75 FR 24544 - Revisions to the California State Implementation Plan, Placer County Air Pollution Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-05

... Metropolitan Air Quality Management District, San Joaquin Valley Unified Air Pollution Control District, and South Coast Air Quality Management District AGENCY: Environmental Protection Agency (EPA). ACTION... District (PCAPCD), Sacramento Metropolitan Air Quality Management District (SMAQMD), San Joaquin Valley...

[Effect of fluoride on human hypothalamus-hypophysis-testis axis hormones].

PubMed

Hao, Pengfei; Ma, Xiaoying; Cheng, Xuemin; Ba, Yue; Zhu, Jingyuan; Cui, Liuxin

2010-01-01

To study of endocrine disturbing effect of fluoride on human hypothalamus-hypophysis-testis axis hormones. Sunying County, Kaifeng City was selected as polluted district which the fluoride in drinking water was 3.89 mg/L, and Shenlilou county was selected as control district which the fluoride was less than 1.0 mg/L. 150 individual lived there more than 5 years were srlected randomly. And investigated by medical examination, then blood and urine sample were collected, and the serum level of gonadotropin-releasing hormone (GnRH), luteinizing hormone (LH), testosterone (T) and estradiol (E2) were measured by RIA method, and the urine level of fluoride were measured. Other than that, the concentration of fluoride in the water, food, soil and air were detected by the standard methods. The concentrations of fluoride in the water, food and soil of the fluoride polluted district were significantly higher than those of control district (P < 0.05), and the concentration fluoride in the air of two district were not found. There was no significant difference of serum level of GnRH between fluoride polluted district and control district (P > 0.05). The serum level of LH in men of fluoride polluted district was significantly higher than that of control group (P < 0.05), and the serum level of T in men of fluoride polluted district was significantly less than that of control group (P < 0.05). There was no significant difference of serum level of LH between fluoride polluted district and control district (P > 0.05), and the serum level of T in women of fluoride polluted district was significantly higher than that of control group (P < 0.05). There was no significant difference of serum level of E2 between fluoride polluted district and control district (P > 0.05). Fluoride could effect hormone levels of each layer of the hypothalamus-hypophysis-testis axis, and show the reproductive endocrine disturbing effects. The reproductive endocrine disturbing effects of male maybe more severe than those of female.

76 FR 60405 - Revisions to the California State Implementation Plan, Santa Barbara Air Pollution Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-29

... Municipal Air Quality Management District and South Coast Air Quality Management District AGENCY... the Santa Barbara Air Pollution Control District (SBAPCD), Sacramento Municipal Air Quality Management District (SMAQMD) and South Coast Air Quality Management District (SCAQMD) portions of the California State...

The Abrams report--communicable disease control; how do Health Districts measure up to the recommendations?

PubMed

Grime, L P; Horsley, S D

1995-12-01

The aims of the study were to examine whether Health Districts in the North Western Region complied with the recommendations in the Abrams report regarding the control of communicable disease [incorporated into the Annex to Circular HSG(93)56], and to identify areas that need further attention. The recommendations were extracted and arranged in questionnaire form. Further items were included dealing with the use of Epinet in communicating with the profession. A compliance score was derived from affirmative and qualified affirmative responses. Many recommendations were met by all or most Districts. Compliance was 90 percent or over for 58 percent of the questions where an assessment was appropriate. Of the 16 Districts in consortia, 75 percent did not have a consortium plan. Day-to-day plans were informal in 21 percent of Districts. In 63 percent of Districts the Family Health Services Authority (FHSA) was not involved to the extent that it should be. The Consultant in Communicable Disease Control (CCDC) had insufficient District Health Authority support in 42 percent of Districts and insufficient Local Authority support in 16 percent of Districts. In 58 percent of Districts there was lack of inclusion of matters relating to the control of infectious disease in contractual statements between purchaser and provider. There was a lack of audit in 47 percent of Districts. One plan or a compatible series of plans are required across each District. Informal day-to-day plans should be formalized. The FHSA should be fully involved in infectious disease control plans. Certain Districts require a Community Infection Control Nurse, accountable to the CCDC and/or administrative support to input and scan surveillance data. Contractual statements between purchaser and provider should include appropriate infection control requirements when this is not already the case. Communicable disease control audit should be a regular part of CCDC duties.

78 FR 53249 - Revisions to the California State Implementation Plan, Placer County Air Pollution Control District

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-29

... the California State Implementation Plan, Placer County Air Pollution Control District AGENCY... the Placer County Air Pollution Control District (PCAPCD) portion of the California State... 40 CFR Part 52 Environmental protection, Air pollution control, Incorporation by reference...

40 CFR 52.222 - Negative declarations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... County Air Pollution Control District. (i) Industrial Wastewater, Plastic Parts Coating: Business... Pollution Control District. (i) Aerospace Coatings; Industrial Waste Water Treatment; Plastic Parts Coating..., 2011. (a) The following air pollution control districts submitted negative declarations for volatile...

77 FR 22676 - Revisions to the Arizona State Implementation Plan, Pinal County Air Quality Control District

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-17

... the Arizona State Implementation Plan, Pinal County Air Quality Control District AGENCY: Environmental... disapproval of a revision to the Pinal County Air Quality Control District portion of the Arizona State... the Control Officer to determine whether the manner of control of fugitive emissions is satisfactory...

33 CFR 274.6 - Division/district pest control programs.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Division/district pest control..., DEPARTMENT OF DEFENSE PEST CONTROL PROGRAM FOR CIVIL WORKS PROJECTS Project Operation § 274.6 Division/district pest control programs. (a) Guides. Referenced technical manuals, and Engineer Circulars issued...

33 CFR 274.6 - Division/district pest control programs.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Division/district pest control..., DEPARTMENT OF DEFENSE PEST CONTROL PROGRAM FOR CIVIL WORKS PROJECTS Project Operation § 274.6 Division/district pest control programs. (a) Guides. Referenced technical manuals, and Engineer Circulars issued...

33 CFR 274.6 - Division/district pest control programs.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Division/district pest control..., DEPARTMENT OF DEFENSE PEST CONTROL PROGRAM FOR CIVIL WORKS PROJECTS Project Operation § 274.6 Division/district pest control programs. (a) Guides. Referenced technical manuals, and Engineer Circulars issued...

33 CFR 274.6 - Division/district pest control programs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Division/district pest control..., DEPARTMENT OF DEFENSE PEST CONTROL PROGRAM FOR CIVIL WORKS PROJECTS Project Operation § 274.6 Division/district pest control programs. (a) Guides. Referenced technical manuals, and Engineer Circulars issued...

75 FR 1284 - Revisions to the California State Implementation Plan, Ventura County Air Pollution Control District

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-11

... the California State Implementation Plan, Ventura County Air Pollution Control District AGENCY... the Ventura County Air Pollution Control District (VCAPCD) portion of the California State...)(2)). List of Subjects in 40 CFR Part 52 Environmental protection, Air pollution control...

40 CFR 52.220 - Identification of plan.

Code of Federal Regulations, 2014 CFR

2014-07-01

... replacement, Regulation 3, Rules 40, 42, 43, and 44. (5) Ventura County Air Pollution Control District. (i... Control in California”) to chapter 7. (13) El Dorado County Air Pollution Control District. (i) Previously..., 79, and 80. (14) Imperial County Air Pollution Control District. (i) Previously approved on May 31...

76 FR 75795 - Revisions to the California State Implementation Plan, Placer County Air Pollution Control District

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-05

... the California State Implementation Plan, Placer County Air Pollution Control District AGENCY... approve revisions to the Placer County Air Pollution Control District (PCAPCD) portion of the California...)). List of Subjects in 40 CFR Part 52 Environmental protection, Air pollution control, Incorporation by...

78 FR 37130 - Revisions to the California State Implementation Plan, San Diego Air Pollution Control District

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-20

... the California State Implementation Plan, San Diego Air Pollution Control District AGENCY... approve a revision to the San Diego Air Pollution Control District (SDAPCD) portion of the California...)). List of Subjects in 40 CFR Part 52 Environmental protection, Air pollution control, Incorporation by...

75 FR 3996 - Revisions to the California State Implementation Plan, San Joaquin Valley Air Pollution Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-26

... the California State Implementation Plan, San Joaquin Valley Air Pollution Control District AGENCY... limited disapproval of revisions to the San Joaquin Valley Air Pollution Control District (SJVAPCD or... Valley Air Pollution Control District; letter dated and received August 17, 2009. After the close of the...

An inventory of published and unpublished fluvial-sediment data for California, 1956-70

USGS Publications Warehouse

Porterfield, George

1972-01-01

This inventory was prepared to provide a convenient reference to published and unpublished fluvial-sediment data for water years 1956-70, and updates substantially previous inventories. Sediment stations are listed in downstream order, and an alphabetical list of stations is also included. Figure 1 shows the approximate location of sediment stations in California. Most of the fluvial-sediment data in California were collected by the U.S. Geological Survey, under cooperative agreements with the following Federal, State, and local agencies: California Department of Water Resources, California Department of Navigation and Ocean Development, California Department of Fish and Game, Bolinas Harbor District, Monterey County Flood Control and Water Conservation District, Orange County Flood Control District, Riverside County Flood Control and Water Conservation District, San Diego County Department of Sanitation and Flood Control, San Luis Obispo County, San Mateo County, Santa Clara County Flood Control and Water District, Santa Cruz County Flood Control and Water Conservation District, Santa Cruz, city of, University of California, Ventura County Flood Control District, Forest Service, U.S. Department of Agriculture, Soil Conservation Service, U.S. Department of Agriculture, Corps of Engineers, U.S. Army, Bureau of Reclamation, U.S. Department of the Interior, National Park Service, U.S. Department of the Interior. This report was prepared by the Geological Survey under the general supervision of R. Stanley Lord, district chief in charge of water-resources investigations in California.

Effectiveness of a new long-lasting insecticidal nets delivery model in two rural districts of Mozambique: a before-after study.

PubMed

Arroz, Jorge A H; Candrinho, Baltazar; Mendis, Chandana; Varela, Pablo; Pinto, João; Martins, Maria do Rosário O

2018-02-05

In 2015, Mozambique piloted a new model of long-lasting insecticidal nets (LLINs) delivery in a campaign. The new delivery model was used in two rural districts were, and two others were considered as control, maintaining the old delivery model. The aim of this study is to compare the coverage of ownership and use of LLINs in intervention and control districts in Mozambique. A before-after design with control group was carried out 6 months after LLINs distribution. Using systematic probabilistic sampling, 1547 households were surveyed by means of a questionnaire. To find associations between the district categories (intervention and control) and the main outcomes of the study (LLIN ownership, use, and universal coverage achievement), odds ratio (OR) and respective confidence intervals were calculated. Of the 760 households surveyed in the intervention districts, 98.8% had at least one LLIN; of the 787 households surveyed in the control districts, 89.6% had at least one LLIN [OR: 9.7, 95% (CI 4.84-19.46)]. Around 95 and 87% of households owning at least one LLIN reported having slept under the LLIN the previous night in the intervention and control districts, respectively [OR: 3.2; 95% (CI 2.12-4.69)]. Seventy-one percent of the households surveyed achieved universal coverage in the intervention districts against 59.6% in the control districts [OR: 1.6; 95% (CI 1.33-2.03)]. The universal coverage campaign piloted with the new delivery model has increased LLINs ownership, use, and progression for reaching universal coverage targets in the community.

76 FR 71886 - Revisions to the California State Implementation Plan, Placer County Air Pollution Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-21

... the California State Implementation Plan, Placer County Air Pollution Control District and Sacramento... Pollution Control District (PCAPCD) and Sacramento Metropolitan Air Quality Management District (SMAQMD... Guidelines for Miscellaneous Metal and Plastic Parts Coatings,'' EPA-453/R-08-003, September 2008. 7...

76 FR 76046 - Interim Final Determination To Defer Sanctions, San Joaquin Valley Unified Air Pollution Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-06

... Determination To Defer Sanctions, San Joaquin Valley Unified Air Pollution Control District AGENCY... Valley Unified Air Pollution Control District (SJVUAPCD or District) portion of the California State...), we finalized a limited approval and limited disapproval of San Joaquin Valley Unified Air Pollution...

77 FR 64427 - Revisions to the California State Implementation Plan, San Joaquin Valley Unified Air Pollution...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-22

... the California State Implementation Plan, San Joaquin Valley Unified Air Pollution Control District... revisions to the San Joaquin Valley Unified Air Pollution Control District (SJVUAPCD) portion of the..., Gas, and Geothermal Resources confirmed that in the Ventura County Air Pollution Control District...

76 FR 75857 - Revisions to the California State Implementation Plan, Placer County Air Pollution Control District

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-05

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2011-0846; FRL-9493-3] Revisions to the California State Implementation Plan, Placer County Air Pollution Control District AGENCY... the Placer County Air Pollution Control District (PCAPCD) portion of the California State...

78 FR 6784 - Revisions to the California State Implementation Plan, Placer County Air Pollution Control District

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-31

... the California State Implementation Plan, Placer County Air Pollution Control District AGENCY... the Placer County Air Pollution Control District (PCAPCD) portion of the California State... regulate this emission source under the Clean Air Act (CAA or the Act). DATES: Any comments on this...

76 FR 68103 - Revisions to the California State Implementation Plan, San Joaquin Valley Unified Air Pollution...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-03

... the California State Implementation Plan, San Joaquin Valley Unified Air Pollution Control District... revisions to the San Joaquin Valley Unified Air Pollution Control District (SJVUAPCD) portion of the... State Implementation Plan, San Joaquin Valley Unified Air Pollution Control District Rule 4692...

Primary nocturnal enuresis is associated with lower intelligence quotient scores in boys from poorer socioeconomic status families.

PubMed

Basiri, Abbas; Bahrainian, Seyed Abdolmajid; Khoshdel, Alireza; Jalaly, Niloofar; Golshan, Shabnam; Pakmanesh, Hamid

2017-03-01

To explore intelligence quotient in boys with primary nocturnal enuresis compared with normal boys considering their socioeconomic status. A total of 152 school-aged boys (including 55 boys with primary nocturnal enuresis and 97 matched normal controls) were assessed. Boys with a history of any neurological or urological disease were excluded. Two different districts of Tehran: Khani-Abad (a poor district) and Pirouzi (a middle class district) districts were enrolled according to socioeconomic status data reported by the World Health Organization. Intelligence tests were carried out using a validated Iranian translation of the Wechsler Intelligence Scale for Children Revised. Total, as well as performance intelligence quotient and verbal intelligence quotient scores and verbal-performance discrepancy (the difference between verbal and performance intelligence quotient scores for each individual) were compared using a t-test between boys with primary nocturnal enuresis in each district and their matched controls. Considering each district separately, the total intelligence quotient score was lower in primary nocturnal enuresis cases than controls only in the lower income district (90.7 ± 23.3 vs 104.8 ± 14.7, P = 0.002). Similarly, boys with primary nocturnal enuresis ranked lower in verbal intelligence quotient (P = 0.002) and performance intelligence quotient (P = 0.004) compared with their matched normal controls only in lower income district, whereas in the higher income district, boys with primary nocturnal enuresis ranked similar in total intelligence quotient to their matched controls. Boys with primary nocturnal enuresis had a lower intelligence quotient compared with the control participants only in low-income district. It seems important to adjust the results of the intelligence quotient assessment in these children according to their socioeconomic status. © 2017 The Japanese Urological Association.

77 FR 214 - Revisions to the California State Implementation Plan, San Joaquin Valley Unified Air Pollution...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-04

... the California State Implementation Plan, San Joaquin Valley Unified Air Pollution Control District... approval of revisions to the San Joaquin Valley Air Pollution Control District (SJVUAPCD) portion of the... used by the California Air Resources Board and air districts for evaluating air pollution control...

76 FR 67396 - Revisions to the California State Implementation Plan, Placer County Air Pollution Control District

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-01

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2011-0382; FRL-9477-3] Revisions to the California State Implementation Plan, Placer County Air Pollution Control District AGENCY... the Placer County Air Pollution Control District (PCAPCD) and Sacramento Metro Air Quality Management...

78 FR 37176 - Revisions to the California State Implementation Plan, San Diego Air Pollution Control District

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-20

... the California State Implementation Plan, San Diego Air Pollution Control District AGENCY... the San Diego Air Pollution Control District (SDAPCD) portion of the California State Implementation... coatings. We are proposing to approve a local rule to regulate these emission sources under the Clean Air...

75 FR 28509 - Revisions to the California State Implementation Plan, San Joaquin Valley Unified Air Pollution...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-21

... the California State Implementation Plan, San Joaquin Valley Unified Air Pollution Control District... approve revisions to the San Joaquin Valley Unified Air Pollution Control District (SJVUAPCD) portion of... Joaquin Valley Unified Air Pollution Control District, No. 08-17309 (9th Circuit)). In that case, NAHB...

7 CFR 1781.4 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... III of the Bankhead-Jones Farm Tenant Act (7 U.S.C. 1011). (c) Watershed plan. A plan agreed upon by..., irrigation districts, drainage districts, flood prevention and control districts, school districts, other...

7 CFR 1781.4 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... III of the Bankhead-Jones Farm Tenant Act (7 U.S.C. 1011). (c) Watershed plan. A plan agreed upon by..., irrigation districts, drainage districts, flood prevention and control districts, school districts, other...

7 CFR 1781.4 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... III of the Bankhead-Jones Farm Tenant Act (7 U.S.C. 1011). (c) Watershed plan. A plan agreed upon by..., irrigation districts, drainage districts, flood prevention and control districts, school districts, other...

Indicators of asthma control among students in a rural, school-based asthma management program

PubMed Central

Rasberry, Catherine N.; Cheung, Karen; Buckley, Rebekah; Dunville, Richard; Daniels, Brandy; Cook, Deborah; Robin, Leah; Dean, Blair

2015-01-01

Objective The evaluation sought to determine if a comprehensive, school-based asthma management program in a small, rural school district helped students improve asthma control. Methods To determine if students in the asthma program demonstrated better asthma control than students in a comparison school district, the evaluation team used a quasi-experimental, cross-sectional design and administered questionnaires assessing asthma control (which included FEV1 measurement) to 456 students with asthma in the intervention and comparison districts. Data were analyzed for differences in asthma control between students in the two districts. To determine if students in the intervention experienced increased asthma control between baseline and follow-up, the evaluation team used a one-group retrospective design. Program records for 323 students were analyzed for differences in percent of predicted forced expiratory volume in one second (FEV1) between baseline and follow-up. Results Students with asthma in the intervention district exhibited significantly better asthma control than students with asthma in the comparison district. Percent of predicted FEV1 did not change significantly between baseline and follow-up for the intervention participants; however, post hoc analyses revealed students with poorly-controlled asthma at baseline had significantly higher FEV1 scores at follow-up, and students with well-controlled asthma at baseline had significantly lower FEV1 scores at follow-up. Conclusions Findings suggest the comprehensive school-based program led to improvements in asthma control for students with poorly controlled asthma at baseline, and school-based programs need mechanisms for tracking students with initially well-controlled asthma in order to ensure they maintain control. PMID:24730771

76 FR 67366 - Revisions to the California State Implementation Plan, Placer County Air Pollution Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-01

... Metro Air Quality Management District AGENCY: Environmental Protection Agency (EPA). ACTION: Direct... Pollution Control District (PCAPCD) and Sacramento Metro Air Quality Management District (SMAQMD) portions..., this action: Is not a ``significant regulatory action'' subject to review by the Office of Management...

40 CFR 55.15 - Specific designation of corresponding onshore areas.

Code of Federal Regulations, 2014 CFR

2014-07-01

... corresponding onshore areas. (a) California. (1) The South Coast Air Quality Management District is designated... Air Pollution Control District is designated as the COA for the following OCS facilities: Grace, Gilda, Gail and Gina. (3) The Santa Barbara County Air Pollution Control District is designated as the COA for...

40 CFR 55.15 - Specific designation of corresponding onshore areas.

Code of Federal Regulations, 2012 CFR

2012-07-01

... corresponding onshore areas. (a) California. (1) The South Coast Air Quality Management District is designated... Air Pollution Control District is designated as the COA for the following OCS facilities: Grace, Gilda, Gail and Gina. (3) The Santa Barbara County Air Pollution Control District is designated as the COA for...

40 CFR 55.15 - Specific designation of corresponding onshore areas.

Code of Federal Regulations, 2013 CFR

2013-07-01

... corresponding onshore areas. (a) California. (1) The South Coast Air Quality Management District is designated... Air Pollution Control District is designated as the COA for the following OCS facilities: Grace, Gilda, Gail and Gina. (3) The Santa Barbara County Air Pollution Control District is designated as the COA for...

40 CFR 55.15 - Specific designation of corresponding onshore areas.

Code of Federal Regulations, 2010 CFR

2010-07-01

... corresponding onshore areas. (a) California. (1) The South Coast Air Quality Management District is designated... Air Pollution Control District is designated as the COA for the following OCS facilities: Grace, Gilda, Gail and Gina. (3) The Santa Barbara County Air Pollution Control District is designated as the COA for...

40 CFR 55.15 - Specific designation of corresponding onshore areas.

Code of Federal Regulations, 2011 CFR

2011-07-01

... corresponding onshore areas. (a) California. (1) The South Coast Air Quality Management District is designated... Air Pollution Control District is designated as the COA for the following OCS facilities: Grace, Gilda, Gail and Gina. (3) The Santa Barbara County Air Pollution Control District is designated as the COA for...

Application of Canal Automation at the Central Arizona Irrigation and Drainage District

USDA-ARS?s Scientific Manuscript database

The Central Arizona Irrigation and Drainage District (CAIDD) began delivering water to users in 1987. Although designed for automatic control, the system was run manually until a homemade SCADA (Supervisory Control and Data Acquisition) system was developed by a district employee. In 2002, problem...

The Relationship between Pupil Control Ideology and Academic Optimism

ERIC Educational Resources Information Center

Gilbert, Michael J.

2012-01-01

This study investigates the relationship between pupil control ideology and academic optimism. Information was generated through responses to a questionnaire emailed to teachers in two school districts in Central New Jersey. The districts were categorized GH, as determined by the State's district factor grouping. The research concludes that there…

The Local Control Funding Formula: An Opportunity for Early Childhood & Low-Income Students. Increasing Resources for Early Childhood through the Local Control Funding Formula: A Guide for Early Childhood Advocates

ERIC Educational Resources Information Center

Children Now, 2016

2016-01-01

According to the new Local Control Funding Formula (LCFF) law, most school districts in the state are responsible for using LCFF funds to improve outcomes for low-income students. Each district has created a Local Control Accountability Plan (LCAP), the funding plan for LCFF. The LCAP is reviewed and revised annually by each district. Early…

76 FR 60376 - Revisions to the California State Implementation Plan, Santa Barbara Air Pollution Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-29

... Municipal Air Quality Management District and South Coast Air Quality Management District AGENCY... Quality Management District (SMAQMD) and South Coast Air Quality Management District (SCAQMD) portions of...,'' revised September 20, 2010. (D) Sacramento Metropolitan Air Quality Management District. (1) Rule 466...

Using Synthetic Controls to Evaluate the Effect of Unique Interventions: The Case of Say Yes to Education.

PubMed

Bifulco, Robert; Rubenstein, Ross; Sohn, Hosung

2017-12-01

"Place-based" scholarships seek to improve student outcomes in urban school districts and promote urban revitalization in economically challenged cities. Say Yes to Education is a unique district-wide school reform effort adopted in Syracuse, NY, in 2008. It includes full-tuition scholarships for public and private universities, coupled with extensive wraparound support services in schools. This study uses synthetic control methods to evaluate the effect of Say Yes on district enrollment and graduation rates. It also introduces the synthetic control method and provides guidance for its use in evaluating single-site interventions. Combining school district-level data from the National Center for Education Statistics' Common Core of Data and New York State School Report Cards, this article uses synthetic control methods to construct a synthetic comparison district to estimate counterfactual enrollment and graduation trends for Syracuse. We find that Say Yes to Education was associated with enrollment increases in the Syracuse City School District, a district that had previously experienced decades of sustained enrollment declines. We do not find consistent evidence of changes in graduation rates following adoption of the program. Graduation rate analyses demonstrate that estimates of treatment effects can be sensitive to choices that the researcher has to make in applying synthetic control methods, particularly when pretreatment outcome measures appear to have considerable amounts of noise.

78 FR 42018 - Determination of Attainment for the Sacramento Nonattainment Area for the 2006 Fine Particle...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-15

... control agencies in the area: Sacramento Metropolitan Air Quality Management District, Placer County Air Pollution Control District, and Yolo-Solano Air Quality Management District. Based on these reviews, EPA..., 2007) (Miami, Arizona area); and 75 FR 27944 (May 19, 2010) (Coso Junction, California area). Thus EPA...

75 FR 4759 - Withdrawal of Proposed Rule Revising the California State Implementation Plan, San Joaquin Valley...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-29

... Proposed Rule Revising the California State Implementation Plan, San Joaquin Valley Unified Air Pollution... approval of revisions to the San Joaquin Valley Unified Air Pollution Control District portion of the... revisions to the San Joaquin Valley Unified Air Pollution Control District (``District'') portion of the...

Building Suburban Dreams: School District Secession and Mayoral Control in Suburban Utah

ERIC Educational Resources Information Center

Buendia, Edward; Humbert-Fisk, Paul

2015-01-01

Background/Context: Mayoral control of large city school districts has become the newest form of school district reorganization. Researchers have documented how real and perceived crises have propelled mayors in Chicago, Baltimore, and Washington DC, amongst others, to redefine the role of board governance by situating the operations of districts…

Controlling Special Education Costs at the School District Level.

ERIC Educational Resources Information Center

Morgan, W. Daniel

1992-01-01

Describes the financing of a New York school district for emotionally disturbed children. Summarizes suggestions for controlling special education costs at the district level obtained from a nationwide sample of school business officials. Among the suggestions offered are to include a review of private placements and an annual caseload review,…

Controlled drugs and the principle of double effect: the role of the district nurse.

PubMed

Griffith, Richard

2016-12-02

The role of district nurses in the effective management of pain in palliative care has been strengthened by the Misuse of Drugs (Amendment No.2) (England, Wales and Scotland) Regulations 2012 that allow district nurses who are independent or supplementary prescribers to prescribe and administer controlled drugs. However, prescribing controlled drugs brings increased responsibility and accountability for the safe management of these medicines. In this article Richard Griffith considers the principle of double effect that seeks to ensure that patients in intractable pain receive the analgesia they require to manage that pain while district nurses avoid liability and prosecution under the law of murder.

People Participation Towards Opisthorchis viverrini Prevention and Control in Chaiyaphum Province, Northeastern Thailand.

PubMed

Phongsiripapat, Rutjirapat; Chimplee, Kanokporn; Rujirakul, Ratana; Kaewpitoon, Soraya; Keawpitoon, Natthawut

2016-01-01

This cross-sectional descriptive and qualitative study was aimed to study the people participation and their approaches toward the human carcinogenic liver fluke, Opisthorchis viverrini, prevention and control in Ban Chaun sub-district administrative organization (BCSAO) and Bamnet Narong sub-district municipality (BNSM), Bamnet Narong district, Chaiyaphum Province, Thailand between June 2013 and February 2014. Participants were purposive selected, included chiefs of sub-district administrative organizations, sub-district municipalities, sub-district health promotion hospitals (SHPHs), heads of village, and a further sample was selected with a multi- stage random sampling for public health volunteers, and villagers. The pre-designed questionnaire contained items for individualized status and the participatory steps of sharing ideas, decision-making, and planning, procession, evaluation, and mutual benefit, for the project O. viverrini prevention and control (POPC). In-depth interviews were used for collection of need approaches to POPC. With 375 participants who completed the questionnaire, it was found that people had a high level regarding to participate in the POPC, particularly in the process stage (X_ =3.78, S.D. = 0.56), but the lowest level was found in sharing ideas, decision making, and planning step (X_ =3.65, S.D. = 0.63). By comparison, participant status and organization did not significantly differ with people participation. In each step, Ban Chaun sub-district had a high level of participation in the step of sharing ideas, decision making, and planning toward POPC, more than Bamnet Narong sub-district municipality (t=2.20, p=0.028). Approaches for POPC in Ban Chaun sub-district and Bamnet Narong sub-district municipality included requirements for budget support, annual campaigns for liver fluke prevention and control, campaign promotion, risk group observation, home visiting, community rules regarding reducing raw fish consumption in their communities, and a professional public health officer for working in their communities, BCSAO, BNSM, and SHPH, for O. viverrini prevention and control. This study indicates that people realize that eradication of the liver fluke needs a continuous people participation for O. viverrini prevention and control in their communities.

Playing Hardball with Facilities Expenses.

ERIC Educational Resources Information Center

Fickes, Michael

1997-01-01

Describes one school district manager's tactics for successfully controlling district costs and increasing capital improvements while only marginally increasing the facilities maintenance budget. Highlights guidelines for controlling personnel requirements and cost-reduction methods. Discusses specific cost-control measures involving telephone…

Environmental Considerations for Municipal Waste Combustors

DTIC Science & Technology

1994-07-01

phone as above) 700 H Samet Sacramento, CA 95814 NORTHERN SONOMA COUNTY Air Pollution Control SAN BENITO COUNTY (See Monterey Bay Northern Sonoma County Air...Control Northern Sonoma County Air Pollution Control District San Bernardino County Air Pollution Control District Board of Directors 15428 Civic Drive 575

75 FR 45082 - Revisions to the California State Implementation Plan, Santa Barbara County Air Pollution Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-02

... the California State Implementation Plan, Santa Barbara County Air Pollution Control District AGENCY... limited disapproval of revisions to the Santa Barbara County Air Pollution Control District (SBCAPCD... Environmental protection, Air pollution control, Intergovernmental relations, Nitrogen dioxide, Ozone, Reporting...

77 FR 73322 - Revisions to the California State Implementation Plan, Monterey Bay Unified Air Pollution Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-10

... the California State Implementation Plan, Monterey Bay Unified Air Pollution Control District AGENCY... approve revisions to the Monterey Bay Unified Air Pollution Control District (MBUAPCD) portion of the... Part 52 Environmental protection, Air pollution control, Incorporation by reference, Intergovernmental...

76 FR 30080 - Revisions to the California State Implementation Plan, Placer County Air Pollution Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-24

... the California State Implementation Plan, Placer County Air Pollution Control District and Ventura County Air Pollution Control District AGENCY: Environmental Protection Agency (EPA). ACTION: Proposed rule. SUMMARY: EPA is proposing to approve revisions to the Placer County Air Pollution Control...

75 FR 56889 - Revisions to the California State Implementation Plan, San Diego County Air Pollution Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-17

... the California State Implementation Plan, San Diego County Air Pollution Control District AGENCY... approve revisions to the San Diego County Air Pollution Control District (SDCAPCD) portion of the... CFR Part 52 Environmental protection, Air pollution control, Incorporation by reference...

75 FR 10690 - Revisions to the California State Implementation Plan, San Joaquin Valley Air Pollution Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-09

... the California State Implementation Plan, San Joaquin Valley Air Pollution Control District AGENCY... the San Joaquin Valley Air Pollution Control District (SJVAPCD) portion of the California State...)(2)). List of Subjects in 40 CFR Part 52 Environmental protection, Air pollution control...

76 FR 40660 - Revisions to the California State Implementation Plan, San Joaquin Valley Air Pollution Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-11

... the California State Implementation Plan, San Joaquin Valley Air Pollution Control District (SJVUAPCD... approve revisions to the San Joaquin Valley Air Pollution Control District (SJVUAPCD) portion of the....0 for the following terms: Air Pollution Control Officer, Board, Environmental Protection Agency...

78 FR 53711 - Revisions to the California State Implementation Plan, Placer, Santa Barbara and Ventura County...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-30

...EPA is proposing to approve revisions to the Placer County Air Pollution Control District (PCAPCD), Santa Barbara County Air Pollution Control District (SBCAPCD) and Ventura County Air Pollution Control District (VCAPCD) portions of the California State Implementation Plan (SIP). These revisions concern volatile organic compound (VOC) emissions from adhesives and sealants. We are proposing to approve local rules to regulate these emission sources under the Clean Air Act as amended in 1990 (CAA or the Act).

76 FR 47094 - Revisions to the California State Implementation Plan; South Coast Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-04

... the California State Implementation Plan; South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District portion of the California State Implementation Plan... following local rule: South Coast Air Quality Management District Rule 1175, Control of Emissions from the...

78 FR 58459 - Revisions to the California State Implementation Plan, Antelope Valley Air Quality Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-24

... the California State Implementation Plan, Antelope Valley Air Quality Management District, Santa Barbara County Air Pollution Control District, South Coast Air Quality Management District and Ventura.... SUMMARY: EPA is finalizing approval of revisions to the Antelope Valley Air Quality Management District...

Improving malaria treatment and prevention in India by aiding district managers to manage their programmes with local information: a trial assessing the impact of Lot Quality Assurance Sampling on programme outcomes.

PubMed

Valadez, Joseph J; Devkota, Baburam; Pradhan, Madan Mohan; Meherda, Pramod; Sonal, G S; Dhariwal, Akshay; Davis, Rosemary

2014-10-01

This paper reports the first trial of Lot Quality Assurance Sampling (LQAS) assessing associations between access to LQAS data and subsequent improvements in district programming. This trial concerns India's approach to addressing an increase in malaria-attributable deaths by training community health workers to diagnose, treat and prevent malaria, while using LQAS to monitor sub-district performance and make programme improvements. The Ministry of Health introduced LQAS into four matched high malaria burden districts (Annual Parasite Incidence >5) (N > 5 million). In each sub-district, we sampled four populations in three 6-monthly surveys: households, children <5 years, people with fever in the last 2 weeks and community health workers. In three districts, trained local staff collected, analysed and used data for programme management; in one control district, non-local staff collected data and did not disseminate results. For eight indicators, we calculated the change in proportion from survey one to three and used a Difference-in-Differences test to compare the relative change between intervention and control districts. Coverage increased from survey one to three for 24 of 32 comparisons. Difference-in-Differences tests revealed that intervention districts exhibited significantly greater change in four of six vertical strategies (insecticide treated bed-nets and indoor residual spraying), one of six treatment-seeking behaviours and four of 12 health worker capacity indicators. The control district displayed greater improvement than two intervention districts for one health worker capacity indicator. One district with poor management did not improve. In this study, LQAS results appeared to support district managers to increase coverage in underperforming areas, especially for vertical strategies in the presence of diligent managers. © 2014 The Authors. Tropical Medicine & International Health published by John Wiley & Sons Ltd.

Utilities Expense Report.

ERIC Educational Resources Information Center

Moore, Deborah P.

2001-01-01

Examines how deregulation has affected school district utility costs. Offers ideas that can help school districts save money and energy. Provides several examples of state-wide initiatives intended to help school districts control utility costs. (GR)

75 FR 13330 - Bureau of Political-Military Affairs; Statutory Debarment Under the Arms Export Control Act and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-19

.... District Court, Southern District of Texas, Case 7:08CR01610-001. (24) Reynol Garcia, June 12, 2009, U.S... Quilantan-Garcia, December 9, 2009, U.S. District Court, Southern District of Texas, Case 7:09CR00874-001... Texas, Case 7:09CR01019- 001. (28) Roberto Carlos Garcia-Salazar, January 31, 2009, U.S. District Court...

Developing Sterile Insect Technique (SIT) as a tool Mosquito Control Districts can use for integrated Aedes aegypti control

USDA-ARS?s Scientific Manuscript database

New tools are clearly needed for integrated mosquito management of Ae. aegypti. We describe the sterile insect technique (SIT) that we are developing as a method to control Ae. aegypti by partnering with two prominent Florida mosquito control districts (MCD) and the FAO/IAEA Insect Pest Control Sub...

Up-skilling associate clinicians in Malawi in emergency obstetric, neonatal care and clinical leadership: the ETATMBA cluster randomised controlled trial.

PubMed

Ellard, David R; Chimwaza, Wanangwa; Davies, David; Simkiss, Doug; Kamwendo, Francis; Mhango, Chisale; Quenby, Siobhan; Kandala, Ngianga-Bakwin; O'Hare, Joseph Paul

2016-01-01

The ETATMBA (Enhancing Training And Technology for Mothers and Babies in Africa) project-trained associate clinicians (ACs/clinical officers) as advanced clinical leaders in emergency obstetric and neonatal care. This trial aimed to evaluate the impact of training on obstetric health outcomes in Malawi. A cluster randomised controlled trial with 14 districts of Malawi (8 intervention, 6 control) as units of randomisation. Intervention districts housed the 46 ACs who received the training programme. The primary outcome was district (health facility-based) perinatal mortality rates. Secondary outcomes included maternal mortality ratios, neonatal mortality rate, obstetric and birth variables. The study period was 2011-2013. Mortality rates/ratios were examined using an interrupted time series (ITS) to identify trends over time. The ITS reveals an improving trend in perinatal mortality across both groups, but better in the control group (intervention, effect -3.58, SE 2.65, CI (-9.85 to 2.69), p=0.20; control, effect -17.79, SE 6.83, CI (-33.95 to -1.64), p=0.03). Maternal mortality ratios are seen to have improved in intervention districts while worsening in the control districts (intervention, effect -38.11, SE 50.30, CI (-157.06 to 80.84), p=0.47; control, effect 11.55, SE 87.72, CI (-195.87 to 218.98), p=0.90). There was a 31% drop in neonatal mortality rate in intervention districts while in control districts, the rate rises by 2%. There are no significant differences in the other secondary outcomes. This is one of the first randomised studies looking at the effect of structured training on health outcomes in this setting. Notwithstanding a number of limitations, this study suggests that up-skilling this cadre is possible, and could impact positively on health outcomes. ISRCTN63294155; Results.

The Impact of Computer-Based Information Systems Upon School and School District Administration.

ERIC Educational Resources Information Center

Hansen, Thomas; And Others

1978-01-01

This study investigates the ways in which computer-based information systems interact with the strategic planning, management control, and operational control in 11 Minnesota school districts. (Author/IRT)

75 FR 37727 - Disapproval of California State Implementation Plan Revisions, Monterey Bay Unified Air Pollution...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-30

... California State Implementation Plan Revisions, Monterey Bay Unified Air Pollution Control District AGENCY... to the Monterey Bay Unified Air Pollution Control District (MBUAPCD) portion of the California State... Environmental protection, Air pollution control, Incorporation by reference, Intergovernmental relations...

40 CFR 52.227 - Control strategy and regulations: Particulate matter, Metropolitan Los Angeles Intrastate Region.

Code of Federal Regulations, 2014 CFR

2014-07-01

... IMPLEMENTATION PLANS California § 52.227 Control strategy and regulations: Particulate matter, Metropolitan Los... Los Angeles Intrastate Region. (1) Los Angeles County Air Pollution Control District: (i) Regulation IV, Rule 68.1. (2) Riverside County Air Pollution Control District: (i) Regulation IV, Rule 54 for...

40 CFR 52.227 - Control strategy and regulations: Particulate matter, Metropolitan Los Angeles Intrastate Region.

Code of Federal Regulations, 2013 CFR

2013-07-01

... IMPLEMENTATION PLANS California § 52.227 Control strategy and regulations: Particulate matter, Metropolitan Los... Los Angeles Intrastate Region. (1) Los Angeles County Air Pollution Control District: (i) Regulation IV, Rule 68.1. (2) Riverside County Air Pollution Control District: (i) Regulation IV, Rule 54 for...

40 CFR 52.227 - Control strategy and regulations: Particulate matter, Metropolitan Los Angeles Intrastate Region.

Code of Federal Regulations, 2012 CFR

2012-07-01

... IMPLEMENTATION PLANS California § 52.227 Control strategy and regulations: Particulate matter, Metropolitan Los... Los Angeles Intrastate Region. (1) Los Angeles County Air Pollution Control District: (i) Regulation IV, Rule 68.1. (2) Riverside County Air Pollution Control District: (i) Regulation IV, Rule 54 for...

[Knowledge, attitude and practice on schistosomiasis control of chronic schistosomiasis patients in Poyang Lake area, Nanchang City].

PubMed

Guo-Hua, Peng; Zhu-Hua, Hu; Wei, Hua; Ke, Qian; Xiao-Gang, Li; Zhi-Shu, Zhang; Zhi-Gang, Chen; Xiao-Wu, Feng

2017-06-26

To understand the present situation of the chronic schistosomiasis patients' knowledge, attitude and practice on schistosomiasis control in Nanchang City. The knowledge, attitude and values on schistosomiasis control of 523 chronic schistosomiasis patients in Nanchang County, Jinxian County and Xinjian District in the Poyang Lake District were investigated with questionnaires. And the accuracy rates of the knowledge, attitude and practice among the patient groups of different counties, genders, age groups, occupations and educational levels were analyzed. The accuracy rates of the knowledge, attitude and practice of patients on schistosomiasis control were 95.76%, 82.80%, and 81.73% in Nanchang County; 91.37%, 93.32%, and 76.48% in Jinxian County; 88.25%, 67.56%, and 49.40% in Xinjian District. In the accuracy rates of knowledge, attitude and practice, the differences among the three counties (districts) were statistically significant ( χ 2 = 57.511-301.378, all P < 0.05) . The accuracy rates of chronic schistosomiasis patients' attitude and practice on schistosomiasis control in Nanchang City remain low. Therefore, the intensity of attitude and practice intervention should be strengthened in the Poyang Lake District in order to enhance the self-protection awareness of the patients.

40 CFR 52.220 - Identification of plan.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Pollution Control District. (i) Previously approved on September 22, 1972 and now deleted without... and other Legal Documents Pertinent to Air Pollution Control in California”) to chapter 7. (13) El Dorado County Air Pollution Control District. (i) Previously approved on May 31, 1972 in paragraph (b) of...

40 CFR 52.220 - Identification of plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., 43, and 44. (5) Ventura County Air Pollution Control District. (i) Previously approved on September... (“State Statutes and other Legal Documents Pertinent to Air Pollution Control in California”) to chapter 7. (13) El Dorado County Air Pollution Control District. (i) Previously approved on May 31, 1972 in...

75 FR 13468 - Disapproval of California State Implementation Plan Revisions, Monterey Bay Unified Air Pollution...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-22

... California State Implementation Plan Revisions, Monterey Bay Unified Air Pollution Control District AGENCY... to the Monterey Bay Unified Air Pollution Control District (MBAPCD) portion of the California State... CFR Part 52 Environmental protection, Air pollution control, Intergovernmental relations, Nitrogen...

78 FR 894 - Interim Final Determination To Stay Sanctions, Imperial County Air Pollution Control District

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-07

... Determination To Stay Sanctions, Imperial County Air Pollution Control District AGENCY: Environmental Protection... imposition of sanctions based on a proposed approval of revisions to the Imperial County Air Pollution... Part 52 Environmental protection, Air pollution control, Incorporation by reference, Intergovernmental...

76 FR 70886 - Revisions to the California State Implementation Plan, San Joaquin Valley Unified Air Pollution...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-16

... the California State Implementation Plan, San Joaquin Valley Unified Air Pollution Control District... revisions to the San Joaquin Valley Unified Air Pollution Control District (SJVUAPCD) portion of the... CFR Part 52 Environmental protection, Air pollution control, Incorporation by reference...

77 FR 5709 - Revisions to the California State Implementation Plan, San Joaquin Valley Unified Air Pollution...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-06

... the California State Implementation Plan, San Joaquin Valley Unified Air Pollution Control District... revisions to the San Joaquin Valley Unified Air Pollution Control District (SJVUAPCD) portion of the... pollution control, Incorporation by reference, Intergovernmental relations, Nitrogen dioxide, Ozone...

76 FR 33181 - Revisions to the California State Implementation Plan, San Joaquin Valley Unified Air Pollution...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-08

... the California State Implementation Plan, San Joaquin Valley Unified Air Pollution Control District... approve a revision to the San Joaquin Valley Unified Air Pollution Control District (SJVUAPCD) portion of..., Air pollution control, Intergovernmental relations, Ozone, Reporting and recordkeeping requirements...

76 FR 5276 - Revisions to the California State Implementation Plan, San Joaquin Valley Unified Air Pollution...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-31

... the California State Implementation Plan, San Joaquin Valley Unified Air Pollution Control District... revisions to the San Joaquin Valley Unified Air Pollution Control District (SJVUAPCD) portion of the... protection, Air pollution control, Incorporation by reference, Intergovernmental relations, Nitrogen dioxide...

77 FR 72744 - Outer Continental Shelf Air Regulations Consistency Update for California

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-06

... County Air Pollution Control District (``Santa Barbara County APCD'' or ``District'') is the designated... 52630), EPA proposed to incorporate various Santa Barbara County APCD air pollution control requirements... the Act requires that EPA establish requirements to control air pollution from OCS sources located...

40 CFR 52.476 - Control strategy: ozone.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 3 2010-07-01 2010-07-01 false Control strategy: ozone. 52.476 Section...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS District of Columbia § 52.476 Control strategy: ozone. (a... of Progress Plan for the District of Columbia's portion of the Metropolitan Washington, D.C. ozone...

40 CFR 52.476 - Control strategy: ozone.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 3 2013-07-01 2013-07-01 false Control strategy: ozone. 52.476 Section...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS District of Columbia § 52.476 Control strategy: ozone. (a... of Progress Plan for the District of Columbia's portion of the Metropolitan Washington, D.C. ozone...

40 CFR 52.476 - Control strategy: ozone.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 3 2014-07-01 2014-07-01 false Control strategy: ozone. 52.476 Section...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS District of Columbia § 52.476 Control strategy: ozone. (a... of Progress Plan for the District of Columbia's portion of the Metropolitan Washington, D.C. ozone...

40 CFR 52.476 - Control strategy: ozone.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 3 2012-07-01 2012-07-01 false Control strategy: ozone. 52.476 Section...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS District of Columbia § 52.476 Control strategy: ozone. (a... of Progress Plan for the District of Columbia's portion of the Metropolitan Washington, D.C. ozone...

40 CFR 52.476 - Control strategy: ozone.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 3 2011-07-01 2011-07-01 false Control strategy: ozone. 52.476 Section...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS District of Columbia § 52.476 Control strategy: ozone. (a... of Progress Plan for the District of Columbia's portion of the Metropolitan Washington, D.C. ozone...

40 CFR 52.220 - Identification of plan.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., Rules 40, 42, 43, and 44. (5) Ventura County Air Pollution Control District. (i) Previously approved on... contained in appendix II (“State Statutes and other Legal Documents Pertinent to Air Pollution Control in California”) to chapter 7. (13) El Dorado County Air Pollution Control District. (i) Previously approved on...

40 CFR 52.220 - Identification of plan.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., Rules 40, 42, 43, and 44. (5) Ventura County Air Pollution Control District. (i) Previously approved on... (“State Statutes and other Legal Documents Pertinent to Air Pollution Control in California”) to chapter 7. (13) El Dorado County Air Pollution Control District. (i) Previously approved on May 31, 1972 in...

46 CFR 46.10-60 - Control.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 2 2011-10-01 2011-10-01 false Control. 46.10-60 Section 46.10-60 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) LOAD LINES SUBDIVISION LOAD LINES FOR PASSENGER VESSELS Administration § 46.10-60 Control. (a) The District Director of Customs or the Coast Guard District Commander may...

46 CFR 46.10-60 - Control.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 2 2010-10-01 2010-10-01 false Control. 46.10-60 Section 46.10-60 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) LOAD LINES SUBDIVISION LOAD LINES FOR PASSENGER VESSELS Administration § 46.10-60 Control. (a) The District Director of Customs or the Coast Guard District Commander may...

76 FR 69135 - Revisions to the California State Implementation Plan, San Joaquin Valley Unified Air Pollution...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-08

... the California State Implementation Plan, San Joaquin Valley Unified Air Pollution Control District... revisions to the San Joaquin Valley Unified Air Pollution Control District (SJVUAPCD) portion of the... of Subjects in 40 CFR Part 52 Environmental protection, Air pollution control, Incorporation by...

76 FR 56116 - Interim Final Determination To Stay and Defer Sanctions, San Joaquin Valley Unified Air Pollution...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-12

... Determination To Stay and Defer Sanctions, San Joaquin Valley Unified Air Pollution Control District AGENCY... on a proposed approval of revisions to the San Joaquin Valley Unified Air Pollution Control District... Part 52 Environmental protection, Air pollution control, Incorporation by reference, Intergovernmental...

76 FR 37044 - Revisions to the California State Implementation Plan, San Joaquin Valley Unified Air Pollution...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-24

... the California State Implementation Plan, San Joaquin Valley Unified Air Pollution Control District... approve revisions to the San Joaquin Valley Unified Air Pollution Control District (SJVUAPCD) portion of... Glass Manufacturing'', US EPA, June 1994. 7. ``Integrated Pollution Prevention and Control (IPPC...

77 FR 66429 - Revisions to the California State Implementation Plan, San Joaquin Valley Unified Air Pollution...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-05

... the California State Implementation Plan, San Joaquin Valley Unified Air Pollution Control District... approve revisions to the San Joaquin Valley Unified Air Pollution Control District (SJVUAPCD) portion of... 1994. 11. ``Integrated Pollution Prevention and Control (IPPC) Reference Document on Best Available...

76 FR 56114 - Interim Final Determination to Stay and Defer Sanctions, San Joaquin Valley Unified Air Pollution...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-12

... Determination to Stay and Defer Sanctions, San Joaquin Valley Unified Air Pollution Control District AGENCY... on a proposed approval of revisions to the San Joaquin Valley Unified Air Pollution Control District... Part 52 Environmental protection, Air pollution control, Incorporation by reference, Intergovernmental...

76 FR 16696 - Revisions to the California State Implementation Plan, San Joaquin Valley Unified Air Pollution...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-25

... the California State Implementation Plan, San Joaquin Valley Unified Air Pollution Control District... revisions to the San Joaquin Valley Unified Air Pollution Control District (SJVAPCD) portion of the...)(2)). List of Subjects in 40 CFR Part 52 Environmental protection, Air pollution control...

77 FR 24883 - Revisions to the California State Implementation Plan, San Joaquin Valley Unified Air Pollution...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-26

... the California State Implementation Plan, San Joaquin Valley Unified Air Pollution Control District... approve revisions to the San Joaquin Valley Unified Air Pollution Control District (SJVUAPCD) portion of... of Subjects in 40 CFR Part 52 Environmental protection, Air pollution control, Intergovernmental...

75 FR 24408 - Revisions to the California State Implementation Plan, San Joaquin Valley Unified Air Pollution...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-05

... the California State Implementation Plan, San Joaquin Valley Unified Air Pollution Control District... revisions to the San Joaquin Valley Unified Air Pollution Control District (SJVAPCD) portion of the...)(2)). List of Subjects in 40 CFR Part 52 Environmental protection, Air pollution control...

76 FR 52623 - Revisions to the California State Implementation Plan, San Joaquin Valley Unified Air Pollution...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-23

... the California State Implementation Plan, San Joaquin Valley Unified Air Pollution Control District... approve revisions to the San Joaquin Valley Unified Air Pollution Control District (SJVUAPCD) portion of... Subjects in 40 CFR Part 52 Environmental protection, Air pollution control, Intergovernmental relations...

75 FR 1715 - Revisions to the California State Implementation Plan, San Joaquin Valley Unified Air Pollution...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-13

... the California State Implementation Plan, San Joaquin Valley Unified Air Pollution Control District... revisions to the San Joaquin Valley Unified Air Pollution Control District (SJVAPCD) portion of the...)(2)). List of Subjects in 40 CFR Part 52 Environmental protection, Air pollution control...

76 FR 68106 - Revisions to the California State Implementation Plan, San Joaquin Valley Unified Air Pollution...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-03

... the California State Implementation Plan, San Joaquin Valley Unified Air Pollution Control District... revisions to the San Joaquin Valley Unified Air Pollution Control District (SJVUAPCD) portion of the...)(2)). List of Subjects in 40 CFR Part 52 Environmental protection, Air pollution control...

76 FR 41745 - Revisions to the California State Implementation Plan, San Joaquin Valley Unified Air Pollution...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-15

... the California State Implementation Plan, San Joaquin Valley Unified Air Pollution Control District... approval and limited disapproval of revisions to the San Joaquin Valley Unified Air Pollution Control... Valley Unified Air Pollution Control District (SJVUAPCD) Rule 4682, Polystyrene, Polyethylene, and...

76 FR 56706 - Revisions to the California State Implementation Plan, San Joaquin Valley Unified Air Pollution...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-14

... the California State Implementation Plan, San Joaquin Valley Unified Air Pollution Control District... approve revisions to the San Joaquin Valley Unified Air Pollution Control District (SJVUAPCD) portion of... of Subjects in 40 CFR Part 52 Environmental protection, Air pollution control, Intergovernmental...

77 FR 35329 - Revisions to the California State Implementation Plan, San Joaquin Valley Unified Air Pollution...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-13

... the California State Implementation Plan, San Joaquin Valley Unified Air Pollution Control District... approve revisions to the San Joaquin Valley Unified Air Pollution Control District (SJVUAPCD) portion of... of Subjects in 40 CFR Part 52 Environmental protection, Air pollution control, Intergovernmental...

75 FR 55274 - Change of Address for Region 5 State and Local Agencies; Technical Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-10

... Health District, Air Pollution Control, 33 Mill Street, Painesville, OH 44077. (xiv) Mahoning and...; Director, Canton City Health Department, Air Pollution Control Division, 420 Market Avenue North, Canton.... (xiii) Geauga and Lake Counties; Lake County General Health District, Air Pollution Control, 33 Mill...

40 CFR 52.236 - Rules and regulations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... following Air Pollution Control District (APCD) rules do not define the term “agricultural operations,” the... November 10, 1976. (b) The following Air Pollution Control District (APCD) rules are disapproved because... control rules unenforceable: (1) San Luis Obispo County APCD. (i) Rules 401(B)(4) and 401(B)(6), submitted...

40 CFR 52.236 - Rules and regulations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... following Air Pollution Control District (APCD) rules do not define the term “agricultural operations,” the... November 10, 1976. (b) The following Air Pollution Control District (APCD) rules are disapproved because... control rules unenforceable: (1) San Luis Obispo County APCD. (i) Rules 401(B)(4) and 401(B)(6), submitted...

Inventory Control of Fixed Assets by School District Personnel.

ERIC Educational Resources Information Center

Jensen, Paul E.

