Sample records for facility general service

  1. General service and child immunization-specific readiness assessment of healthcare facilities in two selected divisions in Bangladesh.

    PubMed

    Shawon, Md Shajedur Rahman; Adhikary, Gourab; Ali, Md Wazed; Shamsuzzaman, Md; Ahmed, Shahabuddin; Alam, Nurul; Shackelford, Katya A; Woldeab, Alexander; Lim, Stephen S; Levine, Aubrey; Gakidou, Emmanuela; Uddin, Md Jasim

    2018-01-25

    Service readiness of health facilities is an integral part of providing comprehensive quality healthcare to the community. Comprehensive assessment of general and service-specific (i.e. child immunization) readiness will help to identify the bottlenecks in healthcare service delivery and gaps in equitable service provision. Assessing healthcare facilities readiness also helps in optimal policymaking and resource allocation. A health facility survey was conducted between March 2015 and December 2015 in two purposively selected divisions in Bangladesh; i.e. Rajshahi division (high performing) and Sylhet division (low performing). A total of 123 health facilities were randomly selected from different levels of service, both public and private, with variation in sizes and patient loads from the list of facilities. Data on various aspects of healthcare facility were collected by interviewing key personnel. General service and child immunization specific service readiness were assessed using the Service Availability and Readiness Assessment (SARA) manual developed by World Health Organization (WHO). The analyses were stratified by division and level of healthcare facilities. The general service readiness index for pharmacies, community clinics, primary care facilities and higher care facilities were 40.6%, 60.5%, 59.8% and 69.5%, respectively in Rajshahi division and 44.3%, 57.8%, 57.5% and 73.4%, respectively in Sylhet division. Facilities at all levels had the highest scores for basic equipment (ranged between 51.7% and 93.7%) and the lowest scores for diagnostic capacity (ranged between 0.0% and 53.7%). Though facilities with vaccine storage capacity had very high levels of service readiness for child immunization, facilities without vaccine storage capacity lacked availability of many tracer items. Regarding readiness for newly introduced pneumococcal conjugate vaccine (PCV) and inactivated polio vaccine (IPV), most of the surveyed facilities reported lack of

  2. Savannah River Plant engineering and design history. Volume 4: 300/700 Areas & general services and facilities

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

    Not Available

    1957-01-01

    The primary function of the 300 Area is the production and preparation of the fuel and target elements required for the 100 Area production reactors. Uranium slugs and lithium-aluminium alloy control and blanket rods are prepared in separate structures. Other facilities include a test pile, a physics assembly laboratory, an office and change house, an electrical substation, and various service facilities such as rail lines, roads, sewers, steam and water distribution lines, etc. The 700 Area contains housing and facilities for plant management, general plant services, and certain technical activities. The technical buildings include the Main Technical Laboratory, the Wastemore » Concentration Building, the Health Physics Headquarters, and the Health Physics Calibration building. Sections of this report describe the following: development of the 300-M Area; selection and description of process; design of main facilities of the 300 Area; development of the 700-A Area; design of the main facilities of the 700 Area; and general services and facilities, including transportation, plant protection, waste disposal and drainage, site work, pilot plants, storage, and furniture and fixtures.« less

  3. POLLUTION PREVENTION OPPORTUNITY ASSESSMENT: GENERAL MAIL AND VEHICLE MAINTENANCE FACILITY, UNITED STATES POSTAL SERVICE, BUFFALO, NY

    EPA Science Inventory

    The Pollution Prevention Opportunity Assessment (PPOA) summarized here was conducted at a U.S.Postal Service (USPS) Facility in Buffalo, NY. The PPOA documented and quantified waste generation at the General Mail Facility (GMF) where mail is processed, and at the Vehicle Maintena...

  4. Service quality in contracted facilities.

    PubMed

    Rabbani, Fauziah; Pradhan, Nousheen Akber; Zaidi, Shehla; Azam, Syed Iqbal; Yousuf, Farheen

    2015-01-01

    The purpose of this paper is to explore the readiness of contracted and non-contracted first-level healthcare facilities in Pakistan to deliver quality maternal and neonatal health (MNH) care. A balanced scorecard (BSC) was used as the assessment framework. Using a cross-sectional study design, two rural health centers (RHCs) contracted out to Aga Khan Health Service, Pakistan were compared with four government managed RHCs. A BSC was designed to assess RHC readiness to deliver good quality MNH care. In total 20 indicators were developed, representing five BSC domains: health facility functionality, service provision, staff capacity, staff and patient satisfaction. Validated data collection tools were used to collect information. Pearson χ2, Fisher's Exact and the Mann-Whitney tests were applied as appropriate to detect significant service quality differences among the two facilities. Contracted facilities were generally found to be better than non-contracted facilities in all five BSC domains. Patients' inclination for facility-based delivery at contracted facilities was, however, significantly higher than non-contracted facilities (80 percent contracted vs 43 percent non-contracted, p=0.006). The study shows that contracting out initiatives have the potential to improve MNH care. This is the first study to compare MNH service delivery quality across contracted and non-contracted facilities using BSC as the assessment framework.

  5. 42 CFR 440.140 - Inpatient hospital services, nursing facility services, and intermediate care facility services...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Inpatient hospital services, nursing facility... Definitions § 440.140 Inpatient hospital services, nursing facility services, and intermediate care facility... section 1903(i)(4) of the Act and subpart H of part 456 of this chapter. (b) Nursing facility services...

  6. 42 CFR 440.140 - Inpatient hospital services, nursing facility services, and intermediate care facility services...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Inpatient hospital services, nursing facility... Definitions § 440.140 Inpatient hospital services, nursing facility services, and intermediate care facility... section 1903(i)(4) of the Act and subpart H of part 456 of this chapter. (b) Nursing facility services...

  7. Planning the School Food Service Facilities. Revised 1967.

    ERIC Educational Resources Information Center

    Utah State Board of Education, Salt Lake City.

    Evaluations of food service equipment, kitchen design and food service facilities are comprehensively reviewed for those concerned with the planning and equipping of new school lunchrooms or the remodeling of existing facilities. Information is presented in the form of general guides adaptable to specific local situations and needs, and is…

  8. 42 CFR 440.150 - Intermediate care facility (ICF/MR) services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Intermediate care facility (ICF/MR) services. 440.150 Section 440.150 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.150 Intermediate care facility (ICF/MR) service...

  9. 42 CFR 440.140 - Inpatient hospital services, nursing facility services, and intermediate care facility services...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Inpatient hospital services, nursing facility... Definitions § 440.140 Inpatient hospital services, nursing facility services, and intermediate care facility... under section 1903(i)(4) of the Act and subpart H of part 456 of this chapter. (b) Nursing facility...

  10. 42 CFR 440.140 - Inpatient hospital services, nursing facility services, and intermediate care facility services...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Inpatient hospital services, nursing facility... Definitions § 440.140 Inpatient hospital services, nursing facility services, and intermediate care facility... under section 1903(i)(4) of the Act and subpart H of part 456 of this chapter. (b) Nursing facility...

  11. 42 CFR 440.140 - Inpatient hospital services, nursing facility services, and intermediate care facility services...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Inpatient hospital services, nursing facility... Definitions § 440.140 Inpatient hospital services, nursing facility services, and intermediate care facility... under section 1903(i)(4) of the Act and subpart H of part 456 of this chapter. (b) Nursing facility...

  12. 42 CFR 440.150 - Intermediate care facility (ICF/IID) services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Intermediate care facility (ICF/IID) services. 440.150 Section 440.150 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.150 Intermediate care facility (ICF/IID)...

  13. 2 CFR 200.468 - Specialized service facilities.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... OFFICE OF MANAGEMENT AND BUDGET GUIDANCE Reserved UNIFORM ADMINISTRATIVE REQUIREMENTS, COST PRINCIPLES, AND AUDIT REQUIREMENTS FOR FEDERAL AWARDS Cost Principles General Provisions for Selected Items of Cost § 200.468 Specialized service facilities. (a) The costs of services provided by highly complex or...

  14. 9 CFR 3.50 - Facilities, general.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Facilities, general. 3.50 Section 3.50 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE STANDARDS Specifications for the Humane Handling, Care, Treatment and Transportation of Rabbits...

  15. 9 CFR 3.125 - Facilities, general.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Warmblooded Animals Other Than Dogs, Cats, Rabbits, Hamsters, Guinea Pigs, Nonhuman Primates, and Marine... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Facilities, general. 3.125 Section 3.125 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE...

  16. EPA Facility Registry Service (FRS): CERCLIS

    EPA Pesticide Factsheets

    This data provides location and attribute information on Facilities regulated under the Comprehensive Environmental Responsibility Compensation and Liability Information System (CERCLIS) for a intranet web feature service . The data provided in this service are obtained from EPA's Facility Registry Service (FRS). The FRS is an integrated source of comprehensive (air, water, and waste) environmental information about facilities, sites or places. This service connects directly to the FRS database to provide this data as a feature service. FRS creates high-quality, accurate, and authoritative facility identification records through rigorous verification and management procedures that incorporate information from program national systems, state master facility records, data collected from EPA's Central Data Exchange registrations and data management personnel. Additional Information on FRS is available at the EPA website https://www.epa.gov/enviro/facility-registry-service-frs.

  17. EPA Facility Registry Service (FRS): NEI

    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 National Emissions Inventory (NEI) Program dataset. 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. Additional information on FRS is available at the EPA website https://www.epa.gov/enviro/facility-registry-service-frs

  18. 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.

  19. EPA Facility Registry Service (FRS): RCRA

    EPA Pesticide Factsheets

    This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of hazardous waste facilities that link to the Resource Conservation and Recovery Act Information System (RCRAInfo). EPA's comprehensive information system in support of the Resource Conservation and Recovery Act (RCRA) of 1976 and the Hazardous and Solid Waste Amendments (HSWA) of 1984, RCRAInfo tracks many types of information about generators, transporters, treaters, storers, and disposers of hazardous waste. 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 RCRAInfo hazardous waste facilities once the RCRAInfo 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

  20. EPA Facility Registry Service (FRS): TRI

    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 Toxic Release Inventory (TRI) System. TRI is a publicly available EPA database reported annually by certain covered industry groups, as well as federal facilities. It contains information about more than 650 toxic chemicals that are being used, manufactured, treated, transported, or released into the environment, and includes information about waste management and pollution prevention activities. 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 TRI facilities once the TRI 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.

  1. EPA Facility Registry Service (FRS): ICIS

    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 Integrated Compliance Information System (ICIS). When complete, ICIS will provide a database that will contain integrated enforcement and compliance information across most of EPA's programs. The vision for ICIS is to replace EPA's independent databases that contain enforcement data with a single repository for that information. Currently, ICIS contains all Federal Administrative and Judicial enforcement actions and a subset of the Permit Compliance System (PCS), which supports the National Pollutant Discharge Elimination System (NPDES). ICIS exchanges non-sensitive enforcement/compliance activities, non-sensitive formal enforcement actions and NPDES information with FRS. This web feature service contains the enforcement/compliance activities and formal enforcement action related facilities; the NPDES facilities are contained in the PCS_NPDES web feature service. 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 f

  2. NPDES Permit for General Services Administration (GSA) West Heating Plant

    EPA Pesticide Factsheets

    Under National Pollutant Discharge Elimination System permit number DC0000035, General Services Administration (GSA) West Heating Plant is authorized to discharge from a facility to receiving waters named Rock Creek.

  3. Space Physics Data Facility Web Services

    NASA Technical Reports Server (NTRS)

    Candey, Robert M.; Harris, Bernard T.; Chimiak, Reine A.

    2005-01-01

    The Space Physics Data Facility (SPDF) Web services provides a distributed programming interface to a portion of the SPDF software. (A general description of Web services is available at http://www.w3.org/ and in many current software-engineering texts and articles focused on distributed programming.) The SPDF Web services distributed programming interface enables additional collaboration and integration of the SPDF software system with other software systems, in furtherance of the SPDF mission to lead collaborative efforts in the collection and utilization of space physics data and mathematical models. This programming interface conforms to all applicable Web services specifications of the World Wide Web Consortium. The interface is specified by a Web Services Description Language (WSDL) file. The SPDF Web services software consists of the following components: 1) A server program for implementation of the Web services; and 2) A software developer s kit that consists of a WSDL file, a less formal description of the interface, a Java class library (which further eases development of Java-based client software), and Java source code for an example client program that illustrates the use of the interface.

  4. 16 CFR 240.7 - Services or facilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Services or facilities. 240.7 Section 240.7 Commercial Practices FEDERAL TRADE COMMISSION GUIDES AND TRADE PRACTICE RULES GUIDES FOR ADVERTISING ALLOWANCES AND OTHER MERCHANDISING PAYMENTS AND SERVICES § 240.7 Services or facilities. The terms services...

  5. EPA Facility Registry Service (FRS): OIL

    EPA Pesticide Factsheets

    This dataset contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link to the Oil database. The Oil database contains information on Spill Prevention, Control, and Countermeasure (SPCC) and Facility Response Plan (FRP) subject facilities to prevent and respond to oil spills. FRP facilities are referred to as substantial harm facilities due to the quantities of oil stored and facility characteristics. 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 Oil facilities once the Oil 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.

  6. EPA Facility Registry Service (FRS): Facility Interests Dataset

    EPA Pesticide Factsheets

    This web feature service consists of location and facility identification information from EPA's Facility Registry Service (FRS) for all sites that are available in the FRS individual feature layers. The layers comprise the FRS major program databases, including:Assessment Cleanup and Redevelopment Exchange System (ACRES) : brownfields sites ; Air Facility System (AFS) : stationary sources of air pollution ; Air Quality System (AQS) : ambient air pollution data from monitoring stations; Bureau of Indian Affairs (BIA) : schools data on Indian land; Base Realignment and Closure (BRAC) facilities; Clean Air Markets Division Business System (CAMDBS) : market-based air pollution control programs; Comprehensive Environmental Response, Compensation, and Liability Information System (CERCLIS) : hazardous waste sites; Integrated Compliance Information System (ICIS) : integrated enforcement and compliance information; National Compliance Database (NCDB) : Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) and the Toxic Substances Control Act (TSCA); National Pollutant Discharge Elimination System (NPDES) module of ICIS : NPDES surface water permits; Radiation Information Database (RADINFO) : radiation and radioactivity facilities; RACT/BACT/LAER Clearinghouse (RBLC) : best available air pollution technology requirements; Resource Conservation and Recovery Act Information System (RCRAInfo) : tracks generators, transporters, treaters, storers, and disposers of haz

  7. Use of Telemedicine to Enhance Pharmacist Services in the Nursing Facility.

    PubMed

    Kane-Gill, Sandra L; Niznik, Joshua D; Kellum, John A; Culley, Colleen M; Boyce, Richard D; Marcum, Zachary A; He, Harvey; Perera, Subashan; Handler, Steven M

    2017-02-01

    To conduct a systematic literature review to determine what telemedicine services are provided by pharmacists and the impact of these services in the nursing facility setting. MEDLINE®, Scopus®, and Embase® databases. The terms "telemedicine" or "telehealth" were combined by "and" with the terms "pharmacist" or "pharmacy" to identify pharmacists' use of telemedicine. Also, "telepharmacy" was added as a search term. The initial search yielded 322 results. These abstracts were reviewed by two individuals independently, for selection of articles that discussed telemedicine and involvement of a pharmacist, either as the primary user of the service or as part of an interprofessional health care team. Those abstracts discussing the pharmacist service for purpose of dispensing or product preparation were excluded. A description of pharmacists' services provided and the impact on resident care. Only three manuscripts met inclusion criteria. One was a narrative proposition of the benefits of using telemedicine by senior care pharmacists. Two published original research studies indirectly assessed the pharmacists' use of telemedicine in the nursing facility through an anticoagulation program and an osteoporosis management service. Both services demonstrated improvement in patient care. There is a general paucity of practice-related research to demonstrate potential benefits of pharmacists' services incorporating telemedicine. Telemedicine may be a resource-efficient approach to enhance pharmacist services in the nursing facility and improve resident care.

  8. Psychiatric inpatient services in general hospitals.

    PubMed

    HUME, P B; RUDIN, E

    1960-10-01

    Traditional asylum care of psychiatric patients leads to the isolation, confinement, and restraint of the patients, and to isolation of psychiatric practice from the rest of medicine. Modern psychiatric advances have demonstrated the disadvantages to both patients and their families of such isolation, confinement and restraint. It is in the best interests of patients and professional workers that inpatient psychiatric services be continuous with, and contiguous to, other medical services and to rehabilitation services of all kinds. Examination of currently available information reveals a shortage of psychiatric beds in California, particularly for diagnosis and brief treatment. Thus, not only is there a need to develop psychiatric inpatient facilities, but also an opportunity to develop them along several different lines. Since both the Hill-Burton Act (federal) and the Short-Doyle Act (state) give financial assistance to only those psychiatric services established in general hospitals or affiliated with general hospitals, this requirement calls for examination in the light of experience with services so operated. At first, the Short-Doyle Act was perceived as a panacea for the psychiatric ills of the state. Now it is beginning to be recognized as one method of providing additional mental health resources, rather than the exclusive method. As more short-term cases are treated in local, tax-supported, psychiatric units in general hospitals, an impact can be expected on the state hospital program. In its administration of the Short-Doyle Act, the Department of Mental Hygiene attempts to respond to community needs as locally determined. It tries to insure local option and encourage local responsibility while furthering high standards of staffing and of service.

  9. 9 CFR 3.25 - Facilities, general.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Pigs and Hamsters Facilities and Operating Standards § 3.25 Facilities, general. (a) Structural strength. Indoor and outdoor housing facilities for guinea pigs or hamsters shall be structurally sound and...

  10. 9 CFR 3.25 - Facilities, general.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Pigs and Hamsters Facilities and Operating Standards § 3.25 Facilities, general. (a) Structural strength. Indoor and outdoor housing facilities for guinea pigs or hamsters shall be structurally sound and...

  11. 9 CFR 3.25 - Facilities, general.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Pigs and Hamsters Facilities and Operating Standards § 3.25 Facilities, general. (a) Structural strength. Indoor and outdoor housing facilities for guinea pigs or hamsters shall be structurally sound and...

  12. 9 CFR 3.25 - Facilities, general.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Pigs and Hamsters Facilities and Operating Standards § 3.25 Facilities, general. (a) Structural strength. Indoor and outdoor housing facilities for guinea pigs or hamsters shall be structurally sound and...

  13. Analysis of Student Satisfaction Toward Quality of Service Facility

    NASA Astrophysics Data System (ADS)

    Napitupulu, D.; Rahim, R.; Abdullah, D.; Setiawan, MI; Abdillah, LA; Ahmar, AS; Simarmata, J.; Hidayat, R.; Nurdiyanto, H.; Pranolo, A.

    2018-01-01

    The development of higher education is very rapid rise to the tight competition both public universities and private colleges. XYZ University realized to win the competition, required continuous quality improvement, including the quality of existing service facilities. Amenities quality services is believed to support the success of the learning activities and improve user satisfaction. This study aims to determine the extent to which the quality of the services effect on user satisfaction. The research method used is survey-based questionnaire that measure perception and expectation. The results showed a gap between perception and expectations of the respondents have a negative value for each item. This means XYZ service facility at the university is not currently meet the expectations of society members. Three service facility that has the lowest index is based on the perception of respondents is a laboratory (2.56), computer and multimedia (2.63) as well as wifi network (2.99). The magnitude of the correlation between satisfaction with the quality of service facilities is 0.725 which means a strong and positive relationship. The influence of the quality of service facilities to the satisfaction of the students is 0.525 meaning that the variable quality of the services facility can explain 52.5% of the variable satisfaction. The study provided recommendations for improvements to enhance the quality of services facility at the XYZ university facilities.

  14. 42 CFR 31.3 - Use of Service facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Use of Service facilities. 31.3 Section 31.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS... Service § 31.3 Use of Service facilities. Except as otherwise provided in §§ 31.3 to 31.10, the persons...

  15. Survey of Emergency and Essential Surgical, Obstetric and Anaesthetic Services Available in Bangladeshi Government Health Facilities.

    PubMed

    Loveday, Jonathan; Sachdev, Sonal P; Cherian, Meena N; Katayama, Francisco; Akhtaruzzaman, A K M; Thomas, Joe; Huda, N; Faragher, E Brian; Johnson, Walter D

    2017-07-01

    Evaluate the capacity of government-run hospitals in Bangladesh to provide emergency and essential surgical, obstetric and anaesthetic services. Cross-sectional survey of 240 Bangladeshi Government healthcare facilities using the World Health Organisation Situational Analysis Tool to Assess Emergency and Essential Surgical Care (SAT). This tool evaluates the ability of a healthcare facility to provide basic surgical, obstetric and anaesthetic care based on 108 queries that detail the infrastructure and population demographics, human resources, surgical interventions and reason for referral, and available surgical equipment and supplies. For this survey, the Bangladeshi Ministry of Health sent the SAT to sub-district, district/general and teaching hospitals throughout the country in April 2013. Responses were received from 240 healthcare facilities (49.5% response rate): 218 sub-district and 22 district/general hospitals. At the sub-district level, caesarean section was offered by 55% of facilities, laparotomy by 7% and open fracture repair by 8%. At the district/general hospital level, 95% offered caesarean section, 86% offered laparotomy and 77% offered open fracture treatment. Availability of anaesthesia services, general equipment and supplies reflected this trend, where district/general hospitals were better equipped than sub-district hospitals, though equipment and infrastructure shortages persist. There has been overall impressive progress by the Bangladeshi Government in providing essential surgical services. Areas for improvement remain across all key areas, including infrastructure, human resources, surgical interventions offered and available equipment. Investment in surgical services offers a cost-effective opportunity to continue to improve the health of the Bangladeshi population and move the country towards universal healthcare coverage.

  16. 42 CFR 416.61 - Scope of facility services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Scope of facility services. 416.61 Section 416.61 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... are not limited to— (1) Nursing, technician, and related services; (2) Use of the facilities where the...

  17. 42 CFR 32.86 - Admissions to Service facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Admissions to Service facilities. 32.86 Section 32.86 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND... Hansen's Disease § 32.86 Admissions to Service facilities. Any person with Hansen's disease who presents...

  18. 42 CFR 31.12 - Use of Service facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Use of Service facilities. 31.12 Section 31.12 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND... § 31.12 Use of Service facilities. Except as otherwise provided herein, the persons specified in § 31...

  19. EPA Facility Registry Service (FRS): Facility Interests Dataset - Intranet

    EPA Pesticide Factsheets

    This web feature service consists of location and facility identification information from EPA's Facility Registry Service (FRS) for all sites that are available in the FRS individual feature layers. The layers comprise the FRS major program databases, including:Assessment Cleanup and Redevelopment Exchange System (ACRES) : brownfields sites ; Air Facility System (AFS) : stationary sources of air pollution ; Air Quality System (AQS) : ambient air pollution data from monitoring stations; Bureau of Indian Affairs (BIA) : schools data on Indian land; Base Realignment and Closure (BRAC) facilities; Clean Air Markets Division Business System (CAMDBS) : market-based air pollution control programs; Comprehensive Environmental Response, Compensation, and Liability Information System (CERCLIS) : hazardous waste sites; Integrated Compliance Information System (ICIS) : integrated enforcement and compliance information; National Compliance Database (NCDB) : Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) and the Toxic Substances Control Act (TSCA); National Pollutant Discharge Elimination System (NPDES) module of ICIS : NPDES surface water permits; Radiation Information Database (RADINFO) : radiation and radioactivity facilities; RACT/BACT/LAER Clearinghouse (RBLC) : best available air pollution technology requirements; Resource Conservation and Recovery Act Information System (RCRAInfo) : tracks generators, transporters, treaters, storers, and disposers of haz

  20. 1. GENERAL VIEW OF LAUNCH PAD A WITH MOBILE SERVICE ...

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

    1. GENERAL VIEW OF LAUNCH PAD A WITH MOBILE SERVICE STRUCTURE IN LOCKED POSITION OVER LAUNCHER BUILDING AND RETENTION POND AT RIGHT; VIEW TO NORTHWEST. - Cape Canaveral Air Station, Launch Complex 17, Facility 28501, East end of Lighthouse Road, Cape Canaveral, Brevard County, FL

  1. 42 CFR 456.401 - State plan UR requirements and options; UR plan required for intermediate care facility services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... required for intermediate care facility services. 456.401 Section 456.401 Public Health CENTERS FOR...: General Requirement § 456.401 State plan UR requirements and options; UR plan required for intermediate care facility services. (a) The State plan must provide that— (1) UR is performed for each ICF that...

  2. 42 CFR 456.401 - State plan UR requirements and options; UR plan required for intermediate care facility services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... required for intermediate care facility services. 456.401 Section 456.401 Public Health CENTERS FOR...: General Requirement § 456.401 State plan UR requirements and options; UR plan required for intermediate care facility services. (a) The State plan must provide that— (1) UR is performed for each ICF that...

  3. 42 CFR 456.401 - State plan UR requirements and options; UR plan required for intermediate care facility services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... required for intermediate care facility services. 456.401 Section 456.401 Public Health CENTERS FOR...: General Requirement § 456.401 State plan UR requirements and options; UR plan required for intermediate care facility services. (a) The State plan must provide that— (1) UR is performed for each ICF that...

  4. 9 CFR 3.25 - Facilities, general.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... WELFARE STANDARDS Specifications for the Humane Handling, Care, Treatment, and Transportation of Guinea Pigs and Hamsters Facilities and Operating Standards § 3.25 Facilities, general. (a) Structural strength. Indoor and outdoor housing facilities for guinea pigs or hamsters shall be structurally sound and...

  5. Medicaid program; revision to Medicaid upper payment limit requirements for hospital services, nursing facility services, intermediate care facility services for the mentally retarded, and clinic services. Health Care Financing Administration (HCFA), HHS. Final rule.

    PubMed

    2001-01-12

    This final rule modifies the Medicaid upper payment limits for inpatient hospital services, outpatient hospital services, nursing facility services, intermediate care facility services for the mentally retarded, and clinic services. For each type of Medicaid inpatient service, existing regulations place an upper limit on overall aggregate payments to all facilities and a separate aggregate upper limit on payments made to State-operated facilities. This final rule establishes an aggregate upper limit that applies to payments made to government facilities that are not State government-owned or operated, and a separate aggregate upper limit on payments made to privately-owned and operated facilities. This rule also eliminates the overall aggregate upper limit that had applied to these services. With respect to outpatient hospital and clinic services, this final rule establishes an aggregate upper limit on payments made to State government-owned or operated facilities, an aggregate upper limit on payments made to government facilities that are not State government-owned or operated, and an aggregate upper limit on payments made to privately-owned and operated facilities. These separate upper limits are necessary to ensure State Medicaid payment systems promote economy and efficiency. We are allowing a higher upper limit for payment to non-State public hospitals to recognize the higher costs of inpatient and outpatient services in public hospitals. In addition, to ensure continued beneficiary access to care and the ability of States to adjust to the changes in the upper payment limits, the final rule includes a transition period for States with approved rate enhancement State plan amendments.

  6. Medicaid program; modification of the Medicaid upper payment limit transition period for inpatient hospital services, outpatient hospital services, nursing facility services, intermediate care facility services for the mentally retarded, and clinic services. Final rule.

    PubMed

    2001-09-05

    This final rule modifies the Medicaid upper payment (UPL) limit provisions by establishing a new transition period for States that submitted plan amendments before March 13, 2001 that do not comply with the new UPLs effective on that date (but do comply with the prior UPLs) and were approved on or after January 22, 2001. This new transition period applies to payments for inpatient hospital services, outpatient hospital services, nursing facility services, intermediate care facility services for the mentally retarded, and clinic services.

  7. The effect of the National Health Insurance Scheme (NHIS) on health service delivery in mission facilities in Ghana: a retrospective study.

    PubMed

    Aryeetey, Genevieve Cecilia; Nonvignon, Justice; Amissah, Caroline; Buckle, Gilbert; Aikins, Moses

    2016-06-07

    In 2004, Ghana began implementation of a National Health Insurance Scheme (NHIS) to minimize out-of-pocket expenditure at the point of use of service. The implementation of the scheme was accompanied by increased access and use of health care services. Evidence suggests most health facilities are faced with management challenges in the delivery of services. The study aimed to assess the effect of the introduction of the NHIS on health service delivery in mission health facilities in Ghana. We conceptualised the effect of NHIS on facilities using service delivery indicators such as outpatient and inpatient turn out, estimation of general service readiness, revenue and expenditure, claims processing and availability of essential medicines. We collected data from 38 mission facilities, grouped into the three ecological zones; southern, middle and northern. Structured questionnaires and exit interviews were used to collect data for the periods 2003 and 2010. The data was analysed in SPSS and MS Excel. The facilities displayed high readiness to deliver services. There were significant increases in outpatient and inpatient attendance, revenue, expenditure and improved access to medicines. Generally, facilities reported increased readiness to deliver services. However, challenging issues around high rates of non-reimbursement of NHIS claims due to errors in claims processing, lack of feedback regarding errors, and lack of clarity on claims reporting procedures were reported. The implementation of the NHIS saw improvement and expansion of services resulting in benefits to the facilities as well as constraints. The constraints could be minimized if claims processing is improved at the facility level and delays in reimbursements also reduced.

  8. Design Criteria: School Food Service Facilities.

    ERIC Educational Resources Information Center

    Florida State Dept. of Education, Tallahassee.

    This guide is intended for architects, district superintendents, and food service directors whose responsibility it is to plan food service facilities. It first discusses the factors to be considered in food service planning, presents cost studies, and lists the responsibilities of those involved in the planning. Other sections concern selection,…

  9. Does health facility service environment matter for the receipt of essential newborn care? Linking health facility and household survey data in Malawi.

    PubMed

    Carvajal-Aguirre, Liliana; Mehra, Vrinda; Amouzou, Agbessi; Khan, Shane M; Vaz, Lara; Guenther, Tanya; Kalino, Maggie; Zaka, Nabila

    2017-12-01

    Health facility service environment is an important factor for newborns survival and well-being in general and in particular in high mortality settings such as Malawi where despite high coverage of essential interventions, neonatal mortality remains high. The aim of this study is to assess whether the quality of the health service environment at birth is associated with quality of care received by the newborn. We used data from the Malawi Millennium Development Goals Endline household survey conducted as part of MICS survey program and Service Provision Assessment Survey carried out in 2014. The analysis is based on 6218 facility births that occurred during the past 2 years. Descriptive statistics, bivariate and multivariate random effect models are used to assess the association of health facility service readiness score for normal deliveries and newborn care with newborns receiving appropriate newborn care, defined for this analysis as receiving 5 out of 6 recommended interventions during the first 2 days after birth. Newborns in districts with top facility service readiness score have 1.5 higher odds of receiving appropriate newborn care (adjusted odds ratio (aOR) = 1.52, 95% confidence interval CI = 1.19-1.95, P  = 0.001), as compared to newborns in districts with a lower facility score after adjusting for potential confounders. Newborns in the Northern region were two times more likely to receive 5 newborn care interventions as compared to newborns in the Southern region (aOR = 2.06, 95% CI = 1.50-2.83, P  < 0.001). Living in urban or rural areas did not have an impact on receiving appropriate newborn care. There is need to increase the level of service readiness across all facilities, so that all newborns irrespective of the health facility, district or region of delivery are able to receive all recommended essential interventions. Investments in health systems in Malawi should concentrate on increasing training and availability of

  10. 46 CFR 160.151-45 - Equipment required for servicing facilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 6 2011-10-01 2011-10-01 false Equipment required for servicing facilities. 160.151-45 Section 160.151-45 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT...) § 160.151-45 Equipment required for servicing facilities. Each servicing facility approved by the Coast...

  11. 9 CFR 3.1 - Housing facilities, general.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Transportation of Dogs and Cats 1 Facilities and Operating Standards § 3.1 Housing facilities, general. (a) Structure; construction. Housing facilities for dogs and cats must be designed and constructed so that they... apply only to live dogs and cats, unless stated otherwise. (b) Condition and site. Housing facilities...

  12. 9 CFR 3.1 - Housing facilities, general.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Transportation of Dogs and Cats 1 Facilities and Operating Standards § 3.1 Housing facilities, general. (a) Structure; construction. Housing facilities for dogs and cats must be designed and constructed so that they... apply only to live dogs and cats, unless stated otherwise. (b) Condition and site. Housing facilities...

  13. 10 CFR 429.27 - General service fluorescent lamps, general service incandescent lamps, and incandescent reflector...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 3 2014-01-01 2014-01-01 false General service fluorescent lamps, general service incandescent lamps, and incandescent reflector lamps. 429.27 Section 429.27 Energy DEPARTMENT OF ENERGY ENERGY... EQUIPMENT Certification § 429.27 General service fluorescent lamps, general service incandescent lamps, and...

  14. 10 CFR 429.27 - General service fluorescent lamps, general service incandescent lamps, and incandescent reflector...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 3 2012-01-01 2012-01-01 false General service fluorescent lamps, general service incandescent lamps, and incandescent reflector lamps. 429.27 Section 429.27 Energy DEPARTMENT OF ENERGY ENERGY... EQUIPMENT Certification § 429.27 General service fluorescent lamps, general service incandescent lamps, and...

  15. 10 CFR 429.27 - General service fluorescent lamps, general service incandescent lamps, and incandescent reflector...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 3 2013-01-01 2013-01-01 false General service fluorescent lamps, general service incandescent lamps, and incandescent reflector lamps. 429.27 Section 429.27 Energy DEPARTMENT OF ENERGY ENERGY... EQUIPMENT Certification § 429.27 General service fluorescent lamps, general service incandescent lamps, and...

  16. 42 CFR 440.150 - Intermediate care facility (ICF/MR) services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Intermediate care facility (ICF/MR) services. 440....150 Intermediate care facility (ICF/MR) services. (a) “ICF/MR services” means those items and services furnished in an intermediate care facility for the mentally retarded if the following conditions are met: (1...

  17. Characteristics of U.S. Mental Health Facilities That Offer Suicide Prevention Services.

    PubMed

    Kuramoto-Crawford, S Janet; Smith, Kelley E; McKeon, Richard

    2016-01-01

    This study characterized mental health facilities that offer suicide prevention services or outcome follow-up after discharge. The study analyzed data from 8,459 U.S. mental health facilities that participated in the 2010 National Mental Health Services Survey. Logistic regression analyses were used to compare facilities that offered neither of the prevention services with those that offered both or either service. About one-fifth of mental health facilities reported offering neither suicide prevention services nor outcome follow-up. Approximately one-third offered both, 25% offered suicide prevention services only, and 21% offered only outcome follow-up after discharge. Facilities that offered neither service were less likely than facilities that offered either to offer comprehensive support services or special programs for veterans; to offer substance abuse services; and to be accredited, licensed, or certified. Further examination of facilitators and barriers in implementing suicide prevention services in mental health facilities is warranted.

  18. Optimal pricing policies for services with consideration of facility maintenance costs

    NASA Astrophysics Data System (ADS)

    Yeh, Ruey Huei; Lin, Yi-Fang

    2012-06-01

    For survival and success, pricing is an essential issue for service firms. This article deals with the pricing strategies for services with substantial facility maintenance costs. For this purpose, a mathematical framework that incorporates service demand and facility deterioration is proposed to address the problem. The facility and customers constitute a service system driven by Poisson arrivals and exponential service times. A service demand with increasing price elasticity and a facility lifetime with strictly increasing failure rate are also adopted in modelling. By examining the bidirectional relationship between customer demand and facility deterioration in the profit model, the pricing policies of the service are investigated. Then analytical conditions of customer demand and facility lifetime are derived to achieve a unique optimal pricing policy. The comparative statics properties of the optimal policy are also explored. Finally, numerical examples are presented to illustrate the effects of parameter variations on the optimal pricing policy.

  19. 42 CFR 483.354 - General requirements for psychiatric residential treatment facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... treatment facilities. 483.354 Section 483.354 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... LONG TERM CARE FACILITIES Condition of Participation for the Use of Restraint or Seclusion in Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric Services for Individuals Under...

  20. EPA Facility Registry Service (FRS): PCS_NPDES

    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 Permit Compliance System (PCS) or the National Pollutant Discharge Elimination System (NPDES) module of the Integrated Compliance Information System (ICIS). PCS tracks NPDES surface water permits issued under the Clean Water Act. This system is being incrementally replaced by the NPDES module of ICIS. Under NPDES, all facilities that discharge pollutants from any point source into waters of the United States are required to obtain a permit. The permit will likely contain limits on what can be discharged, impose monitoring and reporting requirements, and include other provisions to ensure that the discharge does not adversely affect water quality. 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 NPDES facilities once the PCS or ICIS-NPDES data has been integrated into the FRS database. Additional information on FRS is available

  1. A Guide for Planning and Construction of Public School Facilities in Georgia. School Food Service Facilities.

    ERIC Educational Resources Information Center

    Georgia State Dept. of Education, Atlanta. Office of School Administrative Services.

    It is the purpose of this guide to provide established, well-tested guidelines for planning and constructing food service facilities. These guidelines attempt to get the most efficient and economical operation from a school's food service facilities by providing pertinent information for expanding and remodeling existing facilities, as well as…

  2. 48 CFR 252.239-7004 - Orders for facilities and services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 3 2011-10-01 2011-10-01 false Orders for facilities and... of Provisions And Clauses 252.239-7004 Orders for facilities and services. As prescribed in 239.7411(a), use the following clause: Orders for Facilities and Services (NOV 2005) The Contractor shall...

  3. Contracting for Facilities Services. Critical Issues in Facilities Management. No. 9.

    ERIC Educational Resources Information Center

    APPA: Association of Higher Education Facilities Officers, Alexandria, VA.

    This book has been designed to provide practical information to managers on how to work with outside contractors in the higher education facilities area, and provides "real world" advice on the opportunities and pitfalls of privatization. Overviews and detailed case studies of contracting-out for services such as custodial services and…

  4. Use of facility assessment data to improve reproductive health service delivery in the Democratic Republic of the Congo

    PubMed Central

    2009-01-01

    Background Prolonged exposure to war has severely impacted the provision of health services in the Democratic Republic of the Congo (DRC). Health infrastructure has been destroyed, health workers have fled and government support to health care services has been made difficult by ongoing conflict. Poor reproductive health (RH) indicators illustrate the effect that the prolonged crisis in DRC has had on the on the reproductive health (RH) of Congolese women. In 2007, with support from the RAISE Initiative, the International Rescue Committee (IRC) and CARE conducted baseline assessments of public hospitals to evaluate their capacities to meet the RH needs of the local populations and to determine availability, utilization and quality of RH services including emergency obstetric care (EmOC) and family planning (FP). Methods Data were collected from facility assessments at nine general referral hospitals in five provinces in the DRC during March, April and November 2007. Interviews, observation and clinical record review were used to assess the general infrastructure, EmOC and FP services provided, and the infection prevention environment in each of the facilities. Results None of the nine hospitals met the criteria for classification as an EmOC facility (either basic or comprehensive). Most facilities lacked any FP services. Shortage of trained staff, essential supplies and medicines and poor infection prevention practices were consistently documented. All facilities had poor systems for routine monitoring of RH services, especially with regard to EmOC. Conclusions Women's lives can be saved and their well-being improved with functioning RH services. As the DRC stabilizes, IRC and CARE in partnership with the local Ministry of Health and other service provision partners are improving RH services by: 1) providing necessary equipment and renovations to health facilities; 2) improving supply management systems; 3) providing comprehensive competency-based training for

  5. EPA Facility Registry Service (FRS): Facility Interests Dataset Download

    EPA Pesticide Factsheets

    This downloadable data package consists of location and facility identification information from EPA's Facility Registry Service (FRS) for all sites that are available in the FRS individual feature layers. The layers comprise the FRS major program databases, including:Assessment Cleanup and Redevelopment Exchange System (ACRES) : brownfields sites ; Air Facility System (AFS) : stationary sources of air pollution ; Air Quality System (AQS) : ambient air pollution data from monitoring stations; Bureau of Indian Affairs (BIA) : schools data on Indian land; Base Realignment and Closure (BRAC) facilities; Clean Air Markets Division Business System (CAMDBS) : market-based air pollution control programs; Comprehensive Environmental Response, Compensation, and Liability Information System (CERCLIS) : hazardous waste sites; Integrated Compliance Information System (ICIS) : integrated enforcement and compliance information; National Compliance Database (NCDB) : Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) and the Toxic Substances Control Act (TSCA); National Pollutant Discharge Elimination System (NPDES) module of ICIS : NPDES surface water permits; Radiation Information Database (RADINFO) : radiation and radioactivity facilities; RACT/BACT/LAER Clearinghouse (RBLC) : best available air pollution technology requirements; Resource Conservation and Recovery Act Information System (RCRAInfo) : tracks generators, transporters, treaters, storers, and disposers

  6. Service quality and patient experiences of ambulatory care in a specialized clinic vs. a general hospital.

    PubMed

    De Regge, Melissa; De Groote, Hélène; Trybou, Jeroen; Gemmel, Paul; Brugada, Pedro

    2017-04-01

    Health care organizations are constantly looking for ways to establish a differential advantage to attract customers. To this end, service quality has become an important differentiator in the strategy of health care organizations. In this study, we compared the service quality and patient experience in an ambulatory care setting of a physician-owned specialized facility with that of a general hospital. A comparative case study with a mixed method design was employed. Data were gathered through a survey on health service quality and patient experience, completed with observations, walkthroughs, and photographic material. Service quality and patient experiences are high in both the investigated health care facilities. A significant distinction can be made between the two facilities in terms of interpersonal quality (p = 0.001) and environmental quality (P ≤ 0.001), in favor of the medical center. The difference in environmental quality is also indicated by the scores given by participants who had been in both facilities. Qualitative analysis showed higher administrative quality in the medical center. Environmental quality and patient experience can predict the interpersonal quality; for environmental quality, interpersonal quality and age are significant predictors. Service quality and patient experiences are high in both facilities. The medical center has higher service quality for interpersonal and environmental service quality and is more process-centered.

  7. Quick-Reaction Report on the Audit of ReCoupment Actions on Medicine Payments to Uniformed Services Treatment Facilities.

