75 FR 37825 - Notice of Proposed Information Collection: Comment Request; Minimum Property Standards for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-30

... Information Collection: Comment Request; Minimum Property Standards for Multifamily and Care-Type Facilities...: Minimum Property Standards for Multifamily and Care-type facilities. OMB Control Number, if applicable... Housing and Urban Development (HUD) developed the Minimum Property Standards (MPS) program in order to...

Using mobile distributed pyrolysis facilities to deliver a forest residue resource for bio-fuel production

NASA Astrophysics Data System (ADS)

Brown, Duncan

Distributed mobile conversion facilities using either fast pyrolysis or torrefaction processes can be used to convert forest residues to more energy dense substances (bio-oil, bio-slurry or torrefied wood) that can be transported as feedstock for bio-fuel facilities. All feedstock are suited for gasification, which produces syngas that can be used to synthesise petrol or diesel via Fischer-Tropsch reactions, or produce hydrogen via water gas shift reactions. Alternatively, the bio-oil product of fast pyrolysis may be upgraded to produce petrol and diesel, or can undergo steam reformation to produce hydrogen. Implementing a network of mobile facilities reduces the energy content of forest residues delivered to a bio-fuel facility as mobile facilities use a fraction of the biomass energy content to meet thermal or electrical demands. The total energy delivered by bio-oil, bio-slurry and torrefied wood is 45%, 65% and 87% of the initial forest residue energy content, respectively. However, implementing mobile facilities is economically feasible when large transport distances are required. For an annual harvest of 1.717 million m3 (equivalent to 2000 ODTPD), transport costs are reduced to less than 40% of the total levelised delivered feedstock cost when mobile facilities are implemented; transport costs account for up to 80% of feedstock costs for conventional woodchip delivery. Torrefaction provides the lowest cost pathway of delivering a forest residue resource when using mobile facilities. Cost savings occur against woodchip delivery for annual forest residue harvests above 2.25 million m3 or when transport distances greater than 250 km are required. Important parameters that influence levelised delivered costs of feedstock are transport distances (forest residue spatial density), haul cost factors, thermal and electrical demands of mobile facilities, and initial moisture content of forest residues. Relocating mobile facilities can be optimised for lowest cost delivery as transport distances of raw biomass are reduced. The overall cost of bio-fuel production is determined by the feedstock delivery pathway and also the bio-fuel production process employed. Results show that the minimum cost of petrol and diesel production is 0.86 litre -1 when a bio-oil feedstock is upgraded. This corresponds to a 2750 TPD upgrading facility requiring an annual harvest of 4.30 million m3. The miniμm cost of hydrogen production is 2.92 kg -1, via the gasification of a woodchip feedstock and subsequent water gas shift reactions. This corresponds to a 1100 ODTPD facility and requires an annual harvest of 947,000 m3. The levelised cost of bio-fuel strongly depends on the size of annual harvest required for bio-fuel facilities. There are optimal harvest volumes (bio-fuel facility sizes) for each bio-fuel production route, which yield minimum bio-fuel production costs. These occur as the benefits of economies of scale for larger bio-fuel facilities compete against increasing transport costs for larger harvests. Optimal harvest volumes are larger for bio-fuel production routes that use feedstock sourced from mobile facilities, as mobile facilities reduce total transport requirements.

Using Facility Condition Assessments to Identify Actions Related to Infrastructure

NASA Technical Reports Server (NTRS)

Rubert, Kennedy F.

2010-01-01

To support cost effective, quality research it is essential that laboratory and testing facilities are maintained in a continuous and reliable state of availability at all times. NASA Langley Research Center (LaRC) and its maintenance contractor, Jacobs Technology, Inc. Research Operations, Maintenance, and Engineering (ROME) group, are in the process of implementing a combined Facility Condition Assessment (FCA) and Reliability Centered Maintenance (RCM) program to improve asset management and overall reliability of testing equipment in facilities such as wind tunnels. Specific areas are being identified for improvement, the deferred maintenance cost is being estimated, and priority is being assigned against facilities where conditions have been allowed to deteriorate. This assessment serves to assist in determining where to commit available funds on the Center. RCM methodologies are being reviewed and enhanced to assure that appropriate preventive, predictive, and facilities/equipment acceptance techniques are incorporated to prolong lifecycle availability and assure reliability at minimum cost. The results from the program have been favorable, better enabling LaRC to manage assets prudently.

The Need for Higher Minimum Staffing Standards in U.S. Nursing Homes

PubMed Central

Harrington, Charlene; Schnelle, John F.; McGregor, Margaret; Simmons, Sandra F.

2016-01-01

Many U.S. nursing homes have serious quality problems, in part, because of inadequate levels of nurse staffing. This commentary focuses on two issues. First, there is a need for higher minimum nurse staffing standards for U.S. nursing homes based on multiple research studies showing a positive relationship between nursing home quality and staffing and the benefits of implementing higher minimum staffing standards. Studies have identified the minimum staffing levels necessary to provide care consistent with the federal regulations, but many U.S. facilities have dangerously low staffing. Second, the barriers to staffing reform are discussed. These include economic concerns about costs and a focus on financial incentives. The enforcement of existing staffing standards has been weak, and strong nursing home industry political opposition has limited efforts to establish higher standards. Researchers should study the ways to improve staffing standards and new payment, regulatory, and political strategies to improve nursing home staffing and quality. PMID:27103819

6 CFR 27.204 - Minimum concentration by security issue.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 6 Domestic Security 1 2010-01-01 2010-01-01 false Minimum concentration by security issue. 27.204 Section 27.204 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY CHEMICAL FACILITY ANTI-TERRORISM STANDARDS Chemical Facility Security Program § 27.204 Minimum concentration by...

Online mass storage system detailed requirements document

NASA Technical Reports Server (NTRS)

1976-01-01

The requirements for an online high density magnetic tape data storage system that can be implemented in a multipurpose, multihost environment is set forth. The objective of the mass storage system is to provide a facility for the compact storage of large quantities of data and to make this data accessible to computer systems with minimum operator handling. The results of a market survey and analysis of candidate vendor who presently market high density tape data storage systems are included.

MINIMUM AREAS FOR ELEMENTARY SCHOOL BUILDING FACILITIES.

ERIC Educational Resources Information Center

Pennsylvania State Dept. of Public Instruction, Harrisburg.

MINIMUM AREA SPACE REQUIREMENTS IN SQUARE FOOTAGE FOR ELEMENTARY SCHOOL BUILDING FACILITIES ARE PRESENTED, INCLUDING FACILITIES FOR INSTRUCTIONAL USE, GENERAL USE, AND SERVICE USE. LIBRARY, CAFETERIA, KITCHEN, STORAGE, AND MULTIPURPOSE ROOMS SHOULD BE SIZED FOR THE PROJECTED ENROLLMENT OF THE BUILDING IN ACCORDANCE WITH THE PROJECTION UNDER THE…

Minimum alcohol pricing policies in practice: A critical examination of implementation in Canada.

PubMed

Thompson, Kara; Stockwell, Tim; Wettlaufer, Ashley; Giesbrecht, Norman; Thomas, Gerald

2017-02-01

There is an interest globally in using Minimum Unit Pricing (MUP) of alcohol to promote public health. Canada is the only country to have both implemented and evaluated some forms of minimum alcohol prices, albeit in ways that fall short of MUP. To inform these international debates, we describe the degree to which minimum alcohol prices in Canada meet recommended criteria for being an effective public health policy. We collected data on the implementation of minimum pricing with respect to (1) breadth of application, (2) indexation to inflation and (3) adjustments for alcohol content. Some jurisdictions have implemented recommended practices with respect to minimum prices; however, the full harm reduction potential of minimum pricing is not fully realised due to incomplete implementation. Key concerns include the following: (1) the exclusion of minimum prices for several beverage categories, (2) minimum prices below the recommended minima and (3) prices are not regularly adjusted for inflation or alcohol content. We provide recommendations for best practices when implementing minimum pricing policy.

14 CFR 171.257 - Minimum requirements for approval.

Code of Federal Regulations, 2010 CFR

2010-01-01

... System (ISMLS) § 171.257 Minimum requirements for approval. (a) The following are the minimum... operate and maintain the ISMLS facility in accordance with § 171.273. (4) The owner must agree to furnish periodic reports as set forth in § 171.275 and agree to allow the FAA to inspect the facility and its...

An analysis of the costs of Uganda's Child Days Plus: do low costs reveal an efficient program or an underfinanced one?

PubMed

Fiedler, John L; Semakula, Richard

2014-03-01

Twice annually, Uganda implements Child Days Plus (CDP), a month-long outreach activity that distributes vitamin A capsules to preschool children and deworms children 6 months to 14 years old. Introduced initially as a temporary, interim strategy, CDP is now a decade old. To assess how well CDP is implemented using an activity-based cost analysis. In the absence of a cost-accounting system for CDP, we defined the six major CDP activities as cost centers and identified five important subactivities required to implement a round of CDP. Based on a purposive sample, we conducted a structured interview survey of 59 Ministry of Health facilities, 9 district offices, and national-level CDP staff. Only one-third of the facilities implemented all 11 CDP core activities. The survey revealed that Ministry of Health staff and volunteers are frequently paid substantially less in allowances than they are entitled to for their CDP outreach activities. Viewing these two practices--nonimplementation and less-than-full-reimbursement--as indicators of CDP's underfinancing, we estimate the program is underfinanced by the equivalent of 37% of its 'full implementation" costs. Two-thirds of underfinancing is manifested in nonimplementation and one-third as less-than full-reimbursement. CDP exploits economies of scale and scope and has an average cost per child served of US$0.22. We estimate that it annually saves 367,000 disability-adjusted life-years (DALYs) at an average cost of US$12.5, making it--despite its underfinancing--highly cost-effective. Increased CDP funding would enable its vitamin A coverage rate of 58% and its deworming coverage rate of 62% to be increased, thereby increasing its effectiveness and efficiency. CDP should be "relaunched," as part of an effort to improve the structure of the program, set expectations about it, and earmark a minimum of resources for CDP. The Ministry of Health should demonstrate its new, greater commitment to CDP by introducing a program-specific budget line item, increasing CDP's budget allocation, and developing and implementing a training program that identifies the minimum uniform activities required to implement CDP.

NASA/ESA CV-990 Spacelab simulation. Appendixes: C, data-handling: Planning and implementation; D, communications; E, mission documentation

NASA Technical Reports Server (NTRS)

Reller, J. O., Jr.

1976-01-01

Data handling, communications, and documentation aspects of the ASSESS mission are described. Most experiments provided their own data handling equipment, although some used the airborne computer for backup, and one experiment required real-time computations. Communications facilities were set up to simulate those to be provided between Spacelab and the ground, including a downlink TV system. Mission documentation was kept to a minimum and proved sufficient. Examples are given of the basic documents of the mission.

Medicare payment changes and nursing home quality: effects on long-stay residents.

PubMed

Konetzka, R Tamara; Norton, Edward C; Stearns, Sally C

2006-09-01

The Balanced Budget Act of 1997 dramatically changed the way that Medicare pays skilled nursing facilities, providing a natural experiment in nursing home behavior. Medicare payment policy (directed at short-stay residents) may have affected outcomes for long-stay, chronic-care residents if services for these residents were subsidized through cost-shifting prior to implementation of Medicare prospective payment for nursing homes. We link changes in both the form and level of Medicare payment at the facility level with changes in resident-level quality, as represented by pressure sores and urinary tract infections in Minimum Data Set (MDS) assessments. Results show that long-stay residents experienced increased adverse outcomes with the elimination of Medicare cost reimbursement.

Take immediate action to protect communities and workers.

PubMed

Wilding, Roberta Chase; Lewis, Sharon E

2007-01-01

In many areas throughout America, thousands of industrial and military facilities and agricultural operations put large numbers of people at risk of serious injury or death due to accidental chemical releases, explosions, fires, and grossly inadequate occupational exposure standards. While some companies are moving toward "greener" production, many others do the minimum required by government agencies. As evidenced by the thousands of permit violations and accidental releases of hazardous chemicals, this means that facilities across the country consistently fail to meet regulations, incorporating the cost of fines and penalties into the cost of doing business and passing that cost on to consumers. Workers at such facilities and residents of the surrounding communities cannot wait for the eventual implementation and enforcement of federal environmental laws or adequate testing of the effect chemicals may have on the human population. Immediate action is needed to protect communities and workers at risk from chemical exposures that can compromise their health.

9 CFR 354.210 - Minimum standards for sanitation, facilities, and operating procedures in official plants.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false Minimum standards for sanitation, facilities, and operating procedures in official plants. 354.210 Section 354.210 Animals and Animal Products... sanitation, facilities, and operating procedures in official plants. The provisions of §§ 354.210 to 354.247...

9 CFR 354.210 - Minimum standards for sanitation, facilities, and operating procedures in official plants.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false Minimum standards for sanitation, facilities, and operating procedures in official plants. 354.210 Section 354.210 Animals and Animal Products... sanitation, facilities, and operating procedures in official plants. The provisions of §§ 354.210 to 354.247...

9 CFR 354.210 - Minimum standards for sanitation, facilities, and operating procedures in official plants.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Minimum standards for sanitation, facilities, and operating procedures in official plants. 354.210 Section 354.210 Animals and Animal Products... sanitation, facilities, and operating procedures in official plants. The provisions of §§ 354.210 to 354.247...

9 CFR 354.210 - Minimum standards for sanitation, facilities, and operating procedures in official plants.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Minimum standards for sanitation, facilities, and operating procedures in official plants. 354.210 Section 354.210 Animals and Animal Products... sanitation, facilities, and operating procedures in official plants. The provisions of §§ 354.210 to 354.247...

9 CFR 354.210 - Minimum standards for sanitation, facilities, and operating procedures in official plants.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 9 Animals and Animal Products 2 2013-01-01 2013-01-01 false Minimum standards for sanitation, facilities, and operating procedures in official plants. 354.210 Section 354.210 Animals and Animal Products... sanitation, facilities, and operating procedures in official plants. The provisions of §§ 354.210 to 354.247...

Indian Test Facility (INTF) and its updates

NASA Astrophysics Data System (ADS)

Bandyopadhyay, M.; Chakraborty, A.; Rotti, C.; Joshi, J.; Patel, H.; Yadav, A.; Shah, S.; Tyagi, H.; Parmar, D.; Sudhir, Dass; Gahlaut, A.; Bansal, G.; Soni, J.; Pandya, K.; Pandey, R.; Yadav, R.; Nagaraju, M. V.; Mahesh, V.; Pillai, S.; Sharma, D.; Singh, D.; Bhuyan, M.; Mistry, H.; Parmar, K.; Patel, M.; Patel, K.; Prajapati, B.; Shishangiya, H.; Vishnudev, M.; Bhagora, J.

2017-04-01

To characterize ITER Diagnostic Neutral Beam (DNB) system with full specification and to support IPR’s negative ion beam based neutral beam injector (NBI) system development program, a R&D facility, named INTF is under commissioning phase. Implementation of a successful DNB at ITER requires several challenges need to be overcome. These issues are related to the negative ion production, its neutralization and corresponding neutral beam transport over the path lengths of ∼ 20.67 m to reach ITER plasma. DNB is a procurement package for INDIA, as an in-kind contribution to ITER. Since ITER is considered as a nuclear facility, minimum diagnostic systems, linked with safe operation of the machine are planned to be incorporated in it and so there is difficulty to characterize DNB after onsite commissioning. Therefore, the delivery of DNB to ITER will be benefited if DNB is operated and characterized prior to onsite commissioning. INTF has been envisaged to be operational with the large size ion source activities in the similar timeline, as with the SPIDER (RFX, Padova) facility. This paper describes some of the development updates of the facility.

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

Dehart, Mark; Mausolff, Zander; Goluoglu, Sedat

This report summarizes university research activities performed in support of TREAT modeling and simulation research. It is a compilation of annual research reports from four universities: University of Florida, Texas A&M University, Massachusetts Institute of Technology and Oregon State University. The general research topics are, respectively, (1) 3-D time-dependent transport with TDKENO/KENO-VI, (2) implementation of the Improved Quasi-Static method in Rattlesnake/MOOSE for time-dependent radiation transport approximations, (3) improved treatment of neutron physics representations within TREAT using OpenMC, and (4) steady state modeling of the minimum critical core of the Transient Reactor Test Facility (TREAT).

6 CFR 27.204 - Minimum concentration by security issue.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Section 27.204 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY CHEMICAL FACILITY ANTI-TERRORISM STANDARDS Chemical Facility Security Program § 27.204 Minimum concentration by security issue. (a) Release Chemicals—(1) Release-Toxic Chemicals. If a release-toxic chemical of interest...

A quality improvement approach to capacity building in low- and middle-income countries.

PubMed

Bardfield, Joshua; Agins, Bruce; Akiyama, Matthew; Basenero, Apollo; Luphala, Patience; Kaindjee-Tjituka, Francina; Natanael, Salomo; Hamunime, Ndapewa

2015-07-01

To describe the HEALTHQUAL framework consisting of the following three components: performance measurement, quality improvement and the quality management program, representing an adaptive approach to building capacity in national quality management programs in low and middle-income countries. We present a case study from Namibia illustrating how this approach is adapted to country context. HEALTHQUAL partners with Ministries of Health to build knowledge and expertise in modern improvement methods, including data collection, analysis and reporting, process analysis and the use of data to implement quality improvement projects that aim to improve systems and processes of care. Clinical performance measures are selected in each country by the Ministry of Health on the basis of national guidelines. Patient records are sampled using a standardized statistical table to achieve a minimum confidence interval of 90%, with a spread of ±8% in participating facilities. Data are routinely reviewed to identify gaps in patient care, and aggregated to produce facility mean scores that are trended over time. A formal organizational assessment is conducted at facility and national levels to review the implementation progress. Aggregate mean rates of performance for 10 of 11 indicators of HIV care improved for adult HIV-positive patients between 2008 and 2013. Quality improvement is an approach to capacity building and health systems strengthening that offers adaptive methodology. Synergistic implementation of elements of a national quality program can lead to improvements in care, in parallel with systematic capacity development for measurement, improvement and quality management throughout the healthcare delivery system.

Notification: EPA Progress on Meeting Resource Conservation and Recovery Act Statutory Mandate for Minimum Frequency of Inspections at Hazardous Waste Disposal Facilities

EPA Pesticide Factsheets

Project #OPE-FY15-0018, January 20, 2015. The EPA OIG plans to begin preliminary research on EPA’s progress in meeting minimum inspection requirements under the RCRA at treatment, storage and disposal facilities (TSDFs).

Design and performance of vacuum system for high heat flux test facility

NASA Astrophysics Data System (ADS)

Swamy Kidambi, Rajamannar; Mokaria, Prakash; Khirwadkar, Samir; Belsare, Sunil; Khan, M. S.; Patel, Tushar; Krishnan, Deepu S.

2017-04-01

High heat flux test facility (HHFTF) at IPR is used for testing thermal performance of plasma facing materials or components. It consists of various subsystems like vacuum system, high power electron beam system, diagnostic and calibration system, data acquisition and control system and high pressure high temperature water circulation system. Vacuum system consists of large D-shaped chamber, target handling system, pumping systems and support structure. The net volume of vacuum chamber is 5 m3 was maintained at the base pressure of the order of 10-6 mbar for operation of electron gun with minimum beam diameter which is achieved with turbo-molecular pump (TMP) and cryo pump. A variable conductance gate valve is used for maintaining required vacuum in the chamber. Initial pumping of the chamber was carried out by using suitable rotary and root pumps. PXI and PLC based faster real time data acquisition and control system is implemented for performing the various operations like remote operation, online vacuum data measurements, display and status indication of all vacuum equipments. This paper describes in detail the design and implementation of various vacuum system for HHFTF.

Walla Walla River Fish Passage Operations Project : Annual Progress Report October 2007 - September 2008.

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

Bronson, James P.; Duke, Bill; Loffink, Ken

2008-12-30

In the late 1990s, the Confederated Tribes of the Umatilla Indian Reservation, Oregon Department of Fish and Wildlife, and Washington Department of Fish and Wildlife, along with many other agencies, began implementing fisheries restoration activities in the Walla Walla Basin. An integral part of these efforts is to alleviate the inadequate fish migration conditions in the basin. Migration concerns are being addressed by removing diversion structures, constructing fish passage facilities, implementing minimum instream flow requirements, and providing trap and haul efforts when needed. The objective of the Walla Walla River Fish Passage Operations Project is to increase the survival ofmore » migrating adult and juvenile salmonids in the Walla Walla River basin. The project is responsible for coordinating operation and maintenance of ladders, screen sites, bypasses, trap facilities, and transportation equipment. In addition, the project provides technical input on passage and trapping facility design, operation, and criteria. Operation of the various passage facilities and passage criteria guidelines are outlined in an annual operations plan that the project develops. Beginning in March of 2007, two work elements from the Walla Walla Fish Passage Operations Project were transferred to other projects. The work element Enumeration of Adult Migration at Nursery Bridge Dam is now conducted under the Walla Walla Basin Natural Production Monitoring and Evaluation Project and the work element Provide Transportation Assistance is conducted under the Umatilla Satellite Facilities Operation and Maintenance Project. Details of these activities can be found in those project's respective annual reports.« less

Groundwater quality assessment plan for single-shell waste management area B-BX-BY at the Hanford Site

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

SM Narbutovskih

2000-03-31

Pacific Northwest National Laboratory conducted a first determination groundwater quality assessment at the Hanford Site. This work was performed for the US Department of Energy, Richland Operations Office, in accordance with the Federal Facility Compliance Agreement during the time period 1996--1998. The purpose of the assessment was to determine if waste from the Single-Shell Tank (SST) Waste Management Area (WMA) B-BX-BY had entered the groundwater at levels above the drinking water standards (DWS). The resulting assessment report documented evidence demonstrating that waste from the WMA has, most likely, impacted groundwater quality. Based on 40 CFR 265.93 [d] paragraph (7), themore » owner-operator must continue to make the minimum required determinations of contaminant level and of rate/extent of migrations on a quarterly basis until final facility closure. These continued determinations are required because the groundwater quality assessment was implemented prior to final closure of the facility.« less

Medicare program; prospective payment system and consolidated billing for skilled nursing facilities for FY 2014. Final rule.

PubMed

2013-08-06

This final rule updates the payment rates used under the prospective payment system for skilled nursing facilities (SNFs) for fiscal year (FY) 2014. In addition, it revises and rebases the SNF market basket, revises and updates the labor related share, and makes certain technical and conforming revisions in the regulations text. This final rule also includes a policy for reporting the SNF market basket forecast error in certain limited circumstances and adds a new item to the Minimum Data Set (MDS), Version 3.0 for reporting the number of distinct therapy days. Finally, this final rule adopts a change to the diagnosis code used to determine which residents will receive the AIDS add-on payment, effective for services provided on or after the October 1, 2014 implementation date for conversion to ICD-10-CM.

42 CFR 483.315 - Specification of resident assessment instrument.

Code of Federal Regulations, 2010 CFR

2010-10-01

... updated periodically, and consists of the following: (1) The minimum data set (MDS) and common definitions... specified by CMS. (4) The requirements for use of the RAI that appear at § 483.20. (e) Minimum data set (MDS...) Specify to a facility the method of transmission of data, and instruct the facility on this method. (3...

42 CFR 483.315 - Specification of resident assessment instrument.

Code of Federal Regulations, 2014 CFR

2014-10-01

... updated periodically, and consists of the following: (1) The minimum data set (MDS) and common definitions... specified by CMS. (4) The requirements for use of the RAI that appear at § 483.20. (e) Minimum data set (MDS...) Specify to a facility the method of transmission of data, and instruct the facility on this method. (3...

42 CFR 483.315 - Specification of resident assessment instrument.

Code of Federal Regulations, 2012 CFR

2012-10-01

... updated periodically, and consists of the following: (1) The minimum data set (MDS) and common definitions... specified by CMS. (4) The requirements for use of the RAI that appear at § 483.20. (e) Minimum data set (MDS...) Specify to a facility the method of transmission of data, and instruct the facility on this method. (3...

42 CFR 483.315 - Specification of resident assessment instrument.

Code of Federal Regulations, 2013 CFR

2013-10-01

... updated periodically, and consists of the following: (1) The minimum data set (MDS) and common definitions... specified by CMS. (4) The requirements for use of the RAI that appear at § 483.20. (e) Minimum data set (MDS...) Specify to a facility the method of transmission of data, and instruct the facility on this method. (3...

42 CFR 483.315 - Specification of resident assessment instrument.

Code of Federal Regulations, 2011 CFR

2011-10-01

... updated periodically, and consists of the following: (1) The minimum data set (MDS) and common definitions... specified by CMS. (4) The requirements for use of the RAI that appear at § 483.20. (e) Minimum data set (MDS...) Specify to a facility the method of transmission of data, and instruct the facility on this method. (3...

Development of the psychometric property of a Minimum Data-Set-Based Depression Rating Scale for use in long-term care facilities in Taiwan.

PubMed

Hsiao, C Y; Lan, C F; Chang, P L; Li, I C

2015-01-01

Our aim is to develop the psychometric property of the Minimum Data-Set-Based Depression Rating Scale (MDS-DRS) to ensure its use to assess service needs and guide care plans for institutionalized residents. 378 residents were recruited from the Haoran Senior Citizen Home in northern Taiwan. The MDS-DRS and GDS-SF were used to identify observable features of depression symptoms in the elderly residents. A total of 378 residents participated in this study. The receiver operating characteristic (ROC) curve indicated that the MDS-DRS has a 43.3% sensitivity and a 90.6% specificity when screening for depression symptoms. The total variance, explained by the two factors 'sadness' and 'distress,' was 58.1% based on the factor analysis. Reliable assessment tools for nurses are important because they allow the early detection of depression symptoms. The MDS-DRS items perform as well as the GDS-SF items in detecting depression symptoms. Furthermore, the MDS-DRS has the advantage of providing information to staff about care process implementation, which can facilitate the identification of areas that need improvement. Further research is needed to validate the use of the MDS-DRS in long-term care facilities.

Quality of physical resources of health facilities in Indonesia: a panel study 1993-2007.

PubMed

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.

Reproductive health services for Syrian refugees in Zaatri Camp and Irbid City, Hashemite Kingdom of Jordan: an evaluation of the Minimum Initial Services Package.

PubMed

Krause, Sandra; Williams, Holly; Onyango, Monica A; Sami, Samira; Doedens, Wilma; Giga, Noreen; Stone, Erin; Tomczyk, Barbara

2015-01-01

The Minimum Initial Services Package (MISP) for reproductive health, a standard of care in humanitarian emergencies, is a coordinated set of priority activities developed to prevent excess morbidity and mortality, particularly among women and girls, which should be implemented at the onset of an emergency. The purpose of the evaluation was to determine the status of MISP implementation for Syrian refugees in Jordan as part of a global evaluation of reproductive health in crises. In March 2013, applying a formative evaluation approach 11 key informant interviews, 13 health facility assessments, and focus group discussions (14 groups; 159 participants) were conducted in two Syrian refugee sites in Jordan, Zaatri Camp, and Irbid City, respectively. Information was coded, themes were identified, and relationships between data explored. Lead health agencies addressed the MISP by securing funding and supplies and establishing reproductive health focal points, services and coordination mechanisms. However, Irbid City was less likely to be included in coordination activities and health facilities reported challenges in human resource capacity. Access to clinical management of rape survivors was limited, and both women and service provider's knowledge about availability of these services was low. Activities to reduce the transmission of HIV and to prevent excess maternal and newborn morbidity and mortality were available, although some interventions needed strengthening. Some planning for comprehensive reproductive health services, including health indicator collection, was delayed. Contraceptives were available to meet demand. Syndromic treatment of sexually transmitted infections and antiretrovirals for continuing users were not available. In general refugee women and adolescent girls perceived clinical services negatively and complained about the lack of basic necessities. MISP services and key elements to support implementation were largely in place. Pre-existing Jordanian health infrastructure, prior MISP trainings, dedicated leadership and available funding and supplies facilitated MISP implementation. The lack of a national protocol on clinical management of rape survivors hindered provision of these services, while communities' lack of information about the health benefits of the services as well as perceived cultural repercussions likely contributed to no recent service uptake from survivors. This information can inform MISP programming in this setting.

Meeting the challenges of bringing a new base facility operation model to Gemini Observatory

NASA Astrophysics Data System (ADS)

Nitta, Atsuko; Arriagada, Gustavo; Adamson, A. J.; Cordova, Martin; Nunez, Arturo; Serio, Andrew; Kleinman, Scot

2016-08-01

The aim of the Gemini Observatory's Base Facilities Project is to provide the capabilities to perform routine night time operations with both telescopes and their instruments from their respective base facilities without anyone present at the summit. Tightening budget constraints prompted this project as both a means to save money and an opportunity to move toward increasing remote operations in the future. We successfully moved Gemini North nighttime operation to our base facility in Hawaii in Nov., 2015. This is the first 8mclass telescope to completely move night time operations to base facility. We are currently working on implementing BFO to Gemini South. Key challenges for this project include: (1) This is a schedule driven project. We have to implement the new capabilities by the end of 2015 for Gemini North and end of 2016 for Gemini South. (2) The resources are limited and shared with operations which has the higher priority than our project. (3) Managing parallel work within the project. (4) Testing, commissioning and introducing new tools to operational systems without adding significant disruptions to nightly operations. (5) Staff buying to the new operational model. (6) The staff involved in the project are spread on two locations separated by 10,000km, seven time zones away from each other. To overcome these challenges, we applied two principles: "Bare Minimum" and "Gradual Descent". As a result, we successfully completed the project ahead of schedule at Gemini North Telescope. I will discuss how we managed the cultural and human aspects of the project through these concepts. The other management aspects will be presented by Gustavo Arriagada [2], the Project Manager of this project. For technical details, please see presentations from Andrew Serio [3] and Martin Cordova [4].

Walla Walla River Fish Passage Operations Program, 2000-2001 Annual Report.

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

Zimmerman, Brian C.; Duke, Bill B.

2004-02-01

In the late 1990's, the Confederated Tribes of the Umatilla Indian Reservation, Oregon Department of Fish and Wildlife, and Washington Department of Fish and Wildlife, along with many other agencies, began implementing fisheries restoration activities in the Walla Walla Basin. An integral part of these efforts is to alleviate the inadequate migration conditions in the basin. The migration concerns are being addressed by removing diversion structures, constructing fish passage facilities, implementing minimum instream flow measures, and initiating trap and haul efforts. The objective of the Walla Walla River Fish Passage Operations Project is to increase the survival of migrating adultmore » and juvenile salmonids in the basin. The project is responsible for coordinating operation and maintenance of ladders, screen sites, bypasses, trap facilities, and transportation equipment. In addition, the project provides technical input on passage criteria and passage and trapping facility design and operation. Operation of the various passage facilities and passage criteria guidelines are outlined in an annual operations plan that the project develops. During the 2000-2001 project year, there were 624 summer steelhead (Oncorhynchus mykiss), 24 bull trout (Salvelinus confluentus), and 47 spring chinook (O. tshawytscha) counted at the Nursery Bridge Dam adult trap between December 27, 2000 and June 7, 2001. The Little Walla Walla River juvenile trap was not operated this year. The project transported 1600 adult spring chinook from Ringold Springs Hatchery to the South Fork Walla Walla Brood Holding Facility and outplanted 1156 for natural spawning in the basin. The project also provided equipment for transportation of juveniles captured during the construction fish salvage at Nursery Bridge Dam.« less

14 CFR 171.201 - Scope.

Code of Federal Regulations, 2010 CFR

2010-01-01

... FACILITIES NON-FEDERAL NAVIGATION FACILITIES VHF Marker Beacons § 171.201 Scope. (a) This subpart sets forth minimum requirements for the approval and operation of non-Federal VHF marker beacon facilities that are...

Analysis of Biomass Feedstock Availability and Variability for the Peace River Region of Alberta, Canada

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

Stephen, Jamie; Sokhansanj, Shahabaddine; Bi, X.T.

2009-11-01

Biorefineries or other biomass-dependent facilities require a predictable, dependable feedstock supplied over many years to justify capital investments. Determining inter-year variability in biomass availability is essential to quantifying the feedstock supply risk. Using a geographic information system (GIS) and historic crop yield data, average production was estimated for 10 sites in the Peace River region of Alberta, Canada. Four high-yielding potential sites were investigated for variability over a 20 year time-frame (1980 2000). The range of availability was large, from double the average in maximum years to nothing in minimum years. Biomass availability is a function of grain yield, themore » biomass to grain ratio, the cropping frequency, and residue retention rate to ensure future crop productivity. Storage strategies must be implemented and alternate feedstock sources identified to supply biomass processing facilities in low-yield years.« less

Facilities Guidelines. North Carolina Public Schools.

ERIC Educational Resources Information Center

North Carolina State Dept. of Public Instruction, Raleigh.

The 1986 North Carolina Public School Facilities Standards were legislated in 1996 to become Facility Guidelines. A Public School Facilities Task Force was appointed to review and make revisions. These 1997 guidelines define and describe minimum facilities to ensure educational program appropriateness and long-term cost efficiency. They were…

The Association Between Residential Care Facility Manager's Educational Attainment and the Presence of Structural and Service Innovations.

PubMed

Davis, Jullet A

For many service-oriented firms, knowledge is a key commodity, and the process by which knowledge is codified is critical for firm survival. The administrator or top manager acts as the repository and disseminator of organizational knowledge. The purpose of this project is to examine the association between the administrator's educational attainment and innovation in residential care facilities. The study hypothesized that administrator academic education and certification or licensure would be positively associated with facility innovation. Data for this project comes from the 2010 National Survey of Residential Care Facilities. There were 2277 facilities included in the sample (weighted 30 811). Innovation, the dependent variable, was operationalized using 5 dichotomized measures: clinical information systems, pharmaceutical information systems, electronic health records, providing adult day care, and providing respite care. The data were analyzed using logistic regression. Overall, the results reveal that college education or certification/licensure increased the likelihood of technology use. In addition, those with a high school diploma and certification/licensure were more likely to use technology than were individuals who had, at a minimum, some college. The services models were not significant. It may be that the resources necessary to implement information systems vary substantially from the resources necessary to provide services.

30 CFR 75.1712-3 - Minimum requirements of surface bathing facilities, change rooms, and sanitary toilet facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

...-1 shall include the following: (1) Bathing facilities. (i) Showers shall be provided with both hot... supply of toilet paper shall be provided with each toilet. (v) Adequate handwashing facilities or hand...

30 CFR 75.1712-3 - Minimum requirements of surface bathing facilities, change rooms, and sanitary toilet facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

...-1 shall include the following: (1) Bathing facilities. (i) Showers shall be provided with both hot... supply of toilet paper shall be provided with each toilet. (v) Adequate handwashing facilities or hand...

30 CFR 75.1712-3 - Minimum requirements of surface bathing facilities, change rooms, and sanitary toilet facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

...-1 shall include the following: (1) Bathing facilities. (i) Showers shall be provided with both hot... supply of toilet paper shall be provided with each toilet. (v) Adequate handwashing facilities or hand...

30 CFR 75.1712-3 - Minimum requirements of surface bathing facilities, change rooms, and sanitary toilet facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

...-1 shall include the following: (1) Bathing facilities. (i) Showers shall be provided with both hot... supply of toilet paper shall be provided with each toilet. (v) Adequate handwashing facilities or hand...

30 CFR 75.1712-3 - Minimum requirements of surface bathing facilities, change rooms, and sanitary toilet facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

...-1 shall include the following: (1) Bathing facilities. (i) Showers shall be provided with both hot... supply of toilet paper shall be provided with each toilet. (v) Adequate handwashing facilities or hand...

SETS. Set Equation Transformation System

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

Worrell, R.B.

1992-01-13

SETS is used for symbolic manipulation of Boolean equations, particularly the reduction of equations by the application of Boolean identities. It is a flexible and efficient tool for performing probabilistic risk analysis (PRA), vital area analysis, and common cause analysis. The equation manipulation capabilities of SETS can also be used to analyze noncoherent fault trees and determine prime implicants of Boolean functions, to verify circuit design implementation, to determine minimum cost fire protection requirements for nuclear reactor plants, to obtain solutions to combinatorial optimization problems with Boolean constraints, and to determine the susceptibility of a facility to unauthorized access throughmore » nullification of sensors in its protection system.« less

Far-ultraviolet refractive index of optical materials for solar blind channel (SBC) filters for the HST advanced camera for surveys (ACS)

NASA Astrophysics Data System (ADS)

Leviton, Douglas B.; Madison, Timothy J.; Petrone, Peter

1998-10-01

Refractive index measurements using the minimum deviation method have been carried out for prisms of a variety of far ultraviolet optical materials used in the manufacture of Solar Blind Channel (SBC) filters for the HST Advanced Camera for Surveys (ACS). Some of the materials measured are gaining popularity in a variety of high technology applications including high power excimer lasers and advanced microlithography optics operating in a wavelength region where high quality knowledge of optical material properties is sparse yet critical. Our measurements are of unusually high accuracy and precision for this wavelength region owing to advanced instrumentation in the large vacuum chamber of the Diffraction Grating Evaluation Facility (DGEF) at Goddard Space Flight Center (GSFC) used to implement a minimum deviation method refractometer. Index values for CaF2, BaF2, LiF, and far ultraviolet grades of synthetic sapphire and synthetic fused silica are reported and compared with values from the literature.

24 CFR 232.535 - Loan multiples-minimum principal.

Code of Federal Regulations, 2011 CFR

2011-04-01

... AUTHORITIES MORTGAGE INSURANCE FOR NURSING HOMES, INTERMEDIATE CARE FACILITIES, BOARD AND CARE HOMES, AND... of Fire Safety Equipment Eligible Security Instruments § 232.535 Loan multiples—minimum principal...

An Object-Oriented Collection of Minimum Degree Algorithms: Design, Implementation, and Experiences

NASA Technical Reports Server (NTRS)

Kumfert, Gary; Pothen, Alex

1999-01-01

The multiple minimum degree (MMD) algorithm and its variants have enjoyed 20+ years of research and progress in generating fill-reducing orderings for sparse, symmetric positive definite matrices. Although conceptually simple, efficient implementations of these algorithms are deceptively complex and highly specialized. In this case study, we present an object-oriented library that implements several recent minimum degree-like algorithms. We discuss how object-oriented design forces us to decompose these algorithms in a different manner than earlier codes and demonstrate how this impacts the flexibility and efficiency of our C++ implementation. We compare the performance of our code against other implementations in C or Fortran.

24 CFR 232.586 - Minimum principal loan amount.

Code of Federal Regulations, 2011 CFR

2011-04-01

... AUTHORITIES MORTGAGE INSURANCE FOR NURSING HOMES, INTERMEDIATE CARE FACILITIES, BOARD AND CARE HOMES, AND... of Fire Safety Equipment Eligible Security Instruments § 232.586 Minimum principal loan amount. A...

Ant colony optimization for solving university facility layout problem

NASA Astrophysics Data System (ADS)

Mohd Jani, Nurul Hafiza; Mohd Radzi, Nor Haizan; Ngadiman, Mohd Salihin

2013-04-01

Quadratic Assignment Problems (QAP) is classified as the NP hard problem. It has been used to model a lot of problem in several areas such as operational research, combinatorial data analysis and also parallel and distributed computing, optimization problem such as graph portioning and Travel Salesman Problem (TSP). In the literature, researcher use exact algorithm, heuristics algorithm and metaheuristic approaches to solve QAP problem. QAP is largely applied in facility layout problem (FLP). In this paper we used QAP to model university facility layout problem. There are 8 facilities that need to be assigned to 8 locations. Hence we have modeled a QAP problem with n ≤ 10 and developed an Ant Colony Optimization (ACO) algorithm to solve the university facility layout problem. The objective is to assign n facilities to n locations such that the minimum product of flows and distances is obtained. Flow is the movement from one to another facility, whereas distance is the distance between one locations of a facility to other facilities locations. The objective of the QAP is to obtain minimum total walking (flow) of lecturers from one destination to another (distance).

Facilities maintenance handbook

NASA Technical Reports Server (NTRS)

1991-01-01

This handbook is a guide for facilities maintenance managers. Its objective is to set minimum facilities maintenance standards. It also provides recommendations on how to meet the standards to ensure that NASA maintains its facilities in a manner that protects and preserves its investment in the facilities in a cost-effective manner while safely and efficiently performing its mission. This handbook implements NMI 8831.1, which states NASA facilities maintenance policy and assigns organizational responsibilities for the management of facilities maintenance activities on all properties under NASA jurisdiction. It is a reference for facilities maintenance managers, not a step-by-step procedural manual. Because of the differences in NASA Field Installation organizations, this handbook does not assume or recommend a typical facilities maintenance organization. Instead, it uses a systems approach to describe the functions that should be included in any facilities maintenance management system, regardless of its organizational structure. For documents referenced in the handbook, the most recent version of the documents is applicable. This handbook is divided into three parts: Part 1 specifies common definitions and facilities maintenance requirements and amplifies the policy requirements contained in NMI 8831. 1; Part 2 provides guidance on how to meet the requirements of Part 1, containing recommendations only; Part 3 contains general facilities maintenance information. One objective of this handbook is to fix commonality of facilities maintenance definitions among the Centers. This will permit the application of uniform measures of facilities conditions, of the relationship between current replacement value and maintenance resources required, and of the backlog of deferred facilities maintenance. The utilization of facilities maintenance system functions will allow the Centers to quantitatively define maintenance objectives in common terms, prepare work plans, and develop management information in order to statistically identify and analyze variances from those plans. It will also add credibility to the NASA facilities maintenance budgeting process. The key to a successful maintenance program is the understanding and support of the senior Center managers.

30 CFR 716.3 - Mountaintop removal.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., agricultural, residential, or public facility (including recreational facilities) use is proposed for the..., except where engineering data substantiates and the regulatory authority finds that a minimum static...

30 CFR 716.3 - Mountaintop removal.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., agricultural, residential, or public facility (including recreational facilities) use is proposed for the..., except where engineering data substantiates and the regulatory authority finds that a minimum static...