By July 1, 1966, each school district in New York State was required to install a system of property accounting. This pamphlet provides a suggested method of property accounting to assist school districts in meeting this requirement. In addition, suggestions are made to help the districts record the information needed for fire insurance purposes.…

Site-Based Budgeting: A New Age of District Finance

ERIC Educational Resources Information Center

Perry, Mary

2013-01-01

The effects of linking school districts' funding directly to the students they serve and providing local school districts and communities with more control over how that money is spent could ripple through the entire K-12 system, from the state Capitol to the classroom. For district leaders anxious to improve their schools and better support…

Determinants of modern family planning use among women of reproductive age in the Nkwanta district of Ghana: a case–control study

PubMed Central

2014-01-01

Background Average contraceptive prevalence rate in the Nkwanta district of Ghana was estimated to be 6.2% relative to the national average at the time, of 19%. While several efforts had been made to improve family planning in the country, the district still had very low use of modern family planning methods. This study sought to determine the factors that influenced modern family planning use in general and specifically, the factors that determined the consistently low use of modern family planning methods in the district. Methods A case–control study was conducted in the Nkwanta district of Ghana to determine socio-economic, socio-cultural and service delivery factors influencing family planning usage. One hundred and thirty cases and 260 controls made up of women aged 15–49 years were interviewed using structured questionnaires. A logistic regression was fitted. Results Awareness and knowledge of modern family planning methods were high among cases and controls (over 90%). Lack of formal education among women, socio-cultural beliefs and spousal communication were found to influence modern family planning use. Furthermore, favourable opening hours of the facilities and distance to health facilities influenced the use of modern contraceptives. Conclusion While modern family planning seemed to be common knowledge among these women, actual use of such contraceptives was limited. There is need to improve use of modern family planning methods in the district. In addition to providing health facilities and consolidating close-to-client service initiatives in the district, policies directed towards improving modern family planning method use need to consider the influence of formal education. Promoting basic education, especially among females, will be a crucial step as the district is faced with high levels of school dropout and illiteracy rates. PMID:25117887

Determinants of modern family planning use among women of reproductive age in the Nkwanta district of Ghana: a case-control study.

PubMed

Eliason, Sebastian; Awoonor-Williams, John K; Eliason, Cecilia; Novignon, Jacob; Nonvignon, Justice; Aikins, Moses

2014-08-13

Average contraceptive prevalence rate in the Nkwanta district of Ghana was estimated to be 6.2% relative to the national average at the time, of 19%. While several efforts had been made to improve family planning in the country, the district still had very low use of modern family planning methods. This study sought to determine the factors that influenced modern family planning use in general and specifically, the factors that determined the consistently low use of modern family planning methods in the district. A case-control study was conducted in the Nkwanta district of Ghana to determine socio-economic, socio-cultural and service delivery factors influencing family planning usage. One hundred and thirty cases and 260 controls made up of women aged 15-49 years were interviewed using structured questionnaires. A logistic regression was fitted. Awareness and knowledge of modern family planning methods were high among cases and controls (over 90%). Lack of formal education among women, socio-cultural beliefs and spousal communication were found to influence modern family planning use. Furthermore, favourable opening hours of the facilities and distance to health facilities influenced the use of modern contraceptives. While modern family planning seemed to be common knowledge among these women, actual use of such contraceptives was limited. There is need to improve use of modern family planning methods in the district. In addition to providing health facilities and consolidating close-to-client service initiatives in the district, policies directed towards improving modern family planning method use need to consider the influence of formal education. Promoting basic education, especially among females, will be a crucial step as the district is faced with high levels of school dropout and illiteracy rates.

Introducing quality management into primary health care services in Uganda.

PubMed Central

Omaswa, F.; Burnham, G.; Baingana, G.; Mwebesa, H.; Morrow, R.

1997-01-01

In 1994, a national quality assurance programme was established in Uganda to strengthen district-level management of primary health care services. Within 18 months both objective and subjective improvements in the quality of services had been observed. In the examples documented here, there was a major reduction in maternal mortality among pregnant women referred to Jinja District Hospital, a reduction in waiting times and increased patient satisfaction at Masaka District Hospital, and a marked reduction in reported cases of measles in Arua District. Beyond these quantitative improvements, increased morale of district health team members, improved satisfaction among patients, and greater involvement of local government in the decisions of district health committees have been observed. At the central level, the increased coordination of activities has led to new guidelines for financial management and the procurement of supplies. District quality management workshops followed up by regular support visits from the Ministry of Health headquarters have led to a greater understanding by central staff of the issues faced at the district level. The quality assurance programme has also fostered improved coordination among national disease-control programmes. Difficulties encountered at the central level have included delays in carrying out district support visits and the failure to provide appropriate support. At the district level, some health teams tackled problems over which they had little control or which were overly complex; others lacked the management capacity for problem solving. PMID:9185368

Impact of a Dutch urban regeneration programme on mental health trends: a quasi-experimental study.

PubMed

Jongeneel-Grimen, Birthe; Droomers, Mariël; Kramer, Daniëlle; Bruggink, Jan-Willem; van Oers, Hans; Kunst, Anton E; Stronks, Karien

2016-10-01

This paper aims to assess the mental health impact of an urban regeneration programme implemented from 2008 onwards in the 40 most deprived districts in the Netherlands. Interventions varied from improvements in the built environment to activities promoting social cohesion. We accessed repeated cross-sectional data from the annual Health Interview Survey, for the period 2004-2011 among adults (n target districts=1445, n rest of the Netherlands=44 795). We used multilevel logistic regression models to compare the development of mental health in the target districts with the rest of the Netherlands and with comparably deprived districts. Results were presented as 'slope estimates' with corresponding 95% CIs. Finally, we analysed the trends by gender and by the intensity of the programme. The trend change in mental health between the intervention and preintervention period was approximately the same in the target districts as in broadly comparably deprived control districts (Δ slope 0.06 (-0.08 to 0.20)). However, among women, a tendency was found towards more positive trend changes in the target districts compared with control districts (Δ slope 0.17 (-0.01 to 0.34)). Those districts that implemented an intensive programme experienced an improvement in mental health, while residents of the comparably deprived control districts experienced a deterioration, resulting in a statistically significantly more positive trend change between the preintervention and intervention period in those target districts (Δ slope 0.19 (0.01 to 0.38)). Implementing an urban regeneration programme with a wide range of intensive interventions may be effective in promoting good mental health. Further research is required to examine which mix of interventions is needed for the programme to be effective. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Return on Educational Investment: 2014. A District-by-District Evaluation of U.S. Educational Productivity

ERIC Educational Resources Information Center

Boser, Ulrich

2014-01-01

In 2011, the Center of American Progress (CAP) released the first-ever attempt to evaluate the productivity of almost every major school district in the country. That project developed a set of relatively simple productivity metrics in order to measure the achievement that a school district produces relative to its spending, while controlling for…

Epidemiological Perspective of National Leprosy Eradication Programme in Maharashtra: Focusing on "Tribal Hot-spot" of Tribal District.

PubMed

Katkar, Dhananjay; Mote, Balu Natha; Adhav, Ambadas; Muthuvel, Thirumugam; Kadam, Suhas

2017-01-01

Leprosy or Hansen's disease, a chronic infectious disease caused by Mycobacterium leprae is a serious public health concern because of associated case load, morbidity and stigma attached to it. India achieved elimination of leprosy as a public health problem (prevalence rate [PR]<1 case/10,000 population) at the national level on January 1, 2006, still 19% districts in the country report PR more than one. In Maharashtra, it is found that very few districts within the state or very few pockets within the district are actually having leprosy burden. (1) Identification of region-wise actual "hot-spot" districts/pockets within state of Maharashtra.(2) Further drop-down below the district and block to tribal belt for understanding the actual high risk area/belt within the tribal districts. Secondary data analysis of leprosy patients registered in the State during the period 2008-2015. PR per 10,000 was found more in Vidharbha region followed by rest of Maharashtra and then Marathwada. Analysis showed that, there are tribal districts and tribal area within tribal districts which are having higher leprosy burden as compared to the all other districts indicating need of allocation of programme funds and facilities to these tribal belts for the effective control and elimination of leprosy. National Leprosy Eradication Programme should focus on tribal belt for effective control. Without giving extra attention to these tribal areas within high risk district/pockets efforts of eradication of leprosy by 2018 would be unrealistic and impractical.

77 FR 73392 - Revisions to the California State Implementation Plan, Monterey Bay Unified Air Pollution Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-10

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76 FR 56134 - Revisions to the California State Implementation Plan, San Joaquin Valley Unified Air Pollution...

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76 FR 59254 - Interim Final Determination To Stay and Defer Sanctions, San Joaquin Valley Unified Air Pollution...

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2011-09-26

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76 FR 53640 - Revisions to the California State Implementation Plan, San Joaquin Valley Unified Air Pollution...

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76 FR 17347 - Revision to the California State Implementation Plan, Great Basin Unified Air Pollution Control...

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2011-03-29

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75 FR 57862 - Revisions to the California State Implementation Plan, San Joaquin Valley Unified Air Pollution...

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77 FR 24857 - Interim Final Determination To Stay and Defer Sanctions, San Joaquin Valley Unified Air Pollution...

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75 FR 56942 - Revisions to the California State Implementation Plan, San Diego County Air Pollution Control...

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2010-09-17

... the California State Implementation Plan, San Diego County Air Pollution Control District AGENCY... the San Diego Air Pollution Control District (SDCAPCD) portion of the California State Implementation... to approve a local rule to regulate these emission sources under the Clean Air Act as amended in 1990...

The impact of area-based initiatives on physical activity trends in deprived areas; a quasi-experimental evaluation of the Dutch District Approach.

PubMed

Kramer, Daniëlle; Droomers, Mariël; Jongeneel-Grimen, Birthe; Wingen, Marleen; Stronks, Karien; Kunst, Anton E

2014-03-11

Numerous area-based initiatives (ABIs) have been implemented in deprived neighbourhoods across Europe. These large-scale initiatives aim to tackle the socio-economic and environmental problems in these areas that might influence physical activity (PA). There is little robust evidence of their impact on PA. This study aimed to assess the impact of a Dutch ABI called the District Approach on trends in leisure-time PA in deprived districts. Repeated cross-sectional data on 48401 adults across the Netherlands were obtained from the Integrated Survey on Household Living Conditions (POLS) 2004-2011. 1517 of these adults resided in deprived target districts and 46884 adults resided elsewhere in the Netherlands. In a quasi-experimental interrupted time-series design, multilevel logistic regression analyses were performed to assess trends in leisure-time walking, cycling, and sports before and during the intervention. Trends in deprived target districts were compared with trends in various control groups. The role of the intensity of environmental interventions was also assessed. Deprived target districts showed a significantly positive change in walking trend between the pre-intervention and intervention period. The trend change in the deprived target districts was significantly larger compared to the rest of the Netherlands, but not compared to other deprived districts. For cycling and sports, neither deprived districts nor control districts showed a significant trend change. For all leisure-time PA outcomes, trend changes were not related to the intensity of environmental interventions in the deprived target districts. Some evidence was found to suggest that ABIs like the District Approach have a positive impact on leisure-time PA in deprived districts, regardless of the intensity of environmental interventions.

The impact of area-based initiatives on physical activity trends in deprived areas; a quasi-experimental evaluation of the Dutch District Approach

PubMed Central

2014-01-01

Background Numerous area-based initiatives (ABIs) have been implemented in deprived neighbourhoods across Europe. These large-scale initiatives aim to tackle the socio-economic and environmental problems in these areas that might influence physical activity (PA). There is little robust evidence of their impact on PA. This study aimed to assess the impact of a Dutch ABI called the District Approach on trends in leisure-time PA in deprived districts. Methods Repeated cross-sectional data on 48401 adults across the Netherlands were obtained from the Integrated Survey on Household Living Conditions (POLS) 2004–2011. 1517 of these adults resided in deprived target districts and 46884 adults resided elsewhere in the Netherlands. In a quasi-experimental interrupted time-series design, multilevel logistic regression analyses were performed to assess trends in leisure-time walking, cycling, and sports before and during the intervention. Trends in deprived target districts were compared with trends in various control groups. The role of the intensity of environmental interventions was also assessed. Results Deprived target districts showed a significantly positive change in walking trend between the pre-intervention and intervention period. The trend change in the deprived target districts was significantly larger compared to the rest of the Netherlands, but not compared to other deprived districts. For cycling and sports, neither deprived districts nor control districts showed a significant trend change. For all leisure-time PA outcomes, trend changes were not related to the intensity of environmental interventions in the deprived target districts. Conclusion Some evidence was found to suggest that ABIs like the District Approach have a positive impact on leisure-time PA in deprived districts, regardless of the intensity of environmental interventions. PMID:24612770

Training pharmacy workers in recognition, management, and prevention of STDs: district-randomized controlled trial.

PubMed Central

Garcia, Patricia; Hughes, James; Carcamo, Cesar; Holmes, King K.

2003-01-01

OBJECTIVES: To determine the effectiveness of an intervention for pharmacy workers in improving their recognition and management of sexually transmitted disease (STD) syndromes. METHODS: We randomly selected 14 districts (total population nearly 4 million) from the 24 districts of low socioeconomic status in Lima, Peru. We randomly assigned paired districts to receive training and support for management and prevention of STDs or a control intervention about management of diarrhoea. The STD intervention included interactive luncheon seminars on recognition and management of four STD syndromes (urethral discharge, vaginal discharge, genital ulcers, and pelvic inflammatory disease) and STD/HIV prevention counselling; monthly pharmacy visits by "prevention salespersons" who distributed materials that included "STD/HIV prevention packets" containing information, condoms, and cards given to patients for referral of their sex partners; and workshops for physicians on managing patients with STD syndromes referred from pharmacies. Standardized simulated patients visited pharmacies in intervention and control districts at one, three, and six months after training to assess outcomes. FINDINGS: Standardized simulated patients reported significantly better recognition and management (appropriate antimicrobial regimens provided for discharge syndromes and referral to specially trained physicians for genital ulcers or pelvic inflammatory disease) by pharmacy workers of all four STD syndromes. They also reported significantly more frequent recommendations for use of condoms and treatment of partners at pharmacies in intervention districts than in control districts (by "intention-to-train" analyses, P<0.05 for 47/48 primary outcome comparisons). CONCLUSION: Training was feasible and effectively improved pharmacy workers' practices. PMID:14758407

A Handbook for School District Financial Management.

ERIC Educational Resources Information Center

Dembowski, Frederick L.

Designed for school business officials, this handbook provides research information and guidelines on school district banking and cash management systems. Section 1 gives an overview of district financial management operations, discussing the administrative framework, cash budgeting, information and control systems, collection and disbursement…

U.S. congressional district cancer death rates.

PubMed

Hao, Yongping; Ward, Elizabeth M; Jemal, Ahmedin; Pickle, Linda W; Thun, Michael J

2006-06-23

Geographic patterns of cancer death rates in the U.S. have customarily been presented by county or aggregated into state economic or health service areas. Herein, we present the geographic patterns of cancer death rates in the U.S. by congressional district. Many congressional districts do not follow state or county boundaries. However, counties are the smallest geographical units for which death rates are available. Thus, a method based on the hierarchical relationship of census geographic units was developed to estimate age-adjusted death rates for congressional districts using data obtained at county level. These rates may be useful in communicating to legislators and policy makers about the cancer burden and potential impact of cancer control in their jurisdictions. Mortality data were obtained from the National Center for Health Statistics (NCHS) for 1990-2001 for 50 states, the District of Columbia, and all counties. We computed annual average age-adjusted death rates for all cancer sites combined, the four major cancers (lung and bronchus, prostate, female breast, and colorectal cancer) and cervical cancer. Cancer death rates varied widely across congressional districts for all cancer sites combined, for the four major cancers, and for cervical cancer. When examined at the national level, broad patterns of mortality by sex, race and region were generally similar with those previously observed based on county and state economic area. We developed a method to generate cancer death rates by congressional district using county-level mortality data. Characterizing the cancer burden by congressional district may be useful in promoting cancer control and prevention programs, and persuading legislators to enact new cancer control programs and/or strengthening existing ones. The method can be applied to state legislative districts and other analyses that involve data aggregation from different geographic units.

U.S. congressional district cancer death rates

PubMed Central

Hao, Yongping; Ward, Elizabeth M; Jemal, Ahmedin; Pickle, Linda W; Thun, Michael J

2006-01-01

Background Geographic patterns of cancer death rates in the U.S. have customarily been presented by county or aggregated into state economic or health service areas. Herein, we present the geographic patterns of cancer death rates in the U.S. by congressional district. Many congressional districts do not follow state or county boundaries. However, counties are the smallest geographical units for which death rates are available. Thus, a method based on the hierarchical relationship of census geographic units was developed to estimate age-adjusted death rates for congressional districts using data obtained at county level. These rates may be useful in communicating to legislators and policy makers about the cancer burden and potential impact of cancer control in their jurisdictions. Results Mortality data were obtained from the National Center for Health Statistics (NCHS) for 1990–2001 for 50 states, the District of Columbia, and all counties. We computed annual average age-adjusted death rates for all cancer sites combined, the four major cancers (lung and bronchus, prostate, female breast, and colorectal cancer) and cervical cancer. Cancer death rates varied widely across congressional districts for all cancer sites combined, for the four major cancers, and for cervical cancer. When examined at the national level, broad patterns of mortality by sex, race and region were generally similar with those previously observed based on county and state economic area. Conclusion We developed a method to generate cancer death rates by congressional district using county-level mortality data. Characterizing the cancer burden by congressional district may be useful in promoting cancer control and prevention programs, and persuading legislators to enact new cancer control programs and/or strengthening existing ones. The method can be applied to state legislative districts and other analyses that involve data aggregation from different geographic units. PMID:16796732

Working conditions of bus drivers in the private sector and bus crashes in Kandy district, Sri Lanka: a case-control study.

PubMed

Jayatilleke, A U; Nakahara, S; Dharmaratne, S D; Jayatilleke, A C; Poudel, K C; Jimba, M

2009-04-01

To explore the effects of working conditions of private-bus drivers on bus crashes in Kandy district, Sri Lanka. A case-control study was carried out from August to September 2006. All private-bus drivers registered in Kandy district and involved in crashes reported to the police between November 2005 and April 2006 (n = 63) were selected as cases. Two control groups were included: private-bus drivers working on the same routes as the case drivers (n = 90) and private-bus drivers selected randomly from other routes of the district (n = 111). Data were collected using an anonymous self-administered questionnaire. Associations between working conditions and crashes were analysed using logistic regression. A strong association was observed between drivers' disagreements about working hours and bus crashes (matched controls, adjusted odds ratio (AOR) 5.98, 95% CI 1.02 to 34.90; unmatched controls, AOR 18.74, 95% CI 2.00 to 175.84). A significant association was also observed between low salaries (

California State Implementation Plan; San Diego County Air Pollution Control District; VOC Emissions from Polyester Resin Operations

EPA Pesticide Factsheets

EPA is taking final action to approve revisions to the San Diego County Air Pollution Control District (SDCAPCD) portion of the California SIP concerning volatile organic compound (VOC) emissions from polyester resin operations.

The interface between the national tuberculosis control programme and district hospitals in Cameroon: missed opportunities for strengthening the local health system -a multiple case study.

PubMed

Keugoung, Basile; Macq, Jean; Buve, Anne; Meli, Jean; Criel, Bart

2013-03-22

Tuberculosis remains a major public health problem in sub-Saharan Africa. District hospitals (DHs) play a central role in district-based health systems, and their relation with vertical programmes is very important. Studies on the impact of vertical programmes on DHs are rare. This study aims to fill this gap. Its purpose is to analyse the interaction between the National Tuberculosis Control Programme (NTCP) and DHs in Cameroon, especially its effects on the human resources, routine health information system (HIS) and technical capacity at the hospital level. We used a multiple case study methodology. From the Adamaoua Region, we selected two DHs, one public and one faith-based. We collected qualitative and quantitative data through document reviews, semi-structured interviews with district and regional staff, and observations in the two DHs. The NTCP trained and supervised staff, designed and provided tuberculosis data collection and reporting tools, and provided anti-tuberculosis drugs, reagents and microscopes to DHs. However, these interventions were limited to the hospital units designated as Tuberculosis Diagnostic and Treatment Centres and to staff dedicated to tuberculosis control activities. The NTCP installed a parallel HIS that bypassed the District Health Services. The DH that performs well in terms of general hospital care and that is well managed was successful in tuberculosis control. Based on the available resources, the two hospitals adapt the organisation of tuberculosis control to their settings. The management teams in charge of the District Health Services are not involved in tuberculosis control. In our study, we identified several opportunities to strengthen the local health system that have been missed by the NTCP and the health system managers. Well-managed DHs perform better in terms of tuberculosis control than DHs that are not well managed. The analysis of the effects of the NTCP on the human resources, HIS and technical capacity of DHs indicates that the NTCP supports, rather than strengthens, the local health system. Moreover, there is potential for this support to be enhanced. Positive synergies between the NTCP and district health systems can be achieved if opportunities to strengthen the district health system are seized. The question remains, however, of why managers do not take advantage of the opportunities to strengthen the health system.

The interface between the national tuberculosis control programme and district hospitals in Cameroon: missed opportunities for strengthening the local health system –a multiple case study

PubMed Central

2013-01-01

Background Tuberculosis remains a major public health problem in sub-Saharan Africa. District hospitals (DHs) play a central role in district-based health systems, and their relation with vertical programmes is very important. Studies on the impact of vertical programmes on DHs are rare. This study aims to fill this gap. Its purpose is to analyse the interaction between the National Tuberculosis Control Programme (NTCP) and DHs in Cameroon, especially its effects on the human resources, routine health information system (HIS) and technical capacity at the hospital level. Methods We used a multiple case study methodology. From the Adamaoua Region, we selected two DHs, one public and one faith-based. We collected qualitative and quantitative data through document reviews, semi-structured interviews with district and regional staff, and observations in the two DHs. Results The NTCP trained and supervised staff, designed and provided tuberculosis data collection and reporting tools, and provided anti-tuberculosis drugs, reagents and microscopes to DHs. However, these interventions were limited to the hospital units designated as Tuberculosis Diagnostic and Treatment Centres and to staff dedicated to tuberculosis control activities. The NTCP installed a parallel HIS that bypassed the District Health Services. The DH that performs well in terms of general hospital care and that is well managed was successful in tuberculosis control. Based on the available resources, the two hospitals adapt the organisation of tuberculosis control to their settings. The management teams in charge of the District Health Services are not involved in tuberculosis control. In our study, we identified several opportunities to strengthen the local health system that have been missed by the NTCP and the health system managers. Conclusion Well-managed DHs perform better in terms of tuberculosis control than DHs that are not well managed. The analysis of the effects of the NTCP on the human resources, HIS and technical capacity of DHs indicates that the NTCP supports, rather than strengthens, the local health system. Moreover, there is potential for this support to be enhanced. Positive synergies between the NTCP and district health systems can be achieved if opportunities to strengthen the district health system are seized. The question remains, however, of why managers do not take advantage of the opportunities to strengthen the health system. PMID:23521866

Puzzling Plans and Budgets: Making Sense of California's Second Year Local Control and Accountability Plans

ERIC Educational Resources Information Center

Chen, Theresa

2016-01-01

On July 1, 2013, Gov. Jerry Brown signed California's landmark Local Control Funding Formula (LCFF) into law. In addition to providing districts with greater control over how to spend funds, LCFF marked a tremendous opportunity for educational equity. The new funding law gave districts additional resources, called supplemental and concentration…

Folly Beach, South Carolina. Survey Report on Beach Erosion Control and Hurricane Protection.

DTIC Science & Technology

1980-03-28

ADAlI1 709 CORPS OF ENGINEERS CHARLESTON SC CHARLESTON DISTRICT F/G 13/2 MAR DFOLLY BEACH, SOUTH CAROLINA SURVEY REPORT ON BEACH EROSION CONT--ETCU...Army Corps of Engineers Charleston District P.O. Box 919, Charleston, S.C. 29402 _____________ S. PERFORMING ORGANIZATION NAME AND ADDRESS 10. PROGRAM...ELEMENT. PROJECT, TASK AREA & WORK UNIT NUMBERS U.S. Army Corps of Engineers Charleston District P.O. Box 919, Charleston, S.C. 29402 1t. CONTROLLING

78 FR 21581 - Revisions to the California State Implementation Plan, Antelope Valley Air Quality Management...

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...EPA is proposing to approve revisions to the Antelope Valley Air Quality Management District (AVAQMD), Monterey Bay Unified Air Pollution Control District (MBUAPCD) and Santa Barbara County Air Pollution Control District (SCAPCD) portions of the California State Implementation Plan (SIP). We are proposing to approve revisions local rules that address emission statements for AVAQMD, rule rescissions that address public records for MBUAPCD, and define terms for SBCAPCD, under the Clean Air Act as amended in 1990 (CAA or the Act).

California State Implementation Plan; Proposed Approval of Revisions; Northern Sonoma County Air Pollution Control District; Stationary Source Permits

EPA Pesticide Factsheets

EPA is proposing to approve revisions to the Northern Sonoma County Air Pollution Control District (NSCAPCD) portion of the California SIP concerning NSCAPCD's PSD permitting program for new and modified sources of air pollution.

40 CFR 52.242 - Disapproved rules and regulations.

Code of Federal Regulations, 2013 CFR

2013-07-01

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40 CFR 52.242 - Disapproved rules and regulations.

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2011-07-01

... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS California § 52.242 Disapproved rules and regulations. (a) The following Air Pollution Control District rules are disapproved because they do not meet... adopted on September 7, 2007. (2) Antelope Valley Air Pollution Control District. (i) Rule 118...

40 CFR 52.242 - Disapproved rules and regulations.

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2014-07-01

... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS California § 52.242 Disapproved rules and regulations. (a) The following Air Pollution Control District rules are disapproved because they do not meet... adopted on September 7, 2007. (2) Antelope Valley Air Pollution Control District. (i) Rule 118...

40 CFR 52.242 - Disapproved rules and regulations.

Code of Federal Regulations, 2012 CFR

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... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS California § 52.242 Disapproved rules and regulations. (a) The following Air Pollution Control District rules are disapproved because they do not meet... adopted on September 7, 2007. (2) Antelope Valley Air Pollution Control District. (i) Rule 118...

77 FR 66780 - Revisions to the California State Implementation Plan, South Coast Air Quality Management District

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CALIFORNIA'S FIRST AERATION PLANTS FOR CORROSION CONTROL

EPA Science Inventory

As required by the Lead and Copper Rule (LCR), Idyllwild Water District (IWD) and Pine Cove Water District (PCWD) conducted a sampling and testing program in 1993-1994. The program began with an evaluation of local household plumbing to identify 20 sites in each District which wo...

78 FR 65302 - Agency Information Collection Activities; Comment Request; Evaluation of a District Wide...

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...; Comment Request; Evaluation of a District Wide Implementation of a Professional Learning Community... Professional Learning Community Initiative. OMB Control Number: 1850--NEW. Type of Review: A new information... need for systematic information about district-wide implementation of professional learning communities...

40 CFR 52.228 - Regulations: Particulate matter, Southeast Desert Intrastate Region.

Code of Federal Regulations, 2012 CFR

2012-07-01

... AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS California... particulate matter in the Southeast Desert Intrastate Region. (1) Imperial County Air Pollution Control District: (i) Rule 114A. (ii) Rule 116B. (2) Los Angeles County Air Pollution Control District: (i...

40 CFR 52.228 - Regulations: Particulate matter, Southeast Desert Intrastate Region.

Code of Federal Regulations, 2014 CFR

2014-07-01

... AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS California... particulate matter in the Southeast Desert Intrastate Region. (1) Imperial County Air Pollution Control District: (i) Rule 114A. (ii) Rule 116B. (2) Los Angeles County Air Pollution Control District: (i...

40 CFR 52.236 - Rules and regulations.

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2011-07-01

...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS California § 52.236 Rules and regulations. (a) Since the following Air Pollution Control District (APCD) rules do not define the term “agricultural operations,” the... November 10, 1976. (b) The following Air Pollution Control District (APCD) rules are disapproved because...

40 CFR 52.228 - Regulations: Particulate matter, Southeast Desert Intrastate Region.

Code of Federal Regulations, 2013 CFR

2013-07-01

... AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS California... particulate matter in the Southeast Desert Intrastate Region. (1) Imperial County Air Pollution Control District: (i) Rule 114A. (ii) Rule 116B. (2) Los Angeles County Air Pollution Control District: (i...

40 CFR 52.236 - Rules and regulations.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS California § 52.236 Rules and regulations. (a) Since the following Air Pollution Control District (APCD) rules do not define the term “agricultural operations,” the... November 10, 1976. (b) The following Air Pollution Control District (APCD) rules are disapproved because...

40 CFR 52.236 - Rules and regulations.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS California § 52.236 Rules and regulations. (a) Since the following Air Pollution Control District (APCD) rules do not define the term “agricultural operations,” the... November 10, 1976. (b) The following Air Pollution Control District (APCD) rules are disapproved because...

75 FR 32293 - Revisions to the California State Implementation Plan, South Coast Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-08

... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... approve revisions to the South Coast Air Quality Management District (SCAQMD) portion of the California... submit regulations that control the primary and secondary National Ambient Air Quality Standards (NAAQS...

78 FR 25011 - Revisions to the California State Implementation Plan, Antelope Valley Air Quality Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-29

... the California State Implementation Plan, Antelope Valley Air Quality Management District, Santa Barbara County Air Pollution Control District, South Coast Air Quality Management District and Ventura... rule. SUMMARY: EPA is proposing to approve revisions to the Antelope Valley Air Quality Management...

78 FR 49925 - Revisions to California State Implementation Plan, Antelope Valley Air Quality Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-16

... California State Implementation Plan, Antelope Valley Air Quality Management District and Ventura County Air...: EPA is taking direct final action to approve revisions to the Antelope Valley Air Quality Air Management District (AVAQMD) and Ventura County Air Pollution Control District (VCAPCD) portions of the...

Discipline for Democracy? School Districts' Management of Conflict and Social Exclusion

ERIC Educational Resources Information Center

Bickmore, Kathy

2004-01-01

An examination of six urban Canadian school districts' policies and co-curricular programs for safe and inclusive schools shows contrasting implicit patterns of citizenship education. Peacekeeping-oriented districts relied heavily on standardized control and exclusion to achieve school safety and allocated few resources to affirming diversity.…

Energy Retrofit Creates an Efficient Building.

ERIC Educational Resources Information Center

Freeman, Laurie

1997-01-01

After 20 years of inadequate heating and cooling, an Indiana school district took advantage of a 1994 state law that allows school districts to bypass the "low-bidder wins" restriction. The district established a guaranteed energy-saving contract for a climate-control-improvements package to retrofit the junior-senior high school. (MLF)

Radio-Frequency Identification: Asset Control at Your Fingertips

ERIC Educational Resources Information Center

Scholes, Marcus

2009-01-01

Times are tough for everyone, including public school districts. During the past decade, school districts have faced the dual challenges of tightening budgets and increasing fiscal responsibility and oversight. Many school districts have found a way to manage their assets, reduce staff requirements, increase accountability, and save money on…

Got Risk? Using Risk Transfers to Control Costs

ERIC Educational Resources Information Center

Bambino, Robert

2010-01-01

For public school districts, risk financing is the financial outlay associated with litigation, such as settlements, verdicts, and the cost of legal defense. Even when districts purchase insurance to finance risk, a viable risk transfer program can still benefit districts in different ways: (1) Liability policies are generally experience-rated;…

Evaluating the electronic tuberculosis register surveillance system in Eden District, Western Cape, South Africa, 2015.

PubMed

Mlotshwa, Mandla; Smit, Sandra; Williams, Seymour; Reddy, Carl; Medina-Marino, Andrew

2017-01-01

Tuberculosis (TB) surveillance data are crucial to the effectiveness of National TB Control Programs. In South Africa, few surveillance system evaluations have been undertaken to provide a rigorous assessment of the platform from which the national and district health systems draws data to inform programs and policies. Evaluate the attributes of Eden District's TB surveillance system, Western Cape Province, South Africa. Data quality, sensitivity and positive predictive value were assessed using secondary data from 40,033 TB cases entered in Eden District's ETR.Net from 2007 to 2013, and 79 purposively selected TB Blue Cards (TBCs), a medical patient file and source document for data entered into ETR.Net. Simplicity, flexibility, acceptability, stability and usefulness of the ETR.Net were assessed qualitatively through interviews with TB nurses, information health officers, sub-district and district coordinators involved in the TB surveillance. TB surveillance system stakeholders report that Eden District's ETR.Net system was simple, acceptable, flexible and stable, and achieves its objective of informing TB control program, policies and activities. Data were less complete in the ETR.Net (66-100%) than in the TBCs (76-100%), and concordant for most variables except pre-treatment smear results, antiretroviral therapy (ART) and treatment outcome. The sensitivity of recorded variables in ETR.Net was 98% for gender, 97% for patient category, 93% for ART, 92% for treatment outcome and 90% for pre-treatment smear grading. Our results reveal that the system provides useful information to guide TB control program activities in Eden District. However, urgent attention is needed to address gaps in clinical recording on the TBC and data capturing into the ETR.Net system. We recommend continuous training and support of TB personnel involved with TB care, management and surveillance on TB data recording into the TBCs and ETR.Net as well as the implementation of a well-structured quality control and assurance system.

Use of structural geology in exploration for and mining of sedimentary rock-hosted Au deposits

USGS Publications Warehouse

Peters, Stephen G.

2001-01-01

Structural geology is an important component in regional-, district- and orebody-scale exploration and development of sedimentary rock-hosted Au deposits.Identification of timing of important structural events in an ore district allows analysis and classification of fluid conduits and construction of genetic models for ore formation.The most practical uses of structural geology deal with measurement and definition of various elements that comprise orebodies, which can then be directly applied to ore-reserve estimation,ground control,grade control, safety issues,and mine planning.District- and regional-scale structural studies are directly applicable to long-term strategic planning,economic analysis,and land ownership. Orebodies in sedimentary rock-hosted Au deposits are discrete, hypogene, epigenetic masses usually hosted in a fault zone,breccia mass, or lithologic bed or unit. These attributes allow structural geology to be directly applied to the mining and exploration of sedimentary rock-hosted Au deposits. Internal constituents in orebodies reflect unique episodes relating to ore formation.The main internal constituents in orebodies are ore minerals, gangue, and alteration minerals that usually are mixed with one another in complex patterns, the relations among which may be used to interpret the processes of orebody formation and control.Controls of orebody location and shape usually are due to structural dilatant zones caused by changes in attitude, splays, lithologic contacts,and intersections of the host conduit or unit.In addition,conceptual parameters such as district fabric,predictable distances, and stacking also are used to understand the geometry of orebodies.Controls in ore districts and location and geometry of orebodies in ore districts can be predicted to various degrees by using a number of qualitative concepts such as internal and external orebody plunges,district plunge, district stacking, conduit classification, geochemical, geobarometric and geothermal gradients, and tectonic warps. These concepts have practical and empirical application in most mining districts where they are of use in the exploration for ore, but are of such broad and general application that they may not represent known or inferred ore formation processes. Close spatial relation among some sedimentary rock- hosted Au deposits and their host structures suggests that the structures and the orebodies are genetically linked because they may have shared the same developmental history. Examples of probable syn-deformational genesis and structural control of sedimentary rock-hosted Au deposits are in the large Betze deposit in the Carlin trend, Nevada and in the Lannigou, Jinlongshan, and Maanqiao Au deposits, China.

Quality-Assurance/Quality-Control Manual for Collection and Analysis of Water-Quality Data in the Ohio District, US Geological Survey

USGS Publications Warehouse

Francy, D.S.; Jones, A.L.; Myers, Donna N.; Rowe, G.L.; Eberle, Michael; Sarver, K.M.

1998-01-01

The U.S. Geological Survey (USGS), Water Resources Division (WRD), requires that quality-assurance/quality-control (QA/QC) activities be included in any sampling and analysis program. Operational QA/QC procedures address local needs while incorporating national policies. Therefore, specific technical policies were established for all activities associated with water-quality project being done by the Ohio District. The policies described in this report provide Ohio District personnel, cooperating agencies, and others with a reference manual on QA/QC procedures that are followed in collecitng and analyzing water-quality samples and reporting water-quality information in the Ohio District. The project chief, project support staff, District Water-Quality Specialist, and District Laboratory Coordinator are all involved in planning and implementing QA/QC activities at the district level. The District Chief and other district-level managers provide oversight, and the Regional Water-Quality Specialist, Office of Water Quality (USGS headquarters), and the Branch of Quality Systems within the Office of Water Quality create national QA/QC polices and provide assistance to District personnel. In the literature, the quality of all measurement data is expressed in terms of precision, variability, bias, accuracy, completeness, representativeness, and comparability. In the Ohio District, bias and variability will be used to describe quality-control data generated from samples in the field and laboratory. Each project chief must plan for implementation and financing of QA/QC activities necessary to achieve data-quality objectives. At least 15 percent of the total project effort must be directed toward QA/QC activities. Of this total, 5-10 percent will be used for collection and analysis of quality-control samples. This is an absolute minimum, and more may be required based on project objectives. Proper techniques must be followed in the collection and processing of surface-water, ground-water, biological, precipitation, bed-sediment, bedload, suspended-sediment, and solid-phase samples. These techniques are briefly described in this report and are extensively documented. The reference documents listed in this report will be kept by the District librarian and District Water-Quality Specialist and updated regularly so that they are available to all District staff. Proper handling and documentation before, during, and after field activities are essential to ensure the integrity of the sample and to correct erroneous reporting of data results. Field sites are to be properly identified and entered into the data base before field data-collection activities begin. During field activities, field notes are to be completed and sample bottles appropriately labeled a nd stored. After field activities, all paperwork is to be completed promptly and samples transferred to the laboratory within allowable holding times. All equipment used by District personnel for the collection and processing of water-quality samples is to be properly operated, maintained, and calibrated by project personnel. This includes equipment for onsite measurement of water-quality characteristics (temperature, specific conductance, pH, dissolved oxygen, alkalinity, acidity, and turbidity) and equipment and instruments used for biological sampling. The District Water-Quality Specialist and District Laboratory Coordinator are responsible for preventive maintenance and calibration of equipment in the Ohio District laboratory. The USGS National Water Quality Laboratory in Arvada, Colo., is the primary source of analytical services for most project work done by the Ohio District. Analyses done at the Ohio District laboratory are usually those that must be completed within a few hours of sample collection. Contract laboratories or other USGS laboratories are sometimes used instead of the NWQL or the Ohio District laboratory. When a contract laboratory is used, the projec

40 CFR 52.245 - New Source Review rules.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS California §52.245 New Source Review rules. (a) Approval of the New Source Review rules for the San Joaquin Valley Unified Air Pollution Control District... Review rules for the San Joaquin Valley Unified Air Pollution Control District Rules 2020 and 2201 as...

78 FR 12267 - Revision of Air Quality Implementation Plan; California; Placer County Air Pollution Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-22

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2013-0094; FRL-9783-2] Revision of Air Quality Implementation Plan; California; Placer County Air Pollution Control District and Feather River Air Quality Management District; Stationary Source Permits AGENCY: Environmental Protection Agency...

76 FR 67369 - Revisions to the California State Implementation Plan, Joaquin Valley Unified Air Pollution...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-01

... the California State Implementation Plan, Joaquin Valley Unified Air Pollution Control District and Imperial County Air Pollution Control District AGENCY: Environmental Protection Agency (EPA). ACTION: Final rule. SUMMARY: EPA is finalizing approval of revisions to the San Joaquin Valley Unified Air Pollution...

78 FR 53680 - Revisions to the California State Implementation Plan, Placer, Santa Barbara and Ventura County...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-30

... the California State Implementation Plan, Placer, Santa Barbara and Ventura County Air Pollution... is taking direct final action to approve revisions to the Placer County Air Pollution Control District (PCAPCD), Santa Barbara County Air Pollution Control District (SBCAPCD) and Ventura County Air...

76 FR 45212 - Revisions to the California State Implementation Plan, San Joaquin Valley Unified Air Pollution...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-28

... the California State Implementation Plan, San Joaquin Valley Unified Air Pollution Control District... proposing to approve San Joaquin Valley Unified Air Pollution Control District (SJVUAPCD) Rule 3170... (CAA or Act). EPA is also proposing to approve SJVUAPCD's fee-equivalent program, which includes Rule...

A Preliminary Analysis of California's New Local Control Funding Formula

ERIC Educational Resources Information Center

Wolf, Rebecca; Sands, Janelle

2016-01-01

California recently overhauled its K-12 public education finance system. Enacted in 2013, the Local Control Funding Formula (LCFF) replaced California's 40-year-old funding formula. The LCFF increases district officials' fiscal flexibility; provides more resources to districts serving larger proportions of low-income, English learner (EL), and…

A Survey of Members of Congress about Drug Abuse in Their Districts. A Report of the Select Committee on Narcotics Abuse and Control. House of Representatives, Ninety-Eighth Congress, Second Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Select Committee on Narcotics Abuse and Control.

Members of the House of Representatives from 92 districts in 32 states, Puerto Rico, and the District of Columbia (21 percent) responded to a questionnaire soliciting information about the drug abuse situation in their congressional districts. Results from the questionnaire showed that over 96 percent of the respondents characterized drug abuse in…

76 FR 28944 - Revisions to the California State Implementation Plan, Placer County Air Pollution Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-19

...EPA is proposing a limited approval and limited disapproval of permitting rules submitted for the Placer County Air Pollution Control District (PCAPCD) and Feather River Air Quality Management District (FRAQMD) portion of the California State Implementation Plan (SIP). The districts are required under Part D of title I of the Clean Air Act (CAA) to adopt and implement a SIP-approved New Source Review (NSR) permit program. These rules update and revise the District's NSR permitting program for new and modified sources of air pollution. If EPA finalizes the limited approval and limited disapproval action, as proposed, then a sanctions clock would be triggered. We are taking comments on this proposal and plan to follow with a final action.

77 FR 26475 - Revisions to the California State Implementation Plan, Antelope Valley Air Quality Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-04

...EPA is proposing to approve revisions to the Antelope Valley Air Quality Management District (AVAQMD), Eastern Kern Air Pollution Control District (EKAPCD), and Santa Barbara County Air Pollution Control District (SBCAPCD) portions of the California State Implementation Plan (SIP). We are proposing to approve revisions to local rules that define terms used in other air pollution regulations in these areas and a rule rescission that address Petroleum Coke Calcining Operations--Oxides of Sulfur, under the Clean Air Act as amended in 1990 (CAA or the Act).

78 FR 21545 - Revisions to the California State Implementation Plan, Antelope Valley Air Quality Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-11

...EPA is taking direct final action to approve revisions to the Antelope Valley Air Quality Management District (AVAQMD) and Monterey Bay Unified Air Pollution Control District (MBUAPCD) and Santa Barbara County Air Pollution Control District (SBCAPCD) portions of the California State Implementation Plan (SIP). Under authority of the Clean Air Act as amended in 1990 (CAA or the Act), we are approving local rules that address emission statements for AVAQMD, rule rescissions that addresses public records for MBUAPCD, and define terms for SBCAPCD.

Preassessment Team Practices in Rural Settings: An Analysis of Team Activities.

ERIC Educational Resources Information Center

Ormsbee, Christine K.; Haring, Kathryn

A study in a small rural school district used district preassessment records of students referred for a comprehensive, special education evaluation to determine if preassessment practices had improved. The district was located in a midwestern state that mandated preassessment practices in the mid-1980s in an effort to control special education…

A Case Study of School District Consolidation

ERIC Educational Resources Information Center

Cronin, Joseph M.

2010-01-01

Several New England states have been rethinking the system whereby small towns make the key decisions about school budgets and staffing under the banner of local control. Maine already has mandated a reduction in the number of local school districts from 290 to 80, allowing localities to vote on the larger districts. This consolidation, unpopular…

Creating Technology Infrastructures in a Rural School District: A Partnership Approach.

ERIC Educational Resources Information Center

Jensen, Dennis

Rural schools face significant challenges in upgrading their technology infrastructures. Rural school districts tend to have older school buildings that have multiple problems and lack climate control, adequate space, and necessary wiring. In rural districts, it may be difficult to find the leadership and expertise needed to provide professional…

Intervention in Deficient School Districts: Re-Establishing Effective Local Control.

ERIC Educational Resources Information Center

Cooperman, Saul

In the wake of January 1988 takeover legislation to improve education in the State of New Jersey, this paper describes and justifies the strict state three-tier monitoring system of school district educational standards. School districts that need improvement after the first level of monitoring must develop an improvement plan to overcome their…

75 FR 14467 - Notice of Inventory Completion: Pierce College District, Lakewood, WA, and Thomas Burke Memorial...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-25

..., Pierce College District, 9401 Farwest Dr. SW, Lakewood, WA 98498, telephone (253) 912-3655, before April... DEPARTMENT OF THE INTERIOR National Park Service Notice of Inventory Completion: Pierce College... completion of an inventory of human remains in the control of the Pierce College District, Lakewood, WA, and...

[Comparative analysis of malaria detection ability of laboratories in Shanghai City from 2012 to 2015].

PubMed

Zhen-Yu, Wang; Li, Jiang; Yao-Guang, Zhang; Min, Zhu; Xiao-Ping, Zhang; Xiao-Jiang, Ma; Qian, Zhu; Yan-Yan, He; Shou-Fu, Jiang; Li, Cai

2017-02-27

To compare the application effects of three methods, namely microscopic examination, antigen detection (RDT) and nucleic acid test (PCR) in malaria detection between municipal and districts/counties centers for disease control and prevention in Shanghai, and analyze the malaria detection ability of the laboratories in Shanghai. The blood smears, whole blood samples, case review confirmation records and case data of malaria cases and suspected cases in Shanghai from 2012 to 2015 were collected by Shanghai Municipal Center for Disease Control and Prevention, and the detection results were analyzed and compared. A total of 212 samples with complete data were submitted by all districts (counties) in Shanghai from 2012 to 2015, the samples submitted by Jinshan Districts were the most (41.98%), and among the first diagnosis hospitals, those submitted by the tertiary hospitals were the most (82.07%). The submitted samples in the whole year were increased gradually from January to October. All the 212 samples were detected by three methods (the microscopic examination, RDT and PCR) in the laboratory of Shanghai Municipal Center for Disease Control and Prevention, and 167 were tested and confirmed comprehensively as positives, accounting for 78.77%, and 45 were confirmed as negatives, accounting for 21.23%. The samples were detected by the method of microscopy and domestic RDT in the laboratories of the centers for disease control and prevention at district/county level, totally 153 were tested as positives, accounting for 72.17%, 41 were unclassified, accounting for 19.34%, 53 were negative, accounting for 25.00%, and 6 were undetected, accounting for 2.83%. The coincidence of microscopic examination between the report hospitals and the centers for disease control and prevention at district/county level was 78.16%, and the coincidence between centers for disease control and prevention at district/county level and municipal level was 93.20%. The utilization rate of RDT in the laboratory of district/county level was 73.58%. The coincidence of RDT tests between those domestic and imported was 93.59%. Compared with the detection results by municipal center for disease control and prevention, 37 samples were misjudged by the laboratories of district/county level. Almost all (99.37%) of the confirmed malaria cases were imported overseas, including Africa (85.44%), Asia (13.92%) and America (0.63%). The surveillance after malaria elimination in Shanghai should be carried out by combining with different detection methods and resource integration.

McGee Creek Drainage and Levee District, Illinois.

DTIC Science & Technology

1973-04-01

J COUNTY MC GEE REEK DRAINAGE BLEVEE DISTRICT N~ i, 0. ~ I I LEGEND Co ,. 3 ~ . -~------~----EXISTING LEVEE _____________PROPOSED LEVEE...Development, Conservation, Environmental Protection Agency, Health, Institute for Environmental Quality, Mines and Minerals. Pollution Control Board...Protection Agency, Health, Institute for Environmental Quality, Mines and Minerals, Pollution Control Board, Registration and Education, Transportation

Local Control and Self-Determination: The San Juan Case.

ERIC Educational Resources Information Center

Garman, Keats; Jack, Donald

Rapidly increasing Navajo enrollment in San Juan County, Utah, public schools in the 1960's forced the rural school district to improve educational services to a sizable Navajo population while attempting to preserve local control in the face of changing Indian self-determination policy. The district implemented a Curriculum Development Center, a…

The Local Control Funding Formula: An Opportunity for Early Childhood & Dual Language Learners. Increasing Resources for Early Childhood through the Local Control Funding Formula: A Guide for Early Childhood Advocates

ERIC Educational Resources Information Center

Children Now, 2016

2016-01-01

According to the new Local Control Funding Formula (LCFF) law, most school districts in the state are responsible for using LCFF funds to improve outcomes for English language learners, also known as dual language learners. Each district has created a Local Control Accountability Plan (LCAP), the funding plan for LCFF. The LCAP is reviewed and…

The Local Control Funding Formula: An Opportunity for Early Childhood & Children in Foster Care. Increasing Resources for Early Childhood through the Local Control Funding Formula: A Guide for Early Childhood Advocates

ERIC Educational Resources Information Center

Children Now, 2016

2016-01-01

According to the new Local Control Funding Formula (LCFF) law, most school districts in California are responsible for using LCFF funds to improve outcomes for children in the foster care system. Each district has created a Local Control Accountability Plan (LCAP), the expenditure plan for LCFF. The LCAP is reviewed and revised annually by each…

Sharing resources to create a district drug formulary: a countywide controlled trial.

PubMed Central

Hill-Smith, I

1996-01-01

BACKGROUND: Creating a drug formulary takes considerable time, but merely adopting one lacks local perspective and ownership. Sharing resources between several practices treads a middle path between these extremes, but is it effective? AIM: The aim of the study was to audit the influence of a district primary care drug formulary on prescribing by general practitioners. METHOD: A controlled trial was carried out to compare prescribing by 50 general practitioners from 11 urban and semirural practices in south Bedfordshire that participated in creating a district drug formulary with prescribing by all other general practitioners in the county. RESULTS: The proportion of prescription items that were for drugs listed in the formulary rose significantly in three therapeutics groups: cardiovascular (by 7-12% above control practice values); musculoskeletal (by 1-11% above control practice values); and obstetrics and gynaecology (by 6-9% above control practice values). The number of items prescribed per prescribing unit fell significantly in three therapeutic groups: musculoskeletal (by 1-7% below control practice values); nervous (by 7-12% below control practice values); and nutrition and blood (by 15-21% below control practice values). The estimated saving resulting from the creation of the formulary was 150,000 pounds (3000 pounds per doctor) per year. CONCLUSIONS: Sharing resources between practices to create a district-wide primary care drug formulary can lead to changes in prescribing and reduce costs sustained over 3 years. PMID:8762741

Potential for Rabies Control through Dog Vaccination in Wildlife-Abundant Communities of Tanzania

PubMed Central

Fitzpatrick, Meagan C.; Hampson, Katie; Cleaveland, Sarah; Meyers, Lauren Ancel; Townsend, Jeffrey P.; Galvani, Alison P.

2012-01-01

Canine vaccination has been successful in controlling rabies in diverse settings worldwide. However, concerns remain that coverage levels which have previously been sufficient might be insufficient in systems where transmission occurs both between and within populations of domestic dogs and other carnivores. To evaluate the effectiveness of vaccination targeted at domestic dogs when wildlife also contributes to transmission, we applied a next-generation matrix model based on contract tracing data from the Ngorongoro and Serengeti Districts in northwest Tanzania. We calculated corresponding values of R 0, and determined, for policy purposes, the probabilities that various annual vaccination targets would control the disease, taking into account the empirical uncertainty in our field data. We found that transition rate estimates and corresponding probabilities of vaccination-based control indicate that rabies transmission in this region is driven by transmission within domestic dogs. Different patterns of rabies transmission between the two districts exist, with wildlife playing a more important part in Ngorongoro and leading to higher recommended coverage levels in that district. Nonetheless, our findings indicate that an annual dog vaccination campaign achieving the WHO-recommended target of 70% will control rabies in both districts with a high level of certainty. Our results support the feasibility of controlling rabies in Tanzania through dog vaccination. PMID:22928056

Changes in the burden of malaria following scale up of malaria control interventions in Mutasa District, Zimbabwe.

PubMed

Mharakurwa, Sungano; Mutambu, Susan L; Mberikunashe, Joseph; Thuma, Philip E; Moss, William J; Mason, Peter R

2013-07-01

To better understand trends in the burden of malaria and their temporal relationship to control activities, a survey was conducted to assess reported cases of malaria and malaria control activities in Mutasa District, Zimbabwe. Data on reported malaria cases were abstracted from available records at all three district hospitals, three rural hospitals and 25 rural health clinics in Mutasa District from 2003 to 2011. Malaria control interventions were scaled up through the support of the Roll Back Malaria Partnership, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and The President's Malaria Initiative. The recommended first-line treatment regimen changed from chloroquine or a combination of chloroquine plus sulphadoxine/pyrimethamine to artemisinin-based combination therapy, the latter adopted by 70%, 95% and 100% of health clinics by 2008, 2009 and 2010, respectively. Diagnostic capacity improved, with rapid diagnostic tests (RDTs) available in all health clinics by 2008. Vector control consisted of indoor residual spraying and distribution of long-lasting insecticidal nets. The number of reported malaria cases initially increased from levels in 2003 to a peak in 2008 but then declined 39% from 2008 to 2010. The proportion of suspected cases of malaria in older children and adults remained high, ranging from 75% to 80%. From 2008 to 2010, the number of RDT positive cases of malaria decreased 35% but the decrease was greater for children younger than five years of age (60%) compared to older children and adults (26%). The burden of malaria in Mutasa District decreased following the scale up of malaria control interventions. However, the persistent high number of cases in older children and adults highlights the need for strategies to identify locally effective control measures that target all age groups.

Education Research and the Shifting Landscape of the American School District, 1816 to 2016

ERIC Educational Resources Information Center

Gamson, David A.; Hodge, Emily M.

2016-01-01

Despite decades of critiques and scores of innovations designed to abolish or weaken it, the school district remains a central institution of the American educational system. Yet, although the district remains the primary agent of local democratic control and serves as the main unit for educational decisions, relatively little attention has been…

The Relationship between Student Transfers and District Academic Performance: Accounting for Feedback Effects

ERIC Educational Resources Information Center

Welsch, David M.; Zimmer, David M.

