An improved out-cell to in-cell rapid transfer system at the HFEF-south
DOE Office of Scientific and Technical Information (OSTI.GOV)
Bacca, J.P.; Sherman, E.K.
1990-01-01
The Argonne National Laboratory (ANL) Hot Fuel Examination Facility-South (HFEF-S), located at the ANL-West site of the Idaho National Engineering Laboratory, is currently undergoing extensive refurbishment and modifications in preparation for its use, beginning in 1991, in demonstrating remote recycling of fast reactor, metal-alloy fuel as part of the US Department of Energy liquid-metal reactor, Integral Fast Reactor (IFR) program. Included in these improvements to HFEF-S is a new, small-item, rapid transfer system (RTS). When installed, this system will enable the rapid transfer of small items from the hot-cell exterior into the argon cell (argon-gas atmosphere) of the facility withoutmore » necessitating the use of time-consuming and laborious procedures. The new RTS will also provide another important function associated with HFEF-S hot-cell operation in the IFR Fuel Recycle Program; namely, the rapid insertion of clean, radioactive contamination-measuring smear paper specimens into the hot cells for area surveys, and the expedited removal of these contaminated (including alpha as well as beta/gamma contamination) smears from the argon cell for transfer to an adjacent health physics field laboratory in the facility for nuclear contamination/radiation counting.« less
Posttest examination of Sodium Loop Safety Facility experiments. [LMFBR
DOE Office of Scientific and Technical Information (OSTI.GOV)
Holland, J.W.
In-reactor, safety experiments performed in the Sodium Loop Safety Facility (SLSF) rely on comprehensive posttest examinations (PTE) to characterize the postirradiation condition of the cladding, fuel, and other test-subassembly components. PTE information and on-line instrumentation data, are analyzed to identify the sequence of events and the severity of the accident for each experiment. Following in-reactor experimentation, the SLSF loop and test assembly are transported to the Hot Fuel Examination Facility (HFEF) for initial disassembly. Goals of the HFEF-phase of the PTE are to retrieve the fuel bundle by dismantling the loop and withdrawing the test assembly, to assess the macro-conditionmore » of the fuel bundle by nondestructive examination techniques, and to prepare the fuel bundle for shipment to the Alpha-Gamma Hot Cell Facility (AGHCF) at Argonne National Laboratory.« less
US RERTR FUEL DEVELOPMENT POST IRRADIATION EXAMINATION RESULTS
DOE Office of Scientific and Technical Information (OSTI.GOV)
A. B. Robinson; D. M. Wachs; D. E. Burkes
2008-10-01
Post irradiation examinations of irradiated RERTR plate type fuel at the Idaho National Laboratory have led to in depth characterization of fuel behavior and performance. Both destructive and non-destructive examination capabilities at the Hot Fuels Examination Facility (HFEF) as well as recent results obtained are discussed herein. New equipment as well as more advanced techniques are also being developed to further advance the investigation into the performance of the high density U-Mo fuel.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Jason M. Harp; Paul A. Demkowicz
2014-10-01
In the High Temperature Gas-Cooled Reactor (HTGR) the TRISO particle fuel serves as the primary fission product containment. However the large number of TRISO particles present in proposed HTGRs dictates that there will be a small fraction (~10 -4 to 10 -5) of as manufactured and in-pile particle failures that will lead to some fission product release. The matrix material surrounding the TRISO particles in fuel compacts and the structural graphite holding the TRISO particles in place can also serve as sinks for containing any released fission products. However data on the migration of solid fission products through these materialsmore » is lacking. One of the primary goals of the AGR-3/4 experiment is to study fission product migration from failed TRISO particles in prototypic HTGR components such as structural graphite and compact matrix material. In this work, the potential for a Gamma Emission Computed Tomography (GECT) technique to non-destructively examine the fission product distribution in AGR-3/4 components and other irradiation experiments is explored. Specifically, the feasibility of using the Idaho National Laboratory (INL) Hot Fuels Examination Facility (HFEF) Precision Gamma Scanner (PGS) system for this GECT application is considered. To test the feasibility, the response of the PGS system to idealized fission product distributions has been simulated using Monte Carlo radiation transport simulations. Previous work that applied similar techniques during the AGR-1 experiment will also be discussed as well as planned uses for the GECT technique during the post irradiation examination of the AGR-2 experiment. The GECT technique has also been applied to other irradiated nuclear fuel systems that were currently available in the HFEF hot cell including oxide fuel pins, metallic fuel pins, and monolithic plate fuel.« less
Four-point Bend Testing of Irradiated Monolithic U-10Mo Fuel
DOE Office of Scientific and Technical Information (OSTI.GOV)
Rabin, B. H.; Lloyd, W. R.; Schulthess, J. L.
2015-03-01
This paper presents results of recently completed studies aimed at characterizing the mechanical properties of irradiated U-10Mo fuel in support of monolithic base fuel qualification. Mechanical properties were evaluated in four-point bending. Specimens were taken from fuel plates irradiated in the RERTR-12 and AFIP-6 Mk. II irradiation campaigns, and tests were conducted in the Hot Fuel Examination Facility (HFEF) at Idaho National Laboratory (INL). The monolithic fuel plates consist of a U-10Mo fuel meat covered with a Zr diffusion barrier layer fabricated by co-rolling, clad in 6061 Al using a hot isostatic press (HIP) bonding process. Specimens exhibited nominal (fresh)more » fuel meat thickness ranging from 0.25 mm to 0.64 mm, and fuel plate average burnup ranged from approximately 0.4 x 1021 fissions/cm 3 to 6.0 x 1021 fissions/cm 3. After sectioning the fuel plates, the 6061 Al cladding was removed by dissolution in concentrated NaOH. Pre- and post-dissolution dimensional inspections were conducted on test specimens to facilitate accurate analysis of bend test results. Four-point bend testing was conducted on the HFEF Remote Load Frame at a crosshead speed of 0.1 mm/min using custom-designed test fixtures and calibrated load cells. All specimens exhibited substantially linear elastic behavior and failed in a brittle manner. The influence of burnup on the observed slope of the stress-strain curve and the calculated fracture strength is discussed.« less
Thermal evaluation of alternative shipping cask for irradiated experiments
Guillen, Donna Post
2015-06-01
Results of a thermal evaluation are provided for a new shipping cask under consideration for transporting irradiated experiments between the test reactor and post-irradiation examination (PIE) facilities. Most of the experiments will be irradiated in the Advanced Test Reactor (ATR) at Idaho National Laboratory (INL), then later shipped to the Hot Fuel Examination Facility (HFEF) located at the Materials and Fuels Complex for PIE. To date, the General Electric (GE)-2000 cask has been used to transport experiment payloads between these facilities. However, the availability of the GE-2000 cask to support future experiment shipping is uncertain. In addition, the internal cavitymore » of the GE-2000 cask is too short to accommodate shipping the larger payloads. Therefore, an alternate shipping capability is being pursued. The Battelle Energy Alliance, LLC, Research Reactor (BRR) cask has been determined to be the best alternative to the GE-2000 cask. An evaluation of the thermal performance of the BRR cask is necessary before proceeding with fabrication of the newly designed cask hardware and the development of handling, shipping and transport procedures. This paper presents the results of the thermal evaluation of the BRR cask loaded with a representative set of fueled and non-fueled payloads. When analyzed with identical payloads, experiment temperatures were found to be lower with the BRR cask than with the GE-2000 cask. Furthermore, from a thermal standpoint, the BRR cask was found to be a suitable alternate to the GE-2000 cask for shipping irradiated experiment payloads.« less
Improving the recognition of fingerprint biometric system using enhanced image fusion
NASA Astrophysics Data System (ADS)
Alsharif, Salim; El-Saba, Aed; Stripathi, Reshma
2010-04-01
Fingerprints recognition systems have been widely used by financial institutions, law enforcement, border control, visa issuing, just to mention few. Biometric identifiers can be counterfeited, but considered more reliable and secure compared to traditional ID cards or personal passwords methods. Fingerprint pattern fusion improves the performance of a fingerprint recognition system in terms of accuracy and security. This paper presents digital enhancement and fusion approaches that improve the biometric of the fingerprint recognition system. It is a two-step approach. In the first step raw fingerprint images are enhanced using high-frequency-emphasis filtering (HFEF). The second step is a simple linear fusion process between the raw images and the HFEF ones. It is shown that the proposed approach increases the verification and identification of the fingerprint biometric recognition system, where any improvement is justified using the correlation performance metrics of the matching algorithm.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Ingham, J.G.
The IDENT 1578 container, which is a 110-in. long 5.5-in. OD tube, is designed for shipping FFTF fuel elements in T-3 casks between HEDL, HFEF, and other laboratories. The thermal analysis was conducted to evaluate whether or not the container satisfies its thermal design criteria (handle a decay heat load of 600 watts, max fuel pin cladding temperature not exceeding 800/sup 0/F).
DOE Office of Scientific and Technical Information (OSTI.GOV)
S. Frank
The current method for the immobilization of fission products that accumulate in electrorefiner salt during the electrochemical processing of used metallic nuclear fuel is to encapsulate the electrorefiner salt in a glass-bonded sodalite ceramic waste form. This process was developed by Argonne National Laboratory in the USA and is currently performed at the Idaho National Laboratory for the treatment of Experimental Breeder Reactor-II (EBR-II) used fuel. This process utilizes a “once-through” option for the disposal of spent electrorefiner salt; where, after the treatment of the EBR-II fuel, the electrorefiner salt containing the active fission products will be disposed of inmore » the ceramic waste form (CWF). The CWF produced will have low fission product loading of approximately 2 to 5 weight percent due to the limited fuel inventory currently being processed. However; the design and implementation of advanced electrochemical processing facilities to treat used fuel would process much greater quantities fuel. With an advanced processing facility, it would be necessary to selectively remove fission products from the electrorefiner salt for salt recycle and to concentrate the fission products to reduce the volume of high-level waste from the treatment facility. The Korean Atomic Energy Research Institute and the Idaho National Laboratory have been collaborating on I-NERI research projects for a number of years to investigate both aspects of selective fission product separation from electrorefiner salt, and to develop advanced waste forms for the immobilization of the collected fission products. The first joint KAERI/INL I-NERI project titled: 2006-002-K, Separation of Fission Products from Molten LiCl-KCl Salt Used for Electrorefining of Metal Fuels, was successfully completed in 2009 by concentrating and isolating fission products from actual electrorefiner salt used for the treated used EBR-II fuel. Two separation methods were tested and from these tests were produced concentrated salt products that acted as the feed material for development of advanced waste forms investigated in this proposal. Accomplishments from the first year activities associated with this I-NERI project included the down selection of candidate waste forms to immobilize fission products separated from electrorefiner salt, and the design of equipment to fabricate actual waste forms in the Hot Fuels Examination Facility (HFEF) at the INL. Reported in this document are accomplishments from the second year (FY10) work performed at the INL, and includes the testing of waste form fabrication equipment, repeating the fission product precipitation experiment, and initial waste form fabrication efforts.« less
Thermal Stress in HFEF Hot Cell Windows Due to an In-Cell Metal Fire
Solbrig, Charles W.; Warmann, Stephen A.
2016-01-01
This work investigates an accident during the pyrochemical extraction of Uranium and Plutonium from PWR spent fuel in an argon atmosphere hot cell. In the accident, the heavy metals (U and Pu) being extracted are accidentally exposed to air from a leaky instrument penetration which goes through the cell walls. The extracted pin size pieces of U and Pu metal readily burn when exposed to air. Technicians perform the electrochemical extraction using manipulators through a 4 foot thick hot cell concrete wall which protects them from the radioactivity of the spent fuel. Four foot thick windows placed in the wallmore » allow the technicians to visually control the manipulators. These windows would be exposed to the heat of the metal fire. As a result, this analysis determines if the thermal stress caused by the fire would crack the windows and if the heat would degrade the window seals allowing radioactivity to escape from the cell.« less
Thermal Stress in HFEF Hot Cell Windows Due to an In-Cell Metal Fire
DOE Office of Scientific and Technical Information (OSTI.GOV)
Solbrig, Charles W.; Warmann, Stephen A.
This work investigates an accident during the pyrochemical extraction of Uranium and Plutonium from PWR spent fuel in an argon atmosphere hot cell. In the accident, the heavy metals (U and Pu) being extracted are accidentally exposed to air from a leaky instrument penetration which goes through the cell walls. The extracted pin size pieces of U and Pu metal readily burn when exposed to air. Technicians perform the electrochemical extraction using manipulators through a 4 foot thick hot cell concrete wall which protects them from the radioactivity of the spent fuel. Four foot thick windows placed in the wallmore » allow the technicians to visually control the manipulators. These windows would be exposed to the heat of the metal fire. As a result, this analysis determines if the thermal stress caused by the fire would crack the windows and if the heat would degrade the window seals allowing radioactivity to escape from the cell.« less
Advanced Test Reactor National Scientific User Facility (ATR NSUF) Monthly Report November 2014
DOE Office of Scientific and Technical Information (OSTI.GOV)
Soelberg, Renae
2014-11-01
Advanced Test Reactor National Scientific User Facility (ATR NSUF) Monthly Report November 2014 Highlights Rory Kennedy and Sarah Robertson attended the American Nuclear Society Winter Meeting and Nuclear Technology Expo in Anaheim, California, Nov. 10-13. ATR NSUF exhibited at the technology expo where hundreds of meeting participants had an opportunity to learn more about ATR NSUF. Dr. Kennedy briefed the Nuclear Engineering Department Heads Organization (NEDHO) on the workings of the ATR NSUF. • Rory Kennedy, James Cole and Dan Ogden participated in a reactor instrumentation discussion with Jean-Francois Villard and Christopher Destouches of CEA and several members of themore » INL staff. • ATR NSUF received approval from the NE-20 office to start planning the annual Users Meeting. The meeting will be held at INL, June 22-25. • Mike Worley, director of the Office of Innovative Nuclear Research (NE-42), visited INL Nov. 4-5. Milestones Completed • Recommendations for the Summer Rapid Turnaround Experiment awards were submitted to DOE-HQ Nov. 12 (Level 2 milestone due Nov. 30). Major Accomplishments/Activities • The University of California, Santa Barbara 2 experiment was unloaded from the GE-2000 at HFEF. The experiment specimen packs will be removed and shipped to ORNL for PIE. • The Terrani experiment, one of three FY 2014 new awards, was completed utilizing the Advanced Photon Source MRCAT beamline. The experiment investigated the chemical state of Ag and Pd in SiC shell of irradiated TRISO particles via X-ray Absorption Fine Structure (XAFS) spectroscopy. Upcoming Meetings/Events • The ATR NSUF program review meeting will be held Dec. 9-10 at L’Enfant Plaza. In addition to NSUF staff and users, NE-4, NE-5 and NE-7 representatives will attend the meeting. Awarded Research Projects Boise State University Rapid Turnaround Experiments (14-485 and 14-486) Nanoindentation and TEM work on the T91, HT9, HCM12A and 9Cr ODS specimens has been completed at CAES by Boise State PI Janelle Wharry and Cory Dolph. PI Corey Dolph returned in early November to complete their research by performing nanoindentation on unirradiated specimens that will be used as a baseline for their research.« less
AGR-3/4 Irradiation Test Train Disassembly and Component Metrology First Look Report
DOE Office of Scientific and Technical Information (OSTI.GOV)
Stempien, John Dennis; Rice, Francine Joyce; Harp, Jason Michael
2016-03-01
The AGR-3/4 experiment was designed to study fission product transport within graphitic matrix material and nuclear-grade graphite. To this end, this experiment consisted of 12 capsules, each fueled with 4 compacts containing UCO TRISO particles as driver fuel and 20 UCO designed-to-fail (DTF) fuel particles in each compact. The DTF fuel was fabricated with a thin pyrocarbon layer which was intended to fail during irradiation and provide a source of fission products. These fission products could then migrate through the compact and into the surrounding concentric rings of graphitic matrix material and/or nuclear graphite. Through post-irradiation examination (PIE) of themore » rings (including physical sampling and gamma scanning) fission product concentration profiles within the rings can be determined. These data can be used to elucidate fission product transport parameters (e.g. diffusion coefficients within the test materials) which will be used to inform and refine models of fission product transport. After irradiation in the Advanced Test Reactor (ATR) had been completed in April 2014, the AGR-3/4 experiment was shipped to the Hot Fuel Examination Facility (HFEF) at the Materials and Fuels Complex (MFC) for inspection, disassembly, and metrology. The AGR-3/4 test train was received at MFC in two separate shipments between February and April 2015. Visual examinations of the test train exterior did not indicate dimensional distortion, and only two small discolored areas were observed at the bottom of Capsules 8 and 9. No corresponding discoloration was found on the inside of these capsules, however. Prior to disassembly, the two test train sections were subject to analysis via the Precision Gamma Scanner (PGS), which did not indicate that any gross fuel relocation had occurred. A series of specialized tools (including clamps, cutters, and drills) had been designed and fabricated in order to carry out test train disassembly and recovery of capsule components (graphite rings and fuel compacts). This equipment performed well for separating each capsule in the test train and extracting the capsule components. Only a few problems were encountered. In one case, the outermost ring (the sink ring) was cracked during removal of the capsule through tubes. Although the sink ring will be analyzed in order to obtain a mass balance of fission products in the experiment, these cracks do not pose a major concern because the sink ring will not be analyzed in detail to obtain the spatial distribution of fission products. In Capsules 4 and 5, the compacts could not be removed from the inner rings. Strategies for removing the compacts are being evaluated. Sampling the inner rings with the compacts in-place is also an option. Dimensional measurements were made on the compacts, inner rings, outer rings, and sink rings. The diameters of all compacts decreased by 0.5 to 2.0 %. Generally, the extent of diametric shrinkage increased linearly with increasing neutron fluence. Most compact lengths also decreased. Compact lengths decreased with increasing fluence, reaching maximum shrinkage of about 0.9 % at a fast fluence of 4.0x10 25 n/m 2 E > 0.18 MeV. Above this fluence, the extent of length shrinkage appeared to decrease with fluence, and two compacts from Capsule 7 were found to have slightly increased in length (< 0.1 %) after a fluence of 5.2x10 25 n/m 2.« less
AGR-3/4 Irradiation Test Train Disassembly and Component Metrology First Look Report
DOE Office of Scientific and Technical Information (OSTI.GOV)
Stempien, John Dennis; Rice, Francine Joyce; Harp, Jason Michael
The AGR-3/4 experiment was designed to study fission product transport within graphitic matrix material and nuclear-grade graphite. To this end, this experiment consisted of 12 capsules, each fueled with 4 compacts containing UCO TRISO particles as driver fuel and 20 UCO designed-to-fail (DTF) fuel particles in each compact. The DTF fuel was fabricated with a thin pyrocarbon layer which was intended to fail during irradiation and provide a source of fission products. These fission products could then migrate through the compact and into the surrounding concentric rings of graphitic matrix material and/or nuclear graphite. Through post-irradiation examination (PIE) of themore » rings (including physical sampling and gamma scanning) fission product concentration profiles within the rings can be determined. These data can be used to elucidate fission product transport parameters (e.g. diffusion coefficients within the test materials) which will be used to inform and refine models of fission product transport. After irradiation in the Advanced Test Reactor (ATR) had been completed in April 2014, the AGR-3/4 experiment was shipped to the Hot Fuel Examination Facility (HFEF) at the Materials and Fuels Complex (MFC) for inspection, disassembly, and metrology. The AGR-3/4 test train was received at MFC in two separate shipments between February and April 2015. Visual examinations of the test train exterior did not indicate dimensional distortion, and only two small discolored areas were observed at the bottom of Capsules 8 and 9. No corresponding discoloration was found on the inside of these capsules, however. Prior to disassembly, the two test train sections were subject to analysis via the Precision Gamma Scanner (PGS), which did not indicate that any gross fuel relocation had occurred. A series of specialized tools (including clamps, cutters, and drills) had been designed and fabricated in order to carry out test train disassembly and recovery of capsule components (graphite rings and fuel compacts). This equipment performed well for separating each capsule in the test train and extracting the capsule components. Only a few problems were encountered. In one case, the outermost ring (the sink ring) was cracked during removal of the capsule through tubes. Although the sink ring will be analyzed in order to obtain a mass balance of fission products in the experiment, these cracks do not pose a major concern because the sink ring will not be analyzed in detail to obtain the spatial distribution of fission products. In Capsules 4 and 5, the compacts could not be removed from the inner rings. Strategies for removing the compacts are being evaluated. Sampling the inner rings with the compacts in-place is also an option. Dimensional measurements were made on the compacts, inner rings, outer rings, and sink rings. The diameters of all compacts decreased by 0.5 to 2.0 %. Generally, the extent of diametric shrinkage increased linearly with increasing neutron fluence. Most compact lengths also decreased. Compact lengths decreased with increasing fluence, reaching maximum shrinkage of about 0.9 % at a fast fluence of 4.0x1025 n/m2 E > 0.18 MeV. Above this fluence, the extent of length shrinkage appeared to decrease with fluence, and two compacts from Capsule 7 were found to have slightly increased in length (< 0.1 %) after a fluence of 5.2x1025 n/m2.« less
33 CFR 154.120 - Facility examinations.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Facility examinations. 154.120...) POLLUTION FACILITIES TRANSFERRING OIL OR HAZARDOUS MATERIAL IN BULK General § 154.120 Facility examinations. (a) The facility operator shall allow the Coast Guard, at any time, to make any examination and shall...
VIEW OF BUILDING 122 EXAMINATION FACILITIES THAT SUPPORT ROUTINE EMPLOYEE ...
VIEW OF BUILDING 122 EXAMINATION FACILITIES THAT SUPPORT ROUTINE EMPLOYEE AND SUBCONTRACTOR PHYSICAL EXAMINATIONS. (10/85) - Rocky Flats Plant, Emergency Medical Services Facility, Southwest corner of Central & Third Avenues, Golden, Jefferson County, CO
ERIC Educational Resources Information Center
2000
This report examines the relations between school design and student productivity and informs policy decisions. It contains three analytic sections: an analysis of school facilities characteristics and student productivity, a review of other research examining school facilities and student productivity, and an analysis of the need for school…
Materials and Fuels Complex Tour
Miley, Don
2017-12-11
The Materials and Fuels Complex at Idaho National Laboratory is home to several facilities used for the research and development of nuclear fuels. Stops include the Fuel Conditioning Facility, the Hot Fuel Examination Facility (post-irradiation examination), and the Space and Security Power System Facility, where radioisotope thermoelectric generators (RTGs) are assembled for deep space missions.
Lee, Ka Yiu; Lee, Paul H.; Macfarlane, Duncan
2014-01-01
Objectives: To examine the associations between objectively-assessed moderate-to-vigorous physical activity (MVPA) and perceived/objective measures of neighbourhood recreational facilities categorized into indoor or outdoor, public, residential or commercial facilities. The associations between facility perceptions and objectively-assessed numbers of recreational facilities were also examined. Method: A questionnaire was used on 480 adults to measure local facility perceptions, with 154 participants wearing ActiGraph accelerometers for ≥4 days. The objectively-assessed number of neighbourhood recreational facilities were examined using direct observations and Geographical Information System data. Results: Both positive and negative associations were found between MVPA and perceived/objective measures of recreational facilities. Some associations depended on whether the recreational facilities were indoor or outdoor, public or residential facilities. The objectively-assessed number of most public recreational facilities was associated with the corresponding facility perceptions, but the size of effect was generally lower than for residential recreational facilities. Conclusions: The objectively-assessed number of residential outdoor table tennis courts and public indoor swimming pools, the objectively-assessed presence of tennis courts and swimming pools, and the perceived presence of bike lanes and swimming pools were positive determinants of MVPA. It is suggested to categorize the recreational facilities into smaller divisions in order to identify unique associations with MVPA. PMID:25485980
DOE Office of Scientific and Technical Information (OSTI.GOV)
None
1968-12-12
The purpose of this Conceptual Facility Design Description (CFDD) is to provide a technical description of the Inert Gas Cell Examination Facility such that agreement with RDT on a Conceptual Design can be reached . The CFDD also serves to establish a common understanding of the facility concept among all responsible FFTF Project parties including the Architect Engineer and Reactor Designer. Included are functions and design requirements, a physical description of the facility, safety considerations, principles of operation, and maintenance principles.
Race, ethnicity, and noxious facilities: Environmental racism re- examined
DOE Office of Scientific and Technical Information (OSTI.GOV)
Nieves, A.L.; Nieves, L.A.
1992-10-01
The charge has been made that hazardous facilities tend to be located in proximity to minority populations. This study uses a facility density measure for three categories of noxious facilities to examine the relationship between facilities and minority population concentrations. County-level data are used in a correlation analysis for African Americans, Hispanics, and Asians in the four major regions of the US. Even controlling for income and housing value, and limiting the data set to urban areas, consistent patterns of moderate to strong association of facility densities with minority population percentages are found.
76 FR 20052 - Notice of Issuance of Regulatory Guide
Federal Register 2010, 2011, 2012, 2013, 2014
2011-04-11
... Guide 1.149, ``Nuclear Power Plant Simulation Facilities for Use in Operator Training, License..., ``Nuclear Power Plant Simulation Facilities for Use in Operator Training, License Examinations, and... simulation facility for use in operator and senior operator training, license examination operating tests...
Agism and burnout among nurses in long-term care facilities in Israel.
Iecovich, Esther; Avivi, Michal
2017-03-01
The extent to which agism and professional qualifications are associated with nurses' burnout in long-term care facilities for older adults has been barely examined. This study is aimed to examine the extent to which agism, professional education, and geriatric training explain work burnout. The study included a convenience sample of 154 nurses working in 17 long-term care facilities in the Tel Aviv area in Israel. To examine agism, Kogan's Attitudes toward Old People Scale was used, and to probe burnout, the Maslach Burnout Inventory was used. Overall burnout was significantly explained by agism, nurses' professional education, length of working as a nurse, and type of facility ownership. When examining each dimension of burnout, agism was a significant predictor of depersonalization and personal achievement. Agism plays a role in overall burnout. Therefore, training programs that can combat agism can reduce burnout of nurses in long-term care facilities.
42 CFR 37.93 - Approval of spirometry facilities.
Code of Federal Regulations, 2014 CFR
2014-10-01
... EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF COAL MINERS Spirometry Examinations § 37.93 Approval of...-approved facilities must meet the requirements specified in this subpart for the following activities... meet required specifications; collecting the respiratory assessment form; transmitting data to NIOSH...
State Capital Spending on PK-12 School Facilities
ERIC Educational Resources Information Center
Filardo, Mary; Bar, Michelle; Cheng, Stephanie; Ulsoy, Jessie; Allen, Marni
2010-01-01
In this study, the 21st Century School Fund (21CSF), with support from the National Clearinghouse for Educational Facilities, examined the state capital outlay funding for elementary and secondary public education facility construction and modernization. The authors examined how much capital outlay has been expended by states from 2005-2008 as…
An Examination of Special Focus Facility Nursing Homes
ERIC Educational Resources Information Center
Castle, Nicholas G.; Engberg, John
2010-01-01
Purpose: Nursing facilities that are determined to have a greater number of quality problems, more serious problems than average, and a demonstrated pattern of quality problems are included in the Special Focus Facility (SFF) initiative. The purpose of this research was to provide descriptive information on these SFFs and to examine the quality…
2017-03-23
Consideration for Department of Defense Medical Facilities Erik B. Schuh Follow this and additional works at: https://scholar.afit.edu/etd Part of the...Citation Schuh, Erik B., "Examining Regionalization Efforts to Develop Lessons Learned and Consideration for Department of Defense Medical Facilities...Consideration for Department of Defense Medical Facilities THESIS Erik B. Schuh, 2Lt, USAF AFIT-ENS-MS-17-M-156 DEPARTMENT OF THE AIR FORCE AIR UNIVERSITY AIR
Ries, Amy V; Yan, Alice F; Voorhees, Carolyn C
2011-08-01
Recreational facility availability has been shown to associate positively with youth physical activity levels. Nonetheless, little is known about additional facility characteristics affecting their use for physical activity as well as differences between private and public facilities. This study examines (1) perceptions and use of public and private recreational facilities and (2) environmental and individual-level correlates of both facility use and physical activity among urban adolescents. Physical activity was assessed using accelerometry, objective measures of facility availability were obtained using Geographical Information Systems data, and facility use and perceptions were measured with a survey (N = 327). Adolescents were more likely to use public than private facilities despite perceiving that private facilities were of higher quality. Adolescents' use of both public and private facilities was associated with perceived (but not objective) availability, perceived quality, and use by friends and family. Public, but not private, facility use was associated with physical activity. This study reveals the importance of public facilities to the physical activity of urban youth.
Goldman, L Elizabeth; Walker, Rod; Hubbard, Rebecca; Kerlikowske, Karla
2013-04-01
Whether timeliness of follow-up after abnormal mammography differs at facilities serving vulnerable populations, such as women with limited education or income, in rural areas, and racial/ethnic minorities is unknown. We examined receipt of diagnostic evaluation after abnormal mammography using 1998-2006 Breast Cancer Surveillance Consortium-linked Medicare claims. We compared whether time to recommended breast imaging or biopsy depended on whether women attended facilities serving vulnerable populations. We characterized a facility by the proportion of mammograms performed on women with limited education or income, in rural areas, or racial/ethnic minorities. We analyzed 30,874 abnormal screening examinations recommended for follow-up imaging across 142 facilities and 10,049 abnormal diagnostic examinations recommended for biopsy across 114 facilities. Women at facilities serving populations with less education or more racial/ethnic minorities had lower rates of follow-up imaging (4%-5% difference, P<0.05), and women at facilities serving more rural and low-income populations had lower rates of biopsy (4%-5% difference, P<0.05). Women undergoing biopsy at facilities serving vulnerable populations had longer times until biopsy than those at facilities serving nonvulnerable populations (21.6 vs. 15.6 d; 95% confidence interval for mean difference 4.1-7.7). The proportion of women receiving recommended imaging within 11 months and biopsy within 3 months varied across facilities (interquartile range, 85.5%-96.5% for imaging and 79.4%-87.3% for biopsy). Among Medicare recipients, follow-up rates were slightly lower at facilities serving vulnerable populations, and among those women who returned for diagnostic evaluation, time to follow-up was slightly longer at facilities that served vulnerable population. Interventions should target variability in follow-up rates across facilities, and evaluate effectiveness particularly at facilities serving vulnerable populations.
Downgrading Nuclear Facilities to Radiological Facilities
DOE Office of Scientific and Technical Information (OSTI.GOV)
Jarry, Jeffrey F.; Farr, Jesse Oscar; Duran, Leroy
2015-08-01
Based on inventory reductions and the use of alternate storage facilities, the Sandia National Laboratories (SNL) downgraded 4 SNL Hazard Category 3 (HC-3) nuclear facilities to less-than-HC-3 radiological facilities. SNL’s Waste Management and Pollution Prevention Department (WMPPD) managed the HC-3 nuclear facilities and implemented the downgrade. This paper will examine the downgrade process,
Ishimori, Yuu; Mitsunobu, Fumihiro; Yamaoka, Kiyonori; Tanaka, Hiroshi; Kataoka, Takahiro; Sakoda, Akihiro
2011-07-01
A radon test facility for small animals was developed in order to increase the statistical validity of differences of the biological response in various radon environments. This paper illustrates the performances of that facility, the first large-scale facility of its kind in Japan. The facility has a capability to conduct approximately 150 mouse-scale tests at the same time. The apparatus for exposing small animals to radon has six animal chamber groups with five independent cages each. Different radon concentrations in each animal chamber group are available. Because the first target of this study is to examine the in vivo behaviour of radon and its effects, the major functions to control radon and to eliminate thoron were examined experimentally. Additionally, radon progeny concentrations and their particle size distributions in the cages were also examined experimentally to be considered in future projects.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Wheeler, W.
1998-12-01
This report estimates the economic and financial effects and the benefits of compliance with the proposed effluent limitations guidelines and standards for the Centralized Waste Treatment (CWT) industry. The Environmental Protection Agency (EPA) has measured these impacts in terms of changes in the profitability of waste treatment operations at CWT facilities, changes in market prices to CWT services, and changes in the quantities of waste management at CWT facilities in six geographic regions. EPA has also examined the impacts on companies owning CWT facilities (including impacts on small entities), on communities in which CWT facilities are located, and on environmentalmore » justice. EPA examined the benefits to society of the CWT effluent limitations guidelines and standards by examining cancer and non-cancer health effects of the regulation, recreational benefits, and cost savings to publicly owned treatment works (POTWs) to which indirect-discharging CWT facilities send their wastewater.« less
ERIC Educational Resources Information Center
Fleming, E. Scott
2000-01-01
Examines the concept of shared-use facilities to help financially support and meet the demand for athletic facilities. Shared-use considerations are explored including cost sharing of ongoing operations, aesthetics, locker rooms, support facilities, parking and site access, and building access and security. (GR)
Life science payloads planning study integration facility survey results
NASA Technical Reports Server (NTRS)
Wells, G. W.; Brown, N. E.; Nelson, W. G.
1976-01-01
The integration facility survey effort described is structured to examine the facility resources needed to conduct life science payload (LSP) integration checkout activities at NASA-JSC. The LSP integration facility operations and functions are defined along with the LSP requirements for facility design. A description of available JSC life science facilities is presented and a comparison of accommodations versus requirements is reported.
The Impact of Special Focus Facility Nursing Homes on Market Quality
ERIC Educational Resources Information Center
Castle, Nicholas G.; Sonon, Kristen; Antonova, Jenya
2010-01-01
Purpose: Special Focus Facilities (SFFs) are nursing facilities designated by the Centers for Medicare & Medicaid Services to be of chronic poor quality. Relatively few nursing facilities are included in this initiative. The purpose of this research was to examine whether nursing facilities included in the 2007 SFF initiative subsequently…
Compensation for risks: host community benefits in siting locally unwanted facilities
NASA Astrophysics Data System (ADS)
Himmelberger, Jeffery J.; Ratick, Samuel J.; White, Allen L.
1991-09-01
This article analyzes the recent negotiations connected with siting 24 solid-waste landfills in Wisconsin. We examine the association between the type and amount of compensation paid to host communities by facility developers and the size of facilities, certain facility characteristics, the timing of negotiated agreements, the size of the host community, and the socioeconomic status of the host area. Our findings suggest that the level of compensation after adjusting for landfill capacity is positively associated with the percentage of total facility capacity dedicated to host community use, positively associated with the percentage of people of the host area who are in poverty, and larger for public facilities that accept municipal wastes. Other explanatory variables we examined, whose association with levels of compensation proved statistically insignificant, were facility size, facility status (new vs expansion), facility use (countyonly vs multicounty), timing of negotiation, host community size, and the host area education level, population density, and per capita income. We discuss the policy implications of our principal findings and future research questions in light of the persistent opposition surrounding the siting of solid-waste and other waste-management facilities.
Goldman, L. Elizabeth; Walker, Rod; Hubbard, Rebecca; Kerlikowske, Karla
2013-01-01
Background Whether timeliness of follow-up after abnormal mammography differs at facilities serving vulnerable populations such as women with limited education or income, in rural areas, and racial/ethnic minorities is unknown. Methods We examined receipt of diagnostic evaluation following abnormal mammography using 1998-2006 Breast Cancer Surveillance Consortium-linked Medicare claims. We compared whether time to recommended breast imaging or biopsy depended on whether women attended facilities serving vulnerable populations. We characterized a facility by the proportion of mammograms performed on women with limited education or income, in rural areas, or racial/ethnic minorities. Results We analyzed 30,874 abnormal screening examinations recommended for follow-up imaging across 142 facilities and 10,049 abnormal diagnostic examinations recommended for biopsy across 114 facilities. Women at facilities serving populations with less education or more racial/ethnic minorities had lower rates of follow-up imaging (4-5% difference, p<0.05), and women at facilities serving more rural and low income populations had lower rates of biopsy (4-5% difference, p<0.05). Women undergoing biopsy at facilities serving vulnerable populations had longer times until biopsy than those at facilities serving non-vulnerable populations (21.6 days vs. 15.6 days; 95% CI for mean difference 4.1-7.7). The proportion of women receiving recommended imaging within 11 months and biopsy within 3 months varied across facilities (interquartile range 85.5%-96.5% for imaging and 79.4%-87.3% for biopsy). Conclusions Among Medicare recipients, follow-up rates were slightly lower at facilities serving vulnerable populations, and among those women who returned for diagnostic evaluation, time to follow-up was slightly longer at facilities that served vulnerable population. Interventions should target variability in follow-up rates across facilities, and evaluate effectiveness particularly at facilities serving vulnerable populations. PMID:23358386
Total Quality Management for Campus Facilities.
ERIC Educational Resources Information Center
Reynolds, Gary L.
1992-01-01
This article examines the total quality management (TQM) concept as it is applied to higher education campus facilities. Each of the fundamental principles of TQM are examined as follows: customer-centered orientation; leadership; improved communication; continuous improvement; accountability; and quality of life. (GLR)
Code of Federal Regulations, 2011 CFR
2011-07-01
..., including any necessary buildings and structures, garage or parking facility. (e) Parking facilities... whom the Secretary is authorized to furnish medical examination or treatment. (c) Garage means a structure or part of a structure in which vehicles may be parked. (d) Medical facility means any facility or...
Code of Federal Regulations, 2014 CFR
2014-07-01
..., including any necessary buildings and structures, garage or parking facility. (e) Parking facilities... whom the Secretary is authorized to furnish medical examination or treatment. (c) Garage means a structure or part of a structure in which vehicles may be parked. (d) Medical facility means any facility or...
Code of Federal Regulations, 2010 CFR
2010-07-01
..., including any necessary buildings and structures, garage or parking facility. (e) Parking facilities... whom the Secretary is authorized to furnish medical examination or treatment. (c) Garage means a structure or part of a structure in which vehicles may be parked. (d) Medical facility means any facility or...
Code of Federal Regulations, 2012 CFR
2012-07-01
..., including any necessary buildings and structures, garage or parking facility. (e) Parking facilities... whom the Secretary is authorized to furnish medical examination or treatment. (c) Garage means a structure or part of a structure in which vehicles may be parked. (d) Medical facility means any facility or...
Code of Federal Regulations, 2013 CFR
2013-07-01
..., including any necessary buildings and structures, garage or parking facility. (e) Parking facilities... whom the Secretary is authorized to furnish medical examination or treatment. (c) Garage means a structure or part of a structure in which vehicles may be parked. (d) Medical facility means any facility or...
Escamilla, Veronica; Calhoun, Lisa; Winston, Jennifer; Speizer, Ilene S
2018-02-01
Universal access to health care requires service availability and accessibility for those most in need of maternal and child health services. Women often bypass facilities closest to home due to poor quality. Few studies have directly linked individuals to facilities where they sought maternal and child health services and examined the role of distance and quality on this facility choice. Using endline data from a longitudinal survey from a sample of women in five cities in Kenya, we examine the role of distance and quality on facility selection for women using delivery, facility-based contraceptives, and child health services. A survey of public and private facilities offering reproductive health services was also conducted. Distances were measured between household cluster location and both the nearest facility and facility where women sought care. A quality index score representing facility infrastructure, staff, and supply characteristics was assigned to each facility. We use descriptive statistics to compare distance and quality between the nearest available facility and visited facility among women who bypassed the nearest facility. Facility distance and quality comparisons were also stratified by poverty status. Logistic regression models were used to measure associations between the quality and distance to the nearest facility and bypassing for each outcome. The majority of women bypassed the nearest facility regardless of service sought. Women bypassing for delivery traveled the furthest and had the fewest facility options near their residential cluster. Poor women bypassing for delivery traveled 4.5 km further than non-poor women. Among women who bypassed, two thirds seeking delivery and approximately 46% seeking facility-based contraception or child health services bypassed to a public hospital. Both poor and non-poor women bypassed to higher quality facilities. Our findings suggest that women in five cities in Kenya prefer public hospitals and are willing to travel further to obtain services at public hospitals, possibly related to free service availability. Over time, it will be important to examine service quality and availability in public sector facilities with reduced or eliminated user fees, and whether it lends itself to a continuum of care where women can visit one facility for multiple services reducing travel burden.
Plantinga, Laura C; Kim, Min; Goetz, Margarethe; Kleinbaum, David G; McClellan, William; Patzer, Rachel E
2014-01-01
Receipt of nephrology care prior to end-stage renal disease (ESRD) is a strong predictor of decreased mortality and morbidity, and neighborhood poverty may influence access to care. Our objective was to examine whether neighborhood poverty is associated with lack of pre-ESRD care at dialysis facilities. In a multi-level ecological study using geospatially linked 2007-2010 Dialysis Facility Report and 2006-2010 American Community Survey data, we examined whether high neighborhood poverty (≥20% of households in census tract living below poverty) was associated with dialysis facility-level lack of pre-ESRD care (percentage of patients with no nephrology care prior to dialysis start) in mixed-effects models, adjusting for facility and neighborhood confounders and allowing for neighborhood and regional random effects. Among the 5,184 facilities examined, 1,778 (34.3%) were located in a high-poverty area. Lack of pre-ESRD care was similar in poverty areas (30.8%) and other neighborhoods (29.6%). With adjustment, the absolute increase in percentage of patients at a facility with no pre-ESRD care associated with facility location in a poverty area versus other neighborhood was only 0.08% (95% CI -1.32, 1.47; p = 0.9). Potential effect modification by race and income inequality was detected. Despite previously reported detrimental effects of neighborhood poverty on health, facility neighborhood poverty was not associated with receipt of pre-ESRD care, suggesting no need to target interventions to increase access to pre-ESRD care at facilities in poorer geographic areas.
Plantinga, Laura C.; Kim, Min; Goetz, Margarethe; Kleinbaum, David G.; McClellan, William; Patzer, Rachel E.
2014-01-01
Background Receipt of nephrology care prior to end-stage renal disease (ESRD) is a strong predictor of decreased mortality and morbidity, and neighborhood poverty may influence access to care. Our objective was to examine whether neighborhood poverty is associated with lack of pre-ESRD care at dialysis facilities. Methods In a multi-level ecological study using geospatially linked 2007-2010 Dialysis Facility Report and 2006-2010 American Community Survey data, we examined whether high neighborhood poverty (≥20% of households in census tract living below poverty) was associated with dialysis facility-level lack of pre-ESRD care (percentage of patients with no nephrology care prior to dialysis start) in mixed-effects models, adjusting for facility and neighborhood confounders and allowing for neighborhood and regional random effects. Results Among the 5184 facilities examined, 1778 (34.3%) were located in a high poverty area. Lack of pre-ESRD care was similar in poverty areas (30.8%) and other neighborhoods (29.6%). With adjustment, the absolute increase in percentage of patients at a facility with no pre-ESRD care associated with facility location in a poverty area vs. other neighborhood was only 0.08% (95% CI: -1.32%, 1.47%; P=0.9). Potential effect modification by race and income inequality was detected. Conclusion Despite previously reported detrimental effects of neighborhood poverty on health, facility neighborhood poverty was not associated with receipt of pre-ESRD care, suggesting no need to target interventions to increase access to pre-ESRD care at facilities in poorer geographic areas. PMID:24434854
A flight test facility design for examining digital information transfer
NASA Technical Reports Server (NTRS)
Knox, Charles E.
1990-01-01
Information is given in viewgraph form on a flight test facility design for examining digital information transfer. Information is given on aircraft/ground exchange, data link research activities, data link display format, a data link flight test, and the flight test setup.
Hodges, Mary K.V.; Davis, Linda C.; Bartholomay, Roy C.
2018-01-30
In 1990, the U.S. Geological Survey, in cooperation with the U.S. Department of Energy Idaho Operations Office, established the Lithologic Core Storage Library at the Idaho National Laboratory (INL). The facility was established to consolidate, catalog, and permanently store nonradioactive drill cores and cuttings from subsurface investigations conducted at the INL, and to provide a location for researchers to examine, sample, and test these materials.The facility is open by appointment to researchers for examination, sampling, and testing of cores and cuttings. This report describes the facility and cores and cuttings stored at the facility. Descriptions of cores and cuttings include the corehole names, corehole locations, and depth intervals available.Most cores and cuttings stored at the facility were drilled at or near the INL, on the eastern Snake River Plain; however, two cores drilled on the western Snake River Plain are stored for comparative studies. Basalt, rhyolite, sedimentary interbeds, and surficial sediments compose most cores and cuttings, most of which are continuous from land surface to their total depth. The deepest continuously drilled core stored at the facility was drilled to 5,000 feet below land surface. This report describes procedures and researchers' responsibilities for access to the facility and for examination, sampling, and return of materials.
NASA Technical Reports Server (NTRS)
1994-01-01
The Task Group on Aeronautics R&D Facilities examined the status and requirements for aeronautics facilities against the competitive need. Emphasis was placed on ground-based facilities for subsonic, supersonic and hypersonic aerodynamics, and propulsion. Subsonic and transonic wind tunnels were judged to be most critical and of highest priority. Results of the study are presented.
New Ideas on Facilities Management.
ERIC Educational Resources Information Center
Grimm, James C.
1986-01-01
Examines trends in facilities management relating to products and people. Reviews new trends in products, including processes, techniques, and programs that are being expounded by business and industry. Discusses the "people factors" involved in facilities management. (ABB)
38 CFR 51.70 - Resident rights.
Code of Federal Regulations, 2010 CFR
2010-07-01
... to participate in experimental research, and to formulate an advance directive as specified in.... (g) Examination of survey results. A resident has the right to— (1) Examine the results of the most recent VA survey with respect to the facility. The facility management must make the results available...
38 CFR 51.70 - Resident rights.
Code of Federal Regulations, 2011 CFR
2011-07-01
... to participate in experimental research, and to formulate an advance directive as specified in.... (g) Examination of survey results. A resident has the right to— (1) Examine the results of the most recent VA survey with respect to the facility. The facility management must make the results available...
38 CFR 51.70 - Resident rights.
Code of Federal Regulations, 2014 CFR
2014-07-01
... to participate in experimental research, and to formulate an advance directive as specified in.... (g) Examination of survey results. A resident has the right to— (1) Examine the results of the most recent VA survey with respect to the facility. The facility management must make the results available...
38 CFR 51.70 - Resident rights.
Code of Federal Regulations, 2012 CFR
2012-07-01
... to participate in experimental research, and to formulate an advance directive as specified in.... (g) Examination of survey results. A resident has the right to— (1) Examine the results of the most recent VA survey with respect to the facility. The facility management must make the results available...
38 CFR 51.70 - Resident rights.
Code of Federal Regulations, 2013 CFR
2013-07-01
... to participate in experimental research, and to formulate an advance directive as specified in.... (g) Examination of survey results. A resident has the right to— (1) Examine the results of the most recent VA survey with respect to the facility. The facility management must make the results available...
Cost analysis and facility reimbursement in the long-term health care industry.
Ullmann, S G
1984-01-01
This article examines costs and develops a system of prospective reimbursement for the industry committed to long-term health care. Together with estimates of average cost functions--for purposes of determining those factors affecting the costs of long-term health care, the author examines in depth the cost effects of patient mix and facility quality. Policy implications are indicated. The article estimates cost savings and predicted improvements in facility performance resulting from adoption of a prospective reimbursement system. PMID:6427138
Examining the Association between Hazardous Waste Facilities and Rural "Brain Drain"
ERIC Educational Resources Information Center
Hunter, Lori M.; Sutton, Jeannette
2004-01-01
Rural communities are increasingly being faced with the prospect of accepting facilities characterized as "opportunity-threat," such as facilities that generate, treat, store, or otherwise dispose of hazardous wastes. Such facilities may offer economic gains through jobs and tax revenue, although they may also act as environmental "disamenities."…
An Examination of Three Forms of Private Sector Financing of Military Facilities
1988-09-01
The purpose of this study was to introduce the concept of Private Sector Financing (PSF) of military facilities instead of acquiring facilities via... Private sector financing; Military construction; Leasing; Contracting out; Outleasing; Military family housing. Theses.
Not in whose backyard? Minority population concentrations and noxious facility sites
DOE Office of Scientific and Technical Information (OSTI.GOV)
Nieves, L.A.
1992-04-01
The NIMBY (not in may backyard) syndrome has become the nemesis of facility siting efforts in the USA. Given people`s reluctance to live near noxious facilities, in whose backyard are such facilities located? This study employs US county-level data to examine relative concentrations of minorities living near noxious facilities. Facility types analyzed include electric generating plants, manufacturing plants, Superfund sites, and radioactive waste disposal sites. While this study does not address which cam first, the minority population concentration or the noxious facilities, it documents their current degree of association.
Not in whose backyard Minority population concentrations and noxious facility sites
DOE Office of Scientific and Technical Information (OSTI.GOV)
Nieves, L.A.
1992-01-01
The NIMBY (not in may backyard) syndrome has become the nemesis of facility siting efforts in the USA. Given people's reluctance to live near noxious facilities, in whose backyard are such facilities located This study employs US county-level data to examine relative concentrations of minorities living near noxious facilities. Facility types analyzed include electric generating plants, manufacturing plants, Superfund sites, and radioactive waste disposal sites. While this study does not address which cam first, the minority population concentration or the noxious facilities, it documents their current degree of association.
20 CFR 655.350 - Public access.
Code of Federal Regulations, 2010 CFR
2010-04-01
... Nurses § 655.350 Public access. (a) Public examination at ETA. ETA shall make available for public... petitions (if any) for H-1A nurses, and for each such facility, a copy of the facility's attestation and any... thereafter for so long as the facility uses any H-1 or H-1A nurse under the attestation, the facility shall...
20 CFR 655.350 - Public access.
Code of Federal Regulations, 2011 CFR
2011-04-01
... Nurses § 655.350 Public access. (a) Public examination at ETA. ETA shall make available for public... petitions (if any) for H-1A nurses, and for each such facility, a copy of the facility's attestation and any... thereafter for so long as the facility uses any H-1 or H-1A nurse under the attestation, the facility shall...
ERIC Educational Resources Information Center
Fareo, Dorcas Oluremi; Ojo, Olakunbi Olubukola
2013-01-01
Facilities have a great impact on academic performances of students, and inadequate facilities translate to poor performance. The study examined the availability and convenience of the facilities that were provided to students with special educational needs in mainstreamed schools. It ascertained the qualifications of teachers teaching in…
Ettarh, Remare R; Kyobutungi, Catherine
2012-09-01
The objective of the study was to determine the spatial variation in modern contraceptive use and unmet need for family planning across the counties of Kenya and to examine whether the spatial patterns were associated with inequalities in physical access to health facilities. Data were obtained from the 2008-2009 Kenya Demographic and Health Survey and linked to the location of health facilities in the country. Multivariate logistic regression was used to examine the influence of distance to the nearest health facility and health facility density, in addition to other covariates, on modern contraceptive use and unmet need. Overall, the prevalence of modern contraceptive use and unmet need among women aged 15-49 in Kenya was 42.1% and 19.7% respectively. Among the respondents who lived more than 5 km from the nearest health facility modern contraceptive use was significantly less likely compared to women resident 5 km or less from the nearest health facility. Women from counties with higher health facility density were 53% more likely to use modern contraceptives compared to women in counties with low health facility density. Distance and health facility density in the county were not significantly associated with unmet need. Physical access to health facilities is an important determinant of modern contraceptive use and unmet need in Kenya. Strategies should be developed in underserved counties to mitigate the challenge of distance to health facilities, such as delivering services by outreach and mobile facilities.
Advanced Post-Irradiation Examination Capabilities Alternatives Analysis Report
DOE Office of Scientific and Technical Information (OSTI.GOV)
Jeff Bryan; Bill Landman; Porter Hill
2012-12-01
An alternatives analysis was performed for the Advanced Post-Irradiation Capabilities (APIEC) project in accordance with the U.S. Department of Energy (DOE) Order DOE O 413.3B, “Program and Project Management for the Acquisition of Capital Assets”. The Alternatives Analysis considered six major alternatives: ? No Action ? Modify Existing DOE Facilities – capabilities distributed among multiple locations ? Modify Existing DOE Facilities – capabilities consolidated at a few locations ? Construct New Facility ? Commercial Partnership ? International Partnerships Based on the alternatives analysis documented herein, it is recommended to DOE that the advanced post-irradiation examination capabilities be provided by amore » new facility constructed at the Materials and Fuels Complex at the Idaho National Laboratory.« less
75 FR 29785 - Draft Regulatory Guide: Issuance, Availability
Federal Register 2010, 2011, 2012, 2013, 2014
2010-05-27
... Guide, DG-1248, ``Nuclear Power Plant Simulation Facilities for Use in Operator Training, License..., ``Nuclear Power Plant Simulation Facilities for Use in Operator Training, License Examinations, and... or acceptance of a nuclear power plant simulation facility for use in operator and senior operator...