    DTIC Science & Technology

    1993-07-21

    OFFICE OF THE INSPECTOR GENERAL QUICK-REACTION REPORT ON THE AUDIT OF RECOUPMENT ACTIONS ON MEDICARE PAYMENTS TO UNIFORMED SERVICES TREATMENT...Quick-Reaction Report on the Audit of Recoupment Actions on Medicare Payments to Uniformed Services Treatment Facilities (Report No. 93-150) We are...Inspectors General will provide a joint report to the congressional committees that requested the audit . The courtesies extended to the audit staff

  8. 42 CFR 31.10 - Dependent members of families; use of Service facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... facilities. 31.10 Section 31.10 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Survey and Public Health Service § 31.10 Dependent members of families; use of Service facilities. (a) A... facilities only at medical relief stations where full-time officers are on duty. (Sec. 326, 58 Stat. 697, as...

  9. 42 CFR 21.33 - General service.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false General service. 21.33 Section 21.33 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PERSONNEL COMMISSIONED OFFICERS Appointment § 21.33 General service. Officers shall be appointed only to general service and shall be subject...

  10. 42 CFR 21.33 - General service.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false General service. 21.33 Section 21.33 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PERSONNEL COMMISSIONED OFFICERS Appointment § 21.33 General service. Officers shall be appointed only to general service and shall be subject...

  11. 42 CFR 21.33 - General service.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false General service. 21.33 Section 21.33 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PERSONNEL COMMISSIONED OFFICERS Appointment § 21.33 General service. Officers shall be appointed only to general service and shall be subject...

  12. 14 CFR 121.123 - Servicing maintenance facilities.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Servicing maintenance facilities. 121.123 Section 121.123 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION..., supplies, and materials) are available for the proper servicing, maintenance, and preventive maintenance of...

  13. 14 CFR 121.123 - Servicing maintenance facilities.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Servicing maintenance facilities. 121.123 Section 121.123 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION..., supplies, and materials) are available for the proper servicing, maintenance, and preventive maintenance of...

  14. 14 CFR 121.123 - Servicing maintenance facilities.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Servicing maintenance facilities. 121.123 Section 121.123 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION..., supplies, and materials) are available for the proper servicing, maintenance, and preventive maintenance of...

  15. 14 CFR 121.123 - Servicing maintenance facilities.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Servicing maintenance facilities. 121.123 Section 121.123 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION..., supplies, and materials) are available for the proper servicing, maintenance, and preventive maintenance of...

  16. Assessment of primary health care facilities' service readiness in Nigeria.

    PubMed

    Oyekale, Abayomi Samuel

    2017-03-01

    Effective delivery of healthcare services requires availability of adequate infrastructure, diagnostic medical equipment, drugs and well-trained medical personnel. In Nigeria, poor funding and mismanagement often characterize healthcare service delivery thereby affecting coverage and quality of healthcare services. Therefore, the state of service delivery in Nigeria's health sector has come under some persistent criticisms. This paper analyzed service readiness of Primary Health Care (PHC) facilities in Nigeria with focus on availability of some essential drugs and medical equipment. Service Delivery Indicator (SDI) data for PHC in Nigeria were used. The data were collected from 2480 healthcare facilities from 12 states in the Nigeria's 6 geopolitical zones between 2013 and 2014. Data were analyzed with descriptive statistics, Principal Component Analysis (PCA) and Ordinary Least Square regression. Medical disposables such as hand gloves and male condoms were reported to be available in 77.18 and 44.03% of all the healthcare facilities respectively, while immunization services were provided by 86.57%. Functional stethoscopes were reported by 77.22% of the healthcare facilities, while only 68.10% had sphygmomanometers. In the combined healthcare facilities, availability of some basic drugs such as Azithromycin, Nifedipine, Dexamethasone and Misoprostol was low with 10.48, 25.20, 21.94 and 17.06%, respectively, while paracetamol and folic acid both had high availability with 74.31%. Regression results showed that indices of drug and medical equipment availability increased significantly (p < 0.05) among states in southern Nigeria and with presence of some power sources (electricity, generators, batteries and solar), but decreased among dispensaries/health posts. Travel time to headquarters and rural facilities significantly reduced indices of equipment availability (p < 0.05). It was concluded that for Nigeria to ensure better equity in access to healthcare

  17. 42 CFR 440.40 - Nursing facility services for individuals age 21 or older (other than services in an institution...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Nursing facility services for individuals age 21 or... Definitions § 440.40 Nursing facility services for individuals age 21 or older (other than services in an institution for mental disease), EPSDT, and family planning services and supplies. (a) Nursing facility...

  18. 42 CFR 440.40 - Nursing facility services for individuals age 21 or older (other than services in an institution...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Nursing facility services for individuals age 21 or... Definitions § 440.40 Nursing facility services for individuals age 21 or older (other than services in an institution for mental disease), EPSDT, and family planning services and supplies. (a) Nursing facility...

  19. 42 CFR 440.40 - Nursing facility services for individuals age 21 or older (other than services in an institution...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Nursing facility services for individuals age 21 or... Definitions § 440.40 Nursing facility services for individuals age 21 or older (other than services in an institution for mental disease), EPSDT, and family planning services and supplies. (a) Nursing facility...

  20. 42 CFR 440.40 - Nursing facility services for individuals age 21 or older (other than services in an institution...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Nursing facility services for individuals age 21 or... Definitions § 440.40 Nursing facility services for individuals age 21 or older (other than services in an institution for mental disease), EPSDT, and family planning services and supplies. (a) Nursing facility...

  1. 42 CFR 440.40 - Nursing facility services for individuals age 21 or older (other than services in an institution...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Nursing facility services for individuals age 21 or... Definitions § 440.40 Nursing facility services for individuals age 21 or older (other than services in an institution for mental disease), EPSDT, and family planning services and supplies. (a) Nursing facility...

  2. 42 CFR 440.150 - Intermediate care facility (ICF/IIDICF/IID) services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Intermediate care facility (ICF/IIDICF/IID... Definitions § 440.150 Intermediate care facility (ICF/IIDICF/IID) services. (a) “ICF/IIDICF/IID services” means those items and services furnished in an intermediate care facility for Individuals with...

  3. 42 CFR 440.150 - Intermediate care facility (ICF/IIDICF/IID) services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Intermediate care facility (ICF/IIDICF/IID... Definitions § 440.150 Intermediate care facility (ICF/IIDICF/IID) services. (a) “ICF/IIDICF/IID services” means those items and services furnished in an intermediate care facility for Individuals with...

  4. Customer satisfaction in medical service encounters -- a comparison between obstetrics and gynecology patients and general medical patients.

    PubMed

    Chang, Ching-Sheng; Weng, Hui-Ching; Chang, Hsin-Hsin; Hsu, Tsuen-Ho

    2006-03-01

    This study is concerned with the "service encounter", and seeks to describe, by use of the Service Encounter Evaluation Model, how the processes involved in the service encounter affect customer satisfaction. Its findings have implications for management practice and research directions, and recommendations are made. With the implementation of a national health insurance scheme, an ever-prospering economy and continually improving educational levels in Taiwan, demand among citizens for good health and medical care is ever increasing. Obstetrics and gynecology patients often differ greatly from general patients, in terms of their moods and emotions. This research involved an empirical study, whose subjects were 590 customers of general clinics and 339 customers of gynecology clinics, in various medical centers in southern Taiwan. By factor analysis, the study established four influencing factors, which were "Medical professionals", "Nursing professionals", "Service personnel" and "Space and facilities". Using the Linear Structural Relation Model (LISREL), it found that medical professionals, nursing professionals, service personnel and space and facilities were effective predictors of medical treatment satisfaction. We also found that the greatest positive impact on overall medical treatment satisfaction resulted from rises in satisfaction with medical professionals, but that the least impact was achieved in relation to service personnel in the general and gynecology clinics.

  5. 48 CFR 3017.204-90 - Detention Facilities and Services (ICE).

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 7 2011-10-01 2011-10-01 false Detention Facilities and Services (ICE). 3017.204-90 Section 3017.204-90 Federal Acquisition Regulations System DEPARTMENT OF... SPECIAL CONTRACTING METHODS Options. 3017.204-90 Detention Facilities and Services (ICE). The ICE Head of...

  6. 48 CFR 3017.204-90 - Detention Facilities and Services (ICE).

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 7 2013-10-01 2012-10-01 true Detention Facilities and Services (ICE). 3017.204-90 Section 3017.204-90 Federal Acquisition Regulations System DEPARTMENT OF... SPECIAL CONTRACTING METHODS Options 3017.204-90 Detention Facilities and Services (ICE). The ICE Head of...

  7. 48 CFR 3017.204-90 - Detention Facilities and Services (ICE).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Detention Facilities and Services (ICE). 3017.204-90 Section 3017.204-90 Federal Acquisition Regulations System DEPARTMENT OF... SPECIAL CONTRACTING METHODS Options. 3017.204-90 Detention Facilities and Services (ICE). The ICE Head of...

  8. 48 CFR 3017.204-90 - Detention Facilities and Services (ICE).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 7 2014-10-01 2014-10-01 false Detention Facilities and Services (ICE). 3017.204-90 Section 3017.204-90 Federal Acquisition Regulations System DEPARTMENT OF... SPECIAL CONTRACTING METHODS Options 3017.204-90 Detention Facilities and Services (ICE). The ICE Head of...

  9. 48 CFR 3017.204-90 - Detention Facilities and Services (ICE).

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 7 2012-10-01 2012-10-01 false Detention Facilities and Services (ICE). 3017.204-90 Section 3017.204-90 Federal Acquisition Regulations System DEPARTMENT OF... SPECIAL CONTRACTING METHODS Options 3017.204-90 Detention Facilities and Services (ICE). The ICE Head of...

  10. EPA Facility Registry Service (FRS): Facility Interests Dataset - Intranet Download

    EPA Pesticide Factsheets

    This downloadable data package consists of location and facility identification information from EPA's Facility Registry Service (FRS) for all sites that are available in the FRS individual feature layers. The layers comprise the FRS major program databases, including:Assessment Cleanup and Redevelopment Exchange System (ACRES) : brownfields sites ; Air Facility System (AFS) : stationary sources of air pollution ; Air Quality System (AQS) : ambient air pollution data from monitoring stations; Bureau of Indian Affairs (BIA) : schools data on Indian land; Base Realignment and Closure (BRAC) facilities; Clean Air Markets Division Business System (CAMDBS) : market-based air pollution control programs; Comprehensive Environmental Response, Compensation, and Liability Information System (CERCLIS) : hazardous waste sites; Integrated Compliance Information System (ICIS) : integrated enforcement and compliance information; National Compliance Database (NCDB) : Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) and the Toxic Substances Control Act (TSCA); National Pollutant Discharge Elimination System (NPDES) module of ICIS : NPDES surface water permits; Radiation Information Database (RADINFO) : radiation and radioactivity facilities; RACT/BACT/LAER Clearinghouse (RBLC) : best available air pollution technology requirements; Resource Conservation and Recovery Act Information System (RCRAInfo) : tracks generators, transporters, treaters, storers, and disposers

  11. 42 CFR 4.4 - Use of Library facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Use of Library facilities. 4.4 Section 4.4 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS NATIONAL LIBRARY OF MEDICINE § 4.4 Use of Library facilities. (a) General. The Library facilities are available to any...

  12. 42 CFR 4.4 - Use of Library facilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Use of Library facilities. 4.4 Section 4.4 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS NATIONAL LIBRARY OF MEDICINE § 4.4 Use of Library facilities. (a) General. The Library facilities are available to any...

  13. 42 CFR 4.4 - Use of Library facilities.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Use of Library facilities. 4.4 Section 4.4 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS NATIONAL LIBRARY OF MEDICINE § 4.4 Use of Library facilities. (a) General. The Library facilities are available to any...

  14. 42 CFR 4.4 - Use of Library facilities.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Use of Library facilities. 4.4 Section 4.4 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS NATIONAL LIBRARY OF MEDICINE § 4.4 Use of Library facilities. (a) General. The Library facilities are available to any...

  15. 42 CFR 4.4 - Use of Library facilities.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Use of Library facilities. 4.4 Section 4.4 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS NATIONAL LIBRARY OF MEDICINE § 4.4 Use of Library facilities. (a) General. The Library facilities are available to any...

  16. Quality of the delivery services in health facilities in Northern Ethiopia.

    PubMed

    Fisseha, Girmatsion; Berhane, Yemane; Worku, Alemayehu; Terefe, Wondwossen

    2017-03-09

    Substantial improvements have been observed in the coverage of and access to maternal health service, especially in skilled birth attendants, in Ethiopia. However, the quality of care has been lagging behind. Therefore, this study investigated the status of the quality of delivery services in Northern Ethiopia. A facility based survey was conducted from December 2014 to February 2015 in Northern Ethiopia. The quality of delivery service was assessed in 32 health facilities using a facility audit checklist, by reviewing delivery, by conducting in-depth interview and observation, and by conducting exit interviews with eligible mothers. Facilities were considered as 'good quality' if they scored positively on 75% of the quality indicators set in the national guidelines for all the three components; input (materials, infrastructure, and human resource), process (adherence to standard care procedures during intrapartum and immediate postpartum periods) and output (the mothers' satisfaction and utilization of lifesaving procedures). Overall 2 of 32 (6.3%) of the study facilities fulfilled all the three quality components; input, process and output. Two of the three components were assessed as good in 11 of the 32 (34.4%) health facilities. The input quality was the better of the other quality components; which was good in 21 out of the 32 (65.6%) health facilities. The process and output quality was good in only 10 of the 32 (31.3%) facilities. Only 6.3% of the studied health facilities had good quality in all three dimensions of quality measures that was done in accordance to the national delivery service guidelines. The most compromised quality component was the process. Systematic and sustained efforts need to be strengthened to improve all dimensions of quality in order to achieve the desired quality of delivery services and increase the proportion of births occurring in health facilities.

  17. Hydroelectric Generating Facilities General Permit ...

    EPA Pesticide Factsheets

    2017-08-28

    The Notice of Availability of the Final NPDES General Permits (HYDROGP) for Discharges at Hydroelectric Generating Facilities in Massachusetts (MAG360000) and New Hampshire (NHG360000) and Tribal Lands in the State of Massachusetts was published in the Federal Register on December 7, 2009 (see 74 Fed. Reg. No. 233, pages 64074 - 64075).

  18. E-government Facilities Analysis for Public Services in Higher Education

    NASA Astrophysics Data System (ADS)

    Astawa, I. P. M.; Dewi, K. C.

    2018-01-01

    E-Government in higher education can be utilized in order to provide public services to stakeholders both internal and external. The research objectives is to analyze the e-government facilities for public services in higher education. The research began by reviewing the concept of public services and e-government, then continued by analysing e-government facilities based on the E-Government Maturity Level developed by Wirtz and Piehler. The research subject was the e-government website of three universities that ranked the top three of webometrics version (Indonesia country rank), while the research object was e-government facilities for public services. Data collection was done by observing e-government sites via online browsing. The research’s results indicated that all three e-government sites have met four e-government business model and provided e-government services in line with the fourth stage on the e-government development stage. It can concluded that the three universities have achieved e-government maturity at the fourth level.

  19. General dental practitioner's views on dental general anaesthesia services.

    PubMed

    Threlfall, A G; King, D; Milsom, K M; Blinkhom, A S; Tickle, M

    2007-06-01

    Policy has recently changed on provision of dental general anaesthetic services in England. The aim of this study was to investigate general dental practitioners' views about dental general anaesthetics, the reduction in its availability and the impact on care of children with toothache. Qualitative study using semi-structured interviews and clinical case scenarios. General dental practitioners providing NHS services in the North West of England. 93 general dental practitioners were interviewed and 91 answered a clinical case scenario about the care they would provide for a 7-year-old child with multiple decayed teeth presenting with toothache. Scenario responses showed variation; 8% would immediately refer for general anaesthesia, 25% would initially prescribe antibiotics, but the majority would attempt to either restore or extract the tooth causing pain. Interview responses also demonstrated variation in care, however most dentists agree general anaesthesia has a role for nervous children but only refer as a last resort. The responses indicated an increase in inequalities, and that access to services did not match population needs, leaving some children waiting in pain. Most general dental practitioners support moving dental general anaesthesia into hospitals but some believe that it has widened health inequalities and there is also a problem associated with variation in treatment provision. Additional general anaesthetic services in some areas with high levels of tooth decay are needed and evidence based guidelines about caring for children with toothache are required.

  20. 42 CFR 440.155 - Nursing facility services, other than in institutions for mental diseases.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Nursing facility services, other than in... PROVISIONS Definitions § 440.155 Nursing facility services, other than in institutions for mental diseases. (a) “Nursing facility services, other than in an institution for mental diseases” means services...

  1. 42 CFR 440.155 - Nursing facility services, other than in institutions for mental diseases.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Nursing facility services, other than in... PROVISIONS Definitions § 440.155 Nursing facility services, other than in institutions for mental diseases. (a) “Nursing facility services, other than in an institution for mental diseases” means services...

  2. 42 CFR 440.155 - Nursing facility services, other than in institutions for mental diseases.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Nursing facility services, other than in... PROVISIONS Definitions § 440.155 Nursing facility services, other than in institutions for mental diseases. (a) “Nursing facility services, other than in an institution for mental diseases” means services...

  3. 42 CFR 440.155 - Nursing facility services, other than in institutions for mental diseases.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Nursing facility services, other than in... PROVISIONS Definitions § 440.155 Nursing facility services, other than in institutions for mental diseases. (a) “Nursing facility services, other than in an institution for mental diseases” means services...

  4. 42 CFR 440.155 - Nursing facility services, other than in institutions for mental diseases.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Nursing facility services, other than in... PROVISIONS Definitions § 440.155 Nursing facility services, other than in institutions for mental diseases. (a) “Nursing facility services, other than in an institution for mental diseases” means services...

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

    NASA Astrophysics Data System (ADS)

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

    2017-12-01

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

  6. Consumer Response to Gastrointestinal Illness Perceived To Originate from Food Service Facilities.

    PubMed

    Garnett, Erin S; Gretsch, Stephanie R; Null, Clair; Moe, Christine L

    2016-10-01

    Consumer responses to food product recalls have been documented, but there is little information on how consumers respond to illnesses or outbreaks associated with food service facilities. This study uses an on-line survey of 885 adults conducted in 2012 to determine how respondents changed their dining behavior following personal experiences with and secondhand reports of gastrointestinal illness believed to be associated with food service facilities. In response to personally experiencing gastrointestinal illness that they attributed to a food service facility, 90% of survey participants reported that they avoided the implicated facility for a time following the incident; almost one-half decided to never return to the facility they believed had made them ill. In response to a secondhand report of gastrointestinal illness, 86% of respondents reported they would avoid the implicated facility for a time, and 22% said they would never return to the facility. After both personal experiences of illness and secondhand reports of illness, consumer responses were significantly more severe toward the implicated facility than toward all other food service facilities. Frequent diners avoided facilities for shorter periods of time and were less likely to never go back to a facility than were infrequent diners. The survey results indicate that 24 to 97 fewer meals were purchased per respondent, or a 11 to 20% reduction in meals purchased outside the home, in the year following respondents' illness. Future estimates of the economic burden of foodborne illnesses, including those caused by noroviruses, should consider the impacts on the food service industry attributable to changes in consumer behavior, in addition to health care costs and loss of productivity.

  7. Provision of family planning services in Tanzania: a comparative analysis of public and private facilities.

    PubMed

    Kakoko, Deodatus C; Ketting, Evert; Kamazima, Switbert R; Ruben, Ruerd

    2012-12-01

    Adherence to the policy guidelines and standards is necessary for family planning services. We compared public and private facilities in terms of provision of family planning services. We analyzed data from health facility questionnaire of the 2006 Tanzania Service Provision Assessment survey, based on 529 health facilities. Majority of public facilities (95.4%) offered family planning services, whereas more than half of private facilities (52.1%) did not offer those. Public facilities were more likely to offer modern contraceptives as compared to private facilities. However, private facilities were more likely to offer counseling on natural methods of family planning [AOR = 2.12 (1.15-3.92), P < or = 0.001]. Public facilities were more likely to report having guidelines or protocols for family planning services and various kinds of visual aids for family planning and STIs when compared to private facilities. This comparative analysis entails the need to enforce the standards of family planning services in Tanzania.

  8. An Earth Orbiting Satellite Service and Repair Facility

    NASA Technical Reports Server (NTRS)

    Berndt, Andrew; Cardoza, Mike; Chen, John; Daley, Gunter; Frizzell, Andy; Linton, Richard; Rast, Wayne

    1989-01-01

    A conceptual design was produced for the Geosynchronous Satellite Servicing Platform (GSSP), an orbital facility capable of repairing and servicing satellites in geosynchronous orbit. The GSSP is a man-tended platform, which consists of a habitation module, operations module, service bay and truss assembly. This design review includes an analysis of life support systems, thermal and power requirements, robotic and automated systems, control methods and navigation, and communications systems. The GSSP will utilize existing technology available at the time of construction, focusing mainly on modifying and integrating existing systems. The entire facility, along with two satellite retrieval vehicles (SRV), will be placed in geosynchronous orbit by the Advanced Launch System. The SRV will be used to ferry satellites to and from the GSSP. Technicians will be transferred from Earth to the GSSP and back in an Apollo-derived Crew Transfer Capsule (CTC). These missions will use advanced telerobotic equipment to inspect and service satellites. Four of these missions are tentatively scheduled per year. At this rate, the GSSP will service over 650 satelites during the projected 25 year lifespan.

  9. 42 CFR 415.204 - Services of residents in skilled nursing facilities and home health agencies.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Services of residents in skilled nursing facilities... SETTINGS Services of Residents § 415.204 Services of residents in skilled nursing facilities and home... nursing facility. Payment to a participating skilled nursing facility may include the cost of services of...

  10. 42 CFR 415.204 - Services of residents in skilled nursing facilities and home health agencies.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Services of residents in skilled nursing facilities... SETTINGS Services of Residents § 415.204 Services of residents in skilled nursing facilities and home... nursing facility. Payment to a participating skilled nursing facility may include the cost of services of...

  11. 42 CFR 415.204 - Services of residents in skilled nursing facilities and home health agencies.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Services of residents in skilled nursing facilities... SETTINGS Services of Residents § 415.204 Services of residents in skilled nursing facilities and home... nursing facility. Payment to a participating skilled nursing facility may include the cost of services of...

  12. What do we really know about UK paediatric dental general anaesthesia services?

    PubMed

    Robertson, S; Ní Chaollaí, A; Dyer, T A

    2012-02-24

    Dental general anaesthesia (DGA) is only permitted within a hospital setting where critical care facilities are available. Recently, concern has been expressed about the number of hospital admissions for the dental care of children following the publication of a high profile paper which highlighted an apparent increase in children being admitted for extractions due to caries under DGA. Coincidentally new best practice standards for paediatric DGA services have been published. An evaluation of DGA services in Yorkshire and the Humber suggested that existing monitoring was inadequate and is unlikely to represent true levels of activity and that any apparent increase may reflect the method of remuneration for services. In fact, recent changes in service structure and changes to improve quality have reduced DGA activity in some areas. In addition, the evaluation revealed that many services were not meeting standards of best practice.

  13. 46 CFR 160.151-41 - Approval of servicing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... of the facility; (2) The name(s) of its competent servicing technician(s); (3) Identification of the... section. A currently trained servicing technician shall successfully demonstrate the complete service to... a Coast Guard inspector or of a third-party inspector accepted by the OCMI, or such technician shall...

  14. Limited Service Availability, Readiness, and Use of Facility-Based Delivery Care in Haiti: A Study Linking Health Facility Data and Population Data

    PubMed Central

    Wang, Wenjuan; Winner, Michelle; Burgert-Brucker, Clara R

    2017-01-01

    Background: Understanding the barriers that women in Haiti face to giving birth at a health facility is important for improving coverage of facility delivery and reducing persistently high maternal mortality. We linked health facility survey data and population survey data to assess the role of the obstetric service environment in affecting women's use of facility delivery care. Methods: Data came from the 2012 Haiti Demographic and Health Survey (DHS) and the 2013 Haiti Service Provision Assessment (SPA) survey. DHS clusters and SPA facilities were linked with their geographic coordinate information. The final analysis sample from the DHS comprised 4,921 women who had a live birth in the 5 years preceding the survey. Service availability was measured with the number of facilities providing delivery services within a specified distance from the cluster (within 5 kilometers for urban areas and 10 kilometers for rural areas). We measured facility readiness to provide obstetric care using 37 indicators defined by the World Health Organization. Random-intercept logistic regressions were used to model the variation in individual use of facility-based delivery care and cluster-level service availability and readiness, adjusting for other factors. Results: Overall, 39% of women delivered their most recent birth at a health facility and 61% delivered at home, with disparities by residence (about 60% delivered at a health facility in urban areas vs. 24% in rural areas). About one-fifth (18%) of women in rural areas and one-tenth (12%) of women in nonmetropolitan urban areas lived in clusters where no facility offered delivery care within the specified distances, while nearly all women (99%) in the metropolitan area lived in clusters that had at least 2 such facilities. Urban clusters had better service readiness compared with rural clusters, with a wide range of variation in both areas. Regression models indicated that in both rural and nonmetropolitan urban areas

  15. The role of service readiness and health care facility factors in attrition from Option B+ in Haiti: a joint examination of electronic medical records and service provision assessment survey data.

    PubMed

    Lipira, Lauren; Kemp, Christopher; Domercant, Jean Wysler; Honoré, Jean Guy; Francois, Kesner; Puttkammer, Nancy

    2018-01-01

    Option B+ is a strategy wherein pregnant or breastfeeding women with HIV are enrolled in lifelong antiretroviral therapy (ART) for prevention of mother-to-child transmission (PMTCT) of HIV. In Haiti, attrition from Option B+ is problematic and variable across health care facilities. This study explores service readiness and other facility factors as predictors of Option B+ attrition in Haiti. This analysis used longitudinal data from 2012 to 2014 from the iSanté electronic medical record system and cross-sectional data from Haiti's 2013 Service Provision Assessment. Predictors included Service Availability and Readiness Assessment (SARA) measures for antenatal care (ANC), PMTCT, HIV care services and ART services; general facility characteristics and patient-level factors. Multivariable Cox proportional hazards models modelled the time to first attrition. Analysis of data from 3147 women at 63 health care facilities showed no significant relationships between SARA measures and attrition. Having integrated ANC/PMTCT care and HIV-related training were significant protective factors. Being a public-sector facility, having a greater number of quality improvement activities and training in ANC were significant risk factors. Several facility-level factors were associated with Option B+ attrition. Future research is needed to explore unmeasured facility factors, clarify causal relationships, and incorporate community-level factors into the analysis of Option B+ attrition. © The Author(s) 2018. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  16. Quality of antenatal care service provision in health facilities across sub-Saharan Africa: Evidence from nationally representative health facility assessments.

    PubMed

    Kanyangarara, Mufaro; Munos, Melinda K; Walker, Neff

    2017-12-01

    Utilization of antenatal care (ANC) services has increased over the past two decades. Continued gains in maternal and newborn health will require an understanding of both access and quality of ANC services. We linked health facility and household survey data to examine the quality of service provision for five ANC interventions across health facilities in sub-Saharan Africa. Using data from 20 nationally representative health facility assessments - the Service Provision Assessment (SPA) and the Service Availability and Readiness Assessment (SARA), we estimated facility level readiness to deliver five ANC interventions: tetanus toxoid vaccine for pregnant women, intermittent preventive treatment for malaria in pregnancy (IPTp), syphilis detection and treatment in pregnancy, iron supplementation and hypertensive disease case management. Facility level indicators were stratified by health facility type, managing authority and location, then linked to estimates of ANC utilization in that stratum from the corresponding Demographic and Health Surveys (DHS) to generate population level estimates of the 'likelihood of appropriate care'. Finally, the association between estimates of the 'likelihood of appropriate care' from the linking approach and estimates of coverage levels from the DHS were assessed. A total of 10 534 health facilities were surveyed in the 20 health facility assessments, of which 8742 reported offering ANC services and were included in the analysis. Health facility readiness to deliver IPTp, iron supplementation, and tetanus toxoid vaccination was higher (median: 84.1%, 84.9% and 82.8% respectively) than readiness to deliver hypertensive disease case management and syphilis detection and treatment (median: 23.0% and 19.9% respectively). Coverage of at least 4 ANC visits ranged from 24.8% to 75.8%. Estimates of the likelihood of appropriate care derived from linking health facility and household survey data showed marked gaps for all interventions

  17. NPDES Draft Permit for U.S. General Services Administration Downing Reservoir Groundwater Treatment Facility in Colorado

    EPA Pesticide Factsheets

    Under NPDES draft permit number CO-0035033, the U.S. General Services Administration is authorized to discharge from its Downing Reservoir Groundwater Treatment Plant to McIntyre Gulch entering Lakewood Gulch, tributary to the South Platte River.

  18. Availability of Youth Services in U.S. Mental Health Treatment Facilities

    PubMed Central

    Cummings, Janet R.; Case, Brady G.; Ji, Xu; Marcus, Steven C.

    2015-01-01

    Despite concern about access to mental health (MH) services for youth, little is known about the specialty treatment infrastructure serving this population. We used national data to examine which types of MH treatment facilities (hospital- and community-based) were most likely to offer youth services and which types of communities were most likely to have this infrastructure. Larger (p<0.001) and privately owned (p<0.001) facilities were more likely to offer youth services. Rural counties, counties in which a majority of residents were nonwhite, and/or counties with a higher percentage of uninsured residents were less likely to have a community-based MH treatment facility that served youth (p<0.001). PMID:26467795

  19. Availability of Youth Services in U.S. Mental Health Treatment Facilities.

    PubMed

    Cummings, Janet R; Case, Brady G; Ji, Xu; Marcus, Steven C

    2016-09-01

    Despite concern about access to mental health (MH) services for youth, little is known about the specialty treatment infrastructure serving this population. We used national data to examine which types of MH treatment facilities (hospital- and community-based) were most likely to offer youth services and which types of communities were most likely to have this infrastructure. Larger (p < 0.001) and privately owned (p < 0.001) facilities were more likely to offer youth services. Rural counties, counties in which a majority of residents were nonwhite, and/or counties with a higher percentage of uninsured residents were less likely to have a community-based MH treatment facility that served youth (p < 0.001).

  20. Perception of quality of maternal healthcare services among women utilising antenatal services in selected primary health facilities in Anambra State, Southeast Nigeria

    PubMed Central

    Emelumadu, Obiageli F.; Onyeonoro, Ugochukwu Uchenna; Ukegbu, Andrew Ugwunna; Ezeama, Nkiru N.; Ifeadike, Chigozie Ozoemena; Okezie, Obasi Kanu

    2014-01-01

    Background: This is a cross-sectional descriptive study aimed at assessing antenatal care service attendees’ perception of quality of maternal healthcare (MHC) services in Anambra State, southeast Nigeria. Materials and Methods: A total of 310 pregnant women utilising antenatal care (ANC) services in three purposively selected primary health centres (PHCs) in rural communities in Anambra State were studied. Reponses were elicited from the participants selected consecutively over a 4-month period, using a pre-tested, semi-structured interviewer-administered questionnaire on socio-demographic characteristics, utilisation and perception of MHC services. Data collected were analysed using SPSS version 17. Results: Findings showed that utilisation of facility for both antenatal (97.0%; 95% CI, 94.4–98.4%) and natal services (92.7%; 95% CI 89.2–95.2%) were quite high. Generally, most of the women were satisfied with MHC services (89.7%). Most of them were satisfied with the staff attitude (85.1%), waiting time (84.1%) and cost of services (79.5%). Being ≥30 years (X2 = 4.61, P = 0.032), married (X2 = 9.70, P = 0.008) and multiparous (X2 = 9.14, P = 0.028), as well as utilisation of formal health facility for antenatal (X2 = 26.94, P = 0.000) and natal (X2 = 33.42, P = 0.000) services were associated with satisfaction with maternal health services. Conclusions: The study showed high level of satisfaction with quality of maternal health services among antenatal attendees and highlights the need to strengthen interventions that increase uptake of formal MHC services. PMID:24791050

  1. 77 FR 7139 - Public Availability of Defense Nuclear Facilities Safety Board; FY 2010 Service Contract...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-10

    ... DEFENSE NUCLEAR FACILITIES SAFETY BOARD Public Availability of Defense Nuclear Facilities Safety Board; FY 2010 Service Contract Inventory Analysis/FY 2011 Service Contract Inventory AGENCY: Defense Nuclear Facilities Safety Board (DNFSB). ACTION: Notice of Public Availability of FY 2010 Service Contract...

  2. Quality of antenatal care service provision in health facilities across sub–Saharan Africa: Evidence from nationally representative health facility assessments

    PubMed Central

    Kanyangarara, Mufaro; Munos, Melinda K; Walker, Neff

    2017-01-01

    Background Utilization of antenatal care (ANC) services has increased over the past two decades. Continued gains in maternal and newborn health will require an understanding of both access and quality of ANC services. We linked health facility and household survey data to examine the quality of service provision for five ANC interventions across health facilities in sub–Saharan Africa. Methods Using data from 20 nationally representative health facility assessments – the Service Provision Assessment (SPA) and the Service Availability and Readiness Assessment (SARA), we estimated facility level readiness to deliver five ANC interventions: tetanus toxoid vaccine for pregnant women, intermittent preventive treatment for malaria in pregnancy (IPTp), syphilis detection and treatment in pregnancy, iron supplementation and hypertensive disease case management. Facility level indicators were stratified by health facility type, managing authority and location, then linked to estimates of ANC utilization in that stratum from the corresponding Demographic and Health Surveys (DHS) to generate population level estimates of the ‘likelihood of appropriate care’. Finally, the association between estimates of the ‘likelihood of appropriate care’ from the linking approach and estimates of coverage levels from the DHS were assessed. Findings A total of 10 534 health facilities were surveyed in the 20 health facility assessments, of which 8742 reported offering ANC services and were included in the analysis. Health facility readiness to deliver IPTp, iron supplementation, and tetanus toxoid vaccination was higher (median: 84.1%, 84.9% and 82.8% respectively) than readiness to deliver hypertensive disease case management and syphilis detection and treatment (median: 23.0% and 19.9% respectively). Coverage of at least 4 ANC visits ranged from 24.8% to 75.8%. Estimates of the likelihood of appropriate care derived from linking health facility and household survey data

  3. Dual indices for prioritizing investment in decentralized HIV services at Nigerian primary health care facilities

    PubMed Central

    Oyediran, Kola’ A; Mullen, Stephanie; Kolapo, Usman M

    2016-01-01

    Decentralizing health services, including those for HIV prevention and treatment, is one strategy for maximizing the use of limited resources and expanding treatment options; yet few methods exist for systematically identifying where investments for service expansion might be most effective, in terms of meeting needs and rapid availability of improved services. The Nigerian Government, the United States Government under the President's Emergency Plan for AIDS Relief (PEPFAR) program and other donors are expanding services for prevention of mother-to-child transmission (PMTCT) of HIV to primary health care facilities in Nigeria. Nigerian primary care facilities vary greatly in their readiness to deliver HIV/AIDS services. In 2012, MEASURE Evaluation assessed 268 PEPFAR-supported primary health care facilities in Nigeria and developed a systematic method for prioritizing these facilities for expansion of PMTCT services. Each assessed facility was scored based on two indices with multiple, weighted variables: one measured facility readiness to provide PMTCT services, the other measured local need for the services and feasibility of expansion. These two scores were compiled and the summary score used as the basis for prioritizing facilities for PMTCT service expansion. The rationale was that using need and readiness to identify where to expand PMTCT services would result in more efficient allocation of resources. A review of the results showed that the indices achieved the desired effect—that is prioritizing facilities with high need even when readiness was problematic and also prioritizing facilities where rapid scale-up was feasible. This article describes the development of the two-part index and discusses advantages of using this approach when planning service expansion. The authors' objective is to contribute to development of methodologies for prioritizing investments in HIV, as well as other public health arenas, that should improve cost-effectiveness and

  4. Virtual Facility at Fermilab: Infrastructure and Services Expand to Public Clouds

    DOE PAGES

    Timm, Steve; Garzoglio, Gabriele; Cooper, Glenn; ...

    2016-02-18

    In preparation for its new Virtual Facility Project, Fermilab has launched a program of work to determine the requirements for running a computation facility on-site, in public clouds, or a combination of both. This program builds on the work we have done to successfully run experimental workflows of 1000-VM scale both on an on-site private cloud and on Amazon AWS. To do this at scale we deployed dynamically launched and discovered caching services on the cloud. We are now testing the deployment of more complicated services on Amazon AWS using native load balancing and auto scaling features they provide. Themore » Virtual Facility Project will design and develop a facility including infrastructure and services that can live on the site of Fermilab, off-site, or a combination of both. We expect to need this capacity to meet the peak computing requirements in the future. The Virtual Facility is intended to provision resources on the public cloud on behalf of the facility as a whole instead of having each experiment or Virtual Organization do it on their own. We will describe the policy aspects of a distributed Virtual Facility, the requirements, and plans to make a detailed comparison of the relative cost of the public and private clouds. Furthermore, this talk will present the details of the technical mechanisms we have developed to date, and the plans currently taking shape for a Virtual Facility at Fermilab.« less

  5. Virtual Facility at Fermilab: Infrastructure and Services Expand to Public Clouds

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

    Timm, Steve; Garzoglio, Gabriele; Cooper, Glenn

    In preparation for its new Virtual Facility Project, Fermilab has launched a program of work to determine the requirements for running a computation facility on-site, in public clouds, or a combination of both. This program builds on the work we have done to successfully run experimental workflows of 1000-VM scale both on an on-site private cloud and on Amazon AWS. To do this at scale we deployed dynamically launched and discovered caching services on the cloud. We are now testing the deployment of more complicated services on Amazon AWS using native load balancing and auto scaling features they provide. Themore » Virtual Facility Project will design and develop a facility including infrastructure and services that can live on the site of Fermilab, off-site, or a combination of both. We expect to need this capacity to meet the peak computing requirements in the future. The Virtual Facility is intended to provision resources on the public cloud on behalf of the facility as a whole instead of having each experiment or Virtual Organization do it on their own. We will describe the policy aspects of a distributed Virtual Facility, the requirements, and plans to make a detailed comparison of the relative cost of the public and private clouds. Furthermore, this talk will present the details of the technical mechanisms we have developed to date, and the plans currently taking shape for a Virtual Facility at Fermilab.« less

  6. Robot Serviced Space Facility

    NASA Technical Reports Server (NTRS)

    Purves, Lloyd R. (Inventor)

    1992-01-01

    A robot serviced space facility includes multiple modules which are identical in physical structure, but selectively differing in function. and purpose. Each module includes multiple like attachment points which are identically placed on each module so as to permit interconnection with immediately adjacent modules. Connection is made through like outwardly extending flange assemblies having identical male and female configurations for interconnecting to and locking to a complementary side of another flange. Multiple rows of interconnected modules permit force, fluid, data and power transfer to be accomplished by redundant circuit paths. Redundant modules of critical subsystems are included. Redundancy of modules and of interconnections results in a space complex with any module being removable upon demand, either for module replacement or facility reconfiguration. without eliminating any vital functions of the complex. Module replacement and facility assembly or reconfiguration are accomplished by a computer controlled articulated walker type robotic manipulator arm assembly having two identical end-effectors in the form of male configurations which are identical to those on module flanges and which interconnect to female configurations on other flanges. The robotic arm assembly moves along a connected set or modules by successively disconnecting, moving and reconnecting alternate ends of itself to a succession of flanges in a walking type maneuver. To transport a module, the robot keeps the transported module attached to one of its end-effectors and uses another flange male configuration of the attached module as a substitute end-effector during walking.

  7. A standards-based approach to quality improvement for HIV services at Zambia Defence Force facilities: results and lessons learned.

    PubMed

    Kols, Adrienne; Kim, Young-Mi; Bazant, Eva; Necochea, Edgar; Banda, Joseph; Stender, Stacie

    2015-07-01

    The Zambia Defence Force adopted the Standards-Based Management and Recognition approach to improve the quality of the HIV-related services at its health facilities. This quality improvement intervention relies on comprehensive, detailed assessment tools to communicate and verify adherence to national standards of care, and to test and implement changes to improve performance. A quasi-experimental evaluation of the intervention was conducted at eight Zambia Defence Force primary health facilities (four facilities implemented the intervention and four did not). Data from three previous analyses are combined to assess the effect of Standards-Based Management and Recognition on three domains: facility readiness to provide services; observed provider performance during antiretroviral therapy (ART) and antenatal care consultations; and provider perceptions of the work environment. Facility readiness scores for ART improved on four of the eight standards at intervention sites, and one standard at comparison sites. Facility readiness scores for prevention of mother-to-child transmission (PMTCT) of HIV increased by 15 percentage points at intervention sites and 7 percentage points at comparison sites. Provider performance improved significantly at intervention sites for both ART services (from 58 to 84%; P < 0.01) and PMTCT services (from 58 to 73%; P = 0.003); there was no significant change at comparison sites. Providers' perceptions of the work environment generally improved at intervention sites and declined at comparison sites; differences in trends between study groups were significant for eight items. A standards-based approach to quality improvement proved effective in supporting healthcare managers and providers to deliver ART and PMTCT services in accordance with evidence-based standards in a health system suffering from staff shortages.

  8. 7 CFR 762.140 - General servicing responsibilities.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 7 2014-01-01 2014-01-01 false General servicing responsibilities. 762.140 Section 762.140 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE SPECIAL PROGRAMS GUARANTEED FARM LOANS § 762.140 General servicing responsibilities...

