback of the quality of STD care.

75 Hour Nurse Aide Course.

ERIC Educational Resources Information Center

Iowa Univ., Iowa City. Coll. of Education.

This 75-hour nurse aide course has been designed to meet the training requirements of the Omnibus Budget Reconciliation Act of 1987 for aides working in nursing facilities and skilled nursing facilities. Emphasis in the course is on students achieving a basic level of knowledge and demonstrating skills to provide safe, effective resident care. The…

Goal is to give every doc an 'AIDS cookbook'.

PubMed

1997-06-01

Before leaving Kaiser Family Foundation in California, Mark Smith helped to lay the groundwork for the first comprehensive HIV treatment standard in almost five years. Smith, former chairman of the Centers for Disease Control and Prevention's (CDC) Advisory Committee on HIV, noted that the most sophisticated practitioners may be using certain information as a basis for their decisions months before it gets published in mainstream journals. The committee to develop the standard includes AIDS clinicians and researchers, as well as managed care medical directors and others who follow evidence-based medicine. The cookbook approach will help unsophisticated practitioners develop effective treatment regimens for their patients, and will direct medical care decisions in managed health facilities. The standards will be a one-stop source for making decisions on everything from viral load testing to immunizations. Critics charge that the standard's approach will leave no room for up-to-date changes.

Systems Engineering and Integration (SE and I)

NASA Technical Reports Server (NTRS)

Chevers, ED; Haley, Sam

1990-01-01

The issue of technology advancement and future space transportation vehicles is addressed. The challenge is to develop systems which can be evolved and improved in small incremental steps where each increment reduces present cost, improves, reliability, or does neither but sets the stage for a second incremental upgrade that does. Future requirements are interface standards for commercial off the shelf products to aid in the development of integrated facilities; enhanced automated code generation system slightly coupled to specification and design documentation; modeling tools that support data flow analysis; and shared project data bases consisting of technical characteristics cast information, measurement parameters, and reusable software programs. Topics addressed include: advanced avionics development strategy; risk analysis and management; tool quality management; low cost avionics; cost estimation and benefits; computer aided software engineering; computer systems and software safety; system testability; and advanced avionics laboratories - and rapid prototyping. This presentation is represented by viewgraphs only.

Alternative financing mechanisms for ART programs in health facilities in Uganda: a mixed-methods approach.

PubMed

Zakumumpa, Henry; Bennett, Sara; Ssengooba, Freddie

2017-01-23

Sub-Saharan Africa is heavily dependent on global health initiatives (GHIs) for funding antiretroviral therapy (ART) scale-up. There are indications that global investments for ART scale-up are flattening. It is unclear what new funding channels can bridge the funding gap for ART service delivery. Many previous studies have focused on domestic government spending and international funding especially from GHIs. The objective of this study was to identify the funding strategies adopted by health facilities in Uganda to sustain ART programs between 2004 and 2014 and to explore variations in financing mechanisms by ownership of health facility. A mixed-methods approach was employed. A survey of health facilities (N = 195) across Uganda which commenced ART delivery between 2004 and 2009 was conducted. Six health facilities were purposively selected for in-depth examination. Semi-structured interviews (N = 18) were conducted with ART Clinic managers (three from each of the six health facilities). Statistical analyses were performed in STATA (Version 12.0) and qualitative data were analyzed by coding and thematic analysis. Multiple funding sources for ART programs were common with 140 (72%) of the health facilities indicating at least two concurrent grants supporting ART service delivery between 2009 and 2014. Private philanthropic aid emerged as an important source of supplemental funding for ART service delivery. ART financing strategies were differentiated by ownership of health facility. Private not-for-profit providers were more externally-focused (multiple grants, philanthropic aid). For-profit providers were more client-oriented (fee-for-service, insurance schemes). Public facilities sought additional funding streams not dissimilar to other health facility ownership-types. Over the 10-year study period, health facilities in Uganda diversified funding sources for ART service delivery. The identified alternative funding mechanisms could reduce dependence on GHI funding and increase local ownership of HIV programs. Further research evaluating the potential contribution of the identified alternative financing mechanisms in bridging the global HIV funding gap is recommended.

New Spaces for Learning: Designing College Facilities to Utilize Instructional Aids and Media. Revised.

ERIC Educational Resources Information Center

Hauf, Harold D.; And Others

Colleges need appropriate large group instructional facilities for effective and efficient use of instructional aids and media. A well planned system of facilities must provide space for learning; production, origination, and support; storage and retrieval. Design begins with a building plan--a statement, made jointly by the administrator and…

A Guide to Federal Financial Aid for Dental Health: Services, Facilities, Training, and Research.

ERIC Educational Resources Information Center

National Institutes of Health (DHEW), Bethesda, MD. Div. of Dental Health.

Federal financial aid is available for a wide range of dental activities, including the provision of services, construction of facilities, education and training of professional and auxiliary personnel, and the conduct of research and demonstration projects. This publication contains a brief description of the purpose of each federal aid program,…

Cost containment and KSC Shuttle facilities or cost containment and aerospace construction

NASA Technical Reports Server (NTRS)

Brown, J. A.

1985-01-01

This presentation has the objective to show examples of Cost Containment of Aerospace Construction at Kennedy Space Center (KSC), taking into account four major levels of Project Development of the Space Shuttle Facilities. The levels are related to conceptual criteria and site selection, the design of construction and ground support equipment, the construction of facilities and ground support equipment (GSE), and operation and maintenance. Examples of cost containment are discussed. The continued reduction of processing time from landing to launching represents a demonstration of the success of the cost containment methods. Attention is given to the factors which led to the selection of KSC, the use of Cost Engineering, the employment of the Construction Management Concept, and the use of Computer Aided Design/Drafting.

Impact of service delivery model on health care access among HIV-positive women in New York City.

PubMed

Pillai, Nandini V; Kupprat, Sandra A; Halkitis, Perry N

2009-01-01

As the New York City HIV=AIDS epidemic began generalizing beyond traditionally high-risk groups in the early 1990s, AIDS Service Organizations (ASO) sought to increase access to medical care and broaden service offerings to incorporate the needs of low-income women and their families. Strategies to achieve entry into and retention in medical care included the development of integrated care facilities, case management, and a myriad of supportive service offerings. This study examines a nonrandom sample of 60 HIV-positive women receiving case management and supportive services at New York City ASOs. Over 55% of the women interviewed reported high access to care, 43% reported the ability to access urgent care all of the time and 94% reported high satisfaction with obstetrics=gynecology (OB=GYN) care. This held true across race=ethnicity, income level, medical coverage, and service delivery model.Women who accessed services at integrated care facilities offering onsite medical care and case management=supportive services perceived lower access to medical specialists as compared to those who received services at nonintegrated sites. Data from this analysis indicate that supportive services increase access to and satisfaction with both HIV and non-HIV-related health care. Additionally, women who received services at a medical model agency were more likely to report accessing non-HIV care at a clinic compared to those receiving services at a nonmedical model agencies, these women were more likely to report receiving non-HIV care at a hospital.

Upstream dispersal of an invasive crayfish aided by a fish passage facility

USGS Publications Warehouse

Welsh, Stuart A.; Loughman, Zachary J.

2015-01-01

Fish passage facilities for reservoir dams have been used to restore habitat connectivity within riverine networks by allowing upstream passage for native species. These facilities may also support the spread of invasive species, an unintended consequence and potential downside of upstream passage structures. We documented dam passage of the invasive virile crayfish, Orconectes virilis (Hagen, 1870), at fish ladders designed for upstream passage of American eels, Anguilla rostrata (Lesueur, 1817), in the Shenandoah River drainage, USA. Ladder use and upstream passage of 11 virile crayfish occurred from 2007–2014 during periods of low river discharge (<30 m3s–1) and within a wide range of water temperatures from 9.0–28.6 °C. Virile crayfish that used the eel ladders were large adults with a mean carapace length and width of 48.0 mm and 24.1 mm, respectively. Our data demonstrated the use of species-specific fish ladders by a non-target non-native species, which has conservation and management implications for the spread of aquatic invasive species and upstream passage facilities. Specifically, managers should consider implementing long-term monitoring of fish passage facilities with emphasis on detection of invasive species, as well as methods to reduce or eliminate passage of invasive species. 

Emerging CAE technologies and their role in Future Ambient Intelligence Environments

NASA Astrophysics Data System (ADS)

Noor, Ahmed K.

2011-03-01

Dramatic improvements are on the horizon in Computer Aided Engineering (CAE) and various simulation technologies. The improvements are due, in part, to the developments in a number of leading-edge technologies and their synergistic combinations/convergence. The technologies include ubiquitous, cloud, and petascale computing; ultra high-bandwidth networks, pervasive wireless communication; knowledge based engineering; networked immersive virtual environments and virtual worlds; novel human-computer interfaces; and powerful game engines and facilities. This paper describes the frontiers and emerging simulation technologies, and their role in the future virtual product creation and learning/training environments. The environments will be ambient intelligence environments, incorporating a synergistic combination of novel agent-supported visual simulations (with cognitive learning and understanding abilities); immersive 3D virtual world facilities; development chain management systems and facilities (incorporating a synergistic combination of intelligent engineering and management tools); nontraditional methods; intelligent, multimodal and human-like interfaces; and mobile wireless devices. The Virtual product creation environment will significantly enhance the productivity and will stimulate creativity and innovation in future global virtual collaborative enterprises. The facilities in the learning/training environment will provide timely, engaging, personalized/collaborative and tailored visual learning.

KSC-2012-2141

NASA Image and Video Library

2012-04-14

CAPE CANAVERAL, Fla. – At the Shuttle Landing Facility at NASA’s Kennedy Space Center in Florida, media representatives interview space shuttle managers following the arrival of space shuttle Discovery. Behind the rope with their backs to the camera are, from left, Bart Pannullo, NASA Transition and Retirement vehicle manager at Kennedy Dorothy Rasco, manager for Space Shuttle Program Transition and Retirement at NASA’s Johnson Space Center Stephanie Stilson, NASA flow director for Orbiter Transition and Retirement at Kennedy and Kevin Templin, transition manager for the Space Shuttle Program at Johnson. Discovery will be hoisted onto a Shuttle Carrier Aircraft, or SCA, with the aid of the mate-demate device at the landing facility. The SCA, a modified Boeing 747 jet airliner, is scheduled to ferry Discovery to the Washington Dulles International Airport in Virginia on April 17, after which the shuttle will be placed on permanent public display in the Smithsonian's National Air and Space Museum Steven F. Udvar-Hazy Center. For more information on shuttle transition and retirement activities, visit http://www.nasa.gov/transition. Photo credit: NASA/Kim Shiflett

World Bank credits Uganda with $50m. -- emphasis on communities, NGOs and health.

PubMed

1994-01-01

Between 1983 and 1984, the World Bank financed 11 AIDS/STD projects in Africa, most of which tended to cost comparatively small amounts. It increased the amount of its AIDS/STD loans considerably in 1993 and 1994 ($75 million in Zimbabwe and $50 million in Uganda). The Ugandan government, Germany, Sweden, and the UK are also funding the AIDS/STD project. Since the money is from the Bank's International Development Association, Uganda does not need to pay any interest on the loan. About 1.5 million people in Uganda are HIV positive. The number of AIDS patients continues to rise. The AIDS project in Uganda focuses on prevention of sexual transmission of HIV, mitigation of the personal impact of the epidemic, and institutional development. Prevention of sexual transmission activities are: promotion of safer sex behavior, condoms, and STD care-seeking behavior and effective STD care. Support for community-based and home-based health care and social support for people with AIDS, training staff about and providing drugs for opportunistic infections, protective supplies for public and private district health facilities, and diagnosis and case management of tuberculosis comprise mitigation of the personal impact of AIDS activities. Institutional development efforts include strengthening the district level's capacity to plan, coordinate, implement, monitor, and evaluate integrated AIDS-related activities, and the national level's capacity to provide adequate technical support on health issues linked to AIDS. Three key policies of the project are decentralization, community mobilization, and encouragement of nongovernmental organizations to work with communities and to complement government efforts. A large scale AIDS/STD mass media program is planned. Project goals are: 50% of the population knowing at least 2 actual ways to protect themselves from HIV. 50% of the population using condoms, and 70% of people seeking STD care receiving appropriate STD case management.

Paris on the Mekong: using the aid effectiveness agenda to support human resources for health in the Lao People's Democratic Republic

PubMed Central

Dodd, Rebecca; Hill, Peter S; Shuey, Dean; Fernandes Antunes, Adélio

2009-01-01

Background This study examines the potential of aid effectiveness to positively influence human resources for health in developing countries, based on research carried out in the Lao People's Democratic Republic (Lao PDR). Efforts to make aid more effective – as articulated in the 2005 Paris Declaration and recently reiterated in the 2008 Accra Agenda for Action – are becoming an increasingly prominent part of the development agenda. A common criticism, though, is that these discussions have limited impact at sector level. Human resources for health are characterized by a rich and complex network of interactions and influences – both across government and the donor community. This complexity provides a good prism through which to assess the potential of the aid effectiveness agenda to support health development and, conversely, possibilities to extend the impact of aid-effectiveness approaches to sector level. Methods The research adopted a case study approach using mixed research methods. It draws on a quantitative analysis of human resources for health in the Lao People's Democratic Republic, supplementing this with a documentary and policy analysis. Qualitative methods, including key informant interviews and observation, were also used. Results The research revealed a number pathways through which aid effectiveness is promoting an integrated, holistic response to a range of human resources for health challenges, and has identified further opportunities for stronger linkages. The pathways include: (1) efforts to improve governance and accountability, which are often central to the aid effectiveness agenda, and can be used as an entry point for reforming workforce planning and regulation; (2) financial management reforms, typically linked to provision of budget support, that open the way for greater transparency and better management of health monies and, ultimately, higher salaries and revenues for health facilities; (3) commitments to harmonization that can be used to improve coherence of donor support in areas such as salary supplementation, training and health information management. Conclusion If these opportunities are to be fully exploited, a number of constraints will need to be overcome: limited awareness of the aid effectiveness agenda beyond a core group in government; a perception that this is a donor-led agenda; and different views among partners as to the optimal pace of aid management reforms. In conclusion, we recommend strategic engagement of health stakeholders in the aid effectiveness agenda as one means of strengthening the health workforce. PMID:19239716

Political economy of decentralising HIV and AIDS treatment services to primary healthcare facilities in three Nigerian states.

PubMed

Mbachu, Chinyere; Onwujekwe, Obinna; Ezumah, Nkoli; Ajayi, Olayinka; Sanwo, Olusola; Uzochukwu, Benjamin

2016-09-01

Decentralisation is defined as the dispersion, distribution or transfer of resources, functions and decision-making power from a central authority to regional and local authorities. It is usually accompanied by assignment of accountability and responsibility for results. Fundamental to understanding decentralisation is learning what motivates central governments to give up power and resources to local governments, and the practical significance of this on their positions regarding decentralisation. This study examined key political and institutional influences on role-players' capacity to support decentralisation of HIV and AIDS treatment services to primary healthcare facilities, and implications for sustainability. In-depth interviews were conducted with 55 purposively selected key informants, drawn from three Nigerian states that were at different stages of decentralising HIV and AIDS treatment services to primary care facilities. Key informants represented different categories of role-players involved in HIV and AIDS control programmes. Thematic framework analysis of data was done. Support for decentralisation of HIV and AIDS treatment services to primary healthcare facilities was substantial among different categories of actors. Political factors such as the local and global agenda for health, political tenure and party affiliations, and institutional factors such as consolidation of decision-making power and improvements in career trajectories, influenced role-players support for decentralisation of HIV and AIDS treatment services. It is feasible and acceptable to decentralise HIV and AIDS treatment services to primary healthcare facilities, to help improve coverage. However, role-players' support largely depends on how well the reform aligns with political structures and current institutional practices.

Long-term care survey reveals challenges. Facilities grapple with five broad issues, including changes in leadership and AIDS.

PubMed

Westhoff, L J; Schaefer, J C

1993-05-01

The Catholic Health Association's 1992 survey of Catholic long-term care (LTC) facilities identified five broad issues LTC facilities face in the 1990s: leadership, system affiliation, community programs, resident issues, and care of persons with AIDS. The transition to lay leadership presents new challenges to the relationship between LTC facilities and their sponsors. Despite the dominance of religious sponsors, an increasing number of laypersons are serving as healthcare administrators both in long-term and acute care. Thirty percent of respondents reported being affiliated with a multi-institutional system. This percentage has changed little in the past few years, although the number of facilities that are system members continues to increase at the fastest rate of any type of LTC facility. Only 27 percent of survey respondents said they provide educational or informational programs for persons in their communities. Thirty-nine percent of system-affiliated LTC facilities reported offering such programs. One encouraging finding shows that 80 percent of facilities have written policies for living wills, 64 percent for designated proxy, and 86 percent for durable power of attorney for healthcare. LTC providers are struggling to determine their role in caring for persons with HIV and AIDS. Only 3.6 percent of respondents care for residents with AIDS. A major problem LTC administrators face is a fear of potential infection of staff or residents.

GEOTAIL Spacecraft historical data report

NASA Technical Reports Server (NTRS)

Boersig, George R.; Kruse, Lawrence F.

1993-01-01

The purpose of this GEOTAIL Historical Report is to document ground processing operations information gathered on the GEOTAIL mission during processing activities at the Cape Canaveral Air Force Station (CCAFS). It is hoped that this report may aid management analysis, improve integration processing and forecasting of processing trends, and reduce real-time schedule changes. The GEOTAIL payload is the third Delta 2 Expendable Launch Vehicle (ELV) mission to document historical data. Comparisons of planned versus as-run schedule information are displayed. Information will generally fall into the following categories: (1) payload stay times (payload processing facility/hazardous processing facility/launch complex-17A); (2) payload processing times (planned, actual); (3) schedule delays; (4) integrated test times (experiments/launch vehicle); (5) unique customer support requirements; (6) modifications performed at facilities; (7) other appropriate information (Appendices A & B); and (8) lessons learned (reference Appendix C).

Adult HIV care resources, management practices and patient characteristics in the Phase 1 IeDEA Central Africa cohort

PubMed Central

Divaris, Kimon; Newman, Jamie; Hemingway-Foday, Jennifer; Akam, Wilfred; Balimba, Ashu; Dusengamungu, Cyrille; Kalenga, Lucien; Mbaya, Marcel; Molu, Brigitte Mfangam; Mugisha, Veronicah; Mukumbi, Henri; Mushingantahe, Jules; Nash, Denis; Niyongabo, Théodore; Atibu, Joseph; Azinyue, Innocent; Kiumbu, Modeste; Woelk, Godfrey

2012-01-01

Introduction Despite recent advances in the management of HIV infection and increased access to treatment, prevention, care and support, the HIV/AIDS epidemic continues to be a major global health problem, with sub-Saharan Africa suffering by far the greatest humanitarian, demographic and socio-economic burden of the epidemic. Information on HIV/AIDS clinical care and established cohorts’ characteristics in the Central Africa region are sparse. Methods A survey of clinical care resources, management practices and patient characteristics was undertaken among 12 adult HIV care sites in four countries of the International Epidemiologic Databases to Evaluate AIDS Central Africa (IeDEA-CA) Phase 1 regional network in October 2009. These facilities served predominantly urban populations and offered primary care in the Democratic Republic of Congo (DRC; six sites), secondary care in Rwanda (two sites) and tertiary care in Cameroon (three sites) and Burundi (one site). Results Despite some variation in facility characteristics, sites reported high levels of monitoring resources, including electronic databases, as well as linkages to prevention of mother-to-child HIV transmission programs. At the time of the survey, there were 21,599 HIV-positive adults (median age=37 years) enrolled in the clinical cohort. Though two-thirds were women, few adults (6.5%) entered HIV care through prevention of mother-to-child transmission services, whereas 55% of the cohort entered care through voluntary counselling and testing. Two-thirds of patients at sites in Cameroon and DRC were in WHO Stage III and IV at baseline, whereas nearly all patients in the Rwanda facilities with clinical stage information available were in Stage I and II. WHO criteria were used for antiretroviral therapy initiation. The most common treatment regimen was stavudine/lamivudine/nevirapine (64%), followed by zidovudine/lamivudine/nevirapine (19%). Conclusions Our findings demonstrate the feasibility of establishing large clinical cohorts of HIV-positive individuals in a relatively short amount of time in spite of challenges experienced by clinics in resource-limited settings such as those in this region. Country differences in the cohort's site and patient characteristics were noted. This information sets the stage for the development of research initiatives and additional programs to enhance adult HIV care and treatment in Central Africa. PMID:23199800

The feasibility of a holistic wellness program for HIV/AIDS patients residing in a voluntary inpatient treatment program.

PubMed

Morgan, Vanessa

2014-03-01

The purpose of this project was to examine the feasibility of an ongoing holistic wellness program in a residential facility treating persons with HIV/AIDS. The goal was to create a voluntary, four week holistic wellness intensive within the established inpatient behavioral health treatment program. Participants were given practicable holistic self care tools to effectively manage HIV related symptoms, general medical issues, addiction, depression, stress and anxiety. The program incorporated evidence-based holistic activities including yoga, therapeutic dance, meditation, Reiki, and reflective journaling. Narrative survey results and post-program evaluation support that an ongoing holistic wellness program within the existing treatment model is feasible and could have numerous potential beneficial effects. This project clearly exemplified the ideal opportunity for holistic nurses to implement innovative holistic interventions within the current healthcare delivery system. It is the author's observation that future studies with a larger participant group to further examine measurable benefits can lend valuable information and insight into the future development of holistic wellness programs for residential treatment facilities.

Characteristics of U.S. Substance Abuse Treatment Facilities Offering HIV Services: Results From a National Survey.

PubMed

Cohn, Amy; Stanton, Cassandra; Elmasry, Hoda; Ehlke, Sarah; Niaura, Ray

2016-06-01

Substance use disorders are common among persons with HIV/AIDS. This study examined the prevalence and correlates of the provision of four HIV services in a national sample of substance abuse treatment facilities. Data were from the 2011 National Survey of Substance Abuse Treatment Services. Prevalence estimates indicated that 28% of facilities offered HIV testing, 26% early intervention, 58% HIV/AIDS education, and 8% special programs for HIV/AIDS. Facilities offering inpatient substance abuse care were more than six times as likely to offer HIV testing but not more likely to offer any other type of HIV service. Facilities offering methadone treatment were 2.5 times more likely to offer HIV services. Given the high rates of substance use among persons with HIV, the prevalence of facilities offering HIV services was low in most domains, with different barriers identified in multivariable models. Integrating comprehensive HIV prevention, testing, and support services into programs that address substance abuse is needed.

78 FR 38983 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-28

... specialties: clinical nurse specialist, nurse practitioner, certified nurse anesthetist, certified nurse... a decision aid for dialysis facility selection; (2) aid facilities with their internal quality... a new OMB control number); Title of Information Collection: Evaluation of the Graduate Nurse...

The effectiveness of empowering in-service training programs for foreign nurse aides in community-based long-term care facilities.

PubMed

Wu, Li-yu; Yin, Teresa J C; Li, I-chuan

2005-01-01

The objective of the study was to examine the effectiveness of empowering in-service training programs for foreign nurse aides working in community-based long-term care (LTC) facilities. The design was a pretest and post-test design with experiment and control groups. The sample consisted of purposeful sampling from 10 LTC facilities in the Shihlin and Peitou areas of Taipei. A total of 35 foreign nurse aides participated in this study; 16 in the experimental group and 19 in the control group. The experimental group attended the training program for a 3-month period, whereas the control group did not receive any training. The research findings reveal that the training program was effective in increasing the work stress of workload/scheduling (Z = 2.01, p

How an integrated change programme has accelerated the reduction in high hazard nuclear facilities at Sellafield

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mackintosh, Angela

For over five decades the Sellafield Site has been central to the UK's nuclear programme. Now operated by Sellafield Ltd, under the management of Parent Body Organisation Nuclear Management Partners (NMP), a consortium of URS Washington Division, AMEC and AREVA is focussed on the decommissioning of historical facilities. When Decommissioning commenced in the late 1980's the site focus at that time was on commercial reprocessing and waste management. Now through the implementation of a company change programme, emphasis has shifted towards accelerated risk and hazard reduction of degraded legacy plants with nuclear inventory whilst ensuring value for money for themore » customer, the Nuclear Decommissioning Authority. This paper will describe the management success by the Site owners in delivering a successful change programme. The paper will explain how the site has transitioned to the INPO Standard Nuclear Performance Model (SNPM) and how through the use of a change maturity matrix has contributed to the accelerated reduction in high risk high hazard nuclear facilities. The paper will explain in detail how the Decommissioning Programme Office has facilitated and coordinated the Governance and assured delivery of the change plan and how successful application of visual management has aided the communication of its progress. Finally, the paper will discuss how the Delivery Schedules have proved critical for presenting the change plan to Key Stakeholders, Government Owners and Powerful Regulators. Overall, this paper provides an insight into how a massive change programme is being managed within one of the world's highest regulated industries. (authors)« less

A Tale of Two Sites: Lessons on Leadership from the Implementation of a Long-term Care Delivery Model (CDM) in Western Canada

PubMed Central

Cloutier, Denise; Cox, Amy; Kampen, Ruth; Kobayashi, Karen; Cook, Heather; Taylor, Deanne; Gaspard, Gina

2016-01-01

Residential, long-term care serves vulnerable older adults in a facility-based environment. A new care delivery model (CDM) designed to promote more equitable care for residents was implemented in a health region in Western Canada. Leaders and managers faced challenges in implementing this model alongside other concurrent changes. This paper explores the question: How did leadership style influence team functioning with the implementation of the CDM? Qualitative data from interviews with leadership personnel (directors and managers, residential care coordinators and clinical nurse educators), and direct care staff (registered nurses, licensed practical nurses, health care aides, and allied health therapists), working in two different facilities comprise the main sources of data for this study. The findings reveal that leaders with a servant leadership style were better able to create and sustain the conditions to support successful model implementation and higher team functioning, compared to a facility in which the leadership style was less inclusive and proactive, and more resistant to the change. Consequently, staff at the second facility experienced a greater sense of overload with the implementation of the CDM. This study concludes that strong leadership is key to facilitating team work and job satisfaction in a context of change. PMID:27417591

A Tale of Two Sites: Lessons on Leadership from the Implementation of a Long-term Care Delivery Model (CDM) in Western Canada.

PubMed

Cloutier, Denise; Cox, Amy; Kampen, Ruth; Kobayashi, Karen; Cook, Heather; Taylor, Deanne; Gaspard, Gina

2016-01-04

Residential, long-term care serves vulnerable older adults in a facility-based environment. A new care delivery model (CDM) designed to promote more equitable care for residents was implemented in a health region in Western Canada. Leaders and managers faced challenges in implementing this model alongside other concurrent changes. This paper explores the question: How did leadership style influence team functioning with the implementation of the CDM? Qualitative data from interviews with leadership personnel (directors and managers, residential care coordinators and clinical nurse educators), and direct care staff (registered nurses, licensed practical nurses, health care aides, and allied health therapists), working in two different facilities comprise the main sources of data for this study. The findings reveal that leaders with a servant leadership style were better able to create and sustain the conditions to support successful model implementation and higher team functioning, compared to a facility in which the leadership style was less inclusive and proactive, and more resistant to the change. Consequently, staff at the second facility experienced a greater sense of overload with the implementation of the CDM. This study concludes that strong leadership is key to facilitating team work and job satisfaction in a context of change.

Corporate crisis management managing a major crisis in a chemical facility.

PubMed

Marwitz, Steve; Maxson, Neil; Koch, Bill; Aukerman, Todd; Cassidy, Jim; Belonger, David

2008-11-15

Chemical sites should have well trained and organized emergency response plans to manage an incident within the plant or during transport. The implementation of an incident command system utilizing either internal resources or external response through mutual aid agreements is generally sufficient to address the direct impact of an event on the site. When the site resources become overwhelmed in addressing resulting issues such as press releases, medical advice/support, employees and family support, Agency notifications, etc, Corporate should be ready and able to respond. This paper, taken from an in-depth CCPS workshop led by the author, describes an outline for corporate assistance in the event of a major incident at a site or during transportation.

14 CFR 135.67 - Reporting potentially hazardous meteorological conditions and irregularities of ground facilities...

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Reporting potentially hazardous meteorological conditions and irregularities of ground facilities or navigation aids. 135.67 Section 135.67... navigation aids. Whenever a pilot encounters a potentially hazardous meteorological condition or an...

14 CFR 135.67 - Reporting potentially hazardous meteorological conditions and irregularities of ground facilities...

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Reporting potentially hazardous meteorological conditions and irregularities of ground facilities or navigation aids. 135.67 Section 135.67... navigation aids. Whenever a pilot encounters a potentially hazardous meteorological condition or an...

14 CFR 135.67 - Reporting potentially hazardous meteorological conditions and irregularities of ground facilities...

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Reporting potentially hazardous meteorological conditions and irregularities of ground facilities or navigation aids. 135.67 Section 135.67... navigation aids. Whenever a pilot encounters a potentially hazardous meteorological condition or an...

Reverse logistics network for municipal solid waste management: The inclusion of waste pickers as a Brazilian legal requirement.

PubMed

Ferri, Giovane Lopes; Chaves, Gisele de Lorena Diniz; Ribeiro, Glaydston Mattos

2015-06-01

This study proposes a reverse logistics network involved in the management of municipal solid waste (MSW) to solve the challenge of economically managing these wastes considering the recent legal requirements of the Brazilian Waste Management Policy. The feasibility of the allocation of MSW material recovery facilities (MRF) as intermediate points between the generators of these wastes and the options for reuse and disposal was evaluated, as well as the participation of associations and cooperatives of waste pickers. This network was mathematically modelled and validated through a scenario analysis of the municipality of São Mateus, which makes the location model more complete and applicable in practice. The mathematical model allows the determination of the number of facilities required for the reverse logistics network, their location, capacities, and product flows between these facilities. The fixed costs of installation and operation of the proposed MRF were balanced with the reduction of transport costs, allowing the inclusion of waste pickers to the reverse logistics network. The main contribution of this study lies in the proposition of a reverse logistics network for MSW simultaneously involving legal, environmental, economic and social criteria, which is a very complex goal. This study can guide practices in other countries that have realities similar to those in Brazil of accelerated urbanisation without adequate planning for solid waste management, added to the strong presence of waste pickers that, through the characteristic of social vulnerability, must be included in the system. In addition to the theoretical contribution to the reverse logistics network problem, this study aids in decision-making for public managers who have limited technical and administrative capacities for the management of solid wastes. Copyright © 2015 Elsevier Ltd. All rights reserved.

Multiparameter Flow Cytometry For Clinical Applications

NASA Astrophysics Data System (ADS)

Stewart, Carleton C.

1989-06-01

Flow Cytometry facilities are well established and provide immunophenotyping and DNA content measurement services. The application of immunophenotyping has been primarily in monitoring therapy and in providing further information to aid in the definitive diagnosis of immunological and neoplastic disease such as: immunodeficiency disease, auto immune disease, organ transplantation, and leukemia and lymphoma. DNA content measurements have been particularly important in determining the fraction of cycling cells and presence of aneuploid cells in neoplasia. This information has been useful in the management of patients with solid tumors.

Contingency plan implementation.

PubMed

Neurath, D; Cober, N; Owens, W; Giulivi, A

2012-06-01

Although the National blood system in Canada reduces the risk of inventory shortages the possibility of a blood supply shortage still exists. The Ontario Ministry of Health and Long-Term Care developed a provincial plan to manage blood transfusion needs and inventory in the event of a National blood shortage. The Ontario plan was developed to align with the National plan as well as other provincial plans in order to ensure consistency in blood management strategies across the country. The Ontario plan was released in 2008, along with a toolkit to aid hospitals in developing their facility specific plans. In the Champlain region of Ontario, a group of 16 hospitals worked collaboratively to develop a regional blood shortage plan. A provincial blood shortage simulation exercise was held in 2010 to test out these plans. The Director of Transfusion Medicine of the largest facility in the group of 16 hospitals (The Ottawa Hospital) took the lead in the development of the regional blood shortage management plan. Working groups from all 16 sites contributed to the plan development. The proposed plan was presented to the Medical Advisory Committee for approval. The plan consists of activities relating to the severity of the supply shortage as defined by Amber, Red, Recovery and Green phases. The plan includes a communication plan for notifying stakeholders including patients whose treatment may be affected. Inventory management and triage guidelines are provided to reduce the demand for blood and to conserve inventory for those patients whose need is prioritized as highest. The regional blood shortage management plan was tested successfully during the provincial simulation exercise. Where regional hospitals work together to provide healthcare, it is beneficial to develop a standardized plan to provide guidance to hospital personnel in response to a blood supply shortage. A consistent plan will ensure patient care is provided in a consistent manner across a health region. Mock or simulation exercises can aid in testing plans and raising the awareness of stakeholders. Copyright © 2012 Elsevier Ltd. All rights reserved.

Integrated management of childhood illness: field test of the WHO/UNICEF training course in Arusha, United Republic of Tanzania. WHO Division of Child Health and Development & WHO Regional Office for Africa.

PubMed Central

1997-01-01

The 11-day training course on integrated management of childhood illness was field tested with three types of first-level facility health workers: medical assistants, rural medical aides, and MCH (maternal and child health) aides. The objective of the field test was to determine whether the materials were effective in preparing participants to manage correctly sick children and to suggest improvements in the course materials and teaching procedures. The course combined classroom work and daily inpatient and outpatient clinical sessions. Each participant individually examined 9-10 inpatients and managed more than 30 sick children as outpatients. Individual feedback from facilitators during clinical practice and module work, combined with data collection documenting the adequacy of the assessment, classification, treatment and counselling carried out by the participants, allowed an assessment of the participants' mastery of key clinical skills. Although some participants had difficulty in reading the modules in English, all three groups overall were able to assess, classify, and treat most sick children by the end of the course, and most of them were able to provide adequate counselling. Specific improvements were suggested and subsequently incorporated into the guidelines and training materials. PMID:9529718

Sexually transmitted disease syndromic case management through public sector facilities: development and assessment study in Punjab Pakistan.

PubMed

Khan, Muhammad Amir; Javed, Wajiha; Ahmed, Maqsood; Walley, John; Munir, Muhammad Arif

2014-01-01

Sexually transmitted infections (STIs) are a priority health problem. We proposed a prospective study in two districts of Punjab, using an intervention package, which included guidelines and protocols on syndrome-based management of STIs, adapted in light of technical guidelines from the National AIDS Control Program and the World Health Organization. The aim of this study was to assess the operational effectiveness of STI case management guidelines and to assess factors that determine the adherence to guidelines for management of STIs at public health facilities in Pakistan. A prospective study lasting 18 months (January 2008 to June 2009), which reviewed early implementation experiences of updated case management guidelines for delivery of syndrome-based STI/reproductive tract infection care, through public-sector health care facilities. The project was implemented in two districts of Punjab, Sargodha and Jhang. A Cox regression model with stratification was done. The prevalence of STI was 26 per 100,000 patients. In women, the reported symptoms were 80% vaginal discharge and 12% abdominal pain. Forty-four percent of men had a genital ulcer and 29% of men had genital discharge. Age of participants ranged from 13 to 60 years. The study comprised 28.6% men and 71.4% women. The majority of the population attending these clinics was from rural areas (70%). The variables independently associated with adherence to guidelines were availability of male paramedic, age of patient, and type of diagnosis made. There was an important interaction (effect modification) present between the area of health facility and patient sex. Screening, diagnosis, and treatment costs for many STIs are expensive and thus an easier, low-cost, syndrome-based public health strategy is the adoption of the proposed STI syndrome case management guidelines. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

Think fungus NOT just a crypto-meningitis in AIDS!

PubMed

Badiye, Amit; Patnaik, Mrinal; Deshpande, Alaka; Rajendran, C; Chandrashekara, K V

2012-12-01

Extrapulmonary cryptococcosis has been defined as AIDS defining illness in HIV infected people. Cryptococcal meningitis is the commonest meningitis with advanced immune deficiency. Therefore clinicians ask for tests only for detection of cryptococci which may be misleading. A prospective study of suspected fungal meningitis with CSF fungal culture is carried out. 70 ART naive cases of suspected fungal meningitis in HIV cases were subjected to CSF cytochemistry, smear exam and CSF fungal culture. The CSF culture was positive in 75.6% cases of these 21 were C. Neoformans as against 28 of Rhodotorula. In addition candida, aspergillus, geotrichum, trichosporon were isolated. Apart from c. neoformans, other fungi also cause meningitis. Each case of suspected fungal meningitis, may be subjected for CSF fungal culture for proper and adequate management. If facility for fungal culture is not available and if CSF smear shows evidence of fungal infection then standard therapy with Amphotericin may be instituted earlier to reduce mortality. This is the largest series isolating Rhodotorula from CSF in AIDS patients.

29 CFR 1926.23 - First aid and medical attention.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 8 2010-07-01 2010-07-01 false First aid and medical attention. 1926.23 Section 1926.23... Provisions § 1926.23 First aid and medical attention. First aid services and provisions for medical care... prescribing specific requirements for first aid, medical attention, and emergency facilities are contained in...

HIV/AIDS among inmates of and releasees from US correctional facilities, 2006: declining share of epidemic but persistent public health opportunity.

PubMed

Spaulding, Anne C; Seals, Ryan M; Page, Matthew J; Brzozowski, Amanda K; Rhodes, William; Hammett, Theodore M

2009-11-11

Because certain groups at high risk for HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome) come together in correctional facilities, seroprevalence was high early in the epidemic. The share of the HIV/AIDS epidemic borne by inmates of and persons released from jails and prisons in the United States (US) in 1997 was estimated in a previous paper. While the number of inmates and releasees has risen, their HIV seroprevalence rates have fallen. We sought to determine if the share of HIV/AIDS borne by inmates and releasees in the US decreased between 1997 and 2006. We created a new model of population flow in and out of correctional facilities to estimate the number of persons released in 1997 and 2006. In 1997, approximately one in five of all HIV-infected Americans was among the 7.3 million who left a correctional facility that year. Nine years later, only one in seven (14%) of infected Americans was among the 9.1 million leaving, a 29.3% decline in the share. For black and Hispanic males, two demographic groups with heightened incarceration rates, recently released inmates comprise roughly one in five of those groups' total HIV-infected persons, a figure similar to the proportion borne by the correctional population as a whole in 1997. Decreasing HIV seroprevalence among those admitted to jails and prisons, prolonged survival and aging of the US population with HIV/AIDS beyond the crime-prone years, and success with discharge planning programs targeting HIV-infected prisoners could explain the declining concentration of the epidemic among correctional populations. Meanwhile, the number of persons with HIV/AIDS leaving correctional facilities remains virtually identical. Jails and prisons continue to be potent targets for public health interventions. The fluid nature of incarcerated populations ensures that effective interventions will be felt not only in correctional facilities but also in communities to which releasees return.

Ethnobotanical Study of Plants Used in the Management of HIV/AIDS-Related Diseases in Livingstone, Southern Province, Zambia.

PubMed

Chinsembu, Kazhila C

2016-01-01

Faced with critical shortages of staff, long queues, and stigma at public health facilities in Livingstone, Zambia, persons who suffer from HIV/AIDS-related diseases use medicinal plants to manage skin infections, diarrhoea, sexually transmitted infections, tuberculosis, cough, malaria, and oral infections. In all, 94 medicinal plant species were used to manage HIV/AIDS-related diseases. Most remedies are prepared from plants of various families such as Combretaceae, Euphorbiaceae, Fabaceae, and Lamiaceae. More than two-thirds of the plants (mostly leaves and roots) are utilized to treat two or more diseases related to HIV infection. Eighteen plants, namely, Achyranthes aspera L., Lannea discolor (Sond.) Engl., Hyphaene petersiana Klotzsch ex Mart., Asparagus racemosus Willd., Capparis tomentosa Lam., Cleome hirta Oliv., Garcinia livingstonei T. Anderson, Euclea divinorum Hiern, Bridelia cathartica G. Bertol., Acacia nilotica Delile, Piliostigma thonningii (Schumach.) Milne-Redh., Dichrostachys cinerea (L.) Wight and Arn., Abrus precatorius L., Hoslundia opposita Vahl., Clerodendrum capitatum (Willd.) Schumach., Ficus sycomorus L., Ximenia americana L., and Ziziphus mucronata Willd., were used to treat four or more disease conditions. About 31% of the plants in this study were administered as monotherapies. Multiuse medicinal plants may contain broad-spectrum antimicrobial agents. However, since widely used plants easily succumb to the threats of overharvesting, they need special protocols and guidelines for their genetic conservation. There is still need to confirm the antimicrobial efficacies, pharmacological parameters, cytotoxicity, and active chemical ingredients of the discovered plants.

Clinician perceptions and patient experiences of antiretroviral treatment integration in primary health care clinics, Tshwane, South Africa.

PubMed

Mathibe, Maphuthego D; Hendricks, Stephen J H; Bergh, Anne-Marie

2015-10-02

Primary Health Care (PHC) clinicians and patients are major role players in the South African antiretroviral treatment programme. Understanding their perceptions and experiences of integrated care and the management of people living with HIV and AIDS in PHC facilities is necessary for successful implementation and sustainability of integration. This study explored clinician perceptions and patient experiences of integration of antiretroviral treatment in PHC clinics. An exploratory, qualitative study was conducted in four city of Tshwane PHC facilities. Two urban and two rural facilities following different models of integration were included. A self-administered questionnaire with open-ended items was completed by 35 clinicians and four focus group interviews were conducted with HIV-positive patients. The data were coded and categories were grouped into sub-themes and themes. Workload, staff development and support for integration affected clinicians' performance and viewpoints. They perceived promotion of privacy, reduced discrimination and increased access to comprehensive care as benefits of service integration. Delays, poor patient care and patient dissatisfaction were viewed as negative aspects of integration. In three facilities patients were satisfied with integration or semi-integration and felt common queues prevented stigma and discrimination, whilst the reverse was true in the facility with separate services. Single-month issuance of antiretroviral drugs and clinic schedule organisation was viewed negatively, as well as poor staff attitudes, poor communication and long waiting times. Although a fully integrated service model is preferable, aspects that need further attention are management support from health authorities for health facilities, improved working conditions and appropriate staff development opportunities.

Health service providers in Somalia: their readiness to provide malaria case-management

PubMed Central

Noor, Abdisalan M; Rage, Ismail A; Moonen, Bruno; Snow, Robert W

2009-01-01

Background Studies have highlighted the inadequacies of the public health sector in sub-Saharan African countries in providing appropriate malaria case management. The readiness of the public health sector to provide malaria case-management in Somalia, a country where there has been no functioning central government for almost two decades, was investigated. Methods Three districts were purposively sampled in each of the two self-declared states of Puntland and Somaliland and the south-central region of Somalia, in April-November 2007. A survey and mapping of all public and private health service providers was undertaken. Information was recorded on services provided, types of anti-malarial drugs used and stock, numbers and qualifications of staff, sources of financial support and presence of malaria diagnostic services, new treatment guidelines and job aides for malaria case-management. All settlements were mapped and a semi-quantitative approach was used to estimate their population size. Distances from settlements to public health services were computed. Results There were 45 public health facilities, 227 public health professionals, and 194 private pharmacies for approximately 0.6 million people in the three districts. The median distance to public health facilities was 6 km. 62.3% of public health facilities prescribed the nationally recommended anti-malarial drug and 37.7% prescribed chloroquine as first-line therapy. 66.7% of public facilities did not have in stock the recommended first-line malaria therapy. Diagnosis of malaria using rapid diagnostic tests (RDT) or microscopy was performed routinely in over 90% of the recommended public facilities but only 50% of these had RDT in stock at the time of survey. National treatment guidelines were available in 31.3% of public health facilities recommended by the national strategy. Only 8.8% of the private pharmacies prescribed artesunate plus sulphadoxine/pyrimethamine, while 53.1% prescribed chloroquine as first-line therapy. 31.4% of private pharmacies also provided malaria diagnosis using RDT or microscopy. Conclusion Geographic access to public health sector is relatively low and there were major shortages of appropriate guidelines, anti-malarials and diagnostic tests required for appropriate malaria case management. Efforts to strengthen the readiness of the health sector in Somalia to provide malaria case management should improve availability of drugs and diagnostic kits; provide appropriate information and training; and engage and regulate the private sector to scale up malaria control. PMID:19439097

Health service providers in Somalia: their readiness to provide malaria case-management.

PubMed

Noor, Abdisalan M; Rage, Ismail A; Moonen, Bruno; Snow, Robert W

2009-05-13

Studies have highlighted the inadequacies of the public health sector in sub-Saharan African countries in providing appropriate malaria case management. The readiness of the public health sector to provide malaria case-management in Somalia, a country where there has been no functioning central government for almost two decades, was investigated. Three districts were purposively sampled in each of the two self-declared states of Puntland and Somaliland and the south-central region of Somalia, in April-November 2007. A survey and mapping of all public and private health service providers was undertaken. Information was recorded on services provided, types of anti-malarial drugs used and stock, numbers and qualifications of staff, sources of financial support and presence of malaria diagnostic services, new treatment guidelines and job aides for malaria case-management. All settlements were mapped and a semi-quantitative approach was used to estimate their population size. Distances from settlements to public health services were computed. There were 45 public health facilities, 227 public health professionals, and 194 private pharmacies for approximately 0.6 million people in the three districts. The median distance to public health facilities was 6 km. 62.3% of public health facilities prescribed the nationally recommended anti-malarial drug and 37.7% prescribed chloroquine as first-line therapy. 66.7% of public facilities did not have in stock the recommended first-line malaria therapy. Diagnosis of malaria using rapid diagnostic tests (RDT) or microscopy was performed routinely in over 90% of the recommended public facilities but only 50% of these had RDT in stock at the time of survey. National treatment guidelines were available in 31.3% of public health facilities recommended by the national strategy. Only 8.8% of the private pharmacies prescribed artesunate plus sulphadoxine/pyrimethamine, while 53.1% prescribed chloroquine as first-line therapy. 31.4% of private pharmacies also provided malaria diagnosis using RDT or microscopy. Geographic access to public health sector is relatively low and there were major shortages of appropriate guidelines, anti-malarials and diagnostic tests required for appropriate malaria case management. Efforts to strengthen the readiness of the health sector in Somalia to provide malaria case management should improve availability of drugs and diagnostic kits; provide appropriate information and training; and engage and regulate the private sector to scale up malaria control.