Overview of NASA White Sands Test Facility Composite Overwrapped Pressure Vessel Testing
NASA Technical Reports Server (NTRS)
Greene, Nathanael; Saulsberry, Regor; Thesken, John; Phoenix, Leigh
2006-01-01
This viewgraph presentation examines the White Sands Test Facility testing of Composite overwrapped pressure vessel (COPV). A COPV is typically a metallic liner overwrapped with a fiber epoxy matrix. There is a weight advantage over the traditional all metal design. The presentation shows pictures of the facilities at White Sands, and then examines some of the testing performed. The tests include fluids compatibility, and Kevlar COPV. Data for the Kevlar tests are given, and an analysis is reviewed. There is also a comparison between Carbon COPVs and the Kevlar COPVs.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Moran, B.; Stern, W.; Colley, J.
International Atomic Energy Agency (IAEA) safeguards involves verification activities at a wide range of facilities in a variety of operational phases (e.g., under construction, start-up, operating, shutdown, closed-down, and decommissioned). Safeguards optimization for each different facility type and operational phase is essential for the effectiveness of safeguards implementation. The IAEA’s current guidance regarding safeguards for the different facility types in the various lifecycle phases is provided in its Design Information Examination (DIE) and Verification (DIV) procedure. 1 Greater efficiency in safeguarding facilities that are shut down or closed down, including those being decommissioned, could allow the IAEA to use amore » greater portion of its effort to conduct other verification activities. Consequently, the National Nuclear Security Administration’s Office of International Nuclear Safeguards sponsored this study to evaluate whether there is an opportunity to optimize safeguards approaches for facilities that are shutdown or closed-down. The purpose of this paper is to examine existing safeguards approaches for shutdown and closed-down facilities, including facilities being decommissioned, and to seek to identify whether they may be optimized.« less
ERIC Educational Resources Information Center
Patchner, Michael A.; Balgopal, Pallassana R.
Three studies were undertaken to examine topics of care planning, personnel management, and quality assurance in long-term care facilities. The first study examined the formulation and implementation processes of care planning for nursing home residents. The exemplary homes' care planning included the existence of strong care planning leadership,…
Kelsey, C M; Medel, Nickole; Mullins, Carson; Dallaire, Danielle; Forestell, Catherine
2017-06-01
The number of incarcerated women in the United States has been steadily increasing over the last 30 years. An estimated 6-10% of these women are pregnant at intake. Previous studies on the health needs and care of pregnant incarcerated women have focused mainly on prison settings. Therefore, we examined the pregnancy-related accommodations and health care provided for regional jail populations. The present study is a quantitative survey (administered through phone or email to employees of predominately jail medical facilities) of common practices and policies employed across 53 jail facilities in the United States as a function of geographic region (North vs. South; West vs. Central vs. East). We examined provision of pregnancy screening, special diets, and drug rehabilitation and prohibition of shackling. Strikingly, across all aspects of the care of pregnant incarcerated women there are areas to be improved upon. Notably, only 37.7% of facilities pregnancy test all women upon entry, 45.7% put opioid addicted women through withdrawal protocol, and 56.7% of facilities use restraints on women hours after having a baby. In this first study to examine practices in regional jails nationwide, we found evidence that standards of care guidelines to improve health and well-being of pregnant incarcerated women, set by agencies such as American College of Obstetricians and Gynecologists, are not being followed in many facilities. Because not following these guidelines could pose major health risks to the mother and developing fetus, better policies, better enforcement of policies, and better common practices are needed to improve the health and welfare of pregnant incarcerated women.
Condition of Florida Educational Facilities and Balancing Budgets
ERIC Educational Resources Information Center
Jones, Margaret Moore
2012-01-01
The purpose of this study was to examine if relationships existed between the condition of instructional facilities within Florida Coastal School District, as measured by the Facilities Condition Index (FCI), and enrollment percentages for special education students, African American students, Caucasian students, and students receiving free and…
ERIC Educational Resources Information Center
Adams, Matthew C.
1998-01-01
Examines off-balance sheet financing, the facilities use of outsourcing for selected needs, as a means of saving operational costs and using facility assets efficiently. Examples of using outside sources for energy supply and food services, as well as partnering with business for facility expansion are provided. Concluding comments address tax…
Tethered orbital refueling study
NASA Technical Reports Server (NTRS)
Fester, Dale A.; Rudolph, L. Kevin; Kiefel, Erlinda R.; Abbott, Peter W.; Grossrode, Pat
1986-01-01
One of the major applications of the space station will be to act as a refueling depot for cryogenic-fueled space-based orbital transfer vehicles (OTV), Earth-storable fueled orbit maneuvering vehicles, and refurbishable satellite spacecraft using hydrazine. One alternative for fuel storage at the space station is a tethered orbital refueling facility (TORF), separated from the space station by a sufficient distance to induce a gravity gradient force that settles the stored fuels. The technical feasibility was examined with the primary focus on the refueling of LO2/LH2 orbital transfer vehicles. Also examined was the tethered facility on the space station. It was compared to a zero-gravity facility. A tethered refueling facility should be considered as a viable alternative to a zero-gravity facility if the zero-gravity fluid transfer technology, such as the propellant management device and no vent fill, proves to be difficult to develop with the required performance.
Rundek, Tatjana; Brown, Scott C; Wang, Kefeng; Dong, Chuanhui; Farrell, Mary Beth; Heller, Gary V; Gornik, Heather L; Hutchisson, Marge; Needleman, Laurence; Benenati, James F; Jaff, Michael R; Meier, George H; Perese, Susana; Bendick, Phillip; Hamburg, Naomi M; Lohr, Joann M; LaPerna, Lucy; Leers, Steven A; Lilly, Michael P; Tegeler, Charles; Alexandrov, Andrei V; Katanick, Sandra L
2014-10-01
There is limited information on the accreditation status and geographic distribution of vascular testing facilities in the US. The Centers for Medicare & Medicaid Services (CMS) provide reimbursement to facilities regardless of accreditation status. The aims were to: (1) identify the proportion of Intersocietal Accreditation Commission (IAC) accredited vascular testing facilities in a 5% random national sample of Medicare beneficiaries receiving outpatient vascular testing services; (2) describe the geographic distribution of these facilities. The VALUE (Vascular Accreditation, Location & Utilization Evaluation) Study examines the proportion of IAC accredited facilities providing vascular testing procedures nationally, and the geographic distribution and utilization of these facilities. The data set containing all facilities that billed Medicare for outpatient vascular testing services in 2011 (5% CMS Outpatient Limited Data Set (LDS) file) was examined, and locations of outpatient vascular testing facilities were obtained from the 2011 CMS/Medicare Provider of Services (POS) file. Of 13,462 total vascular testing facilities billing Medicare for vascular testing procedures in a 5% random Outpatient LDS for the US in 2011, 13% (n=1730) of facilities were IAC accredited. The percentage of IAC accredited vascular testing facilities in the LDS file varied significantly by US region, p<0.0001: 26%, 12%, 11%, and 7% for the Northeast, South, Midwest, and Western regions, respectively. Findings suggest that the proportion of outpatient vascular testing facilities that are IAC accredited is low and varies by region. Increasing the number of accredited vascular testing facilities to improve test quality is a hypothesis that should be tested in future research. © The Author(s) 2014.
Do School Facilities Affect Academic Outcomes?
ERIC Educational Resources Information Center
Schneider, Mark
This review explores which facility attributes affect academic outcomes the most and in what manner and degree. The research is examined in six categories: indoor air quality, ventilation, and thermal comfort; lighting; acoustics; building age and quality; school size; and class size. The review concludes that school facilities affect learning.…
Perceptions of Organizational Functioning in Substance Abuse Treatment Facilities in South Africa
ERIC Educational Resources Information Center
Bowles, Steven; Louw, Johann; Myers, Bronwyn
2011-01-01
Directors' and treatment staff's perceptions of organizational functioning within substance abuse treatment facilities in four provinces in South Africa were examined via the Texas Christian University's Organizational Readiness for Change instrument. Forty-four treatment facilities (out of 89) participated in the study. Results indicated that…
9 CFR 88.5 - Requirements at a slaughtering facility.
Code of Federal Regulations, 2010 CFR
2010-01-01
... COMMERCIAL TRANSPORTATION OF EQUINES FOR SLAUGHTER § 88.5 Requirements at a slaughtering facility. (a) Upon arrival at a slaughtering facility, the owner/shipper must: (1) Ensure that each equine has access to... representative; (3) Allow a USDA representative access to the equines for the purpose of examination; and (4...
Facility Condition Assessment from A to Z
ERIC Educational Resources Information Center
Kaleba, Frank
2013-01-01
This article will provide an overview of the options for performing facility condition assessments. Quite often, the facility manager will choose a condition assessment method without deliberate examination of what type of assessment is best suited to the needs of the organization. In addition, the needs of diverse audiences usually differ--for…
27 CFR 19.86 - Furnishing facilities and assistance.
Code of Federal Regulations, 2010 CFR
2010-04-01
... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Furnishing facilities and assistance. 19.86 Section 19.86 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE... Provisions Entry and Examination of Premises § 19.86 Furnishing facilities and assistance. On the demand of...
A GUIDE FOR PLANNING PHYSICAL EDUCATION AND ATHLETIC FACILITIES.
ERIC Educational Resources Information Center
New Jersey State Dept. of Education, Trenton.
THIS STUDY EXAMINES PHYSICAL EDUCATION FACILITIES, THEIR PHYSICAL NEEDS, AND RELATED DESIGN CONSIDERATIONS. A SYSTEM OF DETERMINING THE TOTAL NUMBER OF TEACHING STATIONS NEEDED IS GIVEN TO AID INITIAL REQUIREMENT ANALYSIS. INDOOR FACILITIES ANALYZED INCLUDE--(1) THE GYMNASIUM, IN TERMS OF LOCATION, SIZE, DESIGN FEATURES, AND RELATED COMPONENTS,…
Academic Computing Facilities and Services in Higher Education--A Survey.
ERIC Educational Resources Information Center
Warlick, Charles H.
1986-01-01
Presents statistics about academic computing facilities based on data collected over the past six years from 1,753 institutions in the United States, Canada, Mexico, and Puerto Rico for the "Directory of Computing Facilities in Higher Education." Organizational, functional, and financial characteristics are examined as well as types of…
Transportation and general aviation in Virginia
NASA Technical Reports Server (NTRS)
1975-01-01
The diversity of Virginia is examined with respect to its transportation facilities and services, the Virginia Air Transportation System Plan, regionalism, and selected case studies of individual facilities.
Weisenthal, Karrin; Karthik, Priyadarshini; Shaw, Melissa; Sengupta, Debapriya; Bhargavan-Chatfield, Mythreyi; Burleson, Judy; Mustafa, Adel; Kalra, Mannudeep; Moore, Christopher
2018-02-01
Purpose To determine if the use of reduced-dose computed tomography (CT) for evaluation of kidney stones increased in 2015-2016 compared with that in 2011-2012, to determine variability in radiation exposure according to facility for this indication, and to establish a current average radiation dose for CT evaluation for kidney stones by querying a national dose registry. Materials and Methods This cross-sectional study was exempt from institutional review board approval. Data were obtained from the American College of Radiology dose registry for CT examinations submitted from July 2015 to June 2016. Study descriptors consistent with single-phase unenhanced CT for evaluation of kidney stones and associated RadLex® Playbook identifiers (RPIDs) were retrospectively identified. Facilities actively submitting data on kidney stone-specific CT examinations were included. Dose metrics including volumetric CT dose index, dose-length product, and size-specific dose estimate, when available, were reported, and a random effects model was run to account for clustering of CT examinations at facilities. A z-ratio was calculated to test for a significant difference between the proportion of reduced-radiation dose CT examinations (defined as those with a dose-length product of 200 mGy · cm or less) performed in 2015-2016 and the proportion performed in 2011-2012. Results Three hundred four study descriptors for kidney stone CT corresponding to data from 328 facilities that submitted 105 334 kidney stone CT examinations were identified. Reduced-dose CT examinations accounted for 8040 of 105 334 (7.6%) CT examinations, a 5.6% increase from the 1010 of 49 903 (2%) examinations in 2011-2012 (P < .001). Mean overall dose-length product was 689 mGy · cm (95% confidence interval: 667, 712), decreased from the mean of 746 mGy · cm observed in 2011-2012. Median facility dose-length product varied up to sevenfold, from less than 200 mGy · cm to greater than 1600 mGy · cm. Conclusion Use of reduced-radiation dose CT for evaluation of kidney stones has increased since 2011-2012, but remains low; variability of radiation dose according to facility continues to be wide. National mean CT radiation exposure for evaluation of renal colic during 2015-2016 decreased relative to 2011-2012 values, but remained well above what is reasonably achievable. © RSNA, 2017.
Breast cancer stage at diagnosis: is travel time important?
Henry, Kevin A; Boscoe, Francis P; Johnson, Christopher J; Goldberg, Daniel W; Sherman, Recinda; Cockburn, Myles
2011-12-01
Recent studies have produced inconsistent results in their examination of the potential association between proximity to healthcare or mammography facilities and breast cancer stage at diagnosis. Using a multistate dataset, we re-examine this issue by investigating whether travel time to a patient's diagnosing facility or nearest mammography facility impacts breast cancer stage at diagnosis. We studied 161,619 women 40 years and older diagnosed with invasive breast cancer from ten state population based cancer registries in the United States. For each woman, we calculated travel time to their diagnosing facility and nearest mammography facility. Logistic multilevel models of late versus early stage were fitted, and odds ratios were calculated for travel times, controlling for age, race/ethnicity, census tract poverty, rural/urban residence, health insurance, and state random effects. Seventy-six percent of women in the study lived less than 20 min from their diagnosing facility, and 93 percent lived less than 20 min from the nearest mammography facility. Late stage at diagnosis was not associated with increasing travel time to diagnosing facility or nearest mammography facility. Diagnosis age under 50, Hispanic and Non-Hispanic Black race/ethnicity, high census tract poverty, and no health insurance were all significantly associated with late stage at diagnosis. Travel time to diagnosing facility or nearest mammography facility was not a determinant of late stage of breast cancer at diagnosis, and better geographic proximity did not assure more favorable stage distributions. Other factors beyond geographic proximity that can affect access should be evaluated more closely, including facility capacity, insurance acceptance, public transportation, and travel costs.
Code of Federal Regulations, 2014 CFR
2014-04-01
...) Provide adequate space for the following when applicable: (1) Private and accurate examinations of... convenient toilet facilities for donors and personnel. Drains shall be of adequate size and, where connected...
Code of Federal Regulations, 2013 CFR
2013-04-01
...) Provide adequate space for the following when applicable: (1) Private and accurate examinations of... convenient toilet facilities for donors and personnel. Drains shall be of adequate size and, where connected...
Code of Federal Regulations, 2012 CFR
2012-04-01
...) Provide adequate space for the following when applicable: (1) Private and accurate examinations of... convenient toilet facilities for donors and personnel. Drains shall be of adequate size and, where connected...
Lunar base launch and landing facility conceptual design, 2nd edition
NASA Technical Reports Server (NTRS)
1988-01-01
This report documents the Lunar Base Launch and Landing Facility Conceptual Design study. The purpose of this study was to examine the requirements for launch and landing facilities for early lunar bases and to prepare conceptual designs for some of these facilities. The emphasis of this study is on the facilities needed from the first manned landing until permanent occupancy. Surface characteristics and flight vehicle interactions are described, and various facility operations are related. Specific recommendations for equipment, facilities, and evolutionary planning are made, and effects of different aspects of lunar development scenarios on facilities and operations are detailed. Finally, for a given scenario, a specific conceptual design is developed and presented.
Lin, Jwu-Rong; Chen, Ching-Yu; Peng, Tso-Kwei
2017-09-11
The purpose of this research is to examine the relation between operating efficiency and the quality of care of senior care facilities. We designed a data envelopment analysis, combining epsilon-based measure and metafrontier efficiency analyses to estimate the operating efficiency for senior care facilities, followed by an iterative seemingly unrelated regression to evaluate the relation between the quality of care and operating efficiency. In the empirical studies, Taiwan census data was utilized and findings include the following: Despite the greater operating scale of the general type of senior care facilities, their average metafrontier technical efficiency is inferior to that of nursing homes. We adopted senior care facility accreditation results from Taiwan as a variable to represent the quality of care and examined the relation of accreditation results and operating efficiency. We found that the quality of care of general senior care facilities is negatively related to operating efficiency; however, for nursing homes, the relationship is not significant. Our findings show that facilities invest more in input resources to obtain better ratings in the accreditation report. Operating efficiency, however, does not improve. Quality competition in the industry in Taiwan is inefficient, especially for general senior care facilities.
Lin, Jwu-Rong; Chen, Ching-Yu; Peng, Tso-Kwei
2017-01-01
The purpose of this research is to examine the relation between operating efficiency and the quality of care of senior care facilities. We designed a data envelopment analysis, combining epsilon-based measure and metafrontier efficiency analyses to estimate the operating efficiency for senior care facilities, followed by an iterative seemingly unrelated regression to evaluate the relation between the quality of care and operating efficiency. In the empirical studies, Taiwan census data was utilized and findings include the following: Despite the greater operating scale of the general type of senior care facilities, their average metafrontier technical efficiency is inferior to that of nursing homes. We adopted senior care facility accreditation results from Taiwan as a variable to represent the quality of care and examined the relation of accreditation results and operating efficiency. We found that the quality of care of general senior care facilities is negatively related to operating efficiency; however, for nursing homes, the relationship is not significant. Our findings show that facilities invest more in input resources to obtain better ratings in the accreditation report. Operating efficiency, however, does not improve. Quality competition in the industry in Taiwan is inefficient, especially for general senior care facilities. PMID:28892019
ERIC Educational Resources Information Center
Davenport, Mona Yvette
2010-01-01
This study tested the perceptions of involvement components (Non-Academic Facility Usage, Intra-Racial Relations, Campus and Charleston Involvement, Faculty Interaction, Academic Facility Usage, Inter-Racial Relations, Cultural Center Usage, and Athletic Facilities Usage) for first generation and non-first generation African American and Hispanic…
19 CFR 151.24 - Unlading facilities for bulk sugar.
Code of Federal Regulations, 2010 CFR
2010-04-01
... 19 Customs Duties 2 2010-04-01 2010-04-01 false Unlading facilities for bulk sugar. 151.24 Section... OF THE TREASURY (CONTINUED) EXAMINATION, SAMPLING, AND TESTING OF MERCHANDISE Sugars, Sirups, and Molasses § 151.24 Unlading facilities for bulk sugar. When dutiable sugar is to be imported in bulk, a full...
19 CFR 151.24 - Unlading facilities for bulk sugar.
Code of Federal Regulations, 2011 CFR
2011-04-01
... 19 Customs Duties 2 2011-04-01 2011-04-01 false Unlading facilities for bulk sugar. 151.24 Section... OF THE TREASURY (CONTINUED) EXAMINATION, SAMPLING, AND TESTING OF MERCHANDISE Sugars, Sirups, and Molasses § 151.24 Unlading facilities for bulk sugar. When dutiable sugar is to be imported in bulk, a full...
Problem Severity Profiles of Substance Abusing Women in Therapeutic Treatment Facilities
ERIC Educational Resources Information Center
Isralowitz, Richard; Reznik, Alexander
2009-01-01
This article aims to examine specific substance use profiles among former Soviet Union (FSU) immigrant and native-born women in Israeli therapeutic treatment facilities. Individuals were sampled at drug treatment facilities and assessed using the Addiction Severity Index. ASI scores suggest differences between the two groups. Among the findings…
ERIC Educational Resources Information Center
General Accounting Office, Washington, DC. Health, Education, and Human Services Div.
This document presents findings of a General Accounting Office study that examined the extent to which America's schools have the physical capacity to support learning into the 21st century. Specifically, it looked at facilities requirements, environmental conditions, educational technologies, and facility infrastructure. Data were collected…
ERIC Educational Resources Information Center
Potthoff, Joy K.
1991-01-01
Examined young adult male patient (n=18) satisfaction with interior environments of three different in-patient drug and alcohol rehabilitation facilities: renovated Elk's Club; hospital wing; and facility built for drug and alcohol treatment. Findings indicated satisfaction declined over four-week treatment period; familiar objects were missed;…
Provision of Mental Health Services in South African Substance Abuse Treatment Facilities
ERIC Educational Resources Information Center
Myers, Bronwyn; Fakier, Nuraan
2009-01-01
To date, South African research has not examined mental health service provision in substance abuse treatment facilities, even though these services improve client retention and treatment outcomes. To describe the extent to which substance abuse treatment facilities in Gauteng and KwaZulu-Natal provinces provide clients with mental health services…
19 CFR 151.24 - Unlading facilities for bulk sugar.
Code of Federal Regulations, 2014 CFR
2014-04-01
... 19 Customs Duties 2 2014-04-01 2014-04-01 false Unlading facilities for bulk sugar. 151.24 Section... OF THE TREASURY (CONTINUED) EXAMINATION, SAMPLING, AND TESTING OF MERCHANDISE Sugars, Sirups, and Molasses § 151.24 Unlading facilities for bulk sugar. When dutiable sugar is to be imported in bulk, a full...
19 CFR 151.24 - Unlading facilities for bulk sugar.
Code of Federal Regulations, 2012 CFR
2012-04-01
... 19 Customs Duties 2 2012-04-01 2012-04-01 false Unlading facilities for bulk sugar. 151.24 Section... OF THE TREASURY (CONTINUED) EXAMINATION, SAMPLING, AND TESTING OF MERCHANDISE Sugars, Sirups, and Molasses § 151.24 Unlading facilities for bulk sugar. When dutiable sugar is to be imported in bulk, a full...
19 CFR 151.24 - Unlading facilities for bulk sugar.
Code of Federal Regulations, 2013 CFR
2013-04-01
... 19 Customs Duties 2 2013-04-01 2013-04-01 false Unlading facilities for bulk sugar. 151.24 Section... OF THE TREASURY (CONTINUED) EXAMINATION, SAMPLING, AND TESTING OF MERCHANDISE Sugars, Sirups, and Molasses § 151.24 Unlading facilities for bulk sugar. When dutiable sugar is to be imported in bulk, a full...
Code of Federal Regulations, 2014 CFR
2014-07-01
... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Records. 154.740 Section 154.740... TRANSFERRING OIL OR HAZARDOUS MATERIAL IN BULK Facility Operations § 154.740 Records. Each facility operator... (e) and (g) except that marked on the hose; (e) The record of all examinations of the facility by the...
Code of Federal Regulations, 2012 CFR
2012-07-01
... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Records. 154.740 Section 154.740... TRANSFERRING OIL OR HAZARDOUS MATERIAL IN BULK Facility Operations § 154.740 Records. Each facility operator... (e) and (g) except that marked on the hose; (e) The record of all examinations of the facility by the...
Code of Federal Regulations, 2010 CFR
2010-07-01
... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Records. 154.740 Section 154.740... TRANSFERRING OIL OR HAZARDOUS MATERIAL IN BULK Facility Operations § 154.740 Records. Each facility operator... (e) and (g) except that marked on the hose; (e) The record of all examinations of the facility by the...
Code of Federal Regulations, 2013 CFR
2013-07-01
... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Records. 154.740 Section 154.740... TRANSFERRING OIL OR HAZARDOUS MATERIAL IN BULK Facility Operations § 154.740 Records. Each facility operator... (e) and (g) except that marked on the hose; (e) The record of all examinations of the facility by the...
Code of Federal Regulations, 2011 CFR
2011-07-01
... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Records. 154.740 Section 154.740... TRANSFERRING OIL OR HAZARDOUS MATERIAL IN BULK Facility Operations § 154.740 Records. Each facility operator... (e) and (g) except that marked on the hose; (e) The record of all examinations of the facility by the...
The Common Core of a Child Care Center. Child Care Facility Design.
ERIC Educational Resources Information Center
Moore, Gary T.
1997-01-01
Examines the notion of an early childhood education center organized as a series of houses around a common core of shared facilities. Discusses examples of child-care centers in Sweden and explores ideas that can promote functional facilities. Suggestions include ideas about physical-motor activities areas, administration offices, centralized…
ERIC Educational Resources Information Center
Kash, Bita A.; Castle, Nicholas G.; Naufal, George S.; Hawes, Catherine
2006-01-01
Purpose: We examined the effects of facility and market-level characteristics on staffing levels and turnover rates for direct care staff, and we examined the effect of staff turnover on staffing levels. Design and Methods: We analyzed cross-sectional data from 1,014 Texas nursing homes. Data were from the 2002 Texas Nursing Facility Medicaid Cost…
Comparison of hospitalization rates among for-profit and nonprofit dialysis facilities.
Dalrymple, Lorien S; Johansen, Kirsten L; Romano, Patrick S; Chertow, Glenn M; Mu, Yi; Ishida, Julie H; Grimes, Barbara; Kaysen, George A; Nguyen, Danh V
2014-01-01
The vast majority of US dialysis facilities are for-profit and profit status has been associated with processes of care and outcomes in patients on dialysis. This study examined whether dialysis facility profit status was associated with the rate of hospitalization in patients starting dialysis. This was a retrospective cohort study of Medicare beneficiaries starting dialysis between 2005 and 2008 using data from the US Renal Data System. All-cause hospitalization was examined and compared between for-profit and nonprofit dialysis facilities through 2009 using Poisson regression. Companion analyses of cause-specific hospitalization that are likely to be influenced by dialysis facility practices including hospitalizations for heart failure and volume overload, access complications, or hyperkalemia were conducted. The cohort included 150,642 patients. Of these, 12,985 (9%) were receiving care in nonprofit dialysis facilities. In adjusted models, patients receiving hemodialysis in for-profit facilities had a 15% (95% confidence interval [95% CI], 13% to 18%) higher relative rate of hospitalization compared with those in nonprofit facilities. Among patients receiving peritoneal dialysis, the rate of hospitalization in for-profit versus nonprofit facilities was not significantly different (relative rate, 1.07; 95% CI, 0.97 to 1.17). Patients on hemodialysis receiving care in for-profit dialysis facilities had a 37% (95% CI, 31% to 44%) higher rate of hospitalization for heart failure or volume overload and a 15% (95% CI, 11% to 20%) higher rate of hospitalization for vascular access complications. Hospitalization rates were significantly higher for patients receiving hemodialysis in for-profit compared with nonprofit dialysis facilities.
Billaudeau, Nathalie; Oppert, Jean-Michel; Simon, Chantal; Charreire, Hélène; Casey, Romain; Salze, Paul; Badariotti, Dominique; Banos, Arnaud; Weber, Christiane; Chaix, Basile
2011-01-01
We conducted an environmental justice study of the spatial distribution of sport facilities, a major resource for physical activity, in the Paris Region in France. Comprehensive data of the French Census of Sport Facilities allowed us to investigate disparities not only in the spatial accessibility to facilities, but also in the characteristics of these facilities. We found that the associations between area income and the presence of facilities or favorable characteristics of these facilities varied from positive to negative depending on the facilities and on the characteristics examined. Sensitivity analyses defining area income in circular areas of different radii permitted a refined identification of areas underserved in sport facilities. Copyright © 2010 Elsevier Ltd. All rights reserved.
Multi-national findings on radiation protection of children.
Rehani, Madan M
2014-10-01
This article reviews issues of radiation protection in children in 52 low-resource countries. Extensive information was obtained through a survey by the International Atomic Energy Agency (IAEA); wide-ranging information was available from 40 countries and data from the other countries pertained to frequency of pediatric CT examinations. Of note is that multi-detector CT (MDCT) was available in 77% of responses to the survey, typically nodal centers in these countries. Nearly 75% of these scanners were reported to have dose displays. The pediatric CT usage was lower in European facilities as compared to Asian and African facilities, where usage was twice as high. The most frequently scanned body part was the head. Frequent use of 120 kVp was reported in children. The ratio of maximum to minimum CT dose index volume (CTDIvol) values varied between 15 for abdomen CT in the age group 5-10 years and 100 for chest CT in the age group <1 year. In 8% of the CT systems, CTDI values for pediatric patients were higher than those for adults in at least one age group and for one type of examination. Use of adult protocols for children was associated with CTDIw or CTDIvol values in children that were double those of adults for head and chest examination and 50% higher for abdomen examination. Patient dose records were kept in nearly half of the facilities, with the highest frequency in Europe (55% of participating facilities), and in 49% of Asian, 36% of Latin American and 14% of African facilities. The analysis of the first-choice examinations in seven clinical conditions showed that practice was in accordance with guidelines for only three of seven specified clinical conditions.
Measuring School Facility Conditions: An Illustration of the Importance of Purpose
ERIC Educational Resources Information Center
Roberts, Lance W.
2009-01-01
Purpose: The purpose of this paper is to argue that taking the educational purposes of schools into account is central to understanding the place and importance of facilities to learning outcomes. The paper begins by observing that the research literature connecting facility conditions to student outcomes is mixed. A closer examination of this…
The Impact of Athletic Facilities on the Recruitment of Potential Student-Athletes
ERIC Educational Resources Information Center
Schneider, Ray; Messenger, Steve
2012-01-01
Purpose: This study examined the impact that athletic facilities and other college choice factors have on the recruitment of student-athletes to play Division I college hockey compared to the influence of other college choice factors. Although athletic facilities and their seeming importance in the recruitment of top level student-athletes are…
42 CFR 31.3 - Use of Service facilities.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 1 2010-10-01 2010-10-01 false Use of Service facilities. 31.3 Section 31.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS... Service § 31.3 Use of Service facilities. Except as otherwise provided in §§ 31.3 to 31.10, the persons...
The Impact of School Facilities on the Learning Environment
ERIC Educational Resources Information Center
Vandiver, Bert
2011-01-01
The purpose of this mixed methods study was to examine the impact of the quality of facilities on the educational environment in high schools located in northeast Texas. The intent of this research study was to determine the relationship between school facilities and the school-learning environment. This study was a mixed method research that used…
The Effect of Art Therapy on Cognitive Performance among Ethnically Diverse Older Adults
ERIC Educational Resources Information Center
Pike, Amanda Alders
2013-01-01
This study examined the effect of art therapy on the cognitive performance of a multisite, ethnically diverse sample ("N" = 91) of older adults. Participants were recruited from several U.S. facilities that included a community center, a retirement center, an adult daycare, an assisted living facility, and a skilled nursing facility.…
A Foundation To Uphold: A Study of Facilities Conditions at U.S. Colleges and Universities.
ERIC Educational Resources Information Center
Kaiser, Harvey H.; Davis, Jerry S.
This report presents the results of a study of the condition of higher education facilities in the United States and offers recommendations to improve the deteriorating state of such facilities. The 1995 survey examined statistical, financial, and operational data gathered through mailed questionnaires returned by 400 institutions. The results…
Federal Register 2010, 2011, 2012, 2013, 2014
2010-06-02
... a License Application for a Fuel Cycle Facility''; Notice of Availability AGENCY: Nuclear Regulatory... Cycle Facility,'' dated May 2010. ADDRESSES: NRC's Public Document Room (PDR): The public may examine... INFORMATION: The SRP for the review of a license application for a fuel cycle facility (NUREG-1520), Revision...
ERIC Educational Resources Information Center
Rivera, Marialena D.
2018-01-01
In an era of expanding global educational privatization and shifting policies on how to fund educational facilities in many states in the US, this study engages the lenses of critical policy analysis and fiscal sociology to examine educational privatization in the school facilities industry in California. Employing critical policy document…
Integrated scheduling and resource management. [for Space Station Information System
NASA Technical Reports Server (NTRS)
Ward, M. T.
1987-01-01
This paper examines the problem of integrated scheduling during the Space Station era. Scheduling for Space Station entails coordinating the support of many distributed users who are sharing common resources and pursuing individual and sometimes conflicting objectives. This paper compares the scheduling integration problems of current missions with those anticipated for the Space Station era. It examines the facilities and the proposed operations environment for Space Station. It concludes that the pattern of interdependecies among the users and facilities, which are the source of the integration problem is well structured, allowing a dividing of the larger problem into smaller problems. It proposes an architecture to support integrated scheduling by scheduling efficiently at local facilities as a function of dependencies with other facilities of the program. A prototype is described that is being developed to demonstrate this integration concept.
Hoshiko, Sumi; Smith, Daniel; Fan, Cathyn; Jones, Carrie R; McNeel, Sandra V; Cohen, Ronald A
2014-05-01
Radiation exposure from medical sources now equals or exceeds that from natural background sources, largely attributable to a 20-fold increase in CT use since 1980. Increasing exposure to children and fetuses is of most concern due to their heightened susceptibility. More recently, CT use may be leveling or decreasing, but it is unclear whether this change is widespread or varies by type of institution. We sought to characterize trends in CT utilization in California hospitals and emergency departments among children and pregnant women, looking at different types of facilities, such as teaching, private, public and nonprofit institutions. We examined frequency of CT examinations by year from 229 facilities reporting CT usage in routinely collected California statewide data for 2005-2012. We modeled trends overall and by facility type. CT scans for pediatric and pregnant patient visits in the emergency department increased initially, then started to decline after 2008. Among hospital admissions, rates declined or leveled after 2005. In the emergency department, CT rates varied between types of facilities, with teaching hospitals reducing use sooner and more sharply than other types of facilities. CT utilization in California among children and pregnant women has begun to level or decline. Still, population exposure remains at historically high levels, warranting consideration of potential public health implications. Further examination of reasons for trends among hospital types, particularly how teaching hospitals have reduced rates of CT utilization, may help identify strategies for CT reduction without compromising patient care.
Winter, Rebecca; Yourkavitch, Jennifer; Wang, Wenjuan; Mallick, Lindsay
2017-01-01
Background Despite the importance of health facility capacity to provide comprehensive care, the most widely used indicators for global monitoring of maternal and child health remain contact measures which assess women’s use of services only and not the capacity of health facilities to provide those services; there is a gap in monitoring health facilities’ capacity to provide newborn care services in low and middle income countries. Methods In this study we demonstrate a measurable framework for assessing health facility capacity to provide newborn care using open access, nationally–representative Service Provision Assessment (SPA) data from the Demographic Health Surveys Program. In particular, we examine whether key newborn–related services are available at the facility (ie, service availability, measured by the availability of basic emergency obstetric care (BEmOC) signal functions, newborn signal functions, and routine perinatal services), and whether the facility has the equipment, medications, training and knowledge necessary to provide those services (ie, service readiness, measured by general facility requirements, equipment, medicines and commodities, and guidelines and staffing) in five countries with high levels of neonatal mortality and recent SPA data: Bangladesh, Haiti, Malawi, Senegal, and Tanzania. Findings In each country, we find that key services and commodities needed for comprehensive delivery and newborn care are missing from a large percentage of facilities with delivery services. Of three domains of service availability examined, scores for routine care availability are highest, while scores for newborn signal function availability are lowest. Of four domains of service readiness examined, scores for general requirements and equipment are highest, while scores for guidelines and staffing are lowest. Conclusions Both service availability and readiness tend to be highest in hospitals and facilities in urban areas, pointing to substantial equity gaps in the availability of essential newborn care services for rural areas and for people accessing lower–level facilities. Together, the low levels of both service availability and readiness across the five countries reinforce the vital importance of monitoring health facility capacity to provide care. In order to save newborn lives and improve equity in child survival, not only does women’s use of services need to increase, but facility capacity to provide those services must also be enhanced. PMID:29423186
Alaska SAR Facility mass storage, current system
NASA Technical Reports Server (NTRS)
Cuddy, David; Chu, Eugene; Bicknell, Tom
1993-01-01
This paper examines the mass storage systems that are currently in place at the Alaska SAR Facility (SAF). The architecture of the facility will be presented including specifications of the mass storage media that are currently used and the performances that we have realized from the various media. The distribution formats and media are also discussed. Because the facility is expected to service future sensors, the new requirements and possible solutions to these requirements are also discussed.
Wall finish selection in hospital design: a survey of facility managers.
Lavy, Sarel; Dixit, Manish K
2012-01-01
This paper seeks to analyze healthcare facility managers' perceptions regarding the materials used for interior wall finishes and the criteria used to select them. It also examines differences in wall finish materials and the selection process in three major hospital spaces: emergency, surgery, and in-patient units. These findings are compared with healthcare designers' perceptions on similar issues, as currently documented in the literature. Hospital design and the materials used for hospital construction have a considerable effect on the environment and health of patients. A 2002 survey revealed which characteristics healthcare facility designers consider when selecting materials for healthcare facilities; however, no similar study has examined the views of facility managers on building finish selection. A 22-question survey questionnaire was distributed to 210 facility managers of metropolitan, for-profit hospitals in Texas; IRB approval was obtained. Respondents were asked to rank 10 interior wall finish materials and 11 selection criteria for wall finishes. Data from 48 complete questionnaires were analyzed using descriptive statistics and nonparametric statistical analysis methods. The study found no statistically significant differences in terms of wall finish materials or the characteristics for material selection in the three major spaces studied. It identified facility managers' four most-preferred wall finish materials and the five-most preferred characteristics, with a statistical confidence level of greater than 95%. The paper underscores the importance of incorporating all perspectives: facility designers and facility managers should work together toward achieving common organizational goals.
Effect of Facility Ownership on Utilization of Arthroscopic Shoulder Surgery.
Black, Eric M; Reynolds, John; Maltenfort, Mitchell G; Williams, Gerald R; Abboud, Joseph A; Lazarus, Mark D
2018-03-01
We examined practice patterns and surgical indications in the management of common shoulder procedures by surgeons practicing at physician-owned facilities. This study was a retrospective analysis of 501 patients who underwent arthroscopic shoulder procedures performed by five surgeons in our practice at one of five facilities during an 18-month period. Two of the facilities were physician-owned, and three of the five surgeons were shareholders. Demographics, insurance status, symptom duration, time from injury/symptom onset to the decision to perform surgery (at which time surgical consent is obtained), and time to schedule surgery were studied to determine the influence of facility type and physician shareholder status. Median duration of symptoms before surgery was significantly shorter in workers' compensation patients than in non-workers' compensation patients (47% less; P < 0.0001) and in men than in women (31% less; P < 0.001), but was not influenced by shareholder status or facility ownership (P > 0.05). Time between presentation and surgical consent was not influenced by facility ownership (P = 0.39) or shareholder status (P = 0.50). Time from consent to procedure was 13% faster in physician-owned facilities than in non-physician-owned facilities (P = 0.03) and 35% slower with shareholder physicians than with nonshareholder physicians (P < 0.0001). The role of physician investment in private healthcare facilities has caused considerable debate in the orthopaedic surgery field. To our knowledge, this study is the first to examine the effects of shareholder status and facility ownership on surgeons' practice patterns, surgical timing, and measures of nonsurgical treatment before shoulder surgery. Neither shareholder status nor facility ownership characteristics influenced the speed with which surgeons determined that shoulder surgery was indicated or surgeons' use of preoperative nonsurgical treatment. After the need for surgery was determined, patients underwent surgery sooner at physician-owned facilities than at non-physician-owned facilities and with nonshareholder physicians than with shareholder physicians. Level III.
Innovation characteristics and intention to adopt sustainable facilities management practices.
Lee, So Young; Kang, Mihyun
2013-01-01
Sustainable facilities management (SFM) is important because typical buildings consume more resources and energy than necessary, negatively impact the environment and generate lots of waste (US Department of Energy, 2003, Green Buildings). This study examined innovation characteristics that relate to facility managers' intention to adopt SFM practices. Based on the diffusion of innovations theory (Rogers 1962, 1995, Diffusion of Innovations. 4th ed. New York: The Free Press), an SFM innovation and adoption model was proposed. A survey was conducted with a convenience sample of 240 public facilities managers in 25 facilities management divisions in Seoul, Korea, and its metropolitan areas. Structural equation modelling was employed to analyse the data. The results showed that economic advantage and human comfort aspects are predictors for the intention of SFM adoption. Observability is positively relevant to the intention of SFM adoption. Complexity, however, is not a significant predictor for the intention of SFM adoption. Practical implications for sustainable products and systems and the built environment are suggested. To incorporate an innovation like sustainable practices, it is required to meet the needs of potential adopters. Innovation characteristics that influence facility managers' intention to adopt sustainable facilities management were examined. A survey was conducted. Economic advantage, human comfort and observability are predictors for the intention of adoption of sustainable practice.
Truckers' parking/rest facility study.
DOT National Transportation Integrated Search
2008-07-01
This study examined the current state of truck parking and rest area facilities in the Northeast Illinois Region to determine if : and how problems from truck parking affect freight transportation infrastructure, safety, and the regions economy an...
Comparison of Hospitalization Rates among For-Profit and Nonprofit Dialysis Facilities
Johansen, Kirsten L.; Romano, Patrick S.; Chertow, Glenn M.; Mu, Yi; Ishida, Julie H.; Grimes, Barbara; Kaysen, George A.; Nguyen, Danh V.
2014-01-01
Summary Background and objectives The vast majority of US dialysis facilities are for-profit and profit status has been associated with processes of care and outcomes in patients on dialysis. This study examined whether dialysis facility profit status was associated with the rate of hospitalization in patients starting dialysis. Design, setting, participants, & methods This was a retrospective cohort study of Medicare beneficiaries starting dialysis between 2005 and 2008 using data from the US Renal Data System. All-cause hospitalization was examined and compared between for-profit and nonprofit dialysis facilities through 2009 using Poisson regression. Companion analyses of cause-specific hospitalization that are likely to be influenced by dialysis facility practices including hospitalizations for heart failure and volume overload, access complications, or hyperkalemia were conducted. Results The cohort included 150,642 patients. Of these, 12,985 (9%) were receiving care in nonprofit dialysis facilities. In adjusted models, patients receiving hemodialysis in for-profit facilities had a 15% (95% confidence interval [95% CI], 13% to 18%) higher relative rate of hospitalization compared with those in nonprofit facilities. Among patients receiving peritoneal dialysis, the rate of hospitalization in for-profit versus nonprofit facilities was not significantly different (relative rate, 1.07; 95% CI, 0.97 to 1.17). Patients on hemodialysis receiving care in for-profit dialysis facilities had a 37% (95% CI, 31% to 44%) higher rate of hospitalization for heart failure or volume overload and a 15% (95% CI, 11% to 20%) higher rate of hospitalization for vascular access complications. Conclusions Hospitalization rates were significantly higher for patients receiving hemodialysis in for-profit compared with nonprofit dialysis facilities. PMID:24370770
38 CFR 13.2 - Field examinations.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Field examinations. 13.2... ADMINISTRATION, FIDUCIARY ACTIVITIES § 13.2 Field examinations. (a) Authority to conduct; generally. Field... facility Director are authorized, when assigned, to conduct investigations (field examinations) and examine...
Impact of a in situ laboratory on physician expectancy.
Brulé, Romain; Sarazin, Marianne; Tayeb, Nicole; Roubille, Martine; Szymanowicz, Anton
2018-01-01
Biological examinations are essential for clinicians' medical care. The aim of this study is to assess clinicians' expectations in healthcare facilities and their perception of medical biology in different types of organization. We performed a prospective transversal study by electronic questionnaire conducted among 242 practitioners in four healthcare facilities. The aspects explored were as follows: quality, reliability, rendering time of examination results and biology platform support. Analyses were conducted after rectification of the sample by weight. Sixty one clinicians responded (25.2% [19.7-30.7]). The rendering time of examination is the main criterion mentioned with a requirement of less than one hour in case of emergency (81.5% [71.8-91.2] of the answers) to less than 72 hours for specialized examinations (81.5% [71.8-91.2] of the answers). Better collaboration with biologists is expected by clinicians (54.7% [50.9-58.5]). Satisfaction with the biology platform support and rendering time of emergency cases results was significantly (p <0.005) lower in facilities without an on-site laboratory. In conclusion, although medical biology performance is generally satisfactory within medical facilities, it remains nonetheless affected when the laboratory is not on site. The rendering time of examination, depending on the biology platform support functions and the proximity of the laboratory, remains the main criterion. Clinician-biologist collaboration, which increases of the medico-economic efficiency of patient's healthcare, appears as an essential criterion in a structural conception of medical biology.
Test facilities of the structural dynamics branch of NASA Lewis Research Center
NASA Technical Reports Server (NTRS)
Montague, Gerald T.; Kielb, Robert E.
1988-01-01
The NASA Lewis Research Center Structural Dynamics Branch conducts experimental and analytical research related to the structural dynamics of aerospace propulsion and power systems. The experimental testing facilities of the branch are examined. Presently there are 10 research rigs and 4 laboratories within the branch. These facilities are described along with current and past research work.
ERIC Educational Resources Information Center
Lowenkron, Ruth; Ponessa, Joan
2005-01-01
The long range facilities planning (LRFP) process presents a wonderful opportunity for New Jersey's school districts to re-examine and strengthen their long term planning for educational adequacy in 21st century school facilities. It provides an opportunity for districts to work closely with the special education community to ensure that New…
Community Discharge of Nursing Home Residents: The Role of Facility Characteristics.
Holup, Amanda A; Gassoumis, Zachary D; Wilber, Kathleen H; Hyer, Kathryn
2016-04-01
Using a socio-ecological model, this study examines the influence of facility characteristics on the transition of nursing home residents to the community after a short stay (within 90 days of admission) or long stay (365 days of admission) across states with different long-term services and supports systems. Data were drawn from the Minimum Data Set, the federal Online Survey, Certification, and Reporting (OSCAR) database, the Area Health Resource File, and the LTCFocUs.org database for all free-standing, certified nursing homes in California (n = 1,127) and Florida (n = 657) from July 2007 to June 2008. Hierarchical generalized linear models were used to examine the impact of facility characteristics on the probability of transitioning to the community. Facility characteristics, including size, occupancy, ownership, average length of stay, proportion of Medicare and Medicaid residents, and the proportion of residents admitted from acute care facilities are associated with discharge but differed by state and whether the discharge occurred after a short or long stay. Short- and long-stay nursing home discharge to the community is affected by resident, facility, and sometimes market characteristics, with Medicaid consistently influencing discharge in both states. © Health Research and Educational Trust.
241-AY Double Shell Tanks (DST) Integrity Assessment Report
DOE Office of Scientific and Technical Information (OSTI.GOV)
JENSEN, C.E.
1999-09-21
This report presents the results of the integrity assessment of the 241-AY double-shell tank farm facility located in the 200 East Area of the Hanford Site. The assessment included the design evaluation and integrity examinations of the tanks and concluded that the facility is adequately designed, is compatible with the waste, and is fit for use. Recommendations including subsequent examinations. are made to ensure the continued safe operation of the tanks.
ERIC Educational Resources Information Center
Celik, Ömer; Sezer, Süreyya Yonca; Karadag, Mustafa; Savucu, Yüksel; Tel, Mikail; Celikel, Baha Engin
2017-01-01
In this study, the level of adequacy of sports facilities in Bingöl province in terms of popularization of sports in the city and the general tendency of the citizens of Bingöl province towards sports were examined. A total of 610 volunteers from various professions, age groups and gender groups from Bingöl city center participated in this study.…
Breast imaging. A practical look at its capabilities and its limitations.
Clark, R; Nemec, L; Love, N
1992-10-01
The film-screen technique is evolving as the standard for mammography. Sonography is the only other method that currently has a defined role in breast imaging. Mammography should be performed at facilities that have received American College of Radiology accreditation or its equivalent, because technical quality assurance is an important part of mammographic practice. Interpretive quality may be assured by outcome audits performed by mammography facilities. Primary care physicians are best suited to encouraging eligible women to undergo screening studies and should consider these recommendations: Refer patients for screening mammography to accredited facilities according to established guidelines. Educate patients about the need for regular screening. Provide annual breast physical examination. Refresh your knowledge on breast health and the techniques of physical examination if necessary. Teach patients breast self-examination techniques. Demand low-cost, high-quality screening mammography; be aware of local variability of charges and quality.
Caring for juveniles with mental disorders in adult corrections facilities.
Wills, Cheryl D
2017-02-01
Although juveniles have developmental, educational, healthcare, and rehabilitation needs that differ from adults, thousands of them have been confined in adult corrections facilities in the past 30 years. This manuscript will review how and why juveniles end up in adult corrections facilities, who they are, their rehabilitative needs, and how they differ from adults in corrections facilities and youths in the juvenile justice system. The importance of providing developmentally-informed mental health services to youths in adult corrections facilities is examined, along with barriers to traditional adolescent psychiatric practice. Recommendations for future directions in adolescent psychiatric care are presented.
Human error in airway facilities.
DOT National Transportation Integrated Search
2001-01-01
This report examines human errors in Airway Facilities (AF) with the intent of preventing these errors from being : passed on to the new Operations Control Centers. To effectively manage errors, they first have to be identified. : Human factors engin...
Active transportation measurement : Minneapolis case study.
DOT National Transportation Integrated Search
2013-06-01
This research examines longitudinal bicycle count data to better understand the impact of new bicycle facilities on use. The study site is Minneapolis which has invested close to $25 million over 8 years to improve active transportation facilities as...
Psychiatric and Medical Health Care Policies in Juvenile Detention Facilities
ERIC Educational Resources Information Center
Pajer, Kathleen A.; Kelleher, Kelly; Gupta, Ravindra A.; Rolls, Jennifer; Gardner, William
2007-01-01
A study aims to examine the existing health care policies in U.S. juvenile detention centres. The results conclude that juvenile detention facilities have many shortfalls in providing care for adolescents, particularly mental health care.
Patient Care Staffing Levels and Facility Characteristics in U.S. Hemodialysis Facilities
Yoder, Laura A. G.; Xin, Wenjun; Norris, Keith C.; Yan, Guofen
2013-01-01
Background Higher numbers of registered nurses per patient have been associated with improved patient outcomes in acute care facilities. Variation and associations of patient-care staffing levels and hemodialysis facility characteristics have not been previously examined. Study Design Cross-sectional study using Poisson regression to examine associations betwee patient-care staffing levels and hemodialysis facility characteristics. Setting & Participants 4,800 U.S. hemodialysis facilities in the 2009 CMS ESRD Annual Facility Survey (CMS-2744), USRDS. Predictors Facility characteristics, including profit status, freestanding status, chain affiliatio and geographic region, adjusted for facility size, capacity, functional type, and urbanicity. Outcomes Patient care staffing levels, including ratios of Registered Nurses (RN), Licensed Practical Nurses (LPN), Patient Care Technicians (PCT), composite staff (RN+LPN+PCT), Social Workers, and Dietitians to in-center hemodialysis patients. Results After adjusting for background facility characteristics, the ratios of RNs and LPNs to patients were 35% (p<0.001) and 42% (p<0.001) lower, but the PCT-to-patient ratio was 16% (p<0.001) higher in for-profit facilities than those in nonprofit facilities (Rate ratio, 0.65, 95%CI, 0.63–0.68; 0.58, 0.51–0.65; 1.16, 1.12–1.19; respectively). Regionally, compared to the Northeast, the adjusted RN-to-patient ratio was 14% (p< 0.001) lower in the Midwest, 25% (p< 0.001) lower in the South, and 18% (p< 0.001) lower in the West. Even after additional adjustments, the large for-profit chains had significantly lower RN and LPN ratios than the largest nonprofit chain, but a significantly higher PCT-to-patient ratio. The overall composite staffing levels were also lower in for-profit and chain-affiliated facilities. The patterns hold when the hospital-based units were excluded. Limitations Nursing hours were not available. Conclusions The significant variation in patient-care staffing levels and its associations with facility characteristics warrants inclusion in future large-scale hemodialysis outcomes studies. ESRD networks and hemodialysis facilities should attend to quality assurance and performance improvement initiatives that maximize licensed nurse-staffing levels in hemodialysis facilities. PMID:23810689
Discriminative facility and its role in the perceived quality of interactional experiences.
Cheng, C; Chiu, C Y; Hong, Y Y; Cheung, J S
2001-10-01
Discriminative facility refers to an individual's sensitivity to subtle cues about the psychological meaning of a situation. This research aimed at examining (a) the conceptual distinctiveness of discriminative facility, (b) the situation-appropriate aspect of this construct, and (c) the relationship between discriminative facility and interpersonal experiences. Discriminative facility was assessed by a new measure of situation-appropriate behaviors across a variety of novel stressful situations. Results from study 1 showed that discriminative facility had weak positive relationships with cognitive complexity and nonsignificant relationships with self-monitoring and social desirability, indicating that discriminative facility is a unique construct. Results from Study 2 revealed that higher levels of discriminative facility were associated with higher levels of perceived social support and a greater number of pleasant interpersonal events experienced, thus providing support for the theoretical proposition that discriminative facility is an aspect of social intelligence.
Indoor tanning facility density in eighty U.S. cities.
Palmer, Richard C; Mayer, Joni A; Woodruff, Susan I; Eckhardt, Laura; Sallis, James F
2002-06-01
The purpose of this study was to examine the number of tanning facilities in select U.S. cities. The twenty most populated cities from each of 4 U.S. regions were selected for the sample. For each city, data on the number of tanning facilities, climate, and general demographic profile were collected. Data for state tanning facility legislation also were collected. A tanning facility density variable was created by dividing the city's number of facilities by its population size. The 80 cities had an average of 50 facilities each. Results of linear regression analysis indicated that higher density was significantly associated with colder climate, lower median income, and higher proportion of Whites. These data indicate that indoor tanning facilities are prevalent in the environments of U.S. urban-dwellers. Cities having the higher density profile may be logical targets for interventions promoting less or safer use of these facilities.