2015-01-01

This paper draws attention to a subtle, but concerning, empirical challenge common in panel data models that seek to estimate the relationship between student transfers and district academic performance. Specifically, if such models have a dynamic element, and if the estimator controls for unobserved traits by including district-level effects,…

Near Death Experience: Treating a Financially Ill School District.

ERIC Educational Resources Information Center

Miller, Norman

1994-01-01

After Proposition 13 passed in California, a series of 19 major bills imposed fiscal limits on the K-12 school system. One action is assigning a fiscal advisor to assume control in a district in financial distress. Lists the symptoms of a financially ill school district and highlights 24 items of a recovery plan. (MLF)

[Effect of comprehensive intervention on capacity in prevention and control of chronic diseases in community medical staff in Hangzhou].

PubMed

Liu, Qingmin; Liu, Bing; Ren, Yanjun; Cao, Chengjian; Lyu, Jun; Li, Liming

2015-11-01

To evaluate the effect of the Oxford Health Alliance-Community Interventions for Health on chronic diseases prevention and control capacity in community medical staff in Hangzhou. A two year comprehensive intervention on chronic disease prevention and control capacity was conducted in the medical staff in Xiacheng district and Gongshu district, Xihu district was used as control according to the study design principal of parallel comparison and non-random grouping. The intervention effect was evaluated with Cochran-Mantel-Haenszel test. A total of 985 questionnaires were completed in the baseline survey and 870 questionnaires were completed in the follow-up survey. After 2 year intervention, the detection rates of blood cholesterol, blood pressure and fasting blood glucose by community medical staff significantly increased compared with the rates before the intervention (χ² =7.97, P =0.05 ; χ² =27.21, P =0.00 ; χ² =21.32, P=0.00). While, in the control district, the fasting blood glucose detection rate increased from 25.37% to 31.19%, the differences showed statistical significance (χ² =15.29, P=0.00). The communication between community medical staff and patients about healthy diet pattern was improved after the intervention, the difference was statistical significant (χ² =8.64, P=0.03). However, no significant differences in communication about increasing physical activity and smoking cessation between community medical staff and patients was found before and after intervention both in intervention districts and in control district. Furthermore, multivariate logistic regression analysis indicated that the interventions on screening of common chronic diseases and management of chronic diseases patients were related with the detections of blood cholesterol, blood pressure and fasting blood glucose. Moreover, the intervention on counsel and suggestion for chronic disease prevention and control had some influence on the communication about chronic disease risk factors between community medical staff and patients. The intervention on chronic disease prevention and control capacity in community medical staff was effective to improve the detection of chronic diseases in community and the communication between the medical staff and patients.

Effects of Reservoir Characteristics on Malaria and its vector Abundance: A Case Study of the Bongo District of Ghana

NASA Astrophysics Data System (ADS)

Ofosu, E.; Awuah, E.; Annor, F. O.

2009-04-01

In the seven (7) administrative zones of the Bongo District of the Upper East Region of Ghana, the occurrences of malaria and relative abundance of the principal malaria vector, Anopheles species, were studied as a function of the presence and characteristics of reservoirs during the rainy season. Case studies in the sub-Sahara Africa indicate that malaria transmission may increase decrease or remain largely unchanged as a consequence of reservoir presence. Analysis made, shows that the distance from reservoir to settlement and surface area of reservoirs significantly affected adult Anopheles mosquito abundance. Percentage of inhabitants using insecticide treated nets, livestock population density, human population density and Anopheles mosquito abundance significantly affected the occurrence of malaria. The results suggest that vector control targeted at reservoir characteristics and larval control, and supplemented by high patronage of insecticide treated nets may be an effective approach for epidemic malaria control in the Bongo District. Key Words: Bongo District, Reservoir, Anopheles species, Malaria, Vector abundance.

Sandia National Laboratories, Tonopah Test Range Fire Control Bunker (Building 09-51): Photographs and Written Historical and Descriptive Data

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

Ullrich, Rebecca A.

The Fire Control Bunker (Building 09-51) is a contributing element to the Sandia National Laboratories (SNL) Tonopah Test Range (TTR) Historic District. The SNL TTR Historic District played a significant role in U.S. Cold War history in the areas of stockpile surveillance and non-nuclear field testing of nuclear weapons design. The district covers approximately 179,200 acres and illustrates Cold War development testing of nuclear weapons components and systems. This report includes historical information, architectural information, sources of information, project information, maps, blueprints, and photographs.

Evaluation of a community-based hypertension improvement program (ComHIP) in Ghana: data from a baseline survey.

PubMed

Lamptey, Peter; Laar, Amos; Adler, Alma J; Dirks, Rebecca; Caldwell, Aya; Prieto-Merino, David; Aerts, Ann; Pearce, Neil; Perel, Pablo

2017-04-28

Ghana faces an increasing burden of non-communicable disease with rates of hypertension estimated as high as 36% in adults. Despite these high rates, hypertension control remains very poor in Ghana (4%). The current project aims to implement and evaluate a community-based programme to raise awareness, and to improve treatment and control of hypertension in the Eastern Region of Ghana. In this paper, we present the findings of the baseline cross-sectional survey focusing on hypertension prevalence, awareness, treatment, and control. To evaluate the ComHIP project, a quasi-experimental design consisted of a before and after evaluations are being implemented in the intervention and comparison districts. A cohort study component is being implemented in the intervention district to assess hypertension control. Background anthropometric and clinical data collected as part of the baseline survey were analyzed in STATA Version 11. We examined the characteristics of individuals, associated with the baseline study outcomes using logistic regression models. We interviewed 2400 respondents (1200 each from the comparison and intervention districts), although final sample sizes after data cleaning were 1170 participants in the comparison district and 1167 in the intervention district. With the exception of ethnicity, the control and intervention districts compare favorably. Overall 32.4% of the study respondents were hypertensive (31.4% in the control site; and 33.4% in the intervention site); 46.2% of hypertensive individuals were aware of a previous diagnosis of hypertension (44.7% in the control site, and 47.7% in the intervention site), and only around 9% of these were being treated in either arm. Hypertension control was 1.3% overall (0.5% in the comparison site, and 2.1% in the intervention site). Age was a predictor of having hypertension, and so was increasing body mass index (BMI), waist, and hip circumferences. After adjusting for age, the risk factors with the greatest association with hypertension were being overweight (aOR = 2.30; 95% CI 1.53-3.46) or obese (aOR = 3.61; 95% CI 2.37-5.51). Older individuals were more likely to be aware of their hypertension status than younger people. After adjusting for age people with a family history of hypertension or CVD, or having an unhealthy waist hip ratio, were more likely to be aware of their hypertension status. The high burden of hypertension among the studied population, coupled with high awareness, yet very low level of hypertension treatment and control requires in-depth investigation of the bottlenecks to treatment and control. The low hypertension treatment and control rates despite current and previous general educational programs particularly in the intervention district, may suggest that such programs are not necessarily impactful on the health of the population.

Local Control Funding Formula in California: How to Monitor Progress and Learn from a Grand Experiment

ERIC Educational Resources Information Center

Fuller, Bruce; Tobben, Laura

2014-01-01

The Local Control Funding Formula (LCFF) was enacted by the California legislature in June 2013 and fundamentally changes the distribution of education dollars to districts. The legislation simplifies the formula for sending money to districts and now takes into account the higher costs of educating certain groups of students, specifically those…

Exploring Improvement Science in Education: Promoting College Access in Fresno Unified School District

ERIC Educational Resources Information Center

Aguilar, Jorge; Nayfack, Michelle; Bush-Mecenas, Susan

2017-01-01

California's Local Control Funding Formula (LCFF) requires districts to report multiple measures of student performance that reflect success in the goal of preparing students for college, career, and citizenship. As they engage in the Local Control Accountability Plan (LCAP) process, they are expected to use state and local indicator data from…

78 FR 66984 - Bureau of Political-Military Affairs; Statutory Debarment Under the Arms Export Control Act and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-07

... 11-01715-004-PHX-NVW; February 1987. (2) Rene Alexandre; March 16, 2013; U.S. District Court, Southern District of Texas; Case No. 7:12CR00626-S2-001; January 1983. (3) Jaime Ariel Amaya-Garcia; March...-NVW; October 1991. (5) Everardo Eleazar Avendano-Camacho; March 25, 2013; U.S. District Court...

77 FR 43414 - Bureau of Political-Military Affairs; Statutory Debarment Under the Arms Export Control Act and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-24

...-00233-001-PHX-FJM; October, 1976. (15) Juan Victorian Gimenez; March 21, 2012; U.S. District Court...; April, 1976. (2) Davoud Baniameri (aka Davoud Baniamery, David Baniameri, David Baniamery); August 12... Edwardo Cantu; March 21, 2012; U.S. District Court, Southern District of Texas; Case No. 7:11CR00686-S1...

7 CFR 610.3 - Assistance through conservation districts.

Code of Federal Regulations, 2011 CFR

2011-01-01

... controlled by local citizens. They provide the leadership and the program needed to meet the conservation... districts. (c) The practical experience of land users is combined with the scientific knowledge and skills...

Effect of supportive supervision on routine immunization service delivery-a randomized post-test study in Odisha.

PubMed

Som, Meena; Panda, Bhuputra; Pati, Sanghamitra; Nallala, Srinivas; Anasuya, Anita; Chauhan, Abhimanyu Singh; Sen, Ashish Kumar; Zodpey, Sanjay

2014-06-30

Routine immunization is a key child survival intervention. Issues related to quality of service delivery pose operational challenges in delivering effective immunization services. Accumulated evidences suggest that "supportive supervision" improves the quality of health care services. During 2009-10, Govt. of Odisha (GoO) and UNICEF jointly piloted this strategy in four districts to improve routine immunization. The present study aims to assess the effect of supportive supervision strategy on improvement of knowledge and practices on routine immunization among service providers. We adopted a 'post-test only' study design to compare the knowledge and practices of frontline health workers and their supervisors in four intervention districts with that of two control districts. Altogether we interviewed 170 supervisors and supervisees (health workers), each, using semi-structured interview schedules. We also directly observed 25 ice lined refrigerator (ILR) points in both groups of districts. The findings were compared with the baseline information, available only for the intervention districts. The health workers in the intervention districts displayed a higher knowledge score in selected items than in the control group. No significant difference in knowledge was observed between control and intervention supervisors. The management practices at ILR points on key routine immunization components were found to have improved significantly in intervention districts. The observed improvements in the ILR management practices indicate positive influence of supportive supervision. Higher level of domain knowledge among intervention health workers on specific items related to routine immunization could be due to successful transfer of knowledge from supervisors. A 'pre-post' study design should be undertaken to gain insights into the effectiveness of supportive supervision in improving routine immunization services.

Integration of multi-source and multi-scale datasets for 3D structural modeling for subsurface exploration targeting, Luanchuan Mo-polymetallic district, China

NASA Astrophysics Data System (ADS)

Wang, Gongwen; Ma, Zhenbo; Li, Ruixi; Song, Yaowu; Qu, Jianan; Zhang, Shouting; Yan, Changhai; Han, Jiangwei

2017-04-01

In this paper, multi-source (geophysical, geochemical, geological and remote sensing) datasets were used to construct multi-scale (district-, deposit-, and orebody-scale) 3D geological models and extract 3D exploration criteria for subsurface Mo-polymetallic exploration targeting in the Luanchuan district in China. The results indicate that (i) a series of region-/district-scale NW-trending thrusts controlled main Mo-polymetallic forming, and they were formed by regional Indosinian Qinling orogenic events, the secondary NW-trending district-scale folds and NE-trending faults and the intrusive stock structure are produced based on thrust structure in Caledonian-Indosinian orogenic events; they are ore-bearing zones and ore-forming structures; (ii) the NW-trending district-scale and NE-trending deposit-scale normal faults were crossed and controlled by the Jurassic granite stocks in 3D space, they are associated with the magma-skarn Mo polymetallic mineralization (the 3D buffer distance of ore-forming granite stocks is 600 m) and the NW-trending hydrothermal Pb-Zn deposits which are surrounded by the Jurassic granite stocks and constrained by NW-trending or NE-trending faults (the 3D buffer distance of ore-forming fault is 700 m); and (iii) nine Mo polymetallic and four Pb-Zn targets were identified in the subsurface of the Luanchuan district.

Trends in Segregation of Hispanic Students in Major School Districts Having Large Hispanic Enrollment. Ethnographic Case Studies, Volume II. Final Report.

ERIC Educational Resources Information Center

Aspira, Inc., New York, NY.

School desegregation did not lead to greater understanding of the Hispanic community by white educational personnel in two school districts analyzed to document the desegregation process and the impact of school desegregation on the Hispanic community. Each district was in a white-controlled, tri-ethnic community in its second year of successful…

Using pathology-specific laboratory profiles in Clinical Pathology to reduce inappropriate test requesting: two completed audit cycles

PubMed Central

2012-01-01

Background Systematic reviews have shown that, although well prepared, the Consensus Guidelines have failed to change clinical practice. In the healthcare district of Castelnovo né Monti (Reggio Emilia, Italy), it became necessary for the GPs and Clinical Pathologists to work together to jointly define laboratory profiles. Methods Observational study with two cycles of retrospective audit on test request forms, in a primary care setting. Objectives of the study were to develop pathology-specific laboratory profiles and to increase the number of provisional diagnoses on laboratory test request forms. A Multiprofessional Multidisciplinary Inter-hospital Work Team developed pathology-specific laboratory profiles for more effective test requesting. After 8 training sessions that used a combined strategy with multifaceted interventions, the 23 General Practitioners (GPs) in the trial district (Castelnovo nè Monti) tested the profiles; the 21 GPs in the Puianello district were the control group; all GPs in both districts participated in the trial. All laboratory tests for both healthcare districts are performed at the Laboratory located in the trial district. A baseline and a 1-year audit were performed in both districts on the GPs’ request forms. Results Seven pathology-specific laboratory profiles for outpatients were developed. In the year after the first audit cycle: 1) the number of tests requested in the trial district was distinctly lower than that in the previous year, with a decrease of about 5% (p < 0.001); 2) the provisional diagnosis on the request forms was 52.8% in the trial district and 42% in the control district (P < 0.001); 3) the decrease of the number of tests on each request form was much more marked in the trial district (8.73 vs. 10.77; p < 0.001). Conclusions The first audit cycle showed a significant decrease in the number of tests ordered only in the trial district. The combined strategy used in this study improved the prescriptive compliance of most of the GPs involved. The presence of the clinical pathologist is seen as an added value. PMID:22759353

Using pathology-specific laboratory profiles in clinical pathology to reduce inappropriate test requesting: two completed audit cycles.

PubMed

Baricchi, Roberto; Zini, Michele; Nibali, Maria Grazia; Vezzosi, Walter; Insegnante, Vincenzo; Manfuso, Clotilde; Polese, Alessandra; Costoli, Valmer; Spelti, Antonio; Formisano, Debora; Orlandini, Danilo; Nicolini, Fausto; Poli, Antonio

2012-07-03

Systematic reviews have shown that, although well prepared, the Consensus Guidelines have failed to change clinical practice. In the healthcare district of Castelnovo né Monti (Reggio Emilia, Italy), it became necessary for the GPs and Clinical Pathologists to work together to jointly define laboratory profiles. Observational study with two cycles of retrospective audit on test request forms, in a primary care setting. Objectives of the study were to develop pathology-specific laboratory profiles and to increase the number of provisional diagnoses on laboratory test request forms. A Multiprofessional Multidisciplinary Inter-hospital Work Team developed pathology-specific laboratory profiles for more effective test requesting. After 8 training sessions that used a combined strategy with multifaceted interventions, the 23 General Practitioners (GPs) in the trial district (Castelnovo nè Monti) tested the profiles; the 21 GPs in the Puianello district were the control group; all GPs in both districts participated in the trial. All laboratory tests for both healthcare districts are performed at the Laboratory located in the trial district. A baseline and a 1-year audit were performed in both districts on the GPs' request forms. Seven pathology-specific laboratory profiles for outpatients were developed. In the year after the first audit cycle: 1) the number of tests requested in the trial district was distinctly lower than that in the previous year, with a decrease of about 5% (p < 0.001); 2) the provisional diagnosis on the request forms was 52.8% in the trial district and 42% in the control district (P < 0.001); 3) the decrease of the number of tests on each request form was much more marked in the trial district (8.73 vs. 10.77; p < 0.001). The first audit cycle showed a significant decrease in the number of tests ordered only in the trial district. The combined strategy used in this study improved the prescriptive compliance of most of the GPs involved. The presence of the clinical pathologist is seen as an added value.

A large Legionnaires' disease outbreak in Pamplona, Spain: early detection, rapid control and no case fatality

PubMed Central

CASTILLA, J.; BARRICARTE, A.; ALDAZ, J.; GARCÍA CENOZ, M.; FERRER, T.; PELAZ, C.; PINEDA, S.; BALADRÓN, B.; MARTÍN, I.; GOÑI, B.; ARATAJO, P.; CHAMORRO, J.; LAMEIRO, F.; TORROBA, L.; DORRONSORO, I.; MARTÍNEZ-ARTOLA, V.; ESPARZA, M. J.; GASTAMINZA, M. A.; FRAILE, P.; ALDAZ, P.

2008-01-01

SUMMARY An outbreak of Legionnaire's disease was detected in Pamplona, Spain, on 1 June 2006. Patients with pneumonia were tested to detect Legionella pneumophila antigen in urine (Binax Now; Binax Inc., Scarborough, ME, USA), and all 146 confirmed cases were interviewed. The outbreak was related to district 2 (22 012 inhabitants), where 45% of the cases lived and 50% had visited; 5% lived in neighbouring districts. The highest incidence was found in the resident population of district 2 (3/1000 inhabitants), section 2 (14/1000). All 31 cooling towers of district 2 were analysed. L. pneumophila antigen (Binax Now) was detected in four towers, which were closed on 2 June. Only the strain isolated in a tower situated in section 2 of district 2 matched all five clinical isolates, as assessed by mAb and two genotyping methods, AFLP and PFGE. Eight days after closing the towers, new cases ceased appearing. Early detection and rapid coordinated medical and environmental actions permitted immediate control of the outbreak and probably contributed to the null case fatality. PMID:17662166

Malaria in Wanokaka and Loli sub-districts, West Sumba District, East Nusa Tenggara Province, Indonesia.

PubMed

Syafruddin, Din; Asih, Puji B S; Coutrier, Farah N; Trianty, Leily; Noviyanti, Rintis; Luase, Yaveth; Sumarto, Wajiyo; Caley, Marten; van der Ven, Andre J A M; Sauerwein, Robert W

2006-05-01

Malaria has long been known as one of the major public health problems in West Sumba District, East Nusa Tenggara Province, Indonesia. To obtain baseline data for establishment of a suitable malaria control program in the area, malariometric surveys were conducted in two sub-districts, Wanokaka and Loli, during the periods of January, May, and August 2005. The survey included three selected villages in each sub-district, and blood smear analyses of 701, 921, and 894 randomly selected subjects in January, May, and August revealed 30.5%, 25.3%, and 28.2% malaria positives, respectively, consisting mainly of Plasmodium falciparum and P. vivax, and in a few cases, P. malariae. Analysis of malaria prevalence at different age groups clearly reflected the common phenomenon that younger individuals are more vulnerable by infection of either P. falciparum or P. vivax. In falciparum malaria, the frequency of cases carrying gametocytes was also relatively high involving all age groups. The findings indicate that the malaria incidence and transmission in the area are relatively high and that further exploration is warranted to establish a precise malaria control program.

A large Legionnaires' disease outbreak in Pamplona, Spain: early detection, rapid control and no case fatality.

PubMed

Castilla, J; Barricarte, A; Aldaz, J; García Cenoz, M; Ferrer, T; Pelaz, C; Pineda, S; Baladrón, B; Martín, I; Goñi, B; Aratajo, P; Chamorro, J; Lameiro, F; Torroba, L; Dorronsoro, I; Martínez-Artola, V; Esparza, M J; Gastaminza, M A; Fraile, P; Aldaz, P

2008-06-01

An outbreak of Legionnaire's disease was detected in Pamplona, Spain, on 1 June 2006. Patients with pneumonia were tested to detect Legionella pneumophila antigen in urine (Binax Now; Binax Inc., Scarborough, ME, USA), and all 146 confirmed cases were interviewed. The outbreak was related to district 2 (22 012 inhabitants), where 45% of the cases lived and 50% had visited; 5% lived in neighbouring districts. The highest incidence was found in the resident population of district 2 (3/1000 inhabitants), section 2 (14/1000). All 31 cooling towers of district 2 were analysed. L. pneumophila antigen (Binax Now) was detected in four towers, which were closed on 2 June. Only the strain isolated in a tower situated in section 2 of district 2 matched all five clinical isolates, as assessed by mAb and two genotyping methods, AFLP and PFGE. Eight days after closing the towers, new cases ceased appearing. Early detection and rapid coordinated medical and environmental actions permitted immediate control of the outbreak and probably contributed to the null case fatality.

State and district policy influences on district-wide elementary and middle school physical education practices.

PubMed

Chriqui, Jamie F; Eyler, Amy; Carnoske, Cheryl; Slater, Sandy

2013-01-01

To examine the influence of state laws and district policies on district-wide elementary school and middle school practices related to physical education (PE) time and the percentage of moderate-to-vigorous physical activity (MVPA) time during PE. Multivariate, cross-sectional analysis of state laws, district wellness and PE policies, and district PE practices for school year 2010-2011 controlling for district-level urbanicity, region, size, race/ethnicity of students, and socioeconomic status and clustered on state. One hundred ninety-five public school districts located in 42 states. District-level PE coordinators for the included districts who responded to an online survey. Minutes and days of PE per week and percent time spent in MVPA during PE time. District PE coordinators reported significantly less PE time than national standards-82.9 and 189.6 minutes at the elementary school and middle school levels, respectively. Physical education was provided an average of 2.5 and 3.7 days per week, respectively; and the percentage of MVPA time in PE was 64.4% and 65.7%, respectively. At the elementary school level, districts in either states with laws governing PE time or in a state and district with a law/policy reported significantly more days of PE (0.63 and 0.67 additional days, respectively), and districts in states with PE time laws reported 18 more minutes of PE per week. At the middle school level, state laws were associated with 0.73 more days of PE per week. Neither state laws nor district policies were positively associated with percent MVPA time in PE. State laws and district policies can influence district-level PE practices-particularly those governing the frequency and duration of PE-although opportunities exist to strengthen PE-related laws, policies, and practices.

Environmental Assessment for Routine Basewide Military-Sponsored Training Exercises, Edwards Air Force Base, California

DTIC Science & Technology

2007-02-01

control AVAQMD Antelope Valley Air Quality Management District AQMD Air Quality Management Districts BACT Best Available Control Technology BLM Bureau...Aeronautics NAGPRA Native American Graves Protection and Repatriation Act NASA National Aeronautics and Space Administration NBCC nuclear, biological...support of the National Aeronautics and Space Administration ( NASA ) shuttle program is required to be maintained. This includes rescue, medical evaluation

Public private mix model in enhancing tuberculosis case detection in District Thatta, Sindh, Pakistan.

PubMed

Ahmed, Jameel; Ahmed, Mubashir; Laghari, A; Lohana, Wasdev; Ali, Sajid; Fatmi, Zafar

2009-02-01

To enhance the TB case detection through Public Private Mix (PPM) model by involving private practitioners in collaboration with National TB Control Program, (NTP) in district Thatta. Private practitioners (PPs) of district Thatta involved in treatment of TB cases were requested to participate in the study. All consenting physicians were provided with training on Directly Observed Treatment Short course (DOTS) module. In addition to routine cases, TB cases diagnosed by private practitioners through sputum microscopy were also registered with the district TB control program and medicines were provided by NTP. After intervention of PPM-DOTS change in Case Detection Rate (CDR) were estimated. An increased number of sputum smear positive cases were found in the intervention period--the third quarter of 2007, from 188 to 211 and CDR from 69% to 77%. The improvement in case detection rate was significant as this moderately added to the total number of cases detected from the whole of the district Thatta during the study period. Public private mix (PPM) model was effective in increasing the CDR of TB cases in district Thatta. It is recommended that the public private partnership model in Tuberculosis case detection needs to be taken on a larger scale so as to reduce the heavy TB burden in the country.

Analysis of respirable particulate exposure and its effect to public health around lead smelter and e-waste processing industry in West Java, Indonesia

NASA Astrophysics Data System (ADS)

Marselina, M.; Roosmini, D.; Salami, I. R. S.; Ayu A, M.; Cahyadi, W.

2016-03-01

Respirable particulate exposure strongly affects human health, especially for children who lived around industrial area. This study was conducted to evaluate the effect of respirable particulate exposure to lung capacity of children. Study location in this study was Parung Panjang District, area of lead smelter industry and also in Astana Anyar District, area of e-waste processing industry. Thirty children were involved in Astana Anyar District and also thirty children in Parung Panjang District. The control groups were also studied in both areas. Predicted average daily intake (ADD) of respirable particulate was estimated and lung or respiration condition of children was measured by using spirometer. The lung condition of respondents was estimated by FEV1.0 and FVC values. As the result, the predicted ADD of children in lead smelter area is 3 times higher than the predicted ADD of children in e-waste processing area. It was correlated positively with the higher PM2.5 concentration in Parung Panjang District than the PM2.5 concentration in Astana Anyar District. Metals concentration in Parung Panjang was also measured with X-Ray Fluorescence (XRF) in this study and it was clearly state that metals concentration in location study were higher than metals concentration in control area.

Smoking Patterns in Oregon Youth: Effects of Funding and Defunding of a Comprehensive State Tobacco Control Program

PubMed Central

Pizacani, Barbara A.; Dent, Clyde W.; Maher, Julie E.; Rohde, Kristen; Stark, Michael J.; Biglan, Anthony; Thompson, Jill

2014-01-01

Purpose Comprehensive tobacco control programs have included school-based prevention programs as a key strategy to reach adolescents. Unfortunately, these programs have undergone extensive budget reductions in recent years. In 2003, funding for the Oregon Tobacco Prevention and Education Program was reduced by about 70%, and the school component was entirely defunded. To assess the effects of program funding and subsequent defunding on smoking prevalence within targeted Oregon schools, we compared the change in 30-day smoking prevalence between grades 8 and 11 in school districts in two periods: namely, during funding and after funding was eliminated. Methods We used annual school-based survey data for grades 8 and 11 to describe district-level changes in smoking prevalence in five age cohorts: two during the funding period and three after defunding. Each cohort was comprised of districts whose 8th-graders completed the survey and participated again 3 years later. Using mixed models, we compared the change in 30-day adjusted smoking prevalence among cohorts in funded districts, defunded districts, and districts that never received funding. Results Smoking prevalence growth was significantly higher among cohorts from the defunded period than for cohorts from the funded period (p = .04) and was not significantly different from schools that were never-funded (p = .79). Conclusions In Oregon, funding a school component of a comprehensive tobacco control strategy was associated with depressed uptake of smoking. Gains were quickly lost upon program defunding. School programs are an important strategy if they are long term, comprehensive, and reinforced in the larger environment. PMID:19237108

Interventions for hiring, retaining and training district health systems managers in low- and middle-income countries.

PubMed

Rockers, Peter C; Bärnighausen, Till

2013-04-30

District managers are playing an increasingly important role in determining the performance of health systems in low- and middle-income countries as a result of decentralization. To assess the effectiveness of interventions to hire, retain and train district health systems managers in low- and middle-income countries. We searched a wide range of international databases, including the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. We also searched online resources of international agencies, including the World Bank, to find relevant grey literature. Searches were conducted in December 2011. District health systems managers are those persons who are responsible for overseeing the operations of the health system within a defined, subnational geographical area that is designated as a district. Hiring and retention interventions include those that aim to increase the attractiveness of district management positions, as well as those related to hiring and retention processes, such as private contracting. Training interventions include education programs to develop future managers and on-the-job training programs for current managers. To be included, studies needed to use one of the following study designs: randomized controlled trial, nonrandomized controlled trial, controlled before-and-after study, and interrupted time series analysis. We report measures of effect in the same way that the primary study authors have reported them. Due to the varied nature of interventions included in this review we could not pool data across studies. Two studies met our inclusion criteria. The findings of one study conducted in Cambodia provide low quality evidence that private contracts with international nongovernmental organizations (NGOs) for district health systems management ('contracting-in') may improve health care access and utilization. Contracting-in increased use of antenatal care by 28% and use of public facilities by 14%. However, contracting-in was not found to have an effect on population health outcomes. The findings of the other study provide low quality evidence that intermittent training courses over 18 months may improve district health system managers' performance. In three countries in Latin America, managers who did not receive the intermittent training courses had between 2.4 and 8.3 times more management deficiencies than managers who received the training courses. No studies that aimed to investigate interventions for retaining district health systems managers met our study selection criteria for inclusion in this review. There is low quality evidence that contracting-in may improve health care accessibility and utilization and that intermittent training courses may improve district health systems managers' performance. More evidence is required before firm conclusions can be drawn regarding the effectiveness of these interventions in diverse settings. Other interventions that might be promising candidates for hiring and retaining (e.g., government regulations, professional support programs) as well as training district health systems managers (e.g., in-service workshops with on-site support) have not been adequately investigated.

Implementation of the Mental Health Services Act--Public Law 98-621. Oversight Hearing before the Subcommittee on Fiscal Affairs and Health of the Committee on the District of Columbia. House of Representatives, Ninety-Ninth Congress, Second Session on the Assumption of Selected Functions, Programs, and Resources of St. Elizabeths Hospital by the District of Columbia.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Committee on the District of Columbia.

This document contains the text of a Congressional oversight hearing on Public Law 98-621, the St. Elizabeths Hospital and District of Columbia Mental Health Services Act, which became law in November 1984 and which transferred St. Elizabeths Hospital from federal control to that of the government of the District of Columbia. The text of Public…

77 FR 47581 - Revisions to the California State Implementation Plan, Mojave Desert, Northern Sierra, Sacramento...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-09

...EPA is proposing to approve revisions to the Mojave Desert Air Quality Management District (MDAQMD), Northern Sierra Air Quality Management District (NSAQMD), Sacramento Metropolitan Air Quality Management District (SMAQMD) and San Diego County Air Pollution Control District (SDCAPCD) portions of the California State Implementation Plan (SIP). These revisions concern volatile organic compound (VOC) emissions from automotive parts and component, automobile refinishing, metal parts and products, and miscellaneous coating and refinishing operations. We are proposing to approve local rules to regulate these emission sources under the Clean Air Act as amended in 1990 (CAA or the Act).

Implementation strategies to increase access and demand of long-lasting insecticidal nets: a before-and-after study and scale-up process in Mozambique.

PubMed

Arroz, Jorge A H; Mendis, Chandana; Pinto, Liliana; Candrinho, Baltazar; Pinto, João; Martins, Maria do Rosário O

2017-10-25

The universal coverage bed nets campaign is a proven health intervention promoting increased access, ownership, and use of bed nets to reduce malaria burden. This article describes the intervention and implementation strategies that Mozambique carried out recently in order to improve access and increase demand for long-lasting insecticidal nets (LLINs). A before-and-after study with a control group was used during Stage I of the implementation process. The following strategies were tested in Stage I: (1) use of coupons during household registration; (2) use of stickers to identify the registered households; (3) new LLIN ascription formula (one LLIN for every two people). In Stage II, the following additional strategies were implemented: (4) mapping and micro-planning; (5) training; and (6) supervision. Odds ratio (OR) and 95% confidence interval (CI) were used to compare and establish differences between intervened and control districts in Stage I. Main outcomes were: percentage of LLINs distributed, percentage of target households benefited. In Stage I, 87.8% (302,648) of planned LLINs were distributed in the intervention districts compared to 77.1% (219,613) in the control districts [OR: 2.14 (95% CI 2.11-2.16)]. Stage I results also showed that 80.6% (110,453) of households received at least one LLIN in the intervention districts compared to 72.8% (87,636) in the control districts [OR: 1.56 (95% CI 1.53-1.59)]. In Stage II, 98.4% (3,536,839) of the allocated LLINs were delivered, covering 98.6% (1,353,827) of the registered households. Stage I results achieved better LLINs and household coverage in districts with the newly implemented strategies. The results of stage II were also encouraging. Additional strategies adaptation is required for a wide-country LLIN campaign.

Determinants of malaria infection in Dembia district, Northwest Ethiopia: a case-control study.

PubMed

Agegnehu, Fisseha; Shimeka, Alemayehu; Berihun, Firnus; Tamir, Melkamu

2018-04-11

Despite the progress in reducing malaria infections and related deaths, the disease remains a major global public health problem. The problem is among the top five leading causes of outpatient visits in Dembia district of the northwest Ethiopia. Therefore, this study aimed to assess the determinants of malaria infections in the district. An institution-based case-control study was conducted in Dembia district from October to November 2016. Out of the ten health centers in the district, four were randomly selected for the study in which 370 participants (185 cases and 185 controls) were enrolled. Data were collected using a pretested structured questionnaire. Factors associated with malaria infections were determined using logistic regression analysis. Odds ratio with 95% CI was used as a measure of association, and variables with a p-value of ≤0.05 were considered as statistically significant. The median age of all participants was 26 years, while that of cases and controls was 22 and 30 with a range of 1 to 80 and 2 to 71, respectively. In the multivariable logistic regression, over 15 years of age adjusted odds ratio(AOR) and confidence interval (CI) of (AOR = 18; 95% CI: 2.1, 161.5), being male (AOR = 2.2; 95% CI: 1.2, 3.9), outdoor activities at night (AOR = 5.7; 95% CI: 2.5, 12.7), bed net sharing (AOR = 3.9; 95% CI: 2.0, 7.7), and proximity to stagnant water sources (AOR = 2.7; 95% CI: 1.3, 5.4) were independent predictors. Being in over 15 years of age group, male gender, night time activity, bed net sharing and proximity to stagnant water sources were determinant factors of malaria infection in Dembia district. Additional interventions and strategies which focus on men, outdoor work at night, household net utilization, and nearby stagnant water sources are essential to reduce malaria infections in the area.

Malaria Control and Elimination in Sri Lanka: Documenting Progress and Success Factors in a Conflict Setting

PubMed Central

Abeyasinghe, Rabindra R.; Galappaththy, Gawrie N. L.; Smith Gueye, Cara; Kahn, James G.; Feachem, Richard G. A.

2012-01-01

Background Sri Lanka has a long history of malaria control, and over the past decade has had dramatic declines in cases amid a national conflict. A case study of Sri Lanka's malaria programme was conducted to characterize the programme and explain recent progress. Methods The case study employed qualitative and quantitative methods. Data were collected from published and grey literature, district-level and national records, and thirty-three key informant interviews. Expenditures in two districts for two years – 2004 and 2009 – were compiled. Findings Malaria incidence in Sri Lanka has declined by 99.9% since 1999. During this time, there were increases in the proportion of malaria infections due to Plasmodium vivax, and the proportion of infections occurring in adult males. Indoor residual spraying and distribution of long-lasting insecticide-treated nets have likely contributed to the low transmission. Entomological surveillance was maintained. A strong passive case detection system captures infections and active case detection was introduced. When comparing conflict and non-conflict districts, vector control and surveillance measures were maintained in conflict areas, often with higher coverage reported in conflict districts. One of two districts in the study reported a 48% decline in malaria programme expenditure per person at risk from 2004 to 2009. The other district had stable malaria spending. Conclusions/Significance Malaria is now at low levels in Sri Lanka – 124 indigenous cases were found in 2011. The majority of infections occur in adult males and are due to P. vivax. Evidence-driven policy and an ability to adapt to new circumstances contributed to this decline. Malaria interventions were maintained in the conflict districts despite an ongoing war. Sri Lanka has set a goal of eliminating malaria by the end of 2014. Early identification and treatment of infections, especially imported ones, together with effective surveillance and response, will be critical to achieving this goal. PMID:22952642

CCIS Experiment : Comparing Transit Information Retrieval Modes at the Southern California Rapid Transit District

DOT National Transportation Integrated Search

1984-03-01

This report documents the results of a controlled experiment performed in the Telephone Information Section of the Marketing Department at the Southern California Rapid Transit District (SCRTD) in Los Angeles. The Telephone Information Section is the...

Preparation of School District Budgets with Microcomputer Electronic Spreadsheets.

ERIC Educational Resources Information Center

Hinitz, Herman J.

1996-01-01

Preparing a microcomputer electronic spreadsheet containing all relevant school district budgetary information is possible with currently available hardware and software (such as Lotus 1-2-3), despite random-access-memory limitations. Spreadsheets can provide financial summaries, inventory-control listings, scheduling alternatives,…

Models for short term malaria prediction in Sri Lanka

PubMed Central

Briët, Olivier JT; Vounatsou, Penelope; Gunawardena, Dissanayake M; Galappaththy, Gawrie NL; Amerasinghe, Priyanie H

2008-01-01

Background Malaria in Sri Lanka is unstable and fluctuates in intensity both spatially and temporally. Although the case counts are dwindling at present, given the past history of resurgence of outbreaks despite effective control measures, the control programmes have to stay prepared. The availability of long time series of monitored/diagnosed malaria cases allows for the study of forecasting models, with an aim to developing a forecasting system which could assist in the efficient allocation of resources for malaria control. Methods Exponentially weighted moving average models, autoregressive integrated moving average (ARIMA) models with seasonal components, and seasonal multiplicative autoregressive integrated moving average (SARIMA) models were compared on monthly time series of district malaria cases for their ability to predict the number of malaria cases one to four months ahead. The addition of covariates such as the number of malaria cases in neighbouring districts or rainfall were assessed for their ability to improve prediction of selected (seasonal) ARIMA models. Results The best model for forecasting and the forecasting error varied strongly among the districts. The addition of rainfall as a covariate improved prediction of selected (seasonal) ARIMA models modestly in some districts but worsened prediction in other districts. Improvement by adding rainfall was more frequent at larger forecasting horizons. Conclusion Heterogeneity of patterns of malaria in Sri Lanka requires regionally specific prediction models. Prediction error was large at a minimum of 22% (for one of the districts) for one month ahead predictions. The modest improvement made in short term prediction by adding rainfall as a covariate to these prediction models may not be sufficient to merit investing in a forecasting system for which rainfall data are routinely processed. PMID:18460204

Teacher Evaluation and Local Control in the US: An Investigation into the Degree of Local Control Afforded to Districts in Defining Evaluation Procedures for Teachers in Non-Tested Subjects and Grades

ERIC Educational Resources Information Center

Gagnon, Douglas J.; Hall, Erika L.; Marion, Scott

2017-01-01

Many states only recently incorporated indicators of student achievement into teacher evaluation systems for Non-Tested Subjects and Grades (NTSG). This study examines how practices related to the inclusion of student achievement measures vary across states as to the discretion left to districts in defining and implementing evaluation systems for…

Coast of California Storm and Tidal Waves Study. Hydraulic Data Inventory. Southern California Coastal Zone.

DTIC Science & Technology

1985-12-01

Obispo County Air Pollution Control District); Don Jones (Santa Barbara County Air Pollution control District); Evan Shipp (Ventura County Air Pollution ...Chaparral plants are evergreen, sclerophyll shrubs with extremely strong root systems. The plants are well adapted to steep, rugged terrain, as they...form deep, extensive root systems. The strong root system makes them a valued watershed protector. *However, chaparral plants are among the most

Comparison of smallpox outbreak control strategies using a spatial metapopulation model.

PubMed

Hall, I M; Egan, J R; Barrass, I; Gani, R; Leach, S

2007-10-01

To determine the potential benefits of regionally targeted mass vaccination as an adjunct to other smallpox control strategies we employed a spatial metapopulation patch model based on the administrative districts of Great Britain. We counted deaths due to smallpox and to vaccination to identify strategies that minimized total deaths. Results confirm that case isolation, and the tracing, vaccination and observation of case contacts can be optimal for control but only for optimistic assumptions concerning, for example, the basic reproduction number for smallpox (R0=3) and smaller numbers of index cases ( approximately 10). For a wider range of scenarios, including larger numbers of index cases and higher reproduction numbers, the addition of mass vaccination targeted only to infected districts provided an appreciable benefit (5-80% fewer deaths depending on where the outbreak started with a trigger value of 1-10 isolated symptomatic individuals within a district).

Spinal and temporo-mandibular disorders in male workers of the State Police.

PubMed

Sancini, Angela; Tomei, Francesco; Tomei, Gianfranco; Caciari, Tiziana; Capozzella, Assunta; Di Famiani, Manuela; Samperi, Ilaria; Scala, Barbara; Fiaschetti, Maria; Cetica, Carlotta; Ciarrocca, Manuela

2013-01-01

The aims of this study are to evaluate the prevalence of disorders of the lumbar region and the temporo-mandibular district co-morbidity in drivers and workers of the State Police employed for different office activities. The study population included 103 drivers as cases and 100 police officers as controls. The study was carried out through questionnaire and clinical evaluation of the spine and temporo-mandibular region. At clinical examination, the drivers were found to have a higher prevalence (p < 0.05) of both symptoms and clinical signs at the spine and temporo-mandibular joint (TMJ), when compared with the controls. The results also showed a higher prevalence (p < 0.05) of co-morbidity in the two districts among the drivers, when compared with the controls. These results confirm that morbidity related to back and TMJ and increase in co-morbidity between the two districts are higher in professional drivers.

To extend to the Mayor of the District of Columbia the same authority over the National Guard of the District of Columbia as the Governors of the several States exercise over the National Guard of those States with respect to administration of the National Guard and its use to respond to natural disasters and other civil disturbances, while ensuring that the President retains control of the National Guard of the District of Columbia to respond to homeland defense emergencies.

THOMAS, 111th Congress

Rep. Norton, Eleanor Holmes [D-DC-At Large

2009-05-07

House - 07/31/2009 Referred to the Subcommittee on Federal Workforce, Post Office, and the District of Columbia. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

40 CFR 147.451 - EPA-administered program.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 22 2010-07-01 2010-07-01 false EPA-administered program. 147.451... (CONTINUED) STATE, TRIBAL, AND EPA-ADMINISTERED UNDERGROUND INJECTION CONTROL PROGRAMS District of Columbia § 147.451 EPA-administered program. (a) Contents. The UIC program for the District of Columbia...

40 CFR 147.451 - EPA-administered program.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 23 2011-07-01 2011-07-01 false EPA-administered program. 147.451... (CONTINUED) STATE, TRIBAL, AND EPA-ADMINISTERED UNDERGROUND INJECTION CONTROL PROGRAMS District of Columbia § 147.451 EPA-administered program. (a) Contents. The UIC program for the District of Columbia...

40 CFR 147.451 - EPA-administered program.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 24 2013-07-01 2013-07-01 false EPA-administered program. 147.451... (CONTINUED) STATE, TRIBAL, AND EPA-ADMINISTERED UNDERGROUND INJECTION CONTROL PROGRAMS District of Columbia § 147.451 EPA-administered program. (a) Contents. The UIC program for the District of Columbia...

40 CFR 147.451 - EPA-administered program.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 23 2014-07-01 2014-07-01 false EPA-administered program. 147.451... (CONTINUED) STATE, TRIBAL, AND EPA-ADMINISTERED UNDERGROUND INJECTION CONTROL PROGRAMS District of Columbia § 147.451 EPA-administered program. (a) Contents. The UIC program for the District of Columbia...

40 CFR 147.451 - EPA-administered program.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 24 2012-07-01 2012-07-01 false EPA-administered program. 147.451... (CONTINUED) STATE, TRIBAL, AND EPA-ADMINISTERED UNDERGROUND INJECTION CONTROL PROGRAMS District of Columbia § 147.451 EPA-administered program. (a) Contents. The UIC program for the District of Columbia...

Transparency and oversight in local wellness policies.

PubMed

Chriqui, Jamie F; Chaloupka, Frank J

2011-02-01

Advocates have called for increased wellness policy transparency and oversight through the use of health advisory councils. This study examines (1) wellness policy transparency, (2) advisory council requirements, (3) factors associated with each, and (4) whether transparency or advisory council requirements are indicative of a stronger policy addressing nutrition and physical activity. Policies for school year 2007-2008 were obtained from a nationally representative sample of 641 districts and analyzed for their applicability to elementary, middle, and high school levels. Main outcome measures included (1) policy transparency (online availability), (2) advisory council requirements, and (3) overall policy strength. T-tests assessed variability in policy strength by transparency and advisory council requirements. Multivariate logistic and linear regression analyses controlled for district size, socioeconomic status, race/ethnicity, region, and locale; models of advisory council/policy strength relationships also controlled for state advisory council requirements. More than 41% of districts posted wellness policies online and more than 43% required advisory councils. Transparency was less likely in small-/medium-sized and non-southern districts; and, for elementary school policies, most common in majority Hispanic districts. Advisory council requirements were less likely in small-/medium-sized districts for middle/high school policies and more likely in majority Hispanic districts for elementary school policies. After adjusting for all covariates, transparency was not associated with policy strength, but advisory council requirements significantly predicted policy strength. Transparency may facilitate awareness, but it does not mean that wellness policies will be stronger; however, advisory council requirements may be a marker for stronger policies. © 2011, American School Health Association.

Public funding of health at the district level in Indonesia after decentralization – sources, flows and contradictions

PubMed Central

Heywood, Peter; Harahap, Nida P

2009-01-01

Background During the Suharto era public funding of health in Indonesia was low and the health services were tightly controlled by the central government; district health staff had practically no discretion over expenditure. Following the downfall of President Suharto there was a radical political, administrative and fiscal decentralization with delivery of services becoming the responsibility of district governments. In addition, public funding for health services more than doubled between 2001 and 2006. It was widely expected that services would improve as district governments now had both more adequate funds and the responsibility for services. To date there has been little improvement in services. Understanding why services have not improved requires careful study of what is happening at the district level. Methods We collected information on public expenditure on health services for the fiscal year 2006 in 15 districts in Java, Indonesia from the district health offices and district hospitals. Data obtained in the districts were collected by three teams, one for each province. Information on district government revenues were obtained from district public expenditure databases maintained by the World Bank using data from the Ministry of Finance. Results The public expenditure information collected in 15 districts as part of this study indicates district governments are reliant on the central government for as much as 90% of their revenue; that approximately half public expenditure on health is at the district level; that at least 40% of district level public expenditure on health is for personnel, almost all of them permanent civil servants; and that districts may have discretion over less than one-third of district public expenditure on health; the extent of discretion over spending is much higher in district hospitals than in the district health office and health centers. There is considerable variation between districts. Conclusion In contrast to the promise of decentralization there has been little increase in the potential for discretion at the district level in managing public funds for health – this is likely to be an important reason for the lack of improvement in publicly funded health services. Key decisions about money are still made by the central government, and no one is held accountable for the performance of the sector – the district blames the center and the central ministries (and their ministers) are not accountable to district populations. PMID:19371410

Public funding of health at the district level in Indonesia after decentralization-sources, flows and contradictions.

PubMed

Heywood, Peter; Harahap, Nida P

2009-04-16

During the Suharto era public funding of health in Indonesia was low and the health services were tightly controlled by the central government; district health staff had practically no discretion over expenditure. Following the downfall of President Suharto there was a radical political, administrative and fiscal decentralization with delivery of services becoming the responsibility of district governments. In addition, public funding for health services more than doubled between 2001 and 2006. It was widely expected that services would improve as district governments now had both more adequate funds and the responsibility for services. To date there has been little improvement in services. Understanding why services have not improved requires careful study of what is happening at the district level. We collected information on public expenditure on health services for the fiscal year 2006 in 15 districts in Java, Indonesia from the district health offices and district hospitals. Data obtained in the districts were collected by three teams, one for each province. Information on district government revenues were obtained from district public expenditure databases maintained by the World Bank using data from the Ministry of Finance. The public expenditure information collected in 15 districts as part of this study indicates district governments are reliant on the central government for as much as 90% of their revenue; that approximately half public expenditure on health is at the district level; that at least 40% of district level public expenditure on health is for personnel, almost all of them permanent civil servants; and that districts may have discretion over less than one-third of district public expenditure on health; the extent of discretion over spending is much higher in district hospitals than in the district health office and health centers. There is considerable variation between districts. In contrast to the promise of decentralization there has been little increase in the potential for discretion at the district level in managing public funds for health - this is likely to be an important reason for the lack of improvement in publicly funded health services. Key decisions about money are still made by the central government, and no one is held accountable for the performance of the sector - the district blames the center and the central ministries (and their ministers) are not accountable to district populations.

Development of temporal modelling for forecasting and prediction of malaria infections using time-series and ARIMAX analyses: a case study in endemic districts of Bhutan.

PubMed

Wangdi, Kinley; Singhasivanon, Pratap; Silawan, Tassanee; Lawpoolsri, Saranath; White, Nicholas J; Kaewkungwal, Jaranit

2010-09-03

Malaria still remains a public health problem in some districts of Bhutan despite marked reduction of cases in last few years. To strengthen the country's prevention and control measures, this study was carried out to develop forecasting and prediction models of malaria incidence in the endemic districts of Bhutan using time series and ARIMAX. This study was carried out retrospectively using the monthly reported malaria cases from the health centres to Vector-borne Disease Control Programme (VDCP) and the meteorological data from Meteorological Unit, Department of Energy, Ministry of Economic Affairs. Time series analysis was performed on monthly malaria cases, from 1994 to 2008, in seven malaria endemic districts. The time series models derived from a multiplicative seasonal autoregressive integrated moving average (ARIMA) was deployed to identify the best model using data from 1994 to 2006. The best-fit model was selected for each individual district and for the overall endemic area was developed and the monthly cases from January to December 2009 and 2010 were forecasted. In developing the prediction model, the monthly reported malaria cases and the meteorological factors from 1996 to 2008 of the seven districts were analysed. The method of ARIMAX modelling was employed to determine predictors of malaria of the subsequent month. It was found that the ARIMA (p, d, q) (P, D, Q)s model (p and P representing the auto regressive and seasonal autoregressive; d and D representing the non-seasonal differences and seasonal differencing; and q and Q the moving average parameters and seasonal moving average parameters, respectively and s representing the length of the seasonal period) for the overall endemic districts was (2,1,1)(0,1,1)12; the modelling data from each district revealed two most common ARIMA models including (2,1,1)(0,1,1)12 and (1,1,1)(0,1,1)12. The forecasted monthly malaria cases from January to December 2009 and 2010 varied from 15 to 82 cases in 2009 and 67 to 149 cases in 2010, where population in 2009 was 285,375 and the expected population of 2010 to be 289,085. The ARIMAX model of monthly cases and climatic factors showed considerable variations among the different districts. In general, the mean maximum temperature lagged at one month was a strong positive predictor of an increased malaria cases for four districts. The monthly number of cases of the previous month was also a significant predictor in one district, whereas no variable could predict malaria cases for two districts. The ARIMA models of time-series analysis were useful in forecasting the number of cases in the endemic areas of Bhutan. There was no consistency in the predictors of malaria cases when using ARIMAX model with selected lag times and climatic predictors. The ARIMA forecasting models could be employed for planning and managing malaria prevention and control programme in Bhutan.

Controls on Mississippi Valley-Type Zn-Pb mineralization in Behabad district, Central Iran: Constraints from spatial and numerical analyses

NASA Astrophysics Data System (ADS)

Parsa, Mohammad; Maghsoudi, Abbas

2018-04-01

The Behabad district, located in the central Iranian microcontinent, contains numerous epigenetic stratabound carbonate-hosted Zn-Pb ore bodies. The mineralizations formed as fault, fracture and karst fillings in the Permian-Triassic formations, especially in Middle Triassic dolostones, and comprise mainly non-sulfides zinc ores. These are all interpreted as Mississippi Valley-type (MVT) base metal deposits. From an economic geological point of view, it is imperative to recognize the processes that have plausibly controlled the emplacement of MVT Zn-Pb mineralization in the Behabad district. To address the foregoing issue, analyses of the spatial distribution of mineral deposits comprising fry and fractal techniques and analysis of the spatial association of mineral deposits with geological features using distance distribution analysis were applied to assess the regional-scale processes that could have operated in the distribution of MVT Zn-Pb deposits in the district. The obtained results based on these analytical techniques show the main trends of the occurrences are NW-SE and NE-SW, which are parallel or subparallel to the major northwest and northeast trending faults, supporting the idea that these particular faults could have acted as the main conduits for transport of mineral-bearing fluids. The results of these analyses also suggest that Permian-Triassic brittle carbonate sedimentary rocks have served as the lithological controls on MVT mineralization in the Behabad district as they are spatially and temporally associated with mineralization.

Nurse-led empowerment strategies for patients with hypertension: a questionnaire survey.

PubMed

Rasjö Wrååk, G; Törnkvist, L; Hasselström, J; Wändell, P E; Josefsson, K

2015-06-01

Hypertension is common and may lead to cerebrovascular and cardiovascular events and mortality. District nurses frequently encounter patients requiring blood pressure monitoring, lifestyle counsel and support. Empowerment as a method enables patients to both increase their control over their health and improve it. This study aims to describe the effects of the counsel and support from district nurses to patients with hypertension. A randomized controlled intervention trial. Questionnaires were answered by patients with hypertension before and after the intervention comprising district nurses' counsel and support based upon empowerment. A specially developed card for blood pressure monitoring was also used. Blood pressure decreased in intervention and the control groups. The intervention group experienced significantly improved health, with better emotional and physical health, and reduced stress. Living habits did not change significantly in either group. Satisfaction with knowledge of hypertension increased significantly in both groups. The intervention group reported that their care was based upon their health needs. Conducting large multi-centre studies with long follow-ups is complicated and results sometimes have a tendency to decline with time. A shorter follow-up might have shown a greater difference between the groups. Nursing interventions through district nurses' counsel and support with empowerment improved patients' health. More research is needed to evaluate nursing interventions' effect on hypertension. This study highlighted that district nurses' counsel and support increased patients' health and decreased stress by focusing on empowerment. © 2015 International Council of Nurses.

District-Owned vs Contracted Bus Service.