Development of a Spanish HIV/AIDS Symptom Management Guidebook.

PubMed

Román, Elizabeth; Chou, Fang-Yu

2011-07-01

To provide culturally appropriate HIV/AIDS patient care, it is important to develop symptom management patient education materials for patients with different cultural backgrounds. The purpose of this study was to develop a Spanish version of the Symptom Management Guidebook: Strategies for People Living with HIV/AIDS guidelines and verify its content, perceived feasibility, and usefulness with HIV/AIDS care providers and people living with HIV/AIDS in Puerto Rico. The Symptom Management Guidebook includes self-care strategies to manage 14 common HIV-related symptoms. The Spanish version was developed by adopting and translating through forward and backward translation methods. Seven HIV/AID Shealth care providers from San Juan, Puerto Rico, were invited to review and revise the contents. Ten people living with HIV/AIDS from a community AIDS clinic in San Juan participated in a focus group to review the guidebook and discussed its usefulness and feasibility for managing their symptoms. Participants expressed positive responses and considered an educational guidebook as a helpful tool for self-managing their symptoms. Results suggested that this guidebook may be useful as an intervention strategy for symptom management in HIV/AIDS patients. Future research can include testing self-managing intervention and its outcomes in culturally diverse HIV/AIDS patients.

33 CFR 62.65 - Procedure for reporting defects and discrepancies.

Code of Federal Regulations, 2012 CFR

2012-07-01

... HOMELAND SECURITY AIDS TO NAVIGATION UNITED STATES AIDS TO NAVIGATION SYSTEM Public Participation in the Aids to Navigation System § 62.65 Procedure for reporting defects and discrepancies. (a) Mariners should notify the nearest Coast Guard facility immediately of any observed aids to navigation defects or...

33 CFR 62.65 - Procedure for reporting defects and discrepancies.

Code of Federal Regulations, 2011 CFR

2011-07-01

... HOMELAND SECURITY AIDS TO NAVIGATION UNITED STATES AIDS TO NAVIGATION SYSTEM Public Participation in the Aids to Navigation System § 62.65 Procedure for reporting defects and discrepancies. (a) Mariners should notify the nearest Coast Guard facility immediately of any observed aids to navigation defects or...

33 CFR 62.65 - Procedure for reporting defects and discrepancies.

Code of Federal Regulations, 2013 CFR

2013-07-01

... HOMELAND SECURITY AIDS TO NAVIGATION UNITED STATES AIDS TO NAVIGATION SYSTEM Public Participation in the Aids to Navigation System § 62.65 Procedure for reporting defects and discrepancies. (a) Mariners should notify the nearest Coast Guard facility immediately of any observed aids to navigation defects or...

33 CFR 62.65 - Procedure for reporting defects and discrepancies.

Code of Federal Regulations, 2014 CFR

2014-07-01

... HOMELAND SECURITY AIDS TO NAVIGATION UNITED STATES AIDS TO NAVIGATION SYSTEM Public Participation in the Aids to Navigation System § 62.65 Procedure for reporting defects and discrepancies. (a) Mariners should notify the nearest Coast Guard facility immediately of any observed aids to navigation defects or...

33 CFR 62.65 - Procedure for reporting defects and discrepancies.

Code of Federal Regulations, 2010 CFR

2010-07-01

... HOMELAND SECURITY AIDS TO NAVIGATION UNITED STATES AIDS TO NAVIGATION SYSTEM Public Participation in the Aids to Navigation System § 62.65 Procedure for reporting defects and discrepancies. (a) Mariners should notify the nearest Coast Guard facility immediately of any observed aids to navigation defects or...

Returning HIV-1 viral load results to participant-selected health facilities in national Population-based HIV Impact Assessment (PHIA) household surveys in three sub-Saharan African Countries, 2015 to 2016.

PubMed

Saito, Suzue; Duong, Yen T; Metz, Melissa; Lee, Kiwon; Patel, Hetal; Sleeman, Katrina; Manjengwa, Julius; Ogollah, Francis M; Kasongo, Webster; Mitchell, Rick; Mugurungi, Owen; Chimbwandira, Frank; Moyo, Crispin; Maliwa, Vusumuzi; Mtengo, Helecks; Nkumbula, Tepa; Ndongmo, Clement B; Vere, Nora Skutayi; Chipungu, Geoffrey; Parekh, Bharat S; Justman, Jessica; Voetsch, Andrew C

2017-11-01

Logistical complexities of returning laboratory test results to participants have precluded most population-based HIV surveys conducted in sub-Saharan Africa from doing so. For HIV positive participants, this presents a missed opportunity for engagement into clinical care and improvement in health outcomes. The Population-based HIV Impact Assessment (PHIA) surveys, which measure HIV incidence and the prevalence of viral load (VL) suppression in selected African countries, are returning VL results to health facilities specified by each HIV positive participant within eight weeks of collection. We describe the performance of the specimen and data management systems used to return VL results to PHIA participants in Zimbabwe, Malawi and Zambia. Consenting participants underwent home-based counseling and HIV rapid testing as per national testing guidelines; all confirmed HIV positive participants had VL measured at a central laboratory on either the Roche CAP/CTM or Abbott m2000 platform. On a bi-weekly basis, a dedicated data management team produced logs linking the VL test result with the participants' contact information and preferred health facility; project staff sent test results confidentially via project drivers, national courier systems, or electronically through an adapted short message service (SMS). Participants who provided cell phone numbers received SMS or phone call alerts regarding availability of VL results. From 29,634 households across the three countries, 78,090 total participants 0 to 64 years in Zimbabwe and Malawi and 0 to 59 years in Zambia underwent blood draw and HIV testing. Of the 8391 total HIV positive participants identified, 8313 (99%) had VL tests performed and 8245 (99%) of these were returned to the selected health facilities. Of the 5979 VL results returned in Zimbabwe and Zambia, 85% were returned within the eight-week goal with a median turnaround time of 48 days (IQR: 33 to 61). In Malawi, where exact return dates were unavailable all 2266 returnable results reached the health facilities by 11 weeks. The first three PHIA surveys returned the vast majority of VL results to each HIV positive participant's preferred health facility within the eight-week target. Even in the absence of national VL monitoring systems, a system to return VL results from a population-based survey is feasible, but it requires developing laboratory and data management systems and dedicated staff. These are likely important requirements to strengthen return of results systems in routine clinical care. © 2017 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society.

Assessing cow-calf welfare. Part 2: Risk factors for beef cow health and behavior and stockperson handling.

PubMed

Simon, G E; Hoar, B R; Tucker, C B

2016-08-01

Epidemiological studies can be used to identify risk factors for livestock welfare concerns but have not been conducted in the cow-calf sector for this purpose. The objectives of this study were to investigate the relationships of 1) herd-level management, facilities, and producer perspectives with cattle health and behavior and stockperson handling and 2) stockperson handling on cattle behavior at the individual cow level. Cow ( = 3,065) health and behavior and stockperson handling during a routine procedure (e.g., pregnancy checks) were observed on 30 California ranches. Management and producer perspectives were evaluated using an interview, and handling facility features were recorded at the chute. After predictors were screened for univariable associations, multivariable models were built for cattle health (i.e., thin body condition, lameness, abrasions, hairless patches, swelling, blind eyes, and dirtiness) and behavior (i.e., balking, vocalizing, stumbling and falling in the chute and while exiting the restraint, and running out of the restraint) and stockperson handling (i.e., electric prod use, moving aid use, tail twisting, and mis-catching cattle). When producers empathized more toward an animal's pain experience, there was a lower risk of swelling (odds ratio [OR] = 0.7) but a higher risk of lameness (OR = 1.3), which may indicate a lack of awareness of the latter. Training stockpersons using the Beef Quality Assurance program had a protective effect on cow cleanliness and mis-catching in the restraint (OR = 0.2 and OR = 0.5, respectively). Hydraulic chutes increased the risk of vocalizations (OR = 2.7), possibly because these systems can apply greater pressure to the sides of the animal than manual restraints. When a moving aid was used to move an individual cow, it increased the risk of her balking, but when hands, in particular, were used, the risk of balking decreased across the herd (OR = 34.1 and OR = 0.3, respectively). Likewise, individual cows were at a greater risk of balking, vocalizing, stumbling and falling in the chute, and stumbling and running at exit when they were touched with an electric prod (OR = 11.0, OR = 3.3, OR = 1.9, OR = 2.3, OR = 1.8, and OR = 1.7, respectively). Although the implications of using moving aids are unclear, reducing the use of electric prods could improve cattle handling. In conclusion, cattle handling was influenced by a number of facility and stockperson factors: personnel training, facility design, and electric prod use are key areas for future improvements.

When disaster hits, where does the standard of care go?

PubMed

Cushman Esq, Dawn

2011-01-01

On July 22, 2011, it was reported in the news that a $25 million-dollar settlement was reached in a class-action lawsuit alleging that Memorial Medical Center in Louisiana failed to adequately prepare for the devastating catastrophe known as Hurricane Katrina. This magnitude of a claim raises serious questions regarding the viability of lawsuits and the lack of immunity available to hospital facilities, physicians, nurses and other healthcare providers for the provision of emergency aid during national disasters. This article is intended to address one aspect of the legal issues facing healthcare providers and to analyze the standard of care by which facilities and individual providers may be judged, measured and assessed following national disasters. © 2011 American Society for Healthcare Risk Management of the American Hospital Association.

Influence of Nurse Aide Absenteeism on Nursing Home Quality.

PubMed

Castle, Nicholas G; Ferguson-Rome, Jamie C

2015-08-01

In this analysis, the association of nurse aide absenteeism with quality is examined. Absenteeism is the failure of nurse aides to report for work when they are scheduled to work. Data used in this investigation came from survey responses from 3,941 nursing homes; Nursing Home Compare; the Online System for Survey, Certification and Administrative Reporting data; and the Area Resource File. Staffing characteristics, quality indicators, facility, and market information from these data sources were all measured in 2008. The specific quality indicators examined are physical restraint use, catheter use, pain management, and pressure sores using negative binomial regression. An average rate of 9.2% for nurse aide absenteeism was reported in the prior week. We find that high levels of absenteeism are associated with poor performance on all four quality indicators examined. The investigation presented, to our knowledge, is one of the first examining the implications of absenteeism in nursing homes. Absenteeism can be a costly staffing issue, one of the potential costs identified in this analysis is an impact on quality of care. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Provision of mouth-care in long-term care facilities: an educational trial.

PubMed

MacEntee, M I; Wyatt, C C L; Beattie, B L; Paterson, B; Levy-Milne, R; McCandless, L; Kazanjian, A

2007-02-01

This randomized clinical trial aimed to assess the effectiveness of a pyramid-based education for improving the oral health of elders in long-term care (LTC) facilities. Fourteen facilities matched for size were assigned randomly to an active or control group. At baseline in each facility, care-aides in the active group participated with a full-time nurse educator in a seminar about oral health care, and had unlimited access to the educator for oral health-related advice throughout the 3-month trial. Care-aides in the control group participated in a similar seminar with a dental hygienist but they received no additional advice. The residents in the facilities at baseline and after 3 months were examined clinically to measure their oral hygiene, gingival health, masticatory potential, Body Mass Index and Malnutrition Indicator Score, and asked to report on chewing difficulties. Clinical measures after 3 months were not significantly different from baseline in either group, indicating that education neither influenced the oral health nor the dental hygiene of the residents. A pyramid-based educational scheme with nurses and care-aides did not improve the oral health of frail elders in this urban sample of LTC facilities.

Virtual environment and computer-aided technologies used for system prototyping and requirements development

NASA Technical Reports Server (NTRS)

Logan, Cory; Maida, James; Goldsby, Michael; Clark, Jim; Wu, Liew; Prenger, Henk

1993-01-01

The Space Station Freedom (SSF) Data Management System (DMS) consists of distributed hardware and software which monitor and control the many onboard systems. Virtual environment and off-the-shelf computer technologies can be used at critical points in project development to aid in objectives and requirements development. Geometric models (images) coupled with off-the-shelf hardware and software technologies were used in The Space Station Mockup and Trainer Facility (SSMTF) Crew Operational Assessment Project. Rapid prototyping is shown to be a valuable tool for operational procedure and system hardware and software requirements development. The project objectives, hardware and software technologies used, data gained, current activities, future development and training objectives shall be discussed. The importance of defining prototyping objectives and staying focused while maintaining schedules are discussed along with project pitfalls.

Skylab

NASA Image and Video Library

1970-01-01

Skylab's Body Mass Measurement chair, the facility of the Body Mass Measurement experiment (M172), is shown here in this 1970 photograph. The M172 experiment determined the body mass of each crew member and observed changes in body masses during flight. Knowledge of exact body mass variations throughout the flight in significantly aided in the correlation of other medical data obtained during the flight. Mass measurements under zero-gravity conditions were achieved by the application of Newton's second law (force equals mass times acceleration). The Marshall Space Flight Center had program management responsibility for the development of Skylab hardware and experiments.

Feasibility Study for an Air Force Environmental Model and Data Exchange. Volume 4. Appendix G. Model Review and Index-Air Multimedia and Other Models, Plus Data Bases.

DTIC Science & Technology

1983-07-01

Analysis of trace contaminants project at ORNL. Medium applied to movement of heavy metals through a forested watershed. OAQPS has not reviewed...computer cartography and site design aids; management information systems for facility planning, construction and * operation; and a computer...4 (5) Comprehensive 4 (6) Spills/ Heavy Gas 5 b. Regional 7 c. Reactive Pollutants 7 d. Special Purpose 8 e. Rocket Firing 8 f. Summary of Models by

Skylab

NASA Image and Video Library

1970-09-01

This 1970 photograph shows Skylab's Dual X-Ray Telescopes, an Apollo Telescope Mount facility. It was designed to gather solar radiation data in the x-ray region of the solar spectrum and provide information on physical processes within the solar atmosphere. In support of the two primary telescopes, auxiliary instruments provided a continuous record of the total x-ray flux in two bands. A flare detector was also provided at the control console as an aid to astronauts for monitoring solar activity. The Marshall Space Flight Center had program management responsibility for the development of Skylab hardware and experiments.

Skylab

NASA Image and Video Library

1973-01-01

This chart details Skylab's Dual X-Ray Telescopes, one of eight Apollo Telescope Mount facilities. It was designed to gather solar radiation data in the x-ray region of the solar spectrum and provide information on physical processes within the solar atmosphere. In support of the two primary telescopes, auxiliary instruments provided a continuous record of the total x-ray flux in two bands. A flare detector was also provided at the control console as an aid to astronauts for monitoring solar activity. The Marshall Space Flight Center had program management responsibility for the development of Skylab hardware and experiments.

Job Satisfaction among Care Aides in Residential Long-Term Care: A Systematic Review of Contributing Factors, Both Individual and Organizational

PubMed Central

Squires, Janet E.; Hoben, Matthias; Linklater, Stefanie; Carleton, Heather L.; Graham, Nicole; Estabrooks, Carole A.

2015-01-01

Despite an increasing literature on professional nurses' job satisfaction, job satisfaction by nonprofessional nursing care providers and, in particular, in residential long-term care facilities, is sparsely described. The purpose of this study was to systematically review the evidence on which factors (individual and organizational) are associated with job satisfaction among care aides, nurse aides, and nursing assistants, who provide the majority of direct resident care, in residential long-term care facilities. Nine online databases were searched. Two authors independently screened, and extracted data and assessed the included publications for methodological quality. Decision rules were developed a priori to draw conclusions on which factors are important to care aide job satisfaction. Forty-two publications were included. Individual factors found to be important were empowerment and autonomy. Six additional individual factors were found to be not important: age, ethnicity, gender, education level, attending specialized training, and years of experience. Organizational factors found to be important were facility resources and workload. Two additional factors were found to be not important: satisfaction with salary/benefits and job performance. Factors important to care aide job satisfaction differ from those reported among hospital nurses, supporting the need for different strategies to improve care aide job satisfaction in residential long-term care. PMID:26345545

Screening and management of mental health and substance use disorders in HIV treatment settings in low- and middle-income countries within the global IeDEA consortium.

PubMed

Parcesepe, Angela M; Mugglin, Catrina; Nalugoda, Fred; Bernard, Charlotte; Yunihastuti, Evy; Althoff, Keri; Jaquet, Antoine; Haas, Andreas D; Duda, Stephany N; Wester, C William; Nash, Denis

2018-03-01

Integration of services to screen and manage mental health and substance use disorders (MSDs) into HIV care settings has been identified as a promising strategy to improve mental health and HIV treatment outcomes among people living with HIV/AIDS (PLWHA) in low- and middle-income countries (LMICs). Data on the extent to which HIV treatment sites in LMICs screen and manage MSDs are limited. The objective of this study was to assess practices for screening and treatment of MSDs at HIV clinics in LMICs participating in the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. We surveyed a stratified random sample of 95 HIV clinics in 29 LMICs in the Caribbean, Central and South America, Asia-Pacific and sub-Saharan Africa. The survey captured information onsite characteristics and screening and treatment practices for depression, post-traumatic stress disorder (PTSD), substance use disorders (SUDs) and other mental health disorders. Most sites (n = 76, 80%) were in urban areas. Mental health screening varied by disorder: 57% of sites surveyed screened for depression, 19% for PTSD, 55% for SUDs and 29% for other mental health disorders. Depression, PTSD, SUDs and other mental health disorders were reported as managed on site (having services provided at the HIV clinic or same health facility) at 70%, 51%, 41% and 47% of sites respectively. Combined availability of screening and on-site management of depression, PTSD, and SUDs, and other mental health disorders was reported by 42%, 14%, 26% and 19% of sites, respectively. On-site management of depression and PTSD was reported significantly less often in rural as compared to urban settings (depression: 33% and 78% respectively; PTSD: 24% and 58% respectively). Screening for depression and SUDs was least commonly reported by HIV programmes that treated only children as compared to HIV programmes that treated only adults or treated both adults and children. Significant gaps exist in the management of MSDs in HIV care settings in LMICs, particularly in rural settings. Identification and evaluation of optimal implementation strategies to scale and sustain integrated MSDs and HIV care is needed. © 2018 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society.

Doe v. Attorney General of the United States.

PubMed

1992-12-28

The U.S. District Court, Northern District of California, held that the Federal Bureau of Investigation did not violate the Rehabilitation Act because it did not discriminate against a doctor based solely on his AIDS-related handicap. The doctor had worked at a health care facility, conducting physical examinations of FBI applicants. Upon receiving unsubstantiated information that the doctor had AIDS, the FBI sought additional information. The doctor and the facility assured the FBI that there was no risk to FBI employees, but failed to provide further information about risks and prevention, or to disclose whether the doctor indeed had AIDS. Therefore, the FBI ceased its use of the facility. The court held that a doctor who refuses to allow an inquiry to determine the risk of disease transmission to patients is not "otherwise qualified," so the FBI could not determine whether reasonable accommodations could have been made. The court emphasized that the possibility of physician-to-patient AIDS transmission is remote if appropriate medical procedures are followed.

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

PubMed

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

2015-01-01

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. 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. 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. 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.

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

Reverse logistics network for municipal solid waste management: The inclusion of waste pickers as a Brazilian legal requirement

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ferri, Giovane Lopes, E-mail: giovane.ferri@aluno.ufes.br; Diniz Chaves, Gisele de Lorena, E-mail: gisele.chaves@ufes.br; Ribeiro, Glaydston Mattos, E-mail: glaydston@pet.coppe.ufrj.br

Highlights: • We propose a reverse logistics network for MSW involving waste pickers. • A generic facility location mathematical model was validated in a Brazilian city. • The results enable to predict the capacity for screening and storage centres (SSC). • We minimise the costs for transporting MSW with screening and storage centres. • The use of SSC can be a potential source of revenue and a better use of MSW. - Abstract: This study proposes a reverse logistics network involved in the management of municipal solid waste (MSW) to solve the challenge of economically managing these wastes considering themore » recent legal requirements of the Brazilian Waste Management Policy. The feasibility of the allocation of MSW material recovery facilities (MRF) as intermediate points between the generators of these wastes and the options for reuse and disposal was evaluated, as well as the participation of associations and cooperatives of waste pickers. This network was mathematically modelled and validated through a scenario analysis of the municipality of São Mateus, which makes the location model more complete and applicable in practice. The mathematical model allows the determination of the number of facilities required for the reverse logistics network, their location, capacities, and product flows between these facilities. The fixed costs of installation and operation of the proposed MRF were balanced with the reduction of transport costs, allowing the inclusion of waste pickers to the reverse logistics network. The main contribution of this study lies in the proposition of a reverse logistics network for MSW simultaneously involving legal, environmental, economic and social criteria, which is a very complex goal. This study can guide practices in other countries that have realities similar to those in Brazil of accelerated urbanisation without adequate planning for solid waste management, added to the strong presence of waste pickers that, through the characteristic of social vulnerability, must be included in the system. In addition to the theoretical contribution to the reverse logistics network problem, this study aids in decision-making for public managers who have limited technical and administrative capacities for the management of solid wastes.« less

42 CFR 483.158 - FFP for nurse aide training and competency evaluation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false FFP for nurse aide training and competency... CARE FACILITIES Requirements That Must Be Met by States and State Agencies: Nurse Aide Training and Competency Evaluation, and Paid Feeding Assistants § 483.158 FFP for nurse aide training and competency...

The Child-Care Teacher Aide--A Guide for Teachers.

ERIC Educational Resources Information Center

Cooper, Dorothy B.

Adaptable to individual student needs and the community, this basic curriculum guide is designed for use in initiating and teaching a high school or adult two-year child-care teacher-aide program in vocational education. Four levels of occupations are covered--babysitter, nursery school facilities aide, nursery school teacher aide, and assistant…

20 CFR 654.417 - Fire, safety, and first aid.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Fire, safety, and first aid. 654.417 Section..., safety, and first aid. (a) All buildings in which people sleep or eat shall be constructed and maintained...-type water extinguisher. (g) First aid facilities shall be provided and readily accessible for use at...

A Self-Instructional Course in Student Financial Aid Administration. Module 15: Internal Aid Office Management and Institutional Quality Control. Second Edition.

ERIC Educational Resources Information Center

Washington Consulting Group, Inc., Washington, DC.

The 15th in a 17-module self-instructional course on student financial aid administration (designed for novice financial aid administrators and other institutional personnel) focuses on internal aid office management and institutional quality control. The course provides a systematic introduction to the management of federal financial aid programs…

Management of Brackish Groundwater Extraction, San Diego-Tijuana area, USA and Mexico

NASA Astrophysics Data System (ADS)

Danskin, W. R.

2017-12-01

Management of brackish groundwater extraction from coastal sediment in the transboundary San Diego-Tijuana area, USA and Mexico, involves monitoring storage depletion, seawater intrusion, and land subsidence. In 2017, five additional extraction wells were installed, doubling capacity of the Reynolds Groundwater Desalination Facility. Environmental permits to expand capacity of the facility, and the recently-enacted Sustainable Groundwater Management Act (SGMA) by the State of California require monitoring the possible adverse effects of the additional extraction. Fortuitously, over the past 14 years, 12 deep multiple-depth, monitoring-well sites were installed by the United States Geological Survey (USGS) to aid in mapping the coastal geology and groundwater conditions. Now these sites are being used for groundwater management. Storage depletion is monitored daily via water levels measured using transducers installed permanently in each of the 4-6 piezometers at each site and transmitted automatically to the Internet. Seawater intrusion is tracked annually via electromagnetic geophysical logging in the deepest piezometer at each site, 500-800 meters below land surface, about twice the depth of the extraction wells. Land subsidence is determined annually from surveys of reference points installed at the well sites and from Interferometric Synthetic Aperature Radar (InSAR) satellite data. Management also involves use of a regional hydrologic model to simulate the likely location and timing of future storage depletion, seawater intrusion, and land subsidence.

23 CFR 810.108 - Designation of existing facilities.

Code of Federal Regulations, 2014 CFR

2014-04-01

... facilities, trail blazer signs, and passenger loading areas and facilities. (2) The approval criteria in 23... approved on any public road if they facilitate more efficient use of any Federal-aid highway. (c...

23 CFR 810.108 - Designation of existing facilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... facilities, trail blazer signs, and passenger loading areas and facilities. (2) The approval criteria in 23... approved on any public road if they facilitate more efficient use of any Federal-aid highway. (c...

23 CFR 810.108 - Designation of existing facilities.

Code of Federal Regulations, 2013 CFR

2013-04-01

... facilities, trail blazer signs, and passenger loading areas and facilities. (2) The approval criteria in 23... approved on any public road if they facilitate more efficient use of any Federal-aid highway. (c...

23 CFR 810.108 - Designation of existing facilities.

Code of Federal Regulations, 2012 CFR

2012-04-01

... facilities, trail blazer signs, and passenger loading areas and facilities. (2) The approval criteria in 23... approved on any public road if they facilitate more efficient use of any Federal-aid highway. (c...

The organized sector mobilizes against AIDS.

PubMed

Mehra-kerpelman, K

1995-01-01

Representatives of English speaking African countries attended the International Labor Organization Tripartite Workshop on the Role of the Organized Sector in Reproductive Health and the Prevention of AIDS held in Uganda. AIDS has robbed these countries of lawyers, physicians, teachers, managers, and other skilled professionals, all of whom are difficult to replace. HIV/AIDS mainly affects persons in their most productive years (20-40 years) and in the higher socioeconomic groups. Professionals with AIDS become ill and die at a faster rate than their replacements can be trained. The young, less experienced work force translates into an increase in breakdowns, accidents, delays, and misjudgments. International and national efforts to control HIV/AIDS have not stopped the spread of HIV in Sub-Saharan Africa (SSA). More than 8 million persons in SSA are HIV infected. 1.5 million in Uganda are HIV infected. As of October 1994, 30,000 persons in Zambia and 33,000 in Zimbabwe had AIDS. These numbers are just the tip of the iceberg due to underreporting. HIV/AIDS increases absenteeism among infected and healthy workers alike. It burdens the already existing scarce health care resources and equipment (e.g., in 1992, AIDS cases occupied 70% of hospital beds in Kigali, Rwanda). Unions, workers, and families must share knowledge about safer sex. The Zimbabwe Confederation of Trade Unions has had an HIV/AIDS education program since 1992. The Zambia Congress of Trade Unions strongly supports government efforts to sensitize the labor force and society to the effects of HIV/AIDS. The Federation of Uganda Employers has reached about 150,000 workers and more than 200 top executives through its AIDS prevention activities. Some company programs provide medical facilities for employees and their families. The Ubombo Ranches, Ltd. in Swaziland, a producer and processor of sugar cane, has a training-of-trainers program on HIV/AIDS and family planning for all village health workers and village headmen.

The Research on Application of Information Technology in sports Stadiums

NASA Astrophysics Data System (ADS)

Can, Han; Lu, Ma; Gan, Luying

With the Olympic glory in the national fitness program planning and the smooth development of China, the public's concern for the sport continues to grow, while their physical health is also increasingly fervent desired, the country launched a modern technological construction of sports facilities. Information technology applications in the sports venues in the increasingly wide range of modern venues and facilities, including not only the intelligent application of office automation systems, intelligent systems and sports facilities, communication systems for event management, ticket access control system, contest information systems, television systems, Command and Control System, but also in action including the use of computer technology, image analysis, computer-aided training athletes, sports training system and related data entry systems, decision support systems.Using documentary data method, this paper focuses on the research on application of information technology in Sports Stadiums, and try to explore its future trends.With a view to promote the growth of China's national economyand,so as to improve the students'quality and promote the cause of Chinese sports.

Hardy Bacterium Isolated From Two Geographically Distinct Spacecraft Assembly Cleanroom Facilities

NASA Technical Reports Server (NTRS)

Vaisham-payan, Parag A.; Venkateswaran, Kasthuri J.; Schwendner, Petra; Moissl-Eichinger, Christine

2012-01-01

Earlier studies have confirmed that a tenacious hardy bacterial population manages to persist and survive throughout a spacecraft assembly process. The widespread detection of these organisms underscores the challenges in eliminating them completely. Only comprehensive and repetitive microbial diversity studies of geographically distinct cleanroom facilities will bolster the understanding of planetary protection relevant microbes. Extensive characterizations of the physiological traits demonstrated by cleanroom microbes will aid NASA in gauging the forward contamination risk that hardy bacteria (such as Tersicoccus phoenicis) pose to spacecraft. This study reports on the isolation and identification of two gram-positive, non-motile, non-spore-forming bacterial strains from the spacecraft assembly facilities at Kennedy Space Center, Florida, USA and Centre Spatial Guyanais, Kourou, French Guiana. DNA-DNA relatedness values between the novel strains indicates that these novel strains were indeed members of a same species. Phylogenetic evidence derived from a 16S ribosomal DNA analysis indicated that both the novel strains are less closely related to all other Arthrobacter species.

PLM in the context of the maritime virtual education

NASA Astrophysics Data System (ADS)

Raicu, Alexandra; Oanta, Emil M.

2016-12-01

This paper presents new approaches regarding the use of Product Lifecycle Management concept to achieve knowledge integration of the academic disciplines in the maritime education context. The philosophy of the educational system is now changing faster worldwide and it is in a continuous developing process. There is a demand to develop modern educational facilities for CAD/CAE/CAM training of the future maritime engineers, which offers collaborative environments between the academic disciplines and the teachers. It is well known that the students must understand the importance of the connectivity between the academic disciplines and the computer aided methods to interface them. Thus, besides the basic knowledge and competences acquired from the CAD courses, students learn how to increase the design productivity, to create a parametric design, the original instruments of automatic design, 3D printing methods, how to interface the CAD/CAE/CAM applications. As an example, the Strength of Materials discipline briefly presents alternate computer aided methods to compute the geometrical characteristics of the cross sections using the CAD geometry, creation the free body diagrams and presentation the deflected shapes of various educational models, including the rotational effect when the forces are not applied in the shear center, using the results of the FEM applications. During the computer aided engineering academic disciplines, after the students design and analyze a virtual 3D model they can convert it into a physical object using 3D printing method. Constanta Maritime University offers a full understanding of the concept of Product Lifecycle Management, collaborative creation, management and dissemination.

Hazardous Materials Management and Emergency Response Training Center at Hanford

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ollero, J.; Muth, G.; Bergland, R.

1994-12-31

The Hanford Site will provide high-fidelity training using simulated job-site situations to prepare workers for known and unknown hazards. Hanford is developing the Hazardous Materials Management and Emergency Response (HAMMER) Training Center to operate as a user facility for the site, region and international labor unions. The center will focus on providing hands-on, realistic training situations. The Training Center is a partnership among U.S. Department of Energy (DOE); its contractors; labor; local, state, and tribal governments; Xavier and Tulane Universities of Louisiana and other Federal agencies. The hands-on training aids at HAMMER is justified based on regulatory training requirements, themore » desire for enhanced safety, and the commitment to continuous improvement of training quality.« less

Use of DHCP to provide essential information for care and management of HIV patients.

PubMed

Pfeil, C N; Ivey, J L; Hoffman, J D; Kuhn, I M

1991-01-01

The Department of Veterans' Affairs (VA) has reported over 10,000 Acquired Immune Deficiency Syndrome (AIDS) cases since the beginning of the epidemic. These cases were distributed throughout 152 of the VA's network of 172 medical centers and outpatient clinics. This network of health care facilities presents a unique opportunity to provide computer based information systems for clinical care and resource monitoring for these patients. The VA further facilitates such a venture through its commitment to the Decentralized Hospital Computer Program (DHCP). This paper describes a new application within DHCP known as the VA's HIV Registry. This project addresses the need to support clinical information as well as the added need to manage the resources necessary to care for HIV patients.

Influence of Computer-Aided Detection on Performance of Screening Mammography

PubMed Central

Fenton, Joshua J.; Taplin, Stephen H.; Carney, Patricia A.; Abraham, Linn; Sickles, Edward A.; D'Orsi, Carl; Berns, Eric A.; Cutter, Gary; Hendrick, R. Edward; Barlow, William E.; Elmore, Joann G.

2011-01-01

Background Computer-aided detection identifies suspicious findings on mammograms to assist radiologists. Since the Food and Drug Administration approved the technology in 1998, it has been disseminated into practice, but its effect on the accuracy of interpretation is unclear. Methods We determined the association between the use of computer-aided detection at mammography facilities and the performance of screening mammography from 1998 through 2002 at 43 facilities in three states. We had complete data for 222,135 women (a total of 429,345 mammograms), including 2351 women who received a diagnosis of breast cancer within 1 year after screening. We calculated the specificity, sensitivity, and positive predictive value of screening mammography with and without computer-aided detection, as well as the rates of biopsy and breast-cancer detection and the overall accuracy, measured as the area under the receiver-operating-characteristic (ROC) curve. Results Seven facilities (16%) implemented computer-aided detection during the study period. Diagnostic specificity decreased from 90.2% before implementation to 87.2% after implementation (P<0.001), the positive predictive value decreased from 4.1% to 3.2% (P = 0.01), and the rate of biopsy increased by 19.7% (P<0.001). The increase in sensitivity from 80.4% before implementation of computer-aided detection to 84.0% after implementation was not significant (P = 0.32). The change in the cancer-detection rate (including invasive breast cancers and ductal carcinomas in situ) was not significant (4.15 cases per 1000 screening mammograms before implementation and 4.20 cases after implementation, P = 0.90). Analyses of data from all 43 facilities showed that the use of computer-aided detection was associated with significantly lower overall accuracy than was nonuse (area under the ROC curve, 0.871 vs. 0.919; P = 0.005). Conclusions The use of computer-aided detection is associated with reduced accuracy of interpretation of screening mammograms. The increased rate of biopsy with the use of computer-aided detection is not clearly associated with improved detection of invasive breast cancer. PMID:17409321

49 CFR 39.63 - What modifications and auxiliary aids and services are required at terminals and other landside...

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 1 2013-10-01 2013-10-01 false What modifications and auxiliary aids and services... modifications and auxiliary aids and services are required at terminals and other landside facilities for... of auxiliary aids and services. To the extent that this information is not available to these...

49 CFR 39.63 - What modifications and auxiliary aids and services are required at terminals and other landside...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 1 2014-10-01 2014-10-01 false What modifications and auxiliary aids and services... modifications and auxiliary aids and services are required at terminals and other landside facilities for... of auxiliary aids and services. To the extent that this information is not available to these...

49 CFR 39.63 - What modifications and auxiliary aids and services are required at terminals and other landside...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 1 2012-10-01 2012-10-01 false What modifications and auxiliary aids and services... modifications and auxiliary aids and services are required at terminals and other landside facilities for... of auxiliary aids and services. To the extent that this information is not available to these...

Integrated computer-aided design using minicomputers

NASA Technical Reports Server (NTRS)

Storaasli, O. O.

1980-01-01

Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM), a highly interactive software, has been implemented on minicomputers at the NASA Langley Research Center. CAD/CAM software integrates many formerly fragmented programs and procedures into one cohesive system; it also includes finite element modeling and analysis, and has been interfaced via a computer network to a relational data base management system and offline plotting devices on mainframe computers. The CAD/CAM software system requires interactive graphics terminals operating at a minimum of 4800 bits/sec transfer rate to a computer. The system is portable and introduces 'interactive graphics', which permits the creation and modification of models interactively. The CAD/CAM system has already produced designs for a large area space platform, a national transonic facility fan blade, and a laminar flow control wind tunnel model. Besides the design/drafting element analysis capability, CAD/CAM provides options to produce an automatic program tooling code to drive a numerically controlled (N/C) machine. Reductions in time for design, engineering, drawing, finite element modeling, and N/C machining will benefit productivity through reduced costs, fewer errors, and a wider range of configuration.

First Aid and Transportation Course Contents Based on Experience gained in the Iran-Iraq War: a Qualitative Study.

PubMed

Sarhangi, Forogh; Gholami, Hamid Reza; Khaghanizade, Morteza; Najafi Mehri, Soheil

2015-02-01

Effective first aid and transportation influences injury-induced mortality. But few qualitative studies have been conducted so far in this area. The aim of this study was to identify the content of the first aid and patient transportation course based on experience gained from the Iran-Iraq war. This was a conventional qualitative content analysis study; a purposeful sample of 14 first aid and transportation experts who had worked during the Iran-Iraq war was recruited. We collected and analyzed the study data by using the semi-structured interview method and the conventional content analysis approach respectively. Each interview transcript was reviewed several times. Words, sentences, and paragraphs were labeled with codes. Codes were compared with each other and categorized according to their similarities. Similar sub-categories and categories were also grouped together and formed themes. Study participants' experiences of wartime first aid and transportation (FAT) education fell into two main themes including 'the congruence of education and educational needs' and 'managers' engagement in FAT education. The four main categories of these two themes were use of appropriate educational facilities, adopting effective teaching strategies, universal FAT education and specialized training skills. The two key requirements of the first aid and transportation courses are practicality and managerial engagement. We developed and provided specific guidance of FAT curriculum by using the study findings. This curriculum is recommended for educating FAT staffs, paramedics, emergency technicians, and military nurses.

Test results management and distributed cognition in electronic health record-enabled primary care.

PubMed

Smith, Michael W; Hughes, Ashley M; Brown, Charnetta; Russo And, Elise; Giardina, Traber D; Mehta, Praveen; Singh, Hardeep

2018-06-01

Managing abnormal test results in primary care involves coordination across various settings. This study identifies how primary care teams manage test results in a large, computerized healthcare system in order to inform health information technology requirements for test results management and other distributed healthcare services. At five US Veterans Health Administration facilities, we interviewed 37 primary care team members, including 16 primary care providers, 12 registered nurses, and 9 licensed practical nurses. We performed content analysis using a distributed cognition approach, identifying patterns of information transmission across people and artifacts (e.g. electronic health records). Results illustrate challenges (e.g. information overload) as well as strategies used to overcome challenges. Various communication paths were used. Some team members served as intermediaries, processing information before relaying it. Artifacts were used as memory aids. Health information technology should address the risks of distributed work by supporting awareness of team and task status for reliable management of results.

Introduction to SIMRAND: Simulation of research and development project

NASA Technical Reports Server (NTRS)

Miles, R. F., Jr.

1982-01-01

SIMRAND: SIMulation of Research ANd Development Projects is a methodology developed to aid the engineering and management decision process in the selection of the optimal set of systems or tasks to be funded on a research and development project. A project may have a set of systems or tasks under consideration for which the total cost exceeds the allocated budget. Other factors such as personnel and facilities may also enter as constraints. Thus the project's management must select, from among the complete set of systems or tasks under consideration, a partial set that satisfies all project constraints. The SIMRAND methodology uses analytical techniques and probability theory, decision analysis of management science, and computer simulation, in the selection of this optimal partial set. The SIMRAND methodology is truly a management tool. It initially specifies the information that must be generated by the engineers, thus providing information for the management direction of the engineers, and it ranks the alternatives according to the preferences of the decision makers.

Reassessing nurse aide job satisfaction in a Texas nursing home.

PubMed

Thompson, Mark A; Horne, Kathleen K; Huerta, Timothy R

2011-09-01

This article reports a study that replicates and extends Castle's 2007 study by examining factors related to satisfaction of nurse aides at Carillon House, a 120-bed nonprofit skilled nursing facility in Lubbock, Texas. The Nursing Home Nurse Aide Job Satisfaction Questionnaire was adapted to allow for the collection of qualitative responses and administered to the nursing staff. The results suggest that satisfaction among nurse aides is related to rewards, workload, and the team environment created among coworkers. These findings differ from what is generally found in the literature and may be related to the higher-than-average satisfaction rating of nurse aides at this facility. The study provides evidence that large-scale surveys may have ignored a stratified effect where higher satisfaction organizations have different driving forces than what has been demonstrated in the literature to date. Copyright 2011, SLACK Incorporated.

Use of information technology for medication management in residential care facilities: correlates of facility characteristics.

PubMed

Bhuyan, Soumitra S; Chandak, Aastha; Powell, M Paige; Kim, Jungyoon; Shiyanbola, Olayinka; Zhu, He; Shiyanbola, Oyewale

2015-06-01

The effectiveness of information technology in resolving medication problems has been well documented. Long-term care settings such as residential care facilities (RCFs) may see the benefits of using such technologies in addressing the problem of medication errors among their resident population, who are usually older and have numerous chronic conditions. The aim of this study was two-fold: to examine the extent of use of Electronic Medication Management (EMM) in RCFs and to analyze the organizational factors associated with the use of EMM functionalities in RCFs. Data on RCFs were obtained from the 2010 National Survey of Residential Care Facilities. The association between facility, director and staff, and resident characteristics of RCFs and adoption of four EMM functionalities was assessed through multivariate logistic regression. The four EMM functionalities included were maintaining lists of medications, ordering for prescriptions, maintaining active medication allergy lists, and warning of drug interactions or contraindications. About 12% of the RCFs adopted all four EMM functionalities. Additionally, maintaining lists of medications had the highest adoption rate (34.5%), followed by maintaining active medication allergy lists (31.6%), ordering for prescriptions (19.7%), and warning of drug interactions or contraindications (17.9%). Facility size and ownership status were significantly associated with adoption of all four EMM functionalities. Medicaid certification status, facility director's age, education and license status, and the use of personal care aides in the RCF were significantly associated with the adoption of some of the EMM functionalities. EMM is expected to improve the quality of care and patient safety in long-term care facilities including RCFs. The extent of adoption of the four EMM functionalities is relatively low in RCFs. Some RCFs may strategize to use these functionalities to cater to the increasing demands from the market and also to provide better quality of care.

International nuclear fuel cycle fact book. Revision 4

DOE Office of Scientific and Technical Information (OSTI.GOV)

Harmon, K.M.; Lakey, L.T.; Leigh, I.W.

This Fact Book has been compiled in an effort to provide (1) an overview of worldwide nuclear power and fuel cycle programs and (2) current data concerning fuel cycle and waste management facilities, R and D programs, and key personnel in countries other than the United States. Additional information on each country's program is available in the International Source Book: Nuclear Fuel Cycle Research and Development, PNL-2478, Rev. 2. The Fact Book is organized as follows: (1) Overview section - summary tables which indicate national involvement in nuclear reactor, fuel cycle, and waste management development activities; (2) national summaries -more » a section for each country which summarizes nuclear policy, describes organizational relationships and provides addresses, names of key personnel, and facilities information; (3) international agencies - a section for each of the international agencies which has significant fuel cycle involvement; (4) energy supply and demand - summary tables, including nuclear power projections; (5) fuel cycle - summary tables; and (6) travel aids - international dialing instructions, international standard time chart, passport and visa requirements, and currency exchange rate.« less

International Nuclear Fuel Cycle Fact Book. Revision 5

DOE Office of Scientific and Technical Information (OSTI.GOV)

Harmon, K.M.; Lakey, L.T.; Leigh, I.W.

This Fact Book has been compiled in an effort to provide: (1) an overview of worldwide nuclear power and fuel cycle programs; and (2) current data concerning fuel cycle and waste management facilities, R and D programs, and key personnel in countries other than the United States. Additional information on each country's program is available in the International Source Book: Nuclear Fuel Cycle Research and Development, PNL-2478, Rev. 2. The Fact Book is organized as follows: (1) Overview section - summary tables which indicate national involvement in nuclear reactor, fuel cycle, and waste management development activities; (2) national summaries -more » a section for each country which summarizes nuclear policy, describes organizational relationships and provides addresses, names of key personnel, and facilities information; (3) international agencies - a section for each of the international agencies which has significant fuel cycle involvement; (4) energy supply and demand - summary tables, including nuclear power projections; (5) fuel cycle - summary tables; and (6) travel aids international dialing instructions, international standard time chart, passport and visa requirements, and currency exchange rate.« less

Praxis language reference manual

DOE Office of Scientific and Technical Information (OSTI.GOV)

Walker, J.H.

1981-01-01

This document is a language reference manual for the programming language Praxis. The document contains the specifications that must be met by any compiler for the language. The Praxis language was designed for systems programming in real-time process applications. Goals for the language and its implementations are: (1) highly efficient code generated by the compiler; (2) program portability; (3) completeness, that is, all programming requirements can be met by the language without needing an assembler; and (4) separate compilation to aid in design and management of large systems. The language does not provide any facilities for input/output, stack and queuemore » handling, string operations, parallel processing, or coroutine processing. These features can be implemented as routines in the language, using machine-dependent code to take advantage of facilities in the control environment on different machines.« less

Costs of HIV/AIDS outpatient services delivered through Zambian public health facilities.