30 CFR 716.3 - Mountaintop removal.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., agricultural, residential, or public facility (including recreational facilities) use is proposed for the..., except where engineering data substantiates and the regulatory authority finds that a minimum static...

25 CFR 170.506 - What are the minimum qualifications for certified bridge inspectors?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false What are the minimum qualifications for certified bridge... Program Facilities Bridge Inspection § 170.506 What are the minimum qualifications for certified bridge inspectors? The person responsible for the bridge inspection team must meet the qualifications for bridge...

The status of medical laboratory towards of AFRO-WHO accreditation process in government and private health facilities in Addis Ababa, Ethiopia

PubMed Central

Mesfin, Eyob Abera; Taye, Bineyam; Belay, Getachew; Ashenafi, Aytenew

2015-01-01

Introduction The World Health Organization Regional Office for Africa (WHO AFRO) introduces a step wise incremental accreditation approach to improving quality of laboratory and it is a new initiative in Ethiopia and activities are performed for implementation of accreditation program. Methods Descriptive cross sectional study was conducted in 30 laboratory facilities including 6 laboratory sections to determine their status towards of accreditation using WHO AFRO accreditation checklist and 213 laboratory professionals were interviewed to assess their knowledge on quality system essentials and accreditation in Addis Ababa Ethiopia. Results Out of 30 laboratory facilities 1 private laboratory scored 156 (62%) points, which is the minimum required point for WHO accreditation and the least score was 32 (12.8%) points from government laboratory. The assessment finding from each section indicate that 2 Clinical chemistry (55.2% & 62.8%), 2 Hematology (55.2% & 62.8%), 2 Serology (55.2% & 62.8%), 2 Microbiology (55.2% & 62.4%), 1 Parasitology (62.8%) & 1 Urinalysis (61.6%) sections scored the minimum required point for WHO accreditation. The average score for government laboratories was 78.2 (31.2%) points, of these 6 laboratories were under accreditation process with 106.2 (42.5%) average score, while the private laboratories had 71.2 (28.5%) average score. Of 213 respondents 197 (92.5%) professionals had a knowledge on quality system essentials whereas 155 (72.8%) respondents on accreditation. Conclusion Although majority of the laboratory professionals had knowledge on quality system and accreditation, laboratories professionals were not able to practice the quality system properly and most of the laboratories had poor status towards the WHO accreditation process. Thus government as well as stakeholders should integrate accreditation program into planning and health policy. PMID:26889317

The status of medical laboratory towards of AFRO-WHO accreditation process in government and private health facilities in Addis Ababa, Ethiopia.

PubMed

Mesfin, Eyob Abera; Taye, Bineyam; Belay, Getachew; Ashenafi, Aytenew

2015-01-01

The World Health Organization Regional Office for Africa (WHO AFRO) introduces a step wise incremental accreditation approach to improving quality of laboratory and it is a new initiative in Ethiopia and activities are performed for implementation of accreditation program. Descriptive cross sectional study was conducted in 30 laboratory facilities including 6 laboratory sections to determine their status towards of accreditation using WHO AFRO accreditation checklist and 213 laboratory professionals were interviewed to assess their knowledge on quality system essentials and accreditation in Addis Ababa Ethiopia. Out of 30 laboratory facilities 1 private laboratory scored 156 (62%) points, which is the minimum required point for WHO accreditation and the least score was 32 (12.8%) points from government laboratory. The assessment finding from each section indicate that 2 Clinical chemistry (55.2% & 62.8%), 2 Hematology (55.2% & 62.8%), 2 Serology (55.2% & 62.8%), 2 Microbiology (55.2% & 62.4%), 1 Parasitology (62.8%) & 1 Urinalysis (61.6%) sections scored the minimum required point for WHO accreditation. The average score for government laboratories was 78.2 (31.2%) points, of these 6 laboratories were under accreditation process with 106.2 (42.5%) average score, while the private laboratories had 71.2 (28.5%) average score. Of 213 respondents 197 (92.5%) professionals had a knowledge on quality system essentials whereas 155 (72.8%) respondents on accreditation. Although majority of the laboratory professionals had knowledge on quality system and accreditation, laboratories professionals were not able to practice the quality system properly and most of the laboratories had poor status towards the WHO accreditation process. Thus government as well as stakeholders should integrate accreditation program into planning and health policy.

Reproductive health services for Syrian refugees in Zaatri Camp and Irbid City, Hashemite Kingdom of Jordan: an evaluation of the Minimum Initial Services Package

PubMed Central

2015-01-01

Background The Minimum Initial Services Package (MISP) for reproductive health, a standard of care in humanitarian emergencies, is a coordinated set of priority activities developed to prevent excess morbidity and mortality, particularly among women and girls, which should be implemented at the onset of an emergency. The purpose of the evaluation was to determine the status of MISP implementation for Syrian refugees in Jordan as part of a global evaluation of reproductive health in crises. Methods In March 2013, applying a formative evaluation approach 11 key informant interviews, 13 health facility assessments, and focus group discussions (14 groups; 159 participants) were conducted in two Syrian refugee sites in Jordan, Zaatri Camp, and Irbid City, respectively. Information was coded, themes were identified, and relationships between data explored. Results Lead health agencies addressed the MISP by securing funding and supplies and establishing reproductive health focal points, services and coordination mechanisms. However, Irbid City was less likely to be included in coordination activities and health facilities reported challenges in human resource capacity. Access to clinical management of rape survivors was limited, and both women and service provider’s knowledge about availability of these services was low. Activities to reduce the transmission of HIV and to prevent excess maternal and newborn morbidity and mortality were available, although some interventions needed strengthening. Some planning for comprehensive reproductive health services, including health indicator collection, was delayed. Contraceptives were available to meet demand. Syndromic treatment of sexually transmitted infections and antiretrovirals for continuing users were not available. In general refugee women and adolescent girls perceived clinical services negatively and complained about the lack of basic necessities. Conclusions MISP services and key elements to support implementation were largely in place. Pre-existing Jordanian health infrastructure, prior MISP trainings, dedicated leadership and available funding and supplies facilitated MISP implementation. The lack of a national protocol on clinical management of rape survivors hindered provision of these services, while communities’ lack of information about the health benefits of the services as well as perceived cultural repercussions likely contributed to no recent service uptake from survivors. This information can inform MISP programming in this setting. PMID:25798190

A minimum data set of water quality parameters to assess and compare treatment efficiency of stormwater facilities.

PubMed

Ingvertsen, Simon Toft; Jensen, Marina Bergen; Magid, Jakob

2011-01-01

Urban stormwater runoff is often of poor quality, impacting aquatic ecosystems and limiting the use of stormwater runoff for recreational purposes. Several stormwater treatment facilities (STFs) are in operation or at the pilot testing stage, but their efficiencies are neither well documented nor easily compared due to the complex contaminant profile of stormwater and the highly variable runoff hydrograph. On the basis of a review of available data sets on urban stormwater quality and environmental contaminant behavior, we suggest a few carefully selected contaminant parameters (the minimum data set) to be obligatory when assessing and comparing the efficiency of STFs. Consistent use of the minimum data set in all future monitoring schemes for STFs will ensure broad-spectrum testing at low costs and strengthen comparability among facilities. The proposed minimum data set includes: (i) fine fraction of suspended solids (<63 μm), (ii) total concentrations of zinc and copper, (iii) total concentrations of phenanthrene, fluoranthene, and benzo(b,k)fluoranthene, and (iv) total concentrations of phosphorus and nitrogen. Indicator pathogens and other specific contaminants (i.e., chromium, pesticides, phenols) may be added if recreational or certain catchment-scale objectives are to be met. Issues that need further investigation have been identified during the iterative process of developing the minimum data set. by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

Walla Walla River Fish Passage Operations Program, 2004-2005 Annual Report.

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

Bronson, James P.; Duke, Bill B.

2006-02-01

In the late 1990s, the Confederated Tribes of the Umatilla Indian Reservation, Oregon Department of Fish and Wildlife, and Washington Department of Fish and Wildlife, along with many other agencies, began implementing fisheries restoration activities in the Walla Walla Basin. An integral part of these efforts is to alleviate the inadequate fish migration conditions in the basin. The migration concerns are being addressed by removing diversion structures, constructing fish passage facilities, implementing minimum instream flow requirements, and providing trap and haul efforts when needed. The objective of the Walla Walla River Fish Passage Operations Project is to increase the survivalmore » of migrating adult and juvenile salmonids in the Walla Walla River basin. The project is responsible for coordinating operation and maintenance of ladders, screen sites, bypasses, trap facilities, and transportation equipment. In addition, the project provides technical input on passage criteria and passage and trapping facility design and operation. Operation of the various passage facilities and passage criteria guidelines are outlined in an annual operations plan that the project develops. During the 2004-2005 project year, there were 590 adult summer steelhead, 31 summer steelhead kelts (Oncorhynchus mykiss), 70 adult bull trout (Salvelinus confluentus); 80 adult and 1 jack spring Chinook (O. tshawytscha) enumerated at the Nursery Bridge Dam fishway video counting window between December 13, 2004, and June 16, 2005. Summer steelhead and spring chinook were observed moving upstream while bull trout were observed moving both upstream and downstream of the facility. In addition, the old ladder trap was operated by ODFW in order to enumerate fish passage. Of the total, 143 adult summer steelhead and 15 summer steelhead kelts were enumerated at the west ladder at Nursery Bridge Dam during the video efforts between February 4 and May 23, 2005. Operation of the Little Walla Walla River juvenile trap for trap and haul purposes was not necessary this year.« less

7 CFR 58.406 - Starter facility.

Code of Federal Regulations, 2010 CFR

2010-01-01

... precaution shall be taken to prevent contamination of the facility, equipment and the air therein. A filtered air supply with a minimum average efficiency of 90 percent when tested in accordance with the ASHRAE....406 Starter facility. A separate starter room or properly designed starter tanks and satisfactory air...

42 CFR 483.20 - Resident assessment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... additional assessment performed on the care areas triggered by the completion of the Minimum Data Set (MDS.... (f) Automated data processing requirement—(1) Encoding data. Within 7 days after a facility completes...) Transmitting data. Within 7 days after a facility completes a resident's assessment, a facility must be capable...

42 CFR 483.20 - Resident assessment.

Code of Federal Regulations, 2012 CFR

2012-10-01

... additional assessment performed on the care areas triggered by the completion of the Minimum Data Set (MDS.... (f) Automated data processing requirement—(1) Encoding data. Within 7 days after a facility completes...) Transmitting data. Within 7 days after a facility completes a resident's assessment, a facility must be capable...

42 CFR 483.20 - Resident assessment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... additional assessment performed on the care areas triggered by the completion of the Minimum Data Set (MDS.... (f) Automated data processing requirement—(1) Encoding data. Within 7 days after a facility completes...) Transmitting data. Within 7 days after a facility completes a resident's assessment, a facility must be capable...

42 CFR 483.20 - Resident assessment.

Code of Federal Regulations, 2013 CFR

2013-10-01

... additional assessment performed on the care areas triggered by the completion of the Minimum Data Set (MDS.... (f) Automated data processing requirement—(1) Encoding data. Within 7 days after a facility completes...) Transmitting data. Within 7 days after a facility completes a resident's assessment, a facility must be capable...

42 CFR 483.20 - Resident assessment.

Code of Federal Regulations, 2014 CFR

2014-10-01

... additional assessment performed on the care areas triggered by the completion of the Minimum Data Set (MDS.... (f) Automated data processing requirement—(1) Encoding data. Within 7 days after a facility completes...) Transmitting data. Within 7 days after a facility completes a resident's assessment, a facility must be capable...

Work plan for the Isotopes Facilities Deactivation Project at Oak Ridge National Laboratory, Oak Ridge, Tennessee

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

NONE

1995-08-01

The purpose of the Isotopes Facilities Deactivation Project (IFDP) is to place former isotopes production facilities at the Oak Ridge National Laboratory in a safe, stable, and environmentally sound condition; suitable for an extended period of minimum surveillance and maintenance (S and M) and as quickly and economical as possible. Implementation and completion of the deactivation project will further reduce the risks to the environment and to public safety and health. Furthermore, completion of the project will result in significant S and M cost savings in future years. The IFDP work plan defines the project schedule, the cost estimate, andmore » the technical approach for the project. A companion document, the EFDP management plan, has been prepared to document the project objectives, define organizational relationships and responsibilities, and outline the management control systems to be employed in the management of the project. The project has adopted the strategy of deactivating the simple facilities first, to reduce the scope of the project and to gain experience before addressing more difficult facilities. A decision support system is being developed to identify the activities that best promote the project mission and result in the largest cost savings. This work plan will be reviewed and revised annually. Deactivation of EFDP Facilities was initiated in FY 1994 and will be completed in FY 2000. The schedule for deactivation of facilities is shown. The total cost of the project is estimated to be $51M. The costs are summarized. Upon completion of deactivation, annual S and M costs of these facilities will be reduced from the current level of $5M per year to less than $1M per year.« less

[Physical medicine in hospital. Minimum standards in a physical medical department in acute inpatient areas in rheumatology].

PubMed

Reißhauer, A; Liebl, M E

2012-07-01

Standards for what should be available in terms of equipment and services in a department of physical medicine caring for acute inpatients do not exist in Germany. The profile of a department determines the therapeutic services it focuses on and hence the technical facilities required. The German catalogue of operations and procedures defines minimum thresholds for treatment. In the opinion of the authors a department caring for inpatients with acute rheumatic diseases must, as a minimum, have the facilities and equipment necessary for offering thermotherapeutic treatment. Staff trained in physical therapeutic procedures and occupational therapy is also crucial. Moreover, it is desirable that the staff should be trained in manual therapy.

28 CFR 115.313 - Supervision and monitoring.

Code of Federal Regulations, 2014 CFR

2014-07-01

... from internal or external oversight bodies; (5) All components of the facility's physical plant... juvenile facility shall maintain staff ratios of a minimum of 1:8 during resident waking hours and 1:16... fully documented. Only security staff shall be included in these ratios. Any facility that, as of the...

28 CFR 115.313 - Supervision and monitoring.

Code of Federal Regulations, 2012 CFR

2012-07-01

... from internal or external oversight bodies; (5) All components of the facility's physical plant... juvenile facility shall maintain staff ratios of a minimum of 1:8 during resident waking hours and 1:16... fully documented. Only security staff shall be included in these ratios. Any facility that, as of the...

28 CFR 115.313 - Supervision and monitoring.

Code of Federal Regulations, 2013 CFR

2013-07-01

... from internal or external oversight bodies; (5) All components of the facility's physical plant... juvenile facility shall maintain staff ratios of a minimum of 1:8 during resident waking hours and 1:16... fully documented. Only security staff shall be included in these ratios. Any facility that, as of the...

77 FR 50014 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-20

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed.... Intl. 20-Sep-12 TX Houston Sugar Land Rgnl.... 2/8058 7/19/12 TAKEOFF MINIMUMS AND (OBSTACLE) DP, Amdt...

A Longitudinal Assessment of the Effect of Resident-Centered Care on Quality in Veterans Health Administration Community Living Centers.

PubMed

Sullivan, Jennifer L; Shwartz, Michael; Stolzmann, Kelly; Afable, Melissa K; Burgess, James F

2018-06-01

To examine whether changes in resident-centered care (RCC) over time were associated with changes in quality. Data sources were the Minimum Dataset quality indicators (which consist of measures of both prevalence and incidence of adverse events) and the Artifacts of Culture Change Tool (which measures RCC; FYs 2009-2012) from 130 Veterans Health Administration community living centers. A retrospective longitudinal study. Data were from VA secondary data sources. The overall relationship between RCC and quality was not statistically significant (p = .22), although there was a weakly significant negative relationship (i.e., increased RCC was associated with poorer quality) in the seven quarters after implementation of an automated version of the Artifacts Tool (p = .08). In facility-specific analyses, there were 15 facilities with a weakly significant (p < .10) positive relationship between RCC and quality and 21 with a weakly significant negative relationship. Adjusted cost per patient day was over 50 percent higher in the 21 facilities with a negative relationship than in the 15 facilities with a positive relationship (p < .05). The Artifacts score is a formal performance metric in the VA, and thus, facilities were explicitly incentivized to increase RCC. Using qualitative methods to identify characteristics that distinguished those facilities able to increase both RCC and quality from those that suffered declines in quality as RCC was improved is an important follow-up to this study. © Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

Walla Walla River Fish Passage Operations Program, 2003-2004 Annual Report.

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

Bronson, James P.

2004-12-01

In the late 1990s, the Confederated Tribes of the Umatilla Indian Reservation, Oregon Department of Fish and Wildlife, and Washington Department of Fish and Wildlife, along with many other agencies, began implementing fisheries restoration activities in the Walla Walla Basin. An integral part of these efforts is to alleviate the inadequate fish migration conditions in the basin. The migration concerns are being addressed by removing diversion structures, constructing fish passage facilities, implementing minimum instream flow requirements, and providing trap and haul efforts when needed. The objective of the Walla Walla River Fish Passage Operations Project is to increase the survivalmore » of migrating adult and juvenile salmonids in the Walla Walla River basin. The project is responsible for coordinating operation and maintenance of ladders, screen sites, bypasses, trap facilities, and transportation equipment. In addition, the project provides technical input on passage criteria and passage and trapping facility design and operation. Operation of the various passage facilities and passage criteria guidelines are outlined in an annual operations plan that the project develops. During the 2003-2004 project year, there were 379 adult summer steelhead (Oncorhynchus mykiss), 36 adult bull trout (Salvelinus confluentus); 108 adult and 3 jack spring chinook (O. tshawytscha) enumerated at the Nursery Bridge Dam fishway video counting window between December 21, 2003, and June 30, 2004. Summer steelhead and spring chinook were observed moving upstream while bull trout were observed moving both upstream and downstream of the facility. In addition, the old ladder trap was operated by the WWBNPME project in order to radio tag spring chinook adults. A total of 2 adult summer steelhead, 4 bull trout, and 23 adult spring chinook were enumerated at the west ladder at Nursery Bridge Dam during the trapping operations between May 6 and May 23, 2004. Operation of the Little Walla Walla River juvenile trap for trap and haul purposes was not necessary this year. The project transported adult spring chinook from Threemile Dam to the South Fork Walla Walla Brood Holding Facility. A total of 239 spring chinook were outplanted in August for natural spawning in the basin.« less

Facilities Standards and Planning Manual for New Jersey County Community Colleges.

ERIC Educational Resources Information Center

New Jersey State Dept. of Higher Education, Trenton. Office of Community Coll. Programs.

After some general comments concerning all guidelines, planning standards are described for--(1) various types of new facilities, (2) expansion of present facilities, (3) minimum space requirements for a college, (4) net-to-gross space ratios, and (5) total project costs. Information regarding capital construction project submissions procedure is…

PRagmatic trial Of Video Education in Nursing homes: The design and rationale for a pragmatic cluster randomized trial in the nursing home setting.

PubMed

Mor, Vincent; Volandes, Angelo E; Gutman, Roee; Gatsonis, Constantine; Mitchell, Susan L

2017-04-01

Background/Aims Nursing homes are complex healthcare systems serving an increasingly sick population. Nursing homes must engage patients in advance care planning, but do so inconsistently. Video decision support tools improved advance care planning in small randomized controlled trials. Pragmatic trials are increasingly employed in health services research, although not commonly in the nursing home setting to which they are well-suited. This report presents the design and rationale for a pragmatic cluster randomized controlled trial that evaluated the "real world" application of an Advance Care Planning Video Program in two large US nursing home healthcare systems. Methods PRagmatic trial Of Video Education in Nursing homes was conducted in 360 nursing homes (N = 119 intervention/N = 241 control) owned by two healthcare systems. Over an 18-month implementation period, intervention facilities were instructed to offer the Advance Care Planning Video Program to all patients. Control facilities employed usual advance care planning practices. Patient characteristics and outcomes were ascertained from Medicare Claims, Minimum Data Set assessments, and facility electronic medical record data. Intervention adherence was measured using a Video Status Report embedded into electronic medical record systems. The primary outcome was the number of hospitalizations/person-day alive among long-stay patients with advanced dementia or cardiopulmonary disease. The rationale for the approaches to facility randomization and recruitment, intervention implementation, population selection, data acquisition, regulatory issues, and statistical analyses are discussed. Results The large number of well-characterized candidate facilities enabled several unique design features including stratification on historical hospitalization rates, randomization prior to recruitment, and 2:1 control to intervention facilities ratio. Strong endorsement from corporate leadership made randomization prior to recruitment feasible with 100% participation of facilities randomized to the intervention arm. Critical regulatory issues included minimal risk determination, waiver of informed consent, and determination that nursing home providers were not engaged in human subjects research. Intervention training and implementation were initiated on 5 January 2016 using corporate infrastructures for new program roll-out guided by standardized training elements designed by the research team. Video Status Reports in facilities' electronic medical records permitted "real-time" adherence monitoring and corrective actions. The Centers for Medicare and Medicaid Services Virtual Research Data Center allowed for rapid outcomes ascertainment. Conclusion We must rigorously evaluate interventions to deliver more patient-focused care to an increasingly frail nursing home population. Video decision support is a practical approach to improve advance care planning. PRagmatic trial Of Video Education in Nursing homes has the potential to promote goal-directed care among millions of older Americans in nursing homes and establish a methodology for future pragmatic randomized controlled trials in this complex healthcare setting.

A First Look at PCMH Implementation for Minority Veterans: Room for Improvement.

PubMed

Hernandez, Susan E; Taylor, Leslie; Grembowski, David; Reid, Robert J; Wong, Edwin; Nelson, Karin M; Liu, Chuan-Fen; Fihn, Stephan D; Hebert, Paul L

2016-03-01

Implementation of Patient Aligned Care Teams (PACT), a patient-centered medical home model, has been inconsistent among the >900 primary care facilities in the Veterans Health Administration. Estimate if the degree of PACT implementation at a facility varied with the percentage of minority veteran patients at the facility. Cross-sectional, facility-level analysis of PACT implementation measures in 2012. Veterans Health Administration hospital-based and community-based primary care facilities. We used a previously validated PACT Implementation Progress Index (Pi) and its 8 domains: access, continuity of care, care coordination, comprehensiveness, self-management support, and patient-centered care and communication, shared decision-making domains, and team functioning. Facilities were categorized as low (<5.2%, n=208), medium (5.2%-25.8%, n=413), and high (>25.8%, n=206) percent minority based on the percent of their own veteran population. Most minority veterans received care in high minority (69%) and medium minority facilities (29%). In adjusted analyses, medium and high minority facilities scored 0.773 (P=0.009) and 0.930 (P=0.008) points lower on the Pi score relative to low minority facilities. Relative to low minority facilities, both medium and high minority facilities were less likely of having high Pi scores (≥2) and more likely of having low Pi scores (≤-2). Both medium and high minority facilities had the same 3 domain scores lower than low minority facilities (care coordination, comprehensiveness, and self-management). Overall PACT implementation varied with respect to the racial/ethnic composition of a facility, with medium and high minority facilities having a lower implementation scores.

Implementation of tuberculosis infection control in health facilities in Mukono and Wakiso districts, Uganda

PubMed Central

2013-01-01

Background Tuberculosis infection control (TBIC) is rarely implemented in the health facilities in resource limited settings. Understanding the reasons for low level of implementation is critical. The study aim was to assess TBIC practices and barriers to implementation in two districts in Uganda. Methods We conducted a cross-sectional study in 51 health facilities in districts of Mukono and Wakiso. The study included: a facility survey, observations of practices and eight focus group discussions with health workers. Results Quantitative: Only 16 facilities (31%) had a TBIC plan. Five facilities (10%) were screening patients for cough. Two facilities (4%) reported providing masks to patients with cough. Ventilation in the waiting areas was inadequate for TBIC in 43% (22/51) of the facilities. No facility possessed N95 particulate respirators. Qualitative: Barriers that hamper implementation of TBIC elicited included: under-staffing, lack of space for patient separation, lack of funds to purchase masks, and health workers not appreciating the importance of TBIC. Conclusion TBIC measures were not implemented in health facilities in the two Ugandan districts where the survey was done. Health system factors like lack of staff, space and funds are barriers to implement TBIC. Effective implementation of TBIC measures occurs when the fundamental health system building blocks -governance and stewardship, financing, infrastructure, procurement and supply chain management are in place and functioning appropriately. PMID:23915376

Implementation of tuberculosis infection control in health facilities in Mukono and Wakiso districts, Uganda.

PubMed

Buregyeya, Esther; Nuwaha, Fred; Verver, Suzanne; Criel, Bart; Colebunders, Robert; Wanyenze, Rhoda; Kalyango, Joan N; Katamba, Achilles; Mitchell, Ellen Mh

2013-08-01

Tuberculosis infection control (TBIC) is rarely implemented in the health facilities in resource limited settings. Understanding the reasons for low level of implementation is critical. The study aim was to assess TBIC practices and barriers to implementation in two districts in Uganda. We conducted a cross-sectional study in 51 health facilities in districts of Mukono and Wakiso. The study included: a facility survey, observations of practices and eight focus group discussions with health workers. Quantitative: Only 16 facilities (31%) had a TBIC plan. Five facilities (10%) were screening patients for cough. Two facilities (4%) reported providing masks to patients with cough. Ventilation in the waiting areas was inadequate for TBIC in 43% (22/51) of the facilities. No facility possessed N95 particulate respirators. Qualitative: Barriers that hamper implementation of TBIC elicited included: under-staffing, lack of space for patient separation, lack of funds to purchase masks, and health workers not appreciating the importance of TBIC. TBIC measures were not implemented in health facilities in the two Ugandan districts where the survey was done. Health system factors like lack of staff, space and funds are barriers to implement TBIC. Effective implementation of TBIC measures occurs when the fundamental health system building blocks--governance and stewardship, financing, infrastructure, procurement and supply chain management are in place and functioning appropriately.

40 CFR 256.42 - Recommendations for assuring facility development.

Code of Federal Regulations, 2014 CFR

2014-07-01

... WASTES GUIDELINES FOR DEVELOPMENT AND IMPLEMENTATION OF STATE SOLID WASTE MANAGEMENT PLANS Facility Planning and Implementation § 256.42 Recommendations for assuring facility development. (a) The State plan... facilities, and (4) Development of schedules of implementation. (d) The State plan should encourage private...

40 CFR 256.42 - Recommendations for assuring facility development.

Code of Federal Regulations, 2012 CFR

2012-07-01

... WASTES GUIDELINES FOR DEVELOPMENT AND IMPLEMENTATION OF STATE SOLID WASTE MANAGEMENT PLANS Facility Planning and Implementation § 256.42 Recommendations for assuring facility development. (a) The State plan... facilities, and (4) Development of schedules of implementation. (d) The State plan should encourage private...

40 CFR 256.42 - Recommendations for assuring facility development.

Code of Federal Regulations, 2013 CFR

2013-07-01

... WASTES GUIDELINES FOR DEVELOPMENT AND IMPLEMENTATION OF STATE SOLID WASTE MANAGEMENT PLANS Facility Planning and Implementation § 256.42 Recommendations for assuring facility development. (a) The State plan... facilities, and (4) Development of schedules of implementation. (d) The State plan should encourage private...

Nursing home facilities in Malaysia (premise, shared facilities & individual accommodation: Space requirement): A literature review

NASA Astrophysics Data System (ADS)

Nordin, Nik Muhammad Faris Bin Nik; Hasbollah, Hasif Rafidee bin; Ibrahim, Mohd Asrul Hery Bin; Marican, Nor Dalila bin; Halim, Muhd Hafzal bin Abdul; Rashid, Ahmad Faezi Bin Ab.; Yasin, Nurul Hafizah Binti Mohd

2017-10-01

The numbers of elderly in Malaysia are increased every year. The request towards elderly care services necessitated by the Nursing Home are in demand. However, Nursing Home in Malaysia is lack of standard of facilities in order to cater the care services for the elderly. This paper intends review the minimum standard facilities for the Nursing Homes in globally. The paper also offered insights in developing standard Nursing Home facilities in Malaysia.

Minimum separation distances for natural gas pipeline and boilers in the 300 area, Hanford Site

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

Daling, P.M.; Graham, T.M.

1997-08-01

The U.S. Department of Energy (DOE) is proposing actions to reduce energy expenditures and improve energy system reliability at the 300 Area of the Hanford Site. These actions include replacing the centralized heating system with heating units for individual buildings or groups of buildings, constructing a new natural gas distribution system to provide a fuel source for many of these units, and constructing a central control building to operate and maintain the system. The individual heating units will include steam boilers that are to be housed in individual annex buildings located at some distance away from nearby 300 Area nuclearmore » facilities. This analysis develops the basis for siting the package boilers and natural gas distribution systems to be used to supply steam to 300 Area nuclear facilities. The effects of four potential fire and explosion scenarios involving the boiler and natural gas pipeline were quantified to determine minimum separation distances that would reduce the risks to nearby nuclear facilities. The resulting minimum separation distances are shown in Table ES.1.« less

Effects of State Policies on Facilities Planning and Construction in Rural Districts. ERIC Digest.

ERIC Educational Resources Information Center

Lawrence, Barbara Kent

State policies greatly affect the decisions rural districts make about building or renovating school facilities. State, federal, and local mechanisms for funding school facilities are briefly described. Some states require a specific percentage of growth or decline in student population or a minimum number of students as a prerequisite for…

78 FR 1851 - Sabine Pass Liquefaction, LLC and Sabine Pass LNG, L.P.; Notice of Intent To Prepare an...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-09

... gas liquids (NGL) truck loading facilities. A Project location map depicting the proposed facilities..., metering and send-out facilities; four gas pipeline meter stations; additional workspaces, laydown and... project is further developed. On natural gas projects, the APE at a minimum encompasses all areas subject...

33 CFR 154.1130 - Requirements for prepositioned response equipment.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Additional Response Plan Requirements for a Trans-Alaska Pipeline Authorization Act (TAPAA) Facility...: (a) On-water recovery equipment with a minimum effective daily recovery rate of 30,000 barrels... of a discharge. (c) On-water recovery equipment with a minimum effective daily recovery rate of 40...

33 CFR 154.1130 - Requirements for prepositioned response equipment.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Additional Response Plan Requirements for a Trans-Alaska Pipeline Authorization Act (TAPAA) Facility...: (a) On-water recovery equipment with a minimum effective daily recovery rate of 30,000 barrels... of a discharge. (c) On-water recovery equipment with a minimum effective daily recovery rate of 40...

33 CFR 154.1130 - Requirements for prepositioned response equipment.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Additional Response Plan Requirements for a Trans-Alaska Pipeline Authorization Act (TAPAA) Facility...: (a) On-water recovery equipment with a minimum effective daily recovery rate of 30,000 barrels... of a discharge. (c) On-water recovery equipment with a minimum effective daily recovery rate of 40...

33 CFR 154.1130 - Requirements for prepositioned response equipment.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Additional Response Plan Requirements for a Trans-Alaska Pipeline Authorization Act (TAPAA) Facility...: (a) On-water recovery equipment with a minimum effective daily recovery rate of 30,000 barrels... of a discharge. (c) On-water recovery equipment with a minimum effective daily recovery rate of 40...

Implementation of Best Practices in Obesity Prevention in Child Care Facilities: The Arizona Empower Program, 2013–2015

PubMed Central

Papa, Jillian; Rodriguez, Gertrudes; Robinson, Deborah

2017-01-01

Introduction Obesity is a major health concern in every US age group. Approximately one in 4 children in Arizona’s Special Supplemental Nutrition Program for Women, Infants, and Children is overweight or obese. The Arizona Department of Health Services developed the Empower program to promote healthy environments in licensed child care facilities. The program consists of 10 standards, including one standard for each of these 5 areas: physical activity and screen time, breastfeeding, fruit juice and water, family-style meals, and staff training. The objective of this evaluation was to determine the level of implementation of these 5 Empower standards. Methods A self-assessment survey was completed from July 2013 through June 2015 by 1,850 facilities to evaluate the level of implementation of 5 Empower standards. We calculated the percentage of facilities that reported the degree to which they implemented each standard and identified common themes in comments recorded in the survey. Results All facilities reported either full or partial implementation of the 5 standards. Of 1,678 facilities, 21.7% (n = 364) reported full implementation of all standards, and 78.3% (n = 1,314) reported at least partial implementation. Staff training, which has only one component, had the highest level of implementation: 77.4% (n = 1,299) reported full implementation. Only 44.0% (n = 738) reported full implementation of the standard on a breastfeeding-friendly environment. Conclusion Arizona child care facilities have begun to implement the Empower program, but facilities will need more education, technical assistance, and support in some areas to fully implement the program. PMID:28880840

Implementation of Best Practices in Obesity Prevention in Child Care Facilities: The Arizona Empower Program, 2013-2015.

PubMed

Papa, Jillian; Agostinelli, Joan; Rodriguez, Gertrudes; Robinson, Deborah

2017-09-07

Obesity is a major health concern in every US age group. Approximately one in 4 children in Arizona's Special Supplemental Nutrition Program for Women, Infants, and Children is overweight or obese. The Arizona Department of Health Services developed the Empower program to promote healthy environments in licensed child care facilities. The program consists of 10 standards, including one standard for each of these 5 areas: physical activity and screen time, breastfeeding, fruit juice and water, family-style meals, and staff training. The objective of this evaluation was to determine the level of implementation of these 5 Empower standards. A self-assessment survey was completed from July 2013 through June 2015 by 1,850 facilities to evaluate the level of implementation of 5 Empower standards. We calculated the percentage of facilities that reported the degree to which they implemented each standard and identified common themes in comments recorded in the survey. All facilities reported either full or partial implementation of the 5 standards. Of 1,678 facilities, 21.7% (n = 364) reported full implementation of all standards, and 78.3% (n = 1,314) reported at least partial implementation. Staff training, which has only one component, had the highest level of implementation: 77.4% (n = 1,299) reported full implementation. Only 44.0% (n = 738) reported full implementation of the standard on a breastfeeding-friendly environment. Arizona child care facilities have begun to implement the Empower program, but facilities will need more education, technical assistance, and support in some areas to fully implement the program.

Compliance with youth access regulations for indoor UV tanning.

PubMed

Hester, Eric J; Heilig, Lauren F; D'Ambrosia, Renee; Drake, Amanda L; Schilling, Lisa M; Dellavalle, Robert P

2005-08-01

To describe youth access to indoor UV tanning and youth discount pricing incentives in 4 states with different age restrictions: Colorado (no age restrictions), Texas (age 13 years), Illinois (age 14 years), and Wisconsin (age 16 years). Cross-sectional telephone survey conducted in October 2003 using a standardized script to assess the practices of randomly selected UV tanning operators. Randomly selected licensed indoor UV tanning facility operators in Colorado, Texas, Illinois, and Wisconsin. Number of facilities (1) complying with indoor UV tanning minimum age regulations for a 12-year-old potential patron and a 15-year-old potential patron and (2) offering youth discounts. For a 12-year-old potential patron, 62% of facilities in states with minimum age restrictions prohibiting 12-year-olds had an operator report that they would not permit indoor tanning (Texas, 23%; Illinois, 74%; and Wisconsin, 89%) compared with 18% in Colorado, a state without youth access regulations. For a 15-year-old patron, most facilities in Wisconsin, the only state with a minimum age restriction for 15-year-olds, prohibited access (77%). Overall, 15% of operators offered youth discounts: Texas, 23%; Illinois, 14%; Wisconsin, 11%; and Colorado, 11%. Tanning facilities in 4 states offered price incentives directed at youths. State youth access regulations were associated with decreased youth access to indoor tanning. High compliance levels in states with long-standing youth access regulations (Illinois and Wisconsin) demonstrate the potential for successful tanning industry youth access regulation.

30 CFR 780.38 - Support facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... COAL MINING AND RECLAMATION OPERATIONS PERMITS AND COAL EXPLORATION SYSTEMS UNDER REGULATORY PROGRAMS SURFACE MINING PERMIT APPLICATIONS-MINIMUM REQUIREMENTS FOR RECLAMATION AND OPERATION PLAN § 780.38... description, plans, and drawings for each support facility to be constructed, used, or maintained within the...

30 CFR 784.30 - Support facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... COAL MINING AND RECLAMATION OPERATIONS PERMITS AND COAL EXPLORATION SYSTEMS UNDER REGULATORY PROGRAMS UNDERGROUND MINING PERMIT APPLICATIONS-MINIMUM REQUIREMENTS FOR RECLAMATION AND OPERATION PLAN § 784.30... description, plans, and drawings for each support facility to be constructed, used, or maintained within the...

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

Not Available

The Office of Civilian Radioactive Waste Management Systems Engineering Management Plan (OCRWM SEMP) specifies the technical management approach for the development of the waste management system, and specifies the approach for the development of each of the system elements -- the waste acceptance system, the transportation system, the Monitored Retrievable Storage (MRS) facility, and the mined geologic disposal system, which includes site characterization activity. The SEMP also delineates how systems engineering will be used by OCRWM to describe the system development process; it identifies responsibilities for its implementation, and specifies the minimum requirements for systems engineering. It also identifies themore » close interrelationship of system engineering and licensing processes. This SEMP, which is a combined OCRWM and M&O SEMP, is part of the top-level program documentation and is prepared in accordance with the direction provided in the Program Management System Manual (PMSM). The relationship of this document to other top level documents in the CRWMS document hierarchy is defined in the PMSM. A systems engineering management plan for each project, which specifies the actions to be taken in implementing systems engineering at the project level, shall be prepared by the respective project managers. [``Program`` refers to the CRWMS-wide activity and ``project`` refers to that level responsible for accomplishing the specific activities of that segment of the program.] The requirements for the project level SEMPs are addressed in Section 4.2.2.2. They represent the minimum set of requirements, and do not preclude the broadening of systems engineering activities to meet the specific needs of each project.« less

The minimum test battery to screen for binocular vision anomalies: report 3 of the BAND study.

PubMed

Hussaindeen, Jameel Rizwana; Rakshit, Archayeeta; Singh, Neeraj Kumar; Swaminathan, Meenakshi; George, Ronnie; Kapur, Suman; Scheiman, Mitchell; Ramani, Krishna Kumar

2018-03-01

This study aims to report the minimum test battery needed to screen non-strabismic binocular vision anomalies (NSBVAs) in a community set-up. When large numbers are to be screened we aim to identify the most useful test battery when there is no opportunity for a more comprehensive and time-consuming clinical examination. The prevalence estimates and normative data for binocular vision parameters were estimated from the Binocular Vision Anomalies and Normative Data (BAND) study, following which cut-off estimates and receiver operating characteristic curves to identify the minimum test battery have been plotted. In the receiver operating characteristic phase of the study, children between nine and 17 years of age were screened in two schools in the rural arm using the minimum test battery, and the prevalence estimates with the minimum test battery were found. Receiver operating characteristic analyses revealed that near point of convergence with penlight and red filter (> 7.5 cm), monocular accommodative facility (< 10 cycles per minute), and the difference between near and distance phoria (> 1.25 prism dioptres) were significant factors with cut-off values for best sensitivity and specificity. This minimum test battery was applied to a cohort of 305 children. The mean (standard deviation) age of the subjects was 12.7 (two) years with 121 males and 184 females. Using the minimum battery of tests obtained through the receiver operating characteristic analyses, the prevalence of NSBVAs was found to be 26 per cent. Near point of convergence with penlight and red filter > 10 cm was found to have the highest sensitivity (80 per cent) and specificity (73 per cent) for the diagnosis of convergence insufficiency. For the diagnosis of accommodative infacility, monocular accommodative facility with a cut-off of less than seven cycles per minute was the best predictor for screening (92 per cent sensitivity and 90 per cent specificity). The minimum test battery of near point of convergence with penlight and red filter, difference between distance and near phoria, and monocular accommodative facility yield good sensitivity and specificity for diagnosis of NSBVAs in a community set-up. © 2017 Optometry Australia.

Implementing a province-wide mandatory vaccinate-or-mask policy at healthcare facilities in British Columbia, Canada.

PubMed

Nunn, Alexandra; Campbell, Audrey C; Naus, Monika; Kwong, Jeffrey C; Puddicombe, David; Quach, Susan; Henry, Bonnie

2018-01-08

In 2012, British Columbia (BC) became the first Canadian province to implement an influenza prevention policy requiring healthcare workers (HCW) to either be vaccinated annually against influenza or wear a mask in patient care areas during the influenza season. This study describes an evaluation of influenza policy implementation processes and identifies supports and challenges related to successful policy implementation at the level of healthcare facilities, during the second policy year (2013/14). Implementation leaders from 262 long-term care (LTC) and acute care facilities, mostly in three of BC's five regional Health Authorities, were invited to participate in an online survey following the 2013/14 influenza season. Descriptive quantitative and qualitative analyses identified common and effective strategies for improving vaccination coverage and policy compliance. A total of 127 respondents completed the survey on behalf of 33 acute care and 99 LTC facilities, representing 36% of acute care and 27% of LTC facilities in BC. Respondents agreed that the policy was successfully implemented at 89% of facilities, and implementation was reported to be easy at 52% of facilities. The findings elaborate on communication and leadership strategies, campaign logistics and enforcement approaches involved in policy implementation. Implementation of a vaccinate-or-mask influenza policy is complex. This study provides insight for other jurisdictions considering implementing such a policy and offers practical recommendations for facilities and health authorities. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

Sherry, T D; Kohlhorst, D P; Little, S K

The accomplishments to date and the long-range planning of the Y-12 Energy Management and Sustainability and Stewardship programs support the DOE and the National Nuclear Security Administration (NNSA) vision for a commitment to energy efficiency and sustainability and to achievement of the Guiding Principles. Specifically, the Y-12 vision is to support the Environment, Safety and Health Policy and the DOE Strategic Sustainability Performance Plan (SSPP) while promoting overall sustainability and reduction of greenhouse gas (GHG) emissions. Table ES.2 gives a comprehensive overview of Y-12's performance status and planned actions. B&W Y-12's Energy Management mission is to incorporate renewable energy andmore » energy efficient technologies site-wide and to position Y-12 to meet NNSA energy requirement needs through 2025 and beyond. During FY 2011, the site formed a sustainability team (Fig. ES.1). The sustainability team provides a coordinated approach to meeting the various sustainability requirements and serves as a forum for increased communication and consistent implementation of sustainability activities at Y-12. The sustainability team serves as an information exchange mechanism to promote general awareness of sustainability information, while providing a system to document progress and to identify resources. These resources are necessary to implement activities that support the overall goals of sustainability, including reducing the use of resources and conserving energy. Additionally, the team's objectives include: (1) Foster a Y-12-wide philosophy to conserve resources; (2) Reduce the impacts of production operations in a cost-effective manner; (3) Increase materials recycling; (4) Use a minimum amount of energy and fuel; (5) Create a minimum of waste and pollution in achieving Y-12-strategic objectives; (6) Develop and implement techniques, technologies, process modifications, and programs that support sustainable acquisition; (7) Minimize the impacts to resources, including energy/fuel, water, waste, pesticides, and pollution generation; (8) Incorporate sustainable design principles into the design and construction of facility upgrades, new facilities, and infrastructure; and (9) Comply with federal and state regulations, executive orders, and DOE requirements. Y-12 is working to communicate its sustainment vision through procedural, engineering, operational, and management practices. The site will make informed decisions based on the application of the five Guiding Principles for HPSBs to the maximum extent possible.« less

Factors that affect implementation of a nurse staffing directive: results from a qualitative multi-case evaluation.

