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...

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...

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.

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

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).

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

The Planning and Implementation of Test Facility Improvements

NASA Technical Reports Server (NTRS)

Oberlander, Larry

2008-01-01

As engineering programs develop, and product testing begins, ideas for process improvement soon become obvious. Engineers envision new holding and handling fixtures. Additional custom-made support equipment may be needed. Perhaps modifications to the building or modifications to facility hardware are the order of the day. This is where a flexible creative test organization is needed. We need not be content with the status quo. All of these desired test innovations can make the difficult easy and improve the work flow. At times, implementing these new ideas demands more time or specialized expertise than test team members have. Through the coordinated use of labor resources, the needed improvements can still be made and in a timely fashion that supports program schedules. This presentation provides practical advice and a method whereby test personnel can creatively develop facility improvements and manage them from start to finish. You can control just how much time you invest and what part of your concepts you will personally design. By wisely defining the requirements and presenting them to the appropriate help sources (vendors, contractors, coworkers, and support departments), you can get the help you need to bring the improvements you have conceived, into fruition. Aspects of this presentation include defining requirements for test facility improvements, choosing labor resources, writing a statement of work, determining cost and benefits, securing department approval, coordinating procurement, managing the project, and training the end users. The process of successfully implementing test facility improvements is thoroughly explained. It has been tried, proven and improved over nearly 25 years of use. Whether considering a $50 improvement or a $50 million dollar improvement, this discussion will provide helpful pointers. Examples of improvements made through this process and their illustration will be included.

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.

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

An implementation framework for wastewater treatment models requiring a minimum programming expertise.

PubMed

Rodríguez, J; Premier, G C; Dinsdale, R; Guwy, A J

2009-01-01

Mathematical modelling in environmental biotechnology has been a traditionally difficult resource to access for researchers and students without programming expertise. The great degree of flexibility required from model implementation platforms to be suitable for research applications restricts their use to programming expert users. More user friendly software packages however do not normally incorporate the necessary flexibility for most research applications. This work presents a methodology based on Excel and Matlab-Simulink for both flexible and accessible implementation of mathematical models by researchers with and without programming expertise. The models are almost fully defined in an Excel file in which the names and values of the state variables and parameters are easily created. This information is automatically processed in Matlab to create the model structure and almost immediate model simulation, after only a minimum Matlab code definition, is possible. The framework proposed also provides programming expert researchers with a highly flexible and modifiable platform on which to base more complex model implementations. The method takes advantage of structural generalities in most mathematical models of environmental bioprocesses while enabling the integration of advanced elements (e.g. heuristic functions, correlations). The methodology has already been successfully used in a number of research studies.

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

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...

77 FR 52791 - Regulatory Capital Rules: Regulatory Capital, Implementation of Basel III, Minimum Regulatory...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-30

...The Office of the Comptroller of the Currency (OCC), Board of Governors of the Federal Reserve System (Board), and the Federal Deposit Insurance Corporation (FDIC) (collectively, the agencies) are seeking comment on three Notices of Proposed Rulemaking (NPR) that would revise and replace the agencies' current capital rules. In this NPR, the agencies are proposing to revise their risk-based and leverage capital requirements consistent with agreements reached by the Basel Committee on Banking Supervision (BCBS) in ``Basel III: A Global Regulatory Framework for More Resilient Banks and Banking Systems'' (Basel III). The proposed revisions would include implementation of a new common equity tier 1 minimum capital requirement, a higher minimum tier 1 capital requirement, and, for banking organizations subject to the advanced approaches capital rules, a supplementary leverage ratio that incorporates a broader set of exposures in the denominator measure. Additionally, consistent with Basel III, the agencies are proposing to apply limits on a banking organization's capital distributions and certain discretionary bonus payments if the banking organization does not hold a specified amount of common equity tier 1 capital in addition to the amount necessary to meet its minimum risk- based capital requirements. This NPR also would establish more conservative standards for including an instrument in regulatory capital. As discussed in the proposal, the revisions set forth in this NPR are consistent with section 171 of the Dodd-Frank Wall Street Reform and Consumer Protection Act (Dodd-Frank Act), which requires the agencies to establish minimum risk-based and leverage capital requirements. In connection with the proposed changes to the agencies' capital rules in this NPR, the agencies are also seeking comment on the two related NPRs published elsewhere in today's Federal Register. The two related NPRs are discussed further in the SUPPLEMENTARY INFORMATION.

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.

STEADY STATE MODELING OF THE MINIMUM CRITICAL CORE OF THE TRANSIENT REACTOR TEST FACILITY

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

Anthony L. Alberti; Todd S. Palmer; Javier Ortensi

2016-05-01

With the advent of next generation reactor systems and new fuel designs, the U.S. Department of Energy (DOE) has identified the need for the resumption of transient testing of nuclear fuels. The DOE has decided that the Transient Reactor Test Facility (TREAT) at Idaho National Laboratory (INL) is best suited for future testing. TREAT is a thermal neutron spectrum, air-cooled, nuclear test facility that is designed to test nuclear fuels in transient scenarios. These specific scenarios range from simple temperature transients to full fuel melt accidents. DOE has expressed a desire to develop a simulation capability that will accurately modelmore » the experiments before they are irradiated at the facility. It is the aim for this capability to have an emphasis on effective and safe operation while minimizing experimental time and cost. The multi physics platform MOOSE has been selected as the framework for this project. The goals for this work are to identify the fundamental neutronics properties of TREAT and to develop an accurate steady state model for future multiphysics transient simulations. In order to minimize computational cost, the effect of spatial homogenization and angular discretization are investigated. It was found that significant anisotropy is present in TREAT assemblies and to capture this effect, explicit modeling of cooling channels and inter-element gaps is necessary. For this modeling scheme, single element calculations at 293 K gave power distributions with a root mean square difference of 0.076% from those of reference SERPENT calculations. The minimum critical core configuration with identical gap and channel treatment at 293 K resulted in a root mean square, total core, radial power distribution 2.423% different than those of reference SERPENT solutions.« less

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

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

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,…

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

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...

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.

Adopting and implementing nutrition guidelines in recreational facilities: tensions between public health and corporate profitability.

PubMed

Olstad, Dana Lee; Raine, Kim D; McCargar, Linda J

2013-05-01

Little is known about how public entities can partner with industry to achieve public health goals. We investigated industry's perspective of factors that influenced their adoption and implementation of voluntary, government-issued nutrition guidelines (Alberta Nutrition Guidelines for Children and Youth, ANGCY) in recreational facilities. In-depth semi-structured interviews were conducted. Data were analysed using directed content analysis. Food services in recreational facilities. Seven managers from industry participated; five from companies that had adopted and implemented the ANGCY (adopters) in recreational facilities and two from companies that had not (non-adopters). Industry views nutrition guidelines through the lens of profitability. Non-adopters were unwilling to implement the ANGCY for fear of sacrificing short-term profitability, whereas adopters adhered to them in an attempt to position themselves for long-term profitability. Adopters faced barriers including few resources, no training, complex guidelines, low availability of and demand for ANGCY-compliant products, competitive pressures and substantial declines in revenue. Managers believed widespread voluntary adoption of the ANGCY was unlikely without government incentives and/or a mandate, as the environmental context for voluntary action was poor. All managers supported government-mandated implementation of the ANGCY to level the playing field upon which companies compete. Public-private partnerships in recreational facilities can embrace public health goals in the short term, provided industry perceives potential for long-term financial gain. Widespread uptake of voluntary nutrition guidelines in this setting is unlikely, however, as market mechanisms do not encourage industry to sell and promote healthier options. Government legislation may therefore be warranted.

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.

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

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...

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

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...

How to implement security controls for an information security program at CBRN facilities

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

Lenaeus, Joseph D.; O'Neil, Lori Ross; Leitch, Rosalyn M.

This document was prepared by PNNL within the framework of Project 19 of the European Union Chemical Biological Radiological and Nuclear Risk Mitigation Centres of Excellence Initiative entitled, ''Development of procedures and guidelines to create and improve secure information management systems and data exchange mechanisms for CBRN materials under regulatory control.'' It provides management and workers at CBRN facilities, parent organization managers responsible for those facilities, and regulatory agencies (governmental and nongovernmental) with guidance on the best practices for protecting information security. The security mitigation approaches presented in this document were chosen because they present generally accepted guidance in anmore » easy-to-understand manner, making it easier for facility personnel to grasp key concepts and envision how security controls could be implemented by the facility. This guidance is presented from a risk management perspective.« less

[Implementation of quality management in medical rehabilitation--current challenges for rehabilitation facilities].

PubMed

Enge, M; Koch, A; Müller, T; Vorländer, T

2010-12-01

The legal responsibilities imposed upon rehabilitation facilities under section 20 (2a) SGB IX, necessitate fundamental decisions to be taken regarding the development of quality management systems over and above the existing framework. This article is intended to provide ideas and suggestions to assist rehabilitation facilities in implementing a quality management system, which is required in addition to participation in the quality assurance programmes stipulated by the rehabilitation carriers. In this context, the additional internal benefit a functioning quality management system can provide for ensuring a high level of quality and for maintaining the competitiveness of the rehabilitation facility should be taken into account. The core element of these observations, hence, is a list of requirements which enables assessment of the quality of consultants' performance in setting up a quality management system. © Georg Thieme Verlag KG Stuttgart · New York.

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

Space Station Furnace Facility Preliminary Project Implementation Plan (PIP). Volume 2, Appendix 2

NASA Technical Reports Server (NTRS)

Perkey, John K.

1992-01-01

The Space Station Furnace Facility (SSFF) is an advanced facility for materials research in the microgravity environment of the Space Station Freedom and will consist of Core equipment and various sets of Furnace Module (FM) equipment in a three-rack configuration. This Project Implementation Plan (PIP) document was developed to satisfy the requirements of Data Requirement Number 4 for the SSFF study (Phase B). This PIP shall address the planning of the activities required to perform the detailed design and development of the SSFF for the Phase C/D portion of this contract.

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…

Challenges Associated With Managing Suicide Risk in Long-Term Care Facilities.

PubMed

O'Riley, Alisa; Nadorff, Michael R; Conwell, Yeates; Edelstein, Barry

2013-06-01

Little information about suicidal ideation and behavior in long-term care (LTC) facilities is available. Nonetheless, the implementation of the Minimum Data Set 3.0 requires that LTC facilities screen their residents for suicide risk and have protocols in place to effectively manage residents' responses. In this article, the authors briefly discuss the risk factors of suicide in the elderly and the problems that suicidal ideation and behavior pose in the LTC environment. The authors explain issues that arise when trying to manage suicide risk in the elderly LTC population with general, traditional approaches. These inherent issues make it difficult to develop an effective protocol for managing suicide risk in LTC facilities, leading the authors to propose their own framework for assessing and managing suicide risk in the LTC setting.

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.

Shuttle Flight Operations Contract Generator Maintenance Facility Land Use Control Implementation Plan (LUCIP)

NASA Technical Reports Server (NTRS)

Applegate, Joseph L.

2014-01-01

This Land Use Control Implementation Plan (LUCIP) has been prepared to inform current and potential future users of the Kennedy Space Center (KSC) Shuttle Flight Operations Contract Generator Maintenance Facility (SFOC; SWMU 081; "the Site") of institutional controls that have been implemented at the Site1. Although there are no current unacceptable risks to human health or the environment associated with the SFOC, an institutional land use control (LUC) is necessary to prevent human health exposure to antimony-affected groundwater at the Site. Controls will include periodic inspection, condition certification, and agency notification.

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…

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

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

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.

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.

Challenges in implementing uncomplicated malaria treatment in children: a health facility survey in rural Malawi.

PubMed

Kabaghe, Alinune N; Phiri, Mphatso D; Phiri, Kamija S; van Vugt, Michèle

2017-10-18

Prompt and effective malaria treatment are key in reducing transmission, disease severity and mortality. With the current scale-up of artemisinin-based combination therapy (ACT) coverage, there is need to focus on challenges affecting implementation of the intervention. Routine indicators focus on utilization and coverage, neglecting implementation quality. A health system in rural Malawi was assessed for uncomplicated malaria treatment implementation in children. A cross-sectional health facility survey was conducted in six health centres around the Majete Wildlife Reserve in Chikwawa district using a health system effectiveness approach to assess uncomplicated malaria treatment implementation. Interviews with health facility personnel and exit interviews with guardians of 120 children under 5 years were conducted. Health workers appropriately prescribed an ACT and did not prescribe an ACT to 73% (95% CI 63-84%) of malaria rapid diagnostic test (RDT) positive and 98% (95% CI 96-100%) RDT negative children, respectively. However, 24% (95% CI 13-37%) of children receiving artemisinin-lumefantrine had an inappropriate dose by weight. Health facility findings included inadequate number of personnel (average: 2.1 health workers per 10,000 population), anti-malarial drug stock-outs or not supplied, and inconsistent health information records. Guardians of 59% (95% CI 51-69%) of children presented within 24 h of onset of child's symptoms. The survey presents an approach for assessing treatment effectiveness, highlighting bottlenecks which coverage indicators are incapable of detecting, and which may reduce quality and effectiveness of malaria treatment. Health service provider practices in prescribing and dosing anti-malarial drugs, due to drug stock-outs or high patient load, risk development of drug resistance, treatment failure and exposure to adverse effects.

Implementation of effective practices in health facilities: a systematic review of cluster randomised trials.

PubMed

Allanson, Emma R; Tunçalp, Özge; Vogel, Joshua P; Khan, Dina N; Oladapo, Olufemi T; Long, Qian; Gülmezoglu, Ahmet Metin

2017-01-01

The capacity for health systems to support the translation of research in to clinical practice may be limited. The cluster randomised controlled trial (cluster RCT) design is often employed in evaluating the effectiveness of implementation of evidence-based practices. We aimed to systematically review available evidence to identify and evaluate the components in the implementation process at the facility level using cluster RCT designs. All cluster RCTs where the healthcare facility was the unit of randomisation, published or written from 1990 to 2014, were assessed. Included studies were analysed for the components of implementation interventions employed in each. Through iterative mapping and analysis, we synthesised a master list of components used and summarised the effects of different combinations of interventions on practices. Forty-six studies met the inclusion criteria and covered the specialty groups of obstetrics and gynaecology (n=9), paediatrics and neonatology (n=4), intensive care (n=4), internal medicine (n=20), and anaesthetics and surgery (n=3). Six studies included interventions that were delivered across specialties. Nine components of multifaceted implementation interventions were identified: leadership, barrier identification, tailoring to the context, patient involvement, communication, education, supportive supervision, provision of resources, and audit and feedback. The four main components that were most commonly used were education (n=42, 91%), audit and feedback (n=26, 57%), provision of resources (n=23, 50%) and leadership (n=21, 46%). Future implementation research should focus on better reporting of multifaceted approaches, incorporating sets of components that facilitate the translation of research into practice, and should employ rigorous monitoring and evaluation.

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...

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

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,

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.

Helping small babies survive: an evaluation of facility-based Kangaroo Mother Care implementation progress in Uganda

PubMed Central

Aliganyira, Patrick; Kerber, Kate; Davy, Karen; Gamache, Nathalie; Sengendo, Namaala Hanifah; Bergh, Anne-Marie

2014-01-01

Introduction Prematurity is the leading cause of newborn death in Uganda, accounting for 38% of the nation's 39,000 annual newborn deaths. Kangaroo mother care is a high-impact; cost-effective intervention that has been prioritized in policy in Uganda but implementation has been limited. Methods A standardised, cross-sectional, mixed-method evaluation design was used, employing semi-structured key-informant interviews and observations in 11 health care facilities implementing kangaroo mother care in Uganda. Results The facilities visited scored between 8.28 and 21.72 out of the possible 30 points with a median score of 14.71. Two of the 3 highest scoring hospitals were private, not-for-profit hospitals whereas the second highest scoring hospital was a central teaching hospital. Facilities with KMC services are not equally distributed throughout the country. Only 4 regions (Central 1, Central 2, East-Central and Southwest) plus the City of Kampala were identified as having facilities providing KMC services. Conclusion KMC services are not instituted with consistent levels of quality and are often dependent on private partner support. With increasing attention globally and in country, Uganda is in a unique position to accelerate access to and quality of health services for small babies across the country. PMID:25667699

Helping small babies survive: an evaluation of facility-based Kangaroo Mother Care implementation progress in Uganda.

PubMed

Aliganyira, Patrick; Kerber, Kate; Davy, Karen; Gamache, Nathalie; Sengendo, Namaala Hanifah; Bergh, Anne-Marie

2014-01-01

Prematurity is the leading cause of newborn death in Uganda, accounting for 38% of the nation's 39,000 annual newborn deaths. Kangaroo mother care is a high-impact; cost-effective intervention that has been prioritized in policy in Uganda but implementation has been limited. A standardised, cross-sectional, mixed-method evaluation design was used, employing semi-structured key-informant interviews and observations in 11 health care facilities implementing kangaroo mother care in Uganda. The facilities visited scored between 8.28 and 21.72 out of the possible 30 points with a median score of 14.71. Two of the 3 highest scoring hospitals were private, not-for-profit hospitals whereas the second highest scoring hospital was a central teaching hospital. Facilities with KMC services are not equally distributed throughout the country. Only 4 regions (Central 1, Central 2, East-Central and Southwest) plus the City of Kampala were identified as having facilities providing KMC services. KMC services are not instituted with consistent levels of quality and are often dependent on private partner support. With increasing attention globally and in country, Uganda is in a unique position to accelerate access to and quality of health services for small babies across the country.

[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.

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...

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...

Hypergol Maintenance Facility Hazardous Waste South Staging Areas, SWMU 070 Corrective Measures Implementation

NASA Technical Reports Server (NTRS)

Miller, Ralinda R.

2016-01-01

This document presents the Corrective Measures Implementation (CMI) Year 10 Annual Report for implementation of corrective measures at the Hypergol Maintenance Facility (HMF) Hazardous Waste South Staging Areas at Kennedy Space Center, Florida. The work is being performed by Tetra Tech, Inc., for the National Aeronautics and Space Administration (NASA) under Indefinite Delivery Indefinite Quantity (IDIQ) NNK12CA15B, Task Order (TO) 07. Mr. Harry Plaza, P.E., of NASA's Environmental Assurance Branch is the Remediation Project Manager for John F. Kennedy Space Center. The Tetra Tech Program Manager is Mr. Mark Speranza, P.E., and the Tetra Tech Project Manager is Robert Simcik, P.E.

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

Implementing an Open Source Electronic Health Record System in Kenyan Health Care Facilities: Case Study

PubMed Central

Magare, Steve; Monda, Jonathan; Kamau, Onesmus; Houston, Stuart; Fraser, Hamish; Powell, John; English, Mike; Paton, Chris

2018-01-01

Background The Kenyan government, working with international partners and local organizations, has developed an eHealth strategy, specified standards, and guidelines for electronic health record adoption in public hospitals and implemented two major health information technology projects: District Health Information Software Version 2, for collating national health care indicators and a rollout of the KenyaEMR and International Quality Care Health Management Information Systems, for managing 600 HIV clinics across the country. Following these projects, a modified version of the Open Medical Record System electronic health record was specified and developed to fulfill the clinical and administrative requirements of health care facilities operated by devolved counties in Kenya and to automate the process of collating health care indicators and entering them into the District Health Information Software Version 2 system. Objective We aimed to present a descriptive case study of the implementation of an open source electronic health record system in public health care facilities in Kenya. Methods We conducted a landscape review of existing literature concerning eHealth policies and electronic health record development in Kenya. Following initial discussions with the Ministry of Health, the World Health Organization, and implementing partners, we conducted a series of visits to implementing sites to conduct semistructured individual interviews and group discussions with stakeholders to produce a historical case study of the implementation. Results This case study describes how consultants based in Kenya, working with developers in India and project stakeholders, implemented the new system into several public hospitals in a county in rural Kenya. The implementation process included upgrading the hospital information technology infrastructure, training users, and attempting to garner administrative and clinical buy-in for adoption of the system. The initial deployment was

Implementation of sustainable evidence-based practice for the assessment and management of pain in residential aged care facilities.

PubMed

Savvas, Steven; Toye, Christine; Beattie, Elizabeth; Gibson, Stephen J

2014-12-01

Pain is common in residential aged care facilities (RACFs). In 2005, the Australian Pain Society developed 27 recommendations for good practice in the identification, assessment, and management of pain in these settings. This study aimed to address implementation of the standards and evaluate outcomes. Five facilities in Australia participated in a comprehensive evaluation of RACF pain practice and outcomes. Pre-existing pain management practices were compared with the 27 recommendations, before an evidence-based pain management program was introduced that included training and education for staff and revised in-house pain-management procedures. Post-implementation audits evaluated the program's success. Aged care staff teams also were assessed on their reports of self-efficacy in pain management. The results show that before the implementation program, the RACFs demonstrated full compliance on 6 to 12 standards. By the project's completion, RACFs demonstrated full compliance with 10 to 23 standards and major improvements toward compliance in the remaining standards. After implementation, the staff also reported better understanding of the standards (p < .001) or of facility pain management guidelines (p < .001), increased confidence in therapies for pain management (p < .001), and increased confidence in their training to assess pain (p < .001) and recognize pain in residents with dementia who are nonverbal (p = .003). The results show that improved evidence-based practice in RACFs can be achieved with appropriate training and education. Investing resources in the aged care workforce via this implementation program has shown improvements in staff self-efficacy and practice. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Infection prevention and control in health facilities in post-Ebola Liberia: don't forget the private sector!

PubMed Central

Musa, E.; Cooper, C.; Van den Bergh, R.; Owiti, P.; Baller, A.; Siafa, T.; Woldeyohannes, D.; Shringarpure, K.; Gasasira, A.

2017-01-01

Setting: Recognising the importance of infection prevention and control (IPC), a minimum standards tool (MST) was developed in Liberia to guide the safe (re-) opening and provision of care in health facilities. Objectives: To analyse the implementation of specific IPC measures after the 2014 Ebola virus outbreak between June 2015 and May 2016, and to compare the relative improvements in IPC between the public and private sectors. Design: A retrospective comparative cohort study. Results: We evaluated 723 (94%) of the 769 health facilities in Liberia. Of these, 437 (60%) were public and 286 (40%) were private. There was an overall improvement in the MST scores from a median of 13 to 14 out of a maximum possible score of 16. While improvements were observed in all aspects of IPC in both public and private health facilities, IPC implementation was systematically higher in public facilities. Conclusions: We demonstrate the feasibility of monitoring IPC implementation using the MST checklist in post-Ebola Liberia. Our study shows that improvements were made in key aspects of IPC after 1 year of evaluations and tailored recommendations. We also highlight the need to increase the focus on the private sector to achieve further improvements in IPC. PMID:28744446

Infection prevention and control in health facilities in post-Ebola Liberia: don't forget the private sector!

PubMed

Tremblay, N; Musa, E; Cooper, C; Van den Bergh, R; Owiti, P; Baller, A; Siafa, T; Woldeyohannes, D; Shringarpure, K; Gasasira, A

2017-06-21

Setting: Recognising the importance of infection prevention and control (IPC), a minimum standards tool (MST) was developed in Liberia to guide the safe (re-) opening and provision of care in health facilities. Objectives: To analyse the implementation of specific IPC measures after the 2014 Ebola virus outbreak between June 2015 and May 2016, and to compare the relative improvements in IPC between the public and private sectors. Design: A retrospective comparative cohort study. Results: We evaluated 723 (94%) of the 769 health facilities in Liberia. Of these, 437 (60%) were public and 286 (40%) were private. There was an overall improvement in the MST scores from a median of 13 to 14 out of a maximum possible score of 16. While improvements were observed in all aspects of IPC in both public and private health facilities, IPC implementation was systematically higher in public facilities. Conclusions: We demonstrate the feasibility of monitoring IPC implementation using the MST checklist in post-Ebola Liberia. Our study shows that improvements were made in key aspects of IPC after 1 year of evaluations and tailored recommendations. We also highlight the need to increase the focus on the private sector to achieve further improvements in IPC.

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

PubMed

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

2010-03-01

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

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…

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

Revising the Belgian Nursing Minimum Dataset: from concept to implementation.

PubMed

Sermeus, Walter; van den Heede, Koen; Michiels, Dominik; Delesie, Lucas; Thonon, Olivier; Van Boven, Caroline; Codognotto, Jean; Gillet, Pierre

2005-12-01

The process of revising the Belgian Nursing Minimum Dataset (B-NMDS) started in 2000 and entailed four major phases. The first phase (June-October 2002) involved the development of a conceptual framework based on a literature review and secondary data analysis. The Nursing Interventions Classification (NIC) was selected as a framework for the revision of the original B-NMDS. The second phase (November 2002-September 2003) focused on language development for six care programs evaluated by panels of clinical experts (N=75). These panels identified the following items as priorities for the revised B-NMDS: hospital financing, nurse staffing allocation, assessment of the appropriateness of hospitalisation, and quality management. During this period, we developed a draft instrument with 92 variables using the NIC. This led to an alpha version of a revised B-NMDS. The third phase (October 2003-December 2004) focused on data collection and validation of the new tool. The revised B-NMDS (alpha version) was tested in 158 nursing wards in 66 Belgian hospitals from December 2003 until March 2004. This test generated data for some 95,000 in-patient days. The interrater reliability of the revised B-NMDS was assessed. The criterion-related validity of the revised B-NMDS was compared to that of the original B-NMDS. The discriminative power of the revised B-NMDS was also assessed to select the most relevant variables for data collection. This resulted in a beta version of the revised B-NMDS in December 2004. The records of the revised B-NMDS were linked to the Hospital Discharge Dataset and other mandatory datasets to integrate the revised B-NMDS into the overall healthcare management system. The fourth phase (January 2005-December 2005) is presently focusing on information management. Nationwide implementation is foreseen by January 2007.

Implementing an Open Source Electronic Health Record System in Kenyan Health Care Facilities: Case Study.

PubMed

Muinga, Naomi; Magare, Steve; Monda, Jonathan; Kamau, Onesmus; Houston, Stuart; Fraser, Hamish; Powell, John; English, Mike; Paton, Chris

2018-04-18

The Kenyan government, working with international partners and local organizations, has developed an eHealth strategy, specified standards, and guidelines for electronic health record adoption in public hospitals and implemented two major health information technology projects: District Health Information Software Version 2, for collating national health care indicators and a rollout of the KenyaEMR and International Quality Care Health Management Information Systems, for managing 600 HIV clinics across the country. Following these projects, a modified version of the Open Medical Record System electronic health record was specified and developed to fulfill the clinical and administrative requirements of health care facilities operated by devolved counties in Kenya and to automate the process of collating health care indicators and entering them into the District Health Information Software Version 2 system. We aimed to present a descriptive case study of the implementation of an open source electronic health record system in public health care facilities in Kenya. We conducted a landscape review of existing literature concerning eHealth policies and electronic health record development in Kenya. Following initial discussions with the Ministry of Health, the World Health Organization, and implementing partners, we conducted a series of visits to implementing sites to conduct semistructured individual interviews and group discussions with stakeholders to produce a historical case study of the implementation. This case study describes how consultants based in Kenya, working with developers in India and project stakeholders, implemented the new system into several public hospitals in a county in rural Kenya. The implementation process included upgrading the hospital information technology infrastructure, training users, and attempting to garner administrative and clinical buy-in for adoption of the system. The initial deployment was ultimately scaled back due to a

Toward the framework and implementation for clearance of materials from regulated facilities.