ERIC Educational Resources Information Center

Lehman, Tom; Harkin, Gary

1979-01-01

A synopsis of the results of a study conducted for the Bozeman, Montana, Public Schools. The study evaluated the feasibility of a district-owned vs a contracted pupil transportation system. Various aspects of school transportation were analyzed by their relationship to safety, control, service, and cost. (Author/MLF)

Navigating Public-Private Partnerships: Introducing the Continuum of Control

ERIC Educational Resources Information Center

DiMartino, Catherine

2014-01-01

In many urban districts, the public education landscape is being transformed as private-sector providers such as educational management organizations, charter management organizations, and partner support organizations partner with or run district schools. While some private-sector providers' visions for school reform have remained static…

76 FR 70805 - Bureau of Political-Military Affairs; Statutory Debarment Under the Arms Export Control Act and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-15

...:10CR01201-001; May 1988. (16) Fidel Jesus Hernandez; November 23, 2010; U.S. District Court, District of... of Florida; Case No. 0:10CR60177-COHN-2; December 1956. (26) Jose Jesus Miramontes-Duarte; April 23...

40 CFR 52.274 - California air pollution emergency plan.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 3 2013-07-01 2013-07-01 false California air pollution emergency plan... pollution emergency plan. (a) Since the California Air Pollution Emergency Plan does not provide complete... District (SCAQMD). (2) Sacramento County Air Pollution Control District. (3) Monterey Bay Unified APCD...

40 CFR 52.274 - California air pollution emergency plan.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 3 2012-07-01 2012-07-01 false California air pollution emergency plan... pollution emergency plan. (a) Since the California Air Pollution Emergency Plan does not provide complete... District (SCAQMD). (2) Sacramento County Air Pollution Control District. (3) Monterey Bay Unified APCD...

40 CFR 52.274 - California air pollution emergency plan.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 3 2014-07-01 2014-07-01 false California air pollution emergency plan... pollution emergency plan. (a) Since the California Air Pollution Emergency Plan does not provide complete... District (SCAQMD). (2) Sacramento County Air Pollution Control District. (3) Monterey Bay Unified APCD...

Whose School Buildings Are They, Anyway?

ERIC Educational Resources Information Center

Smith, Nelson

2012-01-01

School districts held an exclusive franchise on public education services until 1991, when Minnesota passed the first law permitting public charter schools. Charter schools are publicly funded, authorized by various agencies designated in public law, but independently managed. They operate outside district control, and most can draw students from…

40 CFR 52.274 - California air pollution emergency plan.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 3 2011-07-01 2011-07-01 false California air pollution emergency plan... pollution emergency plan. (a) Since the California Air Pollution Emergency Plan does not provide complete... District (SCAQMD). (2) Sacramento County Air Pollution Control District. (3) Monterey Bay Unified APCD...

SCADA OPERATOR TRAINING TOOL APPLIED TO THE CENTRAL ARIZONA IRRIGATION AND DRAINAGE DISTRICT

USDA-ARS?s Scientific Manuscript database

Many irrigation districts use Supervisory Control and Data Acquisition (SCADA) software to manage their canal systems. Whether homegrown or commercial, these programs require a significant amount of training for new operators. While some SCADA operators are hired with extensive field experience, o...

Multi-Stakeholder Taskforces in Bangladesh — A Distinctive Approach to Build Sustainable Tobacco Control Implementation

PubMed Central

Jackson-Morris, Angela M.; Chowdhury, Ishrat; Warner, Valerie; Bleymann, Kayleigh

2015-01-01

The MPOWER policy package enables countries to implement effective, evidence-based strategies to address the threat posed to their population by tobacco. All countries have challenges to overcome when implementing tobacco control policy. Some are generic such as tobacco industry efforts to undermine and circumvent legislation; others are specific to national or local context. Various factors influence how successfully challenges are addressed, including the legal-political framework for enforcement, public and administrative attitudes towards the law, and whether policy implementation measures are undertaken. This paper examines District Tobacco Control Taskforces, a flexible policy mechanism developed in Bangladesh to support the implementation of the Smoking and Tobacco Products Usage (Control) Act 2005 and its 2013 Amendment. At the time of this study published research and/or data was not available and understanding about these structures, their role, contribution, limitations and potential, was limited. We consider Taskforce characteristics and suggest that the “package” comprises a distinctive tobacco control implementation model. Qualitative data is presented from interviews with key informants in ten districts with activated taskforces (n = 70) to provide insight from the perspectives of taskforce members and non-members. In all ten districts taskforces were seen as a crucial tool for tobacco control implementation. Where taskforces were perceived to be functioning well, current positive impacts were perceived, including reduced smoking in public places and tobacco advertising, and increased public awareness and political profile. In districts with less well established taskforces, interviewees believed in their taskforce’s ‘potential’ to deliver similar benefits once their functioning was improved. Recommendations to improve functioning and enhance impact were made. The distinctive taskforce concept and lessons from their development may provide other countries with a flexible local implementation model for tobacco control. PMID:25575369

Multi-stakeholder taskforces in Bangladesh--a distinctive approach to build sustainable tobacco control implementation.

PubMed

Jackson-Morris, Angela M; Chowdhury, Ishrat; Warner, Valerie; Bleymann, Kayleigh

2015-01-07

The MPOWER policy package enables countries to implement effective, evidence-based strategies to address the threat posed to their population by tobacco. All countries have challenges to overcome when implementing tobacco control policy. Some are generic such as tobacco industry efforts to undermine and circumvent legislation; others are specific to national or local context. Various factors influence how successfully challenges are addressed, including the legal-political framework for enforcement, public and administrative attitudes towards the law, and whether policy implementation measures are undertaken. This paper examines District Tobacco Control Taskforces, a flexible policy mechanism developed in Bangladesh to support the implementation of the Smoking and Tobacco Products Usage (Control) Act 2005 and its 2013 Amendment. At the time of this study published research and/or data was not available and understanding about these structures, their role, contribution, limitations and potential, was limited. We consider Taskforce characteristics and suggest that the "package" comprises a distinctive tobacco control implementation model. Qualitative data is presented from interviews with key informants in ten districts with activated taskforces (n = 70) to provide insight from the perspectives of taskforce members and non-members. In all ten districts taskforces were seen as a crucial tool for tobacco control implementation. Where taskforces were perceived to be functioning well, current positive impacts were perceived, including reduced smoking in public places and tobacco advertising, and increased public awareness and political profile. In districts with less well established taskforces, interviewees believed in their taskforce's 'potential' to deliver similar benefits once their functioning was improved. Recommendations to improve functioning and enhance impact were made. The distinctive taskforce concept and lessons from their development may provide other countries with a flexible local implementation model for tobacco control.

[The assessment of vulnerability to floods in Guangdong province at district level].

PubMed

Zhu, Qi; Liu, Tao; Zhang, Yong-hui; Luo, Yuan; Wei, Yao; Xiao, Jian-peng; Zeng, Si-qing; Ma, Wen-jun

2012-11-01

To evaluate the vulnerability to floods in Guangdong province at district level. Data were collected from the sixth census, the 2010 Statistical Yearbook of Guangdong, the 2010 Health Statistics Yearbook of Guangdong and China Disease Prevention and Control information systems, etc. The weight of each indicator was determined based on subjective method and objective method respectively; and finally the results of the two methods were compared. 13 indicators were selected for the assessment of vulnerability to floods, including 6 sensitivity indicators, 5 adaptability indicators and 2 exposure indicators. Indicators with large weight (subjective weight/objective weight) were the proportion of population older than 65 years old (0.31/0.30), the proportion of population older than 65 years old (0.16/0.23), infant mortality rate (0.18/0.20), the total Gross Domestic Product (GDP) per capita (0.33/0.21), the proportion of illiterate in the population older than 15 years old (0.19/0.28), history frequency of floods (0.75/0.75). The mean vulnerability index (VI) calculated by subjective method was 0.35 with the standard deviation of 0.10; the mean vulnerability index calculated by objective method was 0.31 with the standard deviation of 0.08. The two weighting methods showed consistent results of vulnerability index (ICC = 0.975, P < 0.01). VI of most districts dropped in the interval of 0.30 - 0.39. Districts with subjective VI > 0.50 or objective VI > 0.40 should pay more attention to floods, including parts of the coastal areas, Beijiang River Basin, the eastern tributary area of Dongjiang River and the northern part of Pearl River Delta. Dapu district of Meizhou (0.55/0.45), Dianbai district and Maogang district of Maoming (0.54/0.48) were most vulnerable. Districts of Heyuan, Dongguan, Zhaoqing and Huizhou were less vulnerable, Yuancheng district of Heyuan showed least vulnerable to floods (0.15/0.12) followed by Dongguan (0.18/0.16), Duanzhou district (0.18/0.16) and Guangning (0.17/0.15) district of Zhaoqing. The score of indicators differed among different level of vulnerability (P < 0.05). Different regions of Guangdong province showed different vulnerability to floods, vulnerable areas should be priority in the prevention and control of floods.

Today's School Risk Manager

ERIC Educational Resources Information Center

Johnson, Cheryl P.; Levering, Steve

2009-01-01

School districts are held accountable not only for the monies that contribute to the education system but also for mitigating any issues that threaten student learning. Some school districts are fortunate to have professional risk managers on staff who can identify and control the many risks that are unique to school systems. Most schools,…

Controlling Health Care Costs

ERIC Educational Resources Information Center

Dessoff, Alan

2009-01-01

This article examines issues on health care costs and describes measures taken by public districts to reduce spending. As in most companies in America, health plan designs in public districts are being changed to reflect higher out-of-pocket costs, such as higher deductibles on visits to providers, hospital stays, and prescription drugs. District…

Interpretive Study of Research and Development Relative to Educational Cooperatives. Final Report.

ERIC Educational Resources Information Center

Hughes, Larry W.; And Others

This document analyzes some of the aspects of the trend toward educational regionalism and cooperation. Educational cooperatives are designed to provide the flexibility and service associated with large districts while allowing for local control and school district autonomy. Types of educational cooperatives discussed include intermediate…

Monitoring and Controlling Engineering and Construction Management Cost Performance Within the Corps of Engineers

DTIC Science & Technology

1988-12-01

COST MANAGEMENT The CMIF approach addresses total costs but does not permit the analysis of indirect costs. We found that indirect costs vary...responsibility USACE/divisions Increasing CMIF Districts/divisions level of by fund type detail G&A, technical indirect, burden Districts by fund type

77 FR 54863 - Polychlorinated Biphenyls (PCBs): Revisions to Manifesting Regulations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-06

... and Recovery Act (RCRA) Uniform Hazardous Waste Manifest, under the Toxic Substances Control Act (TSCA... implement the Uniform Hazardous Waste Manifest form were promulgated on March, 4, 2005. DATES: Written... governmental jurisdiction that is a government of a city, county, town, school district or special district...

Green Infrastructure in the Mix to Reduce District of Columbia Sewer Overflows

EPA Pesticide Factsheets

District of Columbia's Long Term Control Plan to keep sewage out of the city’s rivers is being modified to include a substantial greening component for the first time, making it a dominant feature of 2 of the 3 drainage areas of the combined sewer system.

Characterization of cotton gin particulate matter emissions – project plan

USDA-ARS?s Scientific Manuscript database

In 2006, EPA implemented a more stringent standard for particulate matter with an effective diameter less than 2.5 microns (PM2.5). The implementation timeline for this standard will vary by state/district regulatory agency. For example, the San Joaquin Valley Air Pollution Control District, has pro...

Characterization of cotton gin particulate matter emissions - project plan

USDA-ARS?s Scientific Manuscript database

In 2006, EPA implemented a more stringent standard for particulate matter with an effective diameter less than 2.5 microns (PM2.5). The implementation time line for this standard will vary by state/district regulatory agency. For example, the San Joaquin Valley Air Pollution Control District has pro...

Collaborative Edge: How Helping Others Helps You

ERIC Educational Resources Information Center

Hargreaves, Andy; Shirley, Dennis; Harris, Alma; Boyle, Alan

2010-01-01

Teachers might be working significantly more with one another, but principals are not. Superintendents might bring principals together for district meetings or even to expose their performance results to colleagues in public, but principal collaboration is too often trumped by district control. Even worse, more and more schools and their…

Closing the access barrier for effective anti-malarials in the private sector in rural Uganda: consortium for ACT private sector subsidy (CAPSS) pilot study.

PubMed

Talisuna, Ambrose O; Daumerie, Penny Grewal; Balyeku, Andrew; Egan, Timothy; Piot, Bram; Coghlan, Renia; Lugand, Maud; Bwire, Godfrey; Rwakimari, John Bosco; Ndyomugyenyi, Richard; Kato, Fred; Byangire, Maria; Kagwa, Paul; Sebisubi, Fred; Nahamya, David; Bonabana, Angela; Mpanga-Mukasa, Susan; Buyungo, Peter; Lukwago, Julius; Batte, Allan; Nakanwagi, Grace; Tibenderana, James; Nayer, Kinny; Reddy, Kishore; Dokwal, Nilesh; Rugumambaju, Sylvester; Kidde, Saul; Banerji, Jaya; Jagoe, George

2012-10-29

Artemisinin-based combination therapy (ACT), the treatment of choice for uncomplicated falciparum malaria, is unaffordable and generally inaccessible in the private sector, the first port of call for most malaria treatment across rural Africa. Between August 2007 and May 2010, the Uganda Ministry of Health and the Medicines for Malaria Venture conducted the Consortium for ACT Private Sector Subsidy (CAPSS) pilot study to test whether access to ACT in the private sector could be improved through the provision of a high level supply chain subsidy. Four intervention districts were purposefully selected to receive branded subsidized medicines - "ACT with a leaf", while the fifth district acted as the control. Baseline and evaluation outlet exit surveys and retail audits were conducted at licensed and unlicensed drug outlets in the intervention and control districts. A survey-adjusted, multivariate logistic regression model was used to analyse the intervention's impact on: ACT uptake and price; purchase of ACT within 24 hours of symptom onset; ACT availability and displacement of sub-optimal anti-malarial. At baseline, ACT accounted for less than 1% of anti-malarials purchased from licensed drug shops for children less than five years old. However, at evaluation, "ACT with a leaf" accounted for 69% of anti-malarial purchased in the interventions districts. Purchase of ACT within 24 hours of symptom onset for children under five years rose from 0.8% at baseline to 26.2% (95% CI: 23.2-29.2%) at evaluation in the intervention districts. In the control district, it rose modestly from 1.8% to 5.6% (95% CI: 4.0-7.3%). The odds of purchasing ACT within 24 hours in the intervention districts compared to the control was 0.46 (95% CI: 0.08-2.68, p=0.4) at baseline and significant increased to 6.11 (95% CI: 4.32-8.62, p<0.0001) at evaluation. Children less than five years of age had "ACT with a leaf" purchased for them more often than those aged above five years. There was no evidence of price gouging. These data demonstrate that a supply-side subsidy and an intensive communications campaign significantly increased the uptake and use of ACT in the private sector in Uganda.

Closing the access barrier for effective anti-malarials in the private sector in rural Uganda: consortium for ACT private sector subsidy (CAPSS) pilot study

PubMed Central

2012-01-01

Background Artemisinin-based combination therapy (ACT), the treatment of choice for uncomplicated falciparum malaria, is unaffordable and generally inaccessible in the private sector, the first port of call for most malaria treatment across rural Africa. Between August 2007 and May 2010, the Uganda Ministry of Health and the Medicines for Malaria Venture conducted the Consortium for ACT Private Sector Subsidy (CAPSS) pilot study to test whether access to ACT in the private sector could be improved through the provision of a high level supply chain subsidy. Methods Four intervention districts were purposefully selected to receive branded subsidized medicines - “ACT with a leaf”, while the fifth district acted as the control. Baseline and evaluation outlet exit surveys and retail audits were conducted at licensed and unlicensed drug outlets in the intervention and control districts. A survey-adjusted, multivariate logistic regression model was used to analyse the intervention’s impact on: ACT uptake and price; purchase of ACT within 24 hours of symptom onset; ACT availability and displacement of sub-optimal anti-malarial. Results At baseline, ACT accounted for less than 1% of anti-malarials purchased from licensed drug shops for children less than five years old. However, at evaluation, “ACT with a leaf” accounted for 69% of anti-malarial purchased in the interventions districts. Purchase of ACT within 24 hours of symptom onset for children under five years rose from 0.8% at baseline to 26.2% (95% CI: 23.2-29.2%) at evaluation in the intervention districts. In the control district, it rose modestly from 1.8% to 5.6% (95% CI: 4.0-7.3%). The odds of purchasing ACT within 24 hours in the intervention districts compared to the control was 0.46 (95% CI: 0.08-2.68, p=0.4) at baseline and significant increased to 6.11 (95% CI: 4.32-8.62, p<0.0001) at evaluation. Children less than five years of age had “ACT with a leaf” purchased for them more often than those aged above five years. There was no evidence of price gouging. Conclusions These data demonstrate that a supply-side subsidy and an intensive communications campaign significantly increased the uptake and use of ACT in the private sector in Uganda. PMID:23107021

The wheels on the bus go "buy buy buy": school bus advertising laws.

PubMed

Pomeranz, Jennifer L

2012-09-01

School buses, a practical necessity for millions of children, are at the center of new efforts to raise revenue. School bus advertising laws bring public health and commercialization concerns to the school setting. In doing so, they potentially expose school districts to First Amendment lawsuits. I examined various school bus advertising bills and laws. I reviewed First Amendment "forum analysis" as applied in the transit and school settings to clarify how this legal test may affect school districts subject to such laws. I have made recommendations for school districts to enact appropriate policies to ensure that such advertising does not undermine public health and to enable the districts to maintain control over their property.

Traffic rule violations of private bus drivers and bus crashes in Sri Lanka: a case-control study.

PubMed

Jayatilleke, Achala Upendra; Poudel, Krishna C; Nakahara, Shinji; Dharmaratne, Samath D; Jayatilleke, Achini Chinthika; Jimba, Masamine

2010-06-01

To explore the association between self-reported traffic rule violations of private sector bus drivers and bus crashes in the Kandy district, Sri Lanka. We carried out a case-control study from August to September 2006. Cases were all the private bus drivers registered in the Kandy district and involved in crashes reported to the police between November 2005 and April 2006 (n = 63). We included two control groups: the private bus drivers working on the same routes of the cases (n = 90; matched controls) and the drivers selected randomly from the other routes of the district (n = 111; unmatched controls). We used a self-administered questionnaire to collect data on the self-reported traffic rule violations and analyzed the association between the self-reported traffic rule violations and crashes using logistic regression. The following variables showed significant associations with private bus crashes: illegal overtaking (matched controls, adjusted odds ratio [AOR] = 14.78, unmatched controls, AOR = 1.04), taking passengers outside the bus bays (matched controls, AOR = 3.96, unmatched controls, AOR = 2.29), and overloading (matched controls, AOR = 10.26, unmatched controls, AOR = 1.93). However, we did not observe an association between high-speed driving and bus crashes matched controls, AOR = 1.22, unmatched controls, AOR = 0.81. Traffic rule violations, such as illegal overtaking, overloading, and taking passengers outside the bus bays, are significant risk factors for private bus crashes in Sri Lanka.

The impact of urban regeneration programmes on health and health-related behaviour: Evaluation of the Dutch District Approach 6.5 years from the start.

PubMed

Ruijsbroek, Annemarie; Wong, Albert; Kunst, Anton E; van den Brink, Carolien; van Oers, Hans A M; Droomers, Mariël; Stronks, Karien

2017-01-01

Large-scale regeneration programmes to improve the personal conditions and living circumstances in deprived areas may affect health and the lifestyle of the residents. Previous evaluations concluded that a large-scale urban regeneration programme in the Netherlands had some positive effects within 3.5 years. The aim of the current study was to evaluate the effects at the longer run. With a quasi-experimental research design we assessed changes in the prevalence of general health, mental health, physical activity, overweight, obesity, and smoking between the pre-intervention (2003-04 -mid 2008) and intervention period (mid 2008-2013-14) in 40 deprived target districts and comparably deprived control districts. We used the Difference-in-Difference (DiD) to assess programme impact. Additionally, we stratified analyses by sex and by the intensity of the regeneration programme. Changes in health and health related behaviours from pre-intervention to the intervention period were about equally large in the target districts as in control districts. DiD impact estimates were inconsistent and not statistically significant. Sex differences in DiD estimates were not consistent or significant. Furthermore, DiD impact estimates were not consistently larger in target districts with more intensive intervention programmes. We found no evidence that this Dutch urban regeneration programme had an impact in the longer run on self-reported health and related behaviour at the area level.

Relation of ground water to stream flow at Battle Creek, Mich.

USGS Publications Warehouse

Eddy, G.E.; Ferris, J.G.

1950-01-01

This is a summary of statements made by G.E. Eddy, State Geologist of Michigan, and J.G. Ferris, district engineer, Ground Water Branch, U.S. Geological Survey, Lansing, Mich., in a conference during the fall of 1949 with John Spoden, Chief of the Maintenance and Fold Control Division of the district office of the Corps of Engineers, Milwaukee, Wis. The conference related to the probably effect on ground-water conditions at Battle Creek of flood-control measures proposed by the Corps of Engineers.

Identification of burden hotspots and risk factors for cholera in India: An observational study

PubMed Central

Sen Gupta, Sanjukta; Arora, Nisha; Khasnobis, Pradeep; Venkatesh, Srinivas; Sur, Dipika; Nair, Gopinath B.; Sack, David A.; Ganguly, Nirmal K.

2017-01-01

Background Even though cholera has existed for centuries and many parts of the country have sporadic, endemic and epidemic cholera, it is still an under-recognized health problem in India. A Cholera Expert Group in the country was established to gather evidence and to prepare a road map for control of cholera in India. This paper identifies cholera burden hotspots and factors associated with an increased risk of the disease. Methodology/Principle findings We acquired district level data on cholera case reports of 2010–2015 from the Integrated Disease Surveillance Program. Socioeconomic characteristics and coverage of water and sanitation was obtained from the 2011 census. Spatial analysis was performed to identify cholera hotspots, and a zero-inflated Poisson regression was employed to identify the factors associated with cholera and predicted case count in the district. 27,615 cholera cases were reported during the 6-year period. Twenty-four of 36 states of India reported cholera during these years, and 13 states were classified as endemic. Of 641 districts, 78 districts in 15 states were identified as “hotspots” based on the reported cases. On the other hand, 111 districts in nine states were identified as “hotspots” from model-based predicted number of cases. The risk for cholera in a district was negatively associated with the coverage of literate persons, households using treated water source and owning mobile telephone, and positively associated with the coverage of poor sanitation and drainage conditions and urbanization level in the district. Conclusions/Significance The study reaffirms that cholera continues to occur throughout a large part of India and identifies the burden hotspots and risk factors. Policymakers may use the findings of the article to develop a roadmap for prevention and control of cholera in India. PMID:28837645

Identification of burden hotspots and risk factors for cholera in India: An observational study.

PubMed

Ali, Mohammad; Sen Gupta, Sanjukta; Arora, Nisha; Khasnobis, Pradeep; Venkatesh, Srinivas; Sur, Dipika; Nair, Gopinath B; Sack, David A; Ganguly, Nirmal K

2017-01-01

Even though cholera has existed for centuries and many parts of the country have sporadic, endemic and epidemic cholera, it is still an under-recognized health problem in India. A Cholera Expert Group in the country was established to gather evidence and to prepare a road map for control of cholera in India. This paper identifies cholera burden hotspots and factors associated with an increased risk of the disease. We acquired district level data on cholera case reports of 2010-2015 from the Integrated Disease Surveillance Program. Socioeconomic characteristics and coverage of water and sanitation was obtained from the 2011 census. Spatial analysis was performed to identify cholera hotspots, and a zero-inflated Poisson regression was employed to identify the factors associated with cholera and predicted case count in the district. 27,615 cholera cases were reported during the 6-year period. Twenty-four of 36 states of India reported cholera during these years, and 13 states were classified as endemic. Of 641 districts, 78 districts in 15 states were identified as "hotspots" based on the reported cases. On the other hand, 111 districts in nine states were identified as "hotspots" from model-based predicted number of cases. The risk for cholera in a district was negatively associated with the coverage of literate persons, households using treated water source and owning mobile telephone, and positively associated with the coverage of poor sanitation and drainage conditions and urbanization level in the district. The study reaffirms that cholera continues to occur throughout a large part of India and identifies the burden hotspots and risk factors. Policymakers may use the findings of the article to develop a roadmap for prevention and control of cholera in India.

Under-Five Mortality in High Focus States in India: A District Level Geospatial Analysis

PubMed Central

Kumar, Chandan; Singh, Prashant Kumar; Rai, Rajesh Kumar

2012-01-01

Background This paper examines if, when controlling for biophysical and geographical variables (including rainfall, productivity of agricultural lands, topography/temperature, and market access through road networks), socioeconomic and health care indicators help to explain variations in the under-five mortality rate across districts from nine high focus states in India. The literature on this subject is inconclusive because the survey data, upon which most studies of child mortality rely, rarely include variables that measure these factors. This paper introduces these variables into an analysis of 284 districts from nine high focus states in India. Methodology/Principal Findings Information on the mortality indicator was accessed from the recently conducted Annual Health Survey of 2011 and other socioeconomic and geographic variables from Census 2011, District Level Household and Facility Survey (2007–08), Department of Economics and Statistics Divisions of the concerned states. Displaying high spatial dependence (spatial autocorrelation) in the mortality indicator (outcome variable) and its possible predictors used in the analysis, the paper uses the Spatial-Error Model in an effort to negate or reduce the spatial dependence in model parameters. The results evince that the coverage gap index (a mixed indicator of district wise coverage of reproductive and child health services), female literacy, urbanization, economic status, the number of newborn care provided in Primary Health Centers in the district transpired as significant correlates of under-five mortality in the nine high focus states in India. The study identifies three clusters with high under-five mortality rate including 30 districts, and advocates urgent attention. Conclusion Even after controlling the possible biophysical and geographical variables, the study reveals that the health program initiatives have a major role to play in reducing under-five mortality rate in the high focus states in India. PMID:22629412

Spatial distribution of soil-transmitted helminths, including Strongyloides stercoralis, among children in Zanzibar.

PubMed

Knopp, Stefanie; Mohammed, Khalfan A; Simba Khamis, I; Mgeni, Ali F; Stothard, J Russell; Rollinson, David; Marti, Hanspeter; Utzinger, Jürg

2008-11-01

A programme periodically distributing anthelminthic drugs to school-aged children for the control of soiltransmitted helminthiasis was launched in Zanzibar in the early 1990s. We investigated the spatial distribution of soiltransmitted helminth infections, including Strongyloides stercoralis, in 336 children from six districts in Unguja, Zanzibar, in 2007. One stool sample per child was examined with the Kato-Katz, Koga agar plate and Baermann methods. The point prevalence of the different helminth infections was compared to the geological characteristics of the study sites. The observed prevalences for Trichuris trichiura, Ascaris lumbricoides, hookworm and S. stercoralis were 35.5%, 12.2%, 11.9% and 2.2%, respectively, with considerable spatial heterogeneity. Whilst T. trichiura and hookworm infections were found in all six districts, no A. lumbricoides infections were recorded in the urban setting and only a low prevalence (2.2%) was observed in the South district. S. stercoralis infections were found in four districts with the highest prevalence (4.0%) in the West district. The prevalence of infection with any soil-transmitted helminth was highest in the North A district (69.6%) and lowest in the urban setting (22.4%). A. lumbricoides, hookworm and, with the exception of the North B district, S. stercoralis infections were observed to be more prevalent in the settings north of Zanzibar Town, which are characterized by alluvial clayey soils, moist forest regions and a higher precipitation. After a decade of large-scale administration of anthelminthic drugs, the prevalence of soil-transmitted helminth infections across Unguja is still considerable. Hence, additional measures, such as improving access to adequate sanitation and clean water and continued health education, are warranted to successfully control soil-transmitted helminthiasis in Zanzibar.

Shrimp farming practices in the puttallam district of sri lanka: implications for disease control, industry sustainability, and rural development.

PubMed

Munasinghe, M Nalaka; Stephen, Craig; Abeynayake, Preeni; Abeygunawardena, Indra S

2010-08-12

Shrimp farming has great potential to diversify and secure income in rural Sri Lanka, but production has significantly declined in recent years due to civil conflicts, some unsustainable practices and devastating outbreaks of disease. We examined management practices affecting disease prevention and control in the Puttalam district to identify extension services outputs that could support sustainable development of Sri Lankan shrimp farming. A survey on 621 shrimp farms (603 operational and 18 nonoperational) was conducted within the Puttalam district over 42 weeks comprising a series of three-day field visits from August 2008 to October 2009, covering two consecutive shrimp crops. Fundamental deficits in disease control, management, and biosecurity practices were found. Farmers had knowledge of biosecurity but the lack of financial resources was a major impediment to improved disease control. Smallholder farmers were disproportionately constrained in their ability to enact basic biosecurity practices due to their economic status. Basic breaches in biosecurity will keep disease as the rate limiting step in this industry. Plans to support this industry must recognize the socioeconomic reality of rural Sri Lankan aquaculture.

School District Policies and Adolescents’ Soda Consumption

PubMed Central

Miller, Gabrielle F.; Sliwa, Sarah; Brener, Nancy D.; Park, Sohyun; Merlo, Caitlin L.

2016-01-01

Purpose Sugar-sweetened beverages (SSBs) are a significant source of calories and added sugars for youth ages 14–18 years in the United States. This study examined the relationship between district-level policies and practices and students’ consumption of regular soda, one type of SSB, in 12 large urban school districts. Methods Data from the 2012 School Health Policies and Practices Study and 2013 Youth Risk Behavior Surveillance System were linked by district. The outcome variable was soda consumption and exposure variables were district policies. We used multivariable logistic regression analyses to calculate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) after controlling for student characteristics and district free/reduced-price meal eligibility. Results About 18% of students reported consuming regular soda at least once per day. Most districts required high schools to have nutrition education, maintain closed campuses, and required/recommended that schools restrict promotional products and sale of beverages. Fewer districts required/recommended that schools offer healthful alternative beverages. Students in districts that restricted promotional products had lower odds of regular soda consumption (AOR = .84, 95% CI = .71–1.00), as did students in districts that restricted access to SSBs and offered healthful beverages when other beverages were available (AOR = .72, 95% CI = .54–.93, AOR = .76, 95% CI = .63–.91). Conclusions This study demonstrates that certain district-level policies are associated with student consumption of regular soda. These findings add to a growing consensus that policies and practices that influence the availability of healthier foods and beverages are needed across multiple settings. PMID:27021401

School District Policies and Adolescents' Soda Consumption.

PubMed

Miller, Gabrielle F; Sliwa, Sarah; Brener, Nancy D; Park, Sohyun; Merlo, Caitlin L

2016-07-01

Sugar-sweetened beverages (SSBs) are a significant source of calories and added sugars for youth ages 14-18 years in the United States. This study examined the relationship between district-level policies and practices and students' consumption of regular soda, one type of SSB, in 12 large urban school districts. Data from the 2012 School Health Policies and Practices Study and 2013 Youth Risk Behavior Surveillance System were linked by district. The outcome variable was soda consumption and exposure variables were district policies. We used multivariable logistic regression analyses to calculate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) after controlling for student characteristics and district free/reduced-price meal eligibility. About 18% of students reported consuming regular soda at least once per day. Most districts required high schools to have nutrition education, maintain closed campuses, and required/recommended that schools restrict promotional products and sale of beverages. Fewer districts required/recommended that schools offer healthful alternative beverages. Students in districts that restricted promotional products had lower odds of regular soda consumption (AOR = .84, 95% CI = .71-1.00), as did students in districts that restricted access to SSBs and offered healthful beverages when other beverages were available (AOR = .72, 95% CI = .54-.93, AOR = .76, 95% CI = .63-.91). This study demonstrates that certain district-level policies are associated with student consumption of regular soda. These findings add to a growing consensus that policies and practices that influence the availability of healthier foods and beverages are needed across multiple settings. Published by Elsevier Inc.

Decentralization in Zambia: resource allocation and district performance.

PubMed

Bossert, Thomas; Chitah, Mukosha Bona; Bowser, Diana

2003-12-01

Zambia implemented an ambitious process of health sector decentralization in the mid 1990s. This article presents an assessment of the degree of decentralization, called 'decision space', that was allowed to districts in Zambia, and an analysis of data on districts available at the national level to assess allocation choices made by local authorities and some indicators of the performance of the health systems under decentralization. The Zambian officials in health districts had a moderate range of choice over expenditures, user fees, contracting, targeting and governance. Their choices were quite limited over salaries and allowances and they did not have control over additional major sources of revenue, like local taxes. The study found that the formula for allocation of government funding which was based on population size and hospital beds resulted in relatively equal per capita expenditures among districts. Decentralization allowed the districts to make decisions on internal allocation of resources and on user fee levels and expenditures. General guidelines for the allocation of resources established a maximum and minimum percentage to be allocated to district offices, hospitals, health centres and communities. Districts tended to exceed the maximum for district offices, but the large urban districts and those without public district hospitals were not even reaching the minimum for hospital allocations. Wealthier and urban districts were more successful in raising revenue through user fees, although the proportion of total expenditures that came from user fees was low. An analysis of available indicators of performance, such as the utilization of health services, immunization coverage and family planning activities, found little variation during the period 1995-98 except for a decline in immunization coverage, which may have also been affected by changes in donor funding. These findings suggest that decentralization may not have had either a positive or negative impact on services.

Evaluation of a Smartphone Decision-Support Tool for Diarrheal Disease Management in a Resource-Limited Setting

PubMed Central

Khatun, Selina; Ahmed, Mujaddeed; Kache, Saraswati; Chisti, Mohammod Jobayer; Sarker, Shafiqul Alam; Maples, Stace D.; Pieri, Dane; Vardhan Korrapati, Teja; Sarnquist, Clea; Federspiel, Nancy; Rahman, Muhammad Waliur; Andrews, Jason R.; Rahman, Mahmudur; Nelson, Eric Jorge

2017-01-01

The emergence of mobile technology offers new opportunities to improve clinical guideline adherence in resource-limited settings. We conducted a clinical pilot study in rural Bangladesh to evaluate the impact of a smartphone adaptation of the World Health Organization (WHO) diarrheal disease management guidelines, including a modality for age-based weight estimation. Software development was guided by end-user input and evaluated in a resource-limited district and sub-district hospital during the fall 2015 cholera season; both hospitals lacked scales which necessitated weight estimation. The study consisted of a 6 week pre-intervention and 6 week intervention period with a 10-day post-discharge follow-up. Standard of care was maintained throughout the study with the exception that admitting clinicians used the tool during the intervention. Inclusion criteria were patients two months of age and older with uncomplicated diarrheal disease. The primary outcome was adherence to guidelines for prescriptions of intravenous (IV) fluids, antibiotics and zinc. A total of 841 patients were enrolled (325 pre-intervention; 516 intervention). During the intervention, the proportion of prescriptions for IV fluids decreased at the district and sub-district hospitals (both p < 0.001) with risk ratios (RRs) of 0.5 and 0.2, respectively. However, when IV fluids were prescribed, the volume better adhered to recommendations. The proportion of prescriptions for the recommended antibiotic azithromycin increased (p < 0.001 district; p = 0.035 sub-district) with RRs of 6.9 (district) and 1.6 (sub-district) while prescriptions for other antibiotics decreased; zinc adherence increased. Limitations included an absence of a concurrent control group and no independent dehydration assessment during the pre-intervention. Despite limitations, opportunities were identified to improve clinical care, including better assessment, weight estimation, and fluid/ antibiotic selection. These findings demonstrate that a smartphone-based tool can improve guideline adherence. This study should serve as a catalyst for a randomized controlled trial to expand on the findings and address limitations. PMID:28103233

Spatiotemporal Evolution of Ebola Virus Disease at Sub-National Level during the 2014 West Africa Epidemic: Model Scrutiny and Data Meagreness.

PubMed

Santermans, Eva; Robesyn, Emmanuel; Ganyani, Tapiwa; Sudre, Bertrand; Faes, Christel; Quinten, Chantal; Van Bortel, Wim; Haber, Tom; Kovac, Thomas; Van Reeth, Frank; Testa, Marco; Hens, Niel; Plachouras, Diamantis

2016-01-01

The Ebola outbreak in West Africa has infected at least 27,443 individuals and killed 11,207, based on data until 24 June, 2015, released by the World Health Organization (WHO). This outbreak has been characterised by extensive geographic spread across the affected countries Guinea, Liberia and Sierra Leone, and by localized hotspots within these countries. The rapid recognition and quantitative assessment of localised areas of higher transmission can inform the optimal deployment of public health resources. A variety of mathematical models have been used to estimate the evolution of this epidemic, and some have pointed out the importance of the spatial heterogeneity apparent from incidence maps. However, little is known about the district-level transmission. Given that many response decisions are taken at sub-national level, the current study aimed to investigate the spatial heterogeneity by using a different modelling framework, built on publicly available data at district level. Furthermore, we assessed whether this model could quantify the effect of intervention measures and provide predictions at a local level to guide public health action. We used a two-stage modelling approach: a) a flexible spatiotemporal growth model across all affected districts and b) a deterministic SEIR compartmental model per district whenever deemed appropriate. Our estimates show substantial differences in the evolution of the outbreak in the various regions of Guinea, Liberia and Sierra Leone, illustrating the importance of monitoring the outbreak at district level. We also provide an estimate of the time-dependent district-specific effective reproduction number, as a quantitative measure to compare transmission between different districts and give input for informed decisions on control measures and resource allocation. Prediction and assessing the impact of control measures proved to be difficult without more accurate data. In conclusion, this study provides us a useful tool at district level for public health, and illustrates the importance of collecting and sharing data.

Evaluation of a Smartphone Decision-Support Tool for Diarrheal Disease Management in a Resource-Limited Setting.

PubMed

Haque, Farhana; Ball, Robyn L; Khatun, Selina; Ahmed, Mujaddeed; Kache, Saraswati; Chisti, Mohammod Jobayer; Sarker, Shafiqul Alam; Maples, Stace D; Pieri, Dane; Vardhan Korrapati, Teja; Sarnquist, Clea; Federspiel, Nancy; Rahman, Muhammad Waliur; Andrews, Jason R; Rahman, Mahmudur; Nelson, Eric Jorge

2017-01-01

The emergence of mobile technology offers new opportunities to improve clinical guideline adherence in resource-limited settings. We conducted a clinical pilot study in rural Bangladesh to evaluate the impact of a smartphone adaptation of the World Health Organization (WHO) diarrheal disease management guidelines, including a modality for age-based weight estimation. Software development was guided by end-user input and evaluated in a resource-limited district and sub-district hospital during the fall 2015 cholera season; both hospitals lacked scales which necessitated weight estimation. The study consisted of a 6 week pre-intervention and 6 week intervention period with a 10-day post-discharge follow-up. Standard of care was maintained throughout the study with the exception that admitting clinicians used the tool during the intervention. Inclusion criteria were patients two months of age and older with uncomplicated diarrheal disease. The primary outcome was adherence to guidelines for prescriptions of intravenous (IV) fluids, antibiotics and zinc. A total of 841 patients were enrolled (325 pre-intervention; 516 intervention). During the intervention, the proportion of prescriptions for IV fluids decreased at the district and sub-district hospitals (both p < 0.001) with risk ratios (RRs) of 0.5 and 0.2, respectively. However, when IV fluids were prescribed, the volume better adhered to recommendations. The proportion of prescriptions for the recommended antibiotic azithromycin increased (p < 0.001 district; p = 0.035 sub-district) with RRs of 6.9 (district) and 1.6 (sub-district) while prescriptions for other antibiotics decreased; zinc adherence increased. Limitations included an absence of a concurrent control group and no independent dehydration assessment during the pre-intervention. Despite limitations, opportunities were identified to improve clinical care, including better assessment, weight estimation, and fluid/ antibiotic selection. These findings demonstrate that a smartphone-based tool can improve guideline adherence. This study should serve as a catalyst for a randomized controlled trial to expand on the findings and address limitations.

Western Australia's public hospital system: some aspects of finance and control.

PubMed

Bell, J

1988-01-01

In 1829 the Governor of the Swan River Colony founded a government-controlled and financed hospital for the destitute but, by charging those who could afford to pay, recognised the admission of patients other than the destitute. In the 1850s and 1860s the Colonial Surgeon, without legislative authority, encouraged District Medical Officers (DMOs) to establish small government hospitals in country districts. Thus a pattern of government financed and controlled hospitals was set early in the State's history. From the 1890s to the 1930s successive governments made many attempts to off-load hospital control onto elected committees and the financing of hospitals onto voluntary subscribers and later taxpayers.

Rapid assessment of Ebola infection prevention and control needs--six districts, Sierra Leone, October 2014.

PubMed

Pathmanathan, Ishani; O'Connor, Katherine A; Adams, Monica L; Rao, Carol Y; Kilmarx, Peter H; Park, Benjamin J; Mermin, Jonathan; Kargbo, Brima; Wurie, Alie H; Clarke, Kevin R

2014-12-12

As of October 31, 2014, the Sierra Leone Ministry of Health and Sanitation had reported 3,854 laboratory-confirmed cases of Ebola virus disease (Ebola) since the outbreak began in May 2014; 199 (5.2%) of these cases were among health care workers. Ebola infection prevention and control (IPC) measures are essential to interrupt Ebola virus transmission and protect the health workforce, a population that is disproportionately affected by Ebola because of its increased risk of exposure yet is essential to patient care required for outbreak control and maintenance of the country's health system at large. To rapidly identify existing IPC resources and high priority outbreak response needs, an assessment by CDC Ebola Response Team members was conducted in six of the 14 districts in Sierra Leone, consisting of health facility observations and structured interviews with key informants in facilities and government district health management offices. Health system gaps were identified in all six districts, including shortages or absence of trained health care staff, personal protective equipment (PPE), safe patient transport, and standardized IPC protocols. Based on rapid assessment findings and key stakeholder input, priority IPC actions were recommended. Progress has since been made in developing standard operating procedures, increasing laboratory and Ebola treatment capacity and training the health workforce. However, further system strengthening is needed. In particular, a successful Ebola outbreak response in Sierra Leone will require an increase in coordinated and comprehensive district-level IPC support to prevent ongoing Ebola virus transmission in household, patient transport, and health facility settings.

Development of temporal modelling for forecasting and prediction of malaria infections using time-series and ARIMAX analyses: A case study in endemic districts of Bhutan

PubMed Central

2010-01-01

Background Malaria still remains a public health problem in some districts of Bhutan despite marked reduction of cases in last few years. To strengthen the country's prevention and control measures, this study was carried out to develop forecasting and prediction models of malaria incidence in the endemic districts of Bhutan using time series and ARIMAX. Methods This study was carried out retrospectively using the monthly reported malaria cases from the health centres to Vector-borne Disease Control Programme (VDCP) and the meteorological data from Meteorological Unit, Department of Energy, Ministry of Economic Affairs. Time series analysis was performed on monthly malaria cases, from 1994 to 2008, in seven malaria endemic districts. The time series models derived from a multiplicative seasonal autoregressive integrated moving average (ARIMA) was deployed to identify the best model using data from 1994 to 2006. The best-fit model was selected for each individual district and for the overall endemic area was developed and the monthly cases from January to December 2009 and 2010 were forecasted. In developing the prediction model, the monthly reported malaria cases and the meteorological factors from 1996 to 2008 of the seven districts were analysed. The method of ARIMAX modelling was employed to determine predictors of malaria of the subsequent month. Results It was found that the ARIMA (p, d, q) (P, D, Q)s model (p and P representing the auto regressive and seasonal autoregressive; d and D representing the non-seasonal differences and seasonal differencing; and q and Q the moving average parameters and seasonal moving average parameters, respectively and s representing the length of the seasonal period) for the overall endemic districts was (2,1,1)(0,1,1)12; the modelling data from each district revealed two most common ARIMA models including (2,1,1)(0,1,1)12 and (1,1,1)(0,1,1)12. The forecasted monthly malaria cases from January to December 2009 and 2010 varied from 15 to 82 cases in 2009 and 67 to 149 cases in 2010, where population in 2009 was 285,375 and the expected population of 2010 to be 289,085. The ARIMAX model of monthly cases and climatic factors showed considerable variations among the different districts. In general, the mean maximum temperature lagged at one month was a strong positive predictor of an increased malaria cases for four districts. The monthly number of cases of the previous month was also a significant predictor in one district, whereas no variable could predict malaria cases for two districts. Conclusions The ARIMA models of time-series analysis were useful in forecasting the number of cases in the endemic areas of Bhutan. There was no consistency in the predictors of malaria cases when using ARIMAX model with selected lag times and climatic predictors. The ARIMA forecasting models could be employed for planning and managing malaria prevention and control programme in Bhutan. PMID:20813066

Risk factors for hematemesis in Hoima and Buliisa Districts, Western Uganda, September-October 2015.

PubMed

Kabwama, Steven Ndugwa; Mafigiri, Richardson; Balinandi, Stephen; Kagirita, Atek; Riolexus, Alex Ario; Zhu, Bao-Ping

2017-01-01

On 17 September 2015, Buliisa District Health Office reported multiple deaths due to haemorrhage to the Uganda Ministry of Health. We conducted an investigation to verify the existence of an outbreak and to identify the disease nature, mode of transmission and risk factors. We defined a suspected case as onset of hematemesis between 1 June 2015 and 15 October 2015 in a resident of Hoima, Buliisa or neighbouring districts. We identified cases by reviewing medical records and actively searching in the community. We interviewed case-patients and health-care workers and performed descriptive epidemiology to generate hypotheses on possible exposures. In a case-control study we compared exposures between 21 cases and 81 controls, matched by age (± 10 years), sex and village of residence. We collected 22 biological specimens from 19 case-patients to test for Viral Haemorrhagic Fevers (VHF). We analysed the data using the Mantel-Haenszel method to account for the matched study design. We identified 56 cases with onset from June to October (attack rate 15/100,000 in Buliisa District and 5.2/100,000 in Hoima District). The age-specific attack rate was highest in persons aged 31-60 years (15/100,000 in Hoima and 47/100,000 in Buliisa); no persons below 15 years of age had the illness. In the case-control study, 42% (5/12) of cases vs. 0.0% (0/77) of controls had liver disease (OR M-H = ∞; 95%CI = 3.7-∞); 71% (10/14) of cases vs. 35% (28/81) of controls had ulcer disease (OR M-H = 13; 95% CI = 1.6-98); 27% (3/11) of cases vs. 14% (11/81) of controls used indomethacin prior to disease onset (OR M-H = 6.0; 95% CI = 1.0-36). None of the blood samples were positive for any of the VHFs. This reported cluster of hematemesis illness was due to predisposing conditions and use of Non-Steroidal Anti-inflammatory Drugs (NSAID). Health education should be conducted on the danger of NSAIDs misuse, especially in persons with pre-disposing conditions.

Effects of Differentiated Reading on Elementary Students' Reading Comprehension and Attitudes toward Reading

ERIC Educational Resources Information Center

Shaunessy-Dedrick, Elizabeth; Evans, Linda; Ferron, John; Lindo, Myriam

2015-01-01

In this investigation, we examined the effects of a differentiated reading approach on fourth grade students' reading comprehension and attitudes toward reading. Eight Title I schools within one urban district were randomly assigned to treatment (Schoolwide Enrichment Model-Reading [SEM-R]) or control (district reading curriculum) conditions.…

78 FR 7703 - Revisions to the California State Implementation Plan, South Coast Air Quality Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-04

... the California State Implementation Plan, South Coast Air Quality Management District, Proposed Rule... approve a revision to the South Coast Air Quality Management District (SCAQMD) portion of the California... digesters. Rule 1127 was designed to implement the 2003 Air Quality Management Plan (AQMP) control measure...

The Effects of Three Models of Teacher Supervision: Cooperative, Supervisor Controlled, and Minimal.

ERIC Educational Resources Information Center

Fenton, Ray; And Others

This paper recounts the development of a cooperative teacher evaluation system by the Anchorage (Alaska) School District and presents the data that led Anchorage educators to conclude that cooperative evaluation is superior to either traditional supervisor-directed evaluation or minimal unstructured evaluation. In 1984, the district formed a task…

Get in the Conversation: Special-Education Efficiencies and Paraprofessional Staffing

ERIC Educational Resources Information Center

Young, Nicholas; Bittel, Peter

2011-01-01

Most districts are facing severe budgetary constraints, and special education is one area that is feeling the effects. Special education consumes an average of 20%-30% of school district budgets. Pacing fiscal and systemic controls on special-education spending, and examining para professional placements in particular, will lead to better delivery…

School District (K-12) Pandemic Influenza Planning Checklist

ERIC Educational Resources Information Center

Centers for Disease Control and Prevention, 2009

2009-01-01

Local educational agencies (LEAs) play an integral role in protecting the health and safety of their district's staff, students and their families. The Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) have developed this checklist to assist LEAs in developing and/or improving plans to prepare…

Local Politics and Portfolio Management Models: National Reform Ideas and Local Control

ERIC Educational Resources Information Center

Bulkley, Katrina E.; Henig, Jeffrey R.

2015-01-01

Amid the growth of charter schools, autonomous schools, and private management organizations, an increasing number of urban districts are moving toward a portfolio management model (PMM). In a PMM, the district central office oversees schools that operate under a variety of governance models. The expansion of PMMs raises questions about local…

Implementing LCFF: Possible Solutions to Emergent LCAP Challenges. Policy and Practice Brief

ERIC Educational Resources Information Center

Blum, Jarah; Knudson, Joel

2016-01-01

The Local Control Funding Formula (LCFF) represents a sea change in the way California funds public education. By directing resources to the students in greatest need, freeing districts from the constraints of categorical programs, and inviting stakeholder participation, the new funding system creates the conditions for districts to advance goals…

78 FR 5185 - Notice of Availability of Final Environmental Assessment (FINAL EA) and a Finding of No...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-24

... Metropolitan Sewer District of Greater Cincinnati Easement on HHS/CDC/NIOSH Taft North Campus, Cincinnati, OH AGENCY: Centers for Disease Control and Prevention (CDC), Department of Health and Human Services (HHS... Significant Impact (FONSI) for Metropolitan Sewer District of Greater Cincinnati Easement on HHS/CDC/NIOSH...

2020 Vision: Rethinking Budget Priorities under the LCFF

ERIC Educational Resources Information Center

Policy Analysis for California Education, PACE, 2014

2014-01-01

After years of painful budget cuts, new revenues will begin to flow to California school districts in 2014. Thanks to the voters' approval of Proposition 30 and the adoption of the Local Control Funding Formula (LCFF), nearly all districts can expect budget increases over the next several years. In this report PACE offers guidance on…

Indianapolis Plan Suggests Blueprint for Other Districts

ERIC Educational Resources Information Center

Samuels, Christina A.

2012-01-01

An Indianapolis-based nonprofit organization has crafted a sweeping plan for reworking the 33,000-student Indianapolis school system that would place the district under the control of the city's mayor, pare down the money spent in central administration, and give principals broad authority to hire and fire teachers. The reform plan created by the…

Implementing LCFF: Communicating about District Plans. Policy and Practice Brief

ERIC Educational Resources Information Center

Knudson, Joel

2016-01-01

California educators continue in their struggle to communicate district plans to parents, teachers, and other members of the school community. Local Control Accountability Plans (LCAPs), have ballooned into jargon-laden stacks of tables, impenetrable to all but the most sophisticated reader. Envisioned as a tool to improve transparency, the LCAP…

Naming and Shaming for Conservation: Evidence from the Brazilian Amazon

PubMed Central

Cisneros, Elías; Zhou, Sophie Lian; Börner, Jan

2015-01-01

Deforestation in the Brazilian Amazon has dropped substantially after a peak of over 27 thousand square kilometers in 2004. Starting in 2008, the Brazilian Ministry of the Environment has regularly published blacklists of critical districts with high annual forest loss. Farms in blacklisted districts face additional administrative hurdles to obtain authorization for clearing forests. In this paper we add to the existing literature on evaluating the Brazilian anti-deforestation policies by specifically quantifying the impact of blacklisting on deforestation. We first use spatial matching techniques using a set of covariates that includes official blacklisting criteria to identify control districts. We then explore the effect of blacklisting on change in deforestation in double difference regressions with panel data covering the period from 2002 to 2012. Multiple robustness checks are conducted including an analysis of potential causal mechanisms behind the success of the blacklist. We find that the blacklist has considerably reduced deforestation in the affected districts even after controlling for the potential mechanism effects of field-based enforcement, environmental registration campaigns, and rural credit. PMID:26398096

3. EAGLE ROCK CONTROL CENTER, OPERATIONS CONTROL. AS SYSTEM BECOMES ...

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

3. EAGLE ROCK CONTROL CENTER, OPERATIONS CONTROL. AS SYSTEM BECOMES INCREASINGLY AUTOMATED, EAGLE ROCK WILL BECOME MORE AND MORE THE CENTRAL CONTROL SYSTEM OF THE METROPOLITAN WATER DISTRICT. - Eagle Rock Operations Control Center, Pasadena, Los Angeles County, CA

Financial management systems under decentralization and their effect on malaria control in Uganda.

PubMed

Kivumbi, George W; Nangendo, Florence; Ndyabahika, Boniface Rutagira

2004-01-01

A descriptive case study with multiple sites and a single level of analysis was carried out in four purposefully selected administrative districts of Uganda to investigate the effect of financial management systems under decentralization on malaria control. Data were primarily collected from 36 interviews with district managers, staff at health units and local leaders. A review of records and documents related to decentralization at the central and district level was also used to generate data for the study. We found that a long, tedious, and bureaucratic process combined with lack of knowledge in working with new financial systems by several actors characterized financial flow under decentralization. This affected the timely use of financial resources for malaria control in that there were funds in the system that could not be accessed for use. We were also told that sometimes these funds were returned to the central government because of non-use due to difficulties in accessing them and/or stringent conditions not to divert them to other uses. Our data showed that a cocktail of bureaucratic control systems, corruption and incompetence make the financial management system under decentralization counter-productive for malaria control. The main conclusion is that good governance through appropriate and efficient financial management systems is very important for effective malaria control under decentralization.