PubMed

Robinson, Claire H; Annis, Ann M; Forman, Jane; Krein, Sarah L; Yankey, Nicholas; Duffy, Sonia A; Taylor, Beth; Sales, Anne E

2016-08-01

To assess implementation of the Veterans Health Administration staffing methodology directive. In 2010 the Veterans Health Administration promulgated a staffing methodology directive for inpatient nursing units to address staffing and budget forecasting. A qualitative multi-case evaluation approach assessed staffing methodology implementation. Semi-structured telephone interviews were conducted from March - June 2014 with Nurse Executives and their teams at 21 facilities. Interviews focused on the budgeting process, implementation experiences, use of data, leadership support, and training. An implementation score was created for each facility using a 4-point rating scale. The scores were used to select three facilities (low, medium and high implementation) for more detailed case studies. After analysing interview summaries, the evaluation team developed a four domain scoring structure: (1) integration of staffing methodology into budget development; (2) implementation of the Directive elements; (3) engagement of leadership and staff; and (4) use of data to support the staffing methodology process. The high implementation facility had leadership understanding and endorsement of staffing methodology, confidence in and ability to work with data, and integration of staffing methodology results into the budgeting process. The low implementation facility reported poor leadership engagement and little understanding of data sources and interpretation. Implementation varies widely across facilities. Implementing staffing methodology in facilities with complex and changing staffing needs requires substantial commitment at all organizational levels especially for facilities that have traditionally relied on historical levels to budget for staffing. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

Implementing the enterprise master patient index.

PubMed

Adragna, L

1998-10-01

In implementing a cross-facility initiative, the importance of planning and understanding the implications for all facilities can't be overlooked. Here's how one integrated delivery network navigated the challenges of implementing a cross-facility enterprise master patient index.

Slew maneuvers on the SCOLE Laboratory Facility

NASA Technical Reports Server (NTRS)

Williams, Jeffrey P.

1987-01-01

The Spacecraft Control Laboratory Experiment (SCOLE) was conceived to provide a physical test bed for the investigation of control techniques for large flexible spacecraft. The control problems studied are slewing maneuvers and pointing operations. The slew is defined as a minimum time maneuver to bring the antenna line-of-sight (LOS) pointing to within an error limit of the pointing target. The second objective is to rotate about the LOS within the 0.02 degree error limit. The SCOLE problem is defined as two design challenges: control laws for a mathematical model of a large antenna attached to the Space Shuttle by a long flexible mast; and a control scheme on a laboratory representation of the structure modelled on the control laws. Control sensors and actuators are typical of those which the control designer would have to deal with on an actual spacecraft. Computational facilities consist of microcomputer based central processing units with appropriate analog interfaces for implementation of the primary control system, and the attitude estimation algorithm. Preliminary results of some slewing control experiments are given.

Summary of Plutonium-238 Production Alternatives Analysis Final Report

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

James Werner; Wade E. Bickford; David B. Lord

The Team implemented a two-phase evaluation process. During the first phase, a wide variety of past and new candidate facilities and processing methods were assessed against the criteria established by DOE for this assessment. Any system or system element selected for consideration as an alternative within the project to reestablish domestic production of Pu-238 must meet the following minimum criteria: Any required source material must be readily available in the United States, without requiring the development of reprocessing technologies or investments in systems to separate material from identified sources. It must be cost, schedule, and risk competitive with existing baselinemore » technology. Any identified facilities required to support the concept must be available to the program for the entire project life cycle (notionally 35 years, unless the concept is so novel as to require a shorter duration). It must present a solution that can generate at least 1.5 Kg of Pu-238 oxide per year, for at least 35 years. It must present a low-risk, near-term solution to the National Aeronautics and Space Administration’s urgent mission need. DOE has implemented this requirement by eliminating from project consideration any alternative with key technologies at less than Technology Readiness Level 5. The Team evaluated the options meeting these criteria using a more detailed assessment of the reasonable facility variations and compared them to the preferred option, which consists of target irradiation at the Advanced Test Reactor (ATR) and the High Flux Isotope Reactor (HFIR), target fabrication and chemical separations processing at the ORNL Radiochemical Engineering Development Center, and neptunium 237 storage at the Materials and Fuels Complex at INL. This preferred option is consistent with the Records of Decision from the earlier National Environmental Policy Act (NEPA) documentation« less

30 CFR 71.402 - Minimum requirements for bathing facilities, change rooms, and sanitary flush toilet facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Showers shall be provided with both hot and cold water. (ii) At least one shower head shall be provided... urinal. (iv) An adequate supply of toilet paper shall be provided with each toilet. (v) Adequate...

30 CFR 71.402 - Minimum requirements for bathing facilities, change rooms, and sanitary flush toilet facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) Showers shall be provided with both hot and cold water. (ii) At least one shower head shall be provided... urinal. (iv) An adequate supply of toilet paper shall be provided with each toilet. (v) Adequate...

30 CFR 71.402 - Minimum requirements for bathing facilities, change rooms, and sanitary flush toilet facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) Showers shall be provided with both hot and cold water. (ii) At least one shower head shall be provided... urinal. (iv) An adequate supply of toilet paper shall be provided with each toilet. (v) Adequate...

30 CFR 71.402 - Minimum requirements for bathing facilities, change rooms, and sanitary flush toilet facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) Showers shall be provided with both hot and cold water. (ii) At least one shower head shall be provided... urinal. (iv) An adequate supply of toilet paper shall be provided with each toilet. (v) Adequate...

30 CFR 71.402 - Minimum requirements for bathing facilities, change rooms, and sanitary flush toilet facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) Showers shall be provided with both hot and cold water. (ii) At least one shower head shall be provided... urinal. (iv) An adequate supply of toilet paper shall be provided with each toilet. (v) Adequate...

28 CFR 540.41 - Visiting facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Visiting facilities. 540.41 Section 540.41 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT CONTACT... visitors. (a) Institutions of minimum and low security levels may permit visits beyond the security...

78 FR 39757 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-02

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... and Instrumented Initial Testing Facilities [[Page 39758

14 CFR 171.161 - Maintenance and operations requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

... meet at a minimum the Federal Communications Commission's licensing requirements and show that he has the special knowledge and skills needed to maintain the facility, including proficiency in maintenance... facility. (2) Maintenance and operations by authorized persons only. (3) Federal Communications Commission...

14 CFR 171.161 - Maintenance and operations requirements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... meet at a minimum the Federal Communications Commission's licensing requirements and show that he has the special knowledge and skills needed to maintain the facility, including proficiency in maintenance... facility. (2) Maintenance and operations by authorized persons only. (3) Federal Communications Commission...

14 CFR 171.161 - Maintenance and operations requirements.

Code of Federal Regulations, 2012 CFR

2012-01-01

... meet at a minimum the Federal Communications Commission's licensing requirements and show that he has the special knowledge and skills needed to maintain the facility, including proficiency in maintenance... facility. (2) Maintenance and operations by authorized persons only. (3) Federal Communications Commission...

14 CFR 171.161 - Maintenance and operations requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... meet at a minimum the Federal Communications Commission's licensing requirements and show that he has the special knowledge and skills needed to maintain the facility, including proficiency in maintenance... facility. (2) Maintenance and operations by authorized persons only. (3) Federal Communications Commission...

The design and implementation of the Technical Facilities Controller (TFC) for the Goldstone deep space communications complex

NASA Technical Reports Server (NTRS)

Killian, D. A.; Menninger, F. J.; Gorman, T.; Glenn, P.

1988-01-01

The Technical Facilities Controller is a microprocessor-based energy management system that is to be implemented in the Deep Space Network facilities. This system is used in conjunction with facilities equipment at each of the complexes in the operation and maintenance of air-conditioning equipment, power generation equipment, power distribution equipment, and other primary facilities equipment. The implementation of the Technical Facilities Controller was completed at the Goldstone Deep Space Communications Complex and is now operational. The installation completed at the Goldstone Complex is described and the utilization of the Technical Facilities Controller is evaluated. The findings will be used in the decision to implement a similar system at the overseas complexes at Canberra, Australia, and Madrid, Spain.

36 CFR Appendix A to Part 1234 - Minimum Security Standards for Level III Federal Facilities

Code of Federal Regulations, 2014 CFR

2014-07-01

... technology and blast standards. Immediate review of ongoing projects may generate savings in the... critical systems (alarm systems, radio communications, computer facilities, etc.) Required. Occupant... all exterior windows (shatter protection) Recommended. Review current projects for blast standards...

36 CFR Appendix A to Part 1234 - Minimum Security Standards for Level III Federal Facilities

Code of Federal Regulations, 2013 CFR

2013-07-01

... construction projects should be reviewed if possible, to incorporate current technology and blast standards... critical systems (alarm systems, radio communications, computer facilities, etc.) Required. Occupant... all exterior windows (shatter protection) Recommended. Review current projects for blast standards...

36 CFR Appendix A to Part 1234 - Minimum Security Standards for Level III Federal Facilities

Code of Federal Regulations, 2012 CFR

2012-07-01

... technology and blast standards. Immediate review of ongoing projects may generate savings in the... critical systems (alarm systems, radio communications, computer facilities, etc.) Required. Occupant... all exterior windows (shatter protection) Recommended. Review current projects for blast standards...

Evaluation of a TB infection control implementation initiative in out-patient HIV clinics in Zambia and Botswana.

PubMed

Emerson, C; Lipke, V; Kapata, N; Mwananyambe, N; Mwinga, A; Garekwe, M; Lanje, S; Moshe, Y; Pals, S L; Nakashima, A K; Miller, B

2016-07-01

Out-patient human immunodeficiency virus (HIV) care and treatment clinics in Zambia and Botswana, countries with a high burden of HIV and TB infection. To develop a tuberculosis infection control (TB IC) training and implementation package and evaluate the implementation of TB IC activities in facilities implementing the package. Prospective program evaluation of a TB IC training and implementation package using a standardized facility risk assessment tool, qualitative interviews with facility health care workers and measures of pre- and post-test performance. A composite measure of facility performance in TB IC improved from 32% at baseline to 50% at 1 year among eight facilities in Zambia, and from 27% to 80% at 6 months among 10 facilities in Botswana. Although there was marked improvement in indicators of managerial, administrative and environmental controls, key ongoing challenges remained in ensuring access to personal protective equipment and implementing TB screening in health care workers. TB IC activities at out-patient HIV clinics in Zambia and Botswana improved after training using the implementation package. Continued infrastructure support, as well as monitoring and evaluation, are needed to support the scale-up and sustainability of TB IC programs in facilities in low-resource countries.

Use of a geographic information system to assess accessibility to health facilities providing emergency obstetric and newborn care in Bangladesh.

PubMed

Chowdhury, Mahbub E; Biswas, Taposh K; Rahman, Monjur; Pasha, Kamal; Hossain, Mollah A

2017-08-01

To use a geographic information system (GIS) to determine accessibility to health facilities for emergency obstetric and newborn care (EmONC) and compare coverage with that stipulated by UN guidelines (5 EmONC facilities per 500 000 individuals, ≥1 comprehensive). A cross-sectional study was undertaken of all public facilities providing EmONC in 24 districts of Bangladesh from March to October 2012. Accessibility to each facility was assessed by applying GIS to estimate the proportion of catchment population (comprehensive 500 000; basic 100 000) able to reach the nearest facility within 2 hours and 1 hour of travel time, respectively, by existing road networks. The minimum number of public facilities providing comprehensive and basic EmONC services (1 and 5 per 500 000 individuals, respectively) was reached in 16 and 3 districts, respectively. However, after applying GIS, in no district did 100% of the catchment population have access to these services. A minimum of 75% and 50% of the population had accessibility to comprehensive services in 11 and 5 districts, respectively. For basic services, accessibility was much lower. Assessing only the number of EmONC facilities does not ensure universal coverage; accessibility should be assessed when planning health systems. © 2017 International Federation of Gynecology and Obstetrics.

MINIMUM CHECK LIST FOR MECHANICAL PLANS AND SPECIFICATIONS.

ERIC Educational Resources Information Center

PIERCE, J.L.

THIS BULLETIN HAS BEEN PREPARED FOR USE AS A MINIMUM CHECK LIST IN THE DEVELOPMENT AND REVIEW OF MECHANICAL AND ELECTRICAL PLANS AND SPECIFICATIONS BY ENGINEERS, ARCHITECTS, AND SUPERINTENDENTS IN PLANNING PUBLIC SCHOOL FACILITIES. THREE LEVELS OF GUIDELINES ARE MENTIONED--(1) MANDATORY BECAUSE OF LAW, CODE, OR REGULATION, (2) RECOMMENDED AS MOST…

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...

75 FR 75485 - Current List of Laboratories Which Meet Minimum Standards To Engage in Urine Drug Testing for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-03

... Current List of Laboratories Which Meet Minimum Standards To Engage in Urine Drug Testing for Federal... Guidelines for Federal Workplace Drug Testing Programs (Mandatory Guidelines). The Mandatory Guidelines were... Laboratories and Instrumented Initial Testing Facilities (IITF) must meet in order to conduct drug and specimen...

75 FR 62842 - Current List of Laboratories Which Meet Minimum Standards To Engage in Urine Drug Testing for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-13

... Current List of Laboratories Which Meet Minimum Standards To Engage in Urine Drug Testing for Federal... Guidelines for Federal Workplace Drug Testing Programs (Mandatory Guidelines). The Mandatory Guidelines were... and Instrumented Initial Testing Facilities (IITF) must meet in order to conduct drug and specimen...

A Study of Minimum Competency Testing Programs. Final Program Development Resource Document.

ERIC Educational Resources Information Center

Gorth, William Phillip; Perkins, Marcy R.

This resource document represents the integration of both practice and theory related to minimum competency testing (MCT), and is largely based on information collected in a nationwide survey of MCT programs. Chapter 1, To Implement or Not to Implement MCT, by Marcy R. Perkins, presents a definition of MCT and a discussion of the perceived…

Why are hospital-based nursing homes so costly? Relative importance of acuity and treatment setting.

PubMed

Pizer, Steven D; White, Alan J; White, Chapin

2002-05-01

To determine the extent to which higher costs in hospital-based skilled nursing facilities (HBSNF) can be explained by observable resident characteristics and unobservable selection effects, implying a design shortcoming of the skilled nursing facility prospective payment system (SNF PPS) implemented for Medicare-covered stays by the Balanced Budget Act of 1997 (BBA 1997). Data on resident characteristics from the Minimum Data Set (MDS) are combined with staff time costs from the Centers for Medicare and Medicaid Services' (CMS, formerly HCFA) 1995 and 1997 SNF Staff Time Measurement (STM) studies and nontherapy ancillary claim costs extracted from CMS SNF claim records. An endogenous switching model was estimated to measure the effect on costs of the relatively high acuity of HBSNF residents, net of differences purely attributable to the treatment setting. It was found that virtually the entire HBSNF differential is attributable to setting effects with resident characteristics and selection effects playing a negligible role. In addition, it was found that marginal costs associated with particular services and conditions are often lower in hospital-based than in freestanding facilities. HBSNFs incur high costs regardless of the characteristics of their residents. Their high fixed costs accompany relatively low marginal costs associated with admitting high-acuity residents. Consequently, a PPS casemix system that depends on resident characteristics and excludes consideration of facility characteristics (as mandated by BBA 1997) need not unfairly penalize HBSNFs, provided a powerful casemix system is used and HBSNFs specialize in the care of high-acuity residents.

77 FR 43196 - Minimum Internal Control Standards and Technical Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-24

... NATIONAL INDIAN GAMING COMMISSION 25 CFR Parts 543 and 547 Minimum Internal Control Standards [email protected] . SUPPLEMENTARY INFORMATION: Part 543 addresses minimum internal control standards (MICS) for Class II gaming operations. The regulations require tribes to establish controls and implement...

7 CFR 1450.201 - Project area proposal submission requirements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... CREDIT CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS BIOMASS CROP... a proposal to CCC that includes, at a minimum: (1) A description of the sources of renewable biomass... commitment from a biomass conversion facility stating that the facility will use, for BCAP purposes, eligible...

7 CFR 1450.201 - Project area proposal submission requirements.

Code of Federal Regulations, 2013 CFR

2013-01-01

... CREDIT CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS BIOMASS CROP... a proposal to CCC that includes, at a minimum: (1) A description of the sources of renewable biomass... commitment from a biomass conversion facility stating that the facility will use, for BCAP purposes, eligible...

7 CFR 1450.201 - Project area proposal submission requirements.

Code of Federal Regulations, 2012 CFR

2012-01-01

... CREDIT CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS BIOMASS CROP... a proposal to CCC that includes, at a minimum: (1) A description of the sources of renewable biomass... commitment from a biomass conversion facility stating that the facility will use, for BCAP purposes, eligible...

7 CFR 1450.201 - Project area proposal submission requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

... CREDIT CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS BIOMASS CROP... a proposal to CCC that includes, at a minimum: (1) A description of the sources of renewable biomass... commitment from a biomass conversion facility stating that the facility will use, for BCAP purposes, eligible...

14 CFR 171.45 - Minimum requirements for approval.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the frequency channel is needed for higher priority common system service. [Doc. No. 5034, 29 FR 11337... (CONTINUED) NAVIGATIONAL FACILITIES NON-FEDERAL NAVIGATION FACILITIES Instrument Landing System (ILS... must be met before the FAA will approve an IFR procedure for a non-Federal Instrument Landing System...

HIV policy implementation in two health and demographic surveillance sites in Uganda: findings from a national policy review, health facility surveys and key informant interviews.

PubMed

McRobie, Ellen; Wringe, Alison; Nakiyingi-Miiro, Jessica; Kiweewa, Francis; Lutalo, Tom; Nakigozi, Gertrude; Todd, Jim; Eaton, Jeffrey William; Zaba, Basia; Church, Kathryn

2017-04-05

Successful HIV testing, care and treatment policy implementation is essential for realising the reductions in morbidity and mortality those policies are designed to target. While adoption of new HIV policies is rapid, less is known about the facility-level implementation of new policies and the factors influencing this. We assessed implementation of national policies about HIV testing, treatment and retention at health facilities serving two health and demographic surveillance sites (HDSS) (10 in Kyamulibwa, 14 in Rakai). Ugandan Ministry of Health HIV policy documents were reviewed in 2013, and pre-determined indicators were extracted relating to the content and nature of guidance on HIV service provision. Facility-level policy implementation was assessed via a structured questionnaire administered to in-charge staff from each health facility. Implementation of policies was classified as wide (≥75% facilities), partial (26-74% facilities) or minimal (≤25% facilities). Semi-structured interviews were conducted with key informants (policy-makers, implementers, researchers) to identify factors influencing implementation; data were analysed using the Framework Method of thematic analysis. Most policies were widely implemented in both HDSS (free testing, free antiretroviral treatment (ART), WHO first-line regimen as standard, Option B+). Both had notable implementation gaps for policies relating to retention on treatment (availability of nutritional supplements, support groups or isoniazid preventive therapy). Rakai implemented more policies relating to provision of antiretroviral treatment than Kyamulibwa and performed better on quality of care indicators, such as frequency of stock-outs. Factors facilitating implementation were donor investment and support, strong scientific evidence, low policy complexity, phased implementation and effective planning. Limited human resources, infrastructure and health management information systems were perceived as major barriers to effective implementation. Most HIV policies were widely implemented in the two settings; however, gaps in implementation coverage prevail and the value of ensuring complete coverage of existing policies should be considered against the adoption of new policies in regard to resource needs and health benefits.

Improving rates of cotrimoxazole prophylaxis in resource-limited settings: implementation of a quality improvement approach.

PubMed

Bardfield, J; Agins, B; Palumbo, M; Wei, A L; Morris, J; Marston, B

2014-12-01

To demonstrate the effectiveness of quality improvement methods to monitor and improve administration of cotrimoxazole (CTX) prophylaxis to improve health outcomes among adults living with HIV/AIDS in low resource countries. Program evaluation. HIV/AIDS health care facilities in Uganda, Mozambique, Namibia and Haiti. Performance measures based on national guidelines are developed in each country. These may include CD4 monitoring, ART adherence and uptake of CTX prophylaxis. CTX prophylaxis is routinely selected, because it has been shown to reduce HIV-related morbidity and mortality. Patient records are sampled using a standard statistical table to achieve a minimum confidence interval of 90% with a spread of ±8% in participating clinics. If an electronic medical record is available, all patients are reviewed. Routine review of performance measures, usually every 6 months, is conducted to identify gaps in care. Improvement interventions are developed and implemented at health facilities, informed by performance results, and local/national public health priorities. Median clinic rates of CTX prophylaxis. Median performance rates of CTX prophylaxis generally improved for adult HIV+ patients between 2006 and 2013 across countries, with median clinic rates higher than baseline at follow-up in 16 of 18 groups of clinics implementing CTX -focused improvement projects. Quality management offers a data-driven method to improve the quality of HIV care in low resource countries. Application of improvement principles has been shown to be effective to increase the rates of CTX prophylaxis in national HIV programs in multiple countries. © The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Current Status of Multidisciplinary Care in Psoriatic Arthritis in Spain: NEXUS 2.0 Project.

PubMed

Queiro, Rubén; Coto, Pablo; Joven, Beatriz; Rivera, Raquel; Navío Marco, Teresa; de la Cueva, Pablo; Alvarez Vega, Jose Luis; Narváez Moreno, Basilio; Rodriguez Martínez, Fernando José; Pardo Sánchez, José; Feced Olmos, Carlos; Pujol, Conrad; Rodríguez, Jesús; Notario, Jaume; Pujol Busquets, Manel; García Font, Mercè; Galindez, Eva; Pérez Barrio, Silvia; Urruticoechea-Arana, Ana; Hergueta, Merce; López Montilla, M Dolores; Vélez García-Nieto, Antonio; Maceiras, Francisco; Rodríguez Pazos, Laura; Rubio Romero, Esteban; Rodríguez Fernandez Freire, Lourdes; Luelmo, Jesús; Gratacós, Jordi

2018-02-26

1) To analyze the implementation of multidisciplinary care models in psoriatic arthritis (PsA) patients, 2) To define minimum and excellent standards of care. A survey was sent to clinicians who already performed multidisciplinary care or were in the process of undertaking it, asking: 1) Type of multidisciplinary care model implemented; 2) Degree, priority and feasibility of the implementation of quality standards in the structure, process and result for care. In 6 regional meetings the results of the survey were presented and discussed, and the ultimate priority of quality standards for care was defined. At a nominal meeting group, 11 experts (rheumatologists and dermatologists) analyzed the results of the survey and the regional meetings. With this information, they defined which standards of care are currently considered as minimum and which are excellent. The simultaneous and parallel models of multidisciplinary care are those most widely implemented, but the implementation of quality standards is highly variable. In terms of structure it ranges from 22% to 74%, in those related to process from 17% to 54% and in the results from 2% to 28%. Of the 25 original quality standards for care, 9 were considered only minimum, 4 were excellent and 12 defined criteria for minimum level and others for excellence. The definition of minimum and excellent quality standards for care will help achieve the goal of multidisciplinary care for patients with PAs, which is the best healthcare possible. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

49 CFR 192.171 - Compressor stations: Additional safety equipment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SAFETY TRANSPORTATION OF NATURAL AND OTHER GAS BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Design of... must have adequate fire protection facilities. If fire pumps are a part of these facilities, their... event of inadequate cooling or lubrication of the unit. (d) Each compressor station gas engine that...

78 FR 46996 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-02

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... and Instrumented Initial Testing Facilities (IITF) must meet in order to conduct drug and specimen...

23 CFR 500.111 - IMS.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 23 Highways 1 2011-04-01 2011-04-01 false IMS. 500.111 Section 500.111 Highways FEDERAL HIGHWAY... SYSTEMS Management Systems § 500.111 IMS. An effective IMS for intermodal facilities and systems provides... the various land-based transportation facilities and systems. An IMS should include, at a minimum: (a...

Facility Programming and Construction Criteria [Planning Guide]. 702 KAR 4:170.

ERIC Educational Resources Information Center

Kentucky State Dept. of Education, Frankfort. Div. of Facilities Management.

This facility construction planning guide presents the minimum instructional space standards for Kentucky's public school system. It provides definitions of terms found in the regulations; presents space requirements for every type of instructional space within a public school, including circulation areas, storage, and mechanical/electrical areas;…

14 CFR 171.105 - Minimum requirements for approval.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the frequency channel is needed for higher priority common system service. ... agree to operate and maintain the facility in accordance with § 171.115. (5) The owner must agree to furnish periodic reports as set forth in § 171.117, and agree to allow the FAA to inspect the facility and...

32 CFR 766.5 - Conditions governing use of aviation facilities by civil aircraft.

Code of Federal Regulations, 2011 CFR

2011-07-01

... weather minimums as follows: (1) Visual Flight Operations shall be conducted in accordance with Federal Aviation Regulations (FAR), § 91.105 of this title. If more stringent visual flight rules minimums have... must be noted in § 766.5 of the license application. If a narrative report from the pilot is available...

32 CFR 766.5 - Conditions governing use of aviation facilities by civil aircraft.

Code of Federal Regulations, 2010 CFR

2010-07-01

... weather minimums as follows: (1) Visual Flight Operations shall be conducted in accordance with Federal Aviation Regulations (FAR), § 91.105 of this title. If more stringent visual flight rules minimums have... must be noted in § 766.5 of the license application. If a narrative report from the pilot is available...

78 FR 76533 - New Mailing Standards for Domestic Mailing Services Products

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-18

... sequencing system (FSS), a mailer association suggested to change the required minimum for an FSS scheme... must make FSS scheme or FSS facility pallets when the quantity reaches 250 pounds, so that minimum is... Standard Mail, FSS scheme pallets may be entered at origin, or at DNDC, DSCF, or DFSS entry points, but the...

Management aspects of Gemini's base facility operations project

NASA Astrophysics Data System (ADS)

Arriagada, Gustavo; Nitta, Atsuko; Adamson, A. J.; Nunez, Arturo; Serio, Andrew; Cordova, Martin

2016-08-01

Gemini's Base Facilities Operations (BFO) Project provided the capabilities to perform routine nighttime operations without anyone on the summit. The expected benefits were to achieve money savings and to become an enabler of the future development of remote operations. The project was executed using a tailored version of Prince2 project management methodology. It was schedule driven and managing it demanded flexibility and creativity to produce what was needed, taking into consideration all the constraints present at the time: Time available to implement BFO at Gemini North (GN), two years. The project had to be done in a matrix resources environment. There were only three resources assigned exclusively to BFO. The implementation of new capabilities had to be done without disrupting operations. And we needed to succeed, introducing the new operational model that implied Telescope and instrumentation Operators (Science Operations Specialists - SOS) relying on technology to assess summit conditions. To meet schedule we created a large number of concurrent smaller projects called Work Packages (WP). To be reassured that we would successfully implement BFO, we initially spent a good portion of time and effort, collecting and learning about user's needs. This was done through close interaction with SOSs, Observers, Engineers and Technicians. Once we had a clear understanding of the requirements, we took the approach of implementing the "bare minimum" necessary technology that would meet them and that would be maintainable in the long term. Another key element was the introduction of the "gradual descent" concept. In this, we increasingly provided tools to the SOSs and Observers to prevent them from going outside the control room during nighttime operations, giving them the opportunity of familiarizing themselves with the new tools over a time span of several months. Also, by using these tools at an early stage, Engineers and Technicians had more time for debugging, problem fixing and systems usage and servicing training as well.

Extent of Implementation of Minimum Standards of Basic Education for the Realisation of the Second Millennium Development Goal in Bayelsa State

ERIC Educational Resources Information Center

Ogochukwu, Emeka; Gbendu, Olaowei Godiva

2015-01-01

The study was carried out in Salga Education Zone of Bayelsa State specifically to determine the extent of implementation of the minimum standards for basic education in order to ensure the realization of the second millennium development goal. The study adopted the descriptive research design. The population of the study comprised of all the…

Planning Considerations for a Mars Sample Receiving Facility: Summary and Interpretation of Three Design Studies

NASA Astrophysics Data System (ADS)

Beaty, David W.; Allen, Carlton C.; Bass, Deborah S.; Buxbaum, Karen L.; Campbell, James K.; Lindstrom, David J.; Miller, Sylvia L.; Papanastassiou, Dimitri A.

2009-10-01

It has been widely understood for many years that an essential component of a Mars Sample Return mission is a Sample Receiving Facility (SRF). The purpose of such a facility would be to take delivery of the flight hardware that lands on Earth, open the spacecraft and extract the sample container and samples, and conduct an agreed-upon test protocol, while ensuring strict containment and contamination control of the samples while in the SRF. Any samples that are found to be non-hazardous (or are rendered non-hazardous by sterilization) would then be transferred to long-term curation. Although the general concept of an SRF is relatively straightforward, there has been considerable discussion about implementation planning. The Mars Exploration Program carried out an analysis of the attributes of an SRF to establish its scope, including minimum size and functionality, budgetary requirements (capital cost, operating costs, cost profile), and development schedule. The approach was to arrange for three independent design studies, each led by an architectural design firm, and compare the results. While there were many design elements in common identified by each study team, there were significant differences in the way human operators were to interact with the systems. In aggregate, the design studies provided insight into the attributes of a future SRF and the complex factors to consider for future programmatic planning.

Planning considerations for a Mars Sample Receiving Facility: summary and interpretation of three design studies.

PubMed

Beaty, David W; Allen, Carlton C; Bass, Deborah S; Buxbaum, Karen L; Campbell, James K; Lindstrom, David J; Miller, Sylvia L; Papanastassiou, Dimitri A

2009-10-01

It has been widely understood for many years that an essential component of a Mars Sample Return mission is a Sample Receiving Facility (SRF). The purpose of such a facility would be to take delivery of the flight hardware that lands on Earth, open the spacecraft and extract the sample container and samples, and conduct an agreed-upon test protocol, while ensuring strict containment and contamination control of the samples while in the SRF. Any samples that are found to be non-hazardous (or are rendered non-hazardous by sterilization) would then be transferred to long-term curation. Although the general concept of an SRF is relatively straightforward, there has been considerable discussion about implementation planning. The Mars Exploration Program carried out an analysis of the attributes of an SRF to establish its scope, including minimum size and functionality, budgetary requirements (capital cost, operating costs, cost profile), and development schedule. The approach was to arrange for three independent design studies, each led by an architectural design firm, and compare the results. While there were many design elements in common identified by each study team, there were significant differences in the way human operators were to interact with the systems. In aggregate, the design studies provided insight into the attributes of a future SRF and the complex factors to consider for future programmatic planning.

Production and feeding strategies for phosphorus management on dairy farms.

PubMed

Rotz, C A; Sharpley, A N; Satter, L D; Gburek, W J; Sanderson, M A

2002-11-01

Long-term accumulation of soil phosphorus (P) is becoming a concern on some watersheds heavily populated with animal feeding facilities, including dairy farms. Management changes in crop production and feeding may help reduce the accumulation of excess P, but farm profitability must be maintained or improved to assure adoption of such changes. Whole-farm simulation was used to evaluate the long-term effects of changes in feeding, cropping, and other production strategies on P loading and the economics of 100-cow and 800-cow dairy farms in southeastern New York. Simulated farms maintained a long-term P balance if the following occurred: 1) animals were fed to meet recommended minimum amounts of dietary P, 2) the cropping strategy and land base supplied all of the forage needed, 3) all animals were fed a high forage diet, and 4) replacement heifers were produced on the farm to utilize more forage. The most easily implemented change was to reduce the supplemental mineral P fed to that required to meet current NRC recommended amounts, and this provided an annual increase in farm profit of about $22/cow. Intensifying the use of grassland and improving grazing practices increased profit along with a small reduction in excess P. Conversion from dairy production to heifer raising or expansion from 100 cows to a 250-cow "state-of-the-art" confinement facility (with a 70% increase in land area) were also profitable options. These options provided a long-term P balance for the farm as long as the production and use of forage was maximized and minimum dietary P amounts were those recommended by the NRC. Thus, management changes can be made to prevent the long-term accumulation of soil P on dairy farms while improving farm profitability.

Impacts of proposed RCRA regulations and other related federal environmental regulations on fossil fuel-fired facilities: Final report, Volume 3

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

Not Available

1987-03-01

Estimation of the costs associated with implementation of the Resource Conservation and Recovery Act (RCRA) regulations for non-hazardous and hazardous material disposal in the utility industry are provided. These costs are based on engineering studies at a number of coal-fired power plants in which the costs for hazardous and non-hazardous disposal are compared to the costs developed for the current practice design for each utility. The relationship of the three costs is displayed. The emphasis of this study is on the determination of incremental costs rather than the absolute costs for each case (current practice, non-hazardous, or hazardous). For themore » purpose of this project, the hazardous design cost was determined for both minimum and maximum compliance.« less

Using the OIG model compliance programs to fight fraud.

PubMed

Lovitky, Jeffrey A; Ahern, Jack

2002-03-01

Many healthcare organizations already have implemented compliance programs for their facilities. However, in light of recent fines and continued scrutiny of such programs by the HHS Office of Inspector General (OIG), healthcare organizations should consider reviewing their current programs against the OIG's relevant model compliance program. Although healthcare organizations are not required to adhere strictly to OIG's model programs, they would benefit from ensuring that their programs meet all the OIG's requirements. The common, minimum elements suggested by the OIG model programs include development and distribution of written compliance policies, the designation of a chief compliance officer to manage the program, the development of a corrective action and enforcement system, and the use of audits to monitor compliance. Using these models as guides, healthcare organizations should be better able to avoid the possibility of fraud and abuse within their organizations.

Site survey for optimum location of Optical Communication Experimental Facility

NASA Technical Reports Server (NTRS)

1968-01-01

Site survey was made to determine the optimum location for an Optical Communication Experimental Facility /OCEF/ and to recommend several sites, graded according to preference. A site was desired which could perform two-way laser communication with a spacecraft and laser tracking with a minimum of interruption by weather effects.

Another Look at Scared Straight

ERIC Educational Resources Information Center

Feinstein, Sheryl

2005-01-01

The purpose of this study was to explore the impact of adult prisoner presentations on juvenile delinquents. The study involved twenty-four students incarcerated in a low security facility for male adolescents. Two adult male prisoners and a guard from a minimum-security federal prison came to the juvenile correctional facility to talk with …

Clinical Practice Guideline Implementation Strategy Patterns in Veterans Affairs Primary Care Clinics

PubMed Central

Hysong, Sylvia J; Best, Richard G; Pugh, Jacqueline A

2007-01-01

Background The Department of Veterans Affairs (VA) mandated the system-wide implementation of clinical practice guidelines (CPGs) in the mid-1990s, arming all facilities with basic resources to facilitate implementation; despite this resource allocation, significant variability still exists across VA facilities in implementation success. Objective This study compares CPG implementation strategy patterns used by high and low performing primary care clinics in the VA. Research Design Descriptive, cross-sectional study of a purposeful sample of six Veterans Affairs Medical Centers (VAMCs) with high and low performance on six CPGs. Subjects One hundred and two employees (management, quality improvement, clinic personnel) involved with guideline implementation at each VAMC primary care clinic. Measures Participants reported specific strategies used by their facility to implement guidelines in 1-hour semi-structured interviews. Facilities were classified as high or low performers based on their guideline adherence scores calculated through independently conducted chart reviews. Findings High performing facilities (HPFs) (a) invested significantly in the implementation of the electronic medical record and locally adapting it to provider needs, (b) invested dedicated resources to guideline-related initiatives, and (c) exhibited a clear direction in their strategy choices. Low performing facilities exhibited (a) earlier stages of development for their electronic medical record, (b) reliance on preexisting resources for guideline implementation, with little local adaptation, and (c) no clear direction in their strategy choices. Conclusion A multifaceted, yet targeted, strategic approach to guideline implementation emphasizing dedicated resources and local adaptation may result in more successful implementation and higher guideline adherence than relying on standardized resources and taxing preexisting channels. PMID:17355583

Improving children's nutrition environments: A survey of adoption and implementation of nutrition guidelines in recreational facilities

PubMed Central

2011-01-01

Background Although the mandate of recreational facilities is to enhance well-being, many offer foods inconsistent with recommendations for healthy eating. Little is known regarding recreational facility food environments and how they might be improved, as few studies exist. The Alberta Nutrition Guidelines for Children and Youth (ANGCY) are intended to ensure access to healthy food choices in schools, childcare and recreational facilities. This study investigated awareness, adoption and implementation of the ANGCY among recreational facilities in Alberta, Canada, one year following their release. Methods A cross-sectional telephone survey was conducted from June - December, 2009 (n = 151) with managers of publicly funded recreational facilities that served food. The questionnaire included 10 closed and 7 open ended questions to assess the organizational priority for healthy eating, awareness, adoption and implementation of the ANGCY. Chi-squared tests examined quantitative variables, while qualitative data were analysed using directed content analysis. Greenhalgh's model of diffusion of complex innovations within health service organizations constituted the theoretical framework for the study. Results One half of respondents had heard of the ANGCY, however their knowledge of them was limited. Although 51% of facilities had made changes to improve the nutritional quality of foods offered in the past year, only a small fraction (11%) of these changes were motivated by the ANGCY. At the time of the survey, 14% of facilities had adopted the ANGCY and 6% had implemented them. Barriers to adoption and implementation were primarily related to perceived negative attributes of the ANGCY, the inner (organizational) context, and negative feedback received during the implementation process. Managers strongly perceived that implementing nutrition guidelines would limit their profit-making ability. Conclusions If fully adopted and implemented, the ANGCY have the potential to make a significant and sustained contribution to improving the recreational facility food environment, however one year following their release, awareness, adoption and implementation of the ANGCY remained low. A mandated policy approach could offer an efficacious, cost-effective means of improving the food environment within recreational facilities. PMID:21631946

Baseline characteristics of study sites and women enrolled in a three-arm cluster randomized controlled trial: PMTCT uptake and retention (pure) Malawi.

PubMed

van Lettow, Monique; Tweya, Hannock; Rosenberg, Nora E; Trapence, Clement; Kayoyo, Virginia; Kasende, Florence; Kaunda, Blessings; Hosseinipour, Mina C; Eliya, Michael; Cataldo, Fabian; Gugsa, Salem; Phiri, Sam

2017-07-11

Malawi introduced an ambitious public health program known as "Option B+" which provides all HIV-infected pregnant and breastfeeding women with lifelong combination antiretroviral therapy, regardless of WHO clinical stage or CD4 cell count. The PMTCT Uptake and REtention (PURE) study aimed at evaluating the effect of peer-support on care-seeking and retention in care. PURE Malawi was a three-arm cluster randomized controlled trial that compared facility-based and community-based models of peer support to standard of care under Option B+ strategy. Each arm was expected to enroll a minimum of 360 women with a total minimum sample size of 1080 participants. 21 sites (clusters) were selected for inclusion in the study. This paper describes the site selection, recruitment, enrollment process and baseline characteristics of study sites and women enrolled in the trial. Study implementation was managed by 3 partner organizations; each responsible for 7 study sites. The trial was conducted in the South East, South West, and Central West zones of Malawi, the zones where the implementing partners operate. Study sites included 2 district hospitals, 2 mission hospitals, 2 rural hospitals, 13 health centers and 1 private clinic. Enrollment occurred from November 2013 to November 2014, over a median period of 31 weeks (range 17-51) by site. A total of 1269 HIV-infected pregnant (1094) and breastfeeding (175) women, who were eligible to initiate ART under Option B+, were enrolled. Each site reached or surpassed the minimum sample size. Comparing the number of women enrolled versus antenatal cohort reports, sites recruited a median of 90% (IQR 75-100) of eligible reported women. In the majority of sites the ratio of pregnant and lactating women enrolled in the study was similar to the ratio of reported pregnant and lactating women starting ART in the same sites. The median age of all women was 27 (IQR 22-31) years. All women have ≥20 months of possible follow-up time; 96% ≥ 2 years (24-32 months). The PURE Malawi study showed that 3 implementing partner organizations could successfully recruit a complex cohort of pregnant and lactating women across 3 geographical zones in Malawi within a reasonable timeline. This study is registered at clinicaltrials.gov - ID Number NCT02005835 . Registered 4 December, 2013.

75 FR 29573 - Concession Contracts; Implementation of Alternate Valuation Formula for Leasehold Surrender...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-26

... to establish the required minimum franchise fee for the new contract under the terms of the standard.... Likewise, if a prospective concessioner offered to meet or exceed the minimum franchise fee established by..., its minimum franchise fee will result in a less than fair return to the government. NPS therefore...