Medical status of adolescents at time of admission to a juvenile detention center.
Feinstein, R A; Lampkin, A; Lorish, C D; Klerman, L V; Maisiak, R; Oh, M K
1998-03-01
To examine the medical status and history of health care utilization of adolescents at the time of their admission to a juvenile detention facility. Data were collected over an 18-month period on all detainees admitted for the first time to a juvenile detention facility in a major southeastern city in the United States. Information was gathered through a private, confidential interview completed by a medical social worker and a physical examination by a physician. Information was obtained regarding past medical history, complaints at the time of admission, health care utilization, and physical examination. Approximately 10% of teenagers admitted to a detention facility have a significant medical problem (excluding drug/alcohol abuse, or uncomplicated sexually transmitted diseases) that requires medical follow-up. The majority of these conditions were known to the adolescent at the time of admission. Only a third of adolescents admitted to the detention facility reported a regular source of medical care, and only about 20% reported having a private physician. A majority of all the detainees had already fallen behind in or dropped out of school. More than half of the families of the adolescents with a medical problem appeared to be unable or unwilling to assist in ensuring proper medical follow-up. A significant percentage of adolescents entering a detention facility have a medical problem requiring health care services. Detention facilities offer an opportunity to deliver and coordinate medical care to high-risk adolescents. Programs linking public and private health care providers with the correctional care system may provide juveniles with an acceptable option for obtaining needed health care services.
Menus and mnemonics in airway facilities.
DOT National Transportation Integrated Search
2003-04-01
This study examines the use of menus and mnemonics in current Airway Facilities (AF) systems and compares them to human factors : guidelines and best practices. Researchers from the William J. Hughes Technical Center traveled to AF field sites and co...
ERIC Educational Resources Information Center
Kennedy, Mike
2001-01-01
Discusses technology's impact on educational facilities and operations. Technology's influence on a school's ability to streamline their business operations and manage their facilities more efficiency is examined, and how Baylor University (Waco, TX) used technology to cut energy costs is highlighted. (GR)
This working paper examines the effect of increased inspection frequency occurring under the Energy Policy Act of 2005 on compliance with release detection and prevention requirements at underground storage tank facilities in Louisiana.
Arbour, Kelly P; Martin Ginis, Kathleen A
2009-07-01
Within the general able-bodied population, proximity of one's home to physical activity facilities is modestly associated with physical activity behavior. Currently, no research has examined whether facility proximity is related to physical activity among persons living with disabilities. To examine (1) the level of agreement between perceived and actual proximity to accessible physical activity facilities and (2) the relationship between facility proximity (perceived and actual) and leisure-time physical activity (LTPA) among persons with spinal cord injury (SCI). It was hypothesized that (1) perceived and actual proximity measures would exhibit low agreement and (2) a small, positive relationship would emerge between proximity (perceived and actual) and LTPA. Data from 50 Ontario residents living with SCI (70% male; 52% tetraplegia) were collected for proximity and LTPA. Perceived facility proximity was determined by a self-report "YES" versus "NO" presence measure, while actual facility proximity was assessed using Geographical Information Systems. An SCI-specific instrument, the PARA-SCI, was used to measure LTPA. Low agreement levels were found between perceived and actual proximity. LTPA status (active versus inactive) was shown to moderate the relationship, with higher agreement levels found for participants who reported engaging in mild or heavy LTPA versus their inactive counterparts, but only for the 30-minute wheeling boundary. Contrary to hypothesis, people living within a 30-minute wheel from an accessible facility were less likely to engage in heavy LTPA than were people who did not have an accessible facility located within a 30-minute wheel. No significant associations were found between LTPA and perceived proximity. Living in close proximity to a facility that provides accessible programming and equipment does not necessarily translate into greater physical activity behavior.
Employee organizational commitment and hospital performance.
Baird, Kevin M; Tung, Amy; Yu, Yanjie
2017-09-15
There is widespread evidence of the purported benefits of employee organizational commitment (EOC) and its impact on both individual and organizational performance. This study contributes to this literature by providing a unique insight into this relationship, focusing on the interrelationship between EOC with hospital performance and the role of the provision of adequate facilities in eliciting EOC. The aim of this study was to introduce and empirically examine a new theoretical model in which it is argued that the performance of hospitals with regard to the provision of adequate facilities (medical facilities, support facilities, and staff resources) influences the level of EOC, which in turn influences hospital performance with regard to patient care and operational effectiveness. To examine the interrelationships between the provision of adequate facilities, EOC, and hospital performance, the study utilizes a survey of hospital managers. The findings support the theoretical model, with the provision of support facilities and staff resources positively indirectly associated with both patient care and operational effectiveness through their impact on EOC. The findings highlight the importance of providing adequate facilities and EOC within hospitals and suggest that CEOs and general managers should try to enhance the provision of such resources in an attempt to elicit EOC within their hospitals. The findings suggest that managers should try to enhance their provision of adequate facilities in order to elicit EOC and enhance hospital performance. With regard to medical facilities, they should consider and incorporate the latest technology and up-to-date equipment. They should also provide adequate staff resources, including appropriate numbers of beds, nurses, and doctors, to prevent "fatigue" (West, 2001, p. 41) and provide adequate support facilities.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Nero, A.V.; Quinby-Hunt, M.S.
1977-01-01
This report sets forth methodologies for review of the health and safety aspects of proposed nuclear, geothermal, and fossil-fuel sites and facilities for electric power generation. The review is divided into a Notice of Intention process and an Application for Certification process, in accordance with the structure to be used by the California Energy Resources Conservation and Development Commission, the first emphasizing site-specific considerations, the second examining the detailed facility design as well. The Notice of Intention review is divided into three possible stages: an examination of emissions and site characteristics, a basic impact analysis, and an assessment of publicmore » impacts. The Application for Certification review is divided into five possible stages: a review of the Notice of Intention treatment, review of the emission control equipment, review of the safety design, review of the general facility design, and an overall assessment of site and facility acceptability.« less
Department of Energy Actions Necessary to Improve DOE’s Training Program
1999-02-01
assessments, the Department has completed analyses and implemented training programs for the defense nuclear facilities technical workforce and...certification standards, such as those examined by the Defense Nuclear Facilities Safety Board in its reviews of Department operations, impose... nuclear facilities will have their technical skills assessed and will receive continuing training to maintain certain necessary skills. Page 17 GAO/RCED
ERIC Educational Resources Information Center
Moore, Andrea Lisa
2013-01-01
Toxic Release Inventory facilities are among the many environmental hazards shown to create environmental inequities in the United States. This project examined four factors associated with Toxic Release Inventory, specifically, manufacturing facility location at multiple spatial scales using spatial analysis techniques (i.e., O-ring statistic and…
Advanced X-ray Astrophysics Facility (AXAF): Science working group report. [space shuttle payload
NASA Technical Reports Server (NTRS)
1980-01-01
The Advanced X-Ray Astrophysics Facility (AXAF) mission concept is examined from a scientific viewpoint. A brief description of the development of X-ray astronomy and a summary description of AXAF, the scientific objectives of the facility, a description of representative scientific instruments, requirements for X-ray ground testing, and a summary of studies related to spacecraft and support subsystems, are included.
Out-of-pocket expenses for maternity care in rural Bangladesh: a public-private comparison.
Rahman, Moshiur; Rob, Ubaidur; Noor, Forhana Rahman; Bellows, Benjamin
Out-of-pocket expenses incurred by women for availing maternal healthcare services at public and private health facilities in Bangladesh were examined using a baseline household survey evaluating the impact of demand side financing vouchers on utilization and service delivery for maternal healthcare. The survey was conducted in 2010 among 3,300 women who gave birth in the previous 12 months from the start of data collection. Information on costs incurred to receive antenatal, delivery, and postnatal care services was collected. Findings reveal that the majority of women reported paying out-of-pocket expenses for availing maternal healthcare services both at public and private health facilities. Out-of-pocket expenses include registration, consultation, laboratory examination, medicine, transportation, and other associated costs incurred for receiving maternal healthcare services. On average, women paid US$3.60 out-of-pocket expenses for receiving antenatal care at public health facilities and US$12.40 at private health facilities. Similarly, women paid one and half times more for normal (US$42.30) and cesarean deliveries (US$136.20) at private health facilities compared to public health facilities. On the other hand, costs for postnatal care services did not vary significantly between public and private health facilities. Utilization of maternal healthcare services can be improved if out-of-pocket expenses can be minimized. At the same time, effective demand generation strategies are necessary to encourage women to utilize health facilities.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Loftin, B.; Abramczyk, G.; Koenig, R.
Radioactive materials are stored in a variety of locations throughout the DOE complex. At the Savannah River Site (SRS), materials are stored within dedicated facilities. Each of those facilities has a documented safety analysis (DSA) that describes accidents that the facility and the materials within it may encounter. Facilities at the SRS are planning on utilizing the certified Model 9977 Shipping Package as a long term storage package and one of these facilities required ballistics testing. Specifically, in order to meet the facility DSA, the radioactive materials (RAM) must be contained within the storage package after impact by a .223more » caliber round. In order to qualify the Model 9977 Shipping Package for storage in this location, the package had to be tested under these conditions. Over the past two years, the Model 9977 Shipping Package has been subjected to a series of ballistics tests. The purpose of the testing was to determine if the 9977 would be suitable for use as a storage package at a Savannah River Site facility. The facility requirements are that the package must not release any of its contents following the impact in its most vulnerable location by a .223 caliber round. A package, assembled to meet all of the design requirements for a certified 9977 shipping configuration and using simulated contents, was tested at the Savannah River Site in March of 2011. The testing was completed and the package was examined. The results of the testing and examination are presented in this paper.« less
Microbiological monitoring of guinea pigs reared conventionally at two breeding facilities in Korea.
Park, Jong-Hwan; Seok, Seung-Hyeok; Baek, Min-Won; Lee, Hui-Young; Kim, Dong-Jae; Cho, Jung-Sik; Kim, Chuel-Kyu; Hwang, Dae-Youn; Park, Jae-Hak
2006-10-01
In this study, microbiological monitoring of guinea pigs reared conventionally in two facilities was performed twice in 2004, with a three-month-interval between surveys. This study was based on the recommendations of the FELASA Working Group, with some modifications. In serological tests in the first survey, some animals from facility A showed positive results for Encephalitozoon cuniculi, Sendai virus, pneumonia virus of mice (PVM), and Reovirus-3 (Reo-3); facility B showed a positive result only for E. cuniculi. The results of the second survey were similar to the first, except for the presence of Sendai virus; all animals from the two facilities were Sendai virus-negative in the second experiment. No pathogenic bacteria were cultured in the organs of any of the animals in the first survey. However, in the second survey, Bordetella bronchiseptica was cultured from the lung tissue of two 10-week-old animals from facility A. Chlamydial infection was examined by the Macchiavello method, but no animal showed positive results. Tests using fecal flotation or the KOH wet mount method showed no infection of endoparasites, protozoa, ectoparasites, or dermatophytes in any animal in both surveys. However, in the histopathological examination, an infection of protozoa-like organisms was observed in the cecum of some animals from facility A. The present study revealed that microbiological contamination was present in guinea pigs reared conventionally in two facilities in Korea, suggesting that there is a need to improve environmental conditions in order to eradicate microbial contamination.
Afulani, Patience A; Sayi, Takudzwa S; Montagu, Dominic
2018-05-11
Low use of maternal health services, as well as poor quality care, contribute to the high maternal mortality in sub-Saharan Africa (SSA). In particular, poor person-centered maternity care (PCMC), which captures user experience, contributes both directly to pregnancy outcomes and indirectly through decreased demand for services. While many studies have examined disparities in use of maternal health services, few have examined disparities in quality of care, and none to our knowledge has empirically examined disparities in PCMC in SSA. The aim of this study is to examine factors associated with PCMC, particularly the role of household wealth, personal empowerment, and type of facility. Data are from a survey conducted in western Kenya in 2016, with women aged 15 to 49 years who delivered in the 9 weeks preceding the survey (N = 877). PCMC is operationalized as a summative score based on responses to 30 items in the PCMC scale capturing dignity and respect, communication and autonomy, and supportive care. We find that net of other factors; wealthier, employed, literate, and married women report higher PCMC than poorer, unemployed, illiterate, and unmarried women respectively. Also, women who have experienced domestic violence report lower PCMC than those who have never experienced domestic violence. In addition, women who delivered in health centers and private facilities reported higher PCMC than those who delivered in public hospitals. The effect of employment and facility type is conditional on wealth, and is strongest for the poorest women. Poor women who are unemployed and poor women who deliver in higher-level facilities receive the lowest quality PCMC. The findings imply the most disadvantaged women receive the lowest quality PCMC, especially when they seek care in higher-level facilities. Interventions to reduce disparities in PCMC are essential to improve maternal outcomes among disadvantaged groups.
Facilities for music education and their acoustical design.
Koskinen, Heli; Toppila, Esko; Olkinuora, Pekka
2010-01-01
Good rehearsal facilities for musicians are essential. Directive 2003/10/EC necessitates that musicians are protected from noise exposure. A code of conduct gives the guidelines how this should be done. This study examines room acoustics recommendations provided by the Finnish code of conduct, and discusses whether they are adequate. Small teaching facilities were measured after renovation and compared to earlier measurements. Teachers' opinions were inquired about the facilities before and after. The renovation did not decrease the noise exposure of the teachers. However, the majority preferred the facilities after the renovation. The Finnish code of conduct is not sufficient for facilities where loud instruments are played, or band practise. Good facilities can be designed but they must be specified at the designing stage for their intended use.
Federal Register 2010, 2011, 2012, 2013, 2014
2013-12-27
... the basis for its determination that the facility has been cleared of radioactive material before the facility is released for unrestricted use. The public may examine and have copied for a fee publicly...
Energy efficiency and reliability solutions for rail operations and facilities.
DOT National Transportation Integrated Search
2014-11-01
The objectives of the study included examining energy consumption of : the facilities comprising the three major rail yards on the New Haven Rail Line as : well as platform stations and identifying energy efficiency and cost savings : opportunities f...
Code of Federal Regulations, 2010 CFR
2010-01-01
... control system for irradiation facilities may be terminated upon the establishment's receipt of a written... irradiation facilities, as specified in section 381.149 of this subpart, has been terminated in accordance...
Code of Federal Regulations, 2011 CFR
2011-01-01
... control system for irradiation facilities may be terminated upon the establishment's receipt of a written... irradiation facilities, as specified in section 381.149 of this subpart, has been terminated in accordance...
Code of Federal Regulations, 2012 CFR
2012-01-01
... control system for irradiation facilities may be terminated upon the establishment's receipt of a written... irradiation facilities, as specified in section 381.149 of this subpart, has been terminated in accordance...
Code of Federal Regulations, 2014 CFR
2014-01-01
... irradiation facilities may be terminated upon the establishment's receipt of a written notice from the... irradiation facilities, as specified in section 381.149 of this subpart, has been terminated in accordance...
Code of Federal Regulations, 2013 CFR
2013-01-01
... control system for irradiation facilities may be terminated upon the establishment's receipt of a written... irradiation facilities, as specified in section 381.149 of this subpart, has been terminated in accordance...
Simiyu, Sheillah; Swilling, Mark; Cairncross, Sandy; Rheingans, Richard
2017-01-11
Shared facilities are not recognised as improved sanitation due to challenges of maintenance as they easily can be avenues for the spread of diseases. Thus there is need to evaluate the quality of shared facilities, especially in informal settlements, where they are commonly used. A shared facility can be equated to a common good whose management depends on the users. If users do not work collectively towards keeping the facility clean, it is likely that the quality may depreciate due to lack of maintenance. This study examined the quality of shared sanitation facilities and used the common pool resource (CPR) management principles to examine the determinants of shared sanitation quality in the informal settlements of Kisumu, Kenya. Using a multiple case study design, the study employed both quantitative and qualitative methods. In both phases, users of shared sanitation facilities were interviewed, while shared sanitation facilities were inspected. Shared sanitation quality was a score which was the dependent variable in a regression analysis. Interviews during the qualitative stage were aimed at understanding management practices of shared sanitation users. Qualitative data was analysed thematically by following the CPR principles. Shared facilities, most of which were dirty, were shared by an average of eight households, and their quality decreased with an increase in the number of households sharing. The effect of numbers on quality is explained by behaviour reflected in the CPR principles, as it was easier to define boundaries of shared facilities when there were fewer users who cooperated towards improving their shared sanitation facility. Other factors, such as defined management systems, cooperation, collective decision making, and social norms, also played a role in influencing the behaviour of users towards keeping shared facilities clean and functional. Apart from hardware factors, quality of shared sanitation is largely due to group behaviour of users. The CPR principles form a crucial lens through which the dynamics of shared sanitation facilities in informal settlements can be understood. Development and policy efforts should incorporate group behaviour as they determine the quality of shared sanitation facilities.
Characteristics of U.S. Mental Health Facilities That Offer Suicide Prevention Services.
Kuramoto-Crawford, S Janet; Smith, Kelley E; McKeon, Richard
2016-01-01
This study characterized mental health facilities that offer suicide prevention services or outcome follow-up after discharge. The study analyzed data from 8,459 U.S. mental health facilities that participated in the 2010 National Mental Health Services Survey. Logistic regression analyses were used to compare facilities that offered neither of the prevention services with those that offered both or either service. About one-fifth of mental health facilities reported offering neither suicide prevention services nor outcome follow-up. Approximately one-third offered both, 25% offered suicide prevention services only, and 21% offered only outcome follow-up after discharge. Facilities that offered neither service were less likely than facilities that offered either to offer comprehensive support services or special programs for veterans; to offer substance abuse services; and to be accredited, licensed, or certified. Further examination of facilitators and barriers in implementing suicide prevention services in mental health facilities is warranted.
Manhattan Project buildings and facilities at the Hanford Site: A construction history
DOE Office of Scientific and Technical Information (OSTI.GOV)
Gerber, M.S.
1993-09-01
This document thoroughly examines the role that the Hanford Engineer Works played in the Manhattan project. The historical aspects of the buildings and facilities are characterized. An in depth look at the facilities, including their functions, methods of fabrication and appearance is given for the 100 AREAS, 200 AREAS, 300 AREAS, 500, 800 and 900 AREAS, 600 AREA, 700 AREA, 1100 AREA and temporary construction structures.
ERIC Educational Resources Information Center
Ballard, Ken
2000-01-01
Discusses planning points when negotiating joint ventures for designing public recreational facilities. The obstacle and impact of money in the negotiations is examined as are handling the definition of operational responsibilities, personnel and maintenance, program and service delivery, and progress of the partnership and facility itself. (GR)
ERIC Educational Resources Information Center
Nixon, Charles W.
1998-01-01
Examines renovation issues involving 30- and 40-year-old school facilities. Explores ways a school district can renovate old buildings to first-class cost-effective facilities while avoiding excessive transition costs. Discussions include installation of new technology and the resulting wiring demands, and developing more energy-efficient heating…
21 CFR 58.210 - Actions upon disqualification.
Code of Federal Regulations, 2011 CFR
2011-04-01
....210 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Disqualification of Testing Facilities § 58.210... laboratory study conducted by the disqualified testing facility may be examined to determine whether such...
21 CFR 58.210 - Actions upon disqualification.
Code of Federal Regulations, 2010 CFR
2010-04-01
....210 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Disqualification of Testing Facilities § 58.210... laboratory study conducted by the disqualified testing facility may be examined to determine whether such...
Monteiro, Heloísa Mirelle Costa; de Mendonça, Débora Carneiro; Sousa, Mariana Séfora Bezerra; Amancio-Dos-Santos, Angela
2018-06-01
This investigation studied whether physical exercise could modulate cortical spreading depression (CSD) propagation velocity in adult rat offspring from dams that had received a high-fat (HF) diet during lactation. Wistar male rats suckled by dams fed either control (C) or HF diet ad libitum. After weaning, pups received standard laboratory chow. From 40 to 60 days of life, half of the animals exercised on a treadmill (group E); the other half remained sedentary (group S). Two additional HF groups (E and S) received fluoxetine (F; 10 mg/kg/day, orogastrically) from 40 to 60 days of life (groups HF/EF and HF/F). At 40 days of life, rats from the maternal HF diet presented higher weight, thoracic circumference, and Lee Index than C animals and remained heavier at 60 days of life. Physical exercise decreased abdominal circumference. HF diet increased CSD propagation velocity (mean ± SD; mm/min) in sedentaries (HF/S 3.47 ± 0.31 versus C/S 3.24 ± 0.26). Treadmill exercise decelerated CSD propagation in both groups C/E (2.94 ± 0.28) and HF/E (2.97 ± 0.40). Fluoxetine alone decreased CSD propagation (HF/F 2.88 ± 0.45) compared with HF/S group. The combination of fluoxetine + exercise under HF condition (2.98 ± 0.27) was similar to HF/E group. Physical exercise is able to reduce CSD propagation velocity in rat adult brains even when they have suffered over-nourishing during lactation. The effects of exercise alone or fluoxetine alone on CSD were similar to the effects of fluoxetine + exercise, under the HF condition. Data reinforce malnutrition during lactation modifies cortical electrophysiology even when the HF condition no longer exists.
Kassa, Hailu; Silverman, Gary S.; Baroudi, Karim
2010-01-01
Food safety is an important public health issue in the U.S. Eating at restaurants and other food service facilities increasingly has been associated with food borne disease outbreaks. Food safety training and certification of food mangers has been used as a method for reducing food safety violations at food service facilities. However, the literature is inconclusive about the effectiveness of such training programs for improving food safety and protecting consumer health. The purpose of this study was to examine the effect of food manger training on reducing food safety violations. We examined food inspection reports from the Toledo/Lucas County Health Department (Ohio) from March 2005 through February 2006 and compared food hygiene violations between food service facilities with certified and without certified food managers. We also examined the impact on food safety of a food service facility being part of a larger group of facilities. Restaurants with trained and certified food managers had significantly fewer critical food safety violations but more non-critical violations than restaurants without certified personnel. Institutional food service facilities had significantly fewer violations than restaurants, and the number of violations did not differ as a function of certification. Similarly, restaurants with many outlets had significantly fewer violations than restaurants with fewer outlets, and training was not associated with lower numbers of violations from restaurants with many outlets. The value of having certified personnel was only observed in independent restaurants and those with few branches. This information may be useful in indicating where food safety problems are most likely to occur. Furthermore, we recommend that those characteristics of institutional and chain restaurants that result in fewer violations should be identified in future research, and efforts made to apply this knowledge at the level of individual restaurants. PMID:20523880
Kassa, Hailu; Silverman, Gary S; Baroudi, Karim
2010-05-06
Food safety is an important public health issue in the U.S. Eating at restaurants and other food service facilities increasingly has been associated with food borne disease outbreaks. Food safety training and certification of food mangers has been used as a method for reducing food safety violations at food service facilities. However, the literature is inconclusive about the effectiveness of such training programs for improving food safety and protecting consumer health. The purpose of this study was to examine the effect of food manger training on reducing food safety violations. We examined food inspection reports from the Toledo/Lucas County Health Department (Ohio) from March 2005 through February 2006 and compared food hygiene violations between food service facilities with certified and without certified food managers. We also examined the impact on food safety of a food service facility being part of a larger group of facilities.Restaurants with trained and certified food managers had significantly fewer critical food safety violations but more non-critical violations than restaurants without certified personnel. Institutional food service facilities had significantly fewer violations than restaurants, and the number of violations did not differ as a function of certification. Similarly, restaurants with many outlets had significantly fewer violations than restaurants with fewer outlets, and training was not associated with lower numbers of violations from restaurants with many outlets. The value of having certified personnel was only observed in independent restaurants and those with few branches. This information may be useful in indicating where food safety problems are most likely to occur. Furthermore, we recommend that those characteristics of institutional and chain restaurants that result in fewer violations should be identified in future research, and efforts made to apply this knowledge at the level of individual restaurants.
Subramaniam, Hamsa L.; Prust, Margaret L.; Prescott, Marta R.; Mpasela, Felton; Mwango, Albert; Namonje, Leah; Moyo, Crispin; Chibuye, Benjamin; van den Broek, Jan Willem; Hehman, Lindsey; Moberley, Sarah
2017-01-01
Introduction In urban areas, crowded HIV treatment facilities with long patient wait times can deter patients from attending their clinical appointments and picking up their medications, ultimately disrupting patient care and compromising patient retention and adherence. Methods Formative research at eight facilities in Lusaka revealed that only 46% of stable HIV treatment patients were receiving a three-month refill supply of antiretroviral drugs, despite it being national policy for stable adult patients. We designed a quality improvement intervention to improve the operationalization of this policy. We conducted a cluster-randomized controlled trial in sixteen facilities in Lusaka with the primary objective of examining the intervention’s impact on the proportion of stable patients receiving three-month refills. The secondary objective was examining whether the quality improvement intervention reduced facility congestion measured through two proxy indicators: daily volume of clinic visits and average clinic wait times for services. Results The mean change in the proportion of three-month refills among control facilities from baseline to endline was 10% (from 38% to 48%), compared to a 25% mean change (an increase from 44% to 69%) among intervention facilities. This represents a significant 15% mean difference (95% CI: 2%-29%; P = 0.03) in the change in proportion of patients receiving three-month refills. On average, control facilities had 15 more visits per day in the endline than in the baseline, while intervention facilities had 20 fewer visits per day in endline than in baseline, a mean difference of 35 fewer visits per day (P = 0.1). The change in the mean facility total wait time for intervention facilities dropped 19 minutes between baseline and endline when compared to control facilities (95% CI: -10.2–48.5; P = 0.2). Conclusion A more patient-centred service delivery schedule of three-month prescription refills for stable patients is viable. We encourage the expansion of this sustainable intervention in Zambia’s urban clinics. PMID:28419106
McCarthy, Elizabeth A; Subramaniam, Hamsa L; Prust, Margaret L; Prescott, Marta R; Mpasela, Felton; Mwango, Albert; Namonje, Leah; Moyo, Crispin; Chibuye, Benjamin; van den Broek, Jan Willem; Hehman, Lindsey; Moberley, Sarah
2017-01-01
In urban areas, crowded HIV treatment facilities with long patient wait times can deter patients from attending their clinical appointments and picking up their medications, ultimately disrupting patient care and compromising patient retention and adherence. Formative research at eight facilities in Lusaka revealed that only 46% of stable HIV treatment patients were receiving a three-month refill supply of antiretroviral drugs, despite it being national policy for stable adult patients. We designed a quality improvement intervention to improve the operationalization of this policy. We conducted a cluster-randomized controlled trial in sixteen facilities in Lusaka with the primary objective of examining the intervention's impact on the proportion of stable patients receiving three-month refills. The secondary objective was examining whether the quality improvement intervention reduced facility congestion measured through two proxy indicators: daily volume of clinic visits and average clinic wait times for services. The mean change in the proportion of three-month refills among control facilities from baseline to endline was 10% (from 38% to 48%), compared to a 25% mean change (an increase from 44% to 69%) among intervention facilities. This represents a significant 15% mean difference (95% CI: 2%-29%; P = 0.03) in the change in proportion of patients receiving three-month refills. On average, control facilities had 15 more visits per day in the endline than in the baseline, while intervention facilities had 20 fewer visits per day in endline than in baseline, a mean difference of 35 fewer visits per day (P = 0.1). The change in the mean facility total wait time for intervention facilities dropped 19 minutes between baseline and endline when compared to control facilities (95% CI: -10.2-48.5; P = 0.2). A more patient-centred service delivery schedule of three-month prescription refills for stable patients is viable. We encourage the expansion of this sustainable intervention in Zambia's urban clinics.
Xing, Jingping; Mukamel, Dana B.; Temkin-Greener, Helena
2013-01-01
Objectives 1) To examine the incidence, variations, and costs in potentially avoidable hospitalizations (PAHs) among nursing home (NH) residents at the end-of-life. 2) To identify the association between NH characteristics and a facility-level quality measure (QM) for PAH. Design Retrospective study. Setting Hospitalizations originating from NHs. Participants Long-term care NH residents who died in 2007. Measurements We constructed a risk-adjusted QM for PAH. Poisson regression model was used to predict the count of PAH given residents’ risk factors. For each facility, the QM was defined as the difference between the observed facility-specific rate (per 1,000 person-years) of PAH (O) and the expected risk-adjusted rate (E). We then fit a logistic regression model with state fixed-effects to examine the association between facility characteristics and the likelihood of having higher than expected rates of PAH (O-E>0). QM values higher than 0 indicate worse than average quality. Results Almost 50% of hospital admissions for NH residents in their last year of life were for potentially avoidable diagnoses, costing Medicare $1billion. Five conditions were responsible for over 80% of PAHs. PAH QM across facilities showed significant variation (mean=11.96; std dev=142.26; range: −399.48-398.09). Chain and hospital-based facilities were more likely to exhibit better performance (O-E<0). Facilities with higher nursing staffing were more likely to have better performance, as did facilities with higher skilled staff ratio, facilities with nurse practitioners/physician assistants, and those with on-site x-ray services. Conclusion Variations in facility-level PAHs suggest that a potential for reducing hospital admissions for these conditions may exist. Presence of modifiable facility characteristics associated with PAH performance provides insights into possible interventions for reducing PAHs at the end-of-life. PMID:24219191
NASA Technical Reports Server (NTRS)
1973-01-01
Skylab 2 Commander Charles Conrad is seen undergoing a dental examination by the Medical Officer, Joseph Kerwin in the Skylab Medical Facility. In the absence of an examination chair, Conrad simply rotated his body to an upside down position to facilitate the procedure.
28 CFR 36.309 - Examinations and courses.
Code of Federal Regulations, 2011 CFR
2011-07-01
... PUBLIC ACCOMMODATIONS AND IN COMMERCIAL FACILITIES Specific Requirements § 36.309 Examinations and... with a disability that impairs sensory, manual, or speaking skills, the examination results accurately... to measure, rather than reflecting the individual's impaired sensory, manual, or speaking skills...
Dalal, Koustuv; Dawad, Suraya
2009-01-01
This article examines women's opinions about their reasons for the non-utilization of appropriate public health care facilities, according to categories of their healthcare seeking in India. This cross-sectional article uses nationally representative samples from the Indian National Family Health Surveys NFHS-3 (2005-2006), which were generated from randomly selected households. Women of reproductive age (15-49 years) from the 29 states of India participated (n = 124 385 women). The respondents were asked why they did not utilize public health care facilities when members of their households were ill, identifying their reasons with a yes/no choice. The following five reasons were of primary interest: (1) 'there is no nearby facility'; (2) 'facility timing is not convenient'; (3) 'health personnel are often absent'; (4) 'waiting time is too long'; and (5) 'poor quality of care'. Results from logistic regression analyses indicate that respondents' education, economic status and standard of living are significant predictors for non-utilization of public health care facilities. Women who sought the services of care delivery and health check-ups indicated that health personnel were absent. Service seekers for self and child's medical treatments indicated that there were no nearby health facilities, service times were inconvenient, there were long waiting times and poor quality health care. This study concludes that improving public health care facilities with user-friendly opening times, the regular presence of staff, reduced waiting times and improved quality of care are necessary steps to reducing maternal mortality and poverty.
Shared Use of Physical Activity Facilities Among North Carolina Faith Communities, 2013
Edwards, Michael B.; Bocarro, Jason N.; Stein, Anna; Kanters, Michael A.; Sherman, Danielle Marie; Rhew, Lori K.; Stallings, Willona Marie; Bowen, Sarah K.
2017-01-01
Introduction Shared use of recreational facilities is a promising strategy for increasing access to places for physical activity. Little is known about shared use in faith-based settings. This study examined shared use practices and barriers in faith communities in North Carolina. Methods Faith communities in North Carolina (n = 234) completed an online survey (October–December 2013) designed to provide information about the extent and nature of shared use of recreational facilities. We used binary logistic regression to examine differences between congregations that shared use and those that did not share use. Results Most of the faith communities (82.9%) that completed the survey indicated that they share their facilities with outside individuals and organizations. Formal agreements were more common when faith communities shared indoor spaces such as gymnasiums and classroom meeting spaces than when they shared outdoor spaces such as playgrounds or athletic fields. Faith communities in the wealthiest counties were more likely to share their spaces than were faith communities in poorer counties. Faith communities in counties with the best health rankings were more likely to share facilities than faith communities in counties that had lower health rankings. The most frequently cited reasons faith communities did not share their facilities were that they did not know how to initiate the process of sharing their facilities or that no outside groups had ever asked. Conclusion Most faith communities shared their facilities for physical activity. Research is needed on the relationship between shared use and physical activity levels, including the effect of formalizing shared-use policies. PMID:28152362
Shared Use of Physical Activity Facilities Among North Carolina Faith Communities, 2013.
Hardison-Moody, Annie; Edwards, Michael B; Bocarro, Jason N; Stein, Anna; Kanters, Michael A; Sherman, Danielle Marie; Rhew, Lori K; Stallings, Willona Marie; Bowen, Sarah K
2017-02-02
Shared use of recreational facilities is a promising strategy for increasing access to places for physical activity. Little is known about shared use in faith-based settings. This study examined shared use practices and barriers in faith communities in North Carolina. Faith communities in North Carolina (n = 234) completed an online survey (October-December 2013) designed to provide information about the extent and nature of shared use of recreational facilities. We used binary logistic regression to examine differences between congregations that shared use and those that did not share use. Most of the faith communities (82.9%) that completed the survey indicated that they share their facilities with outside individuals and organizations. Formal agreements were more common when faith communities shared indoor spaces such as gymnasiums and classroom meeting spaces than when they shared outdoor spaces such as playgrounds or athletic fields. Faith communities in the wealthiest counties were more likely to share their spaces than were faith communities in poorer counties. Faith communities in counties with the best health rankings were more likely to share facilities than faith communities in counties that had lower health rankings. The most frequently cited reasons faith communities did not share their facilities were that they did not know how to initiate the process of sharing their facilities or that no outside groups had ever asked. Most faith communities shared their facilities for physical activity. Research is needed on the relationship between shared use and physical activity levels, including the effect of formalizing shared-use policies.
Landsbergis, Paul A; Janevic, Teresa; Rothenberg, Laura; Adamu, Mohammed T; Johnson, Sylvia; Mirer, Franklin E
2013-07-01
We examined the association between long work hours, assembly line work and stress-related diseases utilizing objective health and employment data from an employer's administrative databases. A North American automobile manufacturing company provided data for claims for sickness, accident and disability insurance (work absence of at least 4 days) for cardiovascular disease (CVD), hypertension and psychological disorders, employee demographics, and facility hours worked per year for 1996-2001. Age-adjusted claim rates and age-adjusted rate ratios were calculated using Poisson regression, except for comparisons between production and skilled trades workers owing to lack of age denominator data by job category. Associations between overtime hours and claim rates by facility were examined by Poisson regression and multi-level Poisson regression. Claims for hypertension, coronary heart disease, CVD, and psychological disorders were associated with facility overtime hours. We estimate that a facility with 10 more overtime hours per week than another facility would have 4.36 more claims for psychological disorders, 2.33 more claims for CVD, and 3.29 more claims for hypertension per 1,000 employees per year. Assembly plants had the highest rates of claims for most conditions. Production workers tended to have higher rates of claims than skilled trades workers. Data from an auto manufacturer's administrative databases suggest that autoworkers working long hours, and assembly-line workers relative to skilled trades workers or workers in non-assembly facilities, have a higher risk of hypertension, CVD, and psychological disorders. Occupational disease surveillance and disease prevention programs need to fully utilize such administrative data. Copyright © 2013 Wiley Periodicals, Inc.
Shen, Junyi; Nakashima, Takako; Karasawa, Izumi; Furui, Tatsuro; Morishige, Kenichiro; Saijo, Tatsuyoshi
2018-05-21
Perinatal care in rural Japan is currently facing a crisis because of the lack of medical staff, especially obstetricians. In this study, a new style of postnatal care facility that combines both medical and nonmedical support is considered. Contrary to most postnatal care facilities in Japan, this new postnatal care facility accepts a puerperant from the cooperating maternity facility soon after birth (≤2 days). We conducted a hypothetical choice experiment to investigate whether this new postnatal care facility could be accepted by women in Gero City, Hida, Gifu Prefecture and how these women evaluate different kinds of postnatal care services. The results show that after a 2-day hospital stay, women from Gero City preferred to move to the new postnatal care facility over the other alternatives (continued hospitalization or discharge home). In addition, the estimated choice probabilities for selecting the postnatal care facility under different scenarios show a high level of acceptance for this new postnatal care facility. Copyright © 2018 John Wiley & Sons, Ltd.
Benchmarking the FCI at Illinois State's Residential Life.
ERIC Educational Resources Information Center
Cain, David A.
1998-01-01
Describes how Office of Residential Life at one university met maintenance challenges facing its residential and food-service facilities. Discusses study conducted in 1992 to evaluate widespread management practices and addresses its findings, including six recommended practices. Examines development and implementation of facilities audit,…
DOT National Transportation Integrated Search
1994-01-01
This report examines the phenomenon of the unearned increment, which is the often substantial increase in private land values resulting from transportation facility construction, and possible attempts to recoup it to finance transportation projects. ...
Facilities Guidelines for Fine Arts Programs.
ERIC Educational Resources Information Center
Maryland State Dept. of Education, Baltimore.
This manual of facility guidelines examines the planning process and design features and considerations for public school fine arts programs in Maryland. Planning concepts and trends are highlighted followed by planning guidelines for dance, music, theater, visual arts, general education, and performance spaces. General design considerations…
New facilities and additions to existing facilities will be required to meet the EPA's new (early 1970s) environmental quality standards. The report examines extent of these additional demands for construction and their economic impacts.
Perspectives on Leadership in Facilities Management.
ERIC Educational Resources Information Center
Jenkins, Charles W. Ed.
This collection of papers examines issues concerning leadership in facilities management in higher education. Chapters include: (1) "Catch the Spirit of Leadership" (Jack Hug); (2) "Visionary Leadership: Creating a New Tomorrow" (Burt Nanus); (3) "Some Thoughts on Leadership" (Charles W. Jenkins); (4) "Educational Leadership: The Role of…
Call for neonatal nursing specialization in developing countries.
Premji, Shahirose S; Spence, Kaye; Kenner, Carole
2013-01-01
In an attempt to reach Millennium Development Goals, health facility births, which are births occurring in health centers, facilities, or institutions under the care of a skilled birth attendant, are increasing in developing countries. We examined the state of neonatal nursing care in the context of issues related to the capacity of these health facilities to provide quality care and the high facility mortality rates in those neonates admitted to hospital. Neonatal nursing as a specialty within a community-hospital-community network system is proposed as an effective scaling-up strategy to improve neonatal survival. Establishment of international competency standards for neonatal nursing together with regulatory processes with mechanisms to facilitate specialty education forms the basis for the specialty of neonatal nursing. We have identified a strategy to mobilize financial resources for the development of the specialty of neonatal nursing. Evaluation of trends in mortality and identification of process indicators will facilitate examination of the effectiveness of the introduction of the specialty of neonatal nursing as a scaling-up strategy.
Dvorácek, I
2005-10-01
The valid law does not unequivocally define a physician's competence and obligations at the place of a subject's death outside the health-care facilities. The scheme creates a general instruction for the medical personnel to be used in cases of death outside health-care facilities. It is aimed at a better understanding of the problem, and it is supplemented with relevant legal regulations. The scheme is divided into 3 horizontal levels, the death being placed on the first level, the decision about autopsy on the second level, and the burial on the third level. These three levels are interconnected vertically, in order to represent the chronological sequence of individual steps and the respective decisions made by the examining physician. The schematic representation of the problems of death outside health-care facilities resulted in several lines of action, all that with regard to the medical and forensic aspects of the death. In every line of action, the work of the examining physician's is summarised.
Does investor ownership of nursing homes compromise the quality of care?
Harrington, C; Woolhandler, S; Mullan, J; Carrillo, H; Himmelstein, D U
2001-09-01
Two thirds of nursing homes are investor owned. This study examined whether investor ownership affects quality. We analyzed 1998 data from state inspections of 13,693 nursing facilities. We used a multivariate model and controlled for case mix, facility characteristics, and location. Investor-owned facilities averaged 5.89 deficiencies per home, 46.5% higher than nonprofit facilities and 43.0% higher than public facilities. In multivariate analysis, investor ownership predicted 0.679 additional deficiencies per home; chain ownership predicted an additional 0.633 deficiencies. Nurse staffing was lower at investor-owned nursing homes. Investor-owned nursing homes provide worse care and less nursing care than do not-for-profit or public homes.
Reiman, Amanda E
2008-01-01
In an effort to examine and possibly utilise the community-based, bottom-up service design of medical cannabis facilities in the San Francisco Bay area of California, 130 adults who had received medical cannabis recommendations from a physician were surveyed at seven facilities to describe the social service aspects of these unique, community-based programmes. This study used an unselected consecutive sample and cross-sectional survey design that included primary data collection at the medical cannabis facilities themselves. In this exploratory study, individual level data were collected on patient demographics and reported patient satisfaction as gathered by the Patient Satisfaction Questionnaire III. Surveys were filled out on site. In the case of a refusal, the next person was asked. The refusal rate varied depending on the study site and ranged between 25% and 60%, depending on the facility and the day of sampling. Organisational-level data, such as operating characteristics and products offered, created a backdrop for further examination into the social services offered by these facilities and the attempts made by this largely unregulated healthcare system to create a community-based environment of social support for chronically ill people. Informal assessment suggests that chronic pain is the most common malady for which medical cannabis is used. Descriptive statistics were generated to examine sample- and site-related differences. Results show that medical cannabis patients have created a system of dispensing medical cannabis that also includes services such as counselling, entertainment and support groups - all important components of coping with chronic illness. Furthermore, patients tend to be male, over 35, identify with more than one ethnicity, and earn less than US$20 000 annually. Levels of satisfaction with facility care were fairly high, and higher than nationally reported satisfaction with health care in the USA. Facilities tended to follow a social model of cannabis care, including allowing patients to use medicine on site and offering social services. This approach has implications for the creation and maintenance of a continuum of care among bottom-up social and health services agencies.
Martin, Cody; Powell, David
2017-02-01
The 2009 Pinelake Health and Rehab Center shooting in Carthage, North Carolina, presents a unique case study for examining the specific considerations for mass violence events in senior living facilities. A variety of factors, including reduced sensory perception, reduced mobility, and cognitive decline, may increase the vulnerability of the populations of senior living facilities during mass violence events. Management of response aspects such as evacuation, relocation, and reunification also require special consideration in the context of mass violence at senior living facilities. Better awareness of these vulnerabilities and response considerations can assist facility administrators and emergency managers when preparing for potential mass violence events at senior living facilities. (Disaster Med Public Health Preparedness. 2017;11:150-152).
Everett Jones, Sherry; Wendel, Arthur M
2015-04-16
Joint use or shared use of public school facilities provides community access to facilities for varied purposes. We examined a nationally representative sample of school districts in the United States to identify characteristics associated with having a formal joint use agreement (JUA) and with the kinds of uses to which JUAs apply. We analyzed data from the 2012 School Health Policies and Practices Study. The response rate for the module containing questions about formal JUAs was 60.1% (N = 630). We used multivariate logistic regression models to examine the adjusted odds of having a formal JUA and χ(2) analyses to examine differences in district characteristics associated with the uses of the JUA. Among the 61.6% of school districts with a formal JUA, more than 80% had an agreement for the use of indoor and outdoor recreation facilities; other uses also were identified. JUAs were more common in urban than rural areas, in large than small school districts, and in the West compared with the Midwest, South, and Northeast. In many districts, school facilities appear to be an untapped resource for community members. Formal JUAs provide an opportunity for shared use while addressing issues of liability, cost, and logistics.
49 CFR 109.9 - Transportation for examination and analysis.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 49 Transportation 2 2013-10-01 2013-10-01 false Transportation for examination and analysis. 109.9... ORDERS, AND EMERGENCY RECALLS § 109.9 Transportation for examination and analysis. (a) An agent may direct a package to be transported to a facility for examination and analysis when the agent determines...
DOE Office of Scientific and Technical Information (OSTI.GOV)
Linton, Kory D.; Parish, Chad M.; Smith, Quinlan B.
2017-09-01
This document outlines the results obtained by Oak Ridge National Laboratory (ORNL) in collaboration with the University of Michigan-led Consolidated Innovative Nuclear Research project, “Feasibility of combined ion-neutron irradiation for accessing high dose levels.” In this reporting period, neutron irradiated were prepared and shipped to the University of Michigan for subsequent ion irradiation. The specimens were returned to ORNL’s Low Activation Materials Development and Analysis facility, prepared via focused ion beam for examination using scanning/transmission electron microscopy (S/TEM), and then examined using S/TEM to measure the as-irradiated microstructure. This report briefly summarizes the S/TEM results obtained at ORNL’s Low Activationmore » Materials Development and Analysis facility.« less
77 FR 34367 - Proposed Subsequent Arrangement
Federal Register 2010, 2011, 2012, 2013, 2014
2012-06-11
... reactors, and a research reactor, at the Post Irradiation Examination Facility (PIEF), the Irradiated.../2011, ``Post-Irradiation Examination and R&D Programs Using Irradiated Fuels at KAERI,'' dated June... fuel elements for post-irradiation examination and for research, development and manufacture of DUPIC...
McGregor, Margaret J.; Cohen, Marcy; McGrail, Kimberlyn; Broemeling, Anne Marie; Adler, Reva N.; Schulzer, Michael; Ronald, Lisa; Cvitkovich, Yuri; Beck, Mary
2005-01-01
Background Currently there is a lot of debate about the advantages and disadvantages of for-profit health care delivery. We examined staffing ratios for direct-care and support staff in publicly funded not-for-profit and for-profit nursing homes in British Columbia. Methods We obtained staffing data for 167 long-term care facilities and linked these to the type of facility and ownership of the facility. All staff were members of the same bargaining association and received identical wages in both not-for-profit and for-profit facilities. Similar public funding is provided to both types of facilities, although the amounts vary by the level of functional dependence of the residents. We compared the mean number of hours per resident-day provided by direct-care staff (registered nurses, licensed practical nurses and resident care aides) and support staff (housekeeping, dietary and laundry staff) in not-for-profit versus for-profit facilities, after adjusting for facility size (number of beds) and level of care. Results The nursing homes included in our study comprised 76% of all such facilities in the province. Of the 167 nursing homes examined, 109 (65%) were not-for-profit and 58 (35%) were for-profit; 24% of the for-profit homes were part of a chain, and the remaining homes were owned by a single operator. The mean number of hours per resident-day was higher in the not-for-profit facilities than in the for-profit facilities for both direct-care and support staff and for all facility levels of care. Compared with for-profit ownership, not-for-profit status was associated with an estimated 0.34 more hours per resident-day (95% confidence interval [CI] 0.18–0.49, p < 0.001) provided by direct-care staff and 0.23 more hours per resident-day (95% CI 0.15–0.30, p < 0.001) provided by support staff. Interpretation Not-for-profit facility ownership is associated with higher staffing levels. This finding suggests that public money used to provide care to frail eldery people purchases significantly fewer direct-care and support staff hours per resident-day in for-profit long-term care facilities than in not-for-profit facilities. PMID:15738489
Building Condition and Suitability Evaluation Manual.
ERIC Educational Resources Information Center
MGT of America, Inc., Tallahassee, FL.
This educational facility evaluation manual contains the overall building condition rating form and the supporting check sheets which have been field tested in several states and, where appropriate, modified for use in the Idaho School Facilities Needs Assessment. The exterior building condition form examines the foundation, structure, walls,…
14. Historic view of engineer in Building 100 control room ...
14. Historic view of engineer in Building 100 control room examining data printout. 1957. On file at NASA Plumbrook Research Facility, Sandusky, Ohio. NASA photo number C-46210. - Rocket Engine Testing Facility, GRC Building No. 100, NASA Glenn Research Center, Cleveland, Cuyahoga County, OH
Code of Federal Regulations, 2010 CFR
2010-01-01
..., review of standard referenced design approvals, special projects, inspections and import and export... standard referenced design approvals, special projects, inspections and import and export licenses..., approvals of facility standard reference designs, re-qualification and replacement examinations for reactor...
Code of Federal Regulations, 2014 CFR
2014-01-01
..., review of standard referenced design approvals, special projects, inspections and import and export... standard referenced design approvals, special projects, inspections and import and export licenses..., approvals of facility standard reference designs, re-qualification and replacement examinations for reactor...
Code of Federal Regulations, 2013 CFR
2013-01-01
..., review of standard referenced design approvals, special projects, inspections and import and export... standard referenced design approvals, special projects, inspections and import and export licenses..., approvals of facility standard reference designs, re-qualification and replacement examinations for reactor...
Code of Federal Regulations, 2011 CFR
2011-01-01
..., review of standard referenced design approvals, special projects, inspections and import and export... standard referenced design approvals, special projects, inspections and import and export licenses..., approvals of facility standard reference designs, re-qualification and replacement examinations for reactor...
Fundraising Basics for Private School Facilities.
ERIC Educational Resources Information Center
Roach, Arthur H.
This report examines the process behind setting up and implementing a "capital campaign," a program for raising money for new or renovated facilities at private K-12 schools. The report briefly covers tax information regarding gifts to institutions, then offers advice for setting up a comprehensive development program, including…
Webb, Bettine C; Whittle, Terry; Schwarz, Eli
2016-09-01
To determine the perceptions of dental care held by the residents in aged care facilities (ACFs) in New South Wales (NSW) and to compare these perceptions with clinical observations. No specific data exist relating to NSW residents' perceptions of dental care compared with a clinical examination. Planning for appropriate oral health programs in ACFs necessitate such data. Four Area Health Services of Sydney and 25 low care ACFs were selected from which representative residents were sampled who completed a survey and underwent a basic dental examination. Of the subjects (25 males, 96 females), 76.9% had never received a dental visit as entering the ACF; 14.1% suffered from dental pain; 69.4% wore dentures and of these 18.3% required assistance in cleaning. Dentures were cleaned twice/day in 54.9% of cases. Natural teeth were reported present in 71.9% of residents, and 85.1% did not require assistance in cleaning. Appropriate dental care facilities and dry mouth were most frequent problems highlighted. Clinical examinations showed that 69% were denture wearers; oral hygiene and denture hygiene were considered good in 15.7% of cases. A high level of concordance existed between self-reports and examination. Increased awareness about oral health across leadership, caregivers and residents with appropriate dental health education and dedicated space within facilities would provide a much needed improvement for addressing oral health issues of the ACF residents. This might be the right time to plan for the future challenges that will need to be met by the NSW care system. © 2015 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.
Optimal pricing policies for services with consideration of facility maintenance costs
NASA Astrophysics Data System (ADS)
Yeh, Ruey Huei; Lin, Yi-Fang
2012-06-01
For survival and success, pricing is an essential issue for service firms. This article deals with the pricing strategies for services with substantial facility maintenance costs. For this purpose, a mathematical framework that incorporates service demand and facility deterioration is proposed to address the problem. The facility and customers constitute a service system driven by Poisson arrivals and exponential service times. A service demand with increasing price elasticity and a facility lifetime with strictly increasing failure rate are also adopted in modelling. By examining the bidirectional relationship between customer demand and facility deterioration in the profit model, the pricing policies of the service are investigated. Then analytical conditions of customer demand and facility lifetime are derived to achieve a unique optimal pricing policy. The comparative statics properties of the optimal policy are also explored. Finally, numerical examples are presented to illustrate the effects of parameter variations on the optimal pricing policy.
Ijadunola, Macellina Y; Ojo, Temitope O; Akintan, Florence O; Adeyemo, Ayoade O; Afolayan, Ademola S; Akanji, Olakunle G
2018-03-12
This study assessed awareness and availability of assistive facilities in a Nigerian public university. Study was conducted in Obafemi Awolowo University (OAU), Ile Ife Nigeria using a mixed methods approach. Fifty two students with disability (SWD) were interviewed with a semistructured, self-administered questionnaire. A checklist was used to assess assistive facilities on campus while in-depth interviews (IDI) were conducted with university officials, to assess their perspectives about the availability and use of assistive facilities in the university. Almost three-thirds (57.7%) of SWD were male while more than two-thirds were aged between 21 and 30 years. About seven in 10 (71.1%) respondents, had mobility impairment, while two-fifth had visual impairment (40.8%) and a few had hearing impairment. Only the university's administrative building had a functioning elevator. Slightly more than half (54.5%) of the lecture theatres have public address systems, while only two have special entrances and exits with ramps for SWD. Almost all respondents were unaware of facilities that aid learning (96.2%) and facilities for library use (90.4%). University officials were aware of assistive facilities for SWD but do not know the actual number of SWD. Assistive facilities for SWD on campus are limited. More assistive facilities need to be provided alongside increased awareness about these facilities and a disability register should be open for students on campus. Assistive facilities to aid learning and make SWD more comfortable are required. Implications for Rehabilitation Universities should have an official policy on students with disabilities and implement it, such a policy should address special considerations for disabled students, such as having an updated register for students with disability, having examination questions in large fonts for students with visual disabilities, giving them extra time for examinations and providing special counselling services for students with disabilities. Awareness about assistive facilities in tertiary institutions for students with disability should be increased so that they can utilize the ones available and demand for such if non-existent. The design of buildings on university campus should be made disability friendly. A disability register should be open for SWD on campus.