The Wheels on the Bus Go “Buy Buy Buy”: School Bus Advertising Laws

PubMed Central

2012-01-01

School buses, a practical necessity for millions of children, are at the center of new efforts to raise revenue. School bus advertising laws bring public health and commercialization concerns to the school setting. In doing so, they potentially expose school districts to First Amendment lawsuits. I examined various school bus advertising bills and laws. I reviewed First Amendment “forum analysis” as applied in the transit and school settings to clarify how this legal test may affect school districts subject to such laws. I have made recommendations for school districts to enact appropriate policies to ensure that such advertising does not undermine public health and to enable the districts to maintain control over their property. PMID:22742065

Positive Influence of Behavior Change Communication on Knowledge, Attitudes, and Practices for Visceral Leishmaniasis/Kala-azar in India.

PubMed

Srinivasan, Raghavan; Ahmad, Tanwir; Raghavan, Vidya; Kaushik, Manisha; Pathak, Ramakant

2018-03-21

Visceral leishmaniasis (VL) is endemic to 54 districts in 4 states of India. Poor awareness of the disease and inappropriate health-seeking behavior are major challenges to eliminating the disease. Between February 2016 and March 2017, we implemented a behavior change communication (BCC) intervention in 33 districts of Bihar, 4 districts of Jharkhand, and 3 districts of West Bengal using a mix of channels, including group and interpersonal communication, to improve knowledge, attitudes, and practices of communities, frontline health workers, and opinion leaders. We conducted an impact assessment in October 2016, after the second indoor residual spraying (IRS) round, in Bihar and Jharkhand to evaluate the effect of the BCC intervention. Villages in 10 districts of Bihar and 4 districts in Jharkhand were selected for inclusion in the assessment. Selected villages were categorized as either intervention or control based on where project activities were conducted. Households were randomly selected proportional to caste composition, and interviewers surveyed the head of the household on whether the house was sprayed during the last IRS round and on knowledge, attitudes, and practices related to VL. We interviewed 700 households in intervention villages and 350 households in control villages and conducted correlation analysis to explore the association between IRS refusal and socioeconomic variables, and tested for association between IRS refusal and exposure to BCC activities. Odds ratios (ORs) were calculated. We reached an estimated 3.3 million contacts in Bihar and Jharkhand through the intervention's BCC activities. IRS refusal rates were significantly lower in intervention households than control households (mean=7.95% vs. 24.45%, respectively; OR, 0.27; 95% confidence interval [CI], 0.11 to 0.62; P <.001). Households in intervention villages were more aware than those in control villages that VL is spread by sand flies (68.4% vs. 7.4%, respectively; P <.001) and of IRS as an effective control measure (82.3% vs. 41.7%, respectively; P <.001). A greater percentage of households in intervention villages than control villages indicated they would encourage a patient to go to primary health centers for diagnosis and treatment of VL (77.0% vs. 39.4%, respectively) and to encourage others to accept IRS (78.6% vs. 44.6%, respectively; P <.001). Households that were exposed to community-based BCC activities largely using group and interpersonal communication had better knowledge, attitudes, and practices related to VL, including acceptance of IRS as a preventive measure, than households not exposed. BCC activities are thus an important component of VL elimination strategies. © Srinivasan et al.

Mosquito politics: local vector control policies and the spread of West Nile Virus in the Chicago region.

PubMed

Tedesco, Carmen; Ruiz, Marilyn; McLafferty, Sara

2010-11-01

Differences in mosquito control practices at the local level involve the interplay of place, scale and politics. During the Chicago West Nile Virus (WNV) outbreak of 2002, mosquito abatement districts represent distinct suburban clusters of human WNV cases, independent of characteristics of the local population, housing and physical environment. We examine how the contrasting actions of four districts reveal a distinct local politics of mosquito control that may have contributed to local-scale geographic differences in WNV incidence. This politics is rooted in political, economic and philosophical differences within and between administrative boundaries. Copyright © 2010 Elsevier Ltd. All rights reserved.

Arsenic contamination of ground water and its health impact on population of district of nadia, west bengal, India.

PubMed

Mazumder, Debendra Nath Guha; Ghosh, Aloke; Majumdar, Kunal Kanti; Ghosh, Nilima; Saha, Chandan; Mazumder, Rathindra Nath Guha

2010-04-01

The global health impact and disease burden due to chronic arsenic toxicity has not been well studied in West Bengal. To ascertain these, a scientific epidemiological study was carried out in a district of the state. Epidemiological study was carried out by house-to-house survey of arsenic affected villages in the district of Nadia. A stratified multi-stage design has been adopted for this survey for the selection of the participants. A total number of 2297 households of 37 arsenic affected villages in all the 17 blocks were surveyed in the district. Out of 10469 participants examined, prevalence rate of arsenicosis was found to be 15.43%. Out of 0.84 million people suspected to be exposed to arsenic, 0.14 million people are estimated to be suffering from arsenicosis in the district. Highest level of arsenic in drinking water sources was found to be 1362 μg/l, and in 23% cases it was above 100 μg/l. Majority of the population living in the arsenic affected villages were of low socio-economic condition, inadequate education and were farmers or doing physical labour. Chronic lung disease was found in 207 (12.81%) subjects among cases and 69 (0.78%) in controls. Peripheral neuropathy was found in 257 (15.9%) cases and 136 (1.5%) controls. Large number of people in the district of Nadia are showing arsenical skin lesion. However, insufficient education, poverty, lack of awareness and ineffective health care support are major factors causing immense plight to severely arsenic affected people.

A survey of California public school districts' ant and weed management practices and a review of their use of IPM.

PubMed

Barnes, Carole; Sutherland, Sandra; Brattesani, Madeline; Wilhoit, Larry; Messenger, Belinda

2012-04-01

The U.S. Environmental Protection Agency encourages school officials to adopt integrated pest management (IPM) to reduce children's exposure to potentially harmful pesticides. In California, the Healthy Schools Act of 2000 (HSA) establishes right-to-know requirements for pesticide use in public schools; requires school districts to designate an IPM coordinator; and requires the California Department of Pesticide Regulation (DPR) to collect pesticide-use information from pest control businesses, conduct IPM training workshops, and promote least-toxic pest management practices. DPR periodically surveys school districts statewide to measure compliance with the HSA and the use of least-toxic management practices compatible with IPM and to guide DPR's training and outreach efforts. Results from three surveys, conducted in 2001, 2002, and 2004, show that an increasing number of districts use ant management practices compatible with IPM; however, fewer districts use IPM-compatible weed management practices. DPR's California School IPM program plans to develop technical materials and to conduct training workshops that will provide districts with more information about how to use an IPM program to prevent and manage weeds.

From Zero Energy Buildings to Zero Energy Districts

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

Polly, Ben; Kutscher, Chuck; Macumber, Dan

Some U.S. cities are planning advanced districts that have goals for zero energy, water, waste, and/or greenhouse gas emissions. From an energy perspective, zero energy districts present unique opportunities to cost-effectively achieve high levels of energy efficiency and renewable energy penetration across a collection of buildings that may be infeasible at the individual building scale. These high levels of performance are accomplished through district energy systems that harness renewable and wasted energy at large scales and flexible building loads that coordinate with variable renewable energy supply. Unfortunately, stakeholders face a lack of documented processes, tools, and best practices to assistmore » them in achieving zero energy districts. The National Renewable Energy Laboratory (NREL) is partnering on two new district projects in Denver: the National Western Center and the Sun Valley Neighborhood. We are working closely with project stakeholders in their zero energy master planning efforts to develop the resources needed to resolve barriers and create replicable processes to support future zero energy district efforts across the United States. Initial results of these efforts include the identification and description of key zero energy district design principles (maximizing building efficiency, solar potential, renewable thermal energy, and load control), economic drivers, and master planning principles. The work has also resulted in NREL making initial enhancements to the U.S. Department of Energy's open source building energy modeling platform (OpenStudio and EnergyPlus) with the long-term goal of supporting the design and optimization of energy districts.« less

78 FR 21537 - Revisions to the California State Implementation Plan, Santa Barbara and San Diego County Air...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-11

...EPA is taking direct final action to approve revisions to the Santa Barbara County Air Pollution Control District (SBCAPCD) and San Diego County Air Pollution Control District (SDCAPCD) portions of the California State Implementation Plan (SIP). These revisions concern volatile organic compound (VOC) emissions from surface coating of aerospace vehicles and components and from wood products coating operations. We are approving local rules that regulate these emission sources under the Clean Air Act as amended in 1990 (CAA or the Act).

78 FR 12243 - Interim Final Determination To Stay and Defer Sanctions, Placer County Air Pollution Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-22

...EPA is making an interim final determination to stay the imposition of offset sanctions and to defer the imposition of highway sanctions based on a proposed approval of a revision to the Placer County Air Pollution Control District (PCAPCD) and Feather River Air Quality Management District (FRAQMD) portion of the California State Implementation Plan (SIP) published elsewhere in this Federal Register. The SIP revision concerns two permitting rules submitted by the PCAPCD and FRAQMD, respectively: Rule 502, New Source Review, and Rule 10.1, New Source Review.

78 FR 21580 - Revisions to the California State Implementation Plan, Santa Barbara and San Diego County Air...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-11

...EPA is proposing to approve revisions to the Santa Barbara County Air Pollution Control District (SBCAPCD) and San Diego County Air Pollution Control District (SDCAPCD) portions of the California State Implementation Plan (SIP). These revisions concern volatile organic compound (VOC) emissions from surface coating of aerospace vehicles and components and from wood products coating operations. We are proposing to approve local rules to regulate these emission sources under the Clean Air Act as amended in 1990 (CAA or the Act).

Chapter Nine of the Federal Bankruptcy Act: A Fiscal Alternative for School Districts.

ERIC Educational Resources Information Center

Wood, R. Craig

1985-01-01

Examines and addresses the major issues involved in school districts voluntarily filing for protection under the control and supervision of Chapter 9 of the Federal Bankruptcy Act. Discusses legal and managerial alternatives and examines the most recent Supreme Court ruling regarding the rejection of collective bargaining contracts under the act.…

The Effects of Cluster-Based Mentoring Programme on Classroom Teaching Practices: Lessons from Pakistan

ERIC Educational Resources Information Center

Rizvi, Meher; Nagy, Philip

2016-01-01

This paper presents and evaluates a teacher training approach called the cluster-based mentoring programme (CBMP) for the professional development of government primary school teachers in Pakistan. The study sought to find differences in the teaching practices between districts where the CBMP was used (intervention) and control districts where it…

California State Implementation Plan; Final Approval of Revision; Yolo-Solano Air Quality Management District; Reasonably Available Control Technology Requirements for 1997 8-hour Ozone NAAQS

EPA Pesticide Factsheets

EPA is taking final action to approve a revision to the Yolo-Solano Air Quality Management District (YSAQMD) portion of the California SIP concerning YSAQMD regarding RACT)requirements the 1997 8-hour ozone NAAQS and approve negative declarations into SIP.

The Forgotten Side of School Finance Equity: The Role of Infrastructure Funding in Student Success

ERIC Educational Resources Information Center

Crampton, Faith E.; Thompson, David C.; Vesely, Randall S.

2004-01-01

Traditionally, local school districts have shouldered the burden of funding school infrastructure in the name of local control, relying upon local property tax revenues and the willingness of local voters to approve bond issues. Given vast disparities in school districts' property wealth, gross inequities in school facilities will remain without…

77 FR 39262 - Notice of Lodging of Consent Decree Under the Clean Air Act

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-02

... Frozen Bakery Products, Inc. (collectively ``Cottage'') for violations of the federal Clean Air Act, 42 U... Joaquin Valley Unified Air Pollution Control District v. Cottage Bakery, Inc. and Ralcorp Frozen Bakery Products, Inc., case number 2:12-at-00895, was lodged with the United States District Court for the Eastern...

Outcomes of an HIV Prevention Peer Group Intervention for Rural Adults in Malawi

ERIC Educational Resources Information Center

Kaponda, Chrissie P. N.; Norr, Kathleen F.; Crittenden, Kathleen S.; Norr, James L.; McCreary, Linda L.; Kachingwe, Sitingawawo I.; Mbeba, Mary M.; Jere, Diana L. N.; Dancy, Barbara L.

2011-01-01

This study used a quasi-experimental design to evaluate a six-session peer group intervention for HIV prevention among rural adults in Malawi. Two rural districts were randomly assigned to intervention and control conditions. Independent random samples of community adults compared the districts at baseline and at 6 and 18 months postintervention.…

From Innovation Schools to an Innovation Zone in Denver, Colorado

ERIC Educational Resources Information Center

Iyengar, Nithin; Lewis-LaMonica, Kate; Perigo, Mike

2017-01-01

This article is part of a Bridgespan Group research project that focuses on a new wave of district-led "innovation zones" that holds promise to overcome the challenges of turning around failing schools and deliver significant improvements in student outcomes. This new wave provides a subset of district schools with control over staffing,…

Innovation Network Schools in Indianapolis: Phalen Leadership Academies Takes the Lead

ERIC Educational Resources Information Center

Iyengar, Nithin; Lewis-LaMonica, Kate; Perigo, Mike

2017-01-01

This article is part of a Bridgespan Group research project that focuses on a new wave of district-led "innovation zones" that holds promise to overcome the challenges of turning around failing schools and deliver significant improvements in student outcomes. This new wave provides a subset of district schools with control over staffing,…

Dashboard Lights: Monitoring Implementation of District Instructional Reform Strategies

ERIC Educational Resources Information Center

Supovitz, Jonathan A.; Weathers, John

2004-01-01

Duval County Florida superintendent John Fryer was not used to flying blind. A retired Air Force major general and former tactical fighter wing commander new to school district leadership, Fryer was used to having a control panel packed with information. In front of him in the cockpit, Fryer had a wide range of continually updated data from which…

Making the Most of Opportunities to Learn What Works: A School District's Guide. REL 2014-048

ERIC Educational Resources Information Center

Akers, Lauren; Resch, Alexandra; Berk, Jillian

2014-01-01

This guide for district and school leaders shows how to recognize opportunities to embed randomized controlled trials (RCTs) into planned policies or programs. Opportunistic RCTs can generate strong evidence for informing education decisions--with minimal added cost and disruption. The guide also outlines the key steps to conduct RCTs and responds…

40 CFR 52.1167 - EPA-approved Massachusetts State regulations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 48303 c(117) Adds the following coating operations: plastic parts surface coating, leather surface... Includes Berkshire Air Pollution Control District to 7.05(4)(b)(2) so facilities in that district can apply....18(21) Surface coating of plastic parts 2/17/93 9/3/1999 64 FR 48304 c(117) Adds VOC RACT for plastic...

The Illinois General Purpose Grant-in-Aid System, 1979-1980.

ERIC Educational Resources Information Center

Lundeen, Virginia; And Others

This discussion begins with the five major political values that were reflected in the 1973 reform of the Illinois school aid system. The lawmakers wanted to spend state dollars for education in a way that would improve student and taxpayer equity, maintain local control of school districts, aid poverty-impacted districts, not discriminate against…

The Louisiana Recovery School District: Lessons for the Buckeye State

ERIC Educational Resources Information Center

Smith, Nelson

2012-01-01

Is it time for Ohio to take bolder steps toward turning around its most troubled schools and districts? If so, what might the alternatives look like? Options for rebooting these troubled schools have come in the form of mayoral control, state takeovers, market competition through charter schools and other choice programs, as well as millions of…

School Finance Reform: Can It Support California's College- and Career-Ready Goal? Report 2

ERIC Educational Resources Information Center

Perry, Mary

2013-01-01

For decades, when California's state leaders have wanted to see local school districts respond to shifts in policy and expectations they relied on the state-controlled school finance system to leverage local change. Through the use of categorical programs and earmarked funding, they created incentives for districts that complied and penalties for…

The Triple Challenge of Evaluating Teachers

ERIC Educational Resources Information Center

Weber, Cindy

2013-01-01

School funding always will be a concern to school leaders, but it is an issue that districts have little control over. Teacher evaluation too often is a matter of compliance in school districts, and the author has always wanted to do something about it. Because of recent legislative changes to teacher evaluation in Michigan, where the author led a…

School District Regionalization in Rhode Island: Relationship with Spending and Achievement

ERIC Educational Resources Information Center

Masterson, Jason R.

2012-01-01

In Rhode Island, unless costs for education are controlled, taxpayers could face increased property taxes, increased sales tax on goods and services, and tax increases to existing fees to raise revenue (NEEP, 2010). Reducing the number of school districts was cited as the number two solution by the New England Economic Partnership in 2010 to…

Deforestation in Mwanza District, Malawi, from 1981 to 1992 as determined from Landsat MSS imagery

Treesearch

Andrew T. Hudak; Carol A. Wessman

2000-01-01

Malawi is critically short of fuelwood, the primary energy source for its poverty-stricken populace. Deforestation from 1981 to 1992 in Mwanza District in southern Malawi was assessed using Normalized Difference Vegetation Index (NDVI) values calculated from multitemporal Landsat Multispectral Scanner (MSS) images. A control site, where vegetation change was assumed to...

Environmental Assessment and FONSI for the Bison School District Heating Plant Project (Institutional Conservation Program [ICP]).

ERIC Educational Resources Information Center

Department of Energy, Washington, DC.

This paper examines the environmental impacts of replacing the Bison, South Dakota School District's elementary and high school heating system consisting of oil-fired boilers, and supporting electrical components with a new coal-fired boiler and supporting control system piping. Various alternative systems are also examined, including purchasing a…

Soil erosion and sediment control laws. A review of state laws and their natural resource data requirements

NASA Technical Reports Server (NTRS)

Klein, S. B.

1980-01-01

Twenty states, the District of Columbia, and the Virgin Islands enacted erosion and sediment control legislation during the past decade to provide for the implementation or the strengthening of statewide erosion and sediment control plans for rural and/or urban lands. That legislation and the state programs developed to implement these laws are quoted and reviewed. The natural resource data requirements of each program are also extracted. The legislation includes amendments to conservation district laws, water quality laws, and erosion and sediment control laws. Laws which provides for legislative review of administrative regulations and LANDSAT applications and/or information systems that were involved in implementing or gathering data for a specific soil erosion and sediment control program are summarized as well as principal concerns affecting erosion and sediment control laws.

Implementation research to improve quality of maternal and newborn health care, Malawi.

PubMed

Brenner, Stephan; Wilhelm, Danielle; Lohmann, Julia; Kambala, Christabel; Chinkhumba, Jobiba; Muula, Adamson S; De Allegri, Manuela

2017-07-01

To evaluate the impact of a performance-based financing scheme on maternal and neonatal health service quality in Malawi. We conducted a non-randomized controlled before and after study to evaluate the effects of district- and facility-level performance incentives for health workers and management teams. We assessed changes in the facilities' essential drug stocks, equipment maintenance and clinical obstetric care processes. Difference-in-difference regression models were used to analyse effects of the scheme on adherence to obstetric care treatment protocols and provision of essential drugs, supplies and equipment. We observed 33 health facilities, 23 intervention facilities and 10 control facilities and 401 pregnant women across four districts. The scheme improved the availability of both functional equipment and essential drug stocks in the intervention facilities. We observed positive effects in respect to drug procurement and clinical care activities at non-intervention facilities, likely in response to improved district management performance. Birth assistants' adherence to clinical protocols improved across all studied facilities as district health managers supervised and coached clinical staff more actively. Despite nation-wide stock-outs and extreme health worker shortages, facilities in the study districts managed to improve maternal and neonatal health service quality by overcoming bottlenecks related to supply procurement, equipment maintenance and clinical performance. To strengthen and reform health management structures, performance-based financing may be a promising approach to sustainable improvements in quality of health care.

Pesticide susceptibility status of Anopheles mosquitoes in four flood-affected districts of South Punjab, Pakistan.

PubMed

Rathor, Hamayun Rashid; Nadeem, Ghazala; Khan, Imtinan Akram

2013-01-01

Recent floods drastically increased the burden of disease, in particular the incidence of malaria, in the southern districts of the Punjab province in Pakistan. Control of malaria vector mosquitoes in these districts requires the adoption of an appropriate evidence-based policy on the use of pesticides, and having the latest information on the insecticide resistance status of malaria vector mosquitoes is essential for designing effective disease prevention policy. Using World Health Organization (WHO) test kits, the present study utilized papers impregnated with DDT, malathion, deltamethrin, lambda-cyhalothrin, and permethrin, to determine the insecticide susceptibility/resistance status of malaria vector mosquitoes in four flood-affected districts. The test results showed that both Anopheles stephensi and Anopheles culicifacies remained resistant to DDT and malathion. Tests with three commonly used pyrethroids, permethrin, lambda-cyhalothrin, and deltamethrin, detected resistance in the majority of cases, but in a number of localities mortalities with these three pyrethroids ranged from 80-97% and were therefore placed under verification-required status. This status indicates the presence of susceptible individuals in these populations. These results suggest that if appropriate resistance management strategies are applied in these areas, then the development of high levels of resistance can still be prevented or slowed. This study forms an important evidence base for the strategic planning of vector control in the four flood-affected districts.

[Investigation on awareness rates of malaria prevention knowledge among residents and students in Huai'an District, Huai'an City].

PubMed

Su-Min, Ren; Zhao-Wu, Tang

2016-05-24

To understand the awareness status on malaria control knowledge of residents, primary and middle school students in Huai'an District, Huai'an City, so as to provide the evidences for promoting the malaria elimination process in this district. Three towns in Huai'an District were selected randomly, and one village, one primary school and one junior middle school in each town were chosen as the investigation sites. The residents over 18 years old, the primary school students in Grade 4 to 6, and the junior middle students in the investigation sites were investigated by questionnaires to understand their awareness status on knowledge of malaria control. Totally 305 residents and 618 students were investigated. The awareness rate of students was 89.97%, and the rates of the junior middle school students and primary school students were 85.94% and 94.10%, respectively, the difference between them was statistically significant ( P ＜0.01). The awareness rate of the residents was 80.98%, which was lower than that of the students ( P ＜0.05). For the students, the awareness rate on "precaution of malaria" (96.74%) was the highest, while that on "drug of malaria" (68.93%) was the lowest. For the residents, the rate on "transmission route of malaria" (95.08%) was the highest, that on "4·26 is Malaria Day" (64.26%) was the lowest. Expect the items of "transmission route of malaria" and "precaution of malaria" (both P ＞0.05), the differences of the awareness rates on all the other items between the students and residents were statistically significant (all P ＜0.01). Although the awareness rates of malaria control knowledge in the population of Huai'an District, Huai'an City have achieved the goal of the relevant requirement, the health education on malaria control still should be strengthened, especially for the primary students, female residents and exported labor service personnel.

A comparative evaluation of end-emic and non-endemic region of visceral leishmaniasis (Kala-azar) in India with ground survey and space technology.

PubMed

Kesari, Shreekant; Bhunia, Gouri Sankar; Kumar, Vijay; Jeyaram, Algarswamy; Ranjan, Alok; Das, Pradeep

2011-08-01

In visceral leishmaniasis, phlebotomine vectors are targets for control measures. Understanding the ecosystem of the vectors is a prerequisite for creating these control measures. This study endeavours to delineate the suitable locations of Phlebotomus argentipes with relation to environmental characteristics between endemic and non-endemic districts in India. A cross-sectional survey was conducted on 25 villages in each district. Environmental data were obtained through remote sensing images and vector density was measured using a CDC light trap. Simple linear regression analysis was used to measure the association between climatic parameters and vector density. Using factor analysis, the relationship between land cover classes and P. argentipes density among the villages in both districts was investigated. The results of the regression analysis indicated that indoor temperature and relative humidity are the best predictors for P. argentipes distribution. Factor analysis confirmed breeding preferences for P. argentipes by landscape element. Minimum Normalised Difference Vegetation Index, marshy land and orchard/settlement produced high loading in an endemic region, whereas water bodies and dense forest were preferred in non-endemic sites. Soil properties between the two districts were studied and indicated that soil pH and moisture content is higher in endemic sites compared to non-endemic sites. The present study should be utilised to make critical decisions for vector surveillance and controlling Kala-azar disease vectors.

Status of Urban Bed Bug Infestations in Southern China: An Analysis of Pest Control Service Records in Shenzhen in 2012 and Dongguan in 2013.

PubMed

Wang, Lei; Cai, Xuquan; Xu, Yijuan

2015-01-01

The recent resurgence of bed bugs (Cimex spp.) in many developed countries has drawn increasing attention worldwide. The status of urban bed bug infestations were investigated in Shenzhen and Dongguan, two major cities in southern Guangdong Province of southern China, based on pest control service records from two different companies (one during 2012 and another during 2013). The results showed that Shenzhen and Dongguan have a severe problem with bed bug infestations: the control of bed bugs is a constant concern, except during the winter. In Shenzhen, a similar number of premises were treated for bed bugs in central business districts and suburban districts. However, in Dongguan, more premises were treated for bed bugs in suburban districts than in central business districts. The treatment rate for worker sleeping quarters, apartments, hotel, and private houses in Shenzhen was 53.8, 43.0, 1.9, and 1.3%, respectively. The percentage of treated rooms was 56.1% for worker sleeping quarters and 91.1% for apartments. In Dongguan, the treatment rate for worker sleeping quarters, apartments, hotel, and private houses was 90.0, 10.0, 0.0, and 0.0%, respectively. © The Authors 2015. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A comparative study of the quality of care and glycemic control among ambulatory type 2 diabetes mellitus clients, at a Tertiary Referral Hospital and a Regional Hospital in Central Kenya.

PubMed

Mwavua, Shillah Mwaniga; Ndungu, Edward Kiogora; Mutai, Kenneth K; Joshi, Mark David

2016-01-05

Peripheral public health facilities remain the most frequented by the majority of the population in Kenya; yet remain sub-optimally equipped and not optimized for non-communicable diseases care. We undertook a descriptive, cross sectional study among ambulatory type 2 diabetes mellitus clients, attending Kenyatta National Referral Hospital (KNH), and Thika District Hospital (TDH) in Central Kenya. Systematic random sampling was used. HbA1c was assessed for glycemic control and the following, as markers of quality of care: direct client costs, clinic appointment interval and frequency of self monitoring test, affordability and satisfaction with care. We enrolled 200 clients, (Kenyatta National Hospital 120; Thika District Hospital 80); Majority of the patients 66.5% were females, the mean age was 57.8 years; and 58% of the patients had basic primary education. 67.5% had diabetes for less than 10 years and 40% were on insulin therapy. The proportion (95% CI) with good glycemic was 17% (12.0-22.5 respectively) in the two facilities [Kenyatta National Hospital 18.3% (11.5-25.6); Thika District Hospital 15% (CI 7.4-23.7); P = 0.539]. However, in Thika District Hospital clients were more likely to have a clinic driven routine urinalysis and weight, they were also accorded shorter clinic appointment intervals; incurred half to three quarter lower direct costs, and reported greater affordability and satisfactions with care. In conclusion, we demonstrate that in Thika district hospital, glycemic control and diabetic care is suboptimal; but comparable to that of Kenyatta National Referral hospital. Opportunities for improvement of care abound at peripheral health facilities.

Seasonal prevalence of malaria in West Sumba district, Indonesia

PubMed Central

Syafruddin, Din; Krisin; Asih, Puji; Sekartuti; Dewi, Rita M; Coutrier, Farah; Rozy, Ismail E; Susanti, Augustina I; Elyazar, Iqbal RF; Sutamihardja, Awalludin; Rahmat, Agus; Kinzer, Michael; Rogers, William O

2009-01-01

Background Accurate information about the burden of malaria infection at the district or provincial level is required both to plan and assess local malaria control efforts. Although many studies of malaria epidemiology, immunology, and drug resistance have been conducted at many sites in Indonesia, there is little published literature describing malaria prevalence at the district, provincial, or national level. Methods Two stage cluster sampling malaria prevalence surveys were conducted in the wet season and dry season across West Sumba, Nusa Tenggara Province, Indonesia. Results Eight thousand eight hundred seventy samples were collected from 45 sub-villages in the surveys. The overall prevalence of malaria infection in the West Sumba District was 6.83% (95% CI, 4.40, 9.26) in the wet season and 4.95% (95% CI, 3.01, 6.90) in the dry. In the wet season Plasmodium falciparum accounted for 70% of infections; in the dry season P. falciparum and Plasmodium vivax were present in equal proportion. Malaria prevalence varied substantially across the district; prevalences in individual sub-villages ranged from 0–34%. The greatest malaria prevalence was in children and teenagers; the geometric mean parasitaemia in infected individuals decreased with age. Malaria infection was clearly associated with decreased haemoglobin concentration in children under 10 years of age, but it is not clear whether this association is causal. Conclusion Malaria is hypoendemic to mesoendemic in West Sumba, Indonesia. The age distribution of parasitaemia suggests that transmission has been stable enough to induce some clinical immunity. These prevalence data will aid the design of future malaria control efforts and will serve as a baseline against which the results of current and future control efforts can be assessed. PMID:19134197

Prevalence and spatial distribution of Theileria parva in cattle under crop-livestock farming systems in Tororo District, Eastern Uganda

PubMed Central

2014-01-01

Background Tick-borne diseases (TBDs) present a major economic burden to communities across East Africa. Farmers in East Africa must use acaracides to target ticks and prevent transmission of tick-borne diseases such as anaplasmosis, babesiosis, cowdriosis and theileriosis; the major causes of cattle mortality and morbidity. The costs of controlling East Coast Fever (ECF), caused by Theileria parva, in Uganda are significant and measures taken to control ticks, to be cost-effective, should take into account the burden of disease. The aim of the present work was to estimate the burden presented by T. parva and its spatial distribution in a crop-livestock production system in Eastern Uganda. Methods A cross sectional study was carried out to determine the prevalence and spatial distribution of T. parva in Tororo District, Uganda. Blood samples were taken from all cattle (n: 2,658) in 22 randomly selected villages across Tororo District from September to December 2011. Samples were analysed by PCR and T. parva prevalence and spatial distribution determined. Results The overall prevalence of T. parva was found to be 5.3%. Herd level prevalence ranged from 0% to 21% with majority of the infections located in the North, North-Eastern and South-Eastern parts of Tororo District. No statistically significant differences in risk of infection were found between age classes, sex and cattle breed. Conclusions T. parva infection is widely distributed in Tororo District, Uganda. The prevalence and distribution of T. parva is most likely determined by spatial distribution of R. appendiculatus, restricted grazing of calves and preferential tick control targeting draft animals. PMID:24589227

Mobile-based blended learning for capacity building of health providers in rural Afghanistan.

PubMed

Tirmizi, Syeda Nateela; Khoja, Shariq; Patten, Scott; Yousafzai, Abdul Wahab; Scott, Richard E; Durrani, Hammad; Khoja, Wafa; Husyin, Nida

2017-01-01

Mobile-based blended learning initiative was launched in November 2014 in Badakshan province of Afghanistan by Tech4Life Enterprises, Aga Khan Health Service, Afghanistan (AKHS, A), and the University of Calgary, Canada. The goal of this initiative was to improve knowledge of health providers related to four major mental health problems, namely depression, psychosis, post-traumatic stress disorder (PTSD) and drug abuse. This paper presents the results of quasi-experimental study conducted in 4 intervention districts in Badakshan for improvement in the knowledge among health providers about depression. The results were compared with three control districts for the change in knowledge scores. Sixty-two health providers completed pre and post module questionnaires from case district, while 31 health providers did so from the control sites. Significant change was noticed in the case districts, where overall knowledge scores changed from 45% in pre-intervention test to 63% in post-intervention test. Overall background knowledge of pre to post module test scores changed from 30% to 40%, knowledge of symptoms showed correct responses raised from 25% to 44%, knowledge related to causes of depression from overall districts showed change from 22% to 51%, and treatment knowledge of depression improved from 29% to 35%. Average gain in scores among cases was 16.06, compared to 6.8 in controls. The study confirms that a blended Learning approach with multiple learning techniques for health providers in Badakshan, Afghanistan, enhanced their knowledge and offers an effective solution to overcome challenges in continuing education. Further research is needed to confirm that the gains in knowledge reported here translate into better practice and improved mental health.

Shrimp Farming Practices in the Puttallam District of Sri Lanka: Implications for Disease Control, Industry Sustainability, and Rural Development

PubMed Central

Munasinghe, M. Nalaka; Stephen, Craig; Abeynayake, Preeni; Abeygunawardena, Indra S.

2010-01-01

Shrimp farming has great potential to diversify and secure income in rural Sri Lanka, but production has significantly declined in recent years due to civil conflicts, some unsustainable practices and devastating outbreaks of disease. We examined management practices affecting disease prevention and control in the Puttalam district to identify extension services outputs that could support sustainable development of Sri Lankan shrimp farming. A survey on 621 shrimp farms (603 operational and 18 nonoperational) was conducted within the Puttalam district over 42 weeks comprising a series of three-day field visits from August 2008 to October 2009, covering two consecutive shrimp crops. Fundamental deficits in disease control, management, and biosecurity practices were found. Farmers had knowledge of biosecurity but the lack of financial resources was a major impediment to improved disease control. Smallholder farmers were disproportionately constrained in their ability to enact basic biosecurity practices due to their economic status. Basic breaches in biosecurity will keep disease as the rate limiting step in this industry. Plans to support this industry must recognize the socioeconomic reality of rural Sri Lankan aquaculture. PMID:20847956

[Strategy of comprehensive control for schistosomiasis and its effect in key areas of Jiangsu Province].

PubMed

Sun, Le-Ping; Tian, Zeng-Xi; Yang, Kun; Hong, Qing-Biao; Gao, Yang; Gao, Yuan; Zhang, Lian-Heng; Yang, Guo-Jing; Min, Jie; Ge, Jun; Wu, Hong-Hui; Huang, Yi-Xin; Liang, You-Sheng

2011-12-01

To evaluate the effect of comprehensive control for schistosomiasis in key areas of Jiangsu Province. The basic data and the data of implementation of comprehensive control measures were collected from the key areas of Jiangsu Province, including 30 townships, 87 marshlands and 78 anchor points. A field survey was carried out to investigate the Oncomelania snail status by using the systematic sampling method and schistosomiasis morbidity in humans and animals in the 12 key counties (districts). The changes of snail status and morbidity of humans and animals were statistically analyzed in key counties (districts) where comprehensive control measures was implemented, and the effects of schistosomiasis control before and after the implementation of the comprehensive control were compared. From 2008 to 2010, a total of 84 100 harmless latrines were constructed, 339 600 persons were examined, 2.6938 million people received health education, 112 000 protective creams and 798 000 publicity materials were allocated, 9 085 domestic animals were reared in pens, 11 800 domestic animals were examined, 130 high-risk cattle were eliminated in 30 key townships of 12 countries (districts), Jiangsu Province. A total of 19 640.78 hm2 were controlled with molluscicides, 798 warning tablets were placed, 116.07 hm2 of farmlands were ploughed up and planted, 306.80 hm2 were dug for fish culture, and 506.74 hm2 were planted with trees for snail control in 87 high-risk marshlands. A total of 118.83 million Yuan were invested into the water resources development projects, 39.82 km-long rivers were dredged, 70.04 km-long bank were concreted, 30 culvert gates were re-constructed, and 22 snail sedimentation tanks were built. In the 78 anchor points, 95 harmless public toilets were built, 3 192 stool container were allocated, 28 700 boatmen were examined, 71 600 protective creams and 53 200 publicity materials were allocated, and 46 600 persons received health education. Following the implementation of comprehensive control, the settings with infected snails, infected snail areas, infection rates of snails reduced from 75, 802.73 hm2 and 0.10% before the comprehensive control in 2007 to all 0 in 2010, with reduction rates of all 100%. The infection rates of schistosome in both humans and domestic animals appeared declining trends in 12 counties (districts) from 2005 to 2010, and the human infection rates were 0.16%, 0.04%, 0.02%, 0.02%, 0.01% and 0.01%, respectively, while being 0.11%, 0.05%, 0, 0, 0 and 0, respectively in domestic animals. During the period of comprehensive control, totally 45 transmission-controlled townships and 183 villages were newly added. In 2010, all of the 12 counties (districts) reached the criteria of schistosomiasis transmission control. The comprehensive control with emphasis on the key areas where infected snails are found, is an effective measure to further facilitate schistosomiasis control and rapidly control the transmission of schistosomiasis.

Investigation of induced recirculation during planned ventilation system maintenance

PubMed Central

Pritchard, C.J.; Scott, D.F.; Noll, J.D.; Voss, B.; Leonis, D.

2015-01-01

The Office of Mine Safety and Health Research (OMSHR) investigated ways to increase mine airflow to underground metal/nonmetal (M/NM) mine working areas to improve miners’ health and safety. One of those areas is controlled recirculation. Because the quantity of mine air often cannot be increased, reusing part of the ventilating air can be an effective alternative, if implemented properly, until the capacity of the present system is improved. The additional airflow can be used to provide effective dilution of contaminants and higher flow velocities in the underground mine environment. Most applications of controlled recirculation involve taking a portion of the return air and passing it back into the intake to increase the air volume delivered to the desired work areas. OMSHR investigated a Nevada gold mine where shaft rehabilitation was in progress and one of the two main fans was shut down to allow reduced air velocity for safe shaft work. Underground booster fan operating pressures were kept constant to maintain airflow to work areas, inducing controlled recirculation in one work zone. Investigation into system behavior and the effects of recirculation on the working area during times of reduced primary ventilation system airflow would provide additional information on implementation of controlled recirculation into the system and how these events affect M/NM ventilation systems. The National Institute for Occupational Safety and Health monitored the ventilation district when both main fans were operating and another scenario with one of the units turned off for maintenance. Airflow and contaminants were measured to determine the exposure effects of induced recirculation on miner health. Surveys showed that 19% controlled recirculation created no change in the overall district airflow distribution and a small reduction in district fresh air intake. Total dust levels increased only modestly and respirable dust levels were also low. Diesel particulate matter (DPM) levels showed a high increase in district intake mass flow, but minor increases in exposure levels related to the recirculation percentage. Utilization of DPM mass flow rates allows input into ventilation modeling programs to better understand and plan for ventilation changes and district recirculation effects on miners’ health. PMID:26190862

78 FR 58460 - Revision of Air Quality Implementation Plan; California; Placer County Air Pollution Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-24

...EPA is finalizing a limited approval and limited disapproval of two permitting rules submitted by California as a revision to the Placer County Air Pollution Control District (PCAPCD) and Feather River Air Quality Management District (FRAQMD) portion of the California State Implementation Plan (SIP). These revisions were proposed in the Federal Register on February 22, 2013 and concern construction and modification of stationary sources of air pollution within each District. We are approving local rules that regulate these emission sources under the Clean Air Act as amended in 1990 (CAA). Final approval of these rules makes the rules federally enforceable and corrects program deficiencies identified in a previous EPA rulemaking (76 FR 44809, July 27, 2011). EPA is also making a technical amendment to the Code of Federal Regulations (CFR) to reflect this previous rulemaking, which removed an obsolete provision from the California SIP.

Expanding access to parasite-based malaria diagnosis through retail drug shops in Tanzania: evidence from a randomized trial and implications for treatment.

PubMed

Maloney, Kathleen; Ward, Abigail; Krenz, Bonnie; Petty, Nora; Bryson, Lindsay; Dolkart, Caitlin; Visser, Theodoor; Le Menach, Arnaud; Scott, Valerie K; Cohen, Justin M; Mtumbuka, Esther; Mkude, Sigsbert

2017-01-03

Tanzania has seen a reduction in the fraction of fevers caused by malaria, likely due in part to scale-up of control measures. While national guidelines require parasite-based diagnosis prior to treatment, it is estimated that more than half of suspected malaria treatment-seeking in Tanzania initiates in the private retail sector, where diagnosis by malaria rapid diagnostic test (RDT) or microscopy is illegal. This pilot study investigated whether the introduction of RDTs into Accredited Drug Dispensing Outlets (ADDOs) under realistic market conditions would improve case management practices. Dispensers from ADDOs in two intervention districts in Tanzania were trained to stock and perform RDTs and monitored quarterly. Each district was assigned a different recommended retail price to evaluate the need for a subsidy. Malaria RDT and artemisinin-based combination therapy (ACT) uptake and availability were measured pre-intervention and 1 year post-intervention through structured surveys of ADDO owners and exiting customers in both intervention districts and one contiguous control district. Descriptive analysis and logistic regression were used to compare the three districts and identify predictive variables for testing. A total of 310 dispensers from 262 ADDOs were trained to stock and perform RDTs. RDT availability in intervention ADDOs increased from 1% (n = 172) to 73% (n = 163) during the study; ACT medicines were available in 75% of 260 pre-intervention and 68% of 254 post-intervention ADDOs. Pre-treatment testing performed within the ADDO increased from 0 to 65% of suspected malaria patients who visited a shop (95% CI 60.8-69.6%) with no difference between intervention districts. Overall parasite-based diagnosis increased from 19 to 74% in intervention districts and from 3 to 18% in the control district. Prior knowledge of RDT availability (aOR = 1.9, p = 0.03) and RDT experience (aOR = 1.9, p = 0.01) were predictors for testing. Adherence data indicated that 75% of malaria positives received ACT, while 3% of negatives received ACT. Trained and supervised ADDO dispensers in rural Tanzania performed and sold RDTs under real market conditions to two-thirds of suspected malaria patients during this one-year pilot. These results support the hypothesis that introducing RDTs into regulated private retail sector settings can improve malaria testing and treatment practices without an RDT subsidy. Trial registration ISRCTN ISRCTN14115509.

The Differential Impact of User-Fee Exemption Compared to Conditional Cash Transfers on Safe Deliveries in Nepal.

PubMed

Pradhan, Elina; Fan, Victoria Y

2017-08-01

To assess the differential impact of a copayment exemption compared to a cash incentive on increasing skilled birth attendance (i.e., birth attended by a skilled health worker) in Nepal. This study used data on 8,785 children born between July 2005 and December 2008, obtained from the nationally representative Demographic and Health Surveys, 2006 and 2011. Twenty-five districts received both the policy interventions, and the remaining 50 control districts received only the cash incentive. We employed a difference-in-differences model to compare children born in districts with both interventions to those in districts with conditional cash transfers only. Average marginal effects of the difference-in-difference coefficient on skilled birth attendance measures are estimated. Skilled birth attendance in districts with both interventions was no higher on average than in districts with only the cash incentive. In areas with adequate road networks, however, significantly higher skilled birth attendance was observed in districts with both interventions compared to those with only the cash incentive. The added incentive of the user-fee exemption did not significantly increase skilled birth attendance relative to the presence of the cash incentive. User-fee exemptions may not be effective in areas with inadequate road infrastructure. © Health Research and Educational Trust.

Measuring the inequalities in radiotherapy health resources in Japan: comparison of the Hokkaido-Tohoku and Tokyo districts.

PubMed

Ohba, Hisateru; Narumi, Masakazu; Hosokawa, Yoichiro; Aoki, Masahiko

2010-01-01

The aim of this study was to measure and compare the geographical inequalities in radiotherapy health resources between the Hokkaido-Tohoku and Tokyo districts of Japan. The numbers of radiotherapy facilities, radiologists, and radiological technologists were used to represent radiotherapy health resources. The target areas were 11 prefectures in the Hokkaido-Tohoku and Tokyo districts. The Gini coefficient (GC) was used to measure inequalities in health resources in relation to the population and area of each secondary medical care zone. Correlation analysis was performed to clarify the relation between the GC and the all-cancer mortality rate per 100,000 people. The mean population and area GCs of Yamagata Prefecture were the smallest, whereas the mean population GC of Tokyo and the mean area GC of Hokkaido were the largest. The mean GCs of radiotherapy facilities and radiological technologists were higher in the Tokyo district than in the Hokkaido-Tohoku district. No significant correlation was found between GC and cancer mortality. Geographical inequalities in radiotherapy health resources tended to be larger in the Tokyo district than in the Hokkaido-Tohoku district. It is expected that the radiotherapy system will be substantially improved by the Basic Plan to Promote Cancer Control Programs.

A Quasi-Experimental Analysis of Elementary School Absences and Fine Particulate Air Pollution

PubMed Central

Hales, Nicholas M.; Barton, Caleb C.; Ransom, Michael R.; Allen, Ryan T.; Pope, C. Arden

2016-01-01

Abstract Fine particulate air pollution (PM2.5) has been associated with many adverse health outcomes including school absences. Specifically, a previous study in the Utah Valley area, conducted during a time with relatively high air pollution exposure, found significant positive correlations between school absences and air pollution. We examined the hypothesis that ambient PM2.5 exposures are associated with elementary school absences using a quasi-natural experiment to help control for observed and unobserved structural factors that influence school absences. The Alpine, Provo, and Salt Lake City school districts are located in valleys subject to daily mean PM2.5 concentrations almost twice as high as those in the Park City School District. We used seminonparametric generalized additive Poisson regression models to evaluate associations between absences and daily PM2.5 levels in the 3 districts that were exposed to the most pollution while using Park City absences as a quasi-control. The study covered 3 school years (2011/12-2013/14). School absences were most strongly associated with observed structural factors such as seasonal trends across school years, day-of-week effects, holiday effects, weather, etc. However, after controlling for these structural factors directly and using a control district, a 10 μg/m3 increase in PM2.5 was associated with an approximately 1.7% increase in daily elementary school absences. Exposure to ambient air pollution can contribute to elementary school absences, although this effect is difficult to disentangle from various other factors. PMID:26945391

District-level variations in childhood immunizations in India: The role of socio-economic factors and health infrastructure.

PubMed

Rammohan, Anu; Awofeso, Niyi

2015-11-01

Routine childhood immunizations against measles and DPT are part of the World Health Organization's (WHO) Expanded Program on Immunization (EPI) set up in 1974, with the aim of reducing childhood morbidity and mortality. Despite this, immunization rates are sub-optimal in developing countries such as India, with wide heterogeneity observed across districts and socio-economic characteristics. The aim of this paper is to examine district-level variations in the propensity to vaccinate a child in India for measles and DPT3, and analyse the extent to which these immunizations are given age-inappropriately, either prematurely or delayed. The present study uses data from the Indian District Level Household Survey (DLHS-3) collected in 2008, and the final sample contains detailed information on 42157 children aged between 12 and 60 months, across 549 Indian districts for whom we have complete information on immunization history. Our empirical study analyses: (i) the district-level average immunization rates for measles and DPT3, and (ii) the extent to which these immunizations have been given age-appropriately. A key contribution of this paper is that we link the household-level data at the district level to data on availability and proximity to health infrastructure and district-level socio-economic factors. Our results show that after controlling for an array of socio-economic characteristics, across all our models, the district's income per capita is a strong predictor of better immunization outcomes for children. Mother's education level at the district-level has a statistically significant and positive influence on immunization outcomes across all our models. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Loxosceles Heinecken & Lowe, 1835 (Araneae; Sicariidae) species distribution in the State of Paraná].

PubMed

Marques-da-Silva, Emanuel; Fischer, Marta Luciane

2005-01-01

The State of Paraná registers on average 2,577 loxoscelic accidents annually. For the elaboration of control and management programs one should first determine the distribution of the species of the genus Loxosceles. A mapping was performed of Loxosceles references in various scientific collections. A total of 1,561 spiders were found, identified as Loxosceles intermedia (67%), Loxosceles gaucho (19.5%), Loxosceles laeta (10.8%) and Loxosceles hirsuta (2.4%), originating from 20 regional and 69 municipal health districts. Loxosceles intermedia was present in all areas of the state (50 municipal districts), while Loxosceles gaucho occurred in the north and northwest, (17 municipal districts), Loxosceles laeta in the south (13 municipal districts) and Loxosceles hirsuta in the west and central areas (10 municipal districts). Paraná has four of the eight species of Loxosceles registered in Brazil. Given the medical importance of accidents caused by these spiders, it is necessary to perform studies on the location of such incidents and investigate areas that have not yet been sampled.

Deforestation and Malaria in Mâncio Lima County, Brazil

PubMed Central

Gangnon, Ronald; Silveira, Guilherme Abbad; Patz, Jonathan A.

2010-01-01

Malaria is the most prevalent vector-borne disease in the Amazon. We used malaria reports for health districts collected in 2006 by the Programa Nacional de Controle da Malária to determine whether deforestation is associated with malaria incidence in the county (município) of Mâncio Lima, Acre State, Brazil. Cumulative percent deforestation was calculated for the spatial catchment area of each health district by using 60 × 60–meter, resolution-classified imagery. Statistical associations were identified with univariate and multivariate general additive negative binomial models adjusted for spatial effects. Our cross-sectional study shows malaria incidence across health districts in 2006 is positively associated with greater changes in percentage of cumulative deforestation within respective health districts. After adjusting for access to care, health district size, and spatial trends, we show that a 4.3%, or 1 SD, change in deforestation from August 1997 through August 2000 is associated with a 48% increase of malaria incidence. PMID:20587182

Spatial cluster analysis of human cases of Crimean Congo hemorrhagic fever reported in Pakistan.

PubMed

Abbas, Tariq; Younus, Muhammad; Muhammad, Sayyad Aun

2015-01-01

Crimean Congo hemorrhagic fever (CCHF) is a tick-borne viral zoonotic disease that has been reported in almost all geographic regions in Pakistan. The aim of this study was to identify spatial clusters of human cases of CCHF reported in country. Kulldorff's spatial scan statisitc, Anselin's Local Moran's I and Getis Ord Gi* tests were applied on data (i.e. number of laboratory confirmed cases reported from each district during year 2013). The analyses revealed a large multi-district cluster of high CCHF incidence in the uplands of Balochistan province near it border with Afghanistan. The cluster comprised the following districts: Qilla Abdullah; Qilla Saifullah; Loralai, Quetta, Sibi, Chagai, and Mastung. Another cluster was detected in Punjab and included Rawalpindi district and a part of Islamabad. We provide empirical evidence of spatial clustering of human CCHF cases in the country. The districts in the clusters should be given priority in surveillance, control programs, and further research.

Implementing LCFF: Early Lessons from the Field. Policy and Practice Brief

ERIC Educational Resources Information Center

Knudson, Joel

2014-01-01

The Local Control Funding Formula (LCFF) represents a fundamental transformation of the way California allocates state funds to school districts and the ways the state expects districts to make decisions about (and report on) the use of these funds. This is the first in a series of short briefs that aims to capture some key themes emerging from…

The Issues of Self-Funding Benefits for Texas Independent School Districts.

ERIC Educational Resources Information Center

Cryar, Virginia P.

This paper examines whether self-funding health benefit plans for employees are appropriate for Texas school districts. In a self-funding plan, the cost of benefits is funded directly by the employer without the protection of an insurance contract. Proponents of the self-funding plan argue that it: (1) controls costs and improves the cash flow;…

[Evaluation of effect of prevention and control system for imported falciparum malaria in Hanjiang District].

PubMed

She, Guo-lin; Ma, Yu-Cai; Wang, Fu-biao

2013-08-01

To analyze the current situation of the comprehensive prevention and control system for imported falciparum malaria in Hanjiang District and evaluate its effect. According to the Management Scheme on Control of Imported Falciparum Malaria in Yangzhou City, the comprehensive prevention and control system for imported falciparum malaria was implemented, and the relevant malaria data were collected and analyzed statistically. The data included plasmodium blood test ratio of fever patients among exported labors and those returned, the ratio of laboratory-confirmed cases among all reported cases of falciparum malaria, the ratio of falciparum malaria patients who received the standard treatment within 24 hours after onset, etc from 2010 to 2012. After the implementation of the comprehensive prevention and control system, the confirmation ratio of falciparum malaria cases within 24 hours following first visit has reached 60.47%, the average time from first visit to confirmation has shortened to 1.8 d, and the average time from onset to confirmation has shortened to 3.7 d. The health education coverage ratio was 100%, the health knowledge awareness ratio was 95.56%, the ratio of patients seeking treatment on own initiative was 100%, the laboratory-confirmed ratio was 100%, and the ratio of standard treatment after malaria diagnosis was 100%. The comprehensive prevention and control system carried out by Hanjiang District has made remarkable achievements.

Volatile organic compounds (VOCs) emission characteristics and control strategies for a petrochemical industrial area in middle Taiwan.

PubMed

Yen, Chia-Hsien; Horng, Jao-Jia

2009-11-01

This study investigated VOC emissions from the largest petrochemical industrial district in Taiwan and recommended some control measures to reduce VOC emissions. In addition to the petrochemical industry, the district encompasses a chemical and fiber industry, a plastics industry and a harbor, which together produce more than 95% of the VOC emissions in the area. The sequence of VOC emission was as follows: components (e.g., valves, flanges, and pumps) (47%) > tanks (29%) > stacks (15%) > wastewater treatment facility (6%) > loading (2%) > flares (1%). Other plants producing high-density polyethylene (HDPE), styrene, ethylene glycol (EG), gas oil, and iso-nonyl-alchol (INA) were measured to determine the VOC leaching in the district. The VOC emissions of these 35 plants (90% of all plants) were less than 100 tons/year. About 74% of the tanks were fixed-roof tanks that leached more VOCs than the other types of tanks. To reduce leaching, the components should be checked periodically, and companies should be required to follow the Taiwan EPA regulations. A VOC emission management system was developed in state implementation plans (SIPs) to inspect and reduce emissions in the industrial district.

Comparing the performance of cluster random sampling and integrated threshold mapping for targeting trachoma control, using computer simulation.

PubMed

Smith, Jennifer L; Sturrock, Hugh J W; Olives, Casey; Solomon, Anthony W; Brooker, Simon J

2013-01-01

Implementation of trachoma control strategies requires reliable district-level estimates of trachomatous inflammation-follicular (TF), generally collected using the recommended gold-standard cluster randomized surveys (CRS). Integrated Threshold Mapping (ITM) has been proposed as an integrated and cost-effective means of rapidly surveying trachoma in order to classify districts according to treatment thresholds. ITM differs from CRS in a number of important ways, including the use of a school-based sampling platform for children aged 1-9 and a different age distribution of participants. This study uses computerised sampling simulations to compare the performance of these survey designs and evaluate the impact of varying key parameters. Realistic pseudo gold standard data for 100 districts were generated that maintained the relative risk of disease between important sub-groups and incorporated empirical estimates of disease clustering at the household, village and district level. To simulate the different sampling approaches, 20 clusters were selected from each district, with individuals sampled according to the protocol for ITM and CRS. Results showed that ITM generally under-estimated the true prevalence of TF over a range of epidemiological settings and introduced more district misclassification according to treatment thresholds than did CRS. However, the extent of underestimation and resulting misclassification was found to be dependent on three main factors: (i) the district prevalence of TF; (ii) the relative risk of TF between enrolled and non-enrolled children within clusters; and (iii) the enrollment rate in schools. Although in some contexts the two methodologies may be equivalent, ITM can introduce a bias-dependent shift as prevalence of TF increases, resulting in a greater risk of misclassification around treatment thresholds. In addition to strengthening the evidence base around choice of trachoma survey methodologies, this study illustrates the use of a simulated approach in addressing operational research questions for trachoma but also other NTDs.