PubMed

Chen, S Y; Moeller, D W; Dornsife, W P; Meyer, H R; Lamastra, A; Lubenau, J O; Strom, D J; Yusko, J G

2005-08-01

The disposition of solid materials from nuclear facilities has been a subject of public debate for several decades. The primary concern has been the potential health effects resulting from exposure to residual radioactive materials to be released for unrestricted use. These debates have intensified in the last decade as many regulated facilities are seeking viable management decisions on the disposition of the large amounts of materials potentially containing very low levels of residual radioactivity. Such facilities include the nuclear weapons complex sites managed by the U.S. Department of Energy, commercial power plants licensed by the U.S. Nuclear Regulatory Commission (NRC), and other materials licensees regulated by the NRC or the Agreement States. Other facilities that generate radioactive material containing naturally occurring radioactive materials (NORM) or technologically enhanced NORM (TENORM) are also seeking to dispose of similar materials that may be radioactively contaminated. In contrast to the facilities operated by the DOE and the nuclear power plants licensed by the U.S. Nuclear Regulatory Commission, NORM and TENORM facilities are regulated by the individual states. Current federal laws and regulations do not specify criteria for releasing these materials that may contain residual radioactivity of either man-made or natural origin from regulatory controls. In fact, the current regulatory scheme offers no explicit provision to permit materials being released as "non-radioactive," including those that are essentially free of contamination. The only method used to date with limited success has been case-by-case evaluation and approval. In addition, there is a poorly defined and inconsistent regulatory framework for regulating NORM and TENORM. Some years ago, the International Atomic Energy Agency introduced the concept of clearance, that is, controlling releases of any such materials within the regulatory domain. This paper aims to clarify

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.

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...

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

PubMed Central

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

2016-01-01

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

Implementation of ISO 10110 optics drawing standards for the National Ignition Facility

NASA Astrophysics Data System (ADS)

Wang, David Y.; English, R. Edward, Jr.; Aikens, David M.

1999-11-01

The National Ignition Facility (NIF) project elected to implement ISO 10110 standard for the specifications of NIF optics drawings in 1996. More than 7,000 NIF large optics and 20,000 NIF small optics will be manufactured based on ISO 10110 indications. ISO 10110 standard meets many of the needs of the NIF optics specifications. It allows the optical engineer to quantify and clearly communicate the desired optical specifications. While no single drawing standard specifies all the requirements of high energy laser system, a combination of ISO 10110 standard with detailed notes make it possible to apply international drawing standards to the NIF laser system. This paper will briefly describe LLNL's interpretation and implementation of the ISO 10110 drawing standard, present some examples of NIF optics drawings, and discuss pros and cons of the indications from the perspective of this application. Emphasis will be given to the surface imperfection specifications, known as 5/, for the NIF optics.

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

PubMed

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

2016-03-01

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

The three waves in implementation of facility-based kangaroo mother care: a multi-country case study from Asia.

PubMed

Bergh, Anne-Marie; de Graft-Johnson, Joseph; Khadka, Neena; Om'Iniabohs, Alyssa; Udani, Rekha; Pratomo, Hadi; De Leon-Mendoza, Socorro

2016-01-27

Kangaroo mother care has been highlighted as an effective intervention package to address high neonatal mortality pertaining to preterm births and low birth weight. However, KMC uptake and service coverage have not progressed well in many countries. The aim of this case study was to understand the institutionalisation processes of facility-based KMC services in three Asian countries (India, Indonesia and the Philippines) and the reasons for the slow uptake of KMC in these countries. Three main data sources were available: background documents providing insight in the state of implementation of KMC in the three countries; visits to a selection of health facilities to gauge their progress with KMC implementation; and data from interviews and meetings with key stakeholders. The establishment of KMC services at individual facilities began many years before official prioritisation for scale-up. Three major themes were identified: pioneers of facility-based KMC; patterns of KMC knowledge and skills dissemination; and uptake and expansion of KMC services in relation to global trends and national policies. Pioneers of facility-based KMC were introduced to the concept in the 1990s and established the practice in a few individual tertiary or teaching hospitals, without further spread. A training method beneficial to the initial establishment of KMC services in a country was to send institutional health-professional teams to learn abroad, notably in Colombia. Further in-country cascading took place afterwards and still later on KMC was integrated into newborn and obstetric care programs. The patchy uptake and expansion of KMC services took place in three phases aligned with global trends of the time: the pioneer phase with individual champions while the global focus was on child survival (1998-2006); the newborn-care phase (2007-2012); and lastly the current phase where small babies are also included in action plans. This paper illustrates the complexities of implementing a

People, Process and Technology: Strategies for Assuring Sustainable Implementation of EMRs at Public-Sector Health Facilities in Kenya

PubMed Central

Kang’a, Samuel G.; Muthee, Veronica M.; Liku, Nzisa; Too, Diana; Puttkammer, Nancy

2016-01-01

The Ministry of Health (MoH) rollout of electronic medical record systems (EMRs) has continuously been embraced across health facilities in Kenya since 2012. This has been driven by a government led process supported by PEPFAR that recommended standardized systems for facilities. Various strategies were deployed to assure meaningful and sustainable EMRs implementation: sensitization of leadership; user training, formation of health facility-level multi-disciplinary teams; formation of county-level Technical Working Groups; data migration; routine data quality assessments; point of care adoption; successive release of software upgrades; and power provision. Successes recorded include goodwill and leadership from the county management (22 counties), growth in the number of EMR trained users (2561 health care workers), collaboration in among other things, data migration(90 health facilities completed) and establishment of county TWGs (13 TWGs). Sustenance of EMRs demand across facilities is possible through; county TWGs oversight, timely resolution of users’ issues and provision of reliable power. PMID:28269864

People, Process and Technology: Strategies for Assuring Sustainable Implementation of EMRs at Public-Sector Health Facilities in Kenya.

PubMed

Kang'a, Samuel G; Muthee, Veronica M; Liku, Nzisa; Too, Diana; Puttkammer, Nancy

2016-01-01

The Ministry of Health (MoH) rollout of electronic medical record systems (EMRs) has continuously been embraced across health facilities in Kenya since 2012. This has been driven by a government led process supported by PEPFAR that recommended standardized systems for facilities. Various strategies were deployed to assure meaningful and sustainable EMRs implementation: sensitization of leadership; user training, formation of health facility-level multi-disciplinary teams; formation of county-level Technical Working Groups; data migration; routine data quality assessments; point of care adoption; successive release of software upgrades; and power provision. Successes recorded include goodwill and leadership from the county management (22 counties), growth in the number of EMR trained users (2561 health care workers), collaboration in among other things, data migration(90 health facilities completed) and establishment of county TWGs (13 TWGs). Sustenance of EMRs demand across facilities is possible through; county TWGs oversight, timely resolution of users' issues and provision of reliable power.

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…

Are Health Facility Management Committees in Kenya ready to implement financial management tasks: findings from a nationally representative survey.

PubMed

Waweru, Evelyn; Opwora, Antony; Toda, Mitsuru; Fegan, Greg; Edwards, Tansy; Goodman, Catherine; Molyneux, Sassy

2013-10-10

Community participation in peripheral public health facilities has in many countries focused on including community representatives in Health Facility Management Committees (HFMCs). In Kenya, HFMC roles are being expanded with the phased implementation of the Health Sector Services Fund (HSSF). Under HSSF, HFMCs manage facility funds which are dispersed directly from central level into facility bank accounts. We assessed how prepared HFMCs were to undertake this new role in advance of HSSF roll out, and considered the implications for Kenya and other similar settings. Data were collected through a nationally representative sample of 248 public health centres and dispensaries in 24 districts in 2010. Data collection included surveys with in-charges (n = 248), HFMC members (n = 464) and facility users (n = 698), and record reviews. These data were supplemented by semi-structured interviews with district health managers in each district. Some findings supported preparedness of HFMCs to take on their new roles. Most facilities had bank accounts and HFMCs which met regularly. HFMC members and in-charges generally reported positive relationships, and HFMC members expressed high levels of motivation and job satisfaction. Challenges included users' low awareness of HFMCs, lack of training and clarity in roles among HFMCs, and some indications of strained relations with in-charges. Such challenges are likely to be common to many similar settings, and are therefore important considerations for any health facility based initiatives involving HFMCs. Most HFMCs have the basic requirements to operate. However to manage their own budgets effectively and meet their allocated roles in HSSF implementation, greater emphasis is needed on financial management training, targeted supportive supervision, and greater community awareness and participation. Once new budget management roles are fully established, qualitative and quantitative research on how HFMCs are adapting to

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

PubMed Central

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

2014-01-01

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

Central implementation strategies outperform local ones in improving HIV testing in Veterans Healthcare Administration facilities.

PubMed

Goetz, Matthew Bidwell; Hoang, Tuyen; Knapp, Herschel; Burgess, Jane; Fletcher, Michael D; Gifford, Allen L; Asch, Steven M

2013-10-01

Pilot data suggest that a multifaceted approach may increase HIV testing rates, but the scalability of this approach and the level of support needed for successful implementation remain unknown. To evaluate the effectiveness of a scaled-up multi-component intervention in increasing the rate of risk-based and routine HIV diagnostic testing in primary care clinics and the impact of differing levels of program support. Three arm, quasi-experimental implementation research study. Veterans Health Administration (VHA) facilities. Persons receiving primary care between June 2009 and September 2011 INTERVENTION: A multimodal program, including a real-time electronic clinical reminder to facilitate HIV testing, provider feedback reports and provider education, was implemented in Central and Local Arm Sites; sites in the Central Arm also received ongoing programmatic support. Control Arm sites had no intervention Frequency of performing HIV testing during the 6 months before and after implementation of a risk-based clinical reminder (phase I) or routine clinical reminder (phase II). The adjusted rate of risk-based testing increased by 0.4 %, 5.6 % and 10.1 % in the Control, Local and Central Arms, respectively (all comparisons, p < 0.01). During phase II, the adjusted rate of routine testing increased by 1.1 %, 6.3 % and 9.2 % in the Control, Local and Central Arms, respectively (all comparisons, p < 0.01). At study end, 70-80 % of patients had been offered an HIV test. Use of clinical reminders, provider feedback, education and social marketing significantly increased the frequency at which HIV testing is offered and performed in VHA facilities. These findings support a multimodal approach toward achieving the goal of having every American know their HIV status as a matter of routine clinical practice.

Implementation of a Water Flow Control System into the ISS'S Planned Fluids & Combustion Facility

NASA Technical Reports Server (NTRS)

Edwards, Daryl A.

2003-01-01

The Fluids and Combustion Facility (FCF) will become an ISS facility capable of performing basic combustion and fluids research. The facility consists of two independent payload racks specifically configured to support multiple experiments over the life of the ISS. Both racks will depend upon the ISS's Moderate Temperature Loop (MTL) for removing waste heat generated by the avionics and experiments operating within the racks. By using the MTL, constraints are imposed by the ISS vehicle on how the coolant resource is used. On the other hand, the FCF depends upon effective thermal control for maximizing life of the hardware and for supplying proper boundary conditions for the experiments. In the implementation of a design solution, significant factors in the selection of the hardware included ability to measure and control relatively low flow rates, ability to throttle flow within the time constraints of the ISS MTL, conserve energy usage, observe low mass and small volume requirements. An additional factor in the final design solution selection was considering how the system would respond to a loss of power event. This paper describes the method selected to satisfy the FCF design requirements while maintaining the constraints applied by the ISS vehicle.

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).

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

PubMed

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

2014-03-01

The World Health Organization (WHO) launched a multimodal strategy and campaign in 2009 to improve hand hygiene practices worldwide. Our objective was to evaluate the implementation of the strategy in United States health care facilities. From July through December 2011, US facilities participating in the WHO global campaign were invited to complete the Hand Hygiene Self-Assessment Framework online, a validated tool based on the WHO multimodal strategy. Of 2,238 invited facilities, 168 participated in the survey (7.5%). A detailed analysis of 129, mainly nonteaching public facilities (80.6%), showed that most had an advanced or intermediate level of hand hygiene implementation progress (48.9% and 45.0%, respectively). The total Hand Hygiene Self-Assessment Framework score was 36 points higher for facilities with staffing levels of infection preventionists > 0.75/100 beds than for those with lower ratios (P = .01) and 41 points higher for facilities participating in hand hygiene campaigns (P = .002). Despite the low response rate, the survey results are unique and allow interesting reflections. Whereas the level of progress of most participating facilities was encouraging, this may reflect reporting bias, ie, better hospitals more likely to report. However, even in respondents, further improvement can be achieved, in particular by embedding hand hygiene in a stronger institutional safety climate and optimizing staffing levels dedicated to infection prevention. These results should encourage the launch of a coordinated national campaign and higher participation in the WHO global campaign. Copyright © 2014 World Health Organization. Published by Mosby, Inc. All rights reserved.

Implementation of patient charges at primary care facilities in Kenya: implications of low adherence to user fee policy for users and facility revenue

PubMed Central

Opwora, Antony; Waweru, Evelyn; Toda, Mitsuru; Noor, Abdisalan; Edwards, Tansy; Fegan, Greg; Molyneux, Sassy; Goodman, Catherine

2015-01-01

With user fees now seen as a major hindrance to universal health coverage, many countries have introduced fee reduction or elimination policies, but there is growing evidence that adherence to reduced fees is often highly imperfect. In 2004, Kenya adopted a reduced and uniform user fee policy providing fee exemptions to many groups. We present data on user fee implementation, revenue and expenditure from a nationally representative survey of Kenyan primary health facilities. Data were collected from 248 randomly selected public health centres and dispensaries in 2010, comprising an interview with the health worker in charge, exit interviews with curative outpatients, and a financial record review. Adherence to user fee policy was assessed for eight tracer conditions based on health worker reports, and patients were asked about actual amounts paid. No facilities adhered fully to the user fee policy across all eight tracers, with adherence ranging from 62.2% for an adult with tuberculosis to 4.2% for an adult with malaria. Three quarters of exit interviewees had paid some fees, with a median payment of US dollars (USD) 0.39, and a quarter of interviewees were required to purchase additional medical supplies at a later stage from a private drug retailer. No consistent pattern of association was identified between facility characteristics and policy adherence. User fee revenues accounted for almost all facility cash income, with average revenue of USD 683 per facility per year. Fee revenue was mainly used to cover support staff, non-drug supplies and travel allowances. Adherence to user fee policy was very low, leading to concerns about the impact on access and the financial burden on households. However, the potential to ensure adherence was constrained by the facilities’ need for revenue to cover basic operating costs, highlighting the need for alternative funding strategies for peripheral health facilities. PMID:24837638

Planning the location of facilities to implement a reverse logistic system of post-consumer packaging using a location mathematical model.

PubMed

Couto, Maria Claudia Lima; Lange, Liséte Celina; Rosa, Rodrigo de Alvarenga; Couto, Paula Rogeria Lima

2017-12-01

The implementation of reverse logistics systems (RLS) for post-consumer products provides environmental and economic benefits, since it increases recycling potential. However, RLS implantation and consolidation still face problems. The main shortcomings are the high costs and the low expectation of broad implementation worldwide. This paper presents two mathematical models to decide the number and the location of screening centers (SCs) and valorization centers (VCs) to implement reverse logistics of post-consumer packages, defining the optimum territorial arrangements (OTAs), allowing the inclusion of small and medium size municipalities. The paper aims to fill a gap in the literature on RLS location facilities that not only aim at revenue optimization, but also the participation of the population, the involvement of pickers and the service universalization. The results showed that implementation of VCs can lead to revenue/cost ratio higher than 100%. The results of this study can supply companies and government agencies with a global view on the parameters that influence RLS sustainability and help them make decisions about the location of these facilities and the best reverse flows with the social inclusion of pickers and serving the population of small and medium-sized municipalities.

Implementing a psycho-educational intervention for care assistants working with people with dementia in aged-care facilities: facilitators and barriers.

PubMed

Barbosa, Ana; Nolan, Mike; Sousa, Liliana; Figueiredo, Daniela

2017-06-01

Many intervention studies lack an investigation and description of the factors that are relevant to its success or failure, despite its relevance to inform future interventions. This study aimed to explore the facilitators and barriers to the implementation of a psycho-educational intervention for care assistants caring for people with dementia in aged-care facilities. A process evaluation was carried out alongside a pretest/post-test controlled study conducted in aged-care facilities. Seven focus-group interviews involving 21 care assistants (female; mean age 43.37 ± 10.0) and individual semi-structured interviews with two managers (female; mean age 45.5 ± 10.26) were conducted 2 weeks and 6 months after the intervention, in two aged-care facilities. Interviews were recorded, transcribed and submitted to content analysis by two independent researchers. Results were organised into implementer, participant and organisation level hindered and facilitator factors. Findings enable the interpretation of the experimental results and underscore the importance of collecting the perception of different grades of staff to obtain information relevant to plan effective interventions. © 2016 Nordic College of Caring Science.

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...

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

Implementation of patient charges at primary care facilities in Kenya: implications of low adherence to user fee policy for users and facility revenue.

PubMed

Opwora, Antony; Waweru, Evelyn; Toda, Mitsuru; Noor, Abdisalan; Edwards, Tansy; Fegan, Greg; Molyneux, Sassy; Goodman, Catherine

2015-05-01

With user fees now seen as a major hindrance to universal health coverage, many countries have introduced fee reduction or elimination policies, but there is growing evidence that adherence to reduced fees is often highly imperfect. In 2004, Kenya adopted a reduced and uniform user fee policy providing fee exemptions to many groups. We present data on user fee implementation, revenue and expenditure from a nationally representative survey of Kenyan primary health facilities. Data were collected from 248 randomly selected public health centres and dispensaries in 2010, comprising an interview with the health worker in charge, exit interviews with curative outpatients, and a financial record review. Adherence to user fee policy was assessed for eight tracer conditions based on health worker reports, and patients were asked about actual amounts paid. No facilities adhered fully to the user fee policy across all eight tracers, with adherence ranging from 62.2% for an adult with tuberculosis to 4.2% for an adult with malaria. Three quarters of exit interviewees had paid some fees, with a median payment of US dollars (USD) 0.39, and a quarter of interviewees were required to purchase additional medical supplies at a later stage from a private drug retailer. No consistent pattern of association was identified between facility characteristics and policy adherence. User fee revenues accounted for almost all facility cash income, with average revenue of USD 683 per facility per year. Fee revenue was mainly used to cover support staff, non-drug supplies and travel allowances. Adherence to user fee policy was very low, leading to concerns about the impact on access and the financial burden on households. However, the potential to ensure adherence was constrained by the facilities' need for revenue to cover basic operating costs, highlighting the need for alternative funding strategies for peripheral health facilities. Published by Oxford University Press in association with

Are Health Facility Management Committees in Kenya ready to implement financial management tasks: findings from a nationally representative survey

PubMed Central

2013-01-01

Background Community participation in peripheral public health facilities has in many countries focused on including community representatives in Health Facility Management Committees (HFMCs). In Kenya, HFMC roles are being expanded with the phased implementation of the Health Sector Services Fund (HSSF). Under HSSF, HFMCs manage facility funds which are dispersed directly from central level into facility bank accounts. We assessed how prepared HFMCs were to undertake this new role in advance of HSSF roll out, and considered the implications for Kenya and other similar settings. Methods Data were collected through a nationally representative sample of 248 public health centres and dispensaries in 24 districts in 2010. Data collection included surveys with in-charges (n = 248), HFMC members (n = 464) and facility users (n = 698), and record reviews. These data were supplemented by semi-structured interviews with district health managers in each district. Results Some findings supported preparedness of HFMCs to take on their new roles. Most facilities had bank accounts and HFMCs which met regularly. HFMC members and in-charges generally reported positive relationships, and HFMC members expressed high levels of motivation and job satisfaction. Challenges included users’ low awareness of HFMCs, lack of training and clarity in roles among HFMCs, and some indications of strained relations with in-charges. Such challenges are likely to be common to many similar settings, and are therefore important considerations for any health facility based initiatives involving HFMCs. Conclusion Most HFMCs have the basic requirements to operate. However to manage their own budgets effectively and meet their allocated roles in HSSF implementation, greater emphasis is needed on financial management training, targeted supportive supervision, and greater community awareness and participation. Once new budget management roles are fully established, qualitative and quantitative

[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.

Implementing personal digital assistant documentation of pharmacist interventions in a military treatment facility.

PubMed

Ford, Stephen; Illich, Stan; Smith, Lisa; Franklin, Arthur

2006-01-01

To describe the use of personal digital assistants (PDAs) in documenting pharmacists' clinical interventions. Evans Army Community Hospital (EACH), a 78-bed military treatment facility, in Colorado Springs. Pharmacists on staff at EACH. All pharmacists at EACH used PDAs with the pilot software to record interventions for 1 month. The program underwent final design changes and then became the sole source for recording pharmacist interventions. The results of this project are being evaluated every 3 months for the first year and yearly thereafter. Visual CE (Syware Inc. Cambridge, Mass.) software was selected to develop fields for the documentation tool. This software is simple and easy to use, and users can retrieve reports of interventions from both inpatient and outpatient sections. The software needed to be designed so that data entry would only take a few minutes and ad hoc reports could be produced easily. Number of pharmacist interventions reported, time spent in clinical interventions, and outcome of clinical intervention. Implementing a PDA-based system for documenting pharmacist interventions across ambulatory, inpatient, and clinical services dramatically increased reporting during the first 6 months after implementation (August 2004-February 2005). After initial fielding, clinical pharmacists in advanced practice settings (such as disease management clinic, anticoagulation clinic) recognized a need to tailor the program to their specific activities, which resulted in a spin-off program unique to their practice roles. A PDA-based system for documenting clinical interventions at a military treatment facility increased reporting of interventions across all pharmacy points of service. Pharmacy leadership used these data to document the impact of pharmacist interventions on safety and quality of pharmaceutical care provided.

Availability of essential drugs for managing HIV-related pain and symptoms within 120 PEPFAR-funded health facilities in East Africa: a cross-sectional survey with onsite verification.

PubMed

Harding, Richard; Simms, Victoria; Penfold, Suzanne; Downing, Julia; Powell, Richard A; Mwangi-Powell, Faith; Namisango, Eve; Moreland, Scott; Gikaara, Nancy; Atieno, Mackuline; Kataike, Jennifer; Nsubuga, Clare; Munene, Grace; Banga, Geoffrey; Higginson, Irene J

2014-04-01

World Health Organization's essential drugs list can control the highly prevalent HIV-related pain and symptoms. Availability of essential medicines directly influences clinicians' ability to effectively manage distressing manifestations of HIV. To determine the availability of pain and symptom controlling drugs in East Africa within President's Emergency Plan for AIDS Relief-funded HIV health care facilities. Directly observed quantitative health facilities' pharmacy stock review. We measured availability, expiration and stock-outs of specified drugs required for routine HIV management, including the World Health Organization pain ladder. A stratified random sample in 120 President's Emergency Plan for AIDS Relief-funded HIV care facilities (referral and district hospitals, health posts/centres and home-based care providers) in Kenya and Uganda. Non-opioid analgesics (73%) and co-trimoxazole (64%) were the most commonly available drugs and morphine (7%) the least. Drug availability was higher in hospitals and lower in health centres, health posts and home-based care facilities. Facilities generally did not use minimum stock levels, and stock-outs were frequently reported. The most common drugs had each been out of stock in the past 6 months in 47% of facilities stocking them. When a minimum stock level was defined, probability of a stock-out in the previous 6 months was 32.6%, compared to 45.5% when there was no defined minimum stock level (χ (2) = 5.07, p = 0.024). The data demonstrate poor essential drug availability, particularly analgesia, limited by facility type. The lack of strong opioids, isoniazid and paediatric formulations is concerning. Inadequate drug availability prevents implementation of simple clinical pain and symptom control protocols, causing unnecessary distress. Research is needed to identify supply chain mechanisms that lead to these problems.

The implementation of tissue banking experiences for setting up a cGMP cell manufacturing facility.

PubMed

Arjmand, Babak; Emami-Razavi, Seyed Hassan; Larijani, Bagher; Norouzi-Javidan, Abbas; Aghayan, Hamid Reza

2012-12-01

Cell manufacturing for clinical applications is a unique form of biologics manufacturing that relies on maintenance of stringent work practices designed to ensure product consistency and prevent contamination by microorganisms or by another patient's cells. More extensive, prolonged laboratory processes involve greater risk of complications and possibly adverse events for the recipient, and so the need for control is correspondingly greater. To minimize the associate risks of cell manufacturing adhering to international quality standards is critical. Current good tissue practice (cGTP) and current good manufacturing practice (cGMP) are examples of general standards that draw a baseline for cell manufacturing facilities. In recent years, stem cell researches have found great public interest in Iran and different cell therapy projects have been started in country. In this review we described the role of our tissue banking experiences in establishing a new cGMP cell manufacturing facility. The authors concluded that, tissue banks and tissue banking experts can broaden their roles from preparing tissue grafts to manufacturing cell and tissue engineered products for translational researches and phase I clinical trials. Also they can collaborate with cell processing laboratories to develop SOPs, implement quality management system, and design cGMP facilities.

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.

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...

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

Minimum Bayes risk image correlation

NASA Technical Reports Server (NTRS)

Minter, T. C., Jr.

1980-01-01

In this paper, the problem of designing a matched filter for image correlation will be treated as a statistical pattern recognition problem. It is shown that, by minimizing a suitable criterion, a matched filter can be estimated which approximates the optimum Bayes discriminant function in a least-squares sense. It is well known that the use of the Bayes discriminant function in target classification minimizes the Bayes risk, which in turn directly minimizes the probability of a false fix. A fast Fourier implementation of the minimum Bayes risk correlation procedure is described.

Implementation of a best management practice (BMP) system for a clay mining facility in Taiwan.

PubMed

Lin, Jen-Yang; Chen, Yen-Chang; Chen, Walter; Lee, Tsu-Chuan; Yu, Shaw L

2006-01-01

The present paper describes the planning and implementation of a best management practice (BMP) system for a clay mining facility in Northern Taiwan. It is a challenge to plan and design BMPs for mitigating the impact of clay mining operations due to the fact that clay mining drainage typically contains very high concentrations of suspended solids (SS), Fe-ions, and [H+] concentrations. In the present study, a field monitoring effort was conducted to collect data for runoff quality and quantity from a clay mining area in Northern Taiwan. A BMP system including holding ponds connected in series was designed and implemented and its pollutant removal performance was assessed. The assessment was based on mass balance computations and an analysis of the relationship between BMP design parameters such as pond depth, detention time, surface loading rate, etc. and the pollutant removal efficiency. Field sampling results showed that the surface-loading rate is exponential related to the removing rate. The results provide the basis for a more comprehensive and efficient BMP implementation plan for clay mining operations.

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…

Implementation of Telemedicine Consultation to Assess Unplanned Transfers in Rural Long-Term Care Facilities, 2012-2015: A Pilot Study.