Grainex Mar-M 247 Turbine Disk Life Study for NASA's High Temperature High Speed Turbine Seal Test Facility

NASA Technical Reports Server (NTRS)

Delgado, Irebert R.

2015-01-01

An experimental and analytical fatigue life study was performed on the Grainex Mar-M 247 disk used in NASA s Turbine Seal Test Facility. To preclude fatigue cracks from growing to critical size in the NASA disk bolt holes due to cyclic loading at severe test conditions, a retirement-for-cause methodology was adopted to detect and monitor cracks within the bolt holes using eddy-current inspection. For the NASA disk material that was tested, the fatigue strain-life to crack initiation at a total strain of 0.5 percent, a minimum to maximum strain ratio of 0, and a bolt hole temperature of 649 C was calculated to be 665 cycles using -99.95 percent prediction intervals. The fatigue crack propagation life was calculated to be 367 cycles after implementing a safety factor of 2 on life. Thus, the NASA disk bolt hole total life or retirement life was determined to be 1032 cycles at a crack depth of 0.501 mm. An initial NASA disk bolt hole inspection at 665 cycles is suggested with 50 cycle inspection intervals thereafter to monitor fatigue crack growth.

Insight into implementation of facility-based integrated management of childhood illness strategy in a rural district of Sindh, Pakistan.

PubMed

Pradhan, Nousheen Akber; Rizvi, Narjis; Sami, Neelofar; Gul, Xaher

2013-07-05

Integrated management of childhood illnesses (IMCI) strategy has been proven to improve health outcomes in children under 5 years of age. Pakistan, despite being in the late implementation phase of the strategy, continues to report high under-five mortality due to pneumonia, diarrhea, measles, and malnutrition - the main targets of the strategy. The study determines the factors influencing IMCI implementation at public-sector primary health care (PHC) facilities in Matiari district, Sindh, Pakistan. An exploratory qualitative study with an embedded quantitative strand was conducted. The qualitative part included 16 in-depth interviews (IDIs) with stakeholders which included planners and policy makers at a provincial level (n=5), implementers and managers at a district level (n=3), and IMCI-trained physicians posted at PHC facilities (n=8). Quantitative part included PHC facility survey (n=16) utilizing WHO health facility assessment tool to assess availability of IMCI essential drugs, supplies, and equipments. Qualitative content analysis was used to interpret the textual information, whereas descriptive frequencies were calculated for health facility survey data. The major factors reported to enhance IMCI implementation were knowledge and perception about the strategy and need for separate clinic for children aged under 5 years as potential support factors. The latter can facilitate in strategy implementation through allocated workforce and required equipments and supplies. Constraint factors mainly included lack of clear understanding of the strategy, poor planning for IMCI implementation, ambiguity in defined roles and responsibilities among stakeholders, and insufficient essential supplies and drugs at PHC centers. The latter was further substantiated through health facilities' survey findings, which indicated that none of the facilities had 100% stock of essential supplies and drugs. Only one out of all 16 surveyed facilities had 75% of the total supplies, while 4 out of 16 facilities had 56% of the required IMCI drug stock. The mean availability of supplies ranged from 36.6 to 66%, while the mean availability of drugs ranged from 45.8 to 56.7%. Our findings indicate that the Matiari district has sound implementation potential; however, bottlenecks at health care facility and at health care management level have badly constrained the implementation process. An interdependency exists among the constraining factors, such as lack of sound planning resulting in unclear understanding of the strategy; leading to ambiguous roles and responsibilities among stakeholders which manifest as inadequate availability of supplies and drugs at PHC facilities. Addressing these barriers is likely to have a cumulative effect on facilitating IMCI implementation. On the basis of these findings, we recommend that the provincial Ministry of Health (MoH) and provincial Maternal Neonatal and Child Health (MNCH) program jointly assess the situation and streamline IMCI implementation in the district through sound planning, training, supervision, and logistic support.

Variations in status of preparation of personal protective equipment for preventing norovirus gastroenteritis in long-term care facilities for the elderly.

PubMed

Fujiki, Saori; Ishizaki, Tatsuro; Nakayama, Takeo

2017-12-01

Residents of long-term care facilities are highly susceptible to norovirus gastroenteritis, and each facility is concerned about the need to implement norovirus infection control. Among control measures, personal protective equipment (PPE), such as disposable gloves and masks, plays a major role in reducing infectious spread. However, the preparation status of PPE in facilities before infection outbreaks has not been reported. The aim was to clarify the implementation status of preventive measures for norovirus gastroenteritis and the cost of preparing the necessary PPE in long-term care facilities. A questionnaire survey of facilities affiliated with the Kyoto Prefecture and Osaka Prefecture branches of the Japan Association of Geriatric Health Services Facilities was conducted. The survey items were the characteristics of the facility, whether preventive measures had been implemented for norovirus gastroenteritis from October through the following March in both 2009 and 2010, and the quantities and unit prices of PPE prepared for preventive measures. Twenty-six (11.2%) of 232 surveyed facilities (as of August 2011) answered the survey. Among them, 24 (92.3%) in 2009 and 25 (96.2%) in 2010 reported having implemented preventive measures for norovirus gastroenteritis, while 21 facilities (80.8%) in 2009 and 22 facilities (84.6%) in 2010 had prepared PPE. The median total cost for preparing the PPE needed for the preventive measures was US $2601 (range US $221-9192) in 2009 and US $3904 (range US $305-6427) in 2010. Although the results need careful interpretation because of the low response rate, most of the surveyed long-term care facilities had implemented preventive measures for norovirus gastroenteritis. However, the cost of preparing the PPE needed for the preventive measures varied among the facilities. © 2017 John Wiley & Sons, Ltd.

Corporate environmental policy statements in mainland China: to what extent do they conform to ISO 14000 documentation?

PubMed

Chung, Shan Shan; Fryxell, Gerald E; Lo, Carlos W H

2005-04-01

For decades, industry has been the main source of pollution in China. Determined to make changes, the mainland Chinese authorities have decided to promote mechanisms that incorporate environmental concerns into the internal management of enterprises. This is manifested in the rapid adoption of the ISO14000 standards, including a significant increase in ISO14001 registrations in China. Thus, this study examined the environmental policy statements of 106 certified facilities in mainland China against a strict interpretation of the mandatory requirements of the ISO 14001:1996 standard and the nonmandatory ISO14004 requirements in order to shed some light on the implementation of environmental management systems in an emerging economic giant. It was decided to analyze the environmental policy statement because such a statement is a core element in the ISO system of environmental management of each facility and there are relatively clear and specific requirements on what an environmental policy statement shall include. An analysis of the contents of the environmental policy statements shows that conformance to the relevant requirements of both the mandatory ISO14001 standard and the nonmandatory ISO14004 standard is far from impressive and that the facilities in our sample seldom went beyond the minimum requirements. By using ISO14001 and ISO14004 conformance scores as the dependent variables, we found that conformity to ISO14001 and overall conformance to ISO14000 series can be explained to some extent by the degree of top management commitment, the experience with informal environmental management systems, and the form of ownership of the facilities.

Implementing facility-based kangaroo mother care services: lessons from a multi-country study in Africa

PubMed Central

2014-01-01

Background Some countries have undertaken programs that included scaling up kangaroo mother care. The aim of this study was to systematically evaluate the implementation status of facility-based kangaroo mother care services in four African countries: Malawi, Mali, Rwanda and Uganda. Methods A cross-sectional, mixed-method research design was used. Stakeholders provided background information at national meetings and in individual interviews. Facilities were assessed by means of a standardized tool previously applied in other settings, employing semi-structured key-informant interviews and observations in 39 health care facilities in the four countries. Each facility received a score out of a total of 30 according to six stages of implementation progress. Results Across the four countries 95 per cent of health facilities assessed demonstrated some evidence of kangaroo mother care practice. Institutions that fared better had a longer history of kangaroo mother care implementation or had been developed as centres of excellence or had strong leaders championing the implementation process. Variation existed in the quality of implementation between facilities and across countries. Important factors identified in implementation are: training and orientation; supportive supervision; integrating kangaroo mother care into quality improvement; continuity of care; high-level buy in and support for kangaroo mother care implementation; and client-oriented care. Conclusion The integration of kangaroo mother care into routine newborn care services should be part of all maternal and newborn care initiatives and packages. Engaging ministries of health and other implementing partners from the outset may promote buy in and assist with the mobilization of resources for scaling up kangaroo mother care services. Mechanisms for monitoring these services should be integrated into existing health management information systems. PMID:25001366

Impact of Antimicrobial Stewardship on Physician Practice in a Geriatric Facility

PubMed Central

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

SU-E-CAMPUS-J-04: Image Guided Radiation Therapy (IGRT): Review of Technical Standards and Credentialing in Radiotherapy Clinical Trials

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

Giaddui, T; Chen, W; Yu, J

2014-06-15

Purpose: To review IGRT credentialing experience and unexpected technical issues encountered in connection with advanced radiotherapy technologies as implemented in RTOG clinical trials. To update IGRT credentialing procedures with the aim of improving the quality of the process, and to increase the proportion of IGRT credentialing compliance. To develop a living disease site-specific IGRT encyclopedia. Methods: Numerous technical issues were encountered during the IGRT credentialing process. The criteria used for credentialing review were based on: image quality; anatomy included in fused data sets and shift results. Credentialing requirements have been updated according to the AAPM task group reports for IGRTmore » to ensure that all required technical items are included in the quality review process. Implementation instructions have been updated and expanded for recent protocols. Results: Technical issues observed during the credentialing review process include, but are not limited to: poor quality images; inadequate image acquisition region; poor data quality; shifts larger than acceptable; no soft tissue surrogate. The updated IGRT credentialing process will address these issues and will also include the technical items required from AAPM: TG 104; TG 142 and TG 179 reports. An instruction manual has been developed describing a remote credentialing method for reviewers. Submission requirements are updated, including images/documents as well as facility questionnaire. The review report now includes summary of the review process and the parameters that reviewers check. We have reached consensus on the minimum IGRT technical requirement for a number of disease sites. RTOG 1311(NRG-BR002A Phase 1 Study of Stereotactic Body Radiotherapy (SBRT) for the Treatment of Multiple Metastases) is an example, here; the protocol specified the minimum requirement for each anatomical sites (with/without fiducials). Conclusion: Technical issues are identified and reported. IGRT guidelines are updated, with the corresponding credentialing requirements. An IGRT encyclopedia describing site-specific implementation issues is currently in development.« less

24 CFR 891.310 - Special project standards.

Code of Federal Regulations, 2010 CFR

2010-04-01

... living facility (or all bedrooms and bathrooms in a group home) must be designed to be accessible or... projects funded under §§ 891.655 through 891.790: (a) Minimum group home standards. Each group home must... independent living facility (or 10 percent of all bedrooms and bathrooms in a group home, but at least one of...

AMERICAN STANDARD SPECIFICATIONS FOR MAKING BUILDINGS AND FACILITIES ACCESSIBLE TO, AND USABLE BY, THE PHYSICALLY HANDICAPPED.

ERIC Educational Resources Information Center

National Easter Seal Society for Crippled Children and Adults, Chicago, IL.

THIS STANDARD IS INTENDED TO PROVIDE MINIMUM REQUIREMENTS TO BE USED IN THE CONSTRUCTION OF ALL BUILDINGS AND FACILITIES AND FOR ADOPTION AND ENFORCEMENT BY ADMINISTRATIVE AUTHORITIES IN ORDER TO ALLOW INDIVIDUALS WITH PERMANENT PHYSICAL DISABILITIES TO PURSUE THEIR INTERESTS AND ASPIRATIONS, DEVELOP THEIR TALENTS, AND EXERCISE THEIR SKILLS.…

Nearshore Pipeline Installation Methods.

DTIC Science & Technology

1981-08-01

inches b) Pipe, materials of construction: fully rigid, semi-rigid, flexible c) Pipeline length, maximum 2 miles d) Pipeline design life , minimum 15...common to their operations. Permanent facilities are specified in the Statement of Work. There- fore, a minimum design life of 15 years is chosen, which...makes the pipe leakproof and resists corrosion and abrasion. 5) Interlocked Z-shaped steel or stainless steel carcass - resists internal and external

Improving heart failure disease management in skilled nursing facilities: lessons learned.

PubMed

Dolansky, Mary A; Hitch, Jeanne A; Piña, Ileana L; Boxer, Rebecca S

2013-11-01

The purpose of the study was to design and evaluate an improvement project that implemented HF management in four skilled nursing facilities (SNFs). Kotter's Change Management principles were used to guide the implementation. In addition, half of the facilities had an implementation coach who met with facility staff weekly for 4 months and monthly for 5 months. Weekly and monthly audits were performed that documented compliance with eight key aspects of the protocol. Contextual factors were captured using field notes. Adherence to the HF management protocols was variable ranging from 17% to 82%. Facilitators of implementation included staff who championed the project, an implementation coach, and physician involvement. Barriers were high staff turnover and a hierarchal culture. Opportunities exist to integrate HF management protocols to improve SNF care.

Medical team training and coaching in the Veterans Health Administration; assessment and impact on the first 32 facilities in the programme.

PubMed

Neily, Julia; Mills, Peter D; Lee, Pamela; Carney, Brian; West, Priscilla; Percarpio, Katherine; Mazzia, Lisa; Paull, Douglas E; Bagian, James P

2010-08-01

Communication is problematic in healthcare. The Veterans Health Administration is implementing Medical Team Training. The authors describe results of the first 32 of 130 sites to undergo the programme. This report is unique; it provides aggregate results of a crew resource-management programme for numerous facilities. Facilities were taught medical team training and implemented briefings, debriefings and other projects. The authors coached teams through consultative phone interviews over a year. Implementation teams self-reported implementation and rated programme impact: 1='no impact' and 5='significant impact.' We used logistic regression to examine implementation of briefing/debriefing. Ninety-seven per cent of facilities implemented briefings and debriefings, and all implemented an additional project. As of the final interview, 73% of OR and 67% of ICU implementation teams self-reported and rated staff impact 4-5. Eighty-six per cent of OR and 82% of ICU implementation teams self-reported and rated patient impact 4-5. Improved teamwork was reported by 84% of OR and 75% of ICU implementation teams. Efficiency improvements were reported by 94% of OR implementation teams. Almost all facilities (97%) reported a success story or avoiding an undesirable event. Sites with lower volume were more likely to conduct briefings/debriefings in all cases for all surgical services (p=0.03). Sites are implementing the programme with a positive impact on patients and staff, and improving teamwork, efficiency and safety. A unique feature of the programme is that implementation was facilitated through follow-up support. This may have contributed to the early success of the programme.

Emergency obstetric and newborn care signal functions in public and private facilities in Bangladesh.

PubMed

Roy, Lumbini; Biswas, Taposh Kumar; Chowdhury, Mahbub Elahi

2017-01-01

Signal functions for emergency obstetric and newborn care (EmONC) are the major interventions for averting maternal and neonatal mortalities. Readiness of the facilities is essential to provide all the basic and comprehensive signal functions for EmONC to ensure emergency services from the designated facilities. The study assessed population coverage and availability of EmONC services in public and private facilities in Bangladesh. An assessment was conducted in all the public and private facilities providing obstetric care in to in-patients 24 districts. Data were collected on the performance of signal functions for EmONC from the study facilities in the last three months prior to the date of assessment. Trained data-collectors interviewed the facility managers and key service providers, along with review of records, using contextualized tools. Population coverage of signal functions was assessed by estimating the number of facilities providing the signal functions for EmONC compared to the United Nations requirements. Availability was assessed in terms of the proportion of facilities providing the services by type of facilities and by district. Caesarean section (CS) delivery and blood transfusion (BT) services (the two major components of comprehensive EmONC) were respectively available in 6.4 (0.9 public and 5.5 private) and 5.6 (1.3 public and 4.3 private) facilities per 500,000 population. The signal functions for basic EmONC, except two (parental anticonvulsants and assisted vaginal delivery), were available in a minimum of 5 facilities (public and private sectors combined) per 500,000 population. A major inter-district variation in the availability of signal functions was observed in each public- and private-sector facility. Among the various types of facilities, only the public medical college hospitals had all the signal functions. The situation was poor in other public facilities at the district and sub-district levels as well as in private facilities. In the public sector, CS delivery and BT services were available in the minimum required number of facilities. However, to ensure basic EmONC services, participation of the private sector is necessary. Public-private partnership should be promoted for nationwide coverage of signal functions for EmONC in Bangladesh.

78 FR 39493 - Patient Protection and Affordable Care Act; Exchange Functions: Eligibility for Exemptions...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-01

...This final rule implements certain functions of the Affordable Insurance Exchanges (``Exchanges''). These specific statutory functions include determining eligibility for and granting certificates of exemption from the individual shared responsibility payment described in section 5000A of the Internal Revenue Code. Additionally, this final rule implements the responsibilities of the Secretary of Health and Human Services, in coordination with the Secretary of the Treasury, to designate other health benefits coverage as minimum essential coverage by providing that certain coverage be designated as minimum essential coverage. It also outlines substantive and procedural requirements that other types of individual coverage must fulfill in order to be certified as minimum essential coverage.

Spatial decision support system to evaluate crop residue energy potential by anaerobic digestion.

PubMed

Escalante, Humberto; Castro, Liliana; Gauthier-Maradei, Paola; Rodríguez De La Vega, Reynel

2016-11-01

Implementing anaerobic digestion (AD) in energy production from crop residues requires development of decision tools to assess its feasibility and sustainability. A spatial decision support system (SDSS) was constructed to assist decision makers to select appropriate feedstock according to biomethanation potential, identify the most suitable location for biogas facilities, determine optimum plant capacity and supply chain, and evaluate associated risks and costs. SDSS involves a spatially explicit analysis, fuzzy multi-criteria analysis, and statistical and optimization models. The tool was validated on seven crop residues located in Santander, Colombia. For example, fique bagasse generates about 0.21millionm(3)CH4year(-1) (0.329m(3)CH4kg(-1) volatile solids) with a minimum profitable plant of about 2000tonyear(-1) and an internal rate of return of 10.5%. SDSS can be applied to evaluate other biomass resources, availability periods, and co-digestion potential. Copyright © 2016. Published by Elsevier Ltd.

Nutrition environment measures survey-vending: development, dissemination, and reliability.

PubMed

Voss, Carol; Klein, Susan; Glanz, Karen; Clawson, Margaret

2012-07-01

Researchers determined a need to develop an instrument to assess the vending machine environment that was comparably reliable and valid to other Nutrition Environment Measures Survey tools and that would provide consistent and comparable data for businesses, schools, and communities. Tool development, reliability testing, and dissemination of the Nutrition Environment Measures Survey-Vending (NEMS-V) involved a collaboration of students, professionals, and community leaders. Interrater reliability testing showed high levels of agreement among trained raters on the products and evaluations of products. NEMS-V can benefit public health partners implementing policy and environmental change initiatives as a part of their community wellness activities. The vending machine project will support a policy calling for state facilities to provide a minimum of 30% of foods and beverages in vending machines as healthy options, based on NEMS-V criteria, which will be used as a model for other businesses.

Process control and dosimetry in a multipurpose irradiation facility

NASA Astrophysics Data System (ADS)

Cabalfin, E. G.; Lanuza, L. G.; Solomon, H. M.

1999-08-01

Availability of the multipurpose irradiation facility at the Philippine Nuclear Research Institute has encouraged several local industries to use gamma radiation for sterilization or decontamination of various products. Prior to routine processing, dose distribution studies are undertaken for each product and product geometry. During routine irradiation, dosimeters are placed at the minimum and maximum dose positions of a process load.

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.

The Minimum Grading Controversy: Results of a Quantitative Study of Seven Years of Grading Data from an Urban High School

ERIC Educational Resources Information Center

Carey, Theodore; Carifio, James

2012-01-01

In an effort to reduce failure and drop-out rates, schools have been implementing minimum grading. One form involves raising catastrophically low student quarter grades to a predetermined minimum--typically a 50. Proponents argue it gives struggling students a reasonable chance to recover from failure. Critics contend the practice induces grade…

Market-Based and System-Wide Fuel Cycle Optimization

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

Wilson, Paul

The Dynamic Resource Exchange (DRE) gives agency to consumer facilities to determine the preference of any particular trade that is offered by suppliers to satisfy its requests. This provides a natural balance of power in the relationship between consumers and suppliers. However, in situations in which suppliers have flexibility surrounding the way that they respond to individual requests, they have no mechanism to assess how different bids will be received by the consumer. Theoretically, a supplier can offer multiple bids to respond to a given request in an attempt to “cover their bases”, but this introduces more arcs into themore » underlying network flow problem, increasing the cost to solve the problem. In the extreme, when a supplier can continuously vary the characteristics of the bid, this can represent a large number of additional arcs and have real performance consequences. To remedy this inefficiency in the implementation of the market-level optimization, the definition of a request has been extended to include a function that can be used by the supplier to query the preference that would be assigned by a consumer for a potential bid. The supplier is then free to implement arbitrarily complex algorithms to revise/optimize its bid based on responses to this function. A supplier can chose to not invoke the function at all, mimicking the original DRE behavior, can use it to select among a small set of discrete choices, or can implement an internal algorithm to seek an optimum bid on a continuous parameter space. This capability was demonstrated with a storage facility that preferred material with a specific decay heat that was as close as possible to the maximum allowable decay heat, while requiring the specific decay heat to fall between a minimum and maximum level. This archetype was used to fill multiple storage roles in a simulation that also included a standard recipe reactor: wet storage with no maximum allowable specific decay heat, dry storage with a modest maximum allowable specific decay heat, and a geologic repository with a low maximum allowable specific decay heat. In such a simulation, the reactor, wet storage and dry storage always offer their material to be taken by one of the other storage facilities. The preference function of the consumer would always ensure that material only flowed when the decay heat was sufficiently low, but in the absence of objective function callbacks, would allow for many superfluous offers that exceeded those limits. If this archetype also uses a callback function to probe the preference of the receiving facility for each possible offer, it can avoid making offers that are not going to be accepted by the receiving facility.« less

30 CFR 778.22 - Facilities or structures used in common.

Code of Federal Regulations, 2010 CFR

2010-07-01

... INTERIOR SURFACE COAL MINING AND RECLAMATION OPERATIONS PERMITS AND COAL EXPLORATION SYSTEMS UNDER REGULATORY PROGRAMS PERMIT APPLICATIONS-MINIMUM REQUIREMENTS FOR LEGAL, FINANCIAL, COMPLIANCE, AND RELATED...

Preventing Heel Pressure Ulcers: Sustained Quality Improvement Initiative in a Canadian Acute Care Facility.

PubMed

Hanna-Bull, Debbie

2016-01-01

The setting for this quality improvement initiative designed to reduce the prevalence of facility-acquired heel pressure ulcers was a regional, acute-care, 490-bed facility in Ontario, Canada, responsible for dialysis, vascular, and orthopedic surgery. An interdisciplinary skin and wound care team designed an evidence-based quality improvement initiative based on a systematic literature review and standardization of heel offloading methods. The prevalence of heel pressure ulcers was measured at baseline (immediately prior to implementation of initiative) and at 1 and 4 years following implementation. The prevalence of facility-acquired heel pressure ulcers was 5.8% when measured before project implementation. It was 4.2% at 1 year following implementation and 1.6% when measured at the end of the 4-year initiative. Outcomes demonstrate that the initiative resulted in a continuous and sustained reduction in facility-acquired heel pressure ulcer incidence over a 4-year period.

Facilities Utilization Program Implementation Handbook

NASA Technical Reports Server (NTRS)

1987-01-01

This Facilities Utilization Program Implementation Handbook (FUPIH) prescribes procedures for the review and the reporting on the utilization of NASA facilities. The Directors of NASA Field Installations should designate an Installation Official responsible for coordinating the assignment of buildings space and implementing the facilities utilization reviews and annual report preparation. The individual designated shall be known as the 'Facilities Utilization Officer (FUO).' Functional responsibilities of the FUO are detailed in NASA Management Instruction (NMI) 7234.1. It is recognized that titles used in the implementation of the Facilities Utilization Program may vary between field installations. The Facilities Utilization Program (FUP) is designed to provide a uniform and orderly process for meeting or addressing the following objectives: the establishment of sound facilities requirements to meet NASA's programmatic and institutional needs; the optimum allocation of available facilities and related resources to meet these requirements; and the early identification and request for required additional facilities resources. The detailed review and reporting system enacted by NMI 7234.1 should encourage more comprehensive utilization planning for all NASA facilities and ensure, to the maximum extent practicable, that all such facilities are put to their highest and best use consistent with NASA programmatic and institutional priorities. A principal purpose of the FUP is the early identification of NASA facilities which may be or may become underutilized or excess to NASA needs and to provide a timely reference point from which corrective actions (i.e., consolidation, elimination of duplication, improved utilization of disposal) may be taken. Because the supply of this handbook is limited, distribution should be controlled at the field installation level.

75 FR 5113 - National Park Service Concession Contracts; Implementation of Alternative Valuation for Leasehold...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-01

... inclusion of the standard formula). This is because, in developing the minimum franchise fee to be included... acquiring the existing LSI (and any required new LSI improvements). The minimum franchise fee, accordingly...

Improving the quality of nurse clinical documentation for chronic patients at primary care clinics: A multifaceted intervention.

PubMed

Mahomed, Ozayr H; Naidoo, Salsohni; Asmall, Shaidah; Taylor, Myra

2015-09-25

Deficiencies in record keeping practices have been reported at primary care level in the public health sector in South Africa. These deficiencies have the potential to negatively impact patient health outcomes as the break in information may hinder continuity of care. This disruption in information management has particular relevance for patients with chronic diseases. The aim of this study was to establish if the implementation of a structured clinical record (SCR) as an adjunct tool to the algorithmic guidelines for chronic disease management improved the quality of clinical records at primary care level. A quasi-experimental study (before and after study with a comparison group) was conducted across 30 primary health care clinics (PHCs) located in three districts in South Africa. Twenty PHCs that received the intervention were selected as intervention clinics and 10 facilities were selected as comparison facilities. The lot quality assurance sampling (LQAS) method was used to determine the number of records required to be reviewed per diagnostic condition per facility. There was a a statistically significant increase in the percentage of clinical records achieving compliance to the minimum criteria from the baseline to six months post-intervention for both HIV patients on antiretroviral treatment and patients with non-communicable diseases (hypertension and diabetes). A multifaceted intervention using a SCR to supplement the educational outreach component (PC 101 training) has demonstrated the potential for improving the quality of clinical records for patients with chronic diseases at primary care clinics in South Africa.

Impact of Electronic Health Records on Long-Term Care Facilities: Systematic Review

PubMed Central

Mileski, Michael; Vijaykumar, Alekhya Ganta; Viswanathan, Sneha Vishnampet; Suskandla, Ujwala; Chidambaram, Yazhini

2017-01-01

Background Long-term care (LTC) facilities are an important part of the health care industry, providing care to the fastest-growing group of the population. However, the adoption of electronic health records (EHRs) in LTC facilities lags behind other areas of the health care industry. One of the reasons for the lack of widespread adoption in the United States is that LTC facilities are not eligible for incentives under the Meaningful Use program. Implementation of an EHR system in an LTC facility can potentially enhance the quality of care, provided it is appropriately implemented, used, and maintained. Unfortunately, the lag in adoption of the EHR in LTC creates a paucity of literature on the benefits of EHR implementation in LTC facilities. Objective The objective of this systematic review was to identify the potential benefits of implementing an EHR system in LTC facilities. The study also aims to identify the common conditions and EHR features that received favorable remarks from providers and the discrepancies that needed improvement to build up momentum across LTC settings in adopting this technology. Methods The authors conducted a systematic search of PubMed, Cumulative Index of Nursing and Allied Health (CINAHL), and MEDLINE databases. Papers were analyzed by multiple referees to filter out studies not germane to our research objective. A final sample of 28 papers was selected to be included in the systematic review. Results Results of this systematic review conclude that EHRs show significant improvement in the management of documentation in LTC facilities and enhanced quality outcomes. Approximately 43% (12/28) of the papers reported a mixed impact of EHRs on the management of documentation, and 33% (9/28) of papers reported positive quality outcomes using EHRs. Surprisingly, very few papers demonstrated an impact on patient satisfaction, physician satisfaction, the length of stay, and productivity using EHRs. Conclusions Overall, implementation of EHRs has been found to be effective in the few LTC facilities that have implemented them. Implementation of EHRs in LTC facilities caused improved management of clinical documentation that enabled better decision making. PMID:28963091

Quality of antenatal and delivery care before and after the implementation of a prevention of mother-to-child HIV transmission programme in Côte d'Ivoire.

PubMed

Delvaux, Thérèse; Konan, Jean-Paul Diby; Aké-Tano, Odile; Gohou-Kouassi, Valérie; Bosso, Patrice Emery; Buvé, Anne; Ronsmans, Carine

2008-08-01

To assess whether implementation of a prevention of mother-to-child HIV transmission (PMTCT) programme in Côte d'Ivoire improved the quality of antenatal and delivery care services. Quality of antenatal and delivery care services was assessed in five urban health facilities before (2002-2003) and after (2005) the implementation of a PMTCT programme through review of facility data; observation of antenatal consultations (n = 606 before; n = 591 after) and deliveries (n = 229 before; n = 231 after) and exit interviews of women; and interviews of health facility staff. HIV testing was never proposed at baseline and was proposed to 63% of women at the first ANC visit after PMTCT implementation. The overall testing rate was 42% and 83% of tested HIV-infected pregnant women received nevirapine. In addition, inter-personal communication and confidentiality significantly improved in all health facilities. In the maternity ward, quality of obstetrical care at admission, delivery and post-partum care globally improved in all facilities after the implementation of the programme although some indicators remained poor, such as filling in the partograph directly during labour. Episiotomy rates among primiparous women dropped from 64% to 25% (P < 0.001) after PMTCT implementation. Global scores for quality of antenatal and delivery care significantly improved in all facilities after the implementation of the programme. Introducing comprehensive PMTCT services can improve the quality of antenatal and delivery care in general.

43 CFR 26.5 - Administrative requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... social, economic, ethnic or racial background, with special outreach efforts toward minority... home to a residential YCC project. (c) Capital outlays for facilities should be kept at a minimum. No...

Bio-functionalized silk hydrogel microfluidic systems.

PubMed

Zhao, Siwei; Chen, Ying; Partlow, Benjamin P; Golding, Anne S; Tseng, Peter; Coburn, Jeannine; Applegate, Matthew B; Moreau, Jodie E; Omenetto, Fiorenzo G; Kaplan, David L

2016-07-01

Bio-functionalized microfluidic systems were developed based on a silk protein hydrogel elastomeric materials. A facile multilayer fabrication method using gelatin sacrificial molding and layer-by-layer assembly was implemented to construct interconnected, three dimensional (3D) microchannel networks in silk hydrogels at 100 μm minimum feature resolution. Mechanically activated valves were implemented to demonstrate pneumatic control of microflow. The silk hydrogel microfluidics exhibit controllable mechanical properties, long-term stability in various environmental conditions, tunable in vitro and in vivo degradability in addition to optical transparency, providing unique features for cell/tissue-related applications than conventional polydimethylsiloxane (PDMS) and existing hydrogel-based microfluidic options. As demonstrated in the work here, the all aqueous-based fabrication process at ambient conditions enabled the incorporation of active biological substances in the bulk phase of these new silk microfluidic systems during device fabrication, including enzymes and living cells, which are able to interact with the fluid flow in the microchannels. These silk hydrogel-based microfluidic systems offer new opportunities in engineering active diagnostic devices, tissues and organs that could be integrated in vivo, and for on-chip cell sensing systems. Copyright © 2016 Elsevier Ltd. All rights reserved.

Insight into implementation of facility-based integrated management of childhood illness strategy in a rural district of Sindh, Pakistan

PubMed Central

Akber Pradhan, Nousheen; Rizvi, Narjis; Sami, Neelofar; Gul, Xaher

2013-01-01

Background Integrated management of childhood illnesses (IMCI) strategy has been proven to improve health outcomes in children under 5 years of age. Pakistan, despite being in the late implementation phase of the strategy, continues to report high under-five mortality due to pneumonia, diarrhea, measles, and malnutrition – the main targets of the strategy. Objective The study determines the factors influencing IMCI implementation at public-sector primary health care (PHC) facilities in Matiari district, Sindh, Pakistan. Design An exploratory qualitative study with an embedded quantitative strand was conducted. The qualitative part included 16 in-depth interviews (IDIs) with stakeholders which included planners and policy makers at a provincial level (n=5), implementers and managers at a district level (n=3), and IMCI-trained physicians posted at PHC facilities (n=8). Quantitative part included PHC facility survey (n=16) utilizing WHO health facility assessment tool to assess availability of IMCI essential drugs, supplies, and equipments. Qualitative content analysis was used to interpret the textual information, whereas descriptive frequencies were calculated for health facility survey data. Results The major factors reported to enhance IMCI implementation were knowledge and perception about the strategy and need for separate clinic for children aged under 5 years as potential support factors. The latter can facilitate in strategy implementation through allocated workforce and required equipments and supplies. Constraint factors mainly included lack of clear understanding of the strategy, poor planning for IMCI implementation, ambiguity in defined roles and responsibilities among stakeholders, and insufficient essential supplies and drugs at PHC centers. The latter was further substantiated through health facilities’ survey findings, which indicated that none of the facilities had 100% stock of essential supplies and drugs. Only one out of all 16 surveyed facilities had 75% of the total supplies, while 4 out of 16 facilities had 56% of the required IMCI drug stock. The mean availability of supplies ranged from 36.6 to 66%, while the mean availability of drugs ranged from 45.8 to 56.7%. Conclusion Our findings indicate that the Matiari district has sound implementation potential; however, bottlenecks at health care facility and at health care management level have badly constrained the implementation process. An interdependency exists among the constraining factors, such as lack of sound planning resulting in unclear understanding of the strategy; leading to ambiguous roles and responsibilities among stakeholders which manifest as inadequate availability of supplies and drugs at PHC facilities. Addressing these barriers is likely to have a cumulative effect on facilitating IMCI implementation. On the basis of these findings, we recommend that the provincial Ministry of Health (MoH) and provincial Maternal Neonatal and Child Health (MNCH) program jointly assess the situation and streamline IMCI implementation in the district through sound planning, training, supervision, and logistic support. PMID:23830574

Readiness for Implementation of Lung Cancer Screening. A National Survey of Veterans Affairs Pulmonologists.

PubMed

Tukey, Melissa H; Clark, Jack A; Bolton, Rendelle; Kelley, Michael J; Slatore, Christopher G; Au, David H; Wiener, Renda Soylemez

2016-10-01

To mitigate the potential harms of screening, professional societies recommend that lung cancer screening be conducted in multidisciplinary programs with the capacity to provide comprehensive care, from screening through pulmonary nodule evaluation to treatment of screen-detected cancers. The degree to which this standard can be met at the national level is unknown. To assess the readiness of clinical facilities in a national healthcare system for implementation of comprehensive lung cancer screening programs, as compared with the ideal described in policy recommendations. This was a cross-sectional, self-administered survey of staff pulmonologists in pulmonary outpatient clinics in Veterans Health Administration facilities. The facility-level response rate was 84.1% (106 of 126 facilities with pulmonary clinics); 88.7% of facilities showed favorable provider perceptions of the evidence for lung cancer screening, and 73.6% of facilities had a favorable provider-perceived local context for screening implementation. All elements of the policy-recommended infrastructure for comprehensive screening programs were present in 36 of 106 facilities (34.0%); the most common deficiencies were the lack of on-site positron emission tomography scanners or radiation oncology services. Overall, 26.5% of Veterans Health Administration facilities were ideally prepared for lung cancer screening implementation (44.1% if the policy recommendations for on-site positron emission tomography scanners and radiation oncology services were waived). Many facilities may be less than ideally positioned for the implementation of comprehensive lung cancer screening programs. To ensure safe, effective screening, hospitals may need to invest resources or coordinate care with facilities that can offer comprehensive care for screening through downstream evaluation and treatment of screen-detected cancers.

Implementation of A Better Choice Healthy Food and Drink Supply Strategy for staff and visitors in government-owned health facilities in Queensland, Australia.

PubMed

Miller, Jane; Lee, Amanda; Obersky, Natalie; Edwards, Rachael

2015-06-01

The present paper reports on a quality improvement activity examining implementation of A Better Choice Healthy Food and Drink Supply Strategy for Queensland Health Facilities (A Better Choice). A Better Choice is a policy to increase supply and promotion of healthy foods and drinks and decrease supply and promotion of energy-dense, nutrient-poor choices in all food supply areas including food outlets, staff dining rooms, vending machines, tea trolleys, coffee carts, leased premises, catering, fundraising, promotion and advertising. An online survey targeted 278 facility managers to collect self-reported quantitative and qualitative data. Telephone interviews were sought concurrently with the twenty-five A Better Choice district contact officers to gather qualitative information. Public sector-owned and -operated health facilities in Queensland, Australia. One hundred and thirty-four facility managers and twenty-four district contact officers participated with response rates of 48.2% and 96.0%, respectively. Of facility managers, 78.4% reported implementation of more than half of the A Better Choice requirements including 24.6% who reported full strategy implementation. Reported implementation was highest in food outlets, staff dining rooms, tea trolleys, coffee carts, internal catering and drink vending machines. Reported implementation was more problematic in snack vending machines, external catering, leased premises and fundraising. Despite methodological challenges, the study suggests that policy approaches to improve the food and drink supply can be implemented successfully in public-sector health facilities, although results can be limited in some areas. A Better Choice may provide a model for improving food supply in other health and workplace settings.

NCDOT : bridge policy

DOT National Transportation Integrated Search

1994-11-01

NCDOTs Bridge Policy establishes controlling design elements for new and reconstructed bridges on the state road system. It includes information to address sidewalks and bicycle facilities on bridges, including minimum handrail heights and sidewal...

32 CFR 148.12 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... POLICY AND IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.12 Definitions. Agency. Any...

32 CFR 148.12 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... POLICY AND IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.12 Definitions. Agency. Any...

32 CFR 148.12 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... POLICY AND IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.12 Definitions. Agency. Any...

32 CFR 148.12 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... POLICY AND IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.12 Definitions. Agency. Any...

32 CFR 148.12 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... POLICY AND IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.12 Definitions. Agency. Any...

Minimum Conflict Mainstreaming.

ERIC Educational Resources Information Center

Awen, Ed; And Others

Computer technology is discussed as a tool for facilitating the implementation of the mainstreaming process. Minimum conflict mainstreaming/merging (MCM) is defined as an approach which utilizes computer technology to circumvent such structural obstacles to mainstreaming as transportation scheduling, screening and assignment of students, testing,…

Airing 'clean air' in Clean India Mission.

PubMed

Banerjee, T; Kumar, M; Mall, R K; Singh, R S

2017-03-01

The submission explores the possibility of a policy revision for considering clean air quality in recently launched nationwide campaign, Clean India Mission (CIM). Despite of several efforts for improving availability of clean household energy and sanitation facilities, situation remain still depressing as almost half of global population lacks access to clean energy and proper sanitation. Globally, at least 2.5 billion people do not have access to basic sanitation facilities. There are also evidences of 7 million premature deaths by air pollution in year 2012. The situation is even more disastrous for India especially in rural areas. Although, India has reasonably progressed in developing sanitary facilities and disseminating clean fuel to its urban households, the situation in rural areas is still miserable and needs to be reviewed. Several policy interventions and campaigns were made to improve the scenario but outcomes were remarkably poor. Indian census revealed a mere 31% sanitation coverage (in 2011) compared to 22% in 2001 while 60% of population (700 million) still use solid biofuels and traditional cook stoves for household cooking. Further, last decade (2001-2011) witnessed the progress decelerating down with rural households without sanitation facilities increased by 8.3 million while minimum progress has been made in conversion of conventional to modern fuels. To revamp the sanitation coverage, an overambitious nationwide campaign CIM was initiated in 2014 and present submission explores the possibility of including 'clean air' considerations within it. The article draws evidence from literatures on scenarios of rural sanitation, energy practises, pollution induced mortality and climatic impacts of air pollution. This subsequently hypothesised with possible modification in available technologies, dissemination modes, financing and implementation for integration of CIM with 'clean air' so that access to both sanitation and clean household energy may be effectively addressed.

Quality of Voluntary Medical Male Circumcision Services during Scale-Up: A Comparative Process Evaluation in Kenya, South Africa, Tanzania and Zimbabwe

PubMed Central

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

Implementation evaluation of the Telephone Lifestyle Coaching (TLC) program: organizational factors associated with successful implementation.

PubMed

Damschroder, Laura J; Reardon, Caitlin M; Sperber, Nina; Robinson, Claire H; Fickel, Jacqueline J; Oddone, Eugene Z

2017-06-01

The Telephone Lifestyle Coaching (TLC) program provided telephone-based coaching for six lifestyle behaviors to 5321 Veterans at 24 Veterans Health Administration (VHA) medical facilities. The purpose of the study was to conduct an evaluation of the TLC program to identify factors associated with successful implementation. A mixed-methods study design was used. Quantitative measures of organizational readiness for implementation and facility complexity were used to purposively select a subset of facilities for in-depth evaluation. Context assessments were conducted using interview transcripts. The Consolidated Framework for Implementation Research (CFIR) was used to guide qualitative data collection and analysis. Factors most strongly correlated with referral rates included having a skilled implementation leader who used effective multi-component strategies to engage primary care clinicians as well as general clinic structures that supported implementation. Evaluation findings pointed to recommendations for local and national leaders to help anticipate and mitigate potential barriers to successful implementation.

40 CFR 125.84 - As an owner or operator of a new facility, what must I do to comply with this subpart?

Code of Federal Regulations, 2010 CFR

2010-07-01

... following requirements: (1) You must reduce your intake flow, at a minimum, to a level commensurate with... that the total design intake flow from all cooling water intake structures at your facility meets the... total design intake flow must be no greater than five (5) percent of the source water annual mean flow...