Strengthening primary eye care in South Africa: An assessment of services and prospective evaluation of a health systems support package

PubMed Central

Lilian, Rivka R.; Railton, Jean; Schaftenaar, Erik; Mabitsi, Moyahabo; Grobbelaar, Cornelis J.; Khosa, N. Sellina; Maluleke, Babra H.; Struthers, Helen E.; McIntyre, James A.

2018-01-01

Visual impairment is a significant public health concern, particularly in low- and middle-income countries where eye care is predominantly provided at the primary healthcare (PHC) level, known as primary eye care. This study aimed to perform an evaluation of primary eye care services in three districts of South Africa and to assess whether an ophthalmic health system strengthening (HSS) package could improve these services. Baseline surveys were conducted in Cape Winelands District, Johannesburg Health District and Mopani District at 14, 25 and 36 PHC facilities, respectively. Thereafter, the HSS package, comprising group training, individual mentoring, stakeholder engagement and resource provision, was implemented in 20 intervention sites in Mopani District, with the remaining 16 Mopani facilities serving as control sites. At baseline, less than half the facilities in Johannesburg and Mopani had dedicated eye care personnel or sufficient space to measure visual acuity. Although visual acuity charts were available in most facilities, <50% assessed patients at the correct distance. Median score for availability of nine essential drugs was <70%. Referral criteria knowledge was highest in Cape Winelands and Johannesburg, with poor clinical knowledge across all districts. Several HSS interventions produced successful outcomes: compared to control sites there was a significant increase in the proportion of intervention sites with eye care personnel and resources such as visual acuity charts (p = 0.02 and <0.01, respectively). However, engaging with district pharmacists did not improve availability of essential drugs (p = 0.47). Referral criteria knowledge improved significantly in intervention sites (p<0.01) but there was no improvement in clinical knowledge (p = 0.76). Primary eye care in South Africa faces multiple challenges with regard to organisation of care, resource availability and clinical competence. The HSS package successfully improved some aspects of this care, but further development is warranted together with debate regarding the positioning of eye services at PHC level. PMID:29758069

Assessment of water, sanitation, and hygiene practices and associated factors in a Buruli ulcer endemic district in Benin (West Africa).

PubMed

Johnson, Roch Christian; Boni, Gratien; Barogui, Yves; Sopoh, Ghislain Emmanuel; Houndonougbo, Macaire; Anagonou, Esai; Agossadou, Didier; Diez, Gabriel; Boko, Michel

2015-08-19

Control of neglected tropical diseases (NTDs) requires multiple strategic approaches including water, sanitation and hygiene services (WASH). Buruli ulcer (BU), one of the 17 NTDs, remains a public health issue in Benin particularly in the district of Lalo. The availability of water as well as good hygiene are important for the management of Buruli ulcer particularly in the area of wound care one of the main component of the treatment of BU lesions. Given the growing importance of WASH in controlling NTDs and in order to assess the baseline for future cross-cutting interventions, we report here on the first study evaluating the level of WASH and associated factors in Lalo, one of the most BU-endemic districts in Benin. A cross-sectional study was carried to assess WASH practices and associated factors in the district of Lalo. Data were collected from 600 heads of household using structured pretested questionnaire and observations triangulated with qualitative information obtained from in-depth interviews of patients, care-givers and community members. Univariate and multivariate analysis were carried to determine the relationships between the potential associated factors and the sanitation as well as hygiene status. BU is an important conditions in the district of Lalo with 917 new cases detected from 2006 to 2012. More than 49 % of the household surveyed used unimproved water sources for their daily needs. Only 8.7 % of the investigated household had improved sanitation facilities at home and 9.7 % had improved hygiene behavior. The type of housing as an indicator of the socioeconomic status, the permanent availability of soap and improved hygiene practices were identified as the main factors positively associated with improved sanitation status. In the district of Lalo in Benin, one of the most endemic for BU, the WASH indicators are very low. This study provides baseline informations for future cross-cutting interventions in this district.

Compliance assessment of cigarette and other tobacco products act in public places of Alwar district of Rajasthan.

PubMed

Jain, M L; Chauhan, Mamta; Singh, Rajani

2016-01-01

The Government of India has taken various initiatives for tobacco control by enacting comprehensive tobacco control legislation (Cigarette and Other Tobacco Products Act [COTPA], 2003). The aim of this study was to assess the level of compliance of Sections 4, 5, 6-a, and 6-b, and 7, 8, and 9 of COTPA with respect to public places, educational institutes, point of sale (PoS), and warning on packaging (COTPA) in public places of Alwar District of Rajasthan. A cross-sectional observational study was conducted in 2014 in Alwar city and four blocks of the district. The study was done around 365 public places for observing the compliance of Section 4 of COTPA, 357 educational institutions for observing the compliance of Section 6-b of COTPA, and 357 tobacco retailers for observing the compliance of Sections 5 and 6-a of COTPA. The criteria for the evaluation (the core indicators) and decision criteria for a district to qualify for the "Smoke free" status include six parameters. From the total of 365 places visited, 90% places displayed the "No-smoking" signage and out of total 328 places, 99% were as per the COTPA specification. Alwar city, Ramgarh, Thanagaji, and Alwar rural block followed the compliance of Section 4. The PoS visited Alwar district displayed 93% (332) signage and all the displayed signage followed the COTPA compliance. In Alwar city, Thanagaji, Ramgarh, and Alwar rural block, the compliance of Section 6-a was above 90%. The compliance of Section 6-b was above 90% in Alwar city, Ramgarh, Thanagaji, and Alwar rural block. Ninety-three percent (332) of the PoS did not display tobacco advertisement in Alwar district, which is a positive sign of COTPA compliance. This finding suggest a high level of compliance of Section 4, Section 5, Section 6-a, and Section 6-b of COTPA at Alwar district.

To what extent do site-based training, mentoring, and operational research improve district health system management and leadership in low- and middle-income countries: a systematic review protocol.

PubMed

Belrhiti, Zakaria; Booth, Andrew; Marchal, Bruno; Verstraeten, Roosmarijn

2016-04-27

District health managers play a key role in the effectiveness of decentralized health systems in low- and middle-income countries. Inadequate management and leadership skills often hamper their ability to improve quality of care and effectiveness of health service delivery. Nevertheless, significant investments have been made in capacity-building programmes based on site-based training, mentoring, and operational research. This systematic review aims to review the effectiveness of site-based training, mentoring, and operational research (or action research) on the improvement of district health system management and leadership. Our secondary objectives are to assess whether variations in composition or intensity of the intervention influence its effectiveness and to identify enabling and constraining contexts and underlying mechanisms. We will search the following databases: MEDLINE, PsycInfo, Cochrane Library, CRD database (DARE), Cochrane Effective Practice and Organisation of Care (EPOC) group, ISI Web of Science, Health Evidence.org, PDQ-Evidence, ERIC, EMBASE, and TRIP. Complementary search will be performed (hand-searching journals and citation and reference tracking). Studies that meet the following PICO (Population, Intervention, Comparison, Outcome) criteria will be included: P: professionals working at district health management level; I: site-based training with or without mentoring, or operational research; C: normal institutional arrangements; and O: district health management functions. We will include cluster randomized controlled trials, controlled before-and-after studies, interrupted time series analysis, quasi-experimental designs, and cohort and longitudinal studies. Qualitative research will be included to contextualize findings and identify barriers and facilitators. Primary outcomes that will be reported are district health management and leadership functions. We will assess risk of bias with the Cochrane Collaboration's tools for randomized controlled trials (RCT) and non RCT studies and Critical Appraisal Skills Programme checklists for qualitative studies. We will assess strength of recommendations with the GRADE tool for quantitative studies, and the CERQual approach for qualitative studies. Synthesis of quantitative studies will be performed through meta-analysis when appropriate. Best fit framework synthesis will be used to synthesize qualitative studies. This protocol paper describes a systematic review assessing the effectiveness of site-based training (with or without mentoring programmes or operational research) on the improvement of district health system management and leadership. PROSPERO CRD42015032351.

Information System and Geographic Information System Tools in the Data Analyses of the Control Program for Visceral Leishmaniases from 2006 to 2010 in the Sanitary District of Venda Nova, Belo Horizonte, Minas Gerais, Brazil

PubMed Central

Saraiva, Lara; Leite, Camila Gonçalves; de Carvalho, Luiz Otávio Alves; Andrade Filho, José Dilermando; de Menezes, Fernanda Carvalho; Fiúza, Vanessa de Oliveira Pires

2012-01-01

The aim of this paper is to report a brief history of control actions for Visceral Leishmaniasis (VL) from 2006 to 2010 in the Sanitary District (DS) of Venda Nova, Belo Horizonte, Minas Gerais, Brazil, focusing on the use of information systems and Geographic Information System (GIS) tools. The analyses showed that the use of an automated database allied with geoprocessing tools may favor control measures of VL, especially with regard to the evaluation of control actions carried out. Descriptive analyses of control measures allowed to evaluating that the information system and GIS tools promoted greater efficiency in making decisions and planning activities. These analyses also pointed to the necessity of new approaches to the control of VL in large urban centers. PMID:22518168

Estimation of content of anti-TB drugs supplied at centres of the Revised National TB Control Programme in Tamil Nadu, India.

PubMed

Ramachandran, Geetha; Chandrasekaran, Vedachalam; Hemanth Kumar, Agibothu Kupparam; Dewan, Puneet; Swaminathan, Soumya; Thomas, Aleyamma

2013-09-01

To determine the content of certain antituberculosis (TB) drugs supplied at TB treatment centres of the Revised National TB Control Programme (RNTCP) in the state of Tamil Nadu, India. Eight districts across the state were selected, and the following drugs were collected from five settings (District TB centre, TB unit, designated microscopy centres, DOT providers) in each district: rifampicin (150 and 450 mg), isoniazid (300 mg), pyrazinamide (500 and 750 mg), ethambutol (400 and 600 mg), ethionamide (250 mg), levofloxacin (500 mg) and cycloserine (250 mg). A maximum of 10 tablets/capsules were collected from each setting. The drugs were coded prior to analysis. All drugs were assayed by validated spectrophotometric methods. The acceptable limits for drug content were taken as 90-110% of the stated content. More than 90% of tablets of rifampicin 450 mg, isoniazid 300 mg, pyrazinamide 500 and 750 mg, ethambutol 400 and 600 mg and ethionamide 250 mg were within acceptable limits. Eighty per cent of rifampicin 150 mg, 21% of cycloserine 250 mg and 87% of levofloxacin 500 mg were within acceptable limits. The mean cycloserine content was below the acceptable limit in all districts, the mean drug content being 200 mg (range: 108-245 mg). This systematic study showed that the stated drug content of cycloserine was not reached in all districts. Deterioration of cycloserine could be minimised by storing the drug in refrigerators. The geographical location of the districts had no influence on the drug content. © 2013 John Wiley & Sons Ltd.

76 FR 44809 - Revisions to the California State Implementation Plan, Placer County Air Pollution Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-27

...EPA is finalizing a limited approval and limited disapproval of permitting rules submitted for the Placer County Air Pollution Control District (PCAPCD) and Feather River Air Quality Management District (FRAQMD) portions of the California State Implementation Plan (SIP). These revisions were proposed in the Federal Register on May 19, 2011 and concern New Source Review (NSR) permit programs for new and modified major stationary sources of air pollution. We are approving local rules that regulate these emission sources under the Clean Air Act as amended in 1990 (CAA or the Act).

Bottom lines: the influence of government funding on 20th century district nursing practice in Australia.

PubMed

Madsen, Wendy

2009-10-01

To investigate the impact of past government policy and legislation on the practice of district nursing in Australia. Nurses have historically been politically passive and have not engaged in the political processes of policy development. However, legislation can have profound impacts on the daily work of nurses as demonstrated in this paper. Historical analysis. The archival records of six district nursing services in Australia were analysed within the political, social and economic context of the 20th century, with particular focus on the 1950s and 1970s. Two pieces of Federal legislation passed in 1956 and 1973, respectively, had critical effects on the work of district nurses. Both resulted in significant expansion of district nursing in Australia; neither was formulated with input from district nursing services. However, together these acts shifted district nursing from being a voluntary, charity based activity to one that was greatly controlled by government. Greater government funding allowed district nursing to expand beyond the capacity possible when funding was locally based, but with government funding came other restrictions related to accountability processes and expectations regarding services provided, and these had profound effects on nursing practice, including excess workloads to the point of unsafe practice. Nurses need to engage with the political processes associated with government policy formulation and implementation if they are to avoid placing themselves and their clients in vulnerable situations as a result of government decisions.

Duration of mineralization and fluid-flow history of the Upper Mississippi Valley zinc-lead district

USGS Publications Warehouse

Rowan, E.L.; Goldhaber, M.B.

1995-01-01

Studies of fluid inclusions in sphalerite and biomarkers from the Upper Mississippi Valley zinc district show homogenization temperatures to be primarily between 90 and 150??C, yet show relatively low levels of thermal maturity. Numerical calculations are used to simulate fluid and heat flow through fracture-controlled ore zones and heat transfer to the adjacent rocks. Combining a best-fit path through fluid-inclusion data with measured thermal alteration of biomarkers, the time interval during which mineralizing fluids circulated through the Upper Mississippi Valley district was calculated to be on the order of 200 ka. Cambrian and Ordovician aquifers underlying the district, principally the St. Peter and Mt. Simon Sandstones, were the source of the mineralizing fluid. The duration of mineralization thus reflects the fluid-flow history of these regional aquifers. -from Authors

In-use fuel economy of hybrid-electric school buses in Iowa.

PubMed

Hallmark, Shauna; Sperry, Bob; Mudgal, Abhisek

2011-05-01

Although it is much safer and more fuel-efficient to transport children to school in buses than in private vehicles, school buses in the United States still consume 822 million gal of diesel fuel annually, and school transportation costs can account for a significant portion of resource-constrained school district budgets. Additionally, children in diesel-powered school buses may be exposed to higher levels of particulates and other pollutants than children in cars. One solution to emission and fuel concerns is use of hybrid-electric school buses, which have the potential to reduce emissions and overall lifecycle costs compared with conventional diesel buses. Hybrid-electric technologies are available in the passenger vehicle market as well as the transit bus market and have a track record indicating fuel economy and emissions benefits. This paper summarizes the results of an in-use fuel economy evaluation for two plug-in hybrid school buses deployed in two different school districts in Iowa. Each school district selected a control bus with a route similar to that of the hybrid bus. Odometer readings, fuel consumption, and maintenance needs were recorded for each bus. The buses were deployed in 2008 and data were collected through May 2010. Fuel consumption was calculated for each school district. In Nevada, IA, the overall average fuel economy was 8.23 mpg for the hybrid and 6.35 mpg for the control bus. In Sigourney, IA, the overall average fuel economy was 8.94 mpg for the hybrid and 6.42 mpg for the control bus. The fuel consumption data were compared for the hybrid and control buses using a Wilcoxon signed rank test. Results indicate that fuel economy for the Nevada hybrid bus was 29.6% better than for the Nevada control bus, and fuel economy for the Sigourney hybrid bus was 39.2% higher than for the Sigourney control bus. Both differences were statistically significant.

Challenges for control of taeniasis/cysticercosis in Indonesia.

PubMed

Suroso, Thomas; Margono, Sri S; Wandra, Toni; Ito, Akira

2006-01-01

Taeniasis/cysticercosis has been reported from several provinces of Indonesia: Papua (=former Irian Jaya), Bali, North Sumatra, East Nusa Tenggara, South East Sulawesi, Lampung, North Sulawesi, Jakarta, West Kalimantan, and East Java. The highest level of endemicity of taeniasis/cysticercosis has been found in Papua. Recent surveys in Jayawijaya District of Papua in 2000 and 2001 showed that 5 of 58 local people (8.6%) harbored the adult tapeworm, Taenia solium, whereas 44 of 96 people (45.8%), 50 of 71 pigs (70.4%), and 7 of 64 local dogs (10.9%) were seropositive for T. solium cysticercosis. Current surveys in Bali and Samosir District, North Sumatra during 2002-2005 revealed that Taenia saginata taeniasis has increased in incidence whereas T. solium cysticercosis is now rather rare compared to one-two decades ago in Bali. Taenia asiatica taeniasis is still common in Samosir District. Data from other provinces of Indonesia are very limited or unavailable. Control of these diseases is not a priority in the health or veterinary services, neither at central or local government levels. However, limited efforts toward control of the diseases have been implemented such as training of health personnel, community education on disease prevention, and provision of anthelminthics. A working group for control of the disease in Indonesia and an international collaboration have been established among Ministry of Health, Indonesia; University of Indonesia; and Asahikawa Medical College, Asahikawa, Japan since 1996. Future goals include implementation of active case finding (active surveillance) and treatment of tapeworm carriers, sustainable public health education, establishment of a system to check the quality of beef/pork and determine the distribution of infected animals and strengthening of laboratory capacity. Efforts to motivate provinces and districts should be implemented in developing the strategic plan to control of the disease. Given the considerable differences in cultures, religions, levels of education, socio-economic levels, daily habits and behaviour etc., control programmes must be adapted to the local situations.

Implementation research to improve quality of maternal and newborn health care, Malawi

PubMed Central

Wilhelm, Danielle; Lohmann, Julia; Kambala, Christabel; Chinkhumba, Jobiba; Muula, Adamson S; De Allegri, Manuela

2017-01-01

Abstract Objective To evaluate the impact of a performance-based financing scheme on maternal and neonatal health service quality in Malawi. Methods We conducted a non-randomized controlled before and after study to evaluate the effects of district- and facility-level performance incentives for health workers and management teams. We assessed changes in the facilities’ essential drug stocks, equipment maintenance and clinical obstetric care processes. Difference-in-difference regression models were used to analyse effects of the scheme on adherence to obstetric care treatment protocols and provision of essential drugs, supplies and equipment. Findings We observed 33 health facilities, 23 intervention facilities and 10 control facilities and 401 pregnant women across four districts. The scheme improved the availability of both functional equipment and essential drug stocks in the intervention facilities. We observed positive effects in respect to drug procurement and clinical care activities at non-intervention facilities, likely in response to improved district management performance. Birth assistants’ adherence to clinical protocols improved across all studied facilities as district health managers supervised and coached clinical staff more actively. Conclusion Despite nation-wide stock-outs and extreme health worker shortages, facilities in the study districts managed to improve maternal and neonatal health service quality by overcoming bottlenecks related to supply procurement, equipment maintenance and clinical performance. To strengthen and reform health management structures, performance-based financing may be a promising approach to sustainable improvements in quality of health care. PMID:28670014

Advancing the application of systems thinking in health: realist evaluation of the Leadership Development Programme for district manager decision-making in Ghana.

PubMed

Kwamie, Aku; van Dijk, Han; Agyepong, Irene Akua

2014-06-16

Although there is widespread agreement that strong district manager decision-making improves health systems, understanding about how the design and implementation of capacity-strengthening interventions work is limited. The Ghana Health Service has adopted the Leadership Development Programme (LDP) as one intervention to support the development of management and leadership within district teams. This paper seeks to address how and why the LDP 'works' when it is introduced into a district health system in Ghana, and whether or not it supports systems thinking in district teams. We undertook a realist evaluation to investigate the outcomes, contexts, and mechanisms of the intervention. Building on two working hypotheses developed from our earlier work, we developed an explanatory case study of one rural district in the Greater Accra Region of Ghana. Data collection included participant observation, document review, and semi-structured interviews with district managers prior to, during, and after the intervention. Working backwards from an in-depth analysis of the context and observed short- and medium-term outcomes, we drew a causal loop diagram to explain interactions between contexts, outcomes, and mechanisms. The LDP was a valuable experience for district managers and teams were able to attain short-term outcomes because the novel approach supported teamwork, initiative-building, and improved prioritisation. However, the LDP was not institutionalised in district teams and did not lead to increased systems thinking. This was related to the context of high uncertainty within the district, and hierarchical authority of the system, which triggered the LDP's underlying goal of organisational control. Consideration of organisational context is important when trying to sustain complex interventions, as it seems to influence the gap between short- and medium-term outcomes. More explicit focus on systems thinking principles that enable district managers to better cope with their contexts may strengthen the institutionalisation of the LDP in the future.

Advancing the application of systems thinking in health: realist evaluation of the Leadership Development Programme for district manager decision-making in Ghana

PubMed Central

2014-01-01

Background Although there is widespread agreement that strong district manager decision-making improves health systems, understanding about how the design and implementation of capacity-strengthening interventions work is limited. The Ghana Health Service has adopted the Leadership Development Programme (LDP) as one intervention to support the development of management and leadership within district teams. This paper seeks to address how and why the LDP ‘works’ when it is introduced into a district health system in Ghana, and whether or not it supports systems thinking in district teams. Methods We undertook a realist evaluation to investigate the outcomes, contexts, and mechanisms of the intervention. Building on two working hypotheses developed from our earlier work, we developed an explanatory case study of one rural district in the Greater Accra Region of Ghana. Data collection included participant observation, document review, and semi-structured interviews with district managers prior to, during, and after the intervention. Working backwards from an in-depth analysis of the context and observed short- and medium-term outcomes, we drew a causal loop diagram to explain interactions between contexts, outcomes, and mechanisms. Results The LDP was a valuable experience for district managers and teams were able to attain short-term outcomes because the novel approach supported teamwork, initiative-building, and improved prioritisation. However, the LDP was not institutionalised in district teams and did not lead to increased systems thinking. This was related to the context of high uncertainty within the district, and hierarchical authority of the system, which triggered the LDP’s underlying goal of organisational control. Conclusions Consideration of organisational context is important when trying to sustain complex interventions, as it seems to influence the gap between short- and medium-term outcomes. More explicit focus on systems thinking principles that enable district managers to better cope with their contexts may strengthen the institutionalisation of the LDP in the future. PMID:24935521

Deviant Behavior in Higher Educational Institutions of the Central Federal District and the Northwestern Federal District: Causes, Scale, Varieties, and Prospects of Control and Prevention

ERIC Educational Resources Information Center

Talanov, S. L.

2014-01-01

Corruption and other forms of unacceptable behavior in Russian universities frequently is the result of poor conditions of work, low salaries, and inadequate administrative and oversight structures. A thorough reform and reorganization of institutions of higher education should go a long way to reducing the incidence of this behavior. [This…

Voluntary Counseling and Testing Services: Breaking Resistance to Access and Utilization among the Youths in Rakai District of Uganda

ERIC Educational Resources Information Center

Sebudde, Stephen; Nangendo, Florence

2009-01-01

Voluntary counseling and testing is important in controlling the spread of HIV, especially among adolescents. The aim is to describe the perceptions of adolescents of the best options to providing voluntary counseling and testing services to them in Rakai District Uganda. A cross-sectional descriptive study was carried out among male and female…

The Pit and the Pendulum: The Impact on Teen Smokers of Including a Designated Smoking Area in School Tobacco Control Policy

ERIC Educational Resources Information Center

Baillie, L. E.; Lovato, C. Y.; Taylor, E.; Rutherford, M. B.; Smith, M.

2008-01-01

Thirty per cent of school districts in British Columbia do not ban smoking outright on school grounds, and in several instances, smoking is permitted in smoking pits, regardless of school district policy. While there is evidence to suggest that enforcing a tobacco-free environment for students does reduce adolescent smoking rates, the concomitant…

Operational research on the correlation between skin diseases and HIV infection in Tigray region, Ethiopia.

PubMed

Padovese, Valeska; Racalbuto, Vincenzo; Barnabas, Gebre Ab; Morrone, Aldo

2015-10-01

In Ethiopia, skin diseases are among the leading causes of outpatient attendance to primary health service. Correlation of skin diseases and HIV has long been recognized and used to guide medical management in resource-limited settings. Therefore, this study aims to assess the correlation of skin diseases and HIV infection, to estimate epidemiological distribution in the study area, and to provide health workers of skin indicators for HIV early detection. The operational research was designed as a case-control study and carried out in three intervention districts of Tigray region; baseline and final data on skin diseases and HIV were compared with those of three control districts matched for population size, density, and environmental characteristics. Health workers of intervention districts were trained on skin diseases/STIs diagnosis and treatment. Data were collected from study and control districts and then analyzed at the Italian Dermatological Centre (IDC) in Mekele. In the research period, a total of 1044 HIV positive patients were detected. Disorders of skin and mucous membranes statistically related with HIV (P < 0.05) were tongue papillary atrophy (80%), oral hairy leukoplakia (69%), herpes zoster (66%), oral candidiasis (50%), pruritic papular eruption (43%), condylomata acuminata (38%), and telogen effluvium (27%). The high frequency of oral disorders and telogen effluvium is not described in literature and may be indicative for case detection. Operational research offers significant gains on health service delivery and outcomes at relatively low cost and in a short timeframe. © 2015 The International Society of Dermatology.

Exploring the use of routinely-available, retrospective data to study the association between malaria control scale-up and micro-economic outcomes in Zambia.

PubMed

Comfort, Alison; Leegwater, Anthony; Nakhimovsky, Sharon; Kansembe, Henry; Hamainza, Busiku; Bwalya, Benson; Alilio, Martin; Johns, Ben; Olsho, Lauren

2017-01-04

Country-level evidence on the impact of malaria control on micro-economic outcomes is vital for mobilizing domestic and donor resources for malaria control. Using routinely available survey data could facilitate this investigation in a cost-efficient way. The authors used Malaria Indicator Surveys (MIS) and Living Conditions Monitoring Survey (LCMS) data from 2006 to 2010 for all 72 districts in Zambia to relate malaria control scale-up with household food spending (proxy for household well-being), educational attainment and agricultural production. The authors used two quasi-experimental designs: (1) a generalized propensity score for a continuous treatment variable (defined as coverage from owning insecticide-treated bed nets and/or receipt of indoor residual spraying); and, (2) a district fixed effects model to assess changes in the outcome relative to changes in treatment pre-post scale-up. The unit of analysis was at district level. The authors also conducted simulations post-analysis to assess statistical power. Micro-economic outcomes increased (33% increase in food spending) concurrently with malaria control coverage (62% increase) from 2006 to 2010. Despite using data from all 72 districts, both analytic methods yielded wide confidence intervals that do not conclusively link outcomes and malaria control coverage increases. The authors cannot rule out positive, null or negative effects. The upper bound estimates of the results show that if malaria control coverage increases from 60 to 70%, food spending could increase up to 14%, maize production could increase up to 57%, and years of schooling could increase up to 0.5 years. Simulations indicated that the generalized propensity score model did not have good statistical power. While it is technically possible to use routinely available survey data to relate malaria control scale-up and micro-economic outcomes, it is not clear from this analysis that meaningful results can be obtained when survey data are highly aggregated. Researchers in similar settings should assess the feasibility of disaggregating existing survey data. Additionally, large surveys, such as LCMS and MIS, could incorporate data on both malaria coverage and household expenditures, respectively.

40 CFR 60.4 - Address.

Code of Federal Regulations, 2012 CFR

2012-07-01

.... Environmental Protection Agency, 1200 Sixth Avenue, Seattle, WA 98101. (b) Section 111(c) directs the..., Division of Air Pollution Control, Arkansas Department of Pollution Control and Ecology, 8001 National... Park Avenue, Victorville, CA 92392-2310. Monterey Bay Unified Air Pollution Control District, 24580...

Schistosomiasis and Soil Transmitted Helminths Distribution in Benin: A Baseline Prevalence Survey in 30 Districts.

PubMed

Boko, Pelagie M; Ibikounle, Moudachirou; Onzo-Aboki, Ablawa; Tougoue, Jean-Jacques; Sissinto, Yollande; Batcho, Wilfrid; Kinde-Gazard, Dorothe; Kabore, Achille

2016-01-01

In 2013, Benin developed strategies to control neglected tropical diseases and one of the first step was the disease mapping of the entire country in order to identify endemic districts of schistosomiasis and soil transmitted helminths (STH). This study was carried out in 30 of the 77 districts of Benin. Of these 30 districts 22 were previously treated for Lymphatic Filariasis (LF) using the Ivermectin and Albendazole combination. In each district, five schools were selected and 50 children aged 8 to 14 years were sampled in each school, making a total of 250 children sampled in the district. The schools were selected mainly according to their proximity to lakes or any bodies of water that were likely to have been used by the children. Samples of faeces and urine were collected from each pupil. Urinary schistosomiasis was identified using the urine filtration technique while STH and intestinal schistosomiasis were identified through the Kato Katz method. Overall a total of 7500 pupils were surveyed across 150 schools with a gender ratio of 1:1. Hookworm was identified in all 30 districts with a prevalence ranging from 1.2% (95%CI: 0.0-2.5) to 60% (95%CI: 53.9-66.1). Ascaris lumbricoides was detected in 19 districts with a prevalence rate between 1% (95%CI: 0.0-2.2) and 39% (95%CI: 32.9-45.0). In addition to these common STH, Trichuris trichiura, Enterobius vermicularis and Strongyloides stercoralis were found at low prevalence. Only 16 districts were endemic to Schistosoma mansoni, while 29 districts were endemic to S. haematobium. The S. haematobium prevalence ranged from 0.8% (95% CI: 0.0-1.9) to 56% (95% CI: 50.2-62.5) while the prevalence of S. mansoni varied from 0.4% (95%CI: 0.0-1.2) to 46% (95% CI: 39.8-52.2). The 22 districts, where LF was successfully eliminated, still require mass drug administration (MDA) of albendazole indicating that school-based MDA would be needed even after LF elimination in districts co-endemic to LF and STH in Benin.

Schistosomiasis and Soil Transmitted Helminths Distribution in Benin: A Baseline Prevalence Survey in 30 Districts

PubMed Central

Boko, Pelagie M.; Ibikounle, Moudachirou; Onzo-Aboki, Ablawa; Tougoue, Jean-Jacques; Sissinto, Yollande; Batcho, Wilfrid; Kinde-Gazard, Dorothe; Kabore, Achille

2016-01-01

In 2013, Benin developed strategies to control neglected tropical diseases and one of the first step was the disease mapping of the entire country in order to identify endemic districts of schistosomiasis and soil transmitted helminths (STH). This study was carried out in 30 of the 77 districts of Benin. Of these 30 districts 22 were previously treated for Lymphatic Filariasis (LF) using the Ivermectin and Albendazole combination. In each district, five schools were selected and 50 children aged 8 to 14 years were sampled in each school, making a total of 250 children sampled in the district. The schools were selected mainly according to their proximity to lakes or any bodies of water that were likely to have been used by the children. Samples of faeces and urine were collected from each pupil. Urinary schistosomiasis was identified using the urine filtration technique while STH and intestinal schistosomiasis were identified through the Kato Katz method. Overall a total of 7500 pupils were surveyed across 150 schools with a gender ratio of 1:1. Hookworm was identified in all 30 districts with a prevalence ranging from 1.2% (95%CI: 0.0–2.5) to 60% (95%CI: 53.9–66.1). Ascaris lumbricoides was detected in 19 districts with a prevalence rate between 1% (95%CI: 0.0–2.2) and 39% (95%CI: 32.9–45.0). In addition to these common STH, Trichuris trichiura, Enterobius vermicularis and Strongyloides stercoralis were found at low prevalence. Only 16 districts were endemic to Schistosoma mansoni, while 29 districts were endemic to S. haematobium. The S. haematobium prevalence ranged from 0.8% (95% CI: 0.0–1.9) to 56% (95% CI: 50.2–62.5) while the prevalence of S. mansoni varied from 0.4% (95%CI: 0.0–1.2) to 46% (95% CI: 39.8–52.2). The 22 districts, where LF was successfully eliminated, still require mass drug administration (MDA) of albendazole indicating that school-based MDA would be needed even after LF elimination in districts co-endemic to LF and STH in Benin. PMID:27643795

Maintenance of temporary sediment controls.

DOT National Transportation Integrated Search

1978-01-01

During the summer of 1977, field surveys and conferences with Virginia Department of Highways and Transportation district personnel were conducted to determine the statewide status of maintenance efforts in erosion, and sedimentation control. As a re...

Image Control, not Damage Control.

ERIC Educational Resources Information Center

Rittner-Heir, Robbin M.

2002-01-01

Discusses the need for school districts to practice active community relations in order to positively influence information flowing to the community. Addresses performing a communications audit and ways to disseminate information to the public. (EV)

Map showing potential metal-mine drainage hazards in Colorado, based on mineral-deposit geology

USGS Publications Warehouse

Plumlee, Geoffrey S.; Streufert, Randall K.; Smith, Kathleen S.; Smith, Steven M.; Wallace, Alan R.; Toth, Margo I.; Nash, J. Thomas; Robinson, Rob A.; Ficklin, Walter H.; Lee, Gregory K.

1995-01-01

This map, compiled by the U.S. Geological Survey (USGS) in cooperation with the Colorado Geological Survey (CGS) and the U. S. Bureau of Land Management (BLM), shows potential mine-drainage hazards that may exist in Colorado metal-mining districts, as indicated by the geologic characteristics of the mineral deposits that occur in the respective districts. It was designed to demonstrate how geologic and geochemical information can be used on a regional scale to help assess the potential for mining-related and natural drainage problems in mining districts, unmined mineralized areas, and surrounding watersheds. The map also provides information on the distribution of different mineral deposit types across Colorado. A GIS (Geographic Information System) format was used to integrate geologic, geochemical, water-quality, climate, landuse, and ecological data from diverse sources. Likely mine-drainage signatures were defined for each mining district based on: (1) a review of the geologic characteristics of the mining district, including mineralogy, trace-element content, host-rock lithology, and wallrock alteration, and; (2) results of site specific studies on the geologic controls on mine-drainage composition.

Enhancing the Interpretive Reading and Analytical Writing of Mainstreamed English Learners in Secondary School: Results from a Randomized Field Trial Using a Cognitive Strategies Approach

ERIC Educational Resources Information Center

Olson, Carol Booth; Kim, James S.; Scarcella, Robin; Kramer, Jason; Pearson, Matthew; van Dyk, David A.; Collins, Penny; Land, Robert E.

2012-01-01

In this study, 72 secondary English teachers from the Santa Ana Unified School District were randomly assigned to participate in the Pathway Project, a cognitive strategies approach to teaching interpretive reading and analytical writing, or to a control condition involving typical district training focusing on teaching content from the textbook.…

The Impact of Low, Moderate, and High Military Family Mobility School District Transfer Rates on Graduating Senior High School Dependents' Achievement and School Engagement

ERIC Educational Resources Information Center

Rippe, Jeffrey K.

2012-01-01

The results of this study suggest that there were no significant differences in the academic performance of military dependents' with low (n = 20), moderate (n = 20), and high (n = 20) mobility school district transfer rates compared to non-military control students (n = 20) before completing high school. The findings were not consistent with…

Regional density of private dentists: empirical evidence from Austria.

PubMed

Gächter, Martin; Schwazer, Peter; Theurl, Engelbert; Winner, Hannes

2014-02-01

We investigated the determinants of disparities in the regional density of private dentists in Austria. Specifically, we focused on the relationship between the density of private dentists and their public counterparts, thereby controlling for other possible covariates of dentist density. Dentist density was measured at the district level. We used panel data of dentist density from 121 Austrian districts over the years 2001-2008. We applied a Hausman-Taylor framework to cope with possible endogeneity and to control for cross-district effects in the dentist density. A significant negative relationship was found between the density of private and public dentists, indicating a substitution effect between the two dentist groups. A significant positive spatial relationship also existed for private and public dentists in the neighboring regions. Dental capacities in public and private hospitals and dental laboratories run by the public health insurance system did not have a significant effect on private dentist density. Although a strong negative relationship existed between private and public dentists within the districts, one should not draw the conclusion that private dentists in Austria are close substitutes for public dentists. Such a conclusion would require further empirical analysis on the utilization patterns of dental services and their relationships with financing mechanisms. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[Effect of water conservancy schistosomiasis control projects combined with molluscicide to control Oncomelania hupensis snails in rivers connecting with Yangtze River in Pukou District, Nanjing City].

PubMed

Qiang, Zhou; Li-Xin, Wan; De-Rong, Hang; Qi-Hui, You; Jun, You; Yu-Lin, Zhang; Zhao-Feng, Zhu; Yi-Xin, Huang

2017-12-07

To evaluate the effect of the water conservancy schistosomiasis control projects combined with molluscicide to control Oncomelania hupensis snails in the rivers connecting with the Yangtze River. The water conservancy schistosomiasis control projects of Zhujiashan River, Qili River and Gaowang River were chosen as the study objects in Pukou District, Nanjing City. The data review method and field investigation were used to evaluate the effect of the water conservancy schistosomiasis control projects combined with molluscicide to control O. hupensis snails. After the projects of the water level control and concrete slope protection and mollusciciding were implemented, the snails in the project river sections were completely eliminated. The snail diffusion did not happen in the inland irrigation area too. In the outside of the river beach, though the snails still existed, the snail densities plunged below 1.0 snail per 1.0 m 2 . The comprehensive measures of the combination of water level control, concrete slope protection and mollusciciding can effectively control and eliminate the snails, and prevent the snails from spreading.

Healthier Fundraising in U. S. Elementary Schools: Associations between Policies at the State, District, and School Levels

PubMed Central

Turner, Lindsey; Chriqui, Jamie F.; Chaloupka, Frank J.

2012-01-01

Objectives We examined whether state laws and district policies pertaining to nutritional restrictions on school fundraisers were associated with school policies as reported by administrators in a nationally-representative sample of United States public elementary schools. Methods We gathered data on school-level fundraising policies via a mail-back survey during the 2009–10 and 2010–11 school years. Surveys were received from 1,278 public elementary schools (response rate = 60.9%). Data were also gathered on corresponding school district policies and state laws. After removing cases with missing data, the sample size for analysis was 1,215 schools. Results After controlling for school characteristics, school policies were consistently associated with state laws and district policies, both those pertaining to fundraising generally, as well as specific restrictions on the sale of candy and soda in fundraisers (all Odds Ratios >2.0 and Ps<.05). However, even where district policies and state laws required fundraising restrictions, school policies were not uniformly present; school policies were also in place at only 55.8% of these schools, but were more common at schools in the West (77.1%) and at majority-Latino schools (71.4%), indicating uneven school-level implementation of district policy and state law. Conclusions District policies and state laws were associated with a higher prevalence of elementary school-level fundraising policies, but many schools that were subject to district policies and state laws did not have school-level restrictions in place, suggesting the need for further attention to factors hindering policy implementation in schools. PMID:23166788

Healthier fundraising in U. S. elementary schools: associations between policies at the state, district, and school levels.

PubMed

Turner, Lindsey; Chriqui, Jamie F; Chaloupka, Frank J

2012-01-01

We examined whether state laws and district policies pertaining to nutritional restrictions on school fundraisers were associated with school policies as reported by administrators in a nationally-representative sample of United States public elementary schools. We gathered data on school-level fundraising policies via a mail-back survey during the 2009-10 and 2010-11 school years. Surveys were received from 1,278 public elementary schools (response rate = 60.9%). Data were also gathered on corresponding school district policies and state laws. After removing cases with missing data, the sample size for analysis was 1,215 schools. After controlling for school characteristics, school policies were consistently associated with state laws and district policies, both those pertaining to fundraising generally, as well as specific restrictions on the sale of candy and soda in fundraisers (all Odds Ratios >2.0 and Ps<.05). However, even where district policies and state laws required fundraising restrictions, school policies were not uniformly present; school policies were also in place at only 55.8% of these schools, but were more common at schools in the West (77.1%) and at majority-Latino schools (71.4%), indicating uneven school-level implementation of district policy and state law. District policies and state laws were associated with a higher prevalence of elementary school-level fundraising policies, but many schools that were subject to district policies and state laws did not have school-level restrictions in place, suggesting the need for further attention to factors hindering policy implementation in schools.

Comparative analysis of characteristics and risk factors of traffic injury in aged people from urban and rural areas in Chongqing.

PubMed

Zhang, Liang; Zhou, Ji-Hong; Qiu, Jun; Zhang, Xiu-Zhu; Yuan, Dan-Feng; Gao, Zhi-Ming; Dai, Wei

2012-01-01

To study the epidemiologic characteristics of traffic injuries among people over 60 years old in the Nan'an district (urban) and Jiangjin district (rural) of Chongqing, and to discuss the corresponding strategies for its prevention and cure. Records of traffic injuries in people over 60 years old registered by the traffic police between 2000 and 2006 in Nan'an district and Jiangjin district were collected in the Database of Road Traffic Accidents and Traffic Injuries. Epidemiologic characteristics of traffic injuries among the aged people were analyzed and compared. Between the year 2000 and 2006, the average annual incidence of traffic injuries and mortality rate in the aged people in Nan'an district were 124.62/100 000 and 13.85/ 100 000 respectively, higher than that in Jiangjin district (27.49/ 100 000, 7.13/100 000, P less than 0.01). However, the mortality rate for the aged people who were involved in traffic injuries in Jiangjin district was 20.60%, higher than that in Nan'an district (10.00%, P less than 0.01). Head injury was the primary cause of death. Totally 76.58% of casualties were pede-strians. Over 90% of the traffic accidents occurred in the areas with no traffic signal or traffic control system. The traffic environment is unfavorable to the aged people. It is important to enhance traffic safety consciousness of drivers and the elderly and to strengthen traffic safety system and traffic law, so as to provide a safe road traffic environment for the aged people.

Effects of the Positive Action program on achievement and discipline: two matched-control comparisons.

PubMed

Flay, B R; Allred, C G; Ordway, N

2001-06-01

This paper reports on the effectiveness of an integrated comprehensive school model for character development, problem behavior prevention, and academic achievement enhancement. The Positive Action program consists of a school curriculum, together with schoolwide climate, family, and community components. As evaluated here, the yearly K-6 curriculum consists of over 140 fifteen-to-twenty-minute lessons per year delivered in school classrooms on an almost daily basis. The program is based on theories of self-concept, learning, behavior, and school ecology. We use a matched control design and school-level achievement and disciplinary data to evaluate program effects on student performance and behavior in two separate school districts. The program improved achievement by 16% in one district and 52% in another, and reduced disciplinary referrals by 78% in one district and 85% in the other. We discuss implications of these replicated findings for the prevention of substance abuse and violence, the improvement of school performance, and the reform of American schools.

Quality-assurance plan for water-resources activities of the U.S. Geological Survey in Idaho

USGS Publications Warehouse

Packard, F.A.

1996-01-01

To ensure continued confidence in its products, the Water Resources Division of the U.S. Geological Survey implemented a policy that all its scientific work be performed in accordance with a centrally managed quality-assurance program. This report establishes and documents a formal policy for current (1995) quality assurance within the Idaho District of the U.S. Geological Survey. Quality assurance is formalized by describing district organization and operational responsibilities, documenting the district quality-assurance policies, and describing district functions. The districts conducts its work through offices in Boise, Idaho Falls, Twin Falls, Sandpoint, and at the Idaho National Engineering Laboratory. Data-collection programs and interpretive studies are conducted by two operating units, and operational and technical assistance is provided by three support units: (1) Administrative Services advisors provide guidance on various personnel issues and budget functions, (2) computer and reports advisors provide guidance in their fields, and (3) discipline specialists provide technical advice and assistance to the district and to chiefs of various projects. The district's quality-assurance plan is based on an overall policy that provides a framework for defining the precision and accuracy of collected data. The plan is supported by a series of quality-assurance policy statements that describe responsibilities for specific operations in the district's program. The operations are program planning; project planning; project implementation; review and remediation; data collection; equipment calibration and maintenance; data processing and storage; data analysis, synthesis, and interpretation; report preparation and processing; and training. Activities of the district are systematically conducted under a hierarchy of supervision an management that is designed to ensure conformance with Water Resources Division goals quality assurance. The district quality-assurance plan does not describe detailed technical activities that are commonly termed "quality-control procedures." Instead, it focuses on current policies, operations, and responsibilities that are implemented at the management level. Contents of the plan will be reviewed annually and updated as programs and operations change.

A comparison of hierarchical cluster analysis and league table rankings as methods for analysis and presentation of district health system performance data in Uganda.

PubMed

Tashobya, Christine K; Dubourg, Dominique; Ssengooba, Freddie; Speybroeck, Niko; Macq, Jean; Criel, Bart

2016-03-01

In 2003, the Uganda Ministry of Health introduced the district league table for district health system performance assessment. The league table presents district performance against a number of input, process and output indicators and a composite index to rank districts. This study explores the use of hierarchical cluster analysis for analysing and presenting district health systems performance data and compares this approach with the use of the league table in Uganda. Ministry of Health and district plans and reports, and published documents were used to provide information on the development and utilization of the Uganda district league table. Quantitative data were accessed from the Ministry of Health databases. Statistical analysis using SPSS version 20 and hierarchical cluster analysis, utilizing Wards' method was used. The hierarchical cluster analysis was conducted on the basis of seven clusters determined for each year from 2003 to 2010, ranging from a cluster of good through moderate-to-poor performers. The characteristics and membership of clusters varied from year to year and were determined by the identity and magnitude of performance of the individual variables. Criticisms of the league table include: perceived unfairness, as it did not take into consideration district peculiarities; and being oversummarized and not adequately informative. Clustering organizes the many data points into clusters of similar entities according to an agreed set of indicators and can provide the beginning point for identifying factors behind the observed performance of districts. Although league table ranking emphasize summation and external control, clustering has the potential to encourage a formative, learning approach. More research is required to shed more light on factors behind observed performance of the different clusters. Other countries especially low-income countries that share many similarities with Uganda can learn from these experiences. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

A comparison of hierarchical cluster analysis and league table rankings as methods for analysis and presentation of district health system performance data in Uganda†

PubMed Central

Tashobya, Christine K; Dubourg, Dominique; Ssengooba, Freddie; Speybroeck, Niko; Macq, Jean; Criel, Bart

2016-01-01

In 2003, the Uganda Ministry of Health introduced the district league table for district health system performance assessment. The league table presents district performance against a number of input, process and output indicators and a composite index to rank districts. This study explores the use of hierarchical cluster analysis for analysing and presenting district health systems performance data and compares this approach with the use of the league table in Uganda. Ministry of Health and district plans and reports, and published documents were used to provide information on the development and utilization of the Uganda district league table. Quantitative data were accessed from the Ministry of Health databases. Statistical analysis using SPSS version 20 and hierarchical cluster analysis, utilizing Wards’ method was used. The hierarchical cluster analysis was conducted on the basis of seven clusters determined for each year from 2003 to 2010, ranging from a cluster of good through moderate-to-poor performers. The characteristics and membership of clusters varied from year to year and were determined by the identity and magnitude of performance of the individual variables. Criticisms of the league table include: perceived unfairness, as it did not take into consideration district peculiarities; and being oversummarized and not adequately informative. Clustering organizes the many data points into clusters of similar entities according to an agreed set of indicators and can provide the beginning point for identifying factors behind the observed performance of districts. Although league table ranking emphasize summation and external control, clustering has the potential to encourage a formative, learning approach. More research is required to shed more light on factors behind observed performance of the different clusters. Other countries especially low-income countries that share many similarities with Uganda can learn from these experiences. PMID:26024882

The influence of health system organizational structure and culture on integration of health services: the example of HIV service monitoring in South Africa.

PubMed

Kawonga, Mary; Blaauw, Duane; Fonn, Sharon

2016-11-01

Administrative integration of disease control programmes (DCPs) within the district health system has been a health sector reform priority in South Africa for two decades. The reforms entail district managers assuming authority for the planning and monitoring of DCPs in districts, with DCP managers providing specialist support. There has been little progress in achieving this, and a dearth of research exploring why. Using a case study of HIV programme monitoring and evaluation (M&E), this article explores whether South Africa's health system is configured to support administrative integration. The article draws on data from document reviews and interviews with 54 programme and district managers in two of nine provinces, exploring their respective roles in decision-making regarding HIV M&E system design and in using HIV data for monitoring uptake of HIV interventions in districts. Using Mintzberg's configurations framework, we describe three organizational parameters: (a) extent of centralization (whether district managers play a role in decisions regarding the design of the HIV M&E system); (b) key part of the organization (extent to which sub-national programme managers vs district managers play the central role in HIV monitoring in districts); and (c) coordination mechanisms used (whether highly formalized and rules-based or more output-based to promote agency). We find that the health system can be characterized as Mintzberg's machine bureaucracy. It is centralized and highly formalized with structures, management styles and practices that promote programme managers as lead role players in the monitoring of HIV interventions within districts. This undermines policy objectives of district managers assuming this leadership role. Our study enhances the understanding of organizational factors that may limit the success of administrative integration reforms and suggests interventions that may mitigate this. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Comprehensive assessment of health education and health promotion in five non-communicable disease demonstration districts in China: a cross-sectional study.

PubMed

Xu, Qiaohua; Huang, Yuelong; Chen, Biyun

2017-12-26

This study aims to develop assessment indicators of health education and promotion for non-communicable disease (NCD) demonstration districts in China and to identify significant factors associated with NCD health education and promotion work. Three complementary techniques were used to conduct this study in Hunan Province, China, between late 2013 and 2015. The Delphi technique was used to develop weighted assessment indicators, followed by the rank sum ratio (RSR) to normalise the weights through rank conversion. Lastly, the technique for order of preference by similarity to ideal solution was conducted to assess five randomly selected NCD demonstration districts representing five different orientations in the province. A total of 24 assessment indicators were constructed covering the following sections: organisational management, fund support, personnel supplies, health education and promotion, people's awareness of NCDs, management and control of patients with NCD, satisfaction with health education and promotion and health literacy of residents. Five districts were selected as samples for evaluation (Furong District, Ziyang District, Shaodong County, Shuangfeng County and Luxi County). Performance varied among the sites, with Furong District greatly surpassing the other sites, especially in fund support, media promotion, technical support for publicity materials, community promotion and supportive environment supplies. The latter four factors were also much greater in the second-ranked Luxi County site than those in the other sites (except Furong District). There were gaps in health education and promotion work in NCD demonstration districts in Hunan Province. The districts that performed better had obvious advantages in fund support, media promotion, technical support, community promotion and supportive environment supplies. Our study provided both a methodological reference and an assessment indicator framework for similar future studies. © 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.

Routine Vaccination Coverage in Northern Nigeria: Results from 40 District-Level Cluster Surveys, 2014-2015

PubMed Central

Ogbuanu, Ikechukwu U.; Adegoke, Oluwasegun J.; Scobie, Heather M.; Uba, Belinda V.; Wannemuehler, Kathleen A.; Ruiz, Alicia; Elmousaad, Hashim; Ohuabunwo, Chima J.; Mustafa, Mahmud; Nguku, Patrick; Waziri, Ndadilnasiya Endie; Vertefeuille, John F.

2016-01-01

Background Despite recent success towards controlling poliovirus transmission, Nigeria has struggled to achieve uniformly high routine vaccination coverage. A lack of reliable vaccination coverage data at the operational level makes it challenging to target program improvement. To reliably estimate vaccination coverage, we conducted district-level vaccine coverage surveys using a pre-existing infrastructure of polio technical staff in northern Nigeria. Methods Household-level cluster surveys were conducted in 40 polio high risk districts of Nigeria during 2014–2015. Global positioning system technology and intensive supervision by a pool of qualified technical staff were used to ensure high survey quality. Vaccination status of children aged 12–23 months was documented based on vaccination card or caretaker’s recall. District-level coverage estimates were calculated using survey methods. Results Data from 7,815 children across 40 districts were analyzed. District-level coverage with the third dose of diphtheria-pertussis-tetanus vaccine (DPT3) ranged widely from 1–63%, with all districts having DPT3 coverage below the target of 80%. Median coverage across all districts for each of eight vaccine doses (1 Bacille Calmette-Guérin dose, 3 DPT doses, 3 oral poliovirus vaccine doses, and 1 measles vaccine dose) was <50%. DPT3 coverage by survey was substantially lower (range: 28%–139%) than the 2013 administrative coverage reported among children aged <12 months. Common reported reasons for non-vaccination included lack of knowledge about vaccines and vaccination services (50%) and factors related to access to routine immunization services (15%). Conclusions Survey results highlighted vaccine coverage gaps that were systematically underestimated by administrative reporting across 40 polio high risk districts in northern Nigeria. Given the limitations of administrative coverage data, our approach to conducting quality district-level coverage surveys and providing data to assess and remediate issues contributing to poor vaccination coverage could serve as an example in countries with sub-optimal vaccination coverage, similar to Nigeria. PMID:27936077

Routine Vaccination Coverage in Northern Nigeria: Results from 40 District-Level Cluster Surveys, 2014-2015.

PubMed

Gunnala, Rajni; Ogbuanu, Ikechukwu U; Adegoke, Oluwasegun J; Scobie, Heather M; Uba, Belinda V; Wannemuehler, Kathleen A; Ruiz, Alicia; Elmousaad, Hashim; Ohuabunwo, Chima J; Mustafa, Mahmud; Nguku, Patrick; Waziri, Ndadilnasiya Endie; Vertefeuille, John F

2016-01-01

Despite recent success towards controlling poliovirus transmission, Nigeria has struggled to achieve uniformly high routine vaccination coverage. A lack of reliable vaccination coverage data at the operational level makes it challenging to target program improvement. To reliably estimate vaccination coverage, we conducted district-level vaccine coverage surveys using a pre-existing infrastructure of polio technical staff in northern Nigeria. Household-level cluster surveys were conducted in 40 polio high risk districts of Nigeria during 2014-2015. Global positioning system technology and intensive supervision by a pool of qualified technical staff were used to ensure high survey quality. Vaccination status of children aged 12-23 months was documented based on vaccination card or caretaker's recall. District-level coverage estimates were calculated using survey methods. Data from 7,815 children across 40 districts were analyzed. District-level coverage with the third dose of diphtheria-pertussis-tetanus vaccine (DPT3) ranged widely from 1-63%, with all districts having DPT3 coverage below the target of 80%. Median coverage across all districts for each of eight vaccine doses (1 Bacille Calmette-Guérin dose, 3 DPT doses, 3 oral poliovirus vaccine doses, and 1 measles vaccine dose) was <50%. DPT3 coverage by survey was substantially lower (range: 28%-139%) than the 2013 administrative coverage reported among children aged <12 months. Common reported reasons for non-vaccination included lack of knowledge about vaccines and vaccination services (50%) and factors related to access to routine immunization services (15%). Survey results highlighted vaccine coverage gaps that were systematically underestimated by administrative reporting across 40 polio high risk districts in northern Nigeria. Given the limitations of administrative coverage data, our approach to conducting quality district-level coverage surveys and providing data to assess and remediate issues contributing to poor vaccination coverage could serve as an example in countries with sub-optimal vaccination coverage, similar to Nigeria.