PubMed

Hofmeyer, Joshua; Leider, Jonathon P; Satorius, Jennifer; Tanenbaum, Erin; Basel, David; Knudson, Alana

2016-11-01

Public and private entities in the United States spend billions of dollars each year on potentially avoidable hospitalizations. This is a common occurrence in long-term care (LTC) facilities, especially in rural jurisdictions. This article details the creation of a telemedicine approach to assess residents from rural LTC facilities for potential transfer to hospitals. An electronic LTC (eLTC) pilot was conducted in 20 pilot LTC facilities from 2012-2015. Each site underwent technologic assessment and upgrading to ensure that 2-way video communication was possible. A new central "hub" was staffed with advanced practice providers and registered nurses. Long-term care pilot sites were trained and rolled out over 3 years. This article reports development and implementation of the pilot, as well as descriptive statistics associated with provider assessments and averted transfers. Over 3 years, 736 eLTC consultations occurred in pilot sites. One-quarter of consultations occurred between 10 pm and 9 am. Overall, approximately 31% of cases were transferred. This decreased from 54% of cases in 2013 to 17% in 2015. Rural pilot facilities had an average of 23 eLTC consults per site per year. Averted transfers represent a dramatic benefit to the residents, as potentially avoidable hospitalizations cause undue stress and allow for nosocomial infections, among other risks. In addition, averting these unnecessary transfers likely saved the taxpayers of the United States over $5 million in admission-related charges to Centers for Medicare and Medicaid Services (511 avoided transfers × $11,000 per average hospitalization from a LTC facility). Overall, the eLTC pilot showed promise as a proof-of-concept. The pilot's implementation resulted in increasing utilization and promising reductions in unnecessary transfers to emergency departments and hospitalizations. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. All rights reserved.

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.

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

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...

Feedback brake distribution control for minimum pitch

NASA Astrophysics Data System (ADS)

Tavernini, Davide; Velenis, Efstathios; Longo, Stefano

2017-06-01

The distribution of brake forces between front and rear axles of a vehicle is typically specified such that the same level of brake force coefficient is imposed at both front and rear wheels. This condition is known as 'ideal' distribution and it is required to deliver the maximum vehicle deceleration and minimum braking distance. For subcritical braking conditions, the deceleration demand may be delivered by different distributions between front and rear braking forces. In this research we show how to obtain the optimal distribution which minimises the pitch angle of a vehicle and hence enhances driver subjective feel during braking. A vehicle model including suspension geometry features is adopted. The problem of the minimum pitch brake distribution for a varying deceleration level demand is solved by means of a model predictive control (MPC) technique. To address the problem of the undesirable pitch rebound caused by a full-stop of the vehicle, a second controller is designed and implemented independently from the braking distribution in use. An extended Kalman filter is designed for state estimation and implemented in a high fidelity environment together with the MPC strategy. The proposed solution is compared with the reference 'ideal' distribution as well as another previous feed-forward solution.

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…

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...

Implementation of the next-generation Gas Cherenkov Detector at the National Ignition Facility

NASA Astrophysics Data System (ADS)

Carrera, J. A.; Herrmann, H. W.; Khater, H. Y.; Carpenter, A. C.; Beeman, B. V.; Hernandez, J. E.; Sitaraman, S.; Lopez, F. E.; Zylstra, A. B.; Griego, J. R.; Kim, Y. H.; Gales, S. A.; Horsfield, C. J.; Milnes, J. S.; Hares, J. D.

2017-08-01

The newest Gas Cherenkov Detector (GCD-3) diagnostic has completed its Phase I commissioning/milestone at the National Ignition Facility (NIF). GCD-3 was fielded for several years at the Omega Laser Facility in its initial configuration, before being moved to the NIF. Installation at the NIF involved optimization of GCD-3 for the higher background environment and designing a new insertion carrier assembly. GCD-3 serves as the initial phase towards the implementation of the "Super GCD" (SGCD) at the NIF. During this phase of development GCD-3 took measurements from a re-entrant well, 3.9 meters from target chamber center (TCC). Plans to insert GCD-3 within 20 cm of TCC with a Target and Diagnostic Manipulator (TANDM) will be discussed. Data was collected using a Photomultiplier Tube (PMT) in combination with a Mach-Zehnder based recording system. These measurements were used to aid in shielding analysis, validate MCNP models, and fuel design efforts for the SGCD. Findings from the initial data will be covered extensively, including an in-depth look into sources of background and possible mitigation strategies. Ongoing development of phase two, the addition of an ultra-high bandwidth Pulse Dilatation Photomultiplier Tube (PD-PMT), will also be presented.

Implementation of the WICS Wall Interference Correction System at the National Transonic Facility

NASA Technical Reports Server (NTRS)

Iyer, Venkit; Everhart, Joel L.; Bir, Pamela J.; Ulbrich, Norbert

2000-01-01

The Wall Interference Correction System (WICS) is operational at the National Transonic Facility (NTF) of NASA Langley Research Center (NASA LaRC) for semispan and full span tests in the solid wall (slots covered) configuration. The method is based on the wall pressure signature method for computing corrections to the measured parameters. It is an adaptation of the WICS code operational at the 12 ft pressure wind tunnel (12ft PWT) of NASA Ames Research Center (NASA ARC). This paper discusses the details of implementation of WICS at the NTF including tunnel calibration, code modifications for tunnel and support geometry, changes made for the NTF wall orifices layout, details of interfacing with the tunnel data processing system, and post-processing of results. Example results of applying WICS to a semispan test and a full span test are presented. Comparison with classical correction results and an analysis of uncertainty in the corrections are also given. As a special application of the code, the Mach number calibration data from a centerline pipe test was computed by WICS. Finally, future work for expanding the applicability of the code including online implementation is discussed.

Implementation of the WICS Wall Interference Correction System at the National Transonic Facility

NASA Technical Reports Server (NTRS)

Iyer, Venkit; Martin, Lockheed; Everhart, Joel L.; Bir, Pamela J.; Ulbrich, Norbert

2000-01-01

The Wall Interference Correction System (WICS) is operational at the National Transonic Facility (NTF) of NASA Langley Research Center (NASA LaRC) for semispan and full span tests in the solid wall (slots covered) configuration, The method is based on the wall pressure signature method for computing corrections to the measured parameters. It is an adaptation of the WICS code operational at the 12 ft pressure wind tunnel (12ft PWT) of NASA Ames Research Center (NASA ARC). This paper discusses the details of implementation of WICS at the NTF including, tunnel calibration, code modifications for tunnel and support geometry, changes made for the NTF wall orifices layout, details of interfacing with the tunnel data processing system, and post-processing of results. Example results of applying WICS to a semispan test and a full span test are presented. Comparison with classical correction results and an analysis of uncertainty in the corrections are also given. As a special application of the code, the Mach number calibration data from a centerline pipe test was computed by WICS. Finally, future work for expanding the applicability of the code including online implementation is discussed.

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.

Centrifuge Facility Conceptual System Study. Volume 1: Facility overview and habitats

NASA Technical Reports Server (NTRS)

Synnestvedt, Robert (Editor)

1990-01-01

The results are presented for a NASA Phase 1 study conducted from mid 1987 through mid 1989 at Ames Research Center. The Centrifuge Facility is the major element of the biological research facility for the implementation of NASA's Life Science Research Program on Space Station Freedom using non-human specimens (such as small primates, rodents, plants, insects, cell tissues). Five systems are described which comprise the Facility: habitats, holding units, centrifuge, glovebox, and service unit. Volume 1 presents a facility overview and describes the habitats - modular units which house living specimens.

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…

33 CFR 279.10 - Implementation.

Code of Federal Regulations, 2012 CFR

2012-07-01

... boundaries, conduct of regional studies and content and format of report requirements. As a minimum, one... projects with existing use patterns and constructed facilities. (b) Regional studies are prerequisite to... not be restricted either to States or to District hydrologic boundaries. In those cases where a region...

33 CFR 279.10 - Implementation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... boundaries, conduct of regional studies and content and format of report requirements. As a minimum, one... projects with existing use patterns and constructed facilities. (b) Regional studies are prerequisite to... not be restricted either to States or to District hydrologic boundaries. In those cases where a region...

33 CFR 279.10 - Implementation.

Code of Federal Regulations, 2013 CFR

2013-07-01

... boundaries, conduct of regional studies and content and format of report requirements. As a minimum, one... projects with existing use patterns and constructed facilities. (b) Regional studies are prerequisite to... not be restricted either to States or to District hydrologic boundaries. In those cases where a region...

33 CFR 279.10 - Implementation.

Code of Federal Regulations, 2014 CFR

2014-07-01

... boundaries, conduct of regional studies and content and format of report requirements. As a minimum, one... projects with existing use patterns and constructed facilities. (b) Regional studies are prerequisite to... not be restricted either to States or to District hydrologic boundaries. In those cases where a region...

33 CFR 279.10 - Implementation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... boundaries, conduct of regional studies and content and format of report requirements. As a minimum, one... projects with existing use patterns and constructed facilities. (b) Regional studies are prerequisite to... not be restricted either to States or to District hydrologic boundaries. In those cases where a region...

Local Government Implementation of Long-Term Stewardship at Two DOE Facilities

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

John Pendergrass; Roman Czebiniak; Kelly Mott

2003-08-13

The Department of Energy (DOE) is responsible for cleaning up the radioactive and chemical contamination that resulted from the production of nuclear weapons. At more than one hundred sites throughout the country DOE will leave some contamination in place after the cleanup is complete. In order to protect human health and the environment from the remaining contamination DOE, U.S. Environmental Protection Agency (EPA), state environmental regulatory agencies, local governments, citizens and other entities will need to undertake long-term stewardship of such sites. Long-term stewardship includes a wide range of actions needed to protect human health in the environment for asmore » long as the risk from the contamination remains above acceptable levels, such as barriers, caps, and other engineering controls and land use controls, signs, notices, records, and other institutional controls. In this report the Environmental Law Institute (ELI) and the Energy Communities Alliance (ECA) examine how local governments, state environmental agencies, and real property professionals implement long-term stewardship at two DOE facilities, Losa Alamos National Laboratory and Oak Ridge Reservation.« less

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.

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...

Progress towards implementation of ACT malaria case-management in public health facilities in the Republic of Sudan: a cluster-sample survey

PubMed Central

2012-01-01

Background Effective malaria case-management based on artemisinin-based combination therapy (ACT) and parasitological diagnosis is a major pillar within the 2007-2012 National Malaria Strategic Plan in the Sudan. Three years after the launch of the strategy a health facility survey was undertaken to evaluate case-management practices and readiness of the health facilities and health workers to implement a new malaria case-management strategy. Methods A cross-sectional, cluster sample survey was undertaken at public health facilities in 15 states of Sudan. Data were collected using quality-of-care assessment methods. The main outcomes were the proportions of facilities with ACTs and malaria diagnostics; proportions of health workers exposed to malaria related health systems support activities; and composite and individual indicators of case-management practices for febrile outpatients stratified by age, availability of ACTs and diagnostics, use of malaria diagnostics, and test result. Results We evaluated 244 facilities, 294 health workers and 1,643 consultations for febrile outpatients (425 < 5 years and 1,218 ≥ 5 years). Health facility and health worker readiness was variable: chloroquine was available at only 5% of facilities, 73% stocked recommended artesunate and sulfadoxine/pyrimethamine (AS+SP), 51% had the capacity to perform parasitological diagnosis, 53% of health workers had received in-service training on ACTs, 24% were trained in the use of malaria Rapid Diagnostic Tests, and 19% had received a supervisory visit including malaria case-management. At all health facilities 46% of febrile patients were parasitologically tested and 35% of patients were both, tested and treated according to test result. At facilities where AS+SP and malaria diagnostics were available 66% of febrile patients were tested and 51% were both, tested and treated according to test result. Among test positive patients 64% were treated with AS+SP but 24% were treated with

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.

Implementation of Fuzzy Decision to Control Patient Room Facilities using Eye Blink

NASA Astrophysics Data System (ADS)

Zaeni, Ilham A. E.; Wibawa, Aji P.; Aripriharta; Sendari, Siti

2018-04-01

This study proposed the implementation of Fuzzy decision to control patient’s room facilities. In this study, four icons were sequentially displayed on the computer screen. The icons representing four option that can be selected by the patient is including switch the light on/off, switch the fan on/off, moving the bed’s backrest downward, and moving the bed’s backrest upward. The eye blink was extracted from subject’s electroencephalograph (EEG) signals which acquired from the FP1 region. The attention was also extracted from subject’s EEG signals to ensure that subject concentrate to the task. The eye blink and attention level were used for Fuzzy decision inputs, while the output is a decision that states the selection is valid or not. The selected option is the command that appears on the screen when the selection is valid. In this study, subjects were asked to choose each command several times and the accuracy was computed based on the number of correct selection.

The implementation of Prime Vendor Europe and its successful impact on an overseas naval medical treatment facility.

PubMed

Koerner, S D; Anaya, M A

1996-10-01

Prime Vendor Europe (PVE) is the commercial pharmaceutical ordering and delivery program that is revolutionizing overseas health care delivery at military health care treatment facilities located in the European theater. Mirroring civilian programs already available and replacing the Federal Supply System, PVE offers many benefits never before realized at overseas military health care treatment facilities, including: diminished order turnaround times with resultant decreased Operating Target requirements; rapid order confirmation after order placement; lower carrying costs and inventory needs; better dating of pharmaceuticals received; redistribution and increased efficiency of the current manhours needed to operate a pharmacy supply system; order tracking capabilities; and enhancement of the present cooperative and constructive dichotomous relationship between medical logistics and pharmacy regarding pharmaceutical purchasing practices. This paper will explore the fundamentals, past performance, continuous quality improvement of logistical functions, frame-work establishment for PVE, implementation of PVE, and subsequent observed command benefits of PVE realization.

Implementation of co-trimoxazole preventive therapy policy for malaria in HIV-infected pregnant women in the public health facilities in Tanzania.

PubMed

Kamuhabwa, Appolinary Ar; Gordian, Richard; Mutagonda, Ritah F

2016-01-01

In 2011, Tanzania adopted a policy for provision of daily co-trimoxazole prophylaxis to HIV-infected pregnant women for prevention of malaria and other opportunistic infections. As per the policy, HIV-infected pregnant women should not be given sulfadoxine-pyrimethamine (SP) for intermittent preventive therapy. The challenges associated with this policy change and the extent to which the new policy for prevention of malaria in pregnant women coinfected with HIV was implemented need to be assessed. To assess the implementation of malaria-preventive therapy policy among HIV-infected pregnant women in the public health facilities in Dar es Salaam, Tanzania. The study was conducted in Kinondoni Municipality, Dar es Salaam, Tanzania, from January 2015 to July 2015. Three hundred and fifty-three HIV-infected pregnant women who were attending antenatal clinics (ANCs) and using co-trimoxazole for prevention of malaria were interviewed. Twenty-six health care workers working at the ANCs were also interviewed regarding provision of co-trimoxazole prophylaxis to pregnant women. A knowledge scale was used to grade the level of knowledge of health care providers. Focus group discussions were also conducted with 18 health care workers to assess the level of implementation of the policy and the challenges encountered. Twenty-three (6.5%) pregnant women with known HIV serostatus were using co-trimoxazole for prevention of opportunistic infections even before they became pregnant. Out of the 353 HIV-infected pregnant women, eight (2.5%) were coadministered with both SP and co-trimoxazole. Sixty (16.7%) pregnant women had poor adherence to co-trimoxazole prophylaxis. Out of the 26 interviewed health care providers, 20 had high level of knowledge regarding malaria-preventive therapy in HIV-infected pregnant women. Lack of adequate supply of co-trimoxazole in health facilities and inadequate training of health care providers were among the factors causing poor implementation of co

National Facilities study

NASA Technical Reports Server (NTRS)

1994-01-01

This study provides a set of recommendations for improving the effectiveness of our nation's aeronautics and space facilities. The study plan considers current and future government and commercial needs as well as DOD and NASA mission requirements through the year 2023. It addresses shortfalls in existing capabilities, new facility requirements, upgrades, consolidations, and phase-out of existing facilities. If the recommendations are implemented, they will provide world-class capability where it is vital to our country's needs and make us more efficient in meeting future needs.

Implementing a Capital Plan.

ERIC Educational Resources Information Center

Daigneau, William A.

2003-01-01

Addresses four questions regarding implementation of a long-term capital plan to manage a college's facilities portfolio: When should the projects be implemented? How should the capital improvements be implemented? What will it actually cost in terms of project costs as well as operating costs? Who will implement the plan? (EV)

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.

Design of a Minimum Surface-Effect Three Degree-of-Freedom Micromanipulator

NASA Technical Reports Server (NTRS)

Goldfarb, Michael; Speich, John E.

1997-01-01

This paper describes the fundamental physical motivations for small-scale minimum surface-effect design, and presents a three degree-of-freedom micromanipulator design that incorporates a minimum surface-effect approach. The primary focus of the design is the split-tube flexure, a unique small-scale revolute joint that exhibits a considerably larger range of motion and significantly better multi-axis revolute joint characteristics than a conventional flexure. The development of this joint enables the implementation of a small-scale spatially-loaded revolute joint-based manipulator with well-behaved kinematic characteristics and without the backlash and stick-slip behavior that would otherwise prevent precision control

[The influence of "hygienic minimum" course on quality of catering establishments].

PubMed

Venus, Miroslav; Petrovcić, Darija

2010-01-01

The aim of this article was to define the quality of catering establishments in Virovitica Podravina county before and after the course of "hygienic minimum". Research was realized through interview and assessment of microbiological swabs of the same catering establishments before and after the course of "hygienic minimum". All procedures were performed according to Regulations on standard specification in microbiological cleanness and methods of its determining. Twenty-five catering establishments from a group of restaurants and bars were analyzed. In all of them we found improvement in the most of examined parameters. So, implementation of the course through the existing program has proven to be justified.

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…

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.

Mechanisms which help explain implementation of evidence-based practice in residential aged care facilities: a grounded theory study.

PubMed

Masso, Malcolm; McCarthy, Grace; Kitson, Alison

2014-07-01

The context for the study was a nation-wide programme in Australia to implement evidence-based practice in residential aged care, in nine areas of practice, using a wide range of implementation strategies and involving 108 facilities. The study drew on the experiences of those involved in the programme to answer the question: what mechanisms influence the implementation of evidence-based practice in residential aged care and how do those mechanisms interact? The methodology used grounded theory from a critical realist perspective, informed by a conceptual framework that differentiates between the context, process and content of change. People were purposively sampled and invited to participate in semi-structured interviews, resulting in 44 interviews involving 51 people during 2009 and 2010. Participants had direct experience of implementation in 87 facilities, across nine areas of practice, in diverse locations. Sampling continued until data saturation was reached. The quality of the research was assessed using four criteria for judging trustworthiness: credibility, transferability, dependability and confirmability. Data analysis resulted in the identification of four mechanisms that accounted for what took place and participants' experiences. The core category that provided the greatest understanding of the data was the mechanism On Common Ground, comprising several constructs that formed a 'common ground' for change to occur. The mechanism Learning by Connecting recognised the ability to connect new knowledge with existing practice and knowledge, and make connections between actions and outcomes. Reconciling Competing Priorities was an ongoing mechanism whereby new practices had to compete with an existing set of constantly shifting priorities. Strategies for reconciling priorities ranged from structured approaches such as care planning to more informal arrangements such as conversations during daily work. The mechanism Exercising Agency bridged the gap between

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].

Minimum energy control for in vitro neurons.

PubMed

Nabi, Ali; Stigen, Tyler; Moehlis, Jeff; Netoff, Theoden

2013-06-01

a novel approach in designing minimum energy charge-balanced input waveforms for neurons that are robust to noise and implementable in electrophysiological experiments.

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…

Gaps in the implementation of antenatal syphilis detection and treatment in health facilities across sub-Saharan Africa.

PubMed

Kanyangarara, Mufaro; Walker, Neff; Boerma, Ties

2018-01-01

Syphilis in pregnancy is an under-recognized public health problem, especially in sub-Saharan Africa which accounts for over 60% of the global burden of syphilis. If left untreated, more than half of maternal syphilis cases will result in adverse pregnancy outcomes including stillbirth and fetal loss, neonatal death, prematurity or low birth weight, and neonatal infections. Achieving universal coverage of antenatal syphilis screening and treatment has been the focus of the global campaign for the elimination of mother-to-child transmission of syphilis. However, little is known about the availability of antenatal syphilis screening and treatment across sub-Saharan Africa. The objective of this study was to estimate the 'likelihood of appropriate care' for antenatal syphilis screening and treatment by analyzing health facility surveys and household surveys conducted from 2010 to 2015 in 12 sub-Saharan African countries. In this secondary data analysis, we linked indicators of health facility readiness to provide antenatal syphilis detection and treatment from Service Provision Assessments (SPAs) and Service Availability and Readiness Assessments (SARAs) to indicators of ANC use from the Demographic and Health Surveys (DHS) to compute estimates of the 'likelihood of appropriate care'. Based on data from 5,593 health facilities that reported offering antenatal care (ANC) services, the availability of syphilis detection and treatment in ANC facilities ranged from 2% to 83%. The availability of syphilis detection and treatment was substantially lower in ANC facilities in West Africa compared to the other sub-regions. Levels of ANC attendance were high (median 94.9%), but only 27% of ANC attendees initiated care at less than 4 months gestation. We estimated that about one in twelve pregnant women received ANC early (<4 months) at a facility ready to provide syphilis detection and treatment (median 8%, range 7-32%). The largest implementation bottleneck identified was low

Capacity assessment of selected health care facilities for the pilot implementation of Package for Essential Non-communicable Diseases (PEN) intervention in Ghana.

PubMed

Nyarko, Kofi Mensah; Ameme, Donne Kofi; Ocansey, Dennis; Commeh, Efua; Markwei, Mehitabel Tori; Ohene, Sally-Ann

2016-01-01

Non-communicable diseases (NCDs) continue to pose threats to human health and development worldwide. Though preventable, NCDs kill more people annually than all other diseases combined. The four major NCDs namely cardiovascular diseases, chronic respiratory diseases, diabetes and cancers share common modifiable risk factors. In order to prevent and control NCDs, Ghana has adopted the World Health Organisation Package for Essential NCD (WHO-PEN) intervention, to be piloted in selected districts before a nationwide scale-up. We assessed the capacity of these facilities for the implementation of the WHO-PEN pilot. We conducted a cross-sectional health facility-based survey using a multistage sampling technique. We collected data on human resource, equipment, service utilization, medicines availability and health financing through interviews and observation. Descriptive data analysis was performed and expressed in frequencies and relative frequencies. In all, 23 health facilities comprising two regional hospitals, three district hospitals, nine health centres and nine Community-based Health Planning and Services (CHPS) compounds from three regions were surveyed. All the hospitals had medical officers whilst 4 (44.4%) of the health centres had physician assistants. Health financing is mainly by the National Health Insurance Scheme (NHIS). None of the health facilities had spacers and only one health centre had oxygen cylinder, glucometer and nebulizer. Gaps exist in the human resource capacity and service delivery at the primary care levels, the focus of WHO-PEN intervention. Adequately equipping the primary health care level with trained health workers, basic equipment, medications and diagnostics will optimize the performance of WHO-PEN intervention when implemented.

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.

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 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...

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.

A Minimum Path Algorithm Among 3D-Polyhedral Objects

NASA Astrophysics Data System (ADS)

Yeltekin, Aysin

1989-03-01

In this work we introduce a minimum path theorem for 3D case. We also develop an algorithm based on the theorem we prove. The algorithm will be implemented on the software package we develop using C language. The theorem we introduce states that; "Given the initial point I, final point F and S be the set of finite number of static obstacles then an optimal path P from I to F, such that PA S = 0 is composed of straight line segments which are perpendicular to the edge segments of the objects." We prove the theorem as well as we develop the following algorithm depending on the theorem to find the minimum path among 3D-polyhedral objects. The algorithm generates the point Qi on edge ei such that at Qi one can find the line which is perpendicular to the edge and the IF line. The algorithm iteratively provides a new set of initial points from Qi and exploits all possible paths. Then the algorithm chooses the minimum path among the possible ones. The flowchart of the program as well as the examination of its numerical properties are included.

Implementation of co-trimoxazole preventive therapy policy for malaria in HIV-infected pregnant women in the public health facilities in Tanzania

PubMed Central

Kamuhabwa, Appolinary AR; Gordian, Richard; Mutagonda, Ritah F

2016-01-01

Background In 2011, Tanzania adopted a policy for provision of daily co-trimoxazole prophylaxis to HIV-infected pregnant women for prevention of malaria and other opportunistic infections. As per the policy, HIV-infected pregnant women should not be given sulfadoxine-pyrimethamine (SP) for intermittent preventive therapy. The challenges associated with this policy change and the extent to which the new policy for prevention of malaria in pregnant women coinfected with HIV was implemented need to be assessed. Aim To assess the implementation of malaria-preventive therapy policy among HIV-infected pregnant women in the public health facilities in Dar es Salaam, Tanzania. Methodology The study was conducted in Kinondoni Municipality, Dar es Salaam, Tanzania, from January 2015 to July 2015. Three hundred and fifty-three HIV-infected pregnant women who were attending antenatal clinics (ANCs) and using co-trimoxazole for prevention of malaria were interviewed. Twenty-six health care workers working at the ANCs were also interviewed regarding provision of co-trimoxazole prophylaxis to pregnant women. A knowledge scale was used to grade the level of knowledge of health care providers. Focus group discussions were also conducted with 18 health care workers to assess the level of implementation of the policy and the challenges encountered. Results Twenty-three (6.5%) pregnant women with known HIV serostatus were using co-trimoxazole for prevention of opportunistic infections even before they became pregnant. Out of the 353 HIV-infected pregnant women, eight (2.5%) were coadministered with both SP and co-trimoxazole. Sixty (16.7%) pregnant women had poor adherence to co-trimoxazole prophylaxis. Out of the 26 interviewed health care providers, 20 had high level of knowledge regarding malaria-preventive therapy in HIV-infected pregnant women. Lack of adequate supply of co-trimoxazole in health facilities and inadequate training of health care providers were among the factors

Solar Minimum

NASA Astrophysics Data System (ADS)

Lopresto, James C.; Mathews, John; Manross, Kevin

1995-12-01

Calcium K plage, H alpha plage and sunspot area have been monitored daily on the INTERNET since November of 1992. The plage and sunspot area have been measured by image processing. The purpose of the project is to investigate the degree of correlation between plage area and solar irradiance. The plage variation shows the expected variation produced by solar rotation and the longer secular changes produced by the solar cycle. The H alpha and sunspot plage area reached a minimum in about late 1994 or early 1995. This is in agreement with the K2 spectral index obtained daily from Sacramento Peak Observatory. The Calcium K plage area minimum seems delayed with respect to the others mentioned above. The minimum of the K line plage area is projected to come within the last few months of 1995.

A Randomized Implementation Study of Trauma-Focused Cognitive Behavioral Therapy for Adjudicated Teens in Residential Treatment Facilities.