PubMed

Bratt, John H; Torpey, Kwasi; Kabaso, Mushota; Gondwe, Yebo

2011-01-01

To present evidence on unit and total costs of outpatient HIV/AIDS services in ZPCT-supported facilities in Zambia; specifically, to measure unit costs of selected outpatient HIV/AIDS services, and to estimate total annual costs of antiretroviral therapy (ART) and prevention of mother-to-child transmission (PMTCT) in Zambia. Cost data from 2008 were collected in 12 ZPCT-supported facilities (hospitals and health centres) in four provinces. Costs of all resources used to produce ART, PMTCT and CT visits were included, using the perspective of the provider. All shared costs were distributed to clinic visits using appropriate allocation variables. Estimates of annual costs of HIV/AIDS services were made using ZPCT and Ministry of Health data on numbers of persons receiving services in 2009. Unit costs of visits were driven by costs of drugs, laboratory tests and clinical labour, while variability in visit costs across facilities was explained mainly by differences in utilization. First-year costs of ART per client ranged from US$278 to US$523 depending on drug regimen and facility type; costs of a complete course of antenatal care (ANC) including PMTCT were approximately US$114. Annual costs of ART provided in ZPCT-supported facilities were estimated at US$14.7-$40.1 million depending on regimen, and annual costs of antenatal care including PMTCT were estimated at US$16 million. In Zambia as a whole, the respective estimates were US$41.0-114.2 million for ART and US$57.7 million for ANC including PMTCT. Consistent with the literature, total costs of services were dominated by drugs, laboratory tests and clinical labour. For each visit type, variability across facilities in total costs and cost components suggests that some potential exists to reduce costs through greater harmonization of care protocols and more intensive use of fixed resources. Improving facility-level information on the costs of resources used to produce services should be emphasized as an element of health systems strengthening. © 2010 Blackwell Publishing Ltd.

"The Adopted Children of ART": expert clients and role tensions in ART provision in Uganda.

PubMed

Kyakuwa, Margaret; Hardon, Anita; Goldstein, Zoe

2012-01-01

The implementation of the greater involvement of people living with HIV (GIPA) principle in Ugandan AIDS care is described by focusing on the engagement of expert clients in two rural health centers during a time of antiretroviral therapy (ART) scale-up. We contrast how the expert clients help overburdened nurses to manage the well-attended ART programs in the public and in the nongovernmental organization clinic. They are unpaid, but acquire preferential status in the ART program because of their knowledge of AIDS medicines (and its adverse effects) and because of the compassionate care that they provide. Despite the assistance provided, nurses in the public facility felt threatened in their professional status by these expert clients, who were seen to overstep the boundaries of their role. We pay particular attention to the double burden for HIV-positive nurses, who fear stigma, and (unlike the expert patients) keep their HIV status secret.

Deep learning for cardiac computer-aided diagnosis: benefits, issues & solutions.

PubMed

Loh, Brian C S; Then, Patrick H H

2017-01-01

Cardiovascular diseases are one of the top causes of deaths worldwide. In developing nations and rural areas, difficulties with diagnosis and treatment are made worse due to the deficiency of healthcare facilities. A viable solution to this issue is telemedicine, which involves delivering health care and sharing medical knowledge at a distance. Additionally, mHealth, the utilization of mobile devices for medical care, has also proven to be a feasible choice. The integration of telemedicine, mHealth and computer-aided diagnosis systems with the fields of machine and deep learning has enabled the creation of effective services that are adaptable to a multitude of scenarios. The objective of this review is to provide an overview of heart disease diagnosis and management, especially within the context of rural healthcare, as well as discuss the benefits, issues and solutions of implementing deep learning algorithms to improve the efficacy of relevant medical applications.

Deep learning for cardiac computer-aided diagnosis: benefits, issues & solutions

PubMed Central

Then, Patrick H. H.

2017-01-01

Cardiovascular diseases are one of the top causes of deaths worldwide. In developing nations and rural areas, difficulties with diagnosis and treatment are made worse due to the deficiency of healthcare facilities. A viable solution to this issue is telemedicine, which involves delivering health care and sharing medical knowledge at a distance. Additionally, mHealth, the utilization of mobile devices for medical care, has also proven to be a feasible choice. The integration of telemedicine, mHealth and computer-aided diagnosis systems with the fields of machine and deep learning has enabled the creation of effective services that are adaptable to a multitude of scenarios. The objective of this review is to provide an overview of heart disease diagnosis and management, especially within the context of rural healthcare, as well as discuss the benefits, issues and solutions of implementing deep learning algorithms to improve the efficacy of relevant medical applications. PMID:29184897

Evaluation of Microcomputer-Based Operation and Maintenance Management Systems for Army Water/Wastewater Treatment Plant Operation.

DTIC Science & Technology

1986-07-01

COMPUTER-AIDED OPERATION MANAGEMENT SYSTEM ................. 29 Functions of an Off-Line Computer-Aided Operation Management System Applications of...System Comparisons 85 DISTRIBUTION 5V J. • 0. FIGURES Number Page 1 Hardware Components 21 2 Basic Functions of a Computer-Aided Operation Management System...Plant Visits 26 4 Computer-Aided Operation Management Systems Reviewed for Analysis of Basic Functions 29 5 Progress of Software System Installation and

HIV/AIDS issues in the workplace of nurses.

PubMed

Minnaar, A

2005-08-01

HIV/AIDS is a global problem with an estimated 40 million infected people. In less than two years, this figure will leap to 100 million according to the World Health Organisation (WHO). By 2005, 65 million people will be infected. Half of the number of people in this group will be under 25 years old, and will die before they reach the age of 35. In a South African study done by the Human Science Research Council and published in 2003, regarding the impact of HIV/AIDS on the health sector, the findings were that 15% of health workers in public and private hospitals tested positive for HIV antibodies. Together with these facts above it was found that 46.2 percent of patients served in medical and paediatric wards tested positive for HIV. These factors have major implication for staffing in the future and the role of the nurse manager in South Africa. To explore the management of HIV/AIDS in the workplace of nurses in selected health services in KwaZulu-Natal. This research was part of a greater study on the exploration of the presence of caring as part of nursing management. THE METHODOLOGY: The qualitative research approach was used with a phenomenological design, which ensured that the richness and the complexities are reflected in the study. The data was collected by means of an open-ended question to nurse managers during an interview. The first question posed was; How do you or your services care for nurses in this hospital? Secondly nurse managers were asked, To explain their role in caring for HIV/AIDS positive nurses on their staff establishment. A qualitative analysis of the interviews with nurse managers indicated that they rate HIV/AIDS issues as an important part of their management task. Four main themes were identified, namely HIV/AIDS, counselling, dying of AIDS and funerals. Rich descriptions of these themes are given in this paper. Nurse managers in the health services are managing HIV/AIDS affected nurses, but are doing so without any formal policy on HIV/AIDS in the workplace. It is recommended that nurse managers deal with HIV/AIDS issues in the workplace by raising HIV/AIDS awareness regarding HIV/AIDS issues and HIV/AIDS in the workplace. Nurse managers saw their role regarding nurses with HIV/AIDS mainly as supportive--being involved in family problems and counselling and guiding nurses that live with HIV/AIDS. The health services in KwaZulu-Natal, and especially nurses, are currently affected by HIV/AIDS in a significant way.

22 CFR 214.3 - A.I.D. Advisory Committee Management Officer.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false A.I.D. Advisory Committee Management Officer. 214.3 Section 214.3 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ADVISORY COMMITTEE MANAGEMENT General § 214.3 A.I.D. Advisory Committee Management Officer. The Advisory Committee Management...

77 FR 6915 - Medical Diagnostic Equipment Accessibility Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-09

... Israel Deaconess Medical Center (October 22, 2009) accessible facilities and accessible medical equipment... of types of accessible medical equipment required in different types of health care facilities. If... facilities, accessible medical equipment, and auxiliary aids and services; University of Southern California...

The challenge of Parkinson's disease management in Africa.

PubMed

Dotchin, C L; Msuya, O; Walker, R W

2007-03-01

Parkinson's disease (PD) is said to be less common in Africa than elsewhere in the world, but previous studies have been based on small numbers. Also, the differences may be due to the diagnostic criteria used, case finding methods and different population age structures. Developing countries have few facilities for chronic disease management and non-communicable diseases, although on the increase, tend to play second fiddle to malaria and HIV/AIDS. Previous reports suggest that, at least from anecdotal information, under-diagnosis of PD is common and long-term availability of medication, follow-up, patient education and multidisciplinary input is lacking. Published literature is scarce and there is a lack of recent information. We are currently conducting a door-to-door prevalence study in northern Tanzania in a population of 161,162. We have reviewed previous literature on PD in Africa and illustrate our personal experience of PD and its management in Africa with three cases.

A Self-Instructional Course in Student Financial Aid Administration. Module 17--Evaluation of Student Aid Management: Self-Evaluation, Audit, and Program Review. Second Edition.

ERIC Educational Resources Information Center

Washington Consulting Group, Inc., Washington, DC.

The 17th module in the 17-module self-instructional course on student financial aid administration discusses the evaluation of student aid management in terms of self-evaluation, audit, and program review. The full course offers a systematic introduction to the management of federal financial aid programs authorized by Title IV of the Higher…

75 FR 21175 - Medicare and Medicaid Programs; Waiver of Disapproval of Nurse Aide Training Program in Certain...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-23

... skilled nursing facilities, in the Medicare program, and nursing facilities, in the Medicaid program, that... skilled nursing facilities (SNFs) for Medicare and nursing facilities (NFs) for Medicaid. The Federal... services provided by a nursing home are important, Congressional intent about what constitutes ``quality of...

Facility Design Considerations.

ERIC Educational Resources Information Center

Chase, William W.

1967-01-01

Increasing need for vocational education under the impetus of federal aid is generating a demand for vocational teaching facilities. Factors to be considered in planning these facilities inclued--(1) site development, (2) program needs, (3) administrative considerations, (4) environmental controls. (5) mechanical systems, and (6) area and space…

Water recovery and management test support modeling for Space Station Freedom

NASA Technical Reports Server (NTRS)

Mohamadinejad, Habib; Bacskay, Allen S.

1990-01-01

The water-recovery and management (WRM) subsystem proposed for the Space Station Freedom program is outlined, and its computerized modeling and simulation based on a Computer Aided System Engineering and Analysis (CASE/A) program are discussed. A WRM test model consisting of a pretreated urine processing (TIMES), hygiene water processing (RO), RO brine processing using TIMES, and hygiene water storage is presented. Attention is drawn to such end-user equipment characteristics as the shower, dishwasher, clotheswasher, urine-collection facility, and handwash. The transient behavior of pretreated-urine, RO waste-hygiene, and RO brine tanks is assessed, as well as the total input/output to or from the system. The model is considered to be beneficial for pretest analytical predictions as a program cost-saving feature.

Use of DHCP to provide essential information for care and management of HIV patients.

PubMed Central

Pfeil, C. N.; Ivey, J. L.; Hoffman, J. D.; Kuhn, I. M.

1991-01-01

The Department of Veterans' Affairs (VA) has reported over 10,000 Acquired Immune Deficiency Syndrome (AIDS) cases since the beginning of the epidemic. These cases were distributed throughout 152 of the VA's network of 172 medical centers and outpatient clinics. This network of health care facilities presents a unique opportunity to provide computer based information systems for clinical care and resource monitoring for these patients. The VA further facilitates such a venture through its commitment to the Decentralized Hospital Computer Program (DHCP). This paper describes a new application within DHCP known as the VA's HIV Registry. This project addresses the need to support clinical information as well as the added need to manage the resources necessary to care for HIV patients. PMID:1807575

[A national survey on the activities performed by nurses and aids in Italian outpatients' services].

PubMed

Destrebecq, A; Lusignani, M; Terzoni, S

2009-01-01

In Italy, the National Health System (SSN) grants healthcare to the citizens; its realization is up to the Government, the Regions and local institutions, with the participation of citizens. The Health Ministry determines the essential levels of care, and dictates the general guidelines for the activities of the SSN. On the whole national territory, a network of Local Healthcare Units (ASL) is present; such institutions, although belonging to the SSN, have local autonomy. Their activity is based upon principles of efficacy and efficiency; each one includes one or more Districts, which usually group a minimum of 60,000 citizens. Until 1999, Italian nurses have based their activity on a law that enumerated their tasks (DPR 225/74); nowadays, they work according to the indications of a professional profile (DM 739/94), a code of deontology, a law (L. 42/99) that has eliminated the old DPR, and university programmes. Apart from nurses, both in public and private healthcare facilities it is possible to find aids called OSS; their education consists of a twelve months programme, for which the regional institutions are responsible. Specific laws define their field of activity. For all these reasons, and also because of a major nursing shortage, in Italy it is not possible to talk about tasks delegations from doctors to nurses; we can, however, think about this process from nurses to aids and employees. Italy has the highest number of doctors in the world, with more than 6 every 1000 citizens in 2005 (approximately 370,000 units); nurses suffer from the opposite problem; nurses were 348,415 in 2005 and 360,874 in 2007, that is to say 5.4 nurses each 1000 citizens. This means a shortage of 60,000 nurses. Our research is aimed at: Studying the activities deployed by nurses in outpatients' facilities, that could be assigned to aids,; Identifying the tasks currently deployed by nurses, that are beyond their competence; Estimating how much time nurses could save, if they were not busy with activities that could be assigned to others. Our study sample included only of manager nurses, who were responsible of nursing offices in ASLs which included outpatients. facilities on the whole territory ofl Italy. We choose to make a convenience sampling, choosing a manager nurse for each regional chief town. Our study is an observational, non-experimental quantitative research. To collect our data we used an anonymous questionnaire, based on a reference model, which had already been used in older studies. The model allowed a classification of the tasks performed by nurses in three categories: Nursing activities without chances of delegation; Nursing activities that could be assigned to aids; Activities beyond the competence of nurses. The questionnaire was articulated in 7 categories (general situation, booking, acceptation, preparation of patients' units, nursing care, tasks usually performed in outpatients' services, rearrangement of patients' units). We made a comparison between our data and the reference model. In the studied outpatients' services, nurses take in charge a high percentage of tasks (39%) that should be performed by others. More precisely, there are activities that should be carried out by aids (17%) or employees (22%). For example, in the category "Rearrangement of the patient's units", nurses perform approximately 70% of the tasks. Our study revealed that not employing aids at their fullest affects the problem; overall, our data show that 45% of nurses' everyday working time could be regained, if it were possible to assign to aids and employees all the activities that are not nurses' competence. This would produce a series of positive consequences, such as bringing out of the competences acquired by nurses, a better qualification and a real identification of the contribution given by nurses to the citizenship, other than an adequate employment and usage of human resources.

Factors affecting adherence to national malaria treatment guidelines in management of malaria among public healthcare workers in Kamuli District, Uganda.

PubMed

Bawate, Charles; Callender-Carter, Sylvia T; Nsajju, Ben; Bwayo, Denis

2016-02-24

Malaria remains a major public health threat accounting for 30.4 % of disease morbidity in outpatient clinic visits across all age groups in Uganda. Consequently, malaria control remains a major public health priority in endemic countries such as Uganda. Experiences from other countries in Africa that revised their malaria case management suggest that health workers adherence may be problematic. A descriptive, cross-sectional design was used and collected information on health system, health workers and patients. Using log-binomial regression model, adjusted prevalence risk ratios (PRRs) and their associated 95 % confidence intervals were determined in line with adherence to new treatment guidelines of parasitological diagnosis and prompt treatment with artemisinin combination therapy (ACT). Nine health centres, 24 health workers and 240 patient consultations were evaluated. Overall adherence to national malaria treatment guidelines (NMTG) was 50.6 % (122/241). It was significantly high at HC III [115 (53 %)] than at HC IV (29 %) [PRR = 0.28 (95 % CI 0.148 0.52), p = 0.000]. Compared to the nursing aide, the adherence level was 1.57 times higher among enrolled nurses (p = 0.004) and 1.68 times higher among nursing officers, p = 0.238, with statistical significance among the former. No attendance of facility malaria-specific continuing medical education (CME) sessions [PRR = 1.9 (95 % CI 1.29 2.78), p = 0.001] and no display of malaria treatment job aides in consultation rooms [PRR = 0.64 (95 % CI 0.4 1.03), p = 0.07] was associated with increased adherence to guidelines with the former showing a statistical significance and the association of the latter borderline statistical significance. The adherence was higher when the laboratory was functional [PRR = 0.47 (95 % CI 0.35 0.63)] when the laboratory was functional in previous 6 months. Age of health worker, duration of employment, supervision, educational level, and age of patient were found not associated with adherence to new treatment guidelines. Adherence to malaria treatment guidelines in Uganda is sub-optimal. There is an urgent need for deliberate interventions to improve adherence to these guidelines. Possible interventions to be explored should include: provision of job aides and improved access to laboratory services. There is also a need for continuous medical educational sessions for health workers, especially those at higher-level facilities and higher cadres, on adherence to guidelines in management of fever, including management of other causes of fever.

Evaluation of a Modified User Guide for Hearing Aid Management.

PubMed

Caposecco, Andrea; Hickson, Louise; Meyer, Carly; Khan, Asaduzzaman

2016-01-01

This study investigated if a hearing aid user guide modified using best practice principles for health literacy resulted in superior ability to perform hearing aid management tasks, compared with the user guide in the original form. This research utilized a two-arm study design to compare the original manufacturer's user guide with a modified user guide for the same hearing aid--an Oticon Acto behind-the-ear aid with an open dome. The modified user guide had a lower reading grade level (4.2 versus 10.5), used a larger font size, included more graphics, and had less technical information. Eighty-nine adults ages 55 years and over were included in the study; none had experience with hearing aid use or management. Participants were randomly assigned either the modified guide (n = 47) or the original guide (n = 42). All participants were administered the Hearing Aid Management test, designed for this study, which assessed their ability to perform seven management tasks (e.g., change battery) with their assigned user guide. The regression analysis indicated that the type of user guide was significantly associated with performance on the Hearing Aid Management test, adjusting for 11 potential covariates. In addition, participants assigned the modified guide required significantly fewer prompts to perform tasks and were significantly more likely to perform four of the seven tasks without the need for prompts. The median time taken by those assigned the modified guide was also significantly shorter for three of the tasks. Other variables associated with performance on the Hearing Aid Management test were health literacy level, finger dexterity, and age. Findings indicate that the need to design hearing aid user guides in line with best practice principles of health literacy as a means of facilitating improved hearing aid management in older adults.

42 CFR 483.150 - Statutory basis; Deemed meeting or waiver of requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... CARE FACILITIES Requirements That Must Be Met by States and State Agencies: Nurse Aide Training and... 1919(f)(2) of the Act, which establish standards for training nurse-aides and for evaluating their competency. (b) Deemed meeting of requirements. A nurse aide is deemed to satisfy the requirement of...

Student Aides for Handicapped College Students. Final Report and Manual.

ERIC Educational Resources Information Center

Urie, Robert M.; And Others

The stated purpose of the project was to demonstrate that the use of student aides to assist selected physically handicapped students in the college setting, in conjunction with special physical facilities and individual counseling sessions for both the physically handicapped and the student aides, would result in a more satisfactory academic,…

Information Presentation and Control in a Modern Air Traffic Control Tower Simulator

NASA Technical Reports Server (NTRS)

Haines, Richard F.; Doubek, Sharon; Rabin, Boris; Harke, Stanton

1996-01-01

The proper presentation and management of information in America's largest and busiest (Level V) air traffic control towers calls for an in-depth understanding of many different human-computer considerations: user interface design for graphical, radar, and text; manual and automated data input hardware; information/display output technology; reconfigurable workstations; workload assessment; and many other related subjects. This paper discusses these subjects in the context of the Surface Development and Test Facility (SDTF) currently under construction at NASA's Ames Research Center, a full scale, multi-manned, air traffic control simulator which will provide the "look and feel" of an actual airport tower cab. Special emphasis will be given to the human-computer interfaces required for the different kinds of information displayed at the various controller and supervisory positions and to the computer-aided design (CAD) and other analytic, computer-based tools used to develop the facility.

Facility Targeting, Protection and Mission Decision Making Using the VISAC Code

NASA Technical Reports Server (NTRS)

Morris, Robert H.; Sulfredge, C. David

2011-01-01

The Visual Interactive Site Analysis Code (VISAC) has been used by DTRA and several other agencies to aid in targeting facilities and to predict the associated collateral effects for the go, no go mission decision making process. VISAC integrates the three concepts of target geometric modeling, damage assessment capabilities, and an event/fault tree methodology for evaluating accident/incident consequences. It can analyze a variety of accidents/incidents at nuclear or industrial facilities, ranging from simple component sabotage to an attack with military or terrorist weapons. For nuclear facilities, VISAC predicts the facility damage, estimated downtime, amount and timing of any radionuclides released. Used in conjunction with DTRA's HPAC code, VISAC also can analyze transport and dispersion of the radionuclides, levels of contamination of the surrounding area, and the population at risk. VISAC has also been used by the NRC to aid in the development of protective measures for nuclear facilities that may be subjected to attacks by car/truck bombs.

Application experience with the NASA aircraft interrogation and display system - A ground-support equipment for digital flight systems

NASA Technical Reports Server (NTRS)

Glover, R. D.

1983-01-01

The NASA Dryden Flight Research Facility has developed a microprocessor-based, user-programmable, general-purpose aircraft interrogation and display system (AIDS). The hardware and software of this ground-support equipment have been designed to permit diverse applications in support of aircraft digital flight-control systems and simulation facilities. AIDS is often employed to provide engineering-units display of internal digital system parameters during development and qualification testing. Such visibility into the system under test has proved to be a key element in the final qualification testing of aircraft digital flight-control systems. Three first-generation 8-bit units are now in service in support of several research aircraft projects, and user acceptance has been high. A second-generation design, extended AIDS (XAIDS), incorporating multiple 16-bit processors, is now being developed to support the forward swept wing aircraft project (X-29A). This paper outlines the AIDS concept, summarizes AIDS operational experience, and describes the planned XAIDS design and mechanization.

Pediatric First Aid Practices in Ghana: A Population-Based Survey.

PubMed

Gyedu, Adam; Mock, Charles; Nakua, Emmanuel; Otupiri, Easmon; Donkor, Peter; Ebel, Beth E

2015-08-01

Children in low- and middle-income countries (LMIC) often receive care outside the formal medical sector. Improving pre-hospital first aid has proven to be highly cost-effective in lowering trauma mortality. Few studies in LMIC have examined home first aid practices for injured children. We conducted a representative population-based survey of 200 caregivers of children under 18 years of age, representing 6520 households. Caregivers were interviewed about their first aid practices and care-seeking behaviors when a child sustained an injury at home. Injuries of interest included burns, lacerations, fractures and choking. Reported practices were characterized as recommended, low-risk, and potentially harmful. For common injuries, 75-96% of caregivers reported employing a recommended practice (e.g., running cool water over a burn injury). However, for these same injuries, 13-61% of caregivers also identified potentially harmful management strategies (e.g., applying sand to a laceration). Choking had the highest proportion (96%) of recommended first aid practice: (e.g., hitting the child's back) and the lowest percent (13%) of potentially harmful practices (e.g., attempting manual removal). Fractures had the lowest percent (75%) of recommended practices (e.g., immediately bringing the child to a health facility). Burns had the highest percent (61%) of potentially harmful practices (e.g., applying kerosene). While most caregivers were aware of helpful first aid practices to administer for a child injury, many parents also described potentially harmful practices or delays in seeking medical attention. As parents are the de facto first responders to childhood injury, there are opportunities to strengthen pre-hospital care for children in LMICs.

AIDS in Mexican prisons.

PubMed

Olivero, J M; Roberts, J B

1995-01-01

The human rights organization Americas Watch, which toured Mexican prisons, reported in 1991 that all prisoners with HIV infection in the Mexico City area were housed in a single AIDS ward in Santa Marta Prison. In 1991, the 16-bed facility had 15 patients; in 1993, this number had increased by 5. In Mexico City, with 3 prisons holding over 2000 male adults each, there were only 20 known infected prisoners in the AIDS ward at Santa Marta. In 1991, authorities at Matamoros, in the state of Tamaulipas, insisted that none of their inmates had ever been diagnosed as infected with HIV. The prison physician at Reynosa indicated that only 2 inmates since 1985 had ever been diagnosed as infected. In 1992, the prison in Saltillo, in the state of Coahuila, reported that here had yet to be a single positive test for HIV. The prison at Reynosa held 1500 people and only 2 inmates were diagnosed as having AIDS between 1985 and 1991. Prisons at Matamoros and Saltillo held similar numbers but had no experience of infected inmates. A survey of 2 prisons in the state of Tamaulipas indicates that around 12% of the population may use IV drugs, and 9% indicate sharing needles. It is possible for prisoners to die of diseases like pneumonia, associated with AIDS, without the connection to AIDS being diagnosed. Each state, and possibly each prison in Mexico, has its own particular AIDS policies. Santa Marta was the single facility in Mexico City used to house AIDS-infected prisoners, who were segregated. Finally, the prison at Saltillo required all women entering the facility to have a medical examination, including a test for HIV. High-level prison personnel have demonstrated ignorance and fear of AIDS and intolerance of infected prisoners. Mexico must reassess the need to provide adequate medical care to offenders who are sick and dying behind bars.

Keeping a tight grip on the reins: donor control over aid coordination and management in Bangladesh.

PubMed

Buse, K

1999-09-01

A long-standing consensus that aid coordination should be owned by recipient authorities has been eclipsed by accord on the desirability of recipient management of aid along-side domestic resources. Nonetheless, in many low and lower-middle income countries, donors remain remarkably uncoordinated; where attempts at coordination are made, they are often donor-driven, and only a small proportion of aid is directly managed by recipients. This paper draws on evidence from an in-depth review of aid to the health sector in Bangladesh to analyze the systems by which external resources are managed. Based on interviews with key stakeholders, a questionnaire survey and analysis of documentary sources, the factors constraining the government from assuming a more active role in aid management are explored. The results suggest that donor perceptions of weak government capacity, inadequate accountability and compromised integrity only partially account for the propensity for donor leadership. Equally important is the consideration that aid coordination has a markedly political dimension. Stakeholders are well aware of the power, influence and leverage which aid coordination confers, an awareness which colours the desire of some stakeholders to lead aid coordination processes, and conditions the extent and manner by which others wish to be involved. It is argued that recipient management of external aid is dependent on major changes in the attitudes and behaviours of recipients and donors alike.

75 FR 55341 - Recovery Policy, RP 9523.6, Mutual Aid Agreements for Public Assistance and Fire Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-10

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2010-0055] Recovery Policy, RP 9523.6, Mutual Aid Agreements for Public Assistance and Fire Management Assistance....6, Mutual Aid Agreements for Public Assistance and Fire Management Assistance. This is an existing...

Explaining the heterogeneity in average costs per HIV/AIDS patient in Nigeria: The role of supply-side and service delivery characteristics

PubMed Central

Amanze, Ogbonna O.; La Hera-Fuentes, Gina; Silverman-Retana, Omar; Contreras-Loya, David; Ashefor, Gregory A.; Ogungbemi, Kayode M.

2018-01-01

Objective We estimated the average annual cost per patient of ART per facility (unit cost) in Nigeria, described the variation in costs across facilities, and identified factors associated with this variation. Methods We used facility-level data of 80 facilities in Nigeria, collected between December 2014 and May 2015. We estimated unit costs at each facility as the ratio of total costs (the sum of costs of staff, recurrent inputs and services, capital, training, laboratory tests, and antiretroviral and TB treatment drugs) divided by the annual number of patients. We applied linear regressions to estimate factors associated with ART cost per patient. Results The unit ART cost in Nigeria was $157 USD nationally and the facility-level mean was $231 USD. The study found a wide variability in unit costs across facilities. Variations in costs were explained by number of patients, level of care, task shifting (shifting tasks from doctors to less specialized staff, mainly nurses, to provide ART) and provider´s competence. The study illuminated the potentially important role that management practices can play in improving the efficiency of ART services. Conclusions Our study identifies characteristics of services associated with the most efficient implementation of ART services in Nigeria. These results will help design efficient program scale-up to deliver comprehensive HIV services in Nigeria by distinguishing features linked to lower unit costs. PMID:29718906

NHDOT : process for municipally managed state aid highway program projects

DOT National Transportation Integrated Search

2006-05-23

The design and construction of Municipally Managed State Aid Highway Program projects must comply with the requirements in this guideline in order to receive State Aid under the applicable provisions of RSA 235. Under this process, State Aid Construc...

33 CFR 127.1307 - Emergency Manual.

Code of Federal Regulations, 2010 CFR

2010-07-01

... description of the hazards of the LHG; (iii) First-aid procedures for persons exposed to the LHG or its vapors... shelters, the place of and provisions in each shelter; (7) If the facility has first-aid stations, the...

Water Utility Management Strategies in Turkey: The current situation and the challenges

NASA Astrophysics Data System (ADS)

Alp, E.; Aksoy, M. N.; Koçer, B.

2013-12-01

As the effects of climate change becomes more prominent, current challenges related to water and wastewater management is becoming more serious. Providing water that satisfies environmental and safety standards in terms of quantity and quality is needed to maintain human life without compromising the need of future generations. Besides providing safe and affordable water, necessary treatment should be achieved according to several important factors such as receiving body standards, discharge standards, water reuse options. Therefore, management of water becomes more crucial than ever that states have to provide accessibility of safe water with affordable cost to its citizens with the means of effective utility management, including water treatment facilities, wastewater treatment facilities, water supply facilities and water distribution systems. Water utilities encounter with several challenges related to cost, infrastructure, population, legislation, workforce and resource. This study aims to determine the current situation and the necessary strategies to improve utility management in Turkish municipalities in a sustainable manner. US Environment Protection Agency (EPA) has formed a tool on effective utility management that assists utilities to provide a solution for both current and future challenges. In this study, we used EPA's guidelines and developed a survey consists of 60 questions under 10 sub-topics (Product Quality, Employee & Leadership Development, Stakeholder Understanding & Support, Operational Optimization, Infrastructure Stability, Financial Viability, Community Sustainability, Customer Satisfaction, Operational Resiliency, and Water Resource Adequacy). This survey was sent to the managers of 25 metropolitan municipalities in Turkey to assess the current condition of municipalities. After the evaluation of the survey results for each topic, including the importance given by managers, facilities were rated according to their level of achievement. The scores were given for Rate Achievement from 1 to 5 and Rank Importance from 1 to 10 to the survey outcomes for each topic. Then, rating and ranking matrix was constructed according to score ranges. Results show that Product Quality, Stakeholder Understanding & Support, Infrastructure Stability and Customer Satisfaction are the major topics that needs to be improved according to the utility managers in Turkey. According to the outcomes of the study, water losses and unbilled unmetered consumption of water appeared to be the most important issues with the utility management. The utility managers also think there is still room for improvement to satisfy the needs of the users. Even though the rehabilitation of the infrastructure is a costly investment, it can be compensated with the help of the increased revenues as a result of improvement in water loss and unbilled water use. Suggestions given as a result of this study aim to aid decision makers and local authorities to overcome the significant problems faced during management and to achieve a sustainable utility management.

22 CFR 214.13 - Responsibilities within A.I.D.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 214.13 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ADVISORY COMMITTEE MANAGEMENT... committee to the satisfaction of the A.I.D. Advisory Committee Management Officer, the A.I.D. Administrator, and the OMB Secretariat. (2) Prepares, clears with the Advisory Committee Management Officer and the...

A GUIDE FOR PLANNING PHYSICAL EDUCATION AND ATHLETIC FACILITIES.

ERIC Educational Resources Information Center

New Jersey State Dept. of Education, Trenton.

THIS STUDY EXAMINES PHYSICAL EDUCATION FACILITIES, THEIR PHYSICAL NEEDS, AND RELATED DESIGN CONSIDERATIONS. A SYSTEM OF DETERMINING THE TOTAL NUMBER OF TEACHING STATIONS NEEDED IS GIVEN TO AID INITIAL REQUIREMENT ANALYSIS. INDOOR FACILITIES ANALYZED INCLUDE--(1) THE GYMNASIUM, IN TERMS OF LOCATION, SIZE, DESIGN FEATURES, AND RELATED COMPONENTS,…

Formulation and preparation of Hanford Waste Treatment Plant direct feed low activity waste Effluent Management Facility core simulant

DOE Office of Scientific and Technical Information (OSTI.GOV)

McCabe, Daniel J.; Nash, Charles A.; Adamson, Duane J.

The Hanford Waste Treatment and Immobilization Plant (WTP) Low Activity Waste (LAW) vitrification facility will generate an aqueous condensate recycle stream (LAW Melter Off-Gas Condensate, LMOGC) from the off-gas system. The baseline plan for disposition of this stream during full WTP operations is to send it to the WTP Pretreatment Facility, where it will be blended with LAW, concentrated by evaporation and recycled to the LAW vitrification facility. However, during the Direct Feed LAW (DFLAW) scenario, planned disposition of this stream is to evaporate it in a new evaporator in the Effluent Management Facility (EMF) and then return it tomore » the LAW melter. It is important to understand the composition of the effluents from the melter and new evaporator so that the disposition of these streams can be accurately planned and accommodated. Furthermore, alternate disposition of the LMOGC stream would eliminate recycling of problematic components, and would enable less integrated operation of the LAW melter and the Pretreatment Facilities. Alternate disposition would also eliminate this stream from recycling within WTP when it begins operations and would decrease the LAW vitrification mission duration and quantity of glass waste, amongst the other problems such a recycle stream present. This LAW Melter Off-Gas Condensate stream will contain components that are volatile at melter temperatures and are problematic for the glass waste form, such as halides and sulfate. Because this stream will recycle within WTP, these components accumulate in the Melter Condensate stream, exacerbating their impact on the number of LAW glass containers that must be produced. Diverting the stream reduces the halides and sulfate in the recycled Condensate and is a key outcome of this work. This overall program examines the potential treatment and immobilization of this stream to enable alternative disposal. The objective of this task was to formulate and prepare a simulant of the LAW Melter Off-gas Condensate expected during DFLAW operations. That simulant can be used in evaporator testing to predict the composition of the effluents from the Effluent Management Facility (EMF) evaporator to aid in planning for their disposition. This document describes the method used to formulate a simulant of this LAW Melter Off-Gas Condensate stream, which, after pH adjustment, is the feed to the evaporator in the EMF.« less

Key Issues in Instructional Computer Graphics.

ERIC Educational Resources Information Center

Wozny, Michael J.

1981-01-01

Addresses key issues facing universities which plan to establish instructional computer graphics facilities, including computer-aided design/computer aided manufacturing systems, role in curriculum, hardware, software, writing instructional software, faculty involvement, operations, and research. Thirty-seven references and two appendices are…

Existing capacity to manage pharmaceuticals and related commodities in East Africa: an assessment with specific reference to antiretroviral therapy

PubMed Central

Waako, Paul J; Odoi-adome, Richard; Obua, Celestino; Owino, Erisa; Tumwikirize, Winnie; Ogwal-okeng, Jasper; Anokbonggo, Willy W; Matowe, Lloyd; Aupont, Onesky

2009-01-01

Background East African countries have in the recent past experienced a tremendous increase in the volume of antiretroviral drugs. Capacity to manage these medicines in the region remains limited. Makerere University, with technical assistance from the USAID supported Rational Pharmaceutical Management Plus (RPM Plus) Program of Management Sciences for Health (MSH) established a network of academic institutions to build capacity for pharmaceutical management in the East African region. The initiative includes institutions from Uganda, Tanzania, Kenya and Rwanda and aims to improve access to safe, effective and quality-assured medicines for the treatment of HIV/AIDS, TB and Malaria through spearheading in-country capacity. The initiative conducted a regional assessment to determine the existing capacity for the management of antiretroviral drugs and related commodities. Methods Heads and implementing workers of fifty HIV/AIDS programs and institutions accredited to offer antiretroviral services in Uganda, Kenya, Tanzania and Rwanda were key informants in face-to-face interviews guided by structured questionnaires. The assessment explored categories of health workers involved in the management of ARVs, their knowledge and practices in selection, quantification, distribution and use of ARVs, nature of existing training programs, training preferences and resources for capacity building. Results Inadequate human resource capacity including, inability to select, quantify and distribute ARVs and related commodities, and irrational prescribing and dispensing were some of the problems identified. A competence gap existed in all the four countries with a variety of healthcare professionals involved in the supply and distribution of ARVs. Training opportunities and resources for capacity development were limited particularly for workers in remote facilities. On-the-job training and short courses were the preferred modes of training. Conclusion There is inadequate capacity for managing medicines and related commodities in East Africa. There is an urgent need for training in aspects of pharmaceutical management to different categories of health workers. Skills building activities that do not take healthcare workers from their places of work are preferred. PMID:19272134

Equilibrium in a Production Economy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chiarolla, Maria B., E-mail: maria.chiarolla@uniroma1.it; Haussmann, Ulrich G., E-mail: uhaus@math.ubc.ca

2011-06-15

Consider a closed production-consumption economy with multiple agents and multiple resources. The resources are used to produce the consumption good. The agents derive utility from holding resources as well as consuming the good produced. They aim to maximize their utility while the manager of the production facility aims to maximize profits. With the aid of a representative agent (who has a multivariable utility function) it is shown that an Arrow-Debreu equilibrium exists. In so doing we establish technical results that will be used to solve the stochastic dynamic problem (a case with infinite dimensional commodity space so the General Equilibriummore » Theory does not apply) elsewhere.« less

The visual and radiological inspection of a pipeline using a teleoperated pipe crawler

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fogle, R.F.; Kuelske, K.; Kellner, R.A.

1996-07-01

In the 1950s the Savannah River Site built an open, unlined retention basin for temporary storage of potentially radionuclide-contaminated cooling water form a chemical separations process and storm water drainage from a nearby waste management facility which stored large quantities of nuclear fission by-products in carbon steel tanks. An underground process pipeline lead to the basin. Once the closure of the basin in 1972, further assessment has been required. A visual and radiological inspection of the pipeline was necessary to aid in the decision about further remediation. This article describes the inspection using a teleoperated pipe crawler. 5 figs.

Gender difference in health related quality of life and associated factors among people living with HIV/AIDS attending anti-retroviral therapy at public health facilities, western Ethiopia: comparative cross sectional study.

PubMed

Gebremichael, Delelegn Yilma; Hadush, Kokeb Tesfamariam; Kebede, Ermiyas Mulu; Zegeye, Robel Tezera

2018-04-23

Though HIV/AIDS has multidimensional consequences on quality of life, there is a gap in measuring and monitoring health related quality of life of HIV/AIDS patients. Hence, this study intended to measure health related quality of life domains and associated determinants among people living with HIV/AIDS in western Ethiopia. A comparative cross-sectional study was conducted among 520 HIV/AIDS patients on anti-retroviral therapy in public health facilities in West Shoa Zone, Western Ethiopia from April to May, 2016. Participants were selected using simple random sampling method. Quality of life was measured using WHOQOL-HIV BREF and depression was assessed using Beck Depression Inventory, Second Edition (BDI-II). Data were analyzed using SPSS version 22. An independent sample t-test was used to compare quality of life domains between men and women and logistic regression analysis was used to determine independent predictors. Females had significantly lower quality of life in physical, psychological, independence and environmental domains as compared with males except social relationship and spiritual domains. Depressed HIV patients had significantly lower quality of life in all domains as compared with HIV infected patients without depression in both genders. Malnutrition and anemia were significantly associated with poor physical, psychological, independence and environmental domains. Anemic women had 1.9 times lower independence quality of life compared with women who had no anemia (AOR = 1.9, 95%CI: 1.4, 3.5). Tuberculosis was also predictor of physical, psychological, independence and social domains in both genders. TB/HIV co-infected females had 2.0 times poorer environmental health compared to only HIV infected females (AOR = 2.0, 95%CI: 1.2, 3.5). Family support, education and occupation were also independent significant predictors of QOL domains in both genders. In females, residence was significantly associated with independence (AOR = 1.8, 95%CI: 1.2-3.8) and environmental (AOR = 1.5, 95%CI: 1.1-3.2) domains. Females had significantly lower quality of life compared with males. The findings indicted poor socio-economic status and co-infections significantly associated with poor quality of life among HIV/AIDS patients. So, due emphasis should be given to improve socio-economic status and enhance integrated early detection and management of malnutrition, depression, tuberculosis and anemia among HIV/AIDS patients in Ethiopia.

Management of Student Aid: A Guide for Presidents.

ERIC Educational Resources Information Center

El-Khawas, Elaine

A guide offering a quick review of principles, decisions, and responsibilities in financial aid management has been developed to aid presidents, trustees, and senior administrators of colleges and universities. The handbook stresses the possible implications of aid for enrollment, financial stability, and institutional mission. Topics that are…

Nursing Aides' Attitudes to Elder Abuse in Nursing Homes: The Effect of Work Stressors and Burnout

ERIC Educational Resources Information Center

Shinan-Altman, Shiri; Cohen, Miri

2009-01-01

Background: Nursing aides' attitudes condoning elder abuse are a possible risk factor for executing abusive behaviors against elder residents of long-term care facilities but have been studied infrequently. Purpose: The purpose of the study was to assess nursing aides' attitudes that condone abusive behaviors toward elderly people, as well as the…

Case management of persons with acquired immunodeficiency syndrome in San Francisco

PubMed Central

Benjamin, A. E.; Lee, Philip R.; Solkowitz, Sharon N.

1988-01-01

The acquired immunodeficiency syndrome (AIDS) epidemic represents a growing challenge for the health care system and for case management models applied to persons with AIDS. The experience of San Francisco highlights some of the issues involved in developing a case management system appropriate to the needs of persons with AIDS, as well as providers, and payers. Dramatic growth in the size and complexity of the AIDS caseload and the involvement of public, health maintenance organization, and community providers has required the increasing formalization and centralization of case management roles. Persistent questions about the definition and goals of case management complicate development of these services. PMID:10312974

The Changing Role of Financial Aid and Enrollment Management.

ERIC Educational Resources Information Center

Kurz, Kathy A.

1995-01-01

Explores common institutional strategies for pricing, awarding aid, and controlling the growth of aid budgets in light of changing recruitment practices. Concludes by discussing the new services that aid offices must provide to meet their new challenges effectively. Discusses net tuition revenue goals to enhance effective management of resources.…

Computer-Aided Engineering Education at the K.U. Leuven.

ERIC Educational Resources Information Center

Snoeys, R.; Gobin, R.

1987-01-01

Describes some recent initiatives and developments in the computer-aided design program in the engineering faculty of the Katholieke Universiteit Leuven (Belgium). Provides a survey of the engineering curriculum, the computer facilities, and the main software packages available. (TW)

School Facilities Funding and Capital-Outlay Distribution in the States

ERIC Educational Resources Information Center

Duncombe, William; Wang, Wen

2009-01-01

Traditionally, financing the construction of school facilities has been a local responsibility. In the past several decades, states have increased their support for school facilities. Using data collected from various sources, this study first classifies the design of capital aid programs in all 50 states into various categories based on the scope…

Dressing Rooms & Related Service Facilities for Physical Education, Athletics, and Recreation.

ERIC Educational Resources Information Center

Ragsdale, Lee; And Others

The purpose of this publication is to identify significant considerations in the planning of dressing-locker rooms and related service facilities such as shower rooms, toilet and lavatory rooms, toweling areas, storage and supply rooms, laundries, training and first aid rooms, and custodial facilities. However, only a perfunctory treatment of each…

The care unit in nursing home research: evidence in support of a definition.

PubMed

Estabrooks, Carole A; Morgan, Debra G; Squires, Janet E; Boström, Anne-Marie; Slaughter, Susan E; Cummings, Greta G; Norton, Peter G

2011-04-14

Defining what constitutes a resident care unit in nursing home research is both a conceptual and practical challenge. The aim of this paper is to provide evidence in support of a definition of care unit in nursing homes by demonstrating: (1) its feasibility for use in data collection, (2) the acceptability of aggregating individual responses to the unit level, and (3) the benefit of including unit level data in explanatory models. An observational study design was used. Research (project) managers, healthcare aides, care managers, nursing home administrators and directors of care from thirty-six nursing homes in the Canadian prairie provinces of Alberta, Saskatchewan and Manitoba provided data for the study. A definition of care unit was developed and applied in data collection and analyses. A debriefing session was held with research managers to investigate their experiences with using the care unit definition. In addition, survey responses from 1258 healthcare aides in 25 of the 36 nursing homes in the study, that had more than one care unit, were analyzed using a multi-level modeling approach. Trained field workers administered the Alberta Context Tool (ACT), a 58-item self-report survey reflecting 10 organizational context concepts, to healthcare aides using computer assisted personal interviews. To assess the appropriateness of obtaining unit level scores, we assessed aggregation statistics (ICC(1), ICC(2), η², and ω²), and to assess the value of using the definition of unit in explanatory models, we performed multi-level modeling. In 10 of the 36 nursing homes, the care unit definition developed was used to align the survey data (for analytic purposes) to specific care units as designated by our definition, from that reported by the facility administrator. The aggregation statistics supported aggregating the healthcare aide responses on the ACT to the realigned unit level. Findings from the multi-level modeling further supported unit level aggregation. A significantly higher percentage of variance was explained in the ACT concepts at the unit level compared to the individual and/or nursing home levels. The statistical results support the use of our definition of care unit in nursing home research in the Canadian prairie provinces. Beyond research convenience however, the results also support the resident unit as an important Clinical Microsystem to which future interventions designed to improve resident quality of care and staff (healthcare aide) worklife should be targeted.

Effectiveness of an Integrated Approach to HIV and Hypertension Care in Rural South Africa: Controlled Interrupted Time-Series Analysis.