  9. Provision of Mental Health Services in South African Substance Abuse Treatment Facilities

    ERIC Educational Resources Information Center

    Myers, Bronwyn; Fakier, Nuraan

    2009-01-01

    To date, South African research has not examined mental health service provision in substance abuse treatment facilities, even though these services improve client retention and treatment outcomes. To describe the extent to which substance abuse treatment facilities in Gauteng and KwaZulu-Natal provinces provide clients with mental health services…

  10. Differences between U.S. substance abuse treatment facilities that do and do not offer domestic violence services.

    PubMed

    Cohn, Amy; Najavits, Lisa M

    2014-04-01

    Victimization by and perpetration of domestic violence are associated with co-occurring mental and substance use disorders. This study used data from the National Survey of Substance Abuse Treatment Services to examine differences in organizational factors, treatment approaches offered, and client-level factors among 13,342 substance abuse treatment facilities by whether or not they offered domestic violence services. Only 36% of the facilities offered domestic violence services. Those that offered such services were more likely than those that did not to treat clients with co-occurring disorders. Principal-components analysis reduced eight treatment approaches to two factors: psychosocial services and traditional substance abuse services. Regression models indicated that the frequency with which psychosocial services were offered depended on the percentage of clients with co-occurring disorders who were being treated in the facility and whether or not that facility offered domestic violence services. Specifically, facilities that did not offer domestic violence services and that had a high percentage of clients with co-occurring disorders were more likely to offer psychosocial services than facilities that offered domestic violence services. A larger proportion of facilities offering domestic violence services offered traditional substance abuse treatment services, compared with facilities not offering domestic violence services, but this relationship was not contingent on the percentage of clients with co-occurring disorders at each facility. Improved efforts should be made to tailor treatments to accommodate the links between domestic violence, mental disorders, and substance abuse.

  11. Dual indices for prioritizing investment in decentralized HIV services at Nigerian primary health care facilities.

    PubMed

    Fronczak, Nancy; Oyediran, Kola' A; Mullen, Stephanie; Kolapo, Usman M

    2016-04-01

    Decentralizing health services, including those for HIV prevention and treatment, is one strategy for maximizing the use of limited resources and expanding treatment options; yet few methods exist for systematically identifying where investments for service expansion might be most effective, in terms of meeting needs and rapid availability of improved services. The Nigerian Government, the United States Government under the President's Emergency Plan for AIDS Relief (PEPFAR) program and other donors are expanding services for prevention of mother-to-child transmission (PMTCT) of HIV to primary health care facilities in Nigeria. Nigerian primary care facilities vary greatly in their readiness to deliver HIV/AIDS services. In 2012, MEASURE Evaluation assessed 268 PEPFAR-supported primary health care facilities in Nigeria and developed a systematic method for prioritizing these facilities for expansion of PMTCT services. Each assessed facility was scored based on two indices with multiple, weighted variables: one measured facility readiness to provide PMTCT services, the other measured local need for the services and feasibility of expansion. These two scores were compiled and the summary score used as the basis for prioritizing facilities for PMTCT service expansion. The rationale was that using need and readiness to identify where to expand PMTCT services would result in more efficient allocation of resources. A review of the results showed that the indices achieved the desired effect-that is prioritizing facilities with high need even when readiness was problematic and also prioritizing facilities where rapid scale-up was feasible. This article describes the development of the two-part index and discusses advantages of using this approach when planning service expansion. The authors' objective is to contribute to development of methodologies for prioritizing investments in HIV, as well as other public health arenas, that should improve cost-effectiveness and

  12. 42 CFR 416.125 - ASC facility services payment rate.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false ASC facility services payment rate. 416.125 Section 416.125 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... connection with the performance of that procedure. (b) The payment must be substantially less than would have...

  13. 42 CFR 416.125 - ASC facility services payment rate.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false ASC facility services payment rate. 416.125 Section 416.125 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... connection with the performance of that procedure. (b) The payment must be substantially less than would have...

  14. 78 FR 10174 - Public Availability of General Services Administration FY 2012 Service Contract Inventory

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-13

    ... GENERAL SERVICES ADMINISTRATION [Notice-MV-2013-02; Docket No. 2013-0002; Sequence 3] Public Availability of General Services Administration FY 2012 Service Contract Inventory AGENCY: General Services Administration (GSA). ACTION: Notice of Public Availability of FY 2012 Service Contract Inventories. SUMMARY: In...

  15. Energy Cost Reduction for Automotive Service Facilities.

    ERIC Educational Resources Information Center

    Federal Energy Administration, Washington, DC.

    This handbook on energy cost reduction for automotive service facilities consists of four sections. The importance and economic benefits of energy conservation are discussed in the first section. In the second section six energy cost reduction measures are discussed: relamping interior areas; relamping and reducing interior lighting; setting back…

  16. 1. GENERAL VIEW TO THE WEST OF THE EMAD FACILITY ...

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

    1. GENERAL VIEW TO THE WEST OF THE E-MAD FACILITY AND THE SURROUNDING ENVIRONMENTAL AND TOPOGRAPHICAL SETTING. - Nevada Test Site, Engine Maintenance Assembly & Disassembly Facility, Area 25, Jackass Flats, Mercury, Nye County, NV

  17. Space Transportation and Destination Facilities

    NASA Technical Reports Server (NTRS)

    Smitherman, David; McClure, Wallace

    1999-01-01

    The Space Transportation and Destination Facilities section focused on space transportation vehicles-from use of existing vehicles to development of specialized transports-and on space stations, space business parks, space hotels, and other facilities in space of the kind that eventually would provide services for general public space travel (PST) and tourism. For both transportation and destination facilities, the emphasis was on the identification of various strategies to enable a realistic incremental progression in the development and acquisition of such facilities, and the identification of issues that need resolution to enable formation of viable businesses. The approach was to determine the best: (1) Strategies for general PST and tourism development through the description and analysis of a wide range of possible future scenarios. With these scenarios in mind the section then identified. (2) Key issues to be explored. (3) opportunities to eliminate barriers. (4) Recommendations for future actions. (5) Top-level requirements and characteristics for general PST and tourism systems and services that would guide the development of transportation and destination facilities.

  18. General Services Administration Semiannual Regulatory Agenda

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-20

    ... products and services to be used to facilitate recovery from a major disaster declared by the President or... Services Administration Semiannual Regulatory Agenda] Part XVI General Services Administration Semiannual Regulatory Agenda [[Page 79860

  19. 78 FR 12042 - Public Availability of Defense Nuclear Facilities Safety Board FY 2011 Service Contract Inventory...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-21

    ... DEFENSE NUCLEAR FACILITIES SAFETY BOARD Public Availability of Defense Nuclear Facilities Safety Board FY 2011 Service Contract Inventory Analysis/FY 2012 Service Contract Inventory AGENCY: Defense Nuclear Facilities Safety Board (DNFSB). ACTION: Notice of Public Availability of FY 2011 Service Contract...

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

    PubMed

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

    2011-01-01

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

  1. EPA Facilities and Regional Boundaries Service, US, 2012, US EPA, SEGS

    EPA Pesticide Factsheets

    This SEGS web service contains EPA facilities, EPA facilities labels, small- and large-scale versions of EPA region boundaries, and EPA region boundaries extended to the 200nm Exclusive Economic Zone (EEZ). Small scale EPA boundaries and boundaries extended to the EEZ render at scales of less than 5 million, large scale EPA boundaries draw at scales greater than or equal to 5 million. EPA facilities labels draw at scales greater than 2 million. Data used to create this web service are available as a separate download at the Secondary Linkage listed above. Full FGDC metadata records for each layer may be found by clicking the layer name in the web service table of contents (available through the online link provided above) and viewing the layer description. This SEGS dataset was produced by EPA through the Office of Environmental Information.

  2. New CPT codes: hospital, consultation, emergency and nursing facility services.

    PubMed

    Zuber, T J; Henley, D E

    1992-03-01

    New evaluation and management codes were created by the Current Procedural Terminology (CPT) Editorial Panel to ensure more accurate and consistent reporting of physician services. The new hospital inpatient codes describe three levels of service for both initial and subsequent care. Critical care services are reported according to the total time spent by a physician providing constant attention to a critically ill patient. Consultation codes are divided into four categories: office/outpatient, initial inpatient, follow-up inpatient and confirmatory. Emergency department services for both new and established patients are limited to five codes. In 1992, nursing facility services are described with either comprehensive-assessment codes or subsequent-care codes. Hospital discharge services may be reported in addition to the comprehensive nursing facility assessment. Since the 1992 CPT book will list only the new codes, and since all insurance carriers will not be using these codes in 1992, physicians are encouraged to keep their 1991 code books and contact their local insurance carriers to determine which codes will be used.

  3. 76 FR 5375 - Public Availability of General Services Administration FY 2010 Service Contract Inventory

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-31

    ... GENERAL SERVICES ADMINISTRATION [2011-MV-1; Docket No. 2011-0006; Sequence 4] Public Availability of General Services Administration FY 2010 Service Contract Inventory AGENCY: Office of Acquisition Policy; General Services Administration (GSA). ACTION: Notice. SUMMARY: This notice announces that GSA is...

  4. 77 FR 5253 - Public Availability of General Services Administration FY 2011 Service Contract Inventory

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-02

    ... GENERAL SERVICES ADMINISTRATION [Notice-MV-2012-01; Docket 2012-0002; Sequence 3] Public Availability of General Services Administration FY 2011 Service Contract Inventory AGENCY: Office of Acquisition Policy (MV); General Services Administration (GSA). ACTION: Notice of public availability of FY...

  5. Service providers' experiences of disrespectful and abusive behavior towards women during facility based childbirth in Addis Ababa, Ethiopia.

    PubMed

    Asefa, Anteneh; Bekele, Delayehu; Morgan, Alison; Kermode, Michelle

    2018-01-05

    Disrespect and abuse (D&A) of women during childbirth by the attending staff in health facilities has been widely reported in many countries. Although D&A in labor rooms is recognized as a deterrent to maternal health service utilization, approaches to defining, classifying, and measuring D&A are still at an early stage of development. This study aims to enhance understanding of service providers' experiences of D&A during facility based childbirth in health facilities in Addis Ababa. A facility based cross-sectional study was conducted in August 2013 in one hospital and three health centers. A total of 57 health professionals who had assisted with childbirth during the study period completed a self-administered questionnaire. Service providers' personal observations of mistreatment during childbirth and their perceptions of respectful maternity care (RMC) were assessed. Data were entered into and analyzed using SPSS version 16 software. The majority (83.7%) of participants were aged <30 years (mean = 27.25 ± 5.45). Almost half (43.9%) were midwives, and 77.2% had less than five years experience as a health professional. Work load was reported to be very high by 31.6% of participants, and 28% rated their working environment as poor or very poor. Almost half (50.3%) of participants reported that service providers do not generally obtain women's consent prior to procedures. One-quarter (25.9%) reported having ever witnessed physical abuse (physical force, slapping, or hitting) in their health facility. They also reported observing privacy violations (34.5%), and women being detained against their will (18%). Violations of women's rights were self-reported by 14.5% of participants. More than half (57.1%) felt that they had been disrespected and abused in their work place. The majority of participants (79.6%) believed that lack of respectful care discourages pregnant women from coming to health facilities for delivery. The study findings indicate that most

  6. Satisfaction with general practitioner treatment of depression among residents of aged care facilities.

    PubMed

    Mellor, David; Davison, Tanya; McCabe, Marita; Kuruvilla, George; Moore, Kathleen; Ski, Chantal

    2006-06-01

    This article investigates consumer perspectives on the treatment for depression among older people in residential facilities. Aged care residents who were aware of being treated for depression in the past 6 months (24 women and 7 men, mean age = 83 years) participated in an interview that assessed their perspective on treatments. Although more than half of the participants in the sample reported overall satisfaction with the medical treatments received for depression, qualitative data provided indications of unsatisfactory service delivery, including perceptions of low treatment efficacy, short consultation times, the failure to assess affective symptomatology, and negative responses to residents' disclosure of symptoms. The findings are discussed in relation to previous research on consumer satisfaction with health services and issues that may be pertinent to the elderly depressed. Training for general practitioners providing treatment in aged care is indicated.

  7. Quality management standards for facility services in the Italian health care sector.

    PubMed

    Cesarotti, Vittorio; Di Silvio, Bruna

    2006-01-01

    Health care, one of the most dynamic sectors in Italy, is studied with a particular focus on outsourcing non-core activities such as facility management (FM) services. The project's goals are to define national standards to balance and control facility service evolution, and to drive FM services towards organisational excellence. The authors, in cooperation with a pool of facility service providers and hospitals managers, studied cleaning services--one of the most critical areas. This article describes the research steps and findings following definition and publication of the Italian standard and its application to an international benchmarking process. The method chosen for developing the Italian standard was to merge technical, strategic and organisational aspects with the goal of standardising the contracting system, giving service providers the chance to improve efficiency and quality, while helping healthcare organisations gain from a better, more reliable and less expensive service. The Italian standard not only improved services but also provided adequate control systems for outsourcing organisations. In this win-win context, it is hoped to continually drive FM services towards organisational excellence. This study is specific to the Italian national healthcare system. However, the strategic dynamics described are common to many other contexts. A systematic method for improving hospital FM services is presented. The authors believe that lessons learned from their Italian case study can be used to better understand and drive similar services in other countries or in other FM service outsourcing sectors.

  8. 21 CFR 58.41 - General.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false General. 58.41 Section 58.41 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Facilities § 58.41 General. Each testing facility shall be of suitable size and...

  9. 21 CFR 58.41 - General.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 1 2011-04-01 2011-04-01 false General. 58.41 Section 58.41 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Facilities § 58.41 General. Each testing facility shall be of suitable size and...

  10. Preoperational Subsurface Conditions at the Idaho Nuclear Technology and Engineering Center Service Waste Disposal Facility

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

    Ansley, Shannon Leigh

    2002-02-01

    The Idaho Nuclear Technology and Engineering Center (INTEC) Service Wastewater Discharge Facility replaces the existing percolation ponds as a disposal facility for the INTEC Service Waste Stream. A preferred alternative for helping decrease water content in the subsurface near INTEC, closure of the existing ponds is required by the INTEC Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) Record of Decision (ROD) for Waste Area Group 3 Operable Unit 3-13 (DOE-ID 1999a). By August 2002, the replacement facility was constructed approximately 2 miles southwest of INTEC, near the Big Lost River channel. Because groundwater beneath the Idaho National Engineering andmore » Environmental Laboratory (INEEL) is protected under Federal and State of Idaho regulations from degradation due to INEEL activities, preoperational data required by U.S. Department of Energy (DOE) Order 5400.1 were collected. These data include preexisting physical, chemical, and biological conditions that could be affected by the discharge; background levels of radioactive and chemical components; pertinent environmental and ecological parameters; and potential pathways for human exposure or environmental impact. This document presents specific data collected in support of DOE Order 5400.1, including: four quarters of groundwater sampling and analysis of chemical and radiological parameters; general facility description; site specific geology, stratigraphy, soils, and hydrology; perched water discussions; and general regulatory requirements. However, in order to avoid duplication of previous information, the reader is directed to other referenced publications for more detailed information. Documents that are not readily available are compiled in this publication as appendices. These documents include well and borehole completion reports, a perched water evaluation letter report, the draft INEEL Wellhead Protection Program Plan, and the Environmental Checklist.« less

  11. 38 CFR 21.344 - Facility offering training or rehabilitation services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... and Employment Under 38 U.S.C. Chapter 31 Leaves of Absence § 21.344 Facility offering training or rehabilitation services. (a) Approval of leaves of absence required. Leaves of absence normally must be approved... facility. (c) Conditions permitting approval of leaves of absence. (1) The case manager may approve leaves...

  12. 38 CFR 21.344 - Facility offering training or rehabilitation services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... and Employment Under 38 U.S.C. Chapter 31 Leaves of Absence § 21.344 Facility offering training or rehabilitation services. (a) Approval of leaves of absence required. Leaves of absence normally must be approved... facility. (c) Conditions permitting approval of leaves of absence. (1) The case manager may approve leaves...

  13. 38 CFR 21.344 - Facility offering training or rehabilitation services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... and Employment Under 38 U.S.C. Chapter 31 Leaves of Absence § 21.344 Facility offering training or rehabilitation services. (a) Approval of leaves of absence required. Leaves of absence normally must be approved... facility. (c) Conditions permitting approval of leaves of absence. (1) The case manager may approve leaves...

  14. 38 CFR 21.344 - Facility offering training or rehabilitation services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... and Employment Under 38 U.S.C. Chapter 31 Leaves of Absence § 21.344 Facility offering training or rehabilitation services. (a) Approval of leaves of absence required. Leaves of absence normally must be approved... facility. (c) Conditions permitting approval of leaves of absence. (1) The case manager may approve leaves...

  15. 38 CFR 21.344 - Facility offering training or rehabilitation services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... and Employment Under 38 U.S.C. Chapter 31 Leaves of Absence § 21.344 Facility offering training or rehabilitation services. (a) Approval of leaves of absence required. Leaves of absence normally must be approved... facility. (c) Conditions permitting approval of leaves of absence. (1) The case manager may approve leaves...

  16. 42 CFR 415.204 - Services of residents in skilled nursing facilities and home health agencies.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Services of residents in skilled nursing facilities... Services of Residents § 415.204 Services of residents in skilled nursing facilities and home health...' services furnished in the following settings that meet the specified requirements: (1) Skilled nursing...

  17. 42 CFR 415.204 - Services of residents in skilled nursing facilities and home health agencies.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Services of residents in skilled nursing facilities... Services of Residents § 415.204 Services of residents in skilled nursing facilities and home health...' services furnished in the following settings that meet the specified requirements: (1) Skilled nursing...

  18. The Role of Distance and Quality on Facility Selection for Maternal and Child Health Services in Urban Kenya.

    PubMed

    Escamilla, Veronica; Calhoun, Lisa; Winston, Jennifer; Speizer, Ilene S

    2018-02-01

    Universal access to health care requires service availability and accessibility for those most in need of maternal and child health services. Women often bypass facilities closest to home due to poor quality. Few studies have directly linked individuals to facilities where they sought maternal and child health services and examined the role of distance and quality on this facility choice. Using endline data from a longitudinal survey from a sample of women in five cities in Kenya, we examine the role of distance and quality on facility selection for women using delivery, facility-based contraceptives, and child health services. A survey of public and private facilities offering reproductive health services was also conducted. Distances were measured between household cluster location and both the nearest facility and facility where women sought care. A quality index score representing facility infrastructure, staff, and supply characteristics was assigned to each facility. We use descriptive statistics to compare distance and quality between the nearest available facility and visited facility among women who bypassed the nearest facility. Facility distance and quality comparisons were also stratified by poverty status. Logistic regression models were used to measure associations between the quality and distance to the nearest facility and bypassing for each outcome. The majority of women bypassed the nearest facility regardless of service sought. Women bypassing for delivery traveled the furthest and had the fewest facility options near their residential cluster. Poor women bypassing for delivery traveled 4.5 km further than non-poor women. Among women who bypassed, two thirds seeking delivery and approximately 46% seeking facility-based contraception or child health services bypassed to a public hospital. Both poor and non-poor women bypassed to higher quality facilities. Our findings suggest that women in five cities in Kenya prefer public hospitals and are

  19. Study on Customer Satisfaction with Facilities Management Services in Lithuania

    NASA Astrophysics Data System (ADS)

    Lepkova, Natalija; Žūkaitė-Jefimovienė, Giedrė

    2012-12-01

    The article introduces the concept and content of facilities management (FM) services. The paper presents the concept of customer satisfaction and discusses the key factors which influence the opinions of customers and their satisfaction or dissatisfaction with the services provided. The article presents two studies: a brief survey of several FM service providers and a survey of customer satisfaction with FM services in Lithuania. The conclusions are given at the end of the article.

  20. Hanford facility dangerous waste permit application, general information portion

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

    Hays, C.B.

    1998-05-19

    The Hanford Facility Dangerous Waste Permit Application is considered to be a single application organized into a General Information Portion (document number DOE/RL-91-28) and a Unit-Specific Portion. Both the General Information and Unit-Specific portions of the Hanford Facility Dangerous Waste Permit Application address the content of the Part B permit application guidance prepared by the Washington State Department of Ecology (Ecology 1996) and the U.S. Environmental Protection Agency (40 Code of Federal Regulations 270), with additional information needed by the Hazardous and Solid Waste Amendments and revisions of Washington Administrative Code 173-303. Documentation contained in the General Information Portion ismore » broader in nature and could be used by multiple treatment, storage, and/or disposal units (e.g., the glossary provided in this report).« less

  1. 45 CFR 234.130 - Assistance in the form of institutional services in intermediate care facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... the intermediate care facility. (3) Provide methods of administration that include: (i) Placing of... intermediate care facility, whether the services actually rendered are adequate and responsive to the... intermediate care facility services under the medical assistance program, title XIX of the Act, but not later...

  2. Coverage of emergency obstetric care and availability of services in public and private health facilities in Bangladesh.

    PubMed

    Alam, Badrul; Mridha, Malay K; Biswas, Taposh K; Roy, Lumbini; Rahman, Maksudur; Chowdhury, Mahbub E

    2015-10-01

    To assess the coverage of emergency obstetric care (EmOC) and the availability of obstetric services in Bangladesh. In a national health facility assessment performed between November 2007 and July 2008, all public EmOC facilities and private facilities providing obstetric services in the 64 districts of Bangladesh were mapped. The performance of EmOC services in these facilities during the preceding month was investigated using a semi-structured questionnaire completed through interviews of managers and service providers, and record review. In total, 8.6 (2.1 public and 6.5 private) facilities per 500000 population offered obstetric care services. Population coverage by obstetric care facilities varied by region. Among 281 public facilities designated for comprehensive EmOC, cesarean delivery was available in only 215 (76.5%) and blood transfusion services in 198 (70.5%). In the private sector (for profit and not for profit), these services were available in more than 80% of facilities. In all facility types, performance of assisted vaginal delivery (range 12.2%-48.4%) and use of parenteral anticonvulsants to treat pre-eclampsia/eclampsia (range 48.6%-80.8%) were low. The main reason for non-availability of EmOC services was a lack of specialist/trained providers. Bangladesh needs to increase the availability of EmOC services through innovative public-private partnerships. In the public sector, additional trained manpower supported by an incentivized package should be deployed. Copyright © 2015. Published by Elsevier Ireland Ltd.

  3. Stone Quarrying, Crushing and Screening Facilities General Air Quality Permit Request for Coverage: US Silica - Parshall Transload Facility

    EPA Pesticide Factsheets

    Documents related to Request for Coverage under Stone Quarrying, Crushing, and Screening Facilities General Permit Indian Reservation, US Silica, Parshall Transload Facility, Fort Berthold Indian Reservation, North Dakota.

  4. Is the case-mix of patients who self-present to ED similar to general practice and other acute-care facilities?

    PubMed

    Harris, Tim; McDonald, Keith

    2014-12-01

    To benchmark walk-in presentations to emergency departments (ED) with those presenting to other local acute healthcare facilities. A large teaching hospital with an annual ED census of 140, 000 adult patients and surrounding associated acute healthcare providers. A random sample of 384 patients who self-presented to the ED was obtained. Benchmarking data were drawn from two general practices; the Tower Hamlets Community Services walk-in centre (co-located on-site with the ED) and the GP-run out-of-hours service. The case-mix presenting to the ED was characterised by a higher proportion of injuries and chest pain, but fewer simple infections and non-traumatic musculoskeletal conditions as compared to other acute care facilities in our region. Patients with injuries and possible cardiac chest pain were more likely to attend the ED, and those with infection or musculoskeletal problems less likely, as compared with other acute healthcare facilities. The population presenting to the ED is distinct from that presenting to general practice, out-of-hours clinics, or walk-in centres. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  5. 47 CFR 76.1602 - Customer service-general information.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Customer service-general information. 76.1602 Section 76.1602 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Notices § 76.1602 Customer service—general information. (a) A...

  6. 47 CFR 76.1602 - Customer service-general information.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 4 2014-10-01 2014-10-01 false Customer service-general information. 76.1602 Section 76.1602 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Notices § 76.1602 Customer service—general information. (a) A...

  7. 47 CFR 76.1602 - Customer service-general information.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 4 2013-10-01 2013-10-01 false Customer service-general information. 76.1602 Section 76.1602 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Notices § 76.1602 Customer service—general information. (a) A...

  8. 47 CFR 76.1602 - Customer service-general information.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 4 2012-10-01 2012-10-01 false Customer service-general information. 76.1602 Section 76.1602 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Notices § 76.1602 Customer service—general information. (a) A...

  9. 47 CFR 76.1602 - Customer service-general information.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 4 2011-10-01 2011-10-01 false Customer service-general information. 76.1602 Section 76.1602 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Notices § 76.1602 Customer service—general information. (a) A...

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

    PubMed

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

    2016-06-01

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

  11. 76 FR 57642 - TRICARE: Unfortunate Sequelae From Noncovered Services in a Military Treatment Facility

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-16

    ... TRICARE: Unfortunate Sequelae From Noncovered Services in a Military Treatment Facility AGENCY: Office of... treatment of complications (unfortunate sequelae) resulting from a noncovered incident of treatment provided in a Military Treatment Facility (MTF), when the initial noncovered service has been authorized by...

  12. Policy and Practice of Pre-Service and In-Service Teacher Training Programmes and Facilities in Nigeria

    ERIC Educational Resources Information Center

    Oyebade, Stephen A.

    2012-01-01

    This paper reviewed policy provisions for "pre-service" and "in-service" teacher training programmes and facilities in Nigeria. It also presented reviews on legislations, agencies involved in teacher affairs management in Nigeria, using the historical and case study approach. Data on teaching qualifications of University of…

  13. 38. 100,000 POUND STATIC TEST FACILITY: GENERAL VIEW OF TEST ...

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

    38. 100,000 POUND STATIC TEST FACILITY: GENERAL VIEW OF TEST BAY AND EXHAUST PIT, LOOKING WEST - White Sands Missile Range, V-2 Rocket Facilities, Near Headquarters Area, White Sands, Dona Ana County, NM

  14. 37. 100,000 POUND STATIC TEST FACILITY: GENERAL VIEW OF TEST ...

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

    37. 100,000 POUND STATIC TEST FACILITY: GENERAL VIEW OF TEST BAY AND EXHAUST PIT, LOOKING SOUTHWEST - White Sands Missile Range, V-2 Rocket Facilities, Near Headquarters Area, White Sands, Dona Ana County, NM

  15. 76 FR 5354 - Public Availability of Defense Nuclear Facilities Safety Board FY 2010 Service Contract Inventory

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-31

    ... DEFENSE NUCLEAR FACILITIES SAFETY BOARD Public Availability of Defense Nuclear Facilities Safety Board FY 2010 Service Contract Inventory AGENCY: Defense Nuclear Facilities Safety Board (Board). ACTION: Notice of public availability of FY 2010 Service Contract Inventories. SUMMARY: In accordance with...

  16. 34. 100,000 POUND STATIC TEST FACILITY: GENERAL VIEW OF BLOCKHOUSE ...

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

    34. 100,000 POUND STATIC TEST FACILITY: GENERAL VIEW OF BLOCKHOUSE AND TOP OF TEST BAY, LOOKING NORTHEAST - White Sands Missile Range, V-2 Rocket Facilities, Near Headquarters Area, White Sands, Dona Ana County, NM

  17. Wound center facility billing: A retrospective analysis of time, wound size, and acuity scoring for determining facility level of service.

    PubMed

    Fife, Caroline E; Walker, David; Farrow, Wade; Otto, Gordon

    2007-01-01

    Outpatient wound center facility reimbursement for Medicare beneficiaries can be a challenge to determine and obtain. To compare methods of calculating facility service levels for outpatient wound centers and to demonstrate the advantages of an acuity-based billing system (one that incorporates components of facility work that is non-reimbursable by procedure codes and that represents an activity-based costing approach to medical billing), a retrospective study of 5,098 patient encounters contained in a wound care-specific electronic medical record database was conducted. Approximately 500 patient visits to the outpatient wound center of a Texas regional hospital between April 2003 and November 2004 were categorized by service level in documentation and facility management software. Visits previously billed using a time-based system were compared to the Centers for Medicare and Medicaid Services' proposed three-tiered wound size-based system. The time-based system also was compared to an acuity-based scoring system. The Pearson correlation coefficient between billed level of service by time and estimated level of service by acuity was 0.442 and the majority of follow-up visits were billed as Level 3 and above (on a time level of 1 to 5) , confirming that time is not a surrogate for actual work performed. Wound size also was found to be unrelated to service level (Pearson correlation = 0.017) and 97% of wound areas were < 100 cm2. The acuity-based scoring system produced a near-normal distribution of results, producing more mid-range billings than extremes; no other method produced this distribution. Hospital-based outpatient wound centers should develop, review, and refine acuity score-based models on which to determine billed level of service.

  18. 33. 100,000 POUND STATIC TEST FACILITY: GENERAL VIEW OF BLOCKHOUSE ...

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

    33. 100,000 POUND STATIC TEST FACILITY: GENERAL VIEW OF BLOCKHOUSE AND UPPER LEVEL OF TEST BAY, LOOKING NORTH - White Sands Missile Range, V-2 Rocket Facilities, Near Headquarters Area, White Sands, Dona Ana County, NM

  19. The effect of facility-based antiretroviral therapy programs on outpatient services in Kenya and Uganda.

    PubMed

    Wollum, Alexandra; Dansereau, Emily; Fullman, Nancy; Achan, Jane; Bannon, Kelsey A; Burstein, Roy; Conner, Ruben O; DeCenso, Brendan; Gasasira, Anne; Haakenstad, Annie; Hanlon, Michael; Ikilezi, Gloria; Kisia, Caroline; Levine, Aubrey J; Masters, Samuel H; Njuguna, Pamela; Okiro, Emelda A; Odeny, Thomas A; Allen Roberts, D; Gakidou, Emmanuela; Duber, Herbert C

    2017-08-16

    Considerable debate exists concerning the effects of antiretroviral therapy (ART) service scale-up on non-HIV services and overall health system performance in sub-Saharan Africa. In this study, we examined whether ART services affected trends in non-ART outpatient department (OPD) visits in Kenya and Uganda. Using a nationally representative sample of health facilities in Kenya and Uganda, we estimated the effect of ART programs on OPD visits from 2007 to 2012. We modeled the annual percent change in non-ART OPD visits using hierarchical mixed-effects linear regressions, controlling for a range of facility characteristics. We used four different constructs of ART services to capture the different ways in which the presence, growth, overall, and relative size of ART programs may affect non-ART OPD services. Our final sample included 321 health facilities (140 in Kenya and 181 in Uganda). On average, OPD and ART visits increased steadily in Kenya and Uganda between 2007 and 2012. For facilities where ART services were not offered, the average annual increase in OPD visits was 4·2% in Kenya and 13·5% in Uganda. Among facilities that provided ART services, we found average annual OPD volume increases of 7·2% in Kenya and 5·6% in Uganda, with simultaneous annual increases of 13·7% and 12·5% in ART volumes. We did not find a statistically significant relationship between annual changes in OPD services and the presence, growth, overall, or relative size of ART services. However, in a subgroup analysis, we found that Ugandan hospitals that offered ART services had statistically significantly less growth in OPD visits than Ugandan hospitals that did not provide ART services. Our findings suggest that ART services in Kenya and Uganda did not have a statistically significant deleterious effects on OPD services between 2007 and 2012, although subgroup analyses indicate variation by facility type. Our findings are encouraging, particularly given recent recommendations

  20. 21 CFR 211.52 - Washing and toilet facilities.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR FINISHED PHARMACEUTICALS Buildings and Facilities... cold water, soap or detergent, air driers or single-service towels, and clean toilet facilities easily...

  1. 21 CFR 211.52 - Washing and toilet facilities.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR FINISHED PHARMACEUTICALS Buildings and Facilities... cold water, soap or detergent, air driers or single-service towels, and clean toilet facilities easily...

  2. 21 CFR 211.52 - Washing and toilet facilities.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR FINISHED PHARMACEUTICALS Buildings and Facilities... cold water, soap or detergent, air driers or single-service towels, and clean toilet facilities easily...

  3. 21 CFR 211.52 - Washing and toilet facilities.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR FINISHED PHARMACEUTICALS Buildings and Facilities... cold water, soap or detergent, air driers or single-service towels, and clean toilet facilities easily...

  4. 21 CFR 211.52 - Washing and toilet facilities.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR FINISHED PHARMACEUTICALS Buildings and Facilities... cold water, soap or detergent, air driers or single-service towels, and clean toilet facilities easily...

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

    ERIC Educational Resources Information Center

    Ragsdale, Lee; And Others

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

  6. 12 CFR 7.5002 - Furnishing of products and services by electronic means and facilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Furnishing of products and services by... products and services by electronic means and facilities. (a) Use of electronic means and facilities. A... a collection of links to web sites of third-party vendors, organized by-product type and made...

  7. 34 CFR 361.51 - Standards for facilities and providers of services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Standards for facilities and providers of services. 361.51 Section 361.51 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION STATE VOCATIONAL...

  8. General Air Quality Permit Request for Coverage: US Silica - Parshall Transload Facility

    EPA Pesticide Factsheets

    Documents related to Request for Coverage under Stone Quarrying, Crushing, and Screening Facilities General Permit Indian Reservation, US Silica, Parshall Transload Facility, Fort Berthold Indian Reservation, North Dakota.

  9. 21 CFR 58.45 - Animal supply facilities.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 1 2011-04-01 2011-04-01 false Animal supply facilities. 58.45 Section 58.45 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Facilities § 58.45 Animal supply facilities. There...

  10. 21 CFR 58.45 - Animal supply facilities.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 1 2012-04-01 2012-04-01 false Animal supply facilities. 58.45 Section 58.45 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Facilities § 58.45 Animal supply facilities. There...

  11. 21 CFR 58.45 - Animal supply facilities.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 1 2014-04-01 2014-04-01 false Animal supply facilities. 58.45 Section 58.45 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Facilities § 58.45 Animal supply facilities. There...

  12. 21 CFR 58.45 - Animal supply facilities.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 1 2013-04-01 2013-04-01 false Animal supply facilities. 58.45 Section 58.45 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Facilities § 58.45 Animal supply facilities. There...

  13. 18 CFR 157.18 - Applications to abandon facilities or service; exhibits.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Applications to abandon facilities or service; exhibits. 157.18 Section 157.18 Conservation of Power and Water Resources FEDERAL..., Concerning Any Operation, Sales, Service, Construction, Extension, Acquisition or Abandonment § 157.18...

  14. 18 CFR 157.18 - Applications to abandon facilities or service; exhibits.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false Applications to abandon facilities or service; exhibits. 157.18 Section 157.18 Conservation of Power and Water Resources FEDERAL..., Concerning Any Operation, Sales, Service, Construction, Extension, Acquisition or Abandonment § 157.18...

  15. 18 CFR 157.18 - Applications to abandon facilities or service; exhibits.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false Applications to abandon facilities or service; exhibits. 157.18 Section 157.18 Conservation of Power and Water Resources FEDERAL..., Concerning Any Operation, Sales, Service, Construction, Extension, Acquisition or Abandonment § 157.18...

  16. 18 CFR 157.18 - Applications to abandon facilities or service; exhibits.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Applications to abandon facilities or service; exhibits. 157.18 Section 157.18 Conservation of Power and Water Resources FEDERAL..., Concerning Any Operation, Sales, Service, Construction, Extension, Acquisition or Abandonment § 157.18...

  17. 18 CFR 157.18 - Applications to abandon facilities or service; exhibits.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Applications to abandon facilities or service; exhibits. 157.18 Section 157.18 Conservation of Power and Water Resources FEDERAL..., Concerning Any Operation, Sales, Service, Construction, Extension, Acquisition or Abandonment § 157.18...

  18. Performance of general health workers in leprosy control activities at public health facilities in Amhara and Oromia States, Ethiopia.

    PubMed

    Abeje, Tadiye; Negera, Edessa; Kebede, Eshetu; Hailu, Tsegaye; Hassen, Ismaile; Lema, Tsehainesh; Yamuah, Lawrence; Shiguti, Birru; Fenta, Melkamu; Negasa, Megersa; Beyene, Demissew; Bobosha, Kidist; Aseffa, Abraham

    2016-04-07

    towards leprosy was positive for the majority of the respondents. The result showed that 519 (86.3%) had poor knowledge. Overall 155 (25.8%) of the respondents had positive attitude towards leprosy while 205 (34.1%) had intermediate (mixed) attitude and 241 (40.1%) had negative attitude to the disease. Among 83 respondents assessed for diagnosis of leprosy only 15(18.0%) diagnosed leprosy correctly. Variation in knowledge and attitude indicated a significant difference (p < 0.05) among different health institutions, professions, gender, in-service training and years of experience. The current finding underlines that although leprosy control activities are integrated to the general health services in the country, the knowledge and skills of leprosy diagnosis, treatment and management by health workers was unsatisfactory. Hence, attention should be given to develop training strategies that can improve health worker knowledge and promote better leprosy management at public health facilities. This could be achieved through pre-service and in-service training and giving adequate emphasis to leprosy related practical work and continuous follow- up.

  19. Instructor Guides for Training Food Service Supervisors in Long Term Care Facilities.

    ERIC Educational Resources Information Center

    Eastern Iowa Community Coll. District, Davenport.

    This final report describes a project to develop postsecondary teacher resource guides for supervisor courses in food service management, preparation and service of modified diets, and meal service in long-term care facilities in Iowa. Introductory material includes the following: project objective, a description of how the objective was met, the…

  20. 49 CFR 193.2019 - Mobile and temporary LNG facilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Mobile and temporary LNG facilities. 193.2019... LIQUEFIED NATURAL GAS FACILITIES: FEDERAL SAFETY STANDARDS General § 193.2019 Mobile and temporary LNG facilities. (a) Mobile and temporary LNG facilities for peakshaving application, for service maintenance...

  1. Review of paediatric cardiology services in district general hospitals in the United Kingdom.

    PubMed

    Andrews, Hannah; Singh, Yogen

    2016-03-01

    Following the Safe and Sustainable review of Paediatric Services in 2012/2013, National Health Service England recommended that local paediatric cardiology services should be provided by specially trained paediatricians with expertise in cardiology in all non-specialist hospitals. To understand the variation in local paediatric cardiology services provided across district general hospitals in the United Kingdom. An internet-based questionnaire was sent out via the Paediatrician with Expertise in Cardiology Special Interest Group and the Neonatologists with Interest in Cardiology and Haemodynamics contact databases and the National Health Service directory. Non-responders were followed-up via telephone. The response rate was 80% (141 of 177 hospitals), and paediatricians with expertise in cardiology were available in 68% of those. Local cardiology clinics led by paediatricians with expertise in cardiology were provided in 96 hospitals (68%), whereas specialist outreach clinics were held in 123 centres (87%). A total of 11 hospitals provided neither specialist outreach clinics nor any local cardiology clinics led by paediatricians with expertise in cardiology. Paediatric echocardiography services were provided in 83% of the hospitals, 12-lead electrocardiogram in 96%, Holter electrocardiogram in 91%, and exercise testing in only 47% of the responding hospitals. Telemedicine facilities were established in only 52% of the centres, where sharing echocardiogram images via picture archiving and communication system was used most commonly. There has been a substantial increase in the availability of paediatricians with expertise in cardiology since 2008. Most of the hospitals are well-supported by specialist cardiology centres via outreach clinics; however, there remains significant variation in the local paediatric cardiology services provided across district general hospitals in the United Kingdom.

  2. Does courtesy bias affect how clients report on objective and subjective measures of family planning service quality? A comparison between facility- and home-based interviews.

    PubMed

    Hameed, Waqas; Ishaque, Muhammad; Gul, Xaher; Siddiqui, Junaid-Ur-Rehman; Hussain, Sharmeen; Hussain, Wajahat; Ahmed, Aftab; Balal, Asma

    2017-01-01

    Despite a general understanding that exit interviews being conducted at service providers' facilities may influence clients' responses favorably to health professionals, there is very little evidence available that demonstrates the extent to which this problem exists. This study aimed at assessing and comparing clients' perceptions of the quality of family planning services and their satisfaction levels between facility- and home-based interviews. A cross-sectional survey was conducted among clients receiving family planning services across three service delivery channels - nongovernmental organization (NGO) clinics, social franchise (SF) centers, and outreach camps. The survey took place from December 2015 to January 2016 in 70 districts across all four provinces of Pakistan. A total of 2,807 clients were interviewed, of whom 1,404 clients were interviewed at health facilities after receiving services and 1,403 were interviewed at their homes within 3 days of method uptake. Overall, we found no significant differences between the characteristics of study participants interviewed at health facilities or at home. The findings suggested that experiences reported in exit surveys at facilities were strongly biased positively. This was true for both experiential (service quality) and perception-based (satisfaction) questions in the context of SF centers, while at NGO clinics the interview location only affected clients' responses regarding service quality. However, in outreach settings, clients are more likely to share bad experiences in exit interviews than in home-based interviews on objectively asked questions (service quality). Our study indicates signs of courtesy bias and possibly the Hawthorne effect in exit interviews. Program implementers could opt for home-based interviews for women receiving services at NGO clinics or SF center, whereas exit interviews could be used in outreach settings.

  3. 46 CFR 160.151-43 - Conditions at servicing facilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 6 2011-10-01 2011-10-01 false Conditions at servicing facilities. 160.151-43 Section 160.151-43 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Inflatable Liferafts (SOLAS) § 160.151...

  4. 46 CFR 160.151-41 - Approval of servicing facilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 6 2011-10-01 2011-10-01 false Approval of servicing facilities. 160.151-41 Section 160.151-41 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Inflatable Liferafts (SOLAS) § 160.151-41...