PubMed

Cohen, Judith A; Mannarino, Anthony P; Jankowski, Kay; Rosenberg, Stanley; Kodya, Suzanne; Wolford, George L

2016-05-01

Adjudicated youth in residential treatment facilities (RTFs) have high rates of trauma exposure and post-traumatic stress disorder (PTSD). This study evaluated strategies for implementing trauma-focused cognitive behavioral therapy (TF-CBT) in RTF. Therapists (N = 129) treating adjudicated youth were randomized by RTF program (N = 18) to receive one of the two TF-CBT implementation strategies: (1) web-based TF-CBT training + consultation (W) or (2) W + 2 day live TF-CBT workshop + twice monthly phone consultation (W + L). Youth trauma screening and PTSD symptoms were assessed via online dashboard data entry using the University of California at Los Angeles PTSD Reaction Index. Youth depressive symptoms were assessed with the Mood and Feelings Questionnaire-Short Version. Outcomes were therapist screening; TF-CBT engagement, completion, and fidelity; and youth improvement in PTSD and depressive symptoms. The W + L condition resulted in significantly more therapists conducting trauma screening (p = .0005), completing treatment (p = .03), and completing TF-CBT with fidelity (p = .001) than the W condition. Therapist licensure significantly impacted several outcomes. Adjudicated RTF youth receiving TF-CBT across conditions experienced statistically and clinically significant improvement in PTSD (p = .001) and depressive (p = .018) symptoms. W + L is generally superior to W for implementing TF-CBT in RTF. TF-CBT is effective for improving trauma-related symptoms in adjudicated RTF youth. Implementation barriers are discussed. © The Author(s) 2016.

A Randomized Implementation Study of Trauma-Focused Cognitive Behavioral Therapy for Adjudicated Teens in Residential Treatment Facilities

PubMed Central

Cohen, Judith A.; Mannarino, Anthony P.; Jankowski, Kay; Rosenberg, Stanley; Kodya, Suzanne; Wolford, George L.

2016-01-01

Adjudicated youth in residential treatment facilities (RTFs) have high rates of trauma exposure and post-traumatic stress disorder (PTSD). This study evaluated strategies for implementing trauma-focused cognitive behavioral therapy (TF-CBT) in RTF. Therapists (N = 129) treating adjudicated youth were randomized by RTF program (N = 18) to receive one of the two TF-CBT implementation strategies: (1) web-based TF-CBT training + consultation (W) or (2) W + 2 day live TF-CBT workshop + twice monthly phone consultation (W + L). Youth trauma screening and PTSD symptoms were assessed via online dashboard data entry using the University of California at Los Angeles PTSD Reaction Index. Youth depressive symptoms were assessed with the Mood and Feelings Questionnaire–Short Version. Outcomes were therapist screening; TF-CBT engagement, completion, and fidelity; and youth improvement in PTSD and depressive symptoms. The W + L condition resulted in significantly more therapists conducting trauma screening (p = .0005), completing treatment (p = .03), and completing TF-CBT with fidelity (p = .001) than the W condition. Therapist licensure significantly impacted several outcomes. Adjudicated RTF youth receiving TF-CBT across conditions experienced statistically and clinically significant improvement in PTSD (p = .001) and depressive (p = .018) symptoms. W + L is generally superior to W for implementing TF-CBT in RTF. TF-CBT is effective for improving trauma-related symptoms in adjudicated RTF youth. Implementation barriers are discussed. PMID:26747845

Minimum Information about a Genotyping Experiment (MIGEN)

PubMed Central

Huang, Jie; Mirel, Daniel; Pugh, Elizabeth; Xing, Chao; Robinson, Peter N.; Pertsemlidis, Alexander; Ding, LiangHao; Kozlitina, Julia; Maher, Joseph; Rios, Jonathan; Story, Michael; Marthandan, Nishanth; Scheuermann, Richard H.

2011-01-01

Genotyping experiments are widely used in clinical and basic research laboratories to identify associations between genetic variations and normal/abnormal phenotypes. Genotyping assay techniques vary from single genomic regions that are interrogated using PCR reactions to high throughput assays examining genome-wide sequence and structural variation. The resulting genotype data may include millions of markers of thousands of individuals, requiring various statistical, modeling or other data analysis methodologies to interpret the results. To date, there are no standards for reporting genotyping experiments. Here we present the Minimum Information about a Genotyping Experiment (MIGen) standard, defining the minimum information required for reporting genotyping experiments. MIGen standard covers experimental design, subject description, genotyping procedure, quality control and data analysis. MIGen is a registered project under MIBBI (Minimum Information for Biological and Biomedical Investigations) and is being developed by an interdisciplinary group of experts in basic biomedical science, clinical science, biostatistics and bioinformatics. To accommodate the wide variety of techniques and methodologies applied in current and future genotyping experiment, MIGen leverages foundational concepts from the Ontology for Biomedical Investigations (OBI) for the description of the various types of planned processes and implements a hierarchical document structure. The adoption of MIGen by the research community will facilitate consistent genotyping data interpretation and independent data validation. MIGen can also serve as a framework for the development of data models for capturing and storing genotyping results and experiment metadata in a structured way, to facilitate the exchange of metadata. PMID:22180825

Design for minimum energy in interstellar communication

NASA Astrophysics Data System (ADS)

Messerschmitt, David G.

2015-02-01

Microwave digital communication at interstellar distances is the foundation of extraterrestrial civilization (SETI and METI) communication of information-bearing signals. Large distances demand large transmitted power and/or large antennas, while the propagation is transparent over a wide bandwidth. Recognizing a fundamental tradeoff, reduced energy delivered to the receiver at the expense of wide bandwidth (the opposite of terrestrial objectives) is advantageous. Wide bandwidth also results in simpler design and implementation, allowing circumvention of dispersion and scattering arising in the interstellar medium and motion effects and obviating any related processing. The minimum energy delivered to the receiver per bit of information is determined by cosmic microwave background alone. By mapping a single bit onto a carrier burst, the Morse code invented for the telegraph in 1836 comes closer to this minimum energy than approaches used in modern terrestrial radio. Rather than the terrestrial approach of adding phases and amplitudes increases information capacity while minimizing bandwidth, adding multiple time-frequency locations for carrier bursts increases capacity while minimizing energy per information bit. The resulting location code is simple and yet can approach the minimum energy as bandwidth is expanded. It is consistent with easy discovery, since carrier bursts are energetic and straightforward modifications to post-detection pattern recognition can identify burst patterns. Time and frequency coherence constraints leading to simple signal discovery are addressed, and observations of the interstellar medium by transmitter and receiver constrain the burst parameters and limit the search scope.

A holistic framework for design of cost-effective minimum water utilization network.

PubMed

Wan Alwi, S R; Manan, Z A; Samingin, M H; Misran, N

2008-07-01

Water pinch analysis (WPA) is a well-established tool for the design of a maximum water recovery (MWR) network. MWR, which is primarily concerned with water recovery and regeneration, only partly addresses water minimization problem. Strictly speaking, WPA can only lead to maximum water recovery targets as opposed to the minimum water targets as widely claimed by researchers over the years. The minimum water targets can be achieved when all water minimization options including elimination, reduction, reuse/recycling, outsourcing and regeneration have been holistically applied. Even though WPA has been well established for synthesis of MWR network, research towards holistic water minimization has lagged behind. This paper describes a new holistic framework for designing a cost-effective minimum water network (CEMWN) for industry and urban systems. The framework consists of five key steps, i.e. (1) Specify the limiting water data, (2) Determine MWR targets, (3) Screen process changes using water management hierarchy (WMH), (4) Apply Systematic Hierarchical Approach for Resilient Process Screening (SHARPS) strategy, and (5) Design water network. Three key contributions have emerged from this work. First is a hierarchical approach for systematic screening of process changes guided by the WMH. Second is a set of four new heuristics for implementing process changes that considers the interactions among process changes options as well as among equipment and the implications of applying each process change on utility targets. Third is the SHARPS cost-screening technique to customize process changes and ultimately generate a minimum water utilization network that is cost-effective and affordable. The CEMWN holistic framework has been successfully implemented on semiconductor and mosque case studies and yielded results within the designer payback period criterion.

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.

The Minimum Impulse Thruster

NASA Technical Reports Server (NTRS)

Parker, J. Morgan; Wilson, Michael J.

2005-01-01

The Minimum Impulse Thruster (MIT) was developed to improve the state-of-the-art minimum impulse capability of hydrazine monopropellant thrusters. Specifically, a new fast response solenoid valve was developed, capable of responding to a much shorter electrical pulse width, thereby reducing the propellant flow time and the minimum impulse bit. The new valve was combined with the Aerojet MR-103, 0.2 lbf (0.9 N) thruster and put through an extensive Delta-qualification test program, resulting in a factor of 5 reduction in the minimum impulse bit, from roughly 1.1 milli-lbf-seconds (5 milliNewton seconds) to - 0.22 milli-lbf-seconds (1 mN-s). To maintain it's extensive heritage, the thruster itself was left unchanged. The Minimum Impulse Thruster provides mission and spacecraft designers new design options for precision pointing and precision translation of spacecraft.

Capacity assessment of selected health care facilities for the pilot implementation of Package for Essential Non-communicable Diseases (PEN) intervention in Ghana

PubMed Central

Nyarko, Kofi Mensah; Ameme, Donne Kofi; Ocansey, Dennis; Commeh, Efua; Markwei, Mehitabel Tori; Ohene, Sally-Ann

2016-01-01

Introduction Non-communicable diseases (NCDs) continue to pose threats to human health and development worldwide. Though preventable, NCDs kill more people annually than all other diseases combined. The four major NCDs namely cardiovascular diseases, chronic respiratory diseases, diabetes and cancers share common modifiable risk factors. In order to prevent and control NCDs, Ghana has adopted the World Health Organisation Package for Essential NCD (WHO-PEN) intervention, to be piloted in selected districts before a nationwide scale-up. We assessed the capacity of these facilities for the implementation of the WHO-PEN pilot. Methods We conducted a cross-sectional health facility-based survey using a multistage sampling technique. We collected data on human resource, equipment, service utilization, medicines availability and health financing through interviews and observation. Descriptive data analysis was performed and expressed in frequencies and relative frequencies. Results In all, 23 health facilities comprising two regional hospitals, three district hospitals, nine health centres and nine Community-based Health Planning and Services (CHPS) compounds from three regions were surveyed. All the hospitals had medical officers whilst 4 (44.4%) of the health centres had physician assistants. Health financing is mainly by the National Health Insurance Scheme (NHIS). None of the health facilities had spacers and only one health centre had oxygen cylinder, glucometer and nebulizer. Conclusion Gaps exist in the human resource capacity and service delivery at the primary care levels, the focus of WHO-PEN intervention. Adequately equipping the primary health care level with trained health workers, basic equipment, medications and diagnostics will optimize the performance of WHO-PEN intervention when implemented. PMID:28149441

Implementation of a solid target production facility

NASA Astrophysics Data System (ADS)

Tochon-Danguy, H. J.; Poniger, S. S.; Sachinidis, J. I.; Panopoulos, H. P.; Scott, A. M.

2012-12-01

The desire to utilize long-lived PET isotopes in Australia has significantly increased over the years and several research projects for labelling of peptides, proteins and biomolecules, including labelling of recombinant antibodies has been restricted due to the limited availability of suitable isotopes. This need has led to the recent installation and commissioning of a new facility dedicated to fully automated solid target isotope production, including 24I, 64Cu, 89Zr and 86Y at the Austin Health Centre for PET.

Implementation of Home based management of malaria in children reduces the work load for peripheral health facilities in a rural district of Burkina Faso.

PubMed

Tiono, Alfred B; Kaboré, Youssouf; Traoré, Abdoulaye; Convelbo, Nathalie; Pagnoni, Franco; Sirima, Sodiomon B

2008-10-03

Home Management of Malaria (HMM) is one of the key strategies to reduce the burden of malaria for vulnerable population in endemic countries. It is based on the evidence that well-trained communities health workers can provide prompt and adequate care to patients close to their homes. The strategy has been shown to reduce malaria mortality and severe morbidity and has been adopted by the World Health Organization as a cornerstone of malaria control in Africa. However, the potential fall-out of this community-based strategy on the work burden at the peripheral health facilities level has never been investigated. A two-arm interventional study was conducted in a rural health district of Burkina Faso. The HMM strategy has been implemented in seven community clinics catchment's area (intervention arm). For the other seven community clinics in the control arm, no HMM intervention was implemented. In each of the study arms, presumptive treatment was provided for episodes of fevers/malaria (defined operationally as malaria). The study drug was artemether-lumefantrine, which was sold at a subsidized price by community health workers/Key opinion leaders at the community level and by the pharmacists at the health facility level. The outcome measured was the proportion of malaria cases among all health facility attendance (all causes diseases) in both arms throughout the high transmission season. A total of 7,621 children were enrolled in the intervention arm and 7,605 in the control arm. During the study period, the proportions of malaria cases among all health facility attendance (all causes diseases) were 21.0%, (445/2,111, 95% CI [19.3%-22.7%]) and 70.7% (2,595/3,671, 95% CI 68.5%-71.5%), respectively in the intervention and control arms (p < 0.0001). The relative risk ratio for a fever/malaria episode to be treated at the HF level was 30% (0.30 < RR < 0.32). The number of malaria episodes treated in the intervention arm was much higher than in the control arm (6,661 vs

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.

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...

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

PubMed Central

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

2010-01-01

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

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

PubMed

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

2010-09-01

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

Rising above the Minimum Wage.

ERIC Educational Resources Information Center

Even, William; Macpherson, David

An in-depth analysis was made of how quickly most people move up the wage scale from minimum wage, what factors influence their progress, and how minimum wage increases affect wage growth above the minimum. Very few workers remain at the minimum wage over the long run, according to this study of data drawn from the 1977-78 May Current Population…

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…

California's minimum-nurse-staffing legislation and nurses' wages.

PubMed

Mark, Barbara; Harless, David W; Spetz, Joanne

2009-01-01

In 2004, California became the first state to implement minimum-nurse-staffing ratios in acute care hospitals. We examined the wages of registered nurses (RNs) before and after the legislation was enacted. Using four data sets-the National Sample Survey of Registered Nurses, the Current Population Survey, the National Compensation Survey, and the Occupational Employment Statistics Survey-we found that from 2000 through 2006, RNs in California metropolitan areas experienced real wage growth as much as twelve percentage points higher than the growth in the wages of nurses employed in metropolitan areas outside of California.

6 CFR 27.115 - Implementation.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 6 Domestic Security 1 2012-01-01 2012-01-01 false Implementation. 27.115 Section 27.115 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY CHEMICAL FACILITY ANTI-TERRORISM STANDARDS General § 27.115 Implementation. The Assistant Secretary may implement the section 550 program in...

6 CFR 27.115 - Implementation.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 6 Domestic Security 1 2011-01-01 2011-01-01 false Implementation. 27.115 Section 27.115 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY CHEMICAL FACILITY ANTI-TERRORISM STANDARDS General § 27.115 Implementation. The Assistant Secretary may implement the section 550 program in...

6 CFR 27.115 - Implementation.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 6 Domestic Security 1 2013-01-01 2013-01-01 false Implementation. 27.115 Section 27.115 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY CHEMICAL FACILITY ANTI-TERRORISM STANDARDS General § 27.115 Implementation. The Assistant Secretary may implement the section 550 program in...

6 CFR 27.115 - Implementation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 6 Domestic Security 1 2010-01-01 2010-01-01 false Implementation. 27.115 Section 27.115 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY CHEMICAL FACILITY ANTI-TERRORISM STANDARDS General § 27.115 Implementation. The Assistant Secretary may implement the Section 550 program in...

6 CFR 27.115 - Implementation.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 6 Domestic Security 1 2014-01-01 2014-01-01 false Implementation. 27.115 Section 27.115 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY CHEMICAL FACILITY ANTI-TERRORISM STANDARDS General § 27.115 Implementation. The Assistant Secretary may implement the section 550 program in...

Minimum energy control for in vitro neurons

NASA Astrophysics Data System (ADS)

Nabi, Ali; Stigen, Tyler; Moehlis, Jeff; Netoff, Theoden

2013-06-01

concepts from the theory of optimal control and introduces a novel approach in designing minimum energy charge-balanced input waveforms for neurons that are robust to noise and implementable in electrophysiological experiments.

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

Centrifuge facility conceptual system study. Volume 2: Facility systems and study summary

NASA Technical Reports Server (NTRS)

Synnestvedt, Robert (Editor); Blair, Patricia; Cartledge, Alan; Garces-Porcile, Jorge; Garin, Vladimir; Guerrero, Mike; Haddeland, Peter; Horkachuck, Mike; Kuebler, Ulrich; Nguyen, Frank

1991-01-01

The Centrifuge Facility is a major element of the biological research facility for the implementation of NASA's Life Science Research Program on Space Station Freedom using nonhuman species (small primates, rodents, plants, insects, cell tissues, etc.). The Centrifuge Facility consists of a variable gravity Centrifuge to provide artificial gravity up to 2 earth G's' a Holding System to maintain specimens at microgravity levels, a Glovebox, and a Service Unit for servicing specimen chambers. The following subject areas are covered: (1) Holding System; (2) Centrifuge System; (3) Glovebox System; (4) Service System; and (5) system study summary.

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…

Strategic benefits of master facility plans.

PubMed

Shannon, K

1996-02-01

In recent years, many healthcare executives have stopped developing master facility plans due to some basic misconceptions about them, namely that master facility plans are too rigid or require major capital commitment. By getting past these misconceptions, healthcare executives can help their organizations develop and implement master facility plans that serve as flexible, reliable blueprints in guiding the organizations toward achieving their strategic, operational, and financial goals.

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

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.

Implementation of a Person-Centered Medical Care Model in a Skilled Nursing Facility: A Pilot Evaluation.

PubMed

Abrahamson, Kathleen; Myers, Jaclyn; Nazir, Arif

2017-06-01

The objective of this study was to evaluate the feasibility and impact of implementing a person-centered medical care model for post-acute care residents within a skilled nursing facility (SNF). A mixed-method (qualitative and quantitative) pilot evaluation. An 89-bed SNF located within a large midwestern city. Forty SNF post-acute patients admitted to the facility during a 6-month period were enrolled in the pilot evaluation. The patients were 75% women, 57% African American, and had an average age of 73. To meet inclusion criteria, patients must have been admitted to the facility for rehabilitation with a plan for community discharge, and be cognitively able to consent as indicated by a cognitive screening tool or assent to participation with family member consent. The person-centered medical care model included (1) biweekly interdisciplinary care plan meetings, scheduled at a time of patients' preference and held in the patient's room; (2) patient selection of health-related goals that guide team discussions; (3) use of lay-language that facilitated patient understanding; (4) team accountability to the patient for patient care preferences; and (5) monthly care-team meetings to exchange feedback regarding the team's performance and the model. Evaluation data included admission and discharge Patient Activation Measure surveys; admission and discharge Care of Chronic Conditions surveys; admission and biweekly modified Castle Satisfaction Surveys; admission and discharge Patient and Caregiver Engagement surveys; and semistructured interviews with a sample of staff, family members, and patients. A significant (P < .01) improvement was noted between admission and discharge on both the Care for Chronic Conditions and the Patient Activation Measure surveys. Patient satisfaction surveys trended toward higher ratings over time on most questions, with significant improvement in 2 questions addressing satisfaction with their medical provider. Interviews revealed a

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.

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…

Implementing a comprehensive cost information system in rural health facilities: the case of Nouna health district, Burkina Faso.

PubMed

Flessa, Steffen; Kouyaté, Bocar

2006-09-01

To present first findings of a cost-of-illness (COI) information system implemented in Nouna health district, Burkina Faso. The entire project will include household and provider tangible COI, whereas this article concentrates on the development of a provider cost information system in rural first-line health facilities. Special forms and reports are prepared to routinely collect capital and recurrent costs of first-line facilities. Inventory lists are designed, and buildings and equipment are assessed by engineers. Total, fixed, variable and average costs are calculated for 15 rural health centres with five cost centres: general outpatient consultation, ambulatory nursing care, deliveries, immunization and other services (neonatal consultation, child care and family planning). In 2003, the average costs per service unit were 1.34 US$ for a general consultation, 0.51 US$ for ambulatory nursing care, 6.73 US$ per delivery, 3.64 US$ per vaccination and 1.11 US$ per service unit of other care. On average, a health centre consumes 29,900 US$ per year for a catchment population of 10,000 inhabitants. The major share of costs is fixed and does not depend on the workload of the health centre. Consequently, the costs of first-line facilities will hardly increase if the demand for health services rises. These findings can be used to improve the health financing in Nouna health district, Burkina Faso.

On-orbit technology experiment facility definition

NASA Technical Reports Server (NTRS)

Russell, Richard A.; Buchan, Robert W.; Gates, Richard M.

1988-01-01

A study was conducted to identify on-orbit integrated facility needs to support in-space technology experiments on the Space Station and associated free flyers. In particular, the first task was to examine the proposed technology development missions (TDMX's) from the model mission set and other proposed experimental facilities, both individually and by theme, to determine how and if the experiments might be combined, what equipment might be shared, what equipment might be used as generic equipment for continued experimentation, and what experiments will conflict with the conduct of other experiments or Space Station operations. Then using these results, to determine on-orbit facility needs to optimize the implementation of technology payloads. Finally, to develop one or more scenarios, design concepts, and outfitting requirements for implementation of onboard technology experiments.

Minimum weight structural sandwich

Treesearch

Edward W. Kuenzi

1965-01-01

This note presents theoretical analyses for determination of dimensions of structural sandwich of minimum weight that will have certain stiffness and load-carrying capabilities. Included is a brief discussion of the resultant minimum weight configurations.

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.

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.

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

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.

10 CFR 75.15 - Facility attachments.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 2 2011-01-01 2011-01-01 false Facility attachments. 75.15 Section 75.15 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) SAFEGUARDS ON NUCLEAR MATERIAL-IMPLEMENTATION OF US/IAEA AGREEMENT Material... under Article 39(b) of the main text of the Safeguards Agreement, do not have Facility Attachments or...

10 CFR 75.15 - Facility attachments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Facility attachments. 75.15 Section 75.15 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) SAFEGUARDS ON NUCLEAR MATERIAL-IMPLEMENTATION OF US/IAEA AGREEMENT Material... under Article 39(b) of the main text of the Safeguards Agreement, do not have Facility Attachments or...

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

Employee influenza vaccination in residential care facilities.

PubMed

Apenteng, Bettye A; Opoku, Samuel T

2014-03-01

The organizational literature on infection control in residential care facilities is limited. Using a nationally representative dataset, we examined the organizational factors associated with implementing at least 1 influenza-related employee vaccination policy/program, as well as the effect of vaccination policies on health care worker (HCW) influenza vaccine uptake in residential care facilities. The study was a cross-sectional study using data from the 2010 National Survey of Residential Care Facilities. Multivariate logistic regression analysis was used to address the study's objectives. Facility size, director's educational attainment, and having a written influenza pandemic preparedness plan were significantly associated with the implementation of at least 1 influenza-related employee vaccination policy/program, after controlling for other facility-level factors. Recommending vaccination to employees, providing vaccination on site, providing vaccinations to employees at no cost, and requiring vaccination as a condition of employment were associated with higher employee influenza vaccination rates. Residential care facilities can improve vaccination rates among employees by adopting effective employee vaccination policies. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Study protocol for the SMART2D adaptive implementation trial: a cluster randomised trial comparing facility-only care with integrated facility and community care to improve type 2 diabetes outcomes in Uganda, South Africa and Sweden.

PubMed

Guwatudde, David; Absetz, Pilvikki; Delobelle, Peter; Östenson, Claes-Göran; Olmen Van, Josefien; Alvesson, Helle Molsted; Mayega, Roy William; Ekirapa Kiracho, Elizabeth; Kiguli, Juliet; Sundberg, Carl Johan; Sanders, David; Tomson, Göran; Puoane, Thandi; Peterson, Stefan; Daivadanam, Meena

2018-03-17

Type 2 diabetes (T2D) is increasingly contributing to the global burden of disease. Health systems in most parts of the world are struggling to diagnose and manage T2D, especially in low-income and middle-income countries, and among disadvantaged populations in high-income countries. The aim of this study is to determine the added benefit of community interventions onto health facility interventions, towards glycaemic control among persons with diabetes, and towards reduction in plasma glucose among persons with prediabetes. An adaptive implementation cluster randomised trial is being implemented in two rural districts in Uganda with three clusters per study arm, in an urban township in South Africa with one cluster per study arm, and in socially disadvantaged suburbs in Stockholm, Sweden with one cluster per study arm. Clusters are communities within the catchment areas of participating primary healthcare facilities. There are two study arms comprising a facility plus community interventions arm and a facility-only interventions arm. Uganda has a third arm comprising usual care. Intervention strategies focus on organisation of care, linkage between health facility and the community, and strengthening patient role in self-management, community mobilisation and a supportive environment. Among T2D participants, the primary outcome is controlled plasma glucose; whereas among prediabetes participants the primary outcome is reduction in plasma glucose. The study has received approval in Uganda from the Higher Degrees, Research and Ethics Committee of Makerere University School of Public Health and from the Uganda National Council for Science and Technology; in South Africa from the Biomedical Science Research Ethics Committee of the University of the Western Cape; and in Sweden from the Regional Ethical Board in Stockholm. Findings will be disseminated through peer-reviewed publications and scientific meetings. ISRCTN11913581; Pre-results. © Article author(s) (or their

The effect of implementation strength of basic emergency obstetric and newborn care (BEmONC) on facility deliveries and the met need for BEmONC at the primary health care level in Ethiopia.

PubMed

Tiruneh, Gizachew Tadele; Karim, Ali Mehryar; Avan, Bilal Iqbal; Zemichael, Nebreed Fesseha; Wereta, Tewabech Gebrekiristos; Wickremasinghe, Deepthi; Keweti, Zinar Nebi; Kebede, Zewditu; Betemariam, Wuleta Aklilu

2018-05-02

Basic emergency obstetric and newborn care (BEmONC) is a primary health care level initiative promoted in low- and middle-income countries to reduce maternal and newborn mortality. Tailored support, including BEmONC training to providers, mentoring and monitoring through supportive supervision, provision of equipment and supplies, strengthening referral linkages, and improving infection-prevention practice, was provided in a package of interventions to 134 health centers, covering 91 rural districts of Ethiopia to ensure timely BEmONC care. In recent years, there has been a growing interest in measuring program implementation strength to evaluate public health gains. To assess the effectiveness of the BEmONC initiative, this study measures its implementation strength and examines the effect of its variability across intervention health centers on the rate of facility deliveries and the met need for BEmONC. Before and after data from 134 intervention health centers were collected in April 2013 and July 2015. A BEmONC implementation strength index was constructed from seven input and five process indicators measured through observation, record review, and provider interview; while facility delivery rate and the met need for expected obstetric complications were measured from service statistics and patient records. We estimated the dose-response relationships between outcome and explanatory variables of interest using regression methods. The BEmONC implementation strength index score, which ranged between zero and 10, increased statistically significantly from 4.3 at baseline to 6.7 at follow-up (p < .05). Correspondingly, the health center delivery rate significantly increased from 24% to 56% (p < .05). There was a dose-response relationship between the explanatory and outcome variables. For every unit increase in BEmONC implementation strength score there was a corresponding average of 4.5 percentage points (95% confidence interval: 2.1-6.9) increase in

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.