PubMed

Ameh, Soter; Klipstein-Grobusch, Kerstin; Musenge, Eustasius; Kahn, Kathleen; Tollman, Stephen; Gómez-Olivé, Francesc Xavier

2017-08-01

South Africa faces a dual burden of HIV/AIDS and noncommunicable diseases. In 2011, a pilot integrated chronic disease management (ICDM) model was introduced by the National Health Department into selected primary health care (PHC) facilities. The objective of this study was to assess the effectiveness of the ICDM model in controlling patients' CD4 counts (>350 cells/mm) and blood pressure [BP (<140/90 mm Hg)] in PHC facilities in the Bushbuckridge municipality, South Africa. A controlled interrupted time-series study was conducted using the data from patients' clinical records collected multiple times before and after the ICDM model was initiated in PHC facilities in Bushbuckridge. Patients ≥18 years were recruited by proportionate sampling from the pilot (n = 435) and comparing (n = 443) PHC facilities from 2011 to 2013. Health outcomes for patients were retrieved from facility records for 30 months. We performed controlled segmented regression to model the monthly averages of individuals' propensity scores using autoregressive moving average model at 5% significance level. The pilot facilities had 6% greater likelihood of controlling patients' CD4 counts than the comparison facilities (coefficient = 0.057; 95% confidence interval: 0.056 to 0.058; P < 0.001). Compared with the comparison facilities, the pilot facilities had 1.0% greater likelihood of controlling patients' BP (coefficient = 0.010; 95% confidence interval: 0.003 to 0.016; P = 0.002). Application of the model had a small effect in controlling patients' CD4 counts and BP, but showed no overall clinical benefit for the patients; hence, the need to more extensively leverage the HIV program for hypertension treatment.

Quality of integrated chronic disease care in rural South Africa: user and provider perspectives

PubMed Central

Klipstein-Grobusch, Kerstin; D’ambruoso, Lucia; Kahn, Kathleen; Tollman, Stephen M; Gómez-Olivé, Francesc Xavier

2017-01-01

The integrated chronic disease management (ICDM) model was introduced as a response to the dual burden of HIV/AIDS and non-communicable diseases (NCDs) in South Africa, one of the first of such efforts by an African Ministry of Health. The aim of the ICDM model is to leverage HIV programme innovations to improve the quality of chronic disease care. There is a dearth of literature on the perspectives of healthcare providers and users on the quality of care in the novel ICDM model. This paper describes the viewpoints of operational managers and patients regarding quality of care in the ICDM model. In 2013, we conducted a case study of the seven PHC facilities in the rural Agincourt sub-district in northeast South Africa. Focus group discussions (n = 8) were used to obtain data from 56 purposively selected patients ≥18 years. In-depth interviews were conducted with operational managers of each facility and the sub-district health manager. Donabedian’s structure, process and outcome theory for service quality evaluation underpinned the conceptual framework in this study. Qualitative data were analysed, with MAXQDA 2 software, to identify 17 a priori dimensions of care and unanticipated themes that emerged during the analysis. The manager and patient narratives showed the inadequacies in structure (malfunctioning blood pressure machines and staff shortage); process (irregular prepacking of drugs); and outcome (long waiting times). There was discordance between managers and patients regarding reasons for long patient waiting time which managers attributed to staff shortage and missed appointments, while patients ascribed it to late arrival of managers to the clinics. Patients reported anti-hypertension drug stock-outs (structure); sub-optimal defaulter-tracing (process); rigid clinic appointment system (process). Emerging themes showed that patients reported HIV stigmatisation in the community due to defaulter-tracing activities of home-based carers, while managers reported treatment of chronic diseases by traditional healers and reduced facility-related HIV stigma because HIV and NCD patients attended the same clinic. Leveraging elements of HIV programmes for NCDs, specifically hypertension management, is yet to be achieved in the study setting in part because of malfunctioning blood pressure machines and anti-hypertension drug stock-outs. This has implications for the nationwide scale up of the ICDM model in South Africa and planning of an integrated chronic disease care in other low- and middle-income countries. PMID:28207046

Quality of integrated chronic disease care in rural South Africa: user and provider perspectives.

PubMed

Ameh, Soter; Klipstein-Grobusch, Kerstin; D'ambruoso, Lucia; Kahn, Kathleen; Tollman, Stephen M; Gómez-Olivé, Francesc Xavier

2017-03-01

The integrated chronic disease management (ICDM) model was introduced as a response to the dual burden of HIV/AIDS and non-communicable diseases (NCDs) in South Africa, one of the first of such efforts by an African Ministry of Health. The aim of the ICDM model is to leverage HIV programme innovations to improve the quality of chronic disease care. There is a dearth of literature on the perspectives of healthcare providers and users on the quality of care in the novel ICDM model. This paper describes the viewpoints of operational managers and patients regarding quality of care in the ICDM model. In 2013, we conducted a case study of the seven PHC facilities in the rural Agincourt sub-district in northeast South Africa. Focus group discussions (n = 8) were used to obtain data from 56 purposively selected patients ≥18 years. In-depth interviews were conducted with operational managers of each facility and the sub-district health manager. Donabedian’s structure, process and outcome theory for service quality evaluation underpinned the conceptual framework in this study. Qualitative data were analysed, with MAXQDA 2 software, to identify 17 a priori dimensions of care and unanticipated themes that emerged during the analysis. The manager and patient narratives showed the inadequacies in structure (malfunctioning blood pressure machines and staff shortage); process (irregular prepacking of drugs); and outcome (long waiting times). There was discordance between managers and patients regarding reasons for long patient waiting time which managers attributed to staff shortage and missed appointments, while patients ascribed it to late arrival of managers to the clinics. Patients reported anti-hypertension drug stock-outs (structure); sub-optimal defaulter-tracing (process); rigid clinic appointment system (process). Emerging themes showed that patients reported HIV stigmatisation in the community due to defaulter-tracing activities of home-based carers, while managers reported treatment of chronic diseases by traditional healers and reduced facility-related HIV stigma because HIV and NCD patients attended the same clinic. Leveraging elements of HIV programmes for NCDs, specifically hypertension management, is yet to be achieved in the study setting in part because of malfunctioning blood pressure machines and anti-hypertension drug stock-outs. This has implications for the nationwide scale up of the ICDM model in South Africa and planning of an integrated chronic disease care in other low- and middle-income countries.

Medicare and Medicaid programs; waiver of disapproval of nurse aide training program in certain cases. Final rule.

PubMed

2010-04-23

This final rule will permit a waiver of a nurse aide training disapproval as it applies to skilled nursing facilities, in the Medicare program, and nursing facilities, in the Medicaid program, that are assessed a civil money penalty of at least $5,000 for noncompliance that is not related to quality of care. This is a statutory provision enacted by section 932 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) (Pub. L. 108-173, enacted December 8, 2003).

Advanced human-machine interface for collaborative building control

DOEpatents

Zheng, Xianjun S.; Song, Zhen; Chen, Yanzi; Zhang, Shaopeng; Lu, Yan

2015-08-11

A system for collaborative energy management and control in a building, including an energy management controller, one or more occupant HMIs that supports two-way communication between building occupants and a facility manager, and between building occupants and the energy management controller, and a facility manager HMI that supports two-way communication between the facility manager and the building occupants, and between the facility manager and the energy management controller, in which the occupant HMI allows building occupants to provide temperature preferences to the facility manager and the energy management controller, and the facility manager HMI allows the facility manager to configure an energy policy for the building as a set of rules and to view occupants' aggregated temperature preferences, and the energy management controller determines an optimum temperature range that resolves conflicting occupant temperature preferences and occupant temperature preferences that conflict with the facility manager's energy policy for the building.

Representations of HIV/AIDS management in South African newspapers.

PubMed

Campbell, Catherine; Gibbs, Andy

2008-07-01

In South Africa, numerous strong policy statements emphasise the importance of involving communities in HIV/AIDS management, yet in practice such involvement tends to be tokenistic and minimal. Social representations in the public sphere constitute the symbolic dimension within which responses to HIV and AIDS are conceptualised and transformed into action. Through an analysis of newspaper articles, we explore the dominant representations of HIV/AIDS management circulating in the South African public sphere and examine how community engagement is depicted. We highlight the way media representations reflect narrow understandings of HIV and AIDS as a predominantly medical problem, while depicting HIV/AIDS management as a top-down activity dominated by prominent individuals, such as national leaders, health professionals and philanthropists, thus marginalising the role played by communities, who are often depicted as passive recipients of interventions by active outsiders. These representations fail to reflect the key role played by members of grassroots communities in responding to the HIV epidemic. Such representations provide flawed conceptual tools for shaping responses to the epidemic, given that HIV-related programmes are unlikely to have optimal outcomes unless they resonate with the perceived needs and interests of their target communities, as we contend that effective HIV/AIDS management is best achieved through active participation by communities in HIV/AIDS management strategies. We discuss the implications of a more 'civic-minded journalism.'

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

Effect of the Ebola-virus-disease epidemic on malaria case management in Guinea, 2014: a cross-sectional survey of health facilities.

PubMed

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

2015-09-01

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. 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. 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. 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. Global Fund to Fight AIDS, Tuberculosis and Malaria, and President's Malaria Initiative. Copyright © 2015 Elsevier Ltd. All rights reserved.

48 CFR 970.3770 - Facilities management.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Facilities management. 970... REGULATIONS DOE MANAGEMENT AND OPERATING CONTRACTS Facilities Management Contracting 970.3770 Facilities management. ...

48 CFR 970.3770 - Facilities management.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 5 2012-10-01 2012-10-01 false Facilities management. 970... REGULATIONS DOE MANAGEMENT AND OPERATING CONTRACTS Facilities Management Contracting 970.3770 Facilities management. ...

48 CFR 970.3770 - Facilities management.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false Facilities management. 970... REGULATIONS DOE MANAGEMENT AND OPERATING CONTRACTS Facilities Management Contracting 970.3770 Facilities management. ...

48 CFR 970.3770 - Facilities management.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false Facilities management. 970... REGULATIONS DOE MANAGEMENT AND OPERATING CONTRACTS Facilities Management Contracting 970.3770 Facilities management. ...

48 CFR 970.3770 - Facilities management.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Facilities management. 970... REGULATIONS DOE MANAGEMENT AND OPERATING CONTRACTS Facilities Management Contracting 970.3770 Facilities management. ...

41 CFR 102-74.15 - What are the facility management responsibilities of occupant agencies?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What are the facility management responsibilities of occupant agencies? 102-74.15 Section 102-74.15 Public Contracts and Property... PROPERTY 74-FACILITY MANAGEMENT Facility Management § 102-74.15 What are the facility management...

Guidelines for Analysis of Health Facilities Planning in Developing Countries. Volume 5: Health Facilities Planning. International Health Planning Methods Series.

ERIC Educational Resources Information Center

Porter, Dennis R.; And Others

Intended to assist Agency for International Development (AID) officers, advisors, and health officials in incorporating health planning into national plans for economic development, this fifth of ten manuals in the International Health Planning Methods Series deals with health facilities planning in developing countries. While several specific…

LIFEbeat, the music industry fights AIDS.

PubMed

Applestone, J

1998-02-01

LIFEbeat is a not-for-profit AIDS resource and awareness organization supported primarily by people in the music industry. It was founded in 1982 and provides grants to many community-based organizations and to members of the music industry who are living with HIV/AIDS. Among its programs is Hearts and Voices, a program that eases the suffering and isolation of patients by providing live musical entertainment at hospitals and health care facilities. The group also sets up information booths at concerts and sponsors events such as SkateAID and BoardAID, fundraisers designed to appeal to in-line skaters and snowboarders.

46 CFR 108.241 - Visual aids.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Construction and Arrangement Helicopter Facilities § 108.241 Visual aids. (a) Each helicopter deck must— (1) Have a wind direction indicator located in an unobstructed area readily visible to helicopter pilots... considering deck configuration, helicopter type, and operational requirements. (b) All markings must be in a...

46 CFR 108.241 - Visual aids.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Construction and Arrangement Helicopter Facilities § 108.241 Visual aids. (a) Each helicopter deck must— (1) Have a wind direction indicator located in an unobstructed area readily visible to helicopter pilots... considering deck configuration, helicopter type, and operational requirements. (b) All markings must be in a...

46 CFR 108.241 - Visual aids.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Construction and Arrangement Helicopter Facilities § 108.241 Visual aids. (a) Each helicopter deck must— (1) Have a wind direction indicator located in an unobstructed area readily visible to helicopter pilots... considering deck configuration, helicopter type, and operational requirements. (b) All markings must be in a...

46 CFR 108.241 - Visual aids.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Construction and Arrangement Helicopter Facilities § 108.241 Visual aids. (a) Each helicopter deck must— (1) Have a wind direction indicator located in an unobstructed area readily visible to helicopter pilots... considering deck configuration, helicopter type, and operational requirements. (b) All markings must be in a...

46 CFR 108.241 - Visual aids.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Construction and Arrangement Helicopter Facilities § 108.241 Visual aids. (a) Each helicopter deck must— (1) Have a wind direction indicator located in an unobstructed area readily visible to helicopter pilots... considering deck configuration, helicopter type, and operational requirements. (b) All markings must be in a...

42 CFR 483.75 - Administration.

Code of Federal Regulations, 2013 CFR

2013-10-01

... certified social worker. Nurse aide means any individual providing nursing or nursing-related services to... evaluation program. (8) Regular in-service education. The facility must complete a performance review of every nurse aide at least once every 12 months, and must provide regular in-service education based on...

Nursing delegation and medication administration in assisted living.

PubMed

Mitty, Ethel; Resnick, Barbara; Allen, Josh; Bakerjian, Debra; Hertz, Judith; Gardner, Wendi; Rapp, Mary Pat; Reinhard, Susan; Young, Heather; Mezey, Mathy

2010-01-01

Assisted living (AL) residences are residential long-term care settings that provide housing, 24-hour oversight, personal care services, health-related services, or a combination of these on an as-needed basis. Most residents require some assistance with activities of daily living and instrumental activities of daily living, such as medication management. A resident plan of care (ie, service agreement) is developed to address the health and psychosocial needs of the resident. The amount and type of care provided, and the individual who provides that care, vary on the basis of state regulations and what services are provided within the facility. Some states require that an RN hold a leadership position to oversee medication management and other aspects of care within the facility. A licensed practical nurse/licensed vocational nurse can supervise the day-to-day direct care within the facility. The majority of direct care in AL settings is provided by direct care workers (DCWs), including certified nursing assistants or unlicensed providers. The scope of practice of a DCW varies by state and the legal structure within that state. In some states, the DCW is exempt from the nurse practice act, and in some states, the DCW may practice within a specific scope such as being a medication aide. In most states, however, the DCW scope of practice is conscribed, in part, by the delegation of responsibilities (such as medication administration) by a supervising RN. The issue of RN delegation has become the subject of ongoing discussion for AL residents, facilities, and regulators and for the nursing profession. The purpose of this article is to review delegation in AL and to provide recommendations for future practice and research in this area.

An Indian tribal view of the back end of the nuclear fuel cycle: Historical and cultural lessons

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tano, M.L.; Reuben, J.H.; Powaukee, D.

Indian tribes of the western United States, including the Nez Perce Tribe, the Confederated Tribes of the Umatilla Indian Reservation, and the Yakama Indian Nation, have entered into cooperative agreements with the U.S. Department of Energy to oversee the cleanup of the Hanford Reservation, in Washington state. These and other tribes considering involvement in nuclear waste management programs have been subjected to severe criticism from some Indians and non-Indians, accusing them of aiding and abetting the violation of Mother Earth by acquiescing in the contamination of lands by radioactive wastes. We`d like to suggest that this view of the Indianmore » relationship to nature and the environment is too narrow. While the purpose of this article is not to suggest that Indian beliefs support the location of waste management facilities on Indian lands, we will describe aspects of Indian religion and culture that support tribal involvement in radioactive waste management and environmental restoration, and participation in radioactive waste management decision making.« less

41 CFR 102-74.155 - What energy conservation policy must Federal agencies follow in the management of facilities?

Code of Federal Regulations, 2010 CFR

2010-07-01

... policy must Federal agencies follow in the management of facilities? 102-74.155 Section 102-74.155 Public... MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Energy Conservation § 102-74.155 What energy conservation policy must Federal agencies follow in the management of facilities...

Meeting the needs of people with AIDS: local initiatives and Federal support.

PubMed Central

Sundwall, D N; Bailey, D

1988-01-01

The Health Resources and Services Administration (HRSA), one of the seven agencies of the Public Health Service, is working to meet some of the resource and patient service needs engendered by the epidemic of acquired immune deficiency syndrome (AIDS). Those actions derived from, and support the continuation, expansion, and replication of, initiatives at the community and State levels. HRSA is carrying out many of the recommendations of the Intragovernmental Task Force on AIDS Health Care Delivery by enhancing the AIDS training of health care personnel in prevention, diagnosis, and care and by counseling and encouraging the expansion of facilities outside hospitals to care for AIDS patients. The agency, through its pediatric AIDS demonstration projects, is working on models for the care of children with HIV infections. The needs of AIDS patients are being addressed through a drug therapy reimbursement program; demonstration grants to 13 projects to promote coordinated, integrated systems of care in the community; and grants for the development of intermediate and long-term care facilities for patients. Ten regional education and training centers, funded in 1987 and 1988, will increase the supply of health care providers prepared to diagnose and treat persons with HIV infections. Programs will be conducted for several thousand providers over the next 3 years, using such modalities as televised programs and train-the-trainer courses. The centers will also offer support and referral services for providers. PMID:3131821

Effect of HIV/AIDS on the control environment.

PubMed

Coetzee, Philna

2006-07-01

The management of organizations is responsible for risk management and control systems. HIV/AIDS could be a great threat in the achievement of strategic business objectives, implicating a great concern for management. Management needs to understand this possible risk. This study aims to identify the effect that HIV/AIDS could have on the different elements of the control environment. The archival research method was used. It was established that no formal research was conducted to date on the effect of HIV/AIDS on the control environment as a whole. Various studies have included the effect of HIV/AIDS on certain factors of the control environment. These studies will be discussed briefly to identify relevant findings. The study indicated that the disease could affect various aspects of the control environment, namely: competency of the workforce (e.g. productivity, quality of work, absenteeism, loss of skills and knowledge, training and recruitment, etc.); organizational structure (e.g. increase use of technology labour, disruption of processes, level of employees affected by the disease); human resource (HR) policies and practices (e.g. legislation applicable, prevention and awareness programmes, compensation and benefits). Research limitation: HIV/AIDS is a relatively new potential risk to organizations. Knowledge of the disease is limited. HIV/AIDS is also a very sensitive issue as people fear the disease and do not like to discuss its existence. Government determined that it should be a non-notifiable disease and the disease is currently greatly stigmatized. The databases of companies investigated by other research studies were not developed to gather all the relevant information. Management should be aware that HIV/AIDS poses a possible risk to organizations. Data on the effect of HIV/AIDS should be gathered and used in the decision-making process on how to manage this risk. To be able to fulfil this duty, management first has to determine: whether HIV/AIDS is a risk; the relevant cost involved that the disease is costing the organization; how to control these costs.

HIV/AIDS and disability: a pilot survey of HIV/AIDS knowledge among a deaf population in Swaziland.

PubMed

Groce, Nora; Yousafzai, Aisha; Dlamini, Phindile; Zalud, Sarah; Wirz, Shelia

2006-12-01

This study sought to establish whether there were measurable differences in the level of knowledge about HIV/AIDS between hearing individuals and individuals who identified themselves as deaf sign language users in Swaziland. A cross-sectional survey of 191 rural and urban hearing and deaf adults was undertaken in Swaziland in December 2003. A structured questionnaire was administered, seeking to establish whether there were statistically significant differences between hearing and deaf populations in their level of knowledge about HIV/AIDS symptoms, transmission and prevention, as well as differences in sources of information about HIV/AIDS. Additional questions were asked regarding whether there were differences in accessibility of HIV testing services and HIV/AIDS-related healthcare for the two groups. Significant differences in levels of knowledge about HIV/AIDS were identified between the hearing and deaf respondents. The deaf population was significantly more likely (P<0.05) to believe in incorrect modes of HIV transmission (e.g. hugging and airborne transmission) and HIV prevention (e.g. avoiding sharing utensils and eating healthy foods). Almost all of the deaf respondents (99%) reported difficulties in communicating with healthcare facility staff, which may result in less use of HIV voluntary counseling and testing services. This paper reports the results of this study, and discusses the need for targeted HIV/AIDS education campaigns and improved accessibility in healthcare facilities for deaf sign language users in countries such as Swaziland.

First aid on field management in youth football.

PubMed

Krutsch, Werner; Voss, Andreas; Gerling, Stephan; Grechenig, Stephan; Nerlich, Michael; Angele, Peter

2014-09-01

Sufficient first aid equipment is essential to treat injuries on football fields. Deficits in first aid on field are still present in youth football. Injury pattern in youth football over one season and first aid equipment in youth football were analyzed, retrospectively. PRICE and ABC procedure served as basic principles in emergency management to assess the need for first aid equipment on field. Considering financial limits and adapted on youth football injuries, sufficient first aid equipment for youth football was configured. 84% of 73 participating youth football teams had their own first aid kit, but the majority of them were insufficiently equipped. Team coaches were in 60% of all youth teams responsible for using first aid equipment. The injury evaluation presented 922 injuries to 1,778 youth players over one season. Frequently presented types of injury were contusions and sprains of the lower extremity. Based on the analyzed injury data in youth football, first aid equipment with 90 € is sufficient for 100% of all occurred youth football injuries. Current first aid equipment in youth football is insufficient. Scientific-based first aid equipment with 90 € is adequate to serve all injuries. Football coaches need education in first aid management.

20 CFR 638.303 - Site selection and facilities management.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Site selection and facilities management. 638... Facilities Management § 638.303 Site selection and facilities management. (a) The Job Corps Director shall... center, facilities engineering and real estate management will be conducted by the Job Corps Director or...

An educational intervention to reduce pain and improve pain management for Malawian people living with HIV/AIDS and their family carers: study protocol for a randomised controlled trial.

PubMed

Nkhoma, Kennedy; Seymour, Jane; Arthur, Antony

2013-07-13

Many HIV/AIDS patients experience pain often due to advanced HIV/AIDS infection and side effects of treatment. In sub-Saharan Africa, pain management for people with HIV/AIDS is suboptimal. With survival extended as a direct consequence of improved access to antiretroviral therapy, the prevalence of HIV/AIDS related pain is increasing. As most care is provided at home, the management of pain requires patient and family involvement. Pain education is an important aspect in the management of pain in HIV/AIDS patients. Studies of the effectiveness of pain education interventions for people with HIV/AIDS have been conducted almost exclusively in western countries. A randomised controlled trial is being conducted at the HIV and palliative care clinics of two public hospitals in Malawi. To be eligible, patient participants must have a diagnosis of HIV/AIDS (stage III or IV). Carer participants must be the individual most involved in the patient's unpaid care. Eligible participants are randomised to either: (1) a 30-minute face-to-face educational intervention covering pain assessment and management, augmented by a leaflet and follow-up telephone call at two weeks; or (2) usual care. Those allocated to the usual care group receive the educational intervention after follow-up assessments have been conducted (wait-list control group). The primary outcome is pain severity measured by the Brief Pain Inventory. Secondary outcomes are pain interference, patient knowledge of pain management, patient quality of life, carer knowledge of pain management, caregiver motivation and carer quality of life. Follow-up assessments are conducted eight weeks after randomisation by palliative care nurses blind to allocation. This randomised controlled trial conducted in sub-Saharan Africa among people living with HIV/AIDS and their carers will assess whether a pain education intervention is effective in reducing pain and improving pain management, quality of life and carer motivation. Current Controlled Trials ISRCTN72861423.

Demonstration, Developmental and Research Project for Programs, Materials, Facilities and Educational Technology for Undereducated Adults. Counselor Aides; Virginia State Module. Final Report Series.

ERIC Educational Resources Information Center

Morehead State Univ., KY. Appalachian Adult Basic Education Demonstration Center.

The Counselor-Aide Program is implemented by para-professionals working cooperatively with a certified counselor, in an effort to raise the economic level of the adults in Carroll County, through an improvement in the educational level of achievement. The counselor aides feel that they have been reasonably successful in meeting the objectives as…

Antiretroviral drug supply challenges in the era of scaling up ART in Malawi.

PubMed

Schouten, Erik J; Jahn, Andreas; Ben-Smith, Anne; Makombe, Simon D; Harries, Anthony D; Aboagye-Nyame, Francis; Chimbwandira, Frank

2011-07-06

The number of people receiving antiretroviral treatment (ART) has increased considerably in recent years and is expected to continue to grow in the coming years. A major challenge is to maintain uninterrupted supplies of antiretroviral (ARV) drugs and prevent stock outs. This article discusses issues around the management of ARVs and prevention of stock outs in Malawi, a low-income country with a high HIV/AIDS burden, and a weak procurement and supply chain management system. This system for ARVs, paid for by the Global Fund to Fight AIDS, Tuberculosis and Malaria, and bypassing the government Central Medical Stores, is in place, using the United Nations Children's Fund's (UNICEF's) procurement services. The system, managed by a handful of people who spend limited time on supply management, is characterized by a centrally coordinated quantification based on verified data from all national ART clinics, parallel procurement through UNICEF, and direct distribution to ART clinics. The model worked well in the first years of the ART programme with a single first-line ARV regimen, but with more regimens becoming available (e.g., alternative first-line, second-line and paediatric regimens), it has become more difficult to administer. Managing supplies through a parallel system has the advantage that weaknesses in the national system have limited influence on the ARV procurement and supply chain management system. However, as the current system operates without a central warehouse and national buffer stock capacity, it diminishes the ability to prevent ARV stock outs. The process of ordering ARVs, from the time that estimates are made to the arrival of supplies in health facilities, takes approximately one year. Addressing the challenges involved in maintaining ARVs through an efficient procurement and supply chain management system that prevents ARV stock outs through the establishment of a dedicated procurement team, a central warehouse and/or national buffer stock is a priority.

A multi-agent system for monitoring patient flow.

PubMed

Rosati, Samanta; Tralli, Augusta; Balestra, Gabriella

2013-01-01

Patient flow within a healthcare facility may follow different and, sometimes, complicated paths. Each path phase is associated with the documentation of the activities carried out during it and may require the consultation of clinical guidelines, medical literature and the use of specific software and decision aid systems. In this study we present the design of a Patient Flow Management System (PFMS) based on Multi Agent Systems (MAS) methodology. System requirements were identified by means of process modeling tools and a MAS consisting of six agents was designed and is under construction. Its main goal is to support both the medical staff during the health care process and the hospital managers in assuring that all the required documentation is completed and available. Moreover, such a tool can be used for the assessment and comparison of different clinical pathways, in order to identify possible improvementsand the optimum patient flow.

Interdisciplinary treatment of diabetes mellitus in a military treatment facility.

PubMed

Earles, J E; Hartung, G H; Dickert, J M; Moriyama, H H; Coll, K J; Aiello, L M; Jackson, R; Polonsky, W

2001-10-01

The American Diabetes Association emphasizes interdisciplinary management as the standard of care for patients with diabetes. Many times, however, interdisciplinary means various health care professionals treating a patient but not necessarily interacting with each other regarding the patient's care. Recently, Tripler Army Medical Center replicated the Joslin Diabetes Center's diabetes outpatient intensive treatment program as part of a Joslin Diabetes Center/Department of Defense/Veteran's Administration research collaboration. Tripler Army Medical Center named this interdisciplinary program Holopono, which is Hawaiian for success. Holopono is a team of health care professionals providing integrated care and education to a group of diabetes patients over 3.5 days. Individual care management, aided by an Internet-based telemedicine system, then continues for 1 year after entry into the program. This article describes the Holopono program, the role of each team member, and how the team functions together to provide comprehensive diabetes care.

Scheduling logic for Miles-In-Trail traffic management

NASA Technical Reports Server (NTRS)

Synnestvedt, Robert G.; Swenson, Harry; Erzberger, Heinz

1995-01-01

This paper presents an algorithm which can be used for scheduling arrival air traffic in an Air Route Traffic Control Center (ARTCC or Center) entering a Terminal Radar Approach Control (TRACON) Facility . The algorithm aids a Traffic Management Coordinator (TMC) in deciding how to restrict traffic while the traffic expected to arrive in the TRACON exceeds the TRACON capacity. The restrictions employed fall under the category of Miles-in-Trail, one of two principal traffic separation techniques used in scheduling arrival traffic . The algorithm calculates aircraft separations for each stream of aircraft destined to the TRACON. The calculations depend upon TRACON characteristics, TMC preferences, and other parameters adapted to the specific needs of scheduling traffic in a Center. Some preliminary results of traffic simulations scheduled by this algorithm are presented, and conclusions are drawn as to the effectiveness of using this algorithm in different traffic scenarios.

Challenges facing developers of CAD/CAM models that seek to predict human working postures

NASA Astrophysics Data System (ADS)

Wiker, Steven F.

2005-11-01

This paper outlines the need for development of human posture prediction models for Computer Aided Design (CAD) and Computer Aided Manufacturing (CAM) design applications in product, facility and work design. Challenges facing developers of posture prediction algorithms are presented and discussed.

Aid and Education in the South Pacific.

ERIC Educational Resources Information Center

Luteru, P. H.; Teasdale, G. R.

1993-01-01

Pacific Island nations perceive their main educational needs and priorities to be expansion of primary education, locally relevant curriculum development, provision of adequate facilities and resources, and teacher education. Yet, driven by self-interest, international aid donors such as Australia and New Zealand concentrate their funding on…

Prevalence and management of helminthiasis among underfives living with HIV/AIDS at Amana Hospital, Tanzania.

PubMed

Mwambete, Kennedy D; Tunzo, Jones; Justin-Temu, Mary

2013-01-01

This was a cross-sectional study intended to assess the prevalence and management of helminthiasis (HL) among underfives living with HIV/AIDS (ULHA). Clinical histories of ULHA were scrutinized for HIV/AIDS status, antiretroviral therapy (ART), HL prevalence, and their management. About 364 ULHA were studied, 213 (58.5%) were girls and 151 (41.5%) were boys. Of the 364 ULHA, 171 (47.5%) had HL and 64.3% were treated with albendazole (ABZ). Trichuriasis was ascribed to 23.6% of HL. Majority (72.5%) of ULHA had a CD4 count below 200 cells/mm³. Direct association was observed between CD4 counts and HL. About 55% ULHA were on lamivudine (3TC)-stavudine (d4T)-nevirapine (NVP; LSN) combination therapy. The ABZ-LSN combination was frequently used for HIV/AIDS and HL management. High prevalence of HL and vivid correlation between HIV status and HL were observed. The LSN-ABZ combination was frequently employed for management of HIV/AIDS and HL. We recommended prompt diagnosis of HL to avoid acceleration of HIV infection to AIDS.

Mobile Health Insurance System and Associated Costs: A Cross-Sectional Survey of Primary Health Centers in Abuja, Nigeria.

PubMed

Chukwu, Emeka; Garg, Lalit; Eze, Godson

2016-05-17

Nigeria contributes only 2% to the world's population, accounts for 10% of the global maternal death burden. Health care at primary health centers, the lowest level of public health care, is far below optimal in quality and grossly inadequate in coverage. Private primary health facilities attempt to fill this gap but at additional costs to the client. More than 65% Nigerians still pay out of pocket for health services. Meanwhile, the use of mobile phones and related services has risen geometrically in recent years in Nigeria, and their adoption into health care is an enterprise worth exploring. The purpose of this study was to document costs associated with a mobile technology-supported, community-based health insurance scheme. This analytic cross-sectional survey used a hybrid of mixed methods stakeholder interviews coupled with prototype throw-away software development to gather data from 50 public primary health facilities and 50 private primary care centers in Abuja, Nigeria. Data gathered documents costs relevant for a reliable and sustainable mobile-supported health insurance system. Clients and health workers were interviewed using structured questionnaires on services provided and cost of those services. Trained interviewers conducted the structured interviews, and 1 client and 1 health worker were interviewed per health facility. Clinic expenditure was analyzed to include personnel, fixed equipment, medical consumables, and operation costs. Key informant interviews included a midmanagement staff of a health-management organization, an officer-level staff member of a mobile network operator, and a mobile money agent. All the 200 respondents indicated willingness to use the proposed system. Differences in the cost of services between public and private facilities were analyzed at 95% confidence level (P<.001). This indicates that average out-of-pocket cost of services at private health care facilities is significantly higher than at public primary health care facilities. Key informant interviews with a health management organizations and a telecom operator revealed high investment interests. Cost documentation analysis of income versus expenditure for the major maternal and child health service areas-antenatal care, routine immunization, and birth attendance for 1 year-showed that primary health facilities would still profit if technology-supported, health insurance schemes were adopted. This study demonstrates a case for the implementation of enrolment, encounter management, treatment verification, claims management and reimbursement using mobile technology for health insurance in Abuja, Nigeria. Available data show that the introduction of an electronic job aid improved efficiency. Although it is difficult to make a concrete statement on profitability of this venture but the interest of the health maintenance organizations and telecom experts in this endeavor provides a positive lead.

Mobile Health Insurance System and Associated Costs: A Cross-Sectional Survey of Primary Health Centers in Abuja, Nigeria

PubMed Central

Garg, Lalit; Eze, Godson

2016-01-01

Background Nigeria contributes only 2% to the world’s population, accounts for 10% of the global maternal death burden. Health care at primary health centers, the lowest level of public health care, is far below optimal in quality and grossly inadequate in coverage. Private primary health facilities attempt to fill this gap but at additional costs to the client. More than 65% Nigerians still pay out of pocket for health services. Meanwhile, the use of mobile phones and related services has risen geometrically in recent years in Nigeria, and their adoption into health care is an enterprise worth exploring. Objective The purpose of this study was to document costs associated with a mobile technology–supported, community-based health insurance scheme. Methods This analytic cross-sectional survey used a hybrid of mixed methods stakeholder interviews coupled with prototype throw-away software development to gather data from 50 public primary health facilities and 50 private primary care centers in Abuja, Nigeria. Data gathered documents costs relevant for a reliable and sustainable mobile-supported health insurance system. Clients and health workers were interviewed using structured questionnaires on services provided and cost of those services. Trained interviewers conducted the structured interviews, and 1 client and 1 health worker were interviewed per health facility. Clinic expenditure was analyzed to include personnel, fixed equipment, medical consumables, and operation costs. Key informant interviews included a midmanagement staff of a health-management organization, an officer-level staff member of a mobile network operator, and a mobile money agent. Results All the 200 respondents indicated willingness to use the proposed system. Differences in the cost of services between public and private facilities were analyzed at 95% confidence level (P<.001). This indicates that average out-of-pocket cost of services at private health care facilities is significantly higher than at public primary health care facilities. Key informant interviews with a health management organizations and a telecom operator revealed high investment interests. Cost documentation analysis of income versus expenditure for the major maternal and child health service areas—antenatal care, routine immunization, and birth attendance for 1 year—showed that primary health facilities would still profit if technology-supported, health insurance schemes were adopted. Conclusions This study demonstrates a case for the implementation of enrolment, encounter management, treatment verification, claims management and reimbursement using mobile technology for health insurance in Abuja, Nigeria. Available data show that the introduction of an electronic job aid improved efficiency. Although it is difficult to make a concrete statement on profitability of this venture but the interest of the health maintenance organizations and telecom experts in this endeavor provides a positive lead. PMID:27189312

NHDOT : process for municipally-managed state bridge aid program projects

DOT National Transportation Integrated Search

2007-09-12

The document sets for the requirements for a municipality which to manage the design and construction of a bridge rehabilitation or replacement project and receive Bridge Aid under the applicable provisions of RSA 234. Bridge Aid provided to a Munici...

25 CFR 170.130 - How can tribes use Federal highway funds for toll and ferry facilities?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false How can tribes use Federal highway funds for toll and... Toll, Ferry and Airport Facilities § 170.130 How can tribes use Federal highway funds for toll and ferry facilities? (a) A tribe can use Federal-aid highway funds, including IRR Program funds, to study...

25 CFR 170.130 - How can tribes use Federal highway funds for toll and ferry facilities?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 1 2014-04-01 2014-04-01 false How can tribes use Federal highway funds for toll and... Toll, Ferry and Airport Facilities § 170.130 How can tribes use Federal highway funds for toll and ferry facilities? (a) A tribe can use Federal-aid highway funds, including IRR Program funds, to study...

25 CFR 170.130 - How can tribes use Federal highway funds for toll and ferry facilities?

Code of Federal Regulations, 2012 CFR

2012-04-01

... 25 Indians 1 2012-04-01 2011-04-01 true How can tribes use Federal highway funds for toll and... Toll, Ferry and Airport Facilities § 170.130 How can tribes use Federal highway funds for toll and ferry facilities? (a) A tribe can use Federal-aid highway funds, including IRR Program funds, to study...

25 CFR 170.130 - How can tribes use Federal highway funds for toll and ferry facilities?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false How can tribes use Federal highway funds for toll and... Toll, Ferry and Airport Facilities § 170.130 How can tribes use Federal highway funds for toll and ferry facilities? (a) A tribe can use Federal-aid highway funds, including IRR Program funds, to study...

25 CFR 170.130 - How can tribes use Federal highway funds for toll and ferry facilities?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 1 2013-04-01 2013-04-01 false How can tribes use Federal highway funds for toll and... Toll, Ferry and Airport Facilities § 170.130 How can tribes use Federal highway funds for toll and ferry facilities? (a) A tribe can use Federal-aid highway funds, including IRR Program funds, to study...

A public health initiative for reducing access to pesticides as a means to committing suicide: findings from a qualitative study.

PubMed

Mohanraj, Rani; Kumar, Shuba; Manikandan, Sarojini; Kannaiyan, Veerapandian; Vijayakumar, Lakshmi

2014-08-01

Widespread use of pesticides among farmers in rural India, provides an easy means for suicide. A public health initiative involving storage of pesticides in a central storage facility could be a possible strategy for reducing mortality and morbidity related to pesticide poisoning. This qualitative study explored community perceptions towards a central pesticide storage facility in villages in rural South India. Sixteen focus group discussions held with consenting adults from intervention and control villages were followed by eight more a year after initiation of the storage facility. Analysis revealed four themes, namely, reasons for committing suicide and methods used, exposure to pesticides and first-aid practices, storage and disposal of pesticides, and perceptions towards the storage facility. The facility was appreciated as a means of preventing suicides and for providing a safe haven for pesticide storage. The participatory process that guided its design, construction and location ensured its acceptability. Use of qualitative methods helped provide deep insights into the phenomenon of pesticide suicide and aided the understanding of community perceptions towards the storage facility. The study suggests that communal storage of pesticides could be an important step towards reducing pesticide suicides in rural areas.

The space science data service: A study of its efficiencies and costs

NASA Technical Reports Server (NTRS)

Vette, J. I.; Hilberg, R. H.; Zuhl, D. E.; West, A. E.

1979-01-01

Factors affecting the overall advantages and disadvantages of a centralized facility for both the data base and processing capability for NASA's Office of Space Science programs are examined in an effort to determine the best approach to data management in the light of the increasing number of data bits collected annually. Selected issues considered relate to software and storage savings, security precautions, and the phase-in plan. Information on the current mode of processing and on the potential impact of changes resulting from a conversion to a space science data base service was obtained from five user groups and is presented as an aid in determining the dollar benefits and advantages of a centralized system.

The Federal Aviation Administration's radar training facility and employee selection and training.

DOT National Transportation Integrated Search

1980-09-01

The Federal Aviation Administration (FAA) has recently constructed a Radar Training Facility (RTF) in Oklahoma City, Oklahoma, to aid in screening appropriate personnel for work in radar air traffic control (ATC). The approach is based on the idea th...

38 CFR 39.62 - Space criteria for support facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... assignment for the next 10 years. (a) Administrative building. The administrative building should be.../office/equipment/work area); (5) Family/conference room; (6) Military honors team; (7) Refreshment unit; (8) Housekeeping aide's closet; and (9) Restroom facilities. (b) Maintenance/service building. The...

38 CFR 39.62 - Space criteria for support facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 10 years. (a) Administrative building. The administrative building should be approximately 1,600 NSF.../work area); (5) Family/conference room; (6) Military honors team; (7) Refreshment unit; (8) Housekeeping aide's closet; and (9) Restroom facilities. (b) Maintenance/service building. The maintenance...

45 CFR 605.22 - Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., assignment of aides to beneficiaries, home visits, delivery of health, welfare, or other social services at... changes in existing facilities where other methods are effective in achieving compliance with paragraph (a... in the most integrated setting appropriate. (c) Small health, welfare, or other social service...

Civil Aviation and Facilities. Aerospace Education II. Instructional Unit IV.

ERIC Educational Resources Information Center

Elmer, James D.

This publication accompanies the textbook entitled "Civil Aviation and Facilities," published in the Aerospace Education II series. It provides teacher guidelines with regard to objectives (traditional and behavioral), suggested outlines, orientation, suggested key points, suggestions for teaching, instructional aids, projects, and…

45 CFR 605.22 - Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., assignment of aides to beneficiaries, home visits, delivery of health, welfare, or other social services at... changes in existing facilities where other methods are effective in achieving compliance with paragraph (a... in the most integrated setting appropriate. (c) Small health, welfare, or other social service...

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

PubMed

Rowe, Laura A; Brillant, Sister Barbara; Cleveland, Emily; Dahn, Bernice T; Ramanadhan, Shoba; Podesta, Mae; Bradley, Elizabeth H

2010-03-18

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. 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. 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. 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.

Facility Management's Role in Organizational Sustainability

ERIC Educational Resources Information Center

Adams, Gregory K.

2013-01-01

Facility managers have questions about sustainability. How do an organization's physical facilities--its built environment--and the management of them, influence the sustainability of the organization or institution as a whole? How important is Facility Management (FM) to the overall sustainability profile of an organization? Facility managers…

Interventions and approaches to integrating HIV and mental health services: a systematic review

PubMed Central

Chuah, Fiona Leh Hoon; Haldane, Victoria Elizabeth; Cervero-Liceras, Francisco; Ong, Suan Ee; Sigfrid, Louise A; Murphy, Georgina; Watt, Nicola; Balabanova, Dina; Hogarth, Sue; Maimaris, Will; Otero, Laura; Buse, Kent; McKee, Martin; Piot, Peter; Perel, Pablo; Legido-Quigley, Helena

2017-01-01

Abstract Background The frequency in which HIV and AIDS and mental health problems co-exist, and the complex bi-directional relationship between them, highlights the need for effective care models combining services for HIV and mental health. Here, we present a systematic review that synthesizes the literature on interventions and approaches integrating these services. Methods This review was part of a larger systematic review on integration of services for HIV and non-communicable diseases. Eligible studies included those that described or evaluated an intervention or approach aimed at integrating HIV and mental health care. We searched multiple databases from inception until October 2015, independently screened articles identified for inclusion, conducted data extraction, and assessed evaluative papers for risk of bias. Results Forty-five articles were eligible for this review. We identified three models of integration at the meso and micro levels: single-facility integration, multi-facility integration, and integrated care coordinated by a non-physician case manager. Single-site integration enhances multidisciplinary coordination and reduces access barriers for patients. However, the practicality and cost-effectiveness of providing a full continuum of specialized care on-site for patients with complex needs is arguable. Integration based on a collaborative network of specialized agencies may serve those with multiple co-morbidities but fragmented and poorly coordinated care can pose barriers. Integrated care coordinated by a single case manager can enable continuity of care for patients but requires appropriate training and support for case managers. Involving patients as key actors in facilitating integration within their own treatment plan is a promising approach. Conclusion This review identified much diversity in integration models combining HIV and mental health services, which are shown to have potential in yielding positive patient and service delivery outcomes when implemented within appropriate contexts. Our review revealed a lack of research in low- and middle- income countries, and was limited to most studies being descriptive. Overall, studies that seek to evaluate and compare integration models in terms of long-term outcomes and cost-effectiveness are needed, particularly at the health system level and in regions with high HIV and AIDS burden. PMID:29106512

A Teaching Aid for Physiologists--Simulation of Kidney Function

ERIC Educational Resources Information Center

Packer, J. S.; Packer, J. E.

1977-01-01

Presented is the development of a simulation model of the facultative water transfer mechanism of the mammalian kidney. Discussion topics include simulation philosophy, simulation facilities, the model, and programming the model as a teaching aid. Graphs illustrate typical program displays. A listing of references concludes the article. (MA)

Building Automation System Cyber Networks: An Unmitigated Risk to Federal Facilities

DTIC Science & Technology

2015-12-01

250 Mark Rockwell, “New BPAs to Aid in Cyberdefense,” FCW, August 14, 2013, http://fcw.com/ articles/2013...sgp/crs/homesec/R41138.pdf. Rockwell, Mark. “New BPAs to Aid in Cyberdefense.” FCW. August 14, 2013. http://fcw.com/articles/2013/08/14/dhs

78 FR 66018 - Center for Scientific Review; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-04

... Panel, Accelerator Mass Spectrometry Facility. Date: December 2-3, 2013. Time: 8:00 a.m. to 6:00 p.m... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Center for Scientific Review... personal privacy. Name of Committee: AIDS and Related Research Integrated Review Group, AIDS-associated...

The Americans with Disabilities Act: Accommodations in Ohio.

ERIC Educational Resources Information Center

Carpenter, Scott A.