Gender equality and childbirth in a health facility: Nigeria and MDG5.
Singh, Kavita; Bloom, Shelah; Haney, Erica; Olorunsaiye, Comfort; Brodish, Paul
2012-09-01
This paper examined how addressing gender equality can lead to reductions in maternal mortality in Nigeria through an increased use of facility delivery. Because the majority of maternal complications cannot be predicted and often arise suddenly during labor, delivery and the immediate postpartum period, childbirth in a health facility is key to reducing maternal mortality. This paper used data from the 2008 Nigeria Demographic and Health Survey (DHS) to examine associations of gender measures on the utilization of facility delivery after controlling for socio-demographic factors. Four gender equality measures were studied: household decision-making, financial decision-making, attitudes towards wife beating, and attitudes regarding a wife's ability to refuse sex. Results found older, more educated, wealthier, urban, and working women were more likely to have a facility delivery than their counterparts. In addition ethnicity was a significant variable indicating the importance of cultural and regional diversity. Notably, after controlling for the socioeconomic variables, two of the gender equality variables were significant: household decision-making and attitudes regarding a wife's ability to refuse sex. In resource-poor settings such as Nigeria, women with more decision-making autonomy are likely better able to advocate for and access a health facility for childbirth. Thus programs and policies that focus on gender in addition to focusing on education and poverty have the potential to reduce maternal mortality even further.
Federal Register 2010, 2011, 2012, 2013, 2014
2012-01-27
... Activities; Submission to OMB for Review and Approval; Comment Request; Facility Ground-Water Monitoring... docket, go to www.regulations.gov . Title: Facility Ground-Water Monitoring Requirements (Renewal). ICR.... Abstract: This ICR examines the ground-water monitoring standards for permitted and interim status...
HPV Vaccination Practices Among Juvenile Justice Facilities in the United States
Henderson, Courtney E.; Rich, Josiah D.; Lally, Michelle A.
2010-01-01
The juvenile justice setting provides a unique opportunity to administer the human papillomavirus (HPV) vaccine to a high-risk, medically underserved population. We examined current HPV vaccination practices in the United States. Most states (39) offer the HPV vaccine to females committed to juvenile justice facilities. PMID:20413087
Centralization and Decentralization of Schools' Physical Facilities Management in Nigeria
ERIC Educational Resources Information Center
Ikoya, Peter O.
2008-01-01
Purpose: This research aims to examine the difference in the availability, adequacy and functionality of physical facilities in centralized and decentralized schools districts, with a view to making appropriate recommendations to stakeholders on the reform programmes in the Nigerian education sector. Design/methodology/approach: Principals,…
Financing Academic Research Facilities: A National Need.
ERIC Educational Resources Information Center
Norris, Julie T.
1990-01-01
This article examines possible changes to provide increased federal funding for university-based research facilities. The difficulties of converting between depreciation and use allowances are discussed, as is the possibility of using current market value versus acquisition cost as a basis for costing calculations and splitting the indirect cost…
Housing for Single Graduate Students: A Status Report.
ERIC Educational Resources Information Center
Sullivan, Kathleen; And Others
Residence communities which were designed to house graduate students have become facilities for all students aged 21 or older. This study surveyed 25 colleges that offer housing to older students, examining the areas of programming, facilities, relationship with the graduate school, student or community governance, and the population itself. The…
Indirect Costs and Other Uses of Facilities Data at Institutions
ERIC Educational Resources Information Center
Watt, Catherine E.; Higerd, Thomas B.
2007-01-01
The purpose of this chapter is to examine possible uses for facilities data as they relate to three academic issues: classroom management, personnel management, and research activity. The number of institutions actively using space information to improve decision making is unknown. Most articles available in professional publications such as…
15. Historic view of engineer in Building 100 control room ...
15. Historic view of engineer in Building 100 control room examining data printout. August 28, 1962. On file at NASA Plumbrook Research Facility, Sandusky, Ohio. NASA photo number C-61500. - Rocket Engine Testing Facility, GRC Building No. 100, NASA Glenn Research Center, Cleveland, Cuyahoga County, OH
Occupational radiation Exposure at Agreement State-Licensed Materials Facilities, 1997-2010
DOE Office of Scientific and Technical Information (OSTI.GOV)
U.S. Nuclear Regulatory Commission, Office of Nuclear Regulatory Research
The purpose of this report is to examine occupational radiation exposures received under Agreement State licensees. As such, this report reflects the occupational radiation exposure data contained in the Radiation Exposure Information and Reporting System (REIRS) database, for 1997 through 2010, from Agreement State-licensed materials facilities.
The Challenges and Opportunities of Residence Hall Facilities.
ERIC Educational Resources Information Center
Thaler-Carter, Ruth E.
2001-01-01
Explores the challenges facing college and university residence hall facility managers and how different schools address these issues in diverse ways. Ongoing concerns involving funding needs and maintenance are examined followed by discussions on the new challenges in managing student life, health, and safety. Concluding comments reveal where…
Theaters and Auditoriums. Second Edition.
ERIC Educational Resources Information Center
Burris-Meyer, Harold; Cole, Edward C.
Facilities for the performing arts are examined as to associated problems and possible design solutions. Also included are auditoriums which may not be directly related to theater functions but have similar problems and needs. Existing facilities serve as a basis for the subsequent critical analysis of certain areas and development of optimal…
76 FR 64351 - Agency Forms Undergoing Paperwork Reduction Act Review
Federal Register 2010, 2011, 2012, 2013, 2014
2011-10-18
... of the proposed study is two- fold: (1) To examine healthcare facility compliance with the New Jersey... events, violence prevention committee, written violence prevention plan, violence risk assessments, post... facility violent event reports 3 years pre-regulation (2009-2011) and 3 years post-regulation (2012-2014...
ERIC Educational Resources Information Center
Devlin, Renee S.; Gibbs, John C.
2010-01-01
This article examined cognitive and behavioral changes among participants in Responsible Adult Culture (RAC), a cognitive-behavioral (especially, cognitive restructuring) treatment program in use at the Franklin County Community-Based Correctional Facility (CBCF). Participants were adult felony offenders (approximately three-fourths male). A…
Report of the National Libraries Committee.
ERIC Educational Resources Information Center
Department of Education and Science, London (England).
The study was undertaken to examine the functions and organization of the British Museum Library, the National Central Library, the National Lending Library for Science and Technology, and the Science Museum Library in providing national library facilities; to consider whether in the interests of efficiency and economy such facilities should be…
Product Searching with Shopping Bots.
ERIC Educational Resources Information Center
Rowley, Jennifer
2000-01-01
Using trial searches for three best-selling books, this study examined the search facilities offered by shopping bots, which support consumers with the product search and identification stage in e-shopping. Findings indicate that effectiveness of bots not only depends upon search facilities but also upon product coverage, and other added value…
Mastracchio works with the Ant Forage Habitat Facility
2014-01-13
ISS038-E-031992 (13 Jan. 2014) --- NASA astronaut Rick Mastracchio, Expedition 38 flight engineer, works with the Ant Forage Habitat Facility in the Destiny laboratory of the International Space Station. The study examines the behavior of ants by comparing groups living on Earth to those in space.
Doing Business in the New Technology: Problems for College and University Counsel.
ERIC Educational Resources Information Center
Toohey, Daniel W.; Gray, Todd D.
1984-01-01
Regulatory changes regarding public broadcasting and telecommunications facilities on college and university campuses allowing remunerative use of the facilities, and potential obstacles to remunerative use posed by state statutes, are discussed from legal and tax perspectives. The potential for double taxation is examined. (MSE)
Vulnerability to Elder Abuse and Neglect in Assisted Living Facilities
ERIC Educational Resources Information Center
Wood, Stacey; Stephens, Mary
2003-01-01
Purpose: The purpose of this study was to examine the decision-making abilities of residents in assisted living regarding abuse and neglect. Design and Methods: Twenty-seven residents in assisted living facilities were recruited for this descriptive study. Participants were administered an interview to assess baseline knowledge of support…
Fundraising Basics for Private School Facilities
ERIC Educational Resources Information Center
Roach, Arthur H.
2009-01-01
This report examines the process behind setting up and implementing a "capital campaign": a program for raising money for new or renovated facilities at private K-12 schools. The report covers tax information regarding gifts to institutions then offers advice for setting up a comprehensive development program, including fundraising software and…
Quick, Brian; Harrison, Tyler R; King, Andy J; Bosch, Dave
2013-01-01
The present project applied successful strategies employed in previous driver facility campaigns occurring during the inception of a registry to examine whether these approaches are effective in growing a mature registry, a registry where the majority of individuals have had the opportunity to register as an organ donor. Driver facilities (N = 40) in Illinois with high (n = 20) and low (n = 20) organ donation registration percentages were selected and served as either intervention or control sites for the campaign. Among facilities with historically high and low registration percentages, support for the campaign was found with the intervention facilities experiencing higher organ donation registration rates compared with control facilities. In addition, the results provide partial support for the effectiveness of employing a multi-message, phased driver facility intervention in states with a mature registry. The practical implications of utilizing driver facility campaigns in states with an established first-person consent registry also are discussed. © 2013 John Wiley & Sons A/S.
Ozgen, Hacer; A. Ozcan, Yasar
2002-01-01
Objective To examine market competition and facility characteristics that can be related to technical efficiency in the production of multiple dialysis outputs from the perspective of the industrial organization model. Study Setting Freestanding dialysis facilities that operated in 1997 submitted cost report forms to the Health Care Financing Administration (HCFA), and offered all three outputs—outpatient dialysis, dialysis training, and home program dialysis. Data Sources The Independent Renal Facility Cost Report Data file (IRFCRD) from HCFA was utilized to obtain information on output and input variables and market and facility features for 791 multiple-output facilities. Information regarding population characteristics was obtained from the Area Resources File. Study Design Cross-sectional data for the year 1997 were utilized to obtain facility-specific technical efficiency scores estimated through Data Envelopment Analysis (DEA). A binary variable of efficiency status was then regressed against its market and facility characteristics and control factors in a multivariate logistic regression analysis. Principal Findings The majority of the facilities in the sample are functioning technically inefficiently. Neither the intensity of market competition nor a policy of dialyzer reuse has a significant effect on the facilities' efficiency. Technical efficiency is significantly associated, however, with type of ownership, with the interaction between the market concentration of for-profits and ownership type, and with affiliations with chains of different sizes. Nonprofit and government-owned facilities are more likely than their for-profit counterparts to become inefficient producers of renal dialysis outputs. On the other hand, that relationship between ownership form and efficiency is reversed as the market concentration of for-profits in a given market increases. Facilities that are members of large chains are more likely to be technically inefficient. Conclusions Facilities do not appear to benefit from joint production of a variety of dialysis outputs, which may explain the ongoing tendency toward single-output production. Ownership form does make a positive difference in production efficiency, but only in local markets where competition exists between nonprofit and for-profit facilities. The increasing inefficiency associated with membership in large chains suggests that the growing consolidation in the dialysis industry may not, in fact, be the strategy for attaining more technical efficiency in the production of multiple dialysis outputs. PMID:12132602
Ozgen, Hacer; Ozcan, Yasar A
2002-06-01
To examine market competition and facility characteristics that can be related to technical efficiency in the production of multiple dialysis outputs from the perspective of the industrial organization model. Freestanding dialysis facilities that operated in 1997 submitted cost report fonns to the Health Care Financing Administration (HCFA), and offered all three outputs--outpatient dialysis, dialysis training, and home program dialysis. The Independent Renal Facility Cost Report Data file (IRFCRD) from HCFA was utilized to obtain information on output and input variables and market and facility features for 791 multiple-output facilities. Information regarding population characteristics was obtained from the Area Resources File. Cross-sectional data for the year 1997 were utilized to obtain facility-specific technical efficiency scores estimated through Data Envelopment Analysis (DEA). A binary variable of efficiency status was then regressed against its market and facility characteristics and control factors in a multivariate logistic regression analysis. The majority of the facilities in the sample are functioning technically inefficiently. Neither the intensity of market competition nor a policy of dialyzer reuse has a significant effect on the facilities' efficiency. Technical efficiency is significantly associated, however, with type of ownership, with the interaction between the market concentration of for-profits and ownership type, and with affiliations with chains of different sizes. Nonprofit and government-owned Facilities are more likely than their for-profit counterparts to become inefficient producers of renal dialysis outputs. On the other hand, that relationship between ownership form and efficiency is reversed as the market concentration of for-profits in a given market increases. Facilities that are members of large chains are more likely to be technically inefficient. Facilities do not appear to benefit from joint production of a variety of dialysis outputs, which may explain the ongoing tendency toward single-output production. Ownership form does make a positive difference in production efficiency, but only in local markets where competition exists between nonprofit and for-profit facilities. The increasing inefficiency associated with membership in large chains suggests that the growing consolidation in the dialysis industry may not, in fact, be the strategy for attaining more technical efficiency in the production of multiple dialysis outputs.
Wong, Bonny Yee-Man; Cerin, Ester; Ho, Sai-Yin; Mak, Kwok-Kei; Lo, Wing-Sze; Lam, Tai-Hing
2010-04-01
To examine the independent, competing, and interactive effects of perceived availability of specific types of media in the home and neighborhood sport facilities on adolescents' leisure-time physical activity (PA). Survey data from 34 369 students in 42 Hong Kong secondary schools were collected (2006-07). Respondents reported moderate-to-vigorous leisure-time PA, presence of sport facilities in the neighborhood and of media equipment in the home. Being sufficiently physically active was defined as engaging in at least 30 minutes of non-school leisure-time PA on a daily basis. Logistic regression and post-estimation linear combinations of regression coefficients were used to examine the independent and competing effects of sport facilities and media equipment on leisure-time PA. Perceived availability of sport facilities was positively (OR(boys) = 1.17; OR(girls) = 1.26), and that of computer/Internet negatively (OR(boys) = 0.48; OR(girls) = 0.41), associated with being sufficiently active. A significant positive association between video game console and being sufficiently active was found in girls (OR(girls) = 1.19) but not in boys. Compared with adolescents without sport facilities and media equipment, those who reported sport facilities only were more likely to be physically active (OR(boys) = 1.26; OR(girls) = 1.34), while those who additionally reported computer/Internet were less likely to be physically active (OR(boys) = 0.60; OR(girls) = 0.54). Perceived availability of sport facilities in the neighborhood may positively impact on adolescents' level of physical activity. However, having computer/Internet may cancel out the effects of active opportunities in the neighborhood. This suggests that physical activity programs for adolescents need to consider limiting the access to computer-mediated communication as an important intervention component.
Neighbourhood food and physical activity environments in England, UK: does ethnic density matter?
2012-01-01
Background In England, obesity is more common in some ethnic minority groups than in Whites. This study examines the relationship between ethnic concentration and access to fast food outlets, supermarkets and physical activity facilities. Methods Data on ethnic concentration, fast food outlets, supermarkets and physical activity facilities were obtained at the lower super output area (LSOA) (population average of 1500). Poisson multilevel modelling was used to examine the association between own ethnic concentration and facilities, adjusted for area deprivation, urbanicity, population size and clustering of LSOAs within local authority areas. Results There was a higher proportion of ethnic minorities residing in areas classified as most deprived. Fast food outlets and supermarkets were more common and outdoor physical activity facilities were less common in most than least deprived areas. A gradient was not observed for the relationship between indoor physical activity facilities and area deprivation quintiles. In contrast to White British, increasing ethnic minority concentration was associated with increasing rates of fast food outlets. Rate ratios comparing rates of fast food outlets in high with those in low level of ethnic concentration ranged between 1.28, 95% confidence interval 1.06-1.55 (Bangladeshi) and 2.62, 1.46-4.70 (Chinese). Similar to White British, however, increasing ethnic minority concentration was associated with increasing rate of supermarkets and indoor physical activity facilities. Outdoor physical activity facilities were less likely to be in high than low ethnic concentration areas for some minority groups. Conclusions Overall, ethnic minority concentration was associated with a mixture of both advantages and disadvantages in the provision of food outlets and physical activity facilities. These issues might contribute to ethnic differences in food choices and engagement in physical activity. PMID:22709527
An indoor air quality study of an alligator (Alligator mississippiensis) holding facility.
Wilson, S C; Holder, H W; Martin, J M; Brasel, T L; Andriychuk, L A; Wu, C; Straus, D C; Aguilar, R
2006-06-01
An environmental microbiologic investigation was conducted in an alligator (Alligator mississippiensis) holding facility in a zoo in the southeastern U.S. The facility had housed five alligators between March 1999 and February 2005. In the exhibit, one alligator died and all experienced poor health. It was hypothesized that environmental microbial contamination was associated with these issues. Samples were collected for fungal identification and quantification, microcystin analysis, and airborne mycotoxins. Analyses of air and water were conducted and an examination of the heating, ventilation, and air-conditioning system (HVAC) for design, maintenance, and operating issues was made. Two control sites, a facility for false gharials (Tomistoma schlegelii) and an off-site alligator breeding facility, were also tested. Morbidity and mortality records were examined for all sites. Results showed that, compared to the control sites, the test alligator facility and its HVAC system were extensively contaminated with a range of fungi. Nearly all sampled surfaces featured fungal growth. There were also significantly higher counts of Penicillium/Aspergillus-like and Chrysosporium-like spores in the air (P < 0.004). The design, maintenance, and operation of the HVAC system were all inadequate, resulting in poorly conditioned and mold-contaminated air being introduced to the facility. Morbidity records revealed solitary pulmonary disorders over time in three alligators, with one dying as a result. The other two alligators suffered from general malaise and a range of nonspecific symptoms. The control facilities had no morbidity or mortality issues. In conclusion, although no causal links could be demonstrated because of the nature of the morbidity data, environmental mold contamination appeared to be associated with the history of morbidity and mortality in the alligator exhibit.
Teno, Joan M; Gozalo, Pedro; Mitchell, Susan L; Bynum, Julie P W; Dosa, David; Mor, Vincent
2011-06-01
Terminal hospitalizations are costly and often avoidable with appropriate advance care planning. This study examined the association between advance care planning, as measured by facility rate of do not resuscitate (DNR) orders in U.S. nursing homes (NHs) and changes in terminal hospitalization rates. Retrospective cohort study of the changing prevalence of DNR orders in U.S. NHs. Using a fixed effect multivariate model, we examined whether increasing facility rate of DNR orders correlates with reductions in terminal hospitalizations in the last week of life, controlling for changes in facility characteristics (staffing, use of NP/PA, case mix of nursing residents, admission volume, racial composition, payer mix). The average facility rate of terminal hospitalizations was 15.5%, fluctuating between 1999 (15.0%) and 2007 (14.8%). NHs starting with low rates of DNR orders that increased their rates had fewer terminal hospital admissions in 2007 (11.2%) than facilities with continuously low DNR usage. Even after applying a multivariate fixed effect model, the effect of changes in facility DNR order rate on terminal hospitalization was -0.056 (95% confidence interval: -0.061, -0.050), indicating that for every 10% increase in DNR orders there was 0.56% decrease in terminal hospitalizations. This rate can be compared with the increase of 0.70% in the terminal hospitalization rate when an NH became disproportionately dependent on Medicaid funding or the 0.40% decrease in terminal hospitalization rate associated with adding a nurse practitioner to the clinical staff complement. NHs that changed their culture of decision making by increasing their facility rate of DNR orders decreased their rate of terminal hospitalizations. Copyright © 2011 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
Neighbourhood food and physical activity environments in England, UK: does ethnic density matter?
Molaodi, Oarabile R; Leyland, Alastair H; Ellaway, Anne; Kearns, Ade; Harding, Seeromanie
2012-06-18
In England, obesity is more common in some ethnic minority groups than in Whites. This study examines the relationship between ethnic concentration and access to fast food outlets, supermarkets and physical activity facilities. Data on ethnic concentration, fast food outlets, supermarkets and physical activity facilities were obtained at the lower super output area (LSOA) (population average of 1500). Poisson multilevel modelling was used to examine the association between own ethnic concentration and facilities, adjusted for area deprivation, urbanicity, population size and clustering of LSOAs within local authority areas. There was a higher proportion of ethnic minorities residing in areas classified as most deprived. Fast food outlets and supermarkets were more common and outdoor physical activity facilities were less common in most than least deprived areas. A gradient was not observed for the relationship between indoor physical activity facilities and area deprivation quintiles. In contrast to White British, increasing ethnic minority concentration was associated with increasing rates of fast food outlets. Rate ratios comparing rates of fast food outlets in high with those in low level of ethnic concentration ranged between 1.28, 95% confidence interval 1.06-1.55 (Bangladeshi) and 2.62, 1.46-4.70 (Chinese). Similar to White British, however, increasing ethnic minority concentration was associated with increasing rate of supermarkets and indoor physical activity facilities. Outdoor physical activity facilities were less likely to be in high than low ethnic concentration areas for some minority groups. Overall, ethnic minority concentration was associated with a mixture of both advantages and disadvantages in the provision of food outlets and physical activity facilities. These issues might contribute to ethnic differences in food choices and engagement in physical activity.
The impact of Medicaid payer status on hospitalizations in nursing homes
Cai, Shubing; Miller, Susan C.; Nelson, Dallas L.; Mukamel, Dana B.
2015-01-01
Objectives To examine the association between payer status (Medicaid versus private-pay) and the risk of hospitalizations among long-term stay nursing home (NH) residents who reside in the same facility. Data and study population The 2007–2010 national Medicare Claims and the Minimum Data Set were linked. We identified newly admitted NH residents who became long-stayers and then followed them for 180 days. Analyses Three dichotomous outcomes – all-cause, discretionary and nondiscretionary hospitalizations during the follow-up period – were defined. Linear probability model with facility fixed-effects and robust standard errors were used to examine the within-facility difference in hospitalizations between Medicaid and private-pay residents. A set of sensitivity analyses were performed to examine the robustness of the findings. Results The prevalence of all-cause hospitalization during a 180-day follow-up period was 23.3% among Medicaid residents compared to 21.6% among private-pay residents. After accounting for individual characteristics and facility effects, the probability of any all-cause hospitalization was 1.8 percentage point (P<0.01) higher for Medicaid residents than for private-pay residents within the same facility. We also found Medicaid residents were more likely to be hospitalized for discretionary conditions (5% increase in the likelihood of discretionary hospitalizations), but not for non-discretionary conditions. The findings from the sensitivity analyses were consistent with the main analyses. Conclusion Observed higher hospitalization rates for Medicaid NH residents are at least in part driven by the financial incentive NHs have to hospitalize Medicaid residents. PMID:26067881
2006-10-04
CEV (Crew Escape Vehicle) capsule Balistic Range testing to examine static and dynamic stability characteristics (at the Hypervelocity Free-Flight Facility) HFF - Don Holt (L) & Don Bowling (r) in control room examining poloroids
NASA Technical Reports Server (NTRS)
Haviland, J. K.; Herling, W. W.
1978-01-01
The design and construction of an experimental facility for the investigation of scaling effects in propulsive lift configurations are described. The facility was modeled after an existing full size NASA facility which consisted of a coaxial turbofan jet engine with a rectangular nozzle in a blown surface configuration. The flow field of the model facility was examined with and without a simulated wing surface in place at several locations downstream of the nozzle exit plane. Emphasis was placed on obtaining pressure measurements which were made with static probes and surface pressure ports connected via plastic tubing to condenser microphones for fluctuating measurements. Several pressure spectra were compared with those obtained from the NASA facility, and were used in a preliminary evaluation of scaling laws.
Does Investor Ownership of Nursing Homes Compromise the Quality of Care?
Harrington, Charlene; Woolhandler, Steffie; Mullan, Joseph; Carrillo, Helen; Himmelstein, David U.
2001-01-01
Objectives. Two thirds of nursing homes are investor owned. This study examined whether investor ownership affects quality. Methods. We analyzed 1998 data from state inspections of 13 693 nursing facilities. We used a multivariate model and controlled for case mix, facility characteristics, and location. Results. Investor-owned facilities averaged 5.89 deficiencies per home, 46.5% higher than nonprofit facilities and 43.0% higher than public facilities. In multivariate analysis, investor ownership predicted 0.679 additional deficiencies per home; chain ownership predicted an additional 0.633 deficiencies. Nurse staffing was lower at investor-owned nursing homes. Conclusions. Investor-owned nursing homes provide worse care and less nursing care than do not-for-profit or public homes. PMID:11527781
Dialysis Facility Transplant Philosophy and Access to Kidney Transplantation in the Southeast.
Gander, Jennifer; Browne, Teri; Plantinga, Laura; Pastan, Stephen O; Sauls, Leighann; Krisher, Jenna; Patzer, Rachel E
2015-01-01
Little is known about the impact of dialysis facility treatment philosophy on access to transplant. The aim of our study was to determine the relationship between the dialysis facility transplant philosophy and facility-level access to kidney transplant waitlisting. A 25-item questionnaire administered to Southeastern dialysis facilities (n = 509) in 2012 captured the facility transplant philosophy (categorized as 'transplant is our first choice', 'transplant is a great option for some', and 'transplant is a good option, if the patient is interested'). Facility-level waitlisting and facility characteristics were obtained from the 2008-2011 Dialysis Facility Report. Multivariable logistic regression was used to examine the association between the dialysis facility transplant philosophy and facility waitlisting performance (dichotomized using the national median), where low performance was defined as fewer than 21.7% of dialysis patients waitlisted within a facility. Fewer than 25% (n = 124) of dialysis facilities reported 'transplant is our first option'. A total of 131 (31.4%) dialysis facilities in the Southeast were high-performing facilities with respect to waitlisting. Adjusted analysis showed that facilities who reported 'transplant is our first option' were twice (OR 2.0; 95% CI 1.0-3.9) as likely to have high waitlisting performance compared to facilities who reported that 'transplant is a good option, if the patient is interested'. Facilities with staff who had a more positive transplant philosophy were more likely to have better facility waitlisting performance. Future prospective studies are needed to further investigate if improving the kidney transplant philosophy in dialysis facilities improves access to transplantation.
Quaid, Patrick; Simpson, Trefford
2013-01-01
Approximately one in ten students aged 6 to 16 in Ontario (Canada) school boards have an individual education plan (IEP) in place due to various learning disabilities, many of which are specific to reading difficulties. The relationship between reading (specifically objectively determined reading speed and eye movement data), refractive error, and binocular vision related clinical measurements remain elusive. One hundred patients were examined in this study (50 IEP and 50 controls, age range 6 to 16 years). IEP patients were referred by three local school boards, with controls being recruited from the routine clinic population (non-IEP patients in the same age group). A comprehensive eye examination was performed on all subjects, in addition to a full binocular vision work-up and cycloplegic refraction. In addition to the cycloplegic refractive error, the following binocular vision related data was also acquired: vergence facility, vergence amplitudes, accommodative facility, accommodative amplitudes, near point of convergence, stereopsis, and a standardized symptom scoring scale. Both the IEP and control groups were also examined using the Visagraph III system, which permits recording of the following reading parameters objectively: (i) reading speed, both raw values and values compared to grade normative data, and (ii) the number of eye movements made per 100 words read. Comprehension was assessed via a questionnaire administered at the end of the reading task, with each subject requiring 80% or greater comprehension. The IEP group had significantly greater hyperopia compared to the control group on cycloplegic examination. Vergence facility was significantly correlated to (i) reading speed, (ii) number of eye movements made when reading, and (iii) a standardized symptom scoring system. Vergence facility was also significantly reduced in the IEP group versus controls. Significant differences in several other binocular vision related scores were also found. This research indicates there are significant associations between reading speed, refractive error, and in particular vergence facility. It appears sensible that students being considered for reading specific IEP status should have a full eye examination (including cycloplegia), in addition to a comprehensive binocular vision evaluation.
2009-01-01
Background Bicycling has the potential to improve fitness, diminish obesity, and reduce noise, air pollution, and greenhouse gases associated with travel. However, bicyclists incur a higher risk of injuries requiring hospitalization than motor vehicle occupants. Therefore, understanding ways of making bicycling safer and increasing rates of bicycling are important to improving population health. There is a growing body of research examining transportation infrastructure and the risk of injury to bicyclists. Methods We reviewed studies of the impact of transportation infrastructure on bicyclist safety. The results were tabulated within two categories of infrastructure, namely that at intersections (e.g. roundabouts, traffic lights) or between intersections on "straightaways" (e.g. bike lanes or paths). To assess safety, studies examining the following outcomes were included: injuries; injury severity; and crashes (collisions and/or falls). Results The literature to date on transportation infrastructure and cyclist safety is limited by the incomplete range of facilities studied and difficulties in controlling for exposure to risk. However, evidence from the 23 papers reviewed (eight that examined intersections and 15 that examined straightaways) suggests that infrastructure influences injury and crash risk. Intersection studies focused mainly on roundabouts. They found that multi-lane roundabouts can significantly increase risk to bicyclists unless a separated cycle track is included in the design. Studies of straightaways grouped facilities into few categories, such that facilities with potentially different risks may have been classified within a single category. Results to date suggest that sidewalks and multi-use trails pose the highest risk, major roads are more hazardous than minor roads, and the presence of bicycle facilities (e.g. on-road bike routes, on-road marked bike lanes, and off-road bike paths) was associated with the lowest risk. Conclusion Evidence is beginning to accumulate that purpose-built bicycle-specific facilities reduce crashes and injuries among cyclists, providing the basis for initial transportation engineering guidelines for cyclist safety. Street lighting, paved surfaces, and low-angled grades are additional factors that appear to improve cyclist safety. Future research examining a greater variety of infrastructure would allow development of more detailed guidelines. PMID:19845962
46 CFR 298.37 - Examination and audit.
Code of Federal Regulations, 2013 CFR
2013-10-01
... force. (3) When a Vessel is in port or undergoing repairs, we may make photostatic or other copies of... office space and other facilities that we reasonably require in performing the examination, audit or...
Cost-effectiveness of a quality improvement collaborative for obstetric and newborn care in Niger.
Broughton, Edward; Saley, Zakari; Boucar, Maina; Alagane, Dondi; Hill, Kathleen; Marafa, Aicha; Asma, Yaroh; Sani, Karimou
2013-01-01
The purpose of this paper is to describe a quality improvement collaborative conducted in 33 Nigerian facilities to improve maternal and newborn care outcomes by increasing compliance with high-impact, evidence-based care standards. Intervention costs and cost-effectiveness were examined and costs to the Niger Health Ministry (MoH) were estimated if they were to scale-up the intervention to additional sites. Facility-based maternal care outcomes and costs from pre-quality improvement collaborative baseline monitoring data in participating facilities from January to May 2006 were compared with outcomes and costs from the same facilities from June 2008 to September 2008. Cost data were collected from project accounting records. The MoH costs were determined from interviews with clinic managers and quality improvement teams. Effectiveness data were obtained from facilities' records. The average delivery-cost decreased from $35 before to $28 after the collaborative. The USAID/HCI project's incremental cost was $2.43/delivery. The collaborative incremental cost-effectiveness was $147/disability-adjusted life year averted. If the MoH spread the intervention to other facilities, substantive cost-savings and improved health outcomes can be predicted. The intervention achieved significant positive health benefits for a low cost. The Niger MoH can expect approximately 50 per cent return on its investment if it implements the collaborative in new facilities. The improvement collaborative approach can improve health and save health care resources. This is one of the first studies known to examine collaborative quality improvement and economic efficiency in a developing country.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Bentz, L.K.; Bender, D.S.
This report contains socioeconomic information on the Plainsboro, New Jersey, area, the proposed location of the Compact Ignition Tokamak (CIT) facility. It was prepared as supplemental information for an environmental assessment for the CIT at Princeton Plasma Physics Laboratory (PPPL). The report contains descriptions of the demographic, economic, and community resource characteristics, and, based on information available in early 1987, considers the socioeconomic effect of the proposed facility. In all areas examined, the anticipated socioeconomic impacts of the proposed CIT facility at PPPL are negligible or minimal. 29 refs., 8 figs., 24 tabs.
Guda Obse, Amarech; Darker, Catherine; Biesma, Regien
2018-01-01
Access to and utilisation of quality healthcare promotes positive child health outcomes. However, to be optimally utilised, the healthcare system needs to be responsive to the expectations of the population it serves. Health systems in many sub-Saharan African countries, including Malawi, have historically focused on promoting access to health services by the rural poor. However, in the context of increasing urbanisation and consequent proliferation of urban slums, promoting health of children under five years of age in these settings is a public health imperative. We conducted a discrete choice experiment to determine the relative importance of health facility factors in seeking healthcare for childhood illnesses in urban slums of Malawi. Caregivers of children under five years of age were presented with choice cards that depicted two hypothetical health facilities using six health facility attributes: availability of medicines and supplies, thoroughness of physical examination of the child, attitude of health workers, cost, distance, and waiting time. Caregivers were asked to indicate the health facility they would prefer to use. A mixed logit model was used to estimate the relative importance of and willingness to pay (WTP) for health facility attributes. Attributes with greatest influence on choice were: availability of medicines and supplies (β = 0.842, p<0.001) and thorough examination of the child (β = 0.479, p <0.001) with WTP of MK3698.32 ($11) (95% CI: $8–$13) and MK2049.13 ($6) (95% CI: $3–$9) respectively. Respondents were willing to pay 1.8 and 2.4 times more for medicine availability over thorough examination and positive attitude of health workers respectively. Therefore, strengthening health service delivery system through investment in sustained availability of essential medicines and supplies, sufficient and competent health workforce with positive attitude and clinical discipline to undertake thorough examination, and reductions in waiting times have the potential to improve child healthcare utilization in the urban slums. PMID:29351299
Lungu, Edgar Arnold; Guda Obse, Amarech; Darker, Catherine; Biesma, Regien
2018-01-01
Access to and utilisation of quality healthcare promotes positive child health outcomes. However, to be optimally utilised, the healthcare system needs to be responsive to the expectations of the population it serves. Health systems in many sub-Saharan African countries, including Malawi, have historically focused on promoting access to health services by the rural poor. However, in the context of increasing urbanisation and consequent proliferation of urban slums, promoting health of children under five years of age in these settings is a public health imperative. We conducted a discrete choice experiment to determine the relative importance of health facility factors in seeking healthcare for childhood illnesses in urban slums of Malawi. Caregivers of children under five years of age were presented with choice cards that depicted two hypothetical health facilities using six health facility attributes: availability of medicines and supplies, thoroughness of physical examination of the child, attitude of health workers, cost, distance, and waiting time. Caregivers were asked to indicate the health facility they would prefer to use. A mixed logit model was used to estimate the relative importance of and willingness to pay (WTP) for health facility attributes. Attributes with greatest influence on choice were: availability of medicines and supplies (β = 0.842, p<0.001) and thorough examination of the child (β = 0.479, p <0.001) with WTP of MK3698.32 ($11) (95% CI: $8-$13) and MK2049.13 ($6) (95% CI: $3-$9) respectively. Respondents were willing to pay 1.8 and 2.4 times more for medicine availability over thorough examination and positive attitude of health workers respectively. Therefore, strengthening health service delivery system through investment in sustained availability of essential medicines and supplies, sufficient and competent health workforce with positive attitude and clinical discipline to undertake thorough examination, and reductions in waiting times have the potential to improve child healthcare utilization in the urban slums.
Trends in inequalities in utilization of reproductive health services from 2000 to 2011 in Vietnam.
Duc, Nguyen Huu Chau; Nakamura, Keiko; Kizuki, Masashi; Seino, Kaoruko; Rahman, Mosiur
2015-01-01
This study aimed to examine changes in utilization of reproductive health services by wealth status from 2000 to 2011 in Vietnam. Data from the Vietnam Multiple Indicator Cluster Surveys in 2000, 2006, and 2011 were used. The subjects were 550, 1023, and 1363 women, respectively, aged between 15 and 49 years who had given birth in the previous one or two years. The wealth index, a composite measure of a household's ownership of selected assets, materials used for housing construction, and types of water access and sanitation facilities, was used as a measure of wealth status. Main utilization indicators were utilization of antenatal care services, receipt of a tetanus vaccine, receipt of blood pressure measurement, blood examination and urine examination during antenatal care, receipt of HIV testing, skilled birth attendance at delivery, health-facility-based delivery, and cesarean section delivery. Inequalities by wealth index were measured by prevalence ratios, concentration indices, and multivariable adjusted regression coefficients. Significant increase in overall utilization was observed in all indicators (all p < 0.001). The concentration indices were 0.19 in 2000 and 0.06 in 2011 for antenatal care, 0.10 in 2000 and 0.06 in 2011 for tetanus vaccination, 0.23 in 2000 and 0.08 in 2011 for skilled birth attendance, 0.29 in 2006 and 0.12 in 2011 for blood examination, and 0.18 in 2006 and 0.09 in 2011 for health-facility-based delivery. The multivariable adjusted regression coefficients of reproductive health service utilization by wealth category were 0.06 in 2000 and 0.04 in 2011 for antenatal care, 0.07 in 2000 and 0.05 in 2011 for skilled birth attendance, and 0.07 in 2006 and 0.05 in 2011 for health-facility-based delivery. More women utilized reproductive health services in 2011 than in 2000. Inequality by wealth status in utilization of antenatal care, skilled birth attendance, and health-facility-based delivery had been reduced.
Perimeter security for Minnesota correctional facilities
DOE Office of Scientific and Technical Information (OSTI.GOV)
Crist, D.; Spencer, D.D.
1996-12-31
For the past few years, the Minnesota Department of Corrections, assisted by Sandia National Laboratories, has developed a set of standards for perimeter security at medium, close, and maximum custody correctional facilities in the state. During this process, the threat to perimeter security was examined and concepts about correctional perimeter security were developed. This presentation and paper will review the outcomes of this effort, some of the lessons learned, and the concepts developed during this process and in the course of working with architects, engineers and construction firms as the state upgraded perimeter security at some facilities and planned newmore » construction at other facilities.« less
National facilities study. Volume 5: Space research and development facilities task group
NASA Technical Reports Server (NTRS)
1994-01-01
With the beginnings of the U.S. space program, there was a pressing need to develop facilities that could support the technology research and development, testing, and operations of evolving space systems. Redundancy in facilities that was once and advantage in providing flexibility and schedule accommodation is instead fast becoming a burden on scarce resources. As a result, there is a clear perception in many sectors that the U.S. has many space R&D facilities that are under-utilized and which are no longer cost-effective to maintain. At the same time, it is clear that the U.S. continues to possess many space R&D facilities which are the best -- or among the best -- in the world. In order to remain world class in key areas, careful assessment of current capabilities and planning for new facilities is needed. The National Facility Study (NFS) was initiated in 1992 to develop a comprehensive and integrated long-term plan for future aerospace facilities that meets current and projected government and commercial needs. In order to assess the nation's capability to support space research and development (R&D), a Space R&D Task Group was formed. The Task Group was co-chaired by NASA and DOD. The Task Group formed four major, technologically- and functionally- oriented working groups: Human and Machine Operations; Information and Communications; Propulsion and Power; and Materials, Structures, and Flight Dynamics. In addition to these groups, three supporting working groups were formed: Systems Engineering and Requirements; Strategy and Policy; and Costing Analysis. The Space R&D Task Group examined several hundred facilities against the template of a baseline mission and requirements model (developed in common with the Space Operations Task Group) and a set of excursions from the baseline. The model and excursions are described in Volume 3 of the NFS final report. In addition, as a part of the effort, the group examined key strategic issues associated with space R&D facilities planning for the U.S., and these are discussed in Section 4 of this volume.
NASA Astrophysics Data System (ADS)
McNeill, Alexander, III; Balkey, Kenneth R.
1995-05-01
The current inservice inspection activities at a U.S. nuclear facility are based upon the American Society of Mechanical Engineers (ASME) Boiler and Pressure Vessel Code, Section XI. The Code selects examination locations based upon a sampling criteria which includes component geometry, stress, and usage among other criteria. This can result in a significant number of required examinations. As a result of regulatory action each nuclear facility has conducted probabilistic risk assessments (PRA) or individual plant examinations (IPE), producing plant specific risk-based information. Several initiatives have been introduced to apply this new plant risk information. Among these initiatives is risk-based inservice inspection. A code case has been introduced for piping inspections based upon this new risk- based technology. This effort brought forward to the ASME Section XI Code committee, has been initiated and championed by the ASME Research Task Force on Risk-Based Inspection Guidelines -- LWR Nuclear Power Plant Application. Preliminary assessments associated with the code case have revealed that potential advantages exist in a risk-based inservice inspection program with regard to a number of exams, risk, personnel exposure, and cost.
Facilities in School-Based, Agricultural Education (SBAE): A Historical Inquiry
ERIC Educational Resources Information Center
Twenter, Jason P.; Edwards, M. Craig
2017-01-01
Vocational education, including SBAE, reoriented as its role in U.S. public schools and society changed. However, the types of facilities in which to teach SBAE have remained somewhat consistent, even as the program's curriculum became less dominated by a production agriculture orientation. We examined the historical evolution of learning spaces…
Barriers to Shared Use of Indoor and Outdoor Facilities at US Elementary Schools
ERIC Educational Resources Information Center
Turner, Lindsey; Calvert, Hannah G.; Chaloupka, Frank J.
2018-01-01
Background: School policies and practices, such as the sharing of school facilities with the surrounding community, support physical activity among students and community members, but are often underutilized. This study examined variations in shared use practices, and associations with perceived barriers. Methods: Surveys were completed by a…
ERIC Educational Resources Information Center
Prins, Richard G.; van Empelen, Pepijn; te Velde, Saskia J.; Timperio, Anna; van Lenthe, Frank J.; Tak, Nannah I.; Crawford, David; Brug, Johannes; Oenema, Anke
2010-01-01
This longitudinal study aimed to identify individual and environmental predictors of adolescents' sports participation and to examine whether availability of sports facilities moderated the intention-behaviour relation. Data were obtained from the Environmental Determinants of Obesity in Rotterdam Schoolchildren study (2005/2006 to 2007/2008). A…
ERIC Educational Resources Information Center
Mulder, Yvonne G.; Lazonder, Ard W.; de Jong, Ton
2011-01-01
The educational advantages of inquiry learning environments that incorporate modelling facilities are often challenged by students' poor inquiry skills. This study examined two types of model progression as means to compensate for these skill deficiencies. Model order progression (MOP), the predicted optimal variant, gradually increases the…
ERIC Educational Resources Information Center
Simonsen, Amy E.
2010-01-01
The purpose of this qualitative study was to examine how adolescent girls with diagnosed learning and emotional disabilities described themselves as they negotiated various environments and relationships within a secure residential facility. The goal was to explore how conditions and interactions in these environments promoted both risk and…
International bioenergy synthesis-lessons learned and opportunities for the western United States
D.L. Nicholls; R. Monserud; D. Dykstra
2009-01-01
This synthesis examines international opportunities for utilizing biomass for energy at several different scales, with an emphasis on larger scale electrical power generation at stand-alone facilities as well as smaller scale thermal heating applications such as those at governmental, educational, or other institutional facilities. It identifies barriers that can...
Urbanization and Spatial Organization: Hospital and Orphanage Location in Chicago, 1848-1916
ERIC Educational Resources Information Center
Britton, Marcus; Ocasio, William
2007-01-01
What factors affect where organizations locate facilities in local communities? This paper examines how urban development influenced the neighborhood location of two very different types of facilities, general hospitals and orphanages, over the 70-year period during which Chicago emerged as an urban metropolis. Our results suggest that the human…
Athletic Facilities: Planning, Designing, and Operating Today's Physical-Education Centers.
ERIC Educational Resources Information Center
Spoor, Dana L.
1998-01-01
Examines what should be featured in an athletic facility, how to plan for the many different sports and activities that will be housed, and how to get the community involved. Areas addressed include planning for locker rooms and storage, flooring and lighting, building code adherence, spectator seating, building security, and outdoor recreation…
ERIC Educational Resources Information Center
Young, Morghan Velez; Phillips, Rachel Sophia; Nasir, Na'ilah Suad
2010-01-01
This paper examines schooling inside a youth prison. We draw on interview and observation data from a study of a youth prison school to understand the practices and tensions of schooling in a juvenile incarceration facility. We describe the processes of schooling in the facility with an eye towards understanding both the conditions of learning and…
42 CFR 37.4 - Plans for chest roentgenographic examinations.
Code of Federal Regulations, 2013 CFR
2013-10-01
... covered by the plan; (4) The name and location of the approved X-ray facility or facilities, and the... approval as the originally approved plan. (e) The operator must promptly display in a visible location on... NIOSH. The proposed plan or change in plan must remain posted in a visible location on the bulletin...
Psychotropic Drug Patterns in a Large ICF/MR Facility: A Ten-Year Experience.
ERIC Educational Resources Information Center
Poindexter, Ann R.
1989-01-01
Psychotropic drug-prescribing patterns for 474 adults with mental retardation residing at an intermediate-care facility were examined for a 10-year period. Results indicated a progressive, marked decrease in total psychotropic drug usage and changes in the type of drugs prescribed with overall decline in drug usage. (Author/DB)
ERIC Educational Resources Information Center
Cross, Lara E.; Morrison, William; Peterson, Patricia; Domene, Jose F.
2012-01-01
This article examines how a rural Canadian secure custody facility for youth implemented positive psychology principles in its case management protocols and residential programming. A directed content analysis design was utilized to identify specific factors of positive psychology in the facility's policy and programming manual, as well as in…
The Provision of Informal Support By Elderly People Residing in Assisted Living Facilities.
ERIC Educational Resources Information Center
Litwin, Howard
1998-01-01
Examines factors facilitating support giving to members of the social network by elderly Jewish persons residing in assisted-living facilities in Israel. Results reveal that it is principally the perceived support measure along with two personal characteristics that explains the variance in support provision scores. (Author/MKA)
Insomnia, Sleepiness, and Depression in Adolescents Living in Residential Care Facilities
ERIC Educational Resources Information Center
Moreau, Vincent; Belanger, Lynda; Begin, Gilles; Morin, Charles M.
2009-01-01
The main objective of this study was to document sleep patterns and disturbances reported by youths temporarily living in residential care facilities. A secondary objective was to examine the relationships between sleep disturbances and mood and daytime sleepiness. A self-reported questionnaire on sleep patterns and habits assessing duration,…
A Study of the College of Pharmacy Library Concerning Facilities, Services and User Satisfaction.
ERIC Educational Resources Information Center
Parkin, Derral
This report examines the college of pharmacy library in relation to its historical development, present facilities, services, and user satisfaction, and makes a statistical comparison between the University of Houston College of Pharmacy Library and other accredited pharmacy libraries nationwide. Data were gathered through 28 completed library…
ERIC Educational Resources Information Center
Bair, Howard V.; Leland, Henry
To investigate the appropriate design and utilization of physical facilities being constructed as a rehabilitation center, a variety of centers was examined. Conclusions were that flexibility in construction of the physical plant, including nonpermanent walls and fixtures was necessary; program planning should be included in architectural…
ERIC Educational Resources Information Center
Managan, William H.
1999-01-01
Describes a facilities-management software program that helps managers better document and understand maintenance backlogs, improvements, and future cyclic renewal needs. Major software components are examined including a software tool that filters, groups, and ranks projects to help determine funding requests. (GR)
The Viability of Lease Purchases as a Means for Funding School Facilities.
ERIC Educational Resources Information Center
Bunch, Beverly S.; Smith, Tina
2002-01-01
Examines the use of the lease purchase of school facilities in Texas; provides background on the use of lease purchases by Texas school districts; describes factors influencing the use of lease purchases and superintendents' experiences based on survey responses from 50 school districts; recommends careful evaluation of advantages and…
Exploring Space Management Goals in Institutional Care Facilities in China
Zhang, Jiankun
2017-01-01
Space management has been widely examined in commercial facilities, educational facilities, and hospitals but not in China's institutional care facilities. Poor spatial arrangements, such as wasted space, dysfunctionality, and environment mismanagement, are increasing; in turn, the occupancy rate is decreasing due to residential dissatisfaction. To address these problems, this paper's objective is to explore the space management goals (SMGs) in institutional care facilities in China. Systematic literature analysis was adopted to set SMGs' principles, to identify nine theoretical SMGs, and to develop the conceptual model of SMGs for institutional care facilities. A total of 19 intensive interviews were conducted with stakeholders in seven institutional care facilities to collect data for qualitative analysis. The qualitative evidence was analyzed through open coding, axial coding, and selective coding. As a result, six major categories as well as their interrelationships were put forward to visualize the path diagram for exploring SMGs in China's institutional care facilities. Furthermore, seven expected SMGs that were explored from qualitative evidence were confirmed as China's SMGs in institutional care facilities by a validation test. Finally, a gap analysis among theoretical SMGs and China's SMGs provided recommendations for implementing space management in China's institutional care facilities. PMID:29065629
ADA Compliance and Accessibility of Fitness Facilities in Western Wisconsin.
Johnson, Marquell J; Stoelzle, Hannah Y; Finco, Kristi L; Foss, Sadie E; Carstens, Katie
2012-01-01
The study expands the research on fitness facility accessibility by determining how compliant fitness facilities in rural western Wisconsin were with Title III of the Americans with Disabilities Act (ADA). Comparisons were made with 4 other studies that were conducted in different geographical regions. The study also examined fitness professionals' disability knowledge and awareness. An ADA fitness facility compliance instrument and a fitness professional disability awareness survey were used. Direct observation and physical measurements were taken during on-site visits to 16 of 36 eligible fitness facilities in rural western Wisconsin. Ten fitness professionals from participating facilities completed an online survey. Frequencies were used to analyze the results. None of the participating facilities were in 100% compliance with ADA. Customer service desk (84%) and path of travel throughout the facility (72%) were the highest compliance areas. Telephone (6%) and locker rooms (32%) were the lowest compliance areas. No fitness professional was trained in wheelchair transfers and very few had received training in providing services to individuals with disabilities. Fitness facility accessibility remains a concern nationally. Continued efforts need to be made to raise the awareness of ADA compliance among fitness professionals across the United States, especially in rural areas where fitness facility availability is limited.
Exploring Space Management Goals in Institutional Care Facilities in China.
Li, Lingzhi; Yuan, Jingfeng; Ning, Yan; Shao, Qiuhu; Zhang, Jiankun
2017-01-01
Space management has been widely examined in commercial facilities, educational facilities, and hospitals but not in China's institutional care facilities. Poor spatial arrangements, such as wasted space, dysfunctionality, and environment mismanagement, are increasing; in turn, the occupancy rate is decreasing due to residential dissatisfaction. To address these problems, this paper's objective is to explore the space management goals (SMGs) in institutional care facilities in China. Systematic literature analysis was adopted to set SMGs' principles, to identify nine theoretical SMGs, and to develop the conceptual model of SMGs for institutional care facilities. A total of 19 intensive interviews were conducted with stakeholders in seven institutional care facilities to collect data for qualitative analysis. The qualitative evidence was analyzed through open coding, axial coding, and selective coding. As a result, six major categories as well as their interrelationships were put forward to visualize the path diagram for exploring SMGs in China's institutional care facilities. Furthermore, seven expected SMGs that were explored from qualitative evidence were confirmed as China's SMGs in institutional care facilities by a validation test. Finally, a gap analysis among theoretical SMGs and China's SMGs provided recommendations for implementing space management in China's institutional care facilities.
Challenges for proteomics core facilities.
Lilley, Kathryn S; Deery, Michael J; Gatto, Laurent
2011-03-01
Many analytical techniques have been executed by core facilities established within academic, pharmaceutical and other industrial institutions. The centralization of such facilities ensures a level of expertise and hardware which often cannot be supported by individual laboratories. The establishment of a core facility thus makes the technology available for multiple researchers in the same institution. Often, the services within the core facility are also opened out to researchers from other institutions, frequently with a fee being levied for the service provided. In the 1990s, with the onset of the age of genomics, there was an abundance of DNA analysis facilities, many of which have since disappeared from institutions and are now available through commercial sources. Ten years on, as proteomics was beginning to be utilized by many researchers, this technology found itself an ideal candidate for being placed within a core facility. We discuss what in our view are the daily challenges of proteomics core facilities. We also examine the potential unmet needs of the proteomics core facility that may also be applicable to proteomics laboratories which do not function as core facilities. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Do physical activity facilities near schools affect physical activity in high school girls?