5 CFR 551.301 - Minimum wage.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Minimum wage. 551.301 Section 551.301... FAIR LABOR STANDARDS ACT Minimum Wage Provisions Basic Provision § 551.301 Minimum wage. (a)(1) Except... employees wages at rates not less than the minimum wage specified in section 6(a)(1) of the Act for all...

Minimum Information about a Cardiac Electrophysiology Experiment (MICEE): Standardised Reporting for Model Reproducibility, Interoperability, and Data Sharing

PubMed Central

Quinn, TA; Granite, S; Allessie, MA; Antzelevitch, C; Bollensdorff, C; Bub, G; Burton, RAB; Cerbai, E; Chen, PS; Delmar, M; DiFrancesco, D; Earm, YE; Efimov, IR; Egger, M; Entcheva, E; Fink, M; Fischmeister, R; Franz, MR; Garny, A; Giles, WR; Hannes, T; Harding, SE; Hunter, PJ; Iribe, G; Jalife, J; Johnson, CR; Kass, RS; Kodama, I; Koren, G; Lord, P; Markhasin, VS; Matsuoka, S; McCulloch, AD; Mirams, GR; Morley, GE; Nattel, S; Noble, D; Olesen, SP; Panfilov, AV; Trayanova, NA; Ravens, U; Richard, S; Rosenbaum, DS; Rudy, Y; Sachs, F; Sachse, FB; Saint, DA; Schotten, U; Solovyova, O; Taggart, P; Tung, L; Varró, A; Volders, PG; Wang, K; Weiss, JN; Wettwer, E; White, E; Wilders, R; Winslow, RL; Kohl, P

2011-01-01

Cardiac experimental electrophysiology is in need of a well-defined Minimum Information Standard for recording, annotating, and reporting experimental data. As a step toward establishing this, we present a draft standard, called Minimum Information about a Cardiac Electrophysiology Experiment (MICEE). The ultimate goal is to develop a useful tool for cardiac electrophysiologists which facilitates and improves dissemination of the minimum information necessary for reproduction of cardiac electrophysiology research, allowing for easier comparison and utilisation of findings by others. It is hoped that this will enhance the integration of individual results into experimental, computational, and conceptual models. In its present form, this draft is intended for assessment and development by the research community. We invite the reader to join this effort, and, if deemed productive, implement the Minimum Information about a Cardiac Electrophysiology Experiment standard in their own work. PMID:21745496

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

Implementation of EPA criminal enforcement strategy for RCRA interim status facilities

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

Not Available

1985-11-15

The directive discusses criminal enforcement priorities and procedures related to the RCRA section 3007(e)(2) Loss of Interim Status (LOIS) provision, including: (1) identifying/targeting facilities with violations, (2) verifying receipt of RCRA 3007 letters, and (3) inspections of facilities. The directive supplements directive no. 9930.0-1 RCRA LOIS Enforcement Strategy, dated October 15, 1985. The directive is supplemented by directive no. 9930.0-2a, Accepting Nonhazardous Waste After Losing Interim Status, dated December 20, 1986.

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...

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.

Sustainable Facility Development: Perceived Benefits and Challenges

ERIC Educational Resources Information Center

Stinnett, Brad; Gibson, Fred

2016-01-01

Purpose: The purpose of this paper is to assess the perceived benefits and challenges of implementing sustainable initiatives in collegiate recreational sports facilities. Additionally, this paper intends to contribute to the evolving field of facility sustainability in higher education. Design/methodology/approach The design included qualitative…

Neutron Source Facility Training Simulator Based on EPICS

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

Park, Young Soo; Wei, Thomas Y.; Vilim, Richard B.

A plant operator training simulator is developed for training the plant operators as well as for design verification of plant control system (PCS) and plant protection system (PPS) for the Kharkov Institute of Physics and Technology Neutron Source Facility. The simulator provides the operator interface for the whole plant including the sub-critical assembly coolant loop, target coolant loop, secondary coolant loop, and other facility systems. The operator interface is implemented based on Experimental Physics and Industrial Control System (EPICS), which is a comprehensive software development platform for distributed control systems. Since its development at Argonne National Laboratory, it has beenmore » widely adopted in the experimental physics community, e.g. for control of accelerator facilities. This work is the first implementation for a nuclear facility. The main parts of the operator interface are the plant control panel and plant protection panel. The development involved implementation of process variable database, sequence logic, and graphical user interface (GUI) for the PCS and PPS utilizing EPICS and related software tools, e.g. sequencer for sequence logic, and control system studio (CSS-BOY) for graphical use interface. For functional verification of the PCS and PPS, a plant model is interfaced, which is a physics-based model of the facility coolant loops implemented as a numerical computer code. The training simulator is tested and demonstrated its effectiveness in various plant operation sequences, e.g. start-up, shut-down, maintenance, and refueling. It was also tested for verification of the plant protection system under various trip conditions.« less

NETL's Hybrid Performance, or Hyper, facility

ScienceCinema

None

2018-02-13

NETL's Hybrid Performance, or Hyper, facility is a one-of-a-kind laboratory built to develop control strategies for the reliable operation of fuel cell/turbine hybrids and enable the simulation, design, and implementation of commercial equipment. The Hyper facility provides a unique opportunity for researchers to explore issues related to coupling fuel cell and gas turbine technologies.

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

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

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.

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.

Advance care planning for residents in aged care facilities: what is best practice and how can evidence-based guidelines be implemented?

PubMed

Lyon, Cheryl

2007-12-01

Background  Advance care planning in a residential care setting aims to assist residents to make decisions about future healthcare and to improve end-of-life care through medical and care staff knowing and respecting the wishes of the resident. The process enables individuals and others who are important to them, to reflect on what is important to the resident including their beliefs/values and preferences about care when they are dying. This paper describes a project conducted as part of the Joanna Briggs Institute Clinical Aged Care Fellowship Program implemented at the Manningham Centre in metropolitan Melbourne in a unit providing services for 46 low and high care residents. Objectives  The objectives of the study were to document implementation of best practice in advance care planning in a residential aged care facility using a cycle of audit, feedback and re-audit cycle audit with a clinical audit software program, the Practical Application of Clinical Evidence System. The evidence-based guidelines found in 'Guidelines for a Palliative Approach in Residential Aged Care' were used to inform the process of clinical practice review and to develop a program to implement advance care planning. Results  The pre-implementation audit results showed that advance care planning practice was not based on high level evidence as initial compliance with five audit criteria was 0%. The barriers to implementation that became apparent during the feedback stage included the challenge of creating a culture where advance care planning policy, protocols and guidelines could be implemented, and advance care planning discussions held, by adequately prepared health professionals and carers. Opportunities were made to equip the resident to discuss their wishes with family, friends and healthcare staff. Some residents made the decision to take steps to formally document those wishes and/or appoint a Medical Enduring Power of Attorney to act on behalf of the resident when they

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...

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;…

The magnetohydrodynamics coal-fired flow facility

NASA Astrophysics Data System (ADS)

1995-01-01

In this quarterly technical progress report, UTSI reports on the status of a multitask contract to develop the technology for the steam bottoming portion of a MHD Steam Combined Cycle Power Plant. The report describes the facility maintenance and environmental work completed, status of completing technical reports and certain key administrative actions occurring during the quarter. With program resources at a minimum to closeout the MHD program, no further testing occurred during the quarter, but the DOE CFFF facility was maintained in a standby status with winterization, preventive maintenance and repairs accomplished as needed. Plans and preparations progressed for environmental actions needed at the site to investigate and characterize the groundwater and for removal/disposal of asbestos in the cooling tower. Work continued to progress on archiving the results of the MHD program.

Addressing the minimum fleet problem in on-demand urban mobility.

PubMed

Vazifeh, M M; Santi, P; Resta, G; Strogatz, S H; Ratti, C

2018-05-01

Information and communication technologies have opened the way to new solutions for urban mobility that provide better ways to match individuals with on-demand vehicles. However, a fundamental unsolved problem is how best to size and operate a fleet of vehicles, given a certain demand for personal mobility. Previous studies 1-5 either do not provide a scalable solution or require changes in human attitudes towards mobility. Here we provide a network-based solution to the following 'minimum fleet problem', given a collection of trips (specified by origin, destination and start time), of how to determine the minimum number of vehicles needed to serve all the trips without incurring any delay to the passengers. By introducing the notion of a 'vehicle-sharing network', we present an optimal computationally efficient solution to the problem, as well as a nearly optimal solution amenable to real-time implementation. We test both solutions on a dataset of 150 million taxi trips taken in the city of New York over one year 6 . The real-time implementation of the method with near-optimal service levels allows a 30 per cent reduction in fleet size compared to current taxi operation. Although constraints on driver availability and the existence of abnormal trip demands may lead to a relatively larger optimal value for the fleet size than that predicted here, the fleet size remains robust for a wide range of variations in historical trip demand. These predicted reductions in fleet size follow directly from a reorganization of taxi dispatching that could be implemented with a simple urban app; they do not assume ride sharing 7-9 , nor require changes to regulations, business models, or human attitudes towards mobility to become effective. Our results could become even more relevant in the years ahead as fleets of networked, self-driving cars become commonplace 10-14 .

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

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.

Minimum distance classification in remote sensing

NASA Technical Reports Server (NTRS)

Wacker, A. G.; Landgrebe, D. A.

1972-01-01

The utilization of minimum distance classification methods in remote sensing problems, such as crop species identification, is considered. Literature concerning both minimum distance classification problems and distance measures is reviewed. Experimental results are presented for several examples. The objective of these examples is to: (a) compare the sample classification accuracy of a minimum distance classifier, with the vector classification accuracy of a maximum likelihood classifier, and (b) compare the accuracy of a parametric minimum distance classifier with that of a nonparametric one. Results show the minimum distance classifier performance is 5% to 10% better than that of the maximum likelihood classifier. The nonparametric classifier is only slightly better than the parametric version.

EPA Facility Registry Service (FRS): CAMDBS

EPA Pesticide Factsheets

This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link to the Clean Air Markets Division Business System (CAMDBS). Administered by the EPA Clean Air Markets Division, within the Office of Air and Radiation, CAMDBS supports the implementation of market-based air pollution control programs, including the Acid Rain Program and regional programs designed to reduce the transport of ozone. FRS identifies and geospatially locates facilities, sites or places subject to environmental regulations or of environmental interest. Using vigorous verification and data management procedures, FRS integrates facility data from EPA's national program systems, other federal agencies, and State and tribal master facility records and provides EPA with a centrally managed, single source of comprehensive and authoritative information on facilities. This data set contains the subset of FRS integrated facilities that link to CAMDBS facilities once the CAMDBS data has been integrated into the FRS database. Additional information on FRS is available at the EPA website https://www.epa.gov/enviro/facility-registry-service-frs.

A Sketch of the Taiwan Zebrafish Core Facility.

PubMed

You, May-Su; Jiang, Yun-Jin; Yuh, Chiou-Hwa; Wang, Chien-Ming; Tang, Chih-Hao; Chuang, Yung-Jen; Lin, Bo-Hung; Wu, Jen-Leih; Hwang, Sheng-Ping L

2016-07-01

In the past three decades, the number of zebrafish laboratories has significantly increased in Taiwan. The Taiwan Zebrafish Core Facility (TZCF), a government-funded core facility, was launched to serve this growing community. The Core Facility was built on two sites, one located at the National Health Research Institutes (NHRI, called Taiwan Zebrafish Core Facility at NHRI or TZeNH) and the other is located at the Academia Sinica (Taiwan Zebrafish Core Facility at AS a.k.a. TZCAS). The total surface area of the TZCF is about 180 m(2) encompassing 2880 fish tanks. Each site has a separate quarantine room and centralized water recirculating systems, monitoring key water parameters. To prevent diseases, three main strategies have been implemented: (1) imported fish must be quarantined; (2) only bleached embryos are introduced into the main facilities; and (3) working practices were implemented to minimize pathogen transfer between stocks and facilities. Currently, there is no health program in place; however, a fourth measure for the health program, specific regular pathogen tests, is being planned. In March 2015, the TZCF at NHRI has been AAALAC accredited. It is our goal to ensure that we provide "disease-free" fish and embryos to the Taiwanese research community.

The Manchester Fly Facility: Implementing an objective-driven long-term science communication initiative.

PubMed

Patel, Sanjai; Prokop, Andreas

2017-10-01

Science communication is increasingly important for scientists, although research, teaching and administration activities tend to eat up our time already, and budgets for science communication are usually low. It appears impossible to combine all these tasks and, in addition, to develop engagement activities to a quality and impact that would make the efforts worth their while. Here we argue that these challenges are easier addressed when centering science communication initiatives on a long-term vision with a view to eventually forming outreach networks where the load can be shared whilst being driven to higher momentum. As one example, we explain the science communication initiative of the Manchester Fly Facility. It aims to promote public awareness of research using the model organism Drosophila, which is a timely, economic and most efficient experimental strategy to drive discovery processes in the biomedical sciences and must have a firm place in the portfolios of funding organisations. Although this initiative by the Manchester Fly Facility is sustained on a low budget, its long-term vision has allowed gradual development into a multifaceted initiative: (1) targeting university students via resources and strategies for the advanced training in fly genetics; (2) targeting the general public via science fairs, educational YouTube videos, school visits, teacher seminars and the droso4schools project; (3) disseminating and marketing strategies and resources to the public as well as fellow scientists via dedicated websites, blogs, journal articles, conference presentations and workshops - with a view to gradually forming networks of drosophilists that will have a greater potential to drive the science communication objective to momentum and impact. Here we explain the rationales and implementation strategies for our various science communication activities - which are similarly applicable to other model animals and other areas of academic science - and share our

NASA's Advanced Life Support Systems Human-Rated Test Facility

NASA Technical Reports Server (NTRS)

Henninger, D. L.; Tri, T. O.; Packham, N. J.

1996-01-01

Future NASA missions to explore the solar system will be long-duration missions, requiring human life support systems which must operate with very high reliability over long periods of time. Such systems must be highly regenerative, requiring minimum resupply, to enable the crews to be largely self-sufficient. These regenerative life support systems will use a combination of higher plants, microorganisms, and physicochemical processes to recycle air and water, produce food, and process wastes. A key step in the development of these systems is establishment of a human-rated test facility specifically tailored to evaluation of closed, regenerative life supports systems--one in which long-duration, large-scale testing involving human test crews can be performed. Construction of such a facility, the Advanced Life Support Program's (ALS) Human-Rated Test Facility (HRTF), has begun at NASA's Johnson Space Center, and definition of systems and development of initial outfitting concepts for the facility are underway. This paper will provide an overview of the HRTF project plan, an explanation of baseline configurations, and descriptive illustrations of facility outfitting concepts.

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.

30 CFR 202.53 - Minimum royalty.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Minimum royalty. 202.53 Section 202.53 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR MINERALS REVENUE MANAGEMENT ROYALTIES Oil, Gas, and OCS Sulfur, General § 202.53 Minimum royalty. For leases that provide for minimum royalty...

43 CFR 3923.10 - Minimum bid.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Minimum bid. 3923.10 Section 3923.10 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) OIL SHALE LEASING Minimum Bid § 3923.10 Minimum bid...

43 CFR 3923.10 - Minimum bid.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false Minimum bid. 3923.10 Section 3923.10 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) OIL SHALE LEASING Minimum Bid § 3923.10 Minimum bid...

43 CFR 3923.10 - Minimum bid.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false Minimum bid. 3923.10 Section 3923.10 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) OIL SHALE LEASING Minimum Bid § 3923.10 Minimum bid...

Consensus-based approach to develop a measurement framework and identify a core set of indicators to track implementation and progress towards effective coverage of facility-based Kangaroo Mother Care.

PubMed

Guenther, Tanya; Moxon, Sarah; Valsangkar, Bina; Wetzel, Greta; Ruiz, Juan; Kerber, Kate; Blencowe, Hannah; Dube, Queen; Vani, Shashi N; Vivio, Donna; Magge, Hema; De Leon-Mendoza, Socorro; Patterson, Janna; Mazia, Goldy

2017-12-01

As efforts to scale up the delivery of Kangaroo Mother Care (KMC) in facilities are increasing, a standardized approach to measure implementation and progress towards effective coverage is needed. Here, we describe a consensus-based approach to develop a measurement framework and identify a core set of indicators for monitoring facility-based KMC that would be feasible to measure within existing systems. The KMC measurement framework and core list of indicators were developed through: 1) scoping exercise to identify potential indicators through literature review and requests from researchers and program implementers; and 2) face-to-face consultations with KMC and measurement experts working at country and global levels to review candidate indicators and finalize selection and definitions. The KMC measurement framework includes two main components: 1) service readiness, based on the WHO building blocks framework; and 2) service delivery action sequence covering identification, service initiation, continuation to discharge, and follow-up to graduation. Consensus was reached on 10 core indicators for KMC, which were organized according to the measurement framework. We identified 4 service readiness indicators, capturing national level policy for KMC, availability of KMC indicators in HMIS, costed operational plans for KMC and availability of KMC services at health facilities with inpatient maternity services. Six indicators were defined for service delivery, including weighing of babies at birth, identification of those ≤2000 g, initiation of facility-based KMC, monitoring the quality of KMC, status of babies at discharge from the facility and levels of follow-up (according to country-specific protocol). These core KMC indicators, identified with input from a wide range of global and country-level KMC and measurement experts, can aid efforts to strengthen monitoring systems and facilitate global tracking of KMC implementation. As data collection systems advance, we

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…

43 CFR 3923.10 - Minimum bid.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Minimum bid. 3923.10 Section 3923.10 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR RANGE MANAGEMENT (4000) OIL SHALE LEASING Minimum Bid § 3923.10 Minimum bid. The...

24 CFR 5.630 - Minimum rent.

Code of Federal Regulations, 2010 CFR

2010-04-01

... the family for nonpayment of minimum rent during the 90-day period beginning the month following the... Persons with Disabilities: Family Income and Family Payment; Occupancy Requirements for Section 8 Project-Based Assistance Family Payment § 5.630 Minimum rent. (a) Minimum rent. (1) The PHA must charge a family...

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

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

24 CFR 598.605 - Implementation plan.

Code of Federal Regulations, 2010 CFR

2010-04-01

... URBAN DEVELOPMENT COMMUNITY FACILITIES URBAN EMPOWERMENT ZONES: ROUND TWO AND THREE DESIGNATIONS Empowerment Zone Grants § 598.605 Implementation plan. (a) Implementation plan content. An EZ must submit an... requirements that the state and local governments, as Empowerment Zone designees, have agreed to meet as...

12 CFR 3.6 - Minimum capital ratios.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Minimum capital ratios. 3.6 Section 3.6 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY MINIMUM CAPITAL RATIOS; ISSUANCE OF DIRECTIVES Minimum Capital Ratios § 3.6 Minimum capital ratios. (a) Risk-based capital ratio. All...

IMPLEMENTATION OF USEPA'S METAL FINISHING FACILITY POLLUTION PREVENTION TOOL (MFFP2T) - 2003

EPA Science Inventory

To help metal finishing facilities meet the goal of profitable pollution prevention, the USEPA is developing the Metal Finishing Facility Pollution Prevention Tool (MFFP2T), a computer program that estimates the rate of solid, liquid waste generation and air emissions. This progr...

Understanding the Minimum Wage: Issues and Answers.

ERIC Educational Resources Information Center

Employment Policies Inst. Foundation, Washington, DC.

This booklet, which is designed to clarify facts regarding the minimum wage's impact on marketplace economics, contains a total of 31 questions and answers pertaining to the following topics: relationship between minimum wages and poverty; impacts of changes in the minimum wage on welfare reform; and possible effects of changes in the minimum wage…

5 CFR 551.601 - Minimum age standards.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Minimum age standards. 551.601 Section... ADMINISTRATION UNDER THE FAIR LABOR STANDARDS ACT Child Labor § 551.601 Minimum age standards. (a) 16-year minimum age. The Act, in section 3(l), sets a general 16-year minimum age, which applies to all employment...

5 CFR 551.601 - Minimum age standards.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Minimum age standards. 551.601 Section... ADMINISTRATION UNDER THE FAIR LABOR STANDARDS ACT Child Labor § 551.601 Minimum age standards. (a) 16-year minimum age. The Act, in section 3(l), sets a general 16-year minimum age, which applies to all employment...

5 CFR 551.601 - Minimum age standards.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Minimum age standards. 551.601 Section... ADMINISTRATION UNDER THE FAIR LABOR STANDARDS ACT Child Labor § 551.601 Minimum age standards. (a) 16-year minimum age. The Act, in section 3(l), sets a general 16-year minimum age, which applies to all employment...

5 CFR 551.601 - Minimum age standards.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 1 2012-01-01 2012-01-01 false Minimum age standards. 551.601 Section... ADMINISTRATION UNDER THE FAIR LABOR STANDARDS ACT Child Labor § 551.601 Minimum age standards. (a) 16-year minimum age. The Act, in section 3(l), sets a general 16-year minimum age, which applies to all employment...

14 CFR 25.149 - Minimum control speed.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Minimum control speed. 25.149 Section 25... Minimum control speed. (a) In establishing the minimum control speeds required by this section, the method... prevent a heading change of more than 20 degrees. (e) VMCG, the minimum control speed on the ground, is...

14 CFR 25.149 - Minimum control speed.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Minimum control speed. 25.149 Section 25... Minimum control speed. (a) In establishing the minimum control speeds required by this section, the method... prevent a heading change of more than 20 degrees. (e) VMCG, the minimum control speed on the ground, is...

50 CFR 648.103 - Minimum fish sizes.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Minimum fish sizes. 648.103 Section 648... Summer Flounder Fisheries § 648.103 Minimum fish sizes. (a) The minimum size for summer flounder is 14... carrying more than five crew members. (c) The minimum sizes in this section apply to whole fish or to any...

Minimum dietary diversity and associated factors among children aged 6-23 months in Addis Ababa, Ethiopia.

PubMed

Solomon, Dagmawit; Aderaw, Zewdie; Tegegne, Teketo Kassaw

2017-10-12

Dietary diversity has long been recognized as a key element of high quality diets. Minimum Dietary Diversity (MDD) is the consumption of four or more food groups from the seven food groups. Globally, only few children are receiving nutritionally adequate and diversified foods. More than two-thirds of malnutrition related child deaths are associated with inappropriate feeding practice during the first two years of life. In Ethiopia, only 7 % of children age 6-23 months had received the minimum acceptable diet. Therefore, the main aim of this study was to determine the level of minimum dietary diversity practice and identify the associated factors among children aged 6-23 months in Addis Ababa, Ethiopia. A health facility based cross sectional study was undertaken in the three sub-cities of Addis Ababa from 26th February to 28th April, 2016. A multi-stage sampling technique was used to sample the 352 study participants or mothers who had children aged 6-23 months. Data were collected by using a structured and pretested questionnaire, cleaned and entered into Epi info 7 and analyzed using SPSS 24 software. Logistic regression was fitted and odds ratio with 95% confidence interval (CI) with p-value less than 0.05 was used to identify factors associated with minimum dietary diversity. In this study, the overall children with minimum dietary diversity score were found to be 59.9%. Mother's educational attainment and a higher household monthly income were positively associated with the minimum dietary diversity practice. Similarly, mothers' knowledge on dietary diversity and child feeding was positively associated with minimum dietary diversity child feeding practice, with an adjusted odds ratio of 1.98 (95% CI: 1.11-3.53). In this study, the consumption of minimum dietary diversity was found to be high. In spite of this, more efforts need to be done to achieve the recommended minimum dietary diversity intake for all children aged between 6 and 23 months.

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

Resolving the 180-degree ambiguity in vector magnetic field measurements: The 'minimum' energy solution

NASA Technical Reports Server (NTRS)

Metcalf, Thomas R.

1994-01-01

I present a robust algorithm that resolves the 180-deg ambiguity in measurements of the solar vector magnetic field. The technique simultaneously minimizes both the divergence of the magnetic field and the electric current density using a simulated annealing algorithm. This results in the field orientation with approximately minimum free energy. The technique is well-founded physically and is simple to implement.

Underage drinking: does the minimum age drinking law offer enough protection?

PubMed

Green, Rivka; Jason, Hannah; Ganz, Debora

2015-05-01

Underage drinking is a significant problem in the US. It is responsible for several thousand mortalities and fatalities each year, both among minors and other members of society. Additionally, underage alcohol consumption produces a severe economic burden in the US. Introduction to alcohol in youth poses serious long-term risks for adolescents, including occupational, educational, and psychosocial impairments, and increases the risk for developing alcohol abuse disorders in adulthood. In order to address and mitigate this problem, the US has set a minimum age drinking law of 21 in all 50 states, and has implemented several supplementary laws limiting the possession and consumption of alcohol. Though these laws have successfully reduced underage drinking, several additional strategies are noteworthy, including preventative and intervention efforts incorporating environmental, individual, communal, and parental factors. The following literature review describes these concepts as they relate to underage drinking laws in the US. Directions for future research, interventions, and ongoing challenges related to the minimum drinking age in the US are also discussed.

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…

10 CFR 50.78 - Facility information and verification.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Facility information and verification. 50.78 Section 50.78 Energy NUCLEAR REGULATORY COMMISSION DOMESTIC LICENSING OF PRODUCTION AND UTILIZATION FACILITIES Us/iaea... International Atomic Energy Agency (IAEA) and take other action as necessary to implement the US/IAEA Safeguards...

10 CFR 50.78 - Facility information and verification.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Facility information and verification. 50.78 Section 50.78 Energy NUCLEAR REGULATORY COMMISSION DOMESTIC LICENSING OF PRODUCTION AND UTILIZATION FACILITIES Us/iaea... International Atomic Energy Agency (IAEA) and take other action as necessary to implement the US/IAEA Safeguards...

50 CFR 648.124 - Minimum fish sizes.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Minimum fish sizes. 648.124 Section 648... Scup Fishery § 648.124 Minimum fish sizes. (a) The minimum size for scup is 9 inches (22.9 cm) TL for... charter boat, or more than five crew members if a party boat. (c) The minimum size applies to whole fish...

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.

Routing Algorithm based on Minimum Spanning Tree and Minimum Cost Flow for Hybrid Wireless-optical Broadband Access Network

NASA Astrophysics Data System (ADS)

Le, Zichun; Suo, Kaihua; Fu, Minglei; Jiang, Ling; Dong, Wen

2012-03-01

In order to minimize the average end to end delay for data transporting in hybrid wireless optical broadband access network, a novel routing algorithm named MSTMCF (minimum spanning tree and minimum cost flow) is devised. The routing problem is described as a minimum spanning tree and minimum cost flow model and corresponding algorithm procedures are given. To verify the effectiveness of MSTMCF algorithm, extensively simulations based on OWNS have been done under different types of traffic source.

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...

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.

How Common is Common Use Facilities at Airports

NASA Astrophysics Data System (ADS)

Barbeau, Addison D.