78 FR 67303 - Americans With Disabilities Act (ADA) Accessibility Guidelines for Buildings and Facilities...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-12

... continuing on page 59501, in the first column, Table 208.2--PARKING SPACES is corrected to read as follows: Table 208.2--Parking Spaces Total number of parking spaces provided in Minimum number of required parking facility accessible parking spaces 1 to 25 1. 26 to 50 2. 51 to 75 3. 76 to 100 4. 101 to 150 5...

Proposal for Monitoring Within the Centrifuge Cascades of Uranium Enrichment Facilities

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

Farrar, David R.

2017-04-01

Safeguards are technical measures implemented by the International Atomic Energy Agency (IAEA) to independently verify that nuclear material is not diverted from peaceful purposes to weapons (IAEA, 2017a). Safeguards implemented at uranium enrichment facilities (facilities hereafter) include enrichment monitors (IAEA, 2011). Figure 1 shows a diagram of how a facility could be monitored. The use of a system for monitoring within centrifuge cascades is proposed.

Implementing primary health care-based PMTCT interventions: operational perspectives from Muhima cohort analysis (Rwanda)

PubMed Central

Bucagu, Maurice; Muganda, John

2014-01-01

Introduction In countries with high burden of HIV, major programmatic challenges have been identified to preventing new infections among children and scaling up of treatment for pregnant mothers. We initiated this study to examine operational approaches that were used to enhance implementation of PMTCT interventions in Muhima health Centre (Kigali/Rwanda) from 2007 to 2010. Methods The prospective cohort study was conducted at Muhima health centre. A sample size of 656 was the minimum number required for the study. The main outcome was cumulative incidence of mother - to - child transmission of HIV-1 measured at 6 weeks of life among live born children. Results Among the 679 live born babies and followed up in this study, the overall cumulative rate of HIV-1 mother - to - child transmission observed was 3.2% at 6 weeks of age after birth. Disclosure of HIV status to partner was significantly associated with HIV-1 status of infants at 6 weeks of age (non-disclosure of HIV status adjusted odds ratio [AOR] 4.68, CI 1.39 to 15.77, p. Conclusion The Muhima type of decentralized health facility offered an appropriate platform for implementation of PMTCT interventions, with the following operational features: family - centered approach; integrated service delivery for PMTCT/MCH interventions, task shifting; subsidized membership fees for people living with HIV, allowing for access to the community-based health insurance benefits. PMID:26113893

Strengthening TB infection control in specialized health facilities in Romania--using a participatory approach.

PubMed

Turusbekova, N; Popa, C; Dragos, M; van der Werf, M J; Dinca, I

2016-02-01

In 2012, the tuberculosis (TB) notification rate among Romanian TB facility doctors and nurses was 7.2 times higher than in the general population. This indicates that transmission is ongoing inside TB facilities and that TB infection control measures are insufficient. To help prevent nosocomial TB transmission a project was implemented that aimed at providing nationwide tailor-made technical assistance in TB infection control (TB-IC) in TB treatment facilities, including the development of TB infection control plans. The objective of the present article is to describe the implementation of the project and to discuss successes and challenges. The project was an implementation study using two methods of evaluation: (1) a cross sectional questionnaire study; and (2) collection of information, during the training, on challenges related to infection control and to the project implementation. The project team developed a TB facility infection control (TB-IC) plan template, together with the Romanian experts. The template was discussed and agreed upon with the experts at a meeting and thereafter distributed by email to all TB facilities. Afterwards, a training of trainers (TOT) seminar was organized which included the provision of information about different training methods, as well as information about TB-IC. The TOT was followed by training for key TB-IC providers. Information about use of the TB-IC template was gathered through a self-administered questionnaire sent to all participants of the expert meeting and the training (42 people). Additionally, non-systematized discussions were held on broader challenges in TB-IC implementation during the training. Within the project 42 key TB-IC service providers were trained in TB-IC, including 9 who were trained at a TOT seminar. The trainees were specialists working at the national level, such as country TB coordinators, or at the TB facility level: TB doctors, epidemiologists, laboratory specialists and maintenance engineers. Out of 42 key TB-IC service providers who were trained, only eighteen responded to the questionnaire (no reminders were sent). Out of these, 14 had used the TB-IC plan template after the project team disseminated it to them by email. The remaining four TB-IC service providers indicated that they were planning to use the template to develop or update their facility TB-IC plans. Related to the use of TB-IC plan template, the following broader challenges in TB-IC were identified: a lack of authority of the individuals responsible for TB-IC to implement the TB-IC measures, lack of training among facility epidemiologists on TB, underdeveloped system for reporting TB in healthcare workers, difficulties with triage of the TB suspects, and poor facility infrastructure hampering implementation of TB-IC measures. Implementing TB-IC plans in Romanian health care facilities proved to be challenging, mainly due to the fact that the national infection control plan for TB was not yet adopted at the time of project implementation, and therefore there was neither a regulatory framework to support TB facility-IC planning nor any related budget allocations for the implementation of the facilities' TB-IC plans. Nonetheless, most respondents who answered the questionnaire (18 of 42 responded) indicated that they had started using the TB-IC plan template, which represents a full package of infection control measures that, when implemented effectively and in its entirety, may be expected to reduce nosocomial transmission. The study's limitations are: very low survey response rate, thus there is a likelihood of responder bias. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

77 FR 62429 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-15

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... Control, Airports, Incorporation by reference, and Navigation (Air). [[Page 62430

Tuberculosis infection control measures in health care facilities offering tb services in Ikeja local government area, Lagos, South West, Nigeria.

PubMed

Kuyinu, Y A; Mohammed, A S; Adeyeye, O O; Odugbemi, B A; Goodman, O O; Odusanya, O O

2016-03-15

Tuberculosis infection among health care workers is capable of worsening the existing health human resource problems of low--and middle-income countries. Tuberculosis infection control is often weakly implemented in these parts of the world therefore, understanding the reasons for poor implementation of tuberculosis infection control guidelines are important. This study was aimed at assessing tuberculosis infection control practices and barriers to its implementation in Ikeja, Nigeria. A cross-sectional study in 20 tuberculosis care facilities (16 public and 4 private) in Ikeja, Lagos was conducted. The study included a facility survey to assess the availability of tuberculosis infection control guidelines, the adequacy of facilities to prevent transmission of tuberculosis and observations of practices to assess the implementation of tuberculosis infection control guidelines. Four focus group discussions were carried out to highlight HCWs' perceptions on tuberculosis infection control guidelines and barriers to its implementation. The observational study showed that none of the clinics had a tuberculosis infection control plan. No clinic was consistently screening patients for cough. Twelve facilities (60%) consistently provided masks to patients who were coughing. Ventilation in the waiting areas was assessed to be adequate in 60% of the clinics while four clinics (20%) possessed N-95 respirators. Findings from the focus group discussions showed weak managerial support, poor funding, under-staffing, lack of space and not wanting to be seen as stigmatizing against tuberculosis patients as barriers that hindered the implementation of TB infection control measures. Tuberculosis infection control measures were not adequately implemented in health facilities in Ikeja, Nigeria. A multi-pronged approach is required to address the identified barriers to the implementation of tuberculosis infection control guidelines.

Emergency obstetric and newborn care signal functions in public and private facilities in Bangladesh

PubMed Central

2017-01-01

Background Signal functions for emergency obstetric and newborn care (EmONC) are the major interventions for averting maternal and neonatal mortalities. Readiness of the facilities is essential to provide all the basic and comprehensive signal functions for EmONC to ensure emergency services from the designated facilities. The study assessed population coverage and availability of EmONC services in public and private facilities in Bangladesh. Methods An assessment was conducted in all the public and private facilities providing obstetric care in to in-patients 24 districts. Data were collected on the performance of signal functions for EmONC from the study facilities in the last three months prior to the date of assessment. Trained data-collectors interviewed the facility managers and key service providers, along with review of records, using contextualized tools. Population coverage of signal functions was assessed by estimating the number of facilities providing the signal functions for EmONC compared to the United Nations requirements. Availability was assessed in terms of the proportion of facilities providing the services by type of facilities and by district. Results Caesarean section (CS) delivery and blood transfusion (BT) services (the two major components of comprehensive EmONC) were respectively available in 6.4 (0.9 public and 5.5 private) and 5.6 (1.3 public and 4.3 private) facilities per 500,000 population. The signal functions for basic EmONC, except two (parental anticonvulsants and assisted vaginal delivery), were available in a minimum of 5 facilities (public and private sectors combined) per 500,000 population. A major inter-district variation in the availability of signal functions was observed in each public- and private-sector facility. Among the various types of facilities, only the public medical college hospitals had all the signal functions. The situation was poor in other public facilities at the district and sub-district levels as well as in private facilities. Conclusions In the public sector, CS delivery and BT services were available in the minimum required number of facilities. However, to ensure basic EmONC services, participation of the private sector is necessary. Public-private partnership should be promoted for nationwide coverage of signal functions for EmONC in Bangladesh. PMID:29091965

Study of spatial resolution of coordinate detectors based on Gas Electron Multipliers

NASA Astrophysics Data System (ADS)

Kudryavtsev, V. N.; Maltsev, T. V.; Shekhtman, L. I.

2017-02-01

Spatial resolution of GEM-based tracking detectors is determined in the simulation and measured in the experiments. The simulation includes GEANT4 implemented transport of high energy electrons with careful accounting of atomic relaxation processes including emission of fluorescent photons and Auger electrons and custom post-processing with accounting of diffusion, gas amplification fluctuations, distribution of signals on readout electrodes, electronics noise and particular algorithm of final coordinate calculation (center of gravity). The simulation demonstrates that the minimum of spatial resolution of about 10 μm can be achieved with a gas mixture of Ar -CO2 (75-25 %) at a strips pitch from 250 μm to 300 μm. At a larger pitch the resolution quickly degrades reaching 80-100 μm at a pitch of 460-500 μm. Spatial resolution of low-material triple-GEM detectors for the DEUTERON facility at the VEPP-3 storage ring is measured at the extracted beam facility of the VEPP-4 M collider. One-coordinate resolution of the DEUTERON detector is measured with electron beam of 500 MeV, 1 GeV and 3.5 GeV energies. The determined value of spatial resolution varies in the range from approximately 35 μm to 50 μm for orthogonal tracks in the experiments.

Barriers and facilitators to the implementation of an evidence-based electronic minimum dataset for nursing team leader handover: A descriptive survey.

PubMed

Spooner, Amy J; Aitken, Leanne M; Chaboyer, Wendy

2017-11-15

There is widespread use of clinical information systems in intensive care units however, the evidence to support electronic handover is limited. The study aim was to assess the barriers and facilitators to use of an electronic minimum dataset for nursing team leader shift-to-shift handover in the intensive care unit prior to its implementation. The study was conducted in a 21-bed medical/surgical intensive care unit, specialising in cardiothoracic surgery at a tertiary referral hospital, in Queensland, Australia. An established tool was modified to the intensive care nursing handover context and a survey of all 63 nursing team leaders was undertaken. Survey statements were rated using a 6-point Likert scale with selections from 'strongly disagree' to 'strongly agree', and open-ended questions. Descriptive statistics were used to summarise results. A total of 39 team leaders responded to the survey (62%). Team leaders used general intensive care work unit guidelines to inform practice however they were less familiar with the intensive care handover work unit guideline. Barriers to minimum dataset uptake included: a tool that was not user friendly, time consuming and contained too much information. Facilitators to minimum dataset adoption included: a tool that was user friendly, saved time and contained relevant information. Identifying the complexities of a healthcare setting prior to the implementation of an intervention assists researchers and clinicians to integrate new knowledge into healthcare settings. Barriers and facilitators to knowledge use focused on usability, content and efficiency of the electronic minimum dataset and can be used to inform tailored strategies to optimise team leaders' adoption of a minimum dataset for handover. Copyright © 2017 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

Implementation of tuberculosis infection prevention and control in Mozambican health care facilities.

PubMed

Brouwer, M; Coelho, E; das Dores Mosse, C; van Leth, F

2015-01-01

District and urban health care facilities in three provinces (Manica, Sofala, Tete) in central Mozambique. To assess the level of implementation of selected tuberculosis infection prevention and control (TB-IPC) measures. In a cross-sectional study of TB-IPC implementation in 29 health care facilities, we assessed TB clinics, laboratories, out-patient departments and medical and TB wards. Assessment included selected managerial, administrative and environmental measures and the availability and use of respiratory protective equipment (N95 respirators). Guidelines for diagnosis and treatment of (presumptive) TB patients were not present in all facilities. Staff instructed patients on sputum collection in 91%, but only 4% observed it. Using a pragmatic '20% rule', 52% of the rooms assessed had adequate ventilation. Potentially, this could be increased to 76%. Three quarters of the health care workers had N95 respirators. Only 36% knew how to use it correctly. Implementation of TB-IPC measures showed wide variations within health care facilities. Relatively simple measures to improve TB-IPC include the availability of guidelines, opening doors and windows to improve ventilation, and training and support on correct N95 respirator use. However, even relatively simple measures are challenging to implement, and require careful attention in and evaluation of the implementation process.

The Abbott School Construction Program: NJ Department of Education Proposed Facilities Regulations. Analysis of Preschool Issues

ERIC Educational Resources Information Center

Ponessa, Joan; Boylan, Ellen

2004-01-01

This report on preschool facilities analyzes regulations proposed by the New Jersey Department of Education (NJDOE) to implement the Educational Facilities Construction and Financing Act. (EFCFA). EFCFA, which authorizes and governs New Jersey's public school construction program, was enacted in July 2000 to implement the State Supreme Court's…

77 FR 59735 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-01

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... control, Airports, Incorporation by reference, and Navigation (air). Issued in Washington, DC, on...

78 FR 64168 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-28

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... Control, Airports, Incorporation by reference, and Navigation (air). Issued in Washington, DC, on...

28 CFR 36.602 - General rule.

Code of Federal Regulations, 2013 CFR

2013-07-01

... ACCOMMODATIONS AND IN COMMERCIAL FACILITIES Certification of State Laws or Local Building Codes § 36.602 General... that a code meets or exceeds the minimum requirements of the Act for the accessibility and usability of...

28 CFR 36.602 - General rule.

Code of Federal Regulations, 2014 CFR

2014-07-01

... ACCOMMODATIONS AND IN COMMERCIAL FACILITIES Certification of State Laws or Local Building Codes § 36.602 General... that a code meets or exceeds the minimum requirements of the Act for the accessibility and usability of...

28 CFR 36.602 - General rule.

Code of Federal Regulations, 2011 CFR

2011-07-01

... ACCOMMODATIONS AND IN COMMERCIAL FACILITIES Certification of State Laws or Local Building Codes § 36.602 General... that a code meets or exceeds the minimum requirements of the Act for the accessibility and usability of...

28 CFR 36.602 - General rule.

Code of Federal Regulations, 2012 CFR

2012-07-01

... ACCOMMODATIONS AND IN COMMERCIAL FACILITIES Certification of State Laws or Local Building Codes § 36.602 General... that a code meets or exceeds the minimum requirements of the Act for the accessibility and usability of...

29 CFR 1917.127 - Sanitation.

Code of Federal Regulations, 2012 CFR

2012-07-01

... employees. The facilities shall have: (i) Running water, including hot and cold or tepid water at a minimum... containers shall be clean, containing only water and ice, and shall be fitted with covers. (3) Common...

29 CFR 1917.127 - Sanitation.

Code of Federal Regulations, 2014 CFR

2014-07-01

... employees. The facilities shall have: (i) Running water, including hot and cold or tepid water at a minimum... containers shall be clean, containing only water and ice, and shall be fitted with covers. (3) Common...

29 CFR 1917.127 - Sanitation.

Code of Federal Regulations, 2013 CFR

2013-07-01

... employees. The facilities shall have: (i) Running water, including hot and cold or tepid water at a minimum... containers shall be clean, containing only water and ice, and shall be fitted with covers. (3) Common...

28 CFR 36.602 - General rule.

Code of Federal Regulations, 2010 CFR

2010-07-01

... ACCOMMODATIONS AND IN COMMERCIAL FACILITIES Certification of State Laws or Local Building Codes § 36.602 General... that a code meets or exceeds the minimum requirements of the Act for the accessibility and usability of...

A Preliminary Appraisal of the Needs for and Means of Obtaining the Necessary College Facilities at a Minimal Cost to the Taxpayer.

ERIC Educational Resources Information Center

Bortolazzo, Julio L.

San Joaquin Delta College (California), planning on an enrollment increase of more than 10% annually, has estimated its minimum facility needs for an enrollment of approximately 7500 students by 1972. The gross cost per square foot is expected to be $25.00 for general construction and $38.50 for special construction. For an estimated total of…

Impact of Electronic Health Records on Long-Term Care Facilities: Systematic Review.

PubMed

Kruse, Clemens Scott; Mileski, Michael; Vijaykumar, Alekhya Ganta; Viswanathan, Sneha Vishnampet; Suskandla, Ujwala; Chidambaram, Yazhini

2017-09-29

Long-term care (LTC) facilities are an important part of the health care industry, providing care to the fastest-growing group of the population. However, the adoption of electronic health records (EHRs) in LTC facilities lags behind other areas of the health care industry. One of the reasons for the lack of widespread adoption in the United States is that LTC facilities are not eligible for incentives under the Meaningful Use program. Implementation of an EHR system in an LTC facility can potentially enhance the quality of care, provided it is appropriately implemented, used, and maintained. Unfortunately, the lag in adoption of the EHR in LTC creates a paucity of literature on the benefits of EHR implementation in LTC facilities. The objective of this systematic review was to identify the potential benefits of implementing an EHR system in LTC facilities. The study also aims to identify the common conditions and EHR features that received favorable remarks from providers and the discrepancies that needed improvement to build up momentum across LTC settings in adopting this technology. The authors conducted a systematic search of PubMed, Cumulative Index of Nursing and Allied Health (CINAHL), and MEDLINE databases. Papers were analyzed by multiple referees to filter out studies not germane to our research objective. A final sample of 28 papers was selected to be included in the systematic review. Results of this systematic review conclude that EHRs show significant improvement in the management of documentation in LTC facilities and enhanced quality outcomes. Approximately 43% (12/28) of the papers reported a mixed impact of EHRs on the management of documentation, and 33% (9/28) of papers reported positive quality outcomes using EHRs. Surprisingly, very few papers demonstrated an impact on patient satisfaction, physician satisfaction, the length of stay, and productivity using EHRs. Overall, implementation of EHRs has been found to be effective in the few LTC facilities that have implemented them. Implementation of EHRs in LTC facilities caused improved management of clinical documentation that enabled better decision making. ©Clemens Scott Kruse, Michael Mileski, Alekhya Ganta Vijaykumar, Sneha Vishnampet Viswanathan, Ujwala Suskandla, Yazhini Chidambaram. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 29.09.2017.

Improving palliative care through teamwork (IMPACTT) in nursing homes: Study design and baseline findings.

PubMed

Temkin-Greener, Helena; Ladwig, Susan; Ye, Zhiqiu; Norton, Sally A; Mukamel, Dana B

2017-05-01

The 2014 Institute of Medicine report recommended that healthcare providers caring for individuals with advanced illness have basic palliative care competencies in communication, inter-professional collaboration, and symptom management. Nursing homes, where one in three American decedents live and die, have fallen short of these competency goals. We implemented an intervention study to examine the efficacy of nursing home-based integrated palliative care teams in improving the quality of care processes and outcomes for residents at the end of life. This paper describes the design, rationale, and challenges of a two-arm randomized controlled trial of nursing home-based palliative care teams in 31 facilities. The impact of the intervention on residents' outcomes is measured with four risk-adjusted quality indicators: place of death (nursing home or hospital), number of hospitalizations, and self-reported pain and depression in the last 90-days of life. The effect of the intervention is also evaluated with regard to staff satisfaction and impact on care processes (e.g. palliative care competency, communication, coordination). Both secondary (e.g. the Minimum Data Set) and primary (e.g. staff surveys) data are employed to examine the effect of the intervention. Several challenges in conducting a complex, nursing home-based intervention have been identified. While sustainability of the intervention without research funding is not clear, we surmise that without changes to the payment model that put palliative care services in this care setting on par with the more "skilled" care, it will not be reasonable to expect any widespread efforts to implement facility-based palliative care services. Copyright © 2017 Elsevier Inc. All rights reserved.

Countdown to 2015 country case studies: systematic tools to address the "black box" of health systems and policy assessment.

PubMed

Singh, Neha S; Huicho, Luis; Afnan-Holmes, Hoviyeh; John, Theopista; Moran, Allisyn C; Colbourn, Tim; Grundy, Chris; Matthews, Zoe; Maliqi, Blerta; Mathai, Matthews; Daelmans, Bernadette; Requejo, Jennifer; Lawn, Joy E

2016-09-12

Evaluating health systems and policy (HSP) change and implementation is critical in understanding reproductive, maternal, newborn and child health (RMNCH) progress within and across countries. Whilst data for health outcomes, coverage and equity have advanced in the last decade, comparable analyses of HSP changes are lacking. We present a set of novel tools developed by Countdown to 2015 (Countdown) to systematically analyse and describe HSP change for RMNCH indicators, enabling multi-country comparisons. International experts worked with eight country teams to develop HSP tools via mixed methods. These tools assess RMNCH change over time (e.g. 1990-2015) and include: (i) Policy and Programme Timeline Tool (depicting change according to level of policy); (ii) Health Policy Tracer Indicators Dashboard (showing 11 selected RMNCH policies over time); (iii) Health Systems Tracer Indicators Dashboard (showing four selected systems indicators over time); and (iv) Programme implementation assessment. To illustrate these tools, we present results from Tanzania and Peru, two of eight Countdown case studies. The Policy and Programme Timeline tool shows that Tanzania's RMNCH environment is complex, with increased funding and programmes for child survival, particularly primary-care implementation. Maternal health was prioritised since mid-1990s, yet with variable programme implementation, mainly targeting facilities. Newborn health only received attention since 2005, yet is rapidly scaling-up interventions at facility- and community-levels. Reproductive health lost momentum, with re-investment since 2010. Contrastingly, Peru moved from standalone to integrated RMNCH programme implementation, combined with multi-sectoral, anti-poverty strategies. The HSP Tracer Indicators Dashboards show that Peru has adopted nine of 11 policy tracer indicators and Tanzania has adopted seven. Peru costed national RMNCH plans pre-2000, whereas Tanzania developed a national RMNCH plan in 2006 but only costed the reproductive health component. Both countries included all lifesaving RMNCH commodities on their essential medicines lists. Peru has twice the health worker density of Tanzania (15.4 vs. 7.1/10,000 population, respectively), although both are below the 22.8 WHO minimum threshold. These are the first HSP tools using mixed methods to systematically analyse and describe RMNCH changes within and across countries, important in informing accelerated progress for ending preventable maternal, newborn and child mortality in the post-2015 era.

Technical basis, supporting information, and strategy for development and implementation of DOE policy for natural phenomena hazards

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

Murray, R.C.

1991-09-01

Policy for addressing natural phenomenon comprises a hierarchy of interrelated documents. The top level of policy is contained in the code of Federal Regulations which establishes the framework and intent to ensure overall safety of DOE facilities when subjected to the effects of natural phenomena. The natural phenomena to be considered include earthquakes and tsunami, winds, hurricanes and tornadoes, floods, volcano effects and seiches. Natural phenomena criteria have been established for design of new facilities; evaluation of existing facilities; additions, modifications, and upgrades to existing facilities; and evaluation criteria for new or existing sites. Steps needed to implement these fourmore » general criteria are described. The intent of these criteria is to identify WHAT needs to be done to ensure adequate protection from natural phenomena. The commentary provides discussion of WHY this is needed for DOE facilities within the complex. Implementing procedures identifying HOW to carry out these criteria are next identified. Finally, short and long term tasks needed to identify the implementing procedure are tabulated. There is an overall need for consistency throughout the DOE complex related to natural phenomena including consistent terminology, policy, and implementation. 1 fig, 6 tabs.« less

Strategies to Mitigate a Mycobacterium marinum Outbreak in a Zebrafish Research Facility

PubMed Central

Snell, Kathy; Mittge, Erika; Melancon, Ellie; Montgomery, Rebecca; McFadden, Marcie; Camoriano, Javier; Kent, Michael L.; Whipps, Christopher M.; Peirce, Judy

2016-01-01

Abstract In 2011, the zebrafish research facility at the University of Oregon experienced an outbreak of Mycobacterium marinum that affected both research fish and facility staff. A thorough review of risks to personnel, the zebrafish veterinary care program, and zebrafish husbandry procedures at the research facility followed. In the years since 2011, changes have been implemented throughout the research facility to protect the personnel, the fish colony, and ultimately the continued success of the zebrafish model research program. In this study, we present the history of the outbreak, the changes we implemented, and recommendations to mitigate pathogen outbreaks in zebrafish research facilities. PMID:27351618

The Development and Implementation of a Minimum Objective System in the Hinesburg Elementary School. Hinesburg Elementary School Minimum Objectives for Science, Physical Education, Music, Library. Appendix B: Vol. 3.

ERIC Educational Resources Information Center

Morse, Margaret; And Others

The appendix to the report of the minimum objective system of the Hinesburg Elementary School (Vermont) includes objectives for science, physical education, music, and library skills, from the kindergarten through grade 6 levels. Most objectives are presented in the format of condition (or task), student behavior, and criteria. Also included are…

Implementation of Preoperative Screening Criteria Lowers Infection and Complication Rates Following Elective Total Hip Arthroplasty and Total Knee Arthroplasty in a Veteran Population.

PubMed

Nussenbaum, Fernando D; Rodriguez-Quintana, David; Fish, Sara M; Green, David M; Cahill, Catherine W

2018-01-01

Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are common procedures with a risk of complications. Attempting to minimize complications, our institution implemented preoperative screening criteria for patients undergoing elective total joint replacement. Our study aimed to determine if screening criteria lowered total complications and/or surgical site infections (SSI). Two groups of consecutive patients undergoing TKA and THA at a single Veterans Affairs facility were evaluated prior to and after implementation of screening criteria, 520 and 475 respectively. Screening criteria included hemoglobin A1c ≤7, hemoglobin ≥11, body mass index ≤35, and albumin ≥3.5. Groups were analyzed for demographics, preoperative comorbidities, and postoperative complications. Rates of total complications and SSI were compared. Average follow-up was at least 2 years with minimum of 1 year. Demographics and comorbidities outside the screening criteria were similar. Total complication rate was reduced from 35.4% to 14.8% (P < .01) after implementation of screening criteria. For TKA, total complications were reduced from 33.1% to 15.0% (P < .01) and for THA they were reduced from 42.4% to 14.2% (P < .01). SSI rates for combined TKA and THA were reduced from 4.4% to 1.3% (P < .01). For knees, SSI was reduced from 4.6% to 1.3% (P = .01) and was statistically significant. For THA, SSI decreased from 3.8% to 1.2% (P < .05). Our institution saw a statistically significant decrease in both SSI and total complications following implementation of preoperative screening criteria for elective TKA and THA. Published by Elsevier Inc.

The Abbott School Construction Program: Report on the NJ Department of Education Proposed Regulations on Long-Range Facilities Plans

ERIC Educational Resources Information Center

Ponessa, Joan

2004-01-01

This report on Long Range Facilities Plans (LRFPs) analyzes regulations proposed by the New Jersey Department of Education (NJDOE) to implement the Educational Facilities Construction and Financing Act. (EFCFA). EFCFA, which authorizes and governs New Jersey's public school construction program, was enacted in July 2000 to implement the State…

Performance of buried pipe installation : tech summary.

DOT National Transportation Integrated Search

2010-05-01

Existing codes and recommendations often require standard/minimum values for the bedding, backfi ll, and fi ll cover geometric and : mechanical properties in the installation of buried pipes under transportation facilities. These recommended values a...

78 FR 75456 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-12

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... Control, Airports, Incorporation by reference, and Navigation (Air). Issued in Washington, DC, on November...

77 FR 66536 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-06

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... Control, Airports, Incorporation by reference, and Navigation (Air). Issued in Washington, DC, on October...

78 FR 70491 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-26

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... control, Airports, Incorporation by reference, and Navigation (air). Issued in Washington, DC, on November...

78 FR 68704 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-15

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... traffic control, Airports, Incorporation by reference, and Navigation (air). Issued in Washington, DC, on...

77 FR 59738 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-01

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... control, Airports, Incorporation by reference, and Navigation (air). Dated: Issued in Washington, DC, on...

78 FR 68702 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-15

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... control, Airports, Incorporation by reference, and Navigation (air). Issued in Washington, DC on October...

78 FR 28133 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-14

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... Control, Airports, Incorporation by reference, and Navigation (air). Issued in Washington, DC, on April 26...

76 FR 40598 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-11

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... Control, Airports, Incorporation by reference, and Navigation (Air). Issued in Washington, DC, on June 24...

78 FR 50326 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-19

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... control, Airports, Incorporation by reference, and Navigation (Air). Issued in Washington, DC, on August 2...

78 FR 78714 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-27

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... Control, Airports, Incorporation by reference, and Navigation (Air). Issued in Washington, DC on December...

77 FR 18679 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-28

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... control, Airports, Incorporation by reference, and Navigation (air). Issued in Washington, DC, on March 16...

78 FR 64172 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-28

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... Control, Airports, Incorporation by reference, and Navigation (Air). Issued in Washington, DC, on October...

78 FR 64170 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-28

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... Control, Airports, Incorporation by reference, and Navigation (air). Issued in Washington, DC, on October...

76 FR 47988 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-08

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... Control, Airports, Incorporation by reference, and Navigation (air). Issued in Washington, DC, on July 22...

78 FR 28135 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-14

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... Traffic Control, Airports, Incorporation by reference, and Navigation (Air). Issued in Washington, DC, on...

78 FR 78713 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-27

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... traffic control, Airports, Incorporation by reference, and Navigation (Air). Issued in Washington, DC, on...

77 FR 62427 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-15

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... Control, Airports, Incorporation by reference, and Navigation (Air). Issued in Washington, DC on September...

78 FR 50324 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-19

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... Control, Airports, Incorporation by reference, and Navigation (Air). Issued in Washington, DC, on August 2...

78 FR 25386 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-01

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... Control, Airports, Incorporation by reference, and Navigation (Air). Issued in Washington, DC, on April 12...

78 FR 64167 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-28

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... Control, Airports, Incorporation by reference, and Navigation (Air). Issued in Washington, DC on September...

75 FR 5230 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-02

... facilities, adding new obstacles, or changing air traffic requirements. These changes are designed to provide... control, Airports, Incorporation by reference, and Navigation (air). Issued in Washington, DC, on 22...

40 CFR Table 1a to Subpart Ce of... - Emissions Limits for Small, Medium, and Large HMIWI at Designated Facilities as Defined in § 60...

Code of Federal Regulations, 2011 CFR

2011-07-01

...) (grains per dry standard cubic foot (gr/dscf)) 115 (0.05) 69 (0.03) 34 (0.015) 3-run average (1-hour minimum sample time per run) EPA Reference Method 5 of appendix A-3 of part 60, or EPA Reference Method...-run average (1-hour minimum sample time per run) EPA Reference Method 10 or 10B of appendix A-4 of...

40 CFR Table 1a to Subpart Ce of... - Emissions Limits for Small, Medium, and Large HMIWI at Designated Facilities as Defined in § 60...

Code of Federal Regulations, 2010 CFR

2010-07-01

...) (grains per dry standard cubic foot (gr/dscf)) 115 (0.05) 69 (0.03) 34 (0.015) 3-run average (1-hour minimum sample time per run) EPA Reference Method 5 of appendix A-3 of part 60, or EPA Reference Method...-run average (1-hour minimum sample time per run) EPA Reference Method 10 or 10B of appendix A-4 of...

Computer simulations of optimum boost and buck-boost converters

NASA Technical Reports Server (NTRS)

Rahman, S.

1982-01-01

The development of mathematicl models suitable for minimum weight boost and buck-boost converter designs are presented. The facility of an augumented Lagrangian (ALAG) multiplier-based nonlinear programming technique is demonstrated for minimum weight design optimizations of boost and buck-boost power converters. ALAG-based computer simulation results for those two minimum weight designs are discussed. Certain important features of ALAG are presented in the framework of a comprehensive design example for boost and buck-boost power converter design optimization. The study provides refreshing design insight of power converters and presents such information as weight annd loss profiles of various semiconductor components and magnetics as a function of the switching frequency.

[Estimation of cost-saving for reducing radioactive waste from nuclear medicine facilities by implementing decay in storage (DIS) in Japan].

PubMed

Kida, Tetsuo; Hiraki, Hitoshi; Yamaguchi, Ichirou; Fujibuchi, Toshioh; Watanabe, Hiroshi

2012-01-01

DIS has not yet been implemented in Japan as of 2011. Therefore, even if risk was negligible, medical institutions have to entrust radioactive temporal waste disposal to Japan Radio Isotopes Association (JRIA) in the current situation. To decide whether DIS should be implemented in Japan or not, cost-saving effect of DIS was estimated by comparing the cost that nuclear medical facilities pay. By implementing DIS, the total annual cost for all nuclear medical facilities in Japan is estimated to be decreased to 30 million yen or less from 710 million yen. DIS would save 680 million yen (96%) per year.

23 CFR 630.1014 - Implementation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... PRECONSTRUCTION PROCEDURES Work Zone Safety and Mobility § 630.1014 Implementation. Each State shall work in partnership with the FHWA in the implementation of its policies and procedures to improve work zone safety and mobility. At a minimum, this shall involve an FHWA review of conformance of the State's policies and...

50 CFR 218.174 - Requirements for monitoring and reporting.

Code of Federal Regulations, 2011 CFR

2011-10-01

...-based surveys shall be designed to maximize detections of marine mammals near mission activity event. (2... Navy to implement, at a minimum, the monitoring activities summarized below: (1) Visual Surveys: (i) The Holder of this Authorization shall conduct a minimum of 2 special visual surveys per year to...

Consolidating DoD Housing and Allowance Data Collection

DTIC Science & Technology

1991-01-01

data . In addition, the military staff chains of command, unit chains of command, DMDC, and the Navy’s Facilities Support Office (FACSO) become...non-pay section of the form if the Finance Office abandons it. However, the current methods of collecting data are equally risky, and statistical ...minimum standards are rescored as acceptable. The survey data sheets are then mailed to the Navy’s Facility Support Office (FACSO) at Port Hueneme, CA

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

Paul, I.R.

A pilot study in two states led to the establishment of the Dental Exposure Normalization Technique (DENT) program. This, in brief, is an exposure reduction and quality assurance program for radiological health agencies. The health agency sends X-ray exposure cards to dental X-ray facilities. These are exposed by the dentist and returned for analysis. Facilities which show excessive exposure are then visited to demonstrate the changes in exposure and processing necessary to produce diagnostic quality radiographs with minimum patient exposure.

Implementing apportionment strategy to identify costs in a multidisciplinary clinic.

PubMed

Ferraz, Renato Ribeiro Nogueira; Neri, Anna Sofia Costa; Barbosa, Estela Capelas; Silva, Marcus Vinícius Cesso da

2017-01-01

To present the implementation of an apportionment strategy proportional to the productive areas of a multidisciplinary clinic, defining the minimum values to be passed monthly to health professionals who work there. A study of the clinic structure was carried out, in which the area of occupation of each service was defined. Later the cost was prorated, allocating a value to each room, proportional to the space occupied. The apportionment implementation allowed the clinic managers to visualize the cost of each room, providing a value base for formation of a minimum amount necessary to be passed monthly to each professional, as a form of payment for rent of using their facilities. The risk of financial loss of the clinic was minimized due to variation of its productivity, as well as the conditions of transference at the time of hiring by professionals were clear, promoting greater confidence and safety in contract relations. Apresentar a implantação de uma estratégia de rateio proporcional às áreas produtivas de uma clínica multidisciplinar, definindo valores mínimos a serem repassados mensalmente aos profissionais de saúde que as ocupam. Estudo da estrutura da clínica, no qual foi definida, em metros quadrados, a área de ocupação de cada serviço. Em seguida, o custo foi rateado, alocando um valor a cada sala, proporcional ao espaço ocupado. A implantação do rateio possibilitou aos gestores da clínica estudada visualizar o custo de cada sala, fornecendo uma base de valor para formação de um valor mínimo necessário a ser repassado mensalmente para cada profissional, como forma de pagamento pelo aluguel de utilização de suas instalações. Minimizou-se o risco de prejuízo da clínica pela variação de sua produtividade, bem como ficaram claras as condições de repasse no momento de contratação do aluguel pelos profissionais, promovendo maior confiança e segurança na relação contratual.

Limits of a spatial resolution of the cascaded GEM based detectors

NASA Astrophysics Data System (ADS)

Kudryavtsev, V. N.; Maltsev, T. V.; Shekhtman, L. I.

2017-06-01

Spatial resolution of tracking detectors based on GEM cascades is determined in the simulation and measured. The simulation includes GEANT4 implemented transport of high energy electrons with careful accounting for atomic relaxation processes including emission of fluorescent photons and Auger electrons and custom post-processing taking into account diffusion, gas amplification fluctuations, the distribution of signals over readout electrodes, electronics noise and particular algorithm of final coordinate calculation (centre-of-gravity algorithm). The simulation demonstrates that the minimum of the spatial resolution of about 10-20 μm can be achieved with a gas mixture of Ar-CO2 (75%-25%) at a strip pitch in the range from 250 μm to 300 μm. At a larger pitch the resolution quickly degrades reaching 70-100 μm at a pitch of 450-500 μm. The reasons of such behavior are discussed and corresponding hypothesis is tested. Particularly, the effect of electron cloud modification due to a GEM operation is considered using the ANSYS and Garfield++ simulation programs. The detection efficiency and spatial resolution of low-material triple-GEM detectors for the DEUTERON facility at BINP are measured at the extracted beam facility of the VEPP-4M collider. One-coordinate resolution of two detectors for the DEUTERON facility is measured with a 2 GeV electron beam. The determined values of the detectors' spatial resolution is equal to 46.6 ± 0.1 μm and 38.5 ± 0.2 μm for orthogonal tracks in two detectors, respectively.

An Investment Level Decision Method to Secure Long-term Reliability

NASA Astrophysics Data System (ADS)

Bamba, Satoshi; Yabe, Kuniaki; Seki, Tomomichi; Shibaya, Tetsuji

The slowdown in power demand increase and facility replacement causes the aging and lower reliability in power facility. And the aging is followed by the rapid increase of repair and replacement when many facilities reach their lifetime in future. This paper describes a method to estimate the repair and replacement costs in future by applying the life-cycle cost model and renewal theory to the historical data. This paper also describes a method to decide the optimum investment plan, which replaces facilities in the order of cost-effectiveness by setting replacement priority formula, and the minimum investment level to keep the reliability. Estimation examples applied to substation facilities show that the reasonable and leveled future cash-out can keep the reliability by lowering the percentage of replacements caused by fatal failures.

Proportional Topology Optimization: A New Non-Sensitivity Method for Solving Stress Constrained and Minimum Compliance Problems and Its Implementation in MATLAB

PubMed Central

Biyikli, Emre; To, Albert C.

2015-01-01

A new topology optimization method called the Proportional Topology Optimization (PTO) is presented. As a non-sensitivity method, PTO is simple to understand, easy to implement, and is also efficient and accurate at the same time. It is implemented into two MATLAB programs to solve the stress constrained and minimum compliance problems. Descriptions of the algorithm and computer programs are provided in detail. The method is applied to solve three numerical examples for both types of problems. The method shows comparable efficiency and accuracy with an existing optimality criteria method which computes sensitivities. Also, the PTO stress constrained algorithm and minimum compliance algorithm are compared by feeding output from one algorithm to the other in an alternative manner, where the former yields lower maximum stress and volume fraction but higher compliance compared to the latter. Advantages and disadvantages of the proposed method and future works are discussed. The computer programs are self-contained and publicly shared in the website www.ptomethod.org. PMID:26678849

ART Attrition across Health Facilities Implementing Option B+ in Haiti.

PubMed

Myrtil, Martine Pamphile; Puttkammer, Nancy; Gloyd, Stephen; Robinson, Julia; Yuhas, Krista; Domercant, Jean Wysler; Honoré, Jean Guy; Francois, Kesner

2018-01-01

Describing factors related to high attrition is important in order to improve the implementation of the Option B+ strategy in Haiti. We conducted a retrospective cohort study to describe the variability of antiretroviral therapy (ART) retention across health facilities among pregnant and lactating women and assess for differences in ART retention between Option B+ clients and other ART patients. There were 1989 Option B+ clients who initiated ART in 45 health facilities. The percentage of attrition varied from 9% to 81% across the facilities. The largest health facilities had 38% higher risk of attrition (relative risk [RR]: 1.38, 95% confidence interval [CI]: 1.08-1.77, P = .009). Private institutions had 18% less risk of attrition (RR: 0.82, 95% CI: 0.70-0.96, P = .020). Health facilities located in the West department and the South region had lower risk of attrition. Being on treatment in a large or public health facility or a facility located in the North region was a significant risk factor associated with high attrition among Option B+ clients. The implementation of the Option B+ strategy must be reevaluated in order to effectively eliminate mother-to-child HIV transmission.

78 FR 75455 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-12

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... criteria of the Regulatory Flexibility Act. List of Subjects in 14 CFR part 97 Air Traffic Control...

78 FR 25384 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-01

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... criteria of the Regulatory Flexibility Act. List of Subjects in 14 CFR Part 97 Air traffic control...

78 FR 70494 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-26

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... criteria of the Regulatory Flexibility Act. List of Subjects in 14 CFR Part 97 Air traffic control...

49 CFR 228.311 - Minimum space requirements, beds, storage, and sanitary facilities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... each occupant's clothing and personal articles must be provided in every room used for sleeping... provided by a collective bargaining agreement, clean linens must be provided to each occupant. (d) In a...

49 CFR 228.311 - Minimum space requirements, beds, storage, and sanitary facilities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... each occupant's clothing and personal articles must be provided in every room used for sleeping... provided by a collective bargaining agreement, clean linens must be provided to each occupant. (d) In a...