Mapping the receptivity of malaria risk to plan the future of control in Somalia

PubMed Central

Alegana, Victor Adagi; Patil, Anand Prabhakar; Moloney, Grainne; Borle, Mohammed; Yusuf, Fahmi; Amran, Jamal; Snow, Robert William

2012-01-01

Objectives To measure the receptive risks of malaria in Somalia and compare decisions on intervention scale-up based on this map and the more widely used contemporary risk maps. Design Cross-sectional community Plasmodium falciparum parasite rate (PfPR) data for the period 2007–2010 corrected to a standard age range of 2 to <10 years (PfPR2–10) and used within a Bayesian space–time geostatistical framework to predict the contemporary (2010) mean PfPR2–10 and the maximum annual mean PfPR2–10 (receptive) from the highest predicted PfPR2–10 value over the study period as an estimate of receptivity. Setting Randomly sampled communities in Somalia. Participants Randomly sampled individuals of all ages. Main outcome measure Cartographic descriptions of malaria receptivity and contemporary risks in Somalia at the district level. Results The contemporary annual PfPR2–10 map estimated that all districts (n=74) and population (n=8.4 million) in Somalia were under hypoendemic transmission (≤10% PfPR2–10). Of these, 23% of the districts, home to 13% of the population, were under transmission of <1% PfPR2–10. About 58% of the districts and 55% of the population were in the risk class of 1% to <5% PfPR2–10. In contrast, the receptivity map estimated 65% of the districts and 69% of the population were under mesoendemic transmission (>10%–50% PfPR2–10) and the rest as hypoendemic. Conclusion Compared with maps of receptive risks, contemporary maps of transmission mask disparities of malaria risk necessary to prioritise and sustain future control. As malaria risk declines across Africa, efforts must be invested in measuring receptivity for efficient control planning. PMID:22855625

Inferring a District-Based Hierarchical Structure of Social Contacts from Census Data

PubMed Central

Yu, Zhiwen; Liu, Jiming; Zhu, Xianjun

2015-01-01

Researchers have recently paid attention to social contact patterns among individuals due to their useful applications in such areas as epidemic evaluation and control, public health decisions, chronic disease research and social network research. Although some studies have estimated social contact patterns from social networks and surveys, few have considered how to infer the hierarchical structure of social contacts directly from census data. In this paper, we focus on inferring an individual’s social contact patterns from detailed census data, and generate various types of social contact patterns such as hierarchical-district-structure-based, cross-district and age-district-based patterns. We evaluate newly generated contact patterns derived from detailed 2011 Hong Kong census data by incorporating them into a model and simulation of the 2009 Hong Kong H1N1 epidemic. We then compare the newly generated social contact patterns with the mixing patterns that are often used in the literature, and draw the following conclusions. First, the generation of social contact patterns based on a hierarchical district structure allows for simulations at different district levels. Second, the newly generated social contact patterns reflect individuals social contacts. Third, the newly generated social contact patterns improve the accuracy of the SEIR-based epidemic model. PMID:25679787

Risk factors for Mycobacterium ulcerans infection (Buruli Ulcer) in Togo ─ a case-control study in Zio and Yoto districts of the maritime region.

PubMed

Maman, Issaka; Tchacondo, Tchadjobo; Kere, Abiba Banla; Piten, Ebekalisai; Beissner, Marcus; Kobara, Yiragnima; Kossi, Komlan; Badziklou, Kossi; Wiedemann, Franz Xaver; Amekuse, Komi; Bretzel, Gisela; Karou, Damintoti Simplice

2018-01-19

Buruli ulcer (BU) is a neglected mycobacterial skin infection caused by Mycobacterium ulcerans. This disease mostly affects poor rural populations, especially in areas with low hygiene standards and sanitation coverage. The objective of this study was to identify these risk factors in the districts of Zio and Yoto of the Maritime Region in Togo. We conducted a case-control study in Zio and Yoto, two districts proved BU endemic from November 2014 to May 2015. BU cases were diagnosed according to the WHO clinical case definition at the Centre Hospitalier Régional de Tsévié (CHR Tsévié) and confirmed by Ziehl-Neelsen (ZN) microscopy and IS2404 polymerase chain reaction (PCR). For each case, up to two controls matched by sex and place of residence were recruited. Socio-demographic, environmental or behavioral data were collected and conditional logistic regression analysis was used to identify and compare risk factors between BU cases and controls. A total of 83 cases and 128 controls were enrolled. The median age was 15 years (range 3-65 years). Multivariate conditional logistic regression analysis after adjustment for potential confounders identified age (< 10 years (OR =11.48, 95% CI = 3.72-35.43) and 10-14 years (OR = 3.63, 95% CI = 1.22-10.83)), receiving insect bites near a river (OR = 7.8, 95% CI = 1.48-41.21) and bathing with water from open borehole (OR = 5.77, (1.11-29.27)) as independent predictors of acquiring BU infection. This study identified age, bathing with water from open borehole and receiving insect bites near a river as potential risk of acquiring BU infection in Zio and Yoto districts of the Maritime Region in south Togo.

Participation and diffusion effects of a peer-intervention for HIV prevention among adults in rural Malawi.

PubMed

Crittenden, Kathleen S; Kaponda, Chrissie P N; Jere, Diana L; McCreary, Linda L; Norr, Kathleen F

2015-05-01

This paper examines whether a peer group intervention that reduced self-reported risky behaviors for rural adults in Malawi also had impacts on non-participants in the same communities. We randomly assigned two districts to the intervention and control conditions, and conducted surveys at baseline and 18 months post-intervention using unmatched independent random samples of intervention and control communities in 2003-2006. The six-session peer group intervention was offered to same-gender groups by trained volunteers. In this analysis, we divided the post-intervention sample into three exposure groups: 243 participants and 170 non-participants from the intervention district (total n = 415) and 413 control individuals. Controlling for demographics and participation, there were significant favorable diffusion effects on five partially overlapping behavioral outcomes: partner communication, ever used condoms, unprotected sex, recent HIV test, and a community HIV prevention index. Non-participants in the intervention district had more favorable outcomes on these behaviors than survey respondents in the control district. One behavioral outcome, community HIV prevention, showed both participation and diffusion effects. Participating in the intervention had a significant effect on six psychosocial outcomes: HIV knowledge (two measures), hope, condom attitudes, and self-efficacy for community HIV prevention and for safer sex; there were no diffusion effects. This pattern of results suggests that the behavioral changes promoted in the intervention spread to others in the same community, most likely through direct contact between participants and non-participants. These findings support the idea that diffusion of HIV-related behavior changes can occur for peer group interventions in communities, adding to the body of research supporting diffusion of innovations theory as a robust approach to accelerating change. If diffusion occurs, peer group intervention may be more cost-effective than previously realized. Wider implementation of peer group interventions can help meet the global goal of reducing new HIV infections. Copyright © 2015 Elsevier Ltd. All rights reserved.

Participation and Diffusion Effects of a Peer-Intervention for HIV Prevention among Adults in Rural Malawi

PubMed Central

Crittenden, Kathleen S.; Kaponda, Chrissie P. N.; Jere, Diana L.; McCreary, Linda L.; Norr, Kathleen F.

2015-01-01

This paper examines whether a peer group intervention that reduced self-reported risky behaviors for rural adults in Malawi also had impacts on non-participants in the same communities. We randomly assigned two districts to the intervention and control conditions, and conducted surveys at baseline and 18 months post-intervention using unmatched independent random samples of intervention and control communities in 2003-2006. The six-session peer group intervention was offered to same-gender groups by trained volunteers. In this analysis, we divided the post-intervention sample into three exposure groups: 243 participants and 170 non-participants from the intervention district (total n=415) and 413 control individuals. Controlling for demographics and participation, there were significant favorable diffusion effects on five partially overlapping behavioral outcomes: partner communication, ever used condoms, unprotected sex, recent HIV test, and a community HIV prevention index. Non-participants in the intervention district had more favorable outcomes on these behaviors than survey respondents in the control district. One behavioral outcome, community HIV prevention, showed both participation and diffusion effects. Participating in the intervention had a significant effect on six psychosocial outcomes: HIV knowledge (two measures), hope, condom attitudes, and self-efficacy for community HIV prevention and for safer sex; there were no diffusion effects. This pattern of results suggests that the behavioral changes promoted in the intervention spread to others in the same community, most likely through direct contact between participants and non-participants. These findings support the idea that diffusion of HIV-related behavior changes can occur for peer group interventions in communities, adding to the body of research supporting diffusion of innovations theory as a robust approach to accelerating change. If diffusion occurs, peer group intervention may be more cost-effective than previously realized. Wider implementation of peer group interventions can help meet the global goal of reducing new HIV infections. PMID:25864150

The Status of State Policies Concerning Birth Control Education

ERIC Educational Resources Information Center

Parcel, Guy S.; Kenepp, Diana L.

1972-01-01

This study tried to determine the nature of existing policies concerning birth control education in each of the 50 states and District of Columbia and to obtain an interpretation of these policies. (Author)

The Ins and Outs of Access Control.

ERIC Educational Resources Information Center

Longworth, David

1999-01-01

Presents basic considerations when school districts plan to acquire an access-control system for their education facilities. Topics cover cards and readers, controllers, software, automation, card technology, expandability, price, specification of needs beyond the canned specifications already supplied, and proper usage training to cardholders.…

77 FR 72851 - California State Nonroad Engine Pollution Control Standards; Portable Equipment Registration...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-06

... ENVIRONMENTAL PROTECTION AGENCY [FRL-9758-1] California State Nonroad Engine Pollution Control... throughout California without obtaining permits from local air pollution control districts. DATES: Petitions... faced the need to obtain preconstruction and operating permits from different local air pollution...

Groundwater Regulation in the Houston-Galveston Region to Control Subsidence - Balancing Total Water Demand, Available Alternative Water Supplies, and Groundwater Withdrawal

NASA Astrophysics Data System (ADS)

Turco, M. J.

2014-12-01

In 1975, as a result of area residents and local governments becoming increasingly alarmed by the continued impact of subsidence on economic growth and quality of life in the region, the Harris-Galveston Coastal Subsidence District was created by the 64th Texas Legislature as an underground water conservation district. The primary mission of what is now the Harris-Galveston Subsidence District, is to provide for the regulation of the withdrawal of groundwater to control subsidence. Subsidence has been a concern in the Houston, TX area throughout most of recent history. Since 1906, over 10 feet of subsidence has occurred, with a broad area of 6 feet of subsidence throughout most of the Houston Area.Over its nearly forty years of existence, the District has developed substantial data sets providing the foundation for its regulatory plan. Annual water-level measurements, a network of deep extensometers, over 80 subsidence GPS monitors, and updated numerical and analytical models have been utilized. Periodically, the District utilizes U.S. Census data to predict the future magnitude and location of population and water demand. In 2013, all of these data sets were combined producing an updated regulatory plan outlining the timelines of conversion to alternative sources of water and defining the maximum percentage groundwater can contribute to a user's total water demand.The management of the groundwater resources within the District has involved significant coordination with regional ground and surface water suppliers; ongoing interaction with other state and local regulatory bodies; analysis of accurate and up to date predictions on water usage; the enforcement of real disincentives to those who rely too heavily on groundwater and a commitment to practicing and promoting water conservation.Water supplies in the region are projected to continue to be stressed in the future due to rapid population increases in the region. Future District efforts will be focused on maintaining the successes of the past while evaluating potential deeper groundwater resources and any potential subsidence resulting from future development.

Transfusion-transmitted malaria: donor prevalence of parasitaemia and a survey of healthcare workers knowledge and practices in a district hospital in Ghana.

PubMed

Owusu-Ofori, Alex; Gadzo, Dominic; Bates, Imelda

2016-04-23

Transfusion-transmitted malaria (TTM) is a risk of transfusion that has not been well described in malaria endemic regions. The risk of the recipient getting malaria is related to the prevalence of malaria in the blood donors. There is however little information on the prevalence of malaria among donors in Akatsi district of Ghana. Further, the knowledge and practices of healthcare workers to TTM is unknown. The study was undertaken to determine the prevalence of malaria parasite infection among blood donors and to evaluate the knowledge and practices of healthcare workers to TTM in the Akatsi district of Ghana. The study was conducted at Akatsi South District Hospital between May and August 2014. To screen for Plasmodium falciparum, 5 µl of capillary blood was obtained by finger prick from 200 participants (100 donors and 100 healthy controls). Plasmodium falciparum screening was done using CareStart™ Malaria Antigen kit. To obtain information regarding TTM knowledge and practices, questionnaires were completed by 100 health workers including nurses, doctors and laboratory staff. The prevalence of P. falciparum was the same (10 %) in both donors and controls. All those who were malaria RDT positive were aged 15-25 years. Out of the 100 healthcare workers (31 males and 69 females) surveyed, 45 % of respondents (45/100) had never heard of transfusion-transmitted malaria. Almost all respondents (91 %) had not attended any lecture/seminar/workshop on blood transfusion in the past 12 months. There were 44 respondents (44 %) who wrongly said malaria was being screened for prior to transfusion in their hospital. However, 98.2 % (54/55) of those who had heard about TTM rightly stated that TTM can be prevented. The prevalence of P. falciparum parasitaemia is 10 % in healthy blood donors in the Akatsi district and represents a risk for TTM though the extent of this risk is unclear. Knowledge about TTM in healthcare workers in the district is low. Continuous education and in-service training may be a means to improve TTM knowledge and preventive practices by the health workers in the district.

District health managers' perceptions of supervision in Malawi and Tanzania.

PubMed

Bradley, Susan; Kamwendo, Francis; Masanja, Honorati; de Pinho, Helen; Waxman, Rachel; Boostrom, Camille; McAuliffe, Eilish

2013-09-05

Mid-level cadres are being used to address human resource shortages in many African contexts, but insufficient and ineffective human resource management is compromising their performance. Supervision plays a key role in performance and motivation, but is frequently characterised by periodic inspection and control, rather than support and feedback to improve performance. This paper explores the perceptions of district health management teams in Tanzania and Malawi on their role as supervisors and on the challenges to effective supervision at the district level. This qualitative study took place as part of a broader project, "Health Systems Strengthening for Equity: The Power and Potential of Mid-Level Providers". Semi-structured interviews were conducted with 20 district health management team personnel in Malawi and 37 council health team members in Tanzania. The interviews covered a range of human resource management issues, including supervision and performance assessment, staff job descriptions and roles, motivation and working conditions. Participants displayed varying attitudes to the nature and purpose of the supervision process. Much of the discourse in Malawi centred on inspection and control, while interviewees in Tanzania were more likely to articulate a paradigm characterised by support and improvement. In both countries, facility level performance metrics dominated. The lack of competency-based indicators or clear standards to assess individual health worker performance were considered problematic. Shortages of staff, at both district and facility level, were described as a major impediment to carrying out regular supervisory visits. Other challenges included conflicting and multiple responsibilities of district health team staff and financial constraints. Supervision is a central component of effective human resource management. Policy level attention is crucial to ensure a systematic, structured process that is based on common understandings of the role and purpose of supervision. This is particularly important in a context where the majority of staff are mid-level cadres for whom regulation and guidelines may not be as formalised or well-developed as for traditional cadres, such as registered nurses and medical doctors. Supervision needs to be adequately resourced and supported in order to improve performance and retention at the district level.

District health managers’ perceptions of supervision in Malawi and Tanzania

PubMed Central

2013-01-01

Background Mid-level cadres are being used to address human resource shortages in many African contexts, but insufficient and ineffective human resource management is compromising their performance. Supervision plays a key role in performance and motivation, but is frequently characterised by periodic inspection and control, rather than support and feedback to improve performance. This paper explores the perceptions of district health management teams in Tanzania and Malawi on their role as supervisors and on the challenges to effective supervision at the district level. Methods This qualitative study took place as part of a broader project, “Health Systems Strengthening for Equity: The Power and Potential of Mid-Level Providers”. Semi-structured interviews were conducted with 20 district health management team personnel in Malawi and 37 council health team members in Tanzania. The interviews covered a range of human resource management issues, including supervision and performance assessment, staff job descriptions and roles, motivation and working conditions. Results Participants displayed varying attitudes to the nature and purpose of the supervision process. Much of the discourse in Malawi centred on inspection and control, while interviewees in Tanzania were more likely to articulate a paradigm characterised by support and improvement. In both countries, facility level performance metrics dominated. The lack of competency-based indicators or clear standards to assess individual health worker performance were considered problematic. Shortages of staff, at both district and facility level, were described as a major impediment to carrying out regular supervisory visits. Other challenges included conflicting and multiple responsibilities of district health team staff and financial constraints. Conclusion Supervision is a central component of effective human resource management. Policy level attention is crucial to ensure a systematic, structured process that is based on common understandings of the role and purpose of supervision. This is particularly important in a context where the majority of staff are mid-level cadres for whom regulation and guidelines may not be as formalised or well-developed as for traditional cadres, such as registered nurses and medical doctors. Supervision needs to be adequately resourced and supported in order to improve performance and retention at the district level. PMID:24007354

Do transportation subsidies and living allowances improve tuberculosis control outcomes among internal migrants in urban Shanghai, China?

PubMed

Lu, Hui; Yan, Fei; Wang, Wei; Wu, Laiwa; Ma, Weiping; Chen, Jing; Shen, Xin; Mei, Jian

2013-01-01

Tuberculosis (TB) in internal migrants is one of three threats for TB control in China. To address this threat, a project was launched in eight of the 19 districts of Shanghai in 2007 to provide transportation subsidies and living allowances for all migrant TB cases. This study aims to determine if this project contributed to improved TB control outcomes among migrants in urban Shanghai. This was a community intervention study. The data were derived from the TB Management Information System in three project districts and three non-project districts in Shanghai between 2006 and 2010. The impact of the project was estimated in a difference-in-difference (DID) analysis framework, and a multivariable binary logistic regression analysis. A total of 1872 pulmonary TB (PTB) cases in internal migrants were included in the study. The treatment success rate (TSR) for migrant smear-positive cases in project districts increased from 59.9% in 2006 to 87.6% in 2010 (P < 0.001). The crude DID improvement of TSR was 18.9%. There was an increased probability of TSR in the project group before and after the project intervention period (coefficient = 1.156, odds ratio = 3.178, 95% confidence interval: 1.305-7.736, P = 0.011). The study showed the project could improve treatment success in migrant PTB cases. This was a short-term programme using special financial subsidies for all migrant PTB cases. It is recommended that project funds be continuously invested by governments with particular focus on the more vulnerable PTB cases among migrants.

Economic Effects of 1978 Tabas Earthquake (Iran).

PubMed

Zandian, Elham; Rimaz, Shahnaz; Holakouie Naieni, Kourosh; Nedjat, Saharnaz; Naderimagham, Shohreh; Larijani, Bagher; Farzadfar, Farshad

2016-06-01

Natural disasters are one of the most important adverse health events. The earthquake that happened in the city of Tabas in 1978 was ranked third in terms of number of deaths caused by natural disasters over the past 100 years in Iran. This study was aimed to evaluate the economic and human capital consequences of earthquake in Tabas district. We used a two percent random sample of Iran Census Dataset from 2006 to run a difference-in-difference study. The difference-in-difference methodology was used to evaluate (1) the mean changes in variables including years of schooling and wealth; (2) the odds changes in primary school completion and literacy of people born (5 or 10 years) post-event versus (5 or 10 years) pre-event in Tabas compared with the same values for those born in the same period of time in the control districts. Differential increase in years of schooling for being born 10 years after the earthquake versus in 10 years before earthquake in Tabas was one-third of a school year less than in the control districts. There were 89.5% and 65.4% decrease in odds that an individual is literate, and 0.26 and 0.104 average decrease in the SES index for those born in Tabas in periods of 5 and 10 years, respectively, compared with control districts. Tabas earthquake had negative long-term effects on human capital and wealth. This study can help official authorities to promote educational and economic plans and to implement comprehensive reforms in earthquake-stricken areas.

Integration of leprosy services into the General Health Service in Sri Lanka: overcoming challenges to implementation in a remote district.

PubMed

Wijesinghe, Thushanthi S; Wijesinghe, Pushpa Ranjan

2013-01-01

Sri Lanka took a policy decision to integrate leprosy services into the general health services (GHS) in 1999. This paper aims to summarize the emergence of new, specific challenges and how they were overcome during the integration of leprosy services to the GHS in a remote, leprosy endemic district in Sri Lanka. In this article, the regional epidemiologist as the team leader describes the principles used for transition to an effective integrated model of leprosy services from a centralized leprosy control model in the district. In addition, rationale for integration is viewed from the epidemiological and operational perspectives. National and district leprosy epidemiological data from secondary sources are also reviewed for corroborating the effectiveness of integration. Challenges surfaced were mainly related to the transfer of ownership of the programme, selection of appropriate service providing institutions easily accessible to clients, sustainability of leprosy services at the GHS, ensuring participation of all stakeholders in capacity building programmes and co-ordination of patient care in the absence of a dermatologist in the district. An empowered district team leader with specified roles and responsibilities, his sound technical and managerial know how and ability to translate 'team work' concept to practice were found to be essential for successful implementation of integration. Decision-making powers at the district level and flexibility to introduce new, area-specific changes to the centrally prepared core activities of integration were also vital to overcome locally surfaced challenges.

Examining the influence of family physician supply on district health system performance in South Africa: An ecological analysis of key health indicators.

PubMed

Von Pressentin, Klaus B; Mash, Bob J; Esterhuizen, Tonya M

2017-04-28

The supply of appropriate health workers is a key building block in the World Health Organization's model of effective health systems. Primary care teams are stronger if they contain doctors with postgraduate training in family medicine. The contribution of such family physicians to the performance of primary care systems has not been evaluated in the African context. Family physicians with postgraduate training entered the South African district health system (DHS) from 2011. This study aimed to evaluate the impact of family physicians within the DHS of South Africa. The objectives were to evaluate the impact of an increase in family physician supply in each district (number per 10 000 population) on key health indicators. All 52 South African health districts were included as units of analysis. An ecological study evaluated the correlations between the supply of family physicians and routinely collected data on district performance for two time periods: 2010/2011 and 2014/2015. Five years after the introduction of the new generation of family physicians, this study showed no demonstrable correlation between family physician supply and improved health indicators from the macro-perspective of the district. The lack of a measurable impact at the level of the district is most likely because of the very low supply of family physicians in the public sector. Studies which evaluate impact closer to the family physician's circle of control may be better positioned to demonstrate a measurable impact in the short term.

From enumeration districts to output areas: experiments in the automated creation of a census output geography.

PubMed

Martin, D

1997-01-01

This article briefly reviews the advantages of using separate geographies for census enumeration and output, and explains how a geographical information system is being used for the planning of enumeration districts for the 1997 Census Test. Experimental work is described which offers the potential to automatically create a new output geography, formed from aggregations of unit postcodes, and which offers control over output area population and boundaries.

District of Columbia Public Education: Agencies Have Enhanced Internal Controls over Federal Payments for School Improvement, but More Consistent Monitoring Needed. Report to Congressional Requesters. GAO-11-16

ERIC Educational Resources Information Center

Ashby, Cornelia M.

2010-01-01

Between fiscal years 2004 and 2009, Congress appropriated nearly $190 million in federal payments for school improvement to the District of Columbia (D.C.). This includes $85 million to the state education office--currently the Office of the State Superintendent of Education (OSSE)--to expand public charter schools and $105 million to D.C. Public…

Some Restructuring Needed in District’s Contracting Program to Serve Minority Businesses.

DTIC Science & Technology

1981-06-24

control as well as ownership. Originally, a minority firm must have had a local business license and/or be subject to D.C. business franchise taxes as...following. TABLE 2-1 Extent Minority Business Goals Being Achieved Increase in Increase in Increase in business minority franchise capability... Businesses The District’s program has placed too much stress on meeting minority contracting dollar goals and not enough on developing business

Community and District Empowerment for Scale-up (CODES): a complex district-level management intervention to improve child survival in Uganda: study protocol for a randomized controlled trial.

PubMed

Waiswa, Peter; O'Connell, Thomas; Bagenda, Danstan; Mullachery, Pricila; Mpanga, Flavia; Henriksson, Dorcus Kiwanuka; Katahoire, Anne Ruhweza; Ssegujja, Eric; Mbonye, Anthony K; Peterson, Stefan Swartling

2016-03-11

Innovative and sustainable strategies to strengthen districts and other sub-national health systems and management are urgently required to reduce child mortality. Although highly effective evidence-based and affordable child survival interventions are well-known, at the district level, lack of data, motivation, analytic and planning capacity often impedes prioritization and management weaknesses impede implementation. The Community and District Empowerment for Scale-up (CODES) project is a complex management intervention designed to test whether districts when empowered with data and management tools can prioritize and implement evidence-based child survival interventions equitably. The CODES strategy combines management, diagnostic, and evaluation tools to identify and analyze the causes of bottlenecks to implementation, build capacity of district management teams to implement context-specific solutions, and to foster community monitoring and social accountability to increase demand for services. CODES combines UNICEF tools designed to systematize priority setting, allocation of resources and problem solving with Community dialogues based on Citizen Report Cards and U-Reports used to engage and empower communities in monitoring health service provision and to demand for quality services. Implementation and all data collection will be by the districts teams or local Community-based Organizations who will be supported by two local implementing partners. The study will be evaluated as a cluster randomized trial with eight intervention and eight comparison districts over a period of 3 years. Evaluation will focus on differences in uptake of child survival interventions and will follow an intention-to-treat analysis. We will also document and analyze experiences in implementation including changes in management practices. By increasing the District Health Management Teams' capacity to prioritize and implement context-specific solutions, and empowering communities to become active partners in service delivery, coverage of child survival interventions will increase. Lessons learned on strengthening district-level managerial capacities and mechanisms for community monitoring may have implications, not only in Uganda but also in other similar settings, especially with regard to accelerating effective coverage of key child survival interventions using locally available resources. ISRCTN15705788 , Date of registration; 24 July 2015.

An ecological study of food desert prevalence and 4th grade academic achievement in new york state school districts.

PubMed

Frndak, Seth E

2014-12-02

This ecological study examines the relationship between food desert prevalence and academic achievement at the school district level. Sample included 232 suburban and urban school districts in New York State. Multiple open-source databases were merged to obtain: 4(th) grade science, English and math scores, school district demographic composition (NYS Report Card), regional socioeconomic indicators (American Community Survey), school district quality (US Common Core of Data), and food desert data (USDA Food Desert Atlas). Multiple regression models assessed the percentage of variation in achievement scores explained by food desert variables, after controlling for additional predictors. The proportion of individuals living in food deserts significantly explained 4th grade achievement scores, after accounting for additional predictors. School districts with higher proportions of individuals living in food desert regions demonstrated lower 4th grade achievement across science, English and math. Food deserts appear to be related to academic achievement at the school district level among urban and suburban regions. Further research is needed to better understand how food access is associated with academic achievement at the individual level. Significance for public healthThe prevalence of food deserts in the United States is of national concern. As poor nutrition in United States children continues to spark debate, food deserts are being evaluated as potential sources of low fruit and vegetable intake and high obesity rates. Cognitive development and IQ have been linked to nutrition patterns, suggesting that children in food desert regions may have a disadvantage academically. This research evaluates if an ecological relationship between food desert prevalence and academic achievement at the school district level can be demonstrated. Results suggest that food desert prevalence may relate to poor academic performance at the school district level. Significant variation in academic achievement among urban and suburban school districts is explained by food desert prevalence, above additional predictors. This research lays the groundwork for future studies at the individual level, with possible implications for community interventions in school districts containing food desert regions.

Fluid inclusions and biomarkers in the Upper Mississippi Valley zinc-lead district; implications for the fluid-flow and thermal history of the Illinois Basin

USGS Publications Warehouse

Rowan, E. Lanier; Goldhaber, Martin B.

1996-01-01

The Upper Mississippi Valley zinc-lead district is hosted by Ordovician carbonate rocks at the northern margin of the Illinois Basin. Fluid inclusion temperature measurements on Early Permian sphalerite ore from the district are predominantly between 90?C and I50?C. These temperatures are greater than can be explained by their reconstructed burial depth, which was a maximum of approximately 1 km at the time of mineralization. In contrast to the temperatures of mineral formation derived from fluid inclusions, biomarker maturities in the Upper Mississippi Valley district give an estimate of total thermal exposure integrated over time. Temperatures from fluid inclusions trapped during ore genesis with biomarker maturities were combined to construct an estimate of the district's overall thermal history and, by inference, the late Paleozoic thermal and hydrologic history of the Illinois Basin. Circulation of groundwater through regional aquifers, given sufficient flow rates, can redistribute heat from deep in a sedimentary basin to its shallower margins. Evidence for regional-scale circulation of fluids is provided by paleomagnetic studies, regionally correlated zoned dolomite, fluid inclusions, and thermal maturity of organic matter. Evidence for igneous acti vity contemporaneous with mineralization in the vicinity of the Upper Mississippi Valley district is absent. Regional fluid and heat circulation is the most likely explanation for the elevated fluid inclusion temperatures (relative to maximum estimated burial depth) in the Upper Mississippi Valley district. One plausible driving mechanism and flow path for the ore-forming fluids is groundwater recharge in the late Paleozoic Appalachian-Ouachita mountain belt and northward flow through the Reelfoot rift and the proto- Illinois Basin to the Upper Mississippi Valley district. Warm fluid flowing laterally through Cambrian and Ordovician aquifers would then move vertically upward through the fractures that control sphalerite mineralization in the Upper Mississippi Valley district. Biomarker reactant-product measurements on rock extracts from the Upper Mississippi Valley district define a relatively low level ofthermal maturity for the district, 0.353 for sterane and 0.577 for hopane. Recently published kinetic constants permit a time-temperature relationship to be determined from these biomarker maturities. Numerical calculations were made to simulate fluid heat flow through the fracture-controlled ore zones of the Thompson-Temperly mine and heat transfer to the adjacent rocks where biomarker samples were collected. Calculations that combine the fluid inclusion temperatures and the biomarker constraints on thermal maturity indicate that the time interval during which mineralizing fluids circulated through the Upper Mississippi Valley district is on the order of 200,000 years. Fluid inclusion measurements and thermal maturities from biomarkers in the district reflect the duration of peak temperatures resulting from regional fluid circulation. On the basis of thermal considerations, the timing of fluorite mineralization in southern Illinois, and the northward-decreasing pattern of fluorine enrichment in sediments, we hypothesize that the principal flow direction was northward through the Cambrian and Ordovician aquifers of the Illinois Basin. A basin-scale flow system would result in mass transport (hydrocarbon migration, transport of metals in solution) and energy (heat) transport, which would in turn drive chemical reactions (for example, maturation of organic matter, mineralization, diagenetic reactions) within the Illinois Basin and at its margins.

Single dose of SA 14-14-2 vaccine provides long-term protection against Japanese encephalitis: a case-control study in Nepalese children 5 years after immunization. drjbtandan@yahoo.com.

PubMed

Tandan, J B; Ohrr, Heechoul; Sohn, Young Mo; Yoksan, Sutee; Ji, Min; Nam, Chung Mo; Halstead, Scott B

2007-06-28

In July 1999, a single dose of live-attenuated SA 14-14-2 Japanese encephalitis (JE) vaccine was administered to children living in the Bardiya, Banke and Kailali districts of Nepal. In 2004, the original vaccinated population experienced a fifth seasonal exposure to JE. We performed a case-control study comparing the prevalence of the administration of vaccine in patients with JE hospitalized in the Bardiya and Bheri Zonal hospitals and in age-sex matched controls resident in the Bardiya district. Among the 219 village controls, 114 had been vaccinated (52.1%) while only one of 20 JE cases had received live-attenuated JE vaccine. Five years after administration of a single dose, SA 14-14-2 provided a protective efficacy of 96.2% (CI 73.1-99.9%).

Controlled-Choice Desegregation Plans: Not Enough Choice, Too Much Control?

ERIC Educational Resources Information Center

Rossell, Christine H.

1995-01-01

Examines whether controlled choice is a superior desegregation tool for urban schools. A study of 20 school districts with minority populations above 30% revealed controlled choice to be as unpopular as mandatory reassignments, to produce greater white flight than magnet-voluntary plans, and to offer less interracial exposure than do voluntary…

Considering Institutional Character and Leadership Domains in K-12 Principal Training, Licensing, and Selection

ERIC Educational Resources Information Center

Painter, Suzanne R.

2006-01-01

Selection of educational leaders in the United States typically involves four decision points controlled by three types of institutions: admission to and graduation from a principal preparation program controlled by an institution of higher education, certification controlled by the state, and employment controlled by a local school district.…

46 CFR 42.07-60 - Control.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 2 2011-10-01 2011-10-01 false Control. 42.07-60 Section 42.07-60 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) LOAD LINES DOMESTIC AND FOREIGN VOYAGES BY SEA Control, Enforcement, and Rights of Appeal § 42.07-60 Control. (a) The District Director of Customs or the Coast Guard...

46 CFR 42.07-60 - Control.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 2 2010-10-01 2010-10-01 false Control. 42.07-60 Section 42.07-60 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) LOAD LINES DOMESTIC AND FOREIGN VOYAGES BY SEA Control, Enforcement, and Rights of Appeal § 42.07-60 Control. (a) The District Director of Customs or the Coast Guard...

Developing the use of quality indicators in sterilization practices.

PubMed

Jabbari, H; Alikhah, H; Sahebkaram Alamdari, N; Behzad, M Naghavi; Mehrabi, E; Borzui, L; Bakhshian, F

2012-01-01

Health-care-associated infections are a major threat to the safety of patient care. Control of such problem is a major criterion for hospital accreditation. This study was aimed to determine the developing use of chemical (class 6 products) and biological indicators in Tabriz district hospitals since 1997 to 2011. We conducted this time-trend interventional study with all of the public and private hospitals, which counted to 21 in Tabriz district as a sample. The situations of indicator use were presented for each time in the base of indicator groups. Furthermore, the results were showed in the base of hospital groups. All of district hospital (n=21) with 74 autoclave machine and 22 central sterilization room were studied. The result of second time study in 2008 showed a markedly improvement in the control of sterilization processes. Furthermore, we continued our intervention results 6 month later in 2009 and 2 years later in 2011. The most striking result were use of chemical indicator in 100% of hospitals. However, there are defects in the use of biological indicators (63.65%). The most obvious finding was significant improvement in sterilization control especially in development the use of chemical indicators. The finding of this study has a number of important implications for hospital managers and infection control practitioners such as continuous practical training of CSSD personnel in hospitals and mandating of indicator using in all sterilization process with controlling of this subject in evaluation and accreditation of hospital programs.

Using a geographical information system to plan a malaria control programme in South Africa.

PubMed Central

Booman, M.; Durrheim, D. N.; La Grange, K.; Martin, C.; Mabuza, A. M.; Zitha, A.; Mbokazi, F. M.; Fraser, C.; Sharp, B. L.

2000-01-01

INTRODUCTION: Sustainable control of malaria in sub-Saharan Africa is jeopardized by dwindling public health resources resulting from competing health priorities that include an overwhelming acquired immunodeficiency syndrome (AIDS) epidemic. In Mpumalanga province, South Africa, rational planning has historically been hampered by a case surveillance system for malaria that only provided estimates of risk at the magisterial district level (a subdivision of a province). METHODS: To better map control programme activities to their geographical location, the malaria notification system was overhauled and a geographical information system implemented. The introduction of a simplified notification form used only for malaria and a carefully monitored notification system provided the good quality data necessary to support an effective geographical information system. RESULTS: The geographical information system displays data on malaria cases at a village or town level and has proved valuable in stratifying malaria risk within those magisterial districts at highest risk, Barberton and Nkomazi. The conspicuous west-to-east gradient, in which the risk rises sharply towards the Mozambican border (relative risk = 4.12, 95% confidence interval = 3.88-4.46 when the malaria risk within 5 km of the border was compared with the remaining areas in these two districts), allowed development of a targeted approach to control. DISCUSSION: The geographical information system for malaria was enormously valuable in enabling malaria risk at town and village level to be shown. Matching malaria control measures to specific strata of endemic malaria has provided the opportunity for more efficient malaria control in Mpumalanga province. PMID:11196490

Persistent foci of falciparum malaria among tribes over two decades in Koraput district of Odisha State, India.

PubMed

Sahu, Sudhansu Sekhar; Gunasekaran, Kasinathan; Vanamail, Perumal; Jambulingam, Purusothaman

2013-02-21

Koraput, a predominantly tribe-inhabited and one of the highly endemic districts of Odisha State that contributes a substantial number of malaria cases to the India's total. Control of malaria in such districts would contribute to change the national scenario on malaria situation. Hence, a study was carried out to measure the magnitude of malaria prevalence in the district to strengthen the malaria control activities. Prevalence of malaria was assessed through a sample blood survey (SBS) in seven randomly selected community health centres (CHCs). Individuals of all age groups in the villages selected (one in each subcentre) were screened for malaria infection. Both thick and thin smears were prepared from blood samples collected by finger prick, stained and examined for malaria parasites searching 100 fields in each smear. The results of a blood survey (n = 10,733) carried out, as a part of another study, during 1986-87 covering a population of 17,722 spread in 37 villages of Koraput district were compared with the current survey results. Software SPSS version 16.0 was used for data analysis. During the current study, blood survey was done in 135 villages screening 12,045 individuals (16.1% of the total population) and among them, 1,983 (16.5%) were found positive for malaria parasites. Plasmodium falciparum was the major malaria parasite species accounted for 89.1% (1,767) of the total positives; Plasmodium vivax and Plasmodium malariae accounted for 9.3% (184) and 0.2% (5), respectively. Gametocytes were found in 7.7% (n = 152) of the positive cases. The majority of parasite carriers (78.9%) were afebrile. The 1986-87 blood survey showed that of 10,733 people screened, 833 (7.8%) were positive for malaria parasites, 714 (85.7%) with P. falciparum, 86 (10.3%) with P. vivax, 12 (1.4%) with P. malariae and 21 (2.5%) with mixed infections. The results of the current study indicated a rising trend in transmission of malaria in Koraput district compared to the situation during 1986-87 and indicated the necessity for a focused and reinforced approach for the control of the disease by improving people's access to diagnosis and treatment and ensuring implementation of the intervention measures with adequate coverage and compliance.

Spatial Distribution of the Population at Risk of Cholangiocarcinoma in Chum Phaung District, Nakhon Ratchasima Province of Thailand.

PubMed

Kaewpitoon, Soraya J; Rujirakul, Ratana; Loyd, Ryan A; Matrakool, Likit; Sangkudloa, Amnat; Kaewthani, Sarochinee; Khemplila, Kritsakorn; Eaksanti, Thawatchai; Phatisena, Tanida; Kujapun, Jirawoot; Norkaew, Jun; Joosiri, Apinya; Kaewpitoon, Natthawut

2016-01-01

Cholangiocarcinoma (CCA) is a serious health problem in Thailand, particularly in northeastern and northern regions, but epidemiological studies are scarce and the spatial distribution of CCA remains to be determined. A database for the population at risk is required for monitoring, surveillance and organization of home health care. This study aim was to geo-visually display the distribution of CCA in northeast Thailand, using a geographic information system and Google Earth. A cross-sectional survey was carried out in 9 sub-districts and 133 villages in Chum Phuang district, Nakhon Ratchasima province during June and October 2015. Data on demography, and the population at risk for CCA were combined with the points of villages, sub-district boundaries, district boundaries, and points of hospitals in districts, then fed into a geographical information system. After the conversion, all of the data were imported into Google Earth for geo-visualization. A total of 11,960 from 83,096 population were included in this study. Females and male were 52.5%, and 47.8%, the age group 41-50 years old 33.3%. Individual risk for CCA was identifed and classified by using the Korat CCA verbal screening test as low (92.8%), followed by high risk (6.74%), and no (0.49%), respectively. Gender (X2-test=1143.63, p-value= 0.001), age group (X2-test==211.36, p-value=0.0001), and sub-district (X2-test=1471.858, p-value=0.0001) were significantly associated with CCA risk. Spatial distribution of the population at risk for CCA in Chum Phuang district was viewed with Google Earth. Geo-visual display followed Layer 1: District, Layer 2: Sub-district, Layer 3: Number of low risk in village, Layer 4: Number of high risk in village, and Layer 5: Hospital in Chum Phuang District and their related catchment areas. We present the first risk geo-visual display of CCA in this rural community, which is important for spatial targeting of control efforts. Risk appears to be strongly associated with gender, age group, and sub-district. Therefor, spatial distribution is suitable for the use in the further monitoring, surveillance, and home health care for CCA.

Build It Yourself.

ERIC Educational Resources Information Center

Lundt, John C.; Matt, John

2001-01-01

As serving as its own contractor, a small district in western Montana saved money, had better control over the project, and inspired public confidence. Major advantages were cost savings, controlling the pace of construction, and the ability to cope with change orders. (MLF)

Pupil Control Ideology and Teacher Influence in the Classroom.

ERIC Educational Resources Information Center

Goldenberg, Ronald

A study investigated whether pupil control ideology of teachers differentially affected their operational behavior in the classroom. Elementary school teachers employed in a suburban St. Louis district (N=260) responded to the Pupil Control Ideology Form (PCI). From this group 20 were selected to comprise two experimental groups: those with…

How to Design a Quiet School.

ERIC Educational Resources Information Center

The American School Board Journal, 1968

1968-01-01

Problems of sound insulation and control particularly in areas where there is a high level in exterior noise conditions, resulted in this study to determine approaches to sound control in school construction. After a general discussion of noise problems in school districts and teaching situations, two examples of sound control solutions are…

46 CFR 46.10-60 - Control.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 2 2013-10-01 2013-10-01 false Control. 46.10-60 Section 46.10-60 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) LOAD LINES SUBDIVISION LOAD LINES FOR PASSENGER VESSELS Administration § 46.10-60 Control. The Director, Field Operations (DFO) or the Coast Guard District Commander may...

46 CFR 46.10-60 - Control.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 2 2014-10-01 2014-10-01 false Control. 46.10-60 Section 46.10-60 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) LOAD LINES SUBDIVISION LOAD LINES FOR PASSENGER VESSELS Administration § 46.10-60 Control. The Director, Field Operations (DFO) or the Coast Guard District Commander may...

46 CFR 46.10-60 - Control.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 2 2012-10-01 2012-10-01 false Control. 46.10-60 Section 46.10-60 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) LOAD LINES SUBDIVISION LOAD LINES FOR PASSENGER VESSELS Administration § 46.10-60 Control. The Director, Field Operations (DFO) or the Coast Guard District Commander may...

An Examination of Controlled School Corporations.

ERIC Educational Resources Information Center

Wood, R. Craig; Dawson, Brian K.

This comparative study examines the functioning of Indiana school districts that are placed under control of the state school property tax review board for the purpose of emergency relief. The study sought to determine the fiscal status on selected criteria of seven such "controlled school corporations" (CSCs) for the 1985 budget year by…

Annual Anastasia Arbovirus Surveillance and Mosquito Control Workshops: Summary of the Past 11 Years

USDA-ARS?s Scientific Manuscript database

Realizing the needs of local mosquito control workers for advance training and education the Anastasia Mosquito Control District (AMCD) and the USDA-ARS Center for Medical, Agricultural and Veterinary entomology (CMAVE) developed a regional workshop to address these needs. Since 2004 the AMCD and CM...

75 FR 63177 - Availability of FY 09 Grantee Performance Evaluation Reports for the Eight States of EPA Region 4...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-14

...-year evaluations of eight state air pollution control programs (Alabama Department of Environmental... Management, FL; Louisville Metro Air Pollution Control District, KY; Forsyth County Environmental Affairs... Regional Air Quality Agency, NC; Chattanooga-Hamilton County Air Pollution Control Bureau, TN; Memphis...

The Cost of Dengue Vector Control Activities in Malaysia by Different Service Providers.

PubMed

Packierisamy, P Raviwharmman; Ng, Chiu-Wan; Dahlui, Maznah; Venugopalan, B; Halasa, Yara A; Shepard, Donald S

2015-11-01

We examined variations in dengue vector control costs and resource consumption between the District Health Departments (DHDs) and Local Authorities (LAs) to assist informed decision making as to the future roles of these agencies in the delivery of dengue vector control services in Malaysia. Data were collected from the vector control units of DHDs and LAs in 8 selected districts. We captured costs and resource consumption in 2010 for premise inspection for mosquito breeding sites, fogging to destroy adult mosquitoes and larviciding of potential breeding sites. Overall, DHDs spent US$5.62 million or US$679 per case and LAs spent US$2.61 million or US$499 per case. The highest expenditure for both agencies was for fogging, 51.0% and 45.8% of costs for DHDs and LAs, respectively. The DHDs had higher resource costs for human personnel, vehicles, pesticides, and equipment. The findings provide some evidence to rationalize delivery of dengue vector control services in Malaysia. © 2015 APJPH.

Enterobius vermicularis infection is well controlled among preschool children in nurseries of Taipei City, Taiwan.

PubMed

Chu, Tu-Bin; Liao, Chien-Wei; Nara, Takeshi; Huang, Ying-Chie; Chou, Chia-Mei; Liu, Yu-Hsin; Fan, Chia-Kwung

2012-10-01

Whether Enterobius vermicularis (pinworm) infections among preschool children in Taipei City had truly declined was investigated. A total of 6,661 preschool children from 28 nurseries were randomly selected from 4 major geographic districts in Taipei City to examine the status of pinworm infection by using adhesive thin cellophane tape swab method. The overall prevalence of pinworm infection was 0.5% (30/6,661). Boys (0.6%; 21/3,524) had higher prevalence than girls (0.3%; 9/3,137) (p=0.06). Southern district (0.6%; 10/1,789) showed insignificantly higher prevalence than Western district (0.2%; 1/606) (p=0.22). Pinworm screening program remains necessary for some parts of Taipei City.

Into the Second Century: Memphis Engineer District, 1976-1981

DTIC Science & Technology

1983-01-01

stream out of Lake Itasca in central Minnesota, the river begins a 2,340-mile journey to the Gulf of Mexico. In making the long journey, the river...McKellar Lake in honor of the senior Senator from Tennessee, Kenneth D. McKellar. Part of Tennessee Chute was dredged and then used as a slack...Missouri; and the Reelfoot -Obion areas in west Tennessee to monitor flood control structures. Under Phase I operations the Memphis District provided

The Headwaters District: A History of the Pittsburgh District, U.S. Army Corps of Engineers

DTIC Science & Technology

1978-01-01

bridges an average of 52 days each year and small towboats were obstructed 17.7 days a year. Sibert recommended in 1904 that the government require...not "unreasonable" obstructions , but his successor William Howard Taft disagreed and appointed an investigating board which in 1911 recommended the...Senator William B. Rodgers, Jr ., uniting political and civic leaders of the Pittsburgh vicinity in a campaign for federal flood control. They pressed

77 FR 12527 - Revisions to the California State Implementation Plan, Antelope Valley Air Quality Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-01

...EPA is proposing to approve revisions to the Antelope Valley Air Quality Management District (AVAQMD) and San Joaquin Valley Unified Air Pollution Control District (SJVUAPCD) portions of the California State Implementation Plan (SIP). These revisions concern negative declarations for volatile organic compound (VOC) and oxides of sulfur source categories. We are proposing to approve these negative declarations under the Clean Air Act as amended in 1990 (CAA or the Act).

Identification of the hot-spot areas for sickle cell disease using cord blood screening at a district hospital: an Indian perspective.

PubMed

Dixit, Sujata; Sahu, Pushpansu; Kar, Shantanu Kumar; Negi, Sapna

2015-10-01

Sickle cell disease (SCD), a genetic disorder often reported late, can be identified early in life, and hot-spot areas may be identified to conduct genetic epidemiology studies. This study was undertaken to estimate prevalence and to identify hot spot area for SCD in Kalahandi district, by screening cord blood of neonates delivered at the district hospital as first-hand information. Kalahandi District Hospital selected for the study is predominated by tribal population with higher prevalence of SCD as compared to other parts of Odisha. Cord blood screening of SCD was carried out on 761 newborn samples of which 13 were screened to be homozygous for SCD. Information on area of parent's residence was also collected. Madanpur Rampur area was found to be with the highest prevalence of SCD (10.52 %) and the gene distribution did not follow Hardy-Weinberg Equation indicating un-natural selection. The approach of conducting neonatal screening in a district hospital for identification of SCD is feasible and appropriate for prioritizing area for the implementation of large-scale screening and planning control measures thereof.

Seroprevalence of bovine herpesvirus-1 antibodies in bovines in five districts of Uttarakhand

PubMed Central

Thakur, Vipul; Kumar, Mahesh; Rathish, R. L.

2017-01-01

Aim: This study was conducted to know the status of bovine herpesvirus-1 (BHV-1) antibodies in the bovines of the selected area of Uttarakhand. Materials and Methods: A total of 489 serum samples, 392 of cattle and 97 of buffaloes were randomly collected from the unvaccinated bovine population of five districts viz., Dehradun, Haridwar, Nainital, Pithoragarh, and Udham Singh Nagar and were tested by avidin biotin enzyme-linked immunosorbent assay for BHV-1 antibodies. Results: The overall prevalence was observed to be 29.03%. At district level, the highest prevalence was recorded in Pithoragarh district (40.00%) while it was lowest in district Udham Singh Nagar (16.00%). The prevalence of BHV-1 antibodies was found to be higher in unorganized dairy units (31.02%) compared to organized farms (26.51%) in Uttarakhand. Buffaloes were found to have greater prevalence (38.14%) than cattle (26.78%) while on sex-wise basis; it was found that more females (30.08%) were harboring antibodies to the virus than males (16.21%). Conclusion: The study revealed that the population in the area under study has been exposed to BHV-1 and hence prevention and control strategies must be implemented. PMID:28344394

Implementation of tuberculosis infection control in health facilities in Mukono and Wakiso districts, Uganda

PubMed Central

2013-01-01

Background Tuberculosis infection control (TBIC) is rarely implemented in the health facilities in resource limited settings. Understanding the reasons for low level of implementation is critical. The study aim was to assess TBIC practices and barriers to implementation in two districts in Uganda. Methods We conducted a cross-sectional study in 51 health facilities in districts of Mukono and Wakiso. The study included: a facility survey, observations of practices and eight focus group discussions with health workers. Results Quantitative: Only 16 facilities (31%) had a TBIC plan. Five facilities (10%) were screening patients for cough. Two facilities (4%) reported providing masks to patients with cough. Ventilation in the waiting areas was inadequate for TBIC in 43% (22/51) of the facilities. No facility possessed N95 particulate respirators. Qualitative: Barriers that hamper implementation of TBIC elicited included: under-staffing, lack of space for patient separation, lack of funds to purchase masks, and health workers not appreciating the importance of TBIC. Conclusion TBIC measures were not implemented in health facilities in the two Ugandan districts where the survey was done. Health system factors like lack of staff, space and funds are barriers to implement TBIC. Effective implementation of TBIC measures occurs when the fundamental health system building blocks -governance and stewardship, financing, infrastructure, procurement and supply chain management are in place and functioning appropriately. PMID:23915376

Implementation of tuberculosis infection control in health facilities in Mukono and Wakiso districts, Uganda.

PubMed

Buregyeya, Esther; Nuwaha, Fred; Verver, Suzanne; Criel, Bart; Colebunders, Robert; Wanyenze, Rhoda; Kalyango, Joan N; Katamba, Achilles; Mitchell, Ellen Mh

2013-08-01

Tuberculosis infection control (TBIC) is rarely implemented in the health facilities in resource limited settings. Understanding the reasons for low level of implementation is critical. The study aim was to assess TBIC practices and barriers to implementation in two districts in Uganda. We conducted a cross-sectional study in 51 health facilities in districts of Mukono and Wakiso. The study included: a facility survey, observations of practices and eight focus group discussions with health workers. Quantitative: Only 16 facilities (31%) had a TBIC plan. Five facilities (10%) were screening patients for cough. Two facilities (4%) reported providing masks to patients with cough. Ventilation in the waiting areas was inadequate for TBIC in 43% (22/51) of the facilities. No facility possessed N95 particulate respirators. Qualitative: Barriers that hamper implementation of TBIC elicited included: under-staffing, lack of space for patient separation, lack of funds to purchase masks, and health workers not appreciating the importance of TBIC. TBIC measures were not implemented in health facilities in the two Ugandan districts where the survey was done. Health system factors like lack of staff, space and funds are barriers to implement TBIC. Effective implementation of TBIC measures occurs when the fundamental health system building blocks--governance and stewardship, financing, infrastructure, procurement and supply chain management are in place and functioning appropriately.

Prevalence, economic analysis and chemotherapeutic control of small ruminant fasciolosis in the Sargodha district of Punjab, Pakistan.

PubMed

Ahmad, Mansoor; Khan, Muhammad Nisar; Sajid, Muhammad Sohail; Muhammad, Ghulam; Qudoos, Abdul; Rizwan, Hafiz Muhammad

2017-03-31

This study describes the epidemiology, the economic significance of small ruminant fasciolosis in animals slaughtered in the abattoirs of the Sargodha district, Punjab, Pakistan between January and June 2012. In vivo fasciolicidal efficacy of commercially available compounds was examined using a randomised complete block design. Microscopically screened faecal samples revealed 40.51% positive animals for fasciolosis. The prevalent species included Fasciola hepatica (35.64%) and Fasciola gigantica (8.21%). Mixed infections were noted in 3.33% subjects. Prevalence rates were significantly higher in females (42.25%) than in males (39.52%), and in adults (51.20%) compared to younger animals (33.98%). The disease was recorded more often in emaciated animals (63.63%) followed in order by average (43.45%), thin (43.22%), and fat (32.12%) animals. Between January and June 2012, fasciolosis in Sargodha district, Punjab, Pakistan, was estimated to incur US$0.036 million and US$0.177 million direct (liver condemnation) and indirect (carcass depreciation) economic losses, respectively. In vivo fasciolicidal efficacy of oxyclozanide proved to be the most effective method of control, compared to triclabendazole, and levamisole. Results provide useful information on the frequency distribution of fasciolosis and its economic significance. Finally, data on in vivo fasciolicidal trials show that oxyclozanide is the most efficacious compound for the treatment of the disease in the district Sargodha, Punjab, Pakistan.