This study looked at common use airports across the country and at the implementation of common use facailities at airports. Common use consists of several elements that maybe installed at an airport. One of the elements is the self-service kiosks that allow passengers to have a faster check-in process, therefore moving them more quickly within the airport. Another element is signage and the incorporation of each airline's logo. Another aspect of common useis an airport regaining control of terminal gates by reducing the number of gates that are exclusively leased to a specific air carrier. This research focused on the current state of the common use facilities across the United States and examines the advantages and disadvantages of this approach. The research entailed interviews with personnel at a wide range of airports and found that each airport is in a different stage of implementation; some have fully implemented the common use concept while others are in the beginning stages of implementation. The questions were tailored to determine what the advantages and disadvantages are of a common use facility. The most common advantages reported included flexibility and cost. In the commom use system the airport reserves the right to move any airline to a different gate at any time for any reason. In turn, this helps reduce gates delays at that facility. For the airports that were interviewed no major disadvantages were reported. One down side of common use facilities for the airport involved is the major capital cost that is required to move to a common use system.

The planned Alaska SAR Facility - An overview

NASA Technical Reports Server (NTRS)

Carsey, Frank; Weeks, Wilford

1987-01-01

The Alaska SAR Facility (ASF) is described in an overview fashion. The facility consists of three major components, a Receiving Ground System, a SAR Processing System and an Analysis and Archiving System; the ASF Program also has a Science Working Team and the requisite management and operations systems. The ASF is now an approved and fully funded activity; detailed requirements and science background are presented for the facility to be implemented for data from the European ERS-1, the Japanese ERS-1 and Radarsat.

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.

Quantitative Comparison of Minimum Inductance and Minimum Power Algorithms for the Design of Shim Coils for Small Animal Imaging

PubMed Central

HUDSON, PARISA; HUDSON, STEPHEN D.; HANDLER, WILLIAM B.; SCHOLL, TIMOTHY J.; CHRONIK, BLAINE A.

2010-01-01

High-performance shim coils are required for high-field magnetic resonance imaging and spectroscopy. Complete sets of high-power and high-performance shim coils were designed using two different methods: the minimum inductance and the minimum power target field methods. A quantitative comparison of shim performance in terms of merit of inductance (ML) and merit of resistance (MR) was made for shim coils designed using the minimum inductance and the minimum power design algorithms. In each design case, the difference in ML and the difference in MR given by the two design methods was <15%. Comparison of wire patterns obtained using the two design algorithms show that minimum inductance designs tend to feature oscillations within the current density; while minimum power designs tend to feature less rapidly varying current densities and lower power dissipation. Overall, the differences in coil performance obtained by the two methods are relatively small. For the specific case of shim systems customized for small animal imaging, the reduced power dissipation obtained when using the minimum power method is judged to be more significant than the improvements in switching speed obtained from the minimum inductance method. PMID:20411157

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.

40 CFR 256.42 - Recommendations for assuring facility development.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 25 2011-07-01 2011-07-01 false Recommendations for assuring facility development. 256.42 Section 256.42 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID... Planning and Implementation § 256.42 Recommendations for assuring facility development. (a) The State plan...

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

Comprehensive Medication Reviews in Long-term Care Facilities: History of Process Implementation and 2015 Results.

PubMed

O'Shea, Terrence E; Zarowitz, Barbara J; Erwin, W Gary

2017-01-01

Since 2013, Part D sponsors have been required to offer comprehensive medication reviews (CMRs) to all beneficiaries enrolled in their medication therapy management (MTM) programs at least annually, including those in long-term care (LTC) settings. Since that time, MTM providers have found that accessing and completing CMRs with beneficiaries is frequently prohibitively complex, since the process often requires a live, face-to-face interactive interview where the beneficiary resides. However, with the migration of the CMR completion rate from a star ratings display measure to an active measure, coupled with the new CMR completion rate cutpoints for 2016, accessing this population for CMR completion has heightened importance. Our proprietary consultant pharmacist (CP) software was programmed in 2012 to produce a cover letter, medication action plan, and personal medication list per CMS standardized format specifications. Using this system, CPs were trained to perform and document CMRs and the interactive interviews. MTM-eligible Part D beneficiaries, identified by several contracted clients as residing in LTC serviced by Omnicare, were provided CMRs and summaries written in CMS standardized format by CPs. Residents with cognitive impairment were identified using 3 data elements in the Minimum Data Set (MDS). In 2015, 7,935 MTM-eligible beneficiaries were identified as receiving medications from an Omnicare pharmacy. After excluding those who were disenrolled by their prescription drug plans, discharged from the LTC facility, or resided in a LTC facility no longer serviced by Omnicare, 5,593 residents were available for CMR completion. Of these, only 3% refused the CMR offer, and 5,392 CMRs (96%) were completed successfully. Thirty-nine percent of residents had cognitive impairment per MDS assessments; in those instances, CMRs were conducted with someone other than the beneficiary. Based on the CMRs and interactive interviews, 7,527 drug therapy problem

Protograph based LDPC codes with minimum distance linearly growing with block size

NASA Technical Reports Server (NTRS)

Divsalar, Dariush; Jones, Christopher; Dolinar, Sam; Thorpe, Jeremy

2005-01-01

We propose several LDPC code constructions that simultaneously achieve good threshold and error floor performance. Minimum distance is shown to grow linearly with block size (similar to regular codes of variable degree at least 3) by considering ensemble average weight enumerators. Our constructions are based on projected graph, or protograph, structures that support high-speed decoder implementations. As with irregular ensembles, our constructions are sensitive to the proportion of degree-2 variable nodes. A code with too few such nodes tends to have an iterative decoding threshold that is far from the capacity threshold. A code with too many such nodes tends to not exhibit a minimum distance that grows linearly in block length. In this paper we also show that precoding can be used to lower the threshold of regular LDPC codes. The decoding thresholds of the proposed codes, which have linearly increasing minimum distance in block size, outperform that of regular LDPC codes. Furthermore, a family of low to high rate codes, with thresholds that adhere closely to their respective channel capacity thresholds, is presented. Simulation results for a few example codes show that the proposed codes have low error floors as well as good threshold SNFt performance.

Effectiveness and implementation aspects of interventions for preventing falls in elderly people in long-term care facilities: a systematic review of RCTs.

PubMed

Neyens, Jacques C; van Haastregt, Jolanda C; Dijcks, Béatrice P; Martens, Mark; van den Heuvel, Wim J; de Witte, Luc P; Schols, Jos M

2011-07-01

There is extensive literature on interventions to prevent or reduce falls in elderly people. These findings, however, were based mainly on studies of community-living persons. The primary aim of the present study was to report the effectiveness and implementation aspects of interventions aimed at reducing falls in elderly residents in long-term care facilities: a systematic review of randomized controlled trials (RCTs). MEDLINE, EMBASE, CINAHL, and hand searching of reference lists of included RCTs. RCTs that assessed fall incidents (falls, fallers, recurrent fallers, fall-related injuries) among elderly residents in long-term care facilities were included in this narrative review. Two independent reviewers abstracted data: general program characteristics (setting, population, intervention program) and outcomes, detailed program characteristics (assessment, intervention content, individually tailored, multidisciplinary), and implementation aspects (feasibility, implications for practice). The CONSORT Statement 2001 Checklist was used regarding the quality of reporting RCTs. Twenty trials met the inclusion criteria. Seven trials, 4 multifactorial and 3 monofactorial, showed a significant reduction in the fall rate, the percentage of recurrent fallers, or both the fall rate and the percentage of persons sustaining femoral fractures. The positive effective programs were as follows: a comprehensive structured individual assessment with specific safety recommendations; a multidisciplinary program including general strategies tailored to the setting and strategies tailored specifically to residents; a multifaceted intervention including education, environmental adaptation, balance, resistance training, and hip protector; calcium plus vitamin D supplementation; vitamin D supplementation; a clinical medication review; and a multifactorial intervention (fall risk evaluation, specific and general interventions). In general, because of the limited number of included trials

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

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

Solar Effects on Climate and the Maunder Minimum: Minimum Certainty

NASA Technical Reports Server (NTRS)

Rind, David

2003-01-01

The current state of our understanding of solar effects on climate is reviewed. As an example of the relevant issues, the climate during the Maunder Minimum is compared with current conditions in GCM simulations that include a full stratosphere and parameterized ozone response to solar spectral irradiance variability and trace gas changes. The GISS Global Climate/Middle Atmosphere Model coupled to a q-flux/mixed layer model is used for the simulations, which begin in 1500 and extend to the present. Experiments were made to investigate the effect of total versus spectrally-varying solar irradiance changes; spectrally-varying solar irradiance changes on the stratospheric ozone/climate response with both pre-industrial and present trace gases; and the impact on climate and stratospheric ozone of the preindustrial trace gases and aerosols by themselves. The results showed that: (1) the Maunder Minimum cooling relative to today was primarily associated with reduced anthropogenic radiative forcing, although the solar reduction added 40% to the overall cooling. There is no obvious distinguishing surface climate pattern between the two forcings. (2)The global and tropical response was greater than 1 C, in a model with a sensitivity of 1.2 C per W m-2. To reproduce recent low-end estimates would require a sensitivity 1/4 as large. (3) The global surface temperature change was similar when using the total and spectral irradiance prescriptions, although the tropical response was somewhat greater with the former, and the stratospheric response greater with the latter. (4) Most experiments produce a relative negative phase of the NAO/AO during the Maunder Minimum, with both solar and anthropogenic forcing equally capable, associated with the tropical cooling and relative poleward EP flux refraction. (5) A full stratosphere appeared to be necessary for the negative AO/NAO phase, as was the case with this model for global warming experiments, unless the cooling was very large

28 CFR 50.24 - Annuity broker minimum qualifications.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Annuity broker minimum qualifications. 50....24 Annuity broker minimum qualifications. (a) Minimum standards. The Civil Division, United States Department of Justice, shall establish a list of annuity brokers who meet minimum qualifications for...

49 CFR 387.33 - Financial responsibility, minimum levels.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 5 2010-10-01 2010-10-01 false Financial responsibility, minimum levels. 387.33... MINIMUM LEVELS OF FINANCIAL RESPONSIBILITY FOR MOTOR CARRIERS Motor Carriers of Passengers § 387.33 Financial responsibility, minimum levels. The minimum levels of financial responsibility referred to in...

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

PubMed Central

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

2015-01-01

Health service delivery is a key pillar of the health system management .The World Health Organization recently emphasized the need to develop adolescent -friendly health services to improve the care provided to young people throughout the world. However, there is limited peer reviewed literature on this subject therefore necessitating assessment of whether the existing health facilities are prepared to implement the adolescent friendly health services. Adolescent friendly health services remains a relatively new and sensitive area mainly due to restrictive norms and policies guiding the services. After International Conference on Population and Development in 1994, countries started implementing adolescent friendly health services. The Government of Kenya together with partners in an attempt to address the health challenges came up with the Adolescent package of care (APOC) in 2013 whose guidelines were finalized in November 2014 and released for use by service providers . Despite this package of care, there is still ineffective staff capacity in relation to skills and knowledge gap of health professionals, training needs, health resources as well as health system factors that can affect implementation of AFHS. The study explored ways of mitigating or addressing the barriers to implementation of these services. The study used both quantitative and qualitative approaches to collect data. The study utilized survey research adapting descriptive cross sectional design and semi-structured questionnaire to interview 348 health care providers and 472 adolescents in Mam Lucy Kibaki Hospital from 3rd May 2014 to 16 June 2014 .The key informants were mainly nurses, clinical officers and Medical doctors who were working at the health service delivery area at the time of study and were interviewed using an interview guide. The managers at the hospital were interviewed using an in-depth interview guide while the adolescents were interviewed through interview guide and focused

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

PubMed

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

2015-03-25

Health service delivery is a key pillar of the health system management. The World Health Organization recently emphasized the need to develop adolescent -friendly health services to improve the care provided to young people throughout the world. However, there is limited peer reviewed literature on this subject therefore necessitating assessment of whether the existing health facilities are prepared to implement the adolescent friendly health services. Adolescent friendly health services remains a relatively new and sensitive area mainly due to restrictive norms and policies guiding the services. After International Conference on Population and Development in 1994, countries started implementing adolescent friendly health services. The Government of Kenya together with partners in an attempt to address the health challenges came up with the Adolescent package of care (APOC) in 2013 whose guidelines were finalized in November 2014 and released for use by service providers . Despite this package of care, there is still ineffective staff capacity in relation to skills and knowledge gap of health professionals, training needs, health resources as well as health system factors that can affect implementation of AFHS. The study explored ways of mitigating or addressing the barriers to implementation of these services. The study used both quantitative and qualitative approaches to collect data. The study utilized survey research adapting descriptive cross sectional design and semi-structured questionnaire to interview 348 health care providers and 472 adolescents in Mam Lucy Kibaki Hospital from 3rd May 2014 to 16 June 2014. The key informants were mainly nurses, clinical officers and Medical doctors who were working at the health service delivery area at the time of study and were interviewed using an interview guide. The managers at the hospital were interviewed using an in-depth interview guide while the adolescents were interviewed through interview guide and focused

20 CFR 225.15 - Overall Minimum PIA.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Security Act based on combined railroad and social security earnings. The Overall Minimum PIA is used in computing the social security overall minimum guaranty amount. The overall minimum guaranty rate annuity... INSURANCE AMOUNT DETERMINATIONS PIA's Used in Computing Employee, Spouse and Divorced Spouse Annuities § 225...

Observation d'un minimum plat pour RZ Cas [Observation of a flat minimum of RZ Cas

NASA Astrophysics Data System (ADS)

Dumont, M.

1995-07-01

We observed a minimum of RZ Cas during the night 15/16 august 1991 with the 76 cm telescope of the Fungfraujoch Observatory. We found: Min = HJD 2,448,484.50062 and observed a flat minimum during 10 minutes.

49 CFR 387.9 - Financial responsibility, minimum levels.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 5 2010-10-01 2010-10-01 false Financial responsibility, minimum levels. 387.9... MINIMUM LEVELS OF FINANCIAL RESPONSIBILITY FOR MOTOR CARRIERS Motor Carriers of Property § 387.9 Financial responsibility, minimum levels. The minimum levels of financial responsibility referred to in § 387.7 of this...

14 CFR 25.1523 - Minimum flight crew.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Minimum flight crew. 25.1523 Section 25.1523 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT... Limitations § 25.1523 Minimum flight crew. The minimum flight crew must be established so that it is...

14 CFR 29.1523 - Minimum flight crew.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Minimum flight crew. 29.1523 Section 29.1523 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT... Limitations § 29.1523 Minimum flight crew. The minimum flight crew must be established so that it is...

14 CFR 27.1523 - Minimum flight crew.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Minimum flight crew. 27.1523 Section 27.1523 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT... § 27.1523 Minimum flight crew. The minimum flight crew must be established so that it is sufficient for...

12 CFR 3.10 - Minimum capital requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 12 Banks and Banking 1 2014-01-01 2014-01-01 false Minimum capital requirements. 3.10 Section 3.10 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY CAPITAL ADEQUACY STANDARDS Capital Ratio Requirements and Buffers § 3.10 Minimum capital requirements. (a) Minimum capital...

12 CFR 564.4 - Minimum appraisal standards.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Minimum appraisal standards. 564.4 Section 564.4 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY APPRAISALS § 564.4 Minimum appraisal standards. For federally related transactions, all appraisals shall, at a minimum: (a...

14 CFR 23.1513 - Minimum control speed.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Minimum control speed. 23.1513 Section 23.1513 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT... Information § 23.1513 Minimum control speed. The minimum control speed V MC, determined under § 23.149, must...

14 CFR 23.1513 - Minimum control speed.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Minimum control speed. 23.1513 Section 23.1513 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT... Information § 23.1513 Minimum control speed. The minimum control speed V MC, determined under § 23.149, must...

The Application of a Trade Study Methodology to Determine Which Capabilities to Implement in a Test Facility Data Acquisition System Upgrade

NASA Technical Reports Server (NTRS)

McDougal, Kristopher J.

2008-01-01

More and more test programs are requiring high frequency measurements. Marshall Space Flight Center s Cold Flow Test Facility has an interest in acquiring such data. The acquisition of this data requires special hardware and capabilities. This document provides a structured trade study approach for determining which additional capabilities of a VXI-based data acquisition system should be utilized to meet the test facility objectives. The paper is focused on the trade study approach detailing and demonstrating the methodology. A case is presented in which a trade study was initially performed to provide a recommendation for the data system capabilities. Implementation details of the recommended alternative are briefly provided as well as the system s performance during a subsequent test program. The paper then addresses revisiting the trade study with modified alternatives and attributes to address issues that arose during the subsequent test program. Although the model does not identify a single best alternative for all sensitivities, the trade study process does provide a much better understanding. This better understanding makes it possible to confidently recommend Alternative 3 as the preferred alternative.

50 CFR 648.83 - Multispecies minimum fish sizes.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Multispecies minimum fish sizes. 648.83... Measures for the NE Multispecies and Monkfish Fisheries § 648.83 Multispecies minimum fish sizes. (a) Minimum fish sizes. (1) Minimum fish sizes for recreational vessels and charter/party vessels that are not...

14 CFR 23.1523 - Minimum flight crew.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Minimum flight crew. 23.1523 Section 23... Information § 23.1523 Minimum flight crew. The minimum flight crew must be established so that it is... commuter category airplanes, each crewmember workload determination must consider the following: (1) Flight...

14 CFR 23.1523 - Minimum flight crew.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Minimum flight crew. 23.1523 Section 23... Information § 23.1523 Minimum flight crew. The minimum flight crew must be established so that it is... commuter category airplanes, each crewmember workload determination must consider the following: (1) Flight...

29 CFR 570.118 - Sixteen-year minimum.

Code of Federal Regulations, 2010 CFR

2010-07-01

... for employment in manufacturing or mining occupations. Furthermore, this age minimum is applicable to... convenience of the user, the revised text is set forth as follows: § 570.118 Sixteen-year minimum. The Act sets a 16-year-age minimum for employment in manufacturing or mining occupations, although under FLSA...

14 CFR 23.1523 - Minimum flight crew.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Minimum flight crew. 23.1523 Section 23... Information § 23.1523 Minimum flight crew. The minimum flight crew must be established so that it is... commuter category airplanes, each crewmember workload determination must consider the following: (1) Flight...

50 CFR 648.162 - Minimum fish sizes.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Minimum fish sizes. 648.162 Section 648... Atlantic Bluefish Fishery § 648.162 Minimum fish sizes. If the Council determines through its annual review or framework adjustment process that minimum fish sizes are necessary to assure that the fishing...

41 CFR 50-201.1101 - Minimum wages.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Minimum wages. 50-201... Contracts PUBLIC CONTRACTS, DEPARTMENT OF LABOR 201-GENERAL REGULATIONS § 50-201.1101 Minimum wages. Determinations of prevailing minimum wages or changes therein will be published in the Federal Register by the...

14 CFR 25.1513 - Minimum control speed.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Minimum control speed. 25.1513 Section 25.1513 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT... Limitations § 25.1513 Minimum control speed. The minimum control speed V MC determined under § 25.149 must be...

14 CFR 25.1513 - Minimum control speed.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Minimum control speed. 25.1513 Section 25.1513 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT... Limitations § 25.1513 Minimum control speed. The minimum control speed V MC determined under § 25.149 must be...

United Space Alliance LLC Parachute Refurbishment Facility Model

NASA Technical Reports Server (NTRS)

Esser, Valerie; Pessaro, Martha; Young, Angela

2007-01-01

The Parachute Refurbishment Facility Model was created to reflect the flow of hardware through the facility using anticipated start and delivery times from a project level IV schedule. Distributions for task times were built using historical build data for SFOC work and new data generated for CLV/ARES task times. The model currently processes 633 line items from 14 SFOC builds for flight readiness, 16 SFOC builds returning from flight for defoul, wash, and dry operations, 12 builds for CLV manufacturing operations, and 1 ARES 1X build. Modeling the planned workflow through the PRF is providing a reliable way to predict the capability of the facility as well as the manpower resource need. Creating a real world process allows for real world problems to be identified and potential workarounds to be implemented in a safe, simulated world before taking it to the next step, implementation in the real world.

Minimum Wage Laws and the Distribution of Employment.

ERIC Educational Resources Information Center

Lang, Kevin

The desirability of raising the minimum wage long revolved around just one question: the effect of higher minimum wages on the overall level of employment. An even more critical effect of the minimum wage rests on the composition of employment--who gets the minimum wage job. An examination of employment in eating and drinking establishments…

29 CFR 505.3 - Prevailing minimum compensation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 3 2010-07-01 2010-07-01 false Prevailing minimum compensation. 505.3 Section 505.3 Labor... HUMANITIES § 505.3 Prevailing minimum compensation. (a)(1) In the absence of an alternative determination...)(2) of this section, the prevailing minimum compensation required to be paid under the Act to the...

42 CFR 476.76 - Cooperation with health care facilities.

Code of Federal Regulations, 2012 CFR

2012-10-01

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

The labor market effects of California's minimum nurse staffing law.

PubMed

Munnich, Elizabeth L

2014-08-01

In 2004, California became the first state to implement statewide minimum nurse-to-patient ratios in general hospitals. In spite of years of work to establish statewide staffing regulations, there is little evidence that the law was effective in attracting more nurses to the hospital workforce or improving patient outcomes. This paper examines the effects of this legislation on employment and wages of registered nurses. By using annual financial data from California hospitals, I show that nurse-to-patient ratios in medical/surgical units increased substantially following the staffing mandate. However, survey data from two nationally representative datasets indicate that the law had no effect on the aggregate number of registered nurses or the hours they worked in California hospitals, and at most a modest effect on wages. My findings suggest that offsetting changes in labor demand due to hospital closures, combined with reclassification of workers within hospitals, and mitigated the employment effects of California's staffing regulation. This paper cautions that California's experience with minimum nurse staffing legislation may not be generalizable to states considering similar policies in very different hospital markets. Copyright © 2013 John Wiley & Sons, Ltd.

Facility Decontamination and Decommissioning Program Surveillance and Maintenance Plan, Revision 2

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

Poderis, Reed J.; King, Rebecca A.

This Surveillance and Maintenance (S&M) Plan describes the activities performed between deactivation and final decommissioning of the following facilities located on the Nevada National Security Site, as documented in the Federal Facility Agreement and Consent Order under the Industrial Sites program as decontamination and decommissioning sites: ? Engine Maintenance, Assembly, and Disassembly (EMAD) Facility: o EMAD Building (Building 25-3900) o Locomotive Storage Shed (Building 25-3901) ? Test Cell C (TCC) Facility: o Equipment Building (Building 25-3220) o Motor Drive Building (Building 25-3230) o Pump Shop (Building 25-3231) o Cryogenic Lab (Building 25-3232) o Ancillary Structures (e.g., dewars, water tower, piping,more » tanks) These facilities have been declared excess and are in various stages of deactivation (low-risk, long-term stewardship disposition state). This S&M Plan establishes and implements a solid, cost-effective, and balanced S&M program consistent with federal, state, and regulatory requirements. A graded approach is used to plan and conduct S&M activities. The goal is to maintain the facilities in a safe condition in a cost-effective manner until their final end state is achieved. This plan accomplishes the following: ? Establishes S&M objectives and framework ? Identifies programmatic guidance for S&M activities to be conducted by National Security Technologies, LLC, for the U.S. Department of Energy, National Nuclear Security Administration Nevada Field Office (NNSA/NFO) ? Provides present facility condition information and identifies hazards ? Identifies facility-specific S&M activities to be performed and their frequency ? Identifies regulatory drivers, NNSA/NFO policies and procedures, and best management practices that necessitate implementation of S&M activities ? Provides criteria and frequencies for revisions and updates ? Establishes the process for identifying and dispositioning a condition that has not been previously identified

50 CFR 648.72 - Minimum surf clam size.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Atlantic Surf Clam and Ocean Quahog Fisheries § 648.72 Minimum surf clam size. (a) Minimum length. The minimum length for surf clams is 4.75 inches (12.065 cm). (b) Determination of compliance. No more than 50... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Minimum surf clam size. 648.72 Section 648...

Pressure Safety Program Implementation at ORNL

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

Lower, Mark; Etheridge, Tom; Oland, C. Barry

2013-01-01

The Oak Ridge National Laboratory (ORNL) is a US Department of Energy (DOE) facility that is managed by UT-Battelle, LLC. In February 2006, DOE promulgated worker safety and health regulations to govern contractor activities at DOE sites. These regulations, which are provided in 10 CFR 851, Worker Safety and Health Program, establish requirements for worker safety and health program that reduce or prevent occupational injuries, illnesses, and accidental losses by providing DOE contractors and their workers with safe and healthful workplaces at DOE sites. The regulations state that contractors must achieve compliance no later than May 25, 2007. According tomore » 10 CFR 851, Subpart C, Specific Program Requirements, contractors must have a structured approach to their worker safety and health programs that at a minimum includes provisions for pressure safety. In implementing the structured approach for pressure safety, contractors must establish safety policies and procedures to ensure that pressure systems are designed, fabricated, tested, inspected, maintained, repaired, and operated by trained, qualified personnel in accordance with applicable sound engineering principles. In addition, contractors must ensure that all pressure vessels, boilers, air receivers, and supporting piping systems conform to (1) applicable American Society of Mechanical Engineers (ASME) Boiler and Pressure Vessel Code (2004) Sections I through XII, including applicable code cases; (2) applicable ASME B31 piping codes; and (3) the strictest applicable state and local codes. When national consensus codes are not applicable because of pressure range, vessel geometry, use of special materials, etc., contractors must implement measures to provide equivalent protection and ensure a level of safety greater than or equal to the level of protection afforded by the ASME or applicable state or local codes. This report documents the work performed to address legacy pressure vessel deficiencies and

Improving Data for Behavioral Health Workforce Planning: Development of a Minimum Data Set.

PubMed

Beck, Angela J; Singer, Phillip M; Buche, Jessica; Manderscheid, Ronald W; Buerhaus, Peter

2018-06-01

The behavioral health workforce, which encompasses a broad range of professions providing prevention, treatment, and rehabilitation services for mental health conditions and substance use disorders, is in the midst of what is considered by many to be a workforce crisis. The workforce shortage can be attributed to both insufficient numbers and maldistribution of workers, leaving some communities with no behavioral health providers. In addition, demand for behavioral health services has increased more rapidly as a result of federal legislation over the past decade supporting mental health and substance use parity and by healthcare reform. In order to address workforce capacity issues that impact access to care, the field must engage in extensive planning; however, these efforts are limited by the lack of timely and useable data on the behavioral health workforce. One method for standardizing data collection efforts is the adoption of a Minimum Data Set. This article describes workforce data limitations, the need for standardizing data collection, and the development of a behavioral health workforce Minimum Data Set intended to address these gaps. The Minimum Data Set includes five categorical data themes to describe worker characteristics: demographics, licensure and certification, education and training, occupation and area of practice, and practice characteristics and settings. Some data sources align with Minimum Data Set themes, although deficiencies in the breadth and quality of data exist. Development of a Minimum Data Set is a foundational step for standardizing the collection of behavioral health workforce data. Key challenges for dissemination and implementation of the Minimum Data Set are also addressed. This article is part of a supplement entitled The Behavioral Health Workforce: Planning, Practice, and Preparation, which is sponsored by the Substance Abuse and Mental Health Services Administration and the Health Resources and Services Administration of

An Application of Business Process Management to Health Care Facilities.