  5. Cost of delivering health care services at primary health facilities in Ghana.

    PubMed

    Dalaba, Maxwell Ayindenaba; Welaga, Paul; Matsubara, Chieko

    2017-11-17

    There is limited knowledge on the cost of delivering health services at primary health care facilities in Ghana which is posing a challenge in resource allocations. This study therefore estimated the cost of providing health care in primary health care facilities such as Health Centres (HCs) and Community-based Health Planning and Services (CHPS) in Ghana. The study was cross-sectional and quantitative data was collected from the health provider perspective. Data was collected between July and August, 2016 at nine primary health facilities (six CHPS and three HCs) from the Upper West region of Ghana. All health related costs for the year 2015 and revenue generated for the period were collected. Data were captured and analysed using Microsoft excel. Costs of delivery health services were estimated. In addition, unit costs such as cost per Outpatient Department (OPD) attendance were estimated. The average annual cost of delivering health services through CHPS and HCs was US$10,923 and US$44,638 respectively. Personnel cost accounted for the largest proportion of cost (61% for CHPS and 59% for HC). The cost per OPD attendance was higher at CHPS (US$8.79) than at HCs (US$5.16). The average Internally Generated Funds (IGF) recorded for the period at CHPS and HCs were US$2327 and US$ 15,795 respectively. At all the facilities, IGFs were greatly lower than costs of running the health facilities. Also, at both the CHPS and HCs, the National Health Insurance Scheme (NHIS) reimbursement was the main source of revenue accounting for over 90% total IGF. The average annual cost of delivering primary health services through CHPS and HCs is US$10,923 and US$44,638 respectively and personnel cost accounts for the major cost. The government should be guided by these findings in their financial planning, decision making and resource allocation in order to improve primary health care in the country. However, more similar studies involving large numbers of primary health facilities in

  6. Social work services in Army medical treatment facilities: are they reorganizing?

    PubMed

    Hamlin, E R; Pehrson, K L; Gemmill, R

    1996-01-01

    The end of the Cold War and the fall of Communism in Europe resulted in profound changes in U.S. defense policy. Those changes led to dramatic reductions in personnel and programs within the Army. The Army Medical Department (AMEDD) is also being reduced in size and reorganized. At the same time, the AMEDD is facing escalating health care costs associated with demand and access to medical care. Social work services in Army medical treatment facilities are being directly affected by these system changes. Therefore, the question is raised whether changes in the organization and delivery of social work services are being initiated or anticipated. To what extent are social work chiefs of service involved in these decisions at the medical treatment facility level, and what are the positive and negative effects of reorganization on social work staff and the clients they serve?

  7. Integrating postabortion care, menstrual regulation and family planning services in Bangladesh: a pre-post evaluation.

    PubMed

    Biswas, Kamal K; Pearson, Erin; Shahidullah, S M; Sultana, Sharmin; Chowdhury, Rezwana; Andersen, Kathryn L

    2017-03-11

    In Bangladesh, abortion is restricted except to save the life of a woman, but menstrual regulation is allowed to induce menstruation and return to non-pregnancy after a missed period. MR services are typically provided through the Directorate General of Family Planning, while postabortion care services for incomplete abortion are provided by facilities under the Directorate General of Health Services. The bifurcated health system results in reduced quality of care, particularly for postabortion care patients whose procedures are often performed using sub-optimal uterine evacuation technology and typically do not receive postabortion contraceptive services. This study evaluated the success of a pilot project that aimed to integrate menstrual regulation, postabortion care and family planning services across six Directorate General of Health Services and Directorate General of Family Planning facilities by training providers on woman-centered abortion care and adding family planning services at sites offering postabortion care. A pre-post evaluation was conducted in the six large intervention facilities. Structured client exit interviews were administered to all uterine evacuation clients presenting in the 2-week data collection period for each facility at baseline (n = 105; December 2011-January 2012) and endline (n = 107; February-March 2013). Primary outcomes included service integration indicators such as provision of menstrual regulation, postabortion care and family planning services in both facility types, and quality of care indicators such as provision of pain management, provider communication and women's satisfaction with the services received. Outcomes were compared between baseline and endline for Directorate General of Family Planning and Directorate General of Health Services facilities, and chi-square tests and t-tests were used to test for differences between baseline and endline. At the end of the project there was an increase in menstrual

  8. 38 CFR 59.130 - General requirements for all State home facilities.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... all State home facilities. 59.130 Section 59.130 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES § 59.130 General requirements for all State home facilities. As a condition for receiving a grant and grant funds...

  9. 38 CFR 59.130 - General requirements for all State home facilities.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... all State home facilities. 59.130 Section 59.130 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES § 59.130 General requirements for all State home facilities. As a condition for receiving a grant and grant funds...

  10. 38 CFR 59.130 - General requirements for all State home facilities.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... all State home facilities. 59.130 Section 59.130 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES § 59.130 General requirements for all State home facilities. As a condition for receiving a grant and grant funds...

  11. 38 CFR 59.130 - General requirements for all State home facilities.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... all State home facilities. 59.130 Section 59.130 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES § 59.130 General requirements for all State home facilities. As a condition for receiving a grant and grant funds...

  12. 40 CFR 63.11166 - What General Provisions apply to primary beryllium production facilities?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Primary Nonferrous Metals Area Sources-Zinc, Cadmium, and Beryllium Primary Beryllium Production Facilities § 63.11166 What General Provisions apply to primary beryllium production facilities? (a) You must... primary beryllium production facilities? 63.11166 Section 63.11166 Protection of Environment ENVIRONMENTAL...

  13. Experts stress both wellness and amenity aspects of food and nutrition services in assisted living facilities for older adults.

    PubMed

    Chao, Shirley Y; Dwyer, Johanna T; Houser, Robert F; Jacques, Paul; Tennstedt, Sharon

    2008-10-01

    There has been no consensus on best practices in food and nutrition services in assisted living facilities for older adults. We documented experts' views on optimal food and nutrition services emphases in assisted living facilities, and factors affecting their views. One hundred thirty-five national experts specializing in health, aging, nutrition and assisted living facilities completed a survey consisting four scenarios (ie, home-style, restaurant/hotel, and health/medical, and a combination of these three) in six food and nutrition services areas: dining room environment, meal services, meal quality, nutrition services, employees' qualifications, and therapeutic nutrition services. Sixty-three percent of experts favored the combination scenario. Dietetics education and experts' beliefs that assisted living facilities should be health promotion and maintenance facilities were significant predictors of emphases, including wellness considerations. Experts' personal views exerted a powerful influence. Experts chose food and nutrition service quality indicators that emphasized a focus on both wellness and amenities as their ideal scenarios for optimal food and nutrition services in assisted living facilities.

  14. 76 FR 34103 - In the Matter of Areva Enrichment Services, LLC (Eagle Rock Enrichment Facility); Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-10

    .... 10-899-02-ML-BD01] In the Matter of Areva Enrichment Services, LLC (Eagle Rock Enrichment Facility... gas centrifuge uranium enrichment facility--denoted as the Eagle Rock Enrichment Facility (EREF)--in... Information for Contention Preparation; In the Matter of Areva Enrichment Services, LLC (Eagle Rock Enrichment...

  15. Can contracted out health facilities improve access, equity, and quality of maternal and newborn health services? Evidence from Pakistan.

    PubMed

    Zaidi, Shehla; Riaz, Atif; Rabbani, Fauziah; Azam, Syed Iqbal; Imran, Syeda Nida; Pradhan, Nouhseen Akber; Khan, Gul Nawaz

    2015-11-25

    The case of contracting out government health services to non-governmental organizations (NGOs) has been weak for maternal, newborn, and child health (MNCH) services, with documented gains being mainly in curative services. We present an in-depth assessment of the comparative advantages of contracting out on MNCH access, quality, and equity, using a case study from Pakistan. An end-line, cross-sectional assessment was conducted of government facilities contracted out to a large national NGO and government-managed centres serving as controls, in two remote rural districts of Pakistan. Contracting out was specific for augmenting MNCH services but without contractual performance incentives. A household survey, a health facility survey, and focus group discussions with client and spouses were used for assessment. Contracted out facilities had a significantly higher utilization as compared to control facilities for antenatal care, delivery, postnatal care, emergency obstetric care, and neonatal illness. Contracted facilities had comparatively better quality of MNCH services but not in all aspects. Better household practices were also seen in the district where contracting involved administrative control over outreach programs. Contracting was also faced with certain drawbacks. Facility utilization was inequitably higher amongst more educated and affluent clients. Contracted out catchments had higher out-of-pocket expenses on MNCH services, driven by steeper transport costs and user charges for additional diagnostics. Contracting out did not influence higher MNCH service coverage rates across the catchment. Physical distances, inadequate transport, and low demand for facility-based care in non-emergency settings were key client-reported barriers. Contracting out MNCH services at government health facilities can improve facility utilization and bring some improvement in  quality of services. However, contracting out of health facilities is insufficient to increase

  16. 40 CFR 63.11164 - What General Provisions apply to primary zinc production facilities?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... primary zinc production facilities? 63.11164 Section 63.11164 Protection of Environment ENVIRONMENTAL... Primary Nonferrous Metals Area Sources-Zinc, Cadmium, and Beryllium Primary Zinc Production Facilities § 63.11164 What General Provisions apply to primary zinc production facilities? (a) If you own or...

  17. 40 CFR 63.11164 - What General Provisions apply to primary zinc production facilities?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... primary zinc production facilities? 63.11164 Section 63.11164 Protection of Environment ENVIRONMENTAL... Primary Nonferrous Metals Area Sources-Zinc, Cadmium, and Beryllium Primary Zinc Production Facilities § 63.11164 What General Provisions apply to primary zinc production facilities? (a) If you own or...

  18. Facility-level, state, and financial factors associated with changes in the provision of smoking cessation services in US substance abuse treatment facilities: Results from the National Survey of Substance Abuse Treatment Services 2006 to 2012.

    PubMed

    Cohn, Amy; Elmasry, Hoda; Niaura, Ray

    2017-06-01

    Cigarette smoking is common among patients in substance abuse treatment. Tobacco control programs have advocated for integrated tobacco dependence treatment into behavioral healthcare, including within substance abuse treatment facilities (SATFs) to reduce the public health burden of tobacco use. This study used data from seven waves (2006 to 2012) of the National Survey of Substance Abuse Treatment Services (n=94,145) to examine state and annual changes in the provision of smoking cessation services within US SATFs and whether changes over time could be explained by facility-level (private vs public ownership, receipt of earmarks, facility admissions, acceptance of government insurance) and state-level factors (cigarette tax per pack, smoke free policies, and percent of CDC recommended tobacco prevention spending). Results showed that the prevalence of SATFs offering smoking cessation services increased over time, from 13% to 65%. The amount of tax per cigarette pack, accepting government insurance, government (vs private) ownership, facility admissions, and CDC recommended tobacco prevention spending (per state) were the strongest correlates of the provision of smoking cessation programs in SATFs. Facilities that received earmarks were less likely to provide cessation services. Adult smoking prevalence and state-level smoke free policies were not significant correlates of the provision of smoking cessation services over time. Policies aimed at increasing the distribution of tax revenues to cessation services in SATFs may offset tobacco-related burden among those with substance abuse problems. Copyright © 2017. Published by Elsevier Inc.

  19. 21 CFR 58.31 - Testing facility management.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Organization and Personnel § 58.31 Testing facility management. For each nonclinical laboratory study, testing facility management shall: (a) Designate a study...

  20. Health sciences libraries in Kuwait: a study of their resources, facilities, and services

    PubMed Central

    Al-Ansari, Husain A.; Al-Enezi, Sana

    2001-01-01

    The purpose of this study was to examine the current status of health sciences libraries in Kuwait in terms of their staff, collections, facilities, use of information technology, information services, and cooperation. Seventeen libraries participated in the study. Results show that the majority of health sciences libraries were established during the 1980s. Their collections are relatively small. The majority of their staff is nonprofessional. The majority of libraries provide only basic information services. Cooperation among libraries is limited. Survey results also indicate that a significant number of health sciences libraries are not automated. Some recommendations for the improvement of existing resources, facilities, and services are made. PMID:11465688

  1. Quality Assessment of Family Planning Sterilization Services at Health Care Facilities: Case Record Audit.

    PubMed

    Mathur, Medha; Goyal, Ram Chandra; Mathur, Navgeet

    2017-05-01

    Quality of sterilization services is a matter of concern in India because population control is a necessity. Family Planning Sterilization (FPS) services provided at public health care facilities need to be as per Standard Operating Procedures. To assess the quality of FPS services by audit of case records at selected health care facilities. This cross-sectional study was conducted for two and a half year duration at selected public health care facilities of central India by simple random sampling where FPS services were provided. As per the standards of Government of India, case records were audited and compliance was calculated to assess the quality of services. Results of record audit were satisfactory but important criteria like previous contraceptive history and postoperative counselling were found to be deviated from standards. At Primary Health Centres (PHCs) only 89.5% and at Community Health Centres (CHCs) 58.7% of records were having details of previous contraceptive history. Other criteria like mental illness (only 70% at CHCs) assessment were also inadequate. Although informed consent was found to be having 100% compliance in all records. Quality of care in FPS services is the matter of concern in present scenario for better quality of services. This study may enlighten the policy makers regarding improvements needed for providing quality care.

  2. Energy efficiency in U.S. Forest Service facilities: a multiregion review

    Treesearch

    Rachelle S. Meyer; David L. Nicholls; Trista M. Patterson; Rachel E. White

    2013-01-01

    We reviewed energy efficiency measures in facilities across the U.S. Department of Agriculture Forest Service, examining opportunities and obstacles, and identifying factors of project success. The adoption of energy efficiency measures at Forest Service sites was seen to be most likely when decision control was local to the site and when budget timing and structures...

  3. Does courtesy bias affect how clients report on objective and subjective measures of family planning service quality? A comparison between facility- and home-based interviews

    PubMed Central

    Hameed, Waqas; Ishaque, Muhammad; Gul, Xaher; Siddiqui, Junaid-ur-Rehman; Hussain, Sharmeen; Hussain, Wajahat; Ahmed, Aftab; Balal, Asma

    2017-01-01

    Purpose Despite a general understanding that exit interviews being conducted at service providers’ facilities may influence clients’ responses favorably to health professionals, there is very little evidence available that demonstrates the extent to which this problem exists. This study aimed at assessing and comparing clients’ perceptions of the quality of family planning services and their satisfaction levels between facility- and home-based interviews. Methods A cross-sectional survey was conducted among clients receiving family planning services across three service delivery channels – nongovernmental organization (NGO) clinics, social franchise (SF) centers, and outreach camps. The survey took place from December 2015 to January 2016 in 70 districts across all four provinces of Pakistan. A total of 2,807 clients were interviewed, of whom 1,404 clients were interviewed at health facilities after receiving services and 1,403 were interviewed at their homes within 3 days of method uptake. Results Overall, we found no significant differences between the characteristics of study participants interviewed at health facilities or at home. The findings suggested that experiences reported in exit surveys at facilities were strongly biased positively. This was true for both experiential (service quality) and perception-based (satisfaction) questions in the context of SF centers, while at NGO clinics the interview location only affected clients’ responses regarding service quality. However, in outreach settings, clients are more likely to share bad experiences in exit interviews than in home-based interviews on objectively asked questions (service quality). Conclusion Our study indicates signs of courtesy bias and possibly the Hawthorne effect in exit interviews. Program implementers could opt for home-based interviews for women receiving services at NGO clinics or SF center, whereas exit interviews could be used in outreach settings. PMID:29760573

  4. A Care Pathway for Children Unable to Accept Dental Care Within the General Dental Services Involving the Use of Inhalation Sedation and General Anaesthesia.

    PubMed

    Shepherd, Allyson R; Ali, Halimah

    2015-05-01

    Dental treatment is the commonest reason for a child to be in hospital in the UK. This is a shocking statistic for a preventable disease. How can we reduce the high numbers of dental general anaesthetics? It is essential that dental treatment under general anaesthesia (GA) is fully justifiable, ensuring that the right patients receive the right treatment. Guidance for general dental practitioners on when to refer a child for a dental GA is discussed. Treatment planning for this dentally high-risk group of children requires a holistic approach. It is complex and requires an experienced and competent clinical team, including dental care professionals with additional postgraduate qualifications. Often, alternative treatments are successful and a GA can be avoided. An audit of 85 patients referred for GA with Oldham Community Dental Service demonstrated 35% of patients accepted treatment with local anaesthesia only, 25% required inhalation sedation and only 25% were actually referred on for GA. Treatment for this group of patients must include the availability and provision of appropriate alternative treatment modalities, with the right staff and facilities, including those for dental general anaesthetic sessions. Ongoing follow-up within the general dental services is essential for this group of patients.

  5. 42 CFR 424.14 - Requirements for inpatient services of inpatient psychiatric facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... psychiatric facilities. 424.14 Section 424.14 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Certification and Plan Requirements § 424.14 Requirements for inpatient services of inpatient psychiatric... requirements differ from those for other hospitals because the care furnished in psychiatric hospitals is often...

  6. 46 CFR 160.151-49 - Approval of servicing facilities at remote sites.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... remote site, equipment needed for repair does not need to be available at that site. A facility must be... 46 Shipping 6 2011-10-01 2011-10-01 false Approval of servicing facilities at remote sites. 160.151-49 Section 160.151-49 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT...

  7. Trade study comparing specimen chamber servicing methods for the Space Station Centrifuge Facility

    NASA Technical Reports Server (NTRS)

    Calvisi, Michael L.; Sun, Sidney C.

    1991-01-01

    The Specimen Chamber Service Unit, a component of the Space Station Centrifuge Facility, must provide a clean enclosure on a continuing basis for the facility's plant, rodent and primate specimens. The specimen chambers can become soiled and can require periodic servicing to maintain a clean environment for the specimens. Two methods of servicing the specimen chambers are discussed: washing the chambers with an on-board washer, or disposing of the soiled chambers and replacing them with clean ones. Many of these issues are addressed by developing several servicing options, using either cleaning or replacement as the method of providing clean specimen chambers, and then evaluating each option according to a set of established quantitative and qualitative criteria. Disposing and replacing the Specimen Chambers is preferable to washing them.

  8. 47 CFR 22.805 - Channels for general aviation air-ground service.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 2 2013-10-01 2013-10-01 false Channels for general aviation air-ground... CARRIER SERVICES PUBLIC MOBILE SERVICES Air-Ground Radiotelephone Service General Aviation Air-Ground Stations § 22.805 Channels for general aviation air-ground service. The following channels are allocated...

  9. 47 CFR 22.805 - Channels for general aviation air-ground service.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 2 2012-10-01 2012-10-01 false Channels for general aviation air-ground... CARRIER SERVICES PUBLIC MOBILE SERVICES Air-Ground Radiotelephone Service General Aviation Air-Ground Stations § 22.805 Channels for general aviation air-ground service. The following channels are allocated...

  10. 47 CFR 22.805 - Channels for general aviation air-ground service.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 2 2014-10-01 2014-10-01 false Channels for general aviation air-ground... CARRIER SERVICES PUBLIC MOBILE SERVICES Air-Ground Radiotelephone Service General Aviation Air-Ground Stations § 22.805 Channels for general aviation air-ground service. The following channels are allocated...

  11. 47 CFR 22.805 - Channels for general aviation air-ground service.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 2 2011-10-01 2011-10-01 false Channels for general aviation air-ground... CARRIER SERVICES PUBLIC MOBILE SERVICES Air-Ground Radiotelephone Service General Aviation Air-Ground Stations § 22.805 Channels for general aviation air-ground service. The following channels are allocated...

  12. 47 CFR 22.805 - Channels for general aviation air-ground service.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Channels for general aviation air-ground... CARRIER SERVICES PUBLIC MOBILE SERVICES Air-Ground Radiotelephone Service General Aviation Air-Ground Stations § 22.805 Channels for general aviation air-ground service. The following channels are allocated...

  13. 46 CFR 160.151-47 - Requirements for owners or operators of servicing facilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... facilities. 160.151-47 Section 160.151-47 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Inflatable Liferafts (SOLAS) § 160.151-47 Requirements for owners or operators of servicing facilities. To maintain...

  14. Consumer preferences for general practitioner services.

    PubMed

    Morrison, Mark; Murphy, Tom; Nalder, Craig

    2003-01-01

    This study focuses on segmenting the market for General Practitioner services in a regional setting. Using factor analysis, five main service attributes are identified. These are clear communication, ongoing doctor-patient relationship, same gender as the patient, provides advice to the patient, and empowers the patient to make his/her own decisions. These service attributes are used as a basis for market segmentation, using both socio-demographic variables and cluster analysis. Four distinct market segments are identified, with varying degrees of viability in terms of target marketing.

  15. Service-Learning General Chemistry: Lead Paint Analyses

    NASA Astrophysics Data System (ADS)

    Kesner, Laya; Eyring, Edward M.

    1999-07-01

    Houses painted with lead-based paints are ubiquitous in the United States because the houses and the paint have not worn out two decades after federal regulations prohibited inclusion of lead in paint. Remodeling older homes thus poses a health threat for infants and small children living in those homes. In a service-learning general chemistry class, students disseminate information about this health threat in an older neighborhood. At some of the homes they collect paint samples that they analyze for lead both qualitatively and quantitatively. This service-learning experience generates enthusiasm for general chemistry through the process of working on a "real" problem. Sample collection familiarizes the students with the concept of "representative" sampling. The sample preparation for atomic absorption spectroscopic (AAS) analysis enhances their laboratory skills. The focus of this paper is on the mechanics of integrating this particular service project into the first-term of the normal general chemistry course.

  16. 77 FR 18272 - Uranium Enrichment Fuel Cycle Facility Inspection Reports Regarding Louisiana Energy Services LLC...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-27

    ... that cascades number 1.5, 1.6, 1.7, 1.8, 2.1, and 2.4 as well as autoclave one of the facility have... 2.4 as well as autoclave one of the facility have been constructed in accordance with the... Facility Inspection Reports Regarding Louisiana Energy Services LLC, National Enrichment Facility, Eunice...

  17. 47 CFR 69.307 - General support facilities.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ....307 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED... computer investment used in the provision of the Line Information Database sub-element at § 69.120(b) shall be assigned to that sub-element. (b) General purpose computer investment used in the provision of the...

  18. 47 CFR 69.307 - General support facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ....307 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED... computer investment used in the provision of the Line Information Database sub-element at § 69.120(b) shall be assigned to that sub-element. (b) General purpose computer investment used in the provision of the...

  19. 47 CFR 69.307 - General support facilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ....307 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED... computer investment used in the provision of the Line Information Database sub-element at § 69.120(b) shall be assigned to that sub-element. (b) General purpose computer investment used in the provision of the...

  20. 47 CFR 69.307 - General support facilities.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ....307 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED... computer investment used in the provision of the Line Information Database sub-element at § 69.120(b) shall be assigned to that sub-element. (b) General purpose computer investment used in the provision of the...

  1. 47 CFR 69.307 - General support facilities.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ....307 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED... computer investment used in the provision of the Line Information Database sub-element at § 69.120(b) shall be assigned to that sub-element. (b) General purpose computer investment used in the provision of the...

  2. 42 CFR 412.90 - General rules.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false General rules. 412.90 Section 412.90 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Special Treatment of Certain Facilities Under the...

  3. MINIMUM AREAS FOR ELEMENTARY SCHOOL BUILDING FACILITIES.

    ERIC Educational Resources Information Center

    Pennsylvania State Dept. of Public Instruction, Harrisburg.

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

  4. 42 CFR 431.105 - Consultation to medical facilities.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Consultation to medical facilities. 431.105 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS STATE ORGANIZATION AND GENERAL ADMINISTRATION Administrative Requirements: Provider Relations § 431.105 Consultation to medical facilities. (a) Basis and...

  5. 42 CFR 431.105 - Consultation to medical facilities.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Consultation to medical facilities. 431.105 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS STATE ORGANIZATION AND GENERAL ADMINISTRATION Administrative Requirements: Provider Relations § 431.105 Consultation to medical facilities. (a) Basis and...

  6. 42 CFR 431.105 - Consultation to medical facilities.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Consultation to medical facilities. 431.105 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS STATE ORGANIZATION AND GENERAL ADMINISTRATION Administrative Requirements: Provider Relations § 431.105 Consultation to medical facilities. (a) Basis and...

  7. 42 CFR 431.105 - Consultation to medical facilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Consultation to medical facilities. 431.105 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS STATE ORGANIZATION AND GENERAL ADMINISTRATION Administrative Requirements: Provider Relations § 431.105 Consultation to medical facilities. (a) Basis and...

  8. Facilities Policies and Procedures Manual. South Carolina Commission on Higher Education. Division of Finance, Facilities, and Statistical Services.

    ERIC Educational Resources Information Center

    South Carolina Commission on Higher Education, Columbia.

    This manual outlines the policies and procedures related to the submission and review of facilities projects at South Carolina's public colleges and universities. It provides an overview of the South Carolina Commission on Higher Education's role and responsibilities and its general policy regarding permanent improvements to facilities. The report…

  9. 77 FR 31841 - Notice of Applications for Authorization To Abandon Facilities and Services and To Acquire...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-30

    ... To Abandon Facilities and Services and To Acquire Facilities by Merger Steuben Gas Storage Company... Field Storage Facilities (Adrian Field) which Steuben operates pursuant to certificates of public... authorization to charge market based rates following its acquisition of the Adrian Field Storage Facility. The...

  10. Regulating food service in North Carolina's long-term care facilities.

    PubMed

    DePorter, Cindy H

    2005-01-01

    Other commentaries in this issue of the North Carolina Medical Journal describe innovative food and dining practices in some of our state's long-term care facilities. Federal and state regulations do not prohibit these innovations, and DFS supports the concept of "enhancements" of the dining experience in these facilities. The Division of Facilities Services, therefore, encourages facilities to assess and operationalize various dining methods, allowing residents to select their foods, dining times, dining partners, and other preferences. The regulations allow facilities to utilize innovative dining approaches, such as buffet lines, or family-style serving options, which allow residents to order at the table as they would in a restaurant. The regulations do not dictate whether facilities should serve food to residents on trays, in buffet lines, or in a family style. While there are many regulations, they leave room for innovative new ideas as long as these ideas do not compromise resident health or safety.. Food consumption and the dining experience are an integral part of the resident's life in a nursing facility. It is important that resident preferences are being honored, and the dining experience is as pleasant and home-like as possible. The facility's responsibility is to provide adequate nutrition and hydration that assures the resident is at his/her highest level of functioning emotionally, functionally, and physically. Meeting the unique needs of each resident in a facility can be a daunting task, but one of immense importance to the quality long-term care.

  11. Linking household and health facility surveys to assess obstetric service availability, readiness and coverage: evidence from 17 low- and middle-income countries.

    PubMed

    Kanyangarara, Mufaro; Chou, Victoria B; Creanga, Andreea A; Walker, Neff

    2018-06-01

    Improving access and quality of obstetric service has the potential to avert preventable maternal, neonatal and stillborn deaths, yet little is known about the quality of care received. This study sought to assess obstetric service availability, readiness and coverage within and between 17 low- and middle-income countries. We linked health facility data from the Service Provision Assessments and Service Availability and Readiness Assessments, with corresponding household survey data obtained from the Demographic and Health Surveys and Multiple Indicator Cluster Surveys. Based on performance of obstetric signal functions, we defined four levels of facility emergency obstetric care (EmOC) functionality: comprehensive (CEmOC), basic (BEmOC), BEmOC-2, and low/substandard. Facility readiness was evaluated based on the direct observation of 23 essential items; facilities "ready to provide obstetric services" had ≥20 of 23 items available. Across countries, we used medians to characterize service availability and readiness, overall and by urban-rural location; analyses also adjusted for care-seeking patterns to estimate population-level coverage of obstetric services. Of the 111 500 health facilities surveyed, 7545 offered obstetric services and were included in the analysis. The median percentages of facilities offering EmOC and "ready to provide obstetric services" were 19% and 10%, respectively. There were considerable urban-rural differences, with absolute differences of 19% and 29% in the availability of facilities offering EmOC and "ready to provide obstetric services", respectively. Adjusting for care-seeking patterns, results from the linking approach indicated that among women delivering in a facility, a median of 40% delivered in facilities offering EmOC, and 28% delivered in facilities "ready to provide obstetric services". Relatively higher coverage of facility deliveries (≥65%) and coverage of deliveries in facilities "ready to provide obstetric

  12. Improving Services to Deaf-Blind/Multihandicapped Individuals in Residential Facilities.

    ERIC Educational Resources Information Center

    Texas Education Agency, Austin.

    The 35 articles represent presentations made during a conference on improving services to deaf-blind/multihandicapped individuals in residential facilities. Among entries are the following titles and authors: "Federal Thrust of Deaf-Blind Multihandicapped Funding" (J. Franklin); "Prevocational Training for Deaf-Blind (A Research Endeavor)" (J.…

  13. 46 CFR 160.151-45 - Equipment required for servicing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...); (d) Hot presses (if applicable); (e) Safety-type glue pots or equivalents; (f) Abrasive devices; (g..., or other pressure-measurement device or pressure gauge of equivalent accuracy and sensitivity; (j... liferafts, unless the facility services only non-davit-launched liferafts; (q) A supply of parts for all...

  14. 7 CFR 1726.176 - Communications and control facilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 11 2010-01-01 2010-01-01 false Communications and control facilities. 1726.176... SERVICE, DEPARTMENT OF AGRICULTURE ELECTRIC SYSTEM CONSTRUCTION POLICIES AND PROCEDURES General Plant § 1726.176 Communications and control facilities. This section covers the purchase of microwave and power...

  15. ANKA, a customer-oriented synchrotron radiation facility for microfabrication and analytical services

    NASA Astrophysics Data System (ADS)

    Pea Anka Project Group; Buth, G.; Doyle, S.; Einfeld, D.; Hagelstein, M.; Hermle, S.; Huttel, E.; Krüssel, A.; Lange, M.; Mathis, Y.-L.; Mexner, W.; Moser, H. O.; Pellegrin, E.; Ristau, U.; Rossmanith, R.; Schaper, J.; Schieler, H.; Simon, R.; Steininger, R.; Voigt, S.; Walther, R.; Perez, F.; Pont, M.; Plesko, M.

    1998-03-01

    ANKA (Angströmquelle Karlsruhe) is a state-of-the-art synchrotron radiation facility under construction at the Forschungszentrum Karlsruhe. Based on a 2.5 GeV electron storage ring it will deliver photons predominantly in the hard X-ray range but it will also feature both XUV and infrared beamlines. In its first operational phase the radiation will be taken out of normal-conducting dipole bending magnets, while five free long straight sections are foreseen to accommodate insertion devices later on. ANKA has a novel mission, namely to provide synchrotron-radiation based services to industrial and other customers, in the fields of microfabrication and materials analysis. A limited liability company, ANKA GmbH, is being founded to operate the facility. Although commercial services to customers will represent more than half of the overall activity, these services will be complemented by providing beam time for research users.

  16. Provision of Rehabilitation Services in Residential Care Facilities: Evidence From a National Survey.

    PubMed

    Bhuyan, Soumitra S; Chandak, Aastha; Gupta, Niodita; Wyant, David K; Kim, Jungyoon; Bhatt, Jay; Singh, Ayesha; Gilmore, Sean; Ahn, SangNam; Chang, Cyril F

    2017-06-01

    To examine the association between organizational factors and provision of rehabilitation services that include physical therapy (PT) and occupational therapy (OT) in residential care facilities (RCFs) in the United States. A cross-sectional, observational study conducted using a national sample from the 2010 National Survey of Residential Care Facilities conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics. U.S. RCFs. RCFs (N=2302; weighted sample, 31,134 RCFs). Not applicable. The association between characteristics of the facilities, director and staff, and residents, and provision of PT and OT services was assessed using multivariate logistic regression analyses. Among all RCFs in the United States, 43.9% provided PT and 40.0% provided OT. Medicaid-certified RCFs, larger-sized RCFs, RCFs with a licensed director, RCFs that used volunteers, and RCFs with higher personal care aide hours per patient per day were more likely to provide both PT and OT, while private, for-profit RCFs were less likely to provide PT and OT. RCFs with a higher percentage of white residents were more likely to provide PT, while RCFs with chain affiliation were more likely to provide OT. Less than half of the RCFs in the United States provide PT and OT, and this provision of therapy services is associated with organizational characteristics of the facilities. Future research should explore the effectiveness of rehabilitation services in RCFs on residents' health outcomes. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  17. Hydroelectric Generating Facilities General Permit (HYDROGP) for Massachusetts & New Hampshire

    EPA Pesticide Factsheets

    Documents, links & contacts for the Notice of Availability of the Final NPDES General Permits (HYDROGP) for Discharges at Hydroelectric Generating Facilities in Massachusetts (MAG360000) and New Hampshire (NHG360000) and Tribal Lands in the State of MA.

  18. Special Education: Financing Health and Educational Services for Handicapped Children.

    DTIC Science & Technology

    1986-07-01

    ABBREVIATIONS GAO General Accounting Office HCFA Health Care Financing Administration HHS Department of Health and Human Services lN ICF/MR intermediate care facility for...individuals discharged from a skilled nursing facility or intermediate care facility to the extent that the services are available through a local education

  19. Clinical characteristics and service use of persons with mental illness living in an intermediate care facility.

    PubMed

    Anderson, R L; Lewis, D A

    1999-10-01

    The study examined the characteristics of residents living in a 450-bed intermediate care facility for persons with severe mental illness in Illinois and sought to determine the factors predicting their utilization of mental health services. Data on 100 randomly selected residents with a chart diagnosis of schizophrenia were collected using chart review and interviews. Data for 78 residents whose diagnosis of schizophrenia or schizoaffective disorder was confirmed using the Structured Clinical Interview for DSM-IV were included in the analyses. Fifty-three percent of the residents used facility-based specialty mental health services beyond medication management, such as group therapy or a day program. Persons with the least severe psychiatric illnesses and with higher levels of motivation for overall care used the most mental health services. Thirty-five percent of the residents had been discharged to an inpatient psychiatric unit during the previous year. Residents most likely to be discharged to those settings were young men with a history of homelessness who refused facility-based health services. Despite recent policy-driven efforts to improve care in this intermediate care facility for persons with mental illness, the facility continues to have problems addressing the mental health needs of the residents.

  20. An audit of the use of isolation facilities in a UK National Health Service trust.

    PubMed

    Damji, S; Barlow, G D; Patterson, L; Nathwani, D

    2005-07-01

    To aid the ongoing battle against hospital-acquired infection in the UK, all acute National Health Service (NHS) trusts should have audit data about how dedicated isolation beds within the trust are being used. In a previously published audit, we demonstrated that one-third of patients admitted to a dedicated isolation room in Tayside were not thought to be an infection risk by experienced healthcare staff. Since this audit, Tayside's isolation facilities have moved from a small peripheral 'fever' hospital to a large central teaching hospital site. At the time of this move, and using the above audit data, we designed and implemented a guideline for general practitioners and hospital doctors regarding the admission of patients to an isolation bed. The aim of this study was to compare the use of isolation beds before and after the move to the new facilities, which we anticipated would increase the demand for isolation. The results show that by all three criteria used, the utilization of isolation beds has deteriorated following the move, mainly due to the increased admission of general medical 'boarders' and low-risk infection patients. At a time when hospital-acquired infections are increasing, NHS trusts should ensure that dedicated isolation beds are used appropriately.

  1. Synthetic Minor NSR Permit: Chemtrade Refinery Services, Inc. Riverton, Wyoming Facility

    EPA Pesticide Factsheets

    This page contains the response to public comments and final synthetic minor NSR permit for the Chemtrade Refinery Services, Inc. Riverton, Wyoming Facility, operated by Chemtrade Logistics and located on the Wind River Indian Reservation in Fremont County

  2. LAFD: TA-55 General Facility Familiarization Tour, Course #55261

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

    Rutherford, Victor Stephen; Miller, Joshua; Mason, Robert Clifford

    Los Alamos National Laboratory (LANL) will conduct familiarization tours for personnel of the Los Alamos County Fire Department (LAFD) at the TA-55 General Facility. These familiarization tours are official LANL business; the purpose of these tours is to orient LAFD firefighters to the facility so that they can respond efficiently and quickly to a variety of emergency situations. This orientation includes, among other topics, ingress and egress of the area and buildings, layout and organization of the facility, evacuation procedures and assembly points, and areas of concern within the various buildings at the facility. LAFD firefighters have the skills andmore » abilities to perform firefighting operations and other emergency response tasks that cannot be provided by LANL personnel who have the required clearance level. This handout provides details of the information, along with maps and diagrams, to be presented during the familiarization tours. The handout will be distributed to the trainees at the time of the tour. A corresponding checklist will also be used as guidance during the familiarization tours to ensure that all required information is presented to LAFD personnel.« less

  3. A Decentralized VPN Service over Generalized Mobile Ad-Hoc Networks

    NASA Astrophysics Data System (ADS)

    Fujita, Sho; Shima, Keiichi; Uo, Yojiro; Esaki, Hiroshi

    We present a decentralized VPN service that can be built over generalized mobile ad-hoc networks (Generalized MANETs), in which topologies can be represented as a time-varying directed multigraph. We address wireless ad-hoc networks and overlay ad-hoc networks as instances of Generalized MANETs. We first propose an architecture to operate on various kinds of networks through a single set of operations. Then, we design and implement a decentralized VPN service on the proposed architecture. Through the development and operation of a prototype system we implemented, we found that the proposed architecture makes the VPN service applicable to each instance of Generalized MANETs, and that the VPN service makes it possible for unmodified applications to operate on the networks.

  4. Can psychiatric liaison reduce neuroleptic use and reduce health service utilization for dementia patients residing in care facilities.

    PubMed

    Ballard, Clive; Powell, Ian; James, Ian; Reichelt, Katharina; Myint, Pat; Potkins, Dawn; Bannister, Carol; Lana, Marisa; Howard, Robert; O'Brien, John; Swann, Alan; Robinson, Damian; Shrimanker, Jay; Barber, Robert

    2002-02-01

    The quality of care and overuse of neuroleptic medication in care environments are major issues in the care of elderly people with dementia. The quality of care (Dementia Care Mapping), the severity of Behavioural and Psychological Symptoms (BPSD--Neuropsychiatric Inventory), expressive language skills (Sheffield Acquired Language Disorder scale), service utilization and use of neuroleptic drugs was compared over 9 months between six care facilities receiving a psychiatric liaison service and three facilities receiving the usual clinical support, using a single blind design. There was a significant reduction in neuroleptic usage in the facilities receiving the liaison service (McNemar test p<0.0001), but not amongst those receiving standard clinical support (McNemar test p=0.07). There were also significantly less GP contacts (t=3.9 p=0.0001) for residents in the facilities receiving the liaison service, and a three fold reduction in psychiatric in-patient bed usage (Bed days per person 0.6 vs. 1.5). Residents in care facilities receiving the liaison service experienced significantly less deterioration in expressive language skills (t=2.2 p=0.03), but there were no significant differences in BPSD or wellbeing. A resource efficient psychiatric liaison service can reduce neuroleptic drug use and reduce some aspects of health service utilization; but a more extensive intervention is probably required to improve the overall quality of care. Copyright 2002 John Wiley & Sons, Ltd.

  5. Audit of availability and distribution of paediatric cardiology services and facilities in Nigeria

    PubMed Central

    Ekure, Ekanem N; Sadoh, Wilson E; Bode-Thomas, Fidelia; Yilgwan, Christopher S; Orogade, Adeola A; Animasahun, Adeola B; Ogunkunle, Oluwatoyin O; Omokhodion, Samuel I; Babaniyi, Iretiola; Anah, Maxwell U; Otaigbe, Barbara E; Olowu, Adebiyi; Okpokowuruk, Frances; Maduka, Ogechi C; Onakpoya, Uvie U; Adiele, Daberechi K; Sani, Usman. M; Asani, Mustapha; Daniels, Queennette; Uzodimma, Chinyere C; Duru, Chika O; Abdulkadir, Mohammad B; Afolabi, Joseph K; Okeniyi, John A

    2017-01-01

    Summary Background Paediatric cardiac services in Nigeria have been perceived to be inadequate but no formal documentation of availability and distribution of facilities and services has been done. Objective: To evaluate and document the currently available paediatric cardiac services in Nigeria. Methods In this questionnaire-based, cross-sectional descriptive study, an audit was undertaken from January 2010 to December 2014, of the personnel and infrastructure, with their distributions according to geopolitical zones of Nigeria. Results Forty-eight centres participated in the study, with 33 paediatric cardiologists and 31 cardiac surgeons. Echocardiography, electrocardiography and pulse oximetry were available in 45 (93.8%) centres while paediatric intensive care units were in 23 (47.9%). Open-heart surgery was performed in six (12.5%) centres. South-West zone had the majority of centres (20; 41.7%). Conclusions Available paediatric cardiac services in Nigeria are grossly inadequate and poorly distributed. Efforts should be intensified to upgrade existing facilities, establish new and functional centres, and train personnel. PMID:27701490

  6. Audit of availability and distribution of paediatric cardiology services and facilities in Nigeria.

    PubMed

    Ekure, Ekanem N; Sadoh, Wilson E; Bode-Thomas, Fidelia; Orogade, Adeola A; Animasahun, Adeola B; Ogunkunle, Oluwatoyin O; Babaniyi, Iretiola; Anah, Maxwell U; Otaigbe, Barbara E; Olowu, Adebiyi; Okpokowuruk, Frances; Omokhodion, Samuel I; Maduka, Ogechi C; Onakpoya, Uvie U; Adiele, Daberechi K; Sani, Usman M; Asani, Mustapha; Yilgwan, Christopher S; Daniels, Queennette; Uzodimma, Chinyere C; Duru, Chika O; Abdulkadir, Mohammad B; Afolabi, Joseph K; Okeniyi, John A

    Paediatric cardiac services in Nigeria have been perceived to be inadequate but no formal documentation of availability and distribution of facilities and services has been done. To evaluate and document the currently available paediatric cardiac services in Nigeria. In this questionnaire-based, cross-sectional descriptive study, an audit was undertaken from January 2010 to December 2014, of the personnel and infrastructure, with their distributions according to geopolitical zones of Nigeria. Forty-eight centres participated in the study, with 33 paediatric cardiologists and 31 cardiac surgeons. Echocardiography, electrocardiography and pulse oximetry were available in 45 (93.8%) centres while paediatric intensive care units were in 23 (47.9%). Open-heart surgery was performed in six (12.5%) centres. South-West zone had the majority of centres (20; 41.7%). Available paediatric cardiac services in Nigeria are grossly inadequate and poorly distributed. Efforts should be intensified to upgrade existing facilities, establish new and functional centres, and train personnel.