1996-01-01

A survey of 97 Ohio college and university libraries provided data on types of accommodations made in Title II (public), Title III (private), and Title IV (communication services and auxiliary aids) with respect to: access; auxiliary aids and services; restroom facilities; signage; and staff and policy making. Investigated the effects of…

41 CFR 102-72.40 - What are facility management delegations?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What are facility management delegations? 102-72.40 Section 102-72.40 Public Contracts and Property Management Federal Property... AUTHORITY Delegation of Authority § 102-72.40 What are facility management delegations? Facility management...

41 CFR 102-74.270 - Are vehicles required to display parking permits in parking facilities?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Are vehicles required to... Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Parking Facilities § 102-74.270 Are vehicles required...

Major Earthquakes of the Past Decade (2000-2010): A Comparative Review of Various Aspects of Management

PubMed Central

Kalantar Motamedi, Mohammad Hosein; Sagafinia, Masoud; Ebrahimi, Ali; Shams, Ehsan; Kalantar Motamedi, Mostafa

2012-01-01

Objectives: This article sought to review and compare data of major earthquakes of the past decade and their aftermath in order to compare the magnitude, death toll, type of injuries, management procedures, extent of destruction and effectiveness of relief efforts. Materials and Methods: A retrospective study of the various aspects of management and aftermath of 5 major earthquakes of the past decade (2000–2010) was undertaken. This included earthquakes occurring in Bam Iran, Sichuan China, Port-au-Prince Haiti, Kashmir Pakistan and Ica Peru. A literature search was done via computer of published articles (indexed in Pubmed). The issues assessed included: 1)Local magnitude,2)Type of building structure 3)Time of the earthquake (day/time/season), 4)Time to rescue, 5)Triage, Transfer, and Treatment 6) Distribution of casualties (dead/ injured), 7)Degree of city damage, 8)Degree of damage to health facilities, 9)Field hospital availability, 10)International aid, 11)Air transfer, 12) Telecommunication systems availability, 13) PTSD prevalence, 14) Most common injury and 15) Most common disease outbreak. Results: The Bam earthquake had the lowest (6.6 Richter’s) and the Sichuan earthquake had the greatest magnitude (8.0 Richter’s). Mortality in Haiti was 212,000 and it was the deadliest earthquake of the past decade. Collapse of heavy clay roofing structures was a major cause of death in Iran and Pakistan. Earthquakes occurring at night and nonworking days carried a high death toll. The time to rescue and treat was the lengthiest in Haiti (possibly contributing to the death to injured ratio). However, the worst dead to injured ratios were in Bam (51%) and in Pakistan (47%); the best ratio was in China (15%). Iran and Pakistan suffered the highest percentage of damage to the health facilities (90%). Field hospital availability, international aid and air transfer were important issues. Telecommunication systems were best in China and worst in Pakistan. PTSD prevalence was highest in Iran. Respiratory infection was the most common infection following all 5 earthquakes. Conclusions: Earthquake damage, death toll, managerial protocols etc. vary in different countries and are influenced by many factors including the hour the earthquake hits and the day of the week. Additionally, social, structural and geographic factors as well as the medical, governmental and NGO respondents are influential. Engineered residential construction remains to be of importance in reducing mortality in developing countries. It is essential that hospitals, fire departments and police stations, water, telephone and electrical facilities be made earthquake proof. PMID:24829886

Major earthquakes of the past decade (2000-2010): a comparative review of various aspects of management.

PubMed

Kalantar Motamedi, Mohammad Hosein; Sagafinia, Masoud; Ebrahimi, Ali; Shams, Ehsan; Kalantar Motamedi, Mostafa

2012-01-01

This article sought to review and compare data of major earthquakes of the past decade and their aftermath in order to compare the magnitude, death toll, type of injuries, management procedures, extent of destruction and effectiveness of relief efforts. A retrospective study of the various aspects of management and aftermath of 5 major earthquakes of the past decade (2000-2010) was undertaken. This included earthquakes occurring in Bam Iran, Sichuan China, Port-au-Prince Haiti, Kashmir Pakistan and Ica Peru. A literature search was done via computer of published articles (indexed in Pubmed). The issues assessed included: 1)Local magnitude,2)Type of building structure 3)Time of the earthquake (day/time/season), 4)Time to rescue, 5)Triage, Transfer, and Treatment 6) Distribution of casualties (dead/ injured), 7)Degree of city damage, 8)Degree of damage to health facilities, 9)Field hospital availability, 10)International aid, 11)Air transfer, 12) Telecommunication systems availability, 13) PTSD prevalence, 14) Most common injury and 15) Most common disease outbreak. The Bam earthquake had the lowest (6.6 Richter's) and the Sichuan earthquake had the greatest magnitude (8.0 Richter's). Mortality in Haiti was 212,000 and it was the deadliest earthquake of the past decade. Collapse of heavy clay roofing structures was a major cause of death in Iran and Pakistan. Earthquakes occurring at night and nonworking days carried a high death toll. The time to rescue and treat was the lengthiest in Haiti (possibly contributing to the death to injured ratio). However, the worst dead to injured ratios were in Bam (51%) and in Pakistan (47%); the best ratio was in China (15%). Iran and Pakistan suffered the highest percentage of damage to the health facilities (90%). Field hospital availability, international aid and air transfer were important issues. Telecommunication systems were best in China and worst in Pakistan. PTSD prevalence was highest in Iran. Respiratory infection was the most common infection following all 5 earthquakes. Earthquake damage, death toll, managerial protocols etc. vary in different countries and are influenced by many factors including the hour the earthquake hits and the day of the week. Additionally, social, structural and geographic factors as well as the medical, governmental and NGO respondents are influential. Engineered residential construction remains to be of importance in reducing mortality in developing countries. It is essential that hospitals, fire departments and police stations, water, telephone and electrical facilities be made earthquake proof.

Protease inhibitors: changing the way AIDS case management does business.

PubMed

Merithew, M A; Davis-Satterla, L

2000-09-01

The purpose of the qualitative evaluation study discussed in this article was to examine the AIDS case management model under which five nonprofit AIDS service organizations (ASOs) in Midcity were operating. The study was organized around 40 qualitative interviews with executive directors, directors, and case managers. The finding was that AIDS case management is evolving to accommodate the changing environmental/contextual conditions that have resulted from combination drug therapies (protease inhibitors) introduced in 1996. The agencies are responding to the changes individually rather than as a network, and responses vary among the agencies. Institutional theory, an examination of the interconnectedness of clients, the ASOs, and their environmental context guided the analysis of the findings.

The effect of an electronic cognitive aid on the management of ST-elevation myocardial infarction during caesarean section: a prospective randomised simulation study.

PubMed

St Pierre, Michael; Luetcke, Bjoern; Strembski, Dieter; Schmitt, Christopher; Breuer, Georg

2017-03-20

Cognitive aids have come to be viewed as promising tools in the management of perioperative critical events. The majority of published simulation studies have focussed on perioperative crises that are characterised by time pressure, rare occurrence, or complex management steps (e.g., cardiac arrest emergencies, management of the difficult airway). At present, there is limited information on the usefulness of cognitive aids in critical situations with moderate time pressure and complexity. Intraoperative myocardial infarction may be an emergency to which these limitations apply. Anaesthetic teams were allocated to control (no cognitive aid; n = 10) or intervention (cognitive aid provided; n = 10) groups. The primary aim of this study was to compare cognitive aid versus memory for intraoperative ST-elevation myocardial infarction (STEMI) management in a simulation of caesarean delivery under spinal anaesthesia. We identified nine evidence-based metrics of essential care from current guidelines and subdivided them into mandatory (high level of evidence; no interference with surgery) and optional (lower class of recommendation; possible impact on surgery) tasks. Six clinically relevant tasks were added by consensus. Implementation of these steps was measured by scoring task items in a binary fashion (yes/no). The interval between the diagnosis of STEMI and the first contact with the cardiac catheterisation lab was measured. To determine whether or not the cognitive aid had prompted an action, participants from the cognitive aid group were interviewed during debriefing on every single treatment step. At the end of the simulation, session participants were asked to complete a survey. The presence of the cognitive aid did not shorten the time interval until the cardiac catheterisation lab was contacted. The availability of the cognitive aid improved task performance in the tasks identified from the guidelines (93% vs. 69%; p < 0.001) as well as overall task performance (87.5% vs. 59%; p < 0.001). The observed difference in performance can be attributed to the use of the cognitive aid, as performance from memory alone would have been comparable across both groups. Trainees appeared to derive greater benefit from the cognitive aid than did consultants and nurses. The management of intraoperative ST-elevation myocardial infarction can be improved if teams use a cognitive aid. Trainees appeared to derive greater benefit from the cognitive aid than did consultants and nurses.

Design and development of a new facility for teaching and research in clinical anatomy.

PubMed

Greene, John Richard T

2009-01-01

This article discusses factors in the design, commissioning, project management, and intellectual property protection of developments within a new clinical anatomy facility in the United Kingdom. The project was aimed at creating cost-effective facilities that would address widespread concerns over anatomy teaching, and support other activities central to the university mission-namely research and community interaction. The new facilities comprise an engaging learning environment and were designed to support a range of pedagogies appropriate to the needs of healthcare professionals at different stages of their careers. Specific innovations include integrated workstations each comprising of a dissection table, with removable top sections, an overhead operating light, and ceiling-mounted camera. The tables incorporate waterproof touch-screen monitors to display images from the camera, an endoscope or a database of images, videos, and tutorials. The screens work independently so that instructors can run different teaching sessions simultaneously and students can progress at different speeds to suit themselves. Further, database access is provided from within an integrated anatomy and pathology museum and display units dedicated to the correlation of cross-sectional anatomy with medical imaging. A new functional neuroanatomy modeling system, called the BrainTower, has been developed to aid integration of anatomy with physiology and clinical neurology. Many aspects of the new facility are reproduced within a Mobile Teaching Unit, which can be driven to hospitals, colleges, and schools to provide appropriate work-based education and community interaction. (c) 2009 American Association of Anatomists

Impact of a Graduate Entry Programme on a medical school library service.

PubMed

Martin, Sam

2003-03-01

The aim of this study was to compare the use of library facilities by first year undergraduate medical students and Graduate Entry Programme students (GEP). More specifically it tried to determine which library services (if any) were more frequently used by GEP so that this could be taken into account in future Information Services planning. A questionnaire on the use of Library and Information Services was posted to all first year GEP students and undergraduates on the 5-year course. In addition, user statistics of library entry and borrowing were collated from gate readings and the library Unicorn management system. Overall, GEP students were found to make a greater daily/weekly use of library facilities than undergraduates on the 5-year course. The facilities most used by both sets of students were essential texts, e-mail, PCs and study facilities. Computer Aided Learning packages, journals and video facilities were least used. However, on a daily/weekly basis GEP students made 74% more use of journals (P < 0.01), 59% more use of e-journals (P < 0.05), 36% more use photocopiers (P < 0.05), 42% more use of printers (P < 0.05), 56% more use of the library catalogue (P < 0.05) and 50% more use of databases (P < 0.05). This difference in use should be taken into account by LIS providers as there is expected to be an increase in fast-track graduate courses offered by medical schools throughout the UK.

The influence of care provider access to structural empowerment on individualized care in long-term-care facilities.

PubMed

Caspar, Sienna; O'Rourke, Norm

2008-07-01

Implementing management initiatives that enable formal caregivers to provide quality, individualized care to older adults in long-term-care (LTC) facilities is increasingly important given that the number of LTC residents is projected to triple by 2031. The objective of this study was to explore the relationship between care provider access to structural empowerment and the provision of individualized care in LTC. We computed structural equation models separately for registered nurses and licensed practical nurses (n = 242) and care aides (n = 326) to examine the relationship between access to empowerment structures (i.e., informal power, formal power, information, support, resources, opportunity) and the provision of individualized care. We subsequently undertook invariance analyses to determine if the association between empowerment structures and reported provision of individualized care differed between caregiver groups. Access to structural empowerment had a statistically significant, positive association with provision of individualized care for both groups. For registered nurses/licensed practical nurses and care aides, empowerment explained 50% and 45% of observed variance in individualized care, respectively. These notable percentages did not differ significantly between caregiver groups. Of the empowerment structures, support, especially in the form of access to educational opportunities and recognition for a job well done, seems to be particularly significant to care providers. Findings from this study suggest that provision of individualized care in LTC may be enhanced when formal caregivers have appreciable access to empowerment structures.

38 CFR 39.21 - Space criteria for support facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... building. The administrative building should be approximately 1,600 NSF in total, providing space, as... room; (6) Military honors team; (7) Refreshment unit; (8) Housekeeping aide's closet; and (9) Restroom facilities. (b) Maintenance/service building. The maintenance/service building may be combined with the...

41 CFR 102-74.265 - Who must provide for the regulation and policing of parking facilities?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Who must provide for the... Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Parking Facilities § 102-74.265 Who must provide for...

41 CFR 102-74.55 - Are vending facilities authorized under the Randolph-Sheppard Act operated by permit or contract?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Are vending facilities... Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Concession Services § 102-74...

"HIV is irrelevant to our company": everyday practices and the logic of relationships in HIV/AIDS management by Japanese multinational corporations in northern Thailand.

PubMed

Michinobu, Ryoko

2009-03-01

Multinational corporations (MNCs) are important participants in workplace initiatives on HIV/AIDS as they collaborate with international organizations to globally promote various policies and guidelines. To date, MNCs have enacted the majority of such initiatives in North America, Europe and South Africa, but we have little information on how MNCs elsewhere, especially in Japan, have responded to the issue of HIV/AIDS in the workplace. This study examines the actual on the ground situation of HIV/AIDS management in Japanese MNCs, specifically investigating everyday corporate practices in the context of internal interactions and relationships and the resulting practices and outlook concerning HIV/AIDS. It is based on a secondary analysis of ethnographic case studies conducted in 10 Japanese-affiliated companies in northern Thailand. Japanese managers, Thai managers and ordinary Thai workers all considered HIV/AIDS to be "irrelevant" to their company and/or themselves. HIV/AIDS measures in the companies were limited to provision of information. This perception and management of HIV/AIDS developed from their everyday interactions governed by the logic of relationships in the companies. In these interactions, they categorized others based on their ascriptive status, primarily based on class, ethnicity and nationality. They sought scapegoat groups that were lower than them in the class- and ethnicity/nationality-based hierarchical system, and cast the risk of HIV infection upon the scapegoat groups, thus reducing their own sense of risk. The paper shows that the relational logic, not ideals or principles, influences their views of and actions concerning HIV/AIDS management in the companies. This is why Japanese companies are unable to deal with HIV/AIDS in terms of international policies and guidelines that are based on the logic of human rights and the logic of business principles. The results suggest a need for international policymakers to pay more attention to everyday practices in the actual field of policy dissemination.

Description, Normative Data, and Utility of the Hearing Aid Skills and Knowledge Test.

PubMed

Saunders, Gabrielle H; Morse-Fortier, Charlotte; McDermott, Daniel J; Vachhani, Jay J; Grush, Leslie D; Griest, Susan; Lewis, M Samantha

2018-03-01

The ability to manage hearing aids is crucial for successful outcomes and for maintaining hearing aid use. It is therefore important to have a tool that can effectively identify which hearing aid management skills are lacking so that the audiologist can provide additional education and training on that skill. Such a tool can also provide useful quantitative data for researchers. To collect normative data (Experiment 1) and assess inter- and intrarater reliability (Experiment 2) for a hearing aid management assessment tool known as the Hearing Aid Skills and Knowledge (HASK) test. Two hundred thirty-six new hearing aid users recruited from the VA Portland Health Care System and 126 experienced hearing aid users recruited from the local Portland community participated in Experiment 1. The veteran participants were taking part in a larger hearing aid study, and the community participants were recruited at community events that took place around Portland, OR. Three clinical audiologists and two AuD students completing their fourth year externship participated in Experiment 2. In Experiment 1, HASK data were collected from the new hearing aid users at 4-8 wk and 6-8 mo after the fitting of their first pair of hearing aids, and from experienced users on a single occasion. In addition, self-reported hearing aid use, benefit, and satisfaction were assessed for all participants. The audiologists/students in Experiment 2 watched and independently scored videos of six individuals completing the HASK. Intraclass correlation coefficients (ICCs) across audiologists were computed for HASK scores. Three audiologists/students rated at least one video on two occasions to provide interrater reliability data. Mean performance on the HASK was about 70% for knowledge and 80% for skills for both the new and experienced hearing aid users. Performance did not change among the new users between the 4-8 wk and 6-8 mo administration. The specific skills lacking were associated with advanced management abilities (cleaning and troubleshooting). Experiment 2 revealed ICCs for inter- and intrarater reliability for HASK to range from 0.76 to 0.94, showing acceptable to excellent reliability. The HASK is a quick and easy test with good-to-excellent inter- and intrarater reliability. It can effectively identify which hearing aid management skills are lacking so that the audiologist can provide additional education and training on those skills. Data show performance is ∼70% for knowledge and 80% for skills and this does not change with hearing aid experience. The significant positive correlations between HASK scores and hearing aid use and satisfaction highlight the notion that ability to manage hearing aids successfully is integral to good hearing aid outcome. American Academy of Audiology

Simulation of mass storage systems operating in a large data processing facility

NASA Technical Reports Server (NTRS)

Holmes, R.

1972-01-01

A mass storage simulation program was written to aid system designers in the design of a data processing facility. It acts as a tool for measuring the overall effect on the facility of on-line mass storage systems, and it provides the means of measuring and comparing the performance of competing mass storage systems. The performance of the simulation program is demonstrated.

VIEW OF BUILDING 122 WHICH HOUSES THE ONSITE MEDICAL FACILITIES ...

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

VIEW OF BUILDING 122 WHICH HOUSES THE ON-SITE MEDICAL FACILITIES OF THE ROCKY FLATS PLANT AND THE OCCUPATIONAL HEALTH AND INTERNAL DOSIMETRY ORGANIZATIONS. EMERGENCY MEDICAL SERVICES, DIAGNOSIS, DECONTAMINATION, FIRST AID, X-RAY, MINOR SURGICAL TREATMENT, AND AMBULATORY ACTIVITIES ARE CARRIED OUT IN THIS BUILDING. (1/98) - Rocky Flats Plant, Emergency Medical Services Facility, Southwest corner of Central & Third Avenues, Golden, Jefferson County, CO

FY11 Facility Assessment Study for Aeronautics Test Program

NASA Technical Reports Server (NTRS)

Loboda, John A.; Sydnor, George H.

2013-01-01

This paper presents the approach and results for the Aeronautics Test Program (ATP) FY11 Facility Assessment Project. ATP commissioned assessments in FY07 and FY11 to aid in the understanding of the current condition and reliability of its facilities and their ability to meet current and future (five year horizon) test requirements. The principle output of the assessment was a database of facility unique, prioritized investments projects with budgetary cost estimates. This database was also used to identify trends for the condition of facility systems.

Hydrology, description of computer models, and evaluation of selected water-management alternatives in the San Bernardino area, California

USGS Publications Warehouse

Danskin, Wesley R.; McPherson, Kelly R.; Woolfenden, Linda R.

2006-01-01

The San Bernardino area of southern California has complex water-management issues. As an aid to local water managers, this report provides an integrated analysis of the surface-water and ground-water systems, documents ground-water flow and constrained optimization models, and provides seven examples using the models to better understand and manage water resources of the area. As an aid to investigators and water managers in other areas, this report provides an expanded description of constrained optimization techniques and how to use them to better understand the local hydrogeology and to evaluate inter-related water-management problems. In this report, the hydrology of the San Bernardino area, defined as the Bunker Hill and Lytle Creek basins, is described and quantified for calendar years 1945-98. The major components of the surface-water system are identified, and a routing diagram of flow through these components is provided. Annual surface-water inflow and outflow for the area are tabulated using gaged measurements and estimated values derived from linear-regression equations. Average inflow for the 54-year period (1945-98) was 146,452 acre-feet per year; average outflow was 67,931 acre-feet per year. The probability of exceedance for annual surface-water inflow is calculated using a Log Pearson Type III analysis. Cumulative surface-water inflow and outflow and ground-water-level measurements indicate that the relation between the surface-water system and the ground-water system changed in about 1951, in about 1979, and again in about 1992. Higher ground-water levels prior to 1951 and between 1979 and 1992 induced ground-water discharge to Warm Creek. This discharge was quantified using streamflow measurements and can be estimated for other time periods using ground-water levels from a monitoring well (1S/4W-3Q1) and a logarithmic-regression equation. Annual wastewater discharge from the area is tabulated for the major sewage and power-plant facilities. More...

Pressure ulcer prevention in long-term-care facilities: a pilot study implementing standardized nurse aide documentation and feedback reports.

PubMed

Horn, Susan D; Sharkey, Siobhan S; Hudak, Sandra; Gassaway, Julie; James, Roberta; Spector, William

2010-03-01

To design and facilitate implementation of practice-based evidence changes associated with decreases in pressure ulcer (PrU) development in long-term-care (LTC) facilities and promote these practices as part of routine care. Pre/post observational study. Frail older adult residents in 11 US LTC facilities. Project facilitators assisted frontline multidisciplinary teams (certified nurse aides [CNAs], nurses, and dietitians/dietary aides) to develop streamlined standardized CNA documentation and weekly reports to identify high-risk residents and to integrate clinical reports into day-to-day practice and clinical decision making. The program was called "Real-Time Optimal Care Plans for Nursing Home QI" (Real-Time). Prevalence of PrUs using Centers for Medicare & Medicaid Services (CMS) quality measures (QMs), number of in-house-acquired PrUs, and number and completeness of CNA documentation forms. Seven study LTC facilities that reported data to CMS experienced a combined 33% (SD, 36.1%) reduction in the CMS high-risk PrU QM in 18 months and reduction in newly occurring PrUs (number of ulcers in the fourth quarter of 2003: range, 2-19; and in the third quarter of 2005: range, 1-6). Five of these LTC facilities that fully implemented Real-Time experienced a combined 48.1% (SD, 23.4%) reduction in the CMS high-risk PrU QM. Ten facilities reduced by an average of 2 to 5 their number of CNA documentation forms; CNA weekly documentation completeness reached a consistent level of 90% to 95%, and 8 facilities integrated the use of 2 to 4 weekly project reports in routine clinical decision making. Quality improvement efforts that provide access to focused and timely clinical information, facilitate change, and promote staff working together in multidisciplinary teams impacted clinical outcomes. Prevention of PrUs showed a trend of improvement in facilities that fully integrated tools to identify high-risk residents into day-to-day practice. CNA documentation facilitated better information for clinical decision making. More than 70 additional LTC facilities across the United States are implementing this QI program.

41 CFR 102-192.135 - Must we have a mail center manager at our facility?

Code of Federal Regulations, 2010 CFR

2010-07-01

... center manager at our facility? 102-192.135 Section 102-192.135 Public Contracts and Property Management... PROGRAMS 192-MAIL MANAGEMENT Mail Center Manager Requirements § 102-192.135 Must we have a mail center manager at our facility? Yes, every facility that has more than two full time people dedicated to...

Vehicle Thermal Management Facilities | Transportation Research | NREL

Science.gov Websites

Management Facilities Vehicle Thermal Management Facilities Image of a building with two semi truck evaluation facilities to develop advanced thermal management technologies for vehicles. Vehicle Testing and apparatus. Combined fluid loops bench research apparatus in the Vehicle Thermal Management Laboratory. Photo

41 CFR 102-74.585 - What Federal facility telework policy must Executive agencies follow?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What Federal facility... Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Telework § 102-74.585 What Federal facility telework policy must Executive...

Gender asymmetry in healthcare-facility attendance of people living with HIV/AIDS in Burkina Faso.

PubMed

Bila, Blandine; Egrot, Marc

2009-09-01

Anthropological research in Burkina Faso indicates that more HIV-positive women than HIV-positive men are attending care facilities for people living with HIV/AIDS (PLWH) and accessing antiretroviral medicine. This article, situated in the field of study of interactions between gender and AIDS, offers a description of this asymmetry and an anthropological analysis of the socio-cultural determinants, through analysis of data from ethnographic research among PLWH and health actors. Examining social representations of femininity and masculinity in Burkinabe society and the organisation of the healthcare system in connection with gender shed light on the decision-making processes of both sexes around therapeutic choices and the itinerary of care. On the one hand, the social values attached to femininity, maternity and the status of wife create conditions for women that favour their attendance at care facilities for PLWH and encourage a widespread practice where wives take the place of their husbands in healthcare queues. Moreover, health policies and the effects of women's empowerment within the healthcare system strengthen women's access to health services. On the other hand, representations of masculinity are fully implicated in the cultural construction of men's reluctance to attend care facilities for PLWH. The values associated with this masculinity cause men to run great health, economic and social risks, not only for themselves, but also for their wives and children. By better understanding the interaction between gender, the experience of HIV and the institutional organisation of healthcare, we can identify ways to reduce men's reluctance to attend care facilities for PLWH and improve both prevention and treatment-oriented programmes.

Pain in human immunodeficiency virus disease.

PubMed

Newshan, G

1997-02-01

To review the prevalence and etiology of pain in persons with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), and issues and considerations for pain management in this patient population. Research studies, review articles, and books related to pain in persons with HIV/AIDS. Pain is a common problem for individuals with HIV/AIDS that is often poorly managed and net well documented. Many of these patients have multiple, coexisting illnesses that are painful. Adequate assessment of the underlying cause will help in the treatment or eradication of pain. The management of pain in persons with HIV/AIDS is an important responsibility for oncology nurses because increasing numbers of persons with HIV/AIDS are being treated for neoplastic complications, cytopenias, or being referred to hospice care.

78 FR 15016 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-08

... permitted to use paid feeding assistants to supplement the services of certified nurse aides. If facilities choose this option, feeding assistants must complete a training program. Nursing home providers are... collection; Title of Information Collection: Paid Feeding Assistants in Long-Term Care Facilities and...

26 CFR 1.118-2 - Contribution in aid of construction.

Code of Federal Regulations, 2010 CFR

2010-04-01

... adjusted basis of the water facility from zero to $20,000. (e) Statute of limitations—(1) Extension of... Contribution in aid of construction. (a) Special rule for water and sewerage disposal utilities—(1) In general... public utility that provides water or sewerage disposal services if— (i) The amount is a contribution in...

26 CFR 1.118-2 - Contribution in aid of construction.

Code of Federal Regulations, 2013 CFR

2013-04-01

... adjusted basis of the water facility from zero to $20,000. (e) Statute of limitations—(1) Extension of... Contribution in aid of construction. (a) Special rule for water and sewerage disposal utilities—(1) In general... public utility that provides water or sewerage disposal services if— (i) The amount is a contribution in...

26 CFR 1.118-2 - Contribution in aid of construction.

Code of Federal Regulations, 2011 CFR

2011-04-01

... adjusted basis of the water facility from zero to $20,000. (e) Statute of limitations—(1) Extension of... Contribution in aid of construction. (a) Special rule for water and sewerage disposal utilities—(1) In general... public utility that provides water or sewerage disposal services if— (i) The amount is a contribution in...

26 CFR 1.118-2 - Contribution in aid of construction.

Code of Federal Regulations, 2012 CFR

2012-04-01

... adjusted basis of the water facility from zero to $20,000. (e) Statute of limitations—(1) Extension of... Contribution in aid of construction. (a) Special rule for water and sewerage disposal utilities—(1) In general... public utility that provides water or sewerage disposal services if— (i) The amount is a contribution in...

26 CFR 1.118-2 - Contribution in aid of construction.

Code of Federal Regulations, 2014 CFR

2014-04-01

... adjusted basis of the water facility from zero to $20,000. (e) Statute of limitations—(1) Extension of... Contribution in aid of construction. (a) Special rule for water and sewerage disposal utilities—(1) In general... public utility that provides water or sewerage disposal services if— (i) The amount is a contribution in...

42 CFR 483.150 - Statutory basis; Deemed meeting or waiver of requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... CARE FACILITIES Requirements That Must Be Met by States and State Agencies: Nurse Aide Training and Competency Evaluation, and Paid Feeding Assistants § 483.150 Statutory basis; Deemed meeting or waiver of... 1919(f)(2) of the Act, which establish standards for training nurse-aides and for evaluating their...

42 CFR 483.150 - Statutory basis; Deemed meeting or waiver of requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... CARE FACILITIES Requirements That Must Be Met by States and State Agencies: Nurse Aide Training and Competency Evaluation, and Paid Feeding Assistants § 483.150 Statutory basis; Deemed meeting or waiver of... 1919(f)(2) of the Act, which establish standards for training nurse-aides and for evaluating their...

42 CFR 483.150 - Statutory basis; Deemed meeting or waiver of requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... CARE FACILITIES Requirements That Must Be Met by States and State Agencies: Nurse Aide Training and Competency Evaluation, and Paid Feeding Assistants § 483.150 Statutory basis; Deemed meeting or waiver of... 1919(f)(2) of the Act, which establish standards for training nurse-aides and for evaluating their...

42 CFR 483.150 - Statutory basis; Deemed meeting or waiver of requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... CARE FACILITIES Requirements That Must Be Met by States and State Agencies: Nurse Aide Training and Competency Evaluation, and Paid Feeding Assistants § 483.150 Statutory basis; Deemed meeting or waiver of... 1919(f)(2) of the Act, which establish standards for training nurse-aides and for evaluating their...

The effects of nationality differences and work stressors on work adjustment for foreign nurse aides.

PubMed

Huang, Fen Fen; Yang, Hsieh Hua

2011-08-17

The main purpose of this study was to discuss the nationality differences of foreign nurse aides and the effect of work stressors influencing work adjustment. And of helping them adapt to Taiwanese society, we summarized the difficulties that foreign nurse aides face in Taiwan. The subjects included 80 foreign nurse aides from the Philippines, Indonesia, and Vietnam who worked in long-term care facilities in Tao Yuan County. We recruited volunteers at the participating facilities to complete the anonymous questionnaires. The return rate of the questionnaire was 88.75%. The validated instruments of Hershenson's (1981) and Schaefer and Moos (1993) were adopted to measure work stressors and work adjustment, respectively. A forward-backward translation process was used in this study. Indonesian foreign nurse aides respect their work, and are better workers than Vietnamese and Filipino nurse aids in many respects, which shows how the nationality of the foreign nurse aides might affect work adjustment. The stress created from patient care tasks influenced the foreign nurse aides' personal relationships at work and also affected their attitude when they performed their tasks. In addition, pressure from their supervisors might have affected their work skills, work habits, personal relationships, self-concepts or work attitudes. Moreover, a heavy workload and improper scheduling might have affected the personal relationships and work attitudes of the foreign nurse aides. It was found that work stressors had a significant correlation with work adjustment. The results of the present study indicate that training programs are important factors for work adjustment among foreign nurse aides. Furthermore, celebration and leisure activities could be provided to release them from work stressors. More effort should be put into improving the working environment, namely providing a more supportive and enriching atmosphere. Based on these findings, we have a better understanding of how to assist foreign nurse aides in the future.

Quality Assurance of Rapid Diagnostic Tests for Malaria in Routine Patient Care in Rural Tanzania

PubMed Central

McMorrow, Meredith L.; Masanja, M. Irene; Kahigwa, Elizeus; Abdulla, Salim M. K.; Kachur, S. Patrick

2010-01-01

Histidine-rich protein II (HRP2)-based malaria rapid diagnostic tests (RDTs) have shown high sensitivity and specificity for detecting Plasmodium falciparum malaria in a variety of study settings. However, RDTs are susceptible to heat and humidity and variation in individual performance, which may affect their use in field settings. We evaluated sensitivity and specificity of RDTs during routine use for malaria case management in peripheral health facilities. From December 2007 to October 2008, HRP2-based ParaHIT-f RDTs were introduced in 12 facilities without available microscopy in Rufiji District, Tanzania. Health workers received a single day of instruction on how to perform an RDT and thick blood smear. Job aids, Integrated Management of Childhood Illness guidelines, and national malaria treatment algorithms were reviewed. For quality assurance (QA), thick blood smears for reference microscopy were collected for 2 to 3 days per week from patients receiving RDTs; microscopy was not routinely performed at the health facilities. Slides were stained and read centrally within 72 hours of collection by a reference microscopist. When RDT and blood smear results were discordant, blood smears were read by additional reference microscopists blinded to earlier results. Facilities were supervised monthly by the district laboratory supervisor or a member of the study team. Ten thousand six hundred fifty (10,650) patients were tested with RDTs, and 51.5% (5,488/10,650) had a positive test result. Blood smear results were available for 3,914 patients, of whom 40.1% (1,577/3,914) were positive for P. falciparum malaria. Overall RDT sensitivity was 90.7% (range by facility 85.7–96.5%) and specificity was 73.5% (range 50.0–84.3%). Sensitivity increased with increasing parasite density. Successful implementation of RDTs was achieved in peripheral health facilities with adequate training and supervision. Quality assurance is essential to the adequate performance of any laboratory test. Centralized staining and reading of blood smears provided useful monitoring of RDT performance. However, this level of QA may not be sustainable nationwide. PMID:20065013

41 CFR 102-74.310 - What measures must Federal agencies take to improve the utilization of parking facilities?

Code of Federal Regulations, 2010 CFR

2010-07-01

...) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Parking Facilities... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What measures must Federal agencies take to improve the utilization of parking facilities? 102-74.310 Section 102-74.310...

Broadband Outdoor Radiometer Calibration Process for the Atmospheric Radiation Measurement Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dooraghi, Michael

2015-09-01

The Atmospheric Radiation Measurement program (ARM) maintains a fleet of monitoring stations to aid in the improved scientific understanding of the basic physics related to radiative feedback processes in the atmosphere, particularly the interactions among clouds and aerosols. ARM obtains continuous measurements and conducts field campaigns to provide data products that aid in the improvement and further development of climate models. All of the measurement campaigns include a suite of solar measurements. The Solar Radiation Research Laboratory at the National Renewable Energy Laboratory supports ARM's full suite of stations in a number of ways, including troubleshooting issues that arise asmore » part of the data-quality reviews; managing engineering changes to the standard setup; and providing calibration services and assistance to the full fleet of solar-related instruments, including pyranometers, pyrgeometers, pyrheliometers, as well as the temperature/relative humidity probes, multimeters, and data acquisition systems that are used in the calibrations performed at the Southern Great Plains Radiometer Calibration Facility. This paper discusses all aspects related to the support provided to the calibration of the instruments in the solar monitoring fleet.« less

The care unit in nursing home research: Evidence in support of a definition

PubMed Central

2011-01-01

Background Defining what constitutes a resident care unit in nursing home research is both a conceptual and practical challenge. The aim of this paper is to provide evidence in support of a definition of care unit in nursing homes by demonstrating: (1) its feasibility for use in data collection, (2) the acceptability of aggregating individual responses to the unit level, and (3) the benefit of including unit level data in explanatory models. Methods An observational study design was used. Research (project) managers, healthcare aides, care managers, nursing home administrators and directors of care from thirty-six nursing homes in the Canadian prairie provinces of Alberta, Saskatchewan and Manitoba provided data for the study. A definition of care unit was developed and applied in data collection and analyses. A debriefing session was held with research managers to investigate their experiences with using the care unit definition. In addition, survey responses from 1258 healthcare aides in 25 of the 36 nursing homes in the study, that had more than one care unit, were analyzed using a multi-level modeling approach. Trained field workers administered the Alberta Context Tool (ACT), a 58-item self-report survey reflecting 10 organizational context concepts, to healthcare aides using computer assisted personal interviews. To assess the appropriateness of obtaining unit level scores, we assessed aggregation statistics (ICC(1), ICC(2), η2, and ω2), and to assess the value of using the definition of unit in explanatory models, we performed multi-level modeling. Results In 10 of the 36 nursing homes, the care unit definition developed was used to align the survey data (for analytic purposes) to specific care units as designated by our definition, from that reported by the facility administrator. The aggregation statistics supported aggregating the healthcare aide responses on the ACT to the realigned unit level. Findings from the multi-level modeling further supported unit level aggregation. A significantly higher percentage of variance was explained in the ACT concepts at the unit level compared to the individual and/or nursing home levels. Conclusions The statistical results support the use of our definition of care unit in nursing home research in the Canadian prairie provinces. Beyond research convenience however, the results also support the resident unit as an important Clinical Microsystem to which future interventions designed to improve resident quality of care and staff (healthcare aide) worklife should be targeted. PMID:21492456

Epidemiology, determinants, and management of AIDS cholangiopathy: A review

PubMed Central

Naseer, Maliha; Dailey, Francis E; Juboori, Alhareth Al; Samiullah, Sami; Tahan, Veysel

2018-01-01

Diseases of the liver and biliary tree have been described with significant frequency among patients with human immunodeficiency virus (HIV), and its advanced state, acquired immunodeficiency syndrome (AIDS). Through a variety of mechanisms, HIV/AIDS has been shown to affect the hepatic parenchyma and biliary tree, leading to liver inflammation and biliary strictures. One of the potential hepatobiliary complications of this viral infection is AIDS cholangiopathy, a syndrome of biliary obstruction and liver damage due to infection-related strictures of the biliary tract. AIDS cholangiopathy is highly associated with opportunistic infections and advanced immunosuppression in AIDS patients, and due to the increased availability of highly active antiretroviral therapy, is now primarily seen in instances of poor access to anti-retroviral therapy and medication non-compliance. While current published literature describes well the clinical, biochemical, and endoscopic management of AIDS-related cholangiopathy, information on its epidemiology, natural history, and pathology are not as well defined. The objective of this review is to summarize the available literature on AIDS cholangiopathy, emphasizing its epidemiology, course of disease, and determinants, while also revealing an updated approach for its evaluation and management. PMID:29467548

Epidemiology, determinants, and management of AIDS cholangiopathy: A review.

PubMed

Naseer, Maliha; Dailey, Francis E; Juboori, Alhareth Al; Samiullah, Sami; Tahan, Veysel

2018-02-21

Diseases of the liver and biliary tree have been described with significant frequency among patients with human immunodeficiency virus (HIV), and its advanced state, acquired immunodeficiency syndrome (AIDS). Through a variety of mechanisms, HIV/AIDS has been shown to affect the hepatic parenchyma and biliary tree, leading to liver inflammation and biliary strictures. One of the potential hepatobiliary complications of this viral infection is AIDS cholangiopathy, a syndrome of biliary obstruction and liver damage due to infection-related strictures of the biliary tract. AIDS cholangiopathy is highly associated with opportunistic infections and advanced immunosuppression in AIDS patients, and due to the increased availability of highly active antiretroviral therapy, is now primarily seen in instances of poor access to anti-retroviral therapy and medication non-compliance. While current published literature describes well the clinical, biochemical, and endoscopic management of AIDS-related cholangiopathy, information on its epidemiology, natural history, and pathology are not as well defined. The objective of this review is to summarize the available literature on AIDS cholangiopathy, emphasizing its epidemiology, course of disease, and determinants, while also revealing an updated approach for its evaluation and management.

Service Delivery and Patient Outcomes in Ryan White HIV/AIDS Program–Funded and –Nonfunded Health Care Facilities in the United States

PubMed Central

Weiser, John; Beer, Linda; Frazier, Emma L.; Patel, Roshni; Dempsey, Antigone; Hauck, Heather; Skarbinski, Jacek

2016-01-01

IMPORTANCE Outpatient human immunodeficiency virus (HIV) health care facilities receive funding from the Ryan White HIV/AIDS Program (RWHAP) to provide medical care and essential support services that help patients remain in care and adhere to treatment. Increased access to Medicaid and private insurance for HIV-infected persons may provide coverage for medical care but not all needed support services and may not supplant the need for RWHAP funding. OBJECTIVE To examine differences between RWHAP-funded and non–RWHAP-funded facilities and in patient outcomes between the 2 systems. DESIGN, SETTING, AND PARTICIPANTS The study was conducted from June 1, 2009, to May 31, 2012, using data from the 2009 and 2011 cycles of the Medical Monitoring Project, a national probability sample of 8038 HIV-infected adults receiving medical care at 989 outpatient health care facilities providing HIV medical care. MAIN OUTCOMES AND MEASURES Data were used to compare patient characteristics, service needs, and access to services at RWHAP-funded vs non–RWHAP-funded facilities. Differences in prescribed antiretroviral treatment and viral suppression were assessed. Data analysis was performed between February 2012 and June 2015. RESULTS Overall, 34.4% of facilities received RWHAP funding and 72.8% of patients received care at RWHAP-funded facilities. With results reported as percentage (95% CI), patients attending RWHAP-funded facilities were more likely to be aged 18 to 29 years (8.5%[7.4%–9.5%] vs 5.0%[3.9%–6.2%]), female (29.2%[27.2%–31.2%] vs 20.1%[17.0%–23.1%]), black (47.5% [41.5%–53.5%] vs 25.8% [20.6%–31.0%]) or Hispanic (22.5%[16.4%–28.6%] vs 12.9%[10.6%–15.2%]), have less than a high school education (26.1% [24.0%–28.3%] vs 10.9%[8.7%–13.1%]), income at or below the poverty level (53.6%[50.3%–56.9%] vs 23.9%[19.7%–28.0%]), and lack health care coverage (25.0%[21.9%–28.1%] vs 6.1% [4.1%–8.0%]). The RWHAP-funded facilities were more likely to provide case management (76.1% [69.9%–82.2%] vs 15.4%[10.4%–20.4%]) as well as mental health (64.0%[57.0%–71.0%] vs 18.0%[14.0%–21.9%]), substance abuse (33.6%[27.0%–40.2%] vs 12.0%[8.0%–16.0%]), and other support services; patients attending RWHAP-funded facilities were more likely to receive these services. After adjusting for patient characteristics, the percentage prescribed ART antiretroviral therapy, reported as adjusted prevalence ratio (95% CI), was similar between RWHAP-funded and non–RWHAP-funded facilities (1.01 [0.99–1.03]), but among poor patients, those attending RWHAP-funded facilities were more likely to be virally suppressed (1.09 [1.02–1.16]). CONCLUSIONS AND RELEVANCE A total of 72.8% of HIV-positive patients received care at RWHAP-funded facilities. Many had multiple social determinants of poor health and used services at RWHAP-funded facilities associated with improved outcomes. Without facilities supported by the RWHAP, these patients may have had reduced access to services elsewhere. Poor patients were more likely to achieve viral suppression if they received care at a RWHAP-funded facility. PMID:26322677

Service Delivery and Patient Outcomes in Ryan White HIV/AIDS Program-Funded and -Nonfunded Health Care Facilities in the United States.

PubMed

Weiser, John; Beer, Linda; Frazier, Emma L; Patel, Roshni; Dempsey, Antigone; Hauck, Heather; Skarbinski, Jacek

2015-10-01

Outpatient human immunodeficiency virus (HIV) health care facilities receive funding from the Ryan White HIV/AIDS Program (RWHAP) to provide medical care and essential support services that help patients remain in care and adhere to treatment. Increased access to Medicaid and private insurance for HIV-infected persons may provide coverage for medical care but not all needed support services and may not supplant the need for RWHAP funding. To examine differences between RWHAP-funded and non-RWHAP-funded facilities and in patient outcomes between the 2 systems. The study was conducted from June 1, 2009, to May 31, 2012, using data from the 2009 and 2011 cycles of the Medical Monitoring Project, a national probability sample of 8038 HIV-infected adults receiving medical care at 989 outpatient health care facilities providing HIV medical care. Data were used to compare patient characteristics, service needs, and access to services at RWHAP-funded vs non-RWHAP-funded facilities. Differences in prescribed antiretroviral treatment and viral suppression were assessed. Data analysis was performed between February 2012 and June 2015. Overall, 34.4% of facilities received RWHAP funding and 72.8% of patients received care at RWHAP-funded facilities. With results reported as percentage (95% CI), patients attending RWHAP-funded facilities were more likely to be aged 18 to 29 years (8.5% [7.4%-9.5%] vs 5.0% [3.9%-6.2%]), female (29.2% [27.2%-31.2%] vs 20.1% [17.0%-23.1%]), black (47.5% [41.5%-53.5%] vs 25.8% [20.6%-31.0%]) or Hispanic (22.5% [16.4%-28.6%] vs 12.9% [10.6%-15.2%]), have less than a high school education (26.1% [24.0%-28.3%] vs 10.9% [8.7%-13.1%]), income at or below the poverty level (53.6% [50.3%-56.9%] vs 23.9% [19.7%-28.0%]), and lack health care coverage (25.0% [21.9%-28.1%] vs 6.1% [4.1%-8.0%]). The RWHAP-funded facilities were more likely to provide case management (76.1% [69.9%-82.2%] vs 15.4% [10.4%-20.4%]) as well as mental health (64.0% [57.0%-71.0%] vs 18.0% [14.0%-21.9%]), substance abuse (33.6% [27.0%-40.2%] vs 12.0% [8.0%-16.0%]), and other support services; patients attending RWHAP-funded facilities were more likely to receive these services. After adjusting for patient characteristics, the percentage prescribed ART antiretroviral therapy, reported as adjusted prevalence ratio (95% CI), was similar between RWHAP-funded and non-RWHAP-funded facilities (1.01 [0.99-1.03]), but among poor patients, those attending RWHAP-funded facilities were more likely to be virally suppressed (1.09 [1.02-1.16]). A total of 72.8% of HIV-positive patients received care at RWHAP-funded facilities. Many had multiple social determinants of poor health and used services at RWHAP-funded facilities associated with improved outcomes. Without facilities supported by the RWHAP, these patients may have had reduced access to services elsewhere. Poor patients were more likely to achieve viral suppression if they received care at a RWHAP-funded facility.