Trilk, Jennifer L; Ward, Dianne S; Dowda, Marsha; Pfeiffer, Karin A; Porter, Dwayne E; Hibbert, James; Pate, Russell R
2011-03-01
To investigate associations between the number of physical activity facilities within walking distance of school and physical activity behavior in 12th grade girls during after-school hours. Girls (N=1394) from 22 schools completed a self-report to determine physical activity after 3:00 p.m. The number of physical activity facilities within a 0.75-mile buffer of the school was counted with a Geographic Information System. Associations between the number of facilities and girls' physical activity were examined using linear mixed-model analysis of variance. Overall, girls who attended schools with ≥5 facilities within the buffer reported more physical activity per day than girls in schools with <5 facilities. In addition, girls who attended rural schools with ≥5 facilities reported ∼12% more physical activity per day than girls who attended rural schools with <5 facilities. No difference existed for girls in urban/suburban schools with ≥5 vs. <5 facilities. When school siting decisions are made, the number of physical activity facilities surrounding the school should be considered to encourage physical activity in 12th grade girls. Copyright © 2011 Elsevier Ltd. All rights reserved.
Filmless PACS in a multiple facility environment
NASA Astrophysics Data System (ADS)
Wilson, Dennis L.; Glicksman, Robert A.; Prior, Fred W.; Siu, Kai-Yeung; Goldburgh, Mitchell M.
1996-05-01
A Picture Archiving and Communication System centered on a shared image file server can support a filmless hospital. Systems based on this architecture have proven themselves in over four years of clinical operation. Changes in healthcare delivery are causing radiology groups to support multiple facilities for remote clinic support and consolidation of services. There will be a corresponding need for communicating over a standardized wide area network (WAN). Interactive workflow, a natural extension to the single facility case, requires a means to work effectively and seamlessly across moderate to low speed communication networks. Several schemes for supporting a consortium of medical treatment facilities over a WAN are explored. Both centralized and distributed database approaches are evaluated against several WAN scenarios. Likewise, several architectures for distributing image file servers or buffers over a WAN are explored, along with the caching and distribution strategies that support them. An open system implementation is critical to the success of a wide area system. The role of the Digital Imaging and Communications in Medicine (DICOM) standard in supporting multi- facility and multi-vendor open systems is also addressed. An open system can be achieved by using a DICOM server to provide a view of the system-wide distributed database. The DICOM server interface to a local version of the global database lets a local workstation treat the multiple, distributed data servers as though they were one local server for purposes of examination queries. The query will recover information about the examination that will permit retrieval over the network from the server on which the examination resides. For efficiency reasons, the ability to build cross-facility radiologist worklists and clinician-oriented patient folders is essential. The technologies of the World-Wide-Web can be used to generate worklists and patient folders across facilities. A reliable broadcast protocol may be a convenient way to notify many different users and many image servers about new activities in the network of image servers. In addition to ensuring reliability of message delivery and global serialization of each broadcast message in the network, the broadcast protocol should not introduce significant communication overhead.
Accessibility of health clubs for people with mobility disabilities and visual impairments.
Rimmer, James H; Riley, Barth; Wang, Edward; Rauworth, Amy
2005-11-01
We sought to examine the accessibility of health clubs to persons with mobility disabilities and visual impairments. We assessed 35 health clubs and fitness facilities as part of a national field trial of a new instrument, Accessibility Instruments Measuring Fitness and Recreation Environments (AIMFREE), designed to assess accessibility of fitness facilities in the following domains: (1) built environment, (2) equipment, (3) swimming pools, (4) information, (5) facility policies, and (6) professional behavior. All facilities had a low to moderate level of accessibility. Some of the deficiencies concerned specific Americans with Disabilities Act guidelines pertaining to the built environment, whereas other deficiency areas were related to aspects of the facilities' equipment, information, policies, and professional staff. Persons with mobility disabilities and visual impairments have difficulty accessing various areas of fitness facilities and health clubs. AIMFREE is an important tool for increasing awareness of these accessibility barriers for people with disabilities.
Capezza, Nicole M; Najavits, Lisa M
2012-04-01
Trauma-informed treatment increasingly is recognized as an important component of service delivery. This study examined differences in treatment-related characteristics of facilities that offer moderate or high levels of trauma-informed counseling versus those that offer no or low levels of such counseling. Responses from 13,223 substance abuse treatment facilities surveyed in 2009 by the National Survey of Substance Abuse Treatment Services (NSSATS) were used. A majority (66.6%) of facilities reported using trauma counseling sometimes or always or often. Facilities that provided moderate or high levels of trauma counseling were more likely to provide additional treatment services, such as disease testing and specialized group therapy, as well as child care, employment counseling, and other ancillary services. A majority of facilities reported provision of trauma counseling. Additional training and resources may be needed for programs that reported low rates of trauma counseling.
Powell, Lisa M; Slater, Sandy; Chaloupka, Frank J; Harper, Deborah
2006-09-01
We examined associations between neighborhood demographic characteristics and the availability of commercial physical activity-related outlets by zip code across the United States. Multivariate analyses were conducted to assess the availability of 4 types of outlets: (1) physical fitness facilities, (2) membership sports and recreation clubs, (3) dance facilities, and (4) public golf courses. Commercial outlet data were linked by zip code to US Census Bureau population and socioeconomic data. Results showed that commercial physical activity-related facilities were less likely to be present in lower-income neighborhoods and in neighborhoods with higher proportions of African American residents, residents with His-panic ethnicity, and residents of other racial minority backgrounds. In addition, these neighborhoods had fewer such facilities available. Lack of availability of facilities that enable and promote physical activity may, in part, underpin the lower levels of activity observed among populations of low socioeconomic status and minority backgrounds.
20 CFR 725.406 - Medical examinations and tests.
Code of Federal Regulations, 2012 CFR
2012-04-01
... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Medical examinations and tests. 725.406... Medical examinations and tests. (a) The Act requires the Department to provide each miner who applies for... list of medical facilities and physicians in the state of the miner's residence and states contiguous...
49 CFR 109.9 - Transportation for examination and analysis.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 49 Transportation 2 2011-10-01 2011-10-01 false Transportation for examination and analysis. 109.9... analysis. (a) An agent may direct a package to be transported to a facility for examination and analysis... the package conforms to subchapter C of this chapter; (2) Conflicting information concerning the...
Regional differences in the potential exposure of US minority populations to hazardous facilities
DOE Office of Scientific and Technical Information (OSTI.GOV)
Nieves, L.A.; Nieves, A.L.
1992-01-01
In the literature that examines the distribution of environmental disamenities of various types, there is considerable documentation that minority groups and lower income groups are more likely to be exposed. Such differential exposure has been attributed to environmental racism'' by some authors, but there has been no systematic investigation of the factors and dynamics underlying this exposure pattern. This study examines regional differences in the proximity of African-American, Hispanics, Asians, and non-Hispanic Whites to a broad range facility types and explores the degree to which this may be related to urban and income factors.
1986-02-19
The Food and Drug Administration (FDA) is announcing the availability of a document entitled "Recommendations for Evaluation of Radiation Exposure from Diagnostic Radiology Examinations". The recommendations, prepared by FDA's Center for Devices and Radiological Health (CDRH), encourage diagnostic radiology facilities to take voluntary action to: Become aware of the radiation levels experienced by patients undergoing the projections commonly given in the facility; compare their radiation levels to generally accepted levels for these projections; and bring the exposures back into line if their levels fall consistently outside these generally accepted levels.
Autran, Roseanne Gomes; Ramos, Elisabete; Pina, Maria de Fátima de; Santos, Maria Paula
2012-03-01
The built environment can influence sports practice. The objective of this study was to examine the association between proximity (< 500m) to sports facilities and participation in sports. We evaluated 1,175 13-year-olds (54% girls) enrolled in public and private schools in Porto, Portugal. Sports activity was assessed using a self-completed questionnaire. The adolescents' residences and sports facilities were georeferenced. A matrix of distances from each residence to the facilities was calculated. For the majority (87%) of the adolescents, there was at least one sports facility close to their place of residence. No statistically significant differences were found in participation in sports based on proximity to facilities (< 500m vs. > 500m); the proportions were 44% vs. 38% (p = 0.414) in girls and 72% vs. 61% (p = 0.094) in boys. In conclusion, proximity to sports facilities was not significantly associated with participation in sports.
Oral healthcare access and adequacy in alternative long-term care facilities.
Smith, Barbara J; Ghezzi, Elisa M; Manz, Michael C; Markova, Christiana P
2010-01-01
This study was undertaken to determine practices and perceived barriers to access related to oral health by surveying administrators in Michigan alternative long-term care facilities (ALTCF). A 24-item questionnaire was mailed to all 2,275 Michigan ALTCF serving residents aged 60+. Facility response rate was 22% (n = 508). Eleven percent of facilities had a written dental care plan; 18% stated a dentist examined new residents; and 19% of facilities had an agreement with a dentist to come to the facility, with 52% of those being for emergency care only. The greatest perceived barriers were willingness of general and specialty dentists to treat residents at the nursing facility and/or private offices as well as financial concerns. Substantial barriers to care were uniformly perceived. Oral health policies and practices within Michigan ALTCF vary, as measured by resources, attitudes, and the availability of professional care. There is limited involvement by dental professionals in creating policy and providing consultation and service.
Wang, Tiankai; Wang, Yangmei; Moczygemba, Jackie
2014-01-01
Long-term care (LTC) is an important sector of the health care industry. However, the adoption of health information technology (HIT) systems in LTC facilities lags behind that in other sectors of health care. Previous literature has focused on the financial and technical barriers. This study examined the organizational factors associated with HIT adoption in LTC facilities. A survey of 500 LTC facilities in Texas enabled researchers to compile HIT indexes for further statistical analyses. A general linear model was used to study the associations between the clinical/administrative HIT indexes and organizational factors. The empirical outcomes show that the size of an LTC facility has a significant association with HIT adoption. Rural LTC facilities, especially freestanding ones, adopt less HIT than their urban counterparts, whereas freestanding LTC facilities have the lowest HIT adoption overall. There is not enough evidence to support ownership status as a significant factor in HIT adoption. Some implications are proposed, but further research is necessary.
A User's Guide for the Spacecraft Fire Safety Facility
NASA Technical Reports Server (NTRS)
Goldmeer, Jeffrey S.
2000-01-01
The Spacecraft Fire Safety Facility (SFSF) is a test facility that can be flown on NASA's reduced gravity aircraft to perform various types of combustion experiments under a variety of experimental conditions. To date, this facility has flown numerous times on the aircraft and has been used to perform experiments ranging from an examination of the effects transient depressurization on combustion, to ignition and flame spread. A list of pubfications/presentations based on experiments performed in the SFSF is included in the reference section. This facility consists of five main subsystems: combustion chamber, sample holders, gas flow system, imaging system, and the data acquisition/control system. Each of these subsystems will be reviewed in more detail. These subsystems provide the experiment operator with the ability to monitor and/or control numerous experimental parameters.
Everett Jones, Sherry; Brener, Nancy D.; McManus, Tim
2003-01-01
Objectives. We examined the extent to which schools in the United States have health-promoting policies, programs, and facilities. Methods. We analyzed data from the School Health Policies and Programs Study 2000. Results. We found that public schools (vs private and Catholic schools), urban schools (vs rural and suburban schools), and schools with larger enrollments (vs smaller schools) had more health-promoting policies, programs, and facilities in place. On average, middle schools had 11.0 and middle/junior and high schools had 10.4 out of a possible 18 policies, programs, and facilities. Conclusions. Although some schools had many healthy physical environment features, room for improvement exists. Resources are available to help schools improve their health-promoting policies, programs, and facilities. PMID:12948982
Takemura, Toshio; Kielmann, Karina; Blaauw, Duane
2016-01-08
Clinical officers (COs), a mid-level cadre of health worker, are the backbone of healthcare provision in rural Kenya. However, the vacancy rate for COs in rural primary healthcare facilities is high. Little is known about factors motivating COs' preferences for rural postings. A discrete choice experiment (DCE) questionnaire was used with 57 COs at public health facilities in nine districts of Nyanza Province, Kenya. The questionnaire was developed on the basis of formative qualitative interviews with COs (n = 5) and examined how five selected job attributes influenced COs' preferences for working in rural areas. Conditional logit models were employed to examine the relative importance of different job attributes. Analysis of the qualitative data revealed five important job attributes influencing COs' preferences: quality of the facility, educational opportunities, housing, monthly salary and promotion. Analysis of the DCE indicated that a 1-year guaranteed study leave after 3 years of service would have the greatest impact on retention, followed by good quality health facility infrastructure and equipment and a 30% salary increase. Sub-group analysis shows that younger COs demonstrated a significantly stronger preference for study leave than older COs. Female COs placed significantly higher value on promotion than male COs. Although both financial incentives and non-financial incentives were effective in motivating COs to stay in post, the study leave intervention was shown to have the strongest impact on COs' retention in our study. Further research is required to examine appropriate interventions at each career stage that might boost COs' professional identity and status but without leading to larger deficits in the availability of generalist COs.
Travel Burden to Breast MRI and Utilization: Are Risk and Sociodemographics Related?
Onega, Tracy; Lee, Christoph I; Benkeser, David; Alford-Teaster, Jennifer; Haas, Jennifer S; Tosteson, Anna N A; Hill, Deirdre; Shi, Xun; Henderson, Louise M; Hubbard, Rebecca A
2016-06-01
Mammography, unlike MRI, is relatively geographically accessible. Additional travel time is often required to access breast MRI. However, the amount of additional travel time and whether it varies on the basis of sociodemographic or breast cancer risk factors is unknown. The investigators examined screening mammography and MRI between 2005 and 2012 in the Breast Cancer Surveillance Consortium by (1) travel time to the closest and actual mammography facility used and the difference between the two, (2) women's breast cancer risk factors, and (3) sociodemographic characteristics. Logistic regression was used to examine the odds of traveling farther than the closest facility in relation to women's characteristics. Among 821,683 screening mammographic examinations, 76.6% occurred at the closest facility, compared with 51.9% of screening MRI studies (n = 3,687). The median differential travel time among women not using the closest facility for mammography was 14 min (interquartile range, 8-25 min) versus 20 min (interquartile range, 11-40 min) for breast MRI. Differential travel time for both imaging modalities did not vary notably by breast cancer risk factors but was significantly longer for nonurban residents. For non-Hispanic black compared with non-Hispanic white women, the adjusted odds of traveling farther than the closest facility were 9% lower for mammography (odds ratio, 0.91; 95% confidence interval, 0.87-0.95) but more than two times higher for MRI (odds ratio, 2.64; 95% confidence interval, 1.36-5.13). Breast cancer risk factors were not related to excess travel time for screening MRI, but sociodemographic factors were, suggesting the possibility that geographic distribution of advanced imaging may exacerbated disparities for some vulnerable populations. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.
Treatment Study Plan for Nitrate Salt Waste Remediation Revision 1.0
DOE Office of Scientific and Technical Information (OSTI.GOV)
Juarez, Catherine L.; Funk, David John; Vigil-Holterman, Luciana R.
2016-03-07
The two stabilization treatment methods that are to be examined for their effectiveness in the treatment of both the unremediated and remediated nitrate salt wastes include (1) the addition of zeolite and (2) cementation. Zeolite addition is proposed based on the results of several studies and analyses that specifically examined the effectiveness of this process for deactivating nitrate salts. Cementation is also being assessed because of its prevalence as an immobilization method used for similar wastes at numerous facilities around the DOE complex, including at Los Alamos. The results of this Treatment Study Plan will be used to provide themore » basis for a Resource Conservation and Recovery Act (RCRA) permit modification request of the LANL Hazardous Waste Facility Permit for approval by the New Mexico Environment Department-Hazardous Waste Bureau (NMED-HWB) of the proposed treatment process and the associated facilities.« less
Tulik, P; Kowalska, M; Golnik, N; Budzynska, A; Dziuk, M
2017-05-01
This paper presents the results of radiation level measurements at workplaces in a nuclear medicine facility performing PET/CT examinations. This study meticulously determines the staff radiation exposure in a PET/CT facility by tracking the path of patient movement. The measurements of the instantaneous radiation exposure were performed using an electronic radiometer with a proportional counter that was equipped with the option of recording the results on line. The measurements allowed for visualisation of the staff's instantaneous exposure caused by a patient walking through the department after the administration of 18F-FDG. An estimation of low doses associated with each working step and the exposure during a routine day in the department was possible. The measurements were completed by determining the average radiation level using highly sensitive thermoluminescent detectors. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Factors Associated With Injurious Falls in Residential Care Facilities.
Towne, Samuel D; Cho, Jinmyoung; Smith, Matthew Lee; Ory, Marcia G
2017-06-01
Despite a growing literature on the epidemiology of falls, little is known about injurious falls in residential care facilities (RCFs). Addressing this gap, this study examined demographic, interpersonal, institutional, and community factors associated with injurious falls in RCFs. We conducted analyses using a nationally representative sample ( n = 733,309) of RCF residents (2010) examining whether or not a resident experienced a fall that resulted in any injury (past year). Overall, 15% of RCF residents experienced an injurious fall. Residents needing assistance with activities of daily living were more likely to experience injurious falls (adjusted-OR = 1.85), whereas males (adjusted-OR = 0.74) and those residing in smaller facilities (adjusted-OR = 0.68) were less likely. Other resident sociodemographic characteristics, payment status, social connectedness, and rurality were not significant independent predictors. Research further exploring multifactorial fall prevention screening and treatment programs in RCFs is recommended for reducing injurious falls in this understudied setting.
ERIC Educational Resources Information Center
Huang, Bin; Dignan, Mark; Han, Daikwon; Johnson, Owen
2009-01-01
Background: National and regional data indicate that breast cancer early detection is low in Kentucky, especially rural regions, perhaps because access to mammography services can be problematic. Objective: This study examined the distance between residences of women diagnosed with breast cancer and the nearest mammography facility, as a risk…
Energy efficiency in U.S. Forest Service facilities: a multiregion review
Rachelle S. Meyer; David L. Nicholls; Trista M. Patterson; Rachel E. White
2013-01-01
We reviewed energy efficiency measures in facilities across the U.S. Department of Agriculture Forest Service, examining opportunities and obstacles, and identifying factors of project success. The adoption of energy efficiency measures at Forest Service sites was seen to be most likely when decision control was local to the site and when budget timing and structures...
ERIC Educational Resources Information Center
Ndirangu, Waweru Peter; Thinguri, Ruth; Chui, Mary Mugwe
2016-01-01
This paper is premised on the background that the majority of researchers and educationists who have contributed to the discourse on education for sustainability seem to be in agreement that management of physical facilities are critical ingredients in achieving holistic and sustainable education. The study examined the application of physical…
ERIC Educational Resources Information Center
General Accounting Office, Washington, DC.
A General Accounting Office (GAO) study evaluated the Bureau of Indian Affairs' (BIA) new facilities management information system (FMIS). Specifically, the study examined whether the new FMIS addresses the old system's weaknesses and meets BIA's management needs, whether BIA has finished validating the accuracy of data transferred from the old…
Resident Satisfaction and Its Components in Residential Aged Care
ERIC Educational Resources Information Center
Chou, Shu-Chiung; Boldy, Duncan P.; Lee, Andy H.
2002-01-01
Purpose: The purpose of this study was to assess the direction and magnitude of the effects among the components of resident satisfaction in residential aged care and to examine if the relationships among satisfaction components vary according to facility type (i.e., nursing home and hostel). Briefly, a hostel is a low-care facility in which…
42 CFR 37.4 - Plans for chest roentgenographic examinations.
Code of Federal Regulations, 2011 CFR
2011-10-01
... name and location of the approved X-ray facility or facilities, and the approximate date(s) and time(s... shall promptly display in a visible location on the bulletin board at the mine its proposed plan or... posted in a visible location on the bulletin board until ALOSH either grants or denies approval of it at...
42 CFR 37.4 - Plans for chest roentgenographic examinations.
Code of Federal Regulations, 2012 CFR
2012-10-01
... name and location of the approved X-ray facility or facilities, and the approximate date(s) and time(s... shall promptly display in a visible location on the bulletin board at the mine its proposed plan or... posted in a visible location on the bulletin board until ALOSH either grants or denies approval of it at...
42 CFR 37.4 - Plans for chest roentgenographic examinations.
Code of Federal Regulations, 2010 CFR
2010-10-01
... name and location of the approved X-ray facility or facilities, and the approximate date(s) and time(s... shall promptly display in a visible location on the bulletin board at the mine its proposed plan or... posted in a visible location on the bulletin board until ALOSH either grants or denies approval of it at...
ERIC Educational Resources Information Center
Shendell, Derek G.; Barnett, Claire; Boese, Stephen
2004-01-01
The US General Accounting Office (GAO) documented generally poor conditions of school facilities in the early 1990s. Previous papers examined, for time intervals ending before 2002, relationships between education facility indoor air and environmental quality (IEQ), including adequate ventilation, and occupant health and productivity. Research on…
ERIC Educational Resources Information Center
Schwartz, Chaya
2005-01-01
Background: This study examined parental involvement in relocation and post-placement care of offspring in residential facilities for adults with intellectual disability, as well as the characteristics of residents, parents, and residential institutions and the effect of those variables on parental perceptions of their offspring's life…
Acoustics in Research Facilities--Control of Wanted and Unwanted Sound. Laboratory Design Notes.
ERIC Educational Resources Information Center
Newman, Robert B.
Common and special acoustics problems are discussed in relation to the design and construction of research facilities. Following a brief examination of design criteria for the control of wanted and unwanted sound, the technology for achieving desired results is discussed. Emphasis is given to various design procedures and materials for the control…
ERIC Educational Resources Information Center
Lyman, Karen A.
1989-01-01
Considered impact of physical environment on work-related stress and quality of care in day care center integrating demented people and other frail elderly. Examined positive and negative differences before and after move to new facility. Discusses implications for facility design and other program characteristics. (Author/CM)
Energy Efficient Florida Educational Facilities: Phase VI. Progress Report: Phase I and II.
ERIC Educational Resources Information Center
Callahan, Michael P.; Parker, Danny S.
A Florida study examined differences in energy uses in two adjacent portable classrooms to determine if these types of facilities can be made more energy efficient through retrofitting. Retrofitting included an efficient lighting system, new air conditioners, and reflective white metal roofs. Data show the white metal roofing reduced roof,…
The Attractiveness of Regional Towns: Inferring Quality of Life from Higher Education Facilities
ERIC Educational Resources Information Center
Drummond, Aaron; Palmer, Matthew A.; Halsey, R. John
2013-01-01
We examined whether the presence of higher education facilities made regional towns more attractive as potential residences. Metropolitan undergraduate students reported that they were more willing to live in a regional town with (vs. without) a university. Importantly, this applied regardless of whether they intended to work or study at the…
Multiple Use. Instructor Guide. Working for Clean Water: An Information Program for Advisory Groups.
ERIC Educational Resources Information Center
Buskirk, E. Drannon, Jr.
Examined is the use of wastewater treatment facilities for recreation, education, and open space. Objectives of the learning session described in this instructor's manual are to: (1) introduce opportunities for multiple use, (2) identify areas for citizen input in facility planning and design, and (3) provide criteria for determining local needs…
ERIC Educational Resources Information Center
Kelsey, Susan G.; Laditka, Sarah B.; Laditka, James N.
2010-01-01
Purpose: This study examines transitioning residents with Alzheimer's disease or a related disorder (ADRD) from assisted living facilities (ALFs) to memory care units (MCUs) from the perspective of 3 ALF organizational models: freestanding ALFs, ALFs with MCUs, and ALFs in continuing care retirement communities (CCRCs) with MCUs. Design and…
Plantinga, Laura; Pastan, Stephen; Kramer, Michael; McClellan, Ann; Krisher, Jenna; Patzer, Rachel E.
2014-01-01
Background Improving access to optimal healthcare may depend on attributes of neighborhoods where patients receive healthcare services. We investigated whether characteristics of dialysis facility neighborhoods—where most patients with end-stage renal disease are treated—were associated with facility-level kidney transplantation. Methods We examined the association between census tract (neighborhood)-level sociodemographic factors and facility-level kidney transplantation rate in 3,983 U.S. dialysis facilities with reported kidney transplantation rates. Number of kidney transplants and total person-years contributed at the facility level in 2007-2010 were obtained from the Dialysis Facility Report and linked to census tract data on sociodemographic characteristics from the American Community Survey 2006-2010 by dialysis facility location. We used multivariable Poisson models with generalized estimating equations to estimate associations between neighborhood characteristics and transplant incidence. Results U.S. dialysis facilities were located in neighborhoods with substantially greater proportions of black and poor residents, relative to the national average. Most facility neighborhood characteristics were associated with transplant, with incidence rate ratios (95% CI) for standardized increments (in percentage) of neighborhood exposures of: living in poverty, 0.88 (0.84-0.92), black race, 0.83 (0.78-0.89); high school graduates, 1.22 (1.17-1.26); and unemployed, 0.90 (0.85-0.95). Conclusion Dialysis facility neighborhood characteristics may be modestly associated with facility rates of kidney transplantation. The success of dialysis facility interventions to improve access to kidney transplantation may partially depend on reducing neighborhood-level barriers. PMID:25196018
Care outcomes in long-term care facilities in British Columbia, Canada. Does ownership matter?
McGregor, Margaret J; Tate, Robert B; McGrail, Kimberlyn M; Ronald, Lisa A; Broemeling, Anne-Marie; Cohen, Marcy
2006-10-01
This study investigated whether for-profit (FP) versus not-for-profit (NP) ownership of long-term care facilities resulted in a difference in hospital admission and mortality rates among facility residents in British Columbia, Canada. This retrospective cohort study used administrative data on all residents of British Columbia long-term care facilities between April 1, 1996, and August 1, 1999 (n = 43,065). Hospitalizations were examined for 6 diagnoses (falls, pneumonia, anemia, dehydration, urinary tract infection, and decubitus ulcers and/or gangrene), which are considered to be reflective of facility quality of care. In addition to FP versus NP status, facilities were divided into ownership subgroups to investigate outcomes by differences in governance and operational structures. We found that, overall, FP facilities demonstrated higher adjusted hospitalization rates for pneumonia, anemia, and dehydration and no difference for falls, urinary tract infections, or DCU/gangrene. FP facilities demonstrated higher adjusted hospitalization rates compared with NP facilities attached to a hospital, amalgamated to a regional health authority, or that were multisite. This effect was not present when comparing FP facilities to NP single-site facilities. There was no difference in mortality rates in FP versus NP facilities. The higher adjusted hospitalization rates in FP versus NP facilities is consistent with previous research from U.S. authors. However, the superior performance by the NP sector is driven by NP-owned facilities connected to a hospital or health authority, or that had more than one site of operation.
Maternal residential proximity to nuclear facilities and low birth weight in offspring in Texas.
Gong, Xi; Benjamin Zhan, F; Lin, Yan
2017-03-01
Health effects of close residential proximity to nuclear facilities have been a concern for both the general public and health professionals. Here, a study is reported examining the association between maternal residential proximity to nuclear facilities and low birth weight (LBW) in offspring using data from 1996 through 2008 in Texas, USA. A case-control study design was used together with a proximity-based model for exposure assessment. First, the LBW case/control births were categorized into multiple proximity groups based on distances between their maternal residences and nuclear facilities. Then, a binary logistic regression model was used to examine the association between maternal residential proximity to nuclear facilities and low birth weight in offspring. The odds ratios were adjusted for birth year, public health region of maternal residence, child's sex, gestational weeks, maternal age, education, and race/ethnicity. In addition, sensitivity analyses were conducted for the model. Compared with the reference group (more than 50 km from a nuclear facility), the exposed groups did not show a statistically significant increase in LBW risk [adjusted odds ratio (aOR) 0.91 (95% confidence interval (CI): 0.81, 1.03) for group 40-50 km; aOR 0.98 (CI 0.84, 1.13) for group 30-40 km; aOR 0.95 (CI 0.79, 1.15) for group 20-30 km; aOR 0.86 (CI 0.70, 1.04) for group 10-20 km; and aOR 0.98 (CI 0.59, 1.61) for group 0-10 km]. These results were also confirmed by results of the sensitivity analyses. The results suggest that maternal residential proximity to nuclear facilities is not a significant factor for LBW in offspring.
Agoro, Oscar Otieno; Osuga, Ben Onyango; Adoyo, Maureen
2015-01-01
Effective supportive supervision is widely recognized as essential for optimal management of medicines in government health facilities and also in contributing towards improved access and utilization of health services. This study sought to examine the extent supportive supervision for medicines management in government health facilities from a health worker perspective. A cross-sectional study was done targeting health workers managing medicines in government health facilities in Kiambu County. One hundred and thirty eight respondents took part in the study which explored the quality of supportive supervision from a health worker's perspective, and also examined the factors influencing their contentment with the level of supervision received. A statistical analysis was done using SPSS 21 and Excel 2013. Supervisory visits from all levels of health management were not regularly done, standard checklists were not routinely used, and action plans irregularly developed and followed up. Only 54 (38.6%) respondents were satisfied with the levels of supportive supervision that they received, with satisfaction significantly differing across the professional cadres, χ (2) (12, n = 138) = 29.762, p = .003; across the different tiers of health facilities, r s (138) = 0.341, p < .001; and with the education levels of the respondents, r s (138) = 0.381, p < .001. The study concluded that supportive supervision for medicines management that government health facilities received was still inadequate, and health workers were dissatisfied with the level of supervision that they received. The study recommends a review of the support supervision policy at the county level to address the unearthed inefficiencies and improve supervision for medicines management in government health facilities.
Availability of Youth Services in U.S. Mental Health Treatment Facilities
Cummings, Janet R.; Case, Brady G.; Ji, Xu; Marcus, Steven C.
2015-01-01
Despite concern about access to mental health (MH) services for youth, little is known about the specialty treatment infrastructure serving this population. We used national data to examine which types of MH treatment facilities (hospital- and community-based) were most likely to offer youth services and which types of communities were most likely to have this infrastructure. Larger (p<0.001) and privately owned (p<0.001) facilities were more likely to offer youth services. Rural counties, counties in which a majority of residents were nonwhite, and/or counties with a higher percentage of uninsured residents were less likely to have a community-based MH treatment facility that served youth (p<0.001). PMID:26467795
Jennings, Larissa; Bertrand, Jane; Rech, Dino; Harvey, Steven A.; Hatzold, Karin; Samkange, Christopher A.; Omondi Aduda, Dickens S.; Fimbo, Bennett; Cherutich, Peter; Perry, Linnea; Castor, Delivette; Njeuhmeli, Emmanuel
2014-01-01
Background The rapid expansion of voluntary medical male circumcision (VMMC) has raised concerns whether health systems can deliver and sustain VMMC according to minimum quality criteria. Methods and Findings A comparative process evaluation was used to examine data from SYMMACS, the Systematic Monitoring of the Voluntary Medical Male Circumcision Scale-Up, among health facilities providing VMMC across two years of program scale-up. Site-level assessments examined the availability of guidelines, supplies and equipment, infection control, and continuity of care services. Direct observation of VMMC surgeries were used to assess care quality. Two sample tests of proportions and t-tests were used to examine differences in the percent of facilities meeting requisite preparedness standards and the mean number of directly-observed surgical tasks performed correctly. Results showed that safe, high quality VMMC can be implemented and sustained at-scale, although substantial variability was observed over time. In some settings, facility preparedness and VMMC service quality improved as the number of VMMC facilities increased. Yet, lapses in high performance and expansion of considerably deficient services were also observed. Surgical tasks had the highest quality scores, with lower performance levels in infection control, pre-operative examinations, and post-operative patient monitoring and counseling. The range of scale-up models used across countries additionally underscored the complexity of delivering high quality VMMC. Conclusions Greater efforts are needed to integrate VMMC scale-up and quality improvement processes in sub-Saharan African settings. Monitoring of service quality, not just adverse events reporting, will be essential in realizing the full health impact of VMMC for HIV prevention. PMID:24801073
Tran, Bach Xuan; DO, Hoa Thi; Nguyen, Luong Thanh; Boggiano, Victoria; LE, Huong Thi; LE, Xuan Thanh Thi; Trinh, Ngoc Bao; DO, Khanh Nam; Nguyen, Cuong Tat; Nguyen, Thanh Trung; Dang, Anh Kim; Mai, Hue Thi; Nguyen, Long Hoang; Than, Selena; Latkin, Carl A
2018-04-01
Consumption of fast food and street food is increasingly common among Vietnamese, particularly in large cities. The high daily demand for these convenient food services, together with a poor management system, has raised concerns about food hygiene and safety (FHS). This study aimed to examine the FHS knowledge and practices of food processors and sellers in food facilities in Hanoi, Vietnam, and to identify their associated factors. A cross-sectional study was conducted with 1,760 food processors and sellers in restaurants, fast food stores, food stalls, and street vendors in Hanoi in 2015. We assessed each participant's FHS knowledge using a self-report questionnaire and their FHS practices using a checklist. Tobit regression was used to determine potential factors associated with FHS knowledge and practices, including demographics, training experience, and frequency of health examination. Overall, we observed a lack of FHS knowledge among respondents across three domains, including standard requirements for food facilities (18%), food processing procedures (29%), and food poisoning prevention (11%). Only 25.9 and 38.1% of participants used caps and masks, respectively, and 12.8% of food processors reported direct hand contact with food. After adjusting for socioeconomic characteristics, these factors significantly predicted increased FHS knowledge and practice scores: (i) working at restaurants and food stalls, (ii) having FHS training, (iii) having had a physical examination, and (iv) having taken a stool test within the last year. These findings highlight the need of continuous training to improve FHS knowledge and practices among food processors and food sellers. Moreover, regular monitoring of food facilities, combined with medical examination of their staff, should be performed to ensure food safety.
Factors promoting resident deaths at aged care facilities in Japan: a review.
Sugimoto, Kentaro; Ogata, Yasuko; Kashiwagi, Masayo
2018-03-01
Due to an increasingly ageing population, the Japanese government has promoted elderly deaths in aged care facilities. However, existing facilities were not designed to provide resident end-of-life care and the proportion of aged care facility deaths is currently less than 10%. Consequently, the present review evaluated the factors that promote aged care facility resident deaths in Japan from individual- and facility-level perspectives to exploring factors associated with increased resident deaths. To achieve this, MEDLINE, CINAHL, Web of Science and Ichushi databases were searched on 23 January 2016. Influential factors were reviewed for two healthcare services (insourcing and outsourcing facilities) as well as external healthcare agencies operating outside facilities. Of the original 2324 studies retrieved, 42 were included in analysis. Of these studies, five focused on insourcing, two on outsourcing, seven on external agencies and observed facility/agency-level factors. The other 28 studies identified individual-level factors related to death in aged care facilities. The present review found that at both facility and individual levels, in-facility resident deaths were associated with healthcare service provision, confirmation of resident/family end-of-life care preference and staff education. Additionally, while outsourcing facilities did not require employment of physicians/nursing staff to accommodate resident death, these facilities required visits by physicians and nursing staff from external healthcare agencies as well as residents' healthcare input. This review also found few studies examining outsourcing facilities. The number of healthcare outsourcing facilities is rapidly increasing as a result of the Japanese government's new tax incentives. Consequently, there may be an increase in elderly deaths in outsourcing healthcare facilities. Accordingly, it is necessary to identify the factors associated with residents' deaths at outsourcing facilities. © 2016 The Authors. Health and Social Care in the Community Published by John Wiley & Sons Ltd.
Definition of avionics concepts for a heavy lift cargo vehicle. Volume 1: Executive summary
NASA Technical Reports Server (NTRS)
1989-01-01
A cost effective, multiuser simulation, test, and demonstration facility to support the development of avionics systems for future space vehicles is examined. The technology needs and requirements of future Heavy Lift Cargo Vehicles (HLCVs) are analyzed and serve as the basis for sizing of the avionics facility, although the lab is not limited in use to support of HLCVs. Volume 1 provides a summary of the vehicle avionics trade studies, the avionics lab objectives, a summary of the lab's functional requirements and design, physical facility considerations, and cost estimates.
NASA Technical Reports Server (NTRS)
Roskam, J.; Muirhead, V. U.; Smith, H. W.; Henderson, T. D.
1977-01-01
The design, construction, and costs of a test facility for determining the sound transmission loss characteristics of various panels and panel treatments are described. The pressurization system and electronic equipment used in experimental testing are discussed as well as the reliability of the facility and the data gathered. Tests results are compared to pertinent acoustical theories for panel behavior and minor anomalies in the data are examined. A method for predicting panel behavior in the stiffness region is also presented.
Conceptualization and design of a variable-gravity research facility
NASA Technical Reports Server (NTRS)
1987-01-01
The goal is to provide facilities for the study of the effects of variable-gravity levels in reducing the physiological stresses upon the humans of long-term stay time in zero-g. The designs studied include: twin-tethered two module system with a central despun module with docking port and winch gear; and rigid arm tube facility using shuttle external tanks. Topics examined included: despun central capsule configuration, docking clearances, EVA requirements, crew selection, crew scheduling, food supply and preparation, waste handling, leisure use, biomedical issues, and psycho-social issues.
2010-01-01
Background The aim of this study was to examine the distribution of physical activity facilities by area-level deprivation in Scotland, adjusting for differences in urbanicity, and exploring differences between and within the four largest Scottish cities. Methods We obtained a list of all recreational physical activity facilities in Scotland. These were mapped and assigned to datazones. Poisson and negative binomial regression models were used to investigate associations between the number of physical activity facilities relative to population size and quintile of area-level deprivation. Results The results showed that prior to adjustment for urbanicity, the density of all facilities lessened with increasing deprivation from quintiles 2 to 5. After adjustment for urbanicity and local authority, the effect of deprivation remained significant but the pattern altered, with datazones in quintile 3 having the highest estimated mean density of facilities. Within-city associations were identified between the number of physical activity facilities and area-level deprivation in Aberdeen and Dundee, but not in Edinburgh or Glasgow. Conclusions In conclusion, area-level deprivation appears to have a significant association with the density of physical activity facilities and although overall no clear pattern was observed, affluent areas had fewer publicly owned facilities than more deprived areas but a greater number of privately owned facilities. PMID:20955548
Ghazzawi, Andrea; Kuziemsky, Craig; O'Sullivan, Tracey
2016-10-01
Family caregivers provide the stroke survivor with social support and continuity during the transition home from a rehabilitation facility. In this exploratory study we examined family caregivers' perceptions and experiences navigating the stroke rehabilitation system. The theories of continuity of care and complex adaptive systems were integrated to examine the transition from a stroke rehabilitation facility to the patient's home. This study provides an understanding of the interacting complexities at the macro and micro levels. A convenient sample of family caregivers (n = 14) who provide care for a stroke survivor were recruited 4-12 weeks following the patient's discharge from a stroke rehabilitation facility in Ontario, Canada. Interviews were conducted with family caregivers to examine their perceptions and experiences navigating the stroke rehabilitation system. Directed and inductive content analysis and the theory of Complex Adaptive Systems were used to interpret the perceptions of family caregivers. Health system policies and procedures at the macro-level determined the types and timing of information being provided to caregivers, and impacted continuity of care and access to supports and services at the micro-level. Supports and services in the community, such as outpatient physiotherapy services, were limited or did not meet the specific needs of the stroke survivors or family caregivers. Relationships with health providers, informational support, and continuity in case management all influence the family caregiving experience and ultimately the quality of care for the stroke survivor, during the transition home from a rehabilitation facility.
Awoke, Mamaru Ayenew; Negin, Joel; Moller, Jette; Farell, Penny; Yawson, Alfred E.; Biritwum, Richard Berko; Kowal, Paul
2017-01-01
ABSTRACT Background: Previous studies investigating factors associated with healthcare utilization by older Ghanaians lack distinction between public and private health services. The present study examined factors associated with public and private healthcare service use, and the resulting perceived health system responsiveness. Objectives: To identify factors associated with public and private healthcare utilization among older adults aged 50 and older in Ghana; and to compare perceived differences in health system responsiveness between the private and public sectors. Methods: Cross-sectional data was analyzed from the World Health Organization Study on global AGEing and adult health (SAGE) Wave 1 in Ghana. Using Andersen’s conceptual framework, public and private outpatient care utilization was examined using multinomial logistic regression to estimate and identify predictor variables associated with the type of outpatient healthcare facility accessed. Health system responsiveness was compared using chi-square tests. Results: Of 2517 respondents who used outpatient care in the 12 months preceding interview, 51.7% of respondents used a public facility, 17.8% a private facility, and 30.5% used other facilities. Older age group, higher education and higher wealth were associated with the use of private outpatient healthcare services. Using public outpatient care facilities was associated with having health insurance. Respondents with two or more chronic conditions were more likely to use public and private outpatient care than other facilities. Perceived health system responsiveness was better in private for-profit than in public and private not-for-profit healthcare facilities. Conclusions: This study suggested that higher wealth and multimorbidity were significant predictors of public and private outpatient healthcare utilization; however, health insurance was a predictor only for the use of public facilities. Future mixed-method studies could further elucidate factors influencing the choice of public and private outpatient healthcare use. PMID:28578615
Wen, Hefei; Cummings, Janet R; Hockenberry, Jason M; Gaydos, Laura M; Druss, Benjamin G
2013-12-01
The passage of the 2008 Mental Health Parity and Addiction Equity Act and the 2010 Affordable Care Act incorporated parity for substance use disorder (SUD) treatment into federal legislation. However, prior research provides us with scant evidence as to whether federal parity legislation will hold the potential for improving access to SUD treatment. To examine the effect of state-level SUD parity laws on state-aggregate SUD treatment rates and to shed light on the impact of the recent federal SUD parity legislation. We conducted a quasi-experimental study using a 2-way (state and year) fixed-effect method. We included all known specialty SUD treatment facilities in the United States and examined treatment rates from October 1, 2000, through March 31, 2008. Our main source of data was the National Survey of Substance Abuse Treatment Services, which provides facility-level information on specialty SUD treatment. State-level SUD parity laws during the study period. State-aggregate SUD treatment rates in (1) all specialty SUD treatment facilities and (2) specialty SUD treatment facilities accepting private insurance. The implementation of any SUD parity law increased the treatment rate by 9% (P < .001) in all specialty SUD treatment facilities and by 15% (P = .02) in facilities accepting private insurance. Full parity and parity only if SUD coverage is offered increased the SUD treatment rate by 13% (P = .02) and 8% (P = .04), respectively, in all facilities and by 21% (P = .03) and 10% (P = .04), respectively, in facilities accepting private insurance. We found a positive effect of the implementation of state SUD parity legislation on access to specialty SUD treatment. Furthermore, the positive association is more pronounced in states with more comprehensive parity laws. Our findings suggest that federal parity legislation holds the potential to improve access to SUD treatment.
Patel, Rachana; Ladusingh, Laishram
2015-01-01
This study aims to examine the inter-district and inter-village variation of utilization of health services for institutional births in EAG states in presence of rural health program and availability of infrastructures. District Level Household Survey-III (2007–08) data on delivery care and facility information was used for the purpose. Bivariate results examined the utilization pattern by states in presence of correlates of women related while a three-level hierarchical multilevel model illustrates the effect of accessibility, availability of health facility and community health program variables on the utilization of health services for institutional births. The study found a satisfactory improvement in state Rajasthan, Madhya Pradesh and Orissa, importantly, in Bihar and Uttaranchal. The study showed that increasing distance from health facility discouraged institutional births and there was a rapid decline of more than 50% for institutional delivery as the distance to public health facility exceeded 10 km. Additionally, skilled female health worker (ANM) and observed improved public health facility led to significantly increase the probability of utilization as compared to non-skilled ANM and not-improved health centers. Adequacy of essential equipment/laboratory services required for maternal care significantly encouraged deliveries at public health facility. District/village variables neighborhood poverty was negatively related to institutional delivery while higher education levels in the village and women’s residing in more urbanized districts increased the utilization. “Inter-district” variation was 14 percent whereas “between-villages” variation for the utilization was 11 percent variation once controlled for all the three-level variables in the model. This study suggests that the mere availability of health facilities is necessary but not sufficient condition to promote utilization until the quality of service is inadequate and inaccessible considering the inter-districts variation for the program implementation. PMID:26689199
Patel, Rachana; Ladusingh, Laishram
2015-01-01
This study aims to examine the inter-district and inter-village variation of utilization of health services for institutional births in EAG states in presence of rural health program and availability of infrastructures. District Level Household Survey-III (2007-08) data on delivery care and facility information was used for the purpose. Bivariate results examined the utilization pattern by states in presence of correlates of women related while a three-level hierarchical multilevel model illustrates the effect of accessibility, availability of health facility and community health program variables on the utilization of health services for institutional births. The study found a satisfactory improvement in state Rajasthan, Madhya Pradesh and Orissa, importantly, in Bihar and Uttaranchal. The study showed that increasing distance from health facility discouraged institutional births and there was a rapid decline of more than 50% for institutional delivery as the distance to public health facility exceeded 10 km. Additionally, skilled female health worker (ANM) and observed improved public health facility led to significantly increase the probability of utilization as compared to non-skilled ANM and not-improved health centers. Adequacy of essential equipment/laboratory services required for maternal care significantly encouraged deliveries at public health facility. District/village variables neighborhood poverty was negatively related to institutional delivery while higher education levels in the village and women's residing in more urbanized districts increased the utilization. "Inter-district" variation was 14 percent whereas "between-villages" variation for the utilization was 11 percent variation once controlled for all the three-level variables in the model. This study suggests that the mere availability of health facilities is necessary but not sufficient condition to promote utilization until the quality of service is inadequate and inaccessible considering the inter-districts variation for the program implementation.
Mangham, Lindsay J; Cundill, Bonnie; Achonduh, Olivia A; Ambebila, Joel N; Lele, Albertine K; Metoh, Theresia N; Ndive, Sarah N; Ndong, Ignatius C; Nguela, Rachel L; Nji, Akindeh M; Orang-Ojong, Barnabas; Wiseman, Virginia; Pamen-Ngako, Joelle; Mbacham, Wilfred F
2012-03-01
To investigate the quality of malaria case management in Cameroon 5 years after the adoption of artemisinin-based combination therapy (ACT). Treatment patterns were examined in different types of facility, and the factors associated with being prescribed or receiving an ACT were investigated. A cross-sectional cluster survey was conducted among individuals of all ages who left public and private health facilities and medicine retailers in Cameroon and who reported seeking treatment for a fever. Prevalence of malaria was determined by rapid diagnostic tests (RDTs) in consenting patients attending the facilities and medicine retailers. Among the patients, 73% were prescribed or received an antimalarial, and 51% were prescribed or received an ACT. Treatment provided to patients significantly differed by type of facility: 65% of patients at public facilities, 55% of patients at private facilities and 45% of patients at medicine retailers were prescribed or received an ACT (P = 0.023). The odds of a febrile patient being prescribed or receiving an ACT were significantly higher for patients who asked for an ACT (OR = 24.1, P < 0.001), were examined by the health worker (OR = 1.88, P = 0.021), had not previously sought an antimalarial for the illness (OR = 2.29, P = 0.001) and sought treatment at a public (OR = 3.55) or private facility (OR = 1.99, P = 0.003). Malaria was confirmed in 29% of patients and 70% of patients with a negative result were prescribed or received an antimalarial. Malaria case management could be improved. Symptomatic diagnosis is inefficient because two-thirds of febrile patients do not have malaria. Government plans to extend malaria testing should promote rational use of ACT; though, the introduction of rapid diagnostic testing needs to be accompanied by updated clinical guidelines that provide clear guidance for the treatment of patients with negative test results. © 2011 Blackwell Publishing Ltd.
Shared use agreements and leisure time physical activity in North Carolina public schools.
Carlton, Troy A; Kanters, Michael A; Bocarro, Jason N; Floyd, Myron F; Edwards, Michael B; Suau, Luis J
2017-02-01
Although increasing community access to public schools through shared use agreements (SUAs) has been a recommended strategy for promoting physical activity (PA) among national, state and local organizations, empirical evidence examining the efficacy of SUAs is limited. This study examined the degree of usage and production of PA among schools with shared use, and how variation in PA output is related to characteristics of the school, type of activity, facility type, and when activity occurs. Data were collected in 20 schools across North Carolina using System for Observing Play and Recreation in Communities (SOPARC) and Structured Physical Activity Surveys (SPAS) to assess PA in school athletic facilities during out of school time. Findings indicated that although schools had a policy of shared or open use, most facilities were empty during non-school hours. Hierarchal linear regression models also showed that formal programming was positively associated with both use and PA levels. Given the abundance of empty facilities, community groups in need of space to facilitate structured PA programs should pursue avenues of sharing facilities with public schools. Furthermore, to increase the efficacy of shared use, structured physical activity programs may be needed. Future studies are encouraged to further explore the effects of the specific types of shared use programs on PA production as well other aspects of the built environment surrounding schools. Copyright © 2016 Elsevier Inc. All rights reserved.
Proximity to sports facilities and sports participation for adolescents in Germany.
Reimers, Anne K; Wagner, Matthias; Alvanides, Seraphim; Steinmayr, Andreas; Reiner, Miriam; Schmidt, Steffen; Woll, Alexander
2014-01-01
To assess the relationship between proximity to specific sports facilities and participation in the corresponding sports activities for adolescents in Germany. A sample of 1,768 adolescents aged 11-17 years old and living in 161 German communities was examined. Distances to the nearest sports facilities were calculated as an indicator of proximity to sports facilities using Geographic Information Systems (GIS). Participation in specific leisure-time sports activities in sports clubs was assessed using a self-report questionnaire and individual-level socio-demographic variables were derived from a parent questionnaire. Community-level socio-demographics as covariates were selected from the INKAR database, in particular from indicators and maps on land development. Logistic regression analyses were conducted to examine associations between proximity to the nearest sports facilities and participation in the corresponding sports activities. The logistic regression analyses showed that girls residing longer distances from the nearest gym were less likely to engage in indoor sports activities; a significant interaction between distances to gyms and level of urbanization was identified. Decomposition of the interaction term showed that for adolescent girls living in rural areas participation in indoor sports activities was positively associated with gym proximity. Proximity to tennis courts and indoor pools was not associated with participation in tennis or water sports, respectively. Improved proximity to gyms is likely to be more important for female adolescents living in rural areas.
Proximity to Sports Facilities and Sports Participation for Adolescents in Germany
Reimers, Anne K.; Wagner, Matthias; Alvanides, Seraphim; Steinmayr, Andreas; Reiner, Miriam; Schmidt, Steffen; Woll, Alexander
2014-01-01
Objectives To assess the relationship between proximity to specific sports facilities and participation in the corresponding sports activities for adolescents in Germany. Methods A sample of 1,768 adolescents aged 11–17 years old and living in 161 German communities was examined. Distances to the nearest sports facilities were calculated as an indicator of proximity to sports facilities using Geographic Information Systems (GIS). Participation in specific leisure-time sports activities in sports clubs was assessed using a self-report questionnaire and individual-level socio-demographic variables were derived from a parent questionnaire. Community-level socio-demographics as covariates were selected from the INKAR database, in particular from indicators and maps on land development. Logistic regression analyses were conducted to examine associations between proximity to the nearest sports facilities and participation in the corresponding sports activities. Results The logisitic regression analyses showed that girls residing longer distances from the nearest gym were less likely to engage in indoor sports activities; a significant interaction between distances to gyms and level of urbanization was identified. Decomposition of the interaction term showed that for adolescent girls living in rural areas participation in indoor sports activities was positively associated with gym proximity. Proximity to tennis courts and indoor pools was not associated with participation in tennis or water sports, respectively. Conclusions Improved proximity to gyms is likely to be more important for female adolescents living in rural areas. PMID:24675689
NASA Technical Reports Server (NTRS)
Meyer, P. J.
1993-01-01
An image data visual browse facility is developed for a UNIX platform using the X Windows 11 system. It allows one to visually examine reduced resolution image data to determine which data are applicable for further research. Links with a relational data base manager then allow one to extract not only the full resolution image data, but any other ancillary data related to the case study. Various techniques are examined for compression of the image data in order to reduce data storage requirements and time necessary to transmit the data on the internet. Data used were from the WetNet project.
Digital imaging technology assessment: Digital document storage project
NASA Technical Reports Server (NTRS)
1989-01-01
An ongoing technical assessment and requirements definition project is examining the potential role of digital imaging technology at NASA's STI facility. The focus is on the basic components of imaging technology in today's marketplace as well as the components anticipated in the near future. Presented is a requirement specification for a prototype project, an initial examination of current image processing at the STI facility, and an initial summary of image processing projects at other sites. Operational imaging systems incorporate scanners, optical storage, high resolution monitors, processing nodes, magnetic storage, jukeboxes, specialized boards, optical character recognition gear, pixel addressable printers, communications, and complex software processes.
Risk of fractures in an intermediate care facility for persons with mental retardation.