  7. The British Telecom radiopaging service in general practice

    PubMed Central

    Cole, F. H.

    1981-01-01

    This paper reports a new radiopaging service supplied by British Telecom that will eventually cover the whole United Kingdom. The use of this service by a three-man practice is described. The service is considered to be a major development in communications that will be of interest to most general practitioners. PMID:7328548

  8. Availability and distribution of safe abortion services in rural areas: a facility assessment study in Madhya Pradesh, India

    PubMed Central

    Chaturvedi, Sarika; Ali, Sayyed; Randive, Bharat; Sabde, Yogesh; Diwan, Vishal; De Costa, Ayesha

    2015-01-01

    Background Unsafe abortion contributes to a significant portion of maternal mortality in India. Access to safe abortion care is known to reduce maternal mortality. Availability and distribution of abortion care facilities can influence women's access to these services, especially in rural areas. Objectives To assess the availability and distribution of abortion care at facilities providing childbirth care in three districts of Madhya Pradesh (MP) province of India. Design Three socio demographically heterogeneous districts of MP were selected for this study. Facilities conducting at least 10 deliveries a month were surveyed to assess availability and provision of abortion services using UN signal functions for emergency obstetric care. Geographical Information System was used for visualisation of the distribution of facilities. Results The three districts had 99 facilities that conducted >10 deliveries a month: 74 in public and 25 in private sector. Overall, 48% of facilities reported an ability to provide safe surgical abortion service. Of public centres, 32% reported the ability compared to 100% among private centres while 18% of public centres and 77% of private centres had performed an abortion in the last 3 months. The availability of abortion services was higher at higher facility levels with better equipped and skilled personnel availability, in urban areas and in private sector facilities. Conclusions Findings showed that availability of safe abortion care is limited especially in rural areas. More emphasis on providing safe abortion services, particularly at primary care level, is important to more significantly dent maternal mortality in India. PMID:25797220

  9. 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

  10. Algebraic Generalization Strategies Used by Kuwaiti Pre-Service Teachers

    ERIC Educational Resources Information Center

    Alajmi, Amal Hussain

    2016-01-01

    This study reports on the algebraic generalization strategies used by elementary and middle/high school pre-service mathematics teachers in Kuwait. They were presented with 9 tasks that involved linear, exponential, and quadratic situations. The results showed that these pre-service teachers had difficulty in generalizing algebraic rules in all 3…

  11. Hanford facility dangerous waste permit application, general information portion. Revision 3

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

    Sonnichsen, J.C.

    1997-08-21

    For purposes of the Hanford facility dangerous waste permit application, the US Department of Energy`s contractors are identified as ``co-operators`` and sign in that capacity (refer to Condition I.A.2. of the Dangerous Waste Portion of the Hanford Facility Resource Conservation and Recovery Act Permit). Any identification of these contractors as an ``operator`` elsewhere in the application is not meant to conflict with the contractors` designation as co-operators but rather is based on the contractors` contractual status with the U.S. Department of Energy, Richland Operations Office. The Dangerous Waste Portion of the initial Hanford Facility Resource Conservation and Recovery Act Permit,more » which incorporated five treatment, storage, and/or disposal units, was based on information submitted in the Hanford Facility Dangerous Waste Permit Application and in closure plan and closure/postclosure plan documentation. During 1995, the Dangerous Waste Portion was modified twice to incorporate another eight treatment, storage, and/or disposal units; during 1996, the Dangerous Waste Portion was modified once to incorporate another five treatment, storage, and/or disposal units. The permit modification process will be used at least annually to incorporate additional treatment, storage, and/or disposal units as permitting documentation for these units is finalized. The units to be included in annual modifications are specified in a schedule contained in the Dangerous Waste Portion of the Hanford Facility Resource Conservation and Recovery Act Permit. Treatment, storage, and/or disposal units will remain in interim status until incorporated into the Permit. The Hanford Facility Dangerous Waste Permit Application is considered to be a single application organized into a General Information Portion (this document, DOE/RL-91-28) and a Unit-Specific Portion. The scope of the Unit-Specific Portion is limited to individual operating treatment, storage, and/or disposal units

  12. Effects of physician-owned specialized facilities in health care: a systematic review.

    PubMed

    Trybou, Jeroen; De Regge, Melissa; Gemmel, Paul; Duyck, Philippe; Annemans, Lieven

    2014-12-01

    Multiple studies have investigated physician-owned specialized facilities (specialized hospitals and ambulatory surgery centres). However, the evidence is fragmented and the literature lacks cohesion. To provide a comprehensive overview of the effects of physician-owned specialized facilities by synthesizing the findings of published empirical studies. Two reviewers independently researched relevant studies using a standardized search strategy. The Institute of Medicine's quality framework (safe, effective, equitable, efficient, patient-centred, and accessible care) was applied in order to evaluate the performance of such facilities. In addition, the impact on the performance of full-service general hospitals was assessed. Forty-six studies were included in the systematic review. Overall, the quality of the included studies was satisfactory. Our results show that little evidence exists to confirm the advantages attributed to physician-owned specialized facilities, and their impact on full-service general hospitals remains limited. Although data is available on a wide variety of effects, the evidence base is surprisingly thin. There is no compelling evidence available demonstrating the added value of physician-owned specialized facilities in terms of quality or cost of the delivered care. More research is necessary on the relative merits of physician-owned specialized facilities. In addition, their corresponding impact on full-service general hospitals remains unclear. The development of physician-owned specialized facilities should thus be monitored carefully. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  13. 26 CFR 49.4252-1 - General telephone service.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... total charge made to a hotel or similar subscriber for general telephone service furnished to the hotel or its guests, but no tax attaches to any charge made by the hotel for service rendered in placing...

  14. 26 CFR 49.4252-1 - General telephone service.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... total charge made to a hotel or similar subscriber for general telephone service furnished to the hotel or its guests, but no tax attaches to any charge made by the hotel for service rendered in placing...

  15. 42 CFR 422.133 - Return to home skilled nursing facility.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Return to home skilled nursing facility. 422.133....133 Return to home skilled nursing facility. (a) General rule. MA plans must provide coverage of posthospital extended care services to Medicare enrollees through a home skilled nursing facility if the...

  16. 42 CFR 422.133 - Return to home skilled nursing facility.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Return to home skilled nursing facility. 422.133....133 Return to home skilled nursing facility. (a) General rule. MA plans must provide coverage of posthospital extended care services to Medicare enrollees through a home skilled nursing facility if the...

  17. A report on an acute, in-hours, outpatient review clinic with ultrasonography facilities for the early evaluation of general surgical patients.

    PubMed

    Pidgeon, T E; Shariff, U; Devine, F; Menon, V

    2016-09-01

    Introduction In 2013 our hospital introduced an in-hours, consultant-led, outpatient acute surgical clinic (ASC) for emergency general surgical patients. In 2014 this clinic was equipped with a dedicated ultrasonography service. This prospective cohort study evaluated this service before and after the introduction of ultrasonography facilities. Methods Data were recorded prospectively for all patients attending the clinic during 2013 and 2014. The primary outcome was patient destination (whether there was follow-up/admission) after clinic attendance. Results The ASC reviewed patients with a wide age range and array of general surgical complaints. In 2013, 186 patients attended the ASC. After the introduction of the ultrasonography service in 2014, 304 patients attended. In 2014, there was a reduction in the proportion of patients admitted to hospital from the clinic (18.3% vs 8.9%, p=0.002). However, the proportion of patients discharged after ASC review remained comparable with 2013 (30.1% in 2013 vs 38.8% in 2014, p=0.051). The proportion of patients undergoing computed tomography (CT) scans also fell (14.0% vs 4.9%, p<0.001). Conclusions The ASC assessed a wide array of general surgical complaints. Only a small proportion required hospital admission. The introduction of an ultrasonography service was associated with a further reduction in admission rates and computed tomography.

  18. Use of Information Technology for Management of U.S. Postal Service Facilities.

    DTIC Science & Technology

    1996-05-01

    change closeout status, request for proposal log) Projected income and expenses of a U.S. Postal Service facility Direct capitalization model Tax...Unclassified 19. SECURITY CLASSIFICATION OF ABSTRACT Unclassified 15. NUMBER OF PAGES 107 16. PRICE CODE 20. LIMITATION OF ABSTRACT UL NSN 7540-01...time and at the right price is a huge and complex job. In any one year, the USPS Facilities organization may acquire more than 100 sites, plan

  19. 42 CFR 416.60 - General rules.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false General rules. 416.60 Section 416.60 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE... Medicare beneficiaries, by a participating facility, in connection with covered surgical procedures...

  20. 42 CFR 416.60 - General rules.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false General rules. 416.60 Section 416.60 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE... Medicare beneficiaries, by a participating facility, in connection with covered surgical procedures...

  1. The availability and functional status of focused antenatal care laboratory services at public health facilities in Addis Ababa, Ethiopia.

    PubMed

    Desalegn, Daniel Melese; Abay, Serebe; Taye, Bineyam

    2016-08-11

    Provision of quality laboratory services is an essential aspect of a promoting safe motherhood and better outcomes for newborn. Therefore; this study was intended to assess status of focused antenatal care (FANC) laboratory services at public health facilities in Addis Ababa, Ethiopia. Institution based, descriptive cross-sectional study was conducted from April to May 2015. The study included 13 randomly selected health facilities and 13 purposively selected laboratory service providers. The status of FANC laboratory service was assessed by using pre-tested structured questionnaire and observation checklist. The study supplemented with qualitative data through in-depth interview of laboratory service providers. The quantitative data were coded and analysed by using SPSS Version 20 software and qualitative data was transcribed, coded, categorized and thematically analysed by the principal investigator. Only 5 (38.5 %) out of 13 visited health facilities reported the availability of all types of basic FANC laboratory investigations. Comparing the availability of individual tests in the study facilities, urine dipstick, urine microscopy and stool examination were available in all institutions. However, only 7 (53.8 %) of the health facilities reported the availability of hepatitis B virus screening test. Rapid syphilis (RPR) test was found in 10 (76.9 %) facilities. All laboratory facilities had at least one or more basic FANC laboratory tests interruption for more than a day within the last 1 year due to shortage of reagent and electric power disruption. Majority of the health facilities reported incomplete provision of FANC laboratory investigations. Laboratory supply shortage and electric power disruption were the facilities' major challenge to screen pregnant women for pregnancy related health conditions. Since such conditions may affect the outcome of pregnancy, therefore extensive efforts should be targeted to avoid services interruption by taking

  2. 26 CFR 49.4253-8 - Exemption for terminal facilities in case of wire mileage service.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... wire mileage service. 49.4253-8 Section 49.4253-8 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT... Communications § 49.4253-8 Exemption for terminal facilities in case of wire mileage service. The taxes imposed by section 4251 do not apply to so much of any amount paid for wire mileage service as is paid for...

  3. 26 CFR 49.4253-8 - Exemption for terminal facilities in case of wire mileage service.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... wire mileage service. 49.4253-8 Section 49.4253-8 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT... Communications § 49.4253-8 Exemption for terminal facilities in case of wire mileage service. The taxes imposed by section 4251 do not apply to so much of any amount paid for wire mileage service as is paid for...

  4. Satisfaction with Massachusetts nursing home care was generally high during 2005-09, with some variability across facilities.

    PubMed

    Li, Yue; Cai, Xueya; Ye, Zhiqiu; Glance, Laurent G; Harrington, Charlene; Mukamel, Dana B

    2013-08-01

    Since 2005 Massachusetts has publicly reported results from biennial surveys of satisfaction with nursing homes, completed by responsible parties for residents, to promote consumer-centered care. Our analysis of the results from 2005, 2007, and 2009 revealed generally high satisfaction with care, which remained stable over time. On a scale of 1 to 5 (from very dissatisfied to very satisfied), average satisfaction with overall care was 4.22-4.31, and satisfaction that overall residents' needs were met was 4.09-4.16. Around 90 percent of respondents would recommend the facility. Satisfaction ratings varied considerably across facilities, with higher scores associated with higher nursing staffing levels, fewer deficiency citations, and nonprofit or government ownership. Scores for six domains of care were, in general, closely associated with satisfaction scores. However, family members seemed less satisfied with the physical and social activities available to residents and with the food and meals served than with such attributes as the physical environment. Our findings suggest that including the consumer's perspective would improve the Centers for Medicare and Medicaid Services' current nursing home reporting efforts. However, refinements may be necessary to detect the impact of consumer reporting on the quality of patient-centered care.

  5. 3 CFR - Designation of Officers of the General Services Administration to Act as Administrator of General...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 3 The President 1 2014-01-01 2014-01-01 false Designation of Officers of the General Services Administration to Act as Administrator of General Services Presidential Documents Other Presidential Documents... Administrator. Sec. 3. Prior Memorandum Superseded. This memorandum supersedes the President's Memorandum of...

  6. Job attitudes of airway facilities personnel.

    DOT National Transportation Integrated Search

    1977-08-01

    A total of 2,366 employees of the Airway Facilities (AF) Service responded to a detailed questionnaire concerning job satisfaction and such factors as salary, shift schedule, workload, and geographic location. : In general, AF employees reported sati...

  7. 45 CFR 98.84 - Construction and renovation of child care facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... services, quality activities, or administrative costs). (h) A construction or renovation project that... facilities. 98.84 Section 98.84 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION... child care services provided by the Tribal Lead Agency as compared to the level of services provided by...

  8. 38 CFR 17.52 - Hospital care and medical services in non-VA facilities.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... the life or health of a veteran receiving hospital care or medical services in a facility over which... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Hospital care and medical... VETERANS AFFAIRS MEDICAL Use of Public Or Private Hospitals § 17.52 Hospital care and medical services in...

  9. 38 CFR 17.52 - Hospital care and medical services in non-VA facilities.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... the life or health of a veteran receiving hospital care or medical services in a facility over which... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Hospital care and medical... VETERANS AFFAIRS MEDICAL Use of Public Or Private Hospitals § 17.52 Hospital care and medical services in...

  10. 77 FR 65729 - Uranium Enrichment Fuel Cycle Facility Inspection Reports Regarding Louisiana Energy Services LLC...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-30

    ... NUCLEAR REGULATORY COMMISSION [Docket No. 70-3103; NRC-2010-0264] Uranium Enrichment Fuel Cycle Facility Inspection Reports Regarding Louisiana Energy Services LLC, National Enrichment Facility, Eunice..., Chief, Uranium Enrichment Branch, Division of Fuel Cycle Safety and Safeguards, Office of Nuclear...

  11. 42 CFR 441.151 - General requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Inpatient Psychiatric Services for Individuals Under Age 21 in Psychiatric Facilities or Programs § 441.151 General requirements. (a) Inpatient psychiatric services for individuals under age 21 must be: (1) Provided under the direction of a physician; (2) Provided by— (i) A psychiatric hospital that undergoes a...

  12. Assessment of health facility capacity to provide newborn care in Bangladesh, Haiti, Malawi, Senegal, and Tanzania

    PubMed Central

    Winter, Rebecca; Yourkavitch, Jennifer; Wang, Wenjuan; Mallick, Lindsay

    2017-01-01

    Background Despite the importance of health facility capacity to provide comprehensive care, the most widely used indicators for global monitoring of maternal and child health remain contact measures which assess women’s use of services only and not the capacity of health facilities to provide those services; there is a gap in monitoring health facilities’ capacity to provide newborn care services in low and middle income countries. Methods In this study we demonstrate a measurable framework for assessing health facility capacity to provide newborn care using open access, nationally–representative Service Provision Assessment (SPA) data from the Demographic Health Surveys Program. In particular, we examine whether key newborn–related services are available at the facility (ie, service availability, measured by the availability of basic emergency obstetric care (BEmOC) signal functions, newborn signal functions, and routine perinatal services), and whether the facility has the equipment, medications, training and knowledge necessary to provide those services (ie, service readiness, measured by general facility requirements, equipment, medicines and commodities, and guidelines and staffing) in five countries with high levels of neonatal mortality and recent SPA data: Bangladesh, Haiti, Malawi, Senegal, and Tanzania. Findings In each country, we find that key services and commodities needed for comprehensive delivery and newborn care are missing from a large percentage of facilities with delivery services. Of three domains of service availability examined, scores for routine care availability are highest, while scores for newborn signal function availability are lowest. Of four domains of service readiness examined, scores for general requirements and equipment are highest, while scores for guidelines and staffing are lowest. Conclusions Both service availability and readiness tend to be highest in hospitals and facilities in urban areas, pointing to

  13. 77 FR 10665 - General Services Administration Acquisition Regulation; Acquisition-Related Thresholds

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-23

    ... GENERAL SERVICES ADMINISTRATION 48 CFR Parts 519 and 552 [GSAR Amendment 2012-02; GSAR Case 2011-G502; (Change 54) Docket 2012- 0003, Sequence 1] RIN 3090-AJ24 General Services Administration Acquisition Regulation; Acquisition-Related Thresholds AGENCIES: Office of Acquisition Policy, General...

  14. The relative patient costs and availability of dental services, materials and equipment in public oral care facilities in Tanzania.

    PubMed

    Nyamuryekung'e, Kasusu K; Lahti, Satu M; Tuominen, Risto J

    2015-07-01

    Patient charges and availability of dental services influence utilization of dental services. There is little available information on the cost of dental services and availability of materials and equipment in public dental facilities in Africa. This study aimed to determine the relative cost and availability of dental services, materials and equipment in public oral care facilities in Tanzania. The local factors affecting availability were also studied. A survey of all district and regional dental clinics in selected regions was conducted in 2014. A total of 28/30 facilities participated in the study. A structured interview was undertaken amongst practitioners and clinic managers within the facilities. Daily resources for consumption (DRC) were used for estimation of patients' relative cost. DRC are the quantified average financial resources required for an adult Tanzanian's overall consumption per day. Tooth extractions were found to cost four times the DRC whereas restorations were 9-10 times the DRC. Studied facilities provided tooth extractions (100%), scaling (86%), fillings (79%), root canal treatment (46%) and fabrication of removable partial dentures (32%). The ratio of tooth fillings to extractions in the facilities was 1:16. Less than 50% of the facilities had any of the investigated dental materials consistently available throughout the year, and just three facilities had all the investigated equipment functional and in use. Dental materials and equipment availability, skills of the practitioners and the cost of services all play major roles in provision and utilization of comprehensive oral care. These factors are likely to be interlinked and should be taken into consideration when studying any of the factors individually.

  15. Unfulfilled expectations to services offered at primary health care facilities: experiences of caretakers of underfive children in rural Tanzania.

    PubMed

    Kahabuka, Catherine; Moland, Karen Marie; Kvåle, Gunnar; Hinderaker, Sven Gudmund

    2012-06-14

    There is growing evidence that patients frequently bypass primary health care (PHC) facilities in favour of higher level hospitals regardless of substantial additional time and costs. Among the reasons given for bypassing are poor services (including lack of drugs and diagnostic facilities) and lack of trust in health workers. The World Health Report 2008 "PHC now more than ever" pointed to the importance of organizing health services around people's needs and expectations as one of the four main issues of PHC reforms. There is limited documentation of user's expectations to services offered at PHC facilities. The current study is a community extension of a hospital-based survey that showed a high bypassing frequency of PHC facilities among caretakers seeking care for their underfive children at two district hospitals. We aimed to explore caretakers' perceptions and expectations to services offered at PHC facilities in their area with reference to their experiences seeking care at such facilities. We conducted four community-based focus group discussions (FGD's) with 47 caretakers of underfive children in Muheza district of Tanga region, Tanzania in October 2009. Lack of clinical examinations and laboratory tests, combined with shortage of drugs and health workers, were common experiences. Across all the focus group discussions, unpleasant health workers' behaviors, lack of urgency and unnecessary delays were major complaints. In some places, unauthorized fees reduced access to services. The study revealed significant disappointments among caretakers with regard to the quality of services offered at PHC facilities in their areas, with implications for their utilization and proper functioning of the referral system. Practices regarding partial drugs administrations, skipping of injections, unofficial payments and consultations by unskilled health care providers need urgent action. There is also a need for proper accountability mechanisms to govern appropriate

  16. 42 CFR 93.300 - General responsibilities for compliance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false General responsibilities for compliance. 93.300 Section 93.300 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE...

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

    PubMed

    Kubota, Satoshi; Kawai, Hiromi

    2015-01-01

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

  18. Suicide prevention in primary care: General practitioners' views on service availability

    PubMed Central

    2010-01-01

    Background Primary care may be a key setting for suicide prevention. However, comparatively little is known about the services available in primary care for suicide prevention. The aims of the current study were to describe services available in general practices for the management of suicidal patients and to examine GPs views on these services. We carried out a questionnaire and interview study in the North West of England. We collected data on GPs views of suicide prevention generally as well as local mental health service provision. Findings During the study period (2003-2005) we used the National Confidential Inquiry Suicide database to identify 286 general practitioners (GPs) who had registered patients who had died by suicide. Data were collected from GPs and practice managers in 167 practices. Responses suggested that there was greater availability of services and training for general mental health issues than for suicide prevention specifically. The three key themes which emerged from GP interviews were: barriers accessing primary or secondary mental health services; obstacles faced when referring a patient to mental health services; managing change within mental health care services Conclusions Health professionals have an important role to play in preventing suicide. However, GPs expressed concerns about the quality of primary care mental health service provision and difficulties with access to secondary mental health services. Addressing these issues could facilitate future suicide prevention in primary care. PMID:20920302

  19. 20 CFR 1001.121 - Performance standard on facilities and support for Veterans' Employment and Training Service...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... support for Veterans' Employment and Training Service (VETS) staff. 1001.121 Section 1001.121 Employees' Benefits OFFICE OF THE ASSISTANT SECRETARY FOR VETERANS' EMPLOYMENT AND TRAINING SERVICE, DEPARTMENT OF... Training Service (VETS) staff. Each State agency shall provide adequate and appropriate facilities and...

  20. 24 CFR 583.300 - General operation.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 3 2011-04-01 2010-04-01 true General operation. 583.300 Section... DEVELOPMENT COMMUNITY FACILITIES SUPPORTIVE HOUSING PROGRAM Program Requirements § 583.300 General operation... condition of the structure and the operation of the housing or services. (b) Habitability standards. Except...

  1. 24 CFR 583.300 - General operation.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 3 2012-04-01 2012-04-01 false General operation. 583.300 Section... DEVELOPMENT COMMUNITY FACILITIES SUPPORTIVE HOUSING PROGRAM Program Requirements § 583.300 General operation... condition of the structure and the operation of the housing or services. (b) Habitability standards. Except...

  2. 24 CFR 583.300 - General operation.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 3 2013-04-01 2013-04-01 false General operation. 583.300 Section... DEVELOPMENT COMMUNITY FACILITIES SUPPORTIVE HOUSING PROGRAM Program Requirements § 583.300 General operation... condition of the structure and the operation of the housing or services. (b) Habitability standards. Except...

  3. 24 CFR 583.300 - General operation.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 3 2014-04-01 2013-04-01 true General operation. 583.300 Section... DEVELOPMENT COMMUNITY FACILITIES SUPPORTIVE HOUSING PROGRAM Program Requirements § 583.300 General operation... condition of the structure and the operation of the housing or services. (b) Habitability standards. Except...

  4. 45 CFR 3.41 - Admission to facilities or grounds.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Admission to facilities or grounds. 3.41 Section 3.41 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CONDUCT OF PERSONS AND TRAFFIC ON THE NATIONAL INSTITUTES OF HEALTH FEDERAL ENCLAVE Facilities and Grounds § 3.41...

  5. 45 CFR 3.41 - Admission to facilities or grounds.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Admission to facilities or grounds. 3.41 Section 3.41 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION CONDUCT OF PERSONS AND TRAFFIC ON THE NATIONAL INSTITUTES OF HEALTH FEDERAL ENCLAVE Facilities and Grounds § 3.41...

  6. 45 CFR 3.41 - Admission to facilities or grounds.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Admission to facilities or grounds. 3.41 Section 3.41 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CONDUCT OF PERSONS AND TRAFFIC ON THE NATIONAL INSTITUTES OF HEALTH FEDERAL ENCLAVE Facilities and Grounds § 3.41...

  7. 45 CFR 3.41 - Admission to facilities or grounds.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Admission to facilities or grounds. 3.41 Section 3.41 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CONDUCT OF PERSONS AND TRAFFIC ON THE NATIONAL INSTITUTES OF HEALTH FEDERAL ENCLAVE Facilities and Grounds § 3.41...

  8. 45 CFR 3.41 - Admission to facilities or grounds.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Admission to facilities or grounds. 3.41 Section 3.41 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CONDUCT OF PERSONS AND TRAFFIC ON THE NATIONAL INSTITUTES OF HEALTH FEDERAL ENCLAVE Facilities and Grounds § 3.41...

  9. 9 CFR 130.5 - User fees for services at privately owned permanent and temporary import quarantine facilities.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... owned permanent and temporary import quarantine facilities. 130.5 Section 130.5 Animals and Animal... User fees for services at privately owned permanent and temporary import quarantine facilities. (a... privately operated permanent or temporary import quarantine facility will be calculated at the hourly user...

  10. 9 CFR 130.5 - User fees for services at privately owned permanent and temporary import quarantine facilities.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... owned permanent and temporary import quarantine facilities. 130.5 Section 130.5 Animals and Animal... User fees for services at privately owned permanent and temporary import quarantine facilities. (a... privately operated permanent or temporary import quarantine facility will be calculated at the hourly user...

  11. 9 CFR 130.5 - User fees for services at privately owned permanent and temporary import quarantine facilities.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... owned permanent and temporary import quarantine facilities. 130.5 Section 130.5 Animals and Animal... User fees for services at privately owned permanent and temporary import quarantine facilities. (a... privately operated permanent or temporary import quarantine facility will be calculated at the hourly user...

  12. 9 CFR 130.5 - User fees for services at privately owned permanent and temporary import quarantine facilities.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... owned permanent and temporary import quarantine facilities. 130.5 Section 130.5 Animals and Animal... User fees for services at privately owned permanent and temporary import quarantine facilities. (a... privately operated permanent or temporary import quarantine facility will be calculated at the hourly user...

  13. 9 CFR 130.5 - User fees for services at privately owned permanent and temporary import quarantine facilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... owned permanent and temporary import quarantine facilities. 130.5 Section 130.5 Animals and Animal... User fees for services at privately owned permanent and temporary import quarantine facilities. (a... privately operated permanent or temporary import quarantine facility will be calculated at the hourly user...

  14. Email consultations in general practice.

    PubMed

    Neville, Ron G; Marsden, Wendy; McCowan, Colin; Pagliari, Claudia; Mullen, Helen; Fannin, Allison

    2004-01-01

    Email is an established method of communication in business, leisure and education but not yet health care. To evaluate an email service enabling communication between patients and their general practice regarding repeat prescriptions, appointment booking and clinical enquiries. Qualitative analysis of interactions and an electronic user survey. An urban practice in Dundee, Scotland. 150 patients aged 24 to 85. We set up a practice facility to allow our patients to use email to book appointments, order repeat prescriptions and consult their general practitioner (GP). Patient satisfaction with the service was very high. Patients specifically commended the practice for setting up a facility to allow communication outside standard working hours and for the ease of ordering repeat prescriptions. Patients were pleased to have a means of seeking their doctor's comment or opinion without bothering him or her by making and attending a formal face-to-face consultation. Email dialogue was polite, factual, but less formal than standard letters. Staff did not experience any perceptible rise in workload. Use of an email consultation facility worked well within an urban practice, was deemed helpful by patients, and resulted in no apparent increase in GP workload. Our results suggest that there may be an unmet need amongst patients for clinical email services, and that such services may have positive outcomes for patients and practices.

  15. 30. 'Gould Island Facilities, General Plan,' submitted 29 December 1941 ...

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

    30. 'Gould Island Facilities, General Plan,' submitted 29 December 1941 by John Brackett, Consulting Engineer, to Public Works Department, Bureau of Yards & Docks. PW Drawing 3859-46, Y&D Drawing 190833. Scales 1' = 50' and 1' = 10'. - Naval Torpedo Station, Firing Pier, North end of Gould Island in Narragansett Bay, Newport, Newport County, RI

  16. Potable Water Treatment Facility General Permit (PWTF GP) for Massachusetts & New Hampshire

    EPA Pesticide Factsheets

    Documents, links & contacts for the Notice of Availability of the draft NPDES General Permit for Discharges from Potable Water Treatment Facilities in Massachusetts (MAG640000) and New Hampshire (NHG640000).

  17. Advanced light microscopy core facilities: Balancing service, science and career

    PubMed Central

    Hartmann, Hella; Reymann, Jürgen; Ansari, Nariman; Utz, Nadine; Fried, Hans‐Ulrich; Kukat, Christian; Peychl, Jan; Liebig, Christian; Terjung, Stefan; Laketa, Vibor; Sporbert, Anje; Weidtkamp‐Peters, Stefanie; Schauss, Astrid; Zuschratter, Werner; Avilov, Sergiy

    2016-01-01

    ABSTRACT Core Facilities (CF) for advanced light microscopy (ALM) have become indispensable support units for research in the life sciences. Their organizational structure and technical characteristics are quite diverse, although the tasks they pursue and the services they offer are similar. Therefore, throughout Europe, scientists from ALM‐CFs are forming networks to promote interactions and discuss best practice models. Here, we present recommendations for ALM‐CF operations elaborated by the workgroups of the German network of ALM‐CFs, German Bio‐Imaging (GerBI). We address technical aspects of CF planning and instrument maintainance, give advice on the organization and management of an ALM‐CF, propose a scheme for the training of CF users, and provide an overview of current resources for image processing and analysis. Further, we elaborate on the new challenges and opportunities for professional development and careers created by CFs. While some information specifically refers to the German academic system, most of the content of this article is of general interest for CFs in the life sciences. Microsc. Res. Tech. 79:463–479, 2016. © 2016 THE AUTHORS MICROSCOPY RESEARCH AND TECHNIQUE PUBLISHED BY WILEY PERIODICALS, INC. PMID:27040755

  18. HIV treatment and care services for adolescents: a situational analysis of 218 facilities in 23 sub-Saharan African countries.

    PubMed

    Mark, Daniella; Armstrong, Alice; Andrade, Catarina; Penazzato, Martina; Hatane, Luann; Taing, Lina; Runciman, Toby; Ferguson, Jane

    2017-05-16

    In 2013, an estimated 2.1 million adolescents (age 10-19 years) were living with HIV globally. The extent to which health facilities provide appropriate treatment and care was unknown. To support understanding of service availability in 2014, Paediatric-Adolescent Treatment Africa (PATA), a non-governmental organisation (NGO) supporting a network of health facilities across sub-Saharan Africa, undertook a facility-level situational analysis of adolescent HIV treatment and care services in 23 countries. Two hundred and eighteen facilities, responsible for an estimated 80,072 HIV-infected adolescents in care, were surveyed. Sixty per cent of the sample were from PATA's network, with the remaining gathered via local NGO partners and snowball sampling. Data were analysed using descriptive statistics and coding to describe central tendencies and identify themes. Respondents represented three subregions: West and Central Africa ( n  = 59; 27%), East Africa ( n  = 77, 35%) and southern Africa ( n  = 82, 38%). Half (50%) of the facilities were in urban areas, 17% peri-urban and 33% rural settings. Insufficient data disaggregation and outcomes monitoring were critical issues. A quarter of facilities did not have a working definition of adolescence. Facilities reported non-adherence as their key challenge in adolescent service provision, but had insufficient protocols for determining and managing poor adherence and loss to follow-up. Adherence counselling focused on implications of non-adherence rather than its drivers. Facilities recommended peer support as an effective adherence and retention intervention, yet not all offered these services. Almost two-thirds reported attending to adolescents with adults and/or children, and half had no transitioning protocols. Of those with transitioning protocols, 21% moved pregnant adolescents into adult services earlier than their peers. There was limited sexual and reproductive health integration, with 63% of facilities

  19. Linking household and health facility surveys to assess obstetric service availability, readiness and coverage: evidence from 17 low- and middle-income countries

    PubMed Central

    Kanyangarara, Mufaro; Chou, Victoria B; Creanga, Andreea A; Walker, Neff

    2018-01-01

    Background Improving access and quality of obstetric service has the potential to avert preventable maternal, neonatal and stillborn deaths, yet little is known about the quality of care received. This study sought to assess obstetric service availability, readiness and coverage within and between 17 low- and middle-income countries. Methods We linked health facility data from the Service Provision Assessments and Service Availability and Readiness Assessments, with corresponding household survey data obtained from the Demographic and Health Surveys and Multiple Indicator Cluster Surveys. Based on performance of obstetric signal functions, we defined four levels of facility emergency obstetric care (EmOC) functionality: comprehensive (CEmOC), basic (BEmOC), BEmOC-2, and low/substandard. Facility readiness was evaluated based on the direct observation of 23 essential items; facilities “ready to provide obstetric services” had ≥20 of 23 items available. Across countries, we used medians to characterize service availability and readiness, overall and by urban-rural location; analyses also adjusted for care-seeking patterns to estimate population-level coverage of obstetric services. Results Of the 111 500 health facilities surveyed, 7545 offered obstetric services and were included in the analysis. The median percentages of facilities offering EmOC and “ready to provide obstetric services” were 19% and 10%, respectively. There were considerable urban-rural differences, with absolute differences of 19% and 29% in the availability of facilities offering EmOC and “ready to provide obstetric services”, respectively. Adjusting for care-seeking patterns, results from the linking approach indicated that among women delivering in a facility, a median of 40% delivered in facilities offering EmOC, and 28% delivered in facilities “ready to provide obstetric services”. Relatively higher coverage of facility deliveries (≥65%) and coverage of deliveries in

  20. 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.

  1. [Diabetes care and incidence of severe hypoglycemia in nursing home facilities and nursing services: The Heidelberg Diabetes Study].

    PubMed

    Bahrmann, A; Wörz, E; Specht-Leible, N; Oster, P; Bahrmann, P

    2015-04-01

    The goal of this study was to perform a structured analysis of the treatment quality and acute complications of geriatric patients with diabetes mellitus (DM) cared for by nursing services and nursing home facilities. Secondly, structural problems and potentials for improvement in the care of multimorbid older people with DM treated by nursing homes and nursing services were analysed from the viewpoint of geriatric nurses, managers of nursing homes and general practitioners. In all, 77 older persons with DM from 13 nursing homes and 3 nursing services were included in the analysis (76.6% female, HbA1c 6.9 ± 1.4%, age 81.6 ± 9.9 years). Structural problems and potentials for improvement were collected from 95 geriatric nurses, 9 managers of nursing homes and 6 general practitioners using semistandardized questionnaires. Metabolic control was too strict in care-dependent older people with DM (mean HbA1c value: 6.9 ± 1.4 %; recommended by guidelines: 7-8%). The measurement of HbA1c was performed in 16 of 77 people (20.8%) within the last year despite a high visitation frequency of the general practitioners (12.7 ± 7.7 within the last 6 months). The incidence of severe hypoglycemia was 7.8%/patient/year. Regarding the management in case of diabetes-related acute complications 33 geriatric nurses (34.7%) stated not having any written standard (nursing home 39%, geriatric services 16.7%). Complex insulin therapies are still used in older people with DM with the consequence of a high incidence of severe hypoglycemia. Concrete management standards in the case of diabetes-related acute complications for geriatric nurses are lacking for more than one third of the nursing services.

  2. Optimization Evaluation, General Motors Former AC Rochester Facility, Sioux City, Iowa

    EPA Pesticide Factsheets

    The General Motors (GM) Former AC Rochester Facility (site) is located within the valley of the Missouri River in Sioux City, Iowa and is bounded by a steep loess bluff to the north, commercial properties to the east, and undeveloped properties to the...

  3. Description of the General Equilibrium Model of Ecosystem Services (GEMES)

    Treesearch

    Travis Warziniack; David Finnoff; Jenny Apriesnig

    2017-01-01

    This paper serves as documentation for the General Equilibrium Model of Ecosystem Services (GEMES). GEMES is a regional computable general equilibrium model that is composed of values derived from natural capital and ecosystem services. It models households, producing sectors, and governments, linked to one another through commodity and factor markets. GEMES was...

  4. General Services Administration: FY 1998 Congressional Justification.

    DTIC Science & Technology

    1997-03-20

    APPROPRIATIONS: Consumer Information Center CIC GSA InSite STATEMENT OF DAVID J. BARRAM ACTING ADMINISTRATOR, GENERAL SERVICES ADMINISTRATION BEFORE THE...in every area in which we operate. I think three impulses drive us toward change. First, we believe the customer is king. We’re learning what that...really means. We thrill our customers with GSA Advantage!, with less than 2 cents a network minute for long distance on-net telephone service, and

  5. Revenue Bond Financing Auxiliary Service Facilities Construction at the State Colleges.

    ERIC Educational Resources Information Center

    Maryland Board of Trustees of the State Colleges, Baltimore.

    Since the State of Maryland does not provide funds for the construction of dormitories, dining halls, student activities, buildings, and similar ancillary services, an outline of cost responsibilities for such facilities in the state college system is presented. Based on a discussion of the financing methods for ancillary projects, the role of the…

  6. 42 CFR 93.100 - General policy.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT General § 93.100 General policy. (a) Research misconduct involving PHS support is contrary to the... of research, and to the conservation of public funds. (b) The U.S. Department of Health and Human...

  7. 42 CFR 93.100 - General policy.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT General § 93.100 General policy. (a) Research misconduct involving PHS support is contrary to the... of research, and to the conservation of public funds. (b) The U.S. Department of Health and Human...

  8. General view from outside the Orbiter Processing Facility at the ...

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

    General view from outside the Orbiter Processing Facility at the Kennedy Space Center with the bay doors open as the Orbiter Discovery is atop the transport vehicle prepared to be moved over to the Vehicle Assembly Building. - Space Transportation System, Orbiter Discovery (OV-103), Lyndon B. Johnson Space Center, 2101 NASA Parkway, Houston, Harris County, TX

  9. Orbiter processing facility service platform failure and redesign

    NASA Technical Reports Server (NTRS)

    Harris, Jesse L.

    1988-01-01

    In a high bay of the Orbiter Processing Facility (OPF) at the Kennedy Space Center, technicians were preparing the space shuttle orbiter Discovery for rollout to the Vehicle Assembly Building (VAB). A service platform, commonly referred to as an OPF Bucket, was being retracted when it suddenly fell, striking a technician and impacting Discovery's payload bay door. A critical component in the OPF Bucket hoist system had failed, allowing the platform to fall. The incident was thoroughly investigated by both NASA and Lockheed, revealing many design deficiencies within the system. The deficiencies and the design changes made to correct them are reviewed.

  10. 24 CFR 206.201 - Mortgage servicing generally; sanctions.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., including 2 CFR part 2424 (Debarment, Suspension, and Limited Denial of Participation), and part 25 of this...; sanctions. 206.201 Section 206.201 Housing and Urban Development Regulations Relating to Housing and Urban... generally; sanctions. (a) General. This subpart identifies servicing practices that the Secretary considers...

  11. 42 CFR 424.27 - Requirements for comprehensive outpatient rehabilitation facility (CORF) services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Requirements for comprehensive outpatient rehabilitation facility (CORF) services. 424.27 Section 424.27 Public Health CENTERS FOR MEDICARE & MEDICAID... PAYMENT Certification and Plan Requirements § 424.27 Requirements for comprehensive outpatient...

  12. Referrals from general practitioners to a social services department

    PubMed Central

    Sheppard, M. G.

    1983-01-01

    One year's referrals from general practitioners to a social services department were studied. There was a low referral rate and a bias towards women, the elderly and the less affluent. The referrals were predominantly made for practical help with problems of ill health. A high proportion of clients were allocated to non-social work staff, and the social service intervention, generally of short duration, showed a sympathetic response to the practical requests of general practitioners. The limited use of social workers by doctors is considered to be the result of ignorance or scepticism about psychodynamic social work skills. Closer liaison between general practitioners and social workers, and a clearer presentation by social workers of their professional skills, are suggested solutions to this problem. PMID:6854536

  13. General College: Provider of Social Services.

    ERIC Educational Resources Information Center

    Hixson, Bruce, Ed.

    1981-01-01

    Three programs in the General College of the University of Minnesota that provide direct social services as well as education to special populations are described: The INSIGHT Program available at Stillwater State Prison; and the Upward Bound and University Day Community programs both offered on the Minneapolis campus. According to Daniel F.…

  14. HIV Testing, HIV Positivity, and Linkage and Referral Services in Correctional Facilities in the United States, 2009–2013

    PubMed Central

    Seth, Puja; Figueroa, Argelia; Wang, Guoshen; Reid, Laurie; Belcher, Lisa

    2016-01-01

    Background Because of health disparities, incarcerated persons are at higher risk for multiple health issues, including HIV. Correctional facilities have an opportunity to provide HIV services to an underserved population. This article describes Centers for Disease Control and Prevention (CDC)–funded HIV testing and service delivery in correctional facilities. Methods Data on HIV testing and service delivery were submitted to CDC by 61 health department jurisdictions in 2013. HIV testing, HIV positivity, receipt of test results, linkage, and referral services were described, and differences across demographic characteristics for linkage and referral services were assessed. Finally, trends were examined for HIV testing, HIV positivity, and linkage from 2009 to 2013. Results Of CDC-funded tests in 2013 among persons 18 years and older, 254,719 (7.9%) were conducted in correctional facilities. HIV positivity was 0.9%, and HIV positivity for newly diagnosed persons was 0.3%. Blacks accounted for the highest percentage of HIV-infected persons (1.3%) and newly diagnosed persons (0.5%). Only 37.9% of newly diagnosed persons were linked within 90 days; 67.5% were linked within any time frame; 49.7% were referred to partner services; and 45.2% were referred to HIV prevention services. There was a significant percent increase in HIV testing, overall HIV positivity, and linkage from 2009 to 2013. However, trends were stable for newly diagnosed persons. Conclusions Identification of newly diagnosed persons in correctional facilities has remained stable from 2009 to 2013. Correctional facilities seem to be reaching blacks, likely due to higher incarceration rates. The current findings indicate that improvements are needed in HIV testing strategies, service delivery during incarceration, and linkage to care postrelease. PMID:26462190

  15. 42 CFR 409.85 - Skilled nursing facility (SNF) care coinsurance.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Skilled nursing facility (SNF) care coinsurance. 409.85 Section 409.85 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Coinsurance § 409.85 Skilled nursing facility (SNF) care coinsurance. (a) General provisions. (1) SNF care...