An ethnobotanical survey of plants used to manage HIV/AIDS opportunistic infections in Katima Mulilo, Caprivi region, Namibia

PubMed Central

2010-01-01

Katima Mulilo has the highest burden of HIV/AIDS in Namibia. Due to several constraints of the antiretroviral therapy programme, HIV-infected persons still use ethnomedicines to manage AIDS-related opportunistic infections. Despite the reliance on plants to manage HIV/AIDS in Katima Mulilo, there have been no empirical studies to document the specific plant species used by traditional healers to treat AIDS-related opportunistic infections. In this study, an ethnobotanical survey was conducted to record the various plant families, species, and plant parts used to manage different HIV/AIDS-related opportunistic infections in Katima Mulilo, Caprivi region, Namibia. The results showed that a total of 71 plant species from 28 families, mostly the Combretaceae (14%), Anacardiaceae (8%), Mimosaceae (8%), and Ebanaceae (7%), were used to treat conditions such as herpes zoster, diarrhoea, coughing, malaria, meningitis, and tuberculosis. The most plant parts used were leaves (33%), bark (32%), and roots (28%) while the least used plant parts were fruits/seeds (4%). Further research is needed to isolate the plants' active chemical compounds and understand their modes of action. PMID:20831821

The State's Role in Addressing the School Facility Funding Crisis.

ERIC Educational Resources Information Center

Sielke, Catherine C.

2000-01-01

Between 1994 and 1998, capital outlay funding bills for school facilities, tax bases, and taxation bills experienced the greatest growth in state legislative activity. This article discusses the reasons for increased funding activity, various state-aid mechanisms to fund capital outlay, and future capital funding directions. (MLH)

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 for...

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 for...

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 for...

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 for...

14 CFR 135.67 - Reporting potentially hazardous meteorological conditions and irregularities of ground facilities...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Reporting potentially hazardous... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR CARRIERS... irregularity in a ground facility or navigation aid in flight, the knowledge of which the pilot considers...

14 CFR 135.67 - Reporting potentially hazardous meteorological conditions and irregularities of ground facilities...

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Reporting potentially hazardous... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR CARRIERS... irregularity in a ground facility or navigation aid in flight, the knowledge of which the pilot considers...

DEVELOPMENT OF THE U.S. EPA'S METAL FINISHING FACILITY POLLUTION PREVENTION TOOL

EPA Science Inventory

Metal finishing processes are a type of chemical processes and can be modeled using Computer Aided Process Engineering (CAPE). Currently, the U.S. EPA is developing the Metal Finishing Facility Pollution Prevention Tool (MFFP2T), a pollution prevention software tool for the meta...

Predicting Nursing Facility Transition Candidates Using AID: A Case Study

ERIC Educational Resources Information Center

James, Mary L.; Wiley, Elizabeth; Fries, Brant E.

2007-01-01

Purpose: Although the nursing facility transition literature is growing, little research has analyzed the characteristics of individuals so assisted or compared participants to those who remain institutionalized. This article describes an analytic method that researchers can apply to address these knowledge gaps, using the Arkansas Passages…

40 CFR 792.31 - Testing facility management.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 31 2010-07-01 2010-07-01 true Testing facility management. 792.31... facility management. For each study, testing facility management shall: (a) Designate a study director as... appropriately tested for identity, strength, purity, stability, and uniformity, as applicable. (e) Assure that...

Effect of health education on trainee teachers' knowledge, attitudes, and first aid management of epilepsy: An interventional study.

PubMed

Eze, Christian N; Ebuehi, Olufunke M; Brigo, Francesco; Otte, Willem M; Igwe, Stanley C

2015-12-01

High rates of poor knowledge of, and negative attitudes towards people with epilepsy (PWE) are generally found among school teachers. Their first aid epilepsy management skills are poor. It remains unknown if this is different among trainee teachers and whether educational intervention might reduce these rates. We examined the effect of health education on the knowledge, attitudes, and first aid management of epilepsy on trainee teachers in Nigeria. Baseline data and socio-demographic determinants were collected from 226 randomly selected trainee teachers, at the Federal College of Education, Lagos, Nigeria, with self-administered questionnaires. They received a health intervention comprising an hour and half epilepsy lecture followed by a discussion. Baseline knowledge of, and attitudes towards PWE and their first aid epilepsy management skills were compared to post-interventional follow-up data collected twelve weeks later with similar questionnaires. At baseline the majority (61.9%) and largest proportion (44.2%) of respondents had negative attitudes and poor knowledge of epilepsy, respectively. The knowledge of, and attitudes towards epilepsy, and the first aid management skill increased in most respondents, post-intervention. The proportion of respondents with poor knowledge and negative attitudes dropped by 15.5% (p<0.0001) and 16.4% (p<0.0001) respectively. Correct knowledge concomitantly increased by 29.6% (p<0.0001) and good first aid management skills increased by 25.0% (p<0.0001) from baseline. Epilepsy health education could increase trainee teachers' knowledge of, and attitudes towards epilepsy and facilitate correct first aid management. This emphasizes the potential benefit of incorporating an epilepsy tailored intervention programme into teachers' training curricula. Copyright © 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Employees' perceptions of the Aid-for-AIDS disease-management programme, South Africa.

PubMed

Rothberg, Alan; Van Huyssteen, Karen

2008-11-01

It is estimated that 18-20% of South Africa's more than 5 million HIV-positive individuals are formally employed. Disease management programmes for these employees vary in scope and sophistication, with services provided by the employer, or third-party specialist disease managers, or through medical aid schemes. This study surveyed 215 HIV-positive employees in two organisations contracted to the Aid for AIDS (AfA) disease management programme through their in-house medical aid schemes. The two organisations differed in their overall approach to HIV and AIDS: one mainly relies on on-site access to voluntary counselling and testing (VCT) and AfA's management of registered HIV-positive employees, while the other has invested in and actively developed a comprehensive programme that also extends to families and the community as well as links employees to the AfA programme. Responses received from 28 of the 215 employees surveyed indicate that fear of disclosure of one's HIV status and of stigmatisation are reasons for late registration with the AfA programme or non-utilisation of other available support programmes. Respondents mentioned that confidence in the employer's ability to maintain confidentiality was also an issue. Respondents' important suggestions for change included: a) on-site educational and awareness programmes for management personnel and staff in order to reduce HIV discrimination and stigmatisation; b) information directed at HIV-positive employees publicising the benefits and effectiveness of medical treatment; c) support groups for HIV-positive employees; and d) management personnel to engage with HIV-infected employees who are willing to take an active role in staff education and the development of workplace policies and programmes.

[Management of the new first aid service at enterprises and construction sites].

PubMed

Prandi, E; Cantoni, S; Mosconi, G

2006-01-01

First aid at work organization and management represents a complex and critical aspect of the manifold problems of hygiene and security at work; nevertheless, even in relatively well organized productions, these themes are often neglected, if not completely ignored. In this work the authors analize the laws which regulate the correct first aid at work organization and management and an approach to the problem based on the preliminary risk assessment is suggested.

22 CFR 214.43 - Agency records.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ADVISORY COMMITTEE MANAGEMENT Administration of Advisory Committees § 214.43 Agency records. (a) The A.I.D. Advisory Committee Management Office maintains the Agency... known to the A.I.D. Advisory Committee Management Officer. These files contain the following information...

EFFECTS OF HIV/AIDS ON MATERNITY CARE PROVIDERS IN KENYA

PubMed Central

Turan, Janet M.; Bukusi, Elizabeth A.; Cohen, Craig R.; Sande, John; Miller, Suellen

2008-01-01

Objective To explore the impact of HIV/AIDS on maternity care providers (MCP) in labor and delivery in a high HIV prevalence setting in sub-Saharan Africa. Design Qualitative one-on-one in-depth interviews with MCPs. Setting Four health facilities providing labor and delivery services (2 public hospitals, a public health center, and a small private maternity hospital) in Kisumu, Nyanza Province, Kenya. Participants Eighteen (18) MCPs, including 14 nurse/midwives, 2 physician assistants, and 2 physicians (ob/gyn specialists). Results The HIV/AIDS epidemic has had numerous adverse effects and a few positive effects on MCPs in this setting. Adverse effects include reductions in the number of health care providers, increased workload, burnout, reduced availability of services in small health facilities when workers are absent due to attending HIV/AIDS training programs, difficulties with confidentiality and unwanted disclosure, and MCPs' fears of becoming HIV infected and the resulting stigma and discrimination. Positive effects include improved infection control procedures on maternity wards and enhanced MCP knowledge and skills. Conclusion A multi-faceted package including policy, infrastructure, and training interventions is needed to support MCPs in these settings and ensure that they are able to perform their critical roles in maternal healthcare and prevention of HIV/AIDS transmission. PMID:18811779

Perceived behavioural predictors of late initiation to HIV/AIDS care in Gurage zone public health facilities: a cohort study using health belief model.

PubMed

Gebru, Teklemichael; Lentiro, Kifle; Jemal, Abdulewhab

2018-05-22

The study was aimed to measure incidence density rate and identify perceived behavioural believes of late initiation to HIV/AIDS care in Gurage zone public health facilities from September 2015 to November 2016. The incidence density rates of late initiation to HIV/AIDS care were 2.21 per 100 person-months of observation. HIV positive individuals who did not perceived susceptibility were 8.46 times more likely delay to start HIV/AIDS care than their counter parts [OR = 8.46 (95% CI 3.92, 18.26)]. HIV infected individuals who did not perceived severity of delayed ART initiation were 6.13 time more likely to delay than HIV infected individuals who perceived its severity [OR = 6.13 (95% CI 2.95, 12.73)]. HIV positive individuals who didn't have self-efficacy were 2.35 times more likely delay to start HIV/AIDS care than HIV positive individuals who have self-efficacy [OR = 2.35 (95% CI 1.09, 5.05)]. The study revealed that high incidence density rates of delayed initiation for HIV care and variations were explained by poor wealth, and perceived threat and benefit. Therefore, interventions should be designed to initiate care at their diagnosis time.

Business leaders form alliance to fight AIDS. Thailand.

PubMed

1993-10-11

It is estimated that 33% of deaths among the working population in Thailand by the year 2000 will result from AIDS. AIDS mortality will bring decreased productivity, increased healthcare costs, a decline in tourism, reduced labor exports, and labor shortages. The AIDS epidemic in the country therefore has a direct impact upon companies' productivity and resulting profitability. Acknowledging this reality and the need for action, the Managing Director of Northwest Airlines for Thailand, Indochina, and West Asia, James P. Reinnoldt, and the General Manager of Bangkok's Regent Hotel, Bill Black, started the nonprofit Thailand Business Coalition on AIDS (TBCA) to combat AIDS. The TBCA will provide leadership, coordination, education, and resources to help companies and the business sector get a positive response to the AIDS dilemma. The organization was established to lead through and beyond the AIDS epidemic in the interest of business by promoting coherent HIV/AIDS policies and workplace education with help from nongovernmental organizations. The TBCA will be supported by membership dues, private contributions, and grants. Member companies will receive a manual and a quarterly newsletter and be allowed to join a training course on managing AIDS in the workplace. The organization's target of enlisting 250 member companies within the next 12 months means that help will be rendered in the training of 50,000 Thai workers.

40 CFR 160.31 - Testing facility management.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Testing facility management. 160.31... GOOD LABORATORY PRACTICE STANDARDS Organization and Personnel § 160.31 Testing facility management. For each study, testing facility management shall: (a) Designate a study director as described in § 160.33...

15 CFR 923.13 - Energy facility planning process.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Energy facility planning process. 923... RESOURCE MANAGEMENT COASTAL ZONE MANAGEMENT PROGRAM REGULATIONS Uses Subject to Management § 923.13 Energy facility planning process. The management program must contain a planning process for energy facilities...

15 CFR 923.13 - Energy facility planning process.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 15 Commerce and Foreign Trade 3 2012-01-01 2012-01-01 false Energy facility planning process. 923... RESOURCE MANAGEMENT COASTAL ZONE MANAGEMENT PROGRAM REGULATIONS Uses Subject to Management § 923.13 Energy facility planning process. The management program must contain a planning process for energy facilities...

15 CFR 923.13 - Energy facility planning process.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 15 Commerce and Foreign Trade 3 2013-01-01 2013-01-01 false Energy facility planning process. 923... RESOURCE MANAGEMENT COASTAL ZONE MANAGEMENT PROGRAM REGULATIONS Uses Subject to Management § 923.13 Energy facility planning process. The management program must contain a planning process for energy facilities...

15 CFR 923.13 - Energy facility planning process.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 15 Commerce and Foreign Trade 3 2011-01-01 2011-01-01 false Energy facility planning process. 923... RESOURCE MANAGEMENT COASTAL ZONE MANAGEMENT PROGRAM REGULATIONS Uses Subject to Management § 923.13 Energy facility planning process. The management program must contain a planning process for energy facilities...

15 CFR 923.13 - Energy facility planning process.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 15 Commerce and Foreign Trade 3 2014-01-01 2014-01-01 false Energy facility planning process. 923... RESOURCE MANAGEMENT COASTAL ZONE MANAGEMENT PROGRAM REGULATIONS Uses Subject to Management § 923.13 Energy facility planning process. The management program must contain a planning process for energy facilities...

Intermodal freight transportation. Volume 2. Fact sheet, federal aid eligibility. Final report

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1995-12-01

The purpose of the Intermodal Freight Fact Sheet is to provide policymakers, planners, carriers, shippers and other interested parties with information that will create a better understanding of intermodal transportation and demonstrate the potential contribution of intermodalism to efficient freight transporation on the United States. This report on Federal Aid Eligibility examines support for facilities serving intermodal freight movements provided by Federal highway programs. Its purpose is to examine the expanding eligibility for Federal aid of intermodal freight projects.

Pilot clinical trial of a robot-aided neuro-rehabilitation workstation with stroke patients

NASA Astrophysics Data System (ADS)

Krebs, Hermano I.; Hogan, Neville; Aisen, Mindy L.; Volpe, Bruce T.

1996-12-01

This paper summarizes our efforts to apply robotics and automation technology to assist, enhance, quantify, and document neuro-rehabilitation. It reviews a pilot clinical trial involving twenty stroke patients with a prototype robot-aided rehabilitation facility developed at MIT and tested at Burke Rehabilitation Hospital. In particular, we present a few results: (a) on the patient's tolerance of the procedure, (b) whether peripheral manipulation of the impaired limb influences brain recovery, (c) on the development of a robot-aided assessment procedure.

Implementation of the affordable care act: a case study of a service line co-management company.

PubMed

Lanese, Bethany

2016-09-19

Purpose The purpose of this paper is to test and measure the outcome of a community hospital in implementing the Affordable Care Act (ACA) through a co-management arrangement. RQ1: do the benefits of a co-management arrangement outweigh the costs? RQ2: does physician alignment aid in the effective implementation of the ACA directives set for hospitals? Design/methodology/approach A case study of a 350-bed non-profit community hospital co-management company. The quantitative data are eight quarters of quality metrics prior and eight quarters post establishment of the co-management company. The quality metrics are all based on standardized national requirements from the Joint Commission and Centers for Medicare and Medicaid Services guidelines. These measures directly impact the quality initiatives under the ACA that are applicable to all healthcare facilities. Qualitative data include survey results from hospital employees of the perceived effectiveness of the co-management company. A paired samples difference of means t-test was conducted to compare the timeframe before co-management and post co-management. Findings The findings indicate that the benefits of a co-management arrangement do outweigh the costs for both the physicians and the hospital ( RQ1). The physicians benefit through actual dollar payout, but also with improved communication and greater input in running the service line. The hospital benefits from reduced cost - or reduced penalties under the ACA - as well as better communication and greater physician involvement in administration of the service line. RQ2: does physician alignment aid in the effective implementation of the ACA directives set for hospitals? The hospital improved in every quality metric under the co-management company. A paired sample difference of means t-test showed a statistically significant improvement in five of the six quality metrics in the study. Originality/value Previous research indicates the potential effectiveness of co-management companies in improving healthcare delivery and hospital-physician relations (Sowers et al., 2013). The current research takes this a step further to show that the data do in fact support these concepts. The hospital and the physicians carrying out the day-to-day actions have shared goals, better communication, and improved quality metrics under the co-management company. As the number of co-management companies increases across the USA, more research can be directed at determining their overall impact on quality care.

Job Skills of the Financial Aid Professional.

ERIC Educational Resources Information Center

Heist, Vali

2002-01-01

Describes the skills practiced by student financial aid professionals which are valued by all employers, including problem solving, human relations, computer programming, teaching/training, information management, money management, business management, and science and math. Also describes how to develop skills outside of the office. (EV)

Review of July 2013 Nuclear Security Insider Threat Exercise November 2013

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pederson, Ann C.; Snow, Catherine L.; Townsend, Jeremy

2013-11-01

This document is a review of the Nuclear Security Insider Threat Exercise which was hosted at ORNL in July 2013. Nuclear security culture and the insider threat are best learned through experience. Culture is inherently difficult to teach, and as such is best learned through modeled behaviors and learning exercise. This TTX, NSITE, is a tool that strives to aid students in learning what an effective (and ineffective) nuclear security culture might look like by simulating dynamic events that strengthen or weaken the nuclear security regime. The goals of NSITE are to stimulate complex thought and discussion and assist decisionmore » makers and management in determining the most effective policies and procedures for their country or facility.« less

CENet: A Cabinet Environmental Sensing Network

PubMed Central

Zhang, Zusheng; Yu, Fengqi; Chen, Liang; Cao, Guangmin

2010-01-01

For data center cooling and intelligent substation systems, real time cabinet environmental monitoring is a strong requirement. Monitoring data, such as temperature, humidity, and noise, is important for operators to manage the facilities in cabinets. We here propose a sensing network, called CENet, which is energy efficient and reliable for cabinet environmental monitoring. CENet achieves above 93% reliable data yield and sends fewer beacons compared to periodic beaconing. It does so through a data-aided routing protocol. In addition, based on B-MAC, we propose a scheduling scheme to increase the lifetime of the network by reducing unnecessary message snooping and channel listening, thus it is more energy efficient than B-MAC. The performance of CENet is evaluated by simulations and experiments. PMID:22205856

29 CFR 1910.122 - Table of contents.

Code of Federal Regulations, 2010 CFR

2010-07-01

... exhaust hood? (e) What requirements must I follow when an employee enters a dip tank? (f) What first-aid procedures must my employees know? (g) What hygiene facilities must I provide? (h) What treatment and first aid must I provide? (i) What must I do before an employee cleans a dip tank? (j) What must I do to...

HIV/AIDS Misconceptions among Latinos: Findings from a Population-Based Survey of California Adults

ERIC Educational Resources Information Center

Ritieni, Assunta; Moskowitz, Joel; Tholandi, Maya

2008-01-01

Misconceptions about HIV/AIDS among Latino adults (N=454) in California were examined using data from a population-based telephone survey conducted in 2000. Common misconceptions concerning modes of HIV transmission included transmission via mosquito or animal bite (64.1%), public facilities (48.3%), or kissing someone on the cheek (24.8%). A…

Sensitivity of disease management decision aids to temperature input errors associated with out-of-canopy and reduced time-resolution measurements

USDA-ARS?s Scientific Manuscript database

Plant disease management decision aids typically require inputs of weather elements such as air temperature. Whereas many disease models are created based on weather elements at the crop canopy, and with relatively fine time resolution, the decision aids commonly are implemented with hourly weather...

Manufacturing Planning Guide

NASA Technical Reports Server (NTRS)

Waid, Michael

2011-01-01

Manufacturing process, milestones and inputs are unknowns to first-time users of the manufacturing facilities. The Manufacturing Planning Guide aids in establishing expectations for both NASA and non-NASA facility customers. The potential audience for this guide includes both internal and commercial spaceflight hardware/software developers. It is intended to assist their project engineering personnel in manufacturing planning and execution. Material covered includes a roadmap of the manufacturing process, roles and responsibilities of facility and user, major milestones, facility capabilities, and inputs required by the facility. Samples of deliverables, products, and inputs necessary to define test scope, cost, and schedule are included as an appendix to the guide.

DeMAID/GA USER'S GUIDE Design Manager's Aid for Intelligent Decomposition with a Genetic Algorithm

NASA Technical Reports Server (NTRS)

Rogers, James L.

1996-01-01

Many companies are looking for new tools and techniques to aid a design manager in making decisions that can reduce the time and cost of a design cycle. One tool that is available to aid in this decision making process is the Design Manager's Aid for Intelligent Decomposition (DeMAID). Since the initial release of DEMAID in 1989, numerous enhancements have been added to aid the design manager in saving both cost and time in a design cycle. The key enhancement is a genetic algorithm (GA) and the enhanced version is called DeMAID/GA. The GA orders the sequence of design processes to minimize the cost and time to converge to a solution. These enhancements as well as the existing features of the original version of DEMAID are described. Two sample problems are used to show how these enhancements can be applied to improve the design cycle. This report serves as a user's guide for DeMAID/GA.

Mass Burns Disaster in Abule-egba, Lagos, Nigeria from a Petroleum Pipeline Explosion Fire

PubMed Central

Fadeyibi, I.O.; Omosebi, D.T.; Jewo, P.I.; Ademiluyi, S.A.

2009-01-01

Summary The aim of this paper is to review the basic principles of triage in mass burns disasters and discuss the experience of the Lagos State University Teaching Hospital (LASUTH), Ikeja, Nigeria, in the December 2006 disaster at Abule-Egba, Lagos, Nigeria. It is hoped that the experience gained will help in the planning for and management of similar disasters in the developing countries with limited facilities. Burn injury has been described as the severest form of trauma and its management is very challenging as it is often accompanied by numerous pathophysiological changes. Successful management requires expert management by well-trained personnel in equipped and dedicated centres. In mass disasters the total number of victims may exceed the capability of the facility and its staff and a system for sorting out the patients and caring for those that will benefit from the facilities available needs to be developed. Other patients will either be sent to other medical facilities for further treatment or discharged after initial care for future follow-up. Documented experiences in the management of mass burns disasters from petroleum pipeline explosions from developing countries are rare. However, petroleum pipeline explosions, especially in the Lagos area of Nigeria, are relatively common. These cases have been associated with a variety of factors. The resulting morbidity and mortality have been high. LASUTH has a dedicated burns centre, which has received and managed many burn patients. Triage is the medical process of screening patients according to their need of treatment and the resources available. The aims and objectives of triage are discussed, its various levels described, and the final goals elaborated. All the burn victims involved in the 2006 disaster were studied, together with the triage carried out at different levels and the consequent sorting of the patients. Standard burns management was carried out. A total of 385 patients sustained burns of various degrees from the fire resulting from the explosion. On site, emergency department (ED) and intra-hospital triage were carried out. Ninety patients were brought to the LASUTH ED. Of these, 51 patients (56.67%) received first-aid treatment and were either discharged for out-patient follow-up or referred to secondary health care facilities. Twenty-eight (31.11%) out of the remaining 39 patients with burns in more than 70% total body surface area (TBSA) were categorized as unsalvageable and 11 (12.22%) with less than 70% TBSA as salvageable. All the patients in the unsalvageable group died (i.e. 100% mortality), while one patient died in the salvageable group (mortality rate, 9.09%). The mortality rate for the ruptured petroleum product pipeline incident was 84.16%; the fatality rate for all patients seen at LASUTH was 32.22%. The need for caution in the handling of petroleum products is discussed and the effectiveness of the triage system used is highlighted. In conclusion, burns from flammable petroleum products can be very dangerous and proper triage should therefore be carried out, with salvageable patients being managed by experts in dedicated burns centres. PMID:21991163

Climate Change Resilience Planning at the Department of Energy's Savannah River Site

NASA Astrophysics Data System (ADS)

Werth, D. W.; Johnson, A.

2015-12-01

The Savannah River National Laboratory (SRNL) is developing a site sustainability plan for the Department of Energy's Savannah River Site (SRS) in South Carolina in accordance with Executive Order 13693, which charges each DOE agency with "identifying and addressing projected impacts of climate change" and "calculating the potential cost and risk to mission associated with agency operations". The plan will comprise i) projections of climate change, ii) surveys of site managers to estimate the effects of climate change on site operations, and iii) a determination of adaptive actions. Climate change projections for SRS are obtained from multiple sources, including an online repository of downscaled global climate model (GCM) simulations of future climate and downscaled GCM simulations produced at SRNL. Taken together, we have projected data for temperature, precipitation, humidity, and wind - all variables with a strong influence on site operations. SRNL is working to engage site facility managers and facilitate a "bottom up" approach to climate change resilience planning, where the needs and priorities of stakeholders are addressed throughout the process. We make use of the Vulnerability Assessment Scoring Tool, an Excel-based program designed to accept as input various climate scenarios ('exposure'), the susceptibility of assets to climate change ('sensitivity'), and the ability of these assets to cope with climate change ('adaptive capacity'). These are combined to produce a series of scores that highlight vulnerabilities. Working with site managers, we have selected the most important assets, estimated their expected response to climate change, and prepared a report highlighting the most endangered facilities. Primary risks include increased energy consumption, decreased water availability, increased forest fire danger, natural resource degradation, and compromised outdoor worker safety in a warmer and more humid climate. Results of this study will aid in driving future management decisions and promoting sustainable practices at SRS.

Interventions to aid patient adherence to physiotherapist prescribed self-management strategies: a systematic review.

PubMed

Peek, Kerry; Sanson-Fisher, Robert; Mackenzie, Lisa; Carey, Mariko

2016-06-01

Physiotherapist prescribed self-management strategies are an important adjunct to 'hands on' treatment. However, treatment outcomes are likely to be related to whether patients adhere to the prescribed strategy. Therefore, physiotherapists should be aware of adherence aiding interventions designed to maximise patient outcomes underpinned by quality research studies. To conduct a systematic review of the interventions used to aid patient adherence to all physiotherapist prescribed self-management strategies. The search included the databases CINAHL, EMBASE, MEDLINE, PUBMED, PSYCINFO, SPORTSDiscus, the Cochrane Central Register of Controlled Trials, PEDro and Mednar for randomised controlled trials (RCTs) published in a peer reviewed journal from inception to November 2014. Data were extracted using a standardised form from twelve included RCTs for patient adherence rates to self-management strategies for interventions used to aid patient adherence and usual care. Two independent reviewers conducted methodological quality assessment. Twelve different interventions to aid patient adherence to exercise were recorded from twelve fair to high quality RCTs. Potential adherence aiding interventions include an activity monitor and feedback system, written exercise instructions, behavioural exercise programme with booster sessions and goal setting. Despite a number of studies demonstrating interventions to positively influence patient adherence to exercise, there is insufficient data to endorse their use in clinical practice. No RCTs examining adherence aiding interventions to self-management strategies other than exercise were identified, indicating a significant gap in the literature. PROSPERO CRD42015014516. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

48 CFR 801.602-80 - Legal and technical review-Office of Construction and Facilities Management and National Cemetery...

Code of Federal Regulations, 2012 CFR

2012-10-01

...-Office of Construction and Facilities Management and National Cemetery Administration. 801.602-80 Section... Responsibilities 801.602-80 Legal and technical review-Office of Construction and Facilities Management and National Cemetery Administration. An Office of Construction and Facilities Management or National Cemetery...

48 CFR 801.602-80 - Legal and technical review-Office of Construction and Facilities Management and National Cemetery...

Code of Federal Regulations, 2011 CFR

2011-10-01

...-Office of Construction and Facilities Management and National Cemetery Administration. 801.602-80 Section... Responsibilities 801.602-80 Legal and technical review-Office of Construction and Facilities Management and National Cemetery Administration. An Office of Construction and Facilities Management or National Cemetery...

48 CFR 801.602-80 - Legal and technical review-Office of Construction and Facilities Management and National Cemetery...

Code of Federal Regulations, 2013 CFR

2013-10-01

...-Office of Construction and Facilities Management and National Cemetery Administration. 801.602-80 Section... Responsibilities 801.602-80 Legal and technical review-Office of Construction and Facilities Management and National Cemetery Administration. An Office of Construction and Facilities Management or National Cemetery...

48 CFR 801.602-80 - Legal and technical review-Office of Construction and Facilities Management and National Cemetery...

Code of Federal Regulations, 2014 CFR

2014-10-01

...-Office of Construction and Facilities Management and National Cemetery Administration. 801.602-80 Section... Responsibilities 801.602-80 Legal and technical review-Office of Construction and Facilities Management and National Cemetery Administration. An Office of Construction and Facilities Management or National Cemetery...

41 CFR 102-74.355 - With what accident and fire prevention standards must Federal facilities comply?

Code of Federal Regulations, 2010 CFR

2010-07-01

... MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Accident and Fire Prevention... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false With what accident and fire prevention standards must Federal facilities comply? 102-74.355 Section 102-74.355 Public...

7 CFR 210.13 - Facilities management.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 4 2010-01-01 2010-01-01 false Facilities management. 210.13 Section 210.13... Participation § 210.13 Facilities management. Link to an amendment published at 74 FR 66216, Dec. 15, 2009. (a..., the added text is set forth as follows: § 210.13 Facilities management. (c) Food safety program. The...

Caribbean Equal Access Program: HIV/AIDS Information Resources from the National Library of Medicine

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nancy Dancy, NLM, and Wilma Templin-Branner, ORISE

2009-01-01

As the treatment and management of HIV/AIDS continues to evolve with new scientific breakthroughs, treatment discoveries, and management challenges, it is difficult for people living with HIV/AIDS and those who care for them to keep up with the latest information on HIV/AIDS prevention, treatment, and research. The National Library of Medicine, of the National Institutes of Health, has a wealth of health information resources freely available on the Internet to address these needs.

Aid for Facilities

ERIC Educational Resources Information Center

Kennedy, Mike

2009-01-01

Even before the state fire marshal ordered the Somersworth (N.H.) School District in 2007 to abandon the top two floors of Hilltop Elementary School because of safety concerns, folks in the city of 12,000 had been debating whether the aging facility should be replaced--and how to pay for it. Finally, in February 2009, the city council approved…

Process Control Manual for Aerobic Biological Wastewater Treatment Facilities.

ERIC Educational Resources Information Center

Environmental Protection Agency, Washington, DC. Office of Water Programs.

This Environmental Protection Agency (EPA) publication is an operations manual for activated sludge and trickling filter wastewater treatment facilities. The stated purpose of the manual is to provide an on-the-job reference for operators of these two types of treatment plants. The overall objective of the manual is to aid the operator in…

Barrier-Free School Facilities for Handicapped Students. ERS Information Aid.

ERIC Educational Resources Information Center

Kunder, Linda H.

The purpose of this document is to assemble and summarize suggestions, recommendations, and regulations--most of which have been made in the light of increasing local, state, and federal mandates--that might be helpful to school officials in making educational facilities barrier-free for handicapped students. Three survey forms are included to…

41 CFR 102-74.290 - May Federal agencies allow employees to use parking spaces not required for official needs?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Public Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Parking Facilities... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false May Federal agencies...

41 CFR 102-74.285 - How must Federal agencies assign priority to parking spaces in controlled areas?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false How must Federal... Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Parking Facilities § 102-74...

41 CFR 102-74.10 - What is the basic facility management policy?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What is the basic facility management policy? 102-74.10 Section 102-74.10 Public Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY...

The role of HIV/AIDS committees in effective workplace governance of HIV/AIDS in South African small and medium-sized enterprises (SMEs).

PubMed

Vaas, Jocelyn R

2008-04-01

The primary purpose of this study was to assess the role, status and scope of workplace HIV/AIDS committees as a means of effective workplace governance of the HIV/AIDS impact, and their role in extending social protective HIV/AIDS-related rights to employees. In-depth qualitative case studies were conducted in five South African small and medium-sized enterprises (SMEs) that were actively implementing HIV/AIDS policies and programmes. Companies commonly implemented HIV/AIDS policies and programmes through a workplace committee dedicated to HIV/AIDS or a generic committee dealing with issues other than HIV/ AIDS. Management, through the human resources department and the occupational health practitioner often drove initial policy formulation, and had virtually sole control of the HIV/AIDS budget. Employee members of committees were mostly volunteers, and were often production or blue collar employees, while there was a notable lack of participation by white-collar employees, line management and trade unions. While the powers of workplace committees were largely consultative, employee committee members often managed in an indirect manner to secure and extend social protective rights on HIV/AIDS to employees, and monitor their effective implementation in practice. In the interim, workplace committees represented one of the best means to facilitate more effective workplace HIV/AIDS governance. However, the increased demands on collective bargaining as a result of an anticipated rises in AIDS-related morbidity and mortality might prove to be beyond the scope of such voluntary committees in the longer term.

76 FR 46774 - Privacy Act of 1974; System of Records-Federal Student Aid Application File

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-03

... Information and Regulatory Affairs in the Office of Management and Budget (OMB), on July 21, 2011. This... altered system of records to: Director, Application Processing Division, Program Management Systems...: Director, Application Processing Division, Program Management Systems, Federal Student Aid, U.S. Department...

22 CFR 214.31 - A.I.D. Advisory Committee Representative.

Code of Federal Regulations, 2010 CFR

2010-04-01

... MANAGEMENT Operation of Advisory Committees § 214.31 A.I.D. Advisory Committee Representative. (a) For each... with the Advisory Committee Management Officer and the General Counsel for decisions by the... Advisory Committee Management Officer. (5) Assuring that open meetings are accessible to the public; (6) As...

23 CFR 660.105 - Planning and route designation.

Code of Federal Regulations, 2013 CFR

2013-04-01

...) regarding the establishment and implementation of pavement, bridge, and safety management systems for FHs... pavement management systems for FHs on Federal-aid highways are to be provided by the SHAs for... pavement management results for FHs which are not Federal-aid highways. (c) The FHWA, in consultation with...

23 CFR 660.105 - Planning and route designation.

Code of Federal Regulations, 2014 CFR

2014-04-01

...) regarding the establishment and implementation of pavement, bridge, and safety management systems for FHs... pavement management systems for FHs on Federal-aid highways are to be provided by the SHAs for... pavement management results for FHs which are not Federal-aid highways. (c) The FHWA, in consultation with...

23 CFR 660.105 - Planning and route designation.

Code of Federal Regulations, 2011 CFR

2011-04-01

...) regarding the establishment and implementation of pavement, bridge, and safety management systems for FHs... pavement management systems for FHs on Federal-aid highways are to be provided by the SHAs for... pavement management results for FHs which are not Federal-aid highways. (c) The FHWA, in consultation with...

23 CFR 660.105 - Planning and route designation.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) regarding the establishment and implementation of pavement, bridge, and safety management systems for FHs... pavement management systems for FHs on Federal-aid highways are to be provided by the SHAs for... pavement management results for FHs which are not Federal-aid highways. (c) The FHWA, in consultation with...

23 CFR 660.105 - Planning and route designation.

Code of Federal Regulations, 2012 CFR

2012-04-01

...) regarding the establishment and implementation of pavement, bridge, and safety management systems for FHs... pavement management systems for FHs on Federal-aid highways are to be provided by the SHAs for... pavement management results for FHs which are not Federal-aid highways. (c) The FHWA, in consultation with...

Management of Student Aid.

ERIC Educational Resources Information Center

Nevin, Jeanne, Ed.

The principles, practices, responsibilities, and controls in student financial aid are described in this manual. It traces the flow of funds, management activities, and legal issues as they occur in the process. The emphasis is on sound management principles of a general and permanent nature rather than on specific government requirements that may…

Applications and requirements for real-time simulators in ground-test facilities

NASA Technical Reports Server (NTRS)

Arpasi, Dale J.; Blech, Richard A.

1986-01-01

This report relates simulator functions and capabilities to the operation of ground test facilities, in general. The potential benefits of having a simulator are described to aid in the selection of desired applications for a specific facility. Configuration options for integrating a simulator into the facility control system are discussed, and a logical approach to configuration selection based on desired applications is presented. The functional and data path requirements to support selected applications and configurations are defined. Finally, practical considerations for implementation (i.e., available hardware and costs) are discussed.

Robot-Aided Neurorehabilitation

PubMed Central

Krebs, Hermano Igo; Hogan, Neville; Aisen, Mindy L.; Volpe, Bruce T.

2009-01-01

Our goal is to apply robotics and automation technology to assist, enhance, quantify, and document neurorehabilitation. This paper reviews a clinical trial involving 20 stroke patients with a prototype robot-aided rehabilitation facility developed at the Massachusetts Institute of Technology, Cambridge, (MIT) and tested at Burke Rehabilitation Hospital, White Plains, NY. It also presents our approach to analyze kinematic data collected in the robot-aided assessment procedure. In particular, we present evidence 1) that robot-aided therapy does not have adverse effects, 2) that patients tolerate the procedure, and 3) that peripheral manipulation of the impaired limb may influence brain recovery. These results are based on standard clinical assessment procedures. We also present one approach using kinematic data in a robot-aided assessment procedure. PMID:9535526

Enrollment Management and Financial Aid Part Two: A Public Policy Perspective

ERIC Educational Resources Information Center

Hossler, Don; Kalsbeek, David

2008-01-01

In our previous essay, we considered the role of institutional financial aid and the practice of enrollment management. In that essay we explored the use of financial aid as a tool to enhance equity increase prestige, as a revenue enhancement tool and as a means to shape institutional image in the various markets that comprise our diverse system…

AIDS in the Workplace: A Training for Managers and Supervisors. District of Oregon.

ERIC Educational Resources Information Center

Tyree, Jimmy L.

This document provides a summary of "AIDS in the Workplace for Court Managers," a 3-hour seminar that was presented to the District of Oregon. The document begins with a summary of the seminar goals and objectives, which included the following: reduce fears and anxieties about HIV/AIDS in the workplace; provide information about the…

Federal Student Aid Handbook, 2006-2007. Volume 4: Processing Aid & Managing FSA Funds

ERIC Educational Resources Information Center

US Department of Education, 2006

2006-01-01

The purpose of this publication is to provide participating schools with guidance on how to request, disburse, manage, and report on the use of Federal Student Aid funds. A summary of the changes and clarifications is presented in greater detail in the chapters that are contained in this volume: Chapter 1, The MPN (Master Promissory Note) and the…

The availability of essential medicines for mental healthcare in Sofala, Mozambique

PubMed Central

Wagenaar, Bradley H.; Stergachis, Andy; Rao, Deepa; Hoek, Roxanne; Cumbe, Vasco; Napúa, Manuel; Sherr, Kenneth

2015-01-01

Objective We assessed the availability of essential medicines for mental healthcare (MH) across levels of the public healthcare system to aid in future systems planning. Design Non-expired MH medications were assessed in 24 public health facilities and 13 district warehouses across Sofala Province, Mozambique, from July to August 2014. Medication categories included: antipsychotics, antidepressants, benzodiazepines, antiepileptics and mood stabilizers, and anticholinergics and antihistamines. Results Only 7 of 12 (58.3%) district warehouses, 11 of 24 (45.8%) of all health facilities, and 10 of 12 (83.3%) of facilities with trained MH staff had availability of at least one medication of each category. Thioridazine was the most commonly available antipsychotic across all facilities (9 of 24, 37.5%), while chlorpromazine and thioridazine were most common at facilities providing MH care (8 of 12, 66.7%). The atypical antipsychotic risperidone was not available at any facility or district warehouse. Amitriptyline was the most commonly available antidepressant (10 of 12 districts; 12 of 24 overall facilities; 9 or 12 MH facilities). Despite being on the national essential drug list, fluoxetine was only available at one quaternary-level facility and no district warehouses. Conclusions Essential psychotropic medicines are routinely unavailable at public health facilities. Current essential drug lists include six typical but no atypical antipsychotics, which is concerning given the side-effect profiles of typical antipsychotics. Ensuring consistent availability of at least one selective serotonin reuptake inhibitor should also be a priority, as they are essential for the treatment of individuals with underlying cardiovascular disease and/or suicidal ideation. Similar to successful task-sharing approaches used for HIV/AIDS, mid-level providers could be retrained and certified to prescribe and monitor first-line psychotropic regimens. PMID:26081970

Nothing prepared me to manage AIDS.

PubMed

Banas, G E

1992-01-01

Articles and seminars about AIDS in the workplace are not adequate preparation for the genuine problems faced by actual managers in real organizations. There are no easy, win-win solutions to the impossible dilemmas AIDS presents, only various forms of damage control and, at best, more or less humane compromises. Gary Banas knows. Over a period of four years, two of his direct reports developed AIDS, and he watched them suffer through debility, slowly deteriorating performance, and eventual death. He also watched the gradual decline of their subordinates' productivity and morale. He found that, to different degrees, both men refused to acknowledge their illness and their decreasing organizational effectiveness. One of them resisted the author's efforts to give him an easier job at no loss in salary. Both insisted on confidentiality long after the rumor mill had identified their problem. In the course of these two consecutive ordeals, Banas discovered that AIDS patients fall into no single, neat category. AIDS is not an issue but a disease, and the people who get it are human beings first and victims second. He also learned that AIDS affects everyone around the sick individual and that almost every choice a manager makes will injure someone. Finally, he came to understand that while managers have an unequivocal obligation to treat AIDS-afflicted employees with compassion and respect, they have an equally unequivocal obligation to keep their organizations functioning. "Don't let anyone kid you," Banas warns. "When you confront AIDS in the workplace, you will face untenable choices that seem to pit your obligation to humanity against your obligation to your organization.(ABSTRACT TRUNCATED AT 250 WORDS)

Self-Managed Work Teams in Nursing Homes: Implementing and Empowering Nurse Aide Teams

ERIC Educational Resources Information Center

Yeatts, Dale E.; Cready, Cynthia; Ray, Beth; DeWitt, Amy; Queen, Courtney

2004-01-01

Purpose: This article describes the progress of our study to examine the advantages and costs of using self-managed nurse aide teams in nursing homes, steps that are being taken to implement such teams, and management strategies being used to manage the teams. Design and Methods: A quasi-experimental design is underway where certified nurse aide…

41 CFR 102-74.210 - What steps must Executive agencies take to promote ridesharing at Federal facilities?

Code of Federal Regulations, 2010 CFR

2010-07-01

... MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Ridesharing § 102-74.210 What... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What steps must Executive agencies take to promote ridesharing at Federal facilities? 102-74.210 Section 102-74.210 Public...

A knowledge-based flight status monitor for real-time application in digital avionics systems

NASA Technical Reports Server (NTRS)

Duke, E. L.; Disbrow, J. D.; Butler, G. F.

1989-01-01

The Dryden Flight Research Facility of the National Aeronautics and Space Administration (NASA) Ames Research Center (Ames-Dryden) is the principal NASA facility for the flight testing and evaluation of new and complex avionics systems. To aid in the interpretation of system health and status data, a knowledge-based flight status monitor was designed. The monitor was designed to use fault indicators from the onboard system which are telemetered to the ground and processed by a rule-based model of the aircraft failure management system to give timely advice and recommendations in the mission control room. One of the important constraints on the flight status monitor is the need to operate in real time, and to pursue this aspect, a joint research activity between NASA Ames-Dryden and the Royal Aerospace Establishment (RAE) on real-time knowledge-based systems was established. Under this agreement, the original LISP knowledge base for the flight status monitor was reimplemented using the intelligent knowledge-based system toolkit, MUSE, which was developed under RAE sponsorship. Details of the flight status monitor and the MUSE implementation are presented.

Evaluation of 5 cleaning and disinfection methods for nets used to collect zebrafish (Danio rerio).

PubMed

Collymore, Chereen; Porelli, Gina; Lieggi, Christine; Lipman, Neil S

2014-11-01

Few standardized methods of cleaning and disinfecting equipment in zebrafish facilities have been published, even though the effectiveness of these procedures is vital to preventing the transmission of pathogenic organisms. Four chemical disinfectants and rinsing with municipal tap water were evaluated for their ability to disinfect nets used to capture zebrafish. The disinfectants included benzalkonium chloride+methylene blue, sodium hypochlorite, chlorine dioxide, and potassium peroxymonosulfate+sodium chloride for a soak time of 5 or 30 min. Disinfection effectiveness was evaluated by using an ATP-based system that measured the reduction in absolute number and percentage of relative light units. In addition, nets were cultured aerobically on blood and MacConkey agar plates to determine the number of bacteria remaining after disinfection procedures. Soaking nets in sodium hypochlorite for 30 min and in potassium peroxymonosulfate+sodium chloride for 5 or 30 min were effective means of disinfection, according to at least 90% reduction in the number of relative light units and no bacterial growth after cleaning. These results will aid facility managers, veterinarians and investigators in selecting net cleaning and disinfection protocols.

Evaluation of 5 Cleaning and Disinfection Methods for Nets Used to Collect Zebrafish (Danio rerio)

PubMed Central

Collymore, Chereen; Porelli, Gina; Lieggi, Christine; Lipman, Neil S

2014-01-01

Few standardized methods of cleaning and disinfecting equipment in zebrafish facilities have been published, even though the effectiveness of these procedures is vital to preventing the transmission of pathogenic organisms. Four chemical disinfectants and rinsing with municipal tap water were evaluated for their ability to disinfect nets used to capture zebrafish. The disinfectants included benzalkonium chloride+methylene blue, sodium hypochlorite, chlorine dioxide, and potassium peroxymonosulfate+sodium chloride for a soak time of 5 or 30 min. Disinfection effectiveness was evaluated by using an ATP-based system that measured the reduction in absolute number and percentage of relative light units. In addition, nets were cultured aerobically on blood and MacConkey agar plates to determine the number of bacteria remaining after disinfection procedures. Soaking nets in sodium hypochlorite for 30 min and in potassium peroxymonosulfate+sodium chloride for 5 or 30 min were effective means of disinfection, according to at least 90% reduction in the number of relative light units and no bacterial growth after cleaning. These results will aid facility managers, veterinarians and investigators in selecting net cleaning and disinfection protocols. PMID:25650972

41 CFR 102-74.305 - How must Federal agencies assign available parking spaces to their employees?

Code of Federal Regulations, 2010 CFR

2010-07-01

... and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Parking Facilities § 102-74.305 How must... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false How must Federal...