Tannenbaum, T N; Lipworth, L; Baker, S
1989-01-01
The epidemiology of fractures among 553 residents of an intermediate care facility for persons with mental retardation was examined. In a 10-month period, 61 fractures occurred among 55 residents; application of fracture rates in the United States revealed an expected number of 15 fractures among the 553 residents, p less than .001. Although 52% of fractures involved small bones of the hands and feet, elderly residents were more likely to fracture major bones and to suffer their fractures from a fall than were younger residents. The relationship between potential risk factors and fracture risk were examined and implications for preventive and rehabilitative measures discussed.
ERIC Educational Resources Information Center
Winterbottom, Christian; Piasta, Shayne B.
2015-01-01
Accreditation is a widely accepted indicator of quality in early education and includes many of the components cited in broad conceptualizations of quality. The purpose of this study was to examine whether kindergarten readiness rates differed between Florida child care facilities that were and were not accredited by any relevant national…
High Hand Contamination Rates During Norovirus Outbreaks in Long-Term Care Facilities.
Park, Geun Woo; Williamson, Keenan J; DeBess, Emilio; Cieslak, Paul R; Gregoricus, Nicole; De Nardo, Elizabeth; Fricker, Christopher; Costantini, Verónica; Vinjé, Jan
2018-02-01
We examined norovirus contamination on hands of ill patients during 12 norovirus outbreaks in 12 long-term care facilities (LTCFs). The higher frequency and norovirus titers on hands of residents compared to hands of heathcare workers highlights the importance of adhering to appropriate hand hygiene practices during norovirus outbreaks in LTCFs. Infect Control Hosp Epidemiol 2018;39:219-221.
Greene, Jan; Scalise, Dagmara; Thrall, Terese Hudson; Haugh, Richard
2002-08-01
Specialty centers that focus on lucrative services such as cardiology and orthopedics pose a challenge to full-service hospitals in already crowded health care markets. We examine how hospitals in three markets have responded, from aggressively working to keep niche facilities from gaining a foothold to partnering with physicians on their own centers.
NASA Technical Reports Server (NTRS)
Griffin, S. A.; Madsen, A. P.; Mcclain, A. A.
1984-01-01
The feasibility of designing advanced technology, highly maneuverable, fighter aircraft models to achieve full scale Reynolds number in the National Transonic Facility (NTF) is examined. Each of the selected configurations are tested for aeroelastic effects through the use of force and pressure data. A review of materials and material processes is also included.
Federal Register 2010, 2011, 2012, 2013, 2014
2012-06-12
...., Pilgrim Nuclear Power Station; Record of Decision and Issuance of Renewed Facility Operating License No... as the record of decision for the renewal of facility operating license No. DPR-35, consistent with... referenced. NRC's PDR: You may examine and purchase copies of public documents at the NRC's PDR, Room O1-F21...
ERIC Educational Resources Information Center
Sharp, Jeff; Tucker, Mark
2005-01-01
The development of large-scale livestock facilities has become a controversial issue in many regions of the U.S. in recent years. In this research, rural-urban differences in familiarity and concern about large-scale livestock facilities among Ohioans is examined as well as the relationship of social distance from agriculture and trust in risk…
Moon Park: A research and educational facility
NASA Technical Reports Server (NTRS)
Kuriki, Kyoichi; Saito, Takao; Ogawa, Yukimasa
1992-01-01
Moon Park has been proposed as an International Space Year (ISY) event for international cooperative efforts. Moon Park will serve as a terrestrial demonstration of a prototype lunar base and provide research and educational opportunities. The kind of data that can be obtained in the Moon Park facilities is examined taking the minimum number of lunar base residents as an example.
ERIC Educational Resources Information Center
Elpers, Kathy; Amano, Takashi; DeCoster, Vaughn; Johnson, Missy
2017-01-01
Managing Behavioral and Psychological Symptoms of Dementia (BPSD) is a significant challenge for staff working in long-term care facilities. This study examines the effectiveness of a psycho-educational training aimed at changing staff's attitudes. The results indicated that participants' attitudes toward dementia were more positive,…
The key to security is a balancing act.
Macdonald, Grant
2011-11-01
Grant Macdonald, managing director at supplier of mechanical and electronic door locks, Codelocks, examines some of the important issues for healthcare estates and facilities personnel considering how best to protect parts of a healthcare facility--large or small--given the need to minimise costs and not "over-specify" on security, while simultaneously ensuring that patients, staff, and hospital property, are safeguarded.
ERIC Educational Resources Information Center
Hughes, Mary F.
This chapter examines the main challenges that rural school districts face in school facilities funding and illustrates these problems with a case study of Arkansas. Most rural school districts serve only a small number of students, which tends to limit the funds available for construction or renovation. In addition, rural districts are likely to…
DOE Office of Scientific and Technical Information (OSTI.GOV)
Broxton, D.E.; Chipera, S.J.; Byers, F.M. Jr.
1993-10-01
Outcrops of nonwelded tuff at six locations in the vicinity of Yucca Mountain, Nevada, were examined to determine their suitability for hosting a surface-based test facility for the Yucca Mountain Project. Investigators will use this facility to test equipment and procedures for the Exploratory Studies Facility and to conduct site characterization field experiments. The outcrops investigated contain rocks that include or are similar to the tuffaceous beds of Calico Hills, an important geologic and hydrologic barrier between the potential repository and the water table. The tuffaceous beds of Calico Hills at the site of the potential repository consist of bothmore » vitric and zeolitic tuffs, thus three of the outcrops examined are vitric tuffs and three are zeolitic tuffs. New data were collected to determine the lithology, chemistry, mineralogy, and modal petrography of the outcrops. Some preliminary data on hydrologic properties are also presented. Evaluation of suitability of the six sites is based on a comparison of their geologic characteristics to those found in the tuffaceous beds of Calico Hills within the exploration block.« less
Adoption and Diffusion of Evidence-Based Addiction Medications in Substance Abuse Treatment
Heinrich, Carolyn J; Cummings, Grant R
2014-01-01
ObjectiveTo examine the roles of facility-and state-level factors in treatment facilities’ adoption and diffusion of pharmaceutical agents used in addiction treatment. Data SourcesSecondary data from the National Survey of Substance Abuse Treatment Services (N-SSATS), Substance Abuse and Mental Health Services Administration (SAMHSA), Centers for Medicare and Medicaid Services, Alcohol Policy Information System, and Kaiser Family Foundation. Study DesignWe estimate ordered logit and multinomial logit models to examine the relationship of state and treatment facility characteristics to the adoption and diffusion of three pharmaceutical agents over 4 years when each was at a different stage of adoption or diffusion. Data CollectionN-SSATS data with facility codes, obtained directly from SAMHSA, were linked by state identifiers to the other publicly available, secondary data. Principal FindingsThe analysis confirms the importance of awareness and exposure to the adoption behavior of others, dissemination of information about the feasibility and effectiveness of innovations, geographical clustering, and licensing and accreditation in legitimizing facilities’ adoption and continued use of pharmacotherapies in addiction treatment. ConclusionsPolicy and administrative levers exist to increase the availability of pharmaceutical technologies and their continued use by substance abuse treatment facilities. PMID:23855719
Staff satisfaction and its components in residential aged care.
Chou, Shu-Chiung; Boldy, Duncan P; Lee, Andy H
2002-06-01
The purpose of this study was to assess the direction and magnitude of the effects among the components of staff satisfaction in residential aged care and to examine whether the relationships among satisfaction components vary according to facility type (i.e. nursing homes and hostels). A hostel is a low care facility in which residents are more independent, have a lower level of care needs, and receive personal but not nursing care. A cross-sectional survey design was adopted to collect the required information, and a stratified random sampling approach was utilized to select facilities. Structural equation modeling was used to examine relationships among satisfaction components. Seventy residential aged care facilities in Western Australia. The sample includes 610 nursing home and 373 hostel care staff. The relationships among satisfaction components are different for nursing home and hostel staff. Professional support is found to have a strong and positive effect on all other aspects of staff satisfaction. The findings lead to an improved understanding of the interrelationship among staff satisfaction components, which has important implications through enhancing professional support. This needs to be recognized and emphasized by managers, care providers, and policy makers so as to maintain stable personnel and continuity of care.
Munro, Trent P; Mahler, Stephen M; Huang, Edwin P; Chin, David Y; Gray, Peter P
2011-01-01
Therapeutic monoclonal antibodies (mAbs) currently dominate the biologics marketplace. Development of a new therapeutic mAb candidate is a complex, multistep process and early stages of development typically begin in an academic research environment. Recently, a number of facilities and initiatives have been launched to aid researchers along this difficult path and facilitate progression of the next mAb blockbuster. Complementing this, there has been a renewed interest from the pharmaceutical industry to reconnect with academia in order to boost dwindling pipelines and encourage innovation. In this review, we examine the steps required to take a therapeutic mAb from discovery through early stage preclinical development and toward becoming a feasible clinical candidate. Discussion of the technologies used for mAb discovery, production in mammalian cells and innovations in single-use bioprocessing is included. We also examine regulatory requirements for product quality and characterization that should be considered at the earliest stages of mAb development. We provide details on the facilities available to help researchers and small-biotech build value into early stage product development, and include examples from within our own facility of how technologies are utilized and an analysis of our client base.
Effect of travel distance and time to radiotherapy on likelihood of receiving mastectomy.
Goyal, Sharad; Chandwani, Sheenu; Haffty, Bruce G; Demissie, Kitaw
2015-04-01
Breast-conserving surgery (BCS) followed by adjuvant radiation therapy (RT) is the standard of care for women with early-stage breast cancer as an alternative to mastectomy. The purpose of this study was to examine the relationship between receipt of mastectomy and travel distance and time to RT facility in New Jersey (NJ). Data were collected from a cohort of 634 NJ women diagnosed with early-stage breast cancer. In patients receiving RT, the precise RT facility was used, whereas in patients not receiving RT, surgeons were contacted to determine the location of RT referral. Travel distance and time to RT facility from the patients' residential address were modeled separately using multiple binomial regression to examine their association with choice of surgery while adjusting for clinical and sociodemographic factors. Overall, 58.5 % patients underwent BCS with median travel distance to the radiation facility of 4.8 miles (vs. 6.6 miles for mastectomy) and median travel time of 12.0 min (vs. 15.0 min for mastectomy). Patients residing > 9.2 miles compared with ≤ 9.2 miles from radiation facility were 44 % more likely to receive mastectomy. Additionally, patients requiring > 19 min compared with ≤ 19 min of travel time were 36 % more likely to receive mastectomy. These data found that travel distance and time from RT facility act as barriers to undergoing BCS in women with early-stage breast cancer. Despite being in an urban region, a significant number of women in NJ with early-stage breast cancer did not receive BCS.
Employee influenza vaccination in residential care facilities.
Apenteng, Bettye A; Opoku, Samuel T
2014-03-01
The organizational literature on infection control in residential care facilities is limited. Using a nationally representative dataset, we examined the organizational factors associated with implementing at least 1 influenza-related employee vaccination policy/program, as well as the effect of vaccination policies on health care worker (HCW) influenza vaccine uptake in residential care facilities. The study was a cross-sectional study using data from the 2010 National Survey of Residential Care Facilities. Multivariate logistic regression analysis was used to address the study's objectives. Facility size, director's educational attainment, and having a written influenza pandemic preparedness plan were significantly associated with the implementation of at least 1 influenza-related employee vaccination policy/program, after controlling for other facility-level factors. Recommending vaccination to employees, providing vaccination on site, providing vaccinations to employees at no cost, and requiring vaccination as a condition of employment were associated with higher employee influenza vaccination rates. Residential care facilities can improve vaccination rates among employees by adopting effective employee vaccination policies. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.
Spatial association of public sports facilities with body mass index in Korea.
Han, Eun Jin; Kang, Kiyeon; Sohn, So Young
2018-05-07
Governments and also local councils create and enforce their own regional public health care plans for the problem of overweight and obesity in the population. Public sports facilities can help these plans. In this paper, we investigated the contribution of public sports facilities to the reduction of the obesity of local residents. We used the data obtained from the Fifth Korea National Health and Nutrition Examination Surveys; and measured the degree of obesity using body mass index (BMI). We conducted various spatial regression analyses including the global Moran's I test and local indicators of spatial autocorrelation analysis finding that there exists spatial dependence in the error term of spatial regression model for BMI. However, we also observed that the number of local public sports facilities is not significantly related to local BMI. This result can be caused by the low utilization ratio and an unbalanced spatial distribution of local public sports facilities. Based on our findings, we suggest that local councils need to improve the quality of public sports facilities encouraging the establishment of preferred types of pubic sports facilities.
Cohn, Amy; Stanton, Cassandra; Elmasry, Hoda; Ehlke, Sarah; Niaura, Ray
2016-06-01
Substance use disorders are common among persons with HIV/AIDS. This study examined the prevalence and correlates of the provision of four HIV services in a national sample of substance abuse treatment facilities. Data were from the 2011 National Survey of Substance Abuse Treatment Services. Prevalence estimates indicated that 28% of facilities offered HIV testing, 26% early intervention, 58% HIV/AIDS education, and 8% special programs for HIV/AIDS. Facilities offering inpatient substance abuse care were more than six times as likely to offer HIV testing but not more likely to offer any other type of HIV service. Facilities offering methadone treatment were 2.5 times more likely to offer HIV services. Given the high rates of substance use among persons with HIV, the prevalence of facilities offering HIV services was low in most domains, with different barriers identified in multivariable models. Integrating comprehensive HIV prevention, testing, and support services into programs that address substance abuse is needed.
Trends in inequalities in utilization of reproductive health services from 2000 to 2011 in Vietnam
Duc, Nguyen Huu Chau; Nakamura, Keiko; Kizuki, Masashi; Seino, Kaoruko; Rahman, Mosiur
2015-01-01
Objective: This study aimed to examine changes in utilization of reproductive health services by wealth status from 2000 to 2011 in Vietnam. Methods: Data from the Vietnam Multiple Indicator Cluster Surveys in 2000, 2006, and 2011 were used. The subjects were 550, 1023, and 1363 women, respectively, aged between 15 and 49 years who had given birth in the previous one or two years. The wealth index, a composite measure of a household’s ownership of selected assets, materials used for housing construction, and types of water access and sanitation facilities, was used as a measure of wealth status. Main utilization indicators were utilization of antenatal care services, receipt of a tetanus vaccine, receipt of blood pressure measurement, blood examination and urine examination during antenatal care, receipt of HIV testing, skilled birth attendance at delivery, health-facility-based delivery, and cesarean section delivery. Inequalities by wealth index were measured by prevalence ratios, concentration indices, and multivariable adjusted regression coefficients. Results: Significant increase in overall utilization was observed in all indicators (all p < 0.001). The concentration indices were 0.19 in 2000 and 0.06 in 2011 for antenatal care, 0.10 in 2000 and 0.06 in 2011 for tetanus vaccination, 0.23 in 2000 and 0.08 in 2011 for skilled birth attendance, 0.29 in 2006 and 0.12 in 2011 for blood examination, and 0.18 in 2006 and 0.09 in 2011 for health-facility-based delivery. The multivariable adjusted regression coefficients of reproductive health service utilization by wealth category were 0.06 in 2000 and 0.04 in 2011 for antenatal care, 0.07 in 2000 and 0.05 in 2011 for skilled birth attendance, and 0.07 in 2006 and 0.05 in 2011 for health-facility-based delivery. Conclusions: More women utilized reproductive health services in 2011 than in 2000. Inequality by wealth status in utilization of antenatal care, skilled birth attendance, and health-facility-based delivery had been reduced. PMID:26705431
Rivera-Hernandez, Maricruz; Rahman, Momotazur; Mukamel, Dana B; Mor, Vincent; Trivedi, Amal N
2018-04-25
Understanding and addressing racial and ethnic disparities in the quality of post-acute care in skilled nursing facilities is an important health policy issue, particularly as the Medicare program initiates value-based payments for these institutions. Our final cohort included 649,187 Medicare beneficiaries in either the fee-for-service or Medicare Advantage programs, who were 65 and older and were admitted to a skilled nursing facility following an acute hospital stay, from 8,375 skilled nursing facilities. We examined the quality of care in skilled nursing facilities that disproportionately serve minority patients compared to non-Hispanic whites. Three measures, all calculated at the level of the facility, were used to assess quality of care in skilled nursing facilities: 1) 30-day rehospitalization rate; 2) successful discharge from the facility to the community; and 3) Medicare five-star quality ratings. We found that African-American post-acute patients are highly concentrated in a small number of institutions, with 28% of facilities accounting for 80% of all post-acute admissions for African-American patients. Similarly, just 20% of facilities accounted for 80% of all admissions for Hispanics. Skilled nursing facilities with higher fractions of African-American patients had worse performance for three publicly-reported quality measures: rehospitalization, successful discharge to the community, and the star rating indicator. Efforts to address disparities should focus attention on institutions that disproportionately serve minority patients and monitor unintended consequences of value-based payments to skilled nursing facilities.
NASA Astrophysics Data System (ADS)
Kendie, S. B.
1996-01-01
In the examination of the implementation of rural drinking water facilities, not enough attention has been paid to analyzing the socioeconomic and political relationships that affect the effective utilization of the facilities, particularly as these relate to women in rural society. This paper suggests that much of the difficulty in instituting the utilization of safe water supply sources has to do with the rather low economic status of women—the main water collectors. Poverty consigns women to long periods of work in activities or jobs that bring little reward. This makes it difficult to effectively digest the messages delivered by program staff and limits the extent of usage of the safe water facilities.
An evaluation of proposed acoustic treatments for the NASA LaRC 4 x 7 meter wind tunnel
NASA Technical Reports Server (NTRS)
Abrahamson, A. L.
1985-01-01
The NASA LaRC 4 x 7 Meter Wind Tunnel is an existing facility specially designed for powered low speed (V/STOL) testing of large scale fixed wing and rotorcraft models. The enhancement of the facility for scale model acoustic testing is examined. The results are critically reviewed and comparisons are drawn with a similar wind tunnel (the DNW Facility in the Netherlands). Discrepancies observed in the comparison stimulated a theoretical investigation using the acoustic finite element ADAM System, of the ways in which noise propagating around the tunnel circuit radiates into the open test section. The reasons for the discrepancies noted above are clarified and assists in the selection of acoustic treatment options for the facility.
Availability of Youth Services in U.S. Mental Health Treatment Facilities.
Cummings, Janet R; Case, Brady G; Ji, Xu; Marcus, Steven C
2016-09-01
Despite concern about access to mental health (MH) services for youth, little is known about the specialty treatment infrastructure serving this population. We used national data to examine which types of MH treatment facilities (hospital- and community-based) were most likely to offer youth services and which types of communities were most likely to have this infrastructure. Larger (p < 0.001) and privately owned (p < 0.001) facilities were more likely to offer youth services. Rural counties, counties in which a majority of residents were nonwhite, and/or counties with a higher percentage of uninsured residents were less likely to have a community-based MH treatment facility that served youth (p < 0.001).
ERIC Educational Resources Information Center
Inuwa, Ibrahim Muhammad; Taranikanti, Varna; Al-Rawahy, Maimouna; Habbal, Omar
2012-01-01
Practical examinations in anatomy are usually conducted on specimens in the anatomy laboratory (referred to here as the "traditional" method). Recently, we have started to administer similar examinations online using the quiz facility in Moodle[TM]. In this study, we compare student scores between two assessment environments viz. online and…
NASA Astrophysics Data System (ADS)
DiGregorio, B. E.
2018-04-01
The only 100% guarantee of protecting Earth's biosphere from a hazardous back contamination event is to use the Moon as a sample return examination facility to qualify samples for eventual return to Earth.
NASA Astrophysics Data System (ADS)
DiGregorio, B. E.
2018-02-01
The only 100% guarantee of protecting our planet's biosphere from a back contamination event is to use the Moon as a sample return examination facility to qualify samples for eventual return to Earth.
Evaluating malaria case management at public health facilities in two provinces in Angola.
Plucinski, Mateusz M; Ferreira, Manzambi; Ferreira, Carolina Miguel; Burns, Jordan; Gaparayi, Patrick; João, Lubaki; da Costa, Olinda; Gill, Parambir; Samutondo, Claudete; Quivinja, Joltim; Mbounga, Eliane; de León, Gabriel Ponce; Halsey, Eric S; Dimbu, Pedro Rafael; Fortes, Filomeno
2017-05-03
Malaria accounts for the largest portion of healthcare demand in Angola. A pillar of malaria control in Angola is the appropriate management of malaria illness, including testing of suspect cases with rapid diagnostic tests (RDTs) and treatment of confirmed cases with artemisinin-based combination therapy (ACT). Periodic systematic evaluations of malaria case management are recommended to measure health facility readiness and adherence to national case management guidelines. Cross-sectional health facility surveys were performed in low-transmission Huambo and high-transmission Uíge Provinces in early 2016. In each province, 45 health facilities were randomly selected from among all public health facilities stratified by level of care. Survey teams performed inventories of malaria commodities and conducted exit interviews and re-examinations, including RDT testing, of a random selection of all patients completing outpatient consultations. Key health facility readiness and case management indicators were calculated adjusting for the cluster sampling design and utilization. Availability of RDTs or microscopy on the day of the survey was 71% (54-83) in Huambo and 85% (67-94) in Uíge. At least one unit dose pack of one formulation of an ACT (usually artemether-lumefantrine) was available in 83% (66-92) of health facilities in Huambo and 79% (61-90) of health facilities in Uíge. Testing rates of suspect malaria cases in Huambo were 30% (23-38) versus 69% (53-81) in Uíge. Overall, 28% (13-49) of patients with uncomplicated malaria, as determined during the re-examination, were appropriately treated with an ACT with the correct dose in Huambo, compared to 60% (42-75) in Uíge. Incorrect case management of suspect malaria cases was associated with lack of healthcare worker training in Huambo and ACT stock-outs in Uíge. The results reveal important differences between provinces. Despite similar availability of testing and ACT, testing and treatment rates were lower in Huambo compared to Uíge. A majority of true malaria cases seeking care in health facilities in Huambo were not appropriately treated with anti-malarials, highlighting the importance of continued training and supervision of healthcare workers in malaria case management, particularly in areas with decreased malaria transmission.
The quality of free antenatal and delivery services in Northern Sierra Leone.
Koroma, Manso M; Kamara, Samuel S; Bangura, Evelyn A; Kamara, Mohamed A; Lokossou, Virgil; Keita, Namoudou
2017-07-12
The number of maternal deaths in sub-Saharan Africa continues to be overwhelmingly high. In West Africa, Sierra Leone leads the list, with the highest maternal mortality ratio. In 2010, financial barriers were removed as an incentive for more women to use available antenatal, delivery and postnatal services. Few published studies have examined the quality of free antenatal services and access to emergency obstetric care in Sierra Leone. A cross-sectional survey was conducted in 2014 in all 97 peripheral health facilities and three hospitals in Bombali District, Northern Region. One hundred antenatal care providers were interviewed, 276 observations were made and 486 pregnant women were interviewed. We assessed the adequacy of antenatal and delivery services provided using national standards. The distance was calculated between each facility providing delivery services and the nearest comprehensive emergency obstetric care (CEOC) facility, and the proportion of facilities in a chiefdom within 15 km of each CEOC facility was also calculated. A thematic map was developed to show inequities. The quality of services was poor. Based on national standards, only 27% of women were examined, 2% were screened on their first antenatal visit and 47% received interventions as recommended. Although 94% of facilities provided delivery services, a minority had delivery rooms (40%), delivery kits (42%) or portable water (46%). Skilled attendants supervised 35% of deliveries, and in only 35% of these were processes adequately documented. None of the five basic emergency obstetric care facilities were fully compliant with national standards, and the central and northernmost parts of the district had the least access to comprehensive emergency obstetric care. The health sector needs to monitor the quality of antenatal interventions in addition to measuring coverage. The quality of delivery services is compromised by poor infrastructure, inadequate skilled staff, stock-outs of consumables, non-functional basic emergency obstetric care facilities, and geographic inequities in access to CEOC facilities. These findings suggest that the health sector needs to urgently investigate continuing inequities adversely influencing the uptake of these services, and explore more sustainable funding mechanisms. Without this, the country is unlikely to achieve its goal of reducing maternal deaths.
Ellaway, Anne; Lamb, Karen E; Ferguson, Neil S; Ogilvie, David
2016-08-09
The aim of this country-wide study was to link individual health and behavioural data with area-level spatial data to examine whether the body mass index (BMI) of adults was associated with access to recreational physical activity (PA) facilities by different modes of transport (bus, car, walking, cycling) and the extent to which any associations were mediated by PA participation. Data on individual objectively-measured BMI, PA (number of days of (a) ≥20 min of moderate-to-vigorous PA, and (b) ≥15 min of sport or exercise, in previous 4 weeks), and socio-demographic characteristics were obtained from a nationally representative sample of 6365 adults. The number of accessible PA facilities per 1,000 individuals in each small area (data zones) was obtained by mapping a representative list of all fixed PA facilities throughout mainland Scotland. A novel transport network was developed for the whole country, and routes on foot, by bike, by car and by bus from the weighted population centroid of each data zone to each facility were calculated. Separate multilevel models were fitted to examine associations between BMI and each of the 24 measures of accessibility of PA facilities and BMI, adjusting for age, gender, longstanding illness, car availability, social class, dietary quality and urban/rural classification. We found associations (p < 0.05) between BMI and 7 of the 24 accessibility measures, with mean BMI decreasing with increasing accessibility of facilities-for example, an estimated decrease of 0.015 BMI units per additional facility within a 20-min walk (p = 0.02). None of these accessibility measures were found to be associated with PA participation. Our national study has shown that some measures of the accessibility of PA facilities by different modes of transport (particularly by walking and cycling) were associated with BMI; but PA participation, as measured here, did not appear to play a part in this relationship. Understanding the multi-factorial environmental influences upon obesity is key to developing effective interventions to reduce it.
Shreay, Sanatan; Ma, Martin; McCluskey, Jill; Mittelhammer, Ron C; Gitlin, Matthew; Stephens, J Mark
2014-01-01
Objective To explore the relative efficiency of dialysis facilities in the United States and identify factors that are associated with efficiency in the production of dialysis treatments. Data Sources/Study Setting Medicare cost report data from 4,343 free-standing dialysis facilities in the United States that offered in-center hemodialysis in 2010. Study Design A cross-sectional, facility-level retrospective database analysis, utilizing data envelopment analysis (DEA) to estimate facility efficiency. Data Collection/Extraction Methods Treatment data and cost and labor inputs of dialysis treatments were obtained from 2010 Medicare Renal Cost Reports. Demographic data were obtained from the 2010 U.S. Census. Principal Findings Only 26.6 percent of facilities were technically efficient. Neither the intensity of market competition nor the profit status of the facility had a significant effect on efficiency. Facilities that were members of large chains were less likely to be efficient. Cost and labor savings due to changes in drug protocols had little effect on overall dialysis center efficiency. Conclusions The majority of free-standing dialysis facilities in the United States were functioning in a technically inefficient manner. As payment systems increasingly employ capitation and bundling provisions, these institutions will need to evaluate their efficiency to remain competitive. PMID:24237043
Okah, Ebiere; Arya, Vibhuti; Rogers, Meighan; Kim, Michelle; Schillinger, Julia Ann
2017-02-01
Expedited partner therapy (EPT) for Chlamydia trachomatis (Ct) is the practice of providing Ct-infected patients with medication, or prescription (prescription-EPT) to deliver to their sex partners without first examining those partners. New York City (NYC) providers commonly use prescription-EPT, yet NYC pharmacists report only occasional receipt of EPT prescriptions. This project assessed the frequency of EPT prescriptions filled in 2 NYC neighborhoods. The 2 NYC facilities reporting the most frequent use of prescription-EPT were identified from Ct provider case reports and contacted to ascertain their EPT practices. Providers at the first facility (facility 1) prescribed two 1-g doses of azithromycin, including sex partner treatment on the index patient's electronic prescription. Providers at the second facility (facility 2) gave patients paper prescriptions for sex partners. We reviewed prescriptions filled in 2015 for azithromycin, 1 or 2 g at pharmacies near these facilities; prescriptions indicating partner therapy were classified "EPT prescriptions". Facility 1 providers submitted 112 Ct case reports indicating prescription-EPT, compared with 114 submitted by facility 2 providers. Twelve of 26 identified pharmacies agreed to participate. At 7 pharmacies near facility 1, we found 61 EPT prescriptions from facility 1 and 37 from other facilities. At 5 pharmacies near facility 2, we found only 1 EPT prescription from facility 2 and 3 from other facilities. Expedited partner therapy prescriptions were received in NYC pharmacies near to EPT-prescribing facilities, but with great variability and at a lower frequency than suggested by provider case reports. Provider EPT prescribing practices may impact the likelihood that partners receive medication and should be further evaluated.
Wartmann, Lukas; Hartmann-Riemer, Matthias; Dinevski, Natascha; Siemerkus, Jakob; Fröbel, Rahel; Seifritz, Erich; Jäger, Matthias
2018-05-28
This paper investigates the subjective needs of psychiatric patients in relation to the housing conditions with an additional focus on inclusion and participation. Furthermore, it examines differences in clinical and socio-demographic parameters, self-measured quality of life, stage of recovery. In this quantitative cross-sectional study, we compared 50 patients in a psychiatric acute ward setting, who were looking for a residence in a sheltered housing facility with 50 patients in a sheltered housing facility using structured interviews. Patients living in a sheltered housing facility reported less unmet needs. However, no differences regarding inclusion and participation were found. More unmet needs were associated with poorer quality of life, and less social inclusion in both groups. Patients in sheltered housing facilities report less unmet needs. Nevertheless, more efforts are needed to regarding inclusion of these patients. A "supported inclusion"-approach should be considered.
Accessibility of Health Clubs for People with Mobility Disabilities and Visual Impairments
Rimmer, James H.; Riley, Barth; Wang, Edward; Rauworth, Amy
2005-01-01
Objective. We sought to examine the accessibility of health clubs to persons with mobility disabilities and visual impairments. Methods. We assessed 35 health clubs and fitness facilities as part of a national field trial of a new instrument, Accessibility Instruments Measuring Fitness and Recreation Environments (AIMFREE), designed to assess accessibility of fitness facilities in the following domains: (1) built environment, (2) equipment, (3) swimming pools, (4) information, (5) facility policies, and (6) professional behavior. Results. All facilities had a low to moderate level of accessibility. Some of the deficiencies concerned specific Americans with Disabilities Act guidelines pertaining to the built environment, whereas other deficiency areas were related to aspects of the facilities’ equipment, information, policies, and professional staff. Conclusions. Persons with mobility disabilities and visual impairments have difficulty accessing various areas of fitness facilities and health clubs. AIMFREE is an important tool for increasing awareness of these accessibility barriers for people with disabilities. PMID:16254234
Conflict resolution styles: a comparison of assisted living and nursing home facilities.
Small, Jeff A; Montoro-Rodriguez, Julian
2006-01-01
In this exploratory study, the authors investigated how interpersonal conflict is resolved in assisted living and nursing home facilities. In particular, the authors examined whether conflict resolution styles differed between type of facility and between residents and staff in each type of facility. Four focus groups were conducted--two with residents and two with staff from each type of facility. The focus groups centered on discussing the occurrence of conflict and how each participant handled it. Discourse analysis was employed to identify participants' use of three styles of conflict resolution: controlling, solution-oriented, and non-confrontational. The results indicate that staff in each care context showed a preference for the solution-oriented approach. Residents in each setting reported equal use of the non-confrontational and solution-oriented styles. The findings suggest that preferred conflict resolution styles may vary more as a function of the role of each communicator than the context of the care setting.
Factors affecting minority population proximity to hazardous facilities
DOE Office of Scientific and Technical Information (OSTI.GOV)
Nieves, L.A.; Nieves, A.L.
1995-04-01
Disproportionate exposure of minority groups to environmental hazards has been attributed to ``environmental racism`` by some authors, without systematic investigation of the factors underlying this exposure pattern. This study examines regional differences in the proximity of African-Americans, Hispanics, Asians, and non-Hispanic Whites to a broad range of facility types and explores the effects of urban and income factors. A statistically significant inverse relationship is found between the percentage of non-Hispanic Whites and virtually all facility categories in all regions. Except for Hispanics in the South, all such associations for minority groups show a direct relationship, though some are nonsignificant. Themore » geographic concentration of facilities is more closely tied to urbanization than to economic factors. Controlling for both urban and economic factors, minority population concentration is still a significant explanatory variable for some facility types in some regions. This finding is most consistent for African-Americans.« less
A feasibility study of a hypersonic real-gas facility
NASA Technical Reports Server (NTRS)
Gully, J. H.; Driga, M. D.; Weldon, W. F.
1987-01-01
A four month feasibility study of a hypersonic real-gas free flight test facility for NASA Langley Research Center (LARC) was performed. The feasibility of using a high-energy electromagnetic launcher (EML) to accelerate complex models (lifting and nonlifting) in the hypersonic, real-gas facility was examined. Issues addressed include: design and performance of the accelerator; design and performance of the power supply; design and operation of the sabot and payload during acceleration and separation; effects of high current, magnetic fields, temperature, and stress on the sabot and payload; and survivability of payload instrumentation during acceleration, flight, and soft catch.
Final Corrective Action Study for the Former CCC/USDA Facility in Hanover, Kansas
DOE Office of Scientific and Technical Information (OSTI.GOV)
LaFreniere, Lorraine M.
Low concentrations of carbon tetrachloride in groundwater and vapor intrusion into a limited number of residences (attributable to the contaminant concentrations in groundwater) have been identified in Hanover, Kansas, at and near a grain storage facility formerly leased and operated by the Commodity Credit Corporation of the U.S. Department of Agriculture (CCC/USDA). At the request of the Kansas Department of Health and Environment (KDHE 2009h), the CCC/USDA has prepared this Corrective Action Study (CAS) for the facility. The CAS examines corrective actions to address the contamination in groundwater and soil vapor.
ERIC Educational Resources Information Center
Chandler, Michele Denise; Chandler, Donald S.; Chandler, Donald S., Jr.; Race, James
2012-01-01
The study examined the relational-behavior survey (RBS) as a predictor of HIV-related parental miscommunication (HPM) among a voluntary sample 75 African American parents at a private healthcare facility located in the southwest region of the United States. A multiple regression analysis indicated that there was significant marginal prediction of…
Information Technology Division’s Technical Paper Abstracts
1994-07-05
antenna systems. 86 Title: An Electromagnetic Interference Study of Potential Transmitter Sites for the HF Active Auroral Research Program ( HAARP ...examined a number of potential sites for the location of the proposed High Frequency Active Auroral Research Program ( HAARP ) transmitter facility. The...proposed HAARP facility will consist of a large planar array of antennas excited by phased high power transmitters operating in the lower portion of the
ERIC Educational Resources Information Center
Akomolafe, Comfort Olufunke; Adesua, Veronica Olubunmi
2016-01-01
The paper examines the relevance of physical facilities in enhancing the level of motivation and the academic performance of senior secondary school students in South West Nigeria. The study adopted ex-post facto design. The population consists of all senior secondary students in South West Nigeria. The sample for the study include one thousand…
ERIC Educational Resources Information Center
Ingle, W. Kyle; Bowers, Alex J.; Davis, Thomas E.
2014-01-01
The American Recovery and Reinvestment Act of 2009 (ARRA) allocated $11 billion per year for 2009 and 2010 for qualified school construction bonds (QSCBs) for America's schools. From a historical perspective, this program is a broad transformation of the federal role in school facility funding. This study examined factors associated with federal…
ERIC Educational Resources Information Center
Chapin, Rosemary; Baca, Beth; Macmillan, Kelley; Rachlin, Roxanne; Zimmerman, Mary
2009-01-01
Purpose: The purpose of this longitudinal study was to determine the length of community tenure for adults aged 60 and older after application for nursing facility (NF) admission and to examine the proportion of older adults who lost community tenure due to either (a) death while a community resident or (b) permanent NF admission. Design and…
ERIC Educational Resources Information Center
Gutiérrez-Zornoza, Myriam; Sánchez-López, Mairena; García-Hermoso, Antonio; González-García, Alberto; Chillón, Palma; Martínez-Vizcaíno, Vicente
2015-01-01
Purpose: The aim of this study was to examine (a) whether distance from home to school is a determinant of active commuting to school (ACS), (b) the relationship between distance from home to heavily used facilities (school, green spaces, and sports facilities) and the weight status and cardiometabolic risk categories, and (c) whether ACS has a…
ERIC Educational Resources Information Center
Bovbjerg, Barbara D.
This report examines how states and local school districts have been dealing with the issues facing their public school facilities, including: (1) the trends since 1990 in elementary and secondary school construction expenditures and how these expenditures were divided between land, buildings, and equipment; (2) trends since 1990 in the amount of…
ERIC Educational Resources Information Center
Erickson, Kenneth A.; And Others
This publication presents the report of a study team that examined the facilities and grade organization of the Phoenix-Talent (Oregon) School District in light of the district's present and anticipated enrollment as of November 1971 and recommended a number of changes in both areas. Chapter 1 presents a brief overview of chapter 3 and also…
ERIC Educational Resources Information Center
Ettelt, Stefanie; Mays, Nicholas; Nolte, Ellen
2013-01-01
In this paper we reflect on our experience of providing a rapid response facility for international healthcare policy comparisons to the English Department of Health. We examine the challenges of developing sustained relationships with policy officials while providing an "on-demand" service in an environment with high turnover of…
ERIC Educational Resources Information Center
Taylor, Lloyd J., III; Poyner, Ilene
2008-01-01
Purpose: This study aims to investigate the problem of trained employee retention in a highly competitive labor market for a manufacturing facility in the oilfields of West Texas. Design/methodology/approach: This article examines how one manufacturing facility should be able to retain their trained employees by using the logic of Eliyahu M.…
Organizational Characteristics Associated with Staff Turnover in Nursing Homes
ERIC Educational Resources Information Center
Castle, Nicholas G.; Engberg, John
2006-01-01
Purpose: The association between certified nurse aide, licensed practical nurse, and registered nurse turnover and the organizational characteristics of nursing homes are examined. Design and Methods: Hypotheses for eight organizational characteristics are examined (staffing levels, top management turnover, resident case mix, facility quality,…
48 CFR 36.213-3 - Invitations for bids.
Code of Federal Regulations, 2010 CFR
2010-10-01
... bidders to inspect the site, obtain subcontract bids, examine data concerning the work, and prepare... examine the data concerning performance of the work (see 36.210). (6) Information concerning any facilities, such as utilities, office space, and warehouse space, to be furnished during construction. (7...
48 CFR 36.213-3 - Invitations for bids.
Code of Federal Regulations, 2011 CFR
2011-10-01
... bidders to inspect the site, obtain subcontract bids, examine data concerning the work, and prepare... examine the data concerning performance of the work (see 36.210). (6) Information concerning any facilities, such as utilities, office space, and warehouse space, to be furnished during construction. (7...
Modifications to the NRAD Reactor, 1977 to present
DOE Office of Scientific and Technical Information (OSTI.GOV)
Weeks, A.A.; Pruett, D.P.; Heidel, C.C.
1986-01-01
Argonne National Laboratory-West, operated by the University of Chicago, is located near Idaho Falls, ID, on the Idaho National Engineering laboratory Site. ANL-West performs work in support of the Liquid Metal Fast Breeder Reactor Program (LMFBR) sponsored by the United States Department of Energy. The NRAD reactor is located at the Argonne Site within the Hot Fuel Examination Facility/North, a large hot cell facility where both non-destructive and destructive examinations are performed on highly irradiated reactor fuels and materials in support of the LMFBR program. The NRAD facility utilizes a 250-kW TRIGA reactor and is completely dedicated to neutron radiographymore » and the development of radiography techniques. Criticality was first achieved at the NRAD reactor in October of 1977. Since that time, a number of modifications have been implemented to improve operational efficiency and radiography production. This paper describes the modifications and changes that significantly improved operational efficiency and reliability of the reactor and the essential auxiliary reactor systems.« less
The Advanced Test Reactor National Scientific User Facility Advancing Nuclear Technology
DOE Office of Scientific and Technical Information (OSTI.GOV)
T. R. Allen; J. B. Benson; J. A. Foster
2009-05-01
To help ensure the long-term viability of nuclear energy through a robust and sustained research and development effort, the U.S. Department of Energy (DOE) designated the Advanced Test Reactor and associated post-irradiation examination facilities a National Scientific User Facility (ATR NSUF), allowing broader access to nuclear energy researchers. The mission of the ATR NSUF is to provide access to world-class nuclear research facilities, thereby facilitating the advancement of nuclear science and technology. The ATR NSUF seeks to create an engaged academic and industrial user community that routinely conducts reactor-based research. Cost free access to the ATR and PIE facilities ismore » granted based on technical merit to U.S. university-led experiment teams conducting non-proprietary research. Proposals are selected via independent technical peer review and relevance to DOE mission. Extensive publication of research results is expected as a condition for access. During FY 2008, the first full year of ATR NSUF operation, five university-led experiments were awarded access to the ATR and associated post-irradiation examination facilities. The ATR NSUF has awarded four new experiments in early FY 2009, and anticipates awarding additional experiments in the fall of 2009 as the results of the second 2009 proposal call. As the ATR NSUF program mature over the next two years, the capability to perform irradiation research of increasing complexity will become available. These capabilities include instrumented irradiation experiments and post-irradiation examinations on materials previously irradiated in U.S. reactor material test programs. The ATR critical facility will also be made available to researchers. An important component of the ATR NSUF an education program focused on the reactor-based tools available for resolving nuclear science and technology issues. The ATR NSUF provides education programs including a summer short course, internships, faculty-student team projects and faculty/staff exchanges. In June of 2008, the first week-long ATR NSUF Summer Session was attended by 68 students, university faculty and industry representatives. The Summer Session featured presentations by 19 technical experts from across the country and covered topics including irradiation damage mechanisms, degradation of reactor materials, LWR and gas reactor fuels, and non-destructive evaluation. High impact research results from leveraging the entire research infrastructure, including universities, industry, small business, and the national laboratories. To increase overall research capability, ATR NSUF seeks to form strategic partnerships with university facilities that add significant nuclear research capability to the ATR NSUF and are accessible to all ATR NSUF users. Current partner facilities include the MIT Reactor, the University of Michigan Irradiated Materials Testing Laboratory, the University of Wisconsin Characterization Laboratory, and the University of Nevada, Las Vegas transmission Electron Microscope User Facility. Needs for irradiation of material specimens at tightly controlled temperatures are being met by dedication of a large in-pile pressurized water loop facility for use by ATR NSUF users. Several environmental mechanical testing systems are under construction to determine crack growth rates and fracture toughness on irradiated test systems.« less
Physical activity in older adults in a combined functional circuit and walking program.
Gallagher, Nancy Ambrose; Clarke, Philippa; Carr, Emily
Our study examined the impact of a 16-week functional circuit/walking program on physical activity (PA) in older adults in independent-living facilities. Exploratory goals included examination of associations among self-efficacy, neighborhood and mobility. Participants (N = 13) were female (M = 77.8, SD = 7.44, range = 65-85 years). One third were African-American; the remainder Caucasian; 1/3 used assistive devices. PA increased from 70 min/week (SD = 35.51) at baseline to 81.31 min/week (SD = 34.21) at 16 weeks. PA was associated with self-efficacy for overcoming neighborhood and facility barriers to walking at all measurement points (baseline r = .73, p < .05 and r = .68, p < .05, respectively). At eight weeks, PA was associated with self-efficacy for walking duration (r = .58, p < .05), self-efficacy for individual (r = .66, p < .05), facility (r = .58, p < .05) and neighborhood (r = .70, p < .05) barriers. At sixteen weeks, physical activity was associated with balance confidence (r = .72, p < .05), and self-efficacy for individual (r = .76, p < .05), facility (r = .71, p < .05), and neighborhood (r = .80, p < .01) barriers. Functional circuit/walking interventions can increase PA in older adults. Further examination of self-efficacy, mobility, neighborhoods and PA is needed. Copyright © 2016 Elsevier Inc. All rights reserved.
NASA Technical Reports Server (NTRS)
Block, P. J. W.
1982-01-01
Operational proof tests of a propeller test stand (PTS) in a quiet flow facility (QFF) are presented. The PTS is an experimental test bed for acoustic propeller research in the quiet flow environment of the QFF. These proof tests validate thrust and torque predictions, examine the repeatability of measurements on the PTS, and determine the effect of applying artificial roughness to the propeller blades. Since a thrusting propeller causes an open jet to contract, the potential flow core was surveyed to examine the magnitude of the contraction. These measurements are compared with predicted values. The predictions are used to determine operational limitations for testing a given propeller design in the QFF.
Reprint of: A healthy island blue space: From space of detention to site of sanctuary.
Kearns, Robin A; Collins, Damian; Conradson, David
2015-09-01
Island blue spaces are associated with restorative potential, but few studies examine this proposition when an island's use has changed over time. We examine Rotoroa Island (near Auckland, New Zealand) where, for almost a century, the Salvation Army ran an alcohol treatment facility. The island's relative isolation was central to its mixed therapeutic and carceral roles. Following change in treatment ideologies, the facility closed in 2005. It subsequently re-opened as a reserve for recreation, remembrance and environmental restoration. Our analysis focuses on the enabling resources at Rotoroa across these two eras, in the context of different constructions of healthy island blue space. Copyright © 2014 Elsevier Ltd. All rights reserved.
A healthy island blue space: from space of detention to site of sanctuary.
Kearns, Robin A; Collins, Damian; Conradson, David
2014-11-01
Island blue spaces are associated with restorative potential, but few studies examine this proposition when an island׳s use has changed over time. We examine Rotoroa Island (near Auckland, New Zealand) where, for almost a century, the Salvation Army ran an alcohol treatment facility. The island׳s relative isolation was central to its mixed therapeutic and carceral roles. Following change in treatment ideologies, the facility closed in 2005. It subsequently re-opened as a reserve for recreation, remembrance and environmental restoration. Our analysis focuses on the enabling resources at Rotoroa across these two eras, in the context of different constructions of healthy island blue space. Copyright © 2014 Elsevier Ltd. All rights reserved.
Leong, Dara; Alvarez-Ordóñez, Avelino; Jordan, Kieran
2014-01-01
Although rates of listeriosis are low in comparison to other foodborne pathogenic illness, listeriosis poses a significant risk to human health as the invasive form can have a mortality rate as high as 30%. Food processors, especially those who produce ready-to-eat (RTE) products, need to be vigilant against Listeria monocytogenes, the causative pathogen of listeriosis, and as such, the occurrence of L. monocytogenes in food and in the food processing environment needs to be carefully monitored. To examine the prevalence and patterns of contamination in food processing facilities in Ireland, 48 food processors submitted 8 samples every 2 months from March 2013 to March 2014 to be analyzed for L. monocytogenes. No positive samples were detected at 38% of the processing facilities tested. Isolates found at the remaining 62% of facilities were characterized by serotyping and Pulsed Field Gel Electrophoresis (PFGE). A general L. monocytogenes prevalence of 4.6% was seen in all samples analyzed with similar rates seen in food and environmental samples. Differences in prevalence were seen across different food processors, food sectors, sampling months etc. and PFGE analysis allowed for the examination of contamination patterns and for the identification of several persistent strains. Seven of the food processing facilities tested showed contamination with persistent strains and evidence of bacterial transfer from the processing environment to food (the same pulsotype found in both) was seen in four of the food processing facilities tested.
Leong, Dara; Alvarez-Ordóñez, Avelino; Jordan, Kieran
2014-01-01
Although rates of listeriosis are low in comparison to other foodborne pathogenic illness, listeriosis poses a significant risk to human health as the invasive form can have a mortality rate as high as 30%. Food processors, especially those who produce ready-to-eat (RTE) products, need to be vigilant against Listeria monocytogenes, the causative pathogen of listeriosis, and as such, the occurrence of L. monocytogenes in food and in the food processing environment needs to be carefully monitored. To examine the prevalence and patterns of contamination in food processing facilities in Ireland, 48 food processors submitted 8 samples every 2 months from March 2013 to March 2014 to be analyzed for L. monocytogenes. No positive samples were detected at 38% of the processing facilities tested. Isolates found at the remaining 62% of facilities were characterized by serotyping and Pulsed Field Gel Electrophoresis (PFGE). A general L. monocytogenes prevalence of 4.6% was seen in all samples analyzed with similar rates seen in food and environmental samples. Differences in prevalence were seen across different food processors, food sectors, sampling months etc. and PFGE analysis allowed for the examination of contamination patterns and for the identification of several persistent strains. Seven of the food processing facilities tested showed contamination with persistent strains and evidence of bacterial transfer from the processing environment to food (the same pulsotype found in both) was seen in four of the food processing facilities tested. PMID:25191314
Measuring Work Environment and Performance in Nursing Homes
Temkin-Greener, Helena; Zheng, Nan (Tracy); Katz, Paul; Zhao, Hongwei; Mukamel, Dana B.
2008-01-01
Background Qualitative studies of the nursing home work environment have long suggested that such attributes as leadership and communication may be related to nursing home performance, including residents' outcomes. However, empirical studies examining these relationships have been scant. Objectives This study is designed to: develop an instrument for measuring nursing home work environment and perceived work effectiveness; test the reliability and validity of the instrument; and identify individual and facility-level factors associated with better facility performance. Research Design and Methods The analysis was based on survey responses provided by managers (N=308) and direct care workers (N=7,418) employed in 162 facilities throughout New York State. Exploratory factor analysis, Chronbach's alphas, analysis of variance, and regression models were used to assess instrument reliability and validity. Multivariate regression models, with fixed facility effects, were used to examine factors associated with work effectiveness. Results The reliability and the validity of the survey instrument for measuring work environment and perceived work effectiveness has been demonstrated. Several individual (e.g. occupation, race) and facility characteristics (e.g. management style, workplace conditions, staffing) that are significant predictors of perceived work effectiveness were identified. Conclusions The organizational performance model used in this study recognizes the multidimensionality of the work environment in nursing homes. Our findings suggest that efforts at improving work effectiveness must also be multifaceted. Empirical findings from such a line of research may provide insights for improving the quality of the work environment and ultimately the quality of residents' care. PMID:19330892
Michael, K E; No, D; Roberts, M C
2017-02-01
Enterococcus spp. are a normal part of the gastrointestinal tract of humans and animals. They are also important pathogens, being responsible for 14% of US nosocomial infections from 2007 to 2010. To examine a laundry facility that processes clinical linens for the presence and seasonality of vancomycin-resistant Enterococcus spp. Surface samples were collected four times in 2015 from the dirty and clean areas of the laundry facility. Isolates were confirmed using biochemical assays, and antibiotic susceptibility testing was performed. Further investigations included molecular characterization by multi-locus sequence typing (MLST), detection of acquired vanA and vanB and/or intrinsic vanC1 genes by polymerase chain reaction, and eBURST analysis. Seventy-four vanA-positive multi-drug-resistant Enterococcus spp. were identified: 64/120 (53%) in the dirty area and 10/120 (8%) in the clean area. There were 14 ST types among the E. faecium isolates identified (ST16, 17, 18, 117, 186, 280, 324, 412, 584, 664, 665, 736, 750 and 1038). Both E. faecalis isolates were ST109. Isolation of vancomycin-resistant enterococci (VRE) isolates was significantly higher (53% vs 8%) in the dirty area of the facility compared with the clean area. This is the first study to examine an industrial laundry facility for the presence of VRE, and may be an unrecognized reservoir. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
Patient education and emotional support practices in abortion care facilities in the United States.
Gould, Heather; Perrucci, Alissa; Barar, Rana; Sinkford, Danielle; Foster, Diana Greene
2012-01-01
Little is known about how patient education and emotional support is provided at abortion facilities. This pilot study documents 27 facilities' practices in this aspect of abortion care. We conducted confidential telephone interviews with staff from 27 abortion facilities about their practices. The majority of facilities reported they rely primarily on trained nonclinician staff to educate patients and provide emotional support. As part of their informed consent and counseling processes, facilities reported that staff always provide patients with information about the procedure (96%), assess the certainty of their abortion decisions (92%), assess their feelings and provide emotional support (74%), and provide contraceptive health education (92%). Time spent providing these components of care varied across facilities and patients. When describing their facility's care philosophy, many respondents expressed support for "patient-centered," "supportive," "nonjudgmental" care. Eighty-two percent agreed that it is the facility's role to provide counseling for emotional issues related to abortion. All facilities valued informed consent, patient education, and emotional support. Although the majority of facilities considered counseling for emotional issues to be a part of their role, some did not. Future research should examine patients' preferences regarding abortion care and counseling and how different approaches to care affect women's emotional well-being after having an abortion. This information is important in light of current, widespread legislative efforts that aim to regulate abortion counseling, which are being proposed without an understanding of patient needs or facility practices. Copyright © 2012 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
Longitudinal variation in pressure injury incidence among long-term aged care facilities.