  16. 42 CFR 409.85 - Skilled nursing facility (SNF) care coinsurance.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Skilled nursing facility (SNF) care coinsurance. 409.85 Section 409.85 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Coinsurance § 409.85 Skilled nursing facility (SNF) care coinsurance. (a) General provisions. (1) SNF care...

  17. 42 CFR 409.85 - Skilled nursing facility (SNF) care coinsurance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Skilled nursing facility (SNF) care coinsurance. 409.85 Section 409.85 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Coinsurance § 409.85 Skilled nursing facility (SNF) care coinsurance. (a) General provisions. (1) SNF care...

  18. 42 CFR 409.85 - Skilled nursing facility (SNF) care coinsurance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Skilled nursing facility (SNF) care coinsurance. 409.85 Section 409.85 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Coinsurance § 409.85 Skilled nursing facility (SNF) care coinsurance. (a) General provisions. (1) SNF care...

  19. 42 CFR 409.85 - Skilled nursing facility (SNF) care coinsurance.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Skilled nursing facility (SNF) care coinsurance. 409.85 Section 409.85 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Coinsurance § 409.85 Skilled nursing facility (SNF) care coinsurance. (a) General provisions. (1) SNF care...

  20. Stakeholder experiences with general practice pharmacist services: a qualitative study.

    PubMed

    Tan, Edwin C K; Stewart, Kay; Elliott, Rohan A; George, Johnson

    2013-09-11

    To explore general practice staff, pharmacist and patient experiences with pharmacist services in Australian general practice clinics within the Pharmacists in Practice Study. Qualitative study. Two general practice clinics in Melbourne, Australia, in which pharmacists provided medication reviews, patient and staff education, medicines information and quality assurance services over a 6-month period. Patients, practice staff and pharmacists. Semi-structured telephone interviews with patients, focus groups with practice staff and semi-structured interviews and periodic narrative reports with practice pharmacists. Data were analysed thematically and theoretical frameworks used to explain the findings. 34 participants were recruited: 18 patients, 14 practice staff (9 general practitioners, 4 practice nurses, 1 practice manager) and 2 practice pharmacists. Five main themes emerged: environment; professional relationships and integration; pharmacist attributes; staff and patient benefits and logistical challenges. Participants reported that colocation and the interdisciplinary environment of general practice enabled better communication and collaboration compared to traditional community and consultant pharmacy services. Participants felt that pharmacists needed to possess certain attributes to ensure successful integration, including being personable and proactive. Attitudinal, professional and logistical barriers were identified but were able to be overcome. The findings were explained using D'Amour's structuration model of collaboration and Roger's diffusion of innovation theory. This is the first qualitative study to explore the experiences of general practice staff, pharmacists and patients on their interactions within the Australian general practice environment. Participants were receptive of colocated pharmacist services, and various barriers and facilitators to integration were identified. Future research should investigate the feasibility and sustainability of

  1. A method for studying the development pattern of urban commercial service facilities based on customer reviews from social media

    NASA Astrophysics Data System (ADS)

    Wang, Y. D.; Jiang, B. T.; Ye, X. Y.

    2016-06-01

    Urbanization is one of the most important human social activities in the 21st century (Chaolin et al., 2012). With an increasing number of people visiting cities, the provision of adequate urban service facilities, including public and commercial service facilities, in locations where people live has become an important guarantee of the success of urbanization. Exploring the commercial service facilities in a specific area of a city can help us understand the progress and trends of urban renewal in the area, provide a quantitative basis for evaluating the rationality of planning implementation, and facilitate an analysis of the effects of different factors on the regional development of a city (Schor et al. 2003). In this paper, we proposed a data processing and analysis method for studying the distribution and development pattern of urban commercial facilities based on customer reviews. In addition, based on road network constraints, we explored the patterns contained in customer reviews data, including patterns for the spatial distribution and spatial-temporal evolution of facilities as well as the number of facilities and degree of satisfaction.

  2. 42 CFR 412.405 - Preadmission services as inpatient operating costs under the inpatient psychiatric facility...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Preadmission services as inpatient operating costs under the inpatient psychiatric facility prospective payment system. 412.405 Section 412.405 Public... PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Inpatient Hospital...

  3. 42 CFR 412.405 - Preadmission services as inpatient operating costs under the inpatient psychiatric facility...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Preadmission services as inpatient operating costs under the inpatient psychiatric facility prospective payment system. 412.405 Section 412.405 Public... PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Inpatient Hospital...

  4. 42 CFR 412.405 - Preadmission services as inpatient operating costs under the inpatient psychiatric facility...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Preadmission services as inpatient operating costs under the inpatient psychiatric facility prospective payment system. 412.405 Section 412.405 Public... PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Inpatient Hospital...

  5. 42 CFR 412.405 - Preadmission services as inpatient operating costs under the inpatient psychiatric facility...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Preadmission services as inpatient operating costs under the inpatient psychiatric facility prospective payment system. 412.405 Section 412.405 Public... PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Inpatient Hospital...

  6. 42 CFR 412.405 - Preadmission services as inpatient operating costs under the inpatient psychiatric facility...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Preadmission services as inpatient operating costs under the inpatient psychiatric facility prospective payment system. 412.405 Section 412.405 Public... PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Inpatient Hospital...

  7. Fuel Cells Provide Reliable Power to U.S. Postal Service Facility in Anchorage, Alaska

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

    Parker, Steven

    2003-01-01

    Working together, the U.S. Postal Service (USPS) and Chugach Electric Association, partnering with the Department of Defense (DOD), Department of Energy (DOE), US Army Corps of Engineers Construction Engineering Research Laboratories (USA CERL), Electric Power Research Institute (EPRI), and National Rural Electric Cooperative Association (NRECA), developed and installed one of the largest fuel cell installations in the world. The one-megawatt fuel cell combined heat and power plant sits behind the Anchorage U.S. Postal Service Mail Processing and Distribution Facility. Chugach Electric owns, operates, and maintains the fuel cell power plant, which provides clean, reliable power to the USPS facility. Inmore » addition, heat recovered from the fuel cells, in the form of hot water, is used to heat the USPS Mail Processing and Distribution Facility. By taking a leadership role, the USPS will save over $800,000 in electricity and natural gas costs over the 5 1/2-year contract term with Chugach Electric.« less

  8. Health services under the General Agreement on Trade in Services.

    PubMed Central

    Adlung, R.; Carzaniga, A.

    2001-01-01

    The potential for trade in health services has expanded rapidly in recent decades. More efficient communication systems have helped to reduce distance-related barriers to trade; rising incomes and enhanced information have increased the mobility of patients; and internal cost pressures have led various governments to consider possibilities for increased private participation. As yet, however, health services have played only a modest role in the General Agreement on Trade in Services (GATS). It is possible that Members of the World Trade Organization have been discouraged from undertaking access commitments by the novelty of the Agreement, coordination problems between relevant agencies, widespread inexperience in concepts of services trade, a traditionally strong degree of government involvement in the health sector, and concerns about basic quality and social objectives. However, more than five years have passed since GATS entered into force, allowing hesitant administrations to familiarize themselves with its main elements and its operation in practice. The present paper is intended to contribute to this process. It provides an overview of the basic structure of GATS and of the patterns of current commitments in health services and of limitations frequently used in this context. The concluding section discusses possibilities of pursuing basic policy objectives in a more open environment and indicates issues that may have to be dealt with in current negotiations on services. PMID:11357215

  9. Community residential facilities in mental health services: A ten-year comparison in Lombardy.

    PubMed

    Barbato, Angelo; Civenti, Graziella; D'Avanzo, Barbara

    2017-06-01

    Residential mental health services grew steadily since 2000 in Italy. A reorganisation of residential facilities was implemented in 2007 in Lombardy, introducing supported housing in addition to staffed facilities. We compare the provision and characteristics of residential facilities in the 2007 and 2016. In 2007 there were 3462 beds (35.9/100,000 population) in 276 facilities. In 2016 beds were 4783 (47.8/100,000) in 520 facilities. The increase were unevenly distributed in the public and private sector, and the overall increase was due to a higher increase in the private sector. 72% of beds were in highly supervised facilities in 2007 and 66% in 2016. The public sector managed more facilities with a rehabilitation goal, while the private sector more for long-term accommodation. Mean numbers of beds were higher in facilities managed by the private sector in both years. The 2007 reorganisation and the stop to opening new facilities in the last years were not enough to correct the imbalance between highly supervised and flexible solutions. A wider and more diverse offer might have triggered off an increased demand, rather than a more rational use. Given the costs of highly staffed facilities, and the risk of reproducing custodial models, close evaluation of the use of residential facilities should inform policies. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. 42 CFR 422.133 - Return to home skilled nursing facility.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Return to home skilled nursing facility. 422.133... Protections § 422.133 Return to home skilled nursing facility. (a) General rule. MA plans must provide coverage of posthospital extended care services to Medicare enrollees through a home skilled nursing...

  11. 42 CFR 422.133 - Return to home skilled nursing facility.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Return to home skilled nursing facility. 422.133... Protections § 422.133 Return to home skilled nursing facility. (a) General rule. MA plans must provide coverage of posthospital extended care services to Medicare enrollees through a home skilled nursing...

  12. 42 CFR 422.133 - Return to home skilled nursing facility.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Return to home skilled nursing facility. 422.133... Protections § 422.133 Return to home skilled nursing facility. (a) General rule. MA plans must provide coverage of posthospital extended care services to Medicare enrollees through a home skilled nursing...

  13. Audit of HIV counselling and testing services among primary healthcare facilities in Cameroon: a protocol for a multicentre national cross-sectional study.

    PubMed

    Tianyi, Frank-Leonel; Tochie, Joel Noutakdie; Agbor, Valirie Ndip; Kadia, Benjamin Momo

    2018-03-01

    HIV testing is an invaluable entry point to prevention, care and treatment services for people living with HIV and AIDS. Poor adherence to recommended protocols and guidelines reduces the performance of rapid diagnostic tests, leading to misdiagnosis and poor estimation of HIV seroprevalence. This study seeks to evaluate the adherence of primary healthcare facilities in Cameroon to recommended HIV counselling and testing (HCT) procedures and the impact this may have on the reliability of HIV test results. This will be an analytical cross-sectional study involving primary healthcare facilities from all the 10 regions of Cameroon, selected by a multistaged random sampling of primary care facilities in each region. The study will last for 9 months. A structured questionnaire will be used to collect general information concerning the health facility, laboratory and other departments involved in the HCT process. The investigators will directly observe at least 10 HIV testing processes in each facility and fill out the checklist accordingly. Clearance has been obtained from the National Ethical Committee to carry out the study. Informed consent will be sought from the patients to observe the HIV testing process. The final study will be published in a peer-reviewed journal and the findings presented to health policy-makers and the general public. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  14. Students' Perceived Quality of Library Facilities and Services in Nigerian Private Universities

    ERIC Educational Resources Information Center

    Oluwunmi, A. O.; Durodola, O. D.; Ajayi, C. A.

    2016-01-01

    In a highly competitive academic environment, students are becoming more selective and demanding in their choice of University. Hence, it is essential for educational institutions, particularly privately-owned institutions, to be interested in getting feedback on the quality of their facilities and services. With a focus on four private…

  15. 76 FR 387 - Atomic Safety and Licensing Board; AREVA Enrichment Services, LLC (Eagle Rock Enrichment Facility)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-04

    ... and Licensing Board; AREVA Enrichment Services, LLC (Eagle Rock Enrichment Facility) December 17, 2010... construction and operation of a gas centrifuge uranium enrichment facility--denoted as the Eagle Rock... site at http://www.nrc.gov/materials/fuel-cycle-fac/arevanc.html . These and other documents relating...

  16. 41 CFR 105-1.101 - General Services Administration Property Management Regulations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...-INTRODUCTION 1.1-Regulations System § 105-1.101 General Services Administration Property Management Regulations... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false General Services Administration Property Management Regulations. 105-1.101 Section 105-1.101 Public Contracts and Property...

  17. Self-efficacy, social support and service integration at medical cannabis facilities in the San Francisco Bay area of California.

    PubMed

    Reiman, Amanda E

    2008-01-01

    In an effort to examine and possibly utilise the community-based, bottom-up service design of medical cannabis facilities in the San Francisco Bay area of California, 130 adults who had received medical cannabis recommendations from a physician were surveyed at seven facilities to describe the social service aspects of these unique, community-based programmes. This study used an unselected consecutive sample and cross-sectional survey design that included primary data collection at the medical cannabis facilities themselves. In this exploratory study, individual level data were collected on patient demographics and reported patient satisfaction as gathered by the Patient Satisfaction Questionnaire III. Surveys were filled out on site. In the case of a refusal, the next person was asked. The refusal rate varied depending on the study site and ranged between 25% and 60%, depending on the facility and the day of sampling. Organisational-level data, such as operating characteristics and products offered, created a backdrop for further examination into the social services offered by these facilities and the attempts made by this largely unregulated healthcare system to create a community-based environment of social support for chronically ill people. Informal assessment suggests that chronic pain is the most common malady for which medical cannabis is used. Descriptive statistics were generated to examine sample- and site-related differences. Results show that medical cannabis patients have created a system of dispensing medical cannabis that also includes services such as counselling, entertainment and support groups - all important components of coping with chronic illness. Furthermore, patients tend to be male, over 35, identify with more than one ethnicity, and earn less than US$20 000 annually. Levels of satisfaction with facility care were fairly high, and higher than nationally reported satisfaction with health care in the USA. Facilities tended to follow a

  18. An evaluation of the benefits and challenges of video consulting between general practitioners and residential aged care facilities.

    PubMed

    Wade, Victoria; Whittaker, Frank; Hamlyn, Jeremy

    2015-12-01

    This research evaluated a project that provided video consultations between general practitioners (GPs) and residential aged care facilities (RACFs), with the aim of enabling faster access to medical care and avoidance of unnecessary hospital transfers. GPs were paid for video consultations at a rate equivalent to existing insurance reimbursement for supporting telehealth services. Evaluation data were gathered by direct observation at the project sites, semi-structured interviews and video call data from the technical network. Three pairs of general practices and RACFs were recruited to the project. 40 video consultations eligible for payment occurred over a 6 month period, three of which were judged to have avoided hospital attendance. The process development and change management aspects of the project required substantially more effort than was anticipated. This was due to problems with RACF technical infrastructure, the need for repeated training and awareness raising in RACFs, the challenge of establishing new clinical procedures, the short length of the project and broader difficulties in the relationships between GPs and RACFs. Video consulting between GPs and RACFs was clinically useful and avoided hospital attendance on a small scale, but further focus on process development is needed to embed this as a routine method of service delivery. © The Author(s) 2015.

  19. Scope of Work for Integration Management and Installation Services of the National Ignition Facility Beampath Infrastructure System

    NASA Astrophysics Data System (ADS)

    Coyle, P. D.

    2000-03-01

    The goal of the National Ignition Facility (NIF) project is to provide an above ground experimental capability for maintaining nuclear competence and weapons effects simulation and to provide a facility capable of achieving fusion ignition using solid-state lasers as the energy driver. The facility will incorporate 192 laser beams, which will be focused onto a small target located at the center of a spherical target chamber-the energy from the laser beams will be deposited in a few billionths of a second. The target will then implode, forcing atomic nuclei to sufficiently high temperatures and densities necessary to achieve a miniature fusion reaction. The NIF is under construction, at Livermore, California, located approximately 50 miles southeast of San Francisco, California. The University of California, Lawrence Livermore National Laboratory (LLNL), operating under Prime Contract W-7405-ENG. 48 with the U.S. Department of Energy (DOE), shall subcontract for Integration Management and Installation (IMI) Services for the Beampath Infrastructure System (BIS). The BIS includes Beampath Hardware and Beampath Utilities. Conventional Facilities work for the NIF Laser and Target Area Building (LTAB) and Optics Assembly Building (OAB) is over 86 percent constructed. This Scope of Work is for Integration Management and Installation (IMI) Services corresponding to Management Services, Design Integration Services, Construction Services, and Commissioning Services for the NIB BIS. The BIS includes Beampath Hardware and Beampath Utilities. Beampath Hardware and Beampath Utilities include beampath vessels, enclosures, and beam tubes; auxiliary and utility systems; and support structures. A substantial amount of GFE will be provided by the University for installation as part of the infrastructure packages.

  20. Purchasing, Division of General Services, Department of Administration,

    Science.gov Websites

    State of Alaska Skip to main content State of Alaska alaska.gov myAlaska My Government Resident Business in Alaska Visiting Alaska State Employees State of Alaska, Department of Administration, Division Search General Services State of Alaska State of Alaska > Departments > Administration > General

  1. 10 CFR 430.35 - Petitions with respect to general service lamps.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 3 2014-01-01 2014-01-01 false Petitions with respect to general service lamps. 430.35 Section 430.35 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CONSERVATION PROGRAM FOR CONSUMER PRODUCTS Energy and Water Conservation Standards § 430.35 Petitions with respect to general service lamps...

  2. 45 CFR 234.130 - Assistance in the form of institutional services in intermediate care facilities.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 2 2012-10-01 2012-10-01 false Assistance in the form of institutional services in intermediate care facilities. 234.130 Section 234.130 Public Welfare Regulations Relating to Public Welfare OFFICE OF FAMILY ASSISTANCE (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES...

  3. Gaps in monitoring systems for Implanon NXT services in South Africa: An assessment of 12 facilities in two districts

    PubMed

    Pillay, D; Morroni, C; Pleaner, M; Adeogba, O; Chersich, M; Naidoo, N; Mullick, S; Rees, H

    2017-10-01

    Background. Implanon NXT, a long-acting subdermal contraceptive implant, was introduced in South Africa (SA) in early 2014 as part of an expanded contraceptive method mix. After initial high levels of uptake, reports emerged of frequent early removals and declines in use. Monitoring of progress and challenges in implant service delivery could identify aspects of the programme that require strengthening. Objectives. To assess data management and record keeping within implant services at primary care facilities. Methods. We developed a checklist to assess the tools used for monitoring implant services and data reporting to district offices. The checklist was piloted in seven facilities. An additional six high-volume and six low-volume implant insertion clinics in the City of Johannesburg (CoJ), Gauteng Province, and the Dr Kenneth Kaunda District, North West Province, were selected for assessment. Results. All 12 facilities completed a Daily Head Count Register, which tallied the number of clients attending the clinic, but not information about implant use. A more detailed Tick Register recorded services that clinic attendees received, with nine documenting number of implant insertions and six implant removals. A more specific tool, an Insertion Checklist, collected data on insertion procedures and client characteristics, but was only used in CoJ (five of six facilities). Other registers, which were developed de novo by staff at individual facilities, captured more detailed information about insertions and removals, including reasons. Five of six low-volume insertion facilities used these registers, but only three of six high-volume facilities. No facilities used the form specifically developed by the National Department of Health for implant pharmacovigilance. Nine of 12 clinics reported data on numbers of insertions to the district office, six reported removals and none provided data on reasons for removals. Conclusion. For data to inform effective decision

  4. 78 FR 9431 - Shaw AREVA MOX Services, LLC (Mixed Oxide Fuel Fabrication Facility); Order Approving Indirect...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-08

    ... established pursuant to the policies duly authorized under the National Industrial Security Program. The proxy... Influence (FOCI) in order to maintain the Facility Security Clearance held by MOX Services. No physical... Facility Security Clearance, is in accordance with the provisions of the AEA of 1954, as amended. The...

  5. 48 CFR 7.403 - General Services Administration assistance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... in lease or purchase decisions by providing information such as— (1) Pending price adjustments to... REGULATION ACQUISITION PLANNING ACQUISITION PLANNING Equipment Lease or Purchase 7.403 General Services...

  6. Advanced light microscopy core facilities: Balancing service, science and career.

    PubMed

    Ferrando-May, Elisa; Hartmann, Hella; Reymann, Jürgen; Ansari, Nariman; Utz, Nadine; Fried, Hans-Ulrich; Kukat, Christian; Peychl, Jan; Liebig, Christian; Terjung, Stefan; Laketa, Vibor; Sporbert, Anje; Weidtkamp-Peters, Stefanie; Schauss, Astrid; Zuschratter, Werner; Avilov, Sergiy

    2016-06-01

    Core Facilities (CF) for advanced light microscopy (ALM) have become indispensable support units for research in the life sciences. Their organizational structure and technical characteristics are quite diverse, although the tasks they pursue and the services they offer are similar. Therefore, throughout Europe, scientists from ALM-CFs are forming networks to promote interactions and discuss best practice models. Here, we present recommendations for ALM-CF operations elaborated by the workgroups of the German network of ALM-CFs, German Bio-Imaging (GerBI). We address technical aspects of CF planning and instrument maintainance, give advice on the organization and management of an ALM-CF, propose a scheme for the training of CF users, and provide an overview of current resources for image processing and analysis. Further, we elaborate on the new challenges and opportunities for professional development and careers created by CFs. While some information specifically refers to the German academic system, most of the content of this article is of general interest for CFs in the life sciences. Microsc. Res. Tech. 79:463-479, 2016. © 2016 THE AUTHORS MICROSCOPY RESEARCH AND TECHNIQUE PUBLISHED BY WILEY PERIODICALS, INC. © 2016 The Authors Microscopy Research and Technique Published by Wiley Periodicals, Inc.

  7. Development and Assessment of Service Learning Projects in General Biology

    ERIC Educational Resources Information Center

    Felzien, Lisa; Salem, Laura

    2008-01-01

    Service learning involves providing service to the community while requiring students to meet learning goals in a specific course. A service learning project was implemented in a general biology course at Rockhurst University to involve students in promoting scientific education in conjunction with community partner educators. Students were…

  8. [Provision of building maintenance services in healthcare facilities].

    PubMed

    Amorim, Gláucia Maria; Quintão, Eliana Cardoso Vieira; Martelli Júnior, Hercílio; Bonan, Paulo Rogério Ferreti

    2013-01-01

    The scope of this paper was to evaluate the provision of building maintenance services in health units, by means of a descriptive, quantitative and cross-sectional study, considering the five types of facilities (Primary Health, Emergency, Specialty, Hospital and Mental Health Units). The research was approved by the Research Ethics Comittee of FHEMIG with the Terms of Agreement signed with the Unified Health System of Betim. Comparative analysis was conducted by checking the requirements of "Physical-Functional Structure Management" of the "Brazilian Hospital Accreditation Manual" of the National Accreditation Organization. Nonconformities were noted in the physical-functional management of the health centers, especially the primary health units. The assessment was important, considering that compliance with formal, technical and structural requirements, welfare activities, according to the service organization and appropriate to the profile and complexity, can collaborate to minimize the risks of users. To improve the quality of health care establishments, it is essential that managers, backed by "top management," prioritize financial, human and material resources in planning to ensure compliance with security requirements of users in buildings.

  9. Customer assessment of long-term care pharmacy provider services.

    PubMed

    Clark, Thomas R

    2008-09-01

    Assess performance of long-term care pharmacy providers on key services offered to nursing facilities. Cross-sectional; nursing facility team. Random phone survey of nursing facility team members. 485 nursing facility team members (practicing in nursing facilities, interacting with > or = 1 consultant pharmacist); 46 members excluded, unable to identify facility's pharmacy provider. Directors of nursing, medical directors, and administrators were asked to rate long-term care pharmacy provider performance of eight commonly offered pharmacy services. All groups evaluated pharmacy provider performance of these services using a five-point scale. Results are broken down by employer type. Average rating for eight pharmacy services was 3.64. Top two services: "Labeling medications accurately" ranked in top 1-2 services for all groups (combined rating of 3.97) and "Provides medication administration system" ranked in top 1-3 services for all groups (combined rating of 3.95). One service, "Provides educational inservices," ranked lowest for all groups (combined rating of 3.54). In general, when looking at the eight services in combination for all providers, all services were ranked between Good and Very Good (average score of 3.64). Therefore, while the pharmacy provider is performing above average for these services, there is room for improvement in all of these services. These results can be used as a benchmark. Detailed data results and sample surveys are available online at www.ascp.com/supplements. These surveys can be used by the pharmacy provider to solicit assessments from their own facilities on these services.

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

    PubMed

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

    2016-09-01

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

  11. Reproductive rights denied: the Hyde Amendment and access to abortion for Native American women using Indian health service facilities.

    PubMed

    Arnold, Shaye Beverly

    2014-10-01

    Restrictions on the use of federal funds to provide abortions have limited the access to abortion services for Native American women receiving care at Indian Health Service facilities. Current data suggest that the vast majority of Indian Health Service facilities are unequipped to provide abortions under any circumstances. Native American women experience disproportionately high rates of sexual assault and unintended pregnancy. Hyde Amendment restrictions systematically infringe on the reproductive rights of Native American women and present a pressing public health policy concern.

  12. Nurse-led HIV services and quality of care at health facilities in Kenya, 2014-2016.

    PubMed

    Rabkin, Miriam; Lamb, Matthew; Osakwe, Zainab T; Mwangi, Peter R; El-Sadr, Wafaa M; Michaels-Strasser, Susan

    2017-05-01

    To develop a novel measure to characterize human immunodeficiency virus (HIV) programme quality at health facilities in Kenya and explore its associations with patient- and facility-level characteristics. We developed a composite indicator to measure quality of HIV care, comprising: assessment of eligibility for antiretroviral therapy (ART); initiation of ART; and retention on ART or in care, if ineligible for ART, for 12 months. We applied the comprehensive retention indicator to routinely collected clinical data from 13 331 patients enrolled in HIV care and treatment at 63 health facilities in the Eastern and Nyanza regions of Kenya from 1 January 2014 to 31 March 2016. We explored the association between facility- and patient-level characteristics and the primary outcome: appropriate staging and management of HIV, and retention in care over 12 months. Of the enrolled patients, 8404 (63%) achieved comprehensive retention 12 months after enrolment in care. In univariate analyses, patients at facilities where nurses delivered HIV treatment services (including eligibility assessment, initiation and follow up of ART) had significantly higher comprehensive retention rates at 12 months. In multivariate analyses, after adjusting for both facility- and patient-level characteristics, patients at facilities where nurses initiated ART had significantly higher comprehensive retention in care at 12 months (relative risk, RR: 1.22; 95% confidence interval, CI: 1.00-1.48). Nurse-led HIV services were significantly associated with quality of care, confirming the central role of nurses in the achievement of global health goals, and the need for further investment in nursing education, training and mentoring.

  13. 77 FR 54917 - Public Availability of General Services Administration FY 2012 Federal Activities Inventory...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-06

    ... GENERAL SERVICES ADMINISTRATION [Notice-MV-2012-02; Docket No. 2012-0002; Sequence 14] Public Availability of General Services Administration FY 2012 Federal Activities Inventory Reform (FAIR) Act Inventory AGENCY: General Services Administration (GSA). ACTION: Notice of Public Availability of Fiscal...

  14. 36 CFR 1254.20 - What general policies apply in all NARA facilities where archival materials are available for...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... What general policies apply in all NARA facilities where archival materials are available for research... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false What general policies apply in all NARA facilities where archival materials are available for research? 1254.20 Section 1254.20...

  15. 21 CFR 58.15 - Inspection of a testing facility.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Inspection of a testing facility. 58.15 Section 58.15 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES General Provisions § 58.15 Inspection of a testing...

  16. An exploration of the socio-economic profile of women and costs of receiving abortion services at public health facilities of Madhya Pradesh, India.

    PubMed

    Banerjee, Sushanta K; Kumar, Rakesh; Warvadekar, Janardan; Manning, Vinoj; Andersen, Kathryn Louise

    2017-03-21

    Maternal mortality, which primarily burdens developing countries, reflects the greatest health divide between rich and poor. This is especially pronounced for access to safe abortion services which alone avert 1 of every 10 maternal deaths in India. Primarily due to confidentiality concerns, poor women in India prefer private services which are often offered by untrained providers and may be expensive. In 2006 the state government of Madhya Pradesh (population 73 million) began a concerted effort to ensure access to safe abortion services at public health facilities to both rural and urban poor women. This study aims to understand the socio-economic profile of women seeking abortion services in public health facilities across this state and out of pocket cost accessing abortion services. In particular, we examine the level of access that poor women have to safe abortion services in Madhya Pradesh. This study consisted of a cross-sectional client follow-up design. A total of 19 facilities were selected using two-stage random sampling and 1036 women presenting to chosen facilities with abortion and post-abortion complications were interviewed between May and December 2014. A structured data collection tool was developed. A composite wealth index computed using principal component analysis derived weights from consumer durables and asset holding and classified women into three categories, poor, moderate, and rich. Findings highlight that overall 57% of women who received abortion care at public health facilities were poor, followed by 21% moderate and 22% rich. More poor women sought care at primary level facilities (58%) than secondary level facilities and among women presenting for postabortion complications (67%) than induced abortion. Women reported spending no money to access abortion services as abortion services are free of cost at public facilities. However, poor women spend INR 64 (1 USD) while visiting primary level facilities and INR 256 (USD 4) while

  17. Synthetic Minor NSR Permit: Thunder Butte Petroleum Services, Inc. - Crude Storage and Loading Facility

    EPA Pesticide Factsheets

    This page contains documents relevant to the synthetic minor NSR permi for the Thunder Butte Petroleum Services, Inc., Crude Storage and Loading Facility, located on the Fort Berthold Indian Reservation in Ward County, ND.

  18. Reproductive Rights Denied: The Hyde Amendment and Access to Abortion for Native American Women Using Indian Health Service Facilities

    PubMed Central

    2014-01-01

    Restrictions on the use of federal funds to provide abortions have limited the access to abortion services for Native American women receiving care at Indian Health Service facilities. Current data suggest that the vast majority of Indian Health Service facilities are unequipped to provide abortions under any circumstances. Native American women experience disproportionately high rates of sexual assault and unintended pregnancy. Hyde Amendment restrictions systematically infringe on the reproductive rights of Native American women and present a pressing public health policy concern. PMID:25122025

  19. 78 FR 73863 - Public Availability of General Services Administration FY 2013 Federal Activities Inventory...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-09

    ... GENERAL SERVICES ADMINISTRATION [Notice-MV-2013-03; Docket No. 2013-0002; Sequence 37] Public... Inventory AGENCY: General Services Administration (GSA). ACTION: Notice of public availability of FY 2013...) Circular A-76, General Services Administration (GSA) is publishing this notice to advise the public of the...

  20. 75 FR 48872 - General Services Administration Acquisition Regulation; Rewrite of GSAR Part 541, Acquisition of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-12

    ... Acquisition Regulation; Rewrite of GSAR Part 541, Acquisition of Utility Services AGENCIES: Office of Acquisition Policy, General Services Administration (GSA). ACTION: Final rule. SUMMARY: The General Services Administration (GSA) is amending the General Services Administration Acquisition Regulation (GSAR) to improve the...

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

    PubMed

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

    2015-10-01

    Outpatient human immunodeficiency virus (HIV) health care facilities receive funding from the Ryan White HIV/AIDS Program (RWHAP) to provide medical care and essential support services that help patients remain in care and adhere to treatment. Increased access to Medicaid and private insurance for HIV-infected persons may provide coverage for medical care but not all needed support services and may not supplant the need for RWHAP funding. To examine differences between RWHAP-funded and non-RWHAP-funded facilities and in patient outcomes between the 2 systems. The study was conducted from June 1, 2009, to May 31, 2012, using data from the 2009 and 2011 cycles of the Medical Monitoring Project, a national probability sample of 8038 HIV-infected adults receiving medical care at 989 outpatient health care facilities providing HIV medical care. Data were used to compare patient characteristics, service needs, and access to services at RWHAP-funded vs non-RWHAP-funded facilities. Differences in prescribed antiretroviral treatment and viral suppression were assessed. Data analysis was performed between February 2012 and June 2015. Overall, 34.4% of facilities received RWHAP funding and 72.8% of patients received care at RWHAP-funded facilities. With results reported as percentage (95% CI), patients attending RWHAP-funded facilities were more likely to be aged 18 to 29 years (8.5% [7.4%-9.5%] vs 5.0% [3.9%-6.2%]), female (29.2% [27.2%-31.2%] vs 20.1% [17.0%-23.1%]), black (47.5% [41.5%-53.5%] vs 25.8% [20.6%-31.0%]) or Hispanic (22.5% [16.4%-28.6%] vs 12.9% [10.6%-15.2%]), have less than a high school education (26.1% [24.0%-28.3%] vs 10.9% [8.7%-13.1%]), income at or below the poverty level (53.6% [50.3%-56.9%] vs 23.9% [19.7%-28.0%]), and lack health care coverage (25.0% [21.9%-28.1%] vs 6.1% [4.1%-8.0%]). The RWHAP-funded facilities were more likely to provide case management (76.1% [69.9%-82.2%] vs 15.4% [10.4%-20.4%]) as well as mental health (64.0% [57.0%-71.0%] vs

  2. An integrated model to measure service management and physical constraints' effect on food consumption in assisted-living facilities.

    PubMed

    Huang, Hui-Chun; Shanklin, Carol W

    2008-05-01

    The United States is experiencing remarkable growth in the elderly population, which provides both opportunities and challenges for assisted-living facilities. The objective of this study was to explore how service management influences residents' actual food consumption in assisted-living facilities. Physical factors influencing residents' service evaluation and food consumption also were investigated. A total of 394 questionnaires were distributed to assisted-living residents in seven randomly selected facilities. The questionnaire was developed based on an in-depth literature review and pilot study. Residents' perceived quality evaluations, satisfaction, and physical constraints were measured. Residents' actual food consumption was measured using a plate waste technique. A total of 118 residents in five facilities completed both questionnaires and food consumption assessments. Descriptive, multivariate analyses and structural equation modeling techniques were employed. Service management, including food and service quality and customer satisfaction, was found to significantly influence residents' food consumption. Physical constraints associated with aging, including a decline in health status, chewing problems, sensory loss, and functional disability, also significantly influenced residents' food consumption. A significant relationship was found between physical constraints and customer satisfaction. Foodservice that provides good food and service quality increases customer satisfaction and affects residents' actual food consumption. Physical constraints also influence residents' food consumption directly, or indirectly through satisfaction. The findings suggest that food and nutrition professionals in assisted-living should consider the physical profiles of their residents to enhance residents' satisfaction and nutrient intake. Recommendations for exploring residents' perspectives are discussed.

  3. Comparison of the socioeconomic impacts of international fuel service centers versus dispersed nuclear facilities

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

    Braid, Jr., R. B.

    1979-01-01

    The paper investigates a variety of community impacts including: public services, fiscal issues, economic matters, land and water use, political and social cohesion, and legal considerations. Comparisons of socioeconomic impacts of colocated versus dispersed sites are made on the basis of the size of the impacted communities, the size and type of nuclear facility, and the facility's construction time frame. The paper concludes that, under similar circumstances, most of the socioeconomic impacts of colocated nuclear facilities would be somewhat less than the sum of the impacts associated with equivalent dispersed sites. While empirical data is non-existent, the paper contends, however,more » that because the socioeconomic impacts of colocated facilities are so great and readily identifiable to a public unskilled in making comparisons with the dispersed alternative, the facilities will likely generate so much public opposition that IFSCs will probably prove infeasible.« less

  4. 77 FR 74631 - General Services Administration Acquisition Regulation: Modifications (Multiple Award Schedules...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-17

    ...-0001; Sequence 21] General Services Administration Acquisition Regulation: Modifications (Multiple... Modifications (Multiple Award Schedule). DATES: Submit comments on or before: February 15, 2013. FOR FURTHER INFORMATION CONTACT: Ms. Dana Munson, General Services Acquisition Policy Division, GSA, (202) 357-9652 or...

  5. Clients' satisfaction with quality of childbirth services: A comparative study between public and private facilities in Limuru Sub-County, Kiambu, Kenya.

    PubMed

    Okumu, Clarice; Oyugi, Boniface

    2018-01-01

    This study intended to compare the clients' satisfaction with the quality of childbirth services in a private and public facility amongst mothers who have delivered within the last twenty four to seventy hours. This was a cross-sectional comparative research design with both quantitative and qualitative data collection and analysis methods. Data were collected through a focused group discussion guide and structured questionnaire collecting information on clients' satisfaction with quality of childbirth services. The study was conducted amongst women of reproductive age (WRA) between 15-49 years in Tigoni District hospital (public hospital) and Limuru Nursing home (private hospital). For quantitative data we conducted descriptive analysis and Mann-Whitney test using SPSS version 20.0 while qualitative data was manually analyzed manually using thematic analysis. A higher proportion of clients from private facility 98.1% were attended within 0-30 minutes of arrival to the facility as compared to 87% from public facility. The overall mean score showed that the respondents in public facility gave to satisfaction with the services was 4.46 out of a maximum of 5.00 score while private facility gave 4.60. The level of satisfaction amongst respondents in the public facility on pain relief after delivery was statistically significantly higher than the respondents in private facilities (U = 8132.50, p<0.001) while the level of satisfaction amongst respondents in the public facility on functional equipment was statistically significantly higher than the respondents in private facilities (U = 9206.50, p = 0.001). Moreover, level of satisfaction with the way staff responded to questions and concerns during labour and delivery was statistically significantly higher than the respondents in private facilities (U = 9964.50, p = 0.022). In overall, majority of clients from both public and private facilities expressed satisfaction with quality of services from admission till discharge

  6. Clients’ satisfaction with quality of childbirth services: A comparative study between public and private facilities in Limuru Sub-County, Kiambu, Kenya

    PubMed Central

    2018-01-01

    Background This study intended to compare the clients’ satisfaction with the quality of childbirth services in a private and public facility amongst mothers who have delivered within the last twenty four to seventy hours. Methods This was a cross-sectional comparative research design with both quantitative and qualitative data collection and analysis methods. Data were collected through a focused group discussion guide and structured questionnaire collecting information on clients’ satisfaction with quality of childbirth services. The study was conducted amongst women of reproductive age (WRA) between 15–49 years in Tigoni District hospital (public hospital) and Limuru Nursing home (private hospital). For quantitative data we conducted descriptive analysis and Mann-Whitney test using SPSS version 20.0 while qualitative data was manually analyzed manually using thematic analysis. Results A higher proportion of clients from private facility 98.1% were attended within 0–30 minutes of arrival to the facility as compared to 87% from public facility. The overall mean score showed that the respondents in public facility gave to satisfaction with the services was 4.46 out of a maximum of 5.00 score while private facility gave 4.60. The level of satisfaction amongst respondents in the public facility on pain relief after delivery was statistically significantly higher than the respondents in private facilities (U = 8132.50, p<0.001) while the level of satisfaction amongst respondents in the public facility on functional equipment was statistically significantly higher than the respondents in private facilities (U = 9206.50, p = 0.001). Moreover, level of satisfaction with the way staff responded to questions and concerns during labour and delivery was statistically significantly higher than the respondents in private facilities (U = 9964.50, p = 0.022). Conclusion In overall, majority of clients from both public and private facilities expressed satisfaction with

  7. 9 CFR 3.75 - Housing facilities, general.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... requirements differ, as do their social and environmental requirements. As a result, the conditions appropriate... for proper husbandry practices and research needs. Housing facilities other than those maintained by research facilities and Federal research facilities must be physically separated from any other businesses...

  8. A Primer on the General Service List

    ERIC Educational Resources Information Center

    Gilner, Leah

    2011-01-01

    This paper aims to be an introduction to the General Service List (GSL) that brings together descriptive data with material otherwise dispersed throughout the literature. The discussion first provides an historical overview of the work that scholars, researchers, and educators used as foundations for the manufacturing of the GSL. Following, a…

  9. US Naval Facilities Engineering Service Center Environmental Program on Climate Change

    DTIC Science & Technology

    2008-09-01

    of environmental issues related to climate change . There is a growing recognition that the Navy will need to perform its national security mission in... climate change -related technology work at the Naval Facilities Engineering Service Center (NAVFAC ESC) in Port Hueneme, California. NAVFAC ESC...categorized technologies that can be applied to climate change as mitigation, adaptation, and intervention. An essential element of the Navy’s response to

  10. 26 CFR 49.4253-2 - Exemption for news services.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 16 2011-04-01 2011-04-01 false Exemption for news services. 49.4253-2 Section...) MISCELLANEOUS EXCISE TAXES FACILITIES AND SERVICES EXCISE TAXES Communications § 49.4253-2 Exemption for news services. (a) In general. The exemption for news services provided by section 4253(b) is applicable to...

  11. 26 CFR 49.4253-2 - Exemption for news services.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 16 2013-04-01 2013-04-01 false Exemption for news services. 49.4253-2 Section...) MISCELLANEOUS EXCISE TAXES FACILITIES AND SERVICES EXCISE TAXES Communications § 49.4253-2 Exemption for news services. (a) In general. The exemption for news services provided by section 4253(b) is applicable to...

  12. 26 CFR 49.4253-2 - Exemption for news services.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 16 2012-04-01 2012-04-01 false Exemption for news services. 49.4253-2 Section...) MISCELLANEOUS EXCISE TAXES FACILITIES AND SERVICES EXCISE TAXES Communications § 49.4253-2 Exemption for news services. (a) In general. The exemption for news services provided by section 4253(b) is applicable to...

  13. 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.

  14. The development of the Canadian Mobile Servicing System Kinematic Simulation Facility

    NASA Technical Reports Server (NTRS)

    Beyer, G.; Diebold, B.; Brimley, W.; Kleinberg, H.