41 CFR 102-74.300 - How must space available for employee parking be allocated among occupant agencies?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Parking Facilities § 102-74... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false How must space available...

Capital Ideas for Facilities Management.

ERIC Educational Resources Information Center

Golding, Stephen T.; Gordon, Janet; Gravina, Arthur

2001-01-01

Asserting that just like chief financial officers, higher education facilities specialists must maximize the long-term performance of assets under their care, describes strategies for strategic facilities management. Discusses three main approaches to facilities management (insourcing, cosourcing, and outsourcing) and where boards of trustees fit…

41 CFR 102-74.295 - Who determines the number of employee parking spaces for each facility?

Code of Federal Regulations, 2010 CFR

2010-07-01

... REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Parking Facilities § 102-74.295 Who... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Who determines the number of employee parking spaces for each facility? 102-74.295 Section 102-74.295 Public Contracts and...

Methods and Models of the Hanford Internal Dosimetry Program, PNNL-MA-860

DOE Office of Scientific and Technical Information (OSTI.GOV)

Carbaugh, Eugene H.; Bihl, Donald E.; Maclellan, Jay A.

2009-09-30

The Hanford Internal Dosimetry Program (HIDP) provides internal dosimetry support services for operations at the Hanford Site. The HIDP is staffed and managed by the Radiation and Health Technology group, within the Pacific Northwest National Laboratory (PNNL). Operations supported by the HIDP include research and development, the decontamination and decommissioning of facilities formerly used to produce and purify plutonium, and waste management activities. Radioelements of particular interest are plutonium, uranium, americium, tritium, and the fission and activation product radionuclides 137Cs, 90Sr, and 60Co. This manual describes the technical basis for the design of the routine bioassay monitoring program and formore » assessment of internal dose. The purposes of the manual are as follows: • Provide assurance that the HIDP derives from a sound technical base. • Promote the consistency and continuity of routine program activities. • Provide a historical record. • Serve as a technical reference for radiation protection personnel. • Aid in identifying and planning for future needs.« less

Rehabilitation after traumatic brain injury.

PubMed

Barnes, M P

1999-01-01

Head injury is a common disabling condition but regrettably facilities for rehabilitation are sparse. There is now increasing evidence of the efficacy of a comprehensive multidisciplinary rehabilitation team compared to natural recovery following brain injury. This chapter outlines some basic concepts of rehabilitation and emphasises the importance of valid and reliable outcome measures. The evidence of the efficacy of a rehabilitation programme is discussed in some detail. A number of specific rehabilitation problems are outlined including the management of spasticity, nutrition, pressure sores and urinary continence. The increasingly important role of assistive technology is illustrated, particularly in terms of communication aids and environmental control equipment. However, the major long-term difficulties after head injury focus around the cognitive, intellectual, behavioural and emotional problems. The complex management of these disorders is briefly addressed and the evidence of the efficacy of some techniques discussed. The importance of recognition of the vegetative stage and avoidance of misdiagnosis is emphasised. Finally, the important, but often neglected, area of employment rehabilitation is covered.

Applying research to AIDS programs in villages. Burkina Faso project learns from community survey.

PubMed

Tankoano, F

1994-01-01

In 1991, 34 cases of acquired immunodeficiency syndrome (AIDS) were recorded for the province of Bam, which has a population of 4239. Since 1992, PLAN and the local Ministry of Health have been conducting an AIDS prevention program in the province. An initial baseline community survey to assess knowledge, attitude, and practices about the disease was conducted in order to tailor the program to the needs and characteristics of the target population. A questionnaire was administered to 300 randomly selected adults in 10 rural villages. The sexes were equally represented. 74% of the villagers were found to be illiterate and the major sources of health information were radio, health facilities, and friends and relatives; therefore, educational activities were carried out through non-written methods (traditional and modern) that employed these communication channels. Initially, 5 men and 5 women ("Village Communicators") were selected by their communities to be trained in information, education, and communication (IEC) techniques regarding AIDS prevention; under the supervision of their trainers, they organized and conducted 2 weekly sessions. An additional 62 women and 50 men were trained as Village Communicators to promote AIDS awareness among their own gender. A team of health personnel, artists, and a traditional music group conducted collective sessions to promote condom use and address problems relating to AIDS (polygamy, remarrying of spouses of AIDS victims, availability of testing during prenuptial visits). Although 90% of respondents had heard about AIDS, 30% did not understand the disease or its routes of transmission; so messages about the effects and the transmission of AIDS were emphasized. Because 56% of respondents admitted having had 2 or more sex partners, and a similar percentage admitted having had 2 or more sexual encounters per week, messages were disseminated on sexuality using community volunteers and the folkloric band. 42% of respondents were aware of the protective effect of condoms, but only 9% used them during their last sexual encounter; so village leaders, traditional healers, and PLAN and MOH staff promoted condom use at community sessions. Since 68% of respondents approved of the sale of condoms, a community-based system, which would be managed by village committees, for the sale and distribution of condoms was established.

Task shifting in maternal and newborn care: a non-inferiority study examining delegation of antenatal counseling to lay nurse aides supported by job aids in Benin.

PubMed

Jennings, Larissa; Yebadokpo, André Sourou; Affo, Jean; Agbogbe, Marthe; Tankoano, Aguima

2011-01-06

Shifting the role of counseling to less skilled workers may improve efficiency and coverage of health services, but evidence is needed on the impact of substitution on quality of care. This research explored the influence of delegating maternal and newborn counseling responsibilities to clinic-based lay nurse aides on the quality of counseling provided as part of a task shifting initiative to expand their role. Nurse-midwives and lay nurse aides in seven public maternities were trained to use job aids to improve counseling in maternal and newborn care. Quality of counseling and maternal knowledge were assessed using direct observation of antenatal consultations and patient exit interviews. Both provider types were interviewed to examine perceptions regarding the task shift. To compare provider performance levels, non-inferiority analyses were conducted where non-inferiority was demonstrated if the lower confidence limit of the performance difference did not exceed a margin of 10 percentage points. Mean percent of recommended messages provided by lay nurse aides was non-inferior to counseling by nurse-midwives in adjusted analyses for birth preparedness (β = -0.0, 95% CI: -9.0, 9.1), danger sign recognition (β = 4.7, 95% CI: -5.1, 14.6), and clean delivery (β = 1.4, 95% CI: -9.4, 12.3). Lay nurse aides demonstrated superior performance for communication on general prenatal care (β = 15.7, 95% CI: 7.0, 24.4), although non-inferiority was not achieved for newborn care counseling (β = -7.3, 95% CI: -23.1, 8.4). The proportion of women with correct knowledge was significantly higher among those counseled by lay nurse aides as compared to nurse-midwives in general prenatal care (β = 23.8, 95% CI: 15.7, 32.0), birth preparedness (β = 12.7, 95% CI: 5.2, 20.1), and danger sign recognition (β = 8.6, 95% CI: 3.3, 13.9). Both cadres had positive opinions regarding task shifting, although several preferred 'task sharing' over full delegation. Lay nurse aides can provide effective antenatal counseling in maternal and newborn care in facility-based settings, provided they receive adequate training and support. Efforts are needed to improve management of human resources to ensure that effective mechanisms for regulating and financing task shifting are sustained.

Task shifting in maternal and newborn care: a non-inferiority study examining delegation of antenatal counseling to lay nurse aides supported by job aids in Benin

PubMed Central

2011-01-01

Background Shifting the role of counseling to less skilled workers may improve efficiency and coverage of health services, but evidence is needed on the impact of substitution on quality of care. This research explored the influence of delegating maternal and newborn counseling responsibilities to clinic-based lay nurse aides on the quality of counseling provided as part of a task shifting initiative to expand their role. Methods Nurse-midwives and lay nurse aides in seven public maternities were trained to use job aids to improve counseling in maternal and newborn care. Quality of counseling and maternal knowledge were assessed using direct observation of antenatal consultations and patient exit interviews. Both provider types were interviewed to examine perceptions regarding the task shift. To compare provider performance levels, non-inferiority analyses were conducted where non-inferiority was demonstrated if the lower confidence limit of the performance difference did not exceed a margin of 10 percentage points. Results Mean percent of recommended messages provided by lay nurse aides was non-inferior to counseling by nurse-midwives in adjusted analyses for birth preparedness (β = -0.0, 95% CI: -9.0, 9.1), danger sign recognition (β = 4.7, 95% CI: -5.1, 14.6), and clean delivery (β = 1.4, 95% CI: -9.4, 12.3). Lay nurse aides demonstrated superior performance for communication on general prenatal care (β = 15.7, 95% CI: 7.0, 24.4), although non-inferiority was not achieved for newborn care counseling (β = -7.3, 95% CI: -23.1, 8.4). The proportion of women with correct knowledge was significantly higher among those counseled by lay nurse aides as compared to nurse-midwives in general prenatal care (β = 23.8, 95% CI: 15.7, 32.0), birth preparedness (β = 12.7, 95% CI: 5.2, 20.1), and danger sign recognition (β = 8.6, 95% CI: 3.3, 13.9). Both cadres had positive opinions regarding task shifting, although several preferred 'task sharing' over full delegation. Conclusions Lay nurse aides can provide effective antenatal counseling in maternal and newborn care in facility-based settings, provided they receive adequate training and support. Efforts are needed to improve management of human resources to ensure that effective mechanisms for regulating and financing task shifting are sustained. PMID:21211045

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

Evaluation of Facility Management by Multivariate Statistics - Factor Analysis

NASA Astrophysics Data System (ADS)

Singovszki, Miloš; Vranayová, Zuzana

2013-06-01

Facility management is evolving, there is no exact than other sciences, although its development is fast forward. The knowledge and practical skills in facility management is not replaced, on the contrary, they complement each other. The existing low utilization of science in the field of facility management is mainly caused by the management of support activities are many variables and prevailing immediate reaction to the extraordinary situation arising from motives of those who have substantial experience and years of proven experience. Facility management is looking for a system that uses organized knowledge and will form the basis, which grows from a wide range of disciplines. Significant influence on its formation as a scientific discipline is the "structure, which follows strategy". The paper deals evaluate technology building as part of an facility management by multivariate statistic - factor analysis.

Human-resources strategies for managing HIV/AIDS: the case of the South African forestry industry.

PubMed

Gow, Jeff; Grant, Bligh

2010-09-01

Previous work has focused on HIV prevalence among forestry workers and the impact of HIV/AIDS on the sustainability of forest resources. Following a review of work examining the impacts of HIV/AIDS on the South African economy, this article presents original qualitative research examining the responses of company management to the HIV epidemic across a range of enterprises in the South African forestry industry, including large companies, contractors and cooperatives. At the level of the enterprise, management occupies a critical nexus, at which the intersecting requirements of complex government legislation, the wellbeing of workers and the demands of the business must be met. The research demonstrates that large forestry companies tend to provide only a small fraction of their workforces with HIV/AIDS education, prevention or treatment services, as they have essentially outsourced the requirement through the use of labour-supply contractors who, by and large, provide workers with scant HIV/AIDS-related programmes or benefits. Moreover, the extent to which the different types of forestry enterprises incorporate the management of HIV/AIDS in the workforce with the management of the business is highly variable, and in most instances falls short of legislative requirements that have been in place for over a decade. The implications of this for the forestry industry in South Africa are acute.

Planning equipment acquisitions.

PubMed

Sadock, J M

1995-08-01

As the mire of healthcare reform continues to grow, many providers are developing an insatiable appetite for alternatives to the way they currently do business. For some, solutions come in the form of repackaging the same old stuff. Others have jumped recklessly into every managed, capitated, or reformed idea that has come along. Old-school thinkers are still awaiting government direction. Providers of quality healthcare face increasing demands on their shrinking capital funds. An aging population, indigent care, AIDS patients, medical waste disposal, nursing shortages, declining reimbursement, increasing labor costs, and the federal healthcare reform threat have negatively affected cash flow. Though previous cost-plus reimbursement encouraged wasteful spending, the threat of healthcare reform has already caused providers and suppliers alike to work together to cut costs even without government mandates. The impact has been the closure of over 600 facilities nationwide in the past ten years. More than 70,000 acute care hospital beds have been lost from the US healthcare system. Many healthcare facilities have merged into managed care systems, integrated delivery networks, and regional alliances whose costs can be consolidated and controlled. At the same time, new services and profit centers are also being created to increase revenue. A healthcare moves into alternative care environments--home care, ambulatory care, diagnostic testing--these providers need more capital equipment to serve an increased patient load. Coupled with an aging installed base of technology in the acute care environment, healthcare managers face an ever-growing need for capital equipment and creative financing programs to meet longer payment options.(ABSTRACT TRUNCATED AT 250 WORDS)

Steve Nixon | NREL

Science.gov Websites

NREL. Steve has an extensive background in facilities engineering, facilities management, and Energy Manager, and a Project Management Professional. Prior to joining NREL, Steve was the Facilities manufacturing engineering, business application programming, and business process management positions

Obstetric hemorrhage and shock management: using the low technology Non-pneumatic Anti-Shock Garment in Nigerian and Egyptian tertiary care facilities.

PubMed

Miller, Suellen; Fathalla, Mohamed M F; Ojengbede, Oladosu A; Camlin, Carol; Mourad-Youssif, Mohammed; Morhason-Bello, Imran O; Galadanci, Hadiza; Nsima, David; Butrick, Elizabeth; Al Hussaini, Tarek; Turan, Janet; Meyer, Carinne; Martin, Hilarie; Mohammed, Aminu I

2010-10-18

Obstetric hemorrhage is the leading cause of maternal mortality globally. The Non-pneumatic Anti-Shock Garment (NASG) is a low-technology, first-aid compression device which, when added to standard hypovolemic shock protocols, may improve outcomes for women with hypovolemic shock secondary to obstetric hemorrhage in tertiary facilities in low-resource settings. This study employed a pre-intervention/intervention design in four facilities in Nigeria and two in Egypt. Primary outcomes were measured mean and median blood loss, severe end-organ failure morbidity (renal failure, pulmonary failure, cardiac failure, or CNS dysfunctions), mortality, and emergency hysterectomy for 1442 women with ≥750 mL blood loss and at least one sign of hemodynamic instability. Comparisons of outcomes by study phase were assessed with rank sum tests, relative risks (RR), number needed to treat for benefit (NNTb), and multiple logistic regression. Women in the NASG phase (n = 835) were in worse condition on study entry, 38.5% with mean arterial pressure <60 mmHg vs. 29.9% in the pre-intervention phase (p = 0.001). Despite this, negative outcomes were significantly reduced in the NASG phase: mean measured blood loss decreased from 444 mL to 240 mL (p < 0.001), maternal mortality decreased from 6.3% to 3.5% (RR 0.56, 95% CI 0.35-0.89), severe morbidities from 3.7% to 0.7% (RR 0.20, 95% CI 0.08-0.50), and emergency hysterectomy from 8.9% to 4.0% (RR 0.44, 0.23-0.86). In multiple logistic regression, there was a 55% reduced odds of mortality during the NASG phase (aOR 0.45, 0.27-0.77). The NNTb to prevent either mortality or severe morbidity was 18 (12-36). Adding the NASG to standard shock and hemorrhage management may significantly improve maternal outcomes from hypovolemic shock secondary to obstetric hemorrhage at tertiary care facilities in low-resource settings.

A retrospective tiered environmental assessment of the Mount Storm Wind Energy Facility, West Virginia,USA

DOE Office of Scientific and Technical Information (OSTI.GOV)

Efroymson, Rebecca Ann; Day, Robin; Strickland, M. Dale

Bird and bat fatalities from wind energy projects are an environmental and public concern, with post-construction fatalities sometimes differing from predictions. Siting facilities in this context can be a challenge. In March 2012 the U.S. Fish and Wildlife Service (USFWS) released Land-based Wind Energy Guidelines to assess collision fatalities and other potential impacts to species of concern and their habitats to aid in siting and management. The Guidelines recommend a tiered approach for assessing risk to wildlife, including a preliminary site evaluation that may evaluate alternative sites, a site characterization, field studies to document wildlife and habitat and to predictmore » project impacts, post construction studies to estimate impacts, and other post construction studies. We applied the tiered assessment framework to a case study site, the Mount Storm Wind Energy Facility in Grant County, West Virginia, USA, to demonstrate the use of the USFWS assessment approach, to indicate how the use of a tiered assessment framework might have altered outputs of wildlife assessments previously undertaken for the case study site, and to assess benefits of a tiered ecological assessment framework for siting wind energy facilities. The conclusions of this tiered assessment for birds are similar to those of previous environmental assessments for Mount Storm. This assessment found risk to individual migratory tree-roosting bats that was not emphasized in previous preconstruction assessments. Differences compared to previous environmental assessments are more related to knowledge accrued in the past 10 years rather than to the tiered structure of the Guidelines. Benefits of the tiered assessment framework include good communication among stakeholders, clear decision points, a standard assessment trajectory, narrowing the list of species of concern, improving study protocols, promoting consideration of population-level effects, promoting adaptive management through post-construction assessment and mitigation, and sharing information that can be used in other assessments.« less

Implementing and measuring the level of laboratory service integration in a program setting in Nigeria.

PubMed

Mbah, Henry; Negedu-Momoh, Olubunmi Ruth; Adedokun, Oluwasanmi; Ikani, Patrick Anibbe; Balogun, Oluseyi; Sanwo, Olusola; Ochei, Kingsley; Ekanem, Maurice; Torpey, Kwasi

2014-01-01

The surge of donor funds to fight HIV&AIDS epidemic inadvertently resulted in the setup of laboratories as parallel structures to rapidly respond to the identified need. However these parallel structures are a threat to the existing fragile laboratory systems. Laboratory service integration is critical to remedy this situation. This paper describes an approach to quantitatively measure and track integration of HIV-related laboratory services into the mainstream laboratory services and highlight some key intervention steps taken, to enhance service integration. A quantitative before-and-after study conducted in 122 Family Health International (FHI360) supported health facilities across Nigeria. A minimum service package was identified including management structure; trainings; equipment utilization and maintenance; information, commodity and quality management for laboratory integration. A check list was used to assess facilities at baseline and 3 months follow-up. Level of integration was assessed on an ordinal scale (0 = no integration, 1 = partial integration, 2 = full integration) for each service package. A composite score grading expressed as a percentage of total obtainable score of 14 was defined and used to classify facilities (≤ 80% FULL, 25% to 79% PARTIAL and <25% NO integration). Weaknesses were noted and addressed. We analyzed 9 (7.4%) primary, 104 (85.2%) secondary and 9 (7.4%) tertiary level facilities. There were statistically significant differences in integration levels between baseline and 3 months follow-up period (p<0.01). Baseline median total integration score was 4 (IQR 3 to 5) compared to 7 (IQR 4 to 9) at 3 months follow-up (p = 0.000). Partial and fully integrated laboratory systems were 64 (52.5%) and 0 (0.0%) at baseline, compared to 100 (82.0%) and 3 (2.4%) respectively at 3 months follow-up (p = 0.000). This project showcases our novel approach to measure the status of each laboratory on the integration continuum.

Electromagnetic Interference/Compatibility (EMI/EMC) Control Test and Measurement Facility: User Test Planning Guide

NASA Technical Reports Server (NTRS)

Scully, Robert C.

2011-01-01

Test process, milestones and inputs are unknowns to first-time users of the EMI/EMC Test Facility. The User Test Planning Guide aids in establishing expectations for both NASA and non-NASA facility customers. The potential audience for this guide includes both internal and commercial spaceflight hardware/software developers. It is intended to assist their test engineering personnel in test planning and execution. Material covered includes a roadmap of the test process, roles and responsibilities of facility and user, major milestones, facility capabilities, and inputs required by the facility. Samples of deliverables, test article interfaces, and inputs necessary to define test scope, cost, and schedule are included as an appendix to the guide.

New Trends in Facility Asset Management.

ERIC Educational Resources Information Center

Adams, Matt

2000-01-01

Explains new, positive trends in facility asset management that encompasses greater acceptance and involvement of facility managers in the financial planning process, greater awareness of the need for maintenance, and facility administrators taking a greater role with business officers. The new climate for alternative renewal financing proposals…

Facility Accounting: Hammering Out a Capital Replacement Budget.

ERIC Educational Resources Information Center

Readinger, Jay

1996-01-01

Most facility and finance managers cannot adequately handle school infrastructure issues because they lack the tools to describe the problem appropriately. Facility accounting gives managers accurate deferral and projected replacement costs, using nationally recognized life-cycle and cost data. Facility accounting enables proper management of…

MANUAL FOR OPERATIONAL DOCUMENTARY PHOTOGRAPHY (ODP)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hendrix, V.V.

1963-12-23

The SL-1 incident showed the need for pre-incident photographs of the facility to aid in rescue or recovery operations. A system of documentary photographic coverage was developed to fill this need for all the NRTS reactors and facilities. In this system, aperture cards with photographic negatives are used, and the cards are coded with respect to facility, room, floor, angle, and other variables. Operational planning for documentary photographs and updating of the cards are discussed. (D.L.C.)

Artificial insemination with donor sperm (AID): heterogeneity in sperm banking facilities in a single country (Belgium).

PubMed

Thijssen, A; Dhont, N; Vandormael, E; Cox, A; Klerkx, E; Creemers, E; Ombelet, W

2014-01-01

Due to the high inflow of foreign patients seeking cross-border reproductive care in Belgium and the increased number of lesbian couples and single women who call for artificial insemination with donor sperm (AID), Belgian sperm banks nowadays face a shortage in donor sperm. However, since there is no central registration system for sperm donors in Belgium, no figures are currently available supporting this statement. Therefore a study was performed to obtain a detailed overview of the sperm banking facilities in Belgium. Questionnaires were sent to all Belgian centres for assisted reproduction with laboratory facilities (n = 18) to report on their sperm banking methods. The results showed that 82% of the centres rely partially or completely on foreign donor sperm. Moreover, four of the thirteen centres that have their own sperm bank use imported donor sperm in > 95% AID cycles. Our results show that in 63% of the Belgian AID cycles imported Danish donor sperm is being used. Donor recruitment is mainly performed through the centre's website (61%) or by distributing flyers in the centre (46%) and 9 to 180 potential donors have been recruited per centre in 2013. Eventually, 15 to 50% of these candidate donors were accepted. Different criteria for donor acceptance are handled by the centres: donor age limits range from 18-25 to 36-46 years old, and thresholds for sperm normality differ considerably. We can conclude that a wide variation in methods associated with sperm banking is observed in Belgian centres.

Artificial insemination with donor sperm (AID): heterogeneity in sperm banking facilities in a single country (Belgium)

PubMed Central

Thijssen, A.; Dhont, N.; Vandormael, E.; Cox, A.; Klerkx, E.; Creemers, E.; Ombelet, W.

2014-01-01

Due to the high inflow of foreign patients seeking cross-border reproductive care in Belgium and the increased number of lesbian couples and single women who call for artificial insemination with donor sperm (AID), Belgian sperm banks nowadays face a shortage in donor sperm. However, since there is no central registration system for sperm donors in Belgium, no figures are currently available supporting this statement. Therefore a study was performed to obtain a detailed overview of the sperm banking facilities in Belgium. Questionnaires were sent to all Belgian centres for assisted reproduction with laboratory facilities (n = 18) to report on their sperm banking methods. The results showed that 82% of the centres rely partially or completely on foreign donor sperm. Moreover, four of the thirteen centres that have their own sperm bank use imported donor sperm in > 95% AID cycles. Our results show that in 63% of the Belgian AID cycles imported Danish donor sperm is being used. Donor recruitment is mainly performed through the centre’s website (61%) or by distributing flyers in the centre (46%) and 9 to 180 potential donors have been recruited per centre in 2013. Eventually, 15 to 50% of these candidate donors were accepted. Different criteria for donor acceptance are handled by the centres: donor age limits range from 18-25 to 36-46 years old, and thresholds for sperm normality differ considerably. We can conclude that a wide variation in methods associated with sperm banking is observed in Belgian centres. PMID:25009728

Lip and tooth injuries at public swimming pools in Austria.

PubMed

Lechner, Katharina; Connert, Thomas; Kühl, Sebastian; Filippi, Andreas

2017-06-01

There is an increased risk of orofacial injuries in swimming pool facilities. Nevertheless, only a few studies have addressed this issue. The aim of this study was to identify the frequency of lip and tooth injuries at public swimming pools in Austria. A further aim was to examine which gender and age groups were affected, where and why these injuries occurred, and whether pool attendants had sufficient knowledge of dental first-aid measures. A total of 764 pool attendants in Austria were contacted by telephone and 689 participated in the study (90.2%). The attendants were interviewed retrospectively about accident occurrences in 2014 by a standardized questionnaire. Responses to the provision of first aid and choice of storage medium for avulsed teeth were subsequently evaluated. The frequency of lip injuries was 19.0%, and tooth injuries were 11.3%. Male bathers (P < .05) and children under 12 years (P < .001) most frequently suffered injuries. The waterslide was the most common accident site. The most common cause of lip injuries was slipping on wet surfaces (39.0%), and for tooth injuries it was collisions with other persons or objects (each 28.1%). The pool attendants' responses were predominantly good or sufficient on first aid, with the exception of what storage medium to choose. Tooth rescue boxes were available in only 8.6% of all pool facilities. Orofacial injuries are a frequently occurring problem in swimming pool facilities. The pool attendants' knowledge on first-aid care of tooth injuries could still be improved. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A guideline for interpersonal capabilities enhancement to support sustainable facility management practice

NASA Astrophysics Data System (ADS)

Sarpin, Norliana; Kasim, Narimah; Zainal, Rozlin; Noh, Hamidun Mohd

2018-04-01

Facility management is the key phase in the development cycle of an assets and spans over a considerable length of time. Therefore, facility managers are in a commanding position to maximise the potential of sustainability through the development phases from construction, operation, maintenance and upgrade leading to decommission and deconstruction. Sustainability endeavours in facility management practices will contribute to reducing energy consumption, waste and running costs. Furthermore, it can also help in improving organisational productivity, financial return and community standing of the organisation. Facility manager should be empowered with the necessary knowledge and capabilities at the forefront facing sustainability challenge. However, literature studies show a gap between the level of awareness, specific knowledge and the necessary skills required to pursue sustainability in the facility management professional. People capability is considered as the key enabler in managing the sustainability agenda as well as being central to the improvement of competency and innovation in an organisation. This paper aims to develop a guidelines for interpersonal capabilities to support sustainability in facility management practice. Starting with a total of 7 critical interpersonal capabilities factors identified from previous questionnaire survey, the authors conducted an interview with 3 experts in facility management to assess the perceived importance of these factors. The findings reveal a set of guidelines for the enhancement of interpersonal capabilities among facility managers by providing what can be done to acquire these factors and how it can support the application of sustainability in their practice. The findings of this paper are expected to form the basis of a mechanism framework developed to equip facility managers with the right knowledge, to continue education and training and to develop new mind-sets to enhance the implementation of sustainability measures in FM practices.

Management of ethical issues related to care of seriously ill dialysis patients in free-standing facilities.

PubMed

Song, Mi-Kyung; Hanson, Laura C; Gilet, Constance A; Jo, Minjeong; Reed, Teresa J; Hladik, Gerald A

2014-09-01

There are few data on the frequency and current management of clinical ethical issues related to care of seriously ill dialysis patients in free-standing dialysis facilities. To examine the extent of clinical ethical challenges experienced by care providers in free-standing facilities and their perceptions about how those issues are managed. A total of 183 care providers recruited from 15 facilities in North Carolina completed a survey regarding the occurrence and management of ethical issues in the past year. Care plan meetings were observed at four of the facilities for three consecutive months. Also, current policies and procedures at each of the facilities were reviewed. The two most frequently experienced challenges involved dialyzing frail patients with multiple comorbidities and caring for disruptive/difficult patients. The most common ways of managing ethical issues were discussions in care plan meetings (n = 47) or discussions with the clinic manager (n = 47). Although policies were in place to guide management of some of the challenges, respondents were often not aware of those policies. Also, although participants reported that ethical issues related to dialyzing undocumented immigrants were fairly common, no facility had a policy for managing this challenge. Participants suggested that all staff obtain training in clinical ethics and communication skills, facilities develop ethics teams, and there be clear policies to guide management of ethical challenges. The scope of ethical challenges was extensive, how these challenges were managed varied widely, and there were limited resources for assistance. Multifaceted efforts, encompassing endeavors at the individual, facility, organization, and national levels, are needed to support staff in improving the management of ethical challenges in dialysis facilities. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Human-centered automation and AI - Ideas, insights, and issues from the Intelligent Cockpit Aids research effort

NASA Technical Reports Server (NTRS)

Abbott, Kathy H.; Schutte, Paul C.

1989-01-01

A development status evaluation is presented for the NASA-Langley Intelligent Cockpit Aids research program, which encompasses AI, human/machine interfaces, and conventional automation. Attention is being given to decision-aiding concepts for human-centered automation, with emphasis on inflight subsystem fault management, inflight mission replanning, and communications management. The cockpit envisioned is for advanced commercial transport aircraft.

How to Make Financial Aid "Freshman-Friendly"

ERIC Educational Resources Information Center

Pugh, Susan L.; Johnson, David B.

2011-01-01

Ultimately, making financial aid "freshman friendly" also makes financial aid "sophomore friendly," "junior friendly," and "senior friendly." Indiana University has in place an Office of Enrollment Management (OEM) model that includes focused financial aid packaging strategies complemented by unique contact…

'Pharmacists have been left out of the loop': exploring the role of pharmacists in the management of HIV/AIDS in South Africa.

PubMed

Gilbert, Leah

2016-02-01

The aim of this paper is to portray and critically analyse the role played by pharmacists in the management of the HIV/AIDS epidemic in South Africa. The data used for this article originate in secondary and primary sources. They were collected by means of a documentary analysis of all relevant documents of significance as well as exploratory telephone interviews conducted with a systematic random sample of community pharmacies in Greater Johannesburg in 2004 and 2010. It is clear from the original strategic framework that the government envisaged pharmacists playing a significant role in the various facets of the epidemic. Following these intentions, the South African Pharmacy Council and the Pharmaceutical Society of South Africa embarked on a process of establishing AIDS Resource Centres in pharmacies. However, although in some areas pharmacists are contributing to the management of HIV/AIDS, the overall scenario revealed is that of lack of willingness to go for additional training and/or to invest in restructuring the pharmacy to 'accommodate' the activities of an 'AIDS Resource Centre' without the prospects of adequate financial gains. In a parallel process, the original, more meaningful role for pharmacists in the management of HIV/AIDS has not been featured in recent professional and governmental documentation. The reality on the ground is that of a missed opportunity as the pharmacists have not risen to the challenge and they remain on the margins, and not at the centre, of those professionals managing HIV/AIDS in South Africa. © 2015 Royal Pharmaceutical Society.

Antenna Test Facility (ATF): User Test Planning Guide

NASA Technical Reports Server (NTRS)

Lin, Greg

2011-01-01

Test process, milestones and inputs are unknowns to first-time users of the ATF. The User Test Planning Guide aids in establishing expectations for both NASA and non-NASA facility customers. The potential audience for this guide includes both internal and commercial spaceflight hardware/software developers. It is intended to assist their test engineering personnel in test planning and execution. Material covered includes a roadmap of the test process, roles and responsibilities of facility and user, major milestones, facility capabilities, and inputs required by the facility. Samples of deliverables, test article interfaces, and inputs necessary to define test scope, cost, and schedule are included as an appendix to the guide.

Radiant Heat Test Facility (RHTF): User Test Planning Guide

NASA Technical Reports Server (NTRS)

DelPapa, Steven

2011-01-01

Test process, milestones and inputs are unknowns to first-time users of the RHTF. The User Test Planning Guide aids in establishing expectations for both NASA and non- NASA facility customers. The potential audience for this guide includes both internal and commercial spaceflight hardware/software developers. It is intended to assist their test engineering personnel in test planning and execution. Material covered includes a roadmap of the test process, roles and responsibilities of facility and user, major milestones, facility capabilities, and inputs required by the facility. Samples of deliverables, test article interfaces, and inputs necessary to define test scope, cost, and schedule are included as an appendix to the guide.

Communication Systems Simulation Laboratory (CSSL): Simulation Planning Guide

NASA Technical Reports Server (NTRS)

Schlesinger, Adam

2012-01-01

The simulation process, milestones and inputs are unknowns to first-time users of the CSSL. The Simulation Planning Guide aids in establishing expectations for both NASA and non-NASA facility customers. The potential audience for this guide includes both internal and commercial spaceflight hardware/software developers. It is intended to assist their engineering personnel in simulation planning and execution. Material covered includes a roadmap of the simulation process, roles and responsibilities of facility and user, major milestones, facility capabilities, and inputs required by the facility. Samples of deliverables, facility interfaces, and inputs necessary to define scope, cost, and schedule are included as an appendix to the guide.

Systems Engineering Simulator (SES) Simulator Planning Guide

NASA Technical Reports Server (NTRS)

McFarlane, Michael

2011-01-01

The simulation process, milestones and inputs are unknowns to first-time users of the SES. The Simulator Planning Guide aids in establishing expectations for both NASA and non-NASA facility customers. The potential audience for this guide includes both internal and commercial spaceflight hardware/software developers. It is intended to assist their engineering personnel in simulation planning and execution. Material covered includes a roadmap of the simulation process, roles and responsibilities of facility and user, major milestones, facility capabilities, and inputs required by the facility. Samples of deliverables, facility interfaces, and inputs necessary to define scope, cost, and schedule are included as an appendix to the guide.

Computational Electromagnetics (CEM) Laboratory: Simulation Planning Guide

NASA Technical Reports Server (NTRS)

Khayat, Michael A.

2011-01-01

The simulation process, milestones and inputs are unknowns to first-time users of the CEM Laboratory. The Simulation Planning Guide aids in establishing expectations for both NASA and non-NASA facility customers. The potential audience for this guide includes both internal and commercial spaceflight hardware/software developers. It is intended to assist their engineering personnel in simulation planning and execution. Material covered includes a roadmap of the simulation process, roles and responsibilities of facility and user, major milestones, facility capabilities, and inputs required by the facility. Samples of deliverables, facility interfaces, and inputs necessary to define scope, cost, and schedule are included as an appendix to the guide.

48 CFR 836.606-72 - Contract price.

Code of Federal Regulations, 2014 CFR

2014-10-01

... officer shall, after authorization by the Director, Office of Construction and Facilities Management, the Director, Office of Construction Management, or the facility or VISN director, as appropriate, terminate... Director, Office of Construction and Facilities Management, the Director, Office of Construction Management...

48 CFR 836.606-72 - Contract price.

Code of Federal Regulations, 2011 CFR

2011-10-01

... officer shall, after authorization by the Director, Office of Construction and Facilities Management, the Director, Office of Construction Management, or the facility or VISN director, as appropriate, terminate... Director, Office of Construction and Facilities Management, the Director, Office of Construction Management...

48 CFR 836.606-72 - Contract price.

Code of Federal Regulations, 2013 CFR

2013-10-01

... officer shall, after authorization by the Director, Office of Construction and Facilities Management, the Director, Office of Construction Management, or the facility or VISN director, as appropriate, terminate... Director, Office of Construction and Facilities Management, the Director, Office of Construction Management...

48 CFR 836.606-72 - Contract price.

Code of Federal Regulations, 2012 CFR

2012-10-01

... officer shall, after authorization by the Director, Office of Construction and Facilities Management, the Director, Office of Construction Management, or the facility or VISN director, as appropriate, terminate... Director, Office of Construction and Facilities Management, the Director, Office of Construction Management...

48 CFR 836.602-2 - Evaluation boards.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Management projects. The Director, Office of Construction and Facilities Management, shall appoint an... appropriate for the particular project. The Director, Office of Construction and Facilities Management may... Evaluation boards. (a) The Director, Office of Construction and Facilities Management, shall appoint an...

41 CFR 102-74.320 - Are there any exceptions to the smoking policy for interior space in Federal facilities?

Code of Federal Regulations, 2014 CFR

2014-01-01

... to the smoking policy for interior space in Federal facilities? 102-74.320 Section 102-74.320 Public... MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Smoking § 102-74.320 Are there any exceptions to the smoking policy for interior space in Federal facilities? Yes, the smoking policy...

41 CFR 102-74.320 - Are there any exceptions to the smoking policy for interior space in Federal facilities?

Code of Federal Regulations, 2011 CFR

2011-01-01

... to the smoking policy for interior space in Federal facilities? 102-74.320 Section 102-74.320 Public... MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Smoking § 102-74.320 Are there any exceptions to the smoking policy for interior space in Federal facilities? Yes, the smoking policy...

41 CFR 102-74.320 - Are there any exceptions to the smoking policy for interior space in Federal facilities?

Code of Federal Regulations, 2013 CFR

2013-07-01

... to the smoking policy for interior space in Federal facilities? 102-74.320 Section 102-74.320 Public... MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Smoking § 102-74.320 Are there any exceptions to the smoking policy for interior space in Federal facilities? Yes, the smoking policy...

41 CFR 102-74.320 - Are there any exceptions to the smoking policy for interior space in Federal facilities?

Code of Federal Regulations, 2010 CFR

2010-07-01

... to the smoking policy for interior space in Federal facilities? 102-74.320 Section 102-74.320 Public... MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Smoking § 102-74.320 Are there any exceptions to the smoking policy for interior space in Federal facilities? Yes, the smoking policy...

41 CFR 102-74.320 - Are there any exceptions to the smoking policy for interior space in Federal facilities?

Code of Federal Regulations, 2012 CFR

2012-01-01

... to the smoking policy for interior space in Federal facilities? 102-74.320 Section 102-74.320 Public... MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Smoking § 102-74.320 Are there any exceptions to the smoking policy for interior space in Federal facilities? Yes, the smoking policy...

Banning traditional birth attendants from conducting deliveries: experiences and effects of the ban in a rural district of Kazungula in Zambia.

PubMed

Cheelo, Chilala; Nzala, Selestine; Zulu, Joseph M

2016-10-21

In 2010 the government of the republic of Zambia stopped training traditional birth attendants and forbade them from conducting home deliveries as they were viewed as contributing to maternal mortality. This study explored positive and negative maternal health related experiences and effects of the ban in a rural district of Kazungula. This was a phenomenological study and data were collected through focus group discussions as well as in-depth interviews with trained traditional birth attendants (tTBAs) and key informant interviews with six female traditional leaders that were selected one from each of the six zones. All 22 trained tTBAs from three clinic catchment areas were included in the study. Content analysis was used to analyse the data after coding it using NVIVO 8 software. Home deliveries have continued despite the community and tTBAs being aware of the ban. The ban has had both negative and positive effects on the community. Positive effects include early detection and management of pregnancy complications, enhanced HIV/AIDS prevention and better management of post-natal conditions, reduced criticisms of tTBAs from the community in case of birth complications, and quick response at health facilities in case of an emergency. Negatives effects of the ban include increased work load on the part of health workers, high cost for lodging at health facilities and traveling to health facilities, as well as tTBAs feeling neglected, loss of respect and recognition by the community. Countries should design their approach to banning tTBAs differently depending on contextual factors. Further, it is important to consider adopting a step wise approach when implementing the ban as the process of banning tTBAs may trigger several negative effects.

Oral trauma and dental emergency management recommendations of first-aid textbooks and manuals.

PubMed

Zadik, Yehuda

2007-10-01

The recommendations of oral trauma and dental emergencies management of nine first-aid textbooks and manuals from the last two decades were evaluated. Only one book includes all the relevant topics: dental anatomy, management of tooth luxations and avulsion, tooth fracture, mandible dislocation, jaw fracture, intraoral bleeding and dental pain. Two books recommend self-replantation of an avulsed tooth, but four books detail the storage media and evaluate the importance of a quick referral to a dental surgery. In three first-aid books, the only mention of oral trauma is the hazard of choking from tooth fragments, and in one other book, only mandible dislocation is mentioned as oral trauma. The insufficient information of oral trauma management in these first-aid texts partly explains the previous reports of poor and inadequate knowledge in that topic among medics, teachers and the general public.

Computer-Assisted School Facility Planning with ONPASS.

ERIC Educational Resources Information Center

Urban Decision Systems, Inc., Los Angeles, CA.

The analytical capabilities of ONPASS, an on-line computer-aided school facility planning system, are described by its developers. This report describes how, using the Canoga Park-Winnetka-Woodland Hills Planning Area as a test case, the Department of City Planning of the city of Los Angeles employed ONPASS to demonstrate how an on-line system can…

38 CFR Appendix A to Subpart A of... - Statutory Provisions to Which This Subpart Applies

Code of Federal Regulations, 2011 CFR

2011-07-01

... home, and hospital care (38 U.S.C. 8131-8137). 3. Space and office facilities for representatives of...). 6. Approval of educational institutions (38 U.S.C. 104). 7. Space and office facilities for.... 1720A). 11. Aid to States for establishment, expansion, and improvement of veterans cemeteries (38 U.S.C...

38 CFR Appendix A to Subpart D of... - Statutory Provisions to Which This Part Applies

Code of Federal Regulations, 2013 CFR

2013-07-01

... certain veterans (38 U.S.C. 1713). 8. Space and office facilities for representatives of State employment service (38 U.S.C. 7725(4)). 9. Space and office facilities for representatives of recognized national... disabilities (38 U.S.C. 1720A). 12. Aid to States for establishment, expansion, and improvement of veterans...

38 CFR Appendix A to Subpart A of... - Statutory Provisions to Which This Subpart Applies

Code of Federal Regulations, 2013 CFR

2013-07-01

... home, and hospital care (38 U.S.C. 8131-8137). 3. Space and office facilities for representatives of...). 6. Approval of educational institutions (38 U.S.C. 104). 7. Space and office facilities for.... 1720A). 11. Aid to States for establishment, expansion, and improvement of veterans cemeteries (38 U.S.C...

38 CFR Appendix A to Subpart D of... - Statutory Provisions to Which This Part Applies

Code of Federal Regulations, 2012 CFR

2012-07-01

... certain veterans (38 U.S.C. 1713). 8. Space and office facilities for representatives of State employment service (38 U.S.C. 7725(4)). 9. Space and office facilities for representatives of recognized national... disabilities (38 U.S.C. 1720A). 12. Aid to States for establishment, expansion, and improvement of veterans...

38 CFR Appendix A to Subpart A of... - Statutory Provisions to Which This Subpart Applies

Code of Federal Regulations, 2014 CFR

2014-07-01

... home, and hospital care (38 U.S.C. 8131-8137). 3. Space and office facilities for representatives of...). 6. Approval of educational institutions (38 U.S.C. 104). 7. Space and office facilities for.... 1720A). 11. Aid to States for establishment, expansion, and improvement of veterans cemeteries (38 U.S.C...

38 CFR Appendix A to Subpart D of... - Statutory Provisions to Which This Part Applies

Code of Federal Regulations, 2014 CFR

2014-07-01

... certain veterans (38 U.S.C. 1713). 8. Space and office facilities for representatives of State employment service (38 U.S.C. 7725(4)). 9. Space and office facilities for representatives of recognized national... disabilities (38 U.S.C. 1720A). 12. Aid to States for establishment, expansion, and improvement of veterans...

38 CFR Appendix A to Subpart D of... - Statutory Provisions to Which This Part Applies

Code of Federal Regulations, 2011 CFR

2011-07-01

... certain veterans (38 U.S.C. 1713). 8. Space and office facilities for representatives of State employment service (38 U.S.C. 7725(4)). 9. Space and office facilities for representatives of recognized national... disabilities (38 U.S.C. 1720A). 12. Aid to States for establishment, expansion, and improvement of veterans...

38 CFR Appendix A to Subpart A of... - Statutory Provisions to Which This Subpart Applies

Code of Federal Regulations, 2012 CFR

2012-07-01

... home, and hospital care (38 U.S.C. 8131-8137). 3. Space and office facilities for representatives of...). 6. Approval of educational institutions (38 U.S.C. 104). 7. Space and office facilities for.... 1720A). 11. Aid to States for establishment, expansion, and improvement of veterans cemeteries (38 U.S.C...

Results of an Initial Field Study of New Techniques for Citizen Participation in Educational Facilities Planning.

ERIC Educational Resources Information Center

Zucker, Charles B.

The utility of a particular citizen participation planning approach as applied to educational facilities planning is described. With the aid of a clear-cut decisionmaking procedure, citizens could participate effectively in the development of specific planning policy statements. Such statements could be used to discuss planning priorities, focus…

Classroom Facilities Planning Aids. March 1964. College and University Physical Facilities Series.

ERIC Educational Resources Information Center

Higgins, E. Eugene; And Others

Based on a survey of higher education institutions in the United States, academic classroom data are presented in tabular form. Tables 1 and 3 (for public and private institutions respectively) show state and regional distribution of classroom data by--(1) number of classrooms, (2) total assignable area, (3) classroom size, (4) number of student…

The Wait Is Over | Poster

Cancer.gov

By Nancy Parrish, Staff Writer At a March 2010 gathering at the construction site of the Advanced Technology Research Facility (ATRF), Craig Reynolds, Ph.D., associate director of the National Cancer Institute (NCI), noted that the facility would be a place where public–private partnerships will produce the next generation of diagnostics and treatments for cancer and AIDS. The

109(b) State Training Center Facility Assessment, Program Evaluation, and Guide Development. Final Report.