PubMed

Hassan, Mohsen M D

The purpose of this article is to help health care facility managers and personnel identify significant elements of their facilities to address, and steps and actions to follow, when applying business process management to them. The ABPMP (Association of Business Process Management Professionals) life-cycle model of business process management is adopted, and steps from Lean, business process reengineering, and Six Sigma, and actions from operations management are presented to implement it. Managers of health care facilities can find in business process management a more comprehensive approach to improving their facilities than Lean, Six Sigma, business process reengineering, and ad hoc approaches that does not conflict with them because many of their elements can be included under its umbrella. Furthermore, the suggested application of business process management can guide and relieve them from selecting among these approaches, as well as provide them with specific steps and actions that they can follow. This article fills a gap in the literature by presenting a much needed comprehensive application of business process management to health care facilities that has specific steps and actions for implementation.

Optimization of an optically implemented on-board FDMA demultiplexer

NASA Technical Reports Server (NTRS)

Fargnoli, J.; Riddle, L.

1991-01-01

Performance of a 30 GHz frequency division multiple access (FDMA) uplink to a processing satellite is modelled for the case where the onboard demultiplexer is implemented optically. Included in the performance model are the effects of adjacent channel interference, intersymbol interference, and spurious signals associated with the optical implementation. Demultiplexer parameters are optimized to provide the minimum bit error probability at a given bandwidth efficiency when filtered QPSK modulation is employed.

Energy Systems Integration News | Energy Systems Integration Facility |

Science.gov Websites

Aids Solar Power in Hawaii Inverter load rejection overvoltage tests completed by NREL with partner the report, Inverter Load Rejection Over-Voltage Testing: SolarCity CRADA Task 1a Final Report. Based % of minimum daytime load (MDL) to 250% of MDL. If those increases are implemented, they will represent

Biological and Chemical Impact to Educational Facilities.

ERIC Educational Resources Information Center

Manicone, Santo

2002-01-01

Discusses preparing an educational facility to address the threat of biological or chemical terrorism, including understanding the potential impact, implementing information and communication systems, and improving medical surveillance and awareness. (EV)

50 CFR 648.124 - Minimum fish sizes.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 50 Wildlife and Fisheries 10 2011-10-01 2011-10-01 false Minimum fish sizes. 648.124 Section 648... Scup Fishery § 648.124 Minimum fish sizes. Link to an amendment published at 76 FR 60633, Sept. 29... if a party boat. (c) The minimum size applies to whole fish or any part of a fish found in possession...

Does the Minimum Wage Affect Welfare Caseloads?

ERIC Educational Resources Information Center

Page, Marianne E.; Spetz, Joanne; Millar, Jane

2005-01-01

Although minimum wages are advocated as a policy that will help the poor, few studies have examined their effect on poor families. This paper uses variation in minimum wages across states and over time to estimate the impact of minimum wage legislation on welfare caseloads. We find that the elasticity of the welfare caseload with respect to the…

Do Some Workers Have Minimum Wage Careers?

ERIC Educational Resources Information Center

Carrington, William J.; Fallick, Bruce C.

2001-01-01

Most workers who begin their careers in minimum-wage jobs eventually gain more experience and move on to higher paying jobs. However, more than 8% of workers spend at least half of their first 10 working years in minimum wage jobs. Those more likely to have minimum wage careers are less educated, minorities, women with young children, and those…

29 CFR 4.159 - General minimum wage.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 1 2010-07-01 2010-07-01 true General minimum wage. 4.159 Section 4.159 Labor Office of... General minimum wage. The Act, in section 2(b)(1), provides generally that no contractor or subcontractor... a contract less than the minimum wage specified under section 6(a)(1) of the Fair Labor Standards...

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.

Fire safety of ground-based space facilities on the spaceport ;Vostochny;

NASA Astrophysics Data System (ADS)

Artamonov, Vladimir S.; Gordienko, Denis M.; Melikhov, Anatoly S.

2017-06-01

The facilities of the spaceport ;Vostochny; and the innovative technologies for fire safety to be implemented are considered. The planned approaches and prospects for fire safety ensuring at the facilities of the spaceport ;Vostochny; are presented herein, based on the study of emergency situations having resulted in fire accidents and explosion cases at the facilities supporting space vehicles operation.

The CV period minimum

NASA Astrophysics Data System (ADS)

Kolb, Ulrich; Baraffe, Isabelle

Using improved, up-to-date stellar input physics tested against observations of low-mass stars and brown dwarfs we calculate the secular evolution of low-donor-mass CVs, including those which form with a brown dwarf donor star. Our models confirm the mismatch between the calculated minimum period (plus or minus in ~= 70 min) and the observed short-period cut-off (~= 80 min) in the CV period histogram. Theoretical period distributions synthesized from our model sequences always show an accumulation of systems at the minimum period, a feature absent in the observed distribution. We suggest that non-magnetic CVs become unobservable as they are effectively trapped in permanent quiescence before they reach plus or minus in, and that small-number statistics may hide the period spike for magnetic CVs. We calculate the minimum period for high mass transfer rate sequences and discuss the relevance of these for explaining the location of CV secondaries in the orbital-period-spectral-type diagram. We also show that a recently suggested revised mass-radius relation for low-mass main-sequence stars cannot explain the CV period gap.

43 CFR 5451.1 - Minimum performance bond requirements; types.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Minimum performance bond requirements... § 5451.1 Minimum performance bond requirements; types. (a) A minimum performance bond of not less than 20... minimum bond as provided in § 5451.2 of this title. A minimum performance bond of not less than $500 will...

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.

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.

Factors affecting electronic health record adoption in long-term care facilities.

PubMed

Cherry, Barbara; Carter, Michael; Owen, Donna; Lockhart, Carol

2008-01-01

Electronic health records (EHRs) hold the potential to significantly improve the quality of care in long-term care (LTC) facilities, yet limited research has been done on how facilities decide to adopt these records. This study was conducted to identify factors that hinder and facilitate EHR adoption in LTC facilities. Study participants were LTC nurses, administrators, and corporate executives. Primary barriers identified were costs, the need for training, and the culture change required to embrace technology. Primary facilitators were training programs, well-defined implementation plans, government assistance with implementation costs, evidence that EHRs will improve care outcomes, and support from state regulatory agencies. These results offer a framework of action for policy makers, LTC Leaders, and researchers.

New Minimum Wage Research: A Symposium.

ERIC Educational Resources Information Center

Ehrenberg, Ronald G.; And Others

1992-01-01

Includes "Introduction" (Ehrenberg); "Effect of the Minimum Wage [MW] on the Fast-Food Industry" (Katz, Krueger); "Using Regional Variation in Wages to Measure Effects of the Federal MW" (Card); "Do MWs Reduce Employment?" (Card); "Employment Effects of Minimum and Subminimum Wages" (Neumark,…

Quality improvement nursing facilities: a nursing leadership perspective.

PubMed

Adams-Wendling, Linda; Lee, Robert

2005-11-01

The purposes of this study were to characterize the state of quality improvement (QI) in nursing facilities and to identify barriers to improvement from nursing leaders' perspectives. The study employed a non-experimental descriptive design, using closed- and open-ended survey questions in a sample of 51 nursing facilities in a midwestern state. Only two of these facilities had active QI programs. Furthermore, turnover and limited training among these nursing leaders represented major barriers to rapid implementation of such programs. This study is consistent with earlier findings that QI programs are limited in nursing homes.

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.

A Review of the Aging Process and Facilities Topic.

PubMed

Jornitz, Maik W

2015-01-01

Aging facilities have become a concern in the pharmaceutical and biopharmaceutical manufacturing industry, so much that task forces are formed by trade organizations to address the topic. Too often, examples of aging or obsolete equipment, unit operations, processes, or entire facilities have been encountered. Major contributors to this outcome are the failure to invest in new equipment, disregarding appropriate maintenance activities, and neglecting the implementation of modern technologies. In some cases, a production process is insufficiently modified to manufacture a new product in an existing process that was used to produce a phased-out product. In other instances, manufacturers expanded the facility or processes to fulfill increasing demand and the scaling occurred in a non-uniform manner, which led to non-optimal results. Regulatory hurdles of post-approval changes in the process may thwart companies' efforts to implement new technologies. As an example, some changes have required 4 years to gain global approval. This paper will address cases of aging processes and facilities aside from modernizing options. © PDA, Inc. 2015.

Implementation of the OECD principles of good laboratory practice in test facilities complying with a quality system accredited to the ISO/IEC 17025 standard.

PubMed

Feller, Etty

2008-01-01

Laboratories with a quality system accredited to the ISO/IEC 17025 standard have a definite advantage, compared to non-accredited laboratories, when preparing their facilities for the implementation of the principles of good laboratory practice (GLP) of the Organisation for Economic Co-operation and Development (OECD). Accredited laboratories have an established quality system covering the administrative and technical issues specified in the standard. The similarities and differences between the ISO/IEC 17025 standard and the OECD principles of GLP are compared and discussed.

Test plan for the soils facility demonstration: A petroleum contaminated soil bioremediation facility

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

Lombard, K.H.

1994-08-01

The objectives of this test plan are to show the value added by using bioremediation as an effective and environmentally sound method to remediate petroleum contaminated soils (PCS) by: demonstrating bioremediation as a permanent method for remediating soils contaminated with petroleum products; establishing the best operating conditions for maximizing bioremediation and minimizing volatilization for SRS PCS during different seasons; determining the minimum set of analyses and sampling frequency to allow efficient and cost-effective operation; determining best use of existing site equipment and personnel to optimize facility operations and conserve SRS resources; and as an ancillary objective, demonstrating and optimizing newmore » and innovative analytical techniques that will lower cost, decrease time, and decrease secondary waste streams for required PCS assays.« less

Teaching the Minimum Wage in Econ 101 in Light of the New Economics of the Minimum Wage.

ERIC Educational Resources Information Center

Krueger, Alan B.

2001-01-01

Argues that the recent controversy over the effect of the minimum wage on employment offers an opportunity for teaching introductory economics. Examines eight textbooks to determine topic coverage but finds little consensus. Describes how minimum wage effects should be taught. (RLH)

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.

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.

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.

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.

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

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.

28 CFR 41.57 - Existing facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 1 2014-07-01 2014-07-01 false Existing facilities. 41.57 Section 41.57 Judicial Administration DEPARTMENT OF JUSTICE IMPLEMENTATION OF EXECUTIVE ORDER 12250, NONDISCRIMINATION ON THE BASIS OF HANDICAP IN FEDERALLY ASSISTED PROGRAMS Guidelines for Determining Discriminatory...

28 CFR 41.57 - Existing facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 1 2012-07-01 2012-07-01 false Existing facilities. 41.57 Section 41.57 Judicial Administration DEPARTMENT OF JUSTICE IMPLEMENTATION OF EXECUTIVE ORDER 12250, NONDISCRIMINATION ON THE BASIS OF HANDICAP IN FEDERALLY ASSISTED PROGRAMS Guidelines for Determining Discriminatory...

28 CFR 41.57 - Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Existing facilities. 41.57 Section 41.57 Judicial Administration DEPARTMENT OF JUSTICE IMPLEMENTATION OF EXECUTIVE ORDER 12250, NONDISCRIMINATION ON THE BASIS OF HANDICAP IN FEDERALLY ASSISTED PROGRAMS Guidelines for Determining Discriminatory...

28 CFR 41.57 - Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Existing facilities. 41.57 Section 41.57 Judicial Administration DEPARTMENT OF JUSTICE IMPLEMENTATION OF EXECUTIVE ORDER 12250, NONDISCRIMINATION ON THE BASIS OF HANDICAP IN FEDERALLY ASSISTED PROGRAMS Guidelines for Determining Discriminatory...

28 CFR 41.57 - Existing facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 1 2013-07-01 2013-07-01 false Existing facilities. 41.57 Section 41.57 Judicial Administration DEPARTMENT OF JUSTICE IMPLEMENTATION OF EXECUTIVE ORDER 12250, NONDISCRIMINATION ON THE BASIS OF HANDICAP IN FEDERALLY ASSISTED PROGRAMS Guidelines for Determining Discriminatory...

30 CFR 1202.352 - Minimum royalty.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 3 2013-07-01 2013-07-01 false Minimum royalty. 1202.352 Section 1202.352 Mineral Resources OFFICE OF NATURAL RESOURCES REVENUE, DEPARTMENT OF THE INTERIOR NATURAL RESOURCES REVENUE ROYALTIES Geothermal Resources § 1202.352 Minimum royalty. In no event shall the lessee's annual...

30 CFR 1202.352 - Minimum royalty.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 3 2012-07-01 2012-07-01 false Minimum royalty. 1202.352 Section 1202.352 Mineral Resources OFFICE OF NATURAL RESOURCES REVENUE, DEPARTMENT OF THE INTERIOR NATURAL RESOURCES REVENUE ROYALTIES Geothermal Resources § 1202.352 Minimum royalty. In no event shall the lessee's annual...

30 CFR 1202.352 - Minimum royalty.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 3 2014-07-01 2014-07-01 false Minimum royalty. 1202.352 Section 1202.352 Mineral Resources OFFICE OF NATURAL RESOURCES REVENUE, DEPARTMENT OF THE INTERIOR NATURAL RESOURCES REVENUE ROYALTIES Geothermal Resources § 1202.352 Minimum royalty. In no event shall the lessee's annual...

30 CFR 202.352 - Minimum royalty.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Minimum royalty. 202.352 Section 202.352 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR MINERALS REVENUE MANAGEMENT ROYALTIES Geothermal Resources § 202.352 Minimum royalty. In no event shall the lessee's annual royalty...

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.

An Implementation Plan for NFS at NASA's NAS Facility

NASA Technical Reports Server (NTRS)

Lam, Terance L.; Kutler, Paul (Technical Monitor)

1998-01-01

This document discusses how NASA's NAS can benefit from the Sun Microsystems' Network File System (NFS). A case study is presented to demonstrate the effects of NFS on the NAS supercomputing environment. Potential problems are addressed and an implementation strategy is proposed.

Unequal-area, fixed-shape facility layout problems using the firefly algorithm

NASA Astrophysics Data System (ADS)

Ingole, Supriya; Singh, Dinesh

2017-07-01

In manufacturing industries, the facility layout design is a very important task, as it is concerned with the overall manufacturing cost and profit of the industry. The facility layout problem (FLP) is solved by arranging the departments or facilities of known dimensions on the available floor space. The objective of this article is to implement the firefly algorithm (FA) for solving unequal-area, fixed-shape FLPs and optimizing the costs of total material handling and transportation between the facilities. The FA is a nature-inspired algorithm and can be used for combinatorial optimization problems. Benchmark problems from the previous literature are solved using the FA. To check its effectiveness, it is implemented to solve large-sized FLPs. Computational results obtained using the FA show that the algorithm is less time consuming and the total layout costs for FLPs are better than the best results achieved so far.

30 CFR 281.30 - Minimum royalty.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Minimum royalty. 281.30 Section 281.30 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR OFFSHORE LEASING OF MINERALS OTHER THAN OIL, GAS, AND SULPHUR IN THE OUTER CONTINENTAL SHELF Financial Considerations § 281.30 Minimum royalty...

30 CFR 1202.53 - Minimum royalty.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 3 2011-07-01 2011-07-01 false Minimum royalty. 1202.53 Section 1202.53 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT, DEPARTMENT OF THE INTERIOR Natural Resources Revenue ROYALTIES Oil, Gas, and OCS Sulfur, General § 1202.53 Minimum royalty. For leases that...

14 CFR 205.5 - Minimum coverage.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Minimum coverage. 205.5 Section 205.5... REGULATIONS AIRCRAFT ACCIDENT LIABILITY INSURANCE § 205.5 Minimum coverage. (a) Insurance contracts and self... maintain the following coverage: (1) Third-party aircraft accident liability coverage for bodily injury to...

A Phosphate Minimum in the Oxygen Minimum Zone (OMZ) off Peru

NASA Astrophysics Data System (ADS)

Paulmier, A.; Giraud, M.; Sudre, J.; Jonca, J.; Leon, V.; Moron, O.; Dewitte, B.; Lavik, G.; Grasse, P.; Frank, M.; Stramma, L.; Garcon, V.

2016-02-01

The Oxygen Minimum Zone (OMZ) off Peru is known to be associated with the advection of Equatorial SubSurface Waters (ESSW), rich in nutrients and poor in oxygen, through the Peru-Chile UnderCurrent (PCUC), but this circulation remains to be refined within the OMZ. During the Pelágico cruise in November-December 2010, measurements of phosphate revealed the presence of a phosphate minimum (Pmin) in various hydrographic stations, which could not be explained so far and could be associated with a specific water mass. This Pmin, localized at a relatively constant layer ( 20<220 m) and with a patchy distribution mainly between 10 and 16°S, is confirmed and characterized in details from the complementary hydrological data acquired during the German Meteor cruise M77 (Legs 3 and 4, January-February 2009). The significant Pmin present an intense minimum with a mean vertical phosphate decrease of 0.6 µM but highly variable between 0.1 and 2.2 µM. In average, these Pmin are associated with a predominant mixing of SubTropical Under- and Surface Waters (STUW and STSW: 20 and 40%, respectively) within ESSW ( 25%), complemented evenly by overlying (ESW, TSW: 8%) and underlying waters (AAIW, SPDW: 7%). The hypotheses and mechanisms leading to the Pmin formation in the OMZ are further explored and discussed, considering the physical regional contribution associated with various circulation pathways ventilating the OMZ and the local biogeochemical contribution including the potential diazotrophic activity.

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.

Water quality facility investigation report : final summary of project and evaluation of monitoring plan implementation.

DOT National Transportation Integrated Search

2005-07-05

The Oregon Department of Transportation (ODOT) has installed several stormwater : treatment facilities throughout the State to improve the quality of runoff discharged from : highways. These facilities include a variety of both above ground and below...

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.

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.

Facility Measurement Uncertainty Analysis at NASA GRC

NASA Technical Reports Server (NTRS)

Stephens, Julia; Hubbard, Erin

2016-01-01

This presentation provides and overview of the measurement uncertainty analysis currently being implemented in various facilities at NASA GRC. This presentation includes examples pertinent to the turbine engine community (mass flow and fan efficiency calculation uncertainties.

State cigarette minimum price laws - United States, 2009.

PubMed

2010-04-09

Cigarette price increases reduce the demand for cigarettes and thereby reduce smoking prevalence, cigarette consumption, and youth initiation of smoking. Excise tax increases are the most effective government intervention to increase the price of cigarettes, but cigarette manufacturers use trade discounts, coupons, and other promotions to counteract the effects of these tax increases and appeal to price-sensitive smokers. State cigarette minimum price laws, initiated by states in the 1940s and 1950s to protect tobacco retailers from predatory business practices, typically require a minimum percentage markup to be added to the wholesale and/or retail price. If a statute prohibits trade discounts from the minimum price calculation, these laws have the potential to counteract discounting by cigarette manufacturers. To assess the status of cigarette minimum price laws in the United States, CDC surveyed state statutes and identified those states with minimum price laws in effect as of December 31, 2009. This report summarizes the results of that survey, which determined that 25 states had minimum price laws for cigarettes (median wholesale markup: 4.00%; median retail markup: 8.00%), and seven of those states also expressly prohibited the use of trade discounts in the minimum retail price calculation. Minimum price laws can help prevent trade discounting from eroding the positive effects of state excise tax increases and higher cigarette prices on public health.

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...

5 CFR 838.133 - Minimum awards.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Minimum awards. 838.133 Section 838.133 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) COURT... § 838.133 Minimum awards. Payments under this part will not be less than one dollar per month. Any court...

24 CFR 200.933 - Changes in minimum property standards.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Register. As the changes are made, they will be incorporated into the volumes of the Minimum Property... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Changes in minimum property... Changes in minimum property standards. Changes in the Minimum Property Standards will generally be made...

24 CFR 200.933 - Changes in minimum property standards.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Register. As the changes are made, they will be incorporated into the volumes of the Minimum Property... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Changes in minimum property... Changes in minimum property standards. Changes in the Minimum Property Standards will generally be made...

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…

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.

Pilot Implementation and Preliminary Evaluation of START:AV Assessments in Secure Juvenile Correctional Facilities

PubMed Central

Sellers, Brian G; Viljoen, Jodi L.; Cruise, Keith R.; Nicholls, Tonia L.; Dvoskin, Joel A.

2012-01-01

The Short-Term Assessment of Risk and Treatability: Adolescent Version (START:AV) is a new structured professional judgment guide for assessing short-term risks in adolescents. The scheme may be distinguished from other youth risk assessment and treatment planning instruments by its inclusion of 23 dynamic factors that are each rated for both vulnerability and strength. In addition, START:AV is also unique in that it focuses on multiple adverse outcomes—namely, violence, self-harm, suicide, unauthorized leave, substance abuse, self-neglect, victimization, and general offending—over the short-term (i.e., weeks to months) rather than long-term (i.e., years). This paper describes a pilot implementation and preliminary evaluation of START:AV in three secure juvenile correctional facilities in the southern United States. Specifically, we examined the descriptive characteristics and psychometric properties of START:AV assessments completed by 21 case managers on 291 adolescent offenders (250 boys and 41 girls) at the time of admission. Results provide preliminary support for the feasibility of completing START:AV assessments as part of routine practice. Findings also highlight differences in the characteristics of START:AV assessments for boys and girls and differential associations between the eight START:AV risk domains. Though results are promising, further research is needed to establish the reliability and validity of START:AV assessments completed in the field. PMID:23316116

ACSB: A minimum performance assessment

NASA Technical Reports Server (NTRS)

Jones, Lloyd Thomas; Kissick, William A.

1988-01-01

Amplitude companded sideband (ACSB) is a new modulation technique which uses a much smaller channel width than does conventional frequency modulation (FM). Among the requirements of a mobile communications system is adequate speech intelligibility. This paper explores this aspect of minimum required performance. First, the basic principles of ACSB are described, with emphasis on those features that affect speech quality. Second, the appropriate performance measures for ACSB are reviewed. Third, a subjective voice quality scoring method is used to determine the values of the performance measures that equate to the minimum level of intelligibility. It is assumed that the intelligibility of an FM system operating at 12 dB SINAD represents that minimum. It was determined that ACSB operating at 12 dB SINAD with an audio-to-pilot ratio of 10 dB provides approximately the same intelligibility as FM operating at 12 dB SINAD.

Experimental investigations of the minimum ignition energy and the minimum ignition temperature of inert and combustible dust cloud mixtures.

PubMed

Addai, Emmanuel Kwasi; Gabel, Dieter; Krause, Ulrich

2016-04-15

The risks associated with dust explosions still exist in industries that either process or handle combustible dust. This explosion risk could be prevented or mitigated by applying the principle of inherent safety (moderation). This is achieved by adding an inert material to a highly combustible material in order to decrease the ignition sensitivity of the combustible dust. The presented paper deals with the experimental investigation of the influence of adding an inert dust on the minimum ignition energy and the minimum ignition temperature of the combustible/inert dust mixtures. The experimental investigation was done in two laboratory scale equipment: the Hartmann apparatus and the Godbert-Greenwald furnace for the minimum ignition energy and the minimum ignition temperature test respectively. This was achieved by mixing various amounts of three inert materials (magnesium oxide, ammonium sulphate and sand) and six combustible dusts (brown coal, lycopodium, toner, niacin, corn starch and high density polyethylene). Generally, increasing the inert materials concentration increases the minimum ignition energy as well as the minimum ignition temperatures until a threshold is reached where no ignition was obtained. The permissible range for the inert mixture to minimize the ignition risk lies between 60 to 80%. Copyright © 2016 Elsevier B.V. All rights reserved.

Skilled nursing facilities reform.

PubMed

1998-06-01

The Medicare prospective payment system for skilled nursing facilities will take effect with cost reporting years beginning on or after July 1, 1998. HCFA is working on the implementation details. While final details are not expected to be published until Summer 1998, the following information has been provided through HCFA and/or the Nursing Home Case-Mix and Quality (NHCMQ) Demonstration project (RUGs-III) procedures.

Minimum nurse staffing legislation and the financial performance of California hospitals.

PubMed

Reiter, Kristin L; Harless, David W; Pink, George H; Mark, Barbara A

2012-06-01

To estimate the effect of minimum nurse staffing ratios on California acute care hospitals' financial performance. Secondary data from Medicare cost reports, the American Hospital Association's (AHA) Annual Survey, and the California Office of Statewide Health Planning and Development (OSHPD) are combined from 2000 to 2006 for 203 hospitals in California and 407 hospitals in 12 comparison states. The study employs a difference-in-difference analytical approach. Hospitals are grouped into quartiles based on pre-regulation nurse staffing levels in adult medical-surgical and pediatric units (quartile 1=lowest staffing). Differences in operating margin, operating expenses per day, and inpatient operating expenses per discharge for California hospitals within a staffing quartile during the period of regulation are compared to differences at hospitals in comparison states during the same period. Hospital data from Medicare cost reports are merged with nurse staffing measures obtained from AHA and from OSPHD. Relative to hospitals in comparison states, operating margins declined significantly for California hospitals in quartiles 2 and 3. Operating expenses increased significantly in quartiles 1, 2, and 3. Implementation of minimum nurse staffing legislation in California put substantial financial pressure on some hospitals. © Health Research and Educational Trust.

Community Discharge of Nursing Home Residents: The Role of Facility Characteristics.

PubMed

Holup, Amanda A; Gassoumis, Zachary D; Wilber, Kathleen H; Hyer, Kathryn

2016-04-01

Using a socio-ecological model, this study examines the influence of facility characteristics on the transition of nursing home residents to the community after a short stay (within 90 days of admission) or long stay (365 days of admission) across states with different long-term services and supports systems. Data were drawn from the Minimum Data Set, the federal Online Survey, Certification, and Reporting (OSCAR) database, the Area Health Resource File, and the LTCFocUs.org database for all free-standing, certified nursing homes in California (n = 1,127) and Florida (n = 657) from July 2007 to June 2008. Hierarchical generalized linear models were used to examine the impact of facility characteristics on the probability of transitioning to the community. Facility characteristics, including size, occupancy, ownership, average length of stay, proportion of Medicare and Medicaid residents, and the proportion of residents admitted from acute care facilities are associated with discharge but differed by state and whether the discharge occurred after a short or long stay. Short- and long-stay nursing home discharge to the community is affected by resident, facility, and sometimes market characteristics, with Medicaid consistently influencing discharge in both states. © Health Research and Educational Trust.

7 CFR 953.43 - Minimum standards of quality.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Minimum standards of quality. 953.43 Section 953.43... SOUTHEASTERN STATES Order Regulating Handling Regulations § 953.43 Minimum standards of quality. (a) Recommendation. Whenever the committee deems it advisable to establish and maintain minimum standards of quality...

7 CFR 953.43 - Minimum standards of quality.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 8 2013-01-01 2013-01-01 false Minimum standards of quality. 953.43 Section 953.43... SOUTHEASTERN STATES Order Regulating Handling Regulations § 953.43 Minimum standards of quality. (a) Recommendation. Whenever the committee deems it advisable to establish and maintain minimum standards of quality...