    1989-01-01

    Canada will develop a Mobile Servicing System (MSS) as its contribution to the U.S./International Space Station Freedom. Components of the MSS will include a remote manipulator (SSRMS), a Special Purpose Dexterous Manipulator (SPDM), and a mobile base (MRS). In order to support requirements analysis and the evaluation of operational concepts related to the use of the MSS, a graphics based kinematic simulation/human-computer interface facility has been created. The facility consists of the following elements: (1) A two-dimensional graphics editor allowing the rapid development of virtual control stations; (2) Kinematic simulations of the space station remote manipulators (SSRMS and SPDM), and mobile base; and (3) A three-dimensional graphics model of the space station, MSS, orbiter, and payloads. These software elements combined with state of the art computer graphics hardware provide the capability to prototype MSS workstations, evaluate MSS operational capabilities, and investigate the human-computer interface in an interactive simulation environment. The graphics technology involved in the development and use of this facility is described.

  15. Full circle to in-house facilities services.

    PubMed

    Payne, Trevor

    2002-08-01

    Careful consideration must be taken prior to in-sourcing in order to ensure that the decision is right for the organisation. There will be pressure to go for the quick fix, or the option that involves the least pain or takes the least time (this may be a knee jerk reaction to go straight back out to the market). Contractors will be alert to this due to market intelligence and as a result one problem may be solved but a number of others created as the organisation is put over yet another barrel. Before any decision is taken, an analysis of the circumstances relating to the outsourced services will need to be undertaken. There are several stages to go through when considering in-sourcing and on the whole the steps will mirror those that need to be considered when outsourcing services in the first instance. It is important to recognise that the change management process associated with in-sourcing services will need to be carefully managed. This point cannot be stressed enough. In-sourcing will require management of the outgoing contractor, the in-house team and the customers during the mobilisation phase. A facilities strategy that is aligned to the organisation's strategic direction--sharing core values and goals alongside a good specification are essential. To ensure services are delivered as specified, a robust and effective monitoring system will need to be developed and put into operation. Just as all organisations are different, the drivers influencing the in-sourcing decision will be different--with factors relevant to the host organisation. If in-sourcing has been thoroughly and carefully considered there is absolutely no reason why it should not be effective (as long as it is specified, resourced, managed and monitored in an appropriate manner). In-sourcing is now being considered as a viable alternative to outsourcing, as a vehicle to add value, a sense of corporatism and team spirit to the organisation.

  16. 75 FR 54025 - Revision of LNG and LHG Waterfront Facility General Requirements

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-03

    ...-372-1410 or by e-mail at [email protected] . If you have questions on viewing or submitting... Revision of LNG and LHG Waterfront Facility General Requirements AGENCY: Coast Guard, DHS. ACTION: Rule; information collection approval. SUMMARY: In a final rule published May 26, 2010, the Coast Guard amended...

  17. Casualty and surgical services in Perthshire general practitioner hospitals 1954-84

    PubMed Central

    Blair, J.S.G.; Grant, J.; McBride, H.; Martin, A.; Ross, R.T.A.

    1986-01-01

    The results are reported of a study of casualty and surgical services in five general practitioner hospitals in Perthshire — Aberfeldy, Auchterarder, Blairgowrie, Crieff and Pitlochry. Details of the total workload, the nature of the conditions treated and the referral rate to major hospitals are given. Figures for the Royal Infirmary, Perth, the main referral hospital for the county, are also given for comparison. The surgical service at one of the rural hospitals is described. Experience has demonstrated the usefulness of these hospitals in providing casualty and surgical services to both the local population and to visitors, and their superiority in providing these services over health centres because staff and beds are available 24 hours a day. Rural general practitioner hospitals merit a continuing share of resources and bed allocation as they spare major hospitals surgical and medical work. The general practitioners serving the hospitals studied here undertook almost 40% of the total accident and emergency workload in the Perth and Kinross area of Scotland. PMID:3735224

  18. Integrating mental health services into a general hospital in Puerto Rico.

    PubMed

    Jiménez, J; Rivera, D; Benítez, P; Tarrats, H; Ramos, A

    2013-09-01

    The prevalence of mental health problems in the general population should be carefully considered. The literature has reported a high co-morbidity of medical and mental illnesses; therefore, collaborative efforts incorporating psychological services into medical settings are imperative. In Puerto Rico, this is not a regular practice in general hospitals. Improving access to mental health services is a challenge and requires the creation of new venues within the healthcare system. This paper describes the theoretical framework, mission, and objectives of the Clinical Psychology Services Program (CPSP) implemented at Damas Hospital in Puerto Rico. From December 2002 to December 2010, a total of 13,580 visits were made to inpatients in diverse clinical units of the hospital; 61% of all inpatients evaluated met the criteria for at least one mental health disorder based on the DSM-IV-TR. The CPSP's outcomes highlight the acceptance and relevance of incorporating mental health services and clinical psychologists into general hospitals.

  19. Systematic review of facility-based sexual and reproductive health services for female sex workers in Africa

    PubMed Central

    2014-01-01

    Background Several biological, behavioural, and structural risk factors place female sex workers (FSWs) at heightened risk of HIV, sexually transmitted infections (STIs), and other adverse sexual and reproductive health (SRH) outcomes. FSW projects in many settings have demonstrated effective ways of altering this risk, improving the health and wellbeing of these women. Yet the optimum delivery model of FSW projects in Africa is unclear. This systematic review describes intervention packages, service-delivery models, and extent of government involvement in these services in Africa. Methods On 22 November 2012, we searched Web of Science and MEDLINE, without date restrictions, for studies describing clinical and non-clinical facility-based SRH prevention and care services for FSWs in low- and middle-income countries in Africa. We also identified articles in key non-indexed journals and on websites of international organizations. A single reviewer screened titles and abstracts, and extracted data from articles using standardised tools. Results We located 149 articles, which described 54 projects. Most were localised and small-scale; focused on research activities (rather than on large-scale service delivery); operated with little coordination, either nationally or regionally; and had scanty government support (instead a range of international donors generally funded services). Almost all sites only addressed HIV prevention and STIs. Most services distributed male condoms, but only 10% provided female condoms. HIV services mainly encompassed HIV counselling and testing; few offered HIV care and treatment such as CD4 testing or antiretroviral therapy (ART). While STI services were more comprehensive, periodic presumptive treatment was only provided in 11 instances. Services often ignored broader SRH needs such as family planning, cervical cancer screening, and gender-based violence services. Conclusions Sex work programmes in Africa have limited coverage and a narrow

  20. Is There a Core General Vocabulary? Introducing the "New General Service List"

    ERIC Educational Resources Information Center

    Brezina, Vaclav; Gablasova, Dana

    2015-01-01

    The current study presents a "New General Service List (new-GSL)", which is a result of robust comparison of four language corpora ("LOB," "BNC," "BE06," and "EnTenTen12") of the total size of over 12 billion running words. The four corpora were selected to represent a variety of corpus sizes and…

  1. 26 CFR 49.4252-6 - Wire mileage service.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 16 2011-04-01 2011-04-01 false Wire mileage service. 49.4252-6 Section 49.4252... EXCISE TAXES FACILITIES AND SERVICES EXCISE TAXES Communications § 49.4252-6 Wire mileage service. (a) In general. The meaning of the term “wire mileage service” differs depending upon the date on which the...

  2. 26 CFR 49.4252-6 - Wire mileage service.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 16 2010-04-01 2010-04-01 true Wire mileage service. 49.4252-6 Section 49.4252... EXCISE TAXES FACILITIES AND SERVICES EXCISE TAXES Communications § 49.4252-6 Wire mileage service. (a) In general. The meaning of the term “wire mileage service” differs depending upon the date on which the...

  3. Actionable Data Projects: Social Science and Service-Learning in General Education Courses

    ERIC Educational Resources Information Center

    Maloyed, Christie L.

    2016-01-01

    The use of service-learning pedagogies in general education courses is often limited to increasing volunteerism or civic literacy with problem-based or research-based projects reserved for upper level courses. This article examines the implementation of an "actionable data" service-learning project in an introductory, general studies…

  4. 21 CFR 58.45 - Animal supply facilities.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Animal supply facilities. 58.45 Section 58.45 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD... infestation or contamination. Perishable supplies shall be preserved by appropriate means. [43 FR 60013, Dec...

  5. Strengthening health system governance using health facility service charters: a mixed methods assessment of community experiences and perceptions in a district in Kenya.

    PubMed

    Atela, Martin; Bakibinga, Pauline; Ettarh, Remare; Kyobutungi, Catherine; Cohn, Simon

    2015-12-04

    Enhancing accountability in health systems is increasingly emphasised as crucial for improving the nature and quality of health service delivery worldwide and particularly in developing countries. Accountability mechanisms include, among others, health facilities committees, suggestion boxes, facility and patient charters. However, there is a dearth of information regarding the nature of and factors that influence the performance of accountability mechanisms, especially in developing countries. We examine community members' experiences of one such accountability mechanism, the health facility charter in Kericho District, Kenya. A household survey was conducted in 2011 among 1,024 respondents (36% male, 64% female) aged 17 years and above stratified by health facility catchment area, situated in a division in Kericho District. In addition, sixteen focus group discussions were conducted with health facility users in the four health facility catchment areas. Quantitative data were analysed through frequency distributions and cross-tabulations. Qualitative data were transcribed and analysed using a thematic approach. The majority (65%) of household survey respondents had seen their local facility service charter, 84% of whom had read the information on the charter. Of these, 83% found the charter to be useful or very useful. According to the respondents, the charters provided useful information about the services offered and their costs, gave users a voice to curb potential overcharging and helped users plan their medical expenses before receiving the service. However, community members cited several challenges with using the charters: non-adherence to charter provisions by health workers; illegibility and language issues; lack of expenditure records; lack of time to read and understand them, often due to pressures around queuing; and socio-cultural limitations. Findings from this study suggest that improving the compliance of health facilities in districts across

  6. 9 CFR 381.155 - General.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 2 2013-01-01 2013-01-01 false General. 381.155 Section 381.155 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY... adequate facilities for such testing. (b) Any binder or antimicrobial agent that has been found to be safe...

  7. 9 CFR 381.155 - General.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false General. 381.155 Section 381.155 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY... adequate facilities for such testing. (b) Any binder or antimicrobial agent that has been found to be safe...

  8. 9 CFR 381.155 - General.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false General. 381.155 Section 381.155 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY... adequate facilities for such testing. (b) Any binder or antimicrobial agent that has been found to be safe...

  9. 9 CFR 381.155 - General.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false General. 381.155 Section 381.155 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY... adequate facilities for such testing. (b) Any binder or antimicrobial agent that has been found to be safe...

  10. 9 CFR 381.155 - General.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false General. 381.155 Section 381.155 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY... adequate facilities for such testing. (b) Any binder or antimicrobial agent that has been found to be safe...

  11. 42 CFR 456.401 - State plan UR requirements and options; UR plan required for intermediate care facility services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false State plan UR requirements and options; UR plan required for intermediate care facility services. 456.401 Section 456.401 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control:...

  12. 42 CFR 456.401 - State plan UR requirements and options; UR plan required for intermediate care facility services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false State plan UR requirements and options; UR plan required for intermediate care facility services. 456.401 Section 456.401 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control:...

  13. Services, Perspective and Directions of the Space Physics Data Facility

    NASA Technical Reports Server (NTRS)

    McGuire, Robert E.; Bilitza, Dieter; Candey, Reine A.; Chimiak, Reine A.; Cooper, John F.; Fung, Shing F.; Harris, Bernard T.; Johnson, Rita C.; King, Joseph H.; Kovalick, Tamara; hide

    2008-01-01

    The multi-mission data and orbit services of NASA's Space Physics Data Facility (SPDF) project offer unique capabilities supporting science of the Heliophysics Great Observatory and that are highly complementary to other services now evolving in the international heliophysics data environment. The VSPO (Virtual Space Physics Observatory) service is an active portal to a wide rage of distributed data sources. CDAWeb (Coordinated Data Analysis Web) offers plots, listings and file downloads for current data from many missions across the boundaries of missions and instrument types. CDAWeb now includes extensive new data from STEREO and THEMIS, plus new ROCSAT IPEI data, the latest data from all four TIMED instruments and high-resolution data from all DE-2 experiments. SSCWeb, Helioweb and out 3D Animated Orbit Viewer (TIPSOD) provide position data and identification of spacecraft and ground conjunctions. OMNI Web, with its new extension to 1- and 5-minute resolution, provides interplanetary parameters at the Earth's bow shock. SPDF maintains NASA's CDF (Common Data Format) standard and a range of associated tools including format translation services. These capabilities are all now available through web services based APIs, one element in SPDF's ongoing work to enable heliophysics community development of Virtual discipline Observatories (e.g. VITMO). We will demonstrate out latest data and capabilities, review the lessons we continue to learn in what science users need and value in this class of services, and discuss out current thinking to the future role and appropriate focus of the SPDF effort in the evolving and increasingly distributed heliophysics data environment.

  14. Efficiency of antenatal care and childbirth services in selected primary health care facilities in rural Tanzania: a cross-sectional study.

    PubMed

    Saronga, Happiness P; Duysburgh, Els; Massawe, Siriel; Dalaba, Maxwell A; Savadogo, Germain; Tonchev, Pencho; Dong, Hengjin; Sauerborn, Rainer; Loukanova, Svetla

    2014-02-28

    Cost studies are paramount for demonstrating how resources have been spent and identifying opportunities for more efficient use of resources. The main objective of this study was to assess the actual dimension and distribution of the costs of providing antenatal care (ANC) and childbirth services in selected rural primary health care facilities in Tanzania. In addition, the study analyzed determining factors of service provision efficiency in order to inform health policy and planning. This was a retrospective quantitative cross-sectional study conducted in 11 health centers and dispensaries in Lindi and Mtwara rural districts. Cost analysis was carried out using step down cost accounting technique. Unit costs reflected efficiency of service provision. Multivariate regression analysis on the drivers of observed relative efficiency in service provision between the study facilities was conducted. Reported personnel workload was also described. The health facilities spent on average 7 USD per capita in 2009. As expected, fewer resources were spent for service provision at dispensaries than at health centers. Personnel costs contributed a high approximate 44% to total costs. ANC and childbirth consumed approximately 11% and 12% of total costs; and 8% and 10% of reported service provision time respectively. On average, unit costs were rather high, 16 USD per ANC visit and 79.4 USD per childbirth. The unit costs showed variation in relative efficiency in providing the services between the health facilities. The results showed that efficiency in ANC depended on the number of staff, structural quality of care, process quality of care and perceived quality of care. Population-staff ratio and structural quality of basic emergency obstetric care services highly influenced childbirth efficiency. Differences in the efficiency of service provision present an opportunity for efficiency improvement. Taking into consideration client heterogeneity, quality improvements are possible

  15. 26 CFR 49.4252-7 - Wire and equipment service.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 16 2010-04-01 2010-04-01 true Wire and equipment service. 49.4252-7 Section 49... EXCISE TAXES FACILITIES AND SERVICES EXCISE TAXES Communications § 49.4252-7 Wire and equipment service. (a) In general. The term “wire and equipment service” includes stock quotation and information...

  16. 26 CFR 49.4252-7 - Wire and equipment service.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 16 2011-04-01 2011-04-01 false Wire and equipment service. 49.4252-7 Section...) MISCELLANEOUS EXCISE TAXES FACILITIES AND SERVICES EXCISE TAXES Communications § 49.4252-7 Wire and equipment service. (a) In general. The term “wire and equipment service” includes stock quotation and information...

  17. Factors influencing integration of TB services in general hospitals in two regions of China: a qualitative study

    PubMed Central

    2012-01-01

    Background In the majority of China, the Centre for Disease Control (CDC) at the county level provides both clinical and public health care for TB cases, with hospitals and other health facilities referring suspected TB cases to the CDC. In recent years, an integrated model has emerged, where the CDC remains the basic management unit for TB control, while a general hospital is designated to provide clinical care for TB patients. This study aims to explore the factors that influence the integration of TB services in general hospitals and generate knowledge to aid the scale-up of integration of TB services in China. Methods This study adopted a qualitative approach using interviews from sites in East and West China. Analysis was conducted using a thematic framework approach. Results The more prosperous site in East China was more coordinated and thus had a better method of resource allocation and more patient-orientated service, compared with the poorer site in the West. The development of public health organizations appeared to influence how effectively integration occurred. An understanding from staff that hospitals had better capacity to treat TB patients than CDCs was a strong rationale for integration. However, the economic and political interests might act as a barrier to effective integration. Both sites shared the same challenges of attracting and retaining a skilled workforce for the TB services. The role of the health bureau was more directive in the Western site, while a more participatory and collaborative approach was adopted in the Eastern site. Conclusion The process of integration identifies similarities and differences between sites in more affluent East China and poorer West China. Integration of TB services in the hospitals needs to address the challenges of stakeholder motivations and resource allocation. Effective inter-organizational collaboration could help to improve the efficiency and quality of TB service. Key words: TB control, service

  18. Deficiencies in the availability of essential musculoskeletal surgical services at 883 health facilities in 24 low- and lower-middle-income countries.

    PubMed

    Spiegel, D A; Nduaguba, A; Cherian, M N; Monono, M; Kelley, E T

    2015-06-01

    The sequelae of acute musculoskeletal conditions, especially injuries and infections, are responsible for significant disability in low- and middle-income countries. This study characterizes the availability of selected musculoskeletal surgical services at different tiers of the health system in a convenience sample of 883 health facilities from 24 low- and lower-middle-income countries. Selected data points from the World Health Organization's (WHO) tool of situational analysis of surgical availability were extracted from the WHO's database in December, 2013. These included infrastructure, physical resources and supplies, interventions, and human resources. For a descriptive analysis, facilities were divided into two groups based on number of beds (<100, 100-300, and >300) and level of facility (primary referral, secondary/tertiary, and Private/NGO/Mission). Statistical comparison was made between public and Private/NGO/Mission facilities based on number of beds (≤100, 100-300, and >300) using a Chi-Square analysis, with statistical significance at p < 0.05. Significant deficiencies were noted in infrastructure, physical resources and supplies, and human resources for the provision of essential orthopedic surgical services at all tiers of the health system. Availability was significantly lower in public versus Private/NGO/Mission facilities for nearly all categories in facilities with ≤100 beds, and in a subset of measures in facilities with between 100 and 300 beds. Deficiencies in the availability of orthopedic surgical services were observed at all levels of health facility and were most pronounced at facilities with ≤100 beds in the public sector. Strengthening the delivery of essential surgical services, including orthopedics, at the primary referral level must be prioritized if we are to reduce the burden of death and disability from a variety of emergent health conditions. There were no sources of funding.

  19. Service readiness, health facility management practices, and delivery care utilization in five states of Nigeria: a cross-sectional analysis.

    PubMed

    Gage, Anastasia J; Ilombu, Onyebuchi; Akinyemi, Akanni Ibukun

    2016-10-06

    Existing studies of delivery care in Nigeria have identified socioeconomic and cultural factors as the primary determinants of health facility delivery. However, no study has investigated the association between supply-side factors and health facility delivery. Our study analyzed the role of supply-side factors, particularly health facility readiness and management practices for provision of quality maternal health services. Using linked data from the 2005 and 2009 health facility and household surveys in the five states in which the Community Participation for Action in the Social Sector (COMPASS) project was implemented, indices of health service readiness and management were developed based on World Health Organization guidelines. Multilevel logistic regression models were run to determine the association between these indices and health facility delivery among 2710 women aged 15-49 years whose last child was born within the five years preceding the surveys and who lived in 51 COMPASS LGAs. The health facility delivery rate increased from 25.4 % in 2005 to 44.1 % in 2009. Basic amenities for antenatal care provision, readiness to deliver basic emergency obstetric and newborn care, and management practices supportive of quality maternal health services were suboptimal in health facilities surveyed and did not change significantly between 2005 and 2009. The LGA mean index of basic amenities for antenatal care provision was more positively associated with the odds of health facility delivery in 2009 than in 2005, and in rural than in urban areas. The LGA mean index of management practices was associated with significantly lower odds of health facility delivery in rural than in urban areas. The LGA mean index of facility readiness to deliver basic emergency obstetric and neonatal care declined slightly from 5.16 in 2005 to 3.98 in 2009 and was unrelated to the odds of health facility delivery. Supply-side factors appeared to play a role in health facility delivery

  20. Availability and acceptability of HIV counselling and testing services. A qualitative study comparing clients' experiences of accessing HIV testing at public sector primary health care facilities or non-governmental mobile services in Cape Town, South Africa.

    PubMed

    Meehan, Sue-Ann; Leon, Natalie; Naidoo, Pren; Jennings, Karen; Burger, Ronelle; Beyers, Nulda

    2015-09-02

    The South African government is striving for universal access to HIV counselling and testing (HCT), a fundamental component of HIV care and prevention. In the Cape Town district, Western Cape Province of South Africa, HCT is provided free of charge at publically funded primary health care (PHC) facilities and through non-governmental organizations (NGOs). This study investigated the availability and accessibility of HCT services; comparing health seeking behaviour and client experiences of HCT across public PHC facilities (fixed sites) and NGO mobile services. This qualitative study used semi-structured interviews. Systematic sampling was used to select 16 participants who accessed HCT in either a PHC facility (8) or a NGO mobile service (8). Interviews, conducted between March and June 2011, were digitally recorded, transcribed and where required, translated into English. Constant comparative and thematic analysis was used to identify common and divergent responses and themes in relation to the key questions (reasons for testing, choice of service provider and experience of HCT). The sample consisted of 12 females and 4 males with an age range of 19-60 years (median age 28 years). Motivations for accessing health facilities and NGO services were similar; opportunity to test, being affected by HIV and a perceived personal risk for contracting HIV. Participants chose a particular service provider based on accessibility, familiarity with and acceptability of that service. Experiences of both services were largely positive, though instances of poor staff attitude and long waiting times were reported at PHC facilities. Those attending NGO services reported shorter waiting times and overall positive testing experiences. Concerns about lack of adequate privacy and associated stigma were expressed about both services. Realised access to HCT is dependent on availability and acceptability of HCT services. Those who utilised either a NGO mobile service or a public PHC

  1. 32 CFR 1699.150 - Program accessibility: existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... SYSTEM ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY SELECTIVE SERVICE SYSTEM § 1699.150 Program accessibility: existing facilities. (a) General. The agency shall operate each program or activity so that the program or activity, when viewed in its entirety, is...

  2. Facility Registry Service (FRS)

    EPA Pesticide Factsheets

    This is a centrally managed database that identifies facilities either subject to environmental regulations or of environmental interest, providing an integrated source of air, water, and waste environmental data.

  3. 77 FR 76446 - General Services Administration Acquisition Regulation (GSAR); Industrial Funding Fee (IFF) and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-28

    ...] RIN 3090-AJ31 General Services Administration Acquisition Regulation (GSAR); Industrial Funding Fee (IFF) and Sales Reporting AGENCY: Office of Acquisition Policy, General Services Administration. ACTION... Services Administration Acquisition Regulation (GSAR) to revise the GSAR clause and to address the use of...

  4. 32 CFR 728.41 - General provisions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false General provisions. 728.41 Section 728.41 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Members of Foreign Military Services and...

  5. 32 CFR 728.41 - General provisions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 false General provisions. 728.41 Section 728.41 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Members of Foreign Military Services and...

  6. 32 CFR 728.41 - General provisions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false General provisions. 728.41 Section 728.41 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Members of Foreign Military Services and...

  7. 32 CFR 728.41 - General provisions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false General provisions. 728.41 Section 728.41 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Members of Foreign Military Services and...

  8. 32 CFR 728.41 - General provisions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 5 2014-07-01 2014-07-01 false General provisions. 728.41 Section 728.41 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Members of Foreign Military Services and...

  9. 16 CFR 254.4 - Misrepresentation of facilities, services, qualifications of staff, status, and employment...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... AND DISTANCE EDUCATION SCHOOLS § 254.4 Misrepresentation of facilities, services, qualifications of... learning disabilities, it will provide students either during or after completion of a course. (9... form of distance education, to fail to clearly and conspicuously disclose that fact in all promotional...

  10. Stone Quarrying, Crushing and Screening Facilities General Air Quality Permit Request for Coverage: Unimin Corporation - Unimin Flat Storage

    EPA Pesticide Factsheets

    Documents related to Request for Coverage under Stone Quarrying, Crushing and Screening Facilities General Permit, for the Unimin Corporation Silica Sand Rail Transloading Facility on the Fort Berhold Indian Reservation, North Dakota.

  11. 77 FR 5020 - General Services Administration Acquisition Regulation; Information Collection; GSA Form 527...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-01

    ... GENERAL SERVICES ADMINISTRATION [OMB Control No. 3090-0007; Docket 2011-0001; Sequence 12] General Services Administration Acquisition Regulation; Information Collection; GSA Form 527, Contractor's Qualifications and Financial Information AGENCY: Office of the Chief Finance Officer, GSA. ACTION: Notice of...

  12. 39 CFR 778.4 - What are the Postal Service's general responsibilities under the Order?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... coordinate proposed direct Federal development projects, the Postal Service, to the extent permitted by law...) Communicates with state and local elected officials as early in a facility project action's planning cycle as...

  13. 39 CFR 778.4 - What are the Postal Service's general responsibilities under the Order?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... coordinate proposed direct Federal development projects, the Postal Service, to the extent permitted by law...) Communicates with state and local elected officials as early in a facility project action's planning cycle as...

  14. 39 CFR 778.4 - What are the Postal Service's general responsibilities under the Order?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... coordinate proposed direct Federal development projects, the Postal Service, to the extent permitted by law...) Communicates with state and local elected officials as early in a facility project action's planning cycle as...

  15. 39 CFR 778.4 - What are the Postal Service's general responsibilities under the Order?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... coordinate proposed direct Federal development projects, the Postal Service, to the extent permitted by law...) Communicates with state and local elected officials as early in a facility project action's planning cycle as...

  16. 39 CFR 778.4 - What are the Postal Service's general responsibilities under the Order?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... coordinate proposed direct Federal development projects, the Postal Service, to the extent permitted by law...) Communicates with state and local elected officials as early in a facility project action's planning cycle as...

  17. Distance from health facility and mothers' perception of quality related to skilled delivery service utilization in northern Ethiopia.

    PubMed

    Fisseha, Girmatsion; Berhane, Yemane; Worku, Alemayehu; Terefe, Wondwossen

    2017-01-01

    Poor maternal health service utilization is one of the contributing factors to a high level of maternal and newborn mortality in Ethiopia. The factors associated with utilization of services are believed to differ from one context to another. We assessed the factors associated with skilled delivery service utilization in rural northern Ethiopia. A community-based survey was conducted among mothers who gave birth in the 12 months preceding the study period, from January to February 2015, in the Tigray region of Ethiopia. Multistage sampling technique was used to select mothers from the identified clusters. Households within a 10 km radius of the health facility were taken as a cluster for a community survey. Data were collected using face-to-face interview at the household level. We compared the mothers who reported giving birth to the index child in a health facility and those who reported delivering at home, in order to identify the predictors of skilled delivery utilization. Multivariable logistic regression model was used to determine the predictors of skilled delivery service utilization. The results are presented with odds ratio (OR) and 95% confidence interval (CI). A total of 1,796 mothers participated in the study, with a 100% response rate. Distance to health facilities (adjusted odds ratio [AOR] =0.53 [95% CI: 0.39, 0.71]), perception of mothers to the availability of adequate equipment in the delivery service in their catchment area (AOR =1.5 [95% CI: 1.11, 2.13]), experiencing any complication during childbirth, using antenatal care, lower birth order and having an educated partner were the significant predictors of skilled delivery service utilization. Implementing community-based intervention programs that will address the physical accessibility of delivery services, such as the ambulance service, road issues and waiting rooms, and improving quality maternity service will likely reduce the current problem.

  18. Distance from health facility and mothers’ perception of quality related to skilled delivery service utilization in northern Ethiopia

    PubMed Central

    Fisseha, Girmatsion; Berhane, Yemane; Worku, Alemayehu; Terefe, Wondwossen

    2017-01-01

    Background Poor maternal health service utilization is one of the contributing factors to a high level of maternal and newborn mortality in Ethiopia. The factors associated with utilization of services are believed to differ from one context to another. We assessed the factors associated with skilled delivery service utilization in rural northern Ethiopia. Subjects and methods A community-based survey was conducted among mothers who gave birth in the 12 months preceding the study period, from January to February 2015, in the Tigray region of Ethiopia. Multistage sampling technique was used to select mothers from the identified clusters. Households within a 10 km radius of the health facility were taken as a cluster for a community survey. Data were collected using face-to-face interview at the household level. We compared the mothers who reported giving birth to the index child in a health facility and those who reported delivering at home, in order to identify the predictors of skilled delivery utilization. Multivariable logistic regression model was used to determine the predictors of skilled delivery service utilization. The results are presented with odds ratio (OR) and 95% confidence interval (CI). Results A total of 1,796 mothers participated in the study, with a 100% response rate. Distance to health facilities (adjusted odds ratio [AOR] =0.53 [95% CI: 0.39, 0.71]), perception of mothers to the availability of adequate equipment in the delivery service in their catchment area (AOR =1.5 [95% CI: 1.11, 2.13]), experiencing any complication during childbirth, using antenatal care, lower birth order and having an educated partner were the significant predictors of skilled delivery service utilization. Conclusion Implementing community-based intervention programs that will address the physical accessibility of delivery services, such as the ambulance service, road issues and waiting rooms, and improving quality maternity service will likely reduce the current

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

    PubMed Central

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

    2016-01-01

    IMPORTANCE Outpatient human immunodeficiency virus (HIV) health care facilities receive funding from the Ryan White HIV/AIDS Program (RWHAP) to provide medical care and essential support services that help patients remain in care and adhere to treatment. Increased access to Medicaid and private insurance for HIV-infected persons may provide coverage for medical care but not all needed support services and may not supplant the need for RWHAP funding. OBJECTIVE To examine differences between RWHAP-funded and non–RWHAP-funded facilities and in patient outcomes between the 2 systems. DESIGN, SETTING, AND PARTICIPANTS The study was conducted from June 1, 2009, to May 31, 2012, using data from the 2009 and 2011 cycles of the Medical Monitoring Project, a national probability sample of 8038 HIV-infected adults receiving medical care at 989 outpatient health care facilities providing HIV medical care. MAIN OUTCOMES AND MEASURES Data were used to compare patient characteristics, service needs, and access to services at RWHAP-funded vs non–RWHAP-funded facilities. Differences in prescribed antiretroviral treatment and viral suppression were assessed. Data analysis was performed between February 2012 and June 2015. RESULTS Overall, 34.4% of facilities received RWHAP funding and 72.8% of patients received care at RWHAP-funded facilities. With results reported as percentage (95% CI), patients attending RWHAP-funded facilities were more likely to be aged 18 to 29 years (8.5%[7.4%–9.5%] vs 5.0%[3.9%–6.2%]), female (29.2%[27.2%–31.2%] vs 20.1%[17.0%–23.1%]), black (47.5% [41.5%–53.5%] vs 25.8% [20.6%–31.0%]) or Hispanic (22.5%[16.4%–28.6%] vs 12.9%[10.6%–15.2%]), have less than a high school education (26.1% [24.0%–28.3%] vs 10.9%[8.7%–13.1%]), income at or below the poverty level (53.6%[50.3%–56.9%] vs 23.9%[19.7%–28.0%]), and lack health care coverage (25.0%[21.9%–28.1%] vs 6.1% [4.1%–8.0%]). The RWHAP-funded facilities were more likely to provide

  20. Measuring facility capability to provide routine and emergency childbirth care to mothers and newborns: An appeal to adjust for delivery caseload of facilities

    PubMed Central

    Allen, Stephanie M.; Opondo, Charles; Campbell, Oona M. R.

    2017-01-01

    Background Measurement of Emergency Obstetric Care capability is common, and measurement of newborn and overall routine childbirth care has begun in recent years. These assessments of facility capabilities can be used to identify geographic inequalities in access to functional health services and to monitor improvements over time. This paper develops an approach for monitoring the childbirth environment that accounts for the delivery caseload of the facility. Methods We used data from the Kenya Service Provision Assessment to examine facility capability to provide quality childbirth care, including infrastructure, routine maternal and newborn care, and emergency obstetric and newborn care. A facility was considered capable of providing a function if necessary tracer items were present and, for emergency functions, if the function had been performed in the previous three months. We weighted facility capability by delivery caseload, and compared results with those generated using traditional “survey weights”. Results Of the 403 facilities providing childbirth care, the proportion meeting criteria for capability were: 13% for general infrastructure, 6% for basic emergency obstetric care, 3% for basic emergency newborn care, 13% and 11% for routine maternal and newborn care, respectively. When the new caseload weights accounting for delivery volume were applied, capability improved and the proportions of deliveries occurring in a facility meeting capability criteria were: 51% for general infrastructure, 46% for basic emergency obstetric care, 12% for basic emergency newborn care, 36% and 18% for routine maternal and newborn care, respectively. This is because most of the caseload was in hospitals, which generally had better capability. Despite these findings, fewer than 2% of deliveries occurred in a facility capable of providing all functions. Conclusion Reporting on the percentage of facilities capable of providing certain functions misrepresents the capacity to

  1. Instrument Systems Analysis and Verification Facility (ISAVF) users guide

    NASA Technical Reports Server (NTRS)

    Davis, J. F.; Thomason, J. O.; Wolfgang, J. L.

    1985-01-01

    The ISAVF facility is primarily an interconnected system of computers, special purpose real time hardware, and associated generalized software systems, which will permit the Instrument System Analysts, Design Engineers and Instrument Scientists, to perform trade off studies, specification development, instrument modeling, and verification of the instrument, hardware performance. It is not the intent of the ISAVF to duplicate or replace existing special purpose facilities such as the Code 710 Optical Laboratories or the Code 750 Test and Evaluation facilities. The ISAVF will provide data acquisition and control services for these facilities, as needed, using remote computer stations attached to the main ISAVF computers via dedicated communication lines.

  2. Service user involvement in preregistration general nurse education: a systematic review.

    PubMed

    Scammell, Janet; Heaslip, Vanessa; Crowley, Emma

    2016-01-01

    A systematic review of published studies on service user involvement in undergraduate, preregistration general nursing education (excluding mental health-specific programmes). The objective is to examine how students are exposed to engagement with service users. The requirement of service user involvement in all nurse education is policy expectation of health professional education providers, in response to the increased public and political expectations. Previous literature reviews have focused solely on mental health. Systematic review using the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines; timeframe 1997-2014; published in English. Search of CINAHL, Cochrane Review, Education Research Complete, Internurse, MEDLINE, PsychINFO, Scopus, SocINDEX and Web of Science yielded 229 citations; 11 studies met the review eligibility criteria. Seven studies used qualitative methodology, two quantitative and two mixed methods. Studies from the United Kingdom dominated (n = 9), the remainder from South Africa and Turkey. The results are described using four themes: benefits and limitations of service user involvement; nursing student selection; education delivery; practice-based learning and assessment. Most studies were small scale; nine had less than 30 participants. Overall the evidence suggests that student, lecturers and service users valued service user involvement in nurse education, to provide an authentic insight into the illness experience. Logistical considerations around support and student cohort size emerged. This is the first systematic review to focus on service user involvement in general nurse education. It reveals that service user involvement commenced later and is more limited in general programmes as compared to equivalent mental health education provision. Most of the evidence focuses on perceptions of the value of involvement. Further research is required to more clearly establish impact on learning and clinical practice

  3. 10 CFR 1707.204 - Service of subpoenas or requests.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Service of subpoenas or requests. 1707.204 Section 1707.204 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD TESTIMONY BY DNFSB EMPLOYEES AND PRODUCTION OF... be served on the General Counsel, Defense Nuclear Facilities Safety Board, 625 Indiana Avenue, NW...

  4. 10 CFR 1707.204 - Service of subpoenas or requests.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Service of subpoenas or requests. 1707.204 Section 1707.204 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD TESTIMONY BY DNFSB EMPLOYEES AND PRODUCTION OF... be served on the General Counsel, Defense Nuclear Facilities Safety Board, 625 Indiana Avenue, NW...

  5. 10 CFR 1707.204 - Service of subpoenas or requests.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Service of subpoenas or requests. 1707.204 Section 1707.204 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD TESTIMONY BY DNFSB EMPLOYEES AND PRODUCTION OF... be served on the General Counsel, Defense Nuclear Facilities Safety Board, 625 Indiana Avenue, NW...

  6. 10 CFR 1707.204 - Service of subpoenas or requests.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Service of subpoenas or requests. 1707.204 Section 1707.204 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD TESTIMONY BY DNFSB EMPLOYEES AND PRODUCTION OF... be served on the General Counsel, Defense Nuclear Facilities Safety Board, 625 Indiana Avenue, NW...

  7. 10 CFR 1707.204 - Service of subpoenas or requests.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Service of subpoenas or requests. 1707.204 Section 1707.204 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD TESTIMONY BY DNFSB EMPLOYEES AND PRODUCTION OF... be served on the General Counsel, Defense Nuclear Facilities Safety Board, 625 Indiana Avenue, NW...

  8. 78 FR 18285 - General Services Administration Acquisition Regulation; Submission for OMB Review; Modifications...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-26

    ...; Modifications 552.243-72 (Multiple Award Schedules) AGENCY: Office of Acquisition Policy, General Services... information collection requirement regarding the Modifications (Multiple Award Schedule) clause. DATES: Submit comments on or before: April 25, 2013. FOR FURTHER INFORMATION CONTACT: Ms. Dana Munson, General Services...

  9. A Study of the College of Pharmacy Library Concerning Facilities, Services and User Satisfaction.

    ERIC Educational Resources Information Center

    Parkin, Derral

    This report examines the college of pharmacy library in relation to its historical development, present facilities, services, and user satisfaction, and makes a statistical comparison between the University of Houston College of Pharmacy Library and other accredited pharmacy libraries nationwide. Data were gathered through 28 completed library…

  10. 40 CFR 63.11164 - What General Provisions apply to primary zinc production facilities?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 15 2013-07-01 2013-07-01 false What General Provisions apply to primary zinc production facilities? 63.11164 Section 63.11164 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED)...

  11. 40 CFR 63.11164 - What General Provisions apply to primary zinc production facilities?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 15 2012-07-01 2012-07-01 false What General Provisions apply to primary zinc production facilities? 63.11164 Section 63.11164 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED)...

  12. 40 CFR 63.11164 - What General Provisions apply to primary zinc production facilities?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 15 2014-07-01 2014-07-01 false What General Provisions apply to primary zinc production facilities? 63.11164 Section 63.11164 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED)...

  13. 45 CFR 1232.9 - General prohibitions against employment and volunteer service discrimination.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... volunteer service discrimination. 1232.9 Section 1232.9 Public Welfare Regulations Relating to Public... IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Employment and Volunteer Service Practices § 1232.9 General prohibitions against employment and volunteer service discrimination. (a) No...

  14. 45 CFR 1232.9 - General prohibitions against employment and volunteer service discrimination.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... volunteer service discrimination. 1232.9 Section 1232.9 Public Welfare Regulations Relating to Public... IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Employment and Volunteer Service Practices § 1232.9 General prohibitions against employment and volunteer service discrimination. (a) No...

  15. Implementation of a psychotropic drug review service in a mental retardation facility.

    PubMed

    Marcoux, A W

    1985-11-01

    A redesigned psychotropic drug review service was needed for our 650-bed intermediate care facility for the mentally retarded (ICF/MR). A committee consisting of a client's rights monitor, pharmacist, and psychologist prepared the necessary policy and procedure as well as data collection sheets. Meetings are now conducted in a semiformal fashion, with each discipline contributing in tis area of expertise. Since the inception of the restructured psychotropic drug review service, psychotropic medication dosages (neuroleptic agents only) have decreased at a projected annual rate of 17% and there have been no significant withdrawal reactions. This dosage decrease has saved the institution approximately $2800 to $3200 in medication costs after a 10-month period.

  16. General layout of reactor and control areas upon advent of ...

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

    General layout of reactor and control areas upon advent of power burst facility (PBF). Shows relationship of PBF to SPERT-I, -II, -III, and -IV. Ebasco Services 1205-PER/PBF-U-102. Date: July 1965. INEEL index no. 761-0100-00-205-123006 - Idaho National Engineering Laboratory, SPERT-I & Power Burst Facility Area, Scoville, Butte County, ID

  17. 12 CFR 7.5002 - Furnishing of products and services by electronic means and facilities.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 1 2011-01-01 2011-01-01 false Furnishing of products and services by electronic means and facilities. 7.5002 Section 7.5002 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY BANK ACTIVITIES AND OPERATIONS Electronic Activities § 7.5002 Furnishing of...