49 CFR 228.311 - Minimum space requirements, beds, storage, and sanitary facilities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... each occupant's clothing and personal articles must be provided in every room used for sleeping... provided by a collective bargaining agreement, clean linens must be provided to each occupant. (d) In a...

UMTRA project list of reportable occurrences

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

Not Available

1994-04-01

This UMTRA Project List of Reportable occurrences is provided to facilitate efficient categorization of reportable occurrences. These guidelines have been established in compliance with DOE minimum reporting requirements under DOE Order 5000.3B. Occurrences are arranged into nine groups relating to US Department of Energy (DOE) Uranium Mill Tailings Remedial Action (UMTRA) Project operations for active sites. These nine groupings are provided for reference to determined whether an occurrence meets reporting requirement criteria in accordance with the minimum reporting requirements. Event groups and significance categories that cannot or will not occur, and that do not apply to UMTRA Project operations, aremore » omitted. Occurrence categorization shall be as follows: Group 1. Facility Condition; Group 2. Environmental; Group 3. Personnel Safety; Group 4. Personnel Radiation Protection; Group 5. Safeguards and Security; Group 6. Transportation; Group 7. Value Basis Reporting; Group 8. Facility Status; and Group 9. Cross-Category Items.« less

Evaluation of the antipsychotic medication review process at four long-term facilities in Alberta.

PubMed

Birney, Arden; Charland, Paola; Cole, Mollie; Aslam Arain, Mubashir

2016-01-01

The goal of this evaluation was to understand how four long-term care (LTC) facilities in Alberta have implemented medication reviews for the Appropriate Use of Antipsychotics (AUA) initiative. We aimed to determine how interprofessional (IP) collaboration was incorporated in the antipsychotic medication reviews and how the reviews had been sustained. Four LTC facilities in Alberta participated in this evaluation. We conducted semistructured interviews with 18 facility staff and observed one antipsychotic medication review at each facility. We analyzed data according to the following key components that we identified as relevant to the antipsychotic medication reviews: the structure of the reviews, IP interactions between the staff members, and strategies for sustaining the reviews. The duration of antipsychotic medication reviews ranged from 1 to 1.5 hours. The number of professions in attendance ranged from 3 to 9; a pharmacist led the review at two sites, while a registered nurse led the review at one site and a nurse practitioner at the remaining site. The number of residents discussed during the review ranged from 6 to 20. The process at some facilities was highly IP, demonstrating each of the six IP competencies. Other facilities conducted the review in a less IP manner due to challenges of physician involvement and staff workload, particularly of health care aides. Facilities that had an nurse practitioner on site were more efficient with the process of implementing recommendations resulting from the medication reviews. The LTC facilities were successful in implementing the medication review process and the process seemed to be sustainable. A few challenges were observed in the implementation process at two facilities. IP practice moved forward the goals of the AUA initiative to reduce the inappropriate use of antipsychotics.

Evaluating Commercial and Private Cloud Services for Facility-Scale Geodetic Data Access, Analysis, and Services

NASA Astrophysics Data System (ADS)

Meertens, C. M.; Boler, F. M.; Ertz, D. J.; Mencin, D.; Phillips, D.; Baker, S.

2017-12-01

UNAVCO, in its role as a NSF facility for geodetic infrastructure and data, has succeeded for over two decades using on-premises infrastructure, and while the promise of cloud-based infrastructure is well-established, significant questions about suitability of such infrastructure for facility-scale services remain. Primarily through the GeoSciCloud award from NSF EarthCube, UNAVCO is investigating the costs, advantages, and disadvantages of providing its geodetic data and services in the cloud versus using UNAVCO's on-premises infrastructure. (IRIS is a collaborator on the project and is performing its own suite of investigations). In contrast to the 2-3 year time scale for the research cycle, the time scale of operation and planning for NSF facilities is for a minimum of five years and for some services extends to a decade or more. Planning for on-premises infrastructure is deliberate, and migrations typically take months to years to fully implement. Migrations to a cloud environment can only go forward with similar deliberate planning and understanding of all costs and benefits. The EarthCube GeoSciCloud project is intended to address the uncertainties of facility-level operations in the cloud. Investigations are being performed in a commercial cloud environment (Amazon AWS) during the first year of the project and in a private cloud environment (NSF XSEDE resource at the Texas Advanced Computing Center) during the second year. These investigations are expected to illuminate the potential as well as the limitations of running facility scale production services in the cloud. The work includes running parallel equivalent cloud-based services to on premises services and includes: data serving via ftp from a large data store, operation of a metadata database, production scale processing of multiple months of geodetic data, web services delivery of quality checked data and products, large-scale compute services for event post-processing, and serving real time data from a network of 700-plus GPS stations. The evaluation is based on a suite of metrics that we have developed to elucidate the effectiveness of cloud-based services in price, performance, and management. Services are currently running in AWS and evaluation is underway.

A MATLAB implementation of the minimum relative entropy method for linear inverse problems

NASA Astrophysics Data System (ADS)

Neupauer, Roseanna M.; Borchers, Brian

2001-08-01

The minimum relative entropy (MRE) method can be used to solve linear inverse problems of the form Gm= d, where m is a vector of unknown model parameters and d is a vector of measured data. The MRE method treats the elements of m as random variables, and obtains a multivariate probability density function for m. The probability density function is constrained by prior information about the upper and lower bounds of m, a prior expected value of m, and the measured data. The solution of the inverse problem is the expected value of m, based on the derived probability density function. We present a MATLAB implementation of the MRE method. Several numerical issues arise in the implementation of the MRE method and are discussed here. We present the source history reconstruction problem from groundwater hydrology as an example of the MRE implementation.

32 CFR 148.14 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... POLICY AND IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.14 Procedures. (a) Agencies that... maximize interagency reciprocity shall be based primarily upon existing organizational reporting channels...

32 CFR 148.14 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... POLICY AND IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.14 Procedures. (a) Agencies that... maximize interagency reciprocity shall be based primarily upon existing organizational reporting channels...

32 CFR 148.13 - Responsibilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... POLICY AND IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.13 Responsibilities. (a) Each Senior Agency Official shall ensure that adequate reciprocity provisions are incorporated within his or...

32 CFR 148.13 - Responsibilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... POLICY AND IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.13 Responsibilities. (a) Each Senior Agency Official shall ensure that adequate reciprocity provisions are incorporated within his or...

32 CFR 148.13 - Responsibilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... POLICY AND IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.13 Responsibilities. (a) Each Senior Agency Official shall ensure that adequate reciprocity provisions are incorporated within his or...

32 CFR 148.14 - Procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... POLICY AND IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.14 Procedures. (a) Agencies that... maximize interagency reciprocity shall be based primarily upon existing organizational reporting channels...

32 CFR 148.14 - Procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... POLICY AND IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.14 Procedures. (a) Agencies that... maximize interagency reciprocity shall be based primarily upon existing organizational reporting channels...

32 CFR 148.14 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... POLICY AND IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.14 Procedures. (a) Agencies that... maximize interagency reciprocity shall be based primarily upon existing organizational reporting channels...

32 CFR 148.13 - Responsibilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... POLICY AND IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.13 Responsibilities. (a) Each Senior Agency Official shall ensure that adequate reciprocity provisions are incorporated within his or...

32 CFR 148.13 - Responsibilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... POLICY AND IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.13 Responsibilities. (a) Each Senior Agency Official shall ensure that adequate reciprocity provisions are incorporated within his or...

40 CFR 49.146 - Recordkeeping requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... ASSISTANCE INDIAN COUNTRY: AIR QUALITY PLANNING AND MANAGEMENT General Federal Implementation Plan Provisions Federal Implementation Plan for Oil and Natural Gas Production Facilities, Fort Berthold Indian... the oil and natural gas production facility each time the oil is unloaded from the produced oil...

Cross-sectional study on factors hampering implementation of measles pre- and postexposure measures in Dutch hospitals during the 2013-2014 measles outbreak.

PubMed

Fievez, L C R; Wong, A; Ruijs, W L M; Meerstadt-Rombach, F S; Timen, A

2017-07-01

This study examined adherence to national recommendations on measles pre- and postexposure measures, including immunization of health care workers (HCWs) in Dutch hospitals, during a national outbreak of measles in The Netherlands. This study also investigated which hospital characteristics and organizational issues hamper implementation. This was a cross-sectional survey among all general and academic hospitals in The Netherlands. An online structured questionnaire (48 questions) was administered. Analysis was performed using descriptive statistics and logistic regression. Of 88 hospitals, 70 (79.5%) were included. Of 68 hospitals, 48 (70.6%) assessed susceptibility to measles in HCWs. Of 70 hospitals, 61 (87.1%) offered vaccination to susceptible HCWs. Of 63 hospitals, 42 (66.7%) had postexposure policies consistent with national recommendations. Of 62 hospitals, 30 (48.4%) implemented all these measures, which is the minimum set of measures considered necessary to adequately prevent measles in HCWs. Logistic regression suggests that hospitals with several locations, hospitals with more employees, and hospitals where infectious disease experts designed infection prevention policies while occupational health experts implemented the policy less often implemented this minimum set of measures (P < .001, P < .01, and P < .001, respectively). During a national measles outbreak, most hospitals took measures to prevent measles in HCWs, but less than half implemented the minimum set of measures required. Implementation strategies in hospitals need to be improved, especially in large-sized hospitals and hospitals with several locations, and with respect to the assignment of responsibilities for infection prevention policies. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Facility effluent monitoring plan for the plutonium uranium extraction facility

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

Wiegand, D.L.

A facility effluent monitoring plan is required by the US Department of Energy in DOE Order 5400.1 for any operations that involve hazardous materials and radioactive substances that could impact employee or public safety or the environment. This document is prepared using the specific guidelines identified in A Guide for Preparing Hanford Site Facility Effluent Monitoring Plans, WHC-EP-0438-01. This facility effluent monitoring plan assesses effluent monitoring systems and evaluates whether they are adequate to ensure the public health and safety as specified in applicable federal, state, and local requirements. This facility effluent monitoring plan shall ensure long-range integrity of themore » effluent monitoring systems by requiring an update whenever a new process or operation introduces new hazardous materials or significant radioactive materials. This document must be reviewed annually even if there are no operational changes, and it must be updated at a minimum of every three years.« less

Update of KSC activities for the space transportation system

NASA Technical Reports Server (NTRS)

Gray, R. H.

1979-01-01

The paper is a status report on the facilities and planned operations at the Kennedy Space Center (KSC) that will support Space Shuttle launches. The conversion of KSC facilities to support efficient and economical checkout and launch operations in the era of the Space Shuttle is nearing completion. The driving force behind the KSC effort has been the necessity of providing adequate and indispensable facilities and support systems at minimum cost. This required the optimum utilization of existing buildings, equipment and systems, both at KSC and at Air Force property on Cape Canaveral, as well as the construction of two major new facilities and several minor ones. The entirely new structures discussed are the Shuttle Landing Facility and Orbiter Processing Facility. KSC stands ready to provide the rapid reliable economical landing-to-launch processing needed to ensure the success of this new space transportation system.

49 CFR 192.907 - What must an operator do to implement this subpart?

Code of Federal Regulations, 2011 CFR

2011-10-01

... management program must consist, at a minimum, of a framework that describes the process for implementing... Transmission Pipeline Integrity Management § 192.907 What must an operator do to implement this subpart? (a... follow a written integrity management program that contains all the elements described in § 192.911 and...

49 CFR 192.907 - What must an operator do to implement this subpart?

Code of Federal Regulations, 2012 CFR

2012-10-01

... management program must consist, at a minimum, of a framework that describes the process for implementing... Transmission Pipeline Integrity Management § 192.907 What must an operator do to implement this subpart? (a... follow a written integrity management program that contains all the elements described in § 192.911 and...

49 CFR 192.907 - What must an operator do to implement this subpart?

Code of Federal Regulations, 2013 CFR

2013-10-01

... management program must consist, at a minimum, of a framework that describes the process for implementing... Transmission Pipeline Integrity Management § 192.907 What must an operator do to implement this subpart? (a... follow a written integrity management program that contains all the elements described in § 192.911 and...

49 CFR 192.907 - What must an operator do to implement this subpart?

Code of Federal Regulations, 2014 CFR

2014-10-01

... management program must consist, at a minimum, of a framework that describes the process for implementing... Transmission Pipeline Integrity Management § 192.907 What must an operator do to implement this subpart? (a... follow a written integrity management program that contains all the elements described in § 192.911 and...

Timeliness and access to healthcare services via telemedicine for adolescents in state correctional facilities.

PubMed

Fox, Karen C; Somes, Grant W; Waters, Teresa M

2007-08-01

The aim of this study was to examine the effectiveness of a telemedicine program in improving timeliness of and access to healthcare services in adolescent correctional facilities. This study is a pre/post quasi-experimental design comparing time to treatment and healthcare use in the year preceding and the 2 years after the implementation of a telemedicine program in four facilities housing adolescents from 12 to 19. Timeliness of care is measured by time from referral to date of service (for behavioral healthcare only). Access to care is measured by use of outpatient care, emergency department (ED) visits, and inpatient visits. Two of the four state correctional facilities had a significant decrease (24%) in time from referral to treatment after the implementation of the telemedicine intervention. The facilities not showing significant improvements in timeliness experienced difficulty implementing the telemedicine program. The telemedicine program was also associated with significant improvements in access to care. Outpatient visits increased by 40% in the 2 years after implementation of telemedicine. For each 1% increase in telemedicine usage, outpatient visits increased by 1%, whereas emergency room visits decreased by 7%. Telemedicine can have a positive impact on timeliness of and access to care for youth in correctional facilities.

Minimum Standards for Tribal Child Care Centers.

ERIC Educational Resources Information Center

Administration on Children, Youth, and Families (DHHS), Washington, DC. Child Care Bureau.

These minimum standards for tribal child care centers are being issued as guidance. An interim period of at least 1 year will allow tribal agencies to identify implementation issues, ensure that the standards reflect tribal needs, and guarantee that the standards provide adequate protection for children. The standards will be issued as regulations…

Online Distance Teaching of Undergraduate Finance: A Case for Musashi University and Konan University, Japan

ERIC Educational Resources Information Center

Kubota, Keiichi; Fujikawa, Kiyoshi

2007-01-01

We implemented a synchronous distance course entitled: Introductory Finance designed for undergraduate students. This course was held between two Japanese universities. Stable Internet connections allowing minimum delay and minimum interruptions of the audio-video streaming signals were used. Students were equipped with their own PCs with…

Minimum Competency Testing In the Dallas Independent School District.

ERIC Educational Resources Information Center

Montgomery, Patricia A.; Arrasmith, Dean G.

The development and implementation of the Dallas Independent School District's Basic Objectives Assessment Test (BOAT) are described. Beginning in 1979, this minimum competency test was administered system-wide to all students in grades 8-12 (except for those enrolled as special education students), and beginning in 1983 it will be used in…

Opportunities and Challenges Within the Veterans Administration

PubMed Central

Schafer, Paul W.

1981-01-01

Because the Veterans Administration operates the largest health care delivery system in the nation under the aegis of a single administration, having 172 medical centers and the third largest federal agency budget, it should assume a logical role at the forefront of automated health care application development. During the past three years, two quite different approaches to the development of medical application software have proceeded side-by-side within the Veterans Administration. One approach employed modern methods and techniques, requiring only a minimum amount of personnel and equipment resources and using local facility funds. It has produced a bounty of cost-effective automated health care application systems that are now in active use at a number of VA Medical Centers (VAMCs) nationwide. The other approach followed methods and techniques known to be unproductive, and used all of the centrally administered funds, personnel and equipment resources available. It has produced nothing of value; on the contrary, it has delayed the implementation of automated systems that could be providing important clinical services to veterans.

An algorithm for minimum-cost set-point ordering in a cryogenic wind tunnel

NASA Technical Reports Server (NTRS)

Tripp, J. S.

1981-01-01

An algorithm for minimum cost ordering of set points in a cryogenic wind tunnel is developed. The procedure generates a matrix of dynamic state transition costs, which is evaluated by means of a single-volume lumped model of the cryogenic wind tunnel and the use of some idealized minimum-costs, which is evaluated by means of a single-volume lumped model of the cryogenic wind tunnel and the use of some idealized minimum-cost state-transition control strategies. A branch and bound algorithm is employed to determine the least costly sequence of state transitions from the transition-cost matrix. Some numerical results based on data for the National Transonic Facility are presented which show a strong preference for state transitions that consume to coolant. Results also show that the choice of the terminal set point in an open odering can produce a wide variation in total cost.

Environmental Assessment: Peterson AFB Military Housing Privatization Initiative, El Paso County, Colorado

DTIC Science & Technology

2006-06-08

would sublease the land from Peterson AFB, and would maintain and manage the housing area for a minimum of 723 military families for 50 years. Under...housing area for a minimum of 723 military families for 50 years. Under the no action alternative, the Air Force would not implement the MHPI at...Peterson AFB, and would maintain and manage the housing area for a minimum of 723 military families for 50 years. No Action Alternative Under the no

32 CFR 148.10 - General.

Code of Federal Regulations, 2011 CFR

2011-07-01

... IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.10 General. (a) Redundant, overlapping, and duplicative... excessive protection and unnecessary expenditure of funds. Lack of reciprocity has also impeded achievement...

32 CFR 148.10 - General.

Code of Federal Regulations, 2010 CFR

2010-07-01

... IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.10 General. (a) Redundant, overlapping, and duplicative... excessive protection and unnecessary expenditure of funds. Lack of reciprocity has also impeded achievement...

32 CFR 148.10 - General.

Code of Federal Regulations, 2014 CFR

2014-07-01

... IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.10 General. (a) Redundant, overlapping, and duplicative... excessive protection and unnecessary expenditure of funds. Lack of reciprocity has also impeded achievement...

32 CFR 148.10 - General.

Code of Federal Regulations, 2012 CFR

2012-07-01

... IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.10 General. (a) Redundant, overlapping, and duplicative... excessive protection and unnecessary expenditure of funds. Lack of reciprocity has also impeded achievement...

32 CFR 148.10 - General.

Code of Federal Regulations, 2013 CFR

2013-07-01

... IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.10 General. (a) Redundant, overlapping, and duplicative... excessive protection and unnecessary expenditure of funds. Lack of reciprocity has also impeded achievement...

Implementing the incident command system in the healthcare setting.

PubMed

Huser, T J

The author discusses a new requirement in NFPA 99 for healthcare facilities--the implementation of an Incident Command System in the event of a disaster. He offers suggestions on how facilities can change their disaster plans to meet this new standard.

Strategies to encourage and facilitate utility owner participation in transportation projects : guidebook.

DOT National Transportation Integrated Search

2012-11-01

Utility accommodation policies around the country provide minimum requirements for the accommodation, adjustment, and maintenance of utility facilities within the highway right of way. Many state rules and guidelines are based on utility accommodatio...

Criteria for Solid Waste Disposal Facilities: A Guide for Owners/Operators

EPA Pesticide Factsheets

EPA's continuing mission to establish the minimum national standards for landfill design, operation, and management that will enhance landfill safety and boost public confidence in landfills as a component of a workable integrated waste management system.

Notices to airmen : domestic/international, September 10, 1998.

DOT National Transportation Integrated Search

1998-09-10

Table of contents: Airway notams; Airports, facilities, and procedural Notams; General FDC Notams; Part 95 Revisions to minimum en route IFR altitudes and changeover points; International Notices to Airmen; Graphic notices.;See also PB99-104317.;pg 2...

75 FR 4488 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-28

... facilities, adding new obstacles, or changing air traffic requirements. These changes are designed to provide... criteria of the Regulatory Flexibility Act. List of Subjects in 14 CFR Part 97 Air Traffic Control...

76 FR 40600 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-11

... facilities, adding new obstacles, or changing air traffic requirements. These changes are designed to provide... Act. List of Subjects in 14 CFR Part 97 Air traffic control, Airports, Incorporation by reference, and...

75 FR 12977 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-18

... facilities, adding new obstacles, or changing air traffic requirements. These changes are designed to provide... Act. List of Subjects in 14 CFR Part 97 Air traffic control, Airports, Incorporation by reference, and...

76 FR 4061 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-24

... facilities, adding new obstacles, or changing air traffic requirements. These changes are designed to provide... criteria of the Regulatory Flexibility Act. List of Subjects in 14 CFR Part 97 Air traffic control...

75 FR 51663 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-23

... facilities, adding new obstacles, or changing air traffic requirements. These changes are designed to provide... Act. List of Subjects in 14 CFR Part 97 Air traffic control, Airports, Incorporation by reference, and...

Evaluating the Implementation of Home-Based Videoconferencing for Providing Mental Health Services.

PubMed

Interian, Alejandro; King, Arlene R; St Hill, Lauren M; Robinson, Claire H; Damschroder, Laura J

2018-01-01

The Veterans Health Administration (VHA) has recently implemented video-to-home (V2H) telehealth as part of a strategy to improve access to mental health treatment. Implementation research of this modality is needed, given that V2H telehealth transforms the traditional face-to-face delivery of mental health services. To address this need, V2H implementation was evaluated by examining barriers and facilitators that were associated with level of staff V2H experience and factors that differentiated facilities with various levels of V2H performance. Semistructured interviews with VHA personnel (N=33) from three facilities were conducted. The facilities were selected by overall number of mental health V2H visits during fiscal year (FY) 2015 as well as by growth in number of visits from FY 2014 through FY 2015. Factors influencing implementation were identified through qualitative analyses that contrasted responses by groups of participants with three different levels of V2H experience (no experience, limited experience, most experience) as well as three facilities that differed in V2H productivity (high visit count, high visit growth, and low visit count and low visit growth). Providers seemed to encounter different barriers and facilitators depending on their level of experience with V2H. Site-level analyses illustrated the importance of logistical support, especially for providers who are newly adopting the technology. Other factors that differentiated the facilities were also identified and described. Key factors related to implementation of V2H telehealth pertained to provider buy-in and logistical support. Facility-level strategies that address these factors may enhance provider progression from nonuse to sustained use.

Nurse staffing levels and Medicaid reimbursement rates in nursing facilities.

PubMed

Harrington, Charlene; Swan, James H; Carrillo, Helen

2007-06-01

To examine the relationship between nursing staffing levels in U.S. nursing homes and state Medicaid reimbursement rates. Facility staffing, characteristics, and case-mix data were from the federal On-Line Survey Certification and Reporting (OSCAR) system and other data were from public sources. Ordinary least squares and two-stage least squares regression analyses were used to separately examine the relationship between registered nurse (RN) and total nursing hours in all U.S. nursing homes in 2002, with two endogenous variables: Medicaid reimbursement rates and resident case mix. RN hours and total nursing hours were endogenous with Medicaid reimbursement rates and resident case mix. As expected, Medicaid nursing home reimbursement rates were positively related to both RN and total nursing hours. Resident case mix was a positive predictor of RN hours and a negative predictor of total nursing hours. Higher state minimum RN staffing standards was a positive predictor of RN and total nursing hours while for-profit facilities and the percent of Medicaid residents were negative predictors. To increase staffing levels, average Medicaid reimbursement rates would need to be substantially increased while higher state minimum RN staffing standards is a stronger positive predictor of RN and total nursing hours.

Implementation of the free maternity services policy and its implications for health system governance in Kenya

PubMed Central

Smith, Helen

2017-01-01

Introduction To move towards universal health coverage, the government of Kenya introduced free maternity services in all public health facilities in June 2013. User fees are, however, important sources of income for health facilities and their removal has implications for the way in which health facilities are governed. Objective To explore how implementation of Kenya’s financing policy has affected the way in which the rules governing health facilities are made, changed, monitored and enforced. Methods Qualitative research was carried out using semistructured interviews with 39 key stakeholders from six counties in Kenya: 10 national level policy makers, 10 county level policy makers and 19 implementers at health facilities. Participants were purposively selected using maximum variation sampling. Data analysis was informed by the institutional analysis framework, in which governance is defined by the rules that distribute roles among key players and shape their actions, decisions and interactions. Results Lack of clarity about the new policy (eg, it was unclear which services were free, leading to instances of service user exploitation), weak enforcement mechanisms (eg, delayed reimbursement to health facilities, which led to continued levying of service charges) and misaligned incentives (eg, the policy led to increased uptake of services thereby increasing the workload for health workers and health facilities losing control of their ability to generate and manage their own resources) led to weak policy implementation, further complicated by the concurrent devolution of the health system. Conclusion The findings show the consequences of discrepancies between formal institutions and informal arrangements. In introducing new policies, policy makers should ensure that corresponding institutional (re)arrangements, enforcement mechanisms and incentives are aligned with the objectives of the implementers. PMID:29177098

The Optimizing Patient Transfers, Impacting Medical Quality, andImproving Symptoms:Transforming Institutional Care approach: preliminary data from the implementation of a Centers for Medicare and Medicaid Services nursing facility demonstration project.

PubMed

Unroe, Kathleen T; Nazir, Arif; Holtz, Laura R; Maurer, Helen; Miller, Ellen; Hickman, Susan E; La Mantia, Michael A; Bennett, Merih; Arling, Greg; Sachs, Greg A

2015-01-01

The Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) project aims to reduce avoidable hospitalizations of long-stay residents enrolled in 19 central Indiana nursing facilities. This clinical demonstration project, funded by the Centers for Medicare and Medicaid Services Innovations Center, places a registered nurse in each nursing facility to implement an evidence-based quality improvement program with clinical support from nurse practitioners. A description of the model is presented, and early implementation experiences during the first year of the project are reported. Important elements include better medical care through implementation of Interventions to Reduce Acute Care Transfers tools and chronic care management, enhanced transitional care, and better palliative care with a focus on systematic advance care planning. There were 4,035 long-stay residents in 19 facilities enrolled in OPTIMISTIC between February 2013 and January 2014. Root-cause analyses were performed for all 910 acute transfers of these long stay residents. Of these transfers, the project RN evaluated 29% as avoidable (57% were not avoidable and 15% were missing), and opportunities for quality improvement were identified in 54% of transfers. Lessons learned in early implementation included defining new clinical roles, integrating into nursing facility culture, managing competing facility priorities, communicating with multiple stakeholders, and developing a system for collecting and managing data. The success of the overall initiative will be measured primarily according to reduction in avoidable hospitalizations of long-stay nursing facility residents. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

Effects of Epoetin Alfa Titration Practices, Implemented After Changes to Product Labeling, on Hemoglobin Levels, Transfusion Use, and Hospitalization Rates.

PubMed

Molony, Julia T; Monda, Keri L; Li, Suying; Beaubrun, Anne C; Gilbertson, David T; Bradbury, Brian D; Collins, Allan J

2016-08-01

Little is known about epoetin alfa (EPO) dosing at dialysis centers after implementation of the US Medicare prospective payment system and revision of the EPO label in 2011. Retrospective cohort study. Approximately 412,000 adult hemodialysis patients with Medicare Parts A and B as primary payer in 2009 to 2012 to describe EPO dosing and hemoglobin patterns; of these, about 70,000 patients clustered in about 1,300 dialysis facilities to evaluate facility-level EPO titration practices and patient-level outcomes in 2012. Facility EPO titration practices when hemoglobin levels were <10 and >11g/dL (grouped treatment variable) determined from monthly EPO dosing and hemoglobin level patterns. Patient mean hemoglobin levels, red blood cell transfusion rates, and all-cause and cause-specific hospitalization rates using a facility-based analysis. Monthly EPO dose and hemoglobin level, red blood cell transfusion rates, and all-cause and cause-specific hospitalization rates. Monthly EPO doses declined across all hemoglobin levels, with the greatest decline in patients with hemoglobin levels < 10g/dL (July-October 2011). In 2012, nine distinct facility titration practices were identified. Across groups, mean hemoglobin levels differed slightly (10.5-10.8g/dL) but within-patient hemoglobin standard deviations were similar (∼0.68g/dL). Patients at facilities implementing greater dose reductions and smaller dose escalations had lower hemoglobin levels and higher transfusion rates. In contrast, patients at facilities that implemented greater dose escalations (and large or small dose reductions) had higher hemoglobin levels and lower transfusion rates. There were no clinically meaningful differences in all-cause or cause-specific hospitalization events across groups. Possibly incomplete claims data; excluded small facilities and those without consistent titration patterns; hemoglobin levels reported monthly; inferred facility practice from observed dosing. Following prospective payment system implementation and labeling revisions, EPO doses declined significantly. Under the new label, facility EPO titration practices were associated with mean hemoglobin levels (but not standard deviations) and transfusion use, but not hospitalization rates. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

40 CFR 60.2030 - Who implements and enforces this subpart?

Code of Federal Regulations, 2013 CFR

2013-07-01

... qualifying small power production facility or cogeneration facility under § 60.2020(e) or (f) is combusting... qualifying small power production facility or cogeneration facility under § 60.2020(e) or (f) is combusting...

32 CFR 148.11 - Policy.

Code of Federal Regulations, 2012 CFR

2012-07-01

... IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.11 Policy. (a) Agency heads, or their designee, shall..., and efficient, and that those policies and procedures enable and promote interagency reciprocity. (b...

32 CFR 148.11 - Policy.

Code of Federal Regulations, 2011 CFR

2011-07-01

... IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.11 Policy. (a) Agency heads, or their designee, shall..., and efficient, and that those policies and procedures enable and promote interagency reciprocity. (b...

32 CFR 148.11 - Policy.

Code of Federal Regulations, 2010 CFR

2010-07-01

... IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.11 Policy. (a) Agency heads, or their designee, shall..., and efficient, and that those policies and procedures enable and promote interagency reciprocity. (b...

32 CFR 148.11 - Policy.

Code of Federal Regulations, 2013 CFR

2013-07-01

... IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.11 Policy. (a) Agency heads, or their designee, shall..., and efficient, and that those policies and procedures enable and promote interagency reciprocity. (b...

32 CFR 148.11 - Policy.

Code of Federal Regulations, 2014 CFR

2014-07-01

... IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.11 Policy. (a) Agency heads, or their designee, shall..., and efficient, and that those policies and procedures enable and promote interagency reciprocity. (b...

78 FR 9016 - Approval and Promulgation of Air Quality Implementation Plans; Massachusetts; Revisions to Fossil...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-07

... Promulgation of Air Quality Implementation Plans; Massachusetts; Revisions to Fossil Fuel Utilization and..., inspection, maintenance and testing requirements for certain fossil fuel utilization facilities, rename and... fossil fuel utilization facility regulation, source registration regulation, and new industrial...

Status of Activities to Implement a Sustainable System of MC&A Equipment and Methodological Support at Rosatom Facilities

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

J.D. Sanders

Under the U.S.-Russian Material Protection, Control and Accounting (MPC&A) Program, the Material Control and Accounting Measurements (MCAM) Project has supported a joint U.S.-Russian effort to coordinate improvements of the Russian MC&A measurement system. These efforts have resulted in the development of a MC&A Equipment and Methodological Support (MEMS) Strategic Plan (SP), developed by the Russian MEM Working Group. The MEMS SP covers implementation of MC&A measurement equipment, as well as the development, attestation and implementation of measurement methodologies and reference materials at the facility and industry levels. This paper provides an overview of the activities conducted under the MEMS SP,more » as well as a status on current efforts to develop reference materials, implement destructive and nondestructive assay measurement methodologies, and implement sample exchange, scrap and holdup measurement programs across Russian nuclear facilities.« less

Who are the innovators? Nursing homes implementing culture change.

PubMed

Grabowski, David C; Elliot, Amy; Leitzell, Brigitt; Cohen, Lauren W; Zimmerman, Sheryl

2014-02-01

A key directive of the Affordable Care Act of 2010 is to transform both institutional and community-based long-term care into a more person-centered system. In the nursing home industry, the culture change movement is central to this shift in philosophy. If policymakers are to further encourage implementation of culture change, they need to better understand the factors associated with implementation. Using logistic regression (N = 16,835), we examined the extent to which resident, facility, and state characteristics relate to a nursing home being identified by experts as having implemented culture change over the period 2004 through 2011. At baseline, the 291 facilities that were later identified by experts to have implemented culture change were more often nonprofit-owned, larger in size, and had fewer Medicaid and Medicare residents. Implementers also had better baseline quality with fewer health-related survey deficiencies and greater licensed practical nurse and nurse aide staffing. States experienced greater culture change implementation when they paid a higher Medicaid per diem. To date, nursing home culture change has been implemented differentially by higher resource facilities, and nursing homes have been responsive to state policy factors when implementing culture change.

Resident and Facility Factors Associated With the Incidence of Urinary Tract Infections Identified in the Nursing Home Minimum Data Set.

PubMed

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.

Real options valuation and optimization of energy assets

NASA Astrophysics Data System (ADS)

Thompson, Matthew

In this thesis we present algorithms for the valuation and optimal operation of natural gas storage facilities, hydro-electric power plants and thermal power generators in competitive markets. Real options theory is used to derive nonlinear partial-integro-differential equations (PIDEs) for the valuation and optimal operating strategies of all types of facilities. The equations are designed to incorporate a wide class of spot price models that can exhibit the same time-dependent, mean-reverting dynamics and price spikes as those observed in most energy markets. Particular attention is paid to the operational characteristics of real energy assets. For natural gas storage facilities these characteristics include: working gas capacities, variable deliverability and injection rates and cycling limitations. For thermal power plants relevant operational characteristics include variable start-up times and costs, control response time lags, minimum generating levels, nonlinear output functions, structural limitations on ramp rates, and minimum up/down time restrictions. For hydro-electric units, head effects and environmental constraints are addressed. We illustrate the models with numerical examples of a gas storage facility, a hydro-electric pump storage facility and a thermal power plant. This PIDE framework is the first in the literature to achieve second order accuracy in characterizing the operating states of hydro-electric and hydro-thermal power plants. The continuous state space representation derived in this thesis can therefore achieve far greater realism in terms of operating state specification than any other method in the literature to date. This thesis is also the first and only to allow for any continuous time jump diffusion processes in order to account for price spikes.

How to improve patient retention in an antiretroviral treatment program in Ethiopia: a mixed-methods study

PubMed Central

2014-01-01

Background Patient retention, defined as continuous engagement of patients in care, is one of the crucial indicators for monitoring and evaluating the performance of antiretroviral treatment (ART) programs. It has been identified that suboptimal patient retention in care is one of the challenges of ART programs in many settings. ART programs have, therefore, been striving hard to identify and implement interventions that improve their suboptimal levels of retention. The objective of this study was to develop a framework for improving patient retention in care based on interventions implemented in health facilities that have achieved higher levels of retention in care. Methods A mixed-methods study, based on the positive deviance approach, was conducted in Ethiopia in 2011/12. Quantitative data were collected to estimate and compare the levels of retention in care in nine health facilities. Key informant interviews and focus group discussions were conducted to identify a package of interventions implemented in the health facilities with relatively higher or improving levels of retention. Results Retention in care in the Ethiopian ART program was found to be variable across health facilities. Among hospitals, the poorest performer had 0.46 (0.35, 0.60) times less retention than the reference; among health centers, the poorest performers had 0.44 (0.28, 0.70) times less retention than the reference. Health facilities with higher and improving patient retention were found to implement a comprehensive package of interventions: (1) retention promoting activities by health facilities, (2) retention promoting activities by community-based organizations, (3) coordination of these activities by case manager(s), and (4) patient information systems by data clerk(s). On the contrary, such interventions were either poorly implemented or did not exist in health facilities with lower retention in care. A framework to improve retention in care was developed based on the evidence found by applying the positive deviance approach. Conclusion A framework for improving retention in care of patients on ART was developed. We recommend that health facilities implement the framework, monitor and evaluate their levels of retention in care, and, if necessary, adapt the framework to their own contexts. PMID:24475889

46 CFR 15.101 - Purpose of regulations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... COAST GUARD, DEPARTMENT OF HOMELAND SECURITY MERCHANT MARINE OFFICERS AND SEAMEN MANNING REQUIREMENTS... uniform minimum requirements for the manning of vessels. In general, they implement, interpret, or apply the specific statutory manning requirements in title 46, U.S.C., implement various international...

The Impact of Pollution Prevention on Toxic Environmental Releases from U.S. Manufacturing Facilities.

PubMed

Ranson, Matthew; Cox, Brendan; Keenan, Cheryl; Teitelbaum, Daniel

2015-11-03

Between 1991 and 2012, the facilities that reported to the U.S. Environmental Protection Agency's Toxic Release Inventory (TRI) Program conducted 370,000 source reduction projects. We use this data set to conduct the first quasi-experimental retrospective evaluation of how implementing a source reduction (pollution prevention) project affects the quantity of toxic chemicals released to the environment by an average industrial facility. We use a differences-in-differences methodology, which measures how implementing a source reduction project affects a facility's releases of targeted chemicals, relative to releases of (a) other untargeted chemicals from the same facility, or (b) the same chemical from other facilities in the same industry. We find that the average source reduction project causes a 9-16% decrease in releases of targeted chemicals in the year of implementation. Source reduction techniques vary in effectiveness: for example, raw material modification causes a large decrease in releases, while inventory control has no detectable effect. Our analysis suggests that in aggregate, the source reduction projects carried out in the U.S. since 1991 have prevented between 5 and 14 billion pounds of toxic releases.

40 CFR Table 1b to Subpart Ce of... - Emissions Limits for Small, Medium, and Large HMIWI at Designated Facilities as Defined in § 60...

Code of Federal Regulations, 2011 CFR

2011-07-01

....011) 3-run average (1-hour minimum sample time per run) EPA Reference Method 5 of appendix A-3 of part... by volume (ppmv) 20 5.5 11 3-run average (1-hour minimum sample time per run) EPA Reference Method 10... dscf) 16 (7.0) or 0.013 (0.0057) 0.85 (0.37) or 0.020 (0.0087) 9.3 (4.1) or 0.054 (0.024) 3-run average...

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.

Extent and Impacts of the Virginia Department of Transportation’s Exception Process for Access Management Design Standards

DOT National Transportation Integrated Search

2018-06-01

The Virginia Department of Transportation (VDOT) Road Design Manual requires that new commercial entrances meet certain minimum spacing standards depending on a facilitys speed limit and functional classification. Landowners, however, may request ...

Preparing No-Migration Demonstrations for Municipal Solid Waste Disposal Facilities: A Screening Tool

EPA Pesticide Factsheets

EPA's mission to establish the minimum national standards for landfill design, operation, and management that will enhance landfill safety and boost public confidence in landfills as a component of a workable integrated waste management system.

Air velocity distribution in a commercial broiler house

USDA-ARS?s Scientific Manuscript database

Increasing air velocity during tunnel ventilation in commercial broiler production facilities improves production efficiency, and many housing design specifications require a minimum air velocity. Air velocities are typically assessed with a hand-held velocity meter at random locations, rather than ...

Establishment and progress of the chest pain unit certification process in Germany and the local experiences of Mainz.

PubMed

Post, Felix; Gori, Tommaso; Senges, Jochen; Giannitsis, Evangelos; Katus, Hugo; Münzel, Thomas

2012-03-01

The establishment of chest pain units (CPUs) in the USA and UK has led to improvements in the prognosis of patients with chest pain and myocardial infarction, optimizing access to specialized diagnostic and therapeutic facilities and reducing costs. To establish a uniform implementation of this type of service in Germany, the German Cardiac Society (DGK) founded a 'CPU task force' in 2007, which developed a set of standard requirements and a nationwide certification programme. The recommendations for minimum standard requirements were published in 2008. As of November 2011, 132 CPUs were certified and 36 units were in the certification process. The aim of the DGK is to certify as many as 250 centres (units) throughout Germany within the next 2 years, to provide nationwide coverage. Applications from Switzerland are also being filed. Public awareness campaigns in cooperation with national league soccer teams were organized to raise awareness of the importance for early diagnosis and treatment of cardiac diseases and to publicize the existence of these new facilities. The German model of CPU certification allows nationwide and prospectively European-wide standardization of patient care and to improve adherence to international guidelines. Coupled with awareness campaigns and with the launch of a German CPU Registry, this process is aimed at improving the education and treatment of patients with chest pain and to provide scientific information about the quality of patient care.

Development of an Enhanced Payback Function for the Superior Energy Performance Program

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

Therkelsen, Peter; Rao, Prakash; McKane, Aimee

2015-08-03

The U.S. DOE Superior Energy Performance (SEP) program provides recognition to industrial and commercial facilities that achieve certification to the ISO 50001 energy management system standard and third party verification of energy performance improvements. Over 50 industrial facilities are participating and 28 facilities have been certified in the SEP program. These facilities find value in the robust, data driven energy performance improvement result that the SEP program delivers. Previous analysis of SEP certified facility data demonstrated the cost effectiveness of SEP and identified internal staff time to be the largest cost component related to SEP implementation and certification. This papermore » analyzes previously reported and newly collected data of costs and benefits associated with the implementation of an ISO 50001 and SEP certification. By disaggregating “sunk energy management system (EnMS) labor costs”, this analysis results in a more accurate and detailed understanding of the costs and benefits of SEP participation. SEP is shown to significantly improve and sustain energy performance and energy cost savings, resulting in a highly attractive return on investment. To illustrate these results, a payback function has been developed and is presented. On average facilities with annual energy spend greater than $2M can expect to implement SEP with a payback of less than 1.5 years. Finally, this paper also observes and details decreasing facility costs associated with implementing ISO 50001 and certifying to the SEP program, as the program has improved from pilot, to demonstration, to full launch.« less

Implementing an electronic hand hygiene monitoring system: Lessons learned from community hospitals.