Jorgensen, Mikaela; Siette, Joyce; Georgiou, Andrew; Westbrook, Johanna I
2018-05-04
To examine variation in pressure injury (PI) incidence among long-term aged care facilities and identify resident- and facility-level factors that explain this variation. Longitudinal incidence study using routinely-collected electronic care management data. A large aged care service provider in New South Wales and the Australian Capital Territory, Australia. About 6556 people aged 65 years and older who were permanent residents in 60 long-term care facilities between December 2014 and November 2016. Risk-adjusted PI incidence rates over eight study quarters. Incidence density over the study period was 1.33 pressure injuries per 1000 resident days (95% confidence interval (CI) = 1.29-1.37). Funnel plots were used to identify variation among facilities. On average, 14% of facilities had risk-adjusted PI rates that were higher than expected in each quarter (above 95% funnel plot control limits). Ten percent of facilities had persistently high rates in any three or more consecutive quarters (n = 6). The variation between facilities was only partly explained by resident characteristics in multilevel regression models. Residents were more likely to have higher-pressure injury rates in facilities in regional areas compared with major city areas (adjusted incidence rate ratio = 1.25, 95% CI = 1.04-1.51), and facilities with persistently high rates were more likely to be located in areas with low socioeconomic status (P = 0.038). There is considerable variation among facilities in PI incidence. This study demonstrates the potential of routinely-collected care management data to monitor PI incidence and to identify facilities that may benefit from targeted intervention.
DOT National Transportation Integrated Search
1988-01-01
This study was conducted to examine existing conditions at Virginia's interstate rest areas and welcome centers and to assess what impact additional services, such as vending machines, might have on the service delivery of these facilities. A selecte...
DOE Office of Scientific and Technical Information (OSTI.GOV)
Denisov, S. P., E-mail: denisov@ihep.ru; Kozelov, A. V.; Petrov, V. A.
Elastic-scattering data were analyzed, and it was concluded on the basis of this analysis that precisionmeasurements of differential cross sections for elastic proton–proton scattering at the accelerator of the Institute for High Energy Physics (IHEP, Protvino, Russia) over a broad momentum-transfer range are of importance and topical interest. The layout of the respective experimental facility detecting the scattered particle and recoil proton and possessing a high momentum-transfer resolution was examined along with the equipment constituting this facility. The facility in question is able to record up to a billion events of elastic proton–proton scattering per IHEP accelerator run (20 days).more » Other lines of physics research with this facility are briefly discussed.« less
On-orbit technology experiment facility definition
NASA Technical Reports Server (NTRS)
Russell, Richard A.; Buchan, Robert W.; Gates, Richard M.
1988-01-01
A study was conducted to identify on-orbit integrated facility needs to support in-space technology experiments on the Space Station and associated free flyers. In particular, the first task was to examine the proposed technology development missions (TDMX's) from the model mission set and other proposed experimental facilities, both individually and by theme, to determine how and if the experiments might be combined, what equipment might be shared, what equipment might be used as generic equipment for continued experimentation, and what experiments will conflict with the conduct of other experiments or Space Station operations. Then using these results, to determine on-orbit facility needs to optimize the implementation of technology payloads. Finally, to develop one or more scenarios, design concepts, and outfitting requirements for implementation of onboard technology experiments.
Geographic access to specialty mental health care across high- and low-income U.S. communities
Cummings, Janet R.; Allen, Lindsay; Clennon, Julie; Ji, Xu; Druss, Benjamin G.
2017-01-01
Importance With the future of the Affordable Care Act and Medicaid program unclear, it is critical to examine the geographic availability of specialty mental health (MH) treatment resources that serve low-income populations across local communities. Objective To examine the geographic availability of community-based specialty MH treatment resources and how these resources are distributed by community socioeconomic status (SES). Design Measures of MH specialty resource availability were derived for 31,836 zip-code tabulation areas (ZCTAs) using national data. Analyses examined the association between community SES (assessed by median household income quartiles) and resource availability using logistic regressions. Models controlled for ZCTA-level demographic characteristics and state indicators. Main Outcome Measures Dichotomous indicators for whether a ZCTA had any: (1) outpatient MH treatment facility (more than nine-tenths of which offer payment arrangements for low-income populations); (2) office-based practice of MH specialist physician(s); (3) office-based practice of non-physician MH practitioners (e.g., therapists); and (4) facility or office-based practice (i.e., any resource). Results More than four-tenths (42.5%) of communities in the highest income quartile had any community-based MH treatment resource versus 23.1% of communities in the lowest income quartile (Adjusted odds ratio [AOR]=1.74, 95% Confidence Interval [CI]=1.50,2.03). When examining the distribution of MH specialist providers, 25.3% of the highest income communities had any MH specialist physician practice versus 8.0% of the lowest income communities (AOR=3.04, 95% CI=2.53,3.66). Similarly, 35.1% of the highest income communities had any non-physician MH specialist practice versus 12.9% of the lowest income communities (AOR=2.77, 95% CI=2.35,3.26). In contrast, MH treatment facilities were less likely to be located in the highest versus lowest income communities (12.9% versus 16.5%, AOR=0.43, 95% CI=0.37,0.51). Over seven-tenths of the lowest income communities with any resource had an outpatient MH treatment facility. Conclusions and Relevance MH treatment facilities are more likely to be located in poorer communities, whereas office-based practices of MH specialist providers are more likely to be located in higher income communities. These findings indicate that MH treatment facilities constitute the backbone of the specialty MH treatment infrastructure in low-income communities. Policies are needed to support and expand available resources for this critical infrastructure. PMID:28384733
Dust exposure in workers from grain storage facilities in Costa Rica.
Rodríguez-Zamora, María G; Medina-Escobar, Lourdes; Mora, Glend; Zock, Jan-Paul; van Wendel de Joode, Berna; Mora, Ana M
2017-08-01
About 12 million workers are involved in the production of basic grains in Central America. However, few studies in the region have examined the occupational factors associated with inhalable dust exposure. (i) To assess the exposure to inhalable dust in workers from rice, maize, and wheat storage facilities in Costa Rica; (ii) to examine the occupational factors associated with this exposure; and (iii) to measure concentrations of respirable and thoracic particles in different areas of the storage facilities. We measured inhalable (<100μm) dust concentrations in 176 personal samples collected from 136 workers of eight grain storage facilities in Costa Rica. We also measured respirable (<4μm) and thoracic (<10μm) dust particles in several areas of the storage facilities. Geometric mean (GM) and geometric standard deviation (GSD) inhalable dust concentrations were 2.0mg/m 3 and 7.8 (range=<0.2-275.4mg/m 3 ). Personal inhalable dust concentrations were associated with job category [GM for category/GM for administrative staff and other workers (95% CI)=4.4 (2.6, 7.2) for packing; 20.4 (12.3, 34.7) for dehulling; 109.6 (50.1, 234.4) for unloading in flat bed sheds; 24.0 (14.5, 39.8) for unloading in pits; and 31.6 (18.6, 52.5) for drying], and cleaning task [15.8 (95% CI: 10.0, 26.3) in workers who cleaned in addition to their regular tasks]. Higher area concentrations of thoracic dust particles were found in wheat (GM and GSD=4.3mg/m 3 and 4.5) and maize (3.0mg/m 3 and 3.9) storage facilities, and in grain drying (2.3mg/m 3 and 3.1) and unloading (1.5mg/m 3 and 4.8) areas. Operators of grain storage facilities showed elevated inhalable dust concentrations, mostly above international exposure limits. Better engineering and administrative controls are needed. Copyright © 2017 Elsevier GmbH. All rights reserved.
Partin, Melissa R; Gravely, Amy; Gellad, Ziad F; Nugent, Sean; Burgess, James F; Shaukat, Aasma; Nelson, David B
2016-02-01
Cancelled and missed colonoscopy appointments waste resources, increase colonoscopy delays, and can adversely affect patient outcomes. We examined individual and organizational factors associated with missed and cancelled colonoscopy appointments in Veteran Health Administration facilities. From 69 facilities meeting inclusion criteria, we identified 27,994 patients with colonoscopy appointments scheduled for follow-up, on the basis of positive fecal occult blood test results, between August 16, 2009 and September 30, 2011. We identified factors associated with colonoscopy appointment status (completed, cancelled, or missed) by using hierarchical multinomial regression. Individual factors examined included age, race, sex, marital status, residence, drive time to nearest specialty care facility, limited life expectancy, comorbidities, colonoscopy in the past decade, referring facility type, referral month, and appointment lead time. Organizational factors included facility region, complexity, appointment reminders, scheduling, and prep education practices. Missed appointments were associated with limited life expectancy (odds ratio [OR], 2.74; P = .0004), no personal history of polyps (OR, 2.74; P < .0001), high facility complexity (OR, 2.69; P = .007), dual diagnosis of psychiatric disorders and substance abuse (OR, 1.82; P < .0001), and opt-out scheduling (OR, 1.57; P = .02). Cancelled appointments were associated with age (OR, 1.61; P = .0005 for 85 years or older and OR, 1.44; P < .0001 for 65-84 years old), no history of polyps (OR, 1.51; P < .0001), and opt-out scheduling (OR, 1.26; P = .04). Additional predictors of both outcomes included race, marital status, and lead time. Several factors within Veterans Health Administration clinic control can be targeted to reduce missed and cancelled colonoscopy appointments. Specifically, developing systems to minimize referrals for patients with limited life expectancy could reduce missed appointments, and use of opt-in scheduling and reductions in appointment lead time could improve both outcomes. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.
ERIC Educational Resources Information Center
Usen, Onodiong Mfreke
2016-01-01
The study examined the relationship between teachers' utilization of school facilities and academic achievement of student nurses in Human Biology in schools of Nursing in Akwa Ibom State. Four (4) specific objectives, four (4) research questions and four (4) null hypotheses were formulated to guide the study. Ex-post facto survey design was…
ERIC Educational Resources Information Center
Lakin, K. Charlie; Doljanac, Robert; Byun, Soo-Yong; Stancliffe, Roger J.; Taub, Sarah; Chiri, Giuseppina
2008-01-01
This article examines expenditures for a random sample of 1,421 adult Home and Community Based Services (HCBS) and Intermediate Care Facility/Mental Retardation (ICF/MR) recipients in 4 states. The article documents variations in expenditures for individuals with different characteristics and service needs and, controlling for individual…
ERIC Educational Resources Information Center
Bowers, Alex J.; Chen, Jingjing
2015-01-01
The purpose of this study is to bring together recent innovations in the research literature around school district capital facility finance, municipal bond elections, statistical models of conditional time-varying outcomes, and data mining algorithms for automated text mining of election ballot proposals to examine the factors that influence the…
Microbiology facilities aboard Space Station Freedom (SSF)
NASA Technical Reports Server (NTRS)
Cioletti, L. A.; Mishra, S. K.; Richard, Elizabeth E.; Taylor, R.
1990-01-01
A comprehensive microbiological facility is being designed for use on board Space Station Freedom (SSF). Its purpose will be to conduct microbial surveillance of the SSF environment and to examine clinical specimens. Air, water, and internal surfaces will be periodically monitored to satisfy requirements for a safe environment. Crew health will remain a principle objective for every mission. This paper will review the Microbiology Subsystem capabilities planned for SSF application.
ERIC Educational Resources Information Center
Klinger, Vera
1989-01-01
Examines the intrusion of female employees into the traditionally male domain of office work from 1860 to 1914. Shows that sex-specific segregation was supported by a lack of training facilities for girls and by fact that these facilities supported the dominant sex-role structure. Focuses on the development of vocational schools for girls.…
Rosenberg, Dori; Ding, Ding; Sallis, James F; Kerr, Jacqueline; Norman, Gregory J; Durant, Nefertiti; Harris, Sion K; Saelens, Brian E
2009-01-01
To examine the psychometric properties of the Neighborhood Environment Walkability Scale-Youth (NEWS-Y) and explore its associations with context-specific and overall physical activity (PA) among youth. In 2005, parents of children ages 5-11 (n=116), parents of adolescents ages 12-18 (n=171), and adolescents ages 12-18 (n=171) from Boston, Cincinnati, and San Diego, completed NEWS-Y surveys regarding perceived land use mix-diversity, recreation facility availability, pedestrian/automobile traffic safety, crime safety, aesthetics, walking/cycling facilities, street connectivity, land use mix-access, and residential density. A standardized neighborhood environment score was derived. Self-reported activity in the street and in parks, and walking to parks, shops, school, and overall physical activity were assessed. The NEWS-Y subscales had acceptable test-retest reliability (ICC range .56-.87). Being active in a park, walking to a park, walking to shops, and walking to school were related to multiple environmental attributes in all three participant groups. Total neighborhood environment, recreation facilities, walking and cycling facilities, and land use mix-access had the most consistent relationships with specific types of activity. The NEWS-Y has acceptable reliability and subscales were significantly correlated with specific types of youth PA. The NEWS-Y can be used to examine neighborhood environment correlates of youth PA.
Burgess, James F; Shwartz, Michael; Stolzmann, Kelly; Sullivan, Jennifer L
2018-05-18
To examine the relationship between cost and quality in Veterans Health Administration (VA) nursing homes (called Community Living Centers, CLCs) using longitudinal data. One hundred and thirty CLCs over 13 quarters (from FY2009 to FY2012) were studied. Costs, resident days, and resident severity (RUGs score) were obtained from the VA Managerial Cost Accounting System. Clinical quality measures were obtained from the Minimum Data Set, and resident-centered care (RCC) was measured using the Artifacts of Culture Change Tool. We used a generalized estimating equation model with facilities included as fixed effects to examine the relationship between total cost and quality after controlling for resident days and severity. The model included linear and squared terms for all independent variables and interactions with resident days. With the exception of RCC, all other variables had a statistically significant relationship with total costs. For most poorer performing smaller facilities (lower size quartile), improvements in quality were associated with higher costs. For most larger facilities, improvements in quality were associated with lower costs. The relationship between cost and quality depends on facility size and current level of performance. © Published 2018. This article is a U.S. Government work and is in the public domain in the USA.
Impact of Antimicrobial Stewardship on Physician Practice in a Geriatric Facility
Kassett, Nina; Sham, Rosalind; Aleong, Rosanne; Yang, Daisy; Kirzner, Michael; Craft, Aidlee
2016-01-01
Background There is a paucity of literature describing the implementation of antimicrobial stewardship programs (ASPs) in long-term care (LTC) facilities. The current study evaluated the impact of an ASP that was implemented across a geriatric facility, which included an inpatient specialty hospital and an LTC facility. The program included prospective audits with feedback, multidisciplinary education, information technology interventions, and guideline development. Objective To investigate the impact of the ASP on physicians’ prescribing practices in this geriatric facility. Methods Utilization data for antibiotics commonly used to treat urinary tract infections were retrieved for the period September 1, 2011, to August 31, 2013. The study examined whether there were significant changes in overall antibiotic use, ciprofloxacin use, and physician prescribing behaviour after program implementation in September 2012. Results There was no significant change in the total number of antibiotic prescriptions for urinary tract infections in the hospital or the LTC facility after ASP implementation. Significant reductions were seen in the average days of therapy initially prescribed and the actual days of therapy after ASP implementation in the LTC facility but not the hospital. Across both facilities, significant reductions were seen in the number of ciprofloxacin prescriptions. Conclusions The current study showed that an ASP can affect physicians’ antibiotic prescribing behaviour and antibiotic usage in an LTC environment. PMID:28123192
The search and selection of assisted living facilities by elders and family.
Castle, Nicholas G; Sonon, Kristen E
2007-08-01
In this study, we examine factors associated with the search, selection, and satisfaction of residents and family members in assisted living. Data were collected from 375 residents of 25 assisted living facilities matched with 375 family members. We conducted face-to-face interviews with the residents to determine: (1) the principal decision maker; (2) the process of searching for a facility; (3) the factors crucial to facility selection; (4) the time frame from the relocation decision to relocation; and (5) satisfaction with selection. Similar questions were asked of family members, using a mail survey. Residents described themselves as extremely influential in 39% of cases when searching for a facility, and in 27% of cases when selecting a facility. Quality, cost, and location were the most influential factors for both residents and family members in selecting a facility. Almost all residents and family would use different search and selection processes if they had to select a facility again, and almost all were dissatisfied with the sources of information available. Consumers and policy makers both favor the use of assisted living settings; but, the information available to choose a setting is far from ideal, and may represent a barrier to both consumer and policy makers' agendas.
The Effect of Dialysis Chains on Mortality among Patients Receiving Hemodialysis
Zhang, Yi; Cotter, Dennis J; Thamer, Mae
2011-01-01
Objective To examine the association between dialysis facility chain affiliation and patient mortality. Study Setting Medicare dialysis population. Study Design Data from the United States Renal Data System (USRDS) were used to identify 3,601 free-standing dialysis facilities and 34,914 Medicare patients' incidence to end-stage renal disease (ESRD) in 2004. Mixed-effect regression models were used to estimate patient mortality by dialysis facility chain and profit status during the 2-year follow-up. Data Collection USRDS data were matched with facility, cost, and census data. Principle Findings Of the five largest dialysis chains, the lowest mortality risk was observed among patients dialyzed at nonprofit (NP) Chain 5 facilities. Compared with Chain 5, hazard ratios were 19 percent higher (95 percent CI 1.06–1.34) and 24 percent higher (95 percent CI 1.10–1.40) for patients dialyzed at for-profit (FP) Chain 1 and Chain 2 facilities, respectively. In addition, patients at FP facilities had a 13 percent higher risk of mortality than those in NP facilities (95 percent CI 1.06–1.22). Conclusions Large chain affiliation is an independent risk factor for ESRD mortality in the United States. Given the movement toward further consolidation of large FP chains, reasons behind the increase in mortality require scrutiny. PMID:21143480
Pont, Lisa G; Raban, Magda Z; Jorgensen, Mikaela L; Georgiou, Andrew; Westbrook, Johanna I
2018-06-08
The aim of this study was to use routinely collected electronic medicines administration (eMAR) data in residential aged care (RAC) to investigate the quality use of medicines. A cross-sectional analysis of eMAR data. 71 RAC facilities in New South Wales and the Australian Capital Territory, Australia. Permanent residents living in a participating facility on 1 October 2015. None. Variation in polypharmacy (≥5 medications), hyper-polypharmacy (≥10 medications) and antipsychotic use across facilities was examined using funnel plot analysis. The study dataset included 4775 long-term residents. The mean resident age was 85.3 years and 70.6% of residents were female. The median facility size was 60 residents and 74.3% were in metropolitan locations. 84.3% of residents had polypharmacy, 41.2% hyper-polypharmacy and 21.0% were using an antipsychotic. The extent of polypharmacy (69.75-100% of residents), hyper-polypharmacy (38.81-76.19%) and use of antipsychotic medicines (0-75.6%) varied considerably across the 71 facilities. Using eMAR data we found substantial variation in polypharmacy, hyper-polypharmacy and antipsychotic medicine use across 71 RAC facilities. Further investigation into the policies and practices of facilities performing above or below expected levels is warranted to understand variation and drive quality improvement.
Eime, Rochelle M; Harvey, Jack; Charity, Melanie J; Casey, Meghan; Westerbeek, Hans; Payne, Warren R
2017-06-01
Ecological models have been applied to investigate multiple domains influencing physical activity behaviour, including individual, social, organisational, community, environmental and policy factors. With regard to the built environment, research to date has been limited to small geographical areas and/or small samples of participants. This study examined the geographical association between provision of sport facilities and participation in sport across an entire Australian state, using objective total enumerations of both, for a group of sports, with adjustment for the effect of socioeconomic status (SES). De-identified membership registration data were obtained from state sport governing bodies of four popular team sports. Associations between participation rate, facility provision rate and SES were investigated using correlation and regression methods. Participation rate was positively associated with provision of facilities, although this was complicated by SES and region effects. The non-metropolitan region generally had higher participation rates and better provision of facilities than the metropolitan region. Better provision of sports facilities is generally associated with increased sport participation, but SES and region are also contributing factors. Implications for public health: Community-level analysis of the population, sport participation and provision of facilities should be used to inform decisions of investments in sports facilities. © 2017 The Authors.
Nakanishi, Miharu; Imai, Hisato
2012-01-01
The aim of the present study is to examine job role quality relating to intention to leave current facility and to leave profession among direct care workers in residential facilities for elderly in Japan. Direct care workers completed a paper questionnaire on October 2009. From 746 facilities in three prefectures (Tokyo, Shizuoka, and Yamagata) 6428 direct care workers with complete data were included in the analyses. The Job Role Quality (JRQ) scale was translated into Japanese language to assess job role quality. Hierarchical multiple regression analysis showed that intention to leave current facility was primarily associated with job role quality: poor skill discretion, high job demand, and poor relationship with supervisor. Intention to leave profession was primarily associated with poor skill discretion. The results of the present study imply the strategies to direct care worker retention for each facility and policy efforts. Each facility can implement specific strategies such as enhanced variety of work and opportunity for use of skills, adequate job allocation, and improvement of supervisor-employee relationship in work place. Policy efforts should enhance broader career opportunities in care working such as advanced specialization and authorized medical practice. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Examining the accuracy of visual diagnosis of tinea pedis and tinea unguium in aged care facilities.
Goto, T; Nakagami, G; Takehara, K; Nakamura, T; Kawashima, M; Tsunemi, Y; Sanada, H
2017-04-02
The aim of this study was to examine the accuracy of visual diagnosis of tinea pedis (Athlete's foot) and tinea unguium (fungal nail infection), as well as to provide information on skin abnormalities that could help identify these diseases in aged care facilities (long-term care facilities (LTCFs) and nursing homes). A multicentre, cross-sectional observational study was conducted in a LTCF and two nursing homes. A dermatologist observed the skin abnormalities in the participants' interdigital and plantar areas, to screen for tinea pedis, and in the participants' toenails, to screen for tinea unguium. If abnormalities were noted, samples such as scales or toenails were collected and examined using direct microscopy. The accuracy of the macroscopic observation for each skin abnormality was examined. A total of 173 residents were recruited. The accuracy of clinical diagnosis using macroscopic observation was relatively low. The sensitivities and specificities for clinical diagnosis were 0.37 and 0.95 for tinea pedis in the interdigital areas, 0.47 and 0.94 for tinea pedis in the plantar areas, and 0.80 and 0.61 for tinea unguium in toenails, respectively. Scales in the plantar areas and discoloration of the toenails were more frequently observed in residents with tinea pedis and tinea unguium than in those without them. Several skin abnormalities were observed in the residents recruited in this study, but there was insufficient correlation with tinea pedis and tinea unguium to be used for screening.
Web-Based Requesting and Scheduling Use of Facilities
NASA Technical Reports Server (NTRS)
Yeager, Carolyn M.
2010-01-01
Automated User's Training Operations Facility Utilization Request (AutoFUR) is prototype software that administers a Web-based system for requesting and allocating facilities and equipment for astronaut-training classes in conjunction with scheduling the classes. AutoFUR also has potential for similar use in such applications as scheduling flight-simulation equipment and instructors in commercial airplane-pilot training, managing preventive- maintenance facilities, and scheduling operating rooms, doctors, nurses, and medical equipment for surgery. Whereas requesting and allocation of facilities was previously a manual process that entailed examination of documents (including paper drawings) from different sources, AutoFUR partly automates the process and makes all of the relevant information available via the requester s computer. By use of AutoFUR, an instructor can fill out a facility-utilization request (FUR) form on line, consult the applicable flight manifest(s) to determine what equipment is needed and where it should be placed in the training facility, reserve the corresponding hardware listed in a training-hardware inventory database, search for alternative hardware if necessary, submit the FUR for processing, and cause paper forms to be printed. Auto-FUR also maintains a searchable archive of prior FURs.
Wright, Caradee Yael; Albers, Patricia Nicole; Reeder, Anthony Ivor; Mathee, Angela
2017-01-01
Introduction In 2009, ultraviolet-emitting tanning devices, i.e. sunbeds and tanning booths, were officially classified as carcinogenic to human health (Group 1) by the International Agency for Research on Cancer. Methods Here, we aim to estimate South African-based facilities with indoor tanning services advertised in the printed Yellow Pages and online in two directories. Printed Yellow Pages telephone directory beauty salon facilities listings (2010-14) for all provinces were examined and those mentioning "sunbed" and/or "tanning bed" recorded. Beauty/spa facilities were also identified using two sunbed listing webpages. Results A total of 40 web-advertised facilities had a sunbed. Beauty facilities in the Yellow Pages specifically mentioning sunbeds declined by 62% between 2010 (n=53) and 2014 (n=20). Gauteng had the highest number of facilities (n=25) with a sunbed. Facilities with sunbeds exist in South Africa, as evidenced by the Yellow Pages and web-advertised data, but their true prevalence remains largely unknown. It is likely that online and walk-by advertising is increasingly more common than print. Conclusion Given that sunbeds may likely soon become regulated in South Africa, further research is needed to better quantify sunbed provision, determine advice provided by facility operators to new users, investigate whether age restrictions or limits exist for sunbed use, and describe typical patterns of sunbed use in South Africa. PMID:28674581
Wright, Caradee Yael; Albers, Patricia Nicole; Reeder, Anthony Ivor; Mathee, Angela
2017-01-01
In 2009, ultraviolet-emitting tanning devices, i.e. sunbeds and tanning booths, were officially classified as carcinogenic to human health (Group 1) by the International Agency for Research on Cancer. Here, we aim to estimate South African-based facilities with indoor tanning services advertised in the printed Yellow Pages and online in two directories. Printed Yellow Pages telephone directory beauty salon facilities listings (2010-14) for all provinces were examined and those mentioning "sunbed" and/or "tanning bed" recorded. Beauty/spa facilities were also identified using two sunbed listing webpages. A total of 40 web-advertised facilities had a sunbed. Beauty facilities in the Yellow Pages specifically mentioning sunbeds declined by 62% between 2010 (n=53) and 2014 (n=20). Gauteng had the highest number of facilities (n=25) with a sunbed. Facilities with sunbeds exist in South Africa, as evidenced by the Yellow Pages and web-advertised data, but their true prevalence remains largely unknown. It is likely that online and walk-by advertising is increasingly more common than print. Given that sunbeds may likely soon become regulated in South Africa, further research is needed to better quantify sunbed provision, determine advice provided by facility operators to new users, investigate whether age restrictions or limits exist for sunbed use, and describe typical patterns of sunbed use in South Africa.
Report on the Procurement and Delivery of Fuel Oil.
ERIC Educational Resources Information Center
Richardson, William M.; Baacke, Clifford M.
Annual use of fuel oil for heating schools and other facilities of the Montgomery County (Maryland) Public Schools, Montgomery County Government, and Montgomery College exceeds four-million gallons. This report examines the processes by which purchases and distributions of fuel oil are made, makes recommendations based on the examination, and…
Juvenile Offender Recidivism: An Examination of Risk Factors
ERIC Educational Resources Information Center
Calley, Nancy G.
2012-01-01
One hundred and seventy three male juvenile offenders were followed two years postrelease from a residential treatment facility to assess recidivism and factors related to recidivism. The overall recidivism rate was 23.9%. Logistic regression with stepwise and backward variable selection methods was used to examine the relationship between…
Implementing a Reentry Framework at a Correctional Facility: Challenges to the Culture
ERIC Educational Resources Information Center
Rudes, Danielle S.; Lerch, Jennifer; Taxman, Faye S.
2011-01-01
Implementation research is emerging in the field of corrections, but few studies have examined the complexities associated with implementing change among frontline workers embedded in specific organizational cultures. Using a mixed methods approach, the authors examine the challenges faced by correctional workers in a work release correctional…
ERIC Educational Resources Information Center
Badmus, Medinat M. O.
2007-01-01
This study was undertaken to assess the contributions of teachers' knowledge of Curriculum Characteristics, value internalization and commitment, perception of adequacy of facilities, equipment and materials, and degree of performance of implementation roles/behaviours to achievements in Junior Secondary Certificate Examination in Home Economics.…
38 CFR 8.24 - Expenses incident to examinations for insurance purposes.
Code of Federal Regulations, 2010 CFR
2010-07-01
... insurance purposes. Except as provided in § 8.22, necessary transportation expenses incident to physical or mental examinations for insurance purposes at regional offices or medical facilities shall be furnished... schedule of fees in effect and approved by the Department of Veterans Affairs for medical and professional...
75 FR 21223 - National Academy of Sciences Study
Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-23
... CHEMICAL SAFETY AND HAZARD INVESTIGATION BOARD [Docket No. CSB-10-01] National Academy of Sciences... Board (CSB) provides funding for a study by the National Academy of Sciences (NAS) to examine the use... processes and an examination of the cost of alternatives at the Bayer CropScience facility in Institute...
An Evaluation of Red Shoulders as a Bicycle and Pedestrian Facility
Hunter, William W.
1999-01-01
Use of color has been popular in European bicycle facilities. As an innovative treatment, the community of Tavares, FL decided to add one mile of shoulders to a scenic roadway and paint the shoulders red to emphasize their use as a bicycle facility. The red shoulders were evaluated by examining: (1) motor vehicle speed data collected before and after the addition of the red shoulders, (2) the amount of use of the shoulder by bicyclists, (3) the lateral positioning of bicyclists being passed by motor vehicles, (4) the amount and severity of vehicular encroachment into the opposing lane of travel, and (5) conflicts between bicycles and motor vehicles.
Sperber, M N
1992-01-01
Over the past decade, there has been an increase in the hospitalization of minors in private, for-profit, psychiatric facilities. This increase suggests a tension between what is medically necessary and what is financially desirable. This Note discusses the hospitalization of minors in private, for-profit, mental health facilities and its attendant implications. This Note then examines various state efforts aimed at protecting minors from inappropriate psychiatric hospitalization. Finally, while there is no catch-all solution to the problem, this Note offers specific recommendations for reforming the for-profit psychiatric industry.
1972-12-21
Hans F. Wuenscher, assistant director for Advanced Space Projects Engineering Laboratory at Marshall Space Flight Center (MSFC), examined the facility to be used by Skylab astronauts in performing a number of experiments in material science and manufacturing in space. The equipment shown here is a duplicate of the M512 Experiment hardware flown in the Multiple Docking Adapter section of the Sky lab. This equipment, itself an experiment, was be used for conducting 5 other experiments in the round vacuum chamber. Inside was a cavity which held the M518 Multipurpose Electric Furnace, a facility which was used for conducting other experiments. In all, a total of 17 experiments were conducted using this facility and furnace.
Issues in providing a reliable multicast facility
NASA Technical Reports Server (NTRS)
Dempsey, Bert J.; Strayer, W. Timothy; Weaver, Alfred C.
1990-01-01
Issues involved in point-to-multipoint communication are presented and the literature for proposed solutions and approaches surveyed. Particular attention is focused on the ideas and implementations that align with the requirements of the environment of interest. The attributes of multicast receiver groups that might lead to useful classifications, what the functionality of a management scheme should be, and how the group management module can be implemented are examined. The services that multicasting facilities can offer are presented, followed by mechanisms within the communications protocol that implements these services. The metrics of interest when evaluating a reliable multicast facility are identified and applied to four transport layer protocols that incorporate reliable multicast.
Cohn, Amy; Najavits, Lisa M
2014-04-01
Victimization by and perpetration of domestic violence are associated with co-occurring mental and substance use disorders. This study used data from the National Survey of Substance Abuse Treatment Services to examine differences in organizational factors, treatment approaches offered, and client-level factors among 13,342 substance abuse treatment facilities by whether or not they offered domestic violence services. Only 36% of the facilities offered domestic violence services. Those that offered such services were more likely than those that did not to treat clients with co-occurring disorders. Principal-components analysis reduced eight treatment approaches to two factors: psychosocial services and traditional substance abuse services. Regression models indicated that the frequency with which psychosocial services were offered depended on the percentage of clients with co-occurring disorders who were being treated in the facility and whether or not that facility offered domestic violence services. Specifically, facilities that did not offer domestic violence services and that had a high percentage of clients with co-occurring disorders were more likely to offer psychosocial services than facilities that offered domestic violence services. A larger proportion of facilities offering domestic violence services offered traditional substance abuse treatment services, compared with facilities not offering domestic violence services, but this relationship was not contingent on the percentage of clients with co-occurring disorders at each facility. Improved efforts should be made to tailor treatments to accommodate the links between domestic violence, mental disorders, and substance abuse.
Nursing home case-mix reimbursement in Mississippi and South Dakota.
Arling, Greg; Daneman, Barry
2002-04-01
To evaluate the effects of nursing home case-mix reimbursement on facility case mix and costs in Mississippi and South Dakota. Secondary data from resident assessments and Medicaid cost reports from 154 Mississippi and 107 South Dakota nursing facilities in 1992 and 1994, before and after implementation of new case-mix reimbursement systems. The study relied on a two-wave panel design to examine case mix (resident acuity) and direct care costs in 1-year periods before and after implementation of a nursing home case-mix reimbursement system. Cross-lagged regression models were used to assess change in case mix and costs between periods while taking into account facility characteristics. Facility-level measures were constructed from Medicaid cost reports and Minimum Data Set-Plus assessment records supplied by each state. Resident case mix was based on the RUG-III classification system. Facility case-mix scores and direct care costs increased significantly between periods in both states. Changes in facility costs and case mix were significantly related in a positive direction. Medicare utilization and the rate of hospitalizations from the nursing facility also increased significantly between periods, particularly in Mississippi. The case-mix reimbursement systems appeared to achieve their intended goals: improved access for heavy-care residents and increased direct care expenditures in facilities with higher acuity residents. However, increases in Medicare utilization may have influenced facility case mix or costs, and some facilities may have been unprepared to care for higher acuity residents, as indicated by increased rates of hospitalization.
Deslich, Stacie Anne; Thistlethwaite, Timothy; Coustasse, Alberto
2013-01-01
It is unclear if telepsychiatry, a subset of telemedicine, increases access to mental health care for inmates in correctional facilities or decreases costs for clinicians or facility administrators. The purpose of this investigation was to determine how utilization of telepsychiatry affected access to care and costs of providing mental health care in correctional facilities. A literature review complemented by a semistructured interview with a telepsychiatry practitioner. Five electronic databases, the National Bureau of Justice, and the American Psychiatric Association Web sites were searched for this research, and 49 sources were referenced. The literature review examined implementation of telepsychiatry in correctional facilities in Arizona, California, Georgia, Kansas, Ohio, Texas, and West Virginia to determine the effect of telepsychiatry on inmate access to mental health services and the costs of providing mental health care in correctional facilities. Telepsychiatry provided improved access to mental health services for inmates, and this increase in access is through the continuum of mental health care, which has been instrumental in increasing quality of care for inmates. Use of telepsychiatry saved correctional facilities from $12,000 to more than $1 million. The semistructured interview with the telepsychiatry practitioner supported utilization of telepsychiatry to increase access and lower costs of providing mental health care in correctional facilities. Increasing access to mental health care for this underserved group through telepsychiatry may improve living conditions and safety inside correctional facilities. Providers, facilities, and state and federal governments can expect increased savings with utilization of telepsychiatry.
Khanam, Rasheda; Baqui, Abdullah H; Syed, Mamun Ibne Moin; Harrison, Meagan; Begum, Nazma; Quaiyum, Abdul; Saha, Samir K; Ahmed, Saifuddin
2018-06-01
Intrapartum complications increase the risk of perinatal deaths. However, population-based data from developing countries assessing the contribution of intrapartum complications to perinatal deaths is scarce. Using data from a cohort of pregnant women followed between 2011 and 2013 in Bangladesh, this study examined the rate and types of intrapartum complications, the association of intrapartum complications with perinatal mortality, and if facility delivery modified the risk of intrapartum-related perinatal deaths. Trained community health workers (CHWs) made two-monthly home visits to identify pregnant women, visited them twice during pregnancy and 10 times in the first two months postpartum. During prenatal visits, CHWs collected data on women's prior obstetric history, socio-demographic status, and complications during pregnancy. They collected data on intrapartum complications, delivery care, and pregnancy outcome during the first postnatal visit within 7 days of delivery. We examined the association of intrapartum complications and facility delivery with perinatal mortality by estimating odds ratios (OR) and 95% confidence intervals (CI) adjusting for covariates using multivariable logistic regression analysis. The overall facility delivery rate was low (3922/24 271; 16.2%). Any intrapartum complications among pregnant women were 20.9% (5,061/24,271) and perinatal mortality was 64.7 per 1000 birth. Compared to women who delivered at home, the risk of perinatal mortality was 2.4 times higher (OR = 2.40; 95% CI = 2.08-2.76) when delivered in a public health facility and 1.3 times higher (OR = 1.32, 95% CI = 1.06-1.64) when delivered in a private health facility. Compared to women who had no intrapartum complications and delivered at home, women with intrapartum complications who delivered at home had a substantially higher risk of perinatal mortality (OR = 3.45; 95% CI = 3.04-3.91). Compared to women with intrapartum complications who delivered at home, the risk of perinatal mortality among women with intrapartum complications was 43.0% lower for women who delivered in a public health facility (OR = 0.57; 95% CI = 0.42-0.78) and 58.0% lower when delivered in a private health facility (OR = 0.42; 95% CI = 0.28-0.63). Maternal health programs need to promote timely recognition of intrapartum complications and delivery in health facilities to improve perinatal outcomes, particularly in populations where overall facility delivery rates are low. The differential risk between public and private health facilities may be due to differences in quality of care. Efforts should be made to improve the quality of care in all health facilities.
Review of attacks on health care facilities in six conflicts of the past three decades.
Briody, Carolyn; Rubenstein, Leonard; Roberts, Les; Penney, Eamon; Keenan, William; Horbar, Jeffrey
2018-01-01
In the ongoing conflicts of Syria and Yemen, there have been widespread reports of attacks on health care facilities and personnel. Tabulated evidence does suggest hospital bombings in Syria and Yemen are far higher than reported in other conflicts but it is unclear if this is a reporting artefact. This article examines attacks on health care facilities in conflicts in six middle- to high- income countries that have occurred over the past three decades to try and determine if attacks have become more common, and to assess the different methods used to collect data on attacks. The six conflicts reviewed are Yemen (2015-Present), Syria (2011- Present), Iraq (2003-2011), Chechnya (1999-2000), Kosovo (1998-1999), and Bosnia and Herzegovina (1992-1995). We attempted to get the highest quality source(s) with summary data of the number of facilities attacked for each of the conflicts. The only conflict that did not have summary data was the conflict in Iraq. In this case, we tallied individual reported events of attacks on health care. Physicians for Human Rights (PHR) reported attacks on 315 facilities (4.38 per month) in Syria over a 7-year period, while the Monitoring Violence against Health Care (MVH) tool launched later by the World Health Organization (WHO) Turkey Health Cluster reported attacks on 135 facilities (9.64 per month) over a 14-month period. Yemen had a reported 93 attacks (4.65 per month), Iraq 12 (0.12 per month), Chechnya > 24 (2.4 per month), Kosovo > 100 (6.67 per month), and Bosnia 21 (0.41 per month). Methodologies to collect data, and definitions of both facilities and attacks varied widely across sources. The number of reported facilities attacked is by far the greatest in Syria, suggesting that this phenomenon has increased compared to earlier conflicts. However, data on attacks of facilities was incomplete for all of the conflicts examined, methodologies varied widely, and in some cases, attacks were not defined at all. A global, standardized system that allows multiple reporting routes with different levels of confirmation, as seen in Syria, would likely allow for a more reliable and reproducible documentation system, and potentially, an increase in accountability.
Burke, Thomas F; Hines, Rosemary; Ahn, Roy; Walters, Michelle; Young, David; Anderson, Rachel Eleanor; Tom, Sabrina M; Clark, Rachel; Obita, Walter; Nelson, Brett D
2014-01-01
Objective Injuries, trauma and non-communicable diseases are responsible for a rising proportion of death and disability in low-income and middle-income countries. Delivering effective emergency and urgent healthcare for these and other conditions in resource-limited settings is challenging. In this study, we sought to examine and characterise emergency and urgent care capacity in a resource-limited setting. Methods We conducted an assessment within all 30 primary and secondary hospitals and within a stratified random sampling of 30 dispensaries and health centres in western Kenya. The key informants were the most senior facility healthcare provider and manager available. Emergency physician researchers utilised a semistructured assessment tool, and data were analysed using descriptive statistics and thematic coding. Results No lower level facilities and 30% of higher level facilities reported having a defined, organised approach to trauma. 43% of higher level facilities had access to an anaesthetist. The majority of lower level facilities had suture and wound care supplies and gloves but typically lacked other basic trauma supplies. For cardiac care, 50% of higher level facilities had morphine, but a minority had functioning ECG, sublingual nitroglycerine or a defibrillator. Only 20% of lower level facilities had glucometers, and only 33% of higher level facilities could care for diabetic emergencies. No facilities had sepsis clinical guidelines. Conclusions Large gaps in essential emergency care capabilities were identified at all facility levels in western Kenya. There are great opportunities for a universally deployed basic emergency care package, an advanced emergency care package and facility designation scheme, and a reliable prehospital care transportation and communications system in resource-limited settings. PMID:25260371
Bazant, Eva S; Koenig, Michael A; Fotso, Jean-Christophe; Mills, Samuel
2009-03-01
The private sector's role in increasing the use of maternal health care for the poor in developing countries has received increasing attention, yet few data exist for urban slums. Using household-survey data from 1,926 mothers in two informal settlements in Nairobi, Kenya, collected in 2006, we describe and examine the factors associated with women's use of private and government health facilities for childbirth. More women gave birth at private facilities located in the settlements than at government facilities, and one-third of the women gave birth at home or with the assistance of a traditional birth attendant. In multivariate models, women's education, ethnic group, and household wealth were associated with institutional deliveries, especially in government hospitals. Residents in the more disadvantaged settlement were more likely than those in the better-off settlement to give birth in private facilities. In urban areas, maternal health services in both the government and private sectors should be strengthened, and efforts made to reach out to women who give birth at home.
A Study on Governance and Human Resources for Cooperative Road Facilities Management
NASA Astrophysics Data System (ADS)
Ohno, Sachiko; Takagi, Akiyoshi; Kurauchi, Fumitaka; Demura, Yoshifumi
Within today's infrastructure management, Asset Management systems are becoming a mainstream feature. For region where the risk is low, it is necessary to create a "cooperative road facilities management system". This research both examined and suggested what kind of cooperative road facilities management system should be promoted by the regional society. Concretely, this study defines the operational realities of a previous case. It discusses the problem of the road facilities management as a governance. Furthermore, its realization depends on "the cooperation between municipalities", "the private-sector initiative", and "residents participation" .Also, it discusses the problem of human resources for governance. Its realization depends on "the engineers' promotion", and "creation of a voluntary activity of the resident" as a human resources. Moreover, it defines that the intermediary is important because the human resources tied to the governance. As a result, the prospect of the road facilities management is shown by the role of the player and the relation among player.
Ni, Jianhua; Qian, Tianlu; Xi, Changbai; Rui, Yikang; Wang, Jiechen
2016-08-18
The spatial distribution of urban service facilities is largely constrained by the road network. In this study, network point pattern analysis and correlation analysis were used to analyze the relationship between road network and healthcare facility distribution. The weighted network kernel density estimation method proposed in this study identifies significant differences between the outside and inside areas of the Ming city wall. The results of network K-function analysis show that private hospitals are more evenly distributed than public hospitals, and pharmacy stores tend to cluster around hospitals along the road network. After computing the correlation analysis between different categorized hospitals and street centrality, we find that the distribution of these hospitals correlates highly with the street centralities, and that the correlations are higher with private and small hospitals than with public and large hospitals. The comprehensive analysis results could help examine the reasonability of existing urban healthcare facility distribution and optimize the location of new healthcare facilities.
Residents' self-reported quality of life in long-term care facilities in Canada.
Kehyayan, Vahe; Hirdes, John P; Tyas, Suzanne L; Stolee, Paul
2015-06-01
Quality of life (QoL) of long-term care (LTC) facility residents is an important outcome of care. This cross-sectional, descriptive study examined the self-reported QoL of LTC facility residents in Canada using the interRAI Self-Report Nursing Home Quality of Life Survey instrument. A secondary purpose was to test the instrument's psychometric properties. Psychometric testing of the instrument supported its reliability and its convergent and content validity for assessing the residents' QoL. Findings showed that residents rated positively several aspects of their life, such as having privacy during visits (76.9%) and staff's being honest with them (73.6%). Residents gave lower ratings to other aspects such as autonomy, staff-resident bonding, and personal relationships. The findings point to gaps between facility philosophies of care and their translation into a care environment where care is truly resident-directed. Moreover, the findings have potential implications for resident care planning, facility programming, social policy development, and future research.
Facilities and Methods Used in Full-scale Airplane Crash-fire Investigation
NASA Technical Reports Server (NTRS)
Black, Dugald O.
1952-01-01
The facilities and the techniques employed in the conduct of full scale airplane crash-fire studies currently being conducted at the NACA Lewis laboratory are discussed herein. This investigation is part of a comprehensive study of the airplane crash-fire problem. The crash configuration chosen, the general physical layout of the crash site, the test methods, the instrumentation, the data-recording systems, and the post-crash examination procedure are described
Castella, Francisco
2005-02-01
The way forward for hospital services and facilities management is examined by Francisco Castella, Doctor of Engineering and a member of the International Federation of Hospital Engineering Council. In this article, which is based on a paper presented at the 18th IFHE Congress, he draws on his experience as facility manager and director of general services in the Teaching Hospital of Badalona, Spain, and on knowledge gained through attending IFHE Congresses - representing the Spanish Hospital Engineering Association.
ERIC Educational Resources Information Center
Lewis, Marcus Wayne
2012-01-01
Self-efficacy has been shown to be an important element in the success of individuals in a variety of different settings. This research examined the impact of a two week new employee orientation training program on the general and social self-efficacy of newly hired direct care employees at state mental health facilities. The research showed that…
Analysis of Silverized Teflon Thermal Control Material Flown on the Long Duration Exposure Facility
NASA Technical Reports Server (NTRS)
Pippin, H. Gary
1995-01-01
Silver backed teflon (Ag/FEP) material used for thermal control on the Long Duration Exposure Facility (LDEF) has been examined in detail. Optical, mechanical, and chemical properties were characterized for specimens exposed to a variety of space environmental conditions. Recession rates were determined for this material. Samples were obtained from virtually every LDEF location except the Earth-end. Atomic oxygen exposed regions changed from specular to diffusely reflective.
Effect of Medicaid Payment on Rehabilitation Care for Nursing Home Residents
Wodchis, Walter P.; Hirth, Richard A.; Fries, Brant E.
2007-01-01
There is considerable interest in examining how Medicaid payment affects nursing home care. This study examines the effect of Medicaid payment methods and reimbursement rates on the delivery of rehabilitation therapy to Medicaid nursing home residents in six States from 1992-1995. In States that changed payment from prospective facility-specific to prospective case-mix adjusted payment methods, Medicaid residents received more rehabilitation therapy after the change. While residents in States using case-mix adjusted payment rates for Medicaid payment were more likely to receive rehabilitation than residents in States using prospective facility-specific Medicaid payment, the differences were general and not specific to Medicaid residents. Retrospective payment for Medicaid resident care was associated with greater use of therapy for Medicaid residents. PMID:17645160
Transient Testing of Nuclear Fuels and Materials in the United States
NASA Astrophysics Data System (ADS)
Wachs, Daniel M.
2012-12-01
The United States has established that transient irradiation testing is needed to support advanced light water reactors fuel development. The U.S. Department of Energy (DOE) has initiated an effort to reestablish this capability. Restart of the Transient Testing Reactor (TREAT) facility located at the Idaho National Laboratory (INL) is being considered for this purpose. This effort would also include the development of specialized test vehicles to support stagnant capsule and flowing loop tests as well as the enhancement of postirradiation examination capabilities and remote device assembly capabilities at the Hot Fuel Examination Facility. It is anticipated that the capability will be available to support testing by 2018, as required to meet the DOE goals for the development of accident-tolerant LWR fuel designs.
Effect of Medicaid payment on rehabilitation care for nursing home residents.
Wodchis, Walter P; Hirth, Richard A; Fries, Brant E
2007-01-01
There is considerable interest in examining how Medicaid payment affects nursing home care. This study examines the effect of Medicaid payment methods and reimbursement rates on the delivery of rehabilitation therapy to Medicaid nursing home residents in six States from 1992-1995. In States that changed payment from prospective facility-specific to prospective case-mix adjusted payment methods, Medicaid residents received more rehabilitation therapy after the change. While residents in States using case-mix adjusted payment rates for Medicaid payment were more likely to receive rehabilitation than residents in States using prospective facility-specific Medicaid payment, the differences were general and not specific to Medicaid residents. Retrospective payment for Medicaid resident care was associated with greater use of therapy for Medicaid residents.
Feasibility of Ground Testing a Moon and Mars Surface Power Reactor in EBR-II
DOE Office of Scientific and Technical Information (OSTI.GOV)
Sheryl Morton; Carl Baily; Tom Hill
Ground testing of a surface fission power system would be necessary to verify the design and validate reactor performance to support safe and sustained human exploration of the Moon and Mars. The Idaho National Laboratory (INL) has several facilities that could be adapted to support a ground test. This paper focuses on the feasibility of ground testing at the Experimental Breeder Reactor II (EBR-II) facility and using other INL existing infrastructure to support such a test. This brief study concludes that the INL EBR-II facility and supporting infrastructure are a viable option for ground testing the surface power system. Itmore » provides features and attributes that offer advantages to locating and performing ground testing at this site, and it could support the National Aeronautics and Space Administration schedules for human exploration of the Moon. This study used the initial concept examined by the U.S. Department of Energy Inter-laboratory Design and Analysis Support Team for surface power, a lowtemperature, liquid-metal, three-loop Brayton power system. With some facility modification, the EBR-II can safely house a test chamber and perform long-term testing of the space reactor power system. The INL infrastructure is available to receive and provide bonded storage for special nuclear materials. Facilities adjacent to EBR-II can provide the clean room environment needed to assemble and store the test article assembly, disassemble the power system at the conclusion of testing, and perform posttest examination. Capability for waste disposal is also available at the INL.« less
Feasibility of Ground Testing a Moon and Mars Surface Power Reactor in EBR-II
DOE Office of Scientific and Technical Information (OSTI.GOV)
Morton, Sheryl L.; Baily, Carl E.; Hill, Thomas J.
Ground testing of a surface fission power system would be necessary to verify the design and validate reactor performance to support safe and sustained human exploration of the Moon and Mars. The Idaho National Laboratory (INL) has several facilities that could be adapted to support a ground test. This paper focuses on the feasibility of ground testing at the Experimental Breeder Reactor II (EBR-II) facility and using other INL existing infrastructure to support such a test. This brief study concludes that the INL EBR-II facility and supporting infrastructure are a viable option for ground testing the surface power system. Itmore » provides features and attributes that offer advantages to locating and performing ground testing at this site, and it could support the National Aeronautics and Space Administration schedules for human exploration of the Moon. This study used the initial concept examined by the U.S. Department of Energy Inter-laboratory Design and Analysis Support Team for surface power, a low-temperature, liquid-metal, three-loop Brayton power system. With some facility modification, the EBR-II can safely house a test chamber and perform long-term testing of the space reactor power system. The INL infrastructure is available to receive and provide bonded storage for special nuclear materials. Facilities adjacent to EBR-II can provide the clean room environment needed to assemble and store the test article assembly, disassemble the power system at the conclusion of testing, and perform posttest examination. Capability for waste disposal is also available at the INL.« less
Use of physical restraints and antipsychotic medications in nursing homes: a cross-national study
Feng, Zhanlian; Hirdes, John P.; Smith, Trevor F.; Finne-Soveri, Harriet; Chi, Iris; Pasquier, Jean-Noel Du; Gilgen, Ruedi; Ikegami, Naoki; Mor, Vincent
2013-01-01
SUMMARY Objectives This study compares inter- and intra-country differences in the prevalence of physical restraints and antipsychotic medications in nursing homes, and examines aggregated resident conditions and organizational characteristics correlated with these treatments. Methods Population-based, cross-sectional data were collected using a standardized Resident Assessment Instrument (RAI) from 14,504 long-term care facilities providing nursing home level services in five countries participating in the interRAI consortium, including Canada, Finland, Hong Kong (Special Administrative Region, China), Switzerland, and the United States. Facility-level prevalence rates of physical restraints and antipsychotic use were examined both between and within the study countries. Results The prevalence of physical restraint use varied more than five-fold across the study countries, from an average 6% in Switzerland, 9% in the US, 20% in Hong Kong, 28% in Finland, and over 31% in Canada. The prevalence of antipsychotic use ranged from 11% in Hong Kong, between 26–27% in Canada and the US, 34% in Switzerland, and nearly 38% in Finland. Within each country, substantial variations existed across facilities in both physical restraint and antipsychotic use rates. In all countries, neither facility case mix nor organizational characteristics were particularly predictive of the prevalence of either treatment. Conclusions There exists large, unexplained variability in the prevalence of physical restraint and antipsychotic use in nursing home facilities both between and within countries. Since restraints and antipsychotics are associated with adverse outcomes, it is important to understand the idiosyncratic factors specific to each country that contribute to variation in use rates. PMID:19280680
Afulani, Patience A; Kirumbi, Leah; Lyndon, Audrey
2017-12-29
Sub-Saharan Africa accounts for approximately 66% of global maternal deaths. Poor person-centered maternity care, which emphasizes the quality of patient experience, contributes both directly and indirectly to these poor outcomes. Yet, few studies in low resource settings have examined what is important to women during childbirth from their perspective. The aim of this study is to examine women's facility-based childbirth experiences in a rural county in Kenya, to identify aspects of care that contribute to a positive or negative birth experience. Data are from eight focus group discussions conducted in a rural county in western Kenya in October and November 2016, with 58 mothers aged 15 to 49 years who gave birth in the preceding nine weeks. We recorded and transcribed the discussions and used a thematic approach for data analysis. The findings suggest four factors influence women's perceptions of quality of care: responsiveness, supportive care, dignified care, and effective communication. Women had a positive experience when they were received well at the health facility, treated with kindness and respect, and given sufficient information about their care. The reverse led to a negative experience. These experiences were influenced by the behavior of both clinical and support staff and the facility environment. This study extends the literature on person-centered maternity care in low resource settings. To improve person-centered maternity care, interventions need to address the responsiveness of health facilities, ensure women receive supportive and dignified care, and promote effective patient-provider communication.