ERIC Educational Resources Information Center

Miklas, Michael P., Jr.

Section 109(b) of the 1972 Federal Water Pollution Control Act Amendments authorized funding for the construction of statewide water treatment training facilities. Described in this report is work conducted by Southwest Research Institute (SwRI) to: (1) aid in developing updated 109(b) Guidance Documents; (2) characterize and evaluate existing…

Guide to Facilities, Capabilities, and Programs of Medical Schools in the United States.

ERIC Educational Resources Information Center

Mayeda, Tadashi A.

The information in this document was gathered to aid analysts and designers of the proposed Biomedical Communications Network (BCN) of the National Library of Medicine. The current capabilities and facilities of medical schools in areas of activity impinging on the concept and role of BCN are summarized. Medical schools are listed geographically…

A Program Management Framework for Facilities Managers

ERIC Educational Resources Information Center

King, Dan

2012-01-01

The challenge faced by senior facility leaders is not how to execute a single project, but rather, how to successfully execute a large program consisting of hundreds of projects. Senior facilities officers at universities, school districts, hospitals, airports, and other organizations with extensive facility inventories, typically manage project…

Does foreign aid crowd out government investments? Evidence from rural health centres in Rwanda

PubMed Central

Lu, Chunling; Cook, Benjamin; Desmond, Chris

2017-01-01

Background Rural healthcare facilities in low-income countries play a major role in providing primary care to rural populations. We examined the link of foreign aid with government investments and medical service provision in rural health centres in Rwanda. Methods Using the District Health System Strengthening Tool, a web-based database built by the Ministry of Health in Rwanda, we constructed two composite indices representing provision of (1) child and maternal care and (2) HIV, tuberculosis (TB) and malaria services in 330 rural health centres between 2009 and 2011. Financing variables in a healthcare centre included received funds from various sources, including foreign donors and government. We used multilevel random-effects model in regression analyses and examined the robustness of results to a range of alternative specification, including scale of dependent variables, estimation methods and timing of aid effects. Findings Both government and foreign donors increased their direct investments in the 330 rural healthcare centres during the period. Foreign aid was positively associated with government investments (0.13, 95% CI 0.06 to 0.19) in rural health centres. Aid in the previous year was positively associated with service provision for child and maternal health (0.008, 95% CI 0.002 to 0.014) and service provision for HIV, TB and malaria (0.014, 95% CI 0.004 to 0.022) in the current year. The results are robust when using fixed-effects models. Conclusions These findings suggest that foreign aid did not crowd out government investments in the rural healthcare centres. Foreign aid programmes, conducted in addition to government investments, could benefit rural residents in low-income countries through increased service provision in rural healthcare facilities. PMID:29082015

Does foreign aid crowd out government investments? Evidence from rural health centres in Rwanda.

PubMed

Lu, Chunling; Cook, Benjamin; Desmond, Chris

2017-01-01

Rural healthcare facilities in low-income countries play a major role in providing primary care to rural populations. We examined the link of foreign aid with government investments and medical service provision in rural health centres in Rwanda. Using the District Health System Strengthening Tool, a web-based database built by the Ministry of Health in Rwanda, we constructed two composite indices representing provision of (1) child and maternal care and (2) HIV, tuberculosis (TB) and malaria services in 330 rural health centres between 2009 and 2011. Financing variables in a healthcare centre included received funds from various sources, including foreign donors and government. We used multilevel random-effects model in regression analyses and examined the robustness of results to a range of alternative specification, including scale of dependent variables, estimation methods and timing of aid effects. Both government and foreign donors increased their direct investments in the 330 rural healthcare centres during the period. Foreign aid was positively associated with government investments (0.13, 95% CI 0.06 to 0.19) in rural health centres. Aid in the previous year was positively associated with service provision for child and maternal health (0.008, 95% CI 0.002 to 0.014) and service provision for HIV, TB and malaria (0.014, 95% CI 0.004 to 0.022) in the current year. The results are robust when using fixed-effects models. These findings suggest that foreign aid did not crowd out government investments in the rural healthcare centres. Foreign aid programmes, conducted in addition to government investments, could benefit rural residents in low-income countries through increased service provision in rural healthcare facilities.

Preparation and evaporation of Hanford Waste treatment plant direct feed low activity waste effluent management facility simulant

DOE Office of Scientific and Technical Information (OSTI.GOV)

Adamson, D.; Nash, C.; Howe, A.

The Hanford Waste Treatment and Immobilization Plant (WTP) Low Activity Waste (LAW) vitrification facility will generate an aqueous condensate recycle stream (LAW Melter Off-Gas Condensate, LMOGC) from the off-gas system. The baseline plan for disposition of this stream during full WTP operations is to send it to the WTP Pretreatment Facility, where it will be blended with LAW, concentrated by evaporation, and recycled to the LAW vitrification facility. However, during the Direct Feed LAW (DFLAW) scenario, planned disposition of this stream involves concentrating the condensate in a new evaporator at the Effluent Management Facility (EMF) and returning it to themore » LAW melter. The LMOGC stream will contain components, e.g. halides and sulfates, that are volatile at melter temperatures, have limited solubility in glass waste forms, and present a material corrosion concern. Because this stream will recycle within WTP, these components are expected to accumulate in the LMOGC stream, exacerbating their impact on the number of LAW glass containers that must be produced. Diverting the stream reduces the halides and sulfates in the glass and is a key objective of this program. In order to determine the disposition path, it is key to experimentally determine the fate of contaminants. To do this, testing is needed to account for the buffering chemistry of the components, determine the achievable evaporation end point, identify insoluble solids that form, determine the formation and distribution of key regulatoryimpacting constituents, and generate an aqueous stream that can be used in testing of the subsequent immobilization step. This overall program examines the potential treatment and immobilization of the LMOGC stream to enable alternative disposal. The objective of this task was to (1) prepare a simulant of the LAW Melter Off-gas Condensate expected during DFLAW operations, (2) demonstrate evaporation in order to predict the final composition of the effluents from the EMF evaporator to aid in planning for their disposition, and (3) generate concentrated evaporator bottoms for use in immobilization testing.« less

25 CFR 170.806 - What is an IRR Transportation Facilities Maintenance Management System?

Code of Federal Regulations, 2010 CFR

2010-04-01

... AND WATER INDIAN RESERVATION ROADS PROGRAM BIA Road Maintenance § 170.806 What is an IRR Transportation Facilities Maintenance Management System? An IRR Transportation Facilities Maintenance Management... 25 Indians 1 2010-04-01 2010-04-01 false What is an IRR Transportation Facilities Maintenance...

41 CFR 102-74.70 - Are commercial vendors and nonprofit organizations required to operate vending facilities by...

Code of Federal Regulations, 2010 CFR

2010-07-01

... Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Are commercial vendors and nonprofit organizations required to operate vending facilities by permit or contractual...

Planning and Managing the Campus Facilities Portfolio

ERIC Educational Resources Information Center

Daigneau, William A., Ed.

2003-01-01

The campus and facilities of a college should be managed using the same principles as any other investment in an institution's financial portfolio. Stemming from the APPA/National Association of College & University Business Officers (NACUBO) Institute for Facilities Finance, this book addresses the totality of managing the facilities investment…

The ICCB Computer Based Facilities Inventory & Utilization Management Information Subsystem.

ERIC Educational Resources Information Center

Lach, Ivan J.

The Illinois Community College Board (ICCB) Facilities Inventory and Utilization subsystem, a part of the ICCB management information system, was designed to provide decision makers with needed information to better manage the facility resources of Illinois community colleges. This subsystem, dependent upon facilities inventory data and course…

18. Topside facility, interior of facility manager's room, view towards ...

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

18. Topside facility, interior of facility manager's room, view towards west. Lyon - Whiteman Air Force Base, Oscar O-1 Minuteman Missile Alert Facility, Southeast corner of Twelfth & Vendenberg Avenues, Knob Noster, Johnson County, MO

Integration of HIV/AIDS services into African primary health care: lessons learned for health system strengthening in Mozambique - a case study

PubMed Central

2010-01-01

Introduction In 2004, Mozambique, supported by large increases in international disease-specific funding, initiated a national rapid scale-up of antiretroviral treatment (ART) and HIV care through a vertical "Day Hospital" approach. Though this model showed substantial increases in people receiving treatment, it diverted scarce resources away from the primary health care (PHC) system. In 2005, the Ministry of Health (MOH) began an effort to use HIV/AIDS treatment and care resources as a means to strengthen their PHC system. The MOH worked closely with a number of NGOs to integrate HIV programs more effectively into existing public-sector PHC services. Case Description In 2005, the Ministry of Health and Health Alliance International initiated an effort in two provinces to integrate ART into the existing primary health care system through health units distributed across 23 districts. Integration included: a) placing ART services in existing units; b) retraining existing workers; c) strengthening laboratories, testing, and referral linkages; e) expanding testing in TB wards; f) integrating HIV and antenatal services; and g) improving district-level management. Discussion: By 2008, treatment was available in nearly 67 health facilities in 23 districts. Nearly 30,000 adults were on ART. Over 80,000 enrolled in the HIV/AIDS program. Loss to follow-up from antenatal and TB testing to ART services has declined from 70% to less than 10% in many integrated sites. Average time from HIV testing to ART initiation is significantly faster and adherence to ART is better in smaller peripheral clinics than in vertical day hospitals. Integration has also improved other non-HIV aspects of primary health care. Conclusion The integration approach enables the public sector PHC system to test more patients for HIV, place more patients on ART more quickly and efficiently, reduce loss-to-follow-up, and achieve greater geographic HIV care coverage compared to the vertical model. Through the integration process, HIV resources have been used to rehabilitate PHC infrastructure (including laboratories and pharmacies), strengthen supervision, fill workforce gaps, and improve patient flow between services and facilities in ways that can benefit all programs. Using aid resources to integrate and better link HIV care with existing services can strengthen wider PHC systems. PMID:20180975

Sport Facility Planning and Management. Sport Management Library.

ERIC Educational Resources Information Center

Farmer, Peter J.; Mulrooney, Aaron L.; Ammon, Rob, Jr.

Students of sports facilities management will need to acquire a wide variety of managerial skills and knowledge in order to be adequately prepared to plan and manage these facilities. This textbook offers students a mix of practical examples and recognized theory to help them in the planning, constructing, promoting, and managing of sports…

An Application of Business Process Management to Health Care Facilities.

PubMed

Hassan, Mohsen M D

The purpose of this article is to help health care facility managers and personnel identify significant elements of their facilities to address, and steps and actions to follow, when applying business process management to them. The ABPMP (Association of Business Process Management Professionals) life-cycle model of business process management is adopted, and steps from Lean, business process reengineering, and Six Sigma, and actions from operations management are presented to implement it. Managers of health care facilities can find in business process management a more comprehensive approach to improving their facilities than Lean, Six Sigma, business process reengineering, and ad hoc approaches that does not conflict with them because many of their elements can be included under its umbrella. Furthermore, the suggested application of business process management can guide and relieve them from selecting among these approaches, as well as provide them with specific steps and actions that they can follow. This article fills a gap in the literature by presenting a much needed comprehensive application of business process management to health care facilities that has specific steps and actions for implementation.

Alternatives to current HIV/AIDS policies and practices in South African prisons.

PubMed

Goyer, K C; Gow, Jeff

2002-01-01

Prisoners in South Africa face problems of overcrowding, violence and poor nutrition. Added to this burden in recent times is the increased threat from HIV. The HIV epidemic has been relatively late in coming to South Africa but infection rates are now 20% in the adult population. However, there is no data available on the level of HIV infection in the prison population. Overseas studies suggest that the characteristics of prisoners place them at much greater risk of HIV infection. Factors which contribute to increased levels of HIV infection include poor health care facilities, lack of condoms and lack of disinfectants. Current policies and practices on HIV in prison attempt to balance the constraints of limited resources with the need to preserve prisoner human rights. The outcomes include: mass testing not freely available, HIV education is limited, and early release of prisoners with advanced AIDS is not allowed. Constraints on the implementation of effective HIV prevention strategies include: bureaucratic inefficiency, lack of resources, and a reluctance by prison authorities to address the issue of HIV in prison. These problems can possibly be overcome by addressing the issue from both management and prisoner perspectives. On the management side, increased resources, increased training of prison officials, and increased political commitment to address the issue are required. Outside partnerships are probably required for an effective response. Prisoners require better nutrition, better living conditions, better health care, freely available condoms and disinfectants.

[Pre-hospital management of adults with life-threatening emergencies].

PubMed

Wattel, Francis; Dubois, François

2012-01-01

In France, acute life-threatening situations are handled by the French Secours a Personne (assistance to persons) and emergency medical facilities. An unequivocal success, this early management of life-threatening emergency situations relies upon centralized call reception, medical dispatching, and immediate on-site emergency medical care. We describe the different emergency care providers and steps involved in the response to emergency situations. Each call centre (Samu, phone number 15; Sapeurs-Pompiers, 18) provides a response tailored to the nature of incoming calls for assistance. A check-list of grounds for an "automatic response" by the SDIS (Service Départemental d'Incendie et de Secours--the French fire brigade) is in use, ensuring that firefighters are often the first on the spot, while the knowledge and skills of the dispatching physician are essential to ascertain the patient's needs, to preserve life and vital functions, and to ensure the patient is sent to the appropriate emergency healthcare facility. In life-threatening emergency situations, patients must be brought straight to the appropriate reference emergency healthcare facility, as quickly as possible, without prior admittance to an emergency department. This is the procedure for extremely acute emergency situations in the following areas: trauma (multiple trauma and/or uncontrolled bleeding, spinal cord trauma), delivery bleeding, other life-threatening situations such as ischemic heart disease, cardiac arrest (sudden death), cerebrovascular stroke and ensuing brain damage, some acute respiratory situations such as anaphylactic shock, foreign-body inhalation, electrocution, drowning, drug overdose, certain forms of poisoning, and conditions requiring initial hyperbaric oxygen (diving accidents, acute carbon monoxide and smoke poisoning). The reasons for suboptimal emergency care in life-threatening situations are currently a major issue, with medical facilities being reduced in some areas, fewer voluntary firemen, hospital reorganization, tight funding, difficulties of medical dispatching, and the varying skills of "first-on-the-scene "emergency workers. Grievances include late emergency responses, inappropriate medical care, and dispatching to the wrong facility. This raises the question of equal opportunity for all in a country with widely varying geographic features and population density. Improvement in the system's efficiency will require a series of objectives to be met in varied and complementary--Enhanced functional coordination, by speeding up the deployment of the ANTARES digital radio-frequency transmission network (Adaptation Nationale des Transmissions Aux Risques Et aux Secours).--Implementation of a network of emergency services with varying degrees of emergency healthcare management related to the technical nature of the facilities. Three levels of emergency healthcare must be made available: level 1 is provided by local hospitals, level 2 includes support facilities available in general hospitals (not necessarily the nearest hospital), and level 3 provides specialized healthcare in large and/or training hospitals with specialized departments. Life-threatening emergency situations are to be handled by level 2 or 3 facilities. Specific facilities must be selected as reference centers. In France, the ARS (Agences Régionales de Santé) is in charge of this procedure, as it provide funding for healthcare continuity--Reducing inequalities in access to emergency care. This will involve improving the network of SDIS brigades, making local medical facilities more responsive, delegating more medical procedures, on-site telemedicine, providing more helicopters equipped with healthcare facilities, more automated external defibrillators, and more dedicated neuro-vascular units.--First aid training must be made widely available. The French National Academy of Medicine has approved ten recommendations regarding organization and facilities.

Interventions and approaches to integrating HIV and mental health services: a systematic review.

PubMed

Chuah, Fiona Leh Hoon; Haldane, Victoria Elizabeth; Cervero-Liceras, Francisco; Ong, Suan Ee; Sigfrid, Louise A; Murphy, Georgina; Watt, Nicola; Balabanova, Dina; Hogarth, Sue; Maimaris, Will; Otero, Laura; Buse, Kent; McKee, Martin; Piot, Peter; Perel, Pablo; Legido-Quigley, Helena

2017-11-01

The frequency in which HIV and AIDS and mental health problems co-exist, and the complex bi-directional relationship between them, highlights the need for effective care models combining services for HIV and mental health. Here, we present a systematic review that synthesizes the literature on interventions and approaches integrating these services. This review was part of a larger systematic review on integration of services for HIV and non-communicable diseases. Eligible studies included those that described or evaluated an intervention or approach aimed at integrating HIV and mental health care. We searched multiple databases from inception until October 2015, independently screened articles identified for inclusion, conducted data extraction, and assessed evaluative papers for risk of bias. Forty-five articles were eligible for this review. We identified three models of integration at the meso and micro levels: single-facility integration, multi-facility integration, and integrated care coordinated by a non-physician case manager. Single-site integration enhances multidisciplinary coordination and reduces access barriers for patients. However, the practicality and cost-effectiveness of providing a full continuum of specialized care on-site for patients with complex needs is arguable. Integration based on a collaborative network of specialized agencies may serve those with multiple co-morbidities but fragmented and poorly coordinated care can pose barriers. Integrated care coordinated by a single case manager can enable continuity of care for patients but requires appropriate training and support for case managers. Involving patients as key actors in facilitating integration within their own treatment plan is a promising approach. This review identified much diversity in integration models combining HIV and mental health services, which are shown to have potential in yielding positive patient and service delivery outcomes when implemented within appropriate contexts. Our review revealed a lack of research in low- and middle- income countries, and was limited to most studies being descriptive. Overall, studies that seek to evaluate and compare integration models in terms of long-term outcomes and cost-effectiveness are needed, particularly at the health system level and in regions with high HIV and AIDS burden. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

42 CFR 483.75 - Administration.

Code of Federal Regulations, 2010 CFR

2010-10-01

... occupational therapy assistant; registered professional nurse; licensed practical nurse; or licensed or... by the facility staff; and (iii) For nurse aides providing services to individuals with cognitive...

Office of Federal Student Aid: Better Strategic and Human Capital Would Help Sustain Management Progress. Report to Congressional Committees. GAO-05-31

ERIC Educational Resources Information Center

Ashby, Cornelia M.

2004-01-01

In 2003, the Department of Education's Office of Federal Student Aid (FSA) managed about $60 billion in new financial aid. In 1998, the Congress designated FSA as a performance-based organization. In so doing, it specified purposes for the agency, such as to reduce program costs and increase accountability of its officials, and provided…

Health care aides use of time in a residential long-term care unit: a time and motion study.

PubMed

Mallidou, Anastasia A; Cummings, Greta G; Schalm, Corinne; Estabrooks, Carole A

2013-09-01

Organizational resources such as caregiver time use with older adults in residential long-term care facilities (nursing homes) have not been extensively studied, while levels of nurse staffing and staffing-mix are the focus of many publications on all types of healthcare organizations. Evidence shows that front-line caregivers' sufficient working time with residents is associated with performance, excellence, comprehensive care, quality of outcomes (e.g., reductions in pressure ulcers, urinary tract infections, and falls), quality of life, cost savings, and may be affiliated with transformation of organizational culture. To explore organizational resources in a long-term care unit within a multilevel residential facility, to measure healthcare aides' use of time with residents, and to describe working environment and unit culture. An observational pilot study was conducted in a Canadian urban 52-bed long-term care unit within a faith-based residential multilevel care facility. A convenience sample of seven healthcare aides consented to participate. To collect the data, we used an observational sheet (to monitor caregiver time use on certain activities such as personal care, assisting with eating, socializing, helping residents to be involved in therapeutic activities, paperwork, networking, personal time, and others), semi-structured interview (to assess caregiver perceptions of their working environment), and field notes (to illustrate the unit culture). Three hundred and eighty seven hours of observation were completed. The findings indicate that healthcare aides spent most of their working time (on an eight-hour day-shift) in "personal care" (52%) and in "other" activities (23%). One-to-three minute activities consumed about 35% of the time spent in personal care and 20% of time spent in assisting with eating. Overall, caregivers' time spent socializing was less than 1%, about 6% in networking, and less than 4% in paperwork. Re-organizing healthcare aides' routine practices may minimize the short one-to-three minute intervals spent on direct care activities, which can be interpreted as interruptions to continuity of care or waste of time. Fewer interruptions may allow healthcare aides to use their time with residents more effectively. Copyright © 2012 Elsevier Ltd. All rights reserved.

41 CFR 50-204.6 - Medical services and first aid.

Code of Federal Regulations, 2010 CFR

2010-07-01

... first aid. 50-204.6 Section 50-204.6 Public Contracts and Property Management Other Provisions Relating... SUPPLY CONTRACTS General Safety and Health Standards § 50-204.6 Medical services and first aid. (a) The... trained to render first aid. First aid supplies approved by the consulting physician shall be readily...

Management of Children Using Cochlear Implants and Hearing Aids.

ERIC Educational Resources Information Center

Ching, Teresa Y. C.; Psarros, Colleen; Incerti, Paula; Hill, Mandy

2001-01-01

Four case studies identify six factors affecting successful use of a hearing aid with a cochlear implant: duration of hearing aid use prior to implantation, amount of residual hearing in the non-implanted ear, educational and listening demands, cosmetic issues, hearing aid rejection, and extended period of non-use of hearing aid. (Contains…

Safety of union home care aides in Washington State.

PubMed

Schoenfisch, Ashley L; Lipscomb, Hester; Phillips, Leslie E

2017-09-01

A rate-based understanding of home care aides' adverse occupational outcomes related to their work location and care tasks is lacking. Within a 30-month, dynamic cohort of 43 394 home care aides in Washington State, injury rates were calculated by aides' demographic and work characteristics. Injury narratives and focus groups provided contextual detail. Injury rates were higher for home care aides categorized as female, white, 50 to <65 years old, less experienced, with a primary language of English, and working through an agency (versus individual providers). In addition to direct occupational hazards, variability in workload, income, and supervisory/social support is of concern. Policies should address the roles and training of home care aides, consumers, and managers/supervisors. Home care aides' improved access to often-existing resources to identify, manage, and eliminate occupational hazards is called for to prevent injuries and address concerns related to the vulnerability of this needed workforce. © 2017 Wiley Periodicals, Inc.

Facility Management as a Way of Reducing Costs in Transport Companies

NASA Astrophysics Data System (ADS)

Matusova, Dominika; Gogolova, Martina

2017-10-01

For facility management exists a several interpretations. These interpretations emerged progressively. At the time of the notion of facility management was designed to manage an administrative building, in the United States (US). They can ensure their operation and maintenance. From the US, this trend is further moved to Europe and now it start becoming a current and actual topic also in Slovakia. Facility management is contractually agreed scheme of services, semantically recalls traditional building management. There by finally pushed for activities related to real estates. For facility management is fundamental - certification and certification systems. Therefore, is essential to know, the cost structure of certification. The most commonly occurring austerity measures include: heat pumps, use of renewable energy, solar panels and water savings. These measures can reduce the cost.

48 CFR 970.3770-1 - Policy.

Code of Federal Regulations, 2010 CFR

2010-10-01

... REGULATIONS DOE MANAGEMENT AND OPERATING CONTRACTS Facilities Management Contracting 970.3770-1 Policy. Contractors managing Department of Energy (DOE) facilities shall be required to comply with the DOE Directives applicable to facilities management. [65 FR 81009, Dec. 22, 2000, as amended at 74 FR 36374, July 22, 2009] ...

21 CFR 58.31 - Testing facility management.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Testing facility management. 58.31 Section 58.31... management. For each nonclinical laboratory study, testing facility management shall: (a) Designate a study... appropriately tested for identity, strength, purity, stability, and uniformity, as applicable. (e) Assure that...

Pediatric hearing aid use: parent-reported challenges.

PubMed

Muñoz, Karen; Olson, Whitney A; Twohig, Michael P; Preston, Elizabeth; Blaiser, Kristina; White, Karl R

2015-01-01

The aim of this study was to investigate parent-reported challenges related to hearing aid management and parental psychosocial characteristics during the first 3 years of the child's life. Using a cross-sectional survey design, surveys were distributed to parents of children with hearing loss via state Early Intervention programs in Utah and Indiana. Packets contained one family demographic form and two sets of three questionnaires to obtain responses from mothers and fathers separately: the Parent Hearing Aid Management Inventory explored parent access to information, parent confidence in performing skills, expectations, communication with the audiologist, and hearing aid use challenges. The Acceptance and Action Questionnaire measured psychological flexibility, experiential avoidance, and internal thought processes that can affect problem-solving ability and decrease an individual's ability to take value-based actions. The Patient Health Questionnaire identified symptoms of depression. Thirty-seven families completed questionnaires (35 mothers and 20 fathers). Most responses were parents of toddlers (M = 22 months) who had been wearing binaural hearing aids for an average of 15 months. Both mothers and fathers reported that even though the amount of information they received was overwhelming, most (84%) preferred to have all the information at the beginning, rather than to receive it over an extended time period. Parents reported an array of challenges related to hearing aid management, with the majority related to daily management, hearing aid use, and emotional adjustment. Sixty-six percent of parents reported an audiologist taught them how to complete a listening check using a stethoscope, however, only one-third reported doing a daily hearing aid listening check. Both mothers and fathers reported a wide range of variability in their confidence in performing activities related to hearing aid management, and most reported minimal confidence in their ability to troubleshoot hearing aid problems. More than half of the parents reported child behavior and activities, such as playing outside, as a major hearing aid use challenge. Parents reported hearing aids were worn all waking hours by 35% of children and less than 5 hr/day by 31%. Almost half of the parents (47%) did not feel that they had enough time to talk about their emotions when speaking with their audiologist(s), 69% reported the audiologist did not help them know what to expect related to emotions about their child's hearing loss, and 22% reported symptoms of depression. Parents reported an array of challenges, even after their child had been wearing hearing aids for a prolonged time, revealing critical implications for how to provide audiological care. Audiologists have an important role in partnering with parents to identify and jointly problem-solving challenges related to their child's hearing aid use. Supporting parents includes not only addressing technical aspects of hearing testing and hearing aid function but also addressing parent thoughts, feelings, and emotions.

SSC OCIO, IT SUMMIT 2011

NASA Technical Reports Server (NTRS)

Cottrell, Dinna L.

2011-01-01

The Stennis Space Center (SSC) Records Retention Facility is a centralized location for all SSC records, Records Management staff, and the SSC History Office. The building is a storm resistant facility and provides a secure environment for records housing. The Records Retention Facility was constructed in accordance with The National Archives and Records Administration (NARA) requirements for records storage, making it the first NARA compliant facility in the agency. Stennis Space Center's Records Retention Facility became operational in May 2010. The SSC Records Retention Facility ensures that the required federal records are preserved, managed and accessible to all interested personnel. The facility provides 20,000 cubic feet of records storage capacity for the purpose of managing the centers consolidated records within a central, protected environment. Records housed in the facility are in the form of paper, optical, film and magnetic media. Located within the SSC Records Retention Facility, the Records Management Office provides comprehensive records management services in the form of: a) Storage and life-cycle management of inactive records of all media types; b) Digitizing/scanning of records and documents; c) Non-textual/digital electronic records media storage, migration and transfer; d) Records Remediation.

Computer-aided dispatch--traffic management center field operational test final detailed test plan : WSDOT deployment

DOT National Transportation Integrated Search

2003-10-01

The purpose of this document is to expand upon the evaluation components presented in "Computer-aided dispatch--traffic management center field operational test final evaluation plan : WSDOT deployment". This document defines the objective, approach,...

Computer-aided dispatch--traffic management center field operational test : Washington State final report

DOT National Transportation Integrated Search

2006-05-01

This document provides the final report for the evaluation of the USDOT-sponsored Computer-Aided Dispatch - Traffic Management Center Integration Field Operations Test in the State of Washington. The document discusses evaluation findings in the foll...

New Ideas on Facilities Management.

ERIC Educational Resources Information Center

Grimm, James C.

1986-01-01

Examines trends in facilities management relating to products and people. Reviews new trends in products, including processes, techniques, and programs that are being expounded by business and industry. Discusses the "people factors" involved in facilities management. (ABB)

Improving First Aid Management of Epilepsy by Trainee Teachers of the Federal College of Education (Technical), Akoka - Lagos, South West Nigeria--Can Health Education have an Effect?

PubMed

Eze, Christian N; Ebuehi, Olufunke M

2013-01-01

lt is estimated that epilepsy affects approximately 50 million people worldwide and about 40 million of them live in developing countries. Studies have indicated high rates of poor knowledge, negative attitude and poor first aid management skills of students with epilepsy among practicing teachers. However, there is paucity of such studies on trainee teachers to ascertain any similarities or differences (if any) and the effect of educational interventions. To determine the effect of a health education intervention on trainee teachers' knowledge, attitude and first aid management of epilepsy. The effect of a health education intervention in first aid management of epilepsy was assessed among 226 trainee teachers, attending the Federal College of Education (Technical), Akoka. This was done using a quasi-experimental study design. Data were analyzed using the SPSS version 15. The respondents had a median age of 22 years with a range of 18 to 56 years. The majority of them were females (68.6%), single (79.2%), Christians (81.9%), Yoruba (70.4%) and in first year (100 level) of their study (69.9%). The highest proportion was from the Accounting department (46.0%). A consistent increase in responses to items on knowledge, attitude and first aid management of epileptic seizure items from baseline to post-intervention was observed. For instance, the proportion of responses that epileptic seizures originate from the brain significantly (p = 0.025) increased from 62.5% at baseline to 74.1% after intervention. Generally, slightly more than two-fifths (44.2%) and about two thirds (61.9%) of the respondents were observed to have poor knowledge and negative attitude to epilepsy respectively at baseline. Overall, giving health education on epilepsy led to a reduction in the proportion of respondents with poor knowledge by 15.5% (increase of good knowledge by 29.6%), decrease of negative attitude by 16.4% and increase of good first aid management skill by 25.0%. The knowledge scores were significantly associated with age (p = 0.001), marital status (p = 0.003) and department (p = 0.004) while the attitude scores were significantly associated with teaching duration (p = 0.020). The knowledge was predicted by department (p = 0.001) while the attitude was predicted by teaching duration (p = 0.036). This study reveals that health education could improve the knowledge, attitude. and first aid management of students with epilepsy among trainee teachers. It is therefore proposed that an intervention programme on baseline knowledge of epilepsy and its first aid management be incorporated into the teacher-training curriculum, particularly those in health-related programmes, to address their deficiencies in knowledge, attitude and first aid management of students with epilepsy.

Mitigating risks related to facilities management.

PubMed

O'Neill, Daniel P; Scarborough, Sydney

2013-07-01

By looking at metrics focusing on the functionality, age, capital investment, transparency, and sustainability (FACTS) of their organizations' facilities, facilities management teams can build potential business cases to justify upgrading the facilities. A FACTS analysis can ensure that capital spent on facilities will produce a higher or more certain ROI than alternatives. A consistent process for managing spending helps to avoid unexpected spikes that cost the enterprise more in the long run.

A low-density boundary-layer wind tunnel facility

NASA Technical Reports Server (NTRS)

White, B. R.

1987-01-01

This abstract describes a low-density wind-tunnel facility that was established at NASA Ames in order to aid interpretation and understanding of data received from the Mariner and Viking spacecraft through earth-based simulation. The wind tunnel is a boundary-layer type which is capable of operating over a range of air densities ranging from 0.01 to 1.24 kg/cu m, with the lower values being equivalent to the near-surface density of the planet Mars. Although the facility was developed for space and extraterrestrial simulation, it also can serve as a relatively large-scale, low-density aerodynamic test facility. A description of this unique test facility and some Pitot-tube and hot-wire anemometry data acquired in the facility are presented.

Nurse Case Managers' Experiences on Case Management for Long-term Hospitalization in Korea.

PubMed

Oh, Jinjoo; Oh, Seieun

2017-12-01

The implementation of case management for long-term hospitalization use has been approved for controlling medical cost increases in other countries. But, introduction of the case management in Korea has created issues that hinder its effective operation. This qualitative study aimed to obtain further understanding of the issues surrounding the management of Medical Aid beneficiaries' use of long-term hospitalization from the case managers' perspectives and to provide suggestions for successful case management. Thematic analysis was employed to analyze the data. Medical Aid case managers with 3 or more years of case management experience were recruited from urban, suburban, and rural regions. Data were collected through in-depth interviews: 12 nurse case managers participated in focus group interviews and 11 participated in individual one-on-one interviews. Four major themes emerged: on-site obstacles that hinder work progress; going in an opposite direction; ambiguous position of case managers; and work-related emotions. Eleven subthemes were discovered: chasing potential candidates; becoming an enemy; discharging patients who have nowhere to go; welfare-centered national policies increasing medical costs; Medical Aid Program that encourages hospitalization; misuse of hospitalization; feeling limited; working without authority; fulfilling the expected role; fretting about social criticism; and feeling neglected and unprotected. The findings highlight the complexity and ambiguity of the issues faced by case managers. Successful management of Medical Aid resources requires the orchestrated efforts and collaboration of multiple stakeholders. More systematized support and resources for nurse case managers are essential to fully implement this nursing innovation in Korea. Copyright © 2017. Published by Elsevier B.V.

7 CFR 1951.224 - Third party agreements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... sufficient control by the borrower over the operation, maintenance, and management of the facility to assure... over its assets and/or over the operation, management, and maintenance of the facility to the extent... of a facility to be operated, maintained or managed by a third party under a contract, management...

HIV/AIDS health care challenges for cross-country migrants in low- and middle-income countries: a scoping review

PubMed Central

Suphanchaimat, Rapeepong; Sommanustweechai, Angkana; Khitdee, Chiraporn; Thaichinda, Chompoonut; Kantamaturapoj, Kanang; Leelahavarong, Pattara; Jumriangrit, Pensom; Topothai, Thitikorn; Wisaijohn, Thunthita; Putthasri, Weerasak

2014-01-01

Introduction HIV/AIDS has been one of the world’s most important health challenges in recent history. The global solidarity in responding to HIV/AIDS through the provision of antiretroviral therapy (ART) and encouraging early screening has been proved successful in saving lives of infected populations in past decades. However, there remain several challenges, one of which is how HIV/AIDS policies keep pace with the growing speed and diversity of migration flows. This study therefore aimed to examine the nature and the extent of HIV/AIDS health services, barriers to care, and epidemic burdens among cross-country migrants in low-and middle-income countries. Methods A scoping review was undertaken by gathering evidence from electronic databases and gray literature from the websites of relevant international initiatives. The articles were reviewed according to the defined themes: epidemic burdens of HIV/AIDS, barriers to health services and HIV/AIDS risks, and the operational management of the current health systems for HIV/AIDS. Results Of the 437 articles selected for an initial screening, 35 were read in full and mapped with the defined research questions. A high HIV/AIDS infection rate was a major concern among cross-country migrants in many regions, in particular sub-Saharan Africa. Despite a large number of studies reported in Africa, fewer studies were found in Asia and Latin America. Barriers of access to HIV/AIDS services comprised inadequate management of guidelines and referral systems, discriminatory attitudes, language differences, unstable legal status, and financial hardship. Though health systems management varied across countries, international partners consistently played a critical role in providing support for HIV/AIDS services to uninsured migrants and refugees. Conclusion It was evident that HIV/AIDS health care problems for migrants were a major concern in many developing nations. However, there was little evidence suggesting if the current health systems effectively addressed those problems or if such management would sustainably function if support from global partners was withdrawn. More in-depth studies were recommended to further explore those knowledge gaps. PMID:24600250

Joint Assessment of Renewable Energy and Water Desalination Research Center (REWDC) Program Capabilities and Facilities In Radioactive Waste Management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bissani, M; Fischer, R; Kidd, S

2006-04-03

The primary goal of this visit was to perform a joint assessment of the Renewable Energy and Water Desalination Center's (REWDC) program in radioactive waste management. The visit represented the fourth technical and scientific interaction with Libya under the DOE/NNSA Sister Laboratory Arrangement. Specific topics addressed during the visit focused on Action Sheet P-05-5, ''Radioactive Waste Management''. The Team, comprised of Mo Bissani (Team Lead), Robert Fischer, Scott Kidd, and Jim Merrigan, consulted with REWDC management and staff. The team collected information, discussed particulars of the technical collaboration and toured the Tajura facility. The tour included the waste treatment facility,more » waste storage/disposal facility, research reactor facility, hot cells and analytical labs. The assessment team conducted the first phase of Task A for Action Sheet 5, which involved a joint assessment of the Radioactive Waste Management Program. The assessment included review of the facilities dedicated to the management of radioactive waste at the Tourja site, the waste management practices, proposed projects for the facility and potential impacts on waste generation and management.« less

Ideologies of aid, practices of power: lessons for Medicaid managed care.

PubMed

Nelson, Nancy L

2005-03-01

The articles in this special issue teach valuable lessons based on what happened in New Mexico with the shift to Medicaid managed care. By reframing these lessons in broader historical and cultural terms with reference to aid programs, we have the opportunity to learn a great deal more about the relationship between poverty, public policy, and ideology. Medicaid as a state and federal aid program in the United States and economic development programs as foreign aid provide useful analogies specifically because they exhibit a variety of parallel patterns. The increasing concatenation of corporate interests with state and nongovernmental interests in aid programs is ultimately producing a less centralized system of power and responsibility. This process of decentralization, however, is not undermining the sources of power behind aid efforts, although it does make the connections between intent, planning, and outcome less direct. Ultimately, the devolution of power produces many unintended consequences for aid policy. But it also reinforces the perspective that aid and the need for it are nonpolitical issues.

A review of community management of paediatric burns.

PubMed

Cox, S G; Martinez, R; Glick, A; Numanoglu, A; Rode, H

2015-12-01

This study was a component of a broader review to evaluate burn care in South Africa. A prospective audit of 353 children with thermal injuries admitted to the Red Cross War Memorial Children's Hospital in Cape Town was performed during 2012/2013. The audit was based to assess the adherence of initial burn management to the provincial policy guidelines on the clinical management of the burn wound. The community management of each patient prior to admission to a burns centre was assessed for the following: basic demographics, emergency home management, wound cover, analgesia and transport to medical facilities. Their ages ranged from 1 month to 14 years. The average total body surface area [TBSA] was 15% [1-86%]. Most of the injuries were due to hot water accidents [78.5%] followed by flame burns (9%), direct contact and electricity burns. Two hundred and twenty five children [63%] received first aid measures at home, including cooling with water [166] ice [30] and a cooling agent. No cooling was instituted in 130 and 65% of the patient's wounds were cooled for 10 min or less. Eighty percent proceeded to the referral centre or burns unit without their wounds being covered; with only 19 patients having any medical type of dressing available at home. Two hundred and ninety five children [83.6%] received pain medication prior to admission at the burns unit. Of the 316 patients not directly attending the burns unit, 137 received i.v. fluids of which 95 had burns greater than 10% TBSA. None of the patients were in shock on admission and all i.v. lines were functioning. Forty-four children with burns greater than 10% did not receive i.v. fluids. The audit identified six factors that were inadequately addressed during the pre-admission period: first aid, cooling of the wound, early covering of the wound, resuscitation, pain management and transfer. If these could be readdressed, basic burn care would be substantially improved in the study area. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

75 FR 42885 - Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-22

...: Rates. As discussed in section I.G.1. of this notice, we established per diem Federal rates for urban... Virus (HIV) Infection). For FY 2011, an urban facility with a resident with AIDS in hybrid RUG-III (HR... application of the MMA adjustment. After an increase of 128 percent, this urban facility would receive a case...

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cozzi, Alex D.; McCabe, Daniel J.

The Hanford Waste Treatment and Immobilization Plant (WTP) Low Activity Waste (LAW) vitrification facility will generate an aqueous condensate recycle stream (LAW Melter Off-Gas Condensate) from the off-gas system. The baseline plan for disposition of this stream during full WTP operations is to send it to the WTP Pretreatment Facility, where it will be blended with LAW, concentrated by evaporation and recycled to the LAW vitrification facility. However, during the Direct Feed LAW (DFLAW) scenario, planned disposition of this stream is to evaporate it in a new evaporator in the Effluent Management Facility (EMF) and then return it to themore » LAW melter. It is important to understand the composition of the effluents from the melter and new evaporator so that the disposition of these streams can be accurately planned and accommodated. Furthermore, alternate disposition of this stream would eliminate recycling of problematic components, and would enable less integrated operation of the LAW melter and the Pretreatment Facilities. Alternate disposition would also eliminate this stream from recycling within WTP when it begins operations and would decrease the LAW vitrification mission duration and quantity of glass waste. This LAW Melter Off-Gas Condensate stream will contain components that are volatile at melter temperatures and are problematic for the glass waste form, such as halides and sulfate, along with entrained, volatile, and semi-volatile metals, such as Hg, As, and Se. Because this stream will recycle within WTP, these components accumulate in the Melter Condensate stream, exacerbating their impact on the number of LAW glass containers that must be produced. Diverting the stream reduces the halides and sulfate that get recycled to the melter, and is a key objective of this work. This overall program examines the potential treatment and immobilization of this stream to enable alternative disposal. The objective of earlier tasks was to formulate and prepare a simulant of the LAW Melter Off-gas Condensate expected during DFLAW operations and use it in evaporator testing to predict the composition of the effluents from the Effluent Management Facility (EMF) evaporator to aid in planning for their disposition. The objective of this task was to test immobilization options for this evaporator bottoms aqueous stream. This document describes the method used to formulate a simulant of this EMF evaporator bottoms stream, immobilize it, and determine if the immobilized waste forms meet disposal criteria.« less

Does an electronic cognitive aid have an effect on the management of severe gynaecological TURP syndrome? A prospective, randomised simulation study.

PubMed

St Pierre, Michael; Breuer, Georg; Strembski, Dieter; Schmitt, Christopher; Luetcke, Bjoern

2017-05-30

Lack of familiarity with the content of current guidelines is a major factor associated with non-compliance by clinicians. It is conceivable that cognitive aids with regularly updated medical content can guide clinicians' task performance by evidence-based practices, even if they are unfamiliar with the actual guideline. Acute hyponatraemia as a consequence of TURP syndrome is a rare intraoperative event, and current practice guidelines have changed from slow correction to rapid correction of serum sodium levels. The primary objective of this study was to compare the management of a simulated severe gynaecological transurethral resection of the prostate (TURP) syndrome under spinal anaesthesia with either: an electronic cognitive aid, or with management from memory alone. The secondary objective was to assess the clinical relevance and participant perception of the usefulness of the cognitive aid. Anaesthetic teams were allocated to control (no cognitive aid; n = 10) or intervention (cognitive aid provided; n = 10) groups. We identified eight evidence-based management tasks for severe TURP syndrome from current guidelines and subdivided them into acute heart failure (AHF)/pulmonary oedema tasks (5) and acute hyponatraemia tasks (3). Implementation of the treatment steps was measured by scoring task items in a binary fashion (yes/no). To assess whether or not the cognitive aid had prompted a treatment step, participants from the cognitive aid group were questioned during debriefing on every single treatment step. At the end of the simulation, session participants were asked to complete a survey. Teams in the cognitive aid group considered evidence-based treatment steps significantly more often than teams of the control group (96% vs. 50% for 'AHF/pulmonary oedema' p < 0.001; 79% vs. 12% for 'acute hyponatraemia' p < 0.001). Without the cognitive aid, performance would have been comparable across both groups. Nurses, trainees, and consultants derived equal benefit from the cognitive aid. The cognitive aid improved the implementation of evidence-based practices in a simulated intraoperative scenario. Cognitive aids with current medical content could help to close the translational gap between guideline publication and implementation in acute patient care. It is important that the cognitive aid should be familiar, in a format that has been used in practice and training.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Templin-Branner, W.

As the treatment and management of HIV/AIDS continues to evolve with new scientific breakthroughs, treatment discoveries, and management challenges, it is difficult for people living with HIV/AIDS and those who care for them to keep up with the latest information on HIV/AIDS screening and testing, prevention, treatment, and research. The National Library of Medicine (NLM), of the National Institutes of Health, has a wealth of health information resources freely available on the Internet to address these needs.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hermeston, Mark W.

BPA proposes total vegetation management (bareground) in the electrical substations, and, noxious weed management and maintenance of landscaping within the property boundaries of the listed facilities. These facilities are all located within the Covington District of the Snohomish Region. BPA proposes to manage vegetation inside and around electrical substations and associated facilities. Vegetation management within the substations will include bareground management by herbicides of all areas within the fenced perimeter of the facility including a bareground zone of up to 3 meters (10 feet) outside of the fenced area. The management of vegetation outside the substation and associated facilities willmore » include: 1) bare ground management of perimeter roads and parking areas; 2) control of noxious weeds throughout property boundaries; 3) mowing, fertilizing, and weed control of landscaped lawn and mulched areas; 4) weed control in ornamental shrub areas; and 5) areas requiring only mechanical control to manage unwanted/danger trees, grasses, and shrubs.« less

Computer-aided dispatch--traffic management center field operational test : state of Utah final report

DOT National Transportation Integrated Search

2006-07-01

This document provides the final report for the evaluation of the USDOT-sponsored Computer-Aided Dispatch Traffic Management Center Integration Field Operations Test in the State of Utah. The document discusses evaluation findings in the followin...

Computer-aided dispatch--traffic management center field operational test final test plans : state of Utah

DOT National Transportation Integrated Search

2004-01-01

The purpose of this document is to expand upon the evaluation components presented in "Computer-aided dispatch--traffic management center field operational test final evaluation plan : state of Utah". This document defines the objective, approach, an...

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.