PubMed

Edmisten, Catherine; Hall, Charles; Kernizan, Lorna; Korwek, Kimberly; Preston, Aaron; Rhoades, Evan; Shah, Shalin; Spight, Lori; Stradi, Silvia; Wellman, Sonia; Zygadlo, Scott

2017-08-01

Measuring and providing feedback about hand hygiene (HH) compliance is a complicated process. Electronic HH monitoring systems have been proposed as a possible solution; however, there is little information available about how to successfully implement and maintain these systems for maximum benefit in community hospitals. An electronic HH monitoring system was implemented in 3 community hospitals by teams at each facility with support from the system vendor. Compliance rates were measured by the electronic monitoring system. The implementation challenges, solutions, and drivers of success were monitored within each facility. The electronic HH monitoring systems tracked on average more than 220,000 compliant HH events per facility per month, with an average monthly compliance rate >85%. The sharing of best practices between facilities was valuable in addressing challenges encountered during implementation and maintaining a high rate of use. Drivers of success included a collaborative environment, leadership commitment, using data to drive improvement, consistent and constant messaging, staff empowerment, and patient involvement. Realizing the full benefit of investments in electronic HH monitoring systems requires careful consideration of implementation strategies, planning for ongoing support and maintenance, and presenting data in a meaningful way to empower and inspire staff. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

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

PubMed Central

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

2016-01-01

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

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

PubMed

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

2016-01-04

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

40 CFR 49.4168 - Notification and reporting requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... FEDERAL ASSISTANCE INDIAN COUNTRY: AIR QUALITY PLANNING AND MANAGEMENT Implementation Plans for Tribes-Region VIII Federal Implementation Plan for Oil and Natural Gas Well Production Facilities; Fort Berthold... you own or operate more than one oil and natural gas production facility, you may submit one report...

40 CFR 49.4168 - Notification and reporting requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... FEDERAL ASSISTANCE INDIAN COUNTRY: AIR QUALITY PLANNING AND MANAGEMENT Implementation Plans for Tribes-Region VIII Federal Implementation Plan for Oil and Natural Gas Well Production Facilities; Fort Berthold... you own or operate more than one oil and natural gas production facility, you may submit one report...

A Study of Minimum Competency Programs. Final Comprehensive Report. Vol. 1. Vol. 2.

ERIC Educational Resources Information Center

Gorth, William Phillip; Perkins, Marcy R.

The status of minimum competency testing programs, as of June 30, 1979, is given through descriptions of 31 state programs and 20 local district programs. For each program, the following information is provided: legislative and policy history; implementation phase; goals; competencies to be tested; standards and standard setting; target groups and…

75 FR 54179 - National Park Service Concession Contracts; Implementation of Alternative Valuation Formula for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-03

... reflects in part the requirement of the 1998 Act that NPS include in concession contracts a franchise fee... consequence, if the NPS were to establish the required minimum franchise fee for the new contract under the... a prospective concessioner offers to meet or exceed the minimum franchise fee established by NPS...

Robust Means and Covariance Matrices by the Minimum Volume Ellipsoid (MVE).

ERIC Educational Resources Information Center

Blankmeyer, Eric

P. Rousseeuw and A. Leroy (1987) proposed a very robust alternative to classical estimates of mean vectors and covariance matrices, the Minimum Volume Ellipsoid (MVE). This paper describes the MVE technique and presents a BASIC program to implement it. The MVE is a "high breakdown" estimator, one that can cope with samples in which as…

40 CFR 122.35 - As an operator of a regulated small MS4, may I share the responsibility to implement the minimum...

Code of Federal Regulations, 2011 CFR

2011-07-01

....35 Section 122.35 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS EPA ADMINISTERED PERMIT PROGRAMS: THE NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM Permit... minimum control measure(s) in your storm water management program. (For example, if a State or Tribe is...

40 CFR 122.35 - As an operator of a regulated small MS4, may I share the responsibility to implement the minimum...

Code of Federal Regulations, 2010 CFR

2010-07-01

....35 Section 122.35 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS EPA ADMINISTERED PERMIT PROGRAMS: THE NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM Permit... minimum control measure(s) in your storm water management program. (For example, if a State or Tribe is...

Feasibility Study of Coal Gasification/Fuel Cell/Cogeneration Project. Washington, DC Site. Project Description

DTIC Science & Technology

1985-06-01

production; - Plant will meet PURPA criteria for recognition as a "Qualifying Facility" (QF). - Plant design allows for sale of byproducts, decreasing...export to the HCP be the minimum necessary to meet PURPA requirements and the remaining steam be used to produce electric power. Since the fuel cell...Policies Act ( PURPA ) criteria to be classified as a "Qualifying Facility" (QF). 14. Plant site conditions are as summarized in Table 2-1. I 9I I I IL

Challenges with implementing malaria rapid diagnostic tests at primary care facilities in a Ghanaian district: a qualitative study.

PubMed

Boadu, Nana Yaa; Amuasi, John; Ansong, Daniel; Einsiedel, Edna; Menon, Devidas; Yanow, Stephanie K

2016-02-27

Rapid diagnostic Tests (RDTs) for malaria enable diagnostic testing at primary care facilities in resource-limited settings, where weak infrastructure limits the use of microscopy. In 2010, Ghana adopted a test-before-treat guideline for malaria, with RDT use promoted to facilitate diagnosis. Yet healthcare practitioners still treat febrile patients without testing, or despite negative malaria test results. Few studies have explored RDT implementation beyond the notions of provider or patient acceptability. The aim of this study was to identify the factors directly influencing malaria RDT implementation at primary care facilities in a Ghanaian district. Qualitative interviews, focus groups and direct observations were conducted with 50 providers at six purposively selected primary care facilities in the Atwima-Nwabiagya district. Data were analysed thematically. RDT implementation was hampered by: (1) healthcare delivery constraints (weak supply chain, limited quality assurance and control, inadequate guideline emphasis, staffing limitations); (2) provider perceptions (entrenched case-management paradigms, limited preparedness for change); (3) social dynamics of care delivery (expected norms of provider-patient interaction, test affordability); and (4) limited provider engagement in policy processes leading to fragmented implementation of health sector reform. Limited health system capacity, socio-economic, political, and historical factors hampered malaria RDT implementation at primary care facilities in the study district. For effective RDT implementation providers must be: (1) adequately enabled through efficient allocation and management of essential healthcare commodities; (2) appropriately empowered with the requisite knowledge and skill through ongoing, effective professional development; and (3) actively engaged in policy dialogue to demystify socio-political misconceptions that hinder health sector reform policies from improving care delivery. Clear, consistent guideline emphasis, with complementary action to address deep-rooted provider concerns will build their confidence in, and promote uptake of recommended policies, practices, and technology for diagnosing malaria.

A facility-wide approach to recreation programming for adults who are severely and profoundly retarded.

PubMed

Burch, M R; Reiss, M; Bailey, J S

1985-01-01

A facility-wide recreation program was designed and implemented in order to increase staff and client participation in daily leisure activities at an intermediate care facility for severely and profoundly mentally retarded adults. The baseline phase of the study consisted of having recreational materials available during scheduled recreation periods. The treatment was a package program consisting of (1) providing the staff with preplanned materials and activities, (2) assigning staff to specific roles, and (3) monitoring staff and providing feedback by supervisors. The treatment was implemented on the two living units of the Liberty Intermediate Care Facility. Treatment effects were similar on both units. Client participation increased from a baseline average of less than 10% to nearly 50% and staff participation increased from less than 10% to an average of 60% during program implementation.

Refurbishment and Automation of the Thermal/Vacuum Facilities at the Goddard Space Flight Center

NASA Technical Reports Server (NTRS)

Donohue, John T.; Johnson, Chris; Ogden, Rick; Sushon, Janet

1998-01-01

The thermal/vacuum facilities located at the Goddard Space Flight Center (GSFC) have supported both manned and unmanned space flight since the 1960s. Of the 11 facilities, currently 10 of the systems are scheduled for refurbishment and/or replacement as part of a 5-year implementation. Expected return on investment includes the reduction in test schedules, improvements in the safety of facility operations, reduction in the complexity of a test and the reduction in personnel support required for a test. Additionally, GSFC will become a global resource renowned for expertise in thermal engineering, mechanical engineering and for the automation of thermal/vacuum facilities and thermal/vacuum tests. Automation of the thermal/vacuum facilities includes the utilization of Programmable Logic Controllers (PLCs) and the use of Supervisory Control and Data Acquisition (SCADA) systems. These components allow the computer control and automation of mechanical components such as valves and pumps. In some cases, the chamber and chamber shroud require complete replacement while others require only mechanical component retrofit or replacement. The project of refurbishment and automation began in 1996 and has resulted in the computer control of one Facility (Facility #225) and the integration of electronically controlled devices and PLCs within several other facilities. Facility 225 has been successfully controlled by PLC and SCADA for over one year. Insignificant anomalies have occurred and were resolved with minimal impact to testing and operations. The amount of work remaining to be performed will occur over the next four to five years. Fiscal year 1998 includes the complete refurbishment of one facility, computer control of the thermal systems in two facilities, implementation of SCADA and PLC systems to support multiple facilities and the implementation of a Database server to allow efficient test management and data analysis.

Summary of Altitude Pulse Testing of a 100-lbf L02/LCH4 Reaction Control Engine

NASA Technical Reports Server (NTRS)

Marshall, William M.; Kleinhenz, Julie E.

2011-01-01

Recently, liquid oxygen-liquid methane (LO2/LCH4) has been considered as a potential "green" propellant alternative for future exploration missions. The Propulsion and Cryogenic Advanced Development (PCAD) project has been tasked by NASA to develop this propulsion combination to enable safe and cost effective exploration missions. To date, limited experience with such combinations exist, and as a result a comprehensive test program is critical to demonstrating the viability of implementing such a system. The NASA Glenn Research Center has conducted a test program of a 100-lbf (445-N) reaction control engine (RCE) at the center s Altitude Combustion Stand (ACS), focusing on altitude testing over a wide variety of operational conditions. The ACS facility includes a unique propellant conditioning feed system (PCFS) which allows precise control of propellant inlet conditions to the engine. Engine performance as a result of these inlet conditions was examined extensively during the test program. This paper is a companion to the previous specific impulse testing paper, and discusses the pulsed mode operation portion of testing, with a focus on minimum impulse bit (I-bit) and repeatable pulse performance. The engine successfully demonstrated target minimum impulse bit performance at all conditions, as well as successful demonstration of repeatable pulse widths. Some anomalous conditions experienced during testing are also discussed, including a double pulse phenomenon which was not noted in previous test programs for this engine.

Implementation of the Generic Safety Analysis Report - Lessons Learned

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

Blanchard, A.

1999-06-02

The Savannah River Site has completed the development, review and approval process for the Generic Safety Analysis Report (GSAR) and implemented this information in facility SARs and BIOs. This includes the yearly revision of the GSAR and the facility-specific SARs. The process has provided us with several lessons learned.

For support of USAMRMC Biological Weapons Convention, treaty and statement implementation activities. Final report, 1 March 1996-28 February 1997

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

Fox, J.

Program of work to provide support to the Biological Arms Control Treaty Office (BACTO) of the U.S. Army Medical Research and Material Command (USAMRMC), in the development of Army and U.S. Government negotiation, implementation and compliance policies and preparations regarding potential verification and confidence measures for the 1975 Biological Weapons Convention (BWC) and related biological weapons agreements. Support services provided included the preparation of Army installations and commands for implementation of visits pursuant to the U.S./UK/Russian Trilateral Statement on BW. Support included site assistance visit, development of required facility documentation and briefings, identification of additional facilities potentially subject to access,more » and support to DOD development of guidelines, procedures, documentation, and other materials for the conduct of visits. Specific tasks under this contract included: identification and delineation of `Military Biological Facilities` and related activities at Army installations; development of visit implementation documentation for the Army; assessment of potentially at-risk equities and sensitivities at relevant facilities; facility staff training and preparation; and review and modification of facility inputs to annual BWC Confidence Building Measure Declarations. Also supported the provision of timely and critical technical support to the Joint Staff and OSD in the development of DoD negotiation biological arms control positions.« less

Conversion and matched filter approximations for serial minimum-shift keyed modulation

NASA Technical Reports Server (NTRS)

Ziemer, R. E.; Ryan, C. R.; Stilwell, J. H.

1982-01-01

Serial minimum-shift keyed (MSK) modulation, a technique for generating and detecting MSK using series filtering, is ideally suited for high data rate applications provided the required conversion and matched filters can be closely approximated. Low-pass implementations of these filters as parallel inphase- and quadrature-mixer structures are characterized in this paper in terms of signal-to-noise ratio (SNR) degradation from ideal and envelope deviation. Several hardware implementation techniques utilizing microwave devices or lumped elements are presented. Optimization of parameter values results in realizations whose SNR degradation is less than 0.5 dB at error probabilities of .000001.

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,

Training and the European Working Time Directive: a 7 year review of paediatric anaesthetic trainee caseload data.

PubMed

Fernandez, E; Williams, D G

2009-10-01

The implementation of the European Working Time Directive (WTD) has reduced the hours worked by trainees in the UK to a maximum of 56 h per week. With a further and final reduction to 48 h per week scheduled for August 2009, there is concern amongst doctors about the impact on training and on patient care. Paediatric anaesthesia is one of the specialist areas of anaesthesia for which the Royal College of Anaesthetists (RCoA) recommends a minimum caseload during the period of advanced training. We conducted a retrospective analysis of theatre logbook data from 62 Specialist Registrars (SpRs) who had completed a 12 month period of advanced training in paediatric anaesthesia in our institution between 2000 and 2007. After the implementation of the WTD 56 h week in 2004, the mean total number of cases performed by SpRs per year decreased from 441 to 336, a 24% reduction. We found a statistically significant reduction across all age groups with the largest reduction in the under 1 month of age group. The post-WTD group did not meet the RCoA recommended total minimum caseload or the minimum number of cases of <1 yr of age. Since the implementation of the WTD, there has been a significant reduction in the number of cases performed by SpRs in paediatric anaesthesia and they are no longer achieving the RCoA recommended minimum numbers for advanced training.

Energy Systems Integration Facility Office Space | Energy Systems

Science.gov Websites

unit has a design capacity of 24,000 cfm (with a minimum outside air of 6,500 cfm) and consists of a pre-filter, heating coil, fan section, cooling coil, and final filter. The office space also has

23 CFR 645.213 - Use and occupancy agreements (permits).

Code of Federal Regulations, 2010 CFR

2010-04-01

... 645.213 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC..., as a minimum, describe the requirements for location, construction, protection of traffic... description of the size, type, nature, and extent of the utility facilities being located within the highway...

23 CFR 645.213 - Use and occupancy agreements (permits).

Code of Federal Regulations, 2011 CFR

2011-04-01

... 645.213 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC..., as a minimum, describe the requirements for location, construction, protection of traffic... description of the size, type, nature, and extent of the utility facilities being located within the highway...

Policy outcomes of applying different nutrient profiling systems in recreational sports settings: the case for national harmonization in Canada.

PubMed

Olstad, Dana Lee; Poirier, Kelly; Naylor, Patti-Jean; Shearer, Cindy; Kirk, Sara F L

2015-08-01

To assess agreement among three nutrient profiling systems used to evaluate the healthfulness of vending machine products in recreation and sport settings in three Canadian provinces. We also assessed whether the nutritional profile of vending machine items in recreation and sport facilities that were adhering to nutrition guidelines (implementers) was superior to that of facilities that were not (non-implementers). Trained research assistants audited the contents of vending machines. Three provincial nutrient profiling systems were used to classify items into each province's most, moderately and least healthy categories. Agreement among systems was assessed using weighted κ statistics. ANOVA assessed whether the average nutritional profile of vending machine items differed according to province and guideline implementation status. Eighteen recreation and sport facilities in three Canadian provinces. One-half of facilities were implementing nutrition guidelines. Snacks (n 531) and beverages (n 618) within thirty-six vending machines were audited. Overall, the systems agreed that the majority of items belonged within their respective least healthy categories (66-69 %) and that few belonged within their most healthy categories (14-22 %). Agreement among profiling systems was moderate to good, with κ w values ranging from 0·49 to 0·69. Implementers offered fewer of the least healthy items (P<0·05) and these items had a better nutritional profile compared with items in non-implementing facilities. The policy outcomes of the three systems are likely to be similar, suggesting there may be scope to harmonize nutrient profiling systems at a national level to avoid unnecessary duplication and support food reformulation by industry.

[Potential analysis for research on Advanced Practice Nursing (APN) for persons with dementia living in long-term care facilities].

PubMed

Koch, Sabine; Fleischer, Steffen

2014-01-01

The nursing Minimum Data Set 3.0 (MDS 3.0) and other nursing quality indices summarise relevant health and nursing outcomes for long-term care that are recommended as quality measures. These are measures like "Percent of High-Risk Residents with Pressure Ulcers", "Percent of Low-Risk Residents Who Lose Control of Their Bowels or Bladder", "Percent of Residents Experiencing One or More Falls with Major Injury", "Percent of Residents Who Lose Too Much Weight" etc. Analyses of healthcare data in Germany showed a substantial higher risk for negative outcomes in the long-term care setting in persons with dementia compared to persons without dementia. There already exist evidence-based guidelines and recommendations for most of the quality measures and underlying health problems (e.g., the German "Expertenstandards in der Pflege"). Implementation and translation of evidence have not been systematically researched yet, and there is uncertainty about structures and processes that support implementation and eventually lead to improved nursing outcomes in people with dementia in long-term care. Studies showed a potential benefit of master-level geriatric advanced practice nurses (GAPNs) concerning the implementation of evidence-based guidelines. This corresponds to the expectation that academic nursing staff positively influences research utilisation in practice. A systematic review identified four controlled trials that evaluated the effectiveness of GAPN on select quality measures. Both the internal and external validity of the trials require a thorough investigation into the intervention before translation and effectiveness research in Germany can be recommended. In accordance with national and international recommendations on the development and clinical evaluation of complex interventions, we recommend a multistage model. Such a model comprises the conceptualisation and adaptation of the original intervention. In this way, the original concept of a GAPN has to be translated into the context of the German healthcare system. Furthermore, feasibility of the intervention in general has to be investigated. This includes acceptance of GAPNs in practice and the necessary prerequisites, especially concerning a comprehensive commitment of one APN to more than one long-term care facility. Copyright © 2014. Published by Elsevier GmbH.

Assessment of core capacities for the International Health Regulations (IHR[2005]) – Uganda, 2009

PubMed Central

2010-01-01

Background Uganda is currently implementing the International Health Regulations (IHR[2005]) within the context of Integrated Disease Surveillance and Response (IDSR). The IHR(2005) require countries to assess the ability of their national structures, capacities, and resources to meet the minimum requirements for surveillance and response. This report describes the results of the assessment undertaken in Uganda. Methods We conducted a descriptive cross-sectional assessment using the protocol developed by the World Health Organisation (WHO). The data collection tools were adapted locally and administered to a convenience sample of HR(2005) stakeholders, and frequency analyses were performed. Results Ugandan national laws relevant to the IHR(2005) existed, but they did not adequately support the full implementation of the IHR(2005). Correspondingly, there was a designated IHR National Focal Point (NFP), but surveillance activities and operational communications were limited to the health sector. All the districts (13/13) had designated disease surveillance offices, most had IDSR technical guidelines (92%, or 12/13), and all (13/13) had case definitions for infectious and zoonotic diseases surveillance. Surveillance guidelines were available at 57% (35/61) of the health facilities, while case definitions were available at 66% (40/61) of the health facilities. The priority diseases list, surveillance guidelines, case definitions and reporting tools were based on the IDSR strategy and hence lacked information on the IHR(2005). The rapid response teams at national and district levels lacked food safety, chemical and radio-nuclear experts. Similarly, there were no guidelines on the outbreak response to food, chemical and radio-nuclear hazards. Comprehensive preparedness plans incorporating IHR(2005) were lacking at national and district levels. A national laboratory policy existed and the strategic plan was being drafted. However, there were critical gaps hampering the efficient functioning of the national laboratory network. Finally, the points of entry for IHR(2005) implementation had not been designated. Conclusions The assessment highlighted critical gaps to guide the IHR(2005) planning process. The IHR(2005) action plan should therefore be developed to foster national and international public health security. PMID:21143831

A qualitative study of health system barriers to accessibility and utilization of maternal and newborn healthcare services in Ghana after user-fee abolition.

PubMed

Ganle, John Kuumuori; Parker, Michael; Fitzpatrick, Raymond; Otupiri, Easmon

2014-12-21

To reduce financial barriers to access, and improve access to and use of skilled maternal and newborn healthcare services, the government of Ghana, in 2003, implemented a new maternal healthcare policy that provided free maternity care services in all public and mission healthcare facilities. Although supervised delivery in Ghana has increased from 47% in 2003 to 55% in 2010, strikingly high maternal mortality ratio and low percentage of skilled attendance are still recorded in many parts of the country. To explore health system factors that inhibit women's access to and use of skilled maternal and newborn healthcare services in Ghana despite these services being provided free. We conducted qualitative research with 185 expectant and lactating mothers and 20 healthcare providers in six communities in Ghana between November 2011 and May 2012. We used Attride-Stirling's thematic network analysis framework to analyze and present our data. We found that in addition to limited and unequal distribution of skilled maternity care services, women's experiences of intimidation in healthcare facilities, unfriendly healthcare providers, cultural insensitivity, long waiting time before care is received, limited birthing choices, poor care quality, lack of privacy at healthcare facilities, and difficulties relating to arranging suitable transportation were important health system barriers to increased and equitable access and use of services in Ghana. Our findings highlight how a focus on patient-side factors can conceal the fact that many health systems and maternity healthcare facilities in low-income settings such as Ghana are still chronically under-resourced and incapable of effectively providing an acceptable minimum quality of care in the event of serious obstetric complications. Efforts to encourage continued use of maternity care services, especially skilled assistance at delivery, should focus on addressing those negative attributes of the healthcare system that discourage access and use.

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

PubMed

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

2014-01-01

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

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

Smith, K.L.

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

40 CFR 52.279 - Food processing facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 3 2012-07-01 2012-07-01 false Food processing facilities. 52.279... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS California § 52.279 Food processing facilities... emissions from food processing facilities without any accompanying analyses demonstrating that these...

40 CFR 52.279 - Food processing facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 3 2014-07-01 2014-07-01 false Food processing facilities. 52.279... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS California § 52.279 Food processing facilities... emissions from food processing facilities without any accompanying analyses demonstrating that these...

40 CFR 52.279 - Food processing facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 3 2011-07-01 2011-07-01 false Food processing facilities. 52.279... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS California § 52.279 Food processing facilities... emissions from food processing facilities without any accompanying analyses demonstrating that these...

40 CFR 52.279 - Food processing facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... emissions from food processing facilities without any accompanying analyses demonstrating that these... 40 Protection of Environment 3 2013-07-01 2013-07-01 false Food processing facilities. 52.279... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS California § 52.279 Food processing facilities...

Medicaid nursing home pay for performance: where do we stand?

PubMed

Arling, Greg; Job, Carol; Cooke, Valerie

2009-10-01

Nursing home pay-for-performance (P4P) programs are intended to maximize the value obtained from public and private expenditures by measuring and rewarding better nursing home performance. We surveyed the 6 states with operational P4P systems in 2007. We describe key features of six Medicaid nursing home P4P systems and make recommendations for further development of nursing home P4P. We surveyed the six states with operational P4P systems in 2007. The range of performance measures employed by the states is quite broad: staffing level and satisfaction, findings from the regulatory system, clinical quality indicators, resident quality of life or satisfaction with care, family satisfaction, access to care for special populations, and efficiency. The main data sources for the measures are the Minimum Data Set (MDS), nursing home inspections, special surveys of nursing home residents, consumers or employees, and facility cost reports or other administrative systems. The most common financial incentive for better performance is a percentage bonus or an add-on to a facility's per diem rate. The bonus is generally proportional to a facility performance score, which consists of simple or weighted sums of scores on individual measures. States undertaking nursing home P4P programs should involve key stakeholders at all stages of P4P system design and implementation. Performance measures should be comprehensive, valid and reliable, risk adjusted where appropriate, and communicated clearly to providers and consumers. The P4P system should encourage provider investment in better care yet recognize state fiscal restraints. Consumer report cards, quality improvement initiatives, and the regulatory process should complement and reinforce P4P. Finally, the P4P system should be transparent and continuously evaluated.

46 CFR 15.101 - Purpose of regulations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... COAST GUARD, DEPARTMENT OF HOMELAND SECURITY MERCHANT MARINE OFFICERS AND SEAMEN MANNING REQUIREMENTS... to set forth uniform minimum requirements for the manning of vessels. In general, they implement, interpret, or apply the specific statutory manning requirements in title 46, U.S.C., parts E & F, implement...

46 CFR 15.101 - Purpose of regulations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... COAST GUARD, DEPARTMENT OF HOMELAND SECURITY MERCHANT MARINE OFFICERS AND SEAMEN MANNING REQUIREMENTS... to set forth uniform minimum requirements for the manning of vessels. In general, they implement, interpret, or apply the specific statutory manning requirements in title 46, U.S.C., parts E & F, implement...

46 CFR 15.101 - Purpose of regulations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... COAST GUARD, DEPARTMENT OF HOMELAND SECURITY MERCHANT MARINE OFFICERS AND SEAMEN MANNING REQUIREMENTS... to set forth uniform minimum requirements for the manning of vessels. In general, they implement, interpret, or apply the specific statutory manning requirements in title 46, U.S.C., parts E & F, implement...

46 CFR 15.101 - Purpose of regulations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... COAST GUARD, DEPARTMENT OF HOMELAND SECURITY MERCHANT MARINE OFFICERS AND SEAMEN MANNING REQUIREMENTS... to set forth uniform minimum requirements for the manning of vessels. In general, they implement, interpret, or apply the specific statutory manning requirements in title 46, U.S.C., parts E & F, implement...

Gemini Observatory base facility operations: systems engineering process and lessons learned

NASA Astrophysics Data System (ADS)

Serio, Andrew; Cordova, Martin; Arriagada, Gustavo; Adamson, Andy; Close, Madeline; Coulson, Dolores; Nitta, Atsuko; Nunez, Arturo

2016-08-01

Gemini North Observatory successfully began nighttime remote operations from the Hilo Base Facility control room in November 2015. The implementation of the Gemini North Base Facility Operations (BFO) products was a great learning experience for many of our employees, including the author of this paper, the BFO Systems Engineer. In this paper we focus on the tailored Systems Engineering processes used for the project, the various software tools used in project support, and finally discuss the lessons learned from the Gemini North implementation. This experience and the lessons learned will be used both to aid our implementation of the Gemini South BFO in 2016, and in future technical projects at Gemini Observatory.

Fayette County Better Buildings Initiative

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

Capella, Arthur

The Fayette County Better Buildings Initiative represented a comprehensive and collaborative approach to promoting and implementing energy efficiency improvements. The initiative was designed to focus on implementing energy efficiency improvements in residential units, while simultaneously supporting general marketing of the benefits of implementing energy efficiency measures. The ultimate goal of Fayette County’s Better Buildings Initiative was to implement a total of 1,067 residential energy efficiency retrofits with a minimum 15% estimated energy efficiency savings per unit. Program partners included: United States Department of Energy, Allegheny Power, and Private Industry Council of Westmoreland-Fayette, Fayette County Redevelopment Authority, and various local partners.more » The program was open to any Fayette County residents who own their home and meet the prequalifying conditions. The level of assistance offered depended upon household income and commitment to undergo a BPI – Certified Audit and implement energy efficiency measures, which aimed to result in at least a 15% reduction in energy usage. The initiative was designed to focus on implementing energy efficiency improvements in residential units, while simultaneously supporting general marketing of the benefits of implementing energy efficiency measures. Additionally, the program had components that involved recruitment and training for employment of persons in the energy sector (green jobs), as well as marketing and implementation of a commercial or community facilities component. The residential component of Fayette County’s Better Buildings Initiative involved a comprehensive approach, providing assistance to low- moderate- and market-rate homeowners. The initiative will also coordinate activities with local utility providers to further incentivize energy efficiency improvements among qualifying homeowners. The commercial component of Fayette County’s Better Building Initiative involved grants and loans to assist up to $15,000 projects per commercial structure with a mixture of a grant and financing at 0% for up to three – (3) years. The maximum award can be a $5,000 grant and a $10,000 loan. For projects less than $15,000, the award will have a ratio of 1/3 grant and 2/3 loan.« less

76 FR 56120 - Atlantic Highly Migratory Species; North and South Atlantic Swordfish Quotas

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-12

... Contracting Parties. Contracting Parties may restrict fishermen to a minimum size of 25 kg live weight OR 125... restrict fishermen to a minimum size of 15 kg live weight OR 119 cm LJFL with no tolerance. In 2009, NMFS... quota, among other things. Per the ATCA, the United States is obligated to implement ICCAT-approved...

Walkthrough screening evaluation field guide. Natural phenomena hazards at Department of Energy facilities: Revision 2

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

Eder, S.J.; Eli, M.W.; Salmon, M.W.

1993-11-01

The US Department of Energy (DOE) has a large inventory of existing facilities. Many of these facilities were not designed and constructed to current natural phenomena hazard (NPH) criteria. The NPH events include earthquakes, extreme winds and tornadoes, and floods. DOE Order 5480.28 establishes policy and requirements for NPH mitigation for DOE facilities. DOE is conducting a multiyear project to develop evaluation guidelines for assessing the condition and determining the need for upgrades at DOE facilities. One element of the NPH evaluation guidelines` development involves the existing systems and components at DOE facilities. This effort is described in detail inmore » a cited reference. In the interim period prior to availability of the final guidelines, DOE facilities are encouraged to implement an NPH walk through screening evaluation process by which systems and components that need attention can be rapidly identified. Guidelines for conducting the walk through screening evaluations are contained herein. The result of the NPH walk through screening evaluation should be a prioritized list of systems and components that need further action. Simple and inexpensive fixes for items identified in the walk through as marginal or inadequate should be implemented without further study. By implementing an NPH walk through screening evaluation, DOE facilities may realize significant reduction in risk from NPH in the short term.« less

HIV policy and implementation: a national policy review and an implementation case study of a rural area of northern Malawi.

PubMed

Dasgupta, Aisha N Z; Wringe, Alison; Crampin, Amelia C; Chisambo, Christina; Koole, Olivier; Makombe, Simon; Sungani, Charles; Todd, Jim; Church, Kathryn

2016-09-01

Malawi is a global leader in the design and implementation of progressive HIV policies. However, there continues to be substantial attrition of people living with HIV across the "cascade" of HIV services from diagnosis to treatment, and program outcomes could improve further. Ability to successfully implement national HIV policy, especially in rural areas, may have an impact on consistency of service uptake. We reviewed Malawian policies and guidelines published between 2003 and 2013 relating to accessibility of adult HIV testing, prevention of mother-to-child transmission and HIV care and treatment services using a policy extraction tool, with gaps completed through key informant interviews. A health facility survey was conducted in six facilities serving the population of a demographic surveillance site in rural northern Malawi to investigate service-level policy implementation. Survey data were analyzed using descriptive statistics. Policy implementation was assessed by comparing policy content and facility practice using pre-defined indicators covering service access: quality of care, service coordination and patient tracking, patient support, and medical management. ART was rolled out in Malawi in 2004 and became available in the study area in 2005. In most areas, practices in the surveyed health facilities complied with or exceeded national policy, including those designed to promote rapid initiation onto treatment, such as free services and task-shifting for treatment initiation. However, policy and/or practice were/was lacking in certain areas, in particular those strategies to promote retention in HIV care (e.g., adherence monitoring and home-based care). In some instances, though, facilities implemented alternative progressive practices aimed at improving quality of care and encouraging adherence. While Malawi has formulated a range of progressive policies aiming to promote rapid initiation onto ART, increased investment in policy implementation strategies and quality service delivery, in particular to promote long-term retention on treatment may improve outcomes further.

Implementation of Robert's Coping with Labor Algorithm© in a large tertiary care facility.

PubMed

Fairchild, Esther; Roberts, Leissa; Zelman, Karen; Michelli, Shelley; Hastings-Tolsma, Marie

2017-07-01

to implement use of Roberts' Coping with Labor Algorithm © (CWLA) with laboring women in a large tertiary care facility. this was a quality improvement project to implement an alternate approach to pain assessment during labor. It included system assessment for change readiness, implementation of the algorithm across a 6-week period, evaluation of usefulness by nursing staff, and determination of sustained change at one month. Stakeholder Theory (Friedman and Miles, 2002) and Deming's (1982) Plan-Do-Check-Act Cycle, as adapted by Roberts et al (2010), provided the framework for project implementation. the project was undertaken on a labor and delivery (L&D) unit of a large tertiary care facility in a southwestern state in the USA. The unit had 19 suites with close to 6000 laboring patients each year. full, part-time, and per diem Registered Nurse (RN) staff (N=80), including a subset (n=18) who served as the pilot group and champions for implementing the change. a majority of RNs held a positive attitude toward use of the CWLA to assess laboring women's coping with the pain of labor as compared to a Numeric Rating Scale (NRS). RNs reported usefulness in using the CWLA with patients from a wide variety of ethnicities. A pre-existing well-developed team which advocated for evidence-based practice on the unit proved to be a significant strength which promoted rapid change in practice. this work provides important knowledge supporting use of the CWLA in a large tertiary care facility and an approach for effectively implementing that change. Strengths identified in this project contributed to rapid implementation and could be emulated in other facilities. Participant reports support usefulness of the CWLA with patients of varied ethnicity. Assessment of change sustainability at 1 and 6 months demonstrated widespread use of the algorithm though long-term determination is yet needed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Enterprise-wide worklist management.

PubMed

Locko, Roberta C; Blume, Hartwig; Goble, John C

2002-01-01

Radiologists in multi-facility health care delivery networks must serve not only their own departments but also departments of associated clinical facilities. We describe our experience with a picture archiving and communication system (PACS) implementation that provides a dynamic view of relevant radiological workload across multiple facilities. We implemented a distributed query system that permits management of enterprise worklists based on modality, body part, exam status, and other criteria that span multiple compatible PACSs. Dynamic worklists, with lesser flexibility, can be constructed if the incompatible PACSs support specific DICOM functionality. Enterprise-wide worklists were implemented across Generations Plus/Northern Manhattan Health Network, linking radiology departments of three hospitals (Harlem, Lincoln, and Metropolitan) with 1465 beds and 4260 ambulatory patients per day. Enterprise-wide, dynamic worklist management improves utilization of radiologists and enhances the quality of care across large multi-facility health care delivery organizations. Integration of other workflow-related components remain a significant challenge.

Computer-implemented security evaluation methods, security evaluation systems, and articles of manufacture

DOEpatents

Muller, George; Perkins, Casey J.; Lancaster, Mary J.; MacDonald, Douglas G.; Clements, Samuel L.; Hutton, William J.; Patrick, Scott W.; Key, Bradley Robert

2015-07-28

Computer-implemented security evaluation methods, security evaluation systems, and articles of manufacture are described. According to one aspect, a computer-implemented security evaluation method includes accessing information regarding a physical architecture and a cyber architecture of a facility, building a model of the facility comprising a plurality of physical areas of the physical architecture, a plurality of cyber areas of the cyber architecture, and a plurality of pathways between the physical areas and the cyber areas, identifying a target within the facility, executing the model a plurality of times to simulate a plurality of attacks against the target by an adversary traversing at least one of the areas in the physical domain and at least one of the areas in the cyber domain, and using results of the executing, providing information regarding a security risk of the facility with respect to the target.

77 FR 23652 - Approval and Promulgation of Air Quality Implementation Plans; Illinois; Leisure Properties LLC/D...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-20

... Promulgation of Air Quality Implementation Plans; Illinois; Leisure Properties LLC/D/B/A Crownline Boats... Properties LLC/D/B/A Crownline Boats (Crownline) at its West Frankfort, Illinois facility. On June 10, 2011... to emissions of volatile organic matter (VOM) from Crownline's manufacturing facility. The adjusted...

75 FR 51490 - Notice; Applications and Amendments to Facility Operating Licenses Involving Proposed No...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-20

...). The proposed amendment would approve the cyber security plan and implementation schedule, and revise... maintain in effect all provisions of the NRC-approved cyber security plan. Basis for proposed no... [facility operating license] to implement and maintain a Cyber Security Plan as part of Energy Northwest's...

28 CFR 115.341 - Obtaining information from residents.

Code of Federal Regulations, 2012 CFR

2012-07-01

... ACT NATIONAL STANDARDS Standards for Juvenile Facilities Screening for Risk of Sexual Victimization... use information about each resident's personal history and behavior to reduce the risk of sexual abuse... instrument. (c) At a minimum, the agency shall attempt to ascertain information about: (1) Prior sexual...

28 CFR 115.341 - Obtaining information from residents.

Code of Federal Regulations, 2013 CFR

2013-07-01

... ACT NATIONAL STANDARDS Standards for Juvenile Facilities Screening for Risk of Sexual Victimization... use information about each resident's personal history and behavior to reduce the risk of sexual abuse... instrument. (c) At a minimum, the agency shall attempt to ascertain information about: (1) Prior sexual...

28 CFR 115.341 - Obtaining information from residents.

Code of Federal Regulations, 2014 CFR

2014-07-01

... ACT NATIONAL STANDARDS Standards for Juvenile Facilities Screening for Risk of Sexual Victimization... use information about each resident's personal history and behavior to reduce the risk of sexual abuse... instrument. (c) At a minimum, the agency shall attempt to ascertain information about: (1) Prior sexual...

Educational Research in North-East India: A Source Material.

ERIC Educational Resources Information Center

Malhotra, Nirmal; Mittal, Pratibha

The Northeast region of India has a distinct geophysical structure and concomitant socio-economic development. New educational development initiatives for Northeastern states include bridging gaps in basic minimum services, enhancing teachers training facilities, and preparing state specific holistic plans. This annotated bibliography represents…

14 CFR 91.1069 - Flight crew: Instrument proficiency check requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... procedures. The instrument approach procedure or procedures must include at least one straight-in approach... conducted to published minimums for that procedure. (d) The instrument proficiency checks required by... emergencies, and standard instrument approaches involving navigational facilities which that pilot is to be...

14 CFR 91.1069 - Flight crew: Instrument proficiency check requirements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... procedures. The instrument approach procedure or procedures must include at least one straight-in approach... conducted to published minimums for that procedure. (d) The instrument proficiency checks required by... emergencies, and standard instrument approaches involving navigational facilities which that pilot is to be...

40 CFR 265.1090 - Recordkeeping requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... applicable to the facility. Except for air emission control equipment design documentation and information... the operating record for a minimum of 3 years. Air emission control equipment design documentation... explain: How use of the required air emission controls on the tanks would affect the tank design features...

40 CFR 264.1089 - Recordkeeping requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... facility. Except for air emission control equipment design documentation and information required by... record for a minimum of 3 years. Air emission control equipment design documentation shall be maintained... the owner or operator stating that the control device is designed to operate at the performance level...

40 CFR 265.1090 - Recordkeeping requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... applicable to the facility. Except for air emission control equipment design documentation and information... the operating record for a minimum of 3 years. Air emission control equipment design documentation... explain: How use of the required air emission controls on the tanks would affect the tank design features...

40 CFR 264.1089 - Recordkeeping requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... facility. Except for air emission control equipment design documentation and information required by... record for a minimum of 3 years. Air emission control equipment design documentation shall be maintained... the owner or operator stating that the control device is designed to operate at the performance level...

40 CFR 264.1089 - Recordkeeping requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... facility. Except for air emission control equipment design documentation and information required by... record for a minimum of 3 years. Air emission control equipment design documentation shall be maintained... the owner or operator stating that the control device is designed to operate at the performance level...

40 CFR 265.1090 - Recordkeeping requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... applicable to the facility. Except for air emission control equipment design documentation and information... the operating record for a minimum of 3 years. Air emission control equipment design documentation... explain: How use of the required air emission controls on the tanks would affect the tank design features...

28 CFR 36.601 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... ACCOMMODATIONS AND IN COMMERCIAL FACILITIES Certification of State Laws or Local Building Codes § 36.601... means a State law or local building code or similar ordinance, or part thereof, that establishes... designee. Certification of equivalency means a final certification that a code meets or exceeds the minimum...

28 CFR 36.601 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... ACCOMMODATIONS AND IN COMMERCIAL FACILITIES Certification of State Laws or Local Building Codes § 36.601... means a State law or local building code or similar ordinance, or part thereof, that establishes... designee. Certification of equivalency means a final certification that a code meets or exceeds the minimum...

28 CFR 36.601 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... ACCOMMODATIONS AND IN COMMERCIAL FACILITIES Certification of State Laws or Local Building Codes § 36.601... means a State law or local building code or similar ordinance, or part thereof, that establishes... designee. Certification of equivalency means a final certification that a code meets or exceeds the minimum...

49 CFR 192.613 - Continuing surveillance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 3 2010-10-01 2010-10-01 false Continuing surveillance. 192.613 Section 192.613... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Operations § 192.613 Continuing surveillance. (a) Each operator shall have a procedure for continuing surveillance of its facilities to determine and take...

49 CFR 192.613 - Continuing surveillance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 3 2011-10-01 2011-10-01 false Continuing surveillance. 192.613 Section 192.613... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Operations § 192.613 Continuing surveillance. (a) Each operator shall have a procedure for continuing surveillance of its facilities to determine and take...

49 CFR 192.613 - Continuing surveillance.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 3 2012-10-01 2012-10-01 false Continuing surveillance. 192.613 Section 192.613... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Operations § 192.613 Continuing surveillance. (a) Each operator shall have a procedure for continuing surveillance of its facilities to determine and take...

49 CFR 192.613 - Continuing surveillance.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 3 2014-10-01 2014-10-01 false Continuing surveillance. 192.613 Section 192.613... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Operations § 192.613 Continuing surveillance. (a) Each operator shall have a procedure for continuing surveillance of its facilities to determine and take...

49 CFR 192.613 - Continuing surveillance.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 3 2013-10-01 2013-10-01 false Continuing surveillance. 192.613 Section 192.613... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Operations § 192.613 Continuing surveillance. (a) Each operator shall have a procedure for continuing surveillance of its facilities to determine and take...

38 CFR 36.4365 - Appraisal requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... statement must also give an estimate of the expected useful life of the roof, elevators, heating and cooling, plumbing and electrical systems assuming normal maintenance. A minimum of 10 years estimated remaining... operation of offsite facilities—(1) Title requirements. Evidence must be presented that the offsite facility...

38 CFR 36.4365 - Appraisal requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... statement must also give an estimate of the expected useful life of the roof, elevators, heating and cooling, plumbing and electrical systems assuming normal maintenance. A minimum of 10 years estimated remaining... operation of offsite facilities—(1) Title requirements. Evidence must be presented that the offsite facility...

38 CFR 36.4365 - Appraisal requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... statement must also give an estimate of the expected useful life of the roof, elevators, heating and cooling, plumbing and electrical systems assuming normal maintenance. A minimum of 10 years estimated remaining... operation of offsite facilities—(1) Title requirements. Evidence must be presented that the offsite facility...

38 CFR 36.4365 - Appraisal requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... statement must also give an estimate of the expected useful life of the roof, elevators, heating and cooling, plumbing and electrical systems assuming normal maintenance. A minimum of 10 years estimated remaining... operation of offsite facilities—(1) Title requirements. Evidence must be presented that the offsite facility...

Optimization models for prioritizing bus stop facility investments for riders with disabilities : March 2010.

DOT National Transportation Integrated Search

2010-03-01

The Americans with Disabilities Act (ADA) of 1990 prescribes the minimum requirements for bus stop accessibility by riders with disabilities. Due to limited budgets, transit agencies can only select a limited number of bus stop locations for ADA impr...

(The AMY experiment)

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

Not Available

1989-01-01

The AMY experiment is one of three major experiments at TRISTAN which is studying the states the matter produced in electron positron annihilations in the center of mass energy range of 50--65GeV. It provides information between the lower energy facilities such as PEP and PETRA and the new facilities SLC and LEP which are designed to operate in the region of the Z{sup 0} mass near 90GeV. In the region of the AMY experiment, interaction cross sections are near their minimum of about 100pb, making it difficult to acquire large data samples during typical running cycles. This last year hasmore » seen an accumulation of about 10--{minus}12pb{sup {minus}1} of integrated luminosity in the energy range from 58 to 61.7GeV. Despite this limited data sample, the AMY experiment has been extremely active in attempting to extract the minimum amount of information from the data. Some of the most significant results are discussed in this paper. 9 refs.« less

Vaccine wastage in Nigeria: An assessment of wastage rates and related vaccinator knowledge, attitudes and practices.

PubMed

Wallace, Aaron S; Willis, Fred; Nwaze, Eric; Dieng, Boubacar; Sipilanyambe, Naawa; Daniels, Danni; Abanida, Emmanuel; Gasasira, Alex; Mahmud, Mustapha; Ryman, Tove K

2017-12-04

The introduction of new vaccines highlights concerns about high vaccine wastage, knowledge of wastage policies and quality of stock management. However, an emphasis on minimizing wastage rates may cause confusion when recommendations are also being made to reduce missed opportunities to routinely vaccinate children. This concern is most relevant for lyophilized vaccines without preservatives [e.g. measles-containing vaccine (MCV)], which can be used for a limited time once reconstituted. We sampled 54 health facilities within 11 local government areas (LGAs) in Nigeria and surveyed health sector personnel regarding routine vaccine usage and wastage-related knowledge and practices, conducted facility exit interviews with caregivers of children about missed opportunities for routine vaccination, and abstracted vaccine stock records and vaccination session data over a 6-month period to calculate wastage rates and vaccine vial usage patterns. Nearly half of facilities had incomplete vaccine stock data for calculating wastage rates. Among facilities with sufficient data, mean monthly facility-level wastage rates were between 18 and 35% across all reviewed vaccines, with little difference between lyophilized and liquid vaccines. Most (98%) vaccinators believed high wastage led to recent vaccine stockouts, yet only 55% were familiar with the multi-dose vial policy for minimizing wastage. On average, vaccinators reported that a minimum of six children must be present prior to opening a 10-dose MCV vial. Third dose of diphtheria-tetanus-pertussis vaccine (DTP3) was administered in 84% of sessions and MCV in 63%; however, the number of MCV and DTP3 doses administered were similar indicating the number of children vaccinated with DTP3 and MCV were similar despite less frequent MCV vaccination opportunities. Among caregivers, 30% reported being turned away for vaccination at least once; 53% of these children had not yet received the missed dose. Our findings show inadequate implementation of vaccine management guidelines, missed opportunities to vaccinate, and lyophilized vaccine wastage rates below expected rates. Missed opportunities for vaccination may occur due to how the health system's contradicting policies may force health workers to prioritize reduced wastage rates over vaccine administration, particularly for multi-dose vials. Published by Elsevier Ltd.

49 CFR 192.907 - What must an operator do to implement this subpart?

Code of Federal Regulations, 2010 CFR

2010-10-01

...) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY TRANSPORTATION OF NATURAL AND OTHER GAS BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Gas Transmission Pipeline Integrity Management § 192.907 What must an operator do to implement this subpart? (a...

Planning Requirements for Small School Facilities.

ERIC Educational Resources Information Center

Davis, J. Clark; McQueen, Robert

The unique requirements of small school facilities, designed to handle multiple curricular functions within the same operational space, necessitate the creation of educational specifications tying the curriculum to that portion of the facility in which each curriculum component will be implemented. Thus, in planning the facility the major concern…

Why Integrate Educational and Community Facilities?

ERIC Educational Resources Information Center

Fessas-Emmanouil, Helen D.

1978-01-01

Discusses coordination of educational and community facilities in order to encourage more rational investments and more efficient use of premises. Such coordination may reduce the economic burden imposed upon citizens for the provision of separate facilities for school and community. However, implementation of such a facility presupposes radical…

78 FR 32088 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-29

...This rule establishes, amends, suspends, or revokes Standard Instrument Approach Procedures (SIAPs) and associated Takeoff Minimums and Obstacle Departure Procedures for operations at certain airports. These regulatory actions are needed because of the adoption of new or revised criteria, or because of changes occurring in the National Airspace System, such as the commissioning of new navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed to provide safe and efficient use of the navigable airspace and to promote safe flight operations under instrument flight rules at the affected airports.

75 FR 69331 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-12

...This establishes, amends, suspends, or revokes Standard Instrument Approach Procedures (SIAPs) and associated Takeoff Minimums and Obstacle Departure Procedures for operations at certain airports. These regulatory actions are needed because of the adoption of new or revised criteria, or because of changes occurring in the National Airspace System, such as the commissioning of new navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed to provide safe and efficient use of the navigable airspace and to promote safe flight operations under instrument flight rules at the affected airports.

77 FR 12454 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-01

...This rule establishes, amends, suspends, or revokes Standard Instrument Approach Procedures (SIAPs) and associated Takeoff Minimums and Obstacle Departure Procedures for operations at certain airports. These regulatory actions are needed because of the adoption of new or revised criteria, or because of changes occurring in the National Airspace System, such as the commissioning of new navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed to provide safe and efficient use of the navigable airspace and to promote safe flight operations under instrument flight rules at the affected airports.

Medical Research and Evaluation Facility (MREF) and studies supporting the medical chemical defense program. Determination of the minimum effective pyridostigmine pretreatment dose in monkeys challenged with 5 x LD50 Soman and treated with atropine/2-PAM. Final report, 22 October 1992-31 August 1993

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

Olson, C.T.; Menton, R.G.; Kiser, R.C.

This task was conducted to determine the minimum dose of pyridostigmine (PYR), and the associated level of erythrocyte acetycholinesterase inhibition (AChE-I), that provides protection from 5 X 48-br GD LD50 of untreated monkeys. Monkeys were injected im with GD and treated with 0.4 mg atropine (ATR) free base and 25.7 mg pralidoxime (2-PAM) per kg BW.

Aeropropulsion facilities configuration control: Procedures manual

NASA Technical Reports Server (NTRS)

Lavelle, James J.

1990-01-01

Lewis Research Center senior management directed that the aeropropulsion facilities be put under configuration control. A Configuration Management (CM) program was established by the Facilities Management Branch of the Aeropropulsion Facilities and Experiments Division. Under the CM program, a support service contractor was engaged to staff and implement the program. The Aeronautics Directorate has over 30 facilities at Lewis of various sizes and complexities. Under the program, a Facility Baseline List (FBL) was established for each facility, listing which systems and their documents were to be placed under configuration control. A Change Control System (CCS) was established requiring that any proposed changes to FBL systems or their documents were to be processed as per the CCS. Limited access control of the FBL master drawings was implemented and an audit system established to ensure all facility changes are properly processed. This procedures manual sets forth the policy and responsibilities to ensure all key documents constituting a facilities configuration are kept current, modified as needed, and verified to reflect any proposed change. This is the essence of the CM program.

Probabilistic Modeling of Settlement Risk at Land Disposal Facilities - 12304

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

Foye, Kevin C.; Soong, Te-Yang

2012-07-01

The long-term reliability of land disposal facility final cover systems - and therefore the overall waste containment - depends on the distortions imposed on these systems by differential settlement/subsidence. The evaluation of differential settlement is challenging because of the heterogeneity of the waste mass (caused by inconsistent compaction, void space distribution, debris-soil mix ratio, waste material stiffness, time-dependent primary compression of the fine-grained soil matrix, long-term creep settlement of the soil matrix and the debris, etc.) at most land disposal facilities. Deterministic approaches to long-term final cover settlement prediction are not able to capture the spatial variability in the wastemore » mass and sub-grade properties which control differential settlement. An alternative, probabilistic solution is to use random fields to model the waste and sub-grade properties. The modeling effort informs the design, construction, operation, and maintenance of land disposal facilities. A probabilistic method to establish design criteria for waste placement and compaction is introduced using the model. Random fields are ideally suited to problems of differential settlement modeling of highly heterogeneous foundations, such as waste. Random fields model the seemingly random spatial distribution of a design parameter, such as compressibility. When used for design, the use of these models prompts the need for probabilistic design criteria. It also allows for a statistical approach to waste placement acceptance criteria. An example design evaluation was performed, illustrating the use of the probabilistic differential settlement simulation methodology to assemble a design guidance chart. The purpose of this design evaluation is to enable the designer to select optimal initial combinations of design slopes and quality control acceptance criteria that yield an acceptable proportion of post-settlement slopes meeting some design minimum. For this specific example, relative density, which can be determined through field measurements, was selected as the field quality control parameter for waste placement. This technique can be extended to include a rigorous performance-based methodology using other parameters (void space criteria, debris-soil mix ratio, pre-loading, etc.). As shown in this example, each parameter range, or sets of parameter ranges can be selected such that they can result in an acceptable, long-term differential settlement according to the probabilistic model. The methodology can also be used to re-evaluate the long-term differential settlement behavior at closed land disposal facilities to identify, if any, problematic facilities so that remedial action (e.g., reinforcement of upper and intermediate waste layers) can be implemented. Considering the inherent spatial variability in waste and earth materials and the need for engineers to apply sound quantitative practices to engineering analysis, it is important to apply the available probabilistic techniques to problems of differential settlement. One such method to implement probability-based differential settlement analyses for the design of landfill final covers has been presented. The design evaluation technique presented is one tool to bridge the gap from deterministic practice to probabilistic practice. (authors)« less

A bandwidth compressive modulation system using multi-amplitude minimum shift keying /MAMSK/. [for spacecraft communication

NASA Technical Reports Server (NTRS)

Weber, W. J., III; Stanton, P. H.; Sumida, J. T.

1978-01-01

A bandwidth compressive modem making use of multi-amplitude minimum shift keying (MAMSK) has been designed and implemented in a laboratory environment at microwave frequencies. This system achieves a substantial bandwidth reduction over binary PSK and operates within 0.5 dB of theoretical performance. A number of easily implemented microwave transmitters have been designed to generate the required set of 16 signals. The receiver has been designed to work at 1 Mbit/s and contains the necessary phase tracking, AGC, and symbol synchronization loops as well as a lock detector, SNR estimator and provisions for differential decoding. This paper describes this entire system and presents the experimental results.

Status and Perspectives of Neutron Imaging Facilities

NASA Astrophysics Data System (ADS)

Lehmann, E.; Trtik, P.; Ridikas, D.

The methodology and the application range of neutron imaging techniques have been significantly improved at numerous facilities worldwide in the last decades. This progress has been achieved by new detector systems, the setup of dedicated, optimized and flexible beam lines and the much better understanding of the complete imaging process thanks to complementary simulations. Furthermore, new applications and research topics were found and implemented. However, since the quality and the number of neutron imaging facilities depend much on the access to suitable beam ports, there is still an enormous potential to implement state-of-the-art neutron imaging techniques at many more facilities. On the one hand, there are prominent and powerful sources which do not intend/accept the implementation of neutron imaging techniques due to the priorities set for neutron scattering and irradiation techniques exclusively. On the other hand, there are modern and useful devices which remain under-utilized and have either not the capacity or not the know-how to develop attractive user programs and/or industrial partnerships. In this overview of the international status of neutron imaging facilities, we will specify details about the current situation.

Decadal Vision Progress Report Implementation Plans and Status for the Next Generation ARM Facility

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

Mather, James

The reconfiguration of the ARM facility, formally initiated in early 2014, is geared toward implementing the Next Generation of the ARM Facility, which will more tightly link ARM measurements and atmospheric models. The strategy is outlined in the ARM Climate Research Facility Decadal Vision (DOE 2014a). The strategy includes the implementation of a high-resolution model, initially at the Southern Great Plains (SGP) site, and enhancements at the SGP and North Slope of Alaska (NSA) sites to provide additional observations to support modeling and process studies. Enhancements at the SGP site focus on ground-based instruments while enhancements at the NSA makemore » use of Unmanned Aerial Systems (UAS) and Tethered Balloon Systems (TBS). It is also recognized that new data tools and data products will need to be developed to take full advantage of these improvements. This document provides an update on the status of these ARM facility enhancements, beginning with the measurement enhancements at the SGP and NSA, followed by a discussion of the modeling project including associated data-processing activities.« less

33 CFR 154.1055 - Exercises.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Exercises. 154.1055 Section 154... Exercises. (a) A response plan submitted by an owner or operator of an MTR facility must include an exercise program containing both announced and unannounced exercises. The following are the minimum exercise...

33 CFR 154.1055 - Exercises.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Exercises. 154.1055 Section 154... Exercises. (a) A response plan submitted by an owner or operator of an MTR facility must include an exercise program containing both announced and unannounced exercises. The following are the minimum exercise...

33 CFR 154.1055 - Exercises.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Exercises. 154.1055 Section 154... Exercises. (a) A response plan submitted by an owner or operator of an MTR facility must include an exercise program containing both announced and unannounced exercises. The following are the minimum exercise...

33 CFR 154.1055 - Exercises.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Exercises. 154.1055 Section 154... Exercises. (a) A response plan submitted by an owner or operator of an MTR facility must include an exercise program containing both announced and unannounced exercises. The following are the minimum exercise...

77 FR 15459 - Procedures To Establish Appropriate Minimum Block Sizes for Large Notional Off-Facility Swaps and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-15

... Commission is of the view that the term swap category is a more descriptive term to convey the concept of a... inappropriate comparative measure for the swaps market.\\46\\ Some of these commenters, for example, argued that...

76 FR 48159 - Integrated System Power Rates

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-08

... rates, as are those of Southwestern's transmission facilities, which consist of 1,380 miles of high... system investments within the required number of years. As indicated in the Integrated System Rate Design... decrease slightly to reflect the incorporation of the White River Minimum Flows legislation as applied to...

76 FR 9025 - Agency Information Collection Activities; Proposed Collection; Comment Request; Good Laboratory...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-16

... consumer protection, the Agency issued GLP regulations. The regulations specify minimum standards for the proper conduct of safety testing and contain sections on facilities, personnel, equipment, standard operating procedures (SOPs), test and control articles, quality assurance, protocol and conduct of a safety...

14 CFR 91.1039 - IFR takeoff, approach and landing minimums.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) For flight planning purposes, if the destination airport does not have a weather reporting facility... TRANSPORTATION (CONTINUED) AIR TRAFFIC AND GENERAL OPERATING RULES GENERAL OPERATING AND FLIGHT RULES Fractional... on a program aircraft operating a program flight may begin an instrument approach procedure to an...

14 CFR 91.1039 - IFR takeoff, approach and landing minimums.

Code of Federal Regulations, 2011 CFR

2011-01-01

...) For flight planning purposes, if the destination airport does not have a weather reporting facility... TRANSPORTATION (CONTINUED) AIR TRAFFIC AND GENERAL OPERATING RULES GENERAL OPERATING AND FLIGHT RULES Fractional... on a program aircraft operating a program flight may begin an instrument approach procedure to an...

14 CFR 91.1039 - IFR takeoff, approach and landing minimums.

Code of Federal Regulations, 2013 CFR

2013-01-01

...) For flight planning purposes, if the destination airport does not have a weather reporting facility... TRANSPORTATION (CONTINUED) AIR TRAFFIC AND GENERAL OPERATING RULES GENERAL OPERATING AND FLIGHT RULES Fractional... on a program aircraft operating a program flight may begin an instrument approach procedure to an...

14 CFR 91.1039 - IFR takeoff, approach and landing minimums.

Code of Federal Regulations, 2012 CFR

2012-01-01

...) For flight planning purposes, if the destination airport does not have a weather reporting facility... TRANSPORTATION (CONTINUED) AIR TRAFFIC AND GENERAL OPERATING RULES GENERAL OPERATING AND FLIGHT RULES Fractional... on a program aircraft operating a program flight may begin an instrument approach procedure to an...

14 CFR 91.1039 - IFR takeoff, approach and landing minimums.

Code of Federal Regulations, 2014 CFR

2014-01-01

...) For flight planning purposes, if the destination airport does not have a weather reporting facility... TRANSPORTATION (CONTINUED) AIR TRAFFIC AND GENERAL OPERATING RULES GENERAL OPERATING AND FLIGHT RULES Fractional... on a program aircraft operating a program flight may begin an instrument approach procedure to an...

7 CFR 1450.103 - Eligible material that qualifies for payment.

Code of Federal Regulations, 2011 CFR

2011-01-01

... CREDIT CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS BIOMASS CROP... this subpart: (1) Eligible material must be renewable biomass that, at a minimum, meets the definition... must be delivered to a qualified biomass conversion facility (as specified in § 1450.101 and other...

7 CFR 1450.103 - Eligible material that qualifies for payment.

Code of Federal Regulations, 2012 CFR

2012-01-01

... CREDIT CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS BIOMASS CROP... this subpart: (1) Eligible material must be renewable biomass that, at a minimum, meets the definition... must be delivered to a qualified biomass conversion facility (as specified in § 1450.101 and other...

7 CFR 1450.103 - Eligible material that qualifies for payment.

Code of Federal Regulations, 2013 CFR

2013-01-01

... CREDIT CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS BIOMASS CROP... this subpart: (1) Eligible material must be renewable biomass that, at a minimum, meets the definition... must be delivered to a qualified biomass conversion facility (as specified in § 1450.101 and other...

7 CFR 1450.103 - Eligible material that qualifies for payment.

Code of Federal Regulations, 2014 CFR

2014-01-01

... CREDIT CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS BIOMASS CROP... this subpart: (1) Eligible material must be renewable biomass that, at a minimum, meets the definition... must be delivered to a qualified biomass conversion facility (as specified in § 1450.101 and other...

Applications of active adaptive noise control to jet engines

NASA Technical Reports Server (NTRS)

Shoureshi, Rahmat; Brackney, Larry

1993-01-01

During phase 2 research on the application of active noise control to jet engines, the development of multiple-input/multiple-output (MIMO) active adaptive noise control algorithms and acoustic/controls models for turbofan engines were considered. Specific goals for this research phase included: (1) implementation of a MIMO adaptive minimum variance active noise controller; and (2) turbofan engine model development. A minimum variance control law for adaptive active noise control has been developed, simulated, and implemented for single-input/single-output (SISO) systems. Since acoustic systems tend to be distributed, multiple sensors, and actuators are more appropriate. As such, the SISO minimum variance controller was extended to the MIMO case. Simulation and experimental results are presented. A state-space model of a simplified gas turbine engine is developed using the bond graph technique. The model retains important system behavior, yet is of low enough order to be useful for controller design. Expansion of the model to include multiple stages and spools is also discussed.

Integrated Display and Simulation for Automatic Dependent Surveillance-Broadcast and Traffic Collision Avoidance System Data Fusion.

PubMed

Wang, Yanran; Xiao, Gang; Dai, Zhouyun

2017-11-13

Automatic Dependent Surveillance-Broadcast (ADS-B) is the direction of airspace surveillance development. Research analyzing the benefits of Traffic Collision Avoidance System (TCAS) and ADS-B data fusion is almost absent. The paper proposes an ADS-B minimum system from ADS-B In and ADS-B Out. In ADS-B In, a fusion model with a variable sampling Variational Bayesian-Interacting Multiple Model (VSVB-IMM) algorithm is proposed for integrated display and an airspace traffic situation display is developed by using ADS-B information. ADS-B Out includes ADS-B Out transmission based on a simulator platform and an Unmanned Aerial Vehicle (UAV) platform. This paper describes the overall implementation of ADS-B minimum system, including theoretical model design, experimental simulation verification, engineering implementation, results analysis, etc. Simulation and implementation results show that the fused system has better performance than each independent subsystem and it can work well in engineering applications.

33 CFR 105.295 - Additional requirements-Certain Dangerous Cargo (CDC) facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Dangerous Cargo (CDC) facilities. 105.295 Section 105.295 Navigation and Navigable Waters COAST GUARD... Requirements § 105.295 Additional requirements-Certain Dangerous Cargo (CDC) facilities. (a) At all MARSEC Levels, owners or operators of CDC facilities must ensure the implementation of the following security...

33 CFR 105.295 - Additional requirements-Certain Dangerous Cargo (CDC) facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Dangerous Cargo (CDC) facilities. 105.295 Section 105.295 Navigation and Navigable Waters COAST GUARD... Requirements § 105.295 Additional requirements-Certain Dangerous Cargo (CDC) facilities. (a) At all MARSEC Levels, owners or operators of CDC facilities must ensure the implementation of the following security...

33 CFR 105.295 - Additional requirements-Certain Dangerous Cargo (CDC) facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Dangerous Cargo (CDC) facilities. 105.295 Section 105.295 Navigation and Navigable Waters COAST GUARD... Requirements § 105.295 Additional requirements-Certain Dangerous Cargo (CDC) facilities. (a) At all MARSEC Levels, owners or operators of CDC facilities must ensure the implementation of the following security...

33 CFR 105.295 - Additional requirements-Certain Dangerous Cargo (CDC) facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Dangerous Cargo (CDC) facilities. 105.295 Section 105.295 Navigation and Navigable Waters COAST GUARD... Requirements § 105.295 Additional requirements-Certain Dangerous Cargo (CDC) facilities. (a) At all MARSEC Levels, owners or operators of CDC facilities must ensure the implementation of the following security...

33 CFR 105.295 - Additional requirements-Certain Dangerous Cargo (CDC) facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Dangerous Cargo (CDC) facilities. 105.295 Section 105.295 Navigation and Navigable Waters COAST GUARD... Requirements § 105.295 Additional requirements-Certain Dangerous Cargo (CDC) facilities. (a) At all MARSEC Levels, owners or operators of CDC facilities must ensure the implementation of the following security...

49 CFR 236.1011 - PTC Implementation Plan content requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... decisions, and shall at a minimum address the following risk factors by track segment: (i) Segment traffic... implemented to address areas of greater risk to the public and railroad employees before areas of lesser risk... risk, including ruling grades and extreme curvature; (6) The following information relating to rolling...

40 CFR 258.58 - Implementation of the corrective action program.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) SOLID WASTES CRITERIA FOR MUNICIPAL SOLID WASTE LANDFILLS Ground-Water Monitoring and Corrective...) Establish and implement a corrective action ground-water monitoring program that: (i) At a minimum, meet the requirements of an assessment monitoring program under § 258.55; (ii) Indicate the effectiveness of the...

40 CFR 258.58 - Implementation of the corrective action program.

Code of Federal Regulations, 2012 CFR

2012-07-01

... WASTES CRITERIA FOR MUNICIPAL SOLID WASTE LANDFILLS Ground-Water Monitoring and Corrective Action § 258... implement a corrective action ground-water monitoring program that: (i) At a minimum, meet the requirements of an assessment monitoring program under § 258.55; (ii) Indicate the effectiveness of the corrective...

40 CFR 258.58 - Implementation of the corrective action program.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) SOLID WASTES CRITERIA FOR MUNICIPAL SOLID WASTE LANDFILLS Ground-Water Monitoring and Corrective...) Establish and implement a corrective action ground-water monitoring program that: (i) At a minimum, meet the requirements of an assessment monitoring program under § 258.55; (ii) Indicate the effectiveness of the...

40 CFR 258.58 - Implementation of the corrective action program.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) SOLID WASTES CRITERIA FOR MUNICIPAL SOLID WASTE LANDFILLS Ground-Water Monitoring and Corrective...) Establish and implement a corrective action ground-water monitoring program that: (i) At a minimum, meet the requirements of an assessment monitoring program under § 258.55; (ii) Indicate the effectiveness of the...

40 CFR 257.28 - Implementation of the corrective action program.

Code of Federal Regulations, 2012 CFR

2012-07-01

...-Hazardous Waste Disposal Units Ground-Water Monitoring and Corrective Action § 257.28 Implementation of the... ground-water monitoring program that: (i) At a minimum, meets the requirements of an assessment monitoring program under § 257.25; (ii) Indicates the effectiveness of the corrective action remedy; and (iii...

Evaluation of Alabama Public School Wellness Policies and State School Mandate Implementation

ERIC Educational Resources Information Center

Gaines, Alisha B.; Lonis-Shumate, Steven R.; Gropper, Sareen S.

2011-01-01

Background: This study evaluated wellness policies created by Alabama public school districts and progress made in the implementation of Alabama State Department of Education (ALSDE) school food and nutrition mandates. Methods: Wellness policies from Alabama public school districts were compared to minimum requirements under the Child Nutrition…

Establishment of a Re-Entry Model to Reduce Recidivism Among Court Ward Students.

ERIC Educational Resources Information Center

Kammuller, Kenneth C.

The development and implementation of a Re-Entry Model designed to facilitate and monitor the adjustment of high school students returned to public school from a county commitment facility is described. Transition and follow-up procedures implemented through the model with a liaison teacher at the commitment facility school designated as the…

77 FR 31856 - Record of Decision for the Department of Homeland Security Headquarters Consolidation at St...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-30

... thereby implement the Preferred Alternative for the FEMA facility, improvements to MLK Avenue and... Alternative that includes implementation of improvements to I-295, it is a public facility under FHWA's and... Environmental Policy Act of 1969 (NEPA), 42 U.S.C. 4321-4347, the Council on Environmental Quality Regulations...

Managing Energy in Your Educational Facility.

ERIC Educational Resources Information Center

2001

This booklet explains how to develop and implement a plan to manage energy in educational facilities. It can be used to identify energy savings opportunities and implement a plan to reduce energy costs. It discusses the following steps for creating an effective energy-use plan: (1) get started and organize for success; (2) look at energy use and…

Sigma 2 Graphic Display Software Program Description

NASA Technical Reports Server (NTRS)

Johnson, B. T.

1973-01-01

A general purpose, user oriented graphic support package was implemented. A comprehensive description of the two software components comprising this package is given: Display Librarian and Display Controller. These programs have been implemented in FORTRAN on the XDS Sigma 2 Computer Facility. This facility consists of an XDS Sigma 2 general purpose computer coupled to a Computek Display Terminal.

History of the development of radiotherapy in Latin America.

PubMed

Pinillos, Luis; Pinto, Joseph A; Sarria, Gustavo

2017-01-01

Radiotherapy was the first nonsurgical treatment for malignant tumours and represents one of the oldest disciplines of oncology. In Latin America, as in many parts of the world, the history of modern oncology begins with the implementation of radiation therapy facilities. The development of radiotherapy in Latin America was possible thanks to the seminal work of radiation oncologists in different countries. As a large territory, there is a need to implement modern facilities and equipment, but unfortunately there are disparities in the access and quality of radiotherapy services across Latin America and even within individual countries. In this review, we describe the history, challenges and success in the implementation of radiotherapy and the frustration caused by the lack of facilities in several Latin American countries.

Chief Student Affairs Officers' Interpretation and Implementation of the Minimum Legal Drinking Age and the Amethyst Initiative: A Discursive Policy Analysis

ERIC Educational Resources Information Center

Caldwell, Rebecca Jane

2012-01-01

High-risk drinking is an endemic health and safety issue for college campuses in the United States (U.S.). While public health officials have recommended various models for campus alcohol prevention efforts, in 2008 a group of college presidents recommended a controversial strategy: reconsidering the U.S. minimum legal drinking age (MLDA). The…

A Study of the Role of a Technology-Enhanced Learning Implementation Group in Mediating an Institutional VLE Minimum Standards Policy

ERIC Educational Resources Information Center

Varga-Atkins, Tünde

2016-01-01

Recent years have seen a focus on responding to student expectations in higher education. As a result, a number of technology-enhanced learning (TEL) policies have stipulated a requirement for a minimum virtual learning environment (VLE) standard to provide a consistent student experience. This paper offers insight into an under-researched area of…

Exploring health facilities' experiences in implementing the free health-care policy (FHCP) in Nepal: how did organizational factors influence the implementation of the user-fee abolition policy?

PubMed

Sato, Midori; Gilson, Lucy

2015-12-01

This article presents an Asian experience of abolishing health-care user fees: Nepal's universal free health-care policy, implemented in 2008. Based on doctoral fieldwork between August 2008 and April 2009, the paper analyses primary-care facilities' and central and district health systems' experiences with the policy. It makes a unique contribution to existing evidence because it explicitly applies organizational theory within a carefully designed, rigorous, multiple case-study analysis to deepen our understanding of the organizational and 'people' factors in the successful removal of user fees. The cases were two pairs of primary-care facilities in one district, paired for comparison of the facilities' experiences with the policy in relation to its effects on health care utilization. Data collection methods included document reviews; key informant interviews at district and central levels; in-depth, semi-structured interviews and group interviews at case facilities. (Data on indicators of utilization and quality changes over time were also collected and will be published separately). Using key elements of Nadler and Tushman's 'Organizational Congruence' model, a degree-of-fit analysis tested the study's initial propositions and yielded generalizations for contexts in and outside Nepal. The study found that Nepal's key implementation challenges were similar to Africa's: insufficient or delayed inputs of drugs and compensation; insufficient workforce and the resulting reduced quality of services that hampered facilities' relationships with their clients and health providers' attitudes. However, the Nepalese case facilities with (1) good intra- and inter-facility relationships, (2) adequate staffing, (3) well-oriented providers and (4) previously trained, better-informed and skilled health management committees experienced higher utilization and better-quality indicators over time. Through its detailed analysis of Nepal's experience in removing user fees, the study highlights the importance of addressing the 'people' and 'organizational' factors in health-policy development and implementation. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2015; all rights reserved.

Adopting and implementing nutrition guidelines in recreational facilities: Public and private sector roles. A multiple case study

PubMed Central

2012-01-01

Background Recreational facilities are an important community resource for health promotion because they provide access to affordable physical activities. However, despite their health mandate, many have unhealthy food environments that may paradoxically increase the risk of childhood obesity. The Alberta Nutrition Guidelines for Children and Youth (ANGCY) are government-initiated, voluntary guidelines intended to facilitate children’s access to healthy food and beverage choices in schools, childcare and recreational facilities, however few recreational facilities are using them. Methods We used mixed methods within an exploratory multiple case study to examine factors that influenced adoption and implementation of the ANGCY and the nature of the food environment within three cases: an adopter, a semi-adopter and a non-adopter of the ANGCY. Diffusion of Innovations theory provided the theoretical platform for the study. Qualitative data were generated through interviews, observations, and document reviews, and were analysed using directed content analysis. Set theoretic logic was used to identify factors that differentiated adopters from the non-adopter. Quantitative sales data were also collected, and the quality of the food environment was scored using four complementary tools. Results The keys to adoption and implementation of nutrition guidelines in recreational facilities related to the managers’ nutrition-related knowledge, beliefs and perceptions, as these shaped his decisions and actions. The manager, however, could not accomplish adoption and implementation alone. Intersectoral linkages with schools and formal, health promoting partnerships with industry were also important for adoption and implementation to occur. The food environment in facilities that had adopted the ANGCY did not appear to be superior to the food environment in facilities that had not adopted the ANGCY. Conclusions ANGCY uptake may continue to falter under the current voluntary approach, as the environmental supports for voluntary action are poor. Where ANGCY uptake does occur, changes to the food environment may be relatively minor. Stronger government measures may be needed to require recreational facilities to improve their food environments and to limit availability of unhealthy foods. PMID:22632384

From home deliveries to health care facilities: establishing a traditional birth attendant referral program in Kenya.

PubMed

Tomedi, Angelo; Stroud, Sophia R; Maya, Tania Ruiz; Plaman, Christopher R; Mwanthi, Mutuku A

2015-07-16

To assess the effectiveness of a traditional birth attendant (TBA) referral program on increasing the number of deliveries overseen by skilled birth attendants (SBA) in rural Kenyan health facilities before and after the implementation of a free maternity care policy. In a rural region of Kenya, TBAs were recruited to educate pregnant women about the importance of delivering in healthcare facilities and were offered a stipend for every pregnant woman whom they brought to the healthcare facility. We evaluated the percentage of prenatal care (PNC) patients who delivered at the intervention site compared with the percentage of PNC patients who delivered at rural control facilities, before and after the referral program was implemented, and before and after the Kenya government implemented a policy of free maternity care. The window period of the study was from July of 2011 through September 2013, with a TBA referral intervention conducted from March to September 2013. The absolute increases from the pre-intervention period to the TBA referral intervention period in SBA deliveries were 5.7 and 24.0% in the control and intervention groups, respectively (p < 0.001). The absolute increases in SBA delivery rates from the pre-intervention period to the intervention period before the implementation of the free maternity care policy were 4.7 and 17.2% in the control and intervention groups, respectively (p < 0.001). After the policy implementation the absolute increases from pre-intervention to post-intervention were 1.8 and 11.6% in the control and intervention groups, respectively (p < 0.001). The percentage of SBA deliveries at the intervention health facility significantly increased compared to control health facilities when TBAs educated women about the need to deliver with a SBA and when TBAs received a stipend for bringing women to local health facilities to deliver. Furthermore, this TBA referral program proved to be far more effective in the target region of Kenya than a policy change to provide free obstetric care.

A continuous plutonium aerosol monitor for use in high radon environments.

PubMed

Li, HuiBin; Jia, MingYan; Li, GuoShen; Wang, YinDong

2012-01-01

Radon concentration is very high in underground basements and other facilities. Radon concentration in a nuclear facility locates in the granite tunnel can be as high as 10(4) Bq m(-3) in summer. Monitoring plutonium aerosol in this circumstance is seriously interfered by radon daughters. In order to solve this problem, a new continuous aerosol monitor that can monitor very low plutonium aerosol concentration in high radon background was developed. Several techniques were used to reduce interference of radon daughters, and the minimum detectable concentrations in various radon concentrations were measured.

The Portuguese gamma irradiation facility

NASA Astrophysics Data System (ADS)

Mendes, C. M.; Almeida, J. C.; Botelho, M. L.; Cavaco, M. C.; Almeida-Vara, E.; Andrade, M. E.

A Gamma Radiation Facility was built up in the National Laboratory of Industrial Technology and Engineering (LNETI), Lisbon, Portugal. This plant (UTR GAMA-Pi) is a Cobalt-60 dry storage continuous facility with a nominal capacity of 1.5X10 16 Bq. The initial activity is 1.1X10 16 Bq and the troughput capacity 10 3 ton/year for product with a bulk density of 0.2 g/cm 3 treated with a minimum absorbed dose of 25 kGy. Complementary control devices were installed: ventilation system, closed water refrigeration circuit, internal TV system, detection and extinction fire system and emergency power group. It must be emphasized that the best attention was given to the conception and efficiency of the interlock safety systems. This facility will be utilized mainly for radiosterilization of medical articles and decontamination of wine cork stoppers.

Improving Tanzanian childbirth service quality.

PubMed

Jaribu, Jennie; Penfold, Suzanne; Green, Cathy; Manzi, Fatuma; Schellenberg, Joanna

2018-04-16

Purpose The purpose of this paper is to describe a quality improvement (QI) intervention in primary health facilities providing childbirth care in rural Southern Tanzania. Design/methodology/approach A QI collaborative model involving district managers and health facility staff was piloted for 6 months in 4 health facilities in Mtwara Rural district and implemented for 18 months in 23 primary health facilities in Ruangwa district. The model brings together healthcare providers from different health facilities in interactive workshops by: applying QI methods to generate and test change ideas in their own facilities; using local data to monitor improvement and decision making; and health facility supervision visits by project and district mentors. The topics for improving childbirth were deliveries and partographs. Findings Median monthly deliveries increased in 4 months from 38 (IQR 37-40) to 65 (IQR 53-71) in Mtwara Rural district, and in 17 months in Ruangwa district from 110 (IQR 103-125) to 161 (IQR 148-174). In Ruangwa health facilities, the women for whom partographs were used to monitor labour progress increased from 10 to 57 per cent in 17 months. Research limitations/implications The time for QI innovation, testing and implementation phases was limited, and the study only looked at trends. The outcomes were limited to process rather than health outcome measures. Originality/value Healthcare providers became confident in the QI method through engagement, generating and testing their own change ideas, and observing improvements. The findings suggest that implementing a QI initiative is feasible in rural, low-income settings.

Impact of school health management committees on health services delivery in Ghana: A national level assessment.

PubMed

Bowman, Angela S; Owusu, Andrew; Trueblood, Amber B; Bosumtwi-Sam, Cynthia

2018-05-07

To examine the prevalence, determinants, and impact of local school health management committees on implementation of minimum-recommended school health services delivery among basic and secondary schools in Ghana. National level cross-sectional data from the first-ever assessment of Ghana Global-School Health Policies and Practices Survey was utilized. Complex sample analyses were used to quantify school-level implementation of recommended minimum package for health services delivery. Of 307 schools, 98% were basic and government run, and 33% offered at least half of the recommended health service delivery areas measured. Schools with a school health management committee (53%) were 4.8 (95% CI = 3.23-5.18) times as likely to offer at least 50% of the minimum health services package than schools that did not. There is significant deficit concerning delivery of school health services in schools across Ghana. However, school health management committees positively impact implementation of health service delivery. School health management committees provide a significant impact on delivery of school health services; thus, it is recommended that policy makers and programmers place greater emphasis on the value and need for these advisory boards in all Ghanaian schools. Copyright © 2018 John Wiley & Sons, Ltd.

Urban School Facilities: An A-Z Primer. IssueTrak: A CEFPI Brief on Educational Facility Issues

ERIC Educational Resources Information Center

DeJong, William S.

2004-01-01

This "IssueTrak" addresses the condition of urban school facilities as a matter of great urgency. Facility planners, are committed to working with urban school districts to develop and implement a systematic approach for modernizing aging urban school facilities. The next generation of school children is far too important and valuable to be forced…

Analysis of oil-pipeline distribution of multiple products subject to delivery time-windows

NASA Astrophysics Data System (ADS)

Jittamai, Phongchai

This dissertation defines the operational problems of, and develops solution methodologies for, a distribution of multiple products into oil pipeline subject to delivery time-windows constraints. A multiple-product oil pipeline is a pipeline system composing of pipes, pumps, valves and storage facilities used to transport different types of liquids. Typically, products delivered by pipelines are petroleum of different grades moving either from production facilities to refineries or from refineries to distributors. Time-windows, which are generally used in logistics and scheduling areas, are incorporated in this study. The distribution of multiple products into oil pipeline subject to delivery time-windows is modeled as multicommodity network flow structure and mathematically formulated. The main focus of this dissertation is the investigation of operating issues and problem complexity of single-source pipeline problems and also providing solution methodology to compute input schedule that yields minimum total time violation from due delivery time-windows. The problem is proved to be NP-complete. The heuristic approach, a reversed-flow algorithm, is developed based on pipeline flow reversibility to compute input schedule for the pipeline problem. This algorithm is implemented in no longer than O(T·E) time. This dissertation also extends the study to examine some operating attributes and problem complexity of multiple-source pipelines. The multiple-source pipeline problem is also NP-complete. A heuristic algorithm modified from the one used in single-source pipeline problems is introduced. This algorithm can also be implemented in no longer than O(T·E) time. Computational results are presented for both methodologies on randomly generated problem sets. The computational experience indicates that reversed-flow algorithms provide good solutions in comparison with the optimal solutions. Only 25% of the problems tested were more than 30% greater than optimal values and approximately 40% of the tested problems were solved optimally by the algorithms.

Preschools Under the Fair Labor Standards Act. (Revised).

ERIC Educational Resources Information Center

Employment Standards Administration (DOL), Washington, DC. Wage and Hour Div.

This pamphlet provides general information concerning the application of the Fair Labor Standards Act (FLSA) to employees of preschool centers. The contents include discussion of the purview of the Act regarding preschools; monetary requirements such as minimum wages and employee facilities; provisions for equal pay, overtime pay, work hours,…

78 FR 52190 - Information Collection Request Submitted to OMB for Review and Approval; Comment Request; NESHAP...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-22

... Submitted to OMB for Review and Approval; Comment Request; NESHAP for Gasoline Distribution Facilities... Protection Agency has submitted an information collection request (ICR), ``NESHAP for Gasoline Distribution... semiannually at a minimum. Form Numbers: None. Respondents/affected entities: Owners or operators of gasoline...

75 FR 20627 - Biweekly Notice: Applications and Amendments to Facility Operating Licenses Involving No...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-20

... designed, on an RAS. Basis for proposed no significant hazards consideration determination: As required by...], Time Response Design Criteria for Safety- Related Operator Actions, 1984 guidance. Although the change... changes to the RAS Allowable Values and RWT minimum required level on the RWT structural design...

How to get parts out of prison (without paperwork).

PubMed

Brown, K

1998-11-01

This article describes the business relationship between a manufacturing company and a vendor that is a minimum-security correctional facility. In particular, it describes a set of revisions in the purchasing and delivery process that reduced the amount of paperwork substantially and also reduced the turnaround time.