  18. Increased ICU resource needs for an academic emergency general surgery service*.

    PubMed

    Lissauer, Matthew E; Galvagno, Samuel M; Rock, Peter; Narayan, Mayur; Shah, Paulesh; Spencer, Heather; Hong, Caron; Diaz, Jose J

    2014-04-01

    ICU needs of nontrauma emergency general surgery patients are poorly described. This study was designed to compare ICU utilization of emergency general surgery patients admitted to an acute care emergency surgery service with other general surgery patients. Our hypothesis is that tertiary care emergency general surgery patients utilize more ICU resources than other general surgical patients. Retrospective database review. Academic, tertiary care, nontrauma surgical ICU. All patients admitted to the surgical ICU over age 18 between March 2004 and June 2012. None. Six thousand ninety-eight patients were evaluated: 1,053 acute care emergency surgery, 1,964 general surgery, 1,491 transplant surgery, 995 facial surgery/otolaryngology, and 595 neurosurgery. Acute care emergency surgery patients had statistically significantly longer ICU lengths of stay than other groups: acute care emergency surgery (13.5 ± 17.4 d) versus general surgery (8.7 ± 12.9), transplant (7.8 ± 11.6), oral-maxillofacial surgery (5.5 ± 4.2), and neurosurgery (4.47 ± 9.8) (all p< 0.01). Ventilator usage, defined by percentage of total ICU days patients required mechanical ventilation, was significantly higher for acute care emergency surgery patients: acute care emergency surgery 73.4% versus general surgery 64.9%, transplant 63.3%, oral-maxillofacial surgery 58.4%, and neurosurgery 53.1% (all p < 0.01). Continuous renal replacement therapy usage, defined as percent of patients requiring this service, was significantly higher in acute care emergency surgery patients: acute care emergency surgery 10.8% versus general surgery 4.3%, transplant 6.6%, oral-maxillofacial surgery 0%, and neurosurgery 0.5% (all p < 0.01). Acute care emergency surgery patients were more likely interhospital transfers for tertiary care services than general surgery or transplant (24.5% vs 15.5% and 8.3% respectively, p < 0.001 for each) and more likely required emergent surgery (13.7% vs 6.7% and 3.5%, all p < 0

  19. Public and private funding of general practice services for children and adolescents in New Zealand.

    PubMed

    Dovey, Susan; Tilyard, Murray; Cunningham, Wayne; Williamson, Martyn

    2011-11-01

    To measure public and private funding of general practice services for New Zealand children. Computerized records from 111 general practices provided private payments for 118,905 general practice services to children aged 6-17 years. Government subsidies and public insurance payments provided public funding amounts for seven services. Overall and for each service we estimated the ratio of public:private payments (RPPP). 64.0% of annual expenditure was public, 36.0% private, (RPPP=1:0.56). General medical consultations were 67.2% of services (RPPP=1:0.57); 15.3% were injury-related (RPPP=1:0.36); 5.2% were prescribing services (all private); 4.9% were immunizations (RPPP=1:0.12); 2.9% were nursing (RPPP=1:1.33); 4.4% were administration (all private); and 0.1% were for maternity care (RPPP=1:0.007). Before capitation funding, public and private funding levels for general medical consultations were similar (RPPP=1:0.93) but after capitation public payments more than doubled (RPPP=1:0.40). There is a complex of pattern of public and private payments for general practice services for children and adolescents in New Zealand. Both funding sources are critical. Capitation funding changed the balance substantially but did not remove ongoing reliance on private funding to support general practice care for children. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  20. Development of a Quality of Meals and Meal Service Set of Indicators for Residential Facilities for Elderly.

    PubMed

    Van Damme, N; Buijck, B; Van Hecke, A; Verhaeghe, S; Goossens, E; Beeckman, D

    2016-01-01

    To develop a content validated set of indicators to evaluate the quality of meals and meal service in residential facilities for elderly. Inadequate food intake is an important risk factor for malnutrition in residential facilities for elderly. Through better meeting the needs and preferences of residents and optimization of meals and meal service, residents' food intake can improve. No indicators were available which could help to guide strategies to improve the quality of meals and meal service. The indicator set was developed according to the Indicator Development Manual of the Dutch Institute for Health Care Improvement (CBO). The working group consisted of three nurse researchers and one expert in gastrology and had expertise in elderly care, malnutrition, indicator development, and food quality. A preliminary list of potential indicators was compiled using the literature and the working group's expertise. Criteria necessary to measure the indicator in practice were developed for each potential indicator. In a double Delphi procedure, the list of potential indicators and respective criteria were analyzed for content validity, using a multidisciplinary expert panel of 11 experts in elderly meal care. A preliminary list of 20 quality indicators, including 45 criteria, was submitted to the expert panel in a double Delphi procedure. After the second Delphi round, 13 indicators and 25 criteria were accepted as having content validity. The content validity index (CVI) ranged from 0.83 to 1. The indicator set consisted of six structural, four result, and three outcome indicators covering the quality domains food, service and choice, as well as nutritional screening. The criteria measure diverse aspects of meal care which are part of the responsibility of kitchen staff and health care professionals. The 'quality of meals and meal service' set of indicators is a resource to map meal quality in residential facilities for elderly. As soon as feasibility tests in practice

  1. 42 CFR 476.76 - Cooperation with health care facilities.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Cooperation with health care facilities. 476.76 Section 476.76 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Responsibilities of Quality Improvement Organizations (QIOs) General Provisions § 476.76 Cooperation with health...

  2. Measuring effective coverage of curative child health services in rural Burkina Faso: a cross-sectional study

    PubMed Central

    Koulidiati, Jean-Louis; Nesbitt, Robin C; Ouedraogo, Nobila; Hien, Hervé; Robyn, Paul Jacob; Compaoré, Philippe; Souares, Aurélia; Brenner, Stephan

    2018-01-01

    Objective To estimate both crude and effective curative health services coverage provided by rural health facilities to under 5-year-old (U5YO) children in Burkina Faso. Methods We surveyed 1298 child health providers and 1681 clinical cases across 494 primary-level health facilities, as well as 12 497 U5YO children across 7347households in the facilities’ catchment areas. Facilities were scored based on a set of indicators along three quality-of-care dimensions: management of common childhood diseases, management of severe childhood diseases and general service readiness. Linking service quality to service utilisation, we estimated both crude and effective coverage of U5YO children by these selected curative services. Results Measured performance quality among facilities was generally low with only 12.7% of facilities surveyed reaching our definition of high and 57.1% our definition of intermediate quality of care. The crude coverage was 69.5% while the effective coverages indicated that 5.3% and 44.6% of children reporting an illness episode received services of only high or high and intermediate quality, respectively. Conclusion Our study showed that the quality of U5YO child health services provided by primary-level health facilities in Burkina Faso was low, resulting in relatively ineffective population coverage. Poor adherence to clinical treatment guidelines combined with the lack of equipment and qualified clinical staff that performed U5YO consultations seemed to be contributors to the gap between crude and effective coverage. PMID:29858415

  3. Opening Our Doors: Taking Public Library Service to Preschool and Day-Care Facilities.

    ERIC Educational Resources Information Center

    Harris, Sally

    The Opening Our Doors Project of the Pioneer Library System of Norman, Oklahoma takes public library service to preschool and day care facilities by means of learning kits housed in tote bags. The sturdy, zippered tote bags are full of books, games, toys, learning folders, and so forth. There is a tote bag for each of 75 different topics. Topics…

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

    ERIC Educational Resources Information Center

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

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

  5. Home, Division of General Services, Department of Administration, State of

    Science.gov Websites

    Alaska Skip to main content State of Alaska alaska.gov myAlaska My Government Resident Business in Alaska Visiting Alaska State Employees State of Alaska, Department of Administration, Division of General Services State of Alaska State of Alaska > Departments > Administration > General

  6. Meeting the contraceptive needs of teens and young adults: youth-friendly and long-acting reversible contraceptive services in U.S. family planning facilities.

    PubMed

    Kavanaugh, Megan L; Jerman, Jenna; Ethier, Kathleen; Moskosky, Susan

    2013-03-01

    Increased use of contraceptive services, including long-acting reversible contraceptives (LARCs), among sexually active teens and young adults could significantly reduce unintended pregnancy. Objectives were to describe youth-friendly contraceptive services (including LARC) available to teens and young adults at U.S. publicly funded family planning facilities. Between April and September 2011, center directors at a nationally representative sample of 1,196 U.S. publicly funded family planning facilities were surveyed to assess accessibility and provision of contraceptive services for teens and young adults; 584 (52%) responded. Facilities were accessible to young clients in several ways, including not requiring scheduled appointments for method refills (67%) and having flexible hours (64%). Most facilities provided outreach and/or education to young people (70%), and 27% used social network media to do this. Most facilities took steps to ensure confidentiality for young clients. These youth-friendly practices were more common at Planned Parenthood, Title X, and reproductive health focused facilities than at other facilities. Long-acting reversible contraceptive methods were regularly discussed with younger clients at less than half the facilities. Youth-friendly sites had increased rates of LARC provision among younger clients. The most common challenges to providing contraceptive and LARC services to younger clients were the costs of LARC methods (60%), inconvenient clinic hours (51%), staff concerns about intrauterine device (IUD) use among teens (47%), and limited training on implant insertion (47%). Improving the ability of family planning facilities to provide youth-friendly contraceptive and LARC-specific methods to younger clients may increase the use of highly effective contraception in this population. Copyright © 2013 Society for Adolescent Health and Medicine. All rights reserved.

  7. Utilisation of health services and geography: deconstructing regional differences in barriers to facility-based delivery in Nepal.

    PubMed

    Hodge, Andrew; Byrne, Abbey; Morgan, Alison; Jimenez-Soto, Eliana

    2015-03-01

    While established that geographical inaccessibility is a key barrier to the utilisation of health services, it remains unknown whether disparities are driven only by limited access to these services, or are also attributable to health behaviour. Significant disparities exist in health outcomes and the coverage of many critical health services between the mountains region of Nepal and the rest of the country, yet the principal factors driving these regional disparities are not well understood. Using national representative data from the 2011 Nepal Demographic and Health Survey, we examine the extent to which observable factors explain the overall differences in the utilisation of maternal health services. We apply nonlinear Blinder-Oaxaca-type decomposition methods to quantify the effect that differences in measurable characteristics have on the regional coverage gap in facility-based delivery. The mean coverage of facility-based deliveries was 18.6 and 36.3 % in the mountains region and the rest of Nepal, respectively. Between 54.8 and 74.1 % of the regional coverage gap was explained by differences in observed characteristics. Factors influencing health behaviours (proxied by mothers' education, TV viewership and tobacco use, and household wealth) and subjective distance to the health facility were the major factors, contributing between 52.9 and 62.5 % of the disparity. Mothers' birth history was also noteworthy. Policies simultaneously addressing access and health behaviours appear necessary to achieve greater coverage and better health outcomes for women and children in isolated areas.

  8. 41 CFR 101-8.710 - Age distinctions contained in General Services Administration regulation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... contained in General Services Administration regulation. 101-8.710 Section 101-8.710 Public Contracts and... Prohibited on the Basis of Age § 101-8.710 Age distinctions contained in General Services Administration regulation. Any age distinctions contained in a rule or regulation issued by GSA are presumed to be necessary...

  9. Health Care Expenditures After Initiating Long-term Services and Supports in the Community Versus in a Nursing Facility.

    PubMed

    Newcomer, Robert J; Ko, Michelle; Kang, Taewoon; Harrington, Charlene; Hulett, Denis; Bindman, Andrew B

    2016-03-01

    Individuals who receive long-term services and supports (LTSS) are among the most costly participants in the Medicare and Medicaid programs. To compare health care expenditures among users of Medicaid home and community-based services (HCBS) versus those using extended nursing facility care. Retrospective cohort analysis of California dually eligible adult Medicaid and Medicare beneficiaries who initiated Medicaid LTSS, identified as HCBS or extended nursing facility care, in 2006 or 2007. Propensity score matching for demographic, health, and functional characteristics resulted in a subsample of 34,660 users who initiated Medicaid HCBS versus extended nursing facility use. Those with developmental disabilities or in managed care plans were excluded. Average monthly adjusted acute, postacute, long-term, and total Medicare and Medicaid expenditures for the 12 months following initiation of either HCBS or extended nursing facility care. Those initiating extended nursing facility care had, on average, $2919 higher adjusted total health care expenditures per month compared with those who initiated HCBS. The difference was primarily attributable to spending on LTSS $2855. On average, the monthly LTSS expenditures were higher for Medicare $1501 and for Medicaid $1344 when LTSS was provided in a nursing facility rather than in the community. The higher cost of delivering LTSS in a nursing facility rather than in the community was not offset by lower acute and postacute spending. Medicare and Medicaid contribute similar amounts to the LTSS cost difference and both could benefit financially by redirecting care from institutions to the community.

  10. 77 FR 55843 - Office of Facilities Management and Program Services; Submission for OMB Review; Background...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-11

    ... of Facilities Management and Program Services; Submission for OMB Review; Background Investigations... collection of personal data for background investigations for child care workers accessing GSA owned and... assumptions and methodology; ways to enhance the quality, utility, and clarity of the information to be...

  11. Validated Competency Task Lists for General Merchandise Retailing, Food Service Management, and Business and Personal Services Marketing.

    ERIC Educational Resources Information Center

    Faught, Suzanne G.

    This publication contains competency task lists that address principal entry-level and career-sustaining jobs in the occupational categories of general merchandise retailing, food service management, and business and personal services marketing. Section I, Development of the Competency Task Lists, provides details on how the competencies were…

  12. Association of U.S. Dialysis Facility Neighborhood Characteristics with Facility-Level Kidney Transplantation

    PubMed Central

    Plantinga, Laura; Pastan, Stephen; Kramer, Michael; McClellan, Ann; Krisher, Jenna; Patzer, Rachel E.

    2014-01-01

    Background Improving access to optimal healthcare may depend on attributes of neighborhoods where patients receive healthcare services. We investigated whether characteristics of dialysis facility neighborhoods—where most patients with end-stage renal disease are treated—were associated with facility-level kidney transplantation. Methods We examined the association between census tract (neighborhood)-level sociodemographic factors and facility-level kidney transplantation rate in 3,983 U.S. dialysis facilities with reported kidney transplantation rates. Number of kidney transplants and total person-years contributed at the facility level in 2007-2010 were obtained from the Dialysis Facility Report and linked to census tract data on sociodemographic characteristics from the American Community Survey 2006-2010 by dialysis facility location. We used multivariable Poisson models with generalized estimating equations to estimate associations between neighborhood characteristics and transplant incidence. Results U.S. dialysis facilities were located in neighborhoods with substantially greater proportions of black and poor residents, relative to the national average. Most facility neighborhood characteristics were associated with transplant, with incidence rate ratios (95% CI) for standardized increments (in percentage) of neighborhood exposures of: living in poverty, 0.88 (0.84-0.92), black race, 0.83 (0.78-0.89); high school graduates, 1.22 (1.17-1.26); and unemployed, 0.90 (0.85-0.95). Conclusion Dialysis facility neighborhood characteristics may be modestly associated with facility rates of kidney transplantation. The success of dialysis facility interventions to improve access to kidney transplantation may partially depend on reducing neighborhood-level barriers. PMID:25196018

  13. Telemental health technology in deaf and general mental-health services: access and use.

    PubMed

    Austen, Sally; McGrath, Melissa

    2006-01-01

    Long-distance travel to provide mental health services for deaf people has implications for efficiency, safety, and equality of service. However, uptake of Telemental Health (TMH) has been slow in both deaf and general mental health services. A quantitative study was used to investigate access to TMH and whether staff confidence, experience, or demographics affect TMH use. It was concluded that staff in neither deaf mental health services nor general mental health services had adequate knowledge of or access to TMH. Staff expressed concerns over TMH's appropriateness in their work. Previous use of videoconferencing was assosciated significantly with confidence, but previous use of videophones was not. Neither staff in deaf services nor deaf staff were more experienced with or more confident about videoconferencing, whereas, within deaf services, deaf staff were significantly more confident about videophone use. Training implications are discussed.

  14. 77 FR 4203 - Energy Conservation Program: Test Procedures for General Service Fluorescent Lamps, General...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-27

    ...On September 14, 2011, the U.S. Department of Energy (DOE) issued a notice of proposed rulemaking (NOPR) to amend the test procedures for general service fluorescent lamps (GSFLs), general service incandescent lamps (GSILs), and incandescent reflector lamps (IRLs). That proposed rulemaking serves as the basis for today's action. DOE is amending its test procedures for GSFLs and GSILs established under the Energy Policy and Conservation Act (EPCA). DOE is not amending in this final rule the existing test procedure for IRLs established under EPCA. For GSFLs and GSILs, DOE is updating several references to the industry standards referenced in DOE's test procedures. DOE is also establishing a lamp lifetime test procedure for GSILs. These test procedures also provide the protocols upon which the Federal Trade Commission bases its energy guide label for these products. DOE's review of the GSFL, GSIL, and IRL test procedures fulfills the EPCA requirement that DOE review test procedures for all covered products at least once every seven years.

  15. How to enhance public health service utilization in community pharmacy?: general public and health providers' perspectives.

    PubMed

    Saramunee, Kritsanee; Krska, Janet; Mackridge, Adam; Richards, Jacqueline; Suttajit, Siritree; Phillips-Howard, Penelope

    2014-01-01

    Community pharmacists (PHs) in England are increasingly providing a range of public health services. However, the general public view pharmacists as drug experts and not experts in health, and therefore, services may be underutilized. To explore experiences and views of 4 groups of participants, the general public, PHs, general practitioners (GPs), and other stakeholders (STs) on pharmacy-based public health services, and identify potential factors affecting service use. The study was undertaken in a locality of North West England. Three focus groups were conducted with the general public (n=16), grouped by socioeconomic status. Fourteen semistructured interviews were undertaken with PHs (n=9), GPs (n=2), and STs (n=3). Discussions/interviews were audio recorded, transcribed verbatim, and analyzed thematically. All 4 groups of participants agreed that community pharmacies are a good source of advice on medicines and minor ailments but were less supportive of public health services. Six factors were identified affecting utilization of pharmacy services: community pharmacy environment, pharmacist and support staff, service publicity, general public, GP services, and health care system and policies. Crucial obstacles that could inhibit service utilization are perceptions of both the general public and other health providers toward pharmacists' competencies, privacy and confidentiality in pharmacies, high dispensing workload, and inadequate financial support. Networking between local health professionals could enhance confidence in service delivery, general awareness, and thus utilization. Community pharmacy has the potential to deliver public health services, although the impact on public health may be limited. Addressing the factors identified could help to increase utilization and impact of pharmacy public health services. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Utilization and expenditure at public and private facilities in 39 low-income countries.

    PubMed

    Saksena, Priyanka; Xu, Ke; Elovainio, Riku; Perrot, Jean

    2012-01-01

    To document the patterns of health service utilization and health payments at public and private facilities across countries. We used data from the World Health Surveys from 39 low- and low-middle income countries to examine differences between public and private sectors. Utilization of outpatient and inpatient services, out-of-pocket payments (OOP) at public and private facilities, and transportation costs were compared. Utilization and payments to public and private sectors differ widely. Public facilities dominated in most countries for both outpatient and inpatient services. But, whereas use of private facilities is more common among the rich, poor people also use them, to a considerable extent and in almost all the countries in the study. The majority of OOP were incurred at public providers for inpatient services. On average, this was not the case for outpatient services. Medicines accounted for the largest share of OOP for all services except inpatient services at private facilities, where consultation fees did. Transportation costs were considerable. Price competition is certainly not the only factor that guides choice of provider. The results support continued efforts by the governments to engage strategically with the private sector. However, they also highlight the importance of not generalizing conditions across countries. Governments may need to reconsider simplistic user-fee abolition strategies at public providers if they simply focus on consultation fees. Policies to make health services more accessible need to consider a comprehensive benefit package that includes a wider scope of costs related to care such as expenditures on medicines and transportation. © 2011 Blackwell Publishing Ltd.

  17. Assessing the pro-poor effect of different contracting schemes for health services on health facilities in rural Afghanistan.

    PubMed

    Alonge, Olakunle; Gupta, Shivam; Engineer, Cyrus; Salehi, Ahmad Shah; Peters, David H

    2015-12-01

    Despite progress in improving health outcomes in Afghanistan by contracting public health services through non-governmental organizations (NGOs), inequity in access persists between the poor and non-poor. This study examined the distributive effect of different contracting types on primary health services provision between the poor and non-poor in rural Afghanistan. Contracts to NGOs were made to deliver a common set of primary care services in each province, with the funding agencies determining contract terms. The contracting approaches could be classified into three contracting out types (CO-1, CO-2 and CO-3) and a contracting-in (CI) approach based on the contract terms, design and implementation. Exit interviews of patients attending randomly sampled primary health facilities were collected through systematic sampling across 28 provinces at two time points. The outcome, the odds that a client attending a health facility is poor, was modelled using logistic regression with a robust variance estimator, and the effect of contracting was estimated using the difference-in-difference approach combined with stratified analyses. The sample covered 5960 interviews from 306 health facilities in 2005 and 2008. The adjusted odds of a poor client attending a health facility over time increased significantly for facilities under CO-1 and CO-2, with odds ratio of 2.82 (1.49, 5.36) P-value 0.001 and 2.00 (1.33, 3.02) P-value 0.001, respectively. The odds ratios for those under CO-3 and CI were not statistically significantly different over time. When compared with the non-contracting facilities, the adjusted ratio of odds ratios of poor status among clients was significantly higher for only those under CO-1, ratio of 2.50 (1.32, 4.74) P-value 0.005. CO-1 arrangement which allows contractors to decide on how funds are allocated within a fixed lump sum with non-negotiable deliverables, and actively managed through an independent government agency, is effective in improving

  18. Internet Services for Communicating With the General Practice: Barely Noticed and Used by Patients

    PubMed Central

    Vermeulen, Joan; Friele, Roland D; van Schayck, Onno CP; de Jong, Judith D; de Witte, Luc P

    2015-01-01

    Background The Netherlands is one of the frontrunners of eHealth in Europe. Many general practices offer Internet services, which can be used by patients to communicate with their general practice. In promoting and implementing such services, it is important to gain insight into patients’ actual use and intention toward using. Objective The objective of the study is to investigate the actual use and intention toward using Internet services to communicate with the general practice by the general practice population. The secondary objective is to study the factors and characteristics that influence their intention to use such services. Methods There were 1500 members of the Dutch Health Care Consumer Panel, age over 18 years, that were invited to participate in this cross-sectional study. People who had contacted their general practitioner at least once in the past year were included. Participants were asked to fill out a questionnaire about the following services: Internet appointment planning, asking questions on the Internet, email reminders about appointments, Internet prescription refill requests, Internet access to medical data, and Internet video consultation. Participants indicated whether they had used these services in the past year, they would like to use them, and whether they thought their general practice had these services. For the first two services, participants rated items based on the unified theory of acceptance and use of technology complemented with additional constructs. These items were divided into six subscales: effort expectancy, performance expectancy, trust, attitude, facilitating conditions, and social influence. Results There were 546 participants that were included in the analyses out of 593 who met the inclusion criteria. The participants had a mean age of 53 years (SD 15.4), 43.6% (n=238) were male, and 66.8% (n=365) had at least one chronic illness. Actual use of the services varied between 0% (n=0, video consultation) and 10

  19. Perceived barriers to utilizing maternal and neonatal health services in contracted-out versus government-managed health facilities in the rural districts of Pakistan.

    PubMed

    Riaz, Atif; Zaidi, Shehla; Khowaja, Asif Raza

    2015-03-06

    A number of developing countries have contracted out public health facilities to the Non-Government Organizations (NGOs) in order to improve service utilization. However, there is a paucity of in-depth qualitative information on barriers to access services as a result of contracting from service users' perspective. The objective of this study was to explore perceived barriers to utilizing Maternal and Neonatal Health (MNH) services, in health facilities contracted out by government to NGO for service provision versus in those which are managed by government (non-contracted). A community-based qualitative exploratory study was conducted between April to September 2012 at two contracted-out and four matched non-contracted primary healthcare facilities in Thatta and Chitral, rural districts of Pakistan. Using semi-structured guide, the data were collected through thirty-six Focus Group Discussions (FGDs) conducted with mothers and their spouses in the catchment areas of selected facilities. Thematic analysis was performed using NVivo version 10.0 in which themes and sub-themes emerged. Key barriers reported in contracted sites included physical distance, user charges and familial influences. Whereas, poor functionality of health centres was the main barrier for non-contracted sites with other issues being comparatively less salient. Decision-making patterns for participants of both catchments were largely similar. Spouses and mother-in-laws particularly influenced the decision to utilize health facilities. Contracting out of health facility reduces supply side barriers to MNH services for the community served but distance, user charges and low awareness remain significant barriers. Contracting needs to be accompanied by measures for transportation in remote settings, oversight on user fee charges by contractor, and strong community-based behavior change strategies. © 2015 by Kerman University of Medical Sciences.

  20. Perceived barriers to utilizing maternal and neonatal health services in contracted-out versus government-managed health facilities in the rural districts of Pakistan

    PubMed Central

    Riaz, Atif; Zaidi, Shehla; Khowaja, Asif Raza

    2015-01-01

    Background: A number of developing countries have contracted out public health facilities to the Non-Government Organizations (NGOs) in order to improve service utilization. However, there is a paucity of in-depth qualitative information on barriers to access services as a result of contracting from service users’ perspective. The objective of this study was to explore perceived barriers to utilizing Maternal and Neonatal Health (MNH) services, in health facilities contracted out by government to NGO for service provision versus in those which are managed by government (non-contracted). Methods: A community-based qualitative exploratory study was conducted between April to September 2012 at two contracted-out and four matched non-contracted primary healthcare facilities in Thatta and Chitral, rural districts of Pakistan. Using semi-structured guide, the data were collected through thirty-six Focus Group Discussions (FGDs) conducted with mothers and their spouses in the catchment areas of selected facilities. Thematic analysis was performed using NVivo version 10.0 in which themes and sub-themes emerged. Results: Key barriers reported in contracted sites included physical distance, user charges and familial influences. Whereas, poor functionality of health centres was the main barrier for non-contracted sites with other issues being comparatively less salient. Decision-making patterns for participants of both catchments were largely similar. Spouses and mother-in-laws particularly influenced the decision to utilize health facilities. Conclusion: Contracting out of health facility reduces supply side barriers to MNH services for the community served but distance, user charges and low awareness remain significant barriers. Contracting needs to be accompanied by measures for transportation in remote settings, oversight on user fee charges by contractor, and strong community-based behavior change strategies. PMID:25905478

  1. The Materials Data Facility: Data Services to Advance Materials Science Research

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

    Blaiszik, B.; Chard, K.; Pruyne, J.

    2016-07-06

    With increasingly strict data management requirements from funding agencies and institutions, expanding focus on the challenges of research replicability, and growing data sizes and heterogeneity, new data needs are emerging in the materials community. The materials data facility (MDF) operates two cloudhosted services, data publication and data discovery, with features to promote open data sharing, self-service data publication and curation, and encourage data reuse, layered with powerful data discovery tools. The data publication service simplifies the process of copying data to a secure storage location, assigning data a citable persistent identifier, and recording custom (e.g., material, technique, or instrument specific)andmore » automatically-extractedmetadata in a registrywhile the data discovery service will provide advanced search capabilities (e.g., faceting, free text range querying, and full text search) against the registered data and metadata. TheMDF services empower individual researchers, research projects, and institutions to (I) publish research datasets, regardless of size, from local storage, institutional data stores, or cloud storage, without involvement of thirdparty publishers; (II) build, share, and enforce extensible domain-specific custom metadata schemas; (III) interact with published data and metadata via representational state transfer (REST) application program interfaces (APIs) to facilitate automation, analysis, and feedback; and (IV) access a data discovery model that allows researchers to search, interrogate, and eventually build on existing published data. We describe MDF’s design, current status, and future plans.« less

  2. The Materials Data Facility: Data Services to Advance Materials Science Research

    NASA Astrophysics Data System (ADS)

    Blaiszik, B.; Chard, K.; Pruyne, J.; Ananthakrishnan, R.; Tuecke, S.; Foster, I.

    2016-08-01

    With increasingly strict data management requirements from funding agencies and institutions, expanding focus on the challenges of research replicability, and growing data sizes and heterogeneity, new data needs are emerging in the materials community. The materials data facility (MDF) operates two cloud-hosted services, data publication and data discovery, with features to promote open data sharing, self-service data publication and curation, and encourage data reuse, layered with powerful data discovery tools. The data publication service simplifies the process of copying data to a secure storage location, assigning data a citable persistent identifier, and recording custom (e.g., material, technique, or instrument specific) and automatically-extracted metadata in a registry while the data discovery service will provide advanced search capabilities (e.g., faceting, free text range querying, and full text search) against the registered data and metadata. The MDF services empower individual researchers, research projects, and institutions to (I) publish research datasets, regardless of size, from local storage, institutional data stores, or cloud storage, without involvement of third-party publishers; (II) build, share, and enforce extensible domain-specific custom metadata schemas; (III) interact with published data and metadata via representational state transfer (REST) application program interfaces (APIs) to facilitate automation, analysis, and feedback; and (IV) access a data discovery model that allows researchers to search, interrogate, and eventually build on existing published data. We describe MDF's design, current status, and future plans.

  3. Views of the Scottish general public on community pharmacy weight management services: international implications.

    PubMed

    Weidmann, Anita Elaine; Cunningham, Scott; Gray, Gwen; Hansford, Denise; Bermano, Giovanna; Stewart, Derek

    2012-04-01

    Obesity has reached pandemic levels, with more than 1.5 billion adults being affected worldwide. In Scotland two-thirds of men and more than half of women are either overweight or obese, placing Scotland overall third behind the United States of America and Mexico. All community pharmacies in Scotland are contracted to provide public health services such as smoking cessation and there is increasing interest in their contribution to weight management. Researching this area in Scotland may provide valuable information to facilitate the development of community pharmacy services in other parts of the UK and internationally. To describe the views of the Scottish general public on the provision of weight management services via community pharmacies. General public in Scotland. A cross-sectional postal questionnaire survey of 6,000 randomly selected members of the Scottish general public aged 18 years and over. Views on community pharmacy led weight management services. Questionnaires were returned by 20.6% (n = 1,236). Over half 60.1% (n = 751) agreed or strongly agreed that they had easy access to pharmacy services in general and around one-third agreed (35%; n = 438) that it was more convenient to obtain weight management advice from a pharmacist than it is to make an appointment with a GP. Most respondents however lacked awareness of the types of health services available through community pharmacy (13.2%; n = 162) and would not feel comfortable speaking to a pharmacist or medicines counter assistant about weight related issues (25%; n = 320). Concerns over privacy (47.3%; n = 592) and perceived lack of pharmacists' specialist knowledge (open comments) were identified as potential barriers to service uptake by the general public. Overall, respondents appear to be receptive to the idea of accessing weight management services through community pharmacy but a perceived lack of privacy, poor knowledge of pharmacists' skill level and of public health services available to

  4. Mapping of pedestrian characteristics and level of service for facilities at Universitas Negeri Malang using geographic information system

    NASA Astrophysics Data System (ADS)

    Rahayuningsih, Titi; Pranoto, Nindyawati, Umniati, B. Sri; Mardhika, Moch Aqfa Syabahid

    2017-09-01

    Universitas Negeri Malang (UM) is a university with the second largest academic community in Malang. The activities of the academic community should be supported by adequate facilities, such as pedestrian facilities—crucial yet much neglected matters, so pedestrians to walk along the roadway. As a result, conflicts between pedestrians with motor vehicle users and accidents might occur at any time. This research aimed at: 1) investigating the geometric conditions of pedestrian facilities at UM; 2) identifying the characteristics of pedestrians and the pedestrian facilities at UM; and 3) determining the level of service for pedestrian facilities at UM using Geographic Information System (GIS). The research was conducted through survey of location, survey of geometric conditions, estimation of the number of pedestrians using sidewalk (data were recorded every 15 minutes), measurement of pedestrian speed, and questionnaire about pedestrians' identity, destination, as well as travel time and distance. Data analysis was carried out to identify the pedestrian characteristics, pedestrian flow characteristics, and pedestrian level of service. The research result showed that the percentage of road segments in campus without sidewalks was 52%. The average width of sidewalk was 1.33 m, which was less than the minimum standard of i.e. 2 m. In terms of pedestrian characteristics, the pedestrians consisted of more female (51%) who were mostly students of the Faculty of Letters whose destination was classroom building. The maximum pedestrian flow was at 10.00-13.30 i.e. 4.2018 p/m/min. The average speed of pedestrian was 63.49 m/min. The highest pedestrian density of 0.0609 p/m2 occurred at 10.00-13.30. The largest walking space was 28.0348 m2/p and occurred in the afternoon at 13.30-17.00. The level of service for pedestrian facilities belonged to category A in the morning and afternoon. The level of service at 10.00-13.30 decreased to category B.

  5. 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.

  6. Policy implementation in practice: the case of national service frameworks in general practice.

    PubMed

    Checkland, Kath; Harrison, Stephen

    2004-10-01

    National Service Frameworks are an integral part of the government's drive to 'modernise' the NHS, intended to standardise both clinical care and the design of the services used to deliver that clinical care. This article uses evidence from qualitative case studies in three general practices to illustrate the difficulties associated with the implementation of such top-down guidelines and models of service. In these studies it was found that, while there had been little explicit activity directed at implementation overall, the National Service Framework for coronary heart disease had in general fared better than that for older people. Gunn's notion of 'perfect implementation' is used to make sense of the findings.

  7. 42 CFR 417.564 - Apportionment and allocation of administrative and general costs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... general costs. 417.564 Section 417.564 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT... providing medical care. Enrollment, marketing, and other administrative and general costs that benefit the... benefit of which cannot be quantitatively measured (such as facility costs), the total allowable costs of...

  8. NASA/IPAC Infrared Archive's General Image Cutouts Service

    NASA Astrophysics Data System (ADS)

    Alexov, A.; Good, J. C.

    2006-07-01

    The NASA/IPAC Infrared Archive (IRSA) ``Cutouts" Service (http://irsa.ipac.caltech.edu/applications/Cutouts) is a general tool for creating small ``cutout" FITS images and JPEGs from collections of data archived at IRSA. This service is a companion to IRSA's Atlas tool (http://irsa.ipac.caltech.edu/applications/Atlas/), which currently serves over 25 different data collections of various sizes and complexity and returns entire images for a user-defined region of the sky. The Cutouts Services sits on top of Atlas and extends the Atlas functionality by generating subimages at locations and sizes requested by the user from images already identified by Atlas. These results can be downloaded individually, in batch mode (using the program wget), or as a tar file. Cutouts re-uses IRSA's software architecture along with the publicly available Montage mosaicking tools. The advantages and disadvantages of this approach to generic cutout serving will be discussed.

  9. Community Extreme Tonnage User Service (CETUS): A 5000 Ton Open Research Facility in the United States

    NASA Technical Reports Server (NTRS)

    Danielson, L.; Righter, K.; McCubbin, F.

    2016-01-01

    Large sample volume 5000 ton multi-anvil presses have contributed to the exploration of deep Earth and planetary interiors, synthesis of ultra-hard and other novel materials, and serve as a sample complement to pressure and temperature regimes already attainable by diamond anvil cell experiments. However, no such facility exists on the North American continent. We propose the establishment of an open user facility for COMPRES members and the entire research community, with the unique capability of a 5000 ton (or more) press, supported by a host of extant co-located experimental and analytical laboratories and research staff. We offer wide range of complementary and/or preparatory experimental options. Any required synthesis of materials or follow up experiments can be carried out controlled atmosphere furnaces, piston cylinders, multi-anvil, or experimental impact apparatus. Additionally, our division houses two machine shops that would facilitate any modification or custom work necessary for development of CETUS, one for general fabrication and one located specifically within our experimental facilities. We also have a general sample preparation laboratory, specifically for experimental samples, that allows users to quickly and easily prepare samples for ebeam analyses and more. A service we can offer to COMPRES community members in general, and CETUS visiting users specifically, is a multitude of analytical instrumentation literally steps away from the experimental laboratories. This year we will be pursuing site funding of our laboratories through NASA's Planetary Science Directorate, which should result in substantial cost savings to all visiting users, and supports our mission of interagency cooperation for the enhancement of science for all (see companion PSAMS abstract). The PI is in a unique position as an employee of Jacobs Technology to draw funding from multiple sources, including those from industry and commerce. We submitted a Planetary Major Equipment

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

    PubMed

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

    2012-10-01

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

  11. Provision of gastrointestinal endoscopy and related services for a district general hospital. Working Party of the Clinical Services Committee of the British Society of Gastroenterology.

    PubMed

    1991-01-01

    (1) The number of endoscopic examinations performed is rising. Epidemiological data and the workload of well developed units show that annual requirements per head of population are approaching: Upper gastrointestinal 1 in 100 Flexible sigmoidoscopy 1 in 500 Colonoscopy 1 in 500 ERCP 1 in 2000 (2) Open access endoscopy to general practitioners is desirable and increasingly sought. For a district general hospital serving a population of 250,000, this workload entails about 3500 procedures annually, performed during 10 half day routine sessions plus emergency work. (3) High standards of training and experience are needed by all staff, who must work in purpose built accommodation designed to promote efficient and safe practice. (4) The endoscopy unit should be adjacent to day care facilities and near the x ray department. There should be easy access to wards. (5) An endoscopy unit needs at least two endoscopy rooms; a fully ventilated cleaning/disinfection area; rooms for patient reception, preparation, and recovery; and accommodation for administration, storage, and staff amenities. (6) The service should be consultant based. At least 10 clinical sessions are required, made up of six or more consultant sessions and two to four clinical assistant, hospital practitioner, or staff specialist sessions. Each consultant should be expected to commit at least two sessions weekly to endoscopy. Extra consultant sessions may be needed to provide an efficient service. (7) A specially trained nursing sister (grade G or H) and five other endoscopy nurses are needed to care for the patients; their work may be supplemented by care assistants. (8) A new post of endoscopy department assistant (analogous to an operating department assistant) is proposed to maintain and prepare instruments, and to give technical assistance during procedures. (9) A full time secretary should be employed. Records, appointments, and audit should be computer based. (10) ERCP needs the collaboration of an

  12. 33 CFR 158.310 - Reception facilities: General.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... order to pass the inspection under § 158.160, must— (1) Be a reception facility as defined under § 158... residue; (5) Be capable of receiving NLS residue from an oceangoing ship within 24 hours after notice by that ship of the need for reception facilities; and (6) Be capable of completing the transfer of NLS...

  13. Drug prescribing in rural health facilities in China: implications for service quality and cost.

    PubMed

    Zhan, S K; Tang, S L; Guo, Y D; Bloom, G

    1998-01-01

    Overuse of drugs in rural areas of China has led to a growing concern regarding service quality and cost. The study found evidence of high levels of drug use in some rural health facilities in comparison with a number of other developing countries. Such a result was significantly associated with the government policy of financing health care, regulation and monitoring of health services, and users' attitudes and behaviour. It underlines the need for measures to be taken in China to improve drug use in order to allow its population access to effective care at reasonable cost.

  14. Factors determining the concentration and chemical composition of particulate matter in the air of selected service facilities

    NASA Astrophysics Data System (ADS)

    Rogula-Kopiec, Patrycja; Pastuszka, Józef; Mathews, Barbara; Widziewicz, Kamila

    2018-01-01

    The link between increased morbidity and mortality and increasing concentrations of particulate matter (PM) resulted in great attention being paid to the presence and physicochemical properties of PM in closed rooms, where people spends most of their time. The least recognized group of such indoor environments are small service facilities. The aim of this study was to identify factors which determine the concentration, chemical composition and sources of PM in the air of different service facilities: restaurant kitchen, printing office and beauty salon. The average PM concentration measured in the kitchen was 5-fold (PM4, particle fraction ≥ 4 μm) and 5.3-fold (TSP, total PM) greater than the average concentration of these PM fractions over the same period. During the same measurement period in the printing office and in the beauty salon, the mean PM concentration was 10- and 4-fold (PM4) and 8- and 3-fold (TSP) respectively greater than the mean concentration of these PM fractions in outdoor air. In both facilities the main source of PM macro-components, especially organic carbon, were chemicals, which are normally used in such places - solvents, varnishes, paints, etc. The influence of some metals inflow from the outdoor air into indoor environment of those facilities was also recognized.

  15. 4. GENERAL VIEW OF LAUNCH PAD B FROM LAUNCH PAD ...

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

    4. GENERAL VIEW OF LAUNCH PAD B FROM LAUNCH PAD A MOBILE SERVICE STRUCTURE; VIEW TO SOUTH. - Cape Canaveral Air Station, Launch Complex 17, Facility 28402, East end of Lighthouse Road, Cape Canaveral, Brevard County, FL

  16. School Nutrition Facility Planning Guide.

    ERIC Educational Resources Information Center

    Pannell, Dorothy VanEgmond

    This publication is designed to help superintendents, local facilities coordinators, and food-service directors in planning the remodeling of an outdated food-service facility or the building of a new one. The introduction describes the roles of the local facility coordinator, the local child-nutrition director, the architect, the food-service…

  17. Variation in Hospice Services by Location of Care: Nursing Home Versus Assisted Living Facility Versus Home.

    PubMed

    Unroe, Kathleen T; Bernard, Brittany; Stump, Timothy E; Tu, Wanzhu; Callahan, Christopher M

    2017-07-01

    To describe differences in hospice services for patients living at home, in nursing homes or in assisted living facilities, including the overall number and duration of visits by different hospice care providers across varying lengths of stay. Retrospective cohort study using hospice patient electronic medical record data. Large, national hospice provider. Data from 32,605 hospice patients who received routine hospice care from 2009 to 2014 were analyzed. Descriptive statistics were calculated for utilization measures for each type of provider and by location of care. Frequency and duration of service contacts were standardized to a 1 week period and pairwise comparisons were used to detect differences in care provided between the three settings. Minimal differences were found in overall intensity of service contacts across settings, however, the mix of services were different for patients living at home versus nursing home versus assisted living facility. Overall, more nurse care was provided at the beginning and end of the hospice episode; intensity of aide care services was higher in the middle portion of the hospice episode. Nearly 43% of the sample had hospice stays less than 2 weeks and up to 20% had stays greater than 6 months. There are significant differences between characteristics of hospice patients in different settings, as well as the mix of services they receive. Medicare hospice payment methodology was revised starting in 2016. While the new payment structure is in greater alignment with the U shape distribution of services, it will be important to evaluate the impact of the new payment methodology on length of stay and mix of services by different providers across settings of care. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  18. 12 CFR 550.160 - What personnel and facilities may I use to perform fiduciary services?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 5 2011-01-01 2011-01-01 false What personnel and facilities may I use to perform fiduciary services? 550.160 Section 550.160 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY FIDUCIARY POWERS OF SAVINGS ASSOCIATIONS Exercising Fiduciary Powers Fiduciary...

  19. 12 CFR 550.160 - What personnel and facilities may I use to perform fiduciary services?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false What personnel and facilities may I use to perform fiduciary services? 550.160 Section 550.160 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY FIDUCIARY POWERS OF SAVINGS ASSOCIATIONS Exercising Fiduciary Powers Fiduciary...

  20. Improving the Quality of Services in Residential Treatment Facilities: A Strength-Based Consultative Review Process

    ERIC Educational Resources Information Center

    Pavkov, Thomas W.; Lourie, Ira S.; Hug, Richard W.; Negash, Sesen

    2010-01-01

    This descriptive case study reports on the positive impact of a consultative review methodology used to conduct quality assurance reviews as part of the Residential Treatment Center Evaluation Project. The study details improvement in the quality of services provided to youth in unmonitored residential treatment facilities. Improvements were…

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