Benchmarking health system performance across districts in Zambia: a systematic analysis of levels and trends in key maternal and child health interventions from 1990 to 2010.

PubMed

Colson, Katherine Ellicott; Dwyer-Lindgren, Laura; Achoki, Tom; Fullman, Nancy; Schneider, Matthew; Mulenga, Peter; Hangoma, Peter; Ng, Marie; Masiye, Felix; Gakidou, Emmanuela

2015-04-02

Achieving universal health coverage and reducing health inequalities are primary goals for an increasing number of health systems worldwide. Timely and accurate measurements of levels and trends in key health indicators at local levels are crucial to assess progress and identify drivers of success and areas that may be lagging behind. We generated estimates of 17 key maternal and child health indicators for Zambia's 72 districts from 1990 to 2010 using surveys, censuses, and administrative data. We used a three-step statistical model involving spatial-temporal smoothing and Gaussian process regression. We generated estimates at the national level for each indicator by calculating the population-weighted mean of the district values and calculated composite coverage as the average of 10 priority interventions. National estimates masked substantial variation across districts in the levels and trends of all indicators. Overall, composite coverage increased from 46% in 1990 to 73% in 2010, and most of this gain was attributable to the scale-up of malaria control interventions, pentavalent immunization, and exclusive breastfeeding. The scale-up of these interventions was relatively equitable across districts. In contrast, progress in routine services, including polio immunization, antenatal care, and skilled birth attendance, stagnated or declined and exhibited large disparities across districts. The absolute difference in composite coverage between the highest-performing and lowest-performing districts declined from 37 to 26 percentage points between 1990 and 2010, although considerable variation in composite coverage across districts persisted. Zambia has made marked progress in delivering maternal and child health interventions between 1990 and 2010; nevertheless, substantial variations across districts and interventions remained. Subnational benchmarking is important to identify these disparities, allowing policymakers to prioritize areas of greatest need. Analyses such as this one should be conducted regularly and feed directly into policy decisions in order to increase accountability at the local, regional, and national levels.

Plausible role for CHW peer support groups in increasing care-seeking in an integrated community case management project in Rwanda: a mixed methods evaluation.

PubMed

Langston, Anne; Weiss, Jennifer; Landegger, Justine; Pullum, Thomas; Morrow, Melanie; Kabadege, Melene; Mugeni, Catherine; Sarriot, Eric

2014-08-01

The Kabeho Mwana project (2006-2011) supported the Rwanda Ministry of Health (MOH) in scaling up integrated community case management (iCCM) of childhood illness in 6 of Rwanda's 30 districts. The project trained and equipped community health workers (CHWs) according to national guidelines. In project districts, Kabeho Mwana staff also trained CHWs to conduct household-level health promotion and established supervision and reporting mechanisms through CHW peer support groups (PSGs) and quality improvement systems. The 2005 and 2010 Demographic and Health Surveys were re-analyzed to evaluate how project and non-project districts differed in terms of care-seeking for fever, diarrhea, and acute respiratory infection symptoms and related indicators. We developed a logit regression model, controlling for the timing of the first CHW training, with the district included as a fixed categorical effect. We also analyzed qualitative data from the final evaluation to examine factors that may have contributed to improved outcomes. While there was notable improvement in care-seeking across all districts, care-seeking from any provider for each of the 3 conditions, and for all 3 combined, increased significantly more in the project districts. CHWs contributed a larger percentage of consultations in project districts (27%) than in non-project districts (12%). Qualitative data suggested that the PSG model was a valuable sub-level of CHW organization associated with improved CHW performance, supervision, and social capital. The iCCM model implemented by Kabeho Mwana resulted in greater improvements in care-seeking than those seen in the rest of the country. Intensive monitoring, collaborative supervision, community mobilization, and CHW PSGs contributed to this success. The PSGs were a unique contribution of the project, playing a critical role in improving care-seeking in project districts. Effective implementation of iCCM should therefore include CHW management and social support mechanisms. Finally, re-analysis of national survey data improved evaluation findings by providing impact estimates.

Early rigorous control interventions can largely reduce dengue outbreak magnitude: experience from Chaozhou, China.

PubMed

Liu, Tao; Zhu, Guanghu; He, Jianfeng; Song, Tie; Zhang, Meng; Lin, Hualiang; Xiao, Jianpeng; Zeng, Weilin; Li, Xing; Li, Zhihao; Xie, Runsheng; Zhong, Haojie; Wu, Xiaocheng; Hu, Wenbiao; Zhang, Yonghui; Ma, Wenjun

2017-08-02

Dengue fever is a severe public heath challenge in south China. A dengue outbreak was reported in Chaozhou city, China in 2015. Intensified interventions were implemented by the government to control the epidemic. However, it is still unknown the degree to which intensified control measures reduced the size of the epidemics, and when should such measures be initiated to reduce the risk of large dengue outbreaks developing? We selected Xiangqiao district as study setting because the majority of the indigenous cases (90.6%) in Chaozhou city were from this district. The numbers of daily indigenous dengue cases in 2015 were collected through the national infectious diseases and vectors surveillance system, and daily Breteau Index (BI) data were reported by local public health department. We used a compartmental dynamic SEIR (Susceptible, Exposed, Infected and Removed) model to assess the effectiveness of control interventions, and evaluate the control effect of intervention timing on dengue epidemic. A total of 1250 indigenous dengue cases was reported from Xiangqiao district. The results of SEIR modeling using BI as an indicator of actual control interventions showed a total of 1255 dengue cases, which is close to the reported number (n = 1250). The size and duration of the outbreak were highly sensitive to the intensity and timing of interventions. The more rigorous and earlier the control interventions implemented, the more effective it yielded. Even if the interventions were initiated several weeks after the onset of the dengue outbreak, the interventions were shown to greatly impact the prevalence and duration of dengue outbreak. This study suggests that early implementation of rigorous dengue interventions can effectively reduce the epidemic size and shorten the epidemic duration.

Assessment of arsenic, fluoride, bacteria, and other contaminants in drinking water sources for rural communities of Kasur and other districts in Punjab, Pakistan.

PubMed

Arshad, Nasima; Imran, Saiqa

2017-01-01

High levels of arsenic contamination in drinking water of two villages, Badarpur and Ibrahimabad of district Kasur, central Punjab, Pakistan is reported first time in present studies. Groundwater quality situation was found to be impaired when samples of different rural areas of district Kasur were monitored according to Pakistan Standards and Quality Control Authority (PSQCA) for all significant water quality constituents and analyzed for trace elements, physico-chemical, and microbiological parameters. Out of 35water sources, 97 % were found unsafe and only 3 % of the sources were within safe limits. High concentrations of arsenic, fluoride, and bacteria were found in 91, 74, and 77 % sources of drinking water, respectively. Very high concentrations of arsenic ranging 58-3800 μg/L were found in the water samples obtained from Badarpur and Ibrahimabad. A decrease in water contamination was observed with increase in source depth. The health issues like arsenicosis and skeletal/dental flourosis were observed in the residents of the monitored areas. Drinking water quality conditions of some rural areas of northen and southern districts of Punjab was also analyzed and compared with Kasur district. High levels of nitrates were found in the samples of Islamabad and Rawalpindi, while high levels of arsenic, iron, fluoride, and TDS were found in Bahawalpur district. Graphical abstract ᅟ.

A report on the indoor residual spraying (IRS) in the control of Phlebotomus argentipes, the vector of visceral leishmaniasis in Bihar (India): an initiative towards total elimination targeting 2015 (Series-1).

PubMed

Kumar, V; Kesari, S; Dinesh, D S; Tiwari, A K; Kumar, A J; Kumar, R; Singh, V P; Das, P

2009-09-01

Visceral leishmaniasis, commonly known as kala-azar is endemic in Bihar state, India. Current vector control programme in Bihar focuses mainly on spraying the sandfly infested dwellings with DDT. The Government of India in collaboration with WHO has fixed the target 2015 for total elimination of kala-azar. The present study was carried out to see the impact of DDT and improved IEC in the containment of vector density vis-à-vis disease transmission. Before the start of the spraying operations training was imparted to all the medical and paramedical personnel regarding the methods of spraying operations. Pre- and post-sandfly density was monitored in four selected districts. Incidences of kala-azar cases were compared for pre- and post-spray periods. Social acceptability and perceptions of households was collected through questionnaires from 500 randomly selected households in the study districts. House index in three study districts reduced considerably during post-spray when compared to pre-spray. Kala-azar incidence in many districts was reduced after the DDT spray. Either partial or complete refusal was reported in 14.4%, while 35% were not satisfied with the suspension concentration and coverage; and 46.6% were found satisfied with the spraying procedure. Strengthening the IEC activities to sensitise the community, proper training of health personnel, monitoring of spray, good surveillance, proper treatment of cases and two rounds of DDT spray with good coverage in the endemic districts up to three years are essential to achieve the desired total elimination of kala-azar in Bihar state.

Schistosomiasis and soil-transmitted helminth control in Niger: cost effectiveness of school based and community distributed mass drug administration [corrected].

PubMed

Leslie, Jacqueline; Garba, Amadou; Oliva, Elisa Bosque; Barkire, Arouna; Tinni, Amadou Aboubacar; Djibo, Ali; Mounkaila, Idrissa; Fenwick, Alan

2011-10-01

In 2004 Niger established a large scale schistosomiasis and soil-transmitted helminths control programme targeting children aged 5-14 years and adults. In two years 4.3 million treatments were delivered in 40 districts using school based and community distribution. Four districts were surveyed in 2006 to estimate the economic cost per district, per treatment and per schistosomiasis infection averted. The study compares the costs of treatment at start up and in a subsequent year, identifies the allocation of costs by activity, input and organisation, and assesses the cost of treatment. The cost of delivery provided by teachers is compared to cost of delivery by community distributers (CDD). The total economic cost of the programme including programmatic, national and local government costs and international support in four study districts, over two years, was US$ 456,718; an economic cost/treatment of $0.58. The full economic delivery cost of school based treatment in 2005/06 was $0.76, and for community distribution was $0.46. Including only the programme costs the figures are $0.47 and $0.41 respectively. Differences at sub-district are more marked. This is partly explained by the fact that a CDD treats 5.8 people for every one treated in school. The range in cost effectiveness for both direct and direct and indirect treatments is quantified and the need to develop and refine such estimates is emphasised. The relative cost effectiveness of school and community delivery differs by country according to the composition of the population treated, the numbers targeted and treated at school and in the community, the cost and frequency of training teachers and CDDs. Options analysis of technical and implementation alternatives including a financial analysis should form part of the programme design process.

The Burden of Leprosy in Cameroon: Fifteen Years into the Post-elimination Era.

PubMed

Tabah, Earnest Njih; Nsagha, Dickson Shey; Bissek, Anne-Cecile Zoung-Kanyi; Bratschi, Martin W; Njamnshi, Theophilus Ngeh; Plushke, Gerd; Njamnshi, Alfred Kongnyu

2016-10-01

Cameroon achieved the elimination target of leprosy in 2000, and has maintained this status ever since. However, a number of health districts in the country continue to report significant numbers of leprosy cases. The aim of this study was to assess the burden of leprosy in Cameroon from 2000 to 2014. We obtained and analysed using the new leprosy burden concept of analysis, leprosy surveillance data collected between 2000 and 2014 from the National Leprosy Control Programme. Cameroon achieved leprosy elimination in 2000, registering a prevalence rate of 0.94/10,000 population. The prevalence rate dropped further to reach 0.20/10,000 population (78% reduction) in 2014. Similarly, the new case detection rate dropped from 4.88/100,000 population in 2000 to 1.46/100,000 population (85.3% reduction) in 2014. All 10 regions of the country achieved leprosy elimination between 2000 and 2014; however, 10 health districts were still to do so by 2014. The number of high-leprosy-burden regions decreased from 8 in 2000 to 1 in 2014. Seven and two regions were respectively medium and low-burdened at the end of 2014. At the health districts level, 18 remained at the high-leprosy-burdened level in 2014. The leprosy prevalence and detection rates as well as the overall leprosy burden in Cameroon have dropped significantly between 2000 and 2014. However, a good number of health districts remain high-leprosy-burdened. The National Leprosy Control Programme should focus efforts on these health districts in the next coming years in order to further reduce the burden of leprosy in the country.

The Burden of Leprosy in Cameroon: Fifteen Years into the Post-elimination Era

PubMed Central

Tabah, Earnest Njih; Nsagha, Dickson Shey; Bissek, Anne-Cecile Zoung-Kanyi; Bratschi, Martin W.; Njamnshi, Theophilus Ngeh; Plushke, Gerd; Njamnshi, Alfred Kongnyu

2016-01-01

Background Cameroon achieved the elimination target of leprosy in 2000, and has maintained this status ever since. However, a number of health districts in the country continue to report significant numbers of leprosy cases. The aim of this study was to assess the burden of leprosy in Cameroon from 2000 to 2014. Methods We obtained and analysed using the new leprosy burden concept of analysis, leprosy surveillance data collected between 2000 and 2014 from the National Leprosy Control Programme. Principal findings Cameroon achieved leprosy elimination in 2000, registering a prevalence rate of 0.94/10,000 population. The prevalence rate dropped further to reach 0.20/10,000 population (78% reduction) in 2014. Similarly, the new case detection rate dropped from 4.88/100,000 population in 2000 to 1.46/100,000 population (85.3% reduction) in 2014. All 10 regions of the country achieved leprosy elimination between 2000 and 2014; however, 10 health districts were still to do so by 2014. The number of high-leprosy-burden regions decreased from 8 in 2000 to 1 in 2014. Seven and two regions were respectively medium and low-burdened at the end of 2014. At the health districts level, 18 remained at the high-leprosy-burdened level in 2014. Conclusion The leprosy prevalence and detection rates as well as the overall leprosy burden in Cameroon have dropped significantly between 2000 and 2014. However, a good number of health districts remain high-leprosy-burdened. The National Leprosy Control Programme should focus efforts on these health districts in the next coming years in order to further reduce the burden of leprosy in the country. PMID:27732603

Application of service oriented architecture for sensors and actuators in district heating substations.

PubMed

Gustafsson, Jonas; Kyusakov, Rumen; Mäkitaavola, Henrik; Delsing, Jerker

2014-08-21

Hardwired sensor installations using proprietary protocols found in today's district heating substations limit the potential usability of the sensors in and around the substations. If sensor resources can be shared and re-used in a variety of applications, the cost of sensors and installation can be reduced, and their functionality and operability can be increased. In this paper, we present a new concept of district heating substation control and monitoring, where a service oriented architecture (SOA) is deployed in a wireless sensor network (WSN), which is integrated with the substation. IP-networking is exclusively used from sensor to server; hence, no middleware is needed for Internet integration. Further, by enabling thousands of sensors with SOA capabilities, a System of Systems approach can be applied. The results of this paper show that it is possible to utilize SOA solutions with heavily resource-constrained embedded devices in contexts where the real-time constrains are limited, such as in a district heating substation.

Application of Service Oriented Architecture for Sensors and Actuators in District Heating Substations

PubMed Central

Gustafsson, Jonas; Kyusakov, Rumen; Mäkitaavola, Henrik; Delsing, Jerker

2014-01-01

Hardwired sensor installations using proprietary protocols found in today's district heating substations limit the potential usability of the sensors in and around the substations. If sensor resources can be shared and re-used in a variety of applications, the cost of sensors and installation can be reduced, and their functionality and operability can be increased. In this paper, we present a new concept of district heating substation control and monitoring, where a service oriented architecture (SOA) is deployed in a wireless sensor network (WSN), which is integrated with the substation. IP-networking is exclusively used from sensor to server; hence, no middleware is needed for Internet integration. Further, by enabling thousands of sensors with SOA capabilities, a System of Systems approach can be applied. The results of this paper show that it is possible to utilize SOA solutions with heavily resource-constrained embedded devices in contexts where the real-time constrains are limited, such as in a district heating substation. PMID:25196165

SURVEY OF HOUSE RAT INTESTINAL PARASITES FROM SURABAYA DISTRICT, EAST JAVA, INDONESIA THAT CAN CAUSE OPPORTUNISTIC INFECTIONS IN HUMANS.

PubMed

Prasetyo, R H

2016-03-01

The purpose of this study was to investigate the prevalence of house rat zoonotic intestinal parasites from Surabaya District, East Java, Indonesia that have the potential to cause opportunistic infection in humans. House rat fecal samples were collected from an area of Surabaya District with a dense rat population during May 2015. Intestinal parasites were detected microscopically using direct smear of feces stained with Lugol's iodine and modified Ziehl-Neelsen stains. The fecal samples were also cultured for Strongyloides stercoralis. Ninety-eight house rat fecal samples were examined. The potential opportunistic infection parasite densities found in those samples were Strongyloides stercoralis in 53%, Hymenolepis nana in 42%, Cryptosporidium spp in 33%, and Blastocystis spp in 6%. This is the first report of this kind in Surabaya District. Measures need to be taken to control the house rat population in the study area to reduce the risk of the public health problem. Keywords: zoonotic intestinal parasites, opportunistic infection, house rat, densely populated area, Indonesia

Forecasting dengue hemorrhagic fever cases using ARIMA model: a case study in Asahan district

NASA Astrophysics Data System (ADS)

Siregar, Fazidah A.; Makmur, Tri; Saprin, S.

2018-01-01

Time series analysis had been increasingly used to forecast the number of dengue hemorrhagic fever in many studies. Since no vaccine exist and poor public health infrastructure, predicting the occurrence of dengue hemorrhagic fever (DHF) is crucial. This study was conducted to determine trend and forecasting the occurrence of DHF in Asahan district, North Sumatera Province. Monthly reported dengue cases for the years 2012-2016 were obtained from the district health offices. A time series analysis was conducted by Autoregressive integrated moving average (ARIMA) modeling to forecast the occurrence of DHF. The results demonstrated that the reported DHF cases showed a seasonal variation. The SARIMA (1,0,0)(0,1,1)12 model was the best model and adequate for the data. The SARIMA model for DHF is necessary and could applied to predict the incidence of DHF in Asahan district and assist with design public health maesures to prevent and control the diseases.

Real-time implementation of model predictive control on Maricopa-Stanfield irrigation and drainage district's WM canal

USDA-ARS?s Scientific Manuscript database

Water resources are limited in many agricultural areas. One method to improve the effective use of water is to improve delivery service from irrigation canals. This can be done by applying automatic control methods that control the gates in an irrigation canal. The model predictive control MPC is ...

Examining the influence of family physician supply on district health system performance in South Africa: An ecological analysis of key health indicators

PubMed Central

Mash, Robert J.

2017-01-01

Background The supply of appropriate health workers is a key building block in the World Health Organization’s model of effective health systems. Primary care teams are stronger if they contain doctors with postgraduate training in family medicine. The contribution of such family physicians to the performance of primary care systems has not been evaluated in the African context. Family physicians with postgraduate training entered the South African district health system (DHS) from 2011. Aim This study aimed to evaluate the impact of family physicians within the DHS of South Africa. The objectives were to evaluate the impact of an increase in family physician supply in each district (number per 10 000 population) on key health indicators. Setting All 52 South African health districts were included as units of analysis. Methods An ecological study evaluated the correlations between the supply of family physicians and routinely collected data on district performance for two time periods: 2010/2011 and 2014/2015. Results Five years after the introduction of the new generation of family physicians, this study showed no demonstrable correlation between family physician supply and improved health indicators from the macro-perspective of the district. Conclusion The lack of a measurable impact at the level of the district is most likely because of the very low supply of family physicians in the public sector. Studies which evaluate impact closer to the family physician’s circle of control may be better positioned to demonstrate a measurable impact in the short term. PMID:28470076

School Sun Protection Policies: Measure Development and Assessments in Two Regions of the United States

PubMed Central

Buller, David B.; French, Simone A.; Buller, Mary K.; Ashley, Jeff L.

2012-01-01

BACKGROUND In 2002, the US Centers for Disease Control and Prevention recommended that schools adopt policies that reduce exposure of children to ultraviolet radiation to prevent skin cancer. We report here the development of a school sun safety policy measure and baseline descriptive statistics from the assessment of written policies collected in 2005-2007 from public school districts that enrolled in a randomized trial evaluating a policy promotion program. METHODS Written policies were collected from 103 of 112 school districts in Colorado and Southern California prior to randomization. We developed methods for selecting policy headings/sections topics likely to contain sun safety policies for students and for assessing the presence, strength, and intent of policies. Trained coders assessed the content of each policy document. RESULTS Overall, 31% of districts had a policy addressing sun safety, most commonly, protective clothing, hats, sunscreen, and education at baseline. More California districts (51.9%) had these policies than Colorado districts (7.8%, p<.001). Policy scores were highest in districts with fewer Caucasian students (b=-0.02, p=.022) in Colorado (b=-0.02, p=.007) but not California (b=0.01, p=.299). CONCLUSION The protocol for assessing sun safety policy in board-approved written policy documents had several advantages over surveys of school officials. Sun protection policies were uncommon and limited in scope in 2005-2007. California has been more active at legislating school policy than Colorado. School district policies remain a largely untapped method for promoting the sun protection of children. PMID:23061553

76 FR 39091 - San Luis Obispo Flood Control and Water Conservation District; Notice of Effectiveness of Surrender

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-05

... Water Treatment Plant Hydropower Generation Unit Project No. 4804. The project was located on the county's water distribution system in San Luis Obispo County, California. \\1\\ San Luis Obispo Flood Control...

Energy efficiency in waste-to-energy and its relevance with regard to climate control.

PubMed

Ragossnig, Arne M; Wartha, Christian; Kirchner, Andreas

2008-02-01

This article focuses on systematically highlighting the ways to optimize waste-to-energy plants in terms of their energy efficiency as an indicator of the positive effect with regard to climate control. Potentials for increasing energy efficiency are identified and grouped into categories. The measures mentioned are illustrated by real-world examples. As an example, district cooling as a means for increasing energy efficiency in the district heating network of Vienna is described. Furthermore a scenario analysis shows the relevance of energy efficiency in waste management scenarios based on thermal treatment of waste with regard to climate control. The description is based on a model that comprises all relevant processes from the collection and transportation up to the thermal treatment of waste. The model has been applied for household-like commercial waste. The alternatives compared are a combined heat and power incinerator, which is being introduced in many places as an industrial utility boiler or in metropolitan areas where there is a demand for district heating and a classical municipal solid waste incinerator producing solely electrical power. For comparative purposes a direct landfilling scenario has been included in the scenario analysis. It is shown that the energy efficiency of thermal treatment facilities is crucial to the quantity of greenhouse gases emitted.

Demand and supply factors affecting the rising overmedicalization of birth in India.

PubMed

Leone, Tiziana

2014-11-01

To understand the interaction between health systems and individual factors in determining the probability of a cesarean delivery in India. In a retrospective study, data from the 2007-2008 District Level Household and Facility Survey was used to determine the risk of cesarean delivery in six states (Punjab, Delhi, Maharashtra, Andhra Pradesh, Kerala, and Tamil Nadu). Multilevel modeling was used to account for district and community effects. After controlling for key risk factors, the analysis showed that cesareans were more likely at private than public institutions (P<0.001). In terms of demand, higher education levels rather than wealth seemed to increase the likelihood of a cesarean delivery. District-level effects were significant in almost all states (P<0.001), demonstrating the need to control for health system factors. Supply factors might contribute more to the rise in cesarean delivery than does demand. Further research is needed to understand whether the quest for increased institutional deliveries in a country with high maternal mortality might be compromised by pressures for overmedicalization. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Assessment of the response to cholera outbreaks in two districts in Ghana.

PubMed

Ohene, Sally-Ann; Klenyuie, Wisdom; Sarpeh, Mark

2016-11-02

Despite recurring outbreaks of cholera in Ghana, very little has been reported on assessments of outbreak response activities undertaken in affected areas. This study assessed the response activities undertaken in two districts, Akatsi District in Volta Region and Komenda-Edina-Eguafo-Abirem (KEEA) Municipal in Central Region during the 2012 cholera epidemic in Ghana. We conducted a retrospective assessment of the events, strengths and weaknesses of the cholera outbreak response activities in the two districts making use of the WHO cholera evaluation tool. Information sources included surveillance and facility records, reports and interviews with relevant health personnel involved in the outbreak response from both district health directorates and health facilities. We collected data on age, sex, area of residence, date of reporting to health facility of cholera cases, district population data and information on the outbreak response activities and performed descriptive analyses of the outbreak data by person, time and place. The cholera outbreak in Akatsi was explosive with a high attack rate (AR) of 374/100,000 and case fatality rate (CFR) of 1.2 % while that in KEEA was on a relatively smaller scale AR of 23/100,000 but with a high case fatality rate of 18.8 %. For both districts, we identified multiple strengths in the response to the outbreak including timely notification of the district health officials which triggered prompt investigation of the suspected outbreak facilitating confirmation of cholera and initiation of public health response activities. Others were coordination of the activities by multi-sectoral committees, instituting water, sanitation and hygiene measures and appropriate case management at health facilities. We also found areas that needed improvement in both districts including incomplete surveillance data, sub-optimal community based surveillance considering the late reporting and the deaths in the community and the inadequate community knowledge about cholera preventive measures. The assessment of the cholera outbreak response in the two districts highlighted strengths in the epidemic control activities. There was however need to strengthen preparedness especially in the area of improving community surveillance and awareness about cholera prevention and the importance of seeking prompt treatment in health facilities in the event of an outbreak.

Piloting the global subsidy: the impact of subsidized artemisinin-based combination therapies distributed through private drug shops in rural Tanzania.

PubMed

Sabot, Oliver J; Mwita, Alex; Cohen, Justin M; Ipuge, Yahya; Gordon, Megumi; Bishop, David; Odhiambo, Moses; Ward, Lorrayne; Goodman, Catherine

2009-09-02

WHO estimates that only 3% of fever patients use recommended artemisinin-based combination therapies (ACTs), partly reflecting their high prices in the retail sector from where many patients seek treatment. To overcome this challenge, a global ACT subsidy has been proposed. We tested this proposal through a pilot program in rural Tanzania. Three districts were assigned to serve either as a control or to receive the subsidy plus a package of supporting interventions. From October 2007, ACTs were sold at a 90% subsidy through the normal private supply chain to intervention district drug shops. Data were collected at baseline and during intervention using interviews with drug shop customers, retail audits, mystery shoppers, and audits of public and NGO facilities. The proportion of consumers in the intervention districts purchasing ACTs rose from 1% at baseline to 44.2% one year later (p<0.001), and was significantly higher among consumers purchasing for children under 5 than for adults (p = 0.005). No change in ACT usage was observed in the control district. Consumers paid a mean price of $0.58 for ACTs, which did not differ significantly from the price paid for sulphadoxine-pyrimethamine, the most common alternative. Drug shops in population centers were significantly more likely to stock ACTs than those in more remote areas (p<0.001). A subsidy introduced at the top of the private sector supply chain can significantly increase usage of ACTs and reduce their retail price to the level of common monotherapies. Additional interventions may be needed to ensure access to ACTs in remote areas and for poorer individuals who appear to seek treatment at drug shops less frequently. Controlled-Trials.com ISRCTN39125414.

Piloting the Global Subsidy: The Impact of Subsidized Artemisinin-Based Combination Therapies Distributed through Private Drug Shops in Rural Tanzania

PubMed Central

Sabot, Oliver J.; Mwita, Alex; Cohen, Justin M.; Ipuge, Yahya; Gordon, Megumi; Bishop, David; Odhiambo, Moses; Ward, Lorrayne; Goodman, Catherine

2009-01-01

Background WHO estimates that only 3% of fever patients use recommended artemisinin-based combination therapies (ACTs), partly reflecting their high prices in the retail sector from where many patients seek treatment. To overcome this challenge, a global ACT subsidy has been proposed. We tested this proposal through a pilot program in rural Tanzania. Methods/Principal Findings Three districts were assigned to serve either as a control or to receive the subsidy plus a package of supporting interventions. From October 2007, ACTs were sold at a 90% subsidy through the normal private supply chain to intervention district drug shops. Data were collected at baseline and during intervention using interviews with drug shop customers, retail audits, mystery shoppers, and audits of public and NGO facilities. The proportion of consumers in the intervention districts purchasing ACTs rose from 1% at baseline to 44.2% one year later (p<0.001), and was significantly higher among consumers purchasing for children under 5 than for adults (p = 0.005). No change in ACT usage was observed in the control district. Consumers paid a mean price of $0.58 for ACTs, which did not differ significantly from the price paid for sulphadoxine-pyrimethamine, the most common alternative. Drug shops in population centers were significantly more likely to stock ACTs than those in more remote areas (p<0.001). Conclusions A subsidy introduced at the top of the private sector supply chain can significantly increase usage of ACTs and reduce their retail price to the level of common monotherapies. Additional interventions may be needed to ensure access to ACTs in remote areas and for poorer individuals who appear to seek treatment at drug shops less frequently. Trial Registration Controlled-Trials.com ISRCTN39125414. PMID:19724644

Insect pests of sweetpotato in Uganda: farmers' perceptions of their importance and control practices.

PubMed

Okonya, Joshua Sikhu; Mwanga, Robert Om; Syndikus, Katja; Kroschel, Jürgen

2014-01-01

Insect pests are among the most important constraints limiting sweetpotato (Ipomoea batatas) production in Africa. However, there is inadequate information about farmers' knowledge, perceptions and practices in the management of key insect pests. This has hindered development of effective pest management approaches for smallholder farmers. A standard questionnaire was used to interview individual sweetpotato farmers (n = 192) about their perception and management practices regarding insect pests in six major sweetpotato producing districts of Uganda. The majority (93%) of farmers perceived insect pests to be a very serious problem. With the exception of Masindi and Wakiso districts where the sweetpotato butterfly (Acraea acerata) was the number one constraint, sweetpotato weevils (Cylas puncticollis and C. brunneus) were ranked as the most important insect pests. Insecticide use in sweetpotato fields was very low being highest (28-38% of households) in districts where A. acerata infestation is the biggest problem. On average, 65% and 87% of the farmers took no action to control A. acerata and Cylas spp., respectively. Farmers were more conversant with the presence of and damage by A. acerata than of Cylas spp. as they thought that Cylas spp. root damage was brought about by a prolonged dry season. Different levels of field resistance (ability of a variety to tolerate damage) of sweetpotato landraces to A. acerata (eight landraces) and Cylas spp. (six landraces) were reported by farmers in all the six districts. This perceived level of resistance to insect damage by landraces needs to be investigated. To improve farmers' capabilities for sweetpotato insect pest management, it is crucial to train them in the basic knowledge of insect pest biology and control.

Distribution of schistosomiasis and soil transmitted helminthiasis in Zimbabwe: towards a national plan of action for control and elimination.

PubMed

Midzi, Nicholas; Mduluza, Takafira; Chimbari, Moses J; Tshuma, Clement; Charimari, Lincoln; Mhlanga, Gibson; Manangazira, Portia; Munyati, Shungu M; Phiri, Isaac; Mutambu, Susan L; Midzi, Stanley S; Ncube, Anastancia; Muranzi, Lawrence P; Rusakaniko, Simbarashe; Mutapi, Francisca

2014-08-01

Schistosomiasis and STH are among the list of neglected tropical diseases considered for control by the WHO. Although both diseases are endemic in Zimbabwe, no nationwide control interventions have been implemented. For this reason in 2009 the Zimbabwe Ministry of Health and Child Care included the two diseases in the 2009-2013 National Health Strategy highlighting the importance of understanding the distribution and burden of the diseases as a prerequisite for elimination interventions. It is against this background that a national survey was conducted. A countrywide cross-sectional survey was carried out in 280 primary schools in 68 districts between September 2010 and August 2011. Schistosoma haematobium was diagnosed using the urine filtration technique. Schistosoma mansoni and STH (hookworms, Trichuris trichiura, Ascaris lumbricoides) were diagnosed using both the Kato Katz and formol ether concentration techniques. Schistosomiasis was more prevalent country-wide (22.7%) than STH (5.5%). The prevalence of S. haematobium was 18.0% while that of S. mansoni was 7.2%. Hookworms were the most common STH with a prevalence of 3.2% followed by A. lumbricoides and T. trichiura with prevalence of 2.5% and 0.1%, respectively. The prevalence of heavy infection intensity as defined by WHO for any schistosome species was 5.8% (range 0%-18.3% in districts). Only light to moderate infection intensities were observed for STH species. The distribution of schistosomiasis and STH varied significantly between provinces, districts and schools (p<0.001). Overall, the prevalence of co-infection with schistosomiasis and STH was 1.5%. The actual co-endemicity of schistosomiasis and STH was observed in 43 (63.2%) of the 68 districts screened. This study provided comprehensive baseline data on the distribution of schistosomiasis and STH that formed the basis for initiating a national control and elimination programme for these two neglected tropical diseases in Zimbabwe.

Socio-Economic and Cultural Determinants of Human African Trypanosomiasis at the Kenya – Uganda Transboundary

PubMed Central

Rutto, Jane Jemeli; Osano, Odipo; Thuranira, Elias Gitonga; Kurgat, Richard Kiptum; Odenyo, Victor Agab Omondi

2013-01-01

Background Kenya and Uganda have reported different Human African Trypanosomiasis incidences in the past more than three decades, with the latter recording more cases. This cross-sectional study assessed the demographic characteristics, tsetse and trypanosomiasis control practices, socio-economic and cultural risk factors influencing Trypanosoma brucei rhodesiense (T.b.r.) infection in Teso and Busia Districts, Western Kenya and Tororo and Busia Districts, Southeast Uganda. A conceptual framework was postulated to explain interactions of various socio-economic, cultural and tsetse control factors that predispose individuals and populations to HAT. Methods A cross-sectional household survey was conducted between April and October 2008. Four administrative districts reporting T.b.r and lying adjacent to each other at the international boundary of Kenya and Uganda were purposely selected. Household data collection was carried out in two villages that had experienced HAT and one other village that had no reported HAT case from 1977 to 2008 in each district. A structured questionnaire was administered to 384 randomly selected household heads or their representatives in each country. The percent of respondents giving a specific answer was reported. Secondary data was also obtained on socio-economic and political issues in both countries. Results Inadequate knowledge on the disease cycle and intervention measures contributed considerable barriers to HAT, and more so in Uganda than in Kenya. Gender-associated socio-cultural practices greatly predisposed individuals to HAT. Pesticides-based crop husbandry in the 1970's reportedly reduced vector population while vegetation of coffee and banana's and livestock husbandry directly increased occurrence of HAT. Livestock husbandry practices in the villages were strong predictors of HAT incidence. The residents in Kenya (6.7%) applied chemoprophylaxis and chemotherapeutic controls against trypanosomiasis to a larger extent than Uganda (2.1%). Conclusion Knowledge on tsetse and its control methods, culture, farming practice, demographic and socio-economic variables explained occurrence of HAT better than landscape features. PMID:23638206

Distribution of Schistosomiasis and Soil Transmitted Helminthiasis in Zimbabwe: Towards a National Plan of Action for Control and Elimination

PubMed Central

Midzi, Nicholas; Mduluza, Takafira; Chimbari, Moses J.; Tshuma, Clement; Charimari, Lincoln; Mhlanga, Gibson; Manangazira, Portia; Munyati, Shungu M.; Phiri, Isaac; Mutambu, Susan L.; Midzi, Stanley S.; Ncube, Anastancia; Muranzi, Lawrence P.; Rusakaniko, Simbarashe; Mutapi, Francisca

2014-01-01

Background Schistosomiasis and STH are among the list of neglected tropical diseases considered for control by the WHO. Although both diseases are endemic in Zimbabwe, no nationwide control interventions have been implemented. For this reason in 2009 the Zimbabwe Ministry of Health and Child Care included the two diseases in the 2009–2013 National Health Strategy highlighting the importance of understanding the distribution and burden of the diseases as a prerequisite for elimination interventions. It is against this background that a national survey was conducted. Methodology A countrywide cross-sectional survey was carried out in 280 primary schools in 68 districts between September 2010 and August 2011. Schistosoma haematobium was diagnosed using the urine filtration technique. Schistosoma mansoni and STH (hookworms, Trichuris trichiura, Ascaris lumbricoides) were diagnosed using both the Kato Katz and formol ether concentration techniques. Main findings Schistosomiasis was more prevalent country-wide (22.7%) than STH (5.5%). The prevalence of S. haematobium was 18.0% while that of S. mansoni was 7.2%. Hookworms were the most common STH with a prevalence of 3.2% followed by A. lumbricoides and T. trichiura with prevalence of 2.5% and 0.1%, respectively. The prevalence of heavy infection intensity as defined by WHO for any schistosome species was 5.8% (range 0%–18.3% in districts). Only light to moderate infection intensities were observed for STH species. The distribution of schistosomiasis and STH varied significantly between provinces, districts and schools (p<0.001). Overall, the prevalence of co-infection with schistosomiasis and STH was 1.5%. The actual co-endemicity of schistosomiasis and STH was observed in 43 (63.2%) of the 68 districts screened. Conclusion and recommendations This study provided comprehensive baseline data on the distribution of schistosomiasis and STH that formed the basis for initiating a national control and elimination programme for these two neglected tropical diseases in Zimbabwe. PMID:25121489

Lymphatic filariasis in Papua New Guinea: distribution at district level and impact of mass drug administration, 1980 to 2011

PubMed Central

2013-01-01

Background Lymphatic filariasis (LF) caused by Wuchereria bancrofti is present at high prevalence in some parts of Papua New Guinea. However, there has been no rigorous data-based representative assessment of nationwide prevalence of LF. The LF programme has been daunted by the scope of the problem, and progress on mass drug administration (MDA) has been slow and lacking in resources. Methods A systematic literature review identified LF surveys in Papua New Guinea between 1980 and 2011. Results were extracted by location, time period and test used (blood slide, immunochromatographic test (ICT) or Og4C3 ELISA) and combined by district. Three criteria schemes based on the Global Programme to Eliminate Lymphatic Filariasis guidelines, with modifications, were developed to classify and prioritize districts by prevalence level. Results of repeated surveys in the same sites were used to investigate the impact of MDA on LF prevalence over the time period. Results There were 312 distinct survey sites identified in 80 of the 89 districts over the 31-year period. The overall LF prevalence in the sites tested was estimated at 18.5 to 27.5% by blood slide for microfilariae (Mf), 10.1% to 12.9% by ICT and 45.4% to 48.8% by Og4C3. Biases in site selection towards areas with LF, and change in type of assay used, affected the prevalence estimates, but overall decline in prevalence over the time period was observed. Depending on the criteria used, 34 to 36 districts (population 2.7 to 2.9 million) were classed as high endemic (≥5% prevalence), 15 to 25 districts (1.7 to 1.9 million) as low endemic (<5%) and 20 to 31 (1.3 to 2.2 million) as non-endemic. Nine districts (0.7 million) had no information. The strong impact of MDA, especially on microfilaria (Mf) prevalence, was noted in sites with repeat surveys. Conclusions This analytical review of past surveys of LF in Papua New Guinea enables better estimation of the national burden, identifies gaps in knowledge, quantifies and locates the population at risk, and can be used to predict the likely impact of MDA and/or vector control. Better targeting of districts by level of prevalence will strengthen the control programme, facilitate monitoring of the disease trend and increase the likelihood of reaching the target of LF elimination by 2020. PMID:23311302

Identifying cholera "hotspots" in Uganda: An analysis of cholera surveillance data from 2011 to 2016

PubMed Central

Bwire, Godfrey; Sack, David A.; Nakinsige, Anne; Naigaga, Martha; Debes, Amanda K.; Ngwa, Moise C.; Brooks, W. Abdullah; Garimoi Orach, Christopher

2017-01-01

Background Despite advance in science and technology for prevention, detection and treatment of cholera, this infectious disease remains a major public health problem in many countries in sub-Saharan Africa, Uganda inclusive. The aim of this study was to identify cholera hotspots in Uganda to guide the development of a roadmap for prevention, control and elimination of cholera in the country. Methodology/Principle findings We obtained district level confirmed cholera outbreak data from 2011 to 2016 from the Ministry of Health, Uganda. Population and rainfall data were obtained from the Uganda Bureau of Statistics, and water, sanitation and hygiene data from the Ministry of Water and Environment. A spatial scan test was performed to identify the significantly high risk clusters. Cholera hotspots were defined as districts whose center fell within a significantly high risk cluster or where a significantly high risk cluster was completely superimposed onto a district. A zero-inflated negative binomial regression model was employed to identify the district level risk factors for cholera. In total 11,030 cases of cholera were reported during the 6-year period. 37(33%) of 112 districts reported cholera outbreaks in one of the six years, and 20 (18%) districts experienced cholera at least twice in those years. We identified 22 districts as high risk for cholera, of which 13 were near a border of Democratic Republic of Congo (DRC), while 9 districts were near a border of Kenya. The relative risk of having cholera inside the high-risk districts (hotspots) were 2 to 22 times higher than elsewhere in the country. In total, 7 million people were within cholera hotspots. The negative binomial component of the ZINB model shows people living near a lake or the Nile river were at increased risk for cholera (incidence rate ratio, IRR = 0.98, 95% CI: 0.97 to 0.99, p < .01); people living near the border of DRC/Kenya or higher incidence rate in the neighboring districts were increased risk for cholera in a district (IRR = 0.99, 95% CI: 0.98 to 1.00, p = .02 and IRR = 1.02, 95% CI: 1.01 to 1.03, p < .01, respectively). The zero inflated component of the ZINB model yielded shorter distance to Kenya or DRC border, higher incidence rate in the neighboring districts, and higher annual rainfall in the district were associated with the risk of having cholera in the district. Conclusions/significance The study identified cholera hotspots during the period 2011–2016. The people located near the international borders, internationally shared lakes and river Nile were at higher risk for cholera outbreaks than elsewhere in the country. Targeting cholera interventions to these locations could prevent and ultimately eliminate cholera in Uganda. PMID:29284003

Identifying cholera "hotspots" in Uganda: An analysis of cholera surveillance data from 2011 to 2016.

PubMed

Bwire, Godfrey; Ali, Mohammad; Sack, David A; Nakinsige, Anne; Naigaga, Martha; Debes, Amanda K; Ngwa, Moise C; Brooks, W Abdullah; Garimoi Orach, Christopher

2017-12-01

Despite advance in science and technology for prevention, detection and treatment of cholera, this infectious disease remains a major public health problem in many countries in sub-Saharan Africa, Uganda inclusive. The aim of this study was to identify cholera hotspots in Uganda to guide the development of a roadmap for prevention, control and elimination of cholera in the country. We obtained district level confirmed cholera outbreak data from 2011 to 2016 from the Ministry of Health, Uganda. Population and rainfall data were obtained from the Uganda Bureau of Statistics, and water, sanitation and hygiene data from the Ministry of Water and Environment. A spatial scan test was performed to identify the significantly high risk clusters. Cholera hotspots were defined as districts whose center fell within a significantly high risk cluster or where a significantly high risk cluster was completely superimposed onto a district. A zero-inflated negative binomial regression model was employed to identify the district level risk factors for cholera. In total 11,030 cases of cholera were reported during the 6-year period. 37(33%) of 112 districts reported cholera outbreaks in one of the six years, and 20 (18%) districts experienced cholera at least twice in those years. We identified 22 districts as high risk for cholera, of which 13 were near a border of Democratic Republic of Congo (DRC), while 9 districts were near a border of Kenya. The relative risk of having cholera inside the high-risk districts (hotspots) were 2 to 22 times higher than elsewhere in the country. In total, 7 million people were within cholera hotspots. The negative binomial component of the ZINB model shows people living near a lake or the Nile river were at increased risk for cholera (incidence rate ratio, IRR = 0.98, 95% CI: 0.97 to 0.99, p < .01); people living near the border of DRC/Kenya or higher incidence rate in the neighboring districts were increased risk for cholera in a district (IRR = 0.99, 95% CI: 0.98 to 1.00, p = .02 and IRR = 1.02, 95% CI: 1.01 to 1.03, p < .01, respectively). The zero inflated component of the ZINB model yielded shorter distance to Kenya or DRC border, higher incidence rate in the neighboring districts, and higher annual rainfall in the district were associated with the risk of having cholera in the district. The study identified cholera hotspots during the period 2011-2016. The people located near the international borders, internationally shared lakes and river Nile were at higher risk for cholera outbreaks than elsewhere in the country. Targeting cholera interventions to these locations could prevent and ultimately eliminate cholera in Uganda.

WWC Review of the Report "A Written Language Intervention for At-Risk Second Grade Students: A Randomized Controlled Trial of the Process Assessment of the Learner Lesson Plans in a Tier 2 Response-to-Intervention (RtI) Model." What Works Clearinghouse Single Study Review

ERIC Educational Resources Information Center

What Works Clearinghouse, 2014

2014-01-01

The study examined the effects of "Process Assessment of the Learner" ("PAL"), a writing expression curriculum. The program was tested with second-grade students in a suburban-rural school district in the southeastern United States. Three sections of PAL lessons were implemented in the district as a small-group curriculum…

Site Management. An Analysis of the Concepts and Fundamental Operational Components Associated with the Delegation of Decision-Making Authority and Control of Resources to the School-Site Level in the California Public School System.

ERIC Educational Resources Information Center

Decker, Erwin A.; And Others

The pros and cons of decentralization of decision-making authority to the school-site level as a public school management technique are intended to serve as an informational summary for the members of the California State Board of Education, and as a resource for school district governing boards and district administrators to use to determine the…

Feasibility of Investigating Smith-Purcell Free-Electron Laser Configurations by Electron Energy Loss Studies.

DTIC Science & Technology

1986-06-09

PROJECT. TASK University of the District of Columbia AREA & WORK UNIT NUMBERS Howard University Washington, D.C. 1" CONTROLLING OFFICE NAME AND...Arthur N. Thorpe, Ph.D. June 9, 1986 U. S. ARMY RESEARCH OFFICE DAAG29-80-G-0013 University of the District of Columbia and Howard University Approved...701. 1958. 9. Speller, L. C. Ph.D. Dissertation, Howard University . 1971. -’ ~ ~ -. -.. o’ -7- 7_ -. -t - --’~ - LOJ 0L ..c U CL) . ...... - -J

40 CFR 52.235 - Control strategy for ozone: Oxides of nitrogen.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 3 2013-07-01 2013-07-01 false Control strategy for ozone: Oxides of... for ozone: Oxides of nitrogen. EPA is approving an exemption request submitted by the Monterey Bay Unified Air Pollution Control District on April 26, 1994 for the Monterey Bay ozone nonattainment area...

40 CFR 52.235 - Control strategy for ozone: Oxides of nitrogen.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 3 2014-07-01 2014-07-01 false Control strategy for ozone: Oxides of... for ozone: Oxides of nitrogen. EPA is approving an exemption request submitted by the Monterey Bay Unified Air Pollution Control District on April 26, 1994 for the Monterey Bay ozone nonattainment area...

40 CFR 52.235 - Control strategy for ozone: Oxides of nitrogen.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 3 2011-07-01 2011-07-01 false Control strategy for ozone: Oxides of... for ozone: Oxides of nitrogen. EPA is approving an exemption request submitted by the Monterey Bay Unified Air Pollution Control District on April 26, 1994 for the Monterey Bay ozone nonattainment area...

40 CFR 52.235 - Control strategy for ozone: Oxides of nitrogen.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 3 2010-07-01 2010-07-01 false Control strategy for ozone: Oxides of... for ozone: Oxides of nitrogen. EPA is approving an exemption request submitted by the Monterey Bay Unified Air Pollution Control District on April 26, 1994 for the Monterey Bay ozone nonattainment area...

40 CFR 52.235 - Control strategy for ozone: Oxides of nitrogen.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 3 2012-07-01 2012-07-01 false Control strategy for ozone: Oxides of... for ozone: Oxides of nitrogen. EPA is approving an exemption request submitted by the Monterey Bay Unified Air Pollution Control District on April 26, 1994 for the Monterey Bay ozone nonattainment area...

78 FR 9648 - Approval and Promulgation of Air Quality Implementation Plans; District of Columbia; Volatile...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-11

... Regulations (DCMR) for the Control of Volatile Organic Compounds (VOC) to meet the requirement to adopt reasonably available control technology (RACT) for sources as recommended by the Ozone Transport Commission (OTC) model rules and EPA's Control Techniques Guidelines (CTG) standards. On January 26, 2010 and...

76 FR 45199 - Interim Final Determination To Defer Sanctions, San Joaquin Valley Unified Air Pollution Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-28

... Determination To Defer Sanctions, San Joaquin Valley Unified Air Pollution Control District, CA AGENCY... limited approval and limited disapproval of revisions to the San Joaquin Valley Unified Air Pollution... section 307(b)(2)). List of Subjects in 40 CFR Part 52 Environmental protection, Air pollution control...

77 FR 58312 - Revisions to the California State Implementation Plan, San Joaquin Valley Unified Air Pollution...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-20

... the California State Implementation Plan, San Joaquin Valley Unified Air Pollution Control District... revisions to the California State Implementation Plan, San Joaquin Valley Unified Air Pollution Control... section 307(b)(2)). List of Subjects in 40 CFR Part 52 Environmental protection, Air pollution control...

33 CFR 274.6 - Division/district pest control programs.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., DEPARTMENT OF DEFENSE PEST CONTROL PROGRAM FOR CIVIL WORKS PROJECTS Project Operation § 274.6 Division... from time to time, will be used as guides in selecting the type of chemicals and the method of application in the control of vegetation and pests at civil works projects. (b) Responsibilities and reports...

Our Cost Control Program Is Real, and Good PR Too.

ERIC Educational Resources Information Center

Harris, James; And Others

The cost control program of the Beaverton School District (Oregon) is presented in three sections. Reviewing the role of the school board in cost control development, Jean Holt (a board member) outlines the fiscal management system, long-range financial strategies, energy conservation, and utilization of facilities. The programs have resulted in a…

Assuring Quality in Education Evaluation.

ERIC Educational Resources Information Center

Trochim, William M. K.; Visco, Ronald J.

1986-01-01

A number of quality assurance educational evaluation methods are illustrated. Evaluation data obtained from the Providence, Rhode Island, school district are used. The methods are: (1) from auditing, internal control; (2) from accounting, double bookkeeping; and (3) from industrial quality control, acceptance sampling and cumulative percentage…

Emissions from gas fired agricultural burners

USDA-ARS?s Scientific Manuscript database

Because of the Federal Clean Air Act, the San Joaquin Valley Unified Air Pollution Control District (SJVUAPCD) began defining Best Available Control Technology (BACT) for NOx emissions from cotton gin drying system gas fired burners in its jurisdiction. The NOx emission levels of conventionally used...

Institutionalizing and sustaining social change in health systems: the case of Uganda.

PubMed

Hage, Jerald; Valadez, Joseph J

2017-11-01

The key to high impact health services is institutionalizing and sustaining programme evaluation. Uganda represents a success story in the use of a specific programme evaluation method: Lot Quality Assurance Sampling (LQAS). Institutionalization is defined by two C's: competent programme evaluators and control mechanisms that effectively use evaluation data to improve health services. Sustainability means continued training and funding for the evaluation approach. Social science literature that researches institutionalization has emphasized 'stability', whereas in global health, the issue is determining how to improve the impact of services by 'changing' programmes. In Uganda, we measured the extent of the institutionalization and sustainability of evaluating programmes that produce change in nine districts sampled to represent three largely rural regions and varying levels of effective health programmes. We used the proportion of mothers with children aged 0-11 months who delivered in a health facility as the principal indicator to measure programme effectiveness. Interviews and focus groups were conducted among directors, evaluation supervisors, data collectors in the district health offices, and informant interviews conducted individually at the central government level. Seven of the nine districts demonstrated a high level of institutionalization of evaluation. The two others had only conducted one round of programme evaluation. When we control for the availability of health facilities, we find that the degree of institutionalization is moderately related to the prevalence of the delivery of a baby in a health facility. Evaluation was institutionalized at the central government level. Sustainability existed at both levels. Several measures indicate that lessons from the nine district case studies may be relevant to the 74 districts that had at least two rounds of programme evaluation. We note that there is an association between the evaluation data being used to change health services, and the four separate indicators being used to measure women's health and child survival services. We conclude that the two C's (competent evaluators and control mechanisms) have been critical for sustaining programme evaluation in Uganda. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Institutionalizing and sustaining social change in health systems: the case of Uganda

PubMed Central

Hage, Jerald; Valadez, Joseph J

2017-01-01

Abstract The key to high impact health services is institutionalizing and sustaining programme evaluation. Uganda represents a success story in the use of a specific programme evaluation method: Lot Quality Assurance Sampling (LQAS). Institutionalization is defined by two C’s: competent programme evaluators and control mechanisms that effectively use evaluation data to improve health services. Sustainability means continued training and funding for the evaluation approach. Social science literature that researches institutionalization has emphasized ‘stability’, whereas in global health, the issue is determining how to improve the impact of services by ‘changing’ programmes. In Uganda, we measured the extent of the institutionalization and sustainability of evaluating programmes that produce change in nine districts sampled to represent three largely rural regions and varying levels of effective health programmes. We used the proportion of mothers with children aged 0–11 months who delivered in a health facility as the principal indicator to measure programme effectiveness. Interviews and focus groups were conducted among directors, evaluation supervisors, data collectors in the district health offices, and informant interviews conducted individually at the central government level. Seven of the nine districts demonstrated a high level of institutionalization of evaluation. The two others had only conducted one round of programme evaluation. When we control for the availability of health facilities, we find that the degree of institutionalization is moderately related to the prevalence of the delivery of a baby in a health facility. Evaluation was institutionalized at the central government level. Sustainability existed at both levels. Several measures indicate that lessons from the nine district case studies may be relevant to the 74 districts that had at least two rounds of programme evaluation. We note that there is an association between the evaluation data being used to change health services, and the four separate indicators being used to measure women's health and child survival services. We conclude that the two C’s (competent evaluators and control mechanisms) have been critical for sustaining programme evaluation in Uganda. PMID:28981663