Felo, Michael; Christensen, Brandon; Higgins, John
2013-01-01
The bioreactor volume delineating the selection of primary clarification technology is not always easily defined. Development of a commercial scale process for the manufacture of therapeutic proteins requires scale-up from a few liters to thousands of liters. While the separation techniques used for protein purification are largely conserved across scales, the separation techniques for primary cell culture clarification vary with scale. Process models were developed to compare monoclonal antibody production costs using two cell culture clarification technologies. One process model was created for cell culture clarification by disc stack centrifugation with depth filtration. A second process model was created for clarification by multi-stage depth filtration. Analyses were performed to examine the influence of bioreactor volume, product titer, depth filter capacity, and facility utilization on overall operating costs. At bioreactor volumes <1,000 L, clarification using multi-stage depth filtration offers cost savings compared to clarification using centrifugation. For bioreactor volumes >5,000 L, clarification using centrifugation followed by depth filtration offers significant cost savings. For bioreactor volumes of ∼ 2,000 L, clarification costs are similar between depth filtration and centrifugation. At this scale, factors including facility utilization, available capital, ease of process development, implementation timelines, and process performance characterization play an important role in clarification technology selection. In the case study presented, a multi-product facility selected multi-stage depth filtration for cell culture clarification at the 500 and 2,000 L scales of operation. Facility implementation timelines, process development activities, equipment commissioning and validation, scale-up effects, and process robustness are examined. © 2013 American Institute of Chemical Engineers.
Use of physical restraints and antipsychotic medications in nursing homes: a cross-national study.
Feng, Zhanlian; Hirdes, John P; Smith, Trevor F; Finne-Soveri, Harriet; Chi, Iris; Du Pasquier, Jean-Noel; Gilgen, Ruedi; Ikegami, Naoki; Mor, Vincent
2009-10-01
This study compares inter- and intra-country differences in the prevalence of physical restraints and antipsychotic medications in nursing homes, and examines aggregated resident conditions and organizational characteristics correlated with these treatments. Population-based, cross-sectional data were collected using a standardized Resident Assessment Instrument (RAI) from 14,504 long-term care facilities providing nursing home level services in five countries participating in the interRAI consortium, including Canada, Finland, Hong Kong (Special Administrative Region, China), Switzerland, and the United States. Facility-level prevalence rates of physical restraints and antipsychotic use were examined both between and within the study countries. The prevalence of physical restraint use varied more than five-fold across the study countries, from an average 6% in Switzerland, 9% in the US, 20% in Hong Kong, 28% in Finland, and over 31% in Canada. The prevalence of antipsychotic use ranged from 11% in Hong Kong, between 26-27% in Canada and the US, 34% in Switzerland, and nearly 38% in Finland. Within each country, substantial variations existed across facilities in both physical restraint and antipsychotic use rates. In all countries, neither facility case mix nor organizational characteristics were particularly predictive of the prevalence of either treatment. There exists large, unexplained variability in the prevalence of physical restraint and antipsychotic use in nursing home facilities both between and within countries. Since restraints and antipsychotics are associated with adverse outcomes, it is important to understand the idiosyncratic factors specific to each country that contribute to variation in use rates. Copyright (c) 2009 John Wiley & Sons, Ltd.
Castle, Nicholas; Engberg, John B; Wagner, Laura M; Handler, Steven
2017-02-01
This research examined resident and facility-specific factors associated with a diagnosis of a urinary tract infection (UTI) in the nursing home setting. Minimum Data Set and Online Survey, Certification and Reporting system data were used to identify all nursing home residents in the United States on April 1, 2006, who did not have a UTI ( n = 1,138,418). Residents were followed until they contracted a UTI (9.5%), died (8.3%), left the nursing home (33.2%), or the year ended (49.0%). A Cox proportional hazards model was estimated, controlling for resident and facility characteristics and for the state of residence. The presence of an indwelling catheter was the primary predictor of whether a resident contracted a UTI (adjusted incidence ratio = 3.35, p < .001), but only 6.1% of the residents in the sample had such a catheter. Therefore, only one eighth of the UTIs were contracted by residents with a catheter. Thus, subsequent analysis examined the populations with and without catheters separately. Demographic characteristics (such as age) have a much greater association with incidence among residents without catheters. The association with facility factors such as percentage of Medicaid residents, for-profit, and chain status was less significant. Estimates regarding staffing levels indicate that increased contact hours with more highly educated nursing staff are associated with less catheter use. Several facility-specific risk factors are of significance. Of significance, UTIs may be reduced by modifying factors such as staffing levels.
Validity of self-assessment in a quality improvement collaborative in Ecuador.
Hermida, Jorge; Broughton, Edward I; Miller Franco, Lynne
2011-12-01
Health care quality improvement (QI) efforts commonly use self-assessment to measure compliance with quality standards. This study investigates the validity of self-assessment of quality indicators. Cross sectional. A maternal and newborn care improvement collaborative intervention conducted in health facilities in Ecuador in 2005. Four external evaluators were trained in abstracting medical records to calculate six indicators reflecting compliance with treatment standards. About 30 medical records per month were examined at 12 participating health facilities for a total of 1875 records. The same records had already been reviewed by QI teams at these facilities (self-assessment). Overall compliance, agreement (using the Kappa statistic), sensitivity and specificity were analyzed. We also examined patterns of disagreement and the effect of facility characteristics on levels of agreement. External evaluators reported compliance of 69-90%, while self-assessors reported 71-92%, with raw agreement of 71-95% and Kappa statistics ranging from fair to almost perfect agreement. Considering external evaluators as the gold standard, sensitivity of self-assessment ranged from 90 to 99% and specificity from 48 to 86%. Simpler indicators had fewer disagreements. When disagreements occurred between self-assessment and external valuators, the former tended to report more positive findings in five of six indicators, but this tendency was not of a magnitude to change program actions. Team leadership, understanding of the tools and facility size had no overall impact on the level of agreement. When compared with external evaluation (gold standard), self-assessment was found to be sufficiently valid for tracking QI team performance. Sensitivity was generally higher than specificity. Simplifying indicators may improve validity.
Feasibility of Ground Testing a Moon and Mars Surface Power Reactor in EBR-II
NASA Astrophysics Data System (ADS)
Morton, Sheryl L.; Baily, Carl E.; Hill, Thomas J.; Werner, James E.
2006-01-01
Ground testing of a surface fission power system would be necessary to verify the design and validate reactor performance to support safe and sustained human exploration of the Moon and Mars. The Idaho National Laboratory (INL) has several facilities that could be adapted to support a ground test. This paper focuses on the feasibility of ground testing at the Experimental Breeder Reactor II (EBR-II) facility and using other INL existing infrastructure to support such a test. This brief study concludes that the INL EBR-II facility and supporting infrastructure are a viable option for ground testing the surface power system. It provides features and attributes that offer advantages to locating and performing ground testing at this site, and it could support the National Aeronautics and Space Administration schedules for human exploration of the Moon. This study used the initial concept examined by the U.S. Department of Energy Inter-laboratory Design and Analysis Support Team for surface power, a low-temperature, liquid-metal, three-loop Brayton power system. With some facility modification, the EBR-II can safely house a test chamber and perform long-term testing of the space reactor power system. The INL infrastructure is available to receive and provide bonded storage for special nuclear materials. Facilities adjacent to EBR-II can provide the clean room environment needed to assemble and store the test article assembly, disassemble the power system at the conclusion of testing, and perform posttest examination. Capability for waste disposal is also available at the INL.
Competency Exams for Drafting-Related Occupations. Student and Instructor Manuals.
ERIC Educational Resources Information Center
Davis, Harley; Denison, John
This document contains 20 competency-based examinations with student and instructor manuals for drafting-related occupations. For each of the examinations, the student manual contains the following: the competency, the performance objective, directions, the facility to be used, the materials needed, a space to note time started and time finished,…
Using "The Happiness Advantage" in a College Honors Program
ERIC Educational Resources Information Center
Rockey, Christine
2015-01-01
In the field of college success and retention, researchers have examined school facilities, grade point averages, SAT scores, high school grades, and student involvement among other variables. One of the additional variables that has been examined is how happiness affects college success. The matter of student happiness is of primary importance to…
42 CFR 37.4 - Chest radiographic examinations conducted by the Secretary.
Code of Federal Regulations, 2014 CFR
2014-10-01
... the Secretary, due to the lack of adequate medical or other necessary facilities or personnel at the... with the approved plan. (b) The operator of the mine shall reimburse the Secretary or other person, agency, or institution as the Secretary may direct, for the cost of conducting each examination made in...
7 CFR 868.91 - Fees for certain Federal rice inspection services.
Code of Federal Regulations, 2014 CFR
2014-01-01
... at the applicant's facility. 2 Services performed at export port locations on lots at rest. Table 2... copies of certificates (per copy) 3.00 Stowage Examination (service-on-request) 3 (a) Ship (per stowage space) (minimum $252.50 per ship) 50.50 (b) Subsequent ship examination (same as original) (minimum $151...
7 CFR 868.91 - Fees for certain Federal rice inspection services.
Code of Federal Regulations, 2013 CFR
2013-01-01
... at the applicant's facility. 2 Services performed at export port locations on lots at rest. Table 2... copies of certificates (per copy) 3.00 Stowage Examination (service-on-request) 3 (a) Ship (per stowage space) (minimum $252.50 per ship) 50.50 (b) Subsequent ship examination (same as original) (minimum $151...
7 CFR 868.91 - Fees for certain Federal rice inspection services.
Code of Federal Regulations, 2012 CFR
2012-01-01
... at the applicant's facility. 2 Services performed at export port locations on lots at rest. Table 2... copies of certificates (per copy) 3.00 Stowage Examination (service-on-request) 3 (a) Ship (per stowage space) (minimum $252.50 per ship) 50.50 (b) Subsequent ship examination (same as original) (minimum $151...
Providing Outcomes Information to Nursing Homes: Can It Improve Quality of Care?
ERIC Educational Resources Information Center
Castle, Nicholas G.
2003-01-01
Purpose: This study examined whether providing outcomes information to 120 nursing homes facilitated improvements in quality over a 12-month period, as compared with 1,171 facilities not receiving this information. The outcomes information provided consisted of a report mailed to administrators that examined six measures of care quality. These…
Never Going Back: An Examination of Financial Health at Selected Private South Carolina Universities
ERIC Educational Resources Information Center
Armstrong, David C., Sr.
2014-01-01
This case study examined the leadership styles and overall financial health of the three South Carolina Baptist Convention universities. Each university share a similar story of financial exigency prior to the current president's arrival. Each institution has increased enrollment, endowment, and facilities over the last decade. This case study…
Facility Issues in Community School Centers. #4 in a Series of 6 Booklets.
ERIC Educational Resources Information Center
Educational Facilities Labs., Inc., New York, NY.
This booklet is the fourth in a series that examines community school centers. The development and substance of the building program, issues related to site selection and development, and overall building design strategies are examined. Also discussed are particularly important design details about which the programming committee and the architect…
The Prepared Environment and Its Relationship to Learning.
ERIC Educational Resources Information Center
Loeffler, Margaret Howard
A proposal to carefully examine some current thinking on early learning and attempts to project their implications into the design of a unique learning facility that would offer a supportive and stimulating environment for young children two to six years of age, providing for their individual needs and differences. The concepts examined were…
Characterization of fast neutron spectrum in the TRIGA for hardness testing of electronic components
DOE Office of Scientific and Technical Information (OSTI.GOV)
Nelson, George W.
1986-07-01
Argonne National Laboratory-West, operated by the University of Chicago, is located near Idaho Falls, ID, on the Idaho National Engineering Laboratory Site. ANL-West performs work in support of the Liquid Metal Fast Breeder Reactor Program (LMFBR) sponsored by the United States Department of Energy. The NRAD reactor is located at the Argonne Site within the Hot Fuel Examination Facility/North, a large hot cell facility where both non-destructive and destructive examinations are performed on highly irradiated reactor fuels and materials in support of the LMFBR program. The NRAD facility utilizes a 250-kW TRIGA reactor and is completely dedicated to neutron radiographymore » and the development of radiography techniques. Criticality was first achieved at the NRAD reactor in October of 1977. Since that time, a number of modifications have been implemented to improve operational efficiency and radiography production. This paper describes the modifications and changes that significantly improved operational efficiency and reliability of the reactor and the essential auxiliary reactor systems. (author)« less
Alford-Teaster, Jennifer; Lange, Jane M; Hubbard, Rebecca A; Lee, Christoph I; Haas, Jennifer S; Shi, Xun; Carlos, Heather A; Henderson, Louise; Hill, Deirdre; Tosteson, Anna N A; Onega, Tracy
2016-02-18
Characterizing geographic access depends on a broad range of methods available to researchers and the healthcare context to which the method is applied. Globally, travel time is one frequently used measure of geographic access with known limitations associated with data availability. Specifically, due to lack of available utilization data, many travel time studies assume that patients use the closest facility. To examine this assumption, an example using mammography screening data, which is considered a geographically abundant health care service in the United States, is explored. This work makes an important methodological contribution to measuring access--which is a critical component of health care planning and equity almost everywhere. We analyzed one mammogram from each of 646,553 women participating in the US based Breast Cancer Surveillance Consortium for years 2005-2012. We geocoded each record to street level address data in order to calculate travel time to the closest and to the actually used mammography facility. Travel time between the closest and the actual facility used was explored by woman-level and facility characteristics. Only 35% of women in the study population used their closest facility, but nearly three-quarters of women not using their closest facility used a facility within 5 min of the closest facility. Individuals that by-passed the closest facility tended to live in an urban core, within higher income neighborhoods, or in areas where the average travel times to work was longer. Those living in small towns or isolated rural areas had longer closer and actual median drive times. Since the majority of US women accessed a facility within a few minutes of their closest facility this suggests that distance to the closest facility may serve as an adequate proxy for utilization studies of geographically abundant services like mammography in areas where the transportation networks are well established.
Morris, Meghan D; Brown, Brandon; Allen, Scott A
2017-09-11
Purpose Worldwide efforts to identify individuals infected with the hepatitis C virus (HCV) focus almost exclusively on community healthcare systems, thereby failing to reach high-risk populations and those with poor access to primary care. In the USA, community-based HCV testing policies and guidelines overlook correctional facilities, where HCV rates are believed to be as high as 40 percent. This is a missed opportunity: more than ten million Americans move through correctional facilities each year. Herein, the purpose of this paper is to examine HCV testing practices in the US correctional system, California and describe how universal opt-out HCV testing could expand early HCV detection, improve public health in correctional facilities and communities, and prove cost-effective over time. Design/methodology/approach A commentary on the value of standardizing screening programs across facilities by mandating all facilities (universal) to implement opt-out testing policies for all prisoners upon entry to the correctional facilities. Findings Current variability in facility-level testing programs results in inconsistent testing levels across correctional facilities, and therefore makes estimating the actual number of HCV-infected adults in the USA difficult. The authors argue that universal opt-out testing policies ensure earlier diagnosis of HCV among a population most affected by the disease and is more cost-effective than selective testing policies. Originality/value The commentary explores the current limitations of selective testing policies in correctional systems and provides recommendations and implications for public health and correctional organizations.
Quality of physical resources of health facilities in Indonesia: a panel study 1993-2007.
Diana, Aly; Hollingworth, Samantha A; Marks, Geoffrey C
2013-10-01
The merits of mixed public and private health systems are debated. Although private providers have become increasingly important in the Indonesian health system, there is no comprehensive assessment of the quality of private facilities. This study examined the quality of physical resources of public and private facilities in Indonesia from 1993 to 2007. Data from the Indonesian Family Life Surveys in 1993, 1997, 2000 and 2007 were used to evaluate trends in the quality of physical resources for public and private facilities, stratified by urban/rural areas and Java-Bali/outer Java-Bali regions. The quality of six categories of resources was measured using an adapted MEASURE Evaluation framework. Overall quality was moderate, but higher in public than in private health facilities in all years regardless of the region. The higher proportion of nurses and midwives in private practice was a determinant of scope of services and facilities available. There was little improvement in quality of physical resources following decentralization. Despite significant increases in public investment in health between 2000 and 2006 and the potential benefits of decentralization (2001), the quality of both public and private health facilities in Indonesia did not improve significantly between 1993 and 2007. As consumers commonly believe the quality is better in private facilities and are increasingly using them, it is essential to improve quality in both private and public facilities. Implementation of minimum standards and effective partnerships with private practice are considered important.
Capabilities and constraints of NASA's ground-based reduced gravity facilities
NASA Technical Reports Server (NTRS)
Lekan, Jack; Neumann, Eric S.; Sotos, Raymond G.
1993-01-01
The ground-based reduced gravity facilities of NASA have been utilized to support numerous investigations addressing various processes and phenomina in several disciplines for the past 30 years. These facilities, which include drop towers, drop tubes, aircraft, and sounding rockets are able to provide a low gravity environment (gravitational levels that range from 10(exp -2)g to 10(exp -6)g) by creating a free fall or semi-free fall condition where the force of gravity on an experiment is offset by its linear acceleration during the 'fall' (drop or parabola). The low gravity condition obtained on the ground is the same as that of an orbiting spacecraft which is in a state of perpetual free fall. The gravitational levels and associated duration times associated with the full spectrum of reduced gravity facilities including spaced-based facilities are summarized. Even though ground-based facilities offer a relatively short experiment time, this available test time has been found to be sufficient to advance the scientific understanding of many phenomena and to provide meaningful hardware tests during the flight experiment development process. Also, since experiments can be quickly repeated in these facilities, multistep phenomena that have longer characteristic times associated with them can sometimes be examined in a step-by-step process. There is a large body of literature which has reported the study results achieved through using reduced-gravity data obtained from the facilities.
Brown, Scott C; Wang, Kefeng; Dong, Chuanhui; Farrell, Mary Beth; Heller, Gary V; Gornik, Heather L; Hutchisson, Marge; Needleman, Laurence; Benenati, James F; Jaff, Michael R; Meier, George H; Perese, Susana; Bendick, Phillip; Hamburg, Naomi M; Lohr, Joann M; LaPerna, Lucy; Leers, Steven A; Lilly, Michael P; Tegeler, Charles; Katanick, Sandra L; Alexandrov, Andrei V; Siddiqui, Adnan H; Rundek, Tatjana
2016-09-01
Accreditation of cerebrovascular ultrasound laboratories by the Intersocietal Accreditation Commission (IAC) and equivalent organizations is supported by the Joint Commission certification of stroke centers. Limited information exists on the accreditation status and geographic distribution of cerebrovascular testing facilities in the United States. Our study objectives were to identify the proportion of IAC-accredited outpatient cerebrovascular testing facilities used by Medicare beneficiaries, describe their geographic distribution, and identify variations in cerebrovascular testing procedure types and volumes by accreditation status. As part of the VALUE (Vascular Accreditation, Location, and Utilization Evaluation) Study, we examined the proportion of IAC-accredited facilities that conducted cerebrovascular testing in a 5% Centers for Medicare and Medicaid Services random Outpatient Limited Data Set in 2011 and investigated their geographic distribution using geocoding. Among 7327 outpatient facilities billing Medicare for cerebrovascular testing, only 22% (1640) were IAC accredited. The proportion of IAC-accredited cerebrovascular testing facilities varied by region (χ(2)[3] = 177.1; P < .0001), with 29%, 15%, 13%, and 10% located in the Northeast, South, Midwest, and West, respectively. However, of the total number of cerebrovascular outpatient procedures conducted in 2011 (38,555), 40% (15,410) were conducted in IAC-accredited facilities. Most cerebrovascular testing procedures were carotid duplex, with 40% of them conducted in IAC-accredited facilities. The proportion of facilities conducting outpatient cerebrovascular testing accredited by the IAC is low and varies by region. The growing number of certified stroke centers should be accompanied by more accredited outpatient vascular testing facilities, which could potentially improve the quality of stroke care.
2006-10-10
CEV (Crew Escape Vehicle) capsule Balistic Range testing to examine static and dynamic stability characteristics (at the Hypervelocity Free-Flight Facility) HFF - Don Holt installing projectile & powder charge
2006-10-10
CEV (Crew Escape Vehicle) capsule Balistic Range testing to examine static and dynamic stability characteristics (at the Hypervelocity Free-Flight Facility) HFF Chuck Cornelison operating 'Firing' control pannel
Is There Extra Cost of Institutional Care for MS Patients?
Noyes, Katia; Bajorska, Alina; Weinstock-Guttman, Bianca
2013-01-01
Throughout life, patients with multiple sclerosis (MS) require increasing levels of support, rehabilitative services, and eventual skilled nursing facility (SNF) care. There are concerns that access to SNF care for MS patients is limited because of perceived higher costs of their care. This study compares costs of caring for an MS patient versus those of a typical SNF patient. We merged SNF cost report data with the 2001–2006 Nursing Home Minimum Data Set (MDS) to calculate percentage of MS residents-days and facility case-mix indices (CMIs). We estimated the average facility daily cost using hybrid cost functions, adjusted for facility ownership, average facility wages, CMI-adjusted number of SNF days, and percentage of MS residents-days. We describe specific characteristics of SNF with high and low MS volumes and examine any sources of variation in cost. MS patients were no longer more costly than typical SNF patients. A greater proportion of MS patients had no significant effect on facility daily costs (P = 0.26). MS patients were more likely to receive care in government-owned facilities (OR = 1.904) located in the Western (OR = 2.133) and Midwestern (OR = 1.3) parts of the USA (P < 0.05). Cost of SNF care is not a likely explanation for the perceived access barriers that MS patients face. PMID:24163769
Trends in the Types of Usual Sources of Care: A Shift from People to Places or Nothing at All.
Liaw, Winston; Jetty, Anuradha; Petterson, Stephen; Bazemore, Andrew; Green, Larry
2017-08-31
(1) To examine usual source of care (USC) trends across four categories (No USC, Person USC, Person, in Facility USC, and Facility USC), and (2) to determine whether USC types are associated with emergency department (ED) visits and hospital admissions. 1996-2014 Medical Expenditure Panel Surveys. We stratified each USC category, by age, region, gender, poverty, insurance, race/ethnicity, and education and used regression to determine the characteristics associated with USC types, ED visits, and hospital admissions. Those with No USC and Facility USCs increased 10 and 18 percent, respectively, while those with Person USCs decreased by 43 percent. Compared to those in the lowest income bracket, those in the highest income bracket were less likely to have a Facility USC. Among those with low incomes, individuals with No USC, Person, in Facility, and Facility USCs were more likely to have ED visits than those with Person USCs. A growing number are reporting facilities as their USCs or none at all. The impact of these trends is uncertain, although we found that some USC types are associated with ED visits and hospital admissions. Tracking USCs will be crucial to measuring progress toward enhanced care efficiency. © Health Research and Educational Trust.
Health sciences libraries in Kuwait: a study of their resources, facilities, and services
Al-Ansari, Husain A.; Al-Enezi, Sana
2001-01-01
The purpose of this study was to examine the current status of health sciences libraries in Kuwait in terms of their staff, collections, facilities, use of information technology, information services, and cooperation. Seventeen libraries participated in the study. Results show that the majority of health sciences libraries were established during the 1980s. Their collections are relatively small. The majority of their staff is nonprofessional. The majority of libraries provide only basic information services. Cooperation among libraries is limited. Survey results also indicate that a significant number of health sciences libraries are not automated. Some recommendations for the improvement of existing resources, facilities, and services are made. PMID:11465688
The new postirradiation examination facility of the Atomic Energy Corporation of South Africa
DOE Office of Scientific and Technical Information (OSTI.GOV)
Walt, P.L. van der; Aspeling, J.C.; Jonker, W.D.
1992-01-01
The Pelindaba Hot Cell Complex (HCC) forms an important part of the infrastructure and support services of the Atomic Energy Corporation (AEC) of South Africa. It is a comprehensive, one-stop facility designed to make South Africa self-sufficient in the fields of spent-fuel qualification and verification, reactor pressure vessel surveillance program testing, ad hoc failure analyses for the nuclear power industry, and research and development studies in conjunction with the Safari I material test reactor (MTR) and irradiation rigs. Local technology and expertise was used for the design and construction of the HCC, which start up in 1980. The facility wasmore » commissioned in 1990.« less
Health spending and political influence: the case of earmarks and health care facilities.
Leider, Jonathon P; Tung, Greg; Castrucci, Brian; Sprague, James B
2015-01-01
Earmarks, otherwise known as Congressionally directed spending requests, are a historically significant means of political influence over budgets. In this brief, we report on the results of a longitudinal study of federal earmarks affecting health care facilities and public health. We analyzed 10 years of earmark for health care facilities and examined the correlates of being in the top 50% of earmark recipients for each year. Having representatives or senators serving on the respective Appropriations committees were shown to have increased odds of being a top earmark recipient, as was being in jurisdictions with greater poverty. However, health-related measures of need were not significantly associated with being a top earmark recipient.
Advance Care Planning in Nursing Homes and Assisted Living Communities
Daaleman, Timothy P.; Williams, Christianna S.; Preisser, John S.; Sloane, Philip D.; Biola, Holly; Zimmerman, Sheryl
2009-01-01
Objectives To determine the prevalence and characteristics of advance care planning (ACP) among persons dying in long-term care (LTC) facilities, and to examine the relationship between respondent, facility, decedent, and family characteristics and ACP. Design After-death interviews of family members of decedents and facility liaisons where decedents received care. Setting Stratified sample of 164 residential care/assisted living facilities and nursing homes in Florida, Maryland, New Jersey, and North Carolina. Subjects Family members and facility liaisons who gave 446 and 1014 reports, respectively, on 1015 decedent residents. Measurements Reports of death/dying discussions, known treatment preferences, and reports and records of signed living wills (LW), health care powers of attorney (HCPOA), do-not-resuscitate orders, and do-not-hospitalize orders. Results Family respondents reported a higher prevalence, compared with facility reports, of HCPOAs (92% vs 49%) and LWs (84% vs 43%). In family reports, non-white race and no private insurance were significantly associated with lower prevalence of LWs and HCPOAs; additionally, residing in nursing homes (vs assisted living facilities) and in North Carolina were associated with lower prevalence of reported LWs. In facility reports, non-white race, unexpected death and residing in North Carolina or Maryland were significantly associated with lower prevalence of LWs, whereas high Medicaid case mix, intact cognitive status and high family involvement were associated with lower prevalence of HCPOAs. Concordance of family and facility reporting of HCPOAs was significantly greater in facilities with fewer than 120 beds. Conclusions The prevalence of ACP in LTC is much higher than previously described, and there is marked variation in characteristics associated with ACP, despite moderately high concordance, when reported by the facility or family caregivers. PMID:19426940
Johnson, Fiifi Amoako; Frempong-Ainguah, Faustina; Matthews, Zoe; Harfoot, Andrew J P; Nyarko, Philomena; Baschieri, Angela; Gething, Peter W; Falkingham, Jane; Atkinson, Peter M
2015-01-01
The Community-based Health Planning and Services (CHPS) initiative is a major government policy to improve maternal and child health and accelerate progress in the reduction of maternal mortality in Ghana. However, strategic intelligence on the impact of the initiative is lacking, given the persistant problems of patchy geographical access to care for rural women. This study investigates the impact of proximity to CHPS on facilitating uptake of skilled birth care in rural areas. Data from the 2003 and 2008 Demographic and Health Survey, on 4,349 births from 463 rural communities were linked to georeferenced data on health facilities, CHPS and topographic data on national road-networks. Distance to nearest health facility and CHPS was computed using the closest facility functionality in ArcGIS 10.1. Multilevel logistic regression was used to examine the effect of proximity to health facilities and CHPS on use of skilled care at birth, adjusting for relevant predictors and clustering within communities. The results show that a substantial proportion of births continue to occur in communities more than 8 km from both health facilities and CHPS. Increases in uptake of skilled birth care are more pronounced where both health facilities and CHPS compounds are within 8 km, but not in communities within 8 km of CHPS but lack access to health facilities. Where both health facilities and CHPS are within 8 km, the odds of skilled birth care is 16% higher than where there is only a health facility within 8km. Where CHPS compounds are set up near health facilities, there is improved access to care, demonstrating the facilitatory role of CHPS in stimulating access to better care at birth, in areas where health facilities are accessible.
Schneider, Jeffrey C; Tan, Wei-Han; Goldstein, Richard; Mix, Jacqueline M; Niewczyk, Paulette; Divita, Margaret A; Ryan, Colleen M; Gerrard, Paul B; Kowalske, Karen; Zafonte, Ross
2013-01-01
A preliminary investigation of the burn rehabilitation population found a large variability of zero onset day frequency between facilities. Onset days is defined as the time from injury to inpatient rehabilitation admission; this variable has not been investigated in burn patients previously. This study explored if this finding was a facility-based phenomena or characteristic of burn inpatient rehabilitation patients. This study was a secondary analysis of Uniform Data System for Medical Rehabilitation (UDSmr) data from 2002 to 2007 examining inpatient rehabilitation characteristics among patients with burn injuries. Exclusion criteria were age less than 18 years and discharge against medical advice. Comparisons of demographic, medical and functional data were made between facilities with a high frequency of zero onset days versus facilities with a low frequency of zero onset days. A total of 4738 patients from 455 inpatient rehabilitation facilities were included. Twenty-three percent of the population exhibited zero onset days (n = 1103). Sixteen facilities contained zero onset patients; two facilities accounted for 97% of the zero onset subgroup. Facilities with a high frequency of zero onset day patients demonstrated significant differences in demographic, medical, and functional variables compared to the remainder of the study population. There were significantly more zero onset day admissions among burn patients (23%) than other diagnostic groups (0.5- 3.6%) in the Uniform Data System for Medical Rehabilitation database, but the majority (97%) came from two inpatient rehabilitation facilities. It is unexpected for patients with significant burn injury to be admitted to a rehabilitation facility on the day of injury. Future studies investigating burn rehabilitation outcomes using the Uniform Data System for Medical Rehabilitation database should exclude facilities with a high percentage of zero onset days, which are not representative of the burn inpatient rehabilitation population.
Johnson, Fiifi Amoako; Frempong-Ainguah, Faustina; Matthews, Zoe; Harfoot, Andrew J. P.; Nyarko, Philomena; Baschieri, Angela; Gething, Peter W.; Falkingham, Jane; Atkinson, Peter M.
2015-01-01
Background The Community-based Health Planning and Services (CHPS) initiative is a major government policy to improve maternal and child health and accelerate progress in the reduction of maternal mortality in Ghana. However, strategic intelligence on the impact of the initiative is lacking, given the persistant problems of patchy geographical access to care for rural women. This study investigates the impact of proximity to CHPS on facilitating uptake of skilled birth care in rural areas. Methods and Findings Data from the 2003 and 2008 Demographic and Health Survey, on 4,349 births from 463 rural communities were linked to georeferenced data on health facilities, CHPS and topographic data on national road-networks. Distance to nearest health facility and CHPS was computed using the closest facility functionality in ArcGIS 10.1. Multilevel logistic regression was used to examine the effect of proximity to health facilities and CHPS on use of skilled care at birth, adjusting for relevant predictors and clustering within communities. The results show that a substantial proportion of births continue to occur in communities more than 8 km from both health facilities and CHPS. Increases in uptake of skilled birth care are more pronounced where both health facilities and CHPS compounds are within 8 km, but not in communities within 8 km of CHPS but lack access to health facilities. Where both health facilities and CHPS are within 8 km, the odds of skilled birth care is 16% higher than where there is only a health facility within 8km. Conclusion Where CHPS compounds are set up near health facilities, there is improved access to care, demonstrating the facilitatory role of CHPS in stimulating access to better care at birth, in areas where health facilities are accessible. PMID:25789874
Assisted living and nursing homes: apples and oranges?
Zimmerman, Sheryl; Gruber-Baldini, Ann L; Sloane, Philip D; Eckert, J Kevin; Hebel, J Richard; Morgan, Leslie A; Stearns, Sally C; Wildfire, Judith; Magaziner, Jay; Chen, Cory; Konrad, Thomas R
2003-04-01
The goals of this study are to describe the current state of residential care/assisted living (RC/AL) care and residents in comparison with nursing home (NH) care and residents, identify different types of RC/AL care and residents, and consider how variation in RC/AL case-mix reflects differences in care provision and/or consumer preference. Data were derived from the Collaborative Studies of Long-Term Care, a four-state study of 193 RC/AL facilities and 40 NHs. Multivariate analyses examined differences in ten process of care measures between RC/AL facilities with less than 16 beds; traditional RC/AL with 16 or more beds; new-model RC/AL; and NHs. Generalized estimating equation models determined differences in resident case-mix across RC/AL facilities using data for 2,078 residents. NHs report provision of significantly more health services and have significantly more lenient admission policies than RC/AL facilities, but provide less privacy. They do not differ from larger RC/AL facilities in policy clarity or resident control. Differences within RC/AL types are evident, with smaller and for-profit facilities scoring lower than other facilities across multiple process measures, including those related to individual freedom and institutional order. Resident impairment is substantial in both NHs and RC/AL settings, but differs by RC/AL facility characteristics. Differences in process of care and resident characteristics by facility type highlight the importance of considering: (1) the adequacy of existing process measures for evaluating smaller facilities; (2) resident case-mix when comparing facility types and outcomes; and (3) the complexity of understanding the implication of the process of care, given the importance of person-environment fit. Work is continuing to clarify the role of RC/AL vis-à-vis NHs in our nation's system of residential long-term care.
Effect of facility on the operative costs of distal radius fractures.
Mather, Richard C; Wysocki, Robert W; Mack Aldridge, J; Pietrobon, Ricardo; Nunley, James A
2011-07-01
The purpose of this study was to investigate whether ambulatory surgery centers can deliver lower-cost care and to identify sources of those cost savings. We performed a cost identification analysis of outpatient volar plating for closed distal radius fractures at a single academic medical center. Multiple costs and time measures were taken from an internal database of 130 consecutive patients and were compared by venue of treatment, either an inpatient facility or an ambulatory, stand-alone surgery facility. The relationships between total cost and operative time and multiple variables, including fracture severity, patient age, gender, comorbidities, use of bone graft, concurrent carpal tunnel release, and surgeon experience, were examined, using multivariate analysis and regression modeling to identify other cost drivers or explanatory variables. The mean operative cost was considerably greater at the inpatient facility ($7,640) than at the outpatient facility ($5,220). Cost drivers of this difference were anesthesia services, post-anesthesia care unit, and operating room costs. Total surgical time, nursing time, set-up, and operative times were 33%, 109%, 105%, and 35% longer, respectively, at the inpatient facility. There was no significant difference between facilities for the additional variables, and none of those variables independently affected cost or operative time. The only predictor of cost and time was facility type. This study supports the use of ambulatory stand-alone surgical facilities to achieve efficient resource utilization in the operative treatment of distal radius fractures. We also identified several specific costs and time measurements that differed between facilities, which can serve as potential targets for tertiary facilities to improve utilization. Economic and Decisional Analysis III. Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
Impact cratering in reduced-gravity environments: Early experiments on the NASA KC-135 aircraft
NASA Technical Reports Server (NTRS)
Cintala, Mark J.; Hoerz, F.; See, T. H.
1987-01-01
Impact experimentation on the NASA KC-135 Reduced-Gravity Aircraft was shown to be possible, practical, and of considerable potential use in examining the role of gravity on various impact phenomena. With a minimal facility, crater dimensional and growth-times were measured, and have demonstrated both agreement and disagreement with predictions. A larger facility with vacuum capability and a high-velocity gun would permit a much wider range of experimentation.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Ethan W. Brown
2001-09-01
Through the National Governors' Association (NGA) project ''Critical Issues Related to Radioactive Waste and Materials Disposition Involving DOE Facilities'' NGA brings together Governors' policy advisors, state regulators, and DOE officials to examine critical issues related to the cleanup and operation of DOE nuclear weapons and research facilities. Topics explored through this project include: Decisions involving disposal of mixed, low-level, and transuranic (TRU) waste and disposition of nuclear materials. Decisions involving DOE budget requests and their effect on environmental cleanup and compliance at DOE facilities. Strategies to treat mixed, low-level, and transuranic (TRU) waste and their effect on individual sites inmore » the complex. Changes to the FFCA site treatment plans as a result of proposals in the Department's Accelerating Cleanup: Paths to Closure plan and contractor integration analysis. Interstate waste and materials shipments. Reforms to existing RCRA and CERCLA regulations/guidance to address regulatory overlap and risks posed by DOE wastes. The overarching theme of this project is to help the Department improve coordination of its major program decisions with Governors' offices and state regulators and to ensure such decisions reflect input from these key state officials and stakeholders. This report summarizes activities conducted during the period from April 1, 2001 through June 30, 2001, under the NGA grant.« less
Corrosion of iron by iodide-oxidizing bacteria isolated from brine in an iodine production facility.
Wakai, Satoshi; Ito, Kimio; Iino, Takao; Tomoe, Yasuyoshi; Mori, Koji; Harayama, Shigeaki
2014-10-01
Elemental iodine is produced in Japan from underground brine (fossil salt water). Carbon steel pipes in an iodine production facility at Chiba, Japan, for brine conveyance were found to corrode more rapidly than those in other facilities. The corroding activity of iodide-containing brine from the facility was examined by immersing carbon steel coupons in "native" and "filter-sterilized" brine samples. The dissolution of iron from the coupons immersed in native brine was threefold to fourfold higher than that in the filter-sterilized brine. Denaturing gradient gel electrophoresis analyses revealed that iodide-oxidizing bacteria (IOBs) were predominant in the coupon-containing native brine samples. IOBs were also detected in a corrosion deposit on the inner surface of a corroded pipe. These results strongly suggested the involvement of IOBs in the corrosion of the carbon steel pipes. Of the six bacterial strains isolated from a brine sample, four were capable of oxidizing iodide ion (I(-)) into molecular iodine (I(2)), and these strains were further phylogenetically classified into two groups. The iron-corroding activity of each of the isolates from the two groups was examined. Both strains corroded iron in the presence of potassium iodide in a concentration-dependent manner. This is the first report providing direct evidence that IOBs are involved in iron corrosion. Further, possible mechanisms by which IOBs corrode iron are discussed.
Onufrak, Stephen J; Watson, Kathleen B; Kimmons, Joel; Pan, Liping; Khan, Laura Kettel; Lee-Kwan, Seung Hee; Park, Sohyun
2018-01-01
To examine the workplace food and physical activity (PA) environments and wellness culture reported by employed United States adults, overall and by employer size. Cross-sectional study using web-based survey on wellness policies and environmental supports for healthy eating and PA. Worksites in the United States. A total of 2101 adults employed outside the home. Survey items were based on the Centers for Disease Control and Prevention Worksite Health ScoreCard and Checklist of Health Promotion Environments and included the availability and promotion of healthy food items, nutrition education, promotion of breast-feeding, availability of PA amenities and programs, facility discounts, time for PA, stairwell signage, health promotion programs, and health risk assessments. Descriptive statistics were used to examine the prevalence of worksite environmental and facility supports by employer size (<100 or ≥100 employees). Chi-square tests were used to examine the differences by employer size. Among employed respondents with workplace food or drink vending machines, approximately 35% indicated the availability of healthy items. Regarding PA, 30.9% of respondents reported that their employer provided opportunities to be physically active and 17.6% reported worksite exercise facilities. Wellness programs were reported by 53.2% working for large employers, compared to 18.1% for smaller employers. Employee reports suggested that workplace supports for healthy eating, PA, and wellness were limited and were less common among smaller employers.
Karimi, Leila; Leggat, Sandra G; Bartram, Timothy; Rada, Jiri
2018-05-09
Emotional intelligence (EI) training is popular among human resource practitioners, but there is limited evidence of the impact of such training on health care workers. In the current article, we examine the effects of EI training on quality of resident care and worker well-being and psychological empowerment in an Australian aged care facility. We use Bar-On's (1997) conceptualization of EI. We used a quasiexperimental design in 2014-2015 with experimental (training) and control (nontraining) groups of 60 participants in each group in two geographically separate facilities. Our final poststudy sample size was 27 participants for the training group and 17 participants for the control group. Over a 6-month period, we examined whether staff improved their well-being, psychological empowerment, and job performance measured as enhanced quality of care (self-rated and client-rated) by applying skills in EI. The results showed significant improvement among workers in the training group for EI scores, quality of care, general well-being, and psychological empowerment. There were no significant differences for the control group. Through examining the impact of EI training on staff and residents of an aged care facility, we demonstrate the benefits of EI training for higher quality of care delivery. This study demonstrates the practical process through which EI training can improve the work experiences of aged care workers, as well as the quality of care for residents.
2006-10-10
CEV (Crew Escape Vehicle) capsule Balistic Range testing to examine static and dynamic stability characteristics (at the Hypervelocity Free-Flight Facility) HFF - Bon Bowling machining sabot to find dimensions
Space station systems analysis study. Part 1, volume 1: Executive study
NASA Technical Reports Server (NTRS)
1976-01-01
Potential space station system options were examined for a permanent, manned, orbital space facility and to provide data to NASA program planners and decision makers for their use in future program planning. There were ten space station system objectives identified. These were categorized into five major objectives and five supporting objectives. The major objectives were to support the development of: (1) satellite power systems, (2) nuclear energy plants in space, (3) space processing, (4) earth services, and (5) space cosmological research and development. The five supporting objectives, to define space facilities which would be basic building blocks for future systems, were: (1) a multidiscipline science laboratory, (2) an orbital depot to maintain, fuel, and service orbital transfer vehicles, (3) cluster support systems to provide power and data processing for multiple orbital elements, (4) a sensor development facility, and (5) the facilities necessary to enhance man's living and working in space.
NASA Technical Reports Server (NTRS)
Yim, John T.; Burt, Jonathan M.
2015-01-01
The background gas in a vacuum facility for electric propulsion ground testing is examined in detail through a series of cold flow simulations using a direct simulation Monte Carlo (DSMC) code. The focus here is on the background gas itself, its structure and characteristics, rather than assessing its interaction and impact on thruster operation. The background gas, which is often incorrectly characterized as uniform, is found to have a notable velocity within a test facility. The gas velocity has an impact on the proper measurement of pressure and the calculation of ingestion flux to a thruster. There are also considerations for best practices for tests that involve the introduction of supplemental gas flows to artificially increase the background pressure. All of these effects need to be accounted for to properly characterize the operation of electric propulsion thrusters across different ground test vacuum facilities.
Racial/ethnic differences in access to substance abuse treatment.
Lo, Celia C; Cheng, Tyrone C
2011-05-01
A secondary dataset, Collaborative Psychiatric Epidemiology Surveys (CPES), 2001-2003, was employed to examine racial/ethnic differences in access to specialty and non-specialty substance abuse treatment (compared with no access to treatment). The study found that non-Hispanic White Americans were (1) likelier than members of all racial/ethnic minority groups (other than Hispanics) to address substance abuse by accessing care through specialty addiction-treatment facilities, and were (2) also less likely to access substance abuse care through non-specialty facilities. Because non-specialty facilities may have staffs whose professional training does not target treating chronic, bio-psycho-social illness such as substance abuse, our results imply that treatment facilities deemed non-specialty may need to enhance staff training, in order to ensure individuals are properly screened for substance use conditions and are referred for or provided with effective counseling and medications as appropriate.
Deshpande, Abhishek; Donskey, Curtis J
2017-09-01
Cleaning and disinfection in healthcare facilities is essential to ensure patient safety. This review examines practical strategies used to assess and improve the effectiveness of daily and post-discharge manual cleaning in healthcare facilities. Effective implementation of cleaning interventions requires objective monitoring of staff performance with regular feedback on performance. Use of fluorescent markers to assess thoroughness of cleaning and measurement of residual ATP can provide rapid and objective feedback to personnel and have been associated with improved cleaning. Direct observation of cleaning and interviews with front-line staff are useful to identify variations and deficiencies in practice that may not be detected by other methods. Although not recommended for routine monitoring, cultures can be helpful for outbreak investigations. Monitoring and feedback can be effective in improving cleaning and disinfection in healthcare facilities. Ongoing commitment within institutions is needed to sustain successful cleaning and disinfection programs.
Provision of mouth-care in long-term care facilities: an educational trial.
MacEntee, M I; Wyatt, C C L; Beattie, B L; Paterson, B; Levy-Milne, R; McCandless, L; Kazanjian, A
2007-02-01
This randomized clinical trial aimed to assess the effectiveness of a pyramid-based education for improving the oral health of elders in long-term care (LTC) facilities. Fourteen facilities matched for size were assigned randomly to an active or control group. At baseline in each facility, care-aides in the active group participated with a full-time nurse educator in a seminar about oral health care, and had unlimited access to the educator for oral health-related advice throughout the 3-month trial. Care-aides in the control group participated in a similar seminar with a dental hygienist but they received no additional advice. The residents in the facilities at baseline and after 3 months were examined clinically to measure their oral hygiene, gingival health, masticatory potential, Body Mass Index and Malnutrition Indicator Score, and asked to report on chewing difficulties. Clinical measures after 3 months were not significantly different from baseline in either group, indicating that education neither influenced the oral health nor the dental hygiene of the residents. A pyramid-based educational scheme with nurses and care-aides did not improve the oral health of frail elders in this urban sample of LTC facilities.
Estimate of air carrier and air taxi crash frequencies from high altitude en route flight operations
DOE Office of Scientific and Technical Information (OSTI.GOV)
Sanzo, D.; Kimura, C.Y.; Prassinos, P.G.
1996-06-03
In estimating the frequency of an aircraft crashing into a facility, it has been found convenient to break the problem down into two broad categories. One category estimates the aircraft crash frequency due to air traffic from nearby airports, the so-called near-airport environment. The other category estimates the aircraft crash frequency onto facilities due to air traffic from airways, jet routes, and other traffic flying outside the near-airport environment The total aircraft crash frequency is the summation of the crash frequencies from each airport near the facility under evaluation and from all airways, jet routes, and other traffic near themore » facility of interest. This paper will examine the problems associated with the determining the aircraft crash frequencies onto facilities outside the near-airport environment. This paper will further concentrate on the estimating the risk of aircraft crashes to ground facilities due to high altitude air carrier and air taxi traffic. High altitude air carrier and air taxi traffic will be defined as all air carrier and air taxi flights above 18,000 feet Mean Sea Level (MSL).« less
Mars Sample Handling and Requirements Panel (MSHARP)
NASA Technical Reports Server (NTRS)
Carr, Michael H.; McCleese, Daniel J.; Bada, Jeffrey L.; Bogard, Donald D.; Clark, Benton C.; DeVincenzi, Donald; Drake, Michael J.; Nealson, Kenneth H.; Papike, James J.; Race, Margaret S.;
1999-01-01
In anticipation of the return of samples from Mars toward the end of the first decade of the next century, NASA's Office of Space Sciences chartered a panel to examine how Mars samples should be handled. The panel was to make recommendations in three areas: (1) sample collection and transport back to Earth; (2) certification of the samples as nonhazardous; and (3) sample receiving, curation, and distribution. This report summarizes the findings of that panel. The samples should be treated as hazardous until proven otherwise. They are to be sealed within a canister on Mars, and the canister is not to be opened until within a Biosafety Hazard Level 4 (BSL-4) containment facility here on Earth. This facility must also meet or exceed the cleanliness requirements of the Johnson Space Center (JSC) facility for curation of extraterrestrial materials. A containment facility meeting both these requirements does not yet exist. Hazard assessment and life detection experiments are to be done at the containment facility, while geochemical characterization is being performed on a sterilized subset of the samples released to the science community. When and if the samples are proven harmless, they are to be transferred to a curation facility, such as that at JSC.
Factors associated with increasing nursing home closures.
Castle, Nicholas G; Engberg, John; Lave, Judith; Fisher, Andrew
2009-06-01
We determine the rate of nursing home closures for 7 years (1999-2005) and examine internal (e.g., quality), organizational (e.g., chain membership), and external (e.g., competition) factors associated with these closures. The names of the closed facilities and dates of closure from state regulators in all 50 states were obtained. This information was linked to the Online Survey, Certification, and Reporting data, which contains information on internal, organizational, and market factors for almost all nursing homes in the United States. One thousand seven hundred and eighty-nine facilities closed over this time period (1999-2005). The average annual rate of closure was about 2 percent of facilities, but the rate of closure was found to be increasing. Nursing homes with higher rates of deficiency citations, hospital-based facilities, chain members, small bed size, and facilities located in markets with high levels of competition were more likely to close. High Medicaid occupancy rates were associated with a high likelihood of closure, especially for facilities with low Medicaid reimbursement rates. As states actively debate about how to redistribute long-term care services/dollars, our findings show that they should be cognizant of the potential these decisions have for facilitating nursing home closures.
Biosecurity and bird movement practices in upland game bird facilities in the United States.
Slota, Katharine E; Hill, Ashley E; Keefe, Thomas J; Bowen, Richard A; Pabilonia, Kristy L
2011-06-01
Since 1996, the emergence of Asian-origin highly pathogenic avian influenza subtype H5N1 has spurred great concern for the global poultry industry. In the United States, there is concern over the potential of a foreign avian disease incursion into the country. Noncommercial poultry operations, such as upland game bird facilities in the United States, may serve as a potential source of avian disease introduction to other bird populations including the commercial poultry industry, backyard flocks, or wildlife. In order to evaluate how to prevent disease transmission from these facilities to other populations, we examined biosecurity practices and bird movement within the upland game bird industry in the United States. Persons that held a current permit to keep, breed, or release upland game birds were surveyed for information on biosecurity practices, flock and release environments, and bird movement parameters. Biosecurity practices vary greatly among permit holders. Many facilities allow for interaction between wild birds and pen-reared birds, and there is regular long-distance movement of live adult birds among facilities. Results suggest that upland game bird facilities should be targeted for biosecurity education and disease surveillance efforts.
Castle, Nicholas; Olson, Doug; Shah, Urvi; Hansen, Kevin
2016-09-01
This study explores the relationship between recipients of an association-sponsored Quality Award Program and select measures of quality in U.S. nursing facilities, examined both cross-sectionally and over time. Data used came from Quality Award Program recipients over 9 years (2003-2011) and a set of quality indicators from the Online Survey Certification and Reporting (OSCAR) database. These data were analyzed using a variety of multivariate regression techniques. Cross-sectionally, the award recipients demonstrated higher performance on most of the quality indicators, compared with both the broader field of nursing facilities and also a more stringent comparison group of facilities. Comparing quality from the 4 years before the award was received to the 4 years after the award, the majority of quality indicators demonstrated improvement in those facilities receiving an award. These results indicate that, in general, the nursing facilities that participate in and receive the Silver or Gold American Health Care Association (AHCA) and National Center for Assisted Living (NCAL) National Quality Award perform at a higher level of quality for residents and sustain that heightened performance over a period of time.
Kanters, Michael A; Bocarro, Jason N; Filardo, Mary; Edwards, Michael B; McKenzie, Thomas L; Floyd, Myron F
2014-05-01
Partnerships between school districts and community-based organizations to share school facilities during afterschool hours can be an effective strategy for increasing physical activity. However, the perceived cost of shared use has been noted as an important reason for restricting community access to schools. This study examined shared use of middle school facilities, the amount and type of afterschool physical activity programs provided at middle schools together with the costs of operating the facilities. Afterschool programs were assessed for frequency, duration, and type of structured physical activity programs provided and the number of boys and girls in each program. School operating costs were used to calculate a cost per student and cost per building square foot measure. Data were collected at all 30 middle schools in a large school district over 12 months in 2010-2011. Policies that permitted more use of school facilities for community-sponsored programs increased participation in afterschool programs without a significant increase in operating expenses. These results suggest partnerships between schools and other community agencies to share facilities and create new opportunities for afterschool physical activity programs are a promising health promotion strategy. © 2014, American School Health Association.