7 CFR 953.43 - Minimum standards of quality.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Minimum standards of quality. 953.43 Section 953.43... SOUTHEASTERN STATES Order Regulating Handling Regulations § 953.43 Minimum standards of quality. (a) Recommendation. Whenever the committee deems it advisable to establish and maintain minimum standards of quality...

7 CFR 953.43 - Minimum standards of quality.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 8 2014-01-01 2014-01-01 false Minimum standards of quality. 953.43 Section 953.43... SOUTHEASTERN STATES Order Regulating Handling Regulations § 953.43 Minimum standards of quality. (a) Recommendation. Whenever the committee deems it advisable to establish and maintain minimum standards of quality...

7 CFR 953.43 - Minimum standards of quality.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 8 2012-01-01 2012-01-01 false Minimum standards of quality. 953.43 Section 953.43... SOUTHEASTERN STATES Order Regulating Handling Regulations § 953.43 Minimum standards of quality. (a) Recommendation. Whenever the committee deems it advisable to establish and maintain minimum standards of quality...

The Politics of Evidence Use in Health Policy Making in Germany-the Case of Regulating Hospital Minimum Volumes.

PubMed

Ettelt, Stefanie

2017-06-01

This article examines the role of scientific evidence in informing health policy decisions in Germany, using minimum volumes policy as a case study. It argues that scientific evidence was used strategically at various stages of the policy process both by individual corporatist actors and by the Federal Joint Committee as the regulator. Minimum volumes regulation was inspired by scientific evidence suggesting a positive relationship between service volume and patient outcomes for complex surgical interventions. Federal legislation was introduced in 2002 to delegate the selection of services and the setting of volumes to corporatist decision makers. Yet, despite being represented in the Federal Joint Committee, hospitals affected by its decisions took the Committee to court to seek legal redress and prevent policy implementation. Evidence has been key to support, and challenge, decisions about minimum volumes, including in court. The analysis of the role of scientific evidence in minimum volumes regulation in Germany highlights the dynamic relationship between evidence use and the political and institutional context of health policy making, which in this case is characterized by the legislative nature of policy making, corporatism, and the role of the judiciary in reviewing policy decisions. Copyright © 2017 by Stefanie Ettelt.

MIP models for connected facility location: A theoretical and computational study☆

PubMed Central

Gollowitzer, Stefan; Ljubić, Ivana

2011-01-01

This article comprises the first theoretical and computational study on mixed integer programming (MIP) models for the connected facility location problem (ConFL). ConFL combines facility location and Steiner trees: given a set of customers, a set of potential facility locations and some inter-connection nodes, ConFL searches for the minimum-cost way of assigning each customer to exactly one open facility, and connecting the open facilities via a Steiner tree. The costs needed for building the Steiner tree, facility opening costs and the assignment costs need to be minimized. We model ConFL using seven compact and three mixed integer programming formulations of exponential size. We also show how to transform ConFL into the Steiner arborescence problem. A full hierarchy between the models is provided. For two exponential size models we develop a branch-and-cut algorithm. An extensive computational study is based on two benchmark sets of randomly generated instances with up to 1300 nodes and 115,000 edges. We empirically compare the presented models with respect to the quality of obtained bounds and the corresponding running time. We report optimal values for all but 16 instances for which the obtained gaps are below 0.6%. PMID:25009366

Implementing an Internet-based communication network for use during skilled nursing facility to emergency department care transitions: challenges and opportunities for improvement.

PubMed

Hustey, Fredric M; Palmer, Robert M

2012-03-01

To explore the feasibility of implementing an Internet-based communication network for communication of health care information during skilled nursing facility (SNF)-to-ED care transitions, and to identify potential barriers to system implementation. Qualitative. The largest SNF affiliated with the ED of an urban tertiary care center. Consecutive sample of all patients transferred from SNF to ED over 8 months between June 2007 and January 2008; ED and SNF care providers. The development and implementation of an Internet-based communication network for use during SNF-to-ED care transitions. This network was developed by adapting a preexisting Internet-based system that is widely used to facilitate placement of hospitalized patients into SNFs. Internet-based SNF and ED surveys were used to help identify barriers to implementation. There were 276/276 care transitions reviewed. The Internet-based communication network was used in 76 (28%) care transitions, with usage peaking at 40% near the end of the study. Barriers to success that were identified included lack of an electronic medical record (EMR) at the SNF; pervasive negative attitudes between ED and SNF personnel; time necessary for network use during care transitions; frustration by emergency physicians at low system usage rates by SNF personnel; and additional login requirements by ED personnel. Although implementing an Internet-based network for nursing home to ED communication may be feasible, significant barriers were identified in this study that are likely generalizable to other health care settings. Understanding such barriers is an essential first step toward building successful electronic communication networks in the future. Copyright © 2012 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

50 CFR 648.165 - Bluefish minimum fish sizes.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 50 Wildlife and Fisheries 12 2014-10-01 2014-10-01 false Bluefish minimum fish sizes. 648.165... Measures for the Atlantic Bluefish Fishery § 648.165 Bluefish minimum fish sizes. If the MAFMC determines through its annual review or framework adjustment process that minimum fish sizes are necessary to ensure...

50 CFR 648.93 - Monkfish minimum fish sizes.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 50 Wildlife and Fisheries 12 2012-10-01 2012-10-01 false Monkfish minimum fish sizes. 648.93... Measures for the NE Multispecies and Monkfish Fisheries § 648.93 Monkfish minimum fish sizes. (a) General... fish size requirements established in this section. Minimum Fish Sizes (Total Length/Tail Length) Total...

50 CFR 648.165 - Bluefish minimum fish sizes.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 50 Wildlife and Fisheries 12 2013-10-01 2013-10-01 false Bluefish minimum fish sizes. 648.165... Measures for the Atlantic Bluefish Fishery § 648.165 Bluefish minimum fish sizes. If the MAFMC determines through its annual review or framework adjustment process that minimum fish sizes are necessary to ensure...

50 CFR 648.93 - Monkfish minimum fish sizes.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 50 Wildlife and Fisheries 12 2013-10-01 2013-10-01 false Monkfish minimum fish sizes. 648.93... Measures for the NE Multispecies and Monkfish Fisheries § 648.93 Monkfish minimum fish sizes. (a) General... fish size requirements established in this section. Minimum Fish Sizes (Total Length/Tail Length) Total...

50 CFR 648.93 - Monkfish minimum fish sizes.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 50 Wildlife and Fisheries 10 2011-10-01 2011-10-01 false Monkfish minimum fish sizes. 648.93... Measures for the NE Multispecies and Monkfish Fisheries § 648.93 Monkfish minimum fish sizes. (a) General... fish size requirements established in this section. Minimum Fish Sizes (Total Length/Tail Length) Total...

50 CFR 648.165 - Bluefish minimum fish sizes.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 50 Wildlife and Fisheries 12 2012-10-01 2012-10-01 false Bluefish minimum fish sizes. 648.165... Measures for the Atlantic Bluefish Fishery § 648.165 Bluefish minimum fish sizes. If the MAFMC determines through its annual review or framework adjustment process that minimum fish sizes are necessary to ensure...

50 CFR 648.93 - Monkfish minimum fish sizes.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Monkfish minimum fish sizes. 648.93... Measures for the NE Multispecies and Monkfish Fisheries § 648.93 Monkfish minimum fish sizes. (a) General... fish size requirements established in this section. Minimum Fish Sizes (Total Length/Tail Length) Total...

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

ERIC Educational Resources Information Center

Wright, Tim; Hyner, Gerald C.

2011-01-01

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

A proposed minimum data set for international primary care optometry: a modified Delphi study.

PubMed

Davey, Christopher J; Slade, Sarah V; Shickle, Darren

2017-07-01

To identify a minimum list of metrics of international relevance to public health, research and service development which can be extracted from practice management systems and electronic patient records in primary optometric practice. A two stage modified Delphi technique was used. Stage 1 categorised metrics that may be recorded as being part of a primary eye examination by their importance to research using the results from a previous survey of 40 vision science and public health academics. Delphi stage 2 then gauged the opinion of a panel of seven vision science academics and achieved consensus on contentious metrics and methods of grading/classification. A consensus regarding inclusion and response categories was achieved for nearly all metrics. A recommendation was made of 53 metrics which would be appropriate in a minimum data set. This minimum data set should be easily integrated into clinical practice yet allow vital data to be collected internationally from primary care optometry. It should not be mistaken for a clinical guideline and should not add workload to the optometrist. A pilot study incorporating an additional Delphi stage prior to implementation is advisable to refine some response categories. © 2017 The Authors. Ophthalmic and Physiological Optics published by John Wiley & Sons Ltd on behalf of College of Optometrists.

10 CFR 63.47 - Facility information and verification.

Code of Federal Regulations, 2011 CFR

2011-01-01

... REPOSITORY AT YUCCA MOUNTAIN, NEVADA Licenses Us/iaea Safeguards Agreement § 63.47 Facility information and... the International Atomic Energy Agency (IAEA) and take other action as necessary to implement the US...

10 CFR 63.47 - Facility information and verification.

Code of Federal Regulations, 2010 CFR

2010-01-01

... REPOSITORY AT YUCCA MOUNTAIN, NEVADA Licenses Us/iaea Safeguards Agreement § 63.47 Facility information and... the International Atomic Energy Agency (IAEA) and take other action as necessary to implement the US...

10 CFR 60.47 - Facility information and verification.

Code of Federal Regulations, 2011 CFR

2011-01-01

... REPOSITORIES Licenses Us/iaea Safeguards Agreement § 60.47 Facility information and verification. (a) In... International Atomic Energy Agency (IAEA) and take other action as necessary to implement the US/IAEA Safeguards...

10 CFR 61.32 - Facility information and verification.

Code of Federal Regulations, 2010 CFR

2010-01-01

... WASTE Licenses Us/iaea Safeguards Agreement § 61.32 Facility information and verification. (a) In... as necessary to implement the US/IAEA Safeguards Agreement, as described in Part 75 of this chapter...

14 CFR 91.157 - Special VFR weather minimums.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false Special VFR weather minimums. 91.157... Flight Rules § 91.157 Special VFR weather minimums. (a) Except as provided in appendix D, section 3, of this part, special VFR operations may be conducted under the weather minimums and requirements of this...

14 CFR 91.157 - Special VFR weather minimums.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 2 2014-01-01 2014-01-01 false Special VFR weather minimums. 91.157... Flight Rules § 91.157 Special VFR weather minimums. (a) Except as provided in appendix D, section 3, of this part, special VFR operations may be conducted under the weather minimums and requirements of this...

14 CFR 91.157 - Special VFR weather minimums.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 2 2012-01-01 2012-01-01 false Special VFR weather minimums. 91.157... Flight Rules § 91.157 Special VFR weather minimums. (a) Except as provided in appendix D, section 3, of this part, special VFR operations may be conducted under the weather minimums and requirements of this...

14 CFR 91.157 - Special VFR weather minimums.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Special VFR weather minimums. 91.157... Flight Rules § 91.157 Special VFR weather minimums. (a) Except as provided in appendix D, section 3, of this part, special VFR operations may be conducted under the weather minimums and requirements of this...

14 CFR 91.157 - Special VFR weather minimums.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false Special VFR weather minimums. 91.157... Flight Rules § 91.157 Special VFR weather minimums. (a) Except as provided in appendix D, section 3, of this part, special VFR operations may be conducted under the weather minimums and requirements of this...

50 CFR 648.93 - Monkfish minimum fish sizes.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 50 Wildlife and Fisheries 12 2014-10-01 2014-10-01 false Monkfish minimum fish sizes. 648.93... Measures for the NE Multispecies and Monkfish Fisheries § 648.93 Monkfish minimum fish sizes. (a) General provisions. All monkfish caught by vessels issued a valid Federal monkfish permit must meet the minimum fish...

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.

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.

50 CFR 622.454 - Minimum size limit.

Code of Federal Regulations, 2013 CFR

2013-10-01

... ADMINISTRATION, DEPARTMENT OF COMMERCE FISHERIES OF THE CARIBBEAN, GULF OF MEXICO, AND SOUTH ATLANTIC Spiny Lobster Fishery of Puerto Rico and the U.S. Virgin Islands § 622.454 Minimum size limit. (a) The minimum...

50 CFR 622.454 - Minimum size limit.

Code of Federal Regulations, 2014 CFR

2014-10-01

... ADMINISTRATION, DEPARTMENT OF COMMERCE FISHERIES OF THE CARIBBEAN, GULF OF MEXICO, AND SOUTH ATLANTIC Spiny Lobster Fishery of Puerto Rico and the U.S. Virgin Islands § 622.454 Minimum size limit. (a) The minimum...

Minimum Covers of Fixed Cardinality in Weighted Graphs.

ERIC Educational Resources Information Center

White, Lee J.

Reported is the result of research on combinatorial and algorithmic techniques for information processing. A method is discussed for obtaining minimum covers of specified cardinality from a given weighted graph. By the indicated method, it is shown that the family of minimum covers of varying cardinality is related to the minimum spanning tree of…

50 CFR 648.126 - Scup minimum fish sizes.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 50 Wildlife and Fisheries 12 2014-10-01 2014-10-01 false Scup minimum fish sizes. 648.126 Section... Scup Fishery § 648.126 Scup minimum fish sizes. (a) Moratorium (commercially) permitted vessels. The... whole fish or any part of a fish found in possession, e.g., fillets. These minimum sizes may be adjusted...

50 CFR 648.126 - Scup minimum fish sizes.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 50 Wildlife and Fisheries 12 2012-10-01 2012-10-01 false Scup minimum fish sizes. 648.126 Section... Scup Fishery § 648.126 Scup minimum fish sizes. (a) Moratorium (commercially) permitted vessels. The... whole fish or any part of a fish found in possession, e.g., fillets. These minimum sizes may be adjusted...

50 CFR 648.126 - Scup minimum fish sizes.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 50 Wildlife and Fisheries 12 2013-10-01 2013-10-01 false Scup minimum fish sizes. 648.126 Section... Scup Fishery § 648.126 Scup minimum fish sizes. (a) Moratorium (commercially) permitted vessels. The... whole fish or any part of a fish found in possession, e.g., fillets. These minimum sizes may be adjusted...

Fundraising Basics for Private School Facilities.

ERIC Educational Resources Information Center

Roach, Arthur H.

This report examines the process behind setting up and implementing a "capital campaign," a program for raising money for new or renovated facilities at private K-12 schools. The report briefly covers tax information regarding gifts to institutions, then offers advice for setting up a comprehensive development program, including…

50 CFR 622.492 - Minimum size limit.

Code of Federal Regulations, 2013 CFR

2013-10-01

... ADMINISTRATION, DEPARTMENT OF COMMERCE FISHERIES OF THE CARIBBEAN, GULF OF MEXICO, AND SOUTH ATLANTIC Queen Conch Resources of Puerto Rico and the U.S. Virgin Islands § 622.492 Minimum size limit. (a) The minimum size...

50 CFR 622.492 - Minimum size limit.

Code of Federal Regulations, 2014 CFR

2014-10-01

... ADMINISTRATION, DEPARTMENT OF COMMERCE FISHERIES OF THE CARIBBEAN, GULF OF MEXICO, AND SOUTH ATLANTIC Queen Conch Resources of Puerto Rico and the U.S. Virgin Islands § 622.492 Minimum size limit. (a) The minimum size...

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...

How unprecedented a solar minimum was it?

PubMed

Russell, C T; Jian, L K; Luhmann, J G

2013-05-01

The end of the last solar cycle was at least 3 years late, and to date, the new solar cycle has seen mainly weaker activity since the onset of the rising phase toward the new solar maximum. The newspapers now even report when auroras are seen in Norway. This paper is an update of our review paper written during the deepest part of the last solar minimum [1]. We update the records of solar activity and its consequent effects on the interplanetary fields and solar wind density. The arrival of solar minimum allows us to use two techniques that predict sunspot maximum from readings obtained at solar minimum. It is clear that the Sun is still behaving strangely compared to the last few solar minima even though we are well beyond the minimum phase of the cycle 23-24 transition.

Can a GIS toolbox assess the environmental risk of oil spills? Implementation for oil facilities in harbors.

PubMed

Valdor, Paloma F; Gómez, Aina G; Velarde, Víctor; Puente, Araceli

2016-04-01

Oil spills are one of the most widespread problems in port areas (loading/unloading of bulk liquid, fuel supply). Specific environmental risk analysis procedures for diffuse oil sources that are based on the evolution of oil in the marine environment are needed. Diffuse sources such as oil spills usually present a lack of information, which makes the use of numerical models an arduous and occasionally impossible task. For that reason, a tool that can assess the risk of oil spills in near-shore areas by using Geographical Information System (GIS) is presented. The SPILL Tool provides immediate results by automating the process without miscalculation errors. The tool was developed using the Python and ArcGIS scripting library to build a non-ambiguous geoprocessing workflow. The SPILL Tool was implemented for oil facilities at Tarragona Harbor (NE Spain) and validated showing a satisfactory correspondence (around 0.60 RSR error index) with the results obtained using a 2D calibrated oil transport numerical model. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Economic Impact of Implementing the Cincinnati Public Schools' Facilities Master Plan on Greater Cincinnati.

ERIC Educational Resources Information Center

Rexhausen, Jeff

The construction proposed in the Cincinnati Public Schools' Facilities Master Plan will have a significant impact on the greater Cincinnati, Ohio, economy. Highlights include: (1) the Facilities Master Plan of the Cincinnati Public Schools envisions a 10-year program with $985 million in construction spending. The funding of this program includes…

California's Class Size Reduction: Implications for Equity, Practice & Implementation.

ERIC Educational Resources Information Center

Wexler, Edward; Izu, JoAnn; Carlos, Lisa; Fuller, Bruce; Hayward, Gerald; Kirst, Mike

When California implemented its class-size reduction (CSR) program in 1996, a number of questions regarding financial burdens, teacher shortages, scarcity of facilities, and collective bargaining were raised. This first-year implementation study aims to provide some contextual information as background for answering questions, to clarify these…

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

Fundraising Basics for Private School Facilities

ERIC Educational Resources Information Center

Roach, Arthur H.

2009-01-01

This report examines the process behind setting up and implementing a "capital campaign": a program for raising money for new or renovated facilities at private K-12 schools. The report covers tax information regarding gifts to institutions then offers advice for setting up a comprehensive development program, including fundraising software and…

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…

47 CFR 22.951 - Minimum coverage requirement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Minimum coverage requirement. 22.951 Section 22.951 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Cellular Radiotelephone Service § 22.951 Minimum coverage requirement. Applications for...

Minimum initial service package (MISP) for sexual and reproductive health in disasters.

PubMed

Lisam, Suchitra

2014-12-01

This paper is based on a presentation given at the Evidence Aid Symposium, on 20 September 2014, at Hyderabad, India. The paper provides background about how the sexual and reproductive health (SRH) got conceived as a humanitarian health response that adopts human right approach, based on core principles driven by needs of adolescent girls and women, and having respect for their values, ethics and morals. Good practices across nations documented by Inter-Agency Working Groups (IAWGs) on Reproductive Health in Humanitarian Crisis has supported the provision of essential SRH care services to adolescent girls and women in humanitarian crisis and in disasters. Secondary desk review is used to document the lessons learnt and good practices followed and documents for SRH. These essential SRH care services are to be provided as "Minimum Initial Service Package (MISP)" for implementation at the outset of disaster. The Sphere Humanitarian Charter and Minimum Standards in Disaster Response incorporated the MISP for SRH as a minimum standard of care in disaster response with a goal to reduce mortality, morbidity and disability among populations affected by crises, particularly women and girls. Disaster prone countries are expected to roll out MISP to improve humanitarian response and emergency preparedness systems. The East Europe and Central Asia (EECA) region including India have rolled out MISP starting from 2011 (EECA) and from 2013-2014 onwards in India across cities such as Chennai, Patna, Bhubaneshwar, Kolkata, Faridabad and Calcutta. Across India, through these national and state level trainings, nearly 600 people from NGOs, institutions, and government agencies were developed as national level trainers and resource persons for MISP who could advocate for RH in emergencies, apply core techniques provided in the MISP, apply coordination skills for the implementation of MISP and develop an action plan to integrate RH and Gender Based Violence (GBV) into Disaster

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.

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.

Minimum entropy deconvolution and blind equalisation

NASA Technical Reports Server (NTRS)

Satorius, E. H.; Mulligan, J. J.

1992-01-01

Relationships between minimum entropy deconvolution, developed primarily for geophysics applications, and blind equalization are pointed out. It is seen that a large class of existing blind equalization algorithms are directly related to the scale-invariant cost functions used in minimum entropy deconvolution. Thus the extensive analyses of these cost functions can be directly applied to blind equalization, including the important asymptotic results of Donoho.

Floor vibration evaluations for medical facilities

NASA Astrophysics Data System (ADS)

Himmel, Chad N.

2003-10-01

The structural floor design for new medical facilities is often selected early in the design phase and in renovation projects, the floor structure already exists. Because the floor structure can often have an influence on the location of vibration sensitive medical equipment and facilities, it is becoming necessary to identify the best locations for equipment and facilities early in the design process. Even though specific criteria for vibration-sensitive uses and equipment may not always be available early in the design phase, it should be possible to determine compatible floor structures for planned vibration-sensitive uses by comparing conceptual layouts with generic floor vibration criteria. Relatively simple evaluations of planned uses and generic criteria, combined with on-site vibration and noise measurements early in design phase, can significantly reduce future design problems and expense. Concepts of evaluation procedures and analyses will be presented in this paper. Generic floor vibration criteria and appropriate parameters to control resonant floor vibration and noise will be discussed for typical medical facilities and medical research facilities. Physical, economic, and logistical limitations that affect implementation will be discussed through case studies.

Common ground, not a battle ground. Violence prevention at a detoxification facility.

PubMed

Adamson, Mary A; Vincent, Audrey A; Cundiff, Jeff

2009-08-01

This article evaluates the results of a workplace violence prevention program implemented in a Colorado detoxification facility. The program interventions are modeled after federal Occupational Safety and Health Administration guidelines and use theories from both nursing and criminology for philosophy and direction. Serving as its own control, the detoxification facility shares data measured over a 4-year period, demonstrating a sharp decline in assault rates after program implementation. The importance of administrative controls, environmental adjustments, recordkeeping and evaluation, and education and training are emphasized as key components of success. Copyright (c) 2009, SLACK Incorporated.

Implementing a Reentry Framework at a Correctional Facility: Challenges to the Culture

ERIC Educational Resources Information Center

Rudes, Danielle S.; Lerch, Jennifer; Taxman, Faye S.

2011-01-01

Implementation research is emerging in the field of corrections, but few studies have examined the complexities associated with implementing change among frontline workers embedded in specific organizational cultures. Using a mixed methods approach, the authors examine the challenges faced by correctional workers in a work release correctional…

Site maps and facilities listings

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

Not Available

1993-11-01

In September 1989, a Memorandum of Agreement among DOE offices regarding the environmental management of DOE facilities was signed by appropriate Assistant Secretaries and Directors. This Memorandum of Agreement established the criteria for EM line responsibility. It stated that EM would be responsible for all DOE facilities, operations, or sites (1) that have been assigned to DOE for environmental restoration and serve or will serve no future production need; (2) that are used for the storage, treatment, or disposal of hazardous, radioactive, and mixed hazardous waste materials that have been properly characterized, packaged, and labelled, but are not used formore » production; (3) that have been formally transferred to EM by another DOE office for the purpose of environmental restoration and the eventual return to service as a DOE production facility; or (4) that are used exclusively for long-term storage of DOE waste material and are not actively used for production, with the exception of facilities, operations, or sites under the direction of the DOE Office of Civilian Radioactive Waste Management. As part of the implementation of the Memorandum of Agreement, Field Offices within DOE submitted their listings of facilities, systems, operation, and sites for which EM would have line responsibility. It is intended that EM facility listings will be revised on a yearly basis so that managers at all levels will have a valid reference for the planning, programming, budgeting and execution of EM activities.« less

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.…

Data Element Dictionary: Facilities. Second Edition.

ERIC Educational Resources Information Center

Martin, James S.

This document is intended to serve as a guide for institutions in the development of data bases to support the implementation of planning and management systems. This publication serves to identify and describe those facilities-related data elements: (1) required to support current National Center for Higher Education Management Systems (NCHEMS)…

9 CFR 2.130 - Minimum age requirements.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Minimum age requirements. 2.130... AGRICULTURE ANIMAL WELFARE REGULATIONS Miscellaneous § 2.130 Minimum age requirements. No dog or cat shall be... least eight (8) weeks of age and has been weaned. ...

9 CFR 2.130 - Minimum age requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Minimum age requirements. 2.130... AGRICULTURE ANIMAL WELFARE REGULATIONS Miscellaneous § 2.130 Minimum age requirements. No dog or cat shall be... least eight (8) weeks of age and has been weaned. ...

9 CFR 2.130 - Minimum age requirements.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Minimum age requirements. 2.130... AGRICULTURE ANIMAL WELFARE REGULATIONS Miscellaneous § 2.130 Minimum age requirements. No dog or cat shall be... least eight (8) weeks of age and has been weaned. ...

9 CFR 2.130 - Minimum age requirements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Minimum age requirements. 2.130... AGRICULTURE ANIMAL WELFARE REGULATIONS Miscellaneous § 2.130 Minimum age requirements. No dog or cat shall be... least eight (8) weeks of age and has been weaned. ...

14 CFR 135.203 - VFR: Minimum altitudes.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false VFR: Minimum altitudes. 135.203 Section 135.203 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED... Operating Limitations and Weather Requirements § 135.203 VFR: Minimum altitudes. Except when necessary for...

14 CFR 135.203 - VFR: Minimum altitudes.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false VFR: Minimum altitudes. 135.203 Section 135.203 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED... Operating Limitations and Weather Requirements § 135.203 VFR: Minimum altitudes. Except when necessary for...

14 CFR 135.203 - VFR: Minimum altitudes.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false VFR: Minimum altitudes. 135.203 Section 135.203 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED... Operating Limitations and Weather Requirements § 135.203 VFR: Minimum altitudes. Except when necessary for...

77 FR 58707 - Minimum Internal Control Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-21

... Gaming Commission 25 CFR Part 543 Minimum Internal Control Standards; Final Rule #0;#0;Federal Register... Control Standards AGENCY: National Indian Gaming Commission, Interior. ACTION: Final rule. SUMMARY: The National Indian Gaming Commission (NIGC) amends its minimum internal control standards for Class II gaming...

78 FR 11793 - Minimum Internal Control Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-20

... Internal Control Standards AGENCY: National Indian Gaming Commission. ACTION: Proposed rule. SUMMARY: The National Indian Gaming Commission (NIGC) proposes to amend its minimum internal control standards for Class... NIGC published a final rule in the Federal Register called Minimum Internal Control Standards. 64 FR...

77 FR 32444 - Minimum Internal Control Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-01

... Internal Control Standards AGENCY: National Indian Gaming Commission. ACTION: Proposed rule. SUMMARY: The National Indian Gaming Commission (NIGC) proposes to amend its minimum internal control standards for Class... the Federal Register called Minimum Internal Control Standards. 64 FR 590. The rule added a new part...

The conservation message of the rehabilitated facilities of the International Institute of Tropical Forestry

Treesearch

Ariel Lugo; J. Rullan

2